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Sample records for clinical performance measures

  1. ESRD - Clinical Performance Measures (CPM) Project

    Data.gov (United States)

    U.S. Department of Health & Human Services — Section 4558 (b) of the Balanced Budget Act (BBA) requires CMS to develop and implement by January 1, 2000, a method to measure and report the quality of renal...

  2. Automating Performance Measures and Clinical Practice Guidelines: Differences and Complementarities.

    Science.gov (United States)

    Tu, Samson W; Martins, Susana; Oshiro, Connie; Yuen, Kaeli; Wang, Dan; Robinson, Amy; Ashcraft, Michael; Heidenreich, Paul A; Goldstein, Mary K

    2016-01-01

    Through close analysis of two pairs of systems that implement the automated evaluation of performance measures (PMs) and guideline-based clinical decision support (CDS), we contrast differences in their knowledge encoding and necessary changes to a CDS system that provides management recommendations for patients failing performance measures. We trace the sources of differences to the implementation environments and goals of PMs and CDS.

  3. Dehydration and performance on clinical concussion measures in collegiate wrestlers.

    Science.gov (United States)

    Weber, Amanda Friedline; Mihalik, Jason P; Register-Mihalik, Johna K; Mays, Sally; Prentice, William E; Guskiewicz, Kevin M

    2013-01-01

    The effects of dehydration induced by wrestling-related weight-cutting tactics on clinical concussion outcomes, such as neurocognitive function, balance performance, and symptoms, have not been adequately studied. To evaluate the effects of dehydration on the outcome of clinical concussion measures in National Collegiate Athletic Association Division I collegiate wrestlers. Repeated-measures design. Clinical research laboratory. Thirty-two Division I healthy collegiate male wrestlers (age = 20.0 ± 1.4 years; height = 175.0 ± 7.5 cm; baseline mass = 79.2 ± 12.6 kg). Participants completed preseason concussion baseline testing in early September. Weight and urine samples were also collected at this time. All participants reported to prewrestling practice and postwrestling practice for the same test battery and protocol in mid-October. They had begun practicing weight-cutting tactics a day before prepractice and postpractice testing. Differences between these measures permitted us to evaluate how dehydration and weight-cutting tactics affected concussion measures. Sport Concussion Assessment Tool 2 (SCAT2), Balance Error Scoring System, Graded Symptom Checklist, and Simple Reaction Time scores. The Simple Reaction Time was measured using the Automated Neuropsychological Assessment Metrics. The SCAT2 measurements were lower at prepractice (P = .002) and postpractice (P < .001) when compared with baseline. The BESS error scores were higher at postpractice when compared with baseline (P = .015). The GSC severity scores were higher at prepractice (P = .011) and postpractice (P < .001) than at baseline and at postpractice when than at prepractice (P = .003). The number of Graded Symptom Checklist symptoms reported was also higher at prepractice (P = .036) and postpractice (P < .001) when compared with baseline, and at postpractice when compared with prepractice (P = .003). Our results suggest that it is important for wrestlers to be evaluated in a euhydrated state to

  4. Measuring performance improvement: total organizational commitment or clinical specialization.

    Science.gov (United States)

    Caron, Aleece; Jones, Paul; Neuhauser, Duncan; Aron, David C

    2004-01-01

    Resources for hospitals are limited when they are faced with multiple publicly reported performance measures as tools to assess quality. The leadership in these organizations may choose to focus on 1 or 2 of these outcomes. An alternative approach is that the leadership may commit resources or create conditions that result in improved quality over a broad range of measures. We used aggregated data on mortality, length of stay, and obstetrical outcomes from Greater Cleveland Health Quality Choice data to test these theories. We used Pearson correlation analysis to determine of outcomes were correlated with one another. We used repeated-measures ANOVA to determine if an association existed between outcome and time and outcome and hospital. All of the outcomes across all hospitals demonstrate a trend of overall improvement. Both the Pearson and ANOVA result support the hypothesis for the organization-wide approach to quality improvement. Hospital that make improvements in one clinical area trend to make improvements in others. Hospitals that produce improvements in limited clinical or administrative areas may not have completely adopted CQI into their culture or may not have yet realized the benefits of their organizational commitments, but use some of the concepts to improve quality outcomes.

  5. Strategic performance management: development of a performance measurement system at the Mayo Clinic.

    Science.gov (United States)

    Curtright, J W; Stolp-Smith, S C; Edell, E S

    2000-01-01

    Managing and measuring performance become exceedingly complex as healthcare institutions evolve into integrated health systems comprised of hospitals, outpatient clinics and surgery centers, nursing homes, and home health services. Leaders of integrated health systems need to develop a methodology and system that align organizational strategies with performance measurement and management. To meet this end, multiple healthcare organizations embrace the performance-indicators reporting system known as a "balanced scorecard" or a "dashboard report." This discrete set of macrolevel indicators gives senior management a fast but comprehensive glimpse of the organization's performance in meeting its quality, operational, and financial goals. The leadership of outpatient operations for Mayo Clinic in Rochester, Minnesota built on this concept by creating a performance management and measurement system that monitors and reports how well the organization achieves its performance goals. Internal stakeholders identified metrics to measure performance in each key category. Through these metrics, the organization links Mayo Clinic's vision, primary value, core principles, and day-to-day operations by monitoring key performance indicators on a weekly, monthly, or quarterly basis.

  6. Clinical Quality Performance Measurement: An Example of a University Hospital

    Directory of Open Access Journals (Sweden)

    Mehmet Nurullah Kurutkan

    2014-06-01

    CONCLUSiON: We determined that The Accountability Measures of the Joint Commission could be applied in the present conditions of Turkey. Only the Pneumonia package needs new requirements to be specified for Turkey. There is no need for a compatibility studies as for the others. Surgical care, heart attack, perinatal and venous thromboembolism packages are the ideal packages for Turkey. [TAF Prev Med Bull 2014; 13(3.000: 201-208

  7. An official American thoracic society workshop report: developing performance measures from clinical practice guidelines.

    Science.gov (United States)

    Kahn, Jeremy M; Gould, Michael K; Krishnan, Jerry A; Wilson, Kevin C; Au, David H; Cooke, Colin R; Douglas, Ivor S; Feemster, Laura C; Mularski, Richard A; Slatore, Christopher G; Wiener, Renda Soylemez

    2014-05-01

    Many health care performance measures are either not based on high-quality clinical evidence or not tightly linked to patient-centered outcomes, limiting their usefulness in quality improvement. In this report we summarize the proceedings of an American Thoracic Society workshop convened to address this problem by reviewing current approaches to performance measure development and creating a framework for developing high-quality performance measures by basing them directly on recommendations from well-constructed clinical practice guidelines. Workshop participants concluded that ideally performance measures addressing care processes should be linked to clinical practice guidelines that explicitly rate the quality of evidence and the strength of recommendations, such as the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) process. Under this framework, process-based performance measures would only be developed from strong recommendations based on high- or moderate-quality evidence. This approach would help ensure that clinical processes specified in performance measures are both of clear benefit to patients and supported by strong evidence. Although this approach may result in fewer performance measures, it would substantially increase the likelihood that quality-improvement programs based on these measures actually improve patient care.

  8. 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

  9. What is the impact of a clinically related readmission measure on the assessment of hospital performance?

    Science.gov (United States)

    Khouri, Roger K; Hou, Hechuan; Dhir, Apoorv; Andino, Juan J; Dupree, James M; Miller, David C; Ellimoottil, Chad

    2017-11-28

    The Hospital Readmission Reduction Program (HRRP) penalizes hospitals for high all-cause unplanned readmission rates. Many have expressed concern that hospitals serving patient populations with more comorbidities, lower incomes, and worse self-reported health status may be disproportionately penalized by readmissions that are not clinically related to the index admission. The impact of including clinically unrelated readmissions on hospital performance is largely unknown. We sought to determine if a clinically related readmission measure would significantly alter the assessment of hospital performance. We analyzed Medicare claims for beneficiaries in Michigan admitted for pneumonia and joint replacement from 2011 to 2013. We compared each hospital's 30-day readmission rate using specifications from the HRRP's all-cause unplanned readmission measure to values calculated using a clinically related readmission measure. We found that the mean 30-day readmission rates were lower when calculated using the clinically related readmission measure (joint replacement: all-cause 5.8%, clinically related 4.9%, p impact hospital performance in the HRRP.

  10. 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.

  11. A Novel Method for Assessing Task Complexity in Outpatient Clinical-Performance Measures.

    Science.gov (United States)

    Hysong, Sylvia J; Amspoker, Amber B; Petersen, Laura A

    2016-04-01

    Clinical-performance measurement has helped improve the quality of health-care; yet success in attaining high levels of quality across multiple domains simultaneously still varies considerably. Although many sources of variability in care quality have been studied, the difficulty required to complete the clinical work itself has received little attention. We present a task-based methodology for evaluating the difficulty of clinical-performance measures (CPMs) by assessing the complexity of their component requisite tasks. Using Functional Job Analysis (FJA), subject-matter experts (SMEs) generated task lists for 17 CPMs; task lists were rated on ten dimensions of complexity, and then aggregated into difficulty composites. Eleven outpatient work SMEs; 133 VA Medical Centers nationwide. Clinical Performance: 17 outpatient CPMs (2000-2008) at 133 VA Medical Centers nationwide. Measure Difficulty: for each CPM, the number of component requisite tasks and the average rating across ten FJA complexity scales for the set of tasks comprising the measure. Measures varied considerably in the number of component tasks (M = 10.56, SD = 6.25, min = 5, max = 25). Measures of chronic care following acute myocardial infarction exhibited significantly higher measure difficulty ratings compared to diabetes or screening measures, but not to immunization measures ([Formula: see text] = 0.45, -0.04, -0.05, and -0.06 respectively; F (3, 186) = 3.57, p = 0.015). Measure difficulty ratings were not significantly correlated with the number of component tasks (r = -0.30, p = 0.23). Evaluating the difficulty of achieving recommended CPM performance levels requires more than simply counting the tasks involved; using FJA to assess the complexity of CPMs' component tasks presents an alternate means of assessing the difficulty of primary-care CPMs and accounting for performance variation among measures and performers. This in turn could be used in designing

  12. Effects of performance measure implementation on clinical manager and provider motivation.

    Science.gov (United States)

    Damschroder, Laura J; Robinson, Claire H; Francis, Joseph; Bentley, Douglas R; Krein, Sarah L; Rosland, Ann-Marie; Hofer, Timothy P; Kerr, Eve A

    2014-12-01

    Clinical performance measurement has been a key element of efforts to transform the Veterans Health Administration (VHA). However, there are a number of signs that current performance measurement systems used within and outside the VHA may be reaching the point of maximum benefit to care and in some settings, may be resulting in negative consequences to care, including overtreatment and diminished attention to patient needs and preferences. Our research group has been involved in a long-standing partnership with the office responsible for clinical performance measurement in the VHA to understand and develop potential strategies to mitigate the unintended consequences of measurement. Our aim was to understand how the implementation of diabetes performance measures (PMs) influences management actions and day-to-day clinical practice. This is a mixed methods study design based on quantitative administrative data to select study facilities and quantitative data from semi-structured interviews. Sixty-two network-level and facility-level executives, managers, front-line providers and staff participated in the study. Qualitative content analyses were guided by a team-based consensus approach using verbatim interview transcripts. A published interpretive motivation theory framework is used to describe potential contributions of local implementation strategies to unintended consequences of PMs. Implementation strategies used by management affect providers' response to PMs, which in turn potentially undermines provision of high-quality patient-centered care. These include: 1) feedback reports to providers that are dissociated from a realistic capability to address performance gaps; 2) evaluative criteria set by managers that are at odds with patient-centered care; and 3) pressure created by managers' narrow focus on gaps in PMs that is viewed as more punitive than motivating. Next steps include working with VHA leaders to develop and test implementation approaches to help

  13. Mortality risk in hemodialysis patients with increased arterial stiffness is reduced by attainment of classical clinical performance measures

    DEFF Research Database (Denmark)

    Scholze, Alexandra; Thies, Christina; Cheikhalfraj, Mohamed

    2009-01-01

    We determined whether attainment of classical clinical performance measures for hemodialysis care improves survival in hemodialysis patients with increased arterial stiffness.......We determined whether attainment of classical clinical performance measures for hemodialysis care improves survival in hemodialysis patients with increased arterial stiffness....

  14. Technology transfer from biomedical research to clinical practice: measuring innovation performance.

    Science.gov (United States)

    Balas, E Andrew; Elkin, Peter L

    2013-12-01

    Studies documented 17 years of transfer time from clinical trials to practice of care. Launched in 2002, the National Institutes of Health (NIH) translational research initiative needs to develop metrics for impact assessment. A recent White House report highlighted that research and development productivity is declining as a result of increased research spending while the new drugs output is flat. The goal of this study was to develop an expanded model of research-based innovation and performance thresholds of transfer from research to practice. Models for transfer of research to practice have been collected and reviewed. Subsequently, innovation pathways have been specified based on common characteristics. An integrated, intellectual property transfer model is described. The central but often disregarded role of research innovation disclosure is highlighted. Measures of research transfer and milestones of progress have been identified based on the Association of University Technology Managers 2012 performance reports. Numeric milestones of technology transfer are recommended at threshold (top 50%), target (top 25%), and stretch goal (top 10%) performance levels. Transfer measures and corresponding target levels include research spending to disclosure (0.81), patents to start-up (>0.1), patents to licenses (>2.25), and average per license income (>$48,000). Several limitations of measurement are described. Academic institutions should take strategic steps to bring innovation to the center of scholarly discussions. Research on research, particularly on pathways to disclosures, is needed to improve R&D productivity. Researchers should be informed about the technology transfer performance of their institution and regulations should better support innovators.

  15. Measuring treatment effects on dual-task performance: a framework for research and clinical practice

    Directory of Open Access Journals (Sweden)

    Prudence ePlummer

    2015-04-01

    Full Text Available The relevance of dual-task walking to everyday ambulation is widely acknowledged, and numerous studies have demonstrated that dual-task interference can significantly impact recovery of functional walking in people with neurological disorders. The magnitude and direction of dual-task interference is influenced by the interaction between the two tasks, including how individuals spontaneously prioritize their attention. Therefore, to accurately interpret and characterize dual-task interference and identify changes over time, it is imperative to evaluate single and dual-task performance in both tasks, as well as the tasks relative to each other. Yet, reciprocal dual-task effects are frequently ignored. The purpose of this perspective paper is to present a framework for measuring treatment effects on dual-task interference, specifically taking into account the interactions between the two tasks and how this can provide information on whether overall dual-task capacity has improved or a different attentional strategy has been adopted. In discussing the clinical implications of using this framework, we provide specific examples of using this method and provide some explicit recommendations for research and clinical practice.

  16. Quality Research in Radiation Oncology Analysis of Clinical Performance Measures in the Management of Gastric Cancer

    International Nuclear Information System (INIS)

    Goodman, Karyn A.; Khalid, Najma; Kachnic, Lisa A.; Minsky, Bruce D.; Crozier, Cheryl; Owen, Jean B.; Devlin, Phillip M.; Thomas, Charles R.

    2013-01-01

    Background: The specific aim was to determine national patterns of radiation therapy (RT) practice in patients treated for stage IB-IV (nonmetastatic) gastric cancer (GC). Methods and Materials: A national process survey of randomly selected US RT facilities was conducted which retrospectively assessed demographics, staging, geographic region, practice setting, and treatment by using on-site record review of eligible GC cases treated from 2005 to 2007. Three clinical performance measures (CPMs), (1) use of computed tomography (CT)-based treatment planning; (2) use of dose volume histograms (DVHs) to evaluate RT dose to the kidneys and liver; and (3) completion of RT within the prescribed time frame; and emerging quality indicators, (i) use of intensity modulated RT (IMRT); (ii) use of image-guided tools (IGRT) other than CT for RT target delineation; and (iii) use of preoperative RT, were assessed. Results: CPMs were computed for 250 eligible patients at 45 institutions (median age, 62 years; 66% male; 60% Caucasian). Using 2000 American Joint Committee on Cancer criteria, 13% of patients were stage I, 29% were stage II, 32% were stage IIIA, 10% were stage IIIB, and 12% were stage IV. Most patients (43%) were treated at academic centers, 32% were treated at large nonacademic centers, and 25% were treated at small to medium sized facilities. Almost all patients (99.5%) underwent CT-based planning, and 75% had DVHs to evaluate normal tissue doses to the kidneys and liver. Seventy percent of patients completed RT within the prescribed time frame. IMRT and IGRT were used in 22% and 17% of patients, respectively. IGRT techniques included positron emission tomography (n=20), magnetic resonance imaging (n=1), respiratory gating and 4-dimensional CT (n=22), and on-board imaging (n=10). Nineteen percent of patients received preoperative RT. Conclusions: This analysis of radiation practice patterns for treating nonmetastatic GC indicates widespread adoption of CT

  17. Quality Research in Radiation Oncology Analysis of Clinical Performance Measures in the Management of Gastric Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Goodman, Karyn A., E-mail: goodmank@mskcc.org [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Khalid, Najma [Quality Research in Radiation Oncology, American College of Radiology Clinical Research Center, Philadelphia, Pennsylvania (United States); Kachnic, Lisa A. [Department of Radiation Oncology, Boston University Medical Center, Boston, Massachusetts (United States); Minsky, Bruce D. [Department of Radiation Oncology, University of Texas MD, Anderson Cancer Center, Houston, Texas (United States); Crozier, Cheryl; Owen, Jean B. [Quality Research in Radiation Oncology, American College of Radiology Clinical Research Center, Philadelphia, Pennsylvania (United States); Devlin, Phillip M. [Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women' s Hospital, Boston, Massachusetts (United States); Thomas, Charles R. [Department of Radiation Medicine, Knight Cancer Institute at the Oregon Health and Science University, Portland, Oregon (United States)

    2013-02-01

    Background: The specific aim was to determine national patterns of radiation therapy (RT) practice in patients treated for stage IB-IV (nonmetastatic) gastric cancer (GC). Methods and Materials: A national process survey of randomly selected US RT facilities was conducted which retrospectively assessed demographics, staging, geographic region, practice setting, and treatment by using on-site record review of eligible GC cases treated from 2005 to 2007. Three clinical performance measures (CPMs), (1) use of computed tomography (CT)-based treatment planning; (2) use of dose volume histograms (DVHs) to evaluate RT dose to the kidneys and liver; and (3) completion of RT within the prescribed time frame; and emerging quality indicators, (i) use of intensity modulated RT (IMRT); (ii) use of image-guided tools (IGRT) other than CT for RT target delineation; and (iii) use of preoperative RT, were assessed. Results: CPMs were computed for 250 eligible patients at 45 institutions (median age, 62 years; 66% male; 60% Caucasian). Using 2000 American Joint Committee on Cancer criteria, 13% of patients were stage I, 29% were stage II, 32% were stage IIIA, 10% were stage IIIB, and 12% were stage IV. Most patients (43%) were treated at academic centers, 32% were treated at large nonacademic centers, and 25% were treated at small to medium sized facilities. Almost all patients (99.5%) underwent CT-based planning, and 75% had DVHs to evaluate normal tissue doses to the kidneys and liver. Seventy percent of patients completed RT within the prescribed time frame. IMRT and IGRT were used in 22% and 17% of patients, respectively. IGRT techniques included positron emission tomography (n=20), magnetic resonance imaging (n=1), respiratory gating and 4-dimensional CT (n=22), and on-board imaging (n=10). Nineteen percent of patients received preoperative RT. Conclusions: This analysis of radiation practice patterns for treating nonmetastatic GC indicates widespread adoption of CT

  18. Medicare Advantage and Fee-for-Service Performance on Clinical Quality and Patient Experience Measures: Comparisons from Three Large States.

    Science.gov (United States)

    Timbie, Justin W; Bogart, Andy; Damberg, Cheryl L; Elliott, Marc N; Haas, Ann; Gaillot, Sarah J; Goldstein, Elizabeth H; Paddock, Susan M

    2017-12-01

    To compare performance between Medicare Advantage (MA) and Fee-for-Service (FFS) Medicare during a time of policy changes affecting both programs. Performance data for 16 clinical quality measures and 6 patient experience measures for 9.9 million beneficiaries living in California, New York, and Florida. We compared MA and FFS performance overall, by plan type, and within service areas associated with contracts between CMS and MA organizations. Case mix-adjusted analyses (for measures not typically adjusted) were used to explore the effect of case mix on MA/FFS differences. Performance measures were submitted by MA organizations, obtained from the nationwide fielding of the Medicare Consumer Assessment of Healthcare Providers and Systems (MCAHPS) Survey, or derived from claims. Overall, MA outperformed FFS on all 16 clinical quality measures. Differences were large for HEDIS measures and small for Part D measures and remained after case mix adjustment. MA enrollees reported better experiences overall, but FFS beneficiaries reported better access to care. Relative to FFS, performance gaps were much wider for HMOs than PPOs. Excluding HEDIS measures, MA/FFS differences were much smaller in contract-level comparisons. Medicare Advantage/Fee-for-Service differences are often large but vary in important ways across types of measures and contracts. © Health Research and Educational Trust.

  19. Self-perceived versus objectively measured competence in performing clinical practical procedures by final year medical students

    OpenAIRE

    Katowa-Mukwato, Patricia; Banda, Sekelani

    2016-01-01

    Objectives To determine and compare the self-perceived and objectively measured competence in performing 14 core-clinical practical procedures by Final Year Medical Students of the University of Zambia. Methods The study included 56 out of 60 graduating University of Zambia Medical Students of the 2012/2013 academic year. Self-perceived competence: students rated their competence on 14 core- clinical practical procedures using a self-administered questionnaire on a 5-point Likert scale. Objec...

  20. Performance measures for improving the prevention of venous thromboembolism: achievement in clinical practice.

    Science.gov (United States)

    Wilson, Kenneth C; Merli, Geno J

    2011-10-01

    Venous thromboembolism (VTE) is a common complication during and after hospitalization for acute medical illness or surgery. Despite the existence of evidence-based guidelines for VTE prevention, real-world prescribing practices are frequently suboptimal. Specific performance measures relating to VTE prevention and treatment have been developed by US health care organizations to increase adherence with best-practice recommendations and ultimately reduce the number of preventable VTE events. Two measures developed by the Surgical Care Improvement Project have been endorsed by the National Quality Forum (NQF) and focus on VTE prevention. In addition, six measures have been developed recently by The Joint Commission in collaboration with the NQF; three measures relate to VTE prevention and three focus on treatment. To attain widespread achievement of these performance goals, it is essential to raise awareness of their existence and specifications. It is also imperative that hospitals develop and implement effective VTE protocols. The use of multiple, active strategies, such as computer decision support systems with regular audit and feedback, may be particularly valuable approaches to improve current practices within an integrated quality improvement program. During practical implementation of VTE protocols at Norton Healthcare (Kentucky's largest healthcare system), strong leadership, physician engagement, and caregiver accountability were identified as key factors influencing the process. As such, more hospitals may be able to increase adherence with guidelines, improve achievement of quality goals, and help to reduce the substantial burden associated with avoidable VTE.

  1. Self-perceived versus objectively measured competence in performing clinical practical procedures by final year medical students.

    Science.gov (United States)

    Katowa-Mukwato, Patricia; Banda, Sekelani

    2016-04-30

    To determine and compare the self-perceived and objectively measured competence in performing 14 core-clinical practical procedures by Final Year Medical Students of the University of Zambia. The study included 56 out of 60 graduating University of Zambia Medical Students of the 2012/2013 academic year. Self-perceived competence: students rated their competence on 14 core- clinical practical procedures using a self-administered questionnaire on a 5-point Likert scale. Objective competence: it was measured by Objective Structured Clinical Examination (OSCE) by faculty using predetermined rating scales. Rank order correlation test was performed for self-perceived and objectively measured competence. Two thirds 36 (66.7%) of the participants perceived themselves as moderately competent, 15 (27.8%) rated themselves as highly competent while 3 (5.6%) had low self-perception. With objective competence, the majority 52 (92.8%) were barely competent while 4 (7.2%) were absolutely competent. When overall self-perception was compared to objectively measured competence, there was a discordance which was demonstrated by a negative correlation (Spearman rho -.123). Significant numbers of students reported low self-competence in performing procedures such as endotracheal intubation, gastric lavage and cardiopulmonary resuscitation which most never performed during the clinical years of medical education. In addition, the negative correlation between self-perceived and objectively measured competence demonstrated the inability of students to assess and rate themselves objectively due to fear that others may know their weaknesses and realize that they are not as competent as expected at a specific level of training.

  2. Traceable working standards with SI units of radiance for characterizing the measurement performance of investigational clinical NIRF imaging devices

    Science.gov (United States)

    Zhu, Banghe; Rasmussen, John C.; Litorja, Maritoni; Sevick-Muraca, Eva M.

    2017-03-01

    All medical devices for Food and Drug market approval require specifications of performance based upon International System of Units (SI) or units derived from SI for reasons of traceability. Recently, near-infrared fluorescence (NIRF) imaging devices of a variety of designs have emerged on the market and in investigational clinical studies. Yet the design of devices used in the clinical studies vary widely, suggesting variable device performance. Device performance depends upon optimal excitation of NIRF imaging agents, rejection of backscattered excitation and ambient light, and selective collection of fluorescence emanating from the fluorophore. There remains no traceable working standards with SI units of radiance to enable prediction that a given molecular imaging agent can be detected in humans by a given NIRF imaging device. Furthermore, as technologies evolve and as NIRF imaging device components change, there remains no standardized means to track device improvements over time and establish clinical performance without involving clinical trials, often costly. In this study, we deployed a methodology to calibrate luminescent radiance of a stable, solid phantom in SI units of mW/cm2/sr for characterizing the measurement performance of ICCD and IsCMOS camera based NIRF imaging devices, such as signal-to-noise ratio (SNR) and contrast. The methodology allowed determination of superior SNR of the ICCD over the IsCMOS system; comparable contrast of ICCD and IsCMOS depending upon binning strategies.

  3. Predicting academic performance and clinical competency for international dental students: seeking the most efficient and effective measures.

    Science.gov (United States)

    Stacey, D Graham; Whittaker, John M

    2005-02-01

    Measures used in the selection of international dental students to a U.S. D.D.S. program were examined to identify the grouping that most effectively and efficiently predicted academic performance and clinical competency. Archival records from the International Dental Program (IDP) at Loma Linda University provided data on 171 students who had trained in countries outside the United States. The students sought admission to the D.D.S. degree program, successful completion of which qualified them to sit for U.S. licensure. As with most dental schools, competition is high for admission to the D.D.S. program. The study's goal was to identify what measures contributed to a fair and accurate selection process for dental school applicants from other nations. Multiple regression analyses identified National Board Part II and dexterity measures as significant predictors of academic performance and clinical competency. National Board Part I, TOEFL, and faculty interviews added no significant additional help in predicting eventual academic performance and clinical competency.

  4. Measuring agreement between rating interpretations and binary clinical interpretations of images: a simulation study of methods for quantifying the clinical relevance of an observer performance paradigm

    International Nuclear Information System (INIS)

    Chakraborty, Dev P

    2012-01-01

    Laboratory receiver operating characteristic (ROC) studies, that are often used to evaluate medical imaging systems, differ from ‘live’ clinical interpretations in several respects which could compromise their clinical relevance. The aim was to develop methodology for quantifying the clinical relevance of a laboratory ROC study. A simulator was developed to generate ROC ratings data and binary clinical interpretations classified as correct or incorrect for a common set of images interpreted under clinical and laboratory conditions. The area under the trapezoidal ROC curve (AUC) was used as the laboratory figure-of-merit and the fraction of correct clinical decisions as the clinical figure-of-merit. Conventional agreement measures (Pearson, Spearman, Kendall and kappa) between the bootstrap-induced fluctuations of the two figures of merit were estimated. A jackknife pseudovalue transformation applied to the figures of merit was also investigated as a way to capture agreement existing at the individual image level that could be lost at the figure-of-merit level. It is shown that the pseudovalues define a relevance-ROC curve. The area under this curve (rAUC) measures the ability of the laboratory figure-of-merit-based pseudovalues to correctly classify incorrect versus correct clinical interpretations. Therefore, rAUC is a measure of the clinical relevance of an ROC study. The conventional measures and rAUC were compared under varying simulator conditions. It was found that design details of the ROC study, namely the number of bins, the difficulty level of the images, the ratio of disease-present to disease-absent images and the unavoidable difference between laboratory and clinical performance levels, can lead to serious underestimation of the agreement as indicated by conventional agreement measures, even for perfectly correlated data, while rAUC showed high agreement and was relatively immune to these details. At the same time rAUC was sensitive to factors such

  5. Clinical performance evaluation of total protein measurement by digital refractometry and characterization of non-protein solute interferences

    Directory of Open Access Journals (Sweden)

    Joshua J.H. Hunsaker

    2016-12-01

    Full Text Available Objectives: Refractometric methods to measure total protein (TP in serum and plasma specimens have been replaced by automated biuret methods in virtually all routine clinical testing. A subset of laboratories, however, still report using refractometry to measure TP in conjunction with serum protein electrophoresis. The objective of this study was therefore to conduct a modern performance evaluation of a digital refractometer for TP measurement. Design and methods: Performance evaluation of a MISCO Palm Abbe™ digital refractometer was conducted through device familiarization, carryover, precision, accuracy, linearity, analytical sensitivity, analytical specificity, and reference interval verification. Comparison assays included a manual refractometer and an automated biuret assay. Results: Carryover risk was eliminated using a demineralized distilled water (ddH2O wash step. Precision studies demonstrated overall imprecision of 2.2% CV (low TP pool and 0.5% CV (high TP pool. Accuracy studies demonstrated correlation to both manual refractometry and the biuret method. An overall positive bias (+5.0% was observed versus the biuret method. On average, outlier specimens had an increased triglyceride concentration. Linearity was verified using mixed dilutions of: a low and high concentration patient pools, or b albumin-spiked ddH2O and high concentration patient pool. Decreased recovery was observed using ddH2O dilutions at low TP concentrations. Significant interference was detected at high concentrations of glucose (>267 mg/dL and triglycerides (>580 mg/dL. Current laboratory reference intervals for TP were verified. Conclusions: Performance characteristics of this digital refractometer were validated in a clinical laboratory setting. Biuret method remains the preferred assay for TP measurement in routine clinical analyses. Keywords: Refractometry, Digital refractometry, Total protein, Biuret, Serum protein electrophoresis, Monoclonal

  6. Clinical performance evaluation of total protein measurement by digital refractometry and characterization of non-protein solute interferences.

    Science.gov (United States)

    Hunsaker, Joshua J H; Wyness, Sara P; Snow, Taylor M; Genzen, Jonathan R

    2016-12-01

    Refractometric methods to measure total protein (TP) in serum and plasma specimens have been replaced by automated biuret methods in virtually all routine clinical testing. A subset of laboratories, however, still report using refractometry to measure TP in conjunction with serum protein electrophoresis. The objective of this study was therefore to conduct a modern performance evaluation of a digital refractometer for TP measurement. Performance evaluation of a MISCO Palm Abbe™ digital refractometer was conducted through device familiarization, carryover, precision, accuracy, linearity, analytical sensitivity, analytical specificity, and reference interval verification. Comparison assays included a manual refractometer and an automated biuret assay. Carryover risk was eliminated using a demineralized distilled water (ddH 2 O) wash step. Precision studies demonstrated overall imprecision of 2.2% CV (low TP pool) and 0.5% CV (high TP pool). Accuracy studies demonstrated correlation to both manual refractometry and the biuret method. An overall positive bias (+5.0%) was observed versus the biuret method. On average, outlier specimens had an increased triglyceride concentration. Linearity was verified using mixed dilutions of: a) low and high concentration patient pools, or b) albumin-spiked ddH 2 O and high concentration patient pool. Decreased recovery was observed using ddH 2 O dilutions at low TP concentrations. Significant interference was detected at high concentrations of glucose (>267 mg/dL) and triglycerides (>580 mg/dL). Current laboratory reference intervals for TP were verified. Performance characteristics of this digital refractometer were validated in a clinical laboratory setting. Biuret method remains the preferred assay for TP measurement in routine clinical analyses.

  7. Clinical Performance Measures and Quality Improvement System Considerations for Dental Education.

    Science.gov (United States)

    Parkinson, Joseph W; Zeller, Gregory G

    2017-03-01

    Quality improvement and quality assurance programs are an integral part of providing excellence in health care delivery. The Dental Quality Alliance and the Commission on Dental Accreditation recognize this and have created standards and recommendations to advise health care providers and health care delivery systems, including dental schools, on measuring the quality of the care delivered to patients. Overall health care expenditures have increased, and the Affordable Care Act has made health care, including dentistry, available to more people in the United States. These increases in cost and in the number of patients accessing care contribute to a heightened interest in measurable quality improvement outcomes that reflect efficiency, effectiveness, and overall value. Practitioners and administrators, both in academia and in the "real world," need an understanding of various quality improvement methodologies available in order to select approaches that support effective monitoring of the quality of care delivered. This article compares and contrasts various quality improvement approaches, programs, and systems currently in use in order to assist dental providers and administrators in choosing quality improvement methodologies pertinent to their practice or institution.

  8. Numerical versus narrative: A comparison between methods to measure medical student performance during clinical clerkships.

    Science.gov (United States)

    Bartels, Josef; Mooney, Christopher John; Stone, Robert Thompson

    2017-11-01

    Medical school evaluations typically rely on both language-based narrative descriptions and psychometrically converted numeric scores to convey performance to the grading committee. We evaluated inter-rater reliability and correlation of numeric versus narrative evaluations for students on their Neurology Clerkship. 50 Neurology Clerkship in-training evaluation reports completed by their residents and faculty members at the University of Rochester School of Medicine were dissected into narrative and numeric components. 5 Clerkship grading committee members retrospectively gave new narrative scores (NNS) while blinded to original numeric scores (ONS). We calculated intra-class correlation coefficients (ICC) and their associated confidence intervals for the ONS and the NNS. In addition, we calculated the correlation between ONS and NNS. The ICC was greater for the NNS (ICC = .88 (95% CI = .70-.94)) than the ONS (ICC = .62 (95% CI = .40-.77)) Pearson correlation coefficient showed that the ONS and NNS were highly correlated (r = .81). Narrative evaluations converted by a small group of experienced graders are at least as reliable as numeric scoring by individual evaluators. We could allow evaluators to focus their efforts on creating richer narrative of greater value to trainees.

  9. Diagnostic colonoscopy: performance measurement study.

    Science.gov (United States)

    Kuznets, Naomi

    2002-07-01

    This is the fifth of a series of best practices studies undertaken by the Performance Measurement Initiative (PMI), the centerpiece of the Institute for Quality Improvement (IQI), a not-for-profit quality improvement subsidiary of the Accreditation Association for Ambulatory Health Care (AAAHC) (Performance Measurement Initiative, 1999a, 1999b, 2000a, 2000b). The IQI was created to offer clinical performance measurement and improvement opportunities to ambulatory health care organizations and others interested in quality patient care. The purpose of the study was to provide opportunities to initiate clinical performance measurement on key processes and outcomes for this procedure and use this information for clinical quality improvement. This article provides performance measurement information on how organizations that have demonstrated and validated differences in clinical practice can have similar outcomes, but at a dramatically lower cost. The intent of the article is to provide organizations with alternatives in practice to provide a better value to their patients.

  10. Traceability Assessment and Performance Evaluation of Results for Measurement of Abbott Clinical Chemistry Assays on 4 Chemistry Analyzers.

    Science.gov (United States)

    Lim, Jinsook; Song, Kyung Eun; Song, Sang Hoon; Choi, Hyun-Jung; Koo, Sun Hoe; Kwon, Gye Choel

    2016-05-01

    -The traceability of clinical results to internationally recognized and accepted reference materials and reference measurement procedures has become increasingly important. Therefore, the establishment of traceability has become a mandatory requirement for all in vitro diagnostics devices. -To evaluate the traceability of the Abbott Architect c8000 system (Abbott Laboratories, Abbott Park, Illinois), consisting of calibrators and reagents, across 4 different chemistry analyzers, and to evaluate its general performance on the Toshiba 2000FR NEO (Toshiba Medical Systems Corporation, Otawara-shi, Tochigi-ken, Japan). -For assessment of traceability, secondary reference materials were evaluated 5 times, and then bias was calculated. Precision, linearity, and carryover were determined according to the guidelines of the Clinical and Laboratory Standards Institute (Wayne, Pennsylvania). -The biases from 4 different analyzers ranged from -2.33% to 2.70% on the Toshiba 2000FR NEO, -2.33% to 5.12% on the Roche Hitachi 7600 (Roche Diagnostics International, Basel, Switzerland), -0.93% to 2.87% on the Roche Modular, and -2.16% to 2.86% on the Abbott Architect c16000. The total coefficients of variance of all analytes were less than 5%. The coefficients of determination (R(2)) were more than 0.9900. The carryover rate ranged from -0.54% to 0.17%. -Abbott clinical chemistry assays met the performance criteria based on desirable biological variation for precision, bias, and total error. They also showed excellent linearity and carryover. Therefore, these clinical chemistry assays were found to be accurate and reliable and are readily applicable on the various platforms used in this study.

  11. Developing Effective Performance Measures

    Science.gov (United States)

    2014-10-14

    University When Performance Measurement Goes Bad Laziness Vanity Narcissism Too Many Pettiness Inanity 52 Developing Effective...Kasunic, October 14, 2014 © 2014 Carnegie Mellon University Narcissism Measuring performance from the organization’s point of view, rather than from

  12. TheClinical Research Tool: a high-performance microdialysis-based system for reliably measuring interstitial fluid glucose concentration.

    Science.gov (United States)

    Ocvirk, Gregor; Hajnsek, Martin; Gillen, Ralph; Guenther, Arnfried; Hochmuth, Gernot; Kamecke, Ulrike; Koelker, Karl-Heinz; Kraemer, Peter; Obermaier, Karin; Reinheimer, Cornelia; Jendrike, Nina; Freckmann, Guido

    2009-05-01

    A novel microdialysis-based continuous glucose monitoring system, the so-called Clinical Research Tool (CRT), is presented. The CRT was designed exclusively for investigational use to offer high analytical accuracy and reliability. The CRT was built to avoid signal artifacts due to catheter clogging, flow obstruction by air bubbles, and flow variation caused by inconstant pumping. For differentiation between physiological events and system artifacts, the sensor current, counter electrode and polarization voltage, battery voltage, sensor temperature, and flow rate are recorded at a rate of 1 Hz. In vitro characterization with buffered glucose solutions (c(glucose) = 0 - 26 x 10(-3) mol liter(-1)) over 120 h yielded a mean absolute relative error (MARE) of 2.9 +/- 0.9% and a recorded mean flow rate of 330 +/- 48 nl/min with periodic flow rate variation amounting to 24 +/- 7%. The first 120 h in vivo testing was conducted with five type 1 diabetes subjects wearing two systems each. A mean flow rate of 350 +/- 59 nl/min and a periodic variation of 22 +/- 6% were recorded. Utilizing 3 blood glucose measurements per day and a physical lag time of 1980 s, retrospective calibration of the 10 in vivo experiments yielded a MARE value of 12.4 +/- 5.7. Clarke error grid analysis resulted in 81.0%, 16.6%, 0.8%, 1.6%, and 0% in regions A, B, C, D, and E, respectively. The CRT demonstrates exceptional reliability of system operation and very good measurement performance. The ability to differentiate between artifacts and physiological effects suggests the use of the CRT as a reference tool in clinical investigations. 2009 Diabetes Technology Society.

  13. Performance Measurement und Environmental Performance Measurement

    OpenAIRE

    Sturm, Anke

    2000-01-01

    Die Zielsetzung der vorliegenden Dissertationsschrift besteht in der Entwicklung einer systematisierten Vorgehensweise, eines Controllingmodells, zur unternehmensinternen Umweltleistungsmessung. Das entwickelte Environmental Performance Measurement (EPM)-Modell umfaßt die fünf Stufen Festlegung der Ziele der Umweltleistungsmessung (1. Stufe), Erfassung der Umwelteinflüsse nach der ökologischen Erfolgsspaltung (2. Stufe), Bewertung der Umwelteinflüsse auf der Grundlage des qualitätszielbezogen...

  14. Aerobic fitness and metabolic health in children: A clinical validation of directly measured maximal oxygen consumption versus performance measures as markers of health.

    Science.gov (United States)

    Aadland, Eivind; Kvalheim, Olav Martin; Rajalahti, Tarja; Skrede, Turid; Resaland, Geir Kåre

    2017-09-01

    High aerobic fitness is consistently associated with a favorable metabolic health profile in children. However, measurement of oxygen uptake, regarded as the gold standard for evaluating aerobic fitness, is often not feasible. Thus, the aim of the present study was to perform a clinical validation of three measures of aerobic fitness (peak oxygen consumption [VO 2peak ] and time to exhaustion [TTE] determined from a graded treadmill protocol to exhaustion, and the Andersen intermittent running test) with clustered metabolic health in 10-year-old children. We included 93 children (55 boys and 38 girls) from Norway during 2012-2013 in the study. Associations between aerobic fitness and three different composite metabolic health scores (including lipoprotein subgroup particle concentrations, triglyceride, glucose, systolic blood pressure, and waist-to-height ratio) were determined by regression analyses adjusting for sex. The relationships among the measures of aerobic fitness were r  = 0.78 for VO 2peak vs. TTE, r  = 0.63 for VO 2peak vs. the Andersen test, and r  = 0.67 for TTE vs. the Andersen test. The Andersen test showed the strongest associations across all markers of metabolic health ( r  = - 0.45 to - 0.31, p  fitness do not stand back as markers of metabolic health status in children, compared to VO 2peak . This is of great importance as good field tests provide opportunities for measuring aerobic fitness in many settings where measuring VO 2peak are impossible.

  15. Performance Measurement at Universities

    DEFF Research Database (Denmark)

    Lueg, Klarissa

    2014-01-01

    This paper proposes empirical approaches to testing the reliability, validity, and organizational effectiveness of student evaluations of teaching (SET) as a performance measurement instrument in knowledge management at the institutional level of universities. Departing from Weber’s concept...

  16. The performance measurement manifesto.

    Science.gov (United States)

    Eccles, R G

    1991-01-01

    The leading indicators of business performance cannot be found in financial data alone. Quality, customer satisfaction, innovation, market share--metrics like these often reflect a company's economic condition and growth prospects better than its reported earnings do. Depending on an accounting department to reveal a company's future will leave it hopelessly mired in the past. More and more managers are changing their company's performance measurement systems to track nonfinancial measures and reinforce new competitive strategies. Five activities are essential: developing an information architecture; putting the technology in place to support this architecture; aligning bonuses and other incentives with the new system; drawing on outside resources; and designing an internal process to ensure the other four activities occur. New technologies and more sophisticated databases have made the change to nonfinancial performance measurement systems possible and economically feasible. Industry and trade associations, consulting firms, and public accounting firms that already have well-developed methods for assessing market share and other performance metrics can add to the revolution's momentum--as well as profit from the business opportunities it presents. Every company will have its own key measures and distinctive process for implementing the change. But making it happen will always require careful preparation, perseverance, and the conviction of the CEO that it must be carried through. When one leading company can demonstrate the long-term advantage of its superior performance on quality or innovation or any other nonfinancial measure, it will change the rules for all its rivals forever.

  17. Enterprise performance measurement systems

    Directory of Open Access Journals (Sweden)

    Milija Bogavac

    2014-10-01

    Full Text Available Performance measurement systems are an extremely important part of the control and management actions, because in this way a company can determine its business potential, its market power, potential and current level of business efficiency. The significance of measurement consists in influencing the relationship between the results of reproduction (total volume of production, value of production, total revenue and profit and investments to achieve these results (factors of production spending and hiring capital in order to achieve the highest possible quality of the economy. (The relationship between the results of reproduction and investment to achieve them quantitatively determines economic success as the quality of the economy. Measuring performance allows the identification of the economic resources the company has, so looking at the key factors that affect its performance can help to determine the appropriate course of action.

  18. Productivity and Performance Measurement

    DEFF Research Database (Denmark)

    Hald, Kim Sundtoft; Spring, Martin

    This study explores conceptually how performance measurement as discussed in the literature, enables or constrains the ability to manage and improve productivity. It uses an inter-disciplinary literature review to identify five areas of concern relating productivity accounting to the ability...... to improve productivity: “Productivity representation”; “productivity incentives”, “productivity intervention”; “productivity trade-off or synergy” and “productivity strategy and context”. The paper discusses these areas of concern and expands our knowledge of how productivity and performance measurement...

  19. Measuring Firm Performance

    DEFF Research Database (Denmark)

    Assaf, A. George; Josiassen, Alexander; Gillen, David

    2014-01-01

    Set in the airport industry, this paper measures firm performance using both desirable and bad outputs (i.e. airport delays). We first estimate a model that does not include the bad outputs and then a model that includes bad outputs. The results show important differences in the efficiency...

  20. Benchmarking and Performance Measurement.

    Science.gov (United States)

    Town, J. Stephen

    This paper defines benchmarking and its relationship to quality management, describes a project which applied the technique in a library context, and explores the relationship between performance measurement and benchmarking. Numerous benchmarking methods contain similar elements: deciding what to benchmark; identifying partners; gathering…

  1. 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

  2. A simple, rapid and validated high-performance liquid chromatography method suitable for clinical measurements of human mercaptalbumin and non-mercaptalbumin.

    Science.gov (United States)

    Yasukawa, Keiko; Shimosawa, Tatsuo; Okubo, Shigeo; Yatomi, Yutaka

    2018-01-01

    Background Human mercaptalbumin and human non-mercaptalbumin have been reported as markers for various pathological conditions, such as kidney and liver diseases. These markers play important roles in redox regulations throughout the body. Despite the recognition of these markers in various pathophysiologic conditions, the measurements of human mercaptalbumin and non-mercaptalbumin have not been popular because of the technical complexity and long measurement time of conventional methods. Methods Based on previous reports, we explored the optimal analytical conditions for a high-performance liquid chromatography method using an anion-exchange column packed with a hydrophilic polyvinyl alcohol gel. The method was then validated using performance tests as well as measurements of various patients' serum samples. Results We successfully established a reliable high-performance liquid chromatography method with an analytical time of only 12 min per test. The repeatability (within-day variability) and reproducibility (day-to-day variability) were 0.30% and 0.27% (CV), respectively. A very good correlation was obtained with the results of the conventional method. Conclusions A practical method for the clinical measurement of human mercaptalbumin and non-mercaptalbumin was established. This high-performance liquid chromatography method is expected to be a powerful tool enabling the expansion of clinical usefulness and ensuring the elucidation of the roles of albumin in redox reactions throughout the human body.

  3. Cardiac performance measure compliance in outpatients: the American College of Cardiology and National Cardiovascular Data Registry's PINNACLE (Practice Innovation And Clinical Excellence) program.

    Science.gov (United States)

    Chan, Paul S; Oetgen, William J; Buchanan, Donna; Mitchell, Kristi; Fiocchi, Fran F; Tang, Fengming; Jones, Philip G; Breeding, Tracie; Thrutchley, Duane; Rumsfeld, John S; Spertus, John A

    2010-06-29

    We examined compliance with performance measures for 14,464 patients enrolled from July 2008 through June 2009 into the American College of Cardiology's PINNACLE (Practice Innovation And Clinical Excellence) program to provide initial insights into the quality of outpatient cardiac care. Little is known about the quality of care of outpatients with coronary artery disease (CAD), heart failure, and atrial fibrillation, and whether sex and racial disparities exist in the treatment of outpatients. The PINNACLE program is the first, national, prospective office-based quality improvement program of cardiac patients designed, in part, to capture, report, and improve outpatient performance measure compliance. We examined the proportion of patients whose care was compliant with established American College of Cardiology, American Heart Association, and American Medical Association-Physician Consortium for Performance Improvement (ACC/AHA/PCPI) performance measures for CAD, heart failure, and atrial fibrillation. There were 14,464 unique patients enrolled from 27 U.S. practices, accounting for 18,021 clinical visits. Of these, 8,132 (56.4%) had CAD, 5,012 (34.7%) had heart failure, and 2,786 (19.3%) had nonvalvular atrial fibrillation. Data from the PINNACLE program were feasibly collected for 24 of 25 ACC/AHA/PCPI performance measures. Compliance with performance measures ranged from being very low (e.g., 13.3% of CAD patients screened for diabetes mellitus) to very high (e.g., 96.7% of heart failure patients with blood pressure assessments), with moderate (70% to 90%) compliance observed for most performance measures. For 3 performance measures, there were small differences in compliance rates by race or sex. For more than 14,000 patients enrolled from 27 practices in the outpatient PINNACLE program, we found that compliance with performance measures was variable, even after accounting for exclusion criteria, suggesting an important opportunity to improve the quality of

  4. Measuring Clinical Productivity.

    Science.gov (United States)

    Hudson, Mark E; Lebovitz, Evan E

    2018-06-01

    Productivity measurements have been used to evaluate and compare physicians and physician practices. Anesthesiology is unique in that factors outside anesthesiologist control impact opportunity for revenue generation and make comparisons between providers and facilities challenging. This article uses data from the multicenter University of Pittsburgh Physicians Department of Anesthesiology to demonstrate factors influencing productivity opportunity by surgical facility, between department divisions and subspecialties within multispecialty divisions, and by individuals within divisions. The complexities of benchmarking anesthesiology productivity are demonstrated, and the potential value of creating a productivity profile for facilities and groups is illustrated. Copyright © 2018 Elsevier Inc. All rights reserved.

  5. Global positioning system derived performance measures are responsive indicators of physical activity, disease and the success of clinical treatments in domestic dogs.

    Directory of Open Access Journals (Sweden)

    Elizabeth A Bruno

    Full Text Available 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.Prospective study.Ten healthy dogs and seven dogs with osteoarthritis of the elbow joint (OA dogs.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.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.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.

  6. Relationships Between Measures of the Ability to Perform Vision-Related Activities, Vision-Related Quality of Life, and Clinical Findings in Patients With Glaucoma.

    Science.gov (United States)

    Ekici, Feyzahan; Loh, Rebecca; Waisbourd, Michael; Sun, Yi; Martinez, Patricia; Nayak, Natasha; Wizov, Sheryl S; Hegarty, Sarah; Hark, Lisa A; Spaeth, George L

    2015-12-01

    To our knowledge, few studies have combined an objective measure of vision-related performance (VRP) and subjective measures of vision-related quality of life (VRQoL) with clinically related visual parameters, particularly in a large, prospective, cohort study setting. To examine the relationships between clinical visual assessments and both a VRP and 2 self-reported VRQoL measurements. Patients (N = 161) with moderate-stage glaucoma recruited from the Glaucoma Service at Wills Eye Hospital, Philadelphia, Pennsylvania, were enrolled from May 2012 to May 2014 in an ongoing prospective, 4-year longitudinal observational study. This report includes cross-sectional results from the baseline visit. Patients received a complete ocular examination, automated visual field (VF) test and Cirrus optical coherence tomographic scan. Contrast sensitivity was measured with the Pelli-Robson and the Spaeth-Richman Contrast Sensitivity (SPARCS) tests. Vision-related performance was assessed by the Compressed Assessment of Ability Related to Vision (CAARV) test. Vision-related QoL was assessed by the National Eye Institute Visual Function Questionnaire 25 (NEI-VFQ-25) and a modified Glaucoma Symptom Scale (MGSS). Correlations between clinical measures and CAARV, NEI-VFQ-25, and MGSS scores. A total of 161 patients were enrolled in the study. The strongest correlation was found between SPARCS score in the better eye and total CAARV score (r = 0.398; 95% CI, 0.235-0.537; P better eye. There were more statistically significant correlations between contrast sensitivity tests and VF mean deviation with VRQoL measurements than with other clinical measures (visual acuity, intraocular pressure, Disc Damage Likelihood Scale, and mean retinal nerve fiber layer thickness). The MGSS scores were lower (worse) in women compared with men (P = .03 for binocular, P = .01 for better eye, and P = .05 for the worse eye). Structural measures (eg, Disc Damage Likelihood Scale, and

  7. Using Technical Performance Measures

    Science.gov (United States)

    Garrett, Christopher J.; Levack, Daniel J. H.; Rhodes, Russel E.

    2011-01-01

    All programs have requirements. For these requirements to be met, there must be a means of measurement. A Technical Performance Measure (TPM) is defined to produce a measured quantity that can be compared to the requirement. In practice, the TPM is often expressed as a maximum or minimum and a goal. Example TPMs for a rocket program are: vacuum or sea level specific impulse (lsp), weight, reliability (often expressed as a failure rate), schedule, operability (turn-around time), design and development cost, production cost, and operating cost. Program status is evaluated by comparing the TPMs against specified values of the requirements. During the program many design decisions are made and most of them affect some or all of the TPMs. Often, the same design decision changes some TPMs favorably while affecting other TPMs unfavorably. The problem then becomes how to compare the effects of a design decision on different TPMs. How much failure rate is one second of specific impulse worth? How many days of schedule is one pound of weight worth? In other words, how to compare dissimilar quantities in order to trade and manage the TPMs to meet all requirements. One method that has been used successfully and has a mathematical basis is Utility Analysis. Utility Analysis enables quantitative comparison among dissimilar attributes. It uses a mathematical model that maps decision maker preferences over the tradeable range of each attribute. It is capable of modeling both independent and dependent attributes. Utility Analysis is well supported in the literature on Decision Theory. It has been used at Pratt & Whitney Rocketdyne for internal programs and for contracted work such as the J-2X rocket engine program. This paper describes the construction of TPMs and describes Utility Analysis. It then discusses the use of TPMs in design trades and to manage margin during a program using Utility Analysis.

  8. Variation in performance measure criteria significantly affects cardiology practice rankings: Insights from the National Cardiovascular Data Registry's Practice Innovation and Clinical Excellence Registry.

    Science.gov (United States)

    Eapen, Zubin J; Tang, Fengming; Jones, Phil G; Maddox, Thomas M; Oetgen, William J; Spertus, John A; Rumsfeld, John S; Heidenreich, Paul A; Peterson, Eric D; Drozda, Joseph P

    2015-06-01

    Million Hearts is a national initiative to prevent 1 million heart attacks and strokes over 5 years by improving cardiovascular prevention. An important tool in the success of programs like Million Hearts is public ranking on the quality of practices, yet different measures may provide different rankings, so the true quality of practices is difficult to discern. We evaluated the quality of ambulatory cardiology care using performance measure metrics. We compared rankings of practices participating in the National Cardiovascular Data Registry's Practice Innovation and Clinical Excellence Registry using measures from (1) the physician quality reporting system and (2) the American College of Cardiology/American Heart Association/Physician Consortium for Performance Improvement. We compared achievement rates for measures between the 2 frameworks and determined correlations in rankings using Spearman correlation coefficients. From January 1, 2008 to December 31, 2012, there were 1,711,326 patients enrolled from 111 US practices. Among eligible patients, the physician quality reporting system and American College of Cardiology/American Heart Association/Physician Consortium for Performance Improvement measures were achieved in 76.1% versus 77.4% for antiplatelet prescription (P performance and failing to achieve public health goals. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Strategic Measures of Teacher Performance

    Science.gov (United States)

    Milanowski, Anthony

    2011-01-01

    Managing the human capital in education requires measuring teacher performance. To measure performance, administrators need to combine measures of practice with measures of outcomes, such as value-added measures, and three measurement systems are needed: classroom observations, performance assessments or work samples, and classroom walkthroughs.…

  10. Clinical validation study to measure the performance of the Nerve Root Sedimentation Sign for the diagnosis of lumbar spinal stenosis

    NARCIS (Netherlands)

    Staub, Lukas P.; Barz, Thomas; Melloh, Markus; Lord, Sarah J.; Chatfield, Mark; Bossuyt, Patrick M.

    2011-01-01

    Lumbar spinal stenosis is a common degenerative disorder of the spine in elderly patients that can be effectively treated with decompression surgery in some patients. Radiological findings in the diagnostic work-up of the patients do not always correlate well with clinical symptoms, and guidance

  11. Freight performance measures : approach analysis.

    Science.gov (United States)

    2010-05-01

    This report reviews the existing state of the art and also the state of the practice of freight performance measurement. Most performance measures at the state level have aimed at evaluating highway or transit infrastructure performance with an empha...

  12. Winter maintenance performance measure.

    Science.gov (United States)

    2016-01-01

    The Winter Performance Index is a method of quantifying winter storm events and the DOTs response to them. : It is a valuable tool for evaluating the States maintenance practices, performing post-storm analysis, training : maintenance personnel...

  13. Performance on a Clinical Quadriceps Activation Battery Is Related to a Laboratory Measure of Activation and Recovery After Total Knee Arthroplasty.

    Science.gov (United States)

    Bade, Michael; Struessel, Tamara; Paxton, Roger; Winters, Joshua; Baym, Carol; Stevens-Lapsley, Jennifer

    2018-01-01

    To determine the relation between performance on a clinical quadriceps activation battery with (1) activation measured by doublet interpolation and (2) recovery of quadriceps strength and functional performance after total knee arthroplasty (TKA). Planned secondary analysis of a randomized controlled trial. University research laboratory. Patients (N=162; mean age, 63±7y; 89 women) undergoing TKA. Patients were classified as high (quadriceps activation battery ≥4/6) or low (quadriceps activation battery ≤3/6) based on performance on the quadriceps activation battery measured 4 days after TKA. Differences between groups in activation and recovery at 1, 2, 3, 6, and 12 months after TKA were compared using a repeated-measures maximum likelihood model. The low quadriceps activation battery group demonstrated poorer quadriceps activation via doublet interpolation (P=.01), greater quadriceps strength loss (P=.01), and greater functional performance decline (all Pbattery group. Differences between low and high quadriceps activation battery groups on all measures did not persist at 3 and 12 months (all P>.05). Poor performance on the quadriceps activation battery early after TKA is related to poor quadriceps activation and poor recovery in the early postoperative period. Patients in the low quadriceps activation battery group took 3 months to recover to the same level as the high quadriceps activation battery group. The quadriceps activation battery may be useful in identifying individuals who need specific interventions to target activation deficits or different care pathways in the early postoperative period to speed recovery after TKA. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  14. Performance Measurement Baseline Change Request

    Data.gov (United States)

    Social Security Administration — The Performance Measurement Baseline Change Request template is used to document changes to scope, cost, schedule, or operational performance metrics for SSA's Major...

  15. Transit performance measures in California.

    Science.gov (United States)

    2016-04-01

    This research is the result of a California Department of Transportation (Caltrans) request to assess the most commonly : available transit performance measures in California. Caltrans wanted to understand performance measures and data used by : Metr...

  16. Measuring the Company Performance

    Directory of Open Access Journals (Sweden)

    Ion Stancu

    2006-03-01

    Full Text Available According to the logics of the efficient capital investment, the management of the investment of the saving capital in the company’s assets must conclude, on the end of the financial year, with a plus ofreal value (NPV > 0. From this point of view, in this paper we suggest the usage of an investment valuationmodel for the assessment of the company managerial and technological performance. Supposing the book value is a proxy of the just value (of assets and operational results and supposing the capital cost iscorrectly estimated, we evaluate the company’s performance both by the net present value model, and also by the company’s ability to create a surplus of the invested capital (NPV >0.Our paper also aims to identify the performance of the financial breakeven point (for which NPV is at least equal to zero as the minimum acceptable level for the company’s activity. Under this critical sales point, the company goes through the undervaluation of shareholders fortune even if the company’s sales are greater than accounting breakeven point. The performance’s activity level is one which the managers recover and surpass the cost of capital, cost which stand for the normal activity benchmark.The risks of applying of our suggested model we support go down to the confidence of accounting data and of the cost of capital estimating. In spite all of this, the usage of a sensitivity analysis to search anaverage NPV would leads to the company’s performance valuation within investment logic with a high information power.

  17. Measuring the Company Performance

    Directory of Open Access Journals (Sweden)

    Ion Stancu

    2006-01-01

    Full Text Available According to the logics of the efficient capital investment, the management of the investment of the saving capital in the company’s assets must conclude, on the end of the financial year, with a plus of real value (NPV > 0. From this point of view, in this paper we suggest the usage of an investment valuation model for the assessment of the company managerial and technological performance. Supposing the book value is a proxy of the just value (of assets and operational results and supposing the capital cost is correctly estimated, we evaluate the company’s performance both by the net present value model, and also by the company’s ability to create a surplus of the invested capital (NPV >0. Our paper also aims to identify the performance of the financial breakeven point (for which NPV is at least equal to zero as the minimum acceptable level for the company’s activity. Under this critical sales point, the company goes through the undervaluation of shareholders fortune even if the company’s sales are greater than accounting breakeven point. The performance’s activity level is one which the managers recover and surpass the cost of capital, cost which stand for the normal activity benchmark. The risks of applying of our suggested model we support go down to the confidence of accounting data and of the cost of capital estimating. In spite all of this, the usage of a sensitivity analysis to search an average NPV would leads to the company’s performance valuation within investment logic with a high information power.

  18. Economic measures of performance

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    Cogeneration systems can reduce the total cost of utility service, and, in some instances where power is sold to an electric utility, can even produce a positive net revenue stream. This is, the total cogeneration revenue is greater than the cogeneration system's operating cost plus the cost of supplemental fuel and power. Whether it is sited at an existing facility or new construction, cogeneration systems do require an incremental investment over and above that which would be required if the end user were to utilize more conventional utility services. While the decision as to whether or not one should invest in cogeneration may consider such intangibles as predictability of future utility costs, reliability of electrical supply and the quality of that supply, the decision ultimately becomes one of basic economics. This chapter briefly reviews several economic measures with regard to ease of use, accuracy and financial objective

  19. 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

  20. THE MEASURABILITY OF CONTROLLING PERFORMANCE

    Directory of Open Access Journals (Sweden)

    V. Laval

    2017-04-01

    Full Text Available The urge to increase the performance of company processes is ongoing. Surveys indicate however, that many companies do not measure the controlling performance with a defined set of key performance indicators. This paper will analyze three categories of controlling key performance indicators based on their degree of measurability and their impact on the financial performance of a company. Potential measures to optimize the performance of the controlling department will be outlined and put in a logical order. The aligning of the controlling activity with the respective management expectation will be discussed as a key success factor of this improvement project.

  1. Comparison of the performance of four different tools in diagnosing disease-associated anorexia and their relationship with nutritional, functional and clinical outcome measures in hospitalized patients.

    Science.gov (United States)

    Arezzo di Trifiletti, Adriana; Misino, Paola; Giannantoni, Patrizia; Giannantoni, Barbara; Cascino, Antonia; Fazi, Lucia; Rossi Fanelli, Filippo; Laviano, Alessandro

    2013-08-01

    In hospitalized patients, lack of appetite, i.e., disease-associated anorexia, is the main factor determining insufficient food intake and weight loss, which in turn increase morbidity and mortality. Controversies exist on which tool should be preferred when diagnosing anorexia. Aim of the study was to evaluate in hospitalized medical patients, the performance of 4 different tools [i.e., self-assessment of appetite, FAACT-ESPEN score, visual analog scale (VAS), and the Anorexia Questionnaire (AQ)] in assessing disease-associated anorexia and predicting nutritional and clinical variables. Hospitalized patients consecutively admitted to the Internal Medicine ward at our institution were considered. After informed consent was obtained, patients were asked to self-assess their appetite vs the previous month. The VAS, the FAACT-ESPEN score and the Anorexia Questionnaire were also submitted. Food intake immediately following the interview was recorded. Nutritional (i.e., body weight, height), functional (i.e., handgrip strength) and clinical variables (i.e., length of stay) were registered upon admission and before discharge. We studied 105 patients (74M:31F; 66.2 ± 16.3 yrs). The prevalence of anorexia as assessed by patients' self assessment, FAACT-ESPEN score, and the Anorexia Questionnaire was 23%, 10% and 48%, respectively. VAS did not show any correlation with food intake. Anorexic patients as identified by the self assessment of appetite showed reduced food intake and weaker handgrip strength than non-anorexic. The FAACT-ESPEN score correlated with body weight, food intake and handgrip strength, but was not related with length of stay. Anorexic patients as identified by the Anorexia Questionnaire showed reduced food intake, lower body weight, weaker handgrip strength and longer hospital stay than non-anorexic patients. The prevalence of anorexia significantly varies according to the diagnostic tool used. Except for VAS, all the tested tools identify patients with

  2. 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...

  3. Clinical Prediction Performance of Glaucoma Progression Using a 2-Dimensional Continuous-Time Hidden Markov Model with Structural and Functional Measurements.

    Science.gov (United States)

    Song, Youngseok; Ishikawa, Hiroshi; Wu, Mengfei; Liu, Yu-Ying; Lucy, Katie A; Lavinsky, Fabio; Liu, Mengling; Wollstein, Gadi; Schuman, Joel S

    2018-03-20

    Previously, we introduced a state-based 2-dimensional continuous-time hidden Markov model (2D CT HMM) to model the pattern of detected glaucoma changes using structural and functional information simultaneously. The purpose of this study was to evaluate the detected glaucoma change prediction performance of the model in a real clinical setting using a retrospective longitudinal dataset. Longitudinal, retrospective study. One hundred thirty-four eyes from 134 participants diagnosed with glaucoma or as glaucoma suspects (average follow-up, 4.4±1.2 years; average number of visits, 7.1±1.8). A 2D CT HMM model was trained using OCT (Cirrus HD-OCT; Zeiss, Dublin, CA) average circumpapillary retinal nerve fiber layer (cRNFL) thickness and visual field index (VFI) or mean deviation (MD; Humphrey Field Analyzer; Zeiss). The model was trained using a subset of the data (107 of 134 eyes [80%]) including all visits except for the last visit, which was used to test the prediction performance (training set). Additionally, the remaining 27 eyes were used for secondary performance testing as an independent group (validation set). The 2D CT HMM predicts 1 of 4 possible detected state changes based on 1 input state. Prediction accuracy was assessed as the percentage of correct prediction against the patient's actual recorded state. In addition, deviations of the predicted long-term detected change paths from the actual detected change paths were measured. Baseline mean ± standard deviation age was 61.9±11.4 years, VFI was 90.7±17.4, MD was -3.50±6.04 dB, and cRNFL thickness was 74.9±12.2 μm. The accuracy of detected glaucoma change prediction using the training set was comparable with the validation set (57.0% and 68.0%, respectively). Prediction deviation from the actual detected change path showed stability throughout patient follow-up. The 2D CT HMM demonstrated promising prediction performance in detecting glaucoma change performance in a simulated clinical setting

  4. Measuring and improving infrastructure performance

    National Research Council Canada - National Science Library

    Committee on Measuring and Improving Infrastructure Performance, National Research Council

    .... Developing a framework for guiding attempts at measuring the performance of infrastructure systems and grappling with the concept of defining good performance are the major themes of this book...

  5. Responsiveness of Clinical Outcome Measures

    DEFF Research Database (Denmark)

    Lauridsen, Henrik Hein

    Background The Oswestry Disability Index (ODI) is one of two standardised functional health measurement scales (HMS) recommended. Despite extensive psychometric testing, little is known about HMS behaviour and the minimal clinically important difference (MCID) in subgroups of LBP patients. Moreover...... obtainable by a certain treatment. Chronic LBP patients seem to have a reasonable idea of an acceptable change in pain but overestimate change in functional and psychological /affective domains....

  6. The Politics of Performance Measurement

    DEFF Research Database (Denmark)

    Bjørnholt, Bente; Larsen, Flemming

    2014-01-01

    Performance measurements are meant to improve public decision making and organizational performance. But performance measurements are far from always rational tools for problem solving, they are also political instruments. The central question addressed in this article is how performance...... impact on the political decision making process, as the focus on performance goals entails a kind of reductionism (complex problems are simplified), sequential decision making processes (with a division in separate policy issues) and short-sighted decisions (based on the need for making operational goals)....... measurement affects public policy. The aim is to conceptualize the political consequences of performance measurements and of special concern is how performance systems influence how political decisions are made, what kind of political decisions are conceivable, and how they are implemented. The literature...

  7. Facilities projects performance measurement system

    International Nuclear Information System (INIS)

    Erben, J.F.

    1979-01-01

    The two DOE-owned facilities at Hanford, the Fuels and Materials Examination Facility (FMEF), and the Fusion Materials Irradiation Test Facility (FMIT), are described. The performance measurement systems used at these two facilities are next described

  8. Performance Measures, Benchmarking and Value.

    Science.gov (United States)

    McGregor, Felicity

    This paper discusses performance measurement in university libraries, based on examples from the University of Wollongong (UoW) in Australia. The introduction highlights the integration of information literacy into the curriculum and the outcomes of a 1998 UoW student satisfaction survey. The first section considers performance indicators in…

  9. Performance of biometric quality measures.

    Science.gov (United States)

    Grother, Patrick; Tabassi, Elham

    2007-04-01

    We document methods for the quantitative evaluation of systems that produce a scalar summary of a biometric sample's quality. We are motivated by a need to test claims that quality measures are predictive of matching performance. We regard a quality measurement algorithm as a black box that converts an input sample to an output scalar. We evaluate it by quantifying the association between those values and observed matching results. We advance detection error trade-off and error versus reject characteristics as metrics for the comparative evaluation of sample quality measurement algorithms. We proceed this with a definition of sample quality, a description of the operational use of quality measures. We emphasize the performance goal by including a procedure for annotating the samples of a reference corpus with quality values derived from empirical recognition scores.

  10. Performance measures for a dialysis setting.

    Science.gov (United States)

    Gu, Xiuzhu; Itoh, Kenji

    2018-03-01

    This study from Japan extracted performance measures for dialysis unit management and investigated their characteristics from professional views. Two surveys were conducted using self-administered questionnaires, in which dialysis managers/staff were asked to rate the usefulness of 44 performance indicators. A total of 255 managers and 2,097 staff responded. Eight performance measures were elicited from dialysis manager and staff responses: these were safety, operational efficiency, quality of working life, financial effectiveness, employee development, mortality, patient/employee satisfaction and patient-centred health care. These performance measures were almost compatible with those extracted in overall healthcare settings in a previous study. Internal reliability, content and construct validity of the performance measures for the dialysis setting were ensured to some extent. As a general trend, both dialysis managers and staff perceived performance measures as highly useful, especially for safety, mortality, operational efficiency and patient/employee satisfaction, but showed relatively low concerns for patient-centred health care and employee development. However, dialysis managers' usefulness perceptions were significantly higher than staff. Important guidelines for designing a holistic hospital/clinic management system were yielded. Performance measures must be balanced for outcomes and performance shaping factors (PSF); a common set of performance measures could be applied to all the healthcare settings, although performance indicators of each measure should be composed based on the application field and setting; in addition, sound causal relationships between PSF and outcome measures/indicators should be explored for further improvement. © 2017 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  11. PERFORMANCE OF HIGH SCHOOL FOOTBALL PLAYERS ON CLINICAL MEASURES OF DEEP CERVICAL FLEXOR ENDURANCE AND CERVICAL ACTIVE RANGE OF MOTION: IS HISTORY OF CONCUSSION A FACTOR?

    Science.gov (United States)

    Smith, Laura; Ruediger, Thomas; Alsalaheen, Bara; Bean, Ryan

    2016-04-01

    More than one million adolescent athletes participated in organized high school sanctioned football during the 2014-15 season. These athletes are at risk for sustaining concussion. Although cervical spine active range of motion (AROM) and deep neck flexor endurance may serve a preventative role in concussion, and widespread clinical use of measurements of these variables, reference values are not available for this population. Cost effective, clinically relevant methods for measuring neck endurance are also well established for adolescent athletes. The purpose of this study was to report reference values for deep cervical flexor endurance and cervical AROM in adolescent football players and examine whether differences in these measures exist in high school football players with and without a history of concussion. Concussion history, cervical AROM, and deep neck flexor endurance were measured in 122 high school football players. Reference values were calculated for AROM and endurance measures; association were examined between various descriptive variables and concussion. No statistically significant differences were found between athletes with a history of concussion and those without. A modest inverse correlation was seen between body mass and AROM in the sagittal and transverse planes. The results of this study indicate that the participants with larger body mass had less cervical AROM in some directions. While cervical AROM and endurance measurements may not be adequate to identify adolescents with a history of previous concussions among high school football players. However, if a concussion is sustained, these measures can offer a baseline to examine whether cervical AROM is affected as compared to healthy adolescents. 2c.

  12. Scalable Performance Measurement and Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Gamblin, Todd [Univ. of North Carolina, Chapel Hill, NC (United States)

    2009-01-01

    Concurrency levels in large-scale, distributed-memory supercomputers are rising exponentially. Modern machines may contain 100,000 or more microprocessor cores, and the largest of these, IBM's Blue Gene/L, contains over 200,000 cores. Future systems are expected to support millions of concurrent tasks. In this dissertation, we focus on efficient techniques for measuring and analyzing the performance of applications running on very large parallel machines. Tuning the performance of large-scale applications can be a subtle and time-consuming task because application developers must measure and interpret data from many independent processes. While the volume of the raw data scales linearly with the number of tasks in the running system, the number of tasks is growing exponentially, and data for even small systems quickly becomes unmanageable. Transporting performance data from so many processes over a network can perturb application performance and make measurements inaccurate, and storing such data would require a prohibitive amount of space. Moreover, even if it were stored, analyzing the data would be extremely time-consuming. In this dissertation, we present novel methods for reducing performance data volume. The first draws on multi-scale wavelet techniques from signal processing to compress systemwide, time-varying load-balance data. The second uses statistical sampling to select a small subset of running processes to generate low-volume traces. A third approach combines sampling and wavelet compression to stratify performance data adaptively at run-time and to reduce further the cost of sampled tracing. We have integrated these approaches into Libra, a toolset for scalable load-balance analysis. We present Libra and show how it can be used to analyze data from large scientific applications scalably.

  13. Measuring performance at trade shows

    DEFF Research Database (Denmark)

    Hansen, Kåre

    2004-01-01

    Trade shows is an increasingly important marketing activity to many companies, but current measures of trade show performance do not adequately capture dimensions important to exhibitors. Based on the marketing literature's outcome and behavior-based control system taxonomy, a model is built...... that captures a outcome-based sales dimension and four behavior-based dimensions (i.e. information-gathering, relationship building, image building, and motivation activities). A 16-item instrument is developed for assessing exhibitors perceptions of their trade show performance. The paper presents evidence...

  14. 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

  15. Performance Measurement of Research Activitities

    DEFF Research Database (Denmark)

    Jakobsen, Morten; Jensen, Tina Blegind; Peyton, Margit Malmmose

    Performance measurements have made their entry into the world of universities. Every research activity is registered in a database and the output measures form the foundation for managerial decisions. The purpose of this chapter is to investigate the registration practices among researchers...... the registrations as a way to be promoted and to legitimise and account for their work; on the other hand, the economic incentives behind ranking lists and bibliographic research indicators threaten the individual researcher's freedom. The findings also show how managers have difficulties in translating back...

  16. From performance measurement to learning

    DEFF Research Database (Denmark)

    Lewis, Jenny; Triantafillou, Peter

    2012-01-01

    Over the last few decades accountability has accommodated an increasing number of different political, legal and administrative goals. This article focuses on the administrative aspect of accountability and explores the potential perils of a shift from performance measurement to learning. While...... overload. We conclude with some comments on limiting the undesirable consequences of such a move. Points for practitioners Public administrators need to identify and weigh the (human, political and economic) benefits and costs of accountability regimes. While output-focused performance measurement regimes...... to comply with accountability requirements, because of the first point. Third, the costs of compliance are likely to increase because learning requires more participation and dialogue. Fourth, accountability as learning may generate a ‘change for the sake of change’ mentality, creating further government...

  17. Patient-reported outcome measures for systemic lupus erythematosus clinical trials: a review of content validity, face validity and psychometric performance.

    Science.gov (United States)

    Holloway, Laura; Humphrey, Louise; Heron, Louise; Pilling, Claire; Kitchen, Helen; Højbjerre, Lise; Strandberg-Larsen, Martin; Hansen, Brian Bekker

    2014-07-22

    Despite overall progress in treatment of autoimmune diseases, patients with systemic lupus erythematosus (SLE) experience many inflammatory symptoms representing an unmet medical need. This study aimed to create a conceptual model of the humanistic and economic burden of SLE, and review the patient-reported outcomes (PROs) used to measure such concepts in SLE clinical trials. A conceptual model for SLE was developed from structured review of published articles from 2007 to August 2013 identified from literature databases (MEDLINE, EMBASE, PsycINFO, EconLit) plus other sources (PROLabels, FDA/EMA websites, Clinicaltrials.gov). PROs targeting key symptoms/impacts were identified from the literature. They were reviewed in the context of available guidance and assessed for face and content validity and psychometric properties to determine appropriateness for use in SLE trials. The conceptual model identified fatigue, pain, cognition, daily activities, emotional well-being, physical/social functioning and work productivity as key SLE concepts. Of the 68 articles reviewed, 38 reported PRO data. From these and the other sources, 15 PROs were selected for review, including SLE-specific health-related quality of life (HRQoL) measures (n = 5), work productivity (n = 1), and generic measures of fatigue (n = 3), pain (n = 2), depression (n = 2) and HRQoL (n = 2). The Functional Assessment of Chronic Illness Therapy - Fatigue Scale (FACIT-Fatigue), Brief Pain Inventory (BPI-SF) and LupusQoL demonstrated the strongest face validity, conceptual coverage and psychometric properties measuring key concepts in the conceptual model. All PROs reviewed, except for three Lupus-specific measures, lacked qualitative SLE patient involvement during development. The Hospital Anxiety and Depression Scale (HADS), Short Form [36 item] Health Survey version 2 (SF-36v2), EuroQoL 5-dimensions (EQ-5D-3L and EQ-5D-5L) and Work Productivity and Activity Impairment Questionnaire: Lupus (WPAI

  18. Patient-reported outcome measures for systemic lupus erythematosus clinical trials: a review of content validity, face validity and psychometric performance

    Science.gov (United States)

    2014-01-01

    Background Despite overall progress in treatment of autoimmune diseases, patients with systemic lupus erythematosus (SLE) experience many inflammatory symptoms representing an unmet medical need. This study aimed to create a conceptual model of the humanistic and economic burden of SLE, and review the patient-reported outcomes (PROs) used to measure such concepts in SLE clinical trials. Methods A conceptual model for SLE was developed from structured review of published articles from 2007 to August 2013 identified from literature databases (MEDLINE, EMBASE, PsycINFO, EconLit) plus other sources (PROLabels, FDA/EMA websites, Clinicaltrials.gov). PROs targeting key symptoms/impacts were identified from the literature. They were reviewed in the context of available guidance and assessed for face and content validity and psychometric properties to determine appropriateness for use in SLE trials. Results The conceptual model identified fatigue, pain, cognition, daily activities, emotional well-being, physical/social functioning and work productivity as key SLE concepts. Of the 68 articles reviewed, 38 reported PRO data. From these and the other sources, 15 PROs were selected for review, including SLE-specific health-related quality of life (HRQoL) measures (n = 5), work productivity (n = 1), and generic measures of fatigue (n = 3), pain (n = 2), depression (n = 2) and HRQoL (n = 2). The Functional Assessment of Chronic Illness Therapy - Fatigue Scale (FACIT-Fatigue), Brief Pain Inventory (BPI-SF) and LupusQoL demonstrated the strongest face validity, conceptual coverage and psychometric properties measuring key concepts in the conceptual model. All PROs reviewed, except for three Lupus-specific measures, lacked qualitative SLE patient involvement during development. The Hospital Anxiety and Depression Scale (HADS), Short Form [36 item] Health Survey version 2 (SF-36v2), EuroQoL 5-dimensions (EQ-5D-3L and EQ-5D-5L) and Work Productivity and

  19. Opcode counting for performance measurement

    Energy Technology Data Exchange (ETDEWEB)

    Gara, Alan; Satterfield, David L.; Walkup, Robert E.

    2018-03-20

    Methods, systems and computer program products are disclosed for measuring a performance of a program running on a processing unit of a processing system. In one embodiment, the method comprises informing a logic unit of each instruction in the program that is executed by the processing unit, assigning a weight to each instruction, assigning the instructions to a plurality of groups, and analyzing the plurality of groups to measure one or more metrics. In one embodiment, each instruction includes an operating code portion, and the assigning includes assigning the instructions to the groups based on the operating code portions of the instructions. In an embodiment, each type of instruction is assigned to a respective one of the plurality of groups. These groups may be combined into a plurality of sets of the groups.

  20. Measurement of sorafenib plasma concentration by high-performance liquid chromatography in patients with advanced hepatocellular carcinoma: is it useful the application in clinical practice? A pilot study.

    Science.gov (United States)

    Fucile, Carmen; Marenco, Simona; Bazzica, Marco; Zuccoli, Maria Laura; Lantieri, Francesca; Robbiano, Luigi; Marini, Valeria; Di Gion, Paola; Pieri, Giulia; Stura, Paola; Martelli, Antonietta; Savarino, Vincenzo; Mattioli, Francesca; Picciotto, Antonino

    2015-01-01

    Pharmacokinetics and dose-finding studies on sorafenib were conducted on heterogeneous groups of patients with solid tumors. Portal hypertension, gut motility impairment and altered bile enterohepatic circulation may explain different sorafenib toxicological profile in cirrhotic patients. This study evaluated sorafenib plasma concentration in a homogeneous group of cirrhotic patients with hepatocellular carcinoma (HCC). Sorafenib concentrations were determined by liquid chromatography in 12 consecutive patients. Data have been evaluated by the generalized estimating equations method (p value statistical level was set at α = 0.05). (1) There were not significant differences between sorafenib concentrations in patients who tolerate the full dose versus patients with reduced dose due to toxicity; (2) the average sorafenib concentrations measured 3 h after the morning dosing were lower than those measured 12 h after the evening dosing (p = 0.005); (3) sorafenib concentrations decrease overtime (p < 10(-4)); (4) it has been found an association between the development of severe adverse reactions and sorafenib concentrations (p < 10(-5)). The relationship between dose and concentration of sorafenib in HCC patients is poor and not clinically predictable, confirming the variability both in the maximum tolerated dose and in plasma concentrations. Several factors may influence the pharmacokinetics in patients with liver disease. This may explain the inter-patient variability of concentrations and the lack of differences in concentration at different dosages. It could be interesting to extend the series of HCC patients to enhance information on the kinetics of the drug; furthermore, to establish a threshold of plasma sorafenib concentrations to predict severe adverse reactions would be clinically useful.

  1. 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.

  2. Performance measurement and pay for performance

    NARCIS (Netherlands)

    Tuijl, van H.F.J.M.; Kleingeld, P.A.M.; Algera, J.A.; Rutten, M.L.; Sonnentag, S.

    2002-01-01

    This chapter, which takes a (re)design perspective, focuses on the management of employees’ contributions to organisational goal attainment. The control loop for the self-regulation of task performance is used as a frame of reference. Several subsets of design requirements are described and related

  3. Evaluation the effectiveness of remote blood pressure monitoring technology in patients with hypertension on the basis of clinical recommendations performance measures

    Directory of Open Access Journals (Sweden)

    Posnenkova O.M.

    2015-06-01

    Material and Methods ― Remote BP monitoring was organized on the basis of computer system which automatically in text messages send requests about BP level to Htn patients. Obtained BP results were stored in the system and automatically worked. A doctor corrected a patient’s therapy if necessary based on this information. To evaluate the effectiveness of a new technology one year observation of 97 Htn patients was organized (54.6% – male aged 49±11 years. Patients regularly responded to automated SMS requests the computer system about the level of blood pressure. The effectiveness was evaluated with the help of the following hypertension guidelines performance measures: 1 a part of patients with four or more BP results during the previous 12 months; 2 a part of patients with BP above the goal level who prescribed two or more antihypertensive drugs on the last visit during the previous 12 months; 3 a part of patients with BP above the goal level 140/90 mm Hg who prescribed two or more antihypertensive drugs on the last visit during the previous 12 months; 4 a part of patients with goal blood pressure (less than 140/90 mmHg on the last visit during the previous 12 months. To evaluate a performance of these measures before BP monitoring the data extracted from patients’ ambulatory cards were used. Results ― 62 patients completed one-year BP monitoring A part of patients with four or more BP results during the previous 12 months increased from 21% to 100% (p<0.001. From 70% to 82% increased the part of patients who were prescribed two or more antihypertensive drugs (p=0.091. From 31% to 15% reduced the part of hypertensives with uncontrolled BP who were prescribed less than two antihypertensive drugs on the last visit (p=0.044. After one-year monitoring a goal BP was registered in 77% of Htn patients versus 13% at the start of the observation (p<0.001. Conclusion ― Htn guidelines performance measures allowed evaluate quantitatively the positive influence

  4. Measuring Cutaneous Lesions: Trends in Clinical Practice.

    Science.gov (United States)

    Zhang, Shali; Blalock, Travis W

    2018-03-01

    Knowing the size of a cutaneous lesion can be important for tracking its progression over time, selecting the proper treatment modality, surgical planning, determining prognosis, and accurate billing. However, providers vary in their consistency, accuracy, and methods of measuring cutaneous lesions. To investigate the clinical practices of US dermatologists and dermatologic surgeons regarding how they determine the size of cutaneous lesions. A survey was electronically distributed to members of the American Society for Dermatologic Surgery. Four hundred twenty-six dermatologists completed the online survey. When a lesion is suspected to be malignant, 85% of respondents obtained exact measurements most, if not all, of the time; however, only 8% did for benign lesions. Most providers determined lesion sizes themselves rather than delegating to staff. When performing visual estimation, approximately three-quarters believed that they were accurate to within 1 to 2 mm. The top reasons for obtaining exact measurements were for tracking atypical pigmented lesions, determining treatment pathways, and accurate billing. The majority of respondents believed that lesion size affected management decisions; however, the need for exact measurement remains controversial, particularly for benign lesions. Future studies may investigate whether taking exact versus estimated measurements has an effect on outcomes.

  5. Performance measurement for information systems: Industry perspectives

    Science.gov (United States)

    Bishop, Peter C.; Yoes, Cissy; Hamilton, Kay

    1992-01-01

    Performance measurement has become a focal topic for information systems (IS) organizations. Historically, IS performance measures have dealt with the efficiency of the data processing function. Today, the function of most IS organizations goes beyond simple data processing. To understand how IS organizations have developed meaningful performance measures that reflect their objectives and activities, industry perspectives on IS performance measurement was studied. The objectives of the study were to understand the state of the practice in IS performance techniques for IS performance measurement; to gather approaches and measures of actual performance measures used in industry; and to report patterns, trends, and lessons learned about performance measurement to NASA/JSC. Examples of how some of the most forward looking companies are shaping their IS processes through measurement is provided. Thoughts on the presence of a life-cycle to performance measures development and a suggested taxonomy for performance measurements are included in the appendices.

  6. 45 CFR 305.2 - Performance measures.

    Science.gov (United States)

    2010-10-01

    ... PROGRAM PERFORMANCE MEASURES, STANDARDS, FINANCIAL INCENTIVES, AND PENALTIES § 305.2 Performance measures. (a) The child support incentive system measures State performance levels in five program areas... 45 Public Welfare 2 2010-10-01 2010-10-01 false Performance measures. 305.2 Section 305.2 Public...

  7. Clinical utility of measures of breathlessness.

    Science.gov (United States)

    Cullen, Deborah L; Rodak, Bernadette

    2002-09-01

    The clinical utility of measures of dyspnea has been debated in the health care community. Although breathlessness can be evaluated with various instruments, the most effective dyspnea measurement tool for patients with chronic lung disease or for measuring treatment effectiveness remains uncertain. Understanding the evidence for the validity and reliability of these instruments may provide a basis for appropriate clinical application. Evaluate instruments designed to measure breathlessness, either as single-symptom or multidimensional instruments, based on psychometrics foundations such as validity, reliability, and discriminative and evaluative properties. Classification of each dyspnea measurement instrument will recommend clinical application in terms of exercise, benchmarking patients, activities of daily living, patient outcomes, clinical trials, and responsiveness to treatment. Eleven dyspnea measurement instruments were selected. Each instrument was assessed as discriminative or evaluative and then analyzed as to its psychometric properties and purpose of design. Descriptive data from all studies were described according to their primary patient application (ie, chronic obstructive pulmonary disease, asthma, or other patient populations). The Borg Scale and the Visual Analogue Scale are applicable to exertion and thus can be applied to any cardiopulmonary patient to determine dyspnea. All other measures were determined appropriate for chronic obstructive pulmonary disease, whereas the Shortness of Breath Questionnaire can be applied to cystic fibrosis and lung transplant patients. The most appropriate utility for all instruments was measuring the effects on activities of daily living and for benchmarking patient progress. Instruments that quantify function and health-related quality of life have great utility for documenting outcomes but may be limited as to documenting treatment responsiveness in terms of clinically important changes. The dyspnea

  8. 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...

  9. Brush seal performance measurement system

    OpenAIRE

    Aksoy, Serdar; Akşit, Mahmut Faruk; Aksit, Mahmut Faruk; Duran, Ertuğrul Tolga; Duran, Ertugrul Tolga

    2009-01-01

    Brush seals are rapidly replacing conventional labyrinth seals in turbomachinery applications. Upon pressure application, seal stiffness increases drastically due to frictional bristle interlocking. Operating stiffness is critical to determine seal wear life. Typically, seal stiffness is measured by pressing a curved shoe to brush bore. The static-unpressurized measurement is extrapolated to pressurized and high speed operating conditions. This work presents a seal stiffness measurement syste...

  10. Korean Clinic Based Outcome Measure Studies

    OpenAIRE

    Jongbae Park

    2003-01-01

    Background: Evidence based medicine has become main tools for medical practice. However, conducting a highly ranked in the evidence hierarchy pyramid is not easy or feasible at all times and places. There remains a room for descriptive clinical outcome measure studies with admitting the limit of the intepretation. Aims: Presents three Korean clinic based outcome measure studies with a view to encouraging Korean clinicians to conduct similar studies. Methods: Three studies are presented...

  11. Mobility and reliability performance measurement.

    Science.gov (United States)

    2013-06-01

    This project grew out of the fact that mobility was identified early on as one of the key performance focus areas of NCDOTs : strategic transformation effort. The Transformation Management Team (TMT) established a TMT Mobility Workstream Team : in...

  12. Traffic Management Systems Performance Measurement: Final Report

    OpenAIRE

    Banks, James H.; Kelly, Gregory

    1997-01-01

    This report documents a study of performance measurement for Transportation Management Centers (TMCs). Performance measurement requirements were analyzed, data collection and management techniques were investigated, and case study traffic data system improvement plans were prepared for two Caltrans districts.

  13. Performance measurement and insurance liabilities

    NARCIS (Netherlands)

    Plantinga, A; Huijgen, C

    2001-01-01

    In this article, the authors develop an attribution framework for evaluating the investment performance of institutional investors such as insurance companies. The model is useful in identifying the investment skills of insurance companies. This is accomplished by developing a dual benchmark for the

  14. Eva versus Other Performance Measures

    OpenAIRE

    Hechmi Soumaya

    2013-01-01

    Create value not only intended to satisfy shareholders. This is also the way to ensure the ability of the company to ensure its sustainability and finance its growth. The company will not attract new capital if it destroys value. "The concept of value creation is none other than the intersection of strategy (create value) and technique (evaluate the company)"(Powilewicz, 2002). The basic idea behind the different measures of value creation by a company is that a company creates value for its ...

  15. Internet Performance and Reliability Measurements

    International Nuclear Information System (INIS)

    Cottrell, Les

    2003-01-01

    Collaborative HEP research is dependent on good Internet connectivity. Although most local- and wide-area networks are carefully watched, there is little monitoring of connections that cross many networks. This paper describes work in progress at several sites to monitor Internet end-to-end performance between hundreds of HEP sites worldwide. At each collection site, ICMP ping packets are automatically sent periodically to sites of interest. The data is recorded and made available to analysis nodes, which collect the data from multiple collection sites and provide analysis and graphing. Future work includes improving the efficiency and accuracy of ping data collection

  16. 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.

  17. PRINCIPLES OF THE SUPPLY CHAIN PERFORMANCE MEASUREMENT

    OpenAIRE

    BEATA ŒLUSARCZYK; SEBASTIAN KOT

    2012-01-01

    Measurement of performance in every business management is a crucial activity allowing for effectiveness increase. The lack of suitable performance measurement is especially noticed in complex systems as supply chains. Responsible persons cannot manage effectively without suitable set of measures those are base for comparison to previous data or effects of other supply chain functioning. The analysis shows that it is very hard to find balanced set of supply chain performance measures those sh...

  18. Performance Measurement in Global Product Development

    DEFF Research Database (Denmark)

    Taylor, Thomas Paul; Ahmed-Kristensen, Saeema

    2013-01-01

    there is a requirement for the process to be monitored and measured relative to the business strategy of an organisation. It was found that performance measurement is a process that helps achieve sustainable business success, encouraging a learning culture within organisations. To this day, much of the research into how...... performance is measured has focussed on the process of product development. However, exploration of performance measurement related to global product development is relatively unexplored and a need for further research is evident. This paper contributes towards understanding how performance is measured...

  19. Clinimetrics: the science of clinical measurements.

    Science.gov (United States)

    Fava, G A; Tomba, E; Sonino, N

    2012-01-01

    'Clinimetrics' is the term introduced by Alvan R. Feinstein in the early 1980s to indicate a domain concerned with indexes, rating scales and other expressions that are used to describe or measure symptoms, physical signs and other clinical phenomena. Clinimetrics has a set of rules that govern the structure of indexes, the choice of component variables, the evaluation of consistency, validity and responsiveness. This review illustrates how clinimetrics may help expanding the narrow range of information that is currently used in clinical science. It will focus on characteristics and types of clinimetric indexes and their current use. The clinimetric perspective provides an intellectual home for clinical judgment, whose implementation is likely to improve outcomes both in clinical research and practice. © 2011 Blackwell Publishing Ltd.

  20. Health Plan Performance Measurement within Medicare Subvention.

    Science.gov (United States)

    1998-06-01

    the causes of poor performance (Siren & Laffel, 1996). Although outcomes measures such as nosocomial infection rates, admission rates for select...defined. Traditional outcomes measures include infection rates, morbidity, and mortality. The problem with these traditional measures is... Maternal /Child Care Indicators Nursing Staffing Indicators Outcome Indicators Technical Outcomes Plan Performance Stability of Health Plan

  1. Clinical Strategies for Sampling Word Recognition Performance.

    Science.gov (United States)

    Schlauch, Robert S; Carney, Edward

    2018-04-17

    Computer simulation was used to estimate the statistical properties of searches for maximum word recognition ability (PB max). These involve presenting multiple lists and discarding all scores but that of the 1 list that produced the highest score. The simulations, which model limitations inherent in the precision of word recognition scores, were done to inform clinical protocols. A secondary consideration was a derivation of 95% confidence intervals for significant changes in score from phonemic scoring of a 50-word list. The PB max simulations were conducted on a "client" with flat performance intensity functions. The client's performance was assumed to be 60% initially and 40% for a second assessment. Thousands of estimates were obtained to examine the precision of (a) single lists and (b) multiple lists using a PB max procedure. This method permitted summarizing the precision for assessing a 20% drop in performance. A single 25-word list could identify only 58.4% of the cases in which performance fell from 60% to 40%. A single 125-word list identified 99.8% of the declines correctly. Presenting 3 or 5 lists to find PB max produced an undesirable finding: an increase in the word recognition score. A 25-word list produces unacceptably low precision for making clinical decisions. This finding holds in both single and multiple 25-word lists, as in a search for PB max. A table is provided, giving estimates of 95% critical ranges for successive presentations of a 50-word list analyzed by the number of phonemes correctly identified.

  2. Measurements of body protein for clinical investigation

    International Nuclear Information System (INIS)

    Mernagh, J.R.; Harrison, J.E.; McNeill, M.G.; Jeejeebhoy, K.N.; Krishnan, S.S.

    1986-01-01

    Body protein (nitrogen) is determined by bilaterally irradiating the body with neutrons using Pu-Be sources and measuring the resultant 10.8 MeV gamma rays from the reaction 14 N(n,8) 15 N. In the authors lab the whole body can be scanned or separate segments of the body can be measured independently. A nitrogen index has been developed based on body size and is used as a predictor of normal total body nitrogen (TBN). They have found that TBN, when normalized to body size in this way, provides a reliable index of protein status which cannot be accurately determined by body weight, anthropometry, or body potassium measurements. Changes in body composition with age were studied by measuring the composition of 56 healthy female volunteers aged 20-80. Measurements were made for K( 40 K), Ca and N. It was shown that protein and bone mineral decrease with age but that this is not reflected in K or anthropometry measurements. Results of other studies to be presented include: body protein measurements pre and post TPN (total parenteral nutrition), nutritional status of patients on long term CAPD (continuous ambulatory peritoneal dialysis) and changes in body composition as a result of TPN in patients with small cell lung cancer receiving chemotherapy. Clinical results show that indirect measurements of body protein based on weight, potassium, or anthropometry, do not give an accurate measure of body protein. For an accurate measurement, direct measurement of body protein is necessary

  3. Measuring Distribution Performance? Benchmarking Warrants Your Attention

    Energy Technology Data Exchange (ETDEWEB)

    Ericson, Sean J [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Alvarez, Paul [The Wired Group

    2018-04-13

    Identifying, designing, and measuring performance metrics is critical to securing customer value, but can be a difficult task. This article examines the use of benchmarks based on publicly available performance data to set challenging, yet fair, metrics and targets.

  4. Synthesis of work-zone performance measures.

    Science.gov (United States)

    2013-09-01

    The main objective of this synthesis was to identify and summarize how agencies collect, analyze, and report different work-zone : traffic-performance measures, which include exposure, mobility, and safety measures. The researchers also examined comm...

  5. Measuring the performance of business incubators

    OpenAIRE

    VANDERSTRAETEN, Johanna; MATTHYSSENS, Paul; VAN WITTELOOSTUIJN, Arjen

    2012-01-01

    This paper focuses on incubator performance measurement. First, we report the findings of an extensive literature review. Both existing individual measures and more comprehensive measurement systems are discussed. This literature review shows that most incubator researchers and practitioners only use one or a few indicators for performance evaluation, and that existing measurement systems do not recognize the importance of short, medium and long-term results, do not always include an incubato...

  6. The service of public services performance measurement

    DEFF Research Database (Denmark)

    Lystbæk, Christian Tang

    2014-01-01

    that performance measurement serves as “rituals of verification” which promotes the interests of political masters and their mistresses rather than public service. Another area of concern is the cost of performance measurement. Hood & Peters (2004:278) note that performance measurement is likely to “distract...... measurement suggests a range of contested and contradictory propositions. Its alleged benefits include public assurance, better functioning of supply markets for public services, and direct improvements of public services. But the literature also demonstrates the existence of significant concern about...... the actual impact, the costs and unintended consequences associated with performance measurement. This paper identifies the main rationales and rationalities in the scholarly discourse on public services performance measurement. It concludes with some suggestions on how to deal with the many rationales...

  7. COMPANY PERFORMANCE MEASUREMENT AND REPORTING METHODS

    Directory of Open Access Journals (Sweden)

    Nicu Ioana Elena

    2012-12-01

    Full Text Available One of the priorities of economic research has been and remains the re-evaluation of the notion of performance and especially exploring and finding some indicators that would reflect as accurately as possible the subtleties of the economic entity. The main purpose of this paper is to highlight the main company performance measurement and reporting methods. Performance is a concept that raises many question marks concerning the most accurate or the best method of reporting the performance at the company level. The research methodology has aimed at studying the Romanian and foreign specialized literature dealing with the analyzed field, studying magazines specialized on company performance measurement. If the financial performance measurement indicators are considered to offer an accurate image of the situation of the company, the modern approach through non-financial indicators offers a new perspective upon performance measurement, which is based on simplicity. In conclusion, after the theoretical study, I have noticed that the methods of performance measurement, reporting and interpretation are various, the opinions regarding the best performance measurement methods are contradictive and the companies prefer resorting to financial indicators that still play a more important role in the consolidation of the company performance measurement than the non-financial indicators do.

  8. A Critique of Health System Performance Measurement.

    Science.gov (United States)

    Lynch, Thomas

    2015-01-01

    Health system performance measurement is a ubiquitous phenomenon. Many authors have identified multiple methodological and substantive problems with performance measurement practices. Despite the validity of these criticisms and their cross-national character, the practice of health system performance measurement persists. Theodore Marmor suggests that performance measurement invokes an "incantatory response" wrapped within "linguistic muddle." In this article, I expand upon Marmor's insights using Pierre Bourdieu's theoretical framework to suggest that, far from an aberration, the "linguistic muddle" identified by Marmor is an indicator of a broad struggle about the representation and classification of public health services as a public good. I present a case study of performance measurement from Alberta, Canada, examining how this representational struggle occurs and what the stakes are. © The Author(s) 2015.

  9. Does hospital financial performance measure up?

    Science.gov (United States)

    Cleverley, W O; Harvey, R K

    1992-05-01

    Comparisons are continuously being made between the financial performance, products and services, of the healthcare industry and those of non-healthcare industries. Several useful measures of financial performance--profitability, liquidity, financial risk, asset management and replacement, and debt capacity, are used by the authors to compare the financial performance of the hospital industry with that of the industrial, transportation and utility sectors. Hospitals exhibit weaknesses in several areas. Goals are suggested for each measure to bring hospitals closer to competitive levels.

  10. On music performance, theories, measurement en diversity

    NARCIS (Netherlands)

    Timmers, R.; Honing, H.J.

    2002-01-01

    Measurement of musical performances is of interest to studies in musicology, music psychology and music performance practice, but in general it has not been considered the main issue: when analyzing Western classical music, these disciplines usually focus on the score rather than the performance.

  11. Development of a Behavioral Performance Measure

    Directory of Open Access Journals (Sweden)

    Marcelo Cabus Klotzle

    2012-09-01

    Full Text Available Since the fifties, several measures have been developed in order to measure the performance of investments or choices involving uncertain outcomes. Much of these measures are based on Expected Utility Theory, but since the nineties a number of measures have been proposed based on Non-Expected Utility Theory. Among the Theories of Non-Expected Utility highlights Prospect Theory, which is the foundation of Behavioral Finance. Based on this theory this study proposes a new performance measure in which are embedded loss aversion along with the likelihood of distortions in the choice of alternatives. A hypothetical example is presented in which various performance measures, including the new measure are compared. The results showed that the ordering of the assets varied depending on the performance measure adopted. According to what was expected, the new performance measure clearly has captured the distortion of probabilities and loss aversion of the decision maker, ie, those assets with the greatest negative deviations from the target were those who had the worst performance.

  12. MEASUREMENT: ACCOUNTING FOR RELIABILITY IN PERFORMANCE ESTIMATES.

    Science.gov (United States)

    Waterman, Brian; Sutter, Robert; Burroughs, Thomas; Dunagan, W Claiborne

    2014-01-01

    When evaluating physician performance measures, physician leaders are faced with the quandary of determining whether departures from expected physician performance measurements represent a true signal or random error. This uncertainty impedes the physician leader's ability and confidence to take appropriate performance improvement actions based on physician performance measurements. Incorporating reliability adjustment into physician performance measurement is a valuable way of reducing the impact of random error in the measurements, such as those caused by small sample sizes. Consequently, the physician executive has more confidence that the results represent true performance and is positioned to make better physician performance improvement decisions. Applying reliability adjustment to physician-level performance data is relatively new. As others have noted previously, it's important to keep in mind that reliability adjustment adds significant complexity to the production, interpretation and utilization of results. Furthermore, the methods explored in this case study only scratch the surface of the range of available Bayesian methods that can be used for reliability adjustment; further study is needed to test and compare these methods in practice and to examine important extensions for handling specialty-specific concerns (e.g., average case volumes, which have been shown to be important in cardiac surgery outcomes). Moreover, it's important to note that the provider group average as a basis for shrinkage is one of several possible choices that could be employed in practice and deserves further exploration in future research. With these caveats, our results demonstrate that incorporating reliability adjustment into physician performance measurements is feasible and can notably reduce the incidence of "real" signals relative to what one would expect to see using more traditional approaches. A physician leader who is interested in catalyzing performance improvement

  13. Towards integrating environmental performance in divisional performance measurement

    Directory of Open Access Journals (Sweden)

    Collins C Ngwakwe

    2014-08-01

    Full Text Available This paper suggests an integration of environmental performance measurement (EPM into conventional divisional financial performance measures as a catalyst to enhance managers’ drive toward cleaner production and sustainable development. The approach is conceptual and normative; and using a hypothetical firm, it suggests a model to integrate environmental performance measure as an ancillary to conventional divisional financial performance measures. Vroom’s motivation theory and other literature evidence indicate that corporate goals are achievable in an environment where managers’ efforts are recognised and thus rewarded. Consequently the paper suggests that environmentally motivated managers are important to propel corporate sustainability strategy toward desired corporate environmental governance and sustainable economic development. Thus this suggested approach modestly adds to existing environmental management accounting (EMA theory and literature. It is hoped that this paper may provide an agenda for further research toward a practical application of the suggested method in a firm.

  14. Measuring pacemaker dose: A clinical perspective

    Energy Technology Data Exchange (ETDEWEB)

    Studenski, Matthew T., E-mail: matthew.studenski@jeffersonhospital.org [Department of Radiation Oncology at the Jefferson Medical College and Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA (United States); Xiao Ying; Harrison, Amy S. [Department of Radiation Oncology at the Jefferson Medical College and Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA (United States)

    2012-07-01

    Recently in our clinic, we have seen an increased number of patients presenting with pacemakers and defibrillators. Precautions are taken to develop a treatment plan that minimizes the dose to the pacemaker because of the adverse effects of radiation on the electronics. Here we analyze different dosimeters to determine which is the most accurate in measuring pacemaker or defibrillator dose while at the same time not requiring a significant investment in time to maintain an efficient workflow in the clinic. The dosimeters analyzed here were ion chambers, diodes, metal-oxide-semiconductor field effect transistor (MOSFETs), and optically stimulated luminescence (OSL) dosimeters. A simple phantom was used to quantify the angular and energy dependence of each dosimeter. Next, 8 patients plans were delivered to a Rando phantom with all the dosimeters located where the pacemaker would be, and the measurements were compared with the predicted dose. A cone beam computed tomography (CBCT) image was obtained to determine the dosimeter response in the kilovoltage energy range. In terms of the angular and energy dependence of the dosimeters, the ion chamber and diode were the most stable. For the clinical cases, all the dosimeters match relatively well with the predicted dose, although the ideal dosimeter to use is case dependent. The dosimeters, especially the MOSFETS, tend to be less accurate for the plans, with many lateral beams. Because of their efficiency, we recommend using a MOSFET or a diode to measure the dose. If a discrepancy is observed between the measured and expected dose (especially when the pacemaker to field edge is <10 cm), we recommend analyzing the treatment plan to see whether there are many lateral beams. Follow-up with another dosimeter rather than repeating multiple times with the same type of dosimeter. All dosimeters should be placed after the CBCT has been acquired.

  15. Measuring the quality of clinical audit projects.

    Science.gov (United States)

    Millard, A D

    2000-11-01

    The aim of the study was to develop and pilot a scale measuring the quality of audit projects through audit project reports. Statements about clinical audit projects were selected from existing instruments assessing the quality of clinical audit projects to form a Likert scale. Audit facilitators based in Scottish health boards and trusts piloted the scale. The participants were known to have over 2 years of experience of supporting clinical audit. The response at first test was 11 of 14 and at the second test 27 of 46. Audit facilitators tested the draft scale by expressing their strength of agreement or disagreement with each statement for three reports. Validity and reliability were assessed by test - re-test, item - total, and total - global indicator correlation. Of the 20 statements, 15 had satisfactory correlation with scale totals. Scale totals had good correlation with global indicators. Test re-test correlation was modest. The wide range of responses means further research is needed to measure the consistency of audit facilitators' interpretations, perhaps comparing a trained group with an untrained group. There may be a need for a separate scale for reaudits. Educational impact is distinct from project impact generally. It may be more meaningful to treat the selection of projects and aims, methodology and impact separately as subscales and take a project profiling approach rather than attempting to produce a global quality index.

  16. 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

  17. 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.

  18. Lung volumes: measurement, clinical use, and coding.

    Science.gov (United States)

    Flesch, Judd D; Dine, C Jessica

    2012-08-01

    Measurement of lung volumes is an integral part of complete pulmonary function testing. Some lung volumes can be measured during spirometry; however, measurement of the residual volume (RV), functional residual capacity (FRC), and total lung capacity (TLC) requires special techniques. FRC is typically measured by one of three methods. Body plethysmography uses Boyle's Law to determine lung volumes, whereas inert gas dilution and nitrogen washout use dilution properties of gases. After determination of FRC, expiratory reserve volume and inspiratory vital capacity are measured, which allows the calculation of the RV and TLC. Lung volumes are commonly used for the diagnosis of restriction. In obstructive lung disease, they are used to assess for hyperinflation. Changes in lung volumes can also be seen in a number of other clinical conditions. Reimbursement for measurement of lung volumes requires knowledge of current procedural terminology (CPT) codes, relevant indications, and an appropriate level of physician supervision. Because of recent efforts to eliminate payment inefficiencies, the 10 previous CPT codes for lung volumes, airway resistance, and diffusing capacity have been bundled into four new CPT codes.

  19. Introduction to control system performance measurements

    CERN Document Server

    Garner, K C

    1968-01-01

    Introduction to Control System Performance Measurements presents the methods of dynamic measurements, specifically as they apply to control system and component testing. This book provides an introduction to the concepts of statistical measurement methods.Organized into nine chapters, this book begins with an overview of the applications of automatic control systems that pervade almost every area of activity ranging from servomechanisms to electrical power distribution networks. This text then discusses the common measurement transducer functions. Other chapters consider the basic wave

  20. Internal Performance Measurement Systems: Problems and Solutions

    DEFF Research Database (Denmark)

    Jakobsen, Morten; Mitchell, Falconer; Nørreklit, Hanne

    2010-01-01

    This article pursues two aims: to identify problems and dangers related to the operational use of internal performance measurement systems of the Balanced Scorecard (BSC) type and to provide some guidance on how performance measurement systems may be designed to overcome these problems....... The analysis uses and extends N rreklit's (2000) critique of the BSC by applying the concepts developed therein to contemporary research on the BSC and to the development of practice in performance measurement. The analysis is of relevance for many companies in the Asia-Pacific area as an increasing numbers...

  1. Measurement uncertainty analysis techniques applied to PV performance measurements

    International Nuclear Information System (INIS)

    Wells, C.

    1992-10-01

    The purpose of this presentation is to provide a brief introduction to measurement uncertainty analysis, outline how it is done, and illustrate uncertainty analysis with examples drawn from the PV field, with particular emphasis toward its use in PV performance measurements. The uncertainty information we know and state concerning a PV performance measurement or a module test result determines, to a significant extent, the value and quality of that result. What is measurement uncertainty analysis? It is an outgrowth of what has commonly been called error analysis. But uncertainty analysis, a more recent development, gives greater insight into measurement processes and tests, experiments, or calibration results. Uncertainty analysis gives us an estimate of the I interval about a measured value or an experiment's final result within which we believe the true value of that quantity will lie. Why should we take the time to perform an uncertainty analysis? A rigorous measurement uncertainty analysis: Increases the credibility and value of research results; allows comparisons of results from different labs; helps improve experiment design and identifies where changes are needed to achieve stated objectives (through use of the pre-test analysis); plays a significant role in validating measurements and experimental results, and in demonstrating (through the post-test analysis) that valid data have been acquired; reduces the risk of making erroneous decisions; demonstrates quality assurance and quality control measures have been accomplished; define Valid Data as data having known and documented paths of: Origin, including theory; measurements; traceability to measurement standards; computations; uncertainty analysis of results

  2. Telerobotic system performance measurement - Motivation and methods

    Science.gov (United States)

    Kondraske, George V.; Khoury, George J.

    1992-01-01

    A systems performance-based strategy for modeling and conducting experiments relevant to the design and performance characterization of telerobotic systems is described. A developmental testbed consisting of a distributed telerobotics network and initial efforts to implement the strategy described is presented. Consideration is given to the general systems performance theory (GSPT) to tackle human performance problems as a basis for: measurement of overall telerobotic system (TRS) performance; task decomposition; development of a generic TRS model; and the characterization of performance of subsystems comprising the generic model. GSPT employs a resource construct to model performance and resource economic principles to govern the interface of systems to tasks. It provides a comprehensive modeling/measurement strategy applicable to complex systems including both human and artificial components. Application is presented within the framework of a distributed telerobotics network as a testbed. Insight into the design of test protocols which elicit application-independent data is described.

  3. Performance measurement in transport sector analysis

    Directory of Open Access Journals (Sweden)

    M. Išoraitė

    2004-06-01

    Full Text Available The article analyses the following issues: 1. Performance measurement in literature. The performance measurement has an important role to play in the efficient and effective management of organizations. Kaplan and Johnson highlighted the failure of the financial measures to reflect changes in the competitive circumstances and strategies of modern organizations. Many authors have focused attention on how organizations can design more appropriate measurement systems. Based on literature, consultancy experience and action research, numerous processes have been developed that organizations can follow in order to design and implement systems. Many frameworks have been proposed that support these processes. The objective of such frameworks is to help organizations define a set of measures that reflect their objectives and assess their performance appropriately. 2. Transport sector performance and its impacts measuring. The purpose of transport measurement is to identify opportunities enhancing transport performance. Successful transport sector management requires a system to analyze its efficiency and effectiveness as well as plan interventions if transport sector performance needs improvement. Transport impacts must be measurable and monitorable so that the person responsible for the project intervention can decide when and how to influence them. Performance indicators provide a means to measure and monitor impacts. These indicators essentially reflect quantitative and qualitative aspects of impacts at given time and places. 3. Transport sector output and input. Transport sector inputs are the resources required to deliver transport sector outputs. Transport sector inputs are typically: human resources, particularly skilled resources (including specialists consulting inputs; technology processes such as equipment and work; and finance, both public and private. 4. Transport sector policy and institutional framework; 5. Cause – effect linkages; 6

  4. Road weather management performance measures : 2012 update.

    Science.gov (United States)

    2013-08-01

    In 2007, the Road Weather Management Program (RWMP) conducted a study with stakeholders from the transportation and meteorological communities to define eleven performance measures that would enable the Federal Highway Administration (FHWA) to determ...

  5. Performance measures for metropolitan planning organizations.

    Science.gov (United States)

    2012-04-01

    Performance measurement is a topic of increasing importance to transportation agencies, as issues with : funding shortfalls and concerns about transportation system efficiency lead to a shift in how transportation : decision making is carried out. In...

  6. Smart city performance measurement framework. CITYkeys

    NARCIS (Netherlands)

    Airaksinen, M.; Seppa, I.P.; Huovilla, A.; Neumann, H.M.; Iglar, B.; Bosch, P.R.

    2017-01-01

    This paper presents a holistic performance measurement framework for harmonized and transparent monitoring and comparability of the European cities activities during the implementation of Smart City solutions. The work methodology was based on extensive collaboration and communication with European

  7. Korean Clinic Based Outcome Measure Studies

    Directory of Open Access Journals (Sweden)

    Jongbae Park

    2003-02-01

    Full Text Available Background: Evidence based medicine has become main tools for medical practice. However, conducting a highly ranked in the evidence hierarchy pyramid is not easy or feasible at all times and places. There remains a room for descriptive clinical outcome measure studies with admitting the limit of the intepretation. Aims: Presents three Korean clinic based outcome measure studies with a view to encouraging Korean clinicians to conduct similar studies. Methods: Three studies are presented briefly here including 1 Quality of Life of liver cancer patients after 8 Constitutional acupuncture; 2 Developing a Korean version of Measuring yourself Medical Outcome profile (MYMOP; and 3 Survey on 5 Shu points: a pilot In the first study, we have included 4 primary or secondary liver cancer patients collecting their diagnostic X-ray film and clinical data f개m their hospital, and asked them to fill in the European Organization Research and Treatment of Cancer, Quality of Life Questionnaire before the commencement of the treatment. The acupuncture treatment is set up format but not disclosed yet. The translation and developing a Korean version of outcome measures that is Korean clinician friendly has been sought for MYMOP is one of the most appropriate one. The permission was granted, the translation into Korean was done, then back translated into English only based on the Korean translation by the researcher who is bilingual in both languages. The back translation was compared by the original developer of MYMOP and confirmed usable. In order to test the existence of acupoints and meridians through popular forms of Korean acupuncture regimes, we aim at collecting opinions from 101 Korean clinicians that have used those forms. The questions asked include most effective symptoms, 5 Shu points, points those are least likely to use due to either adverse events or the lack of effectiveness, theoretical reasons for the above proposals, proposing outcome measures

  8. Clinical quality performance in U.S. health centers.

    Science.gov (United States)

    Shi, Leiyu; Lebrun, Lydie A; Zhu, Jinsheng; Hayashi, Arthur S; Sharma, Ravi; Daly, Charles A; Sripipatana, Alek; Ngo-Metzger, Quyen

    2012-12-01

    To describe current clinical quality among the nation's community health centers and to examine health center characteristics associated with performance excellence. National data from the 2009 Uniform Data System. Health centers reviewed patient records and reported aggregate data to the Uniform Data System. Six measures were examined: first-trimester prenatal care, childhood immunization completion, Pap tests, low birth weight, controlled hypertension, and controlled diabetes. The top 25 percent performing centers were compared with lower performing (bottom 75 percent) centers on these measures. Logistic regressions were utilized to assess the impact of patient, provider, and institutional characteristics on health center performance. Clinical care and outcomes among health centers were generally comparable to national averages. For instance, 67 percent of pregnant patients received timely prenatal care (national = 68 percent), 69 percent of children achieved immunization completion (national = 67 percent), and 63 percent of hypertensive patients had blood pressure under control (national = 48 percent). Depending on the measure, centers with more uninsured patients were less likely to do well, while centers with more physicians and enabling service providers were more likely to do well. Health centers provide quality care at rates comparable to national averages. Performance may be improved by increasing insurance coverage among patients and increasing the ratios of physicians and enabling service providers to patients. © Health Research and Educational Trust.

  9. Work zone performance measures pilot test.

    Science.gov (United States)

    2011-04-01

    Currently, a well-defined and validated set of metrics to use in monitoring work zone performance do not : exist. This pilot test was conducted to assist state DOTs in identifying what work zone performance : measures can and should be targeted, what...

  10. ASUPT Automated Objective Performance Measurement System.

    Science.gov (United States)

    Waag, Wayne L.; And Others

    To realize its full research potential, a need exists for the development of an automated objective pilot performance evaluation system for use in the Advanced Simulation in Undergraduate Pilot Training (ASUPT) facility. The present report documents the approach taken for the development of performance measures and also presents data collected…

  11. Environmental Measurements Laboratory 2002 Unit Performance Plan

    Energy Technology Data Exchange (ETDEWEB)

    None

    2001-10-01

    This EML Unit Performance Plan provides the key goals and performance measures for FY 2002 and continuing to FY 2003. The purpose of the Plan is to inform EML's stakeholders and customers of the Laboratory's products and services, and its accomplishments and future challenges. Also incorporated in the Unit Performance Plan is EML's Communication Plan for FY 2002.

  12. Measuring performance in virtual reality phacoemulsification surgery

    Science.gov (United States)

    Söderberg, Per; Laurell, Carl-Gustaf; Simawi, Wamidh; Skarman, Eva; Nordh, Leif; Nordqvist, Per

    2008-02-01

    We have developed a virtual reality (VR) simulator for phacoemulsification surgery. The current work aimed at developing a relative performance index that characterizes the performance of an individual trainee. We recorded measurements of 28 response variables during three iterated surgical sessions in 9 experienced cataract surgeons, separately for the sculpting phase and the evacuation phase of phacoemulsification surgery and compared their outcome to that of a reference group of naive trainees. We defined an individual overall performance index, an individual class specific performance index and an individual variable specific performance index. We found that on an average the experienced surgeons performed at a lower level than a reference group of naive trainees but that this was particularly attributed to a few surgeons. When their overall performance index was further analyzed as class specific performance index and variable specific performance index it was found that the low level performance was attributed to a behavior that is acceptable for an experienced surgeon but not for a naive trainee. It was concluded that relative performance indices should use a reference group that corresponds to the measured individual since the definition of optimal surgery may vary among trainee groups depending on their level of experience.

  13. 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.

  14. APPROXIMATIONS TO PERFORMANCE MEASURES IN QUEUING SYSTEMS

    Directory of Open Access Journals (Sweden)

    Kambo, N. S.

    2012-11-01

    Full Text Available Approximations to various performance measures in queuing systems have received considerable attention because these measures have wide applicability. In this paper we propose two methods to approximate the queuing characteristics of a GI/M/1 system. The first method is non-parametric in nature, using only the first three moments of the arrival distribution. The second method treads the known path of approximating the arrival distribution by a mixture of two exponential distributions by matching the first three moments. Numerical examples and optimal analysis of performance measures of GI/M/1 queues are provided to illustrate the efficacy of the methods, and are compared with benchmark approximations.

  15. Reconsidering the measurement of ancillary service performance.

    Science.gov (United States)

    Griffin, D T; Rauscher, J A

    1987-08-01

    Prospective payment reimbursement systems have forced hospitals to review their costs more carefully. The result of the increased emphasis on costs is that many hospitals use costs, rather than margin, to judge the performance of ancillary services. However, arbitrary selection of performance measures for ancillary services can result in managerial decisions contrary to hospital objectives. Managerial accounting systems provide models which assist in the development of performance measures for ancillary services. Selection of appropriate performance measures provides managers with the incentive to pursue goals congruent with those of the hospital overall. This article reviews the design and implementation of managerial accounting systems, and considers the impact of prospective payment systems and proposed changes in capital reimbursement on this process.

  16. Measurement Of Shariah Stock Performance Using Risk Adjusted Performance

    Directory of Open Access Journals (Sweden)

    Zuhairan Y Yunan

    2015-03-01

    Full Text Available The aim of this research is to analyze the shariah stock performance using risk adjusted performance method. There are three parameters to measure the stock performance i.e. Sharpe, Treynor, and Jensen. This performance’s measurements calculate the return and risk factor from shariah stocks. The data that used on this research is using the data of stocks at Jakarta Islamic Index. Sampling method that used on this paper is purposive sampling. This research is using ten companies as a sample. The result shows that from three parameters, the stock that have a best performance are AALI, ANTM, ASII, CPIN, INDF, KLBF, LSIP, and UNTR.DOI: 10.15408/aiq.v7i1.1364

  17. Developing Human Performance Measures (PSAM8)

    International Nuclear Information System (INIS)

    Jeffrey C. Joe

    2006-01-01

    Through the reactor oversight process (ROP), the U.S. Nuclear Regulatory Commission (NRC) monitors the performance of utilities licensed to operate nuclear power plants. The process is designed to assure public health and safety by providing reasonable assurance that licensees are meeting the cornerstones of safety and designated crosscutting elements. The reactor inspection program, together with performance indicators (PIs), and enforcement activities form the basis for the NRC's risk-informed, performance based regulatory framework. While human performance is a key component in the safe operation of nuclear power plants and is a designated cross-cutting element of the ROP, there is currently no direct inspection or performance indicator for assessing human performance. Rather, when human performance is identified as a substantive cross cutting element in any 1 of 3 categories (resources, organizational or personnel), it is then evaluated for common themes to determine if follow-up actions are warranted. However, variability in human performance occurs from day to day, across activities that vary in complexity, and workgroups, contributing to the uncertainty in the outcomes of performance. While some variability in human performance may be random, much of the variability may be attributed to factors that are not currently assessed. There is a need to identify and assess aspects of human performance that relate to plant safety and to develop measures that can be used to successfully assure licensee performance and indicate when additional investigation may be required. This paper presents research that establishes a technical basis for developing human performance measures. In particular, we discuss: (1) how historical data already gives some indication of connection between human performance and overall plant performance, (2) how industry led efforts to measure and model human performance and organizational factors could serve as a data source and basis for a

  18. Clinical applications of cortisol measurements in hair.

    Science.gov (United States)

    Wester, Vincent L; van Rossum, Elisabeth F C

    2015-10-01

    Cortisol measurements in blood, saliva and urine are frequently used to examine the hypothalamus-pituitary-adrenal (HPA) axis in clinical practice and in research. However, cortisol levels are subject to variations due to acute stress, the diurnal rhythm and pulsatile secretion. Cortisol measurements in body fluids are not always a reflection of long-term cortisol exposure. The analysis of cortisol in scalp hair is a relatively novel method to measure cumulative cortisol exposure over months up to years. Over the past years, hair cortisol concentrations (HCC) have been examined in association with a large number of somatic and mental health conditions. HCC can be used to evaluate disturbances of the HPA axis, including Cushing's syndrome, and to evaluate hydrocortisone treatment. Using HCC, retrospective timelines of cortisol exposure can be created which can be of value in diagnosing cyclic hypercortisolism. HCC have also been shown to increase with psychological stressors, including major life events, as well as physical stressors, such as endurance exercise and shift work. Initial studies show that HCC may be increased in depression, but decreased in general anxiety disorder. In posttraumatic stress disorder, changes in HCC seem to be dependent on the type of traumatic experience and the time since traumatization. Increased hair cortisol is consistently linked to obesity, metabolic syndrome and cardiovascular disease. Potentially, HCC could form a future marker for cardiovascular risk stratification, as well as serve as a treatment target. © 2015 European Society of Endocrinology.

  19. Measurement uncertainty analysis techniques applied to PV performance measurements

    Energy Technology Data Exchange (ETDEWEB)

    Wells, C.

    1992-10-01

    The purpose of this presentation is to provide a brief introduction to measurement uncertainty analysis, outline how it is done, and illustrate uncertainty analysis with examples drawn from the PV field, with particular emphasis toward its use in PV performance measurements. The uncertainty information we know and state concerning a PV performance measurement or a module test result determines, to a significant extent, the value and quality of that result. What is measurement uncertainty analysis It is an outgrowth of what has commonly been called error analysis. But uncertainty analysis, a more recent development, gives greater insight into measurement processes and tests, experiments, or calibration results. Uncertainty analysis gives us an estimate of the I interval about a measured value or an experiment's final result within which we believe the true value of that quantity will lie. Why should we take the time to perform an uncertainty analysis A rigorous measurement uncertainty analysis: Increases the credibility and value of research results; allows comparisons of results from different labs; helps improve experiment design and identifies where changes are needed to achieve stated objectives (through use of the pre-test analysis); plays a significant role in validating measurements and experimental results, and in demonstrating (through the post-test analysis) that valid data have been acquired; reduces the risk of making erroneous decisions; demonstrates quality assurance and quality control measures have been accomplished; define Valid Data as data having known and documented paths of: Origin, including theory; measurements; traceability to measurement standards; computations; uncertainty analysis of results.

  20. Measurement uncertainty analysis techniques applied to PV performance measurements

    Energy Technology Data Exchange (ETDEWEB)

    Wells, C

    1992-10-01

    The purpose of this presentation is to provide a brief introduction to measurement uncertainty analysis, outline how it is done, and illustrate uncertainty analysis with examples drawn from the PV field, with particular emphasis toward its use in PV performance measurements. The uncertainty information we know and state concerning a PV performance measurement or a module test result determines, to a significant extent, the value and quality of that result. What is measurement uncertainty analysis? It is an outgrowth of what has commonly been called error analysis. But uncertainty analysis, a more recent development, gives greater insight into measurement processes and tests, experiments, or calibration results. Uncertainty analysis gives us an estimate of the I interval about a measured value or an experiment`s final result within which we believe the true value of that quantity will lie. Why should we take the time to perform an uncertainty analysis? A rigorous measurement uncertainty analysis: Increases the credibility and value of research results; allows comparisons of results from different labs; helps improve experiment design and identifies where changes are needed to achieve stated objectives (through use of the pre-test analysis); plays a significant role in validating measurements and experimental results, and in demonstrating (through the post-test analysis) that valid data have been acquired; reduces the risk of making erroneous decisions; demonstrates quality assurance and quality control measures have been accomplished; define Valid Data as data having known and documented paths of: Origin, including theory; measurements; traceability to measurement standards; computations; uncertainty analysis of results.

  1. Breast composition: Measurement and clinical use

    International Nuclear Information System (INIS)

    Ekpo, E.U.; Hogg, P.; Highnam, R.; McEntee, M.F.

    2015-01-01

    Breast density is a measure of the extent of radiodense fibroglandular tissue in the breast. The risk of developing breast cancer and the risk of missing cancer at screening rise with higher breast density. In this paper, the historical background to breast density measurement is outlined and current evidence based practice is explained. The relevance of breast density knowledge to mammographic practice and image interpretation is considered in the light of clinical assessment and notification of mammographic breast density (MBD). The current work also discusses risk stratification for decision-making regarding screening frequency and better modalities for earlier detection of breast cancer in the dense breast. Automated volumetric approaches are explained while ultrasound, digital breast tomosynthesis, molecular breast imaging, and magnetic resonance imaging are introduced as valuable adjuncts to digital mammography for imaging the dense breast. The work concludes on the important note that screened women should be notified of their breast density, and such notification should be accompanied with clear and adequate information about breast density and cancer risk, strategies associated with lower MBD, as well as best screening intervals and pathways for women with dense breasts. Adoption of these strategies may be crucial to early detection and treatment of cancer and improving survival from the disease. - Highlights: • Breast density is associated with breast cancer risk and interval breast cancer. • Breast density can be measured manually or automatically. • Radiographic exposure factors impact on breast density measurements. • Dense breast often require imaging with three-dimensional modalities. • National breast density data could enable breast cancer risk stratification.

  2. Ambulatory care registered nurse performance measurement.

    Science.gov (United States)

    Swan, Beth Ann; Haas, Sheila A; Chow, Marilyn

    2010-01-01

    On March 1-2, 2010, a state-of-the-science invitational conference titled "Ambulatory Care Registered Nurse Performance Measurement" was held to focus on measuring quality at the RN provider level in ambulatory care. The conference was devoted to ambulatory care RN performance measurement and quality of health care. The specific emphasis was on formulating a research agenda and developing a strategy to study the testable components of the RN role related to care coordination and care transitions, improving patient outcomes, decreasing health care costs, and promoting sustainable system change. The objectives were achieved through presentations and discussion among expert inter-professional participants from nursing, public health, managed care, research, practice, and policy. Conference speakers identified priority areas for a unified practice, policy, and research agenda. Crucial elements of the strategic dialogue focused on issues and implications for nursing and inter-professional practice, quality, and pay-for-performance.

  3. Procedure to Measure Indoor Lighting Energy Performance

    Energy Technology Data Exchange (ETDEWEB)

    Deru, M.; Blair, N.; Torcellini, P.

    2005-10-01

    This document provides standard definitions of performance metrics and methods to determine them for the energy performance of building interior lighting systems. It can be used for existing buildings and for proposed buildings. The primary users for whom these documents are intended are building energy analysts and technicians who design, install, and operate data acquisition systems, and who analyze and report building energy performance data. Typical results from the use of this procedure are the monthly and annual energy used for lighting, energy savings from occupancy or daylighting controls, and the percent of the total building energy use that is used by the lighting system. The document is not specifically intended for retrofit applications. However, it does complement Measurement and Verification protocols that do not provide detailed performance metrics or measurement procedures.

  4. Quality Markers in Cardiology. Main Markers to Measure Quality of Results (Outcomes) and Quality Measures Related to Better Results in Clinical Practice (Performance Metrics). INCARDIO (Indicadores de Calidad en Unidades Asistenciales del Área del Corazón): A SEC/SECTCV Consensus Position Paper.

    Science.gov (United States)

    López-Sendón, José; González-Juanatey, José Ramón; Pinto, Fausto; Cuenca Castillo, José; Badimón, Lina; Dalmau, Regina; González Torrecilla, Esteban; López-Mínguez, José Ramón; Maceira, Alicia M; Pascual-Figal, Domingo; Pomar Moya-Prats, José Luis; Sionis, Alessandro; Zamorano, José Luis

    2015-11-01

    Cardiology practice requires complex organization that impacts overall outcomes and may differ substantially among hospitals and communities. The aim of this consensus document is to define quality markers in cardiology, including markers to measure the quality of results (outcomes metrics) and quality measures related to better results in clinical practice (performance metrics). The document is mainly intended for the Spanish health care system and may serve as a basis for similar documents in other countries. Copyright © 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  5. Performance measures for transform data coding.

    Science.gov (United States)

    Pearl, J.; Andrews, H. C.; Pratt, W. K.

    1972-01-01

    This paper develops performance criteria for evaluating transform data coding schemes under computational constraints. Computational constraints that conform with the proposed basis-restricted model give rise to suboptimal coding efficiency characterized by a rate-distortion relation R(D) similar in form to the theoretical rate-distortion function. Numerical examples of this performance measure are presented for Fourier, Walsh, Haar, and Karhunen-Loeve transforms.

  6. Standardization of test conditions for gamma camera performance measurement

    International Nuclear Information System (INIS)

    Jordan, K.

    1982-02-01

    The way of measuring gamma camera performance is to use point sources or flood sources in air, often in combination with bar phantoms. This method has nothing in common with the use of a camera in clinical practice. Particularly in the case of low energy emitters, like Tc-99m, the influence of scattered radiation over the performance of cameras is very high. The IEC document 'Characteristics and test conditions of radionuclide imaging devices' is discussed

  7. Evaluation of performance of veterinary in-clinic hematology analyzers.

    Science.gov (United States)

    Rishniw, Mark; Pion, Paul D

    2016-12-01

    A previous study provided information regarding the quality of in-clinic veterinary biochemistry testing. However, no similar studies for in-clinic veterinary hematology testing have been conducted. The objective of this study was to assess the quality of hematology testing in veterinary in-clinic laboratories using results obtained from testing 3 levels of canine EDTA blood samples. Clinicians prepared blood samples to achieve measurand concentrations within, below, and above their RIs and evaluated the samples in triplicate using their in-clinic analyzers. Quality was assessed by comparison of calculated total error with quality requirements, determination of sigma metrics, use of a quality goal index, and agreement between in-clinic and reference laboratory instruments. Suitability for statistical quality control was determined using adaptations from the computerized program, EZRules3. Evaluation of 10 veterinary in-clinic hematology analyzers showed that these instruments often fail to meet quality requirements. At least 60% of analyzers reasonably determined RBC, WBC, HCT, and HGB, when assessed by most quality goal criteria; platelets were less reliably measured, with 80% deemed suitable for low platelet counts, but only 30% for high platelet counts, and automated differential leukocyte counts were generally considered unsuitable for clinical use with fewer than 40% of analyzers meeting the least stringent quality goal requirements. Fewer than 50% of analyzers were able to meet requirements for statistical quality control for any measurand. These findings reflect the current status of in-clinic hematology analyzer performance and provide a basis for future evaluations of the quality of veterinary laboratory testing. © 2016 American Society for Veterinary Clinical Pathology.

  8. Clinical laboratory as an economic model for business performance analysis.

    Science.gov (United States)

    Buljanović, Vikica; Patajac, Hrvoje; Petrovecki, Mladen

    2011-08-15

    To perform SWOT (strengths, weaknesses, opportunities, and threats) analysis of a clinical laboratory as an economic model that may be used to improve business performance of laboratories by removing weaknesses, minimizing threats, and using external opportunities and internal strengths. Impact of possible threats to and weaknesses of the Clinical Laboratory at Našice General County Hospital business performance and use of strengths and opportunities to improve operating profit were simulated using models created on the basis of SWOT analysis results. The operating profit as a measure of profitability of the clinical laboratory was defined as total revenue minus total expenses and presented using a profit and loss account. Changes in the input parameters in the profit and loss account for 2008 were determined using opportunities and potential threats, and economic sensitivity analysis was made by using changes in the key parameters. The profit and loss account and economic sensitivity analysis were tools for quantifying the impact of changes in the revenues and expenses on the business operations of clinical laboratory. Results of simulation models showed that operational profit of €470 723 in 2008 could be reduced to only €21 542 if all possible threats became a reality and current weaknesses remained the same. Also, operational gain could be increased to €535 804 if laboratory strengths and opportunities were utilized. If both the opportunities and threats became a reality, the operational profit would decrease by €384 465. The operational profit of the clinical laboratory could be significantly reduced if all threats became a reality and the current weaknesses remained the same. The operational profit could be increased by utilizing strengths and opportunities as much as possible. This type of modeling may be used to monitor business operations of any clinical laboratory and improve its financial situation by implementing changes in the next fiscal

  9. Clinical laboratory as an economic model for business performance analysis

    Science.gov (United States)

    Buljanović, Vikica; Patajac, Hrvoje; Petrovečki, Mladen

    2011-01-01

    Aim To perform SWOT (strengths, weaknesses, opportunities, and threats) analysis of a clinical laboratory as an economic model that may be used to improve business performance of laboratories by removing weaknesses, minimizing threats, and using external opportunities and internal strengths. Methods Impact of possible threats to and weaknesses of the Clinical Laboratory at Našice General County Hospital business performance and use of strengths and opportunities to improve operating profit were simulated using models created on the basis of SWOT analysis results. The operating profit as a measure of profitability of the clinical laboratory was defined as total revenue minus total expenses and presented using a profit and loss account. Changes in the input parameters in the profit and loss account for 2008 were determined using opportunities and potential threats, and economic sensitivity analysis was made by using changes in the key parameters. The profit and loss account and economic sensitivity analysis were tools for quantifying the impact of changes in the revenues and expenses on the business operations of clinical laboratory. Results Results of simulation models showed that operational profit of €470 723 in 2008 could be reduced to only €21 542 if all possible threats became a reality and current weaknesses remained the same. Also, operational gain could be increased to €535 804 if laboratory strengths and opportunities were utilized. If both the opportunities and threats became a reality, the operational profit would decrease by €384 465. Conclusion The operational profit of the clinical laboratory could be significantly reduced if all threats became a reality and the current weaknesses remained the same. The operational profit could be increased by utilizing strengths and opportunities as much as possible. This type of modeling may be used to monitor business operations of any clinical laboratory and improve its financial situation by

  10. Corporate Social Performance: From Output Measurement to Impact Measurement

    NARCIS (Netherlands)

    K.E.H. Maas (Karen)

    2009-01-01

    textabstractAll organisations have social, environmental and economic impacts that effect people, their communities and the natural environment. Impacts include intended as well as unintended effects and negative as well as positive effects. Current practice in performance measurement tends to focus

  11. Application of data mining in performance measures

    Science.gov (United States)

    Chan, Michael F. S.; Chung, Walter W.; Wong, Tai Sun

    2001-10-01

    This paper proposes a structured framework for exploiting data mining application for performance measures. The context is set in an airline company is illustrated for the use of such framework. The framework takes in consideration of how a knowledge worker interacts with performance information at the enterprise level to support them to make informed decision in managing the effectiveness of operations. A case study of applying data mining technology for performance data in an airline company is illustrated. The use of performance measures is specifically applied to assist in the aircraft delay management process. The increasingly dispersed and complex operations of airline operation put much strain on the part of knowledge worker in using search, acquiring and analyzing information to manage performance. One major problem faced with knowledge workers is the identification of root causes of performance deficiency. The large amount of factors involved in the analyze the root causes can be time consuming and the objective of applying data mining technology is to reduce the time and resources needed for such process. The increasing market competition for better performance management in various industries gives rises to need of the intelligent use of data. Because of this, the framework proposed here is very much generalizable to industries such as manufacturing. It could assist knowledge workers who are constantly looking for ways to improve operation effectiveness through new initiatives and the effort is required to be quickly done to gain competitive advantage in the marketplace.

  12. Frequency Control Performance Measurement and Requirements

    Energy Technology Data Exchange (ETDEWEB)

    Illian, Howard F.

    2010-12-20

    Frequency control is an essential requirement of reliable electric power system operations. Determination of frequency control depends on frequency measurement and the practices based on these measurements that dictate acceptable frequency management. This report chronicles the evolution of these measurements and practices. As technology progresses from analog to digital for calculation, communication, and control, the technical basis for frequency control measurement and practices to determine acceptable performance continues to improve. Before the introduction of digital computing, practices were determined largely by prior experience. In anticipation of mandatory reliability rules, practices evolved from a focus primarily on commercial and equity issues to an increased focus on reliability. This evolution is expected to continue and place increased requirements for more precise measurements and a stronger scientific basis for future frequency management practices in support of reliability.

  13. CITYkeys Smart city performance measurement system

    NARCIS (Netherlands)

    Huovila, A.; Airaksinen, M.; Pinto-Seppa, I.; Piira, K.; Bosch, P.R.; Penttinen, T.; Neumann, H.M.; Kontinakis, N.

    2017-01-01

    Cities are tackling their economic, social and environmental challenges through smart city solutions. To demonstrate that these solutions achieve the desired impact, an indicator-based assessment system is needed. This paper presents the process of developing CITYkeys performance measurement system

  14. The Validity of Subjective Performance Measures

    DEFF Research Database (Denmark)

    Meier, Kenneth J.; Winter, Søren C.; O'Toole, Laurence J.

    2015-01-01

    to provide, and are highly policy specific rendering generalization difficult. But are perceptual performance measures valid, and do they generate unbiased findings? We examine these questions in a comparative study of middle managers in schools in Texas and Denmark. The findings are remarkably similar...

  15. Performance Measurement in Helicopter Training and Operations.

    Science.gov (United States)

    Prophet, Wallace W.

    For almost 15 years, HumRRO Division No. 6 has conducted an active research program on techniques for measuring the flight performance of helicopter trainees and pilots. This program addressed both the elemental aspects of flying (i.e., maneuvers) and the mission- or goal-oriented aspects. A variety of approaches has been investigated, with the…

  16. Testing for Distortions in Performance Measures

    DEFF Research Database (Denmark)

    Sloof, Randolph; Van Praag, Mirjam

    2015-01-01

    Distorted performance measures in compensation contracts elicit suboptimal behavioral responses that may even prove to be dysfunctional (gaming). This paper applies the empirical test developed by Courty and Marschke (Review of Economics and Statistics, 90, 428-441) to detect whether the widely...

  17. Testing for Distortions in Performance Measures

    DEFF Research Database (Denmark)

    Sloof, Randolph; Van Praag, Mirjam

    Distorted performance measures in compensation contracts elicit suboptimal behavioral responses that may even prove to be dysfunctional (gaming). This paper applies the empirical test developed by Courty and Marschke (2008) to detect whether the widely used class of Residual Income based performa...

  18. Performance measurement in industrial R&D

    NARCIS (Netherlands)

    Kerssens-van Drongelen, I.C.; Nixon, Bill; Pearson, Alan

    2000-01-01

    Currently, the need for R&D performance measurements that are both practically useful and theoretically sound seems to be generally acknowledged; indeed, the rising cost of R&D, greater emphasis on value management and a trend towards decentralization are escalating the need for ways of evaluating

  19. External Innovation Implementation Determinants and Performance Measurement

    DEFF Research Database (Denmark)

    Coates, Matthew; Bals, Lydia

    2013-01-01

    for innovation implementation based on a case study in the pharmaceutical industry. The results of 25 expert interviews and a survey with 67 respondents led to the resulting framework and a corresponding performance measurement system. The results reveal the importance of supporting systems and show differences...

  20. 20 CFR 638.302 - Performance measurement.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Performance measurement. 638.302 Section 638.302 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR JOB CORPS PROGRAM UNDER TITLE IV-B OF THE JOB TRAINING PARTNERSHIP ACT Funding, Site Selection, and Facilities Management...

  1. Tools for Measuring and Improving Performance.

    Science.gov (United States)

    Jurow, Susan

    1993-01-01

    Explains the need for meaningful performance measures in libraries and the Total Quality Management (TQM) approach to data collection. Five tools representing different stages of a TQM inquiry are covered (i.e., the Shewhart Cycle, flowcharts, cause-and-effect diagrams, Pareto charts, and control charts), and benchmarking is addressed. (Contains…

  2. Performance measures for world class maintenance

    International Nuclear Information System (INIS)

    Labib, A.W.

    1998-01-01

    A main problem in maintenance in general, and in power plants and related equipment in particular, is the lack of a practical, consistent, and adaptive performance measure that provides a focused feedback and integrates preventive and corrective modes of maintenance. The presentation defines concepts of world class and benchmarking. Desirable features in an appropriate performance measure are identified. It then, demonstrates current practices in maintenance and criticises their shortcomings. An alternative model is presented through a case study. The model monitors performance from a general view, and then offers a focused analysis. The main conclusion is that the proposed model offers an adaptive and a dynamic framework, and hence production and maintenance are integrated in a 'real time' environment. The system is also flexible in working with any other criteria whether they are of a quantitative or a qualitative nature. (orig.) 16 refs

  3. Performance measures for world class maintenance

    Energy Technology Data Exchange (ETDEWEB)

    Labib, A.W. [Department of Mechanical Engineering, University of Manchester, Institute of Science and Technology, Manchester (United Kingdom)

    1998-12-31

    A main problem in maintenance in general, and in power plants and related equipment in particular, is the lack of a practical, consistent, and adaptive performance measure that provides a focused feedback and integrates preventive and corrective modes of maintenance. The presentation defines concepts of world class and benchmarking. Desirable features in an appropriate performance measure are identified. It then, demonstrates current practices in maintenance and criticises their shortcomings. An alternative model is presented through a case study. The model monitors performance from a general view, and then offers a focused analysis. The main conclusion is that the proposed model offers an adaptive and a dynamic framework, and hence production and maintenance are integrated in a `real time` environment. The system is also flexible in working with any other criteria whether they are of a quantitative or a qualitative nature. (orig.) 16 refs.

  4. Performance measures for world class maintenance

    Energy Technology Data Exchange (ETDEWEB)

    Labib, A W [Department of Mechanical Engineering, University of Manchester, Institute of Science and Technology, Manchester (United Kingdom)

    1999-12-31

    A main problem in maintenance in general, and in power plants and related equipment in particular, is the lack of a practical, consistent, and adaptive performance measure that provides a focused feedback and integrates preventive and corrective modes of maintenance. The presentation defines concepts of world class and benchmarking. Desirable features in an appropriate performance measure are identified. It then, demonstrates current practices in maintenance and criticises their shortcomings. An alternative model is presented through a case study. The model monitors performance from a general view, and then offers a focused analysis. The main conclusion is that the proposed model offers an adaptive and a dynamic framework, and hence production and maintenance are integrated in a `real time` environment. The system is also flexible in working with any other criteria whether they are of a quantitative or a qualitative nature. (orig.) 16 refs.

  5. Standardization of test conditions for gamma camera performance measurement

    International Nuclear Information System (INIS)

    Jordan, K.

    1980-01-01

    The actual way of measuring gamma camera performance is to use point sources or flood sources in air, often in combination with bar phantoms. This method mostly brings best performance parameters for cameras but it has nothing in common with the use of a camera in clinical practice. Particular in the case of low energy emitters, like Tc-99m, the influence of scattered radiation over the performance of cameras is very high. Therefore it is important to have test conditions of radionuclide imaging devices, that will approach as best as practicable the measuring conditions in clinical applications. It is therefore a good news that the International Electrochemical Commission IEC has prepared a draft 'Characteristics and test conditions of radionuclide imaging devices' which is now submitted to the national committees for formal approval under the Six Months' Rule. Some essential points of this document are discussed in the paper. (orig.) [de

  6. Clinical tooth preparations and associated measuring methods: a systematic review.

    Science.gov (United States)

    Tiu, Janine; Al-Amleh, Basil; Waddell, J Neil; Duncan, Warwick J

    2015-03-01

    The geometries of tooth preparations are important features that aid in the retention and resistance of cemented complete crowns. The clinically relevant values and the methods used to measure these are not clear. The purpose of this systematic review was to retrieve, organize, and critically appraise studies measuring clinical tooth preparation parameters, specifically the methodology used to measure the preparation geometry. A database search was performed in Scopus, PubMed, and ScienceDirect with an additional hand search on December 5, 2013. The articles were screened for inclusion and exclusion criteria and information regarding the total occlusal convergence (TOC) angle, margin design, and associated measuring methods were extracted. The values and associated measuring methods were tabulated. A total of 1006 publications were initially retrieved. After removing duplicates and filtering by using exclusion and inclusion criteria, 983 articles were excluded. Twenty-three articles reported clinical tooth preparation values. Twenty articles reported the TOC, 4 articles reported margin designs, 4 articles reported margin angles, and 3 articles reported the abutment height of preparations. A variety of methods were used to measure these parameters. TOC values seem to be the most important preparation parameter. Recommended TOC values have increased over the past 4 decades from an unachievable 2- to 5-degree taper to a more realistic 10 to 22 degrees. Recommended values are more likely to be achieved under experimental conditions if crown preparations are performed outside of the mouth. We recommend that a standardized measurement method based on the cross sections of crown preparations and standardized reporting be developed for future studies analyzing preparation geometry. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  7. Performance measurement for ambulatory care: moving towards a new agenda.

    Science.gov (United States)

    Roski, J; Gregory, R

    2001-12-01

    Despite a shift in care delivery from inpatient to ambulatory care, performance measurement efforts for the different levels in ambulatory care settings such as individual physicians, individual clinics and physician organizations have not been widely instituted in the United States (U.S.). The Health Plan Employer Data and Information Set (HEDIS), the most widely used performance measurement set in the U.S., includes a number of measures that evaluate preventive and chronic care provided in ambulatory care facilities. While HEDIS has made important contributions to the tracking of ambulatory care quality, it is becoming increasingly apparent that the measurement set could be improved by providing quality of care information at the levels of greatest interest to consumers and purchasers of care, namely for individual physicians, clinics and physician organizations. This article focuses on the improvement opportunities for quality performance measurement systems in ambulatory care. Specific challenges to creating a sustainable performance measurement system at the level of physician organizations, such as defining the purpose of the system, the accountability logic, information and reporting needs and mechanisms for sustainable implementation, are discussed.

  8. Improvement an enterprises marketing performance measurement system

    Directory of Open Access Journals (Sweden)

    Stanković Ljiljana

    2013-01-01

    Full Text Available Business conditions in which modern enterprises do business are more and more complex. The complexity of the business environment is caused by activities of external and internal factors, which imposes the need for the turn in management focus. One of key turns is related to the need of adaptation and development of new business performance evaluation systems. The evaluation of marketing contribution to business performance is very important however a complex task as well. The marketing theory and practice indicates the need for developing adequate standards and systems for evaluating the efficiency of marketing decisions. The better understanding of marketing standards and ways that managers use is a very important factor that affects the efficiency of strategic decision-making. The paper presents the results of researching the way in which managers perceive and apply marketing performance measures. The data that were received through the field research sample enabled the consideration of the managers' attitudes on practical ways of implementing marketing performance measurement and identifying measures that managers imply as used mostly in business practice.

  9. Total performance measurement and management: TPM2

    Energy Technology Data Exchange (ETDEWEB)

    Sheather, G. [University of Technology, Sydney, NSW (Australia)

    1996-10-01

    As the rate of incremental improvement activities and business process re-engineering programs increase, product development times reduce, collaborative endeavours between OEMs and out-sourcing suppliers increase, as agile manufacturing responds to the demands of a global marketplace, the `virtual` organisation is becoming a reality. In this context, customers, partners, suppliers and manufacturers are increasingly separated by field geography, time zone, and availability, but linked by distributed information systems. Measuring and monitoring business performance in this environment requires a entirely different framework and set of key performance indicators (KPIs) usually associated with traditional financial accounting approaches. These approaches are critiqued, then the paper introduces a new concept `Total Performance Measurement Management` (TPM2), to distinguish it from the conventional TPM (Total Productive Management). A model for combining both financial and non-financial KPIs relevant to real-time performance measures stretching across strategic, business unit and operational levels, is presented. The results of the model confirm the hypothesis that it is feasible to develop a TPM2 framework for achieving enterprise wide strategic objectives. (author). 6 tabs., 18 figs., refs.

  10. Performance expectations of measurement control programs

    International Nuclear Information System (INIS)

    Hammond, G.A.

    1985-01-01

    The principal index for designing and assessing the effectiveness of safeguards is the sensitivity and reliability of gauging the true status of material balances involving material flows, transfers, inventories, and process holdup. The measurement system must not only be capable of characterizing the material for gradation or intensity of protection, but also be responsive to needs for detection and localization of losses, provide confirmation that no diversion has occurred, and help meet requirements for process control, health and safety. Consequently, the judicious application of a measurement control and quality assurance program is vital to a complete understanding of the capabilities and limitations of the measurement system including systematic and random components of error for weight, volume, sampling, chemical, isotopic, and nondestructive determinations of material quantities in each material balance area. This paper describes performance expectations or criteria for a measurement control program in terms of ''what'' is desired and ''why'', relative to safeguards and security objectives

  11. Coming up short on nonfinancial performance measurement.

    Science.gov (United States)

    Ittner, Christopher D; Larcker, David F

    2003-11-01

    Companies in increasing numbers are measuring customer loyalty, employee satisfaction, and other nonfinancial areas of performance that they believe affect profitability. But they've failed to relate these measures to their strategic goals or establish a connection between activities undertaken and financial outcomes achieved. Failure to make such connections has led many companies to misdirect their investments and reward ineffective managers. Extensive field research now shows that businesses make some common mistakes when choosing, analyzing, and acting on their nonfinancial measures. Among these mistakes: They set the wrong performance targets because they focus too much on short-term financial results, and they use metrics that lack strong statistical validity and reliability. As a result, the companies can't demonstrate that improvements in nonfinancial measures actually affect their financial results. The authors lay out a series of steps that will allow companies to realize the genuine promise of nonfinancial performance measures. First, develop a model that proposes a causal relationship between the chosen nonfinancial drivers of strategic success and specific outcomes. Next, take careful inventory of all the data within your company. Then use established statistical methods for validating the assumed relationships and continue to test the model as market conditions evolve. Finally, base action plans on analysis of your findings, and determine whether those plans and their investments actually produce the desired results. Nonfinancial measures will offer little guidance unless you use a process for choosing and analyzing them that relies on sophisticated quantitative and qualitative inquiries into the factors actually contributing to economic results.

  12. Approaches towards airport economic performance measurement

    Directory of Open Access Journals (Sweden)

    Ivana STRYČEKOVÁ

    2011-01-01

    Full Text Available The paper aims to assess how economic benchmarking is being used by airports as a means of performance measurement and comparison of major international airports in the world. The study focuses on current benchmarking practices and methods by taking into account different factors according to which it is efficient to benchmark airports performance. As methods are considered mainly data envelopment analysis and stochastic frontier analysis. Apart from them other approaches are discussed by airports to provide economic benchmarking. The main objective of this article is to evaluate the efficiency of the airports and answer some undetermined questions involving economic benchmarking of the airports.

  13. MODERN INSTRUMENTS FOR MEASURING ORGANIZATIONAL PERFORMANCE

    Directory of Open Access Journals (Sweden)

    RADU CATALINA

    2010-12-01

    Full Text Available Any significant management action can be assessed both in terms of success of immediate goals and as effect of the organization ability to embrace change. Market competition intensifies with the development of Romanian society and its needs. Companies that offer different products and services need to impose certain advantages and to increase their performances. The paper will present modern tools for measuring and evaluating organizational performance, namely: Balanced Scorecard, Deming model and Baldrige model. We also present an example for Balance Scorecard, of an organizations belonging to the cosmetics industry.

  14. Strategic Performance Measurement of Research and Development

    DEFF Research Database (Denmark)

    Parisi, Cristiana; Rossi, Paola

    2015-01-01

    The paper used an in depth case study to investigate how firms can integrate the strategic performance measurement of R&D with the Balanced Scorecard. Moreover, the paper investigated the crucial role of controller in the decision making process of this integration.The literature review of R......-financial ratio as the R&D measures to introduce in the Balanced Scorecard.In choosing our case study, we have selected the pharmaceutical industry because of its relevant R&D investment. Within the sector we chose the Italian affiliate of a traditional industry leader, Eli Lilly Italia,that was characterized...

  15. Measures to Improve Diagnostic Safety in Clinical Practice.

    Science.gov (United States)

    Singh, Hardeep; Graber, Mark L; Hofer, Timothy P

    2016-10-20

    Timely and accurate diagnosis is foundational to good clinical practice and an essential first step to achieving optimal patient outcomes. However, a recent Institute of Medicine report concluded that most of us will experience at least one diagnostic error in our lifetime. The report argues for efforts to improve the reliability of the diagnostic process through better measurement of diagnostic performance. The diagnostic process is a dynamic team-based activity that involves uncertainty, plays out over time, and requires effective communication and collaboration among multiple clinicians, diagnostic services, and the patient. Thus, it poses special challenges for measurement. In this paper, we discuss how the need to develop measures to improve diagnostic performance could move forward at a time when the scientific foundation needed to inform measurement is still evolving. We highlight challenges and opportunities for developing potential measures of "diagnostic safety" related to clinical diagnostic errors and associated preventable diagnostic harm. In doing so, we propose a starter set of measurement concepts for initial consideration that seem reasonably related to diagnostic safety and call for these to be studied and further refined. This would enable safe diagnosis to become an organizational priority and facilitate quality improvement. Health-care systems should consider measurement and evaluation of diagnostic performance as essential to timely and accurate diagnosis and to the reduction of preventable diagnostic harm.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

  16. 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.

  17. Measurement-based reliability/performability models

    Science.gov (United States)

    Hsueh, Mei-Chen

    1987-01-01

    Measurement-based models based on real error-data collected on a multiprocessor system are described. Model development from the raw error-data to the estimation of cumulative reward is also described. A workload/reliability model is developed based on low-level error and resource usage data collected on an IBM 3081 system during its normal operation in order to evaluate the resource usage/error/recovery process in a large mainframe system. Thus, both normal and erroneous behavior of the system are modeled. The results provide an understanding of the different types of errors and recovery processes. The measured data show that the holding times in key operational and error states are not simple exponentials and that a semi-Markov process is necessary to model the system behavior. A sensitivity analysis is performed to investigate the significance of using a semi-Markov process, as opposed to a Markov process, to model the measured system.

  18. Relating Standardized Visual Perception Measures to Simulator Visual System Performance

    Science.gov (United States)

    Kaiser, Mary K.; Sweet, Barbara T.

    2013-01-01

    Human vision is quantified through the use of standardized clinical vision measurements. These measurements typically include visual acuity (near and far), contrast sensitivity, color vision, stereopsis (a.k.a. stereo acuity), and visual field periphery. Simulator visual system performance is specified in terms such as brightness, contrast, color depth, color gamut, gamma, resolution, and field-of-view. How do these simulator performance characteristics relate to the perceptual experience of the pilot in the simulator? In this paper, visual acuity and contrast sensitivity will be related to simulator visual system resolution, contrast, and dynamic range; similarly, color vision will be related to color depth/color gamut. Finally, we will consider how some characteristics of human vision not typically included in current clinical assessments could be used to better inform simulator requirements (e.g., relating dynamic characteristics of human vision to update rate and other temporal display characteristics).

  19. Team performance measures for abnormal plant operations

    International Nuclear Information System (INIS)

    Montgomery, J.C.; Seaver, D.A.; Holmes, C.W.; Gaddy, C.D.; Toquam, J.L.

    1990-01-01

    In order to work effectively, control room crews need to possess well-developed team skills. Extensive research supports the notion that improved quality and effectiveness are possible when a group works together, rather than as individuals. The Nuclear Regulatory Commission (NRC) has recognized the role of team performance in plant safety and has attempted to evaluate licensee performance as part of audits, inspections, and reviews. However, reliable and valid criteria for team performance have not yet been adequately developed. The purpose of the present research was to develop such reliable and valid measures of team skills. Seven dimensions of team skill performance were developed on the basis of input from NRC operator licensing examiners and from the results of previous research and experience in the area. These dimensions included two-way communications, resource management, inquiry, advocacy, conflict resolution/decision-making, stress management, and team spirit. Several different types of rating formats were developed for use with these dimensions, including a modified Behaviorally Anchored Rating Scale (BARS) format and a Behavioral Frequency format. Following pilot-testing and revision, observer and control room crew ratings of team performance were obtained using 14 control room crews responding to simulator scenarios at a BWR and a PWR reactor. It is concluded, overall, that the Behavioral Frequency ratings appeared quite promising as a measure of team skills but that additional statistical analyses and other follow-up research are needed to refine several of the team skills dimensions and to make the scales fully functional in an applied setting

  20. Performance measurement with fuzzy data envelopment analysis

    CERN Document Server

    Tavana, Madjid

    2014-01-01

    The intensity of global competition and ever-increasing economic uncertainties has led organizations to search for more efficient and effective ways to manage their business operations.  Data envelopment analysis (DEA) has been widely used as a conceptually simple yet powerful tool for evaluating organizational productivity and performance. Fuzzy DEA (FDEA) is a promising extension of the conventional DEA proposed for dealing with imprecise and ambiguous data in performance measurement problems. This book is the first volume in the literature to present the state-of-the-art developments and applications of FDEA. It is designed for students, educators, researchers, consultants and practicing managers in business, industry, and government with a basic understanding of the DEA and fuzzy logic concepts.

  1. IASI instrument: technical description and measured performances

    Science.gov (United States)

    Hébert, Ph.; Blumstein, D.; Buil, C.; Carlier, T.; Chalon, G.; Astruc, P.; Clauss, A.; Siméoni, D.; Tournier, B.

    2017-11-01

    IASI is an infrared atmospheric sounder. It will provide meteorologist and scientific community with atmospheric spectra. The IASI system includes 3 instruments that will be mounted on the Metop satellite series, a data processing software integrated in the EPS (EUMETSAT Polar System) ground segment and a technical expertise centre implemented in CNES Toulouse. The instrument is composed of a Fourier transform spectrometer and an associated infrared imager. The optical configuration is based on a Michelson interferometer and the interferograms are processed by an on-board digital processing subsystem, which performs the inverse Fourier transforms and the radiometric calibration. The infrared imager co-registers the IASI soundings with AVHRR imager (AVHRR is another instrument on the Metop satellite). The presentation will focus on the architectures of the instrument, the description of the implemented technologies and the measured performance of the first flight model. CNES is leading the IASI program in association with EUMETSAT. The instrument Prime is ALCATEL SPACE.

  2. Implementation of renal key performance indicators: promoting improved clinical practice.

    Science.gov (United States)

    Toussaint, Nigel D; McMahon, Lawrence P; Dowling, Gregory; Soding, Jenny; Safe, Maria; Knight, Richard; Fair, Kathleen; Linehan, Leanne; Walker, Rowan G; Power, David A

    2015-03-01

    In the Australian state of Victoria, the Renal Health Clinical Network (RHCN) of the Department of Health Victoria established a Renal Key Performance Indicator (KPI) Working Group in 2011. The group developed four KPIs related to chronic kidney disease and dialysis. A transplant working group of the RHCN developed two additional KPIs. The aim was to develop clinical indicators to measure performance of renal services to drive service improvement. A data collection and benchmarking programme was established, with data provided monthly to the Department using a purpose-designed website portal. The KPI Working Group is responsible for analysing data each quarter and ensuring indicators remain accurate and relevant. Each indicator has clear definitions and targets, and assess (i) patient education, (ii) timely creation of vascular access for haemodialysis, (iii) proportion of patients dialysing at home, (iv) incidence of dialysis-related peritonitis, (v) incidence of pre-emptive renal transplantation, and (vi) timely listing of patients for deceased donor transplantation. Most KPIs have demonstrated improved performance over time with limited gains notably in two: the proportion of patients dialysing at home (KPI 3) and timely listing patients for transplantation (KPI 6). KPI implementation has been established in Victoria for 2 years, providing performance data without additional funding. The six Victorian KPIs are measurable, relevant and modifiable, and implementation relies on enthusiasm and goodwill of physicians and nurses involved in collecting data. The KPIs require further evaluation, but adoption of a similar programme by other jurisdictions could lead to improved national outcomes. © 2014 Asian Pacific Society of Nephrology.

  3. Student´s self-assessment of clinical competence and objective clinical performance in OSCE evaluation

    OpenAIRE

    Jünger, J; Schellberg, D; Nikendei, C

    2006-01-01

    [english] Overestimating one's clinical competence can be dangerous to patient's safety. Therefore the goal of this study was to identify students with high confidence in their own clinical competence but low performance in objective assessment. 171 students in the 14 week course in internal medicine completed the clinical skills-related self-assessment expectations (SE) and were tested in a 12 station OSCE. Both measures were obtained within three days. In total we identified 16% of students...

  4. Developing an instrument to measure effective factors on Clinical Learning.

    Science.gov (United States)

    Dadgaran, Ideh; Shirazi, Mandana; Mohammadi, Aeen; Ravari, Ali

    2016-07-01

    Although nursing students spend a large part of their learning period in the clinical environment, clinical learning has not been perceived by its nature yet. To develop an instrument to measure effective factors on clinical learning in nursing students. This is a mixed methods study performed in 2 steps. First, the researchers defined "clinical learning" in nursing students through qualitative content analysis and designed items of the questionnaire based on semi-structured individual interviews with nursing students. Then, as the second step, psychometric properties of the questionnaire were evaluated using the face validity, content validity, construct validity, and internal consistency evaluated on 227 students from fourth or higher semesters. All the interviews were recorded and transcribed, and then, they were analyzed using Max Qualitative Data Analysis and all of qualitative data were analyzed using SPSS 14. To do the study, we constructed the preliminary questionnaire containing 102 expressions. After determination of face and content validities by qualitative and quantitative approaches, the expressions of the questionnaire were reduced to 45. To determine the construct validity, exploratory factor analysis was applied. The results indicated that the maximum variance percentage (40.55%) was defined by the first 3 factors while the rest of the total variance percentage (59.45%) was determined by the other 42 factors. Results of exploratory factor analysis of this questionnaire indicated the presence of 3 instructor-staff, students, and educational related factors. Finally, 41 expressions were kept in 3 factor groups. The α-Cronbach coefficient (0.93) confirmed the high internal consistency of the questionnaire. Results indicated that the prepared questionnaire was an efficient instrument in the study of the effective factors on clinical learning as viewed by nursing students since it involves 41 expressions and properties such as instrument design based

  5. Measuring the performance of maintenance service outsourcing.

    Science.gov (United States)

    Cruz, Antonio Miguel; Rincon, Adriana Maria Rios; Haugan, Gregory L

    2013-01-01

    The aims of this paper are (1) to identify the characteristics of maintenance service providers that directly impact maintenance service quality, using 18 independent covariables; (2) to quantify the change in risk these covariables present to service quality, measured in terms of equipment turnaround time (TAT). A survey was applied to every maintenance service provider (n = 19) for characterization purposes. The equipment inventory was characterized, and the TAT variable recorded and monitored for every work order of each service provider (N = 1,025). Finally, the research team conducted a statistical analysis to accomplish the research objectives. The results of this study offer strong empirical evidence that the most influential variables affecting the quality of maintenance service performance are the following: type of maintenance, availability of spare parts in the country, user training, technological complexity of the equipment, distance between the company and the hospital, and the number of maintenance visits performed by the company. The strength of the results obtained by the Cox model built are supported by the measure of the Rp,e(2) = 0.57 with a value of Rp,e= 0.75. Thus, the model explained 57% of the variation in equipment TAT, with moderate high positive correlation between the dependent variable (TAT) and independent variables.

  6. 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

  7. 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...

  8. Human performance assessment: methods and measures

    International Nuclear Information System (INIS)

    Andresen, Gisle; Droeivoldsmo, Asgeir

    2000-10-01

    The Human Error Analysis Project (HEAP) was initiated in 1994. The aim of the project was to acquire insights on how and why cognitive errors occur when operators are engaged in problem solving in advanced integrated control rooms. Since human error had not been studied in the HAlden Man-Machine LABoratory (HAMMLAB) before, it was also necessary to carry out research in methodology. In retrospect, it is clear that much of the methodological work is relevant to human-machine research in general, and not only to research on human error. The purpose of this report is, therefore, to give practitioners and researchers an overview of the methodological parts of HEAP. The scope of the report is limited to methods used throughout the data acquisition process, i.e., data-collection methods, data-refinement methods, and measurement methods. The data-collection methods include various types of verbal protocols, simulator logs, questionnaires, and interviews. Data-refinement methods involve different applications of the Eyecon system, a flexible data-refinement tool, and small computer programs used for rearranging, reformatting, and aggregating raw-data. Measurement methods involve assessment of diagnostic behaviour, erroneous actions, complexity, task/system performance, situation awareness, and workload. The report concludes that the data-collection methods are generally both reliable and efficient. The data-refinement methods, however, should be easier to use in order to facilitate explorative analyses. Although the series of experiments provided an opportunity for measurement validation, there are still uncertainties connected to several measures, due to their reliability still being unknown. (Author). 58 refs.,7 tabs

  9. 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.

  10. Introducing care pathway commissioning to primary dental care: measuring performance.

    Science.gov (United States)

    Harris, R; Bridgman, C; Ahmad, M; Bowes, L; Haley, R; Saleem, S; Singh, R; Taylor, S

    2011-12-09

    Care pathways have been used in a variety of ways: firstly to support quality improvement through standardising clinical processes, but also for secondary purposes, by purchasers of healthcare, to monitor activity and health outcomes and to commission services. This paper focuses on reporting a secondary use of care pathways: to commission and monitor performance of primary dental care services. Findings of a project involving three dental practices implementing a system based on rating patients according to their risk of disease and need for care are outlined. Data from surgery-based clinical databases and interviews from commissioners and providers are reported. The use of both process and outcome key performance indicators in this context is discussed, as well as issues which arise such as attributability of outcome measures and strategic approaches to improving quality of care.

  11. Performance measurements of hybrid PIN diode arrays

    International Nuclear Information System (INIS)

    Jernigan, J.G.; Arens, J.F.; Collins, T.; Herring, J.; Shapiro, S.L.; Wilburn, C.D.

    1990-05-01

    We report on the successful effort to develop hybrid PIN diode arrays and to demonstrate their potential as components of vertex detectors. Hybrid pixel arrays have been fabricated by the Hughes Aircraft Co. by bump bonding readout chips developed by Hughes to an array of PIN diodes manufactured by Micron Semiconductor Inc. These hybrid pixel arrays were constructed in two configurations. One array format having 10 x 64 pixels, each 120 μm square, and the other format having 256 x 256 pixels, each 30 μm square. In both cases, the thickness of the PIN diode layer is 300 μm. Measurements of detector performance show that excellent position resolution can be achieved by interpolation. By determining the centroid of the charge cloud which spreads charge into a number of neighboring pixels, a spatial resolution of a few microns has been attained. The noise has been measured to be about 300 electrons (rms) at room temperature, as expected from KTC and dark current considerations, yielding a signal-to-noise ratio of about 100 for minimum ionizing particles. 4 refs., 13 figs

  12. VPN (Virtual Private Network) Performance Measurements

    Energy Technology Data Exchange (ETDEWEB)

    Calderon, Calixto; Goncalves, Joao G.M.; Sequeira, Vitor [Joint Research Centre, Ispra (Italy). Inst. for the Protection and Security of the Citizen; Vandaele, Roland; Meylemans, Paul [European Commission, DG-TREN (Luxembourg)

    2003-05-01

    Virtual Private Networks (VPN) is an important technology allowing for secure communications through insecure transmission media (i.e., Internet) by adding authentication and encryption to the existing protocols. This paper describes some VPN performance indicators measured over international communication links. An ISDN based VPN link was established between the Joint Research Centre, Ispra site, Italy, and EURATOM Safeguards in Luxembourg. This link connected two EURATOM Safeguards FAST surveillance stations, and used different vendor solutions hardware (Cisco router 1720 and Nokia CC-500 Gateway). To authenticate and secure this international link, we have used several methods at the different levels of the seven-layered ISO network protocol stack (i.e., Callback feature, CHAP - Challenge Handshake Protocol - authentication protocol). The tests made involved the use of different encryption algorithms and the way session secret keys are periodically renewed, considering these elements influence significantly the transmission throughput. Future tests will include the use of a wide variety of wireless media transmission and terminal equipment technologies, in particular PDAs (Personal Digital Assistants) and Notebook PCs. These tests aim at characterising the functionality of VPNs whenever field inspectors wish to contact headquarters to access information from a central archive database or transmit local measurements or documents. These technologies cover wireless transmission needs at different geographical scales: roombased level Bluetooth, floor or building level Wi-Fi and region or country level GPRS.

  13. Quantitative clinical uptake measurements using conjugate counting

    International Nuclear Information System (INIS)

    Lathrop, K.A.; Bartlett, R.D.; Chen, C.T.; Chou, J.S.; Faulhaber, P.F.; Harper, P.V.; Stark, V.J.

    1986-01-01

    While the use of conjugate counting for determination of organ uptake in human subjects has been extensively described, in the present study the determination of the organ uptake of ortho-iodohippurate presented several opportunities for validation of the in vivo counting data. Ortho-iodohippurate is distributed in the extracellular space, is largely extracted on each pass through the kidneys, and is not significantly deiodinated in vivo. Thus, the kidney uptake rate should be proportional to the blood level, the appearance rate of activity in the bladder is equal to the disappearance rate from the kidneys, and direct measurement of activity in the urine after voiding provides an internal standard for imaging measurements of bladder activity. Since the activity levels in the kidneys, bladder, and remainder of the body changed fairly rapidly, especially in the first 20 to 30 minutes following injection, posterior images of the trunk including kidneys and bladder were obtained continuously using a gamma camera fitted with a diverging collimator for 30 minutes and then at intervals for several hours. Simultaneous conjugate counting determinations were made using a whole body scanning system previously described at these meetings. Imaging data corrected for decay and adjacent background were fitted by least squares methods to curves representing a sum of exponentials, and the curves were normalized to the conjugate uptake measurements. The uptake curves of the kidneys and bladder matched well with the direct measurements of the urinary excretion. Data were collected in 16 normal subjects, and the estimated absorbed dose was calculated for the kidneys, the bladder and the remainder of the body for seven radioisotopes of iodine. 4 references, 6 figures, 2 tables

  14. 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.

  15. Effects of Clinical Mastitis on Reproductive Performance in Holstein Cows

    OpenAIRE

    A. Gunay; U. Gunay

    2008-01-01

    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 serv...

  16. 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 ...

  17. 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.

  18. 45 CFR 305.40 - Penalty performance measures and levels.

    Science.gov (United States)

    2010-10-01

    ... HUMAN SERVICES PROGRAM PERFORMANCE MEASURES, STANDARDS, FINANCIAL INCENTIVES, AND PENALTIES § 305.40 Penalty performance measures and levels. (a) There are three performance measures for which States must... 45 Public Welfare 2 2010-10-01 2010-10-01 false Penalty performance measures and levels. 305.40...

  19. Learning strategies during clerkships and their effects on clinical performance.

    Science.gov (United States)

    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.

  20. 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....

  1. Composite measures for profiling hospitals on bariatric surgery performance

    Science.gov (United States)

    Dimick, Justin B.; Birkmeyer, Nancy J.; Finks, Jonathan F.; Share, David A.; English, Wayne J.; Carlin, Arthur M.; Birkmeyer, John D.

    2014-01-01

    Objective We sought to develop a novel composite measure for profiling hospital performance with bariatric surgery. Design, Setting, and Patients Using clinical registry data from the Michigan Bariatric Surgery Collaborative (MBSC), we studied all patients undergoing bariatric surgery from 2008 to 2010. For gastric bypass surgery, we used empirical Bayes techniques to create a composite measure by combining several measures, including serious complications, reoperations, and readmissions; hospital and surgeon volume; and outcomes with other, related procedures. Hospitals were ranked based on 2008-09 and placed in one of 3 groups: 3-star (top third), 2-star (middle third), and 1-star (bottom third). We assessed how well these ratings predicted outcomes in the next year (2010), compared to other widely used measures. Main Outcome Measures Risk-adjusted serious complications. Results Composite measures explained a larger proportion of hospital-level variation in serious complication rates with gastric bypass than other measures. For example, the composite measure explained 89% of the variation compared to only 28% for risk-adjusted complication rates alone. Composite measures also appeared better at predicting future performance compared to individual measures. When ranked on the composite measure, 1-star hospitals (bottom 20%), had 2-fold higher serious complication rates (4.6% vs. 2.4%; OR 2.0; 95% CI, 1.1 to 3.5) compared to 3-star (top 20%) hospitals. Differences in serious complications rates between 1-star and 3-star hospitals were much smaller when hospitals were ranked using serious complications (4.0% vs. 2.7%; OR 1.6; 95% CI, 0.8-2.9) and hospital volume (3.3% vs. 3.2%; OR 0.85; 95% CI, 0.4 to 1.7) Conclusions Composite measures are much better at explaining hospital-level variation in serious complications and predicting future performance than other approaches. In this preliminary study, it appears that such composite measures may be better than existing

  2. Radioimmunoassay of erythropoietin: analytical performance and clinical use in hematology.

    Science.gov (United States)

    Schlageter, M H; Toubert, M E; Podgorniak, M P; Najean, Y

    1990-10-01

    We report here the performance of a recently commercialized radioimmunoassay kit for determining erythropoietin (EPO) in serum or plasma. The lower detection limit of the method was 3 U/L. Precision, analyzed by the variation coefficients between different assay runs and in the same experiment, was always less than 10%; accuracy was assessed by recovery and dilution tests. In anemic patients (hematocrit 18-39%), the concentration of EPO was logarithmically related to hematocrit. A relatively large dispersion of the results was noted, as reported by others with various RIAs. Patients with severe renal failure demonstrated a very low EPO value, whatever the degree of their anemia. In some chronic anemias resulting from malignancy, EPO concentrations were also relatively low. In the polycythemia vera group, the EPO mean was below normal for greater than 95% of the patients, whatever their clinical stage (first evaluation, relapse, or remission). In contrast, 91% of the patients with pure erythrocytosis had a normal or increased EPO value, even when the etiology was unknown. Measurement of EPO concentration may be useful for the clinical differentiation of myeloproliferative disorders and, subsequently, for their prognosis and choice of treatment.

  3. Developing an instrument to measure effective factors on clinical learning

    Directory of Open Access Journals (Sweden)

    IDEH DADGARAN

    2016-07-01

    Full Text Available Introduction: Although nursing students spend a large part of their learning period in the clinical environment, clinical learning has not been perceived by its nature yet. To develop an instrument to measure effective factors on clinical learning in nursing students. Methods: This is a mixed methods study performed in 2 steps. First, the researchers defined “clinical learning” in nursing students through qualitative content analysis and designed items of the questionnaire based on semi-structured individual interviews with nursing students. Then, as the second step, psychometric properties of the questionnaire were evaluated using the face validity, content validity, construct validity, and internal consistency evaluated on 227 students from fourth or higher semesters. All the interviews were recorded and transcribed, and then, they were analyzed using Max Qualitative Data Analysis and all of qualitative data were analyzed using SPSS 14. Results: To do the study, we constructed the preliminary questionnaire containing 102 expressions. After determination of face and content validities by qualitative and quantitative approaches, the expressions of the questionnaire were reduced to 45. To determine the construct validity, exploratory factor analysis was applied. The results indicated that the maximum variance percentage (40.55% was defined by the first 3 factors while the rest of the total variance percentage (59.45% was determined by the other 42 factors. Results of exploratory factor analysis of this questionnaire indicated the presence of 3 instructor-staff, students, and educational related factors. Finally, 41 expressions were kept in 3 factor groups. The α-Cronbach coefficient (0.93 confirmed the high internal consistency of the questionnaire. Conclusion: Results indicated that the prepared questionnaire was an efficient instrument in the study of the effective factors on clinical learning as viewed by nursing students since it

  4. Evaluation of emergency department performance - a systematic review on recommended performance and quality-in-care measures.

    Science.gov (United States)

    Sørup, Christian Michel; Jacobsen, Peter; Forberg, Jakob Lundager

    2013-08-09

    Evaluation of emergency department (ED) performance remains a difficult task due to the lack of consensus on performance measures that reflects high quality, efficiency, and sustainability. To describe, map, and critically evaluate which performance measures that the published literature regard as being most relevant in assessing overall ED performance. Following the PRISMA guidelines, a systematic literature review of review articles reporting accentuated ED performance measures was conducted in the databases of PubMed, Cochrane Library, and Web of Science. Study eligibility criteria includes: 1) the main purpose was to discuss, analyse, or promote performance measures best reflecting ED performance, 2) the article was a review article, and 3) the article reported macro-level performance measures, thus reflecting an overall departmental performance level. A number of articles addresses this study's objective (n = 14 of 46 unique hits). Time intervals and patient-related measures were dominant in the identified performance measures in review articles from US, UK, Sweden and Canada. Length of stay (LOS), time between patient arrival to initial clinical assessment, and time between patient arrivals to admission were highlighted by the majority of articles. Concurrently, "patients left without being seen" (LWBS), unplanned re-attendance within a maximum of 72 hours, mortality/morbidity, and number of unintended incidents were the most highlighted performance measures that related directly to the patient. Performance measures related to employees were only stated in two of the 14 included articles. A total of 55 ED performance measures were identified. ED time intervals were the most recommended performance measures followed by patient centeredness and safety performance measures. ED employee related performance measures were rarely mentioned in the investigated literature. The study's results allow for advancement towards improved performance measurement and

  5. On model selections for repeated measurement data in clinical studies.

    Science.gov (United States)

    Zou, Baiming; Jin, Bo; Koch, Gary G; Zhou, Haibo; Borst, Stephen E; Menon, Sandeep; Shuster, Jonathan J

    2015-05-10

    Repeated measurement designs have been widely used in various randomized controlled trials for evaluating long-term intervention efficacies. For some clinical trials, the primary research question is how to compare two treatments at a fixed time, using a t-test. Although simple, robust, and convenient, this type of analysis fails to utilize a large amount of collected information. Alternatively, the mixed-effects model is commonly used for repeated measurement data. It models all available data jointly and allows explicit assessment of the overall treatment effects across the entire time spectrum. In this paper, we propose an analytic strategy for longitudinal clinical trial data where the mixed-effects model is coupled with a model selection scheme. The proposed test statistics not only make full use of all available data but also utilize the information from the optimal model deemed for the data. The performance of the proposed method under various setups, including different data missing mechanisms, is evaluated via extensive Monte Carlo simulations. Our numerical results demonstrate that the proposed analytic procedure is more powerful than the t-test when the primary interest is to test for the treatment effect at the last time point. Simulations also reveal that the proposed method outperforms the usual mixed-effects model for testing the overall treatment effects across time. In addition, the proposed framework is more robust and flexible in dealing with missing data compared with several competing methods. The utility of the proposed method is demonstrated by analyzing a clinical trial on the cognitive effect of testosterone in geriatric men with low baseline testosterone levels. Copyright © 2015 John Wiley & Sons, Ltd.

  6. Use of outcome measures in pulmonary hypertension clinical trials.

    Science.gov (United States)

    Parikh, Kishan S; Rajagopal, Sudarshan; Arges, Kristine; Ahmad, Tariq; Sivak, Joseph; Kaul, Prashant; Shah, Svati H; Tapson, Victor; Velazquez, Eric J; Douglas, Pamela S; Samad, Zainab

    2015-09-01

    To evaluate the use of surrogate measures in pulmonary hypertension (PH) clinical trials and how it relates to clinical practice. Studies of pulmonary arterial hypertension (PAH) employ a variety of surrogate measures in addition to clinical events because of a small patient population, participant burden, and costs. The use of these measures in PH drug trials is poorly defined. We searched PubMed/MEDLINE/Embase for randomized or prospective cohort PAH clinical treatment trials from 1985 to 2013. Extracted data included intervention, trial duration, study design, patient characteristics, and primary and secondary outcome measures. To compare with clinical practice, we assessed the use of surrogate measures in a clinical sample of patients on PH medications at Duke University Medical Center between 2003 and 2014. Between 1985 and 2013, 126 PAH trials were identified and analyzed. Surrogate measures served as primary endpoints in 119 trials (94.0%). Inclusion of invasive hemodynamics decreased over time (78.6%, 75.0%, 52.2%; P for trend = .02), while functional testing (7.1%, 60.0%, 81.5%; P for trend clinical assessments regularly incorporated serial echocardiography and 6-minute walk distance tests (92% and 95% of patients, respectively) and repeat measurement of invasive hemodynamics (46% of patients). The majority of PAH trials have utilized surrogate measures as primary endpoints. The use of these surrogate endpoints has evolved significantly over time with increasing use of patient-centered endpoints and decreasing or stable use of imaging and invasive measures. In contrast, imaging and invasive measures are commonly used in contemporary clinical practice. Further research is needed to validate and standardize currently used measures. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. 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.

  8. High Job Performance Through Co-Developing Performance Measures With Employees

    NARCIS (Netherlands)

    Groen, Bianca A.C.; Wilderom, Celeste P.M.; Wouters, Marc

    2017-01-01

    According to various studies, employee participation in the development of performance measures can increase job performance. This study focuses on how this job performance elevation occurs. We hypothesize that when employees have participated in the development of performance measures, they

  9. Semi-spontaneous oral text production: measurements in clinical practice.

    Science.gov (United States)

    Lind, Marianne; Kristoffersen, Kristian Emil; Moen, Inger; Simonsen, Hanne Gram

    2009-12-01

    Functionally relevant assessment of the language production of speakers with aphasia should include assessment of connected speech production. Despite the ecological validity of everyday conversations, more controlled and monological types of texts may be easier to obtain and analyse in clinical practice. This article discusses some simple measurements for the analysis of semi-spontaneous oral text production by speakers with aphasia. Specifically, the measurements are related to the production of verbs and nouns, and the realization of different sentence types. The proposed measurements should be clinically relevant, easily applicable, and linguistically meaningful. The measurements have been applied to oral descriptions of the 'Cookie Theft' picture by eight monolingual Norwegian speakers, four with an anomic type of aphasia and four without any type of language impairment. Despite individual differences in both the clinical and the non-clinical group, most of the measurements seem to distinguish between speakers with and without aphasia.

  10. CONSIDERATIONS ON MEASURING PERFORMANCE AND MARKET STRUCTURE

    OpenAIRE

    Spiridon Cosmin Alexandru

    2011-01-01

    According to neoclassical theory, the relationship between the price, respectively of marginal cost and market structures, the methods for determining the performance of a firm or of an industry, deviate from the model of perfect competition. Assessing performance involves performing comparisons, reporting that their reference level can be a standard value, or a statistical value which can be a national-regional average, a homogeneous group, or an average value at a market level. Modern theor...

  11. 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.

  12. 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

  13. Developing integrated benchmarks for DOE performance measurement

    Energy Technology Data Exchange (ETDEWEB)

    Barancik, J.I.; Kramer, C.F.; Thode, Jr. H.C.

    1992-09-30

    The objectives of this task were to describe and evaluate selected existing sources of information on occupational safety and health with emphasis on hazard and exposure assessment, abatement, training, reporting, and control identifying for exposure and outcome in preparation for developing DOE performance benchmarks. Existing resources and methodologies were assessed for their potential use as practical performance benchmarks. Strengths and limitations of current data resources were identified. Guidelines were outlined for developing new or improved performance factors, which then could become the basis for selecting performance benchmarks. Data bases for non-DOE comparison populations were identified so that DOE performance could be assessed relative to non-DOE occupational and industrial groups. Systems approaches were described which can be used to link hazards and exposure, event occurrence, and adverse outcome factors, as needed to generate valid, reliable, and predictive performance benchmarks. Data bases were identified which contain information relevant to one or more performance assessment categories . A list of 72 potential performance benchmarks was prepared to illustrate the kinds of information that can be produced through a benchmark development program. Current information resources which may be used to develop potential performance benchmarks are limited. There is need to develop an occupational safety and health information and data system in DOE, which is capable of incorporating demonstrated and documented performance benchmarks prior to, or concurrent with the development of hardware and software. A key to the success of this systems approach is rigorous development and demonstration of performance benchmark equivalents to users of such data before system hardware and software commitments are institutionalized.

  14. Measuring Student Performance in General Organic Chemistry

    Science.gov (United States)

    Austin, Ara C.; Ben-Daat, Hagit; Zhu, Mary; Atkinson, Robert; Barrows, Nathan; Gould, Ian R.

    2015-01-01

    Student performance in general organic chemistry courses is determined by a wide range of factors including cognitive ability, motivation and cultural capital. Previous work on cognitive factors has tended to focus on specific areas rather than exploring performance across all problem types and cognitive skills. In this study, we have categorized…

  15. Performance measures for public transit mobility management.

    Science.gov (United States)

    2011-12-01

    "Mobility management is an innovative approach for managing and delivering coordinated public : transportation services that embraces the full family of public transit options. At a national level, there are : currently no industry recognized perform...

  16. Measured performance of the GTA rf systems

    International Nuclear Information System (INIS)

    Denney, P.M.; Jachim, S.P.

    1993-01-01

    This paper describes the performance of the RF systems on the Ground Test Accelerator (GTA). The RF system architecture is briefly described. Among the RF performance results presented are RF field flatness and stability, amplitude and phase control resolution, and control system bandwidth and stability. The rejection by the RF systems of beam-induced disturbances, such as transients and noise, are analyzed. The observed responses are also compared to computer-based simulations of the RF systems for validation

  17. Performance Measurement Systems in Swedish Health Care Services

    OpenAIRE

    Kollberg, Beata

    2007-01-01

    In the quality management literature, measurements are attributed great importance in improving products and processes. Systems for performance measurement assessing financial and non-financial measurements were developed in the late 1980s and early 1990s. The research on performance measurement systems has mainly been focused on the design of different performance measurement systems. Many authors are occupied with the study of the constructs of measures and developing prescriptive models of...

  18. Measuring collections effort improves cash performance.

    Science.gov (United States)

    Shutts, Joe

    2009-09-01

    Having a satisfied work force can lead to an improved collections effort. Hiring the right people and training them ensures employee engagement. Measuring collections effort and offering incentives is key to revenue cycle success.

  19. 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.

  20. ECG dispersion mapping predicts clinical deterioration, measured by increase in the Simple Clinical Score.

    LENUS (Irish Health Repository)

    Kellett, J

    2012-01-01

    Objective: ECG dispersion mapping (ECG-DM) is a novel technique that reports abnormal ECG microalternations. We report the ability of ECG-DM to predict clinical deterioration of acutely ill medical patients, as measured by an increase in the Simple Clinical Score (SCS) the day after admission to hospital. Methods: 453 acutely ill medical patients (mean age 69.7 +\\/- 14.0 years) had the SCS recorded and ECGDM performed immediately after admission to hospital. Results: 46 patients had an SCS increase 20.8 +\\/- 7.6 hours after admission. Abnormal micro-alternations during left ventricular re-polarization had the highest association with SCS increase (p=0.0005). Logistic regression showed that only nursing home residence and abnormal micro-alternations during re-polarization of the left ventricle were independent predictors of SCS increase with an odds ratio of 2.84 and 3.01, respectively. Conclusion: ECG-DM changes during left ventricular re-polarization are independent predictors of clinical deterioration the day after hospital admission.

  1. Clinical assessment of the accuracy of blood glucose measurement devices.

    Science.gov (United States)

    Pfützner, Andreas; Mitri, Michael; Musholt, Petra B; Sachsenheimer, Daniela; Borchert, Marcus; Yap, Andrew; Forst, Thomas

    2012-04-01

    Blood glucose meters for patient self-measurement need to comply with the accuracy standards of the ISO 15197 guideline. We investigated the accuracy of the two new blood glucose meters BG*Star and iBG*Star (Sanofi-Aventis) in comparison to four other competitive devices (Accu-Chek Aviva, Roche Diagnostics; FreeStyle Freedom Lite, Abbott Medisense; Contour, Bayer; OneTouch Ultra 2, Lifescan) at different blood glucose ranges in a clinical setting with healthy subjects and patients with type 1 and type 2 diabetes. BGStar and iBGStar are employ dynamic electrochemistry, which is supposed to result in highly accurate results. The study was performed on 106 participants (53 female, 53 male, age (mean ± SD): 46 ± 16 years, type 1: 32 patients, type 2: 34 patients, and 40 healthy subjects). Two devices from each type and strips from two different production lots were used for glucose assessment (∼200 readings/meter). Spontaneous glucose assessments and glucose or insulin interventions under medical supervision were applied to perform measurements in the different glucose ranges in accordance with the ISO 15197 requirements. Sample values 400 mg/dL were prepared by laboratory manipulations. The YSI glucose analyzer (glucose oxidase method) served as the standard reference method which may be considered to be a limitation in light of glucose hexokinase-based meters. For all devices, there was a very close correlation between the glucose results compared to the YSI reference method results. The correlation coefficients were r = 0.995 for BGStar and r = 0.992 for iBGStar (Aviva: 0.995, Freedom Lite: 0.990, Contour: 0.993, Ultra 2: 0.990). Error-grid analysis according to Parkes and Clarke revealed both 100% of the readings to be within the clinically acceptable areas (Clarke: A + B with BG*Star (100 + 0), Aviva (97 + 3), and Contour (97 + 3); and 99.5% with iBG*Star (97.5 + 2), Freedom Lite (98 + 1.5), and Ultra 2 (97.5 + 2

  2. 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

  3. 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...

  4. Are estimates of meaningful decline in mobility performance consistent among clinically important subgroups? (Health ABC Study).

    NARCIS (Netherlands)

    Perera, S.; Studenski, S.; Newman, A.; Simonsick, E.; Harris, T.; Schwartz, A.; Visser, M.

    2014-01-01

    Background: Meaningful change criteria help determine if function has improved or declined, but their magnitudes may vary across clinically relevant subgroups. We estimate meaningful decline in four common measures of physical performance in subgroups of older adults based on initial performance,

  5. Reduction in the balanced scorecard performance measurement ...

    African Journals Online (AJOL)

    In this paper, we compare PCA and ordinal logistic regression in ranking the manufacturing systems. In this regard we present an integrated framework for assessment and ranking of manufacturing systems based on management and organizational performance indicators. To achieve the objectives of this study, ...

  6. Measuring Institutional Performance in Higher Education.

    Science.gov (United States)

    Meyerson, Joel W., Ed.; Massy, William F., Ed.

    This collection of seven essays from the Stanford Forum for Higher Education Futures focuses on how downsizing, quality management, and reengineering have are affecting higher education. An introductory paper, "Introduction: Change in Higher Education: Its Effect on Institutional Performance," (Joel W. Meyerson and Sandra L. Johnson)…

  7. 75 FR 38725 - Service Performance Measurement

    Science.gov (United States)

    2010-07-06

    ... proposed rules against the importance of the information that is being gathered. This would have provided... Commission is adopting a final rule on service perfomance measurement and customer satisfaction. The final... is effective on August 5, 2010. FOR FURTHER INFORMATION CONTACT: Stephen L. Sharfman, General Counsel...

  8. CONFOCAL MICROSCOPY SYSTEM PERFORMANCE: LASER POWER MEASUREMENTS

    Science.gov (United States)

    Laser power abstract The reliability of the confocal laser-scanning microscope (CLSM) to obtain intensity measurements and quantify fluorescence data is dependent on using a correctly aligned machine that contains a stable laser power. The laser power test appears to be one ...

  9. 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.)

  10. Measurements of operator performance - an experimental setup

    International Nuclear Information System (INIS)

    Netland, K.

    1980-01-01

    The human has to be considered as an important element in a process control system, even if the degree of automation is extremely high. Other elements, e.g. computer, displays, etc., can to a large extent be described and quantified. The human (operator), is difficult to describe in a precise way, and it is just as difficult to predict his thinking and acting in a control room environment. Many factors influence his performance, such as: experience, motivation, level of knowledge, training, control environment, job organization, etc. These factors have to a certain degree to be described before guidelines for design of the man-process interfaces and the control room layout can be developed. For decades, the psychological science has obtained knowledge of the human mind and behaviour. This knowledge should have the potential of a positive input on our effort to describe the factors influencing the operator performance. Even if the human is complex, a better understanding of his thinking and acting, and a more precise description of the factors influencing his performance can be obtained. At OECD Halden Reactor Project an experimental set-up for such studies has been developed and implemented in the computer laboratory. The present set-up includes elements as a computer- and display-based control room, a simulator representing a nuclear power plant, training programme for the subjects, and methods for the experiments. Set-up modules allow reconfiguration of experiments. (orig./HP)

  11. Evaluating performance measures to determine training effectiveness

    International Nuclear Information System (INIS)

    Klemm, R.W.; Feiza, A.S.

    1987-01-01

    This research was conceived and dedicated to helping the CECo training organization become a more integrated part of the corporate business. The target population for this study was nuclear and fossil generating station employees who directly impacted the production of electricity. The target sample (n = 150) included: instrument, mechanical, and electrical maintenance personnel; control room operators; engineers, radiation chemists, and other technical specialists; and equipment operators and attendants. A total of four instruments were utilized by this study. Three instruments were administered to the generating station personnel. These included a demographic form, a learning style profile, and a motivational style profile. The focal instrument, a performance skills rating form, was administered to supervisory personnel. Data analysis consisted of three major parts. Part one established internal consistency through Cronbach alpha statistics. Part two provides summary statistics and breakdown tables for important variables. Part three provides inferential statistics responding to the research questions. All six Performance Skills variables discriminated significantly between the trained and non-trained groups (p .001). In all cases, the mean value for the trained group exceeded the mean value for the non-trained group. Implications for further research indicate that training does have a quantifiable effect on job performance

  12. 26 CFR 801.2 - Measuring organizational performance.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 20 2010-04-01 2010-04-01 false Measuring organizational performance. 801.2 Section 801.2 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INTERNAL... REVENUE SERVICE § 801.2 Measuring organizational performance. The performance measures that comprise the...

  13. "Productivity performance measurement - follow-up"

    DEFF Research Database (Denmark)

    Kristensen, Troels

    2008-01-01

    The Danish Ministry of Health has published the third annual report on hospital productivity. This experience has contributed to policy goals becoming more detailed and ambitious. New policy goals are: to include hospital productivity measures at less aggregated levels, to include labour producti...... productivity and hospital psychiatric care, to provide web-based solutions that facilitate access to productivity data, and to develop new classifications of hospital levels related to structural reforms....

  14. The impact of endpoint measures in rheumatoid arthritis clinical trials

    NARCIS (Netherlands)

    van der Heide, A.; Jacobs, J. W.; Dinant, H. J.; Bijlsma, J. W.

    1992-01-01

    In clinical trials on the effectiveness of disease-modifying antirheumatic drugs (DMARDs) in patients with rheumatoid arthritis (RA), it is common to apply a large number of endpoint measures. This practice has several disadvantages. To determine which endpoint measures are most valuable, reports of

  15. Measuring systemic performance of the Lithuanian government

    OpenAIRE

    Nakrošis, Vitalis

    2008-01-01

    This paper seeks assessing the dynamics of Lithuania's governmental perfor­mance and comparing it to other countries. It draws on a simple logical model, linking the inputs of the government to its outputs and outcomes. It was found that performance of the Lithuanian government is average and even poor, if compared with the EU aver­age or such countries as Estonia and Ireland. This is despite the fact the public mode of production is rather expensive in Lithuania and the number of public empl...

  16. 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.

  17. Measuring performances of linux hyper visors

    International Nuclear Information System (INIS)

    Chierici, A.; Veraldi, R.; Salomoni, D.

    2009-01-01

    Virtualisation is a now proven software technology that is rapidly transforming the I T landscape and fundamentally changing the way people make computations and implement services. Recently, all major software producers (e.g., Microsoft and Red Hat) developed or acquired virtualisation technologies. Our institute (http://www.CNAF.INFN.it) is a Tier l for experiments carried on at the Large Hadron Collider at CERN (http://lhc.web.CERN.ch/lhc/) and is experiencing several benefits from virtualisation technologies, like improving fault tolerance, providing efficient hardware resource usage and increasing security. Currently, the virtualisation solution we adopted is xen, which is well supported by the Scientific Linux distribution, widely used by the High-Energy Physics (HEP) community. Since Scientific Linux is based on Red Hat E S, we felt the need to investigate performances and usability differences with the new k vm technology, recently acquired by Red Hat. The case study of this work is the Tier2 site for the LHCb experiment hosted at our institute; all major grid elements for this Tier2 run on xen virtual machines smoothly. We will investigate the impact on performance and stability that a migration to k vm would entail on the Tier2 site, as well as the effort required by a system administrator to deploy the migration.

  18. Study of the Relationship Between Nurse Self-Concept and Clinical Performance Among Nursing Students

    Directory of Open Access Journals (Sweden)

    Badiyepeymaie Jahromi

    2015-09-01

    Full Text Available Background Scholars believe that if nursing students appreciate the value of their services, their sense of professionalism will increase and performance will improve. Nevertheless, little is known about the relationship between nursing students’ professional self-concept and clinical performance. Objectives This study examines the relationship between nurse self-concept and clinical performance among nursing students. Patients and Methods This cross-sectional analytical study employed the census method. The sample comprised 86 senior and junior nursing students at Jahrom university of medical sciences. Nurse self-concept and clinical performance were measured by using the nurses’ self-concept questionnaire (NSCQ, and the 6-dimension scale of nurse performance (6-DSNP, respectively. Results The mean and standard deviation of nurse self-concept and clinical performance scores were 5.46 ± 1.11 and 2.94 ± 1.45, respectively. Nurse self-concept was related to clinical performance (r = 0.24, P = 0.02. Total NSCQ scores were significantly related to four of the 6-DSNP dimensions: planning and evaluation, interpersonal relations and communication, critical care, and leadership. Conclusions Attempts should be made to enhance students’ nurse self-concept during their education. Counseling, improving public respect for nurses, and implementing measures to enhance students’ professional self-concept are essential for improving their performance.

  19. Drivers of Performance Measurement Use: Empirical Evidence from Serbia

    Directory of Open Access Journals (Sweden)

    Miloš Milosavljević

    2016-05-01

    Full Text Available In the last decades, the interest of academics and practitioners for the efficiency of performance measurement system use has grown rapidly. The aim of this paper is to examine, articulate and test the relationship between maturity of performance measurement systems, strategic compliance of performance measurement and managerial orientation, on one side, and the portfolio of performance measurement uses, on the other. Data were collected from 86 Serbian companies. The results indicate that the most influential factor for diversified use of performance measurement is the maturity of the system. The paper also discusses theoretical contributions, implications for managers and scholars, and recommendations for decision-makers.

  20. Analysis of Nurse's Clinical Education Performance based on Work Theory and The Indicator of Competence

    Directory of Open Access Journals (Sweden)

    Srinalesti Mahanani

    2016-09-01

    Full Text Available Introduction: Clinical Learning is a process of transformation of the student to become a professional nurse. Clinical Nurse Educator contributes to improve the quality of clinical learning because of variety of roles ranging from planning, implementing and evaluating learning clinical practice. Improving the quality of clinical practice learning, can be reached by improving the performance of Clinical Nurse Educator. The aim of this study was to know the effect of psychological variables and organizational variables to the competence and performance of Clinical Nurse Educators. Sample was Clinical Nurse Educators who work inpatient wards at Kediri Baptist Hospital inpatient wards. Method: This study was conducted in two stages. Phase I measure the competence and performance of Clinical Nurse Educator by Supervisor and students, as well as psychological variables and organizational variables by using questionnaires. Phase II was done by Focused Group Discussion to discuss about the variables that affect Clinical Nurse Educator performance. Data processed using Partial Least Square with α = 0.05, path coefficient = 0.5 and t table = 1.96. Result: The results of this research is showed that Performance Nurse Educator can be improved by increasing Individual Competence with path coefficient= 0.600 and t = 6.741. The individual competence will be increase by improving pscychological aspect nurse educator such as perception, personal aspect, motivation, learning skill and attitude with path coefficient = 0.518 and t = 2.715. Psycological Aspect can be increasing by improving Organization Variable such as Organization Resource, Salary, Organization Structure and Job Description with path coefficient = 0.825 and t = 19.658. Discussion: The conclusion of this result that increase of nurse educator competence and performance can be effort by improving psycological aspect and organizational variable Keywords: competence, performance, clinical nurse

  1. Does adding clinical data to administrative data improve agreement among hospital quality measures?

    Science.gov (United States)

    Hanchate, Amresh D; Stolzmann, Kelly L; Rosen, Amy K; Fink, Aaron S; Shwartz, Michael; Ash, Arlene S; Abdulkerim, Hassen; Pugh, Mary Jo V; Shokeen, Priti; Borzecki, Ann

    2017-09-01

    Hospital performance measures based on patient mortality and readmission have indicated modest rates of agreement. We examined if combining clinical data on laboratory tests and vital signs with administrative data leads to improved agreement with each other, and with other measures of hospital performance in the nation's largest integrated health care system. We used patient-level administrative and clinical data, and hospital-level data on quality indicators, for 2007-2010 from the Veterans Health Administration (VA). For patients admitted for acute myocardial infarction (AMI), heart failure (HF) and pneumonia we examined changes in hospital performance on 30-d mortality and 30-d readmission rates as a result of adding clinical data to administrative data. We evaluated whether this enhancement yielded improved measures of hospital quality, based on concordance with other hospital quality indicators. For 30-d mortality, data enhancement improved model performance, and significantly changed hospital performance profiles; for 30-d readmission, the impact was modest. Concordance between enhanced measures of both outcomes, and with other hospital quality measures - including Joint Commission process measures, VA Surgical Quality Improvement Program (VASQIP) mortality and morbidity, and case volume - remained poor. Adding laboratory tests and vital signs to measure hospital performance on mortality and readmission did not improve the poor rates of agreement across hospital quality indicators in the VA. Efforts to improve risk adjustment models should continue; however, evidence of validation should precede their use as reliable measures of quality. Published by Elsevier Inc.

  2. Predicting failing performance on a standardized patient clinical performance examination: the importance of communication and professionalism skills deficits.

    Science.gov (United States)

    Chang, Anna; Boscardin, Christy; Chou, Calvin L; Loeser, Helen; Hauer, Karen E

    2009-10-01

    The purpose is to determine which assessment measures identify medical students at risk of failing a clinical performance examination (CPX). Retrospective case-control, multiyear design, contingency table analysis, n = 149. We identified two predictors of CPX failure in patient-physician interaction skills: low clerkship ratings (odds ratio 1.79, P = .008) and student progress review for communication or professionalism concerns (odds ratio 2.64, P = .002). No assessments predicted CPX failure in clinical skills. Performance concerns in communication and professionalism identify students at risk of failing the patient-physician interaction portion of a CPX. This correlation suggests that both faculty and standardized patients can detect noncognitive traits predictive of failing performance. Early identification of these students may allow for development of a structured supplemental curriculum with increased opportunities for practice and feedback. The lack of predictors in the clinical skills portion suggests limited faculty observation or feedback.

  3. Employee participation in developing performance measures and job performance: on the role of measurement properties and incentives

    NARCIS (Netherlands)

    Groen, B.; Wouters, M.; Wilderom, C.

    2013-01-01

    Involving employees in the development of performance measures often results in better employee job performance. Yet not all prior studies find such a direct effect. This study explains these inconsistent findings. It focuses on the measurement properties of performance measures and using them for

  4. Sources and performance criteria of uncertainty of reference measurement procedures.

    Science.gov (United States)

    Mosca, Andrea; Paleari, Renata

    2018-05-29

    This article wants to focus on the today available Reference Measurement Procedures (RMPs) for the determination of various analytes in Laboratory Medicine and the possible tools to evaluate their performance in the laboratories who are currently using them. A brief review on the RMPs has been performed by investigating the Joint Committee for Traceability in Laboratory Medicine (JCTLM) database. In order to evaluate their performances, we have checked the organization of three international ring trials, i.e. those regularly performed by the IFCC External Quality assessment scheme for Reference Laboratories in Laboratory Medicine (RELA), by the Center for Disease Control and Prevention (CDC) cholesterol network and by the IFCC Network for HbA 1c . Several RMPs are available through the JCTLM database, but the best way to collect information about the RMPs and their uncertainties is to look at the reference measurement service providers (RMS). This part of the database and the background on how to listed in the database is very helpful for the assessment of expanded uncertainty (MU) and performance in general of RMPs. Worldwide, 17 RMS are listed in the database, and for most of the measurands more than one RMS is able to run the relative RMPs, with similar expanded uncertainties. As an example, for a-amylase, 4 SP offer their services with MU between 1.6 and 3.3%. In other cases (such as total cholesterol, the U may span over a broader range, i.e. from 0.02 to 3.6%). With regard to the performance evaluation, the approach is often heterogenous, and it is difficult to compare the performance of laboratories running the same RMP for the same measurand if involved in more than one EQAS. The reference measurement services have been created to help laboratory professionals and manufacturers to implement the correct metrological traceability, and the JCTLM database is the only correct way to retrieve all the necessary important information to this end. Copyright © 2018

  5. A comparative study of performance measurement standards of railway operator

    Directory of Open Access Journals (Sweden)

    Pongjirawut Siripong

    2017-01-01

    Full Text Available The European standard (EN 13816, is one of the widely accepted standards for measuring the quality of public passenger transport (PPT service. EN 13816 indicates 8 measurement criteria, 29 sub-criteria and 193 Key Performance Indicators (KPIs to be used to measure the performance of railway operators. Nowadays, there are other addition criteria beyond EN13816, developed by various organisations. This research firstly aims to explore the service performance measurement of railway operators used by actual railway operators at international level and in Thailand. After an intensive review of performance measurement standards, 9 standards are compiled and compared in terms of criteria, sub-criteria and KPIs using a cluster analysis methodology. The result found additional performance measurement aspects at 2 sub-criteria and 91 KPIs in addition to EN 13816. This research summarized and compared different performance measurement standards to measure service quality of metro rail line.

  6. Performance Measurement of Complex Event Platforms

    Directory of Open Access Journals (Sweden)

    Eva Zámečníková

    2016-12-01

    Full Text Available The aim of this paper is to find and compare existing solutions of complex event processing platforms (CEP. CEP platforms generally serve for processing and/or predicting of high frequency data. We intend to use CEP platform for processing of complex time series and integrate a solution for newly proposed method of decision making. The decision making process will be described by formal grammar. As there are lots of CEP solutions we will take the following characteristics under consideration - the processing in real time, possibility of processing of high volume data from multiple sources, platform independence, platform allowing integration with user solution and open license. At first we will talk about existing CEP tools and their specific way of use in praxis. Then we will mention the design of method for formalization of business rules used for decision making. Afterwards, we focus on two platforms which seem to be the best fit for integration of our solution and we will list the main pros and cons of each approach. Next part is devoted to benchmark platforms for CEP. Final part is devoted to experimental measurements of platform with integrated method for decision support.

  7. Blood Pressure Measurement: Clinic, Home, Ambulatory, and Beyond

    Science.gov (United States)

    Drawz, Paul E.; Abdalla, Mohamed; Rahman, Mahboob

    2014-01-01

    Blood pressure has traditionally been measured in the clinic setting using the auscultory method and a mercury sphygmomanometer. Technological advances have led to improvements in measuring clinic blood pressure and allowed for measuring blood pressures outside the clinic. This review outlines various methods for evaluating blood pressure and the clinical utility of each type of measurement. Home blood pressures and 24 hour ambulatory blood pressures have improved our ability to evaluate risk for target organ damage and hypertension related morbidity and mortality. Measuring home blood pressures may lead to more active participation in health care by patients and has the potential to improve blood pressure control. Ambulatory blood pressure monitoring enables the measuring nighttime blood pressures and diurnal changes, which may be the most accurate predictors of risk associated with elevated blood pressure. Additionally, reducing nighttime blood pressure is feasible and may be an important component of effective antihypertensive therapy. Finally, estimating central aortic pressures and pulse wave velocity are two of the newer methods for assessing blood pressure and hypertension related target organ damage. PMID:22521624

  8. Motor outcome measures in Huntington disease clinical trials.

    Science.gov (United States)

    Reilmann, Ralf; Schubert, Robin

    2017-01-01

    Deficits in motor function are a hallmark of Huntington disease (HD). The Unified Huntington's Disease Rating Scale Total Motor Score (UHDRS-TMS) is a categoric clinical rating scale assessing multiple domains of motor disability in HD. The UHDRS-TMS or subsets of its items have served as primary or secondary endpoints in numerous clinical trials. In spite of a well-established video-based annual online certification system, intra- and interrater variability, subjective error, and rater-induced placebo effects remain a concern. In addition, the UHDRS-TMS was designed to primarily assess motor symptoms in manifest HD. Recently, advancement of technology resulted in the introduction of the objective Q-Motor (i.e., Quantitative-Motor) assessments in biomarker studies and clinical trials in HD. Q-Motor measures detected motor signs in blinded cross-sectional and longitudinal analyses of manifest, prodromal, and premanifest HD cohorts up to two decades before clinical diagnosis. In a multicenter clinical trial in HD, Q-Motor measures were more sensitive than the UHDRS-TMS and exhibited no placebo effects. Thus, Q-Motor measures are currently explored in several multicenter trials targeting both symptomatic and disease-modifying mechanisms. They may supplement the UHDRS-TMS, increase the sensitivity and reliability in proof-of-concept studies, and open the door for phenotype assessments in clinical trials in prodromal and premanifest HD. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Integrating patient satisfaction into performance measurement to meet improvement challenges.

    Science.gov (United States)

    Smith, J E; Fisher, D L; Endorf-Olson, J J

    2000-05-01

    A Value Compass has been proposed to guide health care data collection. The "compass corners" represent the four types of data needed to meet health care customer expectations: appropriate clinical outcomes, improved functional status, patient satisfaction, and appropriate costs. Collection of all four types of data is necessary to select processes in need of improvement, guide improvement teams, and monitor the success of improvement efforts. INTEGRATED DATA AT BRYANLGH: BryanLGH Medical Center in Lincoln, Nebraska, has adopted multiple performance measurement systems to collect clinical outcome, financial, and patient satisfaction data into integrated databases. Data integration allows quality professionals at BryanLGH to identify quality issues from multiple perspectives and track the interrelated effects of improvement efforts. A CASE EXAMPLE: Data from the fourth quarter of 1997 indicated the need to improve processes related to cesarean section (C-section) deliveries. An interdisciplinary team was formed, which focused on educating nurses, physicians, and the community about labor support measures. Physicians were given their own rates of C-section deliveries. The C-section rate decreased from 27% to 19%, but per-case cost increased. PickerPLUS+ results indicated that BryanLGH obstetric patients reported fewer problems with receiving information than the Picker norm, but they reported more problems with the involvement of family members and friends. The data collected so far have indicated a decrease in the C-section rate and a need to continue to work on cost and psychosocial issues. A complete analysis of results was facilitated by integrated performance management systems. Successes have been easily tracked over time, and the need for further work on related processes has been clearly identified.

  10. Clinical audit training improves undergraduates' performance in root canal therapy.

    Science.gov (United States)

    Fong, J Y M; Tan, V J H; Lee, J R; Tong, Z G M; Foong, Y K; Tan, J M E; Parolia, A; Pau, A

    2017-12-20

    To evaluate the effectiveness of clinical audit-feedback cycle as an educational tool in improving the technical quality of root canal therapy (RCT) and compliance with record keeping performed by dental undergraduates. Clinical audit learning was introduced in Year 3 of a 5-year curriculum for dental undergraduates. During classroom activities, students were briefed on clinical audit, selected their audit topics in groups of 5 or 6 students, and prepared and presented their audit protocols. One chosen topic was RCT, in which 3 different cohorts of Year 3 students conducted retrospective audits of patients' records in 2012, 2014 and 2015 for their compliance with recommended record keeping criteria and their performance in RCT. Students were trained by and calibrated against an endodontist (κ ≥ 0.8). After each audit, the findings were reported in class, and recommendations were made for improvement in performance of RCT and record keeping. Students' compliance with published guidelines was presented and their RCT performances in each year were compared using the chi-square test. Overall compliance with of record keeping guidelines was 44.1% in 2012, 79.6% in 2014 and 94.6% in 2015 (P = .001). In the 2012 audit, acceptable extension, condensation and the absence of mishap were observed in 72.4, 75.7% and 91.5%; in the 2014 audit, 95.1%, 64.8% and 51.4%; and in 2015 audit, 96.4%, 82.1% and 92.8% of cases, respectively. In 2015, 76.8% of root canal fillings met all 3 technical quality criteria when compared to 48.6% in 2014 and 44.7% in 2012 (P = .001). Clinical audit-feedback cycle is an effective educational tool for improving dental undergraduates' compliance with record keeping and performance in the technical quality of RCT. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. 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.

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

    Science.gov (United States)

    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.

  13. Do clinical safety charts improve paramedic key performance indicator results? (A clinical improvement programme evaluation).

    Science.gov (United States)

    Ebbs, Phillip; Middleton, Paul M; Bonner, Ann; Loudfoot, Allan; Elliott, Peter

    2012-07-01

    Is the Clinical Safety Chart clinical improvement programme (CIP) effective at improving paramedic key performance indicator (KPI) results within the Ambulance Service of New South Wales? The CIP intervention area was compared with the non-intervention area in order to determine whether there was a statistically significant improvement in KPI results. The CIP was associated with a statistically significant improvement in paramedic KPI results within the intervention area. The strategies used within this CIP are recommended for further consideration.

  14. Performance measurement, expectancy and agency theory: An experimental study

    NARCIS (Netherlands)

    Sloof, R.; van Praag, C.M.

    2008-01-01

    Theoretical analyses of (optimal) performance measures are typically performed within the realm of the linear agency model. This model implies that, for a given compensation scheme, the agent’s optimal effort is unrelated to the amount of noise in the performance measure. In contrast, expectancy

  15. Measuring Effects on the Clinical Practice from a Configured EHR

    DEFF Research Database (Denmark)

    Møller-Jensen, John; Simonsen, Jesper; K. Iversen, Rikke

    2006-01-01

    during a series of workshops with the clinicians after which the XML configuration files were written and deployed. In parallel with this, the participants from the University specified a number of effects related to the clinical practice to be measured. Measurements were focused on the requested effects......The objective of the project was to measure the clinical usability of an EHR configured by use of participatory design with clinicians from a neurological stroke unit in order to get input to the County’s future strategy for incremental implementation of EHR. The content of the EHR was defined...... and acquired using various techniques including questionnaires, interviews, observations, and Task Load Index (TLX) ratings. In total, 15 nursing handovers, 8 ward rounds, and 11 patient conferences involving a total of 35 patients and more than 20 clinicians were included in the measurements. Data from...

  16. Outcome Measures for Clinical Trials in Down Syndrome.

    Science.gov (United States)

    Esbensen, Anna J; Hooper, Stephen R; Fidler, Deborah; Hartley, Sigan L; Edgin, Jamie; d'Ardhuy, Xavier Liogier; Capone, George; Conners, Frances A; Mervis, Carolyn B; Abbeduto, Leonard; Rafii, Michael; Krinsky-McHale, Sharon J; Urv, Tiina

    2017-05-01

    Increasingly individuals with intellectual and developmental disabilities, including Down syndrome, are being targeted for clinical trials. However, a challenge exists in effectively evaluating the outcomes of these new pharmacological interventions. Few empirically evaluated, psychometrically sound outcome measures appropriate for use in clinical trials with individuals with Down syndrome have been identified. To address this challenge, the National Institutes of Health (NIH) assembled leading clinicians and scientists to review existing measures and identify those that currently are appropriate for trials; those that may be appropriate after expansion of age range addition of easier items, and/or downward extension of psychometric norms; and areas where new measures need to be developed. This article focuses on measures in the areas of cognition and behavior.

  17. Development of material measures for performance verifying surface topography measuring instruments

    International Nuclear Information System (INIS)

    Leach, Richard; Giusca, Claudiu; Rickens, Kai; Riemer, Oltmann; Rubert, Paul

    2014-01-01

    The development of two irregular-geometry material measures for performance verifying surface topography measuring instruments is described. The material measures are designed to be used to performance verify tactile and optical areal surface topography measuring instruments. The manufacture of the material measures using diamond turning followed by nickel electroforming is described in detail. Measurement results are then obtained using a traceable stylus instrument and a commercial coherence scanning interferometer, and the results are shown to agree to within the measurement uncertainties. The material measures are now commercially available as part of a suite of material measures aimed at the calibration and performance verification of areal surface topography measuring instruments

  18. Exploring Patient Activation in the Clinic: Measurement from Three Perspectives

    Science.gov (United States)

    Ledford, Christy J. W.; Ledford, Christopher C.; Childress, Marc A.

    2013-01-01

    Objective. To further conceptualize and operationalize patient activation (PA), using measures from patient, physician, and researcher perspectives. Data Source/Study Setting. Multimethod observation in 2010 within a family medicine clinic. Study Design. Part of an intervention with 130 patients with type 2 diabetes, this observational study…

  19. PERFORMANCE MEASURES OF STUDENTS IN EXAMINATIONS: A STOCHASTIC APPROACH

    OpenAIRE

    Goutam Saha; GOUTAM SAHA

    2013-01-01

    Data on Secondary and Higher Secondary examination (science stream) results from Tripura (North-East India) schools are analyzed to measure the performance of students based on tests and also the performance measures of schools based on final results and continuous assessment processes are obtained. The result variation in terms of grade points in the Secondary and Higher Secondary examinations are analysed using different sets of performance measures. The transition probabilities from one g...

  20. Procedure for Measuring and Reporting Commercial Building Energy Performance

    Energy Technology Data Exchange (ETDEWEB)

    Barley, D.; Deru, M.; Pless, S.; Torcellini, P.

    2005-10-01

    This procedure is intended to provide a standard method for measuring and characterizing the energy performance of commercial buildings. The procedure determines the energy consumption, electrical energy demand, and on-site energy production in existing commercial buildings of all types. The performance metrics determined here may be compared against benchmarks to evaluate performance and verify that performance targets have been achieved.

  1. The Aviation Performance Measuring System (APMS): An Integrated Suite of Tools for Measuring Performance and Safety

    Science.gov (United States)

    Statler, Irving C.; Connor, Mary M. (Technical Monitor)

    1998-01-01

    This is a report of work in progress. In it, I summarize the status of the research and development of the Aviation Performance Measuring System (APMS) for managing, processing, and analyzing digital flight-recorded data, The objectives of the NASA-FAA APMS research project are to establish a sound scientific and technological basis for flight-data analysis, to define an open and flexible architecture for flight-data analysis systems, and to articulate guidelines for a standardized database structure on which to continue to build future flight-data-analysis extensions. APMS offers to the air transport community an open, voluntary standard for flight-data-analysis software; a standard that will help to ensure suitable functionality and data interchangeability among competing software programs. APMS will develop and document the methodologies, algorithms, and procedures for data management and analyses to enable users to easily interpret the implications regarding safety and efficiency of operations. APMS does not entail the implementation of a nationwide flight-data-collection system. It is intended to provide technical tools to ease the large-scale implementation of flight-data analyses at both the air-carrier and the national-airspace levels in support of their Flight Operations and Quality Assurance (FOQA) Programs and Advanced Qualifications Programs (AQP). APMS cannot meet its objectives unless it develops tools that go substantially beyond the capabilities of the current commercially available software and supporting analytic methods that are mainly designed to count special events. These existing capabilities, while of proven value, were created primarily with the needs-of aircrews in mind. APMS tools must serve the needs of the government and air carriers, as well as aircrews, to fully support the FOQA and AQP programs. They must be able to derive knowledge not only through the analysis of single flights (special-event detection), but also through

  2. Transportation performance measures for outcome based system management and monitoring.

    Science.gov (United States)

    2014-09-01

    The Oregon Department of Transportation (ODOT) is mature in its development and use of : performance measures, however there was not a standard approach for selecting measures nor : evaluating if existing ones were used to inform decision-making. Thi...

  3. Performance Measures for Public Participation Methods : Final Report

    Science.gov (United States)

    2018-01-01

    Public engagement is an important part of transportation project development, but measuring its effectiveness is typically piecemealed. Performance measurementdescribed by the Urban Institute as the measurement on a regular basis of the results (o...

  4. Measuring the marketing performances of state forest enterprises in ...

    African Journals Online (AJOL)

    Measuring the marketing performances of state forest enterprises in Turkey. ... This study covers a limited period of time (1999 - 2003), and 41 variables were developed in order to measure the marketing ... AJOL African Journals Online.

  5. Joint Integration Test Facility (JITF) Engineering II Performance Measurement Plans

    National Research Council Canada - National Science Library

    Boucher, Joanne

    2001-01-01

    ..., effectiveness, and accountability in federal programs and spending. The plan establishes six separate performance measurements, which correlate directly to customer satisfaction, Intelligence Mission Application (IMA...

  6. New’ Performance Measures: Determinants of Their Use and Their Impact on Performance

    NARCIS (Netherlands)

    F.H.M. Verbeeten (Frank)

    2005-01-01

    textabstractThis study investigates the extent to which Dutch organizations use ‘new’ performance measures to deal with the perceived inadequacies of traditional accounting performance measures. In addition, the determinants of the use of these ‘new’ performance measures are documented; finally, the

  7. Tumescent liposuction report performance measurement initiative: national survey results.

    Science.gov (United States)

    Hanke, William; Cox, Sue Ellen; Kuznets, Naomi; Coleman, William P

    2004-07-01

    This study was created by the Accreditation Association for Ambulatory Health Care Institute for Quality Improvement to measure clinical performance and improvement opportunities for physicians and ambulatory health-care organizations. Data were collected prospectively between February 2001 and August 2002. Thirty-nine study centers participated, and 688 patients who had tumescent liposuction were surveyed and followed for 6 months. The objective was to determine patient satisfaction with tumescent liposuction and examine current liposuction practice and the safety of tumescent liposuction in a representative cohort of patients. The Accreditation Association for Ambulatory Health Care Institute for Quality Improvement collected prospective data from February 2001 to August 2002 from 68 organizations registered for this study. Ultimately 39 organizations submitted 688 useable cases performed totally with local anesthesia, "tumescent technique." The overall clinical complication rate found in the Accreditation Association for Ambulatory Health Care Institute for Quality Improvement study was 0.7% (5 of 702). There was a minor complication rate of 0.57%. The major complication rate was 0.14% with one patient requiring hospitalization. Seventy-five percent of the patients reported no discomfort during their procedures. Of the 59% of patients who responded to a 6-month postoperative survey, 91% were positive about their decision to have liposuction (rating of 4 or 5 on a scale of 1-5) and 84% had high levels (4 or 5 on a scale of 1-5) of overall satisfaction with the procedure. Our findings are consistent with others in that tumescent liposuction is a safe procedure with a low complication rate and high patient satisfaction.

  8. Measurement of the Clinical Usability of a Configurable EHR

    DEFF Research Database (Denmark)

    Møller-Jensen, John; Lund Pedersen, Ivan; Simonsen, Jesper

    2006-01-01

    during a series of workshops with the clinicians after which the XML configuration files were written and deployed. In parallel with this, the participants from the University identified, prioritised and further specified a number of effects related to the clinical practice to be measured. The effects......The objective of the project was to measure the clinical usability of an EHR configured by use of participatory design with clinicians from a neurological stroke unit in order to get input to the County’s future strategy for incremental implementation of EHR. The content of the EHR was defined...... requested by the clinicians focused on improving their overview and assessment of patients as well as on more efficient coordination in three specific and highly cooperative situations, viz. nursing handover, ward round and patient conference. All three situations were measured before (using paper...

  9. 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.

  10. Verifax: Biometric instruments measuring neuromuscular disorders/performance impairments

    Science.gov (United States)

    Morgenthaler, George W.; Shrairman, Ruth; Landau, Alexander

    1998-01-01

    VeriFax, founded in 1990 by Dr. Ruth Shrairman and Mr. Alex Landau, began operations with the aim of developing a biometric tool for the verification of signatures from a distance. In the course of developing this VeriFax Autograph technology, two other related applications for the technologies under development at VeriFax became apparent. The first application was in the use of biometric measurements as clinical monitoring tools for physicians investigating neuromuscular diseases (embodied in VeriFax's Neuroskill technology). The second application was to evaluate persons with critical skills (e.g., airline pilots, bus drivers) for physical and mental performance impairments caused by stress, physiological disorders, alcohol, drug abuse, etc. (represented by VeriFax's Impairoscope prototype instrument). This last application raised the possibility of using a space-qualified Impairoscope variant to evaluate astronaut performance with respect to the impacts of stress, fatigue, excessive workload, build-up of toxic chemicals within the space habitat, etc. The three applications of VeriFax's patented technology are accomplished by application-specific modifications of the customized VeriFax software. Strong commercial market potentials exist for all three VeriFax technology applications, and market progress will be presented in more detail below.

  11. Positive associations between physical and cognitive performance measures in fibromyalgia.

    Science.gov (United States)

    Cherry, Barbara J; Zettel-Watson, Laura; Chang, Jennifer C; Shimizu, Renee; Rutledge, Dana N; Jones, C Jessie

    2012-01-01

    To investigate the associations between perceived physical function (self-report) and physical and cognitive performance (objective assessments) in persons with fibromyalgia (FM). Correlational study. Exercise testing laboratory in Southern California. Community-residing ambulatory adults meeting the American College of Rheumatology 1990 criteria for FM (N=68; mean age, 59.5y). Not applicable. Composite Physical Function scale, Senior Fitness Test (3 items), Fullerton Advanced Balance scale, 30-foot walk, Trail Making Test parts A and B, Digit Symbol Substitution Test, a composite score of these 3 cognitive measures, attention/executive function composite, processing speed composite, problem solving, inhibition, and episodic memory composite. Hierarchical regression analyses showed that after controlling for age and FM symptoms, better physical performance (based on assessments, not self-report) was associated with higher cognitive function in attention/executive function, processing speed, problem solving, and inhibition. Researchers should continue to investigate the relationship between physical and cognitive function in both clinical and nonclinical populations, as well as explore changes across time. Because physical activity has been associated with neural improvements, further research may identify whether particular mechanisms, such as neurogenesis, synaptogenesis, or changes in inflammatory marker levels, are involved. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    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.

  13. Analysis of repeated measurement data in the clinical trials

    Science.gov (United States)

    Singh, Vineeta; Rana, Rakesh Kumar; Singhal, Richa

    2013-01-01

    Statistics is an integral part of Clinical Trials. Elements of statistics span Clinical Trial design, data monitoring, analyses and reporting. A solid understanding of statistical concepts by clinicians improves the comprehension and the resulting quality of Clinical Trials. In biomedical research it has been seen that researcher frequently use t-test and ANOVA to compare means between the groups of interest irrespective of the nature of the data. In Clinical Trials we record the data on the patients more than two times. In such a situation using the standard ANOVA procedures is not appropriate as it does not consider dependencies between observations within subjects in the analysis. To deal with such types of study data Repeated Measure ANOVA should be used. In this article the application of One-way Repeated Measure ANOVA has been demonstrated by using the software SPSS (Statistical Package for Social Sciences) Version 15.0 on the data collected at four time points 0 day, 15th day, 30th day, and 45th day of multicentre clinical trial conducted on Pandu Roga (~Iron Deficiency Anemia) with an Ayurvedic formulation Dhatrilauha. PMID:23930038

  14. The Effect of Noise on Human Performance: A Clinical Trial

    Directory of Open Access Journals (Sweden)

    P Nassiri

    2013-04-01

    Full Text Available Background: Noise is defined as unwanted or meaningless sound that apart from auditory adverse health effects may distract attention from cues that are important for task performance. Human performance is influenced by many job-related factors and workplace conditions including noise level. Objective: To study the effect of noise on human performance. Methods: The participants included 40 healthy male university students. The experimental design consisted of 3 (sound pressure level x 3 (noise schedule x 2 (noise type factors. To investigate occupational skill performance, some specific test batteries were used: 1 steadiness test, 2 Minnesota manual dexterity test, 3 hand tool dexterity test, and 4 two-arm coordination test. Time duration of test completion was measured as speed response; to determine error response, the time taken during committing an error by participants while performing a task was measured. Results: Speed response obtained from the 4 tests in combined conditions of noise schedule, harmonic index, and sound pressure level was highest for (intermittent, treble, 95 dB, (continuous, treble, 95 dB, (continuous, treble, 85 dB and (intermittent, treble, 95 dB, respectively. Conclusion: Treble noise was found significant in reducing human performance; also, intermittent noise, especially at high pressure levels, was responsible for worsening environmental conditions during performing a task.

  15. Two-year clinical performance of four adhesive strategies

    Directory of Open Access Journals (Sweden)

    Salah Hasab Mahmoud

    2016-01-01

    Full Text Available Objective: To assess the clinical performance of four adhesive strategies; 3-step etch-and-rinse Adper Scotchbond Multi-Purpose (SM, 2-step etch-and-rinse (Adper Single Bond-2 [S2], 2-step self-etch Adper Scotchbond SE (SE and 1-step self-etch (Adper Single Bond Universal [SU]. Materials and Methods: Eighty cervical cavities exhibiting dentin carious lesions were used. Four adhesives from the same manufacturer (3M ESPE, St. Paul, MN, USA representing different bonding strategies were used; SM (3-step etch-and-rinse, Adper S2 (2-step etch-and-rinse, SE (2-step self-etch and SU (1-step self-etch. Cavities were restored with a nanohybrid composite resin (Z-350XT - 3M ESPE, St. Paul, MN, USA, and clinically followed up for 24 months using the modified United States Public Health Service criteria. Results: The outcome of Wilcoxon signed rank test showed no significant difference among the groups for each adhesive material at different evaluation periods (P > 0.05. Furthermore, the Friedman test revealed that there was no significant difference between all materials in all evaluation criteria, except for marginal discoloration at 24-month evaluation period. At 24-month evaluation period, teeth restored with self-etch adhesives showed more marginal staining. Conclusions: The four bonding strategies used in the current study showed an acceptable 2-year clinical performance.

  16. Analysis of Factors that Predict Clinical Performance in Medical School

    Science.gov (United States)

    White, Casey B.; Dey, Eric L.; Fantone, Joseph C.

    2009-01-01

    Academic achievement indices including GPAs and MCAT scores are used to predict the spectrum of medical student academic performance types. However, use of these measures ignores two changes influencing medical school admissions: student diversity and affirmative action, and an increased focus on communication skills. To determine if GPA and MCAT…

  17. Relationship between Clinical and Polysomnography Measures Corrected for CPAP Use.

    Science.gov (United States)

    Kirkham, Erin M; Heckbert, Susan R; Weaver, Edward M

    2015-11-15

    The changes in patient-reported measures of obstructive sleep apnea (OSA) burden are largely discordant with the change in apnea-hypopnea index (AHI) and other polysomnography measures before and after treatment. For patients treated with continuous positive airway pressure (CPAP), some investigators have theorized that this discordance is due in part to the variability in CPAP use. We aim to test the hypothesis that patient-reported outcomes of CPAP treatment have stronger correlations with AHI when it is corrected for mean nightly CPAP use. This was a cross-sectional study of 459 adults treated with CPAP for OSA. Five patient-reported measures of OSA burden were collected at baseline and after 6 months of CPAP therapy. The correlations between the change in each patient-reported measure and the change in AHI as well as mean nightly AHI (corrected for CPAP use with a weighted average formula) were measured after 6 months of treatment. The same analysis was repeated for 4 additional polysomnography measures, including apnea index, arousal index, lowest oxyhemoglobin saturation, and desaturation index. The change in AHI was weakly but significantly correlated with change in 2 of the 5 clinical measures. The change in mean nightly AHI demonstrated statistically significant correlations with 4 out of 5 clinical measures, though each with coefficients less than 0.3. Similar results were seen for apnea index, arousal index, lowest oxyhemoglobin saturation, and desaturation index. Correction for CPAP use yielded overall small but significant improvements in the correlations between patient-reported measures of sleep apnea burden and polysomnography measures after 6 months of treatment. © 2015 American Academy of Sleep Medicine.

  18. Environmental Uncertainty, Performance Measure Variety and Perceived Performance in Icelandic Companies

    DEFF Research Database (Denmark)

    Rikhardsson, Pall; Sigurjonsson, Throstur Olaf; Arnardottir, Audur Arna

    and the perceived performance of the company. The sample was the 300 largest companies in Iceland and the response rate was 27%. Compared to other studies the majority of the respondents use a surprisingly high number of different measures – both financial and non-financial. This made testing of the three......The use of performance measures and performance measurement frameworks has increased significantly in recent years. The type and variety of performance measures in use has been researched in various countries and linked to different variables such as the external environment, performance...... measurement frameworks, and management characteristics. This paper reports the results of a study carried out at year end 2013 of the use of performance measures by Icelandic companies and the links to perceived environmental uncertainty, management satisfaction with the performance measurement system...

  19. Predicting Document Retrieval System Performance: An Expected Precision Measure.

    Science.gov (United States)

    Losee, Robert M., Jr.

    1987-01-01

    Describes an expected precision (EP) measure designed to predict document retrieval performance. Highlights include decision theoretic models; precision and recall as measures of system performance; EP graphs; relevance feedback; and computing the retrieval status value of a document for two models, the Binary Independent Model and the Two Poisson…

  20. A customer perspective on performance measurement in humanitarian supply chains

    OpenAIRE

    Schiffling, Sarah

    2013-01-01

    The increasing importance of services in SCM leads to a stronger focus on the customer perspective. Donors and beneficiaries are two distinct customer groups of humanitarian supply chains. This paper will analyse how this impacts performance measurement for example in the commonly used balanced scorecard, which includes a customer perspective. Keywords: Performance measurement, Humanitarian logistics, Customer perspective

  1. Supply chain oriented performance measurement for automotive spare parts

    NARCIS (Netherlands)

    de Leeuw, S.L.J.M.; Beekman, L.

    2008-01-01

    Literature provides a number of conceptual frameworks and discussions on performance measurement in supply chains. However, most of these frameworks focus on a single link of a supply chain. Furthermore, there is a lack of empirical analysis and case studies on performance metrics and measurements

  2. Clinical effects of pranayama on performance of rifle shooters

    Directory of Open Access Journals (Sweden)

    Amte Snehal Shekhar, Mistry Hetal M

    2014-07-01

    Full Text Available Background: Yoga has an enormous scientifically proven effect on man’s physical and psychological functioning. Pranayama constitute the most vital aspects of yoga. Various methods of pranayama have a sound scientific basis and are traditionally believed to produce equilibrium between psychic and somatic aspects of bodily functions. The link between body and mind is obligatory for the better performance of sports persons. Aim: The aim of the study is to find out the effect of pranayama on the performance of Rifle shooters by measuring the parameters like-breath holding time, lung functional capacity and shooting performance. Method: 52 state level shooters subjects were chosen from 2 centres between the age group of 15-30years. Out of them, 26 shooters were given training in the techniques of pranayama for 3weeks.The other 26 subjects served as control i.e. with out Pranayama training. Variables like shooting performance, breath holding time (BHT, peak expiratory flow rate (PEFR, respiratory rate (RR and pulse rate (PR were measured in both the groups. Results: The study showed highly significant improvement in all the five variables shooting performance (in mm, BHT, PEFR, RR and PR with p value of 3.62E-05, 2.78E-07, 1.31E-09, 0.013, 3.40E-04respectively. Conclusion: So it can be concluded that pranayama is efficacious for better performance of Rifle shooters and should be included in their training practice.

  3. A Study on Relationships between Functional Performance and Task Performance Measure through Experiments in NPP MCR

    International Nuclear Information System (INIS)

    Jang, In Seok; Seong, Poong Hyun; Park, Jin Kyun

    2011-01-01

    Further improvements in levels of organization, management, man-machine interfaces, education, training, etc. are required, if high operating reliability of operators in huge and complex plants such as chemical plants and electrical power generating plants is to be maintained. Improvement requires good understanding of operators' behavior, including defining what is good performance for operators, especially in emergency situations. Human performance measures, therefore, are important to enhance performance and to reduce the probability of incidents and accidents in Nuclear Power Plants (NPPs). Operators' performance measures are used for multi-objectives such as control room design, human system interface evaluation, training, procedure and so on. There are two kinds of representative methods to measure operators' performance. These methods are now known as the functional performance measure and task performance measure. Functional performance measures are basically based on the plant process parameters. Functional performance measures indicate how well the operators controlled selected critical parameters. The parameters selected in this paper are derived from the four Critical Safety Functions (CSFs) identified in the emergency operating procedures such as achievement of subcriticality, maintenance of core cooling, maintenance of heat sink and maintenance of containment integrity. Task performance measures are based on the task analysis. Task analysis is to determine the tasks required and how operators are performed. In this paper, task analysis is done with ideal path for an accident completed by experts and Emergency Operation Procedure (EOP). However, most literatures related to operators' performance have been using one of these measures and there is no research to find out the relationships between two measures. In this paper, the relationships between functional performance measure and task performance measure are investigated using experiments. Shortly

  4. The relationships between common measures of glucose meter performance.

    Science.gov (United States)

    Wilmoth, Daniel R

    2012-09-01

    Glucose meter performance is commonly measured in several different ways, including the relative bias and coefficient of variation (CV), the total error, the mean absolute relative deviation (MARD), and the size of the interval around the reference value that would be necessary to contain a meter measurement at a specified probability. This fourth measure is commonly expressed as a proportion of the reference value and will be referred to as the necessary relative deviation. A deeper understanding of the relationships between these measures may aid health care providers, patients, and regulators in comparing meter performances when different measures are used. The relationships between common measures of glucose meter performance were derived mathematically. Equations are presented for calculating the total error, MARD, and necessary relative deviation using the reference value, relative bias, and CV when glucose meter measurements are normally distributed. When measurements are also unbiased, the CV, total error, MARD, and necessary relative deviation are linearly related and are therefore equivalent measures of meter performance. The relative bias and CV provide more information about meter performance than the other measures considered but may be difficult for some audiences to interpret. Reporting meter performance in multiple ways may facilitate the informed selection of blood glucose meters. © 2012 Diabetes Technology Society.

  5. MEASURING PERFORMANCE IN ORGANIZATIONS FROM MULTI-DIMENSIONAL PERSPECTIVE

    Directory of Open Access Journals (Sweden)

    ȘTEFĂNESCU CRISTIAN

    2017-08-01

    Full Text Available In turbulent financial and economic present conditions a major challenge for the general management of organizations and in particular for the strategic human resources management is to establish a clear, coherent and consistent framework in terms of measuring organizational performance and economic efficiency. This paper aims to conduct an exploratory research of literature concerning measuring organizational performance. Based on the results of research the paper proposes a multi-dimensional model for measuring organizational performance providing a mechanism that will allow quantification of performance based on selected criteria. The model will attempt to eliminate inconsistencies and incongruities of organizational effectiveness models developed by specialists from organization theory area, performance measurement models developed by specialists from accounting management area and models of measuring the efficiency and effectiveness developed by specialists from strategic management and entrepreneurship areas.

  6. Measures of Strategic Alliance Performance, Classified and Assessed

    DEFF Research Database (Denmark)

    Christoffersen, Jeppe; Plenborg, Thomas; Robson, Matthew J.

    2014-01-01

    Over the last three decades, strategic alliance performance has been an important research topic within the international business and management fields. Researchers have investigated a number of factors explaining performance but often find diverging results. Scholars have suggested that one...... reason may be that different performance measures are used as the dependent variable. But which differences exist and how can they matter? Against this backdrop, the present study makes three main contributions. First, we identify dimensions that illustrate differences and similarities between...... performance measures and provide a simple yet comprehensive classification of the different performance measures used in 167 empirical studies in the literature. Second, we suggest how differences in performance measures may influence construct validity under different circumstances. Third, we show...

  7. Assessing clinical reasoning abilities of medical students using clinical performance examination

    Directory of Open Access Journals (Sweden)

    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.

  8. Performance Measurement without Benchmarks: An Examination of Mutual Fund Returns.

    OpenAIRE

    Grinblatt, Mark; Titman, Sheridan

    1993-01-01

    This article introduces a new measure of portfolio performance and applies it to study the performance of a large sample of mutual funds. In contrast to previous studies of mutual fund performance, the measure used in this study employs portfolio holdings and does not require the use of a benchmark portfolio. It finds that the portfolio choices of mutual fund managers, particularly those that managed aggressive growth funds, earned significantly positive risk-adjusted returns in the 1976-85 p...

  9. An Examination of Organizatinal Performance Measurement System Utilization

    OpenAIRE

    DeBusk, Gerald Kenneth

    2003-01-01

    This dissertation provides results of three studies, which examine the utilization of organizational performance measurement systems. Evidence gathered in the first study provides insight into the number of perspectives or components found in the evaluation of an organization's performance and the relative weight placed on those components. The evidence suggests that the number of performance measurement components and their relative composition is situational. Components depend heavily on th...

  10. A framework to improve performance measurement in engineering projects

    OpenAIRE

    Zheng , Li; Baron , Claude; Esteban , Philippe; Xue , Rui; Zhang , Qiang

    2017-01-01

    International audience; A wide range of methods and good practices have been developed for the measurement of projects performance. They help project managers to effectively monitor the project progress and evaluate results. However, from a literature review, we noticed several remaining critical issues in measuring projects performance, such as an unbalanced development of Key Performance Indicators types between lagging and leading indicators. On the other hand, systems engineering measurem...

  11. Performance Measurement, Expectancy and Agency Theory: An Experimental Study

    OpenAIRE

    Randolph Sloof; Mirjam van Praag

    2007-01-01

    Theoretical analyses of (optimal) performance measures are typically performed within the realm of the linear agency model. An important implication of this model is that, for a given compensation scheme, the agent's optimal effort choice is unrelated to the amount of noise in the performance measure. In contrast, expectancy theory as developed by psychologists predicts that effort levels are increasing in the signal-to-noise ratio. We conduct a real effort laboratory experiment to assess the...

  12. Thermal performance measurements on ATLAS-SCT KB forward modules

    CERN Document Server

    Donegà, M; D'Onofrio, M; Ferrère, D; Hirt, C; Ikegami, Y; Kohriki, T; Kondo, T; Lindsay, S; Mangin-Brinet, M; Niinikoski, T O; Pernegger, H; Perrin, E; Taylor, G; Terada, S; Unno, Y; Wallny, R; Weber, M

    2003-01-01

    The thermal design of the KB module is presented. A Finite Elements Analysis (FEA) has been used to finalize the module design. The thermal performance of an outer irradiated KB module has been measured at different cooling conditions. The thermal runaway of the module has been measured. The FEA model has been compared with the measurements and has been used to predict the thermal performance in a realistic SCT scenario.

  13. Balanced Scorecard Based Performance Measurement & Strategic Management System

    OpenAIRE

    Permatasari, Paulina

    2006-01-01

    Developing strategy and performance measurement are an integral part of management control system. Making strategic decision about planning and controlling require information regarding how different subunits in organization work. To be effective, performance measurement, both financial and non-financial must motivate manager and employees at different levels to force goal accomplishment and organization strategic. An organization's measurement system strongly affects the behavior of people b...

  14. Performance measurement in healthcare: part II--state of the science findings by stage of the performance measurement process.

    Science.gov (United States)

    Adair, Carol E; Simpson, Elizabeth; Casebeer, Ann L; Birdsell, Judith M; Hayden, Katharine A; Lewis, Steven

    2006-07-01

    This paper summarizes findings of a comprehensive, systematic review of the peer-reviewed and grey literature on performance measurement according to each stage of the performance measurement process--conceptualization, selection and development, data collection, and reporting and use. It also outlines implications for practice. Six hundred sixty-four articles about organizational performance measurement from the health and business literature were reviewed after systematic searches of the literature, multi-rater relevancy ratings, citation checks and expert author nominations. Key themes were extracted and summarized from the most highly rated papers for each performance measurement stage. Despite a virtually universal consensus on the potential benefits of performance measurement, little evidence currently exists to guide practice in healthcare. Issues in conceptualizing systems include strategic alignment and scope. There are debates on the criteria for selecting measures and on the types and quality of measures. Implementation of data collection and analysis systems is complex and costly, and challenges persist in reporting results, preventing unintended effects and putting findings for improvement into action. There is a need for further development and refinement of performance measures and measurement systems, with a particular focus on strategies to ensure that performance measurement leads to healthcare improvement.

  15. Performance measurement in the context of CREM and FM

    NARCIS (Netherlands)

    Riratanaphong, C.; van der Voordt, Theo; Sarasoja, AL; Jensen, PA; van der Voordt, DJM; Coenen, C

    2012-01-01

    Purpose: To discuss trends in organisational performance measurement, to identify and discuss widely used performance criteria and key performance indicators (KPIs) in general and in the fields of Facility Management (FM) and Corporate Real Estate Management (CREM), and to identify how a more

  16. Designing a performance measurement system: A case study

    NARCIS (Netherlands)

    Lohman, Clemens; Fortuin, Leonard; Wouters, Marc

    2004-01-01

    Performance measurement (PM) by means of local performance indicators (PIs) is developing into performance management at a company-wide scale. But how should PIs at various levels in the organization be incorporated into one system that can help managers, working at levels that range from

  17. Performance measurement, expectancy and agency theory: An experimental study

    NARCIS (Netherlands)

    Sloof, R.; van Praag, C.M.

    2005-01-01

    Theoretical analyses of (optimal) performance measures are typically performed within the realm of the linear agency model. An important implication of this model is that, for a given compensation scheme, the agent's optimal effort choice is unrelated to the amount of noise in the performance

  18. Designing a performance measurement system : a case study

    NARCIS (Netherlands)

    Lohman, C.T.M.; Fortuin, L.; Wouters, M.J.F.

    2004-01-01

    Performance measurement (PM) by means of local performance indicators (PIs) is developing into performance management at a company-wide scale. But how should PIs at various levels in the organization be incorporated into one system that can help managers, working at levels that range from

  19. Disability outcome measures in multiple sclerosis clinical trials

    DEFF Research Database (Denmark)

    Cohen, Jeffrey A; Reingold, Stephen C; Polman, Chris H

    2012-01-01

    Many of the available disability outcome measures used in clinical trials of multiple sclerosis are insensitive to change over time, inadequately validated, or insensitive to patient-perceived health status or quality of life. Increasing focus on therapies that slow or reverse disability...... recommend practical refinements. Conversely, although substantial data support the multiple sclerosis functional composite as an alternative measure, changes to its component tests and scoring method are needed. Novel approaches, including the use of composite endpoints, patient-reported outcomes...... progression makes it essential to refine existing measures or to develop new tools. Major changes to the expanded disability status scale should be avoided to prevent the loss of acceptance by regulators as a measure for primary outcomes in trials that provide substantial evidence of effectiveness. Rather, we...

  20. Rheumatoid arthritis disease activity measures: American College of Rheumatology recommendations for use in clinical practice.

    Science.gov (United States)

    Anderson, Jaclyn; Caplan, Liron; Yazdany, Jinoos; Robbins, Mark L; Neogi, Tuhina; Michaud, Kaleb; Saag, Kenneth G; O'Dell, James R; Kazi, Salahuddin

    2012-05-01

    Although the systematic measurement of disease activity facilitates clinical decision making in rheumatoid arthritis (RA), no recommendations currently exist on which measures should be applied in clinical practice in the US. The American College of Rheumatology (ACR) convened a Working Group (WG) to comprehensively evaluate the validity, feasibility, and acceptability of available RA disease activity measures and derive recommendations for their use in clinical practice. The Rheumatoid Arthritis Clinical Disease Activity Measures Working Group conducted a systematic review of the literature to identify RA disease activity measures. Using exclusion criteria, input from an Expert Advisory Panel (EAP), and psychometric analysis, a list of potential measures was created. A survey was administered to rheumatologists soliciting input. The WG used these survey results in conjunction with the psychometric analyses to derive final recommendations. Systematic review of the literature resulted in identification of 63 RA disease activity measures. Application of exclusion criteria and ratings by the EAP narrowed the list to 14 measures for further evaluation. Practicing rheumatologists rated 9 of these 14 measures as most useful and feasible. From these 9 measures, the WG selected 6 with the best psychometric properties for inclusion in the final set of ACR-recommended RA disease activity measures. We recommend the Clinical Disease Activity Index, Disease Activity Score with 28-joint counts (erythrocyte sedimentation rate or C-reactive protein), Patient Activity Scale (PAS), PAS-II, Routine Assessment of Patient Index Data with 3 measures, and Simplified Disease Activity Index because they are accurate reflections of disease activity; are sensitive to change; discriminate well between low, moderate, and high disease activity states; have remission criteria; and are feasible to perform in clinical settings. Copyright © 2012 by the American College of Rheumatology.

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

    Science.gov (United States)

    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

  2. Performance-Based Measurement: Action for Organizations and HPT Accountability

    Science.gov (United States)

    Larbi-Apau, Josephine A.; Moseley, James L.

    2010-01-01

    Basic measurements and applications of six selected general but critical operational performance-based indicators--effectiveness, efficiency, productivity, profitability, return on investment, and benefit-cost ratio--are presented. With each measurement, goals and potential impact are explored. Errors, risks, limitations to measurements, and a…

  3. Strategy Archetypes Adopted by Icelandic Companies, Their Fit with Performance Measures and Effects on Financial Performance

    DEFF Research Database (Denmark)

    Rikhardsson, Pall; Sigurjonsson, Olaf; Arnardottir, Audur Arna

    Past research seems to suggest that companies adopting certain strategies favor certain sets of performance measures. That is to say companies using entrepreneurial focused strategies favor non-financial measures or a balanced mix of financial and non-financial measures. Companies adopting reactive...... or operational strategies seem to favor financial measures and are less likely to use non-financial measures. We take this research further by focusing not only on the link between strategy types and performance measures but also on what specific performance measures are used in connection to which strategies....... Furthermore, we examine the link between the strategies adopted, the performance measures favored and the financial performance of the companies. The empirical data collection was carried out in winter 2013 with a population of the 300 largest companies in Iceland. The survey was sent to the CFO...

  4. Effective Clinical Supervision in Substance Use Disorder Treatment Programs and Counselor Job Performance.

    Science.gov (United States)

    Rothrauff-Laschober, Tanja C; Eby, Lillian Turner de Tormes; Sauer, Julia B

    2013-01-01

    When mental health counselors have limited and/or inadequate training in substance use disorders (SUDs), effective clinical supervision (ECS) may advance their professional development. The purpose of the current study was to investigate whether ECS is related to the job performance of SUD counselors. Data were obtained in person via paper-and-pencil surveys from 392 matched SUD counselor-clinical supervisor dyads working in 27 SUD treatment organizations across the United States. ECS was rated by counselors and measured with five multi-item scales (i.e., sponsoring counselors' careers, providing challenging assignments, role modeling, accepting/confirming counselors' competence, overall supervisor task proficiency). Clinical supervisors rated counselors' job performance, which was measured with two multi-item scales (i.e., task performance, performance within supervisory relationship). Using mixed-effects models, we found that most aspects of ECS are related to SUD counselor job performance. Thus, ECS may indeed enhance counselors' task performance and performance within the supervisory relationship, and, as a consequence, offset limited formal SUD training.

  5. Performance Measure as Feedback Variable in Image Processing

    Directory of Open Access Journals (Sweden)

    Ristić Danijela

    2006-01-01

    Full Text Available This paper extends the view of image processing performance measure presenting the use of this measure as an actual value in a feedback structure. The idea behind is that the control loop, which is built in that way, drives the actual feedback value to a given set point. Since the performance measure depends explicitly on the application, the inclusion of feedback structures and choice of appropriate feedback variables are presented on example of optical character recognition in industrial application. Metrics for quantification of performance at different image processing levels are discussed. The issues that those metrics should address from both image processing and control point of view are considered. The performance measures of individual processing algorithms that form a character recognition system are determined with respect to the overall system performance.

  6. GRAPH THEORY APPROACH TO QUANTIFY UNCERTAINTY OF PERFORMANCE MEASURES

    Directory of Open Access Journals (Sweden)

    Sérgio D. Sousa

    2015-03-01

    Full Text Available In this work, the performance measurement process is studied to quantify the uncertainty induced in the resulting performance measure (PM. To that end, the causes of uncertainty are identified, analysing the activities undertaken in the three following stages of the performance measurement process: design and implementation, data collection and record, and determination and analysis. A quantitative methodology based on graph theory and on the sources of uncertainty of the performance measurement process is used to calculate an uncertainty index to evaluate the level of uncertainty of a given PM or (key performance indicator. An application example is presented. The quantification of PM uncertainty could contribute to better represent the risk associated with a given decision and also to improve the PM to increase its precision and reliability.

  7. Multi-instance dictionary learning via multivariate performance measure optimization

    KAUST Repository

    Wang, Jim Jing-Yan

    2016-12-29

    The multi-instance dictionary plays a critical role in multi-instance data representation. Meanwhile, different multi-instance learning applications are evaluated by specific multivariate performance measures. For example, multi-instance ranking reports the precision and recall. It is not difficult to see that to obtain different optimal performance measures, different dictionaries are needed. This observation motives us to learn performance-optimal dictionaries for this problem. In this paper, we propose a novel joint framework for learning the multi-instance dictionary and the classifier to optimize a given multivariate performance measure, such as the F1 score and precision at rank k. We propose to represent the bags as bag-level features via the bag-instance similarity, and learn a classifier in the bag-level feature space to optimize the given performance measure. We propose to minimize the upper bound of a multivariate loss corresponding to the performance measure, the complexity of the classifier, and the complexity of the dictionary, simultaneously, with regard to both the dictionary and the classifier parameters. In this way, the dictionary learning is regularized by the performance optimization, and a performance-optimal dictionary is obtained. We develop an iterative algorithm to solve this minimization problem efficiently using a cutting-plane algorithm and a coordinate descent method. Experiments on multi-instance benchmark data sets show its advantage over both traditional multi-instance learning and performance optimization methods.

  8. Multi-instance dictionary learning via multivariate performance measure optimization

    KAUST Repository

    Wang, Jim Jing-Yan; Tsang, Ivor Wai-Hung; Cui, Xuefeng; Lu, Zhiwu; Gao, Xin

    2016-01-01

    The multi-instance dictionary plays a critical role in multi-instance data representation. Meanwhile, different multi-instance learning applications are evaluated by specific multivariate performance measures. For example, multi-instance ranking reports the precision and recall. It is not difficult to see that to obtain different optimal performance measures, different dictionaries are needed. This observation motives us to learn performance-optimal dictionaries for this problem. In this paper, we propose a novel joint framework for learning the multi-instance dictionary and the classifier to optimize a given multivariate performance measure, such as the F1 score and precision at rank k. We propose to represent the bags as bag-level features via the bag-instance similarity, and learn a classifier in the bag-level feature space to optimize the given performance measure. We propose to minimize the upper bound of a multivariate loss corresponding to the performance measure, the complexity of the classifier, and the complexity of the dictionary, simultaneously, with regard to both the dictionary and the classifier parameters. In this way, the dictionary learning is regularized by the performance optimization, and a performance-optimal dictionary is obtained. We develop an iterative algorithm to solve this minimization problem efficiently using a cutting-plane algorithm and a coordinate descent method. Experiments on multi-instance benchmark data sets show its advantage over both traditional multi-instance learning and performance optimization methods.

  9. Associations between structural capabilities of primary care practices and performance on selected quality measures.

    Science.gov (United States)

    Friedberg, Mark W; Coltin, Kathryn L; Safran, Dana Gelb; Dresser, Marguerite; Zaslavsky, Alan M; Schneider, Eric C

    2009-10-06

    Recent proposals to reform primary care have encouraged physician practices to adopt such structural capabilities as performance feedback and electronic health records. Whether practices with these capabilities have higher performance on measures of primary care quality is unknown. To measure associations between structural capabilities of primary care practices and performance on commonly used quality measures. Cross-sectional analysis. Massachusetts. 412 primary care practices. During 2007, 1 physician from each participating primary care practice (median size, 4 physicians) was surveyed about structural capabilities of the practice (responses representing 308 practices were obtained). Data on practice structural capabilities were linked to multipayer performance data on 13 Healthcare Effectiveness Data and Information Set (HEDIS) process measures in 4 clinical areas: screening, diabetes, depression, and overuse. Frequently used multifunctional electronic health records were associated with higher performance on 5 HEDIS measures (3 in screening and 2 in diabetes), with statistically significant differences in performance ranging from 3.1 to 7.6 percentage points. Frequent meetings to discuss quality were associated with higher performance on 3 measures of diabetes care (differences ranging from 2.3 to 3.1 percentage points). Physician awareness of patient experience ratings was associated with higher performance on screening for breast cancer and cervical cancer (1.9 and 2.2 percentage points, respectively). No other structural capabilities were associated with performance on more than 1 measure. No capabilities were associated with performance on depression care or overuse. Structural capabilities of primary care practices were assessed by physician survey. Among the investigated structural capabilities of primary care practices, electronic health records were associated with higher performance across multiple HEDIS measures. Overall, the modest magnitude and

  10. From mission to measures: performance measure development for a Teen Pregnancy Prevention Program.

    Science.gov (United States)

    Farb, Amy Feldman; Burrus, Barri; Wallace, Ina F; Wilson, Ellen K; Peele, John E

    2014-03-01

    The Office of Adolescent Health (OAH) sought to create a comprehensive set of performance measures to capture the performance of the Teen Pregnancy Prevention (TPP) program. This performance measurement system needed to provide measures that could be used internally (by both OAH and the TPP grantees) for management and program improvement as well as externally to communicate the program's progress to other interested stakeholders and Congress. This article describes the selected measures and outlines the considerations behind the TPP measurement development process. Issues faced, challenges encountered, and lessons learned have broad applicability for other federal agencies and, specifically, for TPP programs interested in assessing their own performance and progress. Published by Elsevier Inc.

  11. Measurement properties of existing clinical assessment methods evaluating scapular positioning and function. A systematic review

    DEFF Research Database (Denmark)

    Larsen, Camilla Marie; Juul-Kristensen, Birgit; Lund, Hans

    2014-01-01

    a substantially larger number of clinical scapular assessment methods than previously reported. Using the COSMIN checklist the methodological quality of the included measurement properties in the reliability and validity domains were in general ‘‘fair’’ to ‘‘poor’’. None were examined for all three domains: (1...... utility for clinical practice.......The aims were to compile a schematic overview of clinical scapular assessment methods and critically appraise the methodological quality of the involved studies. A systematic, computerassisted literature search using Medline, CINAHL, SportDiscus and EMBASE was performed from inception to October...

  12. Multiple performance measures are needed to evaluate triage systems in the emergency department.

    Science.gov (United States)

    Zachariasse, Joany M; Nieboer, Daan; Oostenbrink, Rianne; Moll, Henriëtte A; Steyerberg, Ewout W

    2018-02-01

    Emergency department triage systems can be considered prediction rules with an ordinal outcome, where different directions of misclassification have different clinical consequences. We evaluated strategies to compare the performance of triage systems and aimed to propose a set of performance measures that should be used in future studies. We identified performance measures based on literature review and expert knowledge. Their properties are illustrated in a case study evaluating two triage modifications in a cohort of 14,485 pediatric emergency department visits. Strengths and weaknesses of the performance measures were systematically appraised. Commonly reported performance measures are measures of statistical association (34/60 studies) and diagnostic accuracy (17/60 studies). The case study illustrates that none of the performance measures fulfills all criteria for triage evaluation. Decision curves are the performance measures with the most attractive features but require dichotomization. In addition, paired diagnostic accuracy measures can be recommended for dichotomized analysis, and the triage-weighted kappa and Nagelkerke's R 2 for ordinal analyses. Other performance measures provide limited additional information. When comparing modifications of triage systems, decision curves and diagnostic accuracy measures should be used in a dichotomized analysis, and the triage-weighted kappa and Nagelkerke's R 2 in an ordinal approach. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Microvascular imaging: techniques and opportunities for clinical physiological measurements

    International Nuclear Information System (INIS)

    Allen, John; Howell, Kevin

    2014-01-01

    The microvasculature presents a particular challenge in physiological measurement because the vessel structure is spatially inhomogeneous and perfusion can exhibit high variability over time. This review describes, with a clinical focus, the wide variety of methods now available for imaging of the microvasculature and their key applications. Laser Doppler perfusion imaging and laser speckle contrast imaging are established, commercially-available techniques for determining microvascular perfusion, with proven clinical utility for applications such as burn-depth assessment. Nailfold capillaroscopy is also commercially available, with significant published literature that supports its use for detecting microangiopathy secondary to specific connective tissue diseases in patients with Raynaud's phenomenon. Infrared thermography measures skin temperature and not perfusion directly, and it has only gained acceptance for some surgical and peripheral microvascular applications. Other emerging technologies including imaging photoplethysmography, optical coherence tomography, photoacoustic tomography, hyperspectral imaging, and tissue viability imaging are also described to show their potential as techniques that could become established tools for clinical microvascular assessment. Growing interest in the microcirculation has helped drive the rapid development in perfusion imaging of the microvessels, bringing exciting opportunities in microvascular research. (topical review)

  14. Augment clinical measurement using a constraint-based esophageal model

    Science.gov (United States)

    Kou, Wenjun; Acharya, Shashank; Kahrilas, Peter; Patankar, Neelesh; Pandolfino, John

    2017-11-01

    Quantifying the mechanical properties of the esophageal wall is crucial to understanding impairments of trans-esophageal flow characteristic of several esophageal diseases. However, these data are unavailable owing to technological limitations of current clinical diagnostic instruments that instead display esophageal luminal cross sectional area based on intraluminal impedance change. In this work, we developed an esophageal model to predict bolus flow and the wall property based on clinical measurements. The model used the constraint-based immersed-boundary method developed previously by our group. Specifically, we first approximate the time-dependent wall geometry based on impedance planimetry data on luminal cross sectional area. We then fed these along with pressure data into the model and computed wall tension based on simulated pressure and flow fields, and the material property based on the strain-stress relationship. As examples, we applied this model to augment FLIP (Functional Luminal Imaging Probe) measurements in three clinical cases: a normal subject, achalasia, and eosinophilic esophagitis (EoE). Our findings suggest that the wall stiffness was greatest in the EoE case, followed by the achalasia case, and then the normal. This is supported by NIH Grant R01 DK56033 and R01 DK079902.

  15. Analytical and Clinical Performance Evaluation of the Abbott Architect PIVKA Assay.

    Science.gov (United States)

    Ko, Dae-Hyun; Hyun, Jungwon; Kim, Hyun Soo; Park, Min-Jeong; Kim, Jae-Seok; Park, Ji-Young; Shin, Dong Hoon; Cho, Hyoun Chan

    2018-01-01

    Protein induced by vitamin K absence (PIVKA) is measured using various assays and is used to help diagnose hepatocellular carcinoma. The present study evaluated the analytical and clinical performances of the recently released Abbott Architect PIVKA assay. Precision, linearity, and correlation tests were performed in accordance with the Clinical Laboratory Standardization Institute guidelines. Sample type suitability was assessed using serum and plasma samples from the same patients, and the reference interval was established using sera from 204 healthy individuals. The assay had coefficients of variation of 3.2-3.5% and intra-laboratory variation of 3.6-5.5%. Linearity was confirmed across the entire measurable range. The Architect PIVKA assay was comparable to the Lumipulse PIVKA assay, and the plasma and serum samples provided similar results. The lower reference limit was 13.0 mAU/mL and the upper reference limit was 37.4 mAU/mL. The ability of the Architect PIVKA assay to detect hepatocellular carcinoma was comparable to that of the alpha-fetoprotein test and the Lumipulse PIVKA assay. The Architect PIVKA assay provides excellent analytical and clinical performance, is simple for clinical laboratories to adopt, and has improved sample type suitability that could broaden the assay's utility. © 2018 by the Association of Clinical Scientists, Inc.

  16. A combination of clinical balance measures and FRAX® to improve identification of high-risk fallers.

    Science.gov (United States)

    Najafi, David A; Dahlberg, Leif E; Hansson, Eva Ekvall

    2016-05-03

    The FRAX® algorithm quantifies a patient's 10-year probability of a hip or major osteoporotic fracture without taking an individual's balance into account. Balance measures assess the functional ability of an individual and the FRAX® algorithm is a model that integrates the individual patients clinical risk factors [not balance] and bone mineral density. Thus, clinical balance measures capture aspects that the FRAX® algorithm does not, and vice versa. It is therefore possible that combining FRAX® and clinical balance measures can improve the identification of patients at high fall risk and thereby high fracture risk. Our study aim was to explore whether there is an association between clinical balance measures and fracture prediction obtained from FRAX®. A cross-sectional study design was used where post hoc was performed on a dataset of 82 participants (54 to 89 years of age, mean age 71.4, 77 female), with a fall-related wrist-fracture between 2008 and 2012. Balance was measured by tandem stance, standing one leg, walking in the figure of eight, walking heel to toe on a line, walking as fast as possible for 30 m and five times sit to stand balance measures [tandem stance and standing one leg measured first with open and then with closed eyes] and each one analyzed for bivariate relations with the 10-year probability values for hip and major osteoporotic fractures as calculated by FRAX® using Spearman's rank correlation test. Individuals with high FRAX® values had poor outcome in balance measures; however the significance level of the correlation differed between tests. Standing one leg eyes closed had strongest correlation to FRAX® (0.610 p = balance measures and FRAX®. Hence, the use of clinical balance measures and FRAX® in combination, might improve the identification of individuals with high risk of falls and thereby following fractures. Results enable healthcare providers to optimize treatment and prevention of fall-related fractures. The study has

  17. Measures of rheumatoid arthritis disease activity in Australian clinical practice.

    Science.gov (United States)

    Taylor, Andrew; Bagga, Hanish

    2011-01-01

    Objectives. To investigate which rheumatoid arthritis (RA) disease activity measures are being collected in patients receiving glucocorticoids, non-biologic or biologic disease-modifying antirheumatic drugs (DMARDs) in Australian rheumatology practice. Methods. A retrospective audit of medical records was conducted from eight rheumatology practices around Australia. Each rheumatologist recruited 30 consecutive eligible patients into the review, 10 of whom must have been receiving a biological agent for rheumatoid arthritis. Disease activity measures and radiographic assessments were collected from each patient's last consultation. For biologic patients, disease activity measures were also collected from when the patient was first initiated on the biological agent. Results. At last consultation, the disease measures that were recorded most often were ESR (89.2%), haemoglobin (87.5%), and CRP (84.2%). DAS28 was infrequently recorded (16.3%). The rate of recording disease activity measures for patients receiving biologic DMARDs decreased over time (mean 27 months). Conclusion. This review has shown inconsistency of RA activity measures being recorded in Australian rheumatology clinical practice. An accurate assessment of the disease process is necessary to effectively target rheumatoid arthritis patients to treat in order to achieve optimal outcomes.

  18. Academic writing performance measured for research and instruction

    NARCIS (Netherlands)

    Firssova, Olga

    2012-01-01

    Firssova, O. (2011, January 19). Academic writing performance measured for research and instruction. Presentation at the ICO Course Domain specific research on learning and instruction: theories, methodology and curricular innovations, Utrecht, The Netherlands: Interuniversitair Centrum voor

  19. Academic writing performance measured for research and instruction

    NARCIS (Netherlands)

    Firssova, Olga

    2012-01-01

    Firssova, O. (2012, 19 January). Academic writing performance measured for research and instruction. Presentation given at the ICO Masterclass, Theme Domain-Specific Instruction, January 19-February 10, Utrecht, The Netherlands.

  20. Establishing and integrating performance measures : a TPCB peer exchange

    Science.gov (United States)

    2015-08-31

    This report highlights key recommendations and noteworthy practices identified at Establishing and Integrating Performance Measures Peer Exchange held on April 27-28, 2015 in Dimondale, Michigan and via video teleconference. This event was spon...

  1. Decentralization, Interdependence and Performance Measurement System Design : Sequences and Priorities

    NARCIS (Netherlands)

    Abernethy, M.; Bouwens, J.F.M.G.; van Lent, L.A.G.M.

    2001-01-01

    We investigate the determinants of decentralization and performance measurement choices in multidivisional firms.We extend the research on the economics of organizational design choices by examining the impact of two important determinants of those choices, namely, subunit interdependencies and

  2. Issues with performance measures for dynamic multi-objective optimisation

    CSIR Research Space (South Africa)

    Helbig, M

    2013-06-01

    Full Text Available Symposium on Computational Intelligence in Dynamic and Uncertain Environments (CIDUE), Mexico, 20-23 June 2013 Issues with Performance Measures for Dynamic Multi-objective Optimisation Mard´e Helbig CSIR: Meraka Institute Brummeria, South Africa...

  3. design, construction and measured performance of a single-stage

    African Journals Online (AJOL)

    2012-11-03

    Nov 3, 2012 ... Abstract. The design philosophy, construction and measured performances of a single stage, single entry centrifugal pump .... the tachometer spindle to be held against a recess in the motor shaft. The constructed centrifugal ...

  4. Growth performance and certain body measurements of ostrich ...

    African Journals Online (AJOL)

    Growth performance and certain body measurements of ostrich chicks as affected by dietary protein levels during 2–9 weeks of age. Kh M Mahrose, AI Attia, IE Ismail, DE Abou-Kassem, ME Abd El-Hack ...

  5. Procurement performance measurement system in the health care industry.

    Science.gov (United States)

    Kumar, Arun; Ozdamar, Linet; Ng, Chai Peng

    2005-01-01

    The rising operating cost of providing healthcare is of concern to health care providers. As such, measurement of procurement performance will enable competitive advantage and provide a framework for continuous improvement. The objective of this paper is to develop a procurement performance measurement system. The paper reviews the existing literature in procurement performance measurement to identify the key areas of purchasing performance. By studying the three components in the supply chain collectively with the resources, procedures and output, a model is been developed. Additionally, a balanced scorecard is proposed by establishing a set of generic measures and six perspectives. A case study conducted at the Singapore Hospital applies the conceptual model to describe the purchasing department and the activities within and outside the department. The results indicate that the material management department has already made a good start in measuring the procurement process through the implementation of the balanced scorecard. There are many data that are collected but not properly collated and utilized. Areas lacking measurement include cycle time of delivery, order processing time, effectiveness, efficiency and reliability. Though a lot of hard work was involved, the advantages of establishing a measurement system outweigh the costs and efforts involved in its implementation. Results of balanced scorecard measurements provide decision-makers with critical information on efficiency and effectiveness of the purchasing department's work. The measurement model developed could be used for any hospital procurement system.

  6. The effectiveness of performance measuring in Slovenian public libraries

    Directory of Open Access Journals (Sweden)

    Silva Novljan

    1997-01-01

    Full Text Available The article describes methods of performance measuring in Slovenian public libraries, and calls attention to the problems attached to it. The argued presumption is that the performance measuring carried out on the state level, is not always a sufficient and adequate foundation for plarming of the developmenl and functioning of an individual library which has to cater for the needs and wishes of the population in a certain area.

  7. Performance measurement of electricity suppliers using PROMETHEE and balance scorecard

    OpenAIRE

    Mona Osati; Manouchehr Omidvari

    2016-01-01

    Performance measurement in energy industry plays an important role on increasing the productivity. Electricity is also among the most essential components of energy in mega cities like Tehran. The lack of a good service in this city may result unpleasant consequences on most civilians who live in this city. This paper presents an empirical investigation to measure the performance of six major electricity contractors in city of Tehran, Iran. The study implements grey numbers to handle any unce...

  8. Holistic Performance Measurement to Achieve Sustainable Competitive Advantage

    OpenAIRE

    Keni Keni

    2013-01-01

    In the past, companies used balanced scorecard to measure its performance. Now, balanced scorecard as a performance measurement tool is no longer sufficient because business has been affected by changes to the natural environment and developing social expectations. In order to achieve sustainable competitive advantage, companies are beginning to address the risks and opportunities associated with these changes in their longer-term business planning. To turn risks into opportunities, companies...

  9. Students’ performance in the different clinical skills assessed in OSCE: what does it reveal?

    Directory of Open Access Journals (Sweden)

    Joong Hiong Sim

    2015-02-01

    Full Text Available Introduction: The purpose of this study was to compare students’ performance in the different clinical skills (CSs assessed in the objective structured clinical examination. Methods: Data for this study were obtained from final year medical students’ exit examination (n=185. Retrospective analysis of data was conducted using SPSS. Means for the six CSs assessed across the 16 stations were computed and compared. Results: Means for history taking, physical examination, communication skills, clinical reasoning skills (CRSs, procedural skills (PSs, and professionalism were 6.25±1.29, 6.39±1.36, 6.34±0.98, 5.86±0.99, 6.59±1.08, and 6.28±1.02, respectively. Repeated measures ANOVA showed there was a significant difference in the means of the six CSs assessed [F(2.980, 548.332=20.253, p<0.001]. Pairwise multiple comparisons revealed significant differences between the means of the eight pairs of CSs assessed, at p<0.05. Conclusions: CRSs appeared to be the weakest while PSs were the strongest, among the six CSs assessed. Students’ unsatisfactory performance in CRS needs to be addressed as CRS is one of the core competencies in medical education and a critical skill to be acquired by medical students before entering the workplace. Despite its challenges, students must learn the skills of clinical reasoning, while clinical teachers should facilitate the clinical reasoning process and guide students’ clinical reasoning development.

  10. From Performance Measurement to Strategic Management Model: Balanced Scorecard

    Directory of Open Access Journals (Sweden)

    Cihat Savsar

    2015-03-01

    Full Text Available Abstract: In Today’s competitive markets, one of the main conditions of the surviving of enterprises is the necessity to have effective performance management systems. Decisions must be taken by the management according to the performance of assets. In the transition from industrial society to information society, the presence of business structures have changed and the values of non-financial assets have increased in this period. So some systems have emerged based on intangible assets and to measure them instead of tangible assets and their measurements. With economic and technological development multi-dimensional evaluation in the business couldn’t be sufficient.  Performance evaluation methods can be applied in business with an integrated approach by its accordance with business strategy, linking to reward system and cause effects link established between performance measures. Balanced scorecard is one of the commonly used in measurement methods. While it was used for the first time in 1992 as a performance measurement tool today it has been used as a strategic management model besides its conventional uses. BSC contains customer perspective, internal perspective and learning and growth perspective besides financial perspective. Learning and growth perspective is determinant of other perspectives. In order to achieve the objectives set out in the financial perspective in other dimensions that need to be accomplished, is emphasized. Establishing a causal link between performance measures and targets how to achieve specified goals with strategy maps are described.

  11. A Public-Private Partnership Improves Clinical Performance In A Hospital Network In Lesotho.

    Science.gov (United States)

    McIntosh, Nathalie; Grabowski, Aria; Jack, Brian; Nkabane-Nkholongo, Elizabeth Limakatso; Vian, Taryn

    2015-06-01

    Health care public-private partnerships (PPPs) between a government and the private sector are based on a business model that aims to leverage private-sector expertise to improve clinical performance in hospitals and other health facilities. Although the financial implications of such partnerships have been analyzed, few studies have examined the partnerships' impact on clinical performance outcomes. Using quantitative measures that reflected capacity, utilization, clinical quality, and patient outcomes, we compared a government-managed hospital network in Lesotho, Africa, and the new PPP-managed hospital network that replaced it. In addition, we used key informant interviews to help explain differences in performance. We found that the PPP-managed network delivered more and higher-quality services and achieved significant gains in clinical outcomes, compared to the government-managed network. We conclude that health care public-private partnerships may improve hospital performance in developing countries and that changes in management and leadership practices might account for differences in clinical outcomes. Project HOPE—The People-to-People Health Foundation, Inc.

  12. QNOTE: an instrument for measuring the quality of EHR clinical notes.

    Science.gov (United States)

    Burke, Harry B; Hoang, Albert; Becher, Dorothy; Fontelo, Paul; Liu, Fang; Stephens, Mark; Pangaro, Louis N; Sessums, Laura L; O'Malley, Patrick; Baxi, Nancy S; Bunt, Christopher W; Capaldi, Vincent F; Chen, Julie M; Cooper, Barbara A; Djuric, David A; Hodge, Joshua A; Kane, Shawn; Magee, Charles; Makary, Zizette R; Mallory, Renee M; Miller, Thomas; Saperstein, Adam; Servey, Jessica; Gimbel, Ronald W

    2014-01-01

    The outpatient clinical note documents the clinician's information collection, problem assessment, and patient management, yet there is currently no validated instrument to measure the quality of the electronic clinical note. This study evaluated the validity of the QNOTE instrument, which assesses 12 elements in the clinical note, for measuring the quality of clinical notes. It also compared its performance with a global instrument that assesses the clinical note as a whole. Retrospective multicenter blinded study of the clinical notes of 100 outpatients with type 2 diabetes mellitus who had been seen in clinic on at least three occasions. The 300 notes were rated by eight general internal medicine and eight family medicine practicing physicians. The QNOTE instrument scored the quality of the note as the sum of a set of 12 note element scores, and its inter-rater agreement was measured by the intraclass correlation coefficient. The Global instrument scored the note in its entirety, and its inter-rater agreement was measured by the Fleiss κ. The overall QNOTE inter-rater agreement was 0.82 (CI 0.80 to 0.84), and its note quality score was 65 (CI 64 to 66). The Global inter-rater agreement was 0.24 (CI 0.19 to 0.29), and its note quality score was 52 (CI 49 to 55). The QNOTE quality scores were consistent, and the overall QNOTE score was significantly higher than the overall Global score (p=0.04). We found the QNOTE to be a valid instrument for evaluating the quality of electronic clinical notes, and its performance was superior to that of the Global instrument. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  13. Chinese Middle School Teachers' Preferences Regarding Performance Evaluation Measures

    Science.gov (United States)

    Liu, Shujie; Xu, Xianxuan; Stronge, James H.

    2016-01-01

    Teacher performance evaluation currently is receiving unprecedented attention from policy makers, scholars, and practitioners worldwide. This study is one of the few studies of teacher perceptions regarding teacher performance measures that focus on China. We employed a quantitative dominant mixed research design to investigate Chinese teachers'…

  14. Performance measurement of workplace change in two different cultural contexts

    NARCIS (Netherlands)

    Riratanaphong, C.

    2014-01-01

    There is a growing need for performance management and performance measurement that not only covers all aspects of an organisation, but which can be applied to various situations in a changing internal and external environment. The changing organisational and external contexts, such as the

  15. English Value-Added Measures: Examining the Limitations of School Performance Measurement

    Science.gov (United States)

    Perry, Thomas

    2016-01-01

    Value-added "Progress" measures are to be introduced for all English schools in 2016 as "headline" measures of school performance. This move comes despite research highlighting high levels of instability in value-added measures and concerns about the omission of contextual variables in the planned measure. This article studies…

  16. Effectiveness of Human Research Protection Program Performance Measurements.

    Science.gov (United States)

    Tsan, Min-Fu; Nguyen, Yen

    2017-10-01

    We analyzed human research protection program performance metric data of all Department of Veterans Affairs research facilities obtained from 2010 to 2016. Among a total of 25 performance metrics, 21 (84%) showed improvement, four (16%) remained unchanged, and none deteriorated during the study period. The overall improvement from these 21 performance metrics was 81.1% ± 18.7% (mean ± SD), with a range of 30% to 100%. The four performance metrics that did not show improvement all had initial noncompliance/incidence rates of performance metrics that showed improvement ranged from 0.05% to 60%. However, of the 21 performance metrics that showed improvement, 10 had initial noncompliance/incidence rates of performance measurement is an effective tool in improving the performance of human research protection programs.

  17. 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.

  18. Theory and Application of an Economic Performance Measure of Risk

    NARCIS (Netherlands)

    C. Niu (Cuizhen); X. Guo (Xu); M.J. McAleer (Michael); W.-K. Wong (Wing-Keung)

    2017-01-01

    textabstractHomm and Pigorsch (2012a) use the Aumann and Serrano index to develop a new economic performance measure (EPM), which is well known to have advantages over other measures. In this paper, we extend the theory by constructing a one-sample confidence interval of EPM, and construct

  19. Readiness to adopt a performance measurement system for ...

    African Journals Online (AJOL)

    Readiness to adopt a performance measurement system for substance abuse treatment: Findings from the Service Quality Measures initiative. ... system, findings show that the likelihood of adoption can be further increased through improved provider awareness and enhanced leadership support for this health innovation.

  20. Adding Shareholder Value through Project Performance Measurement, Monitoring & Control

    NARCIS (Netherlands)

    M.M. Akalu; J.R. Turner (Rodney)

    2002-01-01

    textabstractWe present the various views and methods of measuring and controlling project performance, and factors affecting a project. The review indicates that there is a shift in the type and understanding of factors of project success or failure. However, the presence of various measurement

  1. New methods for mobility performance measurement in wheelchair basketball

    NARCIS (Netherlands)

    van der Slikke, R.M.A.; Berger, MAM; Bregman, DJJ; Veeger, H.E.J.

    2016-01-01

    Increased professionalism in wheelchair sports demand a more precise and quantitative measure of individual wheelchair mobility performance, to allow it to be an evaluation measure of wheelchair setting or training optimization. This research describes the application of an inertial sensor based

  2. A measure for the batting performance of cricket players : research ...

    African Journals Online (AJOL)

    A single measure that can be used to assess the performance of batsmen in cricket is defined. This study shows how it can be used to rank batsmen. The batting ability of a batsman is generally measured by means of his average. His strike rate is, however, also very important and is often looked at as well. It will furthermore ...

  3. Measurement properties of performance-based measures to assess physical function in hip and knee osteoarthritis

    DEFF Research Database (Denmark)

    Dobson, F; Hinman, R S; Hall, M

    2012-01-01

    OBJECTIVES: To systematically review the measurement properties of performance-based measures to assess physical function in people with hip and/or knee osteoarthritis (OA). METHODS: Electronic searches were performed in MEDLINE, CINAHL, Embase, and PsycINFO up to the end of June 2012. Two...... investigating measurement properties of performance measures, including responsiveness and interpretability in people with hip and/or knee OA, is needed. Consensus on which combination of measures will best assess physical function in people with hip/and or knee OA is urgently required....

  4. 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

  5. Mobile Handset Performance Evaluation Using Radiation Pattern Measurements

    DEFF Research Database (Denmark)

    Nielsen, Jesper Ødum; Pedersen, Gert Frølund

    2006-01-01

    The mean effective gain is an attractive performance measure of mobile handsets, since it incorporates both directional and polarization properties of the handset and environment. In this work the mean effective gain is computed from measured spherical radiation patterns of five different mobile...... pattern is reduced. Furthermore, the frequency dependence of the mean effective gain is investigated, and a method is proposed for reducing the required number of measurements on different frequencies....

  6. Emergency medical services key performance measurement in Asian cities.

    Science.gov (United States)

    Rahman, Nik Hisamuddin; Tanaka, Hideharu; Shin, Sang Do; Ng, Yih Yng; Piyasuwankul, Thammapad; Lin, Chih-Hao; Ong, Marcus Eng Hock

    2015-01-01

    One of the key principles in the recommended standards is that emergency medical service (EMS) providers should continuously monitor the quality and safety of their services. This requires service providers to implement performance monitoring using appropriate and relevant measures including key performance indicators. In Asia, EMS systems are at different developmental phases and maturity. This will create difficultly in benchmarking or assessing the quality of EMS performance across the region. An attempt was made to compare the EMS performance index based on the structure, process, and outcome analysis. The data was collected from the Pan-Asian Resuscitation Outcome Study (PAROS) data among few Asian cities, namely, Tokyo, Osaka, Singapore, Bangkok, Kuala Lumpur, Taipei, and Seoul. The parameters of inclusions were broadly divided into structure, process, and outcome measurements. The data was collected by the site investigators from each city and keyed into the electronic web-based data form which is secured strictly by username and passwords. Generally, there seems to be a more uniformity for EMS performance parameters among the more developed EMS systems. The major problem with the EMS agencies in the cities of developing countries like Bangkok and Kuala Lumpur is inadequate or unavailable data pertaining to EMS performance. There is non-uniformity in the EMS performance measurement across the Asian cities. This creates difficulty for EMS performance index comparison and benchmarking. Hopefully, in the future, collaborative efforts such as the PAROS networking group will further enhance the standardization in EMS performance reporting across the region.

  7. Public Reporting of Primary Care Clinic Quality: Accounting for Sociodemographic Factors in Risk Adjustment and Performance Comparison.

    Science.gov (United States)

    Wholey, Douglas R; Finch, Michael; Kreiger, Rob; Reeves, David

    2018-01-03

    Performance measurement and public reporting are increasingly being used to compare clinic performance. Intended consequences include quality improvement, value-based payment, and consumer choice. Unintended consequences include reducing access for riskier patients and inappropriately labeling some clinics as poor performers, resulting in tampering with stable care processes. Two analytic steps are used to maximize intended and minimize unintended consequences. First, risk adjustment is used to reduce the impact of factors outside providers' control. Second, performance categorization is used to compare clinic performance using risk-adjusted measures. This paper examines the effects of methodological choices, such as risk adjusting for sociodemographic factors in risk adjustment and accounting for patients clustering by clinics in performance categorization, on clinic performance comparison for diabetes care, vascular care, asthma, and colorectal cancer screening. The population includes all patients with commercial and public insurance served by clinics in Minnesota. Although risk adjusting for sociodemographic factors has a significant effect on quality, it does not explain much of the variation in quality. In contrast, taking into account the nesting of patients within clinics in performance categorization has a substantial effect on performance comparison.

  8. The impact of multi-criteria performance measurement on business performance improvement

    Directory of Open Access Journals (Sweden)

    Fentahun Moges Kasie

    2013-06-01

    Full Text Available Purpose: The purpose of this paper is to investigate the relationship between multi-criteria performance measurement (MCPM practice and business performance improvement using the raw data collected from 33 selected manufacturing companies. In addition, it proposes modified MCPM model as an effective approach to improve business performance of manufacturing companies. Design/methodology/approach:Research paper. Primary and secondary data were collected using questionnaire survey, interview and observation of records. The methodology is to evaluate business performances of sampled manufacturing companies and the extent of utilization of crucial non-financial (lagging and non-financial (leading performance measures. The positive correlation between financial business performance and practice of MCPM is clearly shown using Pearson’s correlation coefficient analysis. Findings –This research paper indicates that companies which measure their performance using important financial and non-financial measures achieve better business performance. Even though certain companies are currently using non-financial measures, the researchers have learned that these financial measures were not integrated with each other, financial measures and strategic objectives. Research limitations/implications: The limitation of this paper is that the number of surveyed companies is small to make generalization and they are found in a single country. Further researches which incorporate a large number of companies from various developing nations are suggested to minimize the limitation of this research.Practical Implication: The paper shows that multi-dimensional performance measures with the inclusion of key leading indicator are essential to predict the future environment. But cost-accounting based financial measures are inadequate to do so. These are shown practically using Pearson’s correlation coefficient analysis. Originality/value: The significance of multi

  9. Should we assess clinical performance in single patient encounters or consistent behaviors of clinical performance over a series of encounters? A qualitative exploration of narrative trainee profiles

    NARCIS (Netherlands)

    Oerlemans, M.; Dielissen, P.W.; Timmerman, A.; Ram, P.; Maiburg, B.; Muris, J.; Vleuten, C. van der

    2017-01-01

    BACKGROUND: A variety of tools have been developed to assess performance which typically use a single clinical encounter as a source for making competency inferences. This strategy may miss consistent behaviors. We therefore explored experienced clinical supervisors' perceptions of behavioral

  10. Alternative measure for performance of HLW geologic repository

    International Nuclear Information System (INIS)

    Joonhang, Ahn; Chambre, P.L.

    2001-01-01

    A repository performance model that can show effects of canister multiplicity and repository configuration has been developed. Masses of a radionuclide in the repository and in the far field are proposed as performance measures. Canister multiplicity has significant effects on the release of long-lived radionuclides from the repository. As more canisters are included in the same water stream, the radionuclide concentration in the stream increases, but becomes independent of the number of canisters for sufficiently many canisters. Effects of reduction of radionuclide mass in the repository on the repository performance are clearly observed if the canister multiplicity is taken into account and the mass-based measures are applied. (author)

  11. Determinants of the use of value-based performance measures for managerial performance evaluation

    NARCIS (Netherlands)

    Dekker, H.C.; Groot, T.L.C.M.; Schoute, M.; Wiersma, E.

    2012-01-01

    As value-based (VB) performance measures include firms' cost of capital, they are considered more congruent than earnings measures. Prior studies, however, find that their use for managerial performance evaluation is less extensive than their presumed benefits would suggest. We examine how the

  12. Laterality of repetitive finger movement performance and clinical features of Parkinson's disease.

    Science.gov (United States)

    Stegemöller, Elizabeth; Zaman, Andrew; MacKinnon, Colum D; Tillman, Mark D; Hass, Chris J; Okun, Michael S

    2016-10-01

    Impairments in acoustically cued repetitive finger movement often emerge at rates near to and above 2Hz in persons with Parkinson's Disease (PD) in which some patients move faster (hastening) and others move slower (bradykinetic). The clinical features impacting this differential performance of repetitive finger movement remain unknown. The purpose of this study was to compare repetitive finger movement performance between the more and less affected side, and the difference in clinical ratings among performance groups. Forty-one participants diagnosed with idiopathic PD completed an acoustically cued repetitive finger movement task while "on" medication. Eighteen participants moved faster, 10 moved slower, and 13 were able to maintain the appropriate rate at rates above 2Hz. Clinical measures of laterality, disease severity, and the UPDRS were obtained. There were no significant differences between the more and less affected sides regardless of performance group. Comparison of disease severity, tremor, and rigidity among performance groups revealed no significant differences. Comparison of posture and postural instability scores revealed that the participants that demonstrated hastening had worse posture and postural instability scores. Consideration of movement rate during the clinical evaluation of repetitive finger movement may provide additional insight into varying disease features in persons with PD. Copyright © 2016 Elsevier B.V. All rights reserved.

  13. Progressive learning in endoscopy simulation training improves clinical performance: a blinded randomized trial.

    Science.gov (United States)

    Grover, Samir C; Scaffidi, Michael A; Khan, Rishad; Garg, Ankit; Al-Mazroui, Ahmed; Alomani, Tareq; Yu, Jeffrey J; Plener, Ian S; Al-Awamy, Mohamed; Yong, Elaine L; Cino, Maria; Ravindran, Nikila C; Zasowski, Mark; Grantcharov, Teodor P; Walsh, Catharine M

    2017-11-01

    A structured comprehensive curriculum (SCC) that uses simulation-based training (SBT) can improve clinical colonoscopy performance. This curriculum may be enhanced through the application of progressive learning, a training strategy centered on incrementally challenging learners. We aimed to determine whether a progressive learning-based curriculum (PLC) would lead to superior clinical performance compared with an SCC. This was a single-blinded randomized controlled trial conducted at a single academic center. Thirty-seven novice endoscopists were recruited and randomized to either a PLC (n = 18) or to an SCC (n = 19). The PLC comprised 6 hours of SBT, which progressed in complexity and difficulty. The SCC included 6 hours of SBT, with cases of random order of difficulty. Both groups received expert feedback and 4 hours of didactic teaching. Participants were assessed at baseline, immediately after training, and 4 to 6 weeks after training. The primary outcome was participants' performance during their first 2 clinical colonoscopies, as assessed by using the Joint Advisory Group Direct Observation of Procedural Skills assessment tool (JAG DOPS). Secondary outcomes were differences in endoscopic knowledge, technical and communication skills, and global performance in the simulated setting. The PLC group outperformed the SCC group during first and second clinical colonoscopies, measured by JAG DOPS (P PLC group had superior technical and communication skills and global performance in the simulated setting (P  .05). Our findings demonstrate the superiority of a PLC for endoscopic simulation, compared with an SCC. Challenging trainees progressively is a simple, theory-based approach to simulation whereby the performance of clinical colonoscopies can be improved. (Clinical trial registration number: NCT02000180.). Copyright © 2017 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  14. Shielding Performance Measurements of Spent Fuel Transportation Container

    Directory of Open Access Journals (Sweden)

    SUN Hong-chao

    2015-11-01

    Full Text Available The safety supervision of radioactive material transportation package has been further stressed and implemented. The shielding performance measurements of spent fuel transport container is the important content of supervision. However, some of the problems and difficulties reflected in practice need to be solved, such as the neutron dose rate on the surface of package is too difficult to measure exactly, the monitoring results are not always reliable, etc. The monitoring results using different spectrometers were compared and the simulation results of MCNP runs were considered. An improvement was provided to the shielding performance measurements technique and management of spent fuel transport.

  15. The comprehensive care project: measuring physician performance in ambulatory practice.

    Science.gov (United States)

    Holmboe, Eric S; Weng, Weifeng; Arnold, Gerald K; Kaplan, Sherrie H; Normand, Sharon-Lise; Greenfield, Sheldon; Hood, Sarah; Lipner, Rebecca S

    2010-12-01

    To investigate the feasibility, reliability, and validity of comprehensively assessing physician-level performance in ambulatory practice. Ambulatory-based general internists in 13 states participated in the assessment. We assessed physician-level performance, adjusted for patient factors, on 46 individual measures, an overall composite measure, and composite measures for chronic, acute, and preventive care. Between- versus within-physician variation was quantified by intraclass correlation coefficients (ICC). External validity was assessed by correlating performance on a certification exam. Medical records for 236 physicians were audited for seven chronic and four acute care conditions, and six age- and gender-appropriate preventive services. Performance on the individual and composite measures varied substantially within (range 5-86 percent compliance on 46 measures) and between physicians (ICC range 0.12-0.88). Reliabilities for the composite measures were robust: 0.88 for chronic care and 0.87 for preventive services. Higher certification exam scores were associated with better performance on the overall (r = 0.19; pmeasures and by sampling feasible numbers of patients for each condition. © Health Research and Educational Trust.

  16. Performance Measurement of Management System Standards Using the Balanced Scorecard

    Directory of Open Access Journals (Sweden)

    Jan Kopia

    2017-11-01

    Full Text Available Management system standards (MSS, such as ISO standards, TQM, etc. are widely-used standards adopted by millions of organizations worldwide. It is still an unclear question whether these standards are beneficial for an organization, besides the fact that they might be required or expected by law or customers. The question, whether MSS increase the efficiency, the output, or the performance of an organization is still discussed in scientific research. One reason might be that performance measurement itself is not fully understood or in constant development ranging from pure financial evaluations over intellectual capital rating to calculating of levels of environmental, social or economic expectations known as the Trible Bottom Line. The Balanced Scorecard is one possible solution for performance measurement on a strategic and operational level and therefore useful for the measurement of the influence of MSS within organizations. This study summarized current research in the field of performance measurement in the context of MSS and IMS and the use of BSC and quantitatively and qualitatively tests the usefulness of BSC in measuring the effect of MSSs using the Execution Premium. It was found that BSC is often used, that an average number of companies integrate their measurement initiatives of their MSSs into the BSC-process, and that a high integration of MSS into the BSC improves the organizational performance. This research is useful for researchers and practitioners in order to understand the benefits of the usage of the BSC in the context of MSS or Integrated Management Systems.

  17. 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.

  18. The (mis)Measurement of M&A Performance

    DEFF Research Database (Denmark)

    Meglio, Olimpia; Risberg, Annette

    2011-01-01

    This paper seeks to further the understanding of the variety of meanings M&A scholars attach to the label “M&A performance” by providing an alternative way to interpret the claimed inconsistency of M&A research findings. While many scholars contend that the problem stems from the multiplicity of M......&A performance measures, we believe the problem rests in trying to compare different measures as if they were measuring the same feature of the organization. Through our narrative review of empirical research we analyze factors shaping the M&A – as well as the organizational – performance measurement process....... The conclusion is that it is not possible to talk about M&A performance as if it was a universal construct....

  19. [An instrument in Spanish to evaluate the performance of clinical teachers by students].

    Science.gov (United States)

    Bitran, Marcela; Mena, Beltrán; Riquelme, Arnoldo; Padilla, Oslando; Sánchez, Ignacio; Moreno, Rodrigo

    2010-06-01

    The modernization of clinical teaching has called for the creation of faculty development programs, and the design of suitable instruments to evaluate clinical teachers' performance. To report the development and validation of an instrument in Spanish designed to measure the students' perceptions of their clinical teachers' performance and to provide them with feedback to improve their teaching practices. In a process that included the active participation of authorities, professors in charge of courses and internships, clinical teachers, students and medical education experts, we developed a 30-item questionnaire called MEDUC30 to evaluate the performance of clinical teachers by their students. The internal validity was assessed by factor analysis of 5214 evaluations of 265 teachers, gathered from 2004 to 2007. The reliability was measured with the Cronbach's alpha coefficient and the generalizability coefficient (g). MEDUC30 had good content and construct validity. Its internal structure was compatible with four factors: patient-centered teaching, teaching skills, assessment skills and learning climate, and it proved to be consistent with the structure anticipated by the theory. The scores were highly reliable (Cronbach's alpha: 0.97); five evaluations per teacher were sufficient to reach a reliability coefficient (g) of 0.8. MEDUC30 is a valid, reliable and useful instrument to evaluate the performance of clinical teachers. To our knowledge, this is the first instrument in Spanish for which solid validity and reliability evidences have been reported. We hope that MEDUC30 will be used to improve medical education in Spanish-speaking medical schools, providing teachers a specific feedback upon which to improve their pedagogical practice, and authorities with valuable information for the assessment of their faculty.

  20. Measurement of leukocyte rheology in vascular disease: clinical rationale and methodology. International Society of Clinical Hemorheology.

    Science.gov (United States)

    Wautier, J L; Schmid-Schönbein, G W; Nash, G B

    1999-01-01

    The measurement of leukocyte rheology in vascular disease is a recent development with a wide range of new opportunities. The International Society of Clinical Hemorheology has asked an expert panel to propose guidelines for the investigation of leukocyte rheology in clinical situations. This article first discusses the mechanical, adhesive and related functional properties of leukocytes (especially neutrophils) which influence their circulation, and establishes the rationale for clinically-related measurements of parameters which describe them. It is concluded that quantitation of leukocyte adhesion molecules, and of their endothelial receptors may assist understanding of leukocyte behaviour in vascular disease, along with measurements of flow resistance of leukocytes, free radical production, degranulation and gene expression. For instance, vascular cell adhesion molecule (VCAM-1) is abnormally present on endothelial cells in atherosclerosis, diabetes mellitus and inflammatory conditions. Soluble forms of intercellular adhesion molecule (ICAM-1) or VCAM can be found elevated in the blood of patients with rheumatoid arthritis or infections disease. In the second part of the article, possible technical approaches are presented and possible avenues for leukocyte rheological investigations are discussed.

  1. Measuring service quality in a hospital colposcopy clinic.

    Science.gov (United States)

    Wisniewski, Mik; Wisniewski, Hazel

    2005-01-01

    The issues surrounding the measurement and provision of service quality in a health care setting are becoming increasingly important to nursing. This research study aims to apply the SERVQUAL measurement instrument in a Scottish colposcopy clinic. The study involved adapting the SERVQUAL instrument to the colposcopy setting and asking a sample of patients to complete the questionnaire. Patient expectations of service were obtained on first attendance at the clinic. Patient perceptions of service received were obtained on completion of treatment. Perceptions and expectations are then compared to identify where the largest service gaps exist. Although patient satisfaction with the overall service provided was generally high, the instrument provided evidence of where specific service improvements were needed. The largest service quality gap was for the reliability of service. The research also revealed the need for improved premises. Although the study has a limited sample size, it does appear that the SERVQUAL instrument has a useful diagnostic role to play in assessing and monitoring service quality in nursing, enabling nursing staff to identify where improvements are needed from the patients' perspective. The study has raised a number of issues which would form the basis for useful further research. Service quality from the patients' perspective should be routinely monitored and assessed. The findings should be useful to nursing staff seeking to assess, and improve, service quality.

  2. Performance specifications and six sigma theory: Clinical chemistry and industry compared.

    Science.gov (United States)

    Oosterhuis, W P; Severens, M J M J

    2018-04-11

    Analytical performance specifications are crucial in test development and quality control. Although consensus has been reached on the use of biological variation to derive these specifications, no consensus has been reached which model should be preferred. The Six Sigma concept is widely applied in industry for quality specifications of products and can well be compared with Six Sigma models in clinical chemistry. However, the models for measurement specifications differ considerably between both fields: where the sigma metric is used in clinical chemistry, in industry the Number of Distinct Categories is used instead. In this study the models in both fields are compared and discussed. Copyright © 2018. Published by Elsevier Inc.

  3. 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

  4. The use of performance measurement systems in the public sector: effects on performance

    NARCIS (Netherlands)

    Speklé, R.; Verbeeten, F.H.M.

    2014-01-01

    We study the use of performance measurement systems in the public sector. We hypothesize that the way in which these systems are being used affects organizational performance, and that these performance effects depend on contractibility. Contractibility encompasses clarity of goals, the ability to

  5. Workshop on system tuning, performance measurement and performance optimization of an RSX11M system

    International Nuclear Information System (INIS)

    Downward, J.G.

    1981-01-01

    Topics discussed include thrashing in an RSX11M system - what to do; using solid state disk emulators as the swapping device - performance improvement, performance measurement techniques; capacity planning; bis buffering; and DECNET-11M optimization - performance that can be expected for real environments

  6. CT and MR imaging acquisition performance in a neuroradiology PACS module 1-year clinical experience

    International Nuclear Information System (INIS)

    Lou, S.L.; Loloyan, M.; Weinberg, W.S.; Valentino, D.J.; Lufkin, R.B.; Hanafee, W.N.; Bentson, J.; Jabour, B.A.; Huang, H.K.

    1990-01-01

    This paper analyzes the operational efficiency of our neuroradiology PACS compared with conventional film-based management systems. The authors neuroradiology PACS module has been in clinical evaluation for 6 months. Three SUN microcomputers, two PC/ATs, and an automated optical disk library are connected through Ethernet. Software implemented at the TCP/IP level is used to transfer images from MR imagers and CT scanners to a viewing station. Performance measurements include the time elapsed at each stage of the system

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

    Directory of Open Access Journals (Sweden)

    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.

  8. Achieving organisational competence for clinical leadership: the role of high performance work systems.

    Science.gov (United States)

    Leggat, Sandra G; Balding, Cathy

    2013-01-01

    While there has been substantial discussion about the potential for clinical leadership in improving quality and safety in healthcare, there has been little robust study. The purpose of this paper is to present the results of a qualitative study with clinicians and clinician managers to gather opinions on the appropriate content of an educational initiative being planned to improve clinical leadership in quality and safety among medical, nursing and allied health professionals working in primary, community and secondary care. In total, 28 clinicians and clinician managers throughout the state of Victoria, Australia, participated in focus groups to provide advice on the development of a clinical leadership program in quality and safety. An inductive, thematic analysis was completed to enable the themes to emerge from the data. Overwhelmingly the participants conceptualised clinical leadership in relation to organisational factors. Only four individual factors, comprising emotional intelligence, resilience, self-awareness and understanding of other clinical disciplines, were identified as being important for clinical leaders. Conversely seven organisational factors, comprising role clarity and accountability, security and sustainability for clinical leaders, selective recruitment into clinical leadership positions, teamwork and decentralised decision making, training, information sharing, and transformational leadership, were seen as essential, but the participants indicated they were rarely addressed. The human resource management literature includes these seven components, with contingent reward, reduced status distinctions and measurement of management practices, as the essential organisational underpinnings of high performance work systems. The results of this study propose that clinical leadership is an organisational property, suggesting that capability frameworks and educational programs for clinical leadership need a broader organisation focus. The paper

  9. Using Radiation Pattern Measurements for Mobile Handset Performance Evaluation

    DEFF Research Database (Denmark)

    Nielsen, Jesper Ødum; Pedersen, Gert Frølund

    2005-01-01

    The mean effective gain (MEG) is an attractive performance measure of mobile handsets, since it incorporates both directional and polarization properties of the handset and environment. In this work the MEG is computed from measured spherical radiation patterns of five different mobile handsets...... values obtained for different orientations of the handsets in the environments. For practical measurements it is important to minimize the measurement time. The paper includes a study of the variation in MEG when the number of samples in the spherical radiation pattern is reduced. Furthermore...

  10. The Development of NOAA Education Common Outcome Performance Measures (Invited)

    Science.gov (United States)

    Baek, J.

    2013-12-01

    The National Oceanic and Atmospheric Administration (NOAA) Education Council has embarked on an ambitious Monitoring and Evaluation (M&E) project that will allow it to assess education program outcomes and impacts across the agency, line offices, and programs. The purpose of this internal effort is to link outcome measures to program efforts and to evaluate the success of the agency's education programs in meeting the strategic goals. Using an outcome-based evaluation approach, the NOAA Education Council is developing two sets of common outcome performance measures, environmental stewardship and professional development. This presentation will examine the benefits and tradeoffs of common outcome performance measures that collect program results across a portfolio of education programs focused on common outcomes. Common outcome performance measures have a few benefits to our agency and to the climate education field at large. The primary benefit is shared understanding, which comes from our process for writing common outcome performance measures. Without a shared and agreed upon set of definitions for the measure of an outcome, the reported results may not be measuring the same things and would incorrectly indicate levels of performance. Therefore, our writing process relies on a commitment to developing a shared set of definitions based on consensus. We hope that by taking the time to debate and coming to agreement across a diverse set of programs, the strength of our common measures can indicate real progress towards outcomes we care about. An additional benefit is that these common measures can be adopted and adapted by other agencies and organizations that share similar theories of change. The measures are not without their drawbacks, and we do make tradeoffs as part of our process in order to continue making progress. We know that any measure is necessarily a narrow slice of performance. A slice that may not best represent the unique and remarkable contribution

  11. How to measure kyphosis in everyday clinical practice: a reliability study on different methods.

    Science.gov (United States)

    Zaina, Fabio; Donzelli, Sabrina; Lusini, Monia; Negrini, Stefano

    2012-01-01

    The sagittal plane measures have a relevant role both in Idiopathic Scoliosis (AIS) and in Hyperkyphosis (HK) management. Nevertheless, clinical tools for everyday use are scarce and not adequately studied. To assess the repeatability of different methods for the collection of the sagittal profile of patients with spinal deformities during everyday clinics. We performed 4 different studies in 4 different populations of AIS and HK patients. In the first study we reported the normative data and measurement error of the plumbline measures in a general population of 180 adolescents. In the second study we compared the sagittal distances from the plumbline of C7, T12, L3, and Sagittal Index (SI = C7+L3) with the measures of the Video Rasterstereography at the same levels and the angles of kyphosis and lordosis in 100 AIS patients. In the third study we evaluated the intra and inter-rater repeatability and the measurement error of kyphosis and lordosis angles measured with the Inclimed in 100 AIS patients. In the last study we evaluated the repeatability of the sagittal distances from the plumbline, by using a 1 mm change instead of 5 mm in a population of 40 patients. repeatability has been evaluated according to Bland and Altman, to identify the limits of variation that are clinically significant. Results. Study 1: the normative data were: females: 34 ± 11 mm for C7; 34 ± 15 mm for L3, males: 34 ± 10 mm for C7; 48 ± 10 mm for L3;. Study 2: a coefficient of correlation was calculated in order to compare measures. Study 3: the k value for Inclimed varied from fair to good. Study 4: the repeatability was fair for this measure. Some clinical instruments are now available for sagittal plane assessment in AIS and hyperkyphosis. The results of the present study report the limits during measurements in a clinical setting of parameters that are routinely collected by some clinicians.

  12. 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.

  13. Grading the performance of clinical skills: lessons to be learned from the performing arts.

    Science.gov (United States)

    Roberts, Deborah

    2011-08-01

    The drift towards competency based nurse interventions has seen a growth in concern regarding the most appropriate methods of assessment of such competencies. Nurse educators and practitioners alike are struggling with the concept of measuring the performance of nursing skills; due to an uneasy relationship between competence, capability, intuition and expertise. Different currencies of value may be ascribed to the assessment of nursing practice, resulting in the use of subjective judgements together with the development of assessment criteria which have different weightings, depending on the values of the assessor. Within the performing arts, students' practice performance is also assessed, with seemingly many similarities between applying value to performance in dance or theatre and nursing. Within performing arts assessment a balancing act is also being played out between academic education and professional training (where complex performances are notoriously hard to evaluate). This paper explores the nature of assessment within the performing arts and makes suggestions regarding their application within the context of nurse education. If nursing is indeed a blend of art and science, then it seems sensible to look to the performing arts to see if lessons could be learned. Copyright © 2010 Elsevier Ltd. All rights reserved.

  14. Amotivation in schizophrenia: integrated assessment with behavioral, clinical, and imaging measures.

    Science.gov (United States)

    Wolf, Daniel H; Satterthwaite, Theodore D; Kantrowitz, Jacob J; Katchmar, Natalie; Vandekar, Lillie; Elliott, Mark A; Ruparel, Kosha

    2014-11-01

    Motivational deficits play a central role in disability caused by schizophrenia and constitute a major unmet therapeutic need. Negative symptoms have previously been linked to hypofunction in ventral striatum (VS), a core component of brain motivation circuitry. However, it remains unclear to what extent this relationship holds for specific negative symptoms such as amotivation, and this question has not been addressed with integrated behavioral, clinical, and imaging measures. Here, 41 individuals with schizophrenia and 37 controls performed a brief, computerized progressive ratio task (PRT) that quantifies effort exerted in pursuit of monetary reward. Clinical amotivation was assessed using the recently validated Clinical Assessment Interview for Negative Symptoms (CAINS). VS function was probed during functional magnetic resonance imaging using a monetary guessing paradigm. We found that individuals with schizophrenia had diminished motivation as measured by the PRT, which significantly and selectively related to clinical amotivation as measured by the CAINS. Critically, lower PRT motivation in schizophrenia was also dimensionally related to VS hypofunction. Our results demonstrate robust dimensional associations between behavioral amotivation, clinical amotivation, and VS hypofunction in schizophrenia. Integrating behavioral measures such as the PRT will facilitate translational efforts to identify biomarkers of amotivation and to assess response to novel therapeutic interventions. © The Author 2014. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  15. Performance measurements at the fast flux test facility

    International Nuclear Information System (INIS)

    Baumhardt, R.J.; Newland, D.J.; Praetorius, P.R.

    1987-01-01

    In 1984, Fast Flux Test Facility (FFTF) management recognized the need to develop a measurement system that would quantify the operational performance of the FFTF and the human resources needed to operate it. Driven by declining budgets and the need to safely manage a manpower rampdown at FFTF, an early warning system was developed. Although the initiating event for the early warning system was the need to safely manage a manpower rampdown, many related uses have evolved. The initial desired objective for the FFTF performance measurements was to ensure safety and control of key performance trends. However, the early warning system has provided a more quantitative, supportable basis upon which to make decisions. From this initial narrow focus, efforts in the FFTF plant and supporting organizations are leading to measurement of and, subsequently, improvements in productivity. Pilot projects utilizing statistical process control have started with longer range productivity improvement

  16. In situ performance curves measurements of large pumps

    International Nuclear Information System (INIS)

    Anton, A

    2010-01-01

    The complex energetic system on the river Lotru in Romania comprises of a series of lakes and pumping stations and a major hydroelectric power plant: Lotru-Ciunget. All the efforts have been oriented towards the maintenance of the Pelton turbines and very little attention has been directed to the pumps. In the system, there are three large pumping stations and only in the last 5 years, the pump performances have become a concern. The performances where determined using portable ultrasonic flow meters, a Yates meter, precision manometers and appropriate electrical equipment for power measurement (Power Analiser - NORMA D4000 LEM). The measurements are not supposed to interfere with the normal operation so only a limited number of tests could be performed. Based on those tests, portions of the test curves have been measured and represented in specific diagrams.

  17. In situ performance curves measurements of large pumps

    Science.gov (United States)

    Anton, A.

    2010-08-01

    The complex energetic system on the river Lotru in Romania comprises of a series of lakes and pumping stations and a major hydroelectric power plant: Lotru-Ciunget. All the efforts have been oriented towards the maintenance of the Pelton turbines and very little attention has been directed to the pumps. In the system, there are three large pumping stations and only in the last 5 years, the pump performances have become a concern. The performances where determined using portable ultrasonic flow meters, a Yates meter, precision manometers and appropriate electrical equipment for power measurement (Power Analiser - NORMA D4000 LEM). The measurements are not supposed to interfere with the normal operation so only a limited number of tests could be performed. Based on those tests, portions of the test curves have been measured and represented in specific diagrams.

  18. Business sustainability performance measurement: Eco-ratio analysis

    Directory of Open Access Journals (Sweden)

    Collins C. Ngwakwe

    2016-12-01

    Full Text Available Eco-aware customers and stakeholders are demanding for a measurement that links environmental performance with other business operations. To bridge this seemingly measurement gap, this paper suggests ‘Eco-Ratio Analysis’ and proposes an approach for conducting eco-ratio analysis. It is argued that since accounting ratios function as a tool for evaluating corporate financial viability by management and investors, eco-ratio analysis should be brought to the fore to provide a succinct measurement about the linkage between environmental performance and conventional business performance. It is hoped that this suggestion will usher in a nuance debate and approach in the teaching, research and practice of environmental management and sustainability accounting

  19. Clinical Relationship between Steatocholecystitis and Gallbladder Contractility Measured by Cholescintigraphy

    Directory of Open Access Journals (Sweden)

    Chang Seok Bang

    2015-01-01

    Full Text Available Objective. Contractility of gallbladder is known to be decreased in fatty gallbladder diseases. However, clinical estimation data about this relationship is still lacking. The aim of this study was to investigate the association between steatocholecystitis and contractility of gallbladder. Methods. Patients with cholecystitis (steatocholecystitis versus nonsteatocholecystitis who underwent cholescintigraphy before cholecystectomy were retrospectively evaluated in a single teaching hospital of Korea. The association of steatocholecystitis with contractility of gallbladder, measured by preoperative cholescintigraphy, was assessed by univariable and multivariable analysis. Results. A total of 432 patients were finally enrolled (steatocholecystitis versus nonsteatocholecystitis; 75 versus 357, calculous versus acalculous cholecystitis; 316 versus 116. In the multivariable analysis, age (OR: 0.94, 95% CI: 0.90–0.99, P=0.01 and total serum cholesterol (OR: 1.02, 95% CI: 1.01–1.04, P=0.04 were related to steatocholecystitis in patients with acalculous cholecystitis. Only age (OR: 0.97, 95% CI: 0.94–0.99, P=0.004 was significantly related to steatocholecystitis in patients with calculous cholecystitis. However, ejection fraction of gallbladder reflecting contractility measured by cholescintigraphy was not related to steatocholecystitis irrespective of presence of gallbladder stone in patients with cholecystitis. Conclusion. Ejection fraction of gallbladder measured by cholescintigraphy cannot be used for the detection or confirmation of steatocholecystitis.

  20. Can Emergency Physicians Perform Common Carotid Doppler Flow Measurements to Assess Volume Responsiveness?

    Directory of Open Access Journals (Sweden)

    Stolz, Lori A.

    2015-02-01

    Full Text Available Introduction: Common carotid flow measurements may be clinically useful to determine volume responsiveness. The objective of this study was to assess the ability of emergency physicians (EP to obtain sonographic images and measurements of the common carotid artery velocity time integral (VTi for potential use in assessing volume responsiveness in the clinical setting. Methods: In this prospective observational study, we showed a five-minute instructional video demonstrating a technique to obtain common carotid ultrasound images and measure the common carotid VTi to emergency medicine (EM residents. Participants were then asked to image the common carotid artery and obtain VTi measurements. Expert sonographers observed participants imaging in real time and recorded their performance on nine performance measures. An expert sonographer graded image quality. Participants were timed and answered questions regarding ease of examination and their confidence in obtaining the images. Results: A total of 30 EM residents participated in this study and each performed the examination twice. Average time required to complete one examination was 2.9 minutes (95% CI [2.4-3.4 min]. Participants successfully completed all performance measures greater than 75% of the time, with the exception of obtaining measurements during systole, which was completed in 65% of examinations. Median resident overall confidence in accurately performing carotid VTi measurements was 3 (on a scale of 1 [not confident] to 5 [confident]. Conclusion: EM residents at our institution learned the technique for obtaining common carotid artery Doppler flow measurements after viewing a brief instructional video. When assessed at performing this examination, they completed several performance measures with greater than 75% success. No differences were found between novice and experienced groups. [West J Emerg Med. 2015;16(2:255–259.

  1. Persistent fatigue in young athletes: measuring the clinical course and identifying variables affecting clinical recovery.

    Science.gov (United States)

    Locke, S; Osborne, M; O'Rourke, P

    2011-02-01

    The objective of this paper is to measure the clinical course (months) in young athletes with persistent fatigue and to identify any covariates affecting the duration of recovery. This was a prospective longitudinal study of 68 athletes; 87% were elite (42 males, 26 females), aged 20.5±3.74 years (SD), who presented with the symptom of persistent fatigue. The collective duration to full clinical recovery was estimated using Kaplan-Meier product-limit curves, and covariates associated with prolonging recovery were identified from Cox proportional hazard models. The median recovery was 5 months (range 1-60 months). The range of presenting symptom duration was 0.5-36 months. The covariates identified were an increased duration of presenting symptoms [hazard ratio (HR), 1.06; 95% confidence interval (CI), 1.02-1.12; P=0.005] and the response of serum cortisol concentration to a standard exercise challenge (HR, 1.92; 95% CI, 1.09-3.38; P=0.03). Delay in recovery was not associated with categories of fatigue that included medical, training-related diagnoses, or other causes. In conclusion, the fatigued athlete represents a significant clinical problem with a median recovery of 5 months, whose collective clinical course to recovery can be estimated by Kaplan-Meier curves and appears to be a continuum. © 2009 John Wiley & Sons A/S.

  2. Health status measurement in COPD: the minimal clinically important difference of the clinical COPD questionnaire

    Directory of Open Access Journals (Sweden)

    van den Berg JWK

    2006-04-01

    Full Text Available Abstract Background Patient-reported outcomes (PRO questionnaires are being increasingly used in COPD clinical studies. The challenge facing investigators is to determine what change is significant, ie what is the minimal clinically important difference (MCID. This study aimed to identify the MCID for the clinical COPD questionnaire (CCQ in terms of patient referencing, criterion referencing, and by the standard error of measurement (SEM. Methods Patients were ≥40 years of age, diagnosed with COPD, had a smoking history of >10 pack-years, and were participating in a randomized, controlled clinical trial comparing intravenous and oral prednisolone in patients admitted with an acute exacerbation of COPD. The CCQ was completed on Days 1–7 and 42. A Global Rating of Change (GRC assessment was taken to establish the MCID by patient referencing. For criterion referencing, health events during a period of 1 year after Day 42 were included in this analysis. Results 210 patients were recruited, 168 completed the CCQ questionnaire on Day42. The MCID of the CCQ total score, as indicated by patient referencing in terms of the GRC, was 0.44. The MCID of the CCQ in terms of criterion referencing for the major outcomes was 0.39, and calculation of the SEM resulted in a value of 0.21. Conclusion This investigation, which is the first to determine the MCID of a PRO questionnaire via more than one approach, indicates that the MCID of the CCQ total score is 0.4.

  3. Students' performance in the different clinical skills assessed in OSCE: what does it reveal?

    Science.gov (United States)

    Sim, Joong Hiong; Abdul Aziz, Yang Faridah; Mansor, Azura; Vijayananthan, Anushya; Foong, Chan Choong; Vadivelu, Jamuna

    2015-01-01

    The purpose of this study was to compare students' performance in the different clinical skills (CSs) assessed in the objective structured clinical examination. Data for this study were obtained from final year medical students' exit examination (n=185). Retrospective analysis of data was conducted using SPSS. Means for the six CSs assessed across the 16 stations were computed and compared. Means for history taking, physical examination, communication skills, clinical reasoning skills (CRSs), procedural skills (PSs), and professionalism were 6.25±1.29, 6.39±1.36, 6.34±0.98, 5.86±0.99, 6.59±1.08, and 6.28±1.02, respectively. Repeated measures ANOVA showed there was a significant difference in the means of the six CSs assessed [F(2.980, 548.332)=20.253, pskill to be acquired by medical students before entering the workplace. Despite its challenges, students must learn the skills of clinical reasoning, while clinical teachers should facilitate the clinical reasoning process and guide students' clinical reasoning development.

  4. Developing a performance measurement system for public research centres

    Directory of Open Access Journals (Sweden)

    Masella, C.

    2012-01-01

    Full Text Available This study aims at developing a performance measurement system (PMS for research and development (R&D activities carried out by public research centres. Public research institutions are characterized by multiple stakeholders with different needs, and the management of R&D activities requires balancing the multiple goals of different stakeholders. This characteristic is a key issue in the process of construction of the PMS. Empirical evidence is provided by an Italian public research centre, where the researchers carried out a project aimed to develop a PMS following action research principles. This project gave the possibility to researchers to interact with different stakeholders and integrate their different information needs in a comprehensive set of key performance indicators (KPIs. As a result, multidimensional framework for measuring R&D performance in a public research centre is proposed and a set of Key Performance Indicators is developed, suggesting implications for academics and practitioners.

  5. Oxide thickness measurement for monitoring fuel performance at high burnup

    International Nuclear Information System (INIS)

    Jaeger, M.A.; Van Swam, L.F.P.; Brueck-Neufeld, K.

    1991-01-01

    For on-site monitoring of the fuel performance at high burnup, Advanced Nuclear Fuels uses the linear scan eddy current method to determine the oxide thickness of irradiated Zircaloy fuel cans. Direct digital data acquisition methods are employed to collect the data on magnetic storage media. This field-proven methodology allows oxide thickness measurements and rapid interpretation of the data during the reactor outages and makes it possible to immediately reinsert the assemblies for the next operating cycle. The accuracy of the poolside measurements and data acquisition/interpretation techniques have been verified through hot cell metallographic measurements of rods previously measured in the fuel pool. The accumulated data provide a valuable database against which oxide growth models have been benchmarked and allow for effective monitoring of fuel performance. (orig.) [de

  6. Measuring business performance using indicators of ecologically sustainable organizations

    Science.gov (United States)

    Snow, Charles G., Jr.; Snow, Charles C.

    2001-02-01

    The purpose of this paper is to explore the use of ecology-based performance measures as a way of augmenting the Balanced Scorecard approach to organizational performance measurement. The Balanced Scorecard, as proposed by Kaplan and Norton, focuses on four primary dimensions; financial, internal-business-process, customer, and learning and growth perspectives. Recently, many 'green' organizational theorists have developed the concept of "Ecologically Sustainable Organizations" or ESOs, a concept rooted in open systems theory. The ESO is called upon to consider resource use and conservation as a strategy for long-term viability. This paper asserts that in order to achieve ESO status, an organization must not only measure but also reward resource conservation measures. Only by adding a fifth perspective for ecological dimensions will the entity be truly motivated toward ESO status.

  7. ROLE AND IMPORTANCE OF KEY PERFORMANCE INDICATORS MEASUREMENT

    Directory of Open Access Journals (Sweden)

    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.

  8. Performance measurement of electricity suppliers using PROMETHEE and balance scorecard

    Directory of Open Access Journals (Sweden)

    Mona Osati

    2016-06-01

    Full Text Available Performance measurement in energy industry plays an important role on increasing the productivity. Electricity is also among the most essential components of energy in mega cities like Tehran. The lack of a good service in this city may result unpleasant consequences on most civilians who live in this city. This paper presents an empirical investigation to measure the performance of six major electricity contractors in city of Tehran, Iran. The study implements grey numbers to handle any uncertainty associated with numbers. The study has also adopted four main perspectives used in balanced scorecard as part of PROMETHEE method to rank different contractors.

  9. Modelling and measurement of a moving magnet linear compressor performance

    International Nuclear Information System (INIS)

    Liang, Kun; Stone, Richard; Davies, Gareth; Dadd, Mike; Bailey, Paul

    2014-01-01

    A novel moving magnet linear compressor with clearance seals and flexure bearings has been designed and constructed. It is suitable for a refrigeration system with a compact heat exchanger, such as would be needed for CPU cooling. The performance of the compressor has been experimentally evaluated with nitrogen and a mathematical model has been developed to evaluate the performance of the linear compressor. The results from the compressor model and the measurements have been compared in terms of cylinder pressure, the ‘P–V’ loop, stroke, mass flow rate and shaft power. The cylinder pressure was not measured directly but was derived from the compressor dynamics and the motor magnetic force characteristics. The comparisons indicate that the compressor model is well validated and can be used to study the performance of this type of compressor, to help with design optimization and the identification of key parameters affecting the system transients. The electrical and thermodynamic losses were also investigated, particularly for the design point (stroke of 13 mm and pressure ratio of 3.0), since a full understanding of these can lead to an increase in compressor efficiency. - Highlights: • Model predictions of the performance of a novel moving magnet linear compressor. • Prototype linear compressor performance measurements using nitrogen. • Reconstruction of P–V loops using a model of the dynamics and electromagnetics. • Close agreement between the model and measurements for the P–V loops. • The design point motor efficiency was 74%, with potential improvements identified

  10. The Effects of Performance Measurement and Compensation on Motivation

    OpenAIRE

    Marco van Herpen; C. Mirjam van Praag; Kees Cools

    2003-01-01

    This paper analyzes empirically the relationship between pay and performance. Economic and psychological theories predict that the design and implementation of a performance measurement and compensation system affect the motivation of employees. Our survey results demonstrate a positive relationship between the perceived characteristics of the complete compensation system and extrinsic motivation. Intrinsic motivation is not affected by the design of monetary compensation, but by promotion op...

  11. Women in Jordanian banks and performance: Financial accounting measurement

    OpenAIRE

    Muhannad Akram Ahmad; Seif Obeid Alshbiel

    2016-01-01

    This study highlights the gender diversity issues in the banking sector taking into consideration their impact on the performance measured by profitability (ROA). As the banking sector has widely been ignored from the previous studies due to their strict system, this study empirically examined the impact of the CEO gender and board with a female director on the performance of the Jordanian commercial banks in a period from 2004 to 2013. The multiple regression analysis shows that the banks wi...

  12. Towards Effective Educational Politics through Improving the Performance Measurement System

    Directory of Open Access Journals (Sweden)

    Tuuli Reisberg

    2013-01-01

    Full Text Available Educational field is impelled to increase performance and quality, financial discipline, strategic behaviour and its goals in order to enhance “effectiveness”. As a result the incorporation of private sector management practices into the educational field is taking place. But it is important to notice that a proliferation of private managerial practices into the educational field goes along with a conflict-laden and contradictory process. Education provides an important area of implementation for techniques of performance evaluation aimed at improving the performance of public services. One of the most common conceptual frameworks in measuring organisational performance takes the form of a production function where the educational institution is seen as analogous to a company transforming inputs into outputs and outcomes through a production process. But the problems and the vagueness in determining educational system’s inputs, outputs and outcomes cause difficulties in making political decisions and that is why clear policy prescriptions have been difficult to derive. The purpose of this article is to create a discussion whether performance measurement should be a part of decision-making in educational politics. The authors debate about incorporating private sector management practices into the educational field. The debate is based on the example of evaluating the social impact in the educational field and the performance of teachers’ work in the educational system. The article consists of three parts. Firstly, the theoretical background of the performance measurement in educational field is discussed. Secondly, the important criteria for performance measurement design and political issues are argued. Thirdly, the evaluated shortcomings in Estonian educational organisations, which restrict them to be effective, are brought out. Relieving some of these shortcomings could be in authority of Estonian educational politics.

  13. Performance analysis and evaluation of direct phase measuring deflectometry

    Science.gov (United States)

    Zhao, Ping; Gao, Nan; Zhang, Zonghua; Gao, Feng; Jiang, Xiangqian

    2018-04-01

    Three-dimensional (3D) shape measurement of specular objects plays an important role in intelligent manufacturing applications. Phase measuring deflectometry (PMD)-based methods are widely used to obtain the 3D shapes of specular surfaces because they offer the advantages of a large dynamic range, high measurement accuracy, full-field and noncontact operation, and automatic data processing. To enable measurement of specular objects with discontinuous and/or isolated surfaces, a direct PMD (DPMD) method has been developed to build a direct relationship between phase and depth. In this paper, a new virtual measurement system is presented and is used to optimize the system parameters and evaluate the system's performance in DPMD applications. Four system parameters are analyzed to obtain accurate measurement results. Experiments are performed using simulated and actual data and the results confirm the effects of these four parameters on the measurement results. Researchers can therefore select suitable system parameters for actual DPMD (including PMD) measurement systems to obtain the 3D shapes of specular objects with high accuracy.

  14. Clinical measures of balance in people with type two diabetes: A systematic literature review.

    Science.gov (United States)

    Dixon, C J; Knight, T; Binns, E; Ihaka, B; O'Brien, D

    2017-10-01

    Approximately 422 million people have diabetes mellitus worldwide, with the majority diagnosed with type 2 diabetes mellitus (T2DM). The complications of diabetes mellitus include diabetic peripheral neuropathy (DPN) and retinopathy, both of which can lead to balance impairments. Balance assessment is therefore an integral component of the clinical assessment of a person with T2DM. Although there are a variety of balance measures available, it is uncertain which measures are the most appropriate for this population. Therefore, the aim of this study was to conduct a systematic review on clinical balance measures used with people with T2DM and DPN. Databases searched included: CINAHL plus, MEDLINE, SPORTDiscus, Dentistry and Oral Sciences source, and SCOPUS. Key terms, inclusion and exclusion criteria were used to identify appropriate studies. Identified studies were critiqued using the Downs and Black appraisal tool. Eight studies were included, these studies incorporated a total of ten different clinical balance measures. The balance measures identified included the Dynamic Balance Test, balance walk, tandem and unipedal stance, Functional Reach Test, Clinical Test of Sensory Interaction and Balance, Berg Balance Scale, Tinetti Performance-Oriented Mobility Assessment, Activity-Specific Balance Confidence Scale, Timed Up and Go test, and the Dynamic Gait Index. Numerous clinical balance measures were used for people with T2DM. However, the identified balance measures did not assess all of the systems of balance, and most had not been validated in a T2DM population. Therefore, future research is needed to identify the validity of a balance measure that assesses these systems in people with T2DM. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  15. Measured performance of four PWR liquid radioactive waste treatment systems

    International Nuclear Information System (INIS)

    McIsaac, C.V.; Mandler, J.W.; Stalker, A.C.

    1980-01-01

    This paper presents results of a study of the liquid radwaste treatment and boron recovery systems of four operating PWR power plants. The performance of a given system was determined from measurements of radionuclide inventories in samples drawn from demineralizers, evaporators, filters, and gaseous cleanup systems. The plants at which measurements were made are Fort Calhoun, Zion 1 and 2, Turkey Point 3 and 4, and Rancho Seco

  16. Innovation and organisational performance: A critical review of the instruments used to measure organisational performance

    Directory of Open Access Journals (Sweden)

    Tebogo Sethibe

    2016-10-01

    Full Text Available Background: Innovation is recognised as one of the most important determinant of organisational performance. Yet, the results of studies that investigate the relationship between innovation and organisational performance are inconclusive. The inconsistency has been attributed to a number of factors, which include, among others, the measures used to evaluate organisational performance. Aim: This study was set out to identify, categorise and critically analyse the instruments used to assess organisational performance when investigating the relationship between innovation and organisational performance. Setting: The study focuses on all scientific publications reporting on organisational performance, inclusive of both financial and non-financial indicators of performance, and are not limited to any specific country or industry. Methods: The systematic literature review methodology was used to identify studies which investigated the relationship between innovation and organisational performance. Once identified, articles were analysed on the way organisational performance was measured. Classification was done with reference to financial and non-financial indicators, accounting and market-based, as well as objective and subjective measures. Results: The findings show that profitability, sales growth and return on assets (ROA are the most preferred accounting-based financial measures of organisation performance. In addition, Tobin’s Q was found to be the most favoured market-based financial measure of organisational performance. The study further reveals that market share, customer satisfaction and productivity are the most popular non-financial-based measures of organisational performance. Conclusion: The use of measures of organisational performance is often left to the discussion of the researcher, which is not implicitly wrong, but does little to contribute to the body of knowledge on this important topic. Researchers are firstly urged to

  17. A Framework of Performance Measurement System for Manufacturing Company

    Directory of Open Access Journals (Sweden)

    Dermawan Wibisono

    2012-04-01

    Full Text Available In the current dynamic environment, measuring a company’s performance becomes exceedingly complex since Performance Measurements Systems (PMS not only measure a company’s performance but also reflect their organizational culture and philosophy. Designing and implementing PMS is an integral part of management control systems. However, traditional PMS are criticized for being obsolete, irrelevant to managerial decisionmaking, unrelated to strategic objectives and detrimental to organizational improvements. Given the shortcomings of traditional PMS, there is need for a new framework that canlead to the design of a PMS that balances short-term and long-term measures, internal and external measures, and financial and operational measures. This paper presents issuesassociated with the needs of a dynamic PMS, observe past research achievements in PMS and review past PMS frameworks that have been introduced. The paper then proposes animproved methodology for the design of a realistic PMS and its effective implementation in a manufacturing environment with case for Indonesia’s company.

  18. A Framework of Performance Measurement System for Manufacturing Company

    Directory of Open Access Journals (Sweden)

    Dermawan Wibisono

    2011-10-01

    Full Text Available In the current dynamic environment, measuring a company’s performance becomes exceedingly complex since Performance Measurements Systems (PMS not only measure a company’s performance but also reflect their organizational culture and philosophy. Designing and implementing PMS is an integral part of management control systems. However, traditional PMS are criticized for being obsolete, irrelevant to managerial decision making, unrelated to strategic objectives and detrimental to organizational improvements. Given the shortcomings of traditional PMS, there is need for a new framework that can lead to the design of a PMS that balances short-term and long-term measures, internal and external measures, and financial and operational measures. This paper presents issues associated with the needs of a dynamic PMS, observe past research achievements in PMS and review past PMS frameworks that have been introduced. The paper then proposes an improved methodology for the design of a realistic PMS and its effective implementation in a manufacturing environment with case for Indonesia’s company.

  19. Measuring patient-centered medical home access and continuity in clinics with part-time clinicians.

    Science.gov (United States)

    Rosland, Ann-Marie; Krein, Sarah L; Kim, Hyunglin Myra; Greenstone, Clinton L; Tremblay, Adam; Ratz, David; Saffar, Darcy; Kerr, Eve A

    2015-05-01

    Common patient-centered medical home (PCMH) performance measures value access to a single primary care provider (PCP), which may have unintended consequences for clinics that rely on part-time PCPs and team-based care. Retrospective analysis of 110,454 primary care visits from 2 Veterans Health Administration clinics from 2010 to 2012. Multi-level models examined associations between PCP availability in clinic, and performance on access and continuity measures. Patient experiences with access and continuity were compared using 2012 patient survey data (N = 2881). Patients of PCPs with fewer half-day clinic sessions per week were significantly less likely to get a requested same-day appointment with their usual PCP (predicted probability 17% for PCPs with 2 sessions/week, 20% for 5 sessions/week, and 26% for 10 sessions/week). Among requests that did not result in a same-day appointment with the usual PCP, there were no significant differences in same-day access to a different PCP, or access within 2 to 7 days with patients' usual PCP. Overall, patients had >92% continuity with their usual PCP at the hospital-based site regardless of PCP sessions/week. Patients of full-time PCPs reported timely appointments for urgent needs more often than patients of part-time PCPs (82% vs 71%; P Part-time PCP performance appeared worse when using measures focused on same-day access to patients' usual PCP. However, clinic-level same-day access, same-week access to the usual PCP, and overall continuity were similar for patients of part-time and full-time PCPs. Measures of in-person access to a usual PCP do not capture alternate access approaches encouraged by PCMH, and often used by part-time providers, such as team-based or non-face-to-face care.

  20. Multitasking TORT Under UNICOS: Parallel Performance Models and Measurements

    International Nuclear Information System (INIS)

    Azmy, Y.Y.; Barnett, D.A.

    1999-01-01

    The existing parallel algorithms in the TORT discrete ordinates were updated to function in a UNI-COS environment. A performance model for the parallel overhead was derived for the existing algorithms. The largest contributors to the parallel overhead were identified and a new algorithm was developed. A parallel overhead model was also derived for the new algorithm. The results of the comparison of parallel performance models were compared to applications of the code to two TORT standard test problems and a large production problem. The parallel performance models agree well with the measured parallel overhead

  1. Multitasking TORT under UNICOS: Parallel performance models and measurements

    International Nuclear Information System (INIS)

    Barnett, A.; Azmy, Y.Y.

    1999-01-01

    The existing parallel algorithms in the TORT discrete ordinates code were updated to function in a UNICOS environment. A performance model for the parallel overhead was derived for the existing algorithms. The largest contributors to the parallel overhead were identified and a new algorithm was developed. A parallel overhead model was also derived for the new algorithm. The results of the comparison of parallel performance models were compared to applications of the code to two TORT standard test problems and a large production problem. The parallel performance models agree well with the measured parallel overhead

  2. Performance tests for instruments measuring radon activity concentration

    International Nuclear Information System (INIS)

    Beck, T.R.; Buchroeder, H.; Schmidt, V.

    2009-01-01

    Performance tests of electronic instruments measuring the activity concentration of 222 Rn have been carried out with respect to the standard IEC 61577-2. In total, 9 types of instrument operating with ionization chambers or electrostatic collection have been tested for the influence of different climatic and radiological factors on the measurement characteristics. It is concluded that all types of instrument, which are commercially available, are suitable for indoor radon measurements. Because of the dependence on climatic conditions, the outdoor use is partly limited.

  3. A critical perspective on the measurement of performance in the empirical multinationality and performance literature

    DEFF Research Database (Denmark)

    Richter, Nicole Franziska; Schmidt, Robert; Ladwig, Tina J.

    2017-01-01

    used in empirical studies and the underlying theoretical streams that explain the effects on benefits and costs of multinationality. Our findings indicate that authors still largely rely on overall financial performance measures. Theoretical arguments, in contrast, refer to specific benefit and cost......This paper contributes to the core research in international business (IB), namely the relation between multinationality and performance, and is concerned with the quality of past empirical research designs. On the basis of 49 studies, we critically evaluate the match between performance measures...... positions that are better reflected in operational performance indicators. In our view, the idiosyncratic choice of the performance measures contributes to the varying results in past studies. We offer suggestions for improving future research designs....

  4. Patient-Reported Outcome Measures for Use in Clinical Trials and Clinical Practice in Inflammatory Bowel Diseases: A Systematic Review.

    Science.gov (United States)

    de Jong, Marin J; Huibregtse, Roxanne; Masclee, Ad A M; Jonkers, Daisy M A E; Pierik, Marie J

    2018-05-01

    Mucosal inflammation must be carefully monitored to improve the long-term outcomes of patients with inflammatory bowel diseases (IBD). Patient-reported outcome measures (PROMs) are used increasingly to monitor disease activity in clinical practice and as endpoints in clinical trials. We performed a systematic review to provide an overview of the available PROMs on IBD activity and to evaluate their diagnostic value. A systematic search of the PubMed, Medline, Cochrane library, and Embase databases using defined keywords, identified 973 articles. These were screened by 2 independent reviewers, and 37 articles on development or validation of PROMs to assess IBD activity were identified for further analysis. Based on the recommendations of the Food and Drug Administration (FDA), the following measurement properties were evaluated: content, construct, and criterion validity; reliability; and responsiveness to change. In addition, data on ease of use in clinical practice were collected. Seventeen articles presenting 20 different PROMs were included the final analysis, although none met all the FDA-recommended criteria. Only 2 PROMs (patient-reported Harvey Bradshaw Index and Simple Clinical Colitis Activity Index scores) reported patient involvement during its development. Only 6 PROMs (patient-reported global assessment, patient assessment of disease activity, mobile health index for Crohn's disease, mobile health index for ulcerative colitis, patient-reported outcome derived from the Mayo score, and the 6-point Mayo score) were validated as markers of IBD activity, using findings from endoscopy as the reference standard; these PROMs identified patients with mucosal inflammation with area under the curve values of 0.63-0.82. The mobile health index for CD and UC scores had the best measurement properties for use in clinical practice and in clinical trials. In a systematic review, we identified more than 20 PROMS that have been developed and tested for their ability to

  5. Performance of field measuring probes for SSC magnets

    International Nuclear Information System (INIS)

    Thomas, R.; Ganetis, G.; Herrera, J.; Hogue, R.; Jain, A.; Louie, W.; Marone, A.; Wanderer, P.

    1994-01-01

    Several years of experience have been acquired on the operation of probes (open-quotes molesclose quotes) constructed for the measurement of the multipole components of the magnetic fields of SSC magnets. The field is measured by rotating coils contained in a 2.4-m long tube that is pulled through the aperture of the magnet by an external device - the transporter. In addition to the measuring coils, the tube contains motors for rotating the coil and a system for sensing local vertical using gravity sensors to provide an absolute reference for the field measurements. The authors describe the steps that must be taken in order to ensure accurate, repeatable measurements; the design changes that have been motivated by difficulties encountered (noise, vibration, variations in temperature); and other performance issues. The mechanical interface between the probe and the beam tube of the magnet is also described

  6. Performance of field measuring probes for SSC magnets

    International Nuclear Information System (INIS)

    Thomas, R.; Ganetis, G.; Herrera, J.; Hogue, R.; Jain, A.; Louie, W.; Marone, A.; Wanderer, P.

    1993-01-01

    Several years of experience have been acquired on the operation of probes (''moles'') constructed for the measurement of the multipole components of the magnetic fields of SSC magnets. The field is measured by rotating coils contained in a 2.4-m long tube that is pulled through the aperture of the magnet by an external device-the transporter. In addition to the measuring coils, the tube contains motors for rotating the coil and a system for sensing local vertical using gravity sensors to provide an absolute reference for the field measurements. We describe the steps that must be taken in order to ensure accurate, repeatable measurements; the design changes that have been motivated by difficulties encountered (noise, vibration, variations in temperature); and other performance issues. The mechanical interface between the probe and the hewn tube of the magnet is also described

  7. A key performance measures for evaluating cold supply chain performance in farm industry

    Directory of Open Access Journals (Sweden)

    Shashi Shashi

    2015-08-01

    Full Text Available The main objective of this study was to develop a set of measures, evaluate their importance and effect in cold supply chain performance. This investigation reviewed previous research works on all the stages of the farm product supply chain. Based on farm product supply chain, 4 measures with 31 metrics were identified and developed to measure the cold supply chain performance. A survey was organized to establish the importance and the effect of identified measures. The 5 point Likert scale questionnaire was distributed among SC academics and practitioners. The observed finding infers that the measurement instrument was substantiating for evaluating cold supply chain performance in farm industry. The new developed metrics will help firms improve the visibility of supply among partners and in better decision making. The investigation was enfolded up through the plan of direction intended for future study.

  8. What is the relationship between emotional intelligence and dental student clinical performance?

    Science.gov (United States)

    Victoroff, Kristin Zakariasen; Boyatzis, Richard E

    2013-04-01

    Emotional intelligence has emerged as a key factor in differentiating average from outstanding performers in managerial and leadership positions across multiple business settings, but relatively few studies have examined the role of emotional intelligence in the health care professions. The purpose of this study was to examine the relationship between emotional intelligence (EI) and dental student clinical performance. All third- and fourth-year students at a single U.S. dental school were invited to participate. Participation rate was 74 percent (100/136). Dental students' EI was assessed using the Emotional Competence Inventory-University version (ECI-U), a seventy-two-item, 360-degree questionnaire completed by both self and other raters. The ECI-U measured twenty-two EI competencies grouped into four clusters (Self-Awareness, Self-Management, Social Awareness, and Relationship Management). Clinical performance was assessed using the mean grade assigned by clinical preceptors. This grade represents an overall assessment of a student's clinical performance including diagnostic and treatment planning skills, time utilization, preparation and organization, fundamental knowledge, technical skills, self-evaluation, professionalism, and patient management. Additional variables were didactic grade point average (GPA) in Years 1 and 2, preclinical GPA in Years 1 and 2, Dental Admission Test academic average and Perceptual Ability Test scores, year of study, age, and gender. Multiple linear regression analyses were conducted. The Self-Management cluster of competencies (b=0.448, pintelligence may be an important predictor of clinical performance, which has important implications for students' development during dental school.

  9. 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

  10. Performance measurement of workplace change: in two different cultural contexts

    Directory of Open Access Journals (Sweden)

    Chaiwat Riratanaphong

    2014-01-01

    Full Text Available Nowadays, organisations must cope with the pressure of cost reduction and efficiency in order to succeed in a highly competitive business environment. However, drivers to improve social interaction and employee’s performance and as such to contribute to organisational goals and objectives make it necessary to be concerned with other performance criteria as well, such as effectiveness, flexibility, employee satisfaction, productivity and creativity. There is a growing need for performance management and performance measurement that not only covers all aspects of an organisation, but which can be applied to various situations in a changing internal and external environment. Performance measurement methods which include an integrated perspective of performance have become essential. In addition, it has been realised that corporate real estate can contribute to organisational performance (Nourse and Roulac, 1993, De Vries et al., 2008, Lindholm, 2008, Den Heijer, 2011, Jensen et al., 2012. For this reason, worldwide organisations started to implement new ways of working in a more open and flexible work environment. Although there are various objectives and drivers of workplace change, the common objectives are to reduce costs and to increase efficiency. The changing organisational and external contexts, such as the increasing demand for talented knowledge workers and changing work patterns, have led to the development of new offices that can promote social networks and interaction among employees. The new workplace does not only aim at achieving cost efficiency, but it should also support employee satisfaction and productivity. This PhD research focuses on both themes i.e. performance measurement of workplace change. The aim of this research is to provide a conceptual framework that visualises the impact of workplace change on employees’ responses to the new work environment and to present guidelines on performance measurement of workplace

  11. Relationship between performance measurements and sale price of ...

    African Journals Online (AJOL)

    Unknown

    Abstract. The sale prices of 1 609 Dorper rams sold between 1990 and 1999 were compared with their measured performances. An analysis of variance was carried out in order to determine which variables influenced sale price. The most importance factors were classification (stud vs. commercial), auction weight and coat ...

  12. Managing for Results--Linking Performance Measures and Budgets.

    Science.gov (United States)

    McGee, William L.; Fountain, James R., Jr.

    1995-01-01

    The Government Accounting Standards Board notion of service efforts and accomplishments reporting is one step in a process of managing for results that includes strategic planning, development and use of performance measures of managing ongoing programs, and outputs to budgetary appropriation. Reports a trial application to one school district.…

  13. 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.

  14. Investment horizons : A time-dependent measure of asset performance

    OpenAIRE

    Ingve Simonsen; Anders Johansen; Mogens H. Jensen

    2005-01-01

    We review a resent {\\em time-dependent} performance measure for economical time series -- the (optimal) investment horizon approach. For stock indices, the approach shows a pronounced gain-loss asymmetry that is {\\em not} observed for the individual stocks that comprise the index. This difference may hint towards an synchronize of the draw downs of the stocks.

  15. Introducing the Balanced Scorecard: Creating Metrics to Measure Performance

    Science.gov (United States)

    Gumbus, Andra

    2005-01-01

    This experiential exercise presents the concept of the Balanced Scorecard (BSC) and applies it in a university setting. The Balanced Scorecard was developed 12 years ago and has grown in popularity and is used by more than 50% of the Fortune 500 companies as a performance measurement and strategic management tool. The BSC expands the traditional…

  16. Measuring supply chain performance in the agri-food sector

    NARCIS (Netherlands)

    Aramyan, L.H.

    2007-01-01

    Keywords : PMS,agri-food, supply chain, efficiency, flexibility, responsiveness, food quality

    The main objective of this research is to contribute to the development of a Performance Measurement System (PMS) foragri-food supply chains that involves the entire chain (i.e. all

  17. Quantitative measures of CRE and its link with organizational performance

    NARCIS (Netherlands)

    Appel - Meulenbroek, H.A.J.A.

    2007-01-01

    For CREM (Corporate Real Estate Management) to be able to deliver added value to its client organisation, it has to know 1) which CRE aspects influence its employees, processes, machinery, visitors, etc, 2) how these aspects influence performance and 3) how to measure and manage them. Analysis of

  18. PECULIARITIES OF PERFORMANCE MEASUREMENT IN SOVEREIGN WEALTH FUNDS

    Directory of Open Access Journals (Sweden)

    M. Onopko

    2014-01-01

    Full Text Available Sovereign wealth funds as the subjects of economic relations are analyzed and the main approaches to the assessment of their activities are discussed. The dependence of the performance measurement system and the strategic objectives of the funds and economic policy objectives of the government is indicated.

  19. Performance measurement system for training simulators. Interim report

    International Nuclear Information System (INIS)

    Bockhold, G. Jr.; Roth, D.R.

    1978-05-01

    In the first project phase, the project team has designed, installed, and test run on the Browns Ferry nuclear power plant training simulator a performance measurement system capable of automatic recording of statistical information on operator actions and plant response. Key plant variables and operator actions were monitored and analyzed by the simulator computer for a selected set of four operating and casualty drills. The project has the following objectives: (1) To provide an empirical data base for statistical analysis of operator reliability and for allocation of safety and control functions between operators and automated controls; (2) To develop a method for evaluation of the effectiveness of control room designs and operating procedures; and (3) To develop a system for scoring aspects of operator performance to assist in training evaluations and to support operator selection research. The performance measurement system has shown potential for meeting the research objectives. However, the cost of training simulator time is high; to keep research program costs reasonable, the measurement system is being designed to be an integral part of operator training programs. In the pilot implementation, participating instructors judged the measurement system to be a valuable and objective extension of their abilities to monitor trainee performance

  20. Performance Measures of Academic Faculty--A Case Study

    Science.gov (United States)

    Davidovitch, Nitza; Soen, Dan; Sinuani-Stern, Zila

    2011-01-01

    This case study is the first to track the method used by an Israeli institution of higher education to assess and reward faculty members using a set of performance measures ("Excellence criteria"). The study profiles faculty members who received financial rewards for excellence during 2005-2007, based on the previous year's activities,…

  1. Individual match approach to Bowling performance measures in ...

    African Journals Online (AJOL)

    Match conditions can play a significant role in player performances in a cricket match. If the pitch is in a good condition, the batsmen can achieve good scores, making it difficult for the bowlers. In the case of an uneven pitch or adverse weather conditions, the bowlers may have the upper hand. In order to measure bowlers' ...

  2. Clinical performance of direct versus indirect composite restorations in posterior teeth: A systematic review.

    Science.gov (United States)

    Azeem, Rubeena Abdul; Sureshbabu, Nivedhitha Malli

    2018-01-01

    Composite resin, serves as esthetic alternative to amalgam and cast restorations. Posterior teeth can be restored using direct or indirect composite restorations. The selection between direct and indirect technique is a clinically challenging decision-making process. Most important influencing factor is the amount of remaining tooth substance. The aim of this systematic review was to compare the clinical performance of direct versus indirect composite restorations in posterior teeth. The databases searched included PubMed CENTRAL (until July 2015), Medline, and Cochrane Database of Systematic Reviews. The bibliographies of clinical studies and reviews identified in the electronic search were analyzed to identify studies which were published outside the electronically searched journals. The primary outcome measure was evaluation of the survival of direct and indirect composite restorations in posterior teeth. This review included thirteen studies in which clinical performance of various types of direct and indirect composite restorations in posterior teeth were compared. Out of the thirteen studies which were included seven studies had a high risk of bias and five studies had a moderate risk of bias. One study having a low risk of bias, concluded that there was no significant difference between direct and indirect technique. However, the available evidence revealed inconclusive results. Further research should focus on randomized controlled trials with long term follow-up to give concrete evidence on the clinical performce of direct and indirect composite restorations.

  3. Two Measures for Enhancing Data Association Performance in SLAM

    Directory of Open Access Journals (Sweden)

    Wu Zhou

    2014-01-01

    Full Text Available Data association is one of the key problems in the SLAM community. Several data association failures may cause the SLAM results to be divergent. Data association performance in SLAM is affected by both data association methods and sensor information. Two measures of handling sensor information are introduced herein to enhance data association performance in SLAM. For the first measure, truncating strategy of limited features, instead of all matched features, is used for observation update. These features are selected according to an information variable. This truncating strategy is used to lower the effect of false matched features. For the other measure, a special rejecting mechanism is designed to reject suspected observations. When the predicted robot pose is obviously different from the updated robot pose, all observed sensor information at this moment is discarded. The rejecting mechanism aims at eliminating accidental sensor information. Experimental results indicate that the introduced measures perform well in improving the stability of data association in SLAM. These measures are of extraordinary value for real SLAM applications.

  4. Sampling Approaches for Multi-Domain Internet Performance Measurement Infrastructures

    Energy Technology Data Exchange (ETDEWEB)

    Calyam, Prasad

    2014-09-15

    The next-generation of high-performance networks being developed in DOE communities are critical for supporting current and emerging data-intensive science applications. The goal of this project is to investigate multi-domain network status sampling techniques and tools to measure/analyze performance, and thereby provide “network awareness” to end-users and network operators in DOE communities. We leverage the infrastructure and datasets available through perfSONAR, which is a multi-domain measurement framework that has been widely deployed in high-performance computing and networking communities; the DOE community is a core developer and the largest adopter of perfSONAR. Our investigations include development of semantic scheduling algorithms, measurement federation policies, and tools to sample multi-domain and multi-layer network status within perfSONAR deployments. We validate our algorithms and policies with end-to-end measurement analysis tools for various monitoring objectives such as network weather forecasting, anomaly detection, and fault-diagnosis. In addition, we develop a multi-domain architecture for an enterprise-specific perfSONAR deployment that can implement monitoring-objective based sampling and that adheres to any domain-specific measurement policies.

  5. Contracts, Performance Measurement and Accountability in the Public Sector

    DEFF Research Database (Denmark)

    Drewry, Gavin; Greve, Carsten; Tanquerel, Thierry

    This book addresses issues to do with public accountability, audit and performance measurement that are both highly topical and of crucial importance to the theory and practice of public administration in an era of contractualized public management. The literature on public sector contracting...... of audit and accountability in a variety of countries and contexts; the third part offers some wider, cross-cutting perspectives. Based on the work of the EGPA permanent study group on the history of contractualization, Contracts, Performance Measurement and Accountability in the Public Sector draws upon...... - covering both 'hard' agreements (ones that are legally enforceable) and 'soft' agreements (enforced by negotiation and mutual trust) - has been growing for some time and the present book adds a primarily European perspective on contracting, performance-based management and accountability. One important...

  6. A performance measurement using balanced scorecard and structural equation modeling

    Directory of Open Access Journals (Sweden)

    Rosha Makvandi

    2014-02-01

    Full Text Available During the past few years, balanced scorecard (BSC has been widely used as a promising method for performance measurement. BSC studies organizations in terms of four perspectives including customer, internal processes, learning and growth and financial figures. This paper presents a hybrid of BSC and structural equation modeling (SEM to measure the performance of an Iranian university in province of Alborz, Iran. The proposed study of this paper uses this conceptual method, designs a questionnaire and distributes it among some university students and professors. Using SEM technique, the survey analyzes the data and the results indicate that the university did poorly in terms of all four perspectives. The survey extracts necessary target improvement by presenting necessary attributes for performance improvement.

  7. Building and measuring a high performance network architecture

    Energy Technology Data Exchange (ETDEWEB)

    Kramer, William T.C.; Toole, Timothy; Fisher, Chuck; Dugan, Jon; Wheeler, David; Wing, William R; Nickless, William; Goddard, Gregory; Corbato, Steven; Love, E. Paul; Daspit, Paul; Edwards, Hal; Mercer, Linden; Koester, David; Decina, Basil; Dart, Eli; Paul Reisinger, Paul; Kurihara, Riki; Zekauskas, Matthew J; Plesset, Eric; Wulf, Julie; Luce, Douglas; Rogers, James; Duncan, Rex; Mauth, Jeffery

    2001-04-20

    Once a year, the SC conferences present a unique opportunity to create and build one of the most complex and highest performance networks in the world. At SC2000, large-scale and complex local and wide area networking connections were demonstrated, including large-scale distributed applications running on different architectures. This project was designed to use the unique opportunity presented at SC2000 to create a testbed network environment and then use that network to demonstrate and evaluate high performance computational and communication applications. This testbed was designed to incorporate many interoperable systems and services and was designed for measurement from the very beginning. The end results were key insights into how to use novel, high performance networking technologies and to accumulate measurements that will give insights into the networks of the future.

  8. The merit of cogeneration: Measuring and rewarding performance

    International Nuclear Information System (INIS)

    Verbruggen, Aviel

    2008-01-01

    Cogeneration or combined heat and power (CHP) is a thermal power generation cycle with the merit of recovering part or all of the heat that is fatally discarded by such cycles. This merit of higher efficiency is subject of rewarding by public authorities. When the EU enacts CHP promotion in a Directive (1997-2004), crucial measurement and qualification issues remain unsolved. CEN (coordinator of the European Bureaus of Standards) contributes in clarifying the measurement of CHP activities, but shortfalls remain, while CEN bypasses the debate on qualifying CHP performance. This article offers appropriate methods for measuring CHP activities based on design characteristics of the plants. The co-generated electric output is a necessary and sufficient indicator of CHP merit and performance. Regulators can extend this indicator, but should avoid the perverse effects of biased external benchmarking as the EU Directive entails

  9. A novel method for measuring health care system performance: experience from QIDS in the Philippines.

    Science.gov (United States)

    Solon, Orville; Woo, Kimberly; Quimbo, Stella A; Shimkhada, Riti; Florentino, Jhiedon; Peabody, John W

    2009-05-01

    Measuring and monitoring health system performance is important albeit controversial. Technical, logistic and financial challenges are formidable. We introduced a system of measurement, which we call Q, to measure the quality of hospital clinical performance across a range of facilities. This paper describes how Q was developed, implemented in hospitals in the Philippines and how it compares with typical measures. Q consists of measures of clinical performance, patient satisfaction and volume of physician services. We evaluate Q using experimental data from the Quality Improvement Demonstration Study (QIDS), a randomized policy experiment. We determined its responsiveness over time and to changes in structural measures such as staffing and supplies. We also examined the operational costs of implementing Q. Q was sustainable, minimally disruptive and readily grafted into existing routines in 30 hospitals in 10 provinces semi-annually for a period of 2(1/2) years. We found Q to be more responsive to immediate impacts of policy change than standard structural measures. The operational costs totalled USD2133 or USD305 per assessment per site. Q appears to be an achievable assessment tool that is a comprehensive and responsive measure of system level quality at a limited cost in resource-poor settings.

  10. Online physician ratings fail to predict actual performance on measures of quality, value, and peer review.

    Science.gov (United States)

    Daskivich, Timothy J; Houman, Justin; Fuller, Garth; Black, Jeanne T; Kim, Hyung L; Spiegel, Brennan

    2018-04-01

    Patients use online consumer ratings to identify high-performing physicians, but it is unclear if ratings are valid measures of clinical performance. We sought to determine whether online ratings of specialist physicians from 5 platforms predict quality of care, value of care, and peer-assessed physician performance. We conducted an observational study of 78 physicians representing 8 medical and surgical specialties. We assessed the association of consumer ratings with specialty-specific performance scores (metrics including adherence to Choosing Wisely measures, 30-day readmissions, length of stay, and adjusted cost of care), primary care physician peer-review scores, and administrator peer-review scores. Across ratings platforms, multivariable models showed no significant association between mean consumer ratings and specialty-specific performance scores (β-coefficient range, -0.04, 0.04), primary care physician scores (β-coefficient range, -0.01, 0.3), and administrator scores (β-coefficient range, -0.2, 0.1). There was no association between ratings and score subdomains addressing quality or value-based care. Among physicians in the lowest quartile of specialty-specific performance scores, only 5%-32% had consumer ratings in the lowest quartile across platforms. Ratings were consistent across platforms; a physician's score on one platform significantly predicted his/her score on another in 5 of 10 comparisons. Online ratings of specialist physicians do not predict objective measures of quality of care or peer assessment of clinical performance. Scores are consistent across platforms, suggesting that they jointly measure a latent construct that is unrelated to performance. Online consumer ratings should not be used in isolation to select physicians, given their poor association with clinical performance.

  11. Further examination of embedded performance validity indicators for the Conners' Continuous Performance Test and Brief Test of Attention in a large outpatient clinical sample.

    Science.gov (United States)

    Sharland, Michael J; Waring, Stephen C; Johnson, Brian P; Taran, Allise M; Rusin, Travis A; Pattock, Andrew M; Palcher, Jeanette A

    2018-01-01

    Assessing test performance validity is a standard clinical practice and although studies have examined the utility of cognitive/memory measures, few have examined attention measures as indicators of performance validity beyond the Reliable Digit Span. The current study further investigates the classification probability of embedded Performance Validity Tests (PVTs) within the Brief Test of Attention (BTA) and the Conners' Continuous Performance Test (CPT-II), in a large clinical sample. This was a retrospective study of 615 patients consecutively referred for comprehensive outpatient neuropsychological evaluation. Non-credible performance was defined two ways: failure on one or more PVTs and failure on two or more PVTs. Classification probability of the BTA and CPT-II into non-credible groups was assessed. Sensitivity, specificity, positive predictive value, and negative predictive value were derived to identify clinically relevant cut-off scores. When using failure on two or more PVTs as the indicator for non-credible responding compared to failure on one or more PVTs, highest classification probability, or area under the curve (AUC), was achieved by the BTA (AUC = .87 vs. .79). CPT-II Omission, Commission, and Total Errors exhibited higher classification probability as well. Overall, these findings corroborate previous findings, extending them to a large clinical sample. BTA and CPT-II are useful embedded performance validity indicators within a clinical battery but should not be used in isolation without other performance validity indicators.

  12. 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

  13. The Curvilinear Association between Performance Measurement System Design and Strategic Performance

    DEFF Research Database (Denmark)

    Schneider, Melanie L.; Mahlendorf, Matthias D.; Schäffer, Utz

    This paper reconciles prior research regarding beneficial and detrimental effects of performance measurement system (PMS) design on performance by arguing for a curvilinear association. By taking the too-much-of-a-good-thing effect as a starting point, we challenge the assumption of a linear...

  14. Impact of the site specialty of a continuity practice on students' clinical skills: performance with standardized patients.

    Science.gov (United States)

    Pfeiffer, Carol A; Palley, Jane E; Harrington, Karen L

    2010-07-01

    The assessment of clinical competence and the impact of training in ambulatory settings are two issues of importance in the evaluation of medical student performance. This study compares the clinical skills performance of students placed in three types of community preceptors' offices (pediatrics, medicine, family medicine) on yearly clinical skills assessments with standardized patients. Our goal was to see if the site specialty impacted on clinical performance. The students in the study were completing a 3-year continuity preceptorship at a site representing one of the disciplines. Their performance on the four clinical skills assessments was compared. There was no significant difference in history taking, physical exam, communication, or clinical reasoning in any year (ANOVA p< or = .05) There was a small but significant difference in performance on a measure of interpersonal and interviewing skills during Years 1 and 2. The site specialty of an early clinical experience does not have a significant impact on performance of most of the skills measured by the assessments.

  15. PERFORMANCE MEASUREMENT OF UCITS INVESTMENT FUNDS IN CROATIA

    Directory of Open Access Journals (Sweden)

    Marko Curkovic

    2017-03-01

    Full Text Available UCITS investment funds represent an important investment opportunity for retail, as well for institutional investors in the European Union. The aim of this paper is to analyse the performance of the UCITS investment funds in Croatia and to detect relatively homogeneous groups among the UCITS funds based on its performance. The analysis includes 55 UCITS, in the period from the beginning of 2011 until the end of 2014, and it is conducted on daily data of share prices, available from Bloomberg terminal. Analysis is performed separately within the groups of different investment fund by investment strategy. The research methodology is based on the calculation of various indicators of absolute and relative risk-adjusted performance and riskiness of the funds. In general, based on analysis of performance measures, it can be concluded that funds with higher values of net assets were more successful compared to the funds with below-average asset values. Also, funds with below-average values of net assets were more volatile. At the same time, funds run by foreign own management companies were more successful by the absolute performance measures, compared to funds run by management companies with domestic ownership. On the other hand, those funds were more volatile, as well.

  16. THE PERFORMANCE OF THE ECONOMIC ENTITY MEASURED THROUGH ACCOUNTING INFORMATION

    Directory of Open Access Journals (Sweden)

    Marius Cristian Milos

    2012-01-01

    Full Text Available The users of financial statements need information regarding the resources of an economic entity and also data regarding the way in which the entity’s management is using resources. This information helps users to quantify efficiency and performance within an entity. There are many stakeholders who do show interest in an entity’s financial reports, including existing and potential investors, employees, lenders, suppliers, customers, regulators and other government agencies and not the least the common citizens. The main purpose of this paper is to highlight the importance of the performance measurement and to discuss possible reporting methods. Performance is a concept that raises many questions regarding the most accurate way or the best method for quantifying and reporting performance at the company level .So if financial performance indicators are considered to offer an accurate image of the situation of a company, the modern approach which focuses also on non-financial indicators offers new perspectives upon performance measurement, which may be really expressive and also based on simplicity.

  17. Joint Macro and Femto Field Performance and Interference Measurements

    DEFF Research Database (Denmark)

    Jørgensen, Niels T.K.; Isotalo, Tero; Pedersen, Klaus

    2012-01-01

    In this paper macro performance in a co-channel macro and femto setup is studied. Measurements are performed in a live Universal Mobile Telecommunication System (UMTS) network. It is concluded that femto interference does not affect macro downlink (DL) performance as long as the macro Received Si...... radius smaller than 5 meter – with realistic power settings. This makes co-channel femto deployment less promising in dense macro environments with good macro RSCP coverage.......In this paper macro performance in a co-channel macro and femto setup is studied. Measurements are performed in a live Universal Mobile Telecommunication System (UMTS) network. It is concluded that femto interference does not affect macro downlink (DL) performance as long as the macro Received...... Signal Code Power (RSCP) is stronger than femto RSCP. We also conclude that a macro escape carrier is a robust DL interference management solution. In uplink (UL) direction it is shown that a single femto UE close to macro cell potentially can cause a noise rise of 6 dB in the surrounding macro cell...

  18. The impact of multi-criteria performance measurement on business performance improvement

    OpenAIRE

    Kasie, Fentahun Moges; Belay, Alemu Moges

    2013-01-01

    Purpose: The purpose of this paper is to investigate the relationship between multi-criteria performance measurement (MCPM) practice and business performance improvement using the raw data collected from 33 selected manufacturing companies. In addition, it proposes modified MCPM model as an effective approach to improve business performance of manufacturing companies. Design/methodology/approach:Research paper. Primary and secondary data were collected using questionnaire survey, interview an...

  19. Improved Clinical Performance and Teamwork of Pediatric Interprofessional Resuscitation Teams With a Simulation-Based Educational Intervention.

    Science.gov (United States)

    Gilfoyle, Elaine; Koot, Deanna A; Annear, John C; Bhanji, Farhan; Cheng, Adam; Duff, Jonathan P; Grant, Vincent J; St George-Hyslop, Cecilia E; Delaloye, Nicole J; Kotsakis, Afrothite; McCoy, Carolyn D; Ramsay, Christa E; Weiss, Matthew J; Gottesman, Ronald D

    2017-02-01

    To measure the effect of a 1-day team training course for pediatric interprofessional resuscitation team members on adherence to Pediatric Advanced Life Support guidelines, team efficiency, and teamwork in a simulated clinical environment. Multicenter prospective interventional study. Four tertiary-care children's hospitals in Canada from June 2011 to January 2015. Interprofessional pediatric resuscitation teams including resident physicians, ICU nurse practitioners, registered nurses, and registered respiratory therapists (n = 300; 51 teams). A 1-day simulation-based team training course was delivered, involving an interactive lecture, group discussions, and four simulated resuscitation scenarios, each followed by a debriefing. The first scenario of the day (PRE) was conducted prior to any team training. The final scenario of the day (POST) was the same scenario, with a slightly modified patient history. All scenarios included standardized distractors designed to elicit and challenge specific teamwork behaviors. Primary outcome measure was change (before and after training) in adherence to Pediatric Advanced Life Support guidelines, as measured by the Clinical Performance Tool. Secondary outcome measures were as follows: 1) change in times to initiation of chest compressions and defibrillation and 2) teamwork performance, as measured by the Clinical Teamwork Scale. Correlation between Clinical Performance Tool and Clinical Teamwork Scale scores was also analyzed. Teams significantly improved Clinical Performance Tool scores (67.3-79.6%; p Teamwork Scale scores (56.0-71.8%; p Teamwork Scale (R = 0.281; p teamwork during simulated pediatric resuscitation. A positive correlation between clinical and teamwork performance suggests that effective teamwork improves clinical performance of resuscitation teams.

  20. Performance Measurement using KPKU- BUMN in X School Education Foundation

    Science.gov (United States)

    Arijanto, Sugih; Harsono, Ambar; Taroepratjeka, Harsono

    2016-01-01

    The purpose of this research is to determine X School's Strengths and Opportunity of Improvement through performance measurement using KPKU-BUMN (Kriteria Penilaian Kinerja Unggul - Kementerian Badan Usaha Milik Negara). KPKU-BUMN is developed based on Malcolm Baldrige Criteria for Performance Excellent (MBCfPE). X school is an education foundation at Bandung that has provides education from kindergarten, elementary school, to junior and senior high school. The measurement is implemented by two aspects, Process and Result. The Process is measured by A-D-L-I approaches (Approach- Deployment-Learning- Integration), on the other hand The Result is measured by Le-T-C-I approach (Level-Trend- Comparison-Integration). There are six processes that will be measured: (1) Leadership, (2) Strategic Planning, (3) Customer Focus, (4) Measurement, Analysis and Knowledge Management, (5) Work Force Focus, and (6) Operation Focus. Meanwhile, the result are (a) product & process outcomes, (b) customer-focused outcomes, (c) workforce-focused outcomes, (d) leadership & governance outcomes, and (e) financial & market outcomes. The overall score for X School is 284/1000, which means X School is at “early result” level at “poor” global image.

  1. Measuring the performance of visual to auditory information conversion.

    Directory of Open Access Journals (Sweden)

    Shern Shiou Tan

    Full Text Available BACKGROUND: Visual to auditory conversion systems have been in existence for several decades. Besides being among the front runners in providing visual capabilities to blind users, the auditory cues generated from image sonification systems are still easier to learn and adapt to compared to other similar techniques. Other advantages include low cost, easy customizability, and universality. However, every system developed so far has its own set of strengths and weaknesses. In order to improve these systems further, we propose an automated and quantitative method to measure the performance of such systems. With these quantitative measurements, it is possible to gauge the relative strengths and weaknesses of different systems and rank the systems accordingly. METHODOLOGY: Performance is measured by both the interpretability and also the information preservation of visual to auditory conversions. Interpretability is measured by computing the correlation of inter image distance (IID and inter sound distance (ISD whereas the information preservation is computed by applying Information Theory to measure the entropy of both visual and corresponding auditory signals. These measurements provide a basis and some insights on how the systems work. CONCLUSIONS: With an automated interpretability measure as a standard, more image sonification systems can be developed, compared, and then improved. Even though the measure does not test systems as thoroughly as carefully designed psychological experiments, a quantitative measurement like the one proposed here can compare systems to a certain degree without incurring much cost. Underlying this research is the hope that a major breakthrough in image sonification systems will allow blind users to cost effectively regain enough visual functions to allow them to lead secure and productive lives.

  2. Measurement properties of continuous text reading performance tests.

    Science.gov (United States)

    Brussee, Tamara; van Nispen, Ruth M A; van Rens, Ger H M B

    2014-11-01

    Measurement properties of tests to assess reading acuity or reading performance have not been extensively evaluated. This study aims to provide an overview of the literature on available continuous text reading tests and their measurement properties. A literature search was performed in PubMed, Embase and PsycInfo. Subsequently, information on design and content of reading tests, study design and measurement properties were extracted using consensus-based standards for selection of health measurement instruments. Quality of studies, reading tests and measurement properties were systematically assessed using pre-specified criteria. From 2334 identified articles, 20 relevant articles were found on measurement properties of three reading tests in various languages: IReST, MNread Reading Test and Radner Reading Charts. All three reading tests scored high on content validity. Reproducibility studies (repeated measurements between different testing sessions) of the IReST and MNread of commercially available reading tests in different languages were missing. The IReST scored best on inter-language comparison, the MNread scored well in repeatability studies (repeated measurements under the same conditions) and the Radner showed good reproducibility in studies. Although in daily practice there are other continuous text reading tests available meeting the criteria of this review, measurement properties were described in scientific studies for only three of them. Of the few available studies, the quality and content of study design and methodology used varied. For testing existing reading tests and the development of new ones, for example in other languages, we make several recommendations, including careful description of patient characteristics, use of objective and subjective lighting levels, good control of working distance, documentation of the number of raters and their training, careful documentation of scoring rules and the use of Bland-Altman analyses or similar for

  3. Validity of linear encoder measurement of sit-to-stand performance power in older people.

    Science.gov (United States)

    Lindemann, U; Farahmand, P; Klenk, J; Blatzonis, K; Becker, C

    2015-09-01

    To investigate construct validity of linear encoder measurement of sit-to-stand performance power in older people by showing associations with relevant functional performance and physiological parameters. Cross-sectional study. Movement laboratory of a geriatric rehabilitation clinic. Eighty-eight community-dwelling, cognitively unimpaired older women (mean age 78 years). Sit-to-stand performance power and leg power were assessed using a linear encoder and the Nottingham Power Rig, respectively. Gait speed was measured on an instrumented walkway. Maximum quadriceps and hand grip strength were assessed using dynamometers. Mid-thigh muscle cross-sectional area of both legs was measured using magnetic resonance imaging. Associations of sit-to-stand performance power with power assessed by the Nottingham Power Rig, maximum gait speed and muscle cross-sectional area were r=0.646, r=0.536 and r=0.514, respectively. A linear regression model explained 50% of the variance in sit-to-stand performance power including muscle cross-sectional area (p=0.001), maximum gait speed (p=0.002), and power assessed by the Nottingham Power Rig (p=0.006). Construct validity of linear encoder measurement of sit-to-stand power was shown at functional level and morphological level for older women. This measure could be used in routine clinical practice as well as in large-scale studies. DRKS00003622. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  4. Improving performance in golf: current research and implications from a clinical perspective.

    Science.gov (United States)

    Evans, Kerrie; Tuttle, Neil

    2015-01-01

    Golf, a global sport enjoyed by people of all ages and abilities, involves relatively long periods of low intensity exercise interspersed with short bursts of high intensity activity. To meet the physical demands of full swing shots and the mental and physical demands of putting and walking the course, it is frequently recommended that golfers undertake golf-specific exercise programs. Biomechanics, motor learning, and motor control research has increased the understanding of the physical requirements of the game, and using this knowledge, exercise programs aimed at improving golf performance have been developed. However, while it is generally accepted that an exercise program can improve a golfer's physical measurements and some golf performance variables, translating the findings from research into clinical practice to optimise an individual golfer's performance remains challenging. This paper discusses how biomechanical and motor control research has informed current practice and discusses how emerging sophisticated tools and research designs may better assist golfers improve their performance.

  5. Development of measurement standards for verifying functional performance of surface texture measuring instruments

    Energy Technology Data Exchange (ETDEWEB)

    Fujii, A [Life and Industrial Product Development Department Olympus Corporation, 2951 Ishikawa-machi, Hachiouji-shi, Tokyo (Japan); Suzuki, H [Industrial Marketing and Planning Department Olympus Corporation, Shinjyuku Monolith, 3-1 Nishi-Shinjyuku 2-chome, Tokyo (Japan); Yanagi, K, E-mail: a_fujii@ot.olympus.co.jp [Department of Mechanical Engineering, Nagaoka University of Technology, 1603-1 Kamitomioka-machi, Nagaoka-shi, Niigata (Japan)

    2011-08-19

    A new measurement standard is proposed for verifying overall functional performance of surface texture measuring instruments. Its surface is composed of sinusoidal surface waveforms of chirp signals along horizontal cross sections of the material measure. One of the notable features is that the amplitude of each cycle in the chirp signal form is geometrically modulated so that the maximum slope is kept constant. The maximum slope of the chirp-like signal is gradually decreased according to movement in the lateral direction. We fabricated the measurement standard by FIB processing, and it was calibrated by AFM. We tried to evaluate the functional performance of Laser Scanning Microscope by this standard in terms of amplitude response with varying slope angles. As a result, it was concluded that the proposed standard can easily evaluate the performance of surface texture measuring instruments.

  6. Measuring process performance within healthcare logistics - a decision tool for selecting measuring technologies

    DEFF Research Database (Denmark)

    Feibert, Diana Cordes; Jacobsen, Peter

    2015-01-01

    Performance measurement can support the organization in improving the efficiency and effectiveness of logistical healthcare processes. Selecting the most suitable technologies is important to ensure data validity. A case study of the hospital cleaning process at a public Danish hospital...... was conducted. Monitoring tasks and ascertaining quality of work is difficult in such a process. Based on principal-agent theory, a set of decision indicator has been developed, and a decision framework for assessing technologies to enable performance measurement has been proposed....

  7. Histogram analysis of diffusion measures in clinically isolated syndromes and relapsing-remitting multiple sclerosis

    International Nuclear Information System (INIS)

    Yu Chunshui; Lin Fuchun; Liu Yaou; Duan Yunyun; Lei Hao; Li Kuncheng

    2008-01-01

    Objective: The purposes of our study were to employ diffusion tensor imaging (DTI)-based histogram analysis to determine the presence of occult damage in clinically isolated syndrome (CIS), to compare its severity with relapsing-remitting multiple sclerosis (RRMS), and to determine correlations between DTI histogram measures and clinical and MRI indices in these two diseases. Materials and methods: DTI scans were performed in 19 CIS and 19 RRMS patients and 19 matched healthy volunteers. Histogram analyses of mean diffusivity and fractional anisotropy were performed in normal-appearing brain tissue (NABT), normal-appearing white matter (NAWM) and gray matter (NAGM). Correlations were analyzed between these measures and expanded disability status scale (EDSS) scores, T 2 WI lesion volumes (LV) and normalized brain tissue volumes (NBTV) in CIS and RRMS patients. Results: Significant differences were found among CIS, RRMS and control groups in the NBTV and most of the DTI histogram measures of the NABT, NAWM and NAGM. In CIS patients, some DTI histogram measures showed significant correlations with LV and NBTV, but none of them with EDSS. In RRMS patients, however, some DTI histogram measures were significantly correlated with LV, NBTV and EDSS. Conclusion: Occult damage occurs in both NAGM and NAWM in CIS, but the severity is milder than that in RRMS. In CIS and RRMS, the occult damage might be related to both T2 lesion load and brain tissue atrophy. Some DTI histogram measures might be useful for assessing the disease progression in RRMS patients

  8. Thermal performance measurements on ultimate heat sinks--cooling ponds

    International Nuclear Information System (INIS)

    Hadlock, R.K.; Abbey, O.B.

    1977-12-01

    The primary objective of the studies described is to obtain the requisite data, with respect to modeling requirements, to characterize thermal performance of heat sinks for nuclear facilities existing at elevated water temperatures in result of experiencing a genuinely large heat load and responding to meteorological influence. The data should reflect thermal performance for combinations leading to worst-case meteorological influence. A geothermal water retention basin has been chosen as the site for the first measurement program and data have been obtained in the first of several experiments scheduled to be performed there. These data illustrate the thermal and water budgets during episodes of cooling from an initially high pond water bulk temperature. Monitoring proceeded while the pond experienced only meteorological and seepage influence. The data are discussed and are presented as a data volume which may be used for calculation purposes. Suggestions for future measurement programs are stated with the intent to maintain and improve relevance to nuclear ultimate heat sinks while continuing to examine the performance of the analog geothermal pond. It is further suggested that the geothermal pond, with some modification, may be a suitable site for spray pond measurements

  9. Predicting dynamic knee joint load with clinical measures in people with medial knee osteoarthritis.

    Science.gov (United States)

    Hunt, Michael A; Bennell, Kim L

    2011-08-01

    Knee joint loading, as measured by the knee adduction moment (KAM), has been implicated in the pathogenesis of knee osteoarthritis (OA). Given that the KAM can only currently be accurately measured in the laboratory setting with sophisticated and expensive equipment, its utility in the clinical setting is limited. This study aimed to determine the ability of a combination of four clinical measures to predict KAM values. Three-dimensional motion analysis was used to calculate the peak KAM at a self-selected walking speed in 47 consecutive individuals with medial compartment knee OA and varus malalignment. Clinical predictors included: body mass; tibial angle measured using an inclinometer; walking speed; and visually observed trunk lean toward the affected limb during the stance phase of walking. Multiple linear regression was performed to predict KAM magnitudes using the four clinical measures. A regression model including body mass (41% explained variance), tibial angle (17% explained variance), and walking speed (9% explained variance) explained a total of 67% of variance in the peak KAM. Our study demonstrates that a set of measures easily obtained in the clinical setting (body mass, tibial alignment, and walking speed) can help predict the KAM in people with medial knee OA. Identifying those patients who are more likely to experience high medial knee loads could assist clinicians in deciding whether load-modifying interventions may be appropriate for patients, whilst repeated assessment of joint load could provide a mechanism to monitor disease progression or success of treatment. Copyright © 2010 Elsevier B.V. All rights reserved.

  10. Measuring recent research performance for Chinese universities using bibliometric methods

    KAUST Repository

    Zhu, Jia

    2014-07-29

    This paper focuses on measuring the academic research performance of Chinese universities by using Scopus database from 2007 to 2010. We have provided meaningful indicators to measure the research performance of Chinese universities as compared to world class universities of the US and the European region. Using these indicators, we first measure the quantity and quality of the research outcomes of the universities and then examine the internationalization of research by using international collaborations, international citations and international impact metrics. Using all of this data, we finally present an overall score called research performance point to measure the comprehensive research strength of the universities for the selected subject categories. The comparison identifies the gap between Chinese universities and top-tier universities from selected regions across various subject areas. We find that Chinese universities are doing well in terms of publication volume but receive less citations from their published work. We also find that the Chinese universities have relative low percentage of publications at high impact venues, which may be the reason that they are not receiving more citations. Therefore, a careful selection of publication venues may help the Chinese universities to compete with world class universities and increase their research internationalization. © 2014 Akadémiai Kiadó, Budapest, Hungary.

  11. Statistical Validation for Clinical Measures: Repeatability and Agreement of Kinect™-Based Software.

    Science.gov (United States)

    Lopez, Natalia; Perez, Elisa; Tello, Emanuel; Rodrigo, Alejandro; Valentinuzzi, Max E

    2018-01-01

    The rehabilitation process is a fundamental stage for recovery of people's capabilities. However, the evaluation of the process is performed by physiatrists and medical doctors, mostly based on their observations, that is, a subjective appreciation of the patient's evolution. This paper proposes a tracking platform of the movement made by an individual's upper limb using Kinect sensor(s) to be applied for the patient during the rehabilitation process. The main contribution is the development of quantifying software and the statistical validation of its performance, repeatability, and clinical use in the rehabilitation process. The software determines joint angles and upper limb trajectories for the construction of a specific rehabilitation protocol and quantifies the treatment evolution. In turn, the information is presented via a graphical interface that allows the recording, storage, and report of the patient's data. For clinical purposes, the software information is statistically validated with three different methodologies, comparing the measures with a goniometer in terms of agreement and repeatability. The agreement of joint angles measured with the proposed software and goniometer is evaluated with Bland-Altman plots; all measurements fell well within the limits of agreement, meaning interchangeability of both techniques. Additionally, the results of Bland-Altman analysis of repeatability show 95% confidence. Finally, the physiotherapists' qualitative assessment shows encouraging results for the clinical use. The main conclusion is that the software is capable of offering a clinical history of the patient and is useful for quantification of the rehabilitation success. The simplicity, low cost, and visualization possibilities enhance the use of the software Kinect for rehabilitation and other applications, and the expert's opinion endorses the choice of our approach for clinical practice. Comparison of the new measurement technique with established

  12. TRACEABILITY OF PRECISION MEASUREMENTS ON COORDINATE MEASURING MACHINES – PERFORMANCE VERIFICATION OF CMMs

    DEFF Research Database (Denmark)

    De Chiffre, Leonardo; Sobiecki, René; Tosello, Guido

    This document is used in connection with one exercise of 30 minutes duration as a part of the course VISION ONLINE – One week course on Precision & Nanometrology. The exercise concerns performance verification of the volumetric measuring capability of a small volume coordinate measuring machine...

  13. Measuring cognitive load: performance, mental effort and simulation task complexity.

    Science.gov (United States)

    Haji, Faizal A; Rojas, David; Childs, Ruth; de Ribaupierre, Sandrine; Dubrowski, Adam

    2015-08-01

    Interest in applying cognitive load theory in health care simulation is growing. This line of inquiry requires measures that are sensitive to changes in cognitive load arising from different instructional designs. Recently, mental effort ratings and secondary task performance have shown promise as measures of cognitive load in health care simulation. We investigate the sensitivity of these measures to predicted differences in intrinsic load arising from variations in task complexity and learner expertise during simulation-based surgical skills training. We randomly assigned 28 novice medical students to simulation training on a simple or complex surgical knot-tying task. Participants completed 13 practice trials, interspersed with computer-based video instruction. On trials 1, 5, 9 and 13, knot-tying performance was assessed using time and movement efficiency measures, and cognitive load was assessed using subjective rating of mental effort (SRME) and simple reaction time (SRT) on a vibrotactile stimulus-monitoring secondary task. Significant improvements in knot-tying performance (F(1.04,24.95)  = 41.1, p cognitive load (F(2.3,58.5)  = 57.7, p load among novices engaged in simulation-based learning. These measures can be used to track cognitive load during skills training. Mental effort ratings are also sensitive to small differences in intrinsic load arising from variations in the physical complexity of a simulation task. The complementary nature of these subjective and objective measures suggests their combined use is advantageous in simulation instructional design research. © 2015 John Wiley & Sons Ltd.

  14. Analytical and clinical performance of thyroglobulin autoantibody assays in thyroid cancer follow-up.

    Science.gov (United States)

    Katrangi, Waddah; Grebe, Stephan K G; Algeciras-Schimnich, Alicia

    2017-10-26

    While thyroglobulin autoantibodies (TgAb) can result in false low serum thyroglobulin (Tg) immunoassay (IA) measurements, they might also be indicators of disease persistence/recurrence. Hence, accurate TgAb measurement, in addition to Tg quantification, is crucial for thyroid cancer monitoring. We compared the analytical and clinical performance of four commonly used TgAb IAs. We measured Tg by mass spectrometry (Tg-MS) and by four pairs of Tg and TgAb IAs (Beckman, Roche, Siemens, Thermo) in 576 samples. Limit of quantitation (LOQ) and manufacturers' upper reference interval cut-off (URI) were used for comparisons. Clinical performance was assessed by receiving operator characteristics (ROC) curve analysis. Quantitative and qualitative agreement between TgAb-IAs was moderate with R2 of 0.20-0.70 and κ from 0.41-0.66 using LOQ and 0.47-0.71 using URI. In samples with TgAb interference, detection rates of TgAb were similar using LOQ and URI for Beckman, Siemens, and Thermo, but much lower for the Roche TgAb-IA when the URI was used. In TgAb positive cases, the ROC areas under the curve (AUC) for the TgAb-IAs were 0.59 (Beckman), 0.62 (Siemens), 0.59 (Roche), and 0.59 (Thermo), similar to ROC AUCs achieved with Tg. Combining Tg and TgAb measurements improved the ROC AUCs compared to Tg or TgAb alone. TgAb-IAs show significant qualitative and quantitative differences. For 2 of the 4 TgAb-IAs, using the LOQ improves the detection of interfering TgAbs. All assays showed suboptimal clinical performance when used as surrogate markers of disease, with modest improvements when Tg and TgAb were combined.

  15. A Thermographic Measurement Approach to Assess Supercapacitor Electrical Performances

    Directory of Open Access Journals (Sweden)

    Stanislaw Galla

    2017-12-01

    Full Text Available This paper describes a proposal for the qualitative assessment of condition of supercapacitors based on the conducted thermographic measurements. The presented measurement stand was accompanied by the concept of methodology of performing tests. Necessary conditions, which were needed to minimize the influence of disturbing factors on the performance of thermal imaging measurements, were also indicated. Mentioned factors resulted from both: the hardware limitations and from the necessity to prepare samples. The algorithm that was used to determine the basic parameters for assessment has been presented. The article suggests to use additional factors that may facilitate the analysis of obtained results. Measuring the usefulness of the proposed methodology was tested on commercial samples of supercapacitors. All of the tests were taken in conjunction with the classical methods based on capacitance (C and equivalent series resistance (ESR measurements, which were also presented in the paper. Selected results presenting the observed changes occurring in both: basic parameters of supercapacitors and accompanying fluctuations of thermal fields, along with analysis, were shown. The observed limitations of the proposed assessment method and the suggestions for its development were also described.

  16. Publication trends of clinical trials performed in South Africa

    African Journals Online (AJOL)

    In addition, a manual search of the Open Access Journal of Clinical Trials databases and reference lists ... significant or negative findings or academics simply not completing the process of .... method on Microsoft Excel (USA). Determination of ...

  17. 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....

  18. Optimisation of key performance measures in air cargo demand management

    OpenAIRE

    Alexander May; Adrian Anslow; Udechukwu Ojiako; Yue Wu; Alasdair Marshall; Maxwell Chipulu

    2014-01-01

    This article sought to facilitate the optimisation of key performance measures utilised for demand management in air cargo operations. The focus was on the Revenue Management team at Virgin Atlantic Cargo and a fuzzy group decision-making method was used. Utilising intelligent fuzzy multi-criteria methods, the authors generated a ranking order of ten key outcome-based performance indicators for Virgin Atlantic air cargo Revenue Management. The result of this industry-driven study showed that ...

  19. Improvements in cognition, quality of life, and physical performance with clinical Pilates in multiple sclerosis: a randomized controlled trial.

    Science.gov (United States)

    Küçük, Fadime; Kara, Bilge; Poyraz, Esra Çoşkuner; İdiman, Egemen

    2016-03-01

    [Purpose] The aim of this study was to determine the effects of clinical Pilates in multiple sclerosis patients. [Subjects and Methods] Twenty multiple sclerosis patients were enrolled in this study. The participants were divided into two groups as the clinical Pilates and control groups. Cognition (Multiple Sclerosis Functional Composite), balance (Berg Balance Scale), physical performance (timed performance tests, Timed up and go test), tiredness (Modified Fatigue Impact scale), depression (Beck Depression Inventory), and quality of life (Multiple Sclerosis International Quality of Life Questionnaire) were measured before and after treatment in all participants. [Results] There were statistically significant differences in balance, timed performance, tiredness and Multiple Sclerosis Functional Composite tests between before and after treatment in the clinical Pilates group. We also found significant differences in timed performance tests, the Timed up and go test and the Multiple Sclerosis Functional Composite between before and after treatment in the control group. According to the difference analyses, there were significant differences in Multiple Sclerosis Functional Composite and Multiple Sclerosis International Quality of Life Questionnaire scores between the two groups in favor of the clinical Pilates group. There were statistically significant clinical differences in favor of the clinical Pilates group in comparison of measurements between the groups. Clinical Pilates improved cognitive functions and quality of life compared with traditional exercise. [Conclusion] In Multiple Sclerosis treatment, clinical Pilates should be used as a holistic approach by physical therapists.

  20. Quantification of the flow measurement performance due to installation changes

    Energy Technology Data Exchange (ETDEWEB)

    Ferreira, Ana Luisa Auler da Silva [Petrobras Transporte S.A. (TRANSPETRO), Rio de Janeiro, RJ (Brazil)

    2012-07-01

    The objective is to present a criterion to identify and quantify improvements in the performance of flowmeters due to alterations in the design of a measurement system. The method was developed aiming at improvements in the operational systems, but is also useful in custody transfer systems. Take as base the estimate of uncertainty in the measurement systems, and seek a more intuitive way so as to aggregate the experience and knowledge available in the company. The identification of the measurand is carried out based on available information, the processing of data and the method of calculation. The improvements in the installation of measurement systems are given priority based on the measurement uncertainty of the CTPL (temperature and pressure correction factor) and the MF(meter factor). In the case of the CTPL, the influence of the pressure, temperature and density instruments in the results of the measurement system is evaluated, and in the case of the MF, the influence of the calibration system. The possibilities for calibrating the flowmeter in industry are presented, also detailing the calibration of the operational meter against custody transfer systems. The analysis of networks includes calculating the uncertainty in the closing of the network balance, calculation of the uncertainties and contributions of the measurement systems that form part of the network, and a comparison of improvements and costs, calculation for each alteration in the design of the measurement system, and its cost per improvement of 0.01% in the uncertainty of the closing. (author)

  1. Innovative Performance Measurement: an Integrative Perspective of Stakeholder's View

    Directory of Open Access Journals (Sweden)

    López-Fresno Palmira

    2014-11-01

    Full Text Available Business Process Management (BPM has been increasingly focused as an holistic approach to manage organizations for better organizational effectiveness. BPM involves the use of innovative performance measurement systems to follow up, coordinate, control and improve processes and overall business efficacy and efficiency. In this paper we propose a global holistic perspective of integrated information, combining the view of all stakeholders and both qualitative and quantitative information, as a basic prerequisite for quality of information for better decision making. The paper includes findings from an empirical case study of measuring Parkinson's Disease Neurosurgery process, including stakeholder's view with an integrative perspective.

  2. Clinical applications of measurement of serum immunoreactive levels of erythropoietin

    International Nuclear Information System (INIS)

    Miller, M.E.; Chandra, M.; Garcia, J.F.

    1985-01-01

    The purification of erythropoietin (Ep) in 1977 enabled investigators to more clearly define the role of this hormone in erythropoiesis in man. Radioimmunoassays were rapidly developed. Undoubtedly differences between levels of immunoreactive and biologically active Ep will be found but the resolution of these discrepancies will expand our understanding of the erythron. Recently others described a monoclonal antibody against Ep. Because of this breakthrough, large quantities of pure hormone should soon be available to a larger number of investigators than currently have access to it. The major clinical use of this hormone will probably be in the treatment of the anemia of chronic renal disease. In the relatively few years since the radioimmunoassay (RIA) was developed, measurements of the levels of this hormone have been made in several disease states as well as in normal man. Most of the findings to date confirm the predictions that have been made over the years based on studies done using the rather crude bioassay for Ep. In the present study the authors shall review and expand on what is known about subjects with chronic lung and renal disease

  3. Measuring Early Cortical Visual Processing in the Clinic

    Directory of Open Access Journals (Sweden)

    Linda Bowns

    2017-05-01

    Full Text Available We describe a mobile app that measures early cortical visual processing suitable for use in clinics. The app is called Component Extraction and Motion Integration Test (CEMIT. Observers are asked to respond to the direction of translating plaids that move in one of two very different directions. The plaids have been selected so that the plaid components move in one of the directions and the plaid pattern moves in the other direction. In addition to correctly responding to the pattern motion, observers demonstrate their ability to correctly extract the movement (and therefore the orientation of the underlying components at specific spatial frequencies. We wanted to test CEMIT by seeing if we could replicate the broader tuning observed at low spatial frequencies for this type of plaid. Results from CEMIT were robust and successfully replicated this result for 50 typical observers. We envisage that it will be of use to researchers and clinicians by allowing them to investigate specific deficits at this fundamental level of cortical visual processing. CEMIT may also be used for screening purposes where visual information plays an important role, for example, air traffic controllers.

  4. Influence of Spherical Radiation Pattern Measurement Uncertainty on Handset Performance Measures

    DEFF Research Database (Denmark)

    Nielsen, Jesper Ødum; Pedersen, Gert Frølund

    2005-01-01

    system that may introduce errors in standardized performance measurements. Radiation patterns of six handsets have been measured while they were mounted at various offsets from the reference position defined by the Cellular Telecommunications & Internet Association (CTIA) certification. The change...... in the performance measures are investigated for both the GSM-900 and the GSM-1800 band. Despite the deliberately large deviations from the reference position, the changes in TRP and TIS are generally within ±0.5 dB with a maximum of about 1.4 dB. For the MEG values the results depend on the orientation...

  5. Wear measurement of dental tissues and materials in clinical studies: A systematic review.

    Science.gov (United States)

    Wulfman, C; Koenig, V; Mainjot, A K

    2018-06-01

    This study aims to systematically review the different methods used for wear measurement of dental tissues and materials in clinical studies, their relevance and reliability in terms of accuracy and precision, and the performance of the different steps of the workflow taken independently. An exhaustive search of clinical studies related to wear of dental tissues and materials reporting a quantitative measurement method was conducted. MedLine, Embase, Scopus, Cochrane Library and Web of Science databases were used. Prospective studies, pilot studies and case series (>10 patients), as long as they contained a description of wear measurement methodology. Only studies published after 1995 were considered. After duplicates' removal, 495 studies were identified, and 41 remained for quantitative analysis. Thirty-four described wear-measurement protocols, using digital profilometry and superimposition, whereas 7 used alternative protocols. A specific form was designed to analyze the risk of bias. The methods were described in terms of material analyzed; study design; device used for surface acquisition; matching software details and settings; type of analysis (vertical height-loss measurement vs volume loss measurement); type of area investigated (entire occlusal area or selective areas); and results. There is a need of standardization of clinical wear measurement. Current methods exhibit accuracy, which is not sufficient to monitor wear of restorative materials and tooth tissues. Their performance could be improved, notably limiting the use of replicas, using standardized calibration procedures and positive controls, optimizing the settings of scanners and matching softwares, and taking into account unusable data. Copyright © 2018 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.

  6. A measurement-based performability model for a multiprocessor system

    Science.gov (United States)

    Ilsueh, M. C.; Iyer, Ravi K.; Trivedi, K. S.

    1987-01-01

    A measurement-based performability model based on real error-data collected on a multiprocessor system is described. Model development from the raw errror-data to the estimation of cumulative reward is described. Both normal and failure behavior of the system are characterized. The measured data show that the holding times in key operational and failure states are not simple exponential and that semi-Markov process is necessary to model the system behavior. A reward function, based on the service rate and the error rate in each state, is then defined in order to estimate the performability of the system and to depict the cost of different failure types and recovery procedures.

  7. Interlaboratory analytical performance studies; a way to estimate measurement uncertainty

    Directory of Open Access Journals (Sweden)

    El¿bieta £ysiak-Pastuszak

    2004-09-01

    Full Text Available Comparability of data collected within collaborative programmes became the key challenge of analytical chemistry in the 1990s, including monitoring of the marine environment. To obtain relevant and reliable data, the analytical process has to proceed under a well-established Quality Assurance (QA system with external analytical proficiency tests as an inherent component. A programme called Quality Assurance in Marine Monitoring in Europe (QUASIMEME was established in 1993 and evolved over the years as the major provider of QA proficiency tests for nutrients, trace metals and chlorinated organic compounds in marine environment studies. The article presents an evaluation of results obtained in QUASIMEME Laboratory Performance Studies by the monitoring laboratory of the Institute of Meteorology and Water Management (Gdynia, Poland in exercises on nutrient determination in seawater. The measurement uncertainty estimated from routine internal quality control measurements and from results of analytical performance exercises is also presented in the paper.

  8. Problems of Clinical Nurse Performance Appraisal System: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Nasrin Nikpeyma

    2014-03-01

    Conclusion: The findings of this study reveal that the nurse performance appraisal system confronts with various problems. Some of these problems are related to organizational context while the others concerned structure, process and results of the performance appraisal system. In order to achieve high quality of patient care as the final goal of performance appraisal, changing and revision of this system is necessary.

  9. Performance and some carcass measurements in starter broiler ...

    African Journals Online (AJOL)

    A 28 day feeding trial was conducted to investigate the performance and some carcass measurements in starter broiler birds fed sweet potato meal. Three hundred and five (305) Anak broilers of one week old were randomly assigned to five treatment diets. Diets 1, 2, 3, 4, and 5 contain 0, 2.5, 5.0, 7.5 and 10.0% levels of ...

  10. Analyze of the Measuring Performance for Artificially Business Intelligent Systems

    OpenAIRE

    Vatuiu, Teodora

    2007-01-01

    This paper analyzes the measuring performance of artificially business intelligent systems. Thousands of persons-years have been devoted to the research and development in the vari¬ous aspects of artificially intelligent systems. Much progress has been attained. However, there has been no means of evaluating the progress of the field. How can we assess the cur¬rent state of the science? Most of business intelligent systems are beginning to be deployed commercially. How can a commercial buyer ...

  11. Accounting for heterogeneity in the measurement of hospital performance

    OpenAIRE

    Philippe K. Widmer; Peter Zweifel; Mehdi Farsi

    2011-01-01

    With prospective payment of hospitals becoming more common, measuring their performance is gaining in importance. However, the standard cost frontier model yields biased efficiency scores because it ignores technological heterogeneity between hospitals. In this paper, efficiency scores are derived from a random intercept and an extended random parameter frontier model, designed to overcome the problem of unobserved heterogeneity in stochastic frontier analysis. Using a sample of 100 Swiss ...

  12. Aims and Formats of performance measurement at Danish Universities

    DEFF Research Database (Denmark)

    Raffnsøe-Møller, Morten

    2011-01-01

    Abstract This article traces the aims and formats of performance measurement of Danish Universities as they originate from the Ministry of Finance’s plan for governance of the public sector. The article further show that the fierce conflicts between central administration and the universities over...... and intelligent regimes – is used to propose a way out of the current governance impasse at the universities....

  13. Outcome measures for oral health based on clinical assessments and claims data: feasibility evaluation in practice.

    Science.gov (United States)

    Hummel, Riët; Bruers, Josef; van der Galiën, Onno; van der Sanden, Wil; van der Heijden, Geert

    2017-10-05

    It is well known that treatment variation exists in oral healthcare, but the consequences for oral health are unknown as the development of outcome measures is still in its infancy. The aim of this study was to identify and develop outcome measures for oral health and explore their performance using health insurance claims records and clinical data from general dental practices. The Dutch healthcare insurance company Achmea collaborated with researchers, oral health experts, and general dental practitioners (GDPs) in a proof of practice study to test the feasibility of measures in general dental practices. A literature search identified previously described outcome measures for oral healthcare. Using a structured approach, identified measures were (i) prioritized, adjusted and added to after discussion and then (ii) tested for feasibility of data collection, their face validity and discriminative validity. Data sources were claims records from Achmea, clinical records from dental practices, and prospective, pre-determined clinical assessment data obtained during routine consultations. In total eight measures (four on dental caries, one on tooth wear, two on periodontal health, one on retreatment) were identified, prioritized and tested. The retreatment measure and three measures for dental caries were found promising as data collection was feasible, they had face validity and discriminative validity. Deployment of these measures demonstrated variation in clinical practices of GDPs. Feedback of this data to GDPs led to vivid discussions on best practices and quality of care. The measure 'tooth wear' was not considered sufficiently responsive; 'changes in periodontal health score' was considered a controversial measure. The available data for the measures 'percentage of 18-year-olds with no tooth decay' and 'improvement in gingival bleeding index at reassessment' was too limited to provide accurate estimates per dental practice. The evaluated measures 'time to first

  14. The Role of Clinical and Instrumented Outcome Measures in Balance Control of Individuals with Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Neeta Kanekar

    2013-01-01

    Full Text Available Purpose. The aim of the study was to investigate differences in balance control between individuals with multiple sclerosis (MS and healthy control subjects using clinical scales and instrumented measures of balance and determine relationships between balance measures, fatigue, and disability levels in individuals with MS with and without a history of falls. Method. Twelve individuals with MS and twelve healthy controls were evaluated using the Berg Balance and Activities-specific Balance Confidence Scales, Modified Clinical Test of Sensory Interaction on Balance, and Limits of Stability Tests as well as Fatigue Severity Scale and Barthel Index. Results. Mildly affected individuals with MS had significant balance performance deficits and poor balance confidence levels (P<0.05. MS group had higher sway velocities and diminished stability limits (P<0.05, significant sensory impairments, high fatigue and disability levels (P<0.05. Sway velocity was a significant predictor of balance performance and the ability to move towards stability limits for the MS group. For the MS-fallers group, those with lower disability levels had faster movement velocities and better balance performance. Conclusion. Implementation of both clinical and instrumented tests of balance is important for the planning and evaluation of treatment outcomes in balance rehabilitation of people with MS.

  15. Women in Jordanian banks and performance: Financial accounting measurement

    Directory of Open Access Journals (Sweden)

    Muhannad Akram Ahmad

    2016-08-01

    Full Text Available This study highlights the gender diversity issues in the banking sector taking into consideration their impact on the performance measured by profitability (ROA. As the banking sector has widely been ignored from the previous studies due to their strict system, this study empirically examined the impact of the CEO gender and board with a female director on the performance of the Jordanian commercial banks in a period from 2004 to 2013. The multiple regression analysis shows that the banks with female CEOs underperform their counterparts run by male CEOs. The reason could be due to their harmonious relationships orientation; that is, women do not tend to invest in risky investments. However, female director plays insignificant roles on the performance which supports the evidence of tokenism as argued by the psychological social theory

  16. A programmable Gaussian random pulse generator for automated performance measurements

    International Nuclear Information System (INIS)

    Abdel-Aal, R.E.

    1989-01-01

    This paper describes a versatile random signal generator which produces logic pulses with a Gaussian distribution for the pulse spacing. The average rate at the pulse generator output can be software-programmed, which makes it useful in performing automated measurements of dead time and CPU time performance of data acquisition systems and modules over a wide range of data rates. Hardware and software components are described and data on the input-output characteristics and the statistical properties of the pulse generator are given. Typical applications are discussed together with advantages over using radioactive test sources. Results obtained from an automated performance run on a VAX 11/785 data acquisition system are presented. (orig.)

  17. Accreditation and the Development of Process Performance Measures

    DEFF Research Database (Denmark)

    Bie Bogh, Søren

    Accreditation is an external review process used to assess how well an organisation performs relative to established standards. Accreditation provides a framework for continuous quality improvement, and health services worldwide embrace accreditation and use it as a strategy to improve quality...... on quality of care using nationwide quantitative designs aimed at detecting changes over time in hospital performance in relation to both voluntary (Study 1) and mandatory accreditation (Study 2). Further, a qualitative study (Study 3) was conducted to complement the findings in Study 2. To examine...... was used to examine the mandatory accreditation programme. The quantitative study was a multilevel, longitudinal, stepped-wedge, nationwide study of process performance measures based on data from patients admitted for acute stroke, heart failure, ulcer, diabetes, breast cancer and lung cancer...

  18. Measuring the performance of mutual funds: A case study

    Directory of Open Access Journals (Sweden)

    Jakšić Milena

    2015-01-01

    Full Text Available In this paper we evaluate the performance of eight open-end mutual funds in the Republic of Serbia for the period 2009-2012, with the aim of testing the justification of active portfolio management of mutual funds, and determining the selection capability of Serbian portfolio managers. Risk-weighted returns of mutual funds are compared with the risk-weighted return of the leading Belgrade Stock Exchange index, Belex15, whereas the following are used as performance measures: Sharpe ratio (Si, Treynor ratio (Ti, and Jensen's or Alpha index (αi. The results suggest that the portfolio of Serbian mutual funds has inferior performance compared to the market portfolio, which indicates the lack of selection capabilities of domestic portfolio managers.

  19. Auditing emergency management programmes: Measuring leading indicators of programme performance.

    Science.gov (United States)

    Tomsic, Heather

    Emergency Management Programmes benefit from review and measurement against established criteria. By measuring current vs required programme elements for their actual currency, completeness and effectiveness, the resulting timely reports of achievements and documentation of identified gaps can effectively be used to rationally support prioritised improvement. Audits, with their detailed, triangulated and objectively weighted processes, are the ultimate approach in terms of programme content measurement. Although Emergency Management is often presented as a wholly separate operational mechanism, distinct and functionally different from the organisation's usual management structure, this characterisation is only completely accurate while managing an emergency itself. Otherwise, an organisation's Emergency Management Programme is embedded within that organisation and dependent upon it. Therefore, the organisation's culture and structure of management, accountability and measurement must be engaged for the programme to exist, much less improve. A wise and successful Emergency Management Coordinator does not let the separate and distinct nature of managing an emergency obscure their realisation of the need for an organisation to understand and manage all of the other programme components as part of its regular business practices. This includes its measurement. Not all organisations are sufficiently large or capable of supporting the use of an audit. This paper proposes that alternate, less formal, yet effective mechanisms can be explored, as long as they reflect and support organisational management norms, including a process of relatively informal measurement focused on the organisation's own perception of key Emergency Management Programme performance indicators.

  20. Predicting in-patient falls in a geriatric clinic: a clinical study combining assessment data and simple sensory gait measurements.

    Science.gov (United States)

    Marschollek, M; Nemitz, G; Gietzelt, M; Wolf, K H; Meyer Zu Schwabedissen, H; Haux, R

    2009-08-01

    Falls are among the predominant causes for morbidity and mortality in elderly persons and occur most often in geriatric clinics. Despite several studies that have identified parameters associated with elderly patients' fall risk, prediction models -- e.g., based on geriatric assessment data -- are currently not used on a regular basis. Furthermore, technical aids to objectively assess mobility-associated parameters are currently not used. To assess group differences in clinical as well as common geriatric assessment data and sensory gait measurements between fallers and non-fallers in a geriatric sample, and to derive and compare two prediction models based on assessment data alone (model #1) and added sensory measurement data (model #2). For a sample of n=110 geriatric in-patients (81 women, 29 men) the following fall risk-associated assessments were performed: Timed 'Up & Go' (TUG) test, STRATIFY score and Barthel index. During the TUG test the subjects wore a triaxial accelerometer, and sensory gait parameters were extracted from the data recorded. Group differences between fallers (n=26) and non-fallers (n=84) were compared using Student's t-test. Two classification tree prediction models were computed and compared. Significant differences between the two groups were found for the following parameters: time to complete the TUG test, transfer item (Barthel), recent falls (STRATIFY), pelvic sway while walking and step length. Prediction model #1 (using common assessment data only) showed a sensitivity of 38.5% and a specificity of 97.6%, prediction model #2 (assessment data plus sensory gait parameters) performed with 57.7% and 100%, respectively. Significant differences between fallers and non-fallers among geriatric in-patients can be detected for several assessment subscores as well as parameters recorded by simple accelerometric measurements during a common mobility test. Existing geriatric assessment data may be used for falls prediction on a regular basis

  1. Development of clinical pharmacy key performance indicators for hospital pharmacists using a modified Delphi approach.

    Science.gov (United States)

    Fernandes, Olavo; Gorman, Sean K; Slavik, Richard S; Semchuk, William M; Shalansky, Steve; Bussières, Jean-François; Doucette, Douglas; Bannerman, Heather; Lo, Jennifer; Shukla, Simone; Chan, Winnie W Y; Benninger, Natalie; MacKinnon, Neil J; Bell, Chaim M; Slobodan, Jeremy; Lyder, Catherine; Zed, Peter J; Toombs, Kent

    2015-06-01

    Key performance indicators (KPIs) are quantifiable measures of quality. There are no published, systematically derived clinical pharmacy KPIs (cpKPIs). A group of hospital pharmacists aimed to develop national cpKPIs to advance clinical pharmacy practice and improve patient care. A cpKPI working group established a cpKPI definition, 8 evidence-derived cpKPI critical activity areas, 26 candidate cpKPIs, and 11 cpKPI ideal attributes in addition to 1 overall consensus criterion. Twenty-six clinical pharmacists and hospital pharmacy leaders participated in an internet-based 3-round modified Delphi survey. Panelists rated 26 candidate cpKPIs using 11 cpKPI ideal attributes and 1 overall consensus criterion on a 9-point Likert scale. A meeting was facilitated between rounds 2 and 3 to debate the merits and wording of candidate cpKPIs. Consensus was reached if 75% or more of panelists assigned a score of 7 to 9 on the consensus criterion during the third Delphi round. All panelists completed the 3 Delphi rounds, and 25/26 (96%) attended the meeting. Eight candidate cpKPIs met the consensus definition: (1) performing admission medication reconciliation (including best-possible medication history), (2) participating in interprofessional patient care rounds, (3) completing pharmaceutical care plans, (4) resolving drug therapy problems, (5) providing in-person disease and medication education to patients, (6) providing discharge patient medication education, (7) performing discharge medication reconciliation, and (8) providing bundled, proactive direct patient care activities. A Delphi panel of hospital pharmacists was successful in determining 8 consensus cpKPIs. Measurement and assessment of these cpKPIs will serve to advance clinical pharmacy practice and improve patient care. © The Author(s) 2015.

  2. Design and experimentally measure a high performance metamaterial filter

    Science.gov (United States)

    Xu, Ya-wen; Xu, Jing-cheng

    2018-03-01

    Metamaterial filter is a kind of expecting optoelectronic device. In this paper, a metal/dielectric/metal (M/D/M) structure metamaterial filter is simulated and measured. Simulated results indicate that the perfect impedance matching condition between the metamaterial filter and the free space leads to the transmission band. Measured results show that the proposed metamaterial filter achieves high performance transmission on TM and TE polarization directions. Moreover, the high transmission rate is also can be obtained when the incident angle reaches to 45°. Further measured results show that the transmission band can be expanded through optimizing structural parameters. The central frequency of the transmission band is also can be adjusted through optimizing structural parameters. The physical mechanism behind the central frequency shifted is solved through establishing an equivalent resonant circuit model.

  3. 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.

  4. Zone of Acceptance Under Performance Measurement: Does Performance Information Affect Employee Acceptance of Management Authority?

    DEFF Research Database (Denmark)

    Nielsen, Poul Aaes; Jacobsen, Christian Bøtcher

    2018-01-01

    Public sector employees have traditionally enjoyed substantial influence and bargaining power in organizational decision making, but few studies have investigated the formation of employee acceptance of management authority. Drawing on the “romance of leadership” perspective, the authors argue th...... that performance measurement can alter public sector authority relations and have implications regarding how public managers can use performance information strategically to gain acceptance of management authority and organizational change....

  5. Predicting the performance of a strategic alliance: an analysis of the Community Clinical Oncology Program.

    Science.gov (United States)

    Kaluzny, A D; Lacey, L M; Warnecke, R; Hynes, D M; Morrissey, J; Ford, L; Sondik, E

    1993-06-01

    This study is designed to examine the effects of environment and structure of the Community Clinical Oncology Program (CCOP) on performance as measured by patient accrual to National Cancer Institute (NCI)-approved treatment protocols. Data and analysis are part of a larger evaluation of the NCI Community Clinical Oncology Program during its second funding cycle, June 1987-May 1990. Data, taken from primary and secondary sources, included a survey of selected informants in CCOPs and research bases, CCOP grant applications, CCOP annual progress reports, and site visits to a subsample of CCOPs (N = 20) and research bases (N = 5). Accrual data were obtained from NCI records. Analysis involved three complementary sets of factors: the local health care resources environment available to the CCOP, the larger policy environment as reflected by the relationship of the CCOP to selected research bases and the NCI, and the operational structure of the CCOP itself. A hierarchical model examined the separate and cumulative effects of local and policy environment and structure on performance. Other things equal, the primary predictors of treatment accrual were: (1) the larger policy environment, as measured by the attendance of nurses at research base meetings; and (2) operational structure, as measured by the number and character of components within participating CCOPs and the number of hours per week worked by data managers. These factors explained 73 percent of the total variance in accrual performance. Findings suggest criteria for selecting the types of organizations to participate in the alliance, as well as for establishing guidelines for managing such alliances. A future challenge is to determine the extent to which factors predicting accrual to cancer treatment clinical trials are equally important as predictors of accrual to cancer prevention and control trials.

  6. Why do employees take more initiatives to improve their performance after co-developing performance measures? A field study

    NARCIS (Netherlands)

    Groen, B.A.C.; Wouters, M.J.F.; Wilderom, C.P.M.

    2012-01-01

    Performance measurements may stimulate employee initiatives to improve operational performance, especially when employees themselves participate in the development of their own departmental performance measures. Using the theory of planned behavior, we examine why this occurs in a beverage

  7. Why do employees take more initiatives to improve their performance after co-developing performance measures? A field study.

    NARCIS (Netherlands)

    Groen, B.A.C.; Wouters, Marc; Wilderom, Celeste P.M.

    2012-01-01

    Performance measurements may stimulate employee initiatives to improve operational performance, especially when employees themselves participate in the development of their own departmental performance measures. Using the theory of planned behavior, we examine why this occurs in a beverage

  8. Performance measurement systems, TQM, and multi-level firm performance: a person-organisation fit perspective

    OpenAIRE

    Wei, Jo-Ting; Chang, Yeun Wen; Zhang, Xiaoxiang; Wu, Hsin-Hung

    2017-01-01

    For firms implementing TQM, there is a need to redesign performance measurement systems (PMS). Innovated PMS ought to have measurement diversity in their structure with considering the spirit of TQM and emphasize the congruence of goals between employees and firms by adding the viewpoint of person-organisation fit (P-O fit). This paper adopts structural equation modeling (SEM) to examine Taiwanese manufacturing firms to study the association between the P-O fit of PMS and the implementation o...

  9. Clinical Performance of Emergency Surgical Officers in Southern ...

    African Journals Online (AJOL)

    GB

    The proportion of cesarean and instrumental deliveries over the total deliveries were 13% and 0.7%, respectively. Explorative laparotomies and appendectomies were the majority of the non-obstetric emergency operations. Interviewed staff in the respective hospitals stated that ESOs' clinical decision making, surgical skill ...

  10. Reducing Uncertainty: Implementation of Heisenberg Principle to Measure Company Performance

    Directory of Open Access Journals (Sweden)

    Anna Svirina

    2015-08-01

    Full Text Available The paper addresses the problem of uncertainty reduction in estimation of future company performance, which is a result of wide range of enterprise's intangible assets probable efficiency. To reduce this problem, the paper suggests to use quantum economy principles, i.e. implementation of Heisenberg principle to measure efficiency and potential of intangible assets of the company. It is proposed that for intangibles it is not possible to estimate both potential and efficiency at a certain time point. To provide a proof for these thesis, the data on resources potential and efficiency from mid-Russian companies was evaluated within deterministic approach, which did not allow to evaluate probability of achieving certain resource efficiency, and quantum approach, which allowed to estimate the central point around which the probable efficiency of resources in concentrated. Visualization of these approaches was performed by means of LabView software. It was proven that for tangible assets performance estimation a deterministic approach should be used; while for intangible assets the quantum approach allows better quality of future performance prediction. On the basis of these findings we proposed the holistic approach towards estimation of company resource efficiency in order to reduce uncertainty in modeling company performance.

  11. Performance Evaluation of an Automated ELISA System for Alzheimer's Disease Detection in Clinical Routine.

    Science.gov (United States)

    Chiasserini, Davide; Biscetti, Leonardo; Farotti, Lucia; Eusebi, Paolo; Salvadori, Nicola; Lisetti, Viviana; Baschieri, Francesca; Chipi, Elena; Frattini, Giulia; Stoops, Erik; Vanderstichele, Hugo; Calabresi, Paolo; Parnetti, Lucilla

    2016-07-22

    The variability of Alzheimer's disease (AD) cerebrospinal fluid (CSF) biomarkers undermines their full-fledged introduction into routine diagnostics and clinical trials. Automation may help to increase precision and decrease operator errors, eventually improving the diagnostic performance. Here we evaluated three new CSF immunoassays, EUROIMMUNtrademark amyloid-β 1-40 (Aβ1-40), amyloid-β 1-42 (Aβ1-42), and total tau (t-tau), in combination with automated analysis of the samples. The CSF biomarkers were measured in a cohort consisting of AD patients (n = 28), mild cognitive impairment (MCI, n = 77), and neurological controls (OND, n = 35). MCI patients were evaluated yearly and cognitive functions were assessed by Mini-Mental State Examination. The patients clinically diagnosed with AD and MCI were classified according to the CSF biomarkers profile following NIA-AA criteria and the Erlangen score. Technical evaluation of the immunoassays was performed together with the calculation of their diagnostic performance. Furthermore, the results for EUROIMMUN Aβ1-42 and t-tau were compared to standard immunoassay methods (INNOTESTtrademark). EUROIMMUN assays for Aβ1-42 and t-tau correlated with INNOTEST (r = 0.83, p ratio measured with EUROIMMUN was the best parameter for AD detection and improved the diagnostic accuracy of Aβ1-42 (area under the curve = 0.93). In MCI patients, the Aβ1-42/Aβ1-40 ratio was associated with cognitive decline and clinical progression to AD.The diagnostic performance of the EUROIMMUN assays with automation is comparable to other currently used methods. The variability of the method and the value of the Aβ1-42/Aβ1-40 ratio in AD diagnosis need to be validated in large multi-center studies.

  12. 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.

  13. Analysis of Illinois Home Performance with ENERGY STAR® Measure Packages

    Energy Technology Data Exchange (ETDEWEB)

    Baker, J. [Partnership for Advanced Residential Retrofit (PARR), Chicago, IL (United States); Yee, S. [Partnership for Advanced Residential Retrofit (PARR), Chicago, IL (United States); Brand, L. [Partnership for Advanced Residential Retrofit (PARR), Chicago, IL (United States)

    2013-09-01

    Through the Chicagoland Single Family Housing Characterization and Retrofit Prioritization report, the Partnership for Advanced Residential Retrofit research team characterized 15 housing types in the Chicagoland region based on assessor data, utility billing history, and available data from prior energy efficiency programs. Within these 15 groups, a subset showed the greatest opportunity for energy savings based on BEopt Version 1.1 modeling of potential energy efficiency package options and the percent of the housing stock represented by each group. In this project, collected field data from a whole-home program in Illinois are utilized to compare marketplace-installed measures to the energy saving optimal packages previously developed for the 15 housing types. Housing type, conditions, energy efficiency measures installed, and retrofit cost information were collected from 19 homes that participated in the Illinois Home Performance with ENERGY STAR program in 2012, representing eight of the characterized housing groups. Two were selected for further case study analysis to provide an illustration of the differences between optimal and actually installed measures. Taken together, these homes are representative of 34.8% of the Chicagoland residential building stock. In one instance, actual installed measures closely matched optimal recommended measures.

  14. DESIGNING COMPANY PERFORMANCE MEASUREMENT SYSTEM USING BALANCE SCORECARD APPROACH

    Directory of Open Access Journals (Sweden)

    Cecep Mukti Soleh

    2015-05-01

    Full Text Available This research aimed to design how to measure company performance by using balance scorecard approach in coal transportation services industry. Depth interview was used to obtain qualitative data determination of strategic objectives, key performance indicators, strategic initiatives, and in charge units for each balanced scorecard perspectives while the quantitative data were obtained from weighting through questionnaires and analyzed using paired comparison to get a perspective what mostly affected the performance of the company. To measure the achievement of corporate performance, each KPI used (1 the scoring system with the methods that higher is better, lower is better and precise is better; (2 traffic light system with the help of green, yellow, red for identification of target achievement. This research result shows that in the balance scorecard perspective, the most influences on the overall performance of the company include the customer's perspective (31%, financial perspective (29%, internal business processes (21%, learning, and growth 19%. Keywords: balance scorecard, paired comparison, coal transportation serviceABSTRAKPenelitian ini bertujuan untuk merancang pengukuran kinerja perusahaan dengan menggunakan pendekatan balance scorecard di industri jasa pengangkutan batu bara. Data kualitatif diperoleh melalui indepth interview digunakan untuk menentukan sasaran strategik, indikator kinerja utama, inisiatif strategi dan penanggungjawab setiap divisi setiap perspektif balance scorecard, sedangkan data kuantitatif digunakan untuk pembobotan melalui kuesioner dan dianalisis dengan menggunakan metode paired comparisson untuk mendapatkan perspektif yang paling berpengaruh terhadap kinerja perusahaan. Ukuran pencapaian kinerja perusahaan dari setiap KPI menggunakan; (1 scoring system dengan bantuan metode higher is better, lower is better dan precise is better;(2 traffic light system dengan menggunakan bantuan warna hijau, kuning, merah

  15. Measuring the performance of G2G services in Iran

    Science.gov (United States)

    Zarei, Behrouz; Safdari, Maryam

    To highlight the growth of e-government and the importance of its services it is essential to evaluate the performance of the service delivery to customers. Research indicates that traditional performance indexes are not suitable for this evaluation; moreover, it is noticeable that the e-government services are intangible and invisible. Among different e-government services, measurement of quality government to government (G2G) services has been less attractive for researchers while crucial for government policy-makers. This calls for a better understanding of the specific needs of users of these services in order to provide appropriate type and level of services that meets those needs. In this paper, the performance of the G2G services is measured in the Iranian context. For this purpose, SERVQUAL, which is a well-known method for assessing service quality, is employed. This study proposes and tests a five-factor of SERVQUAL instrument to explain user satisfaction and gap analysis, between expectations and perceptions of its customers, consisting thirty ministries and main governmental organizations. Based on a Chi-square test, factor analysis, gap analysis and correlations, it is concluded the gap between expectations and perceptions of G2G customers is significant and customer satisfaction of G2G services is at low level.

  16. Subsurface Biogeochemical Research FY11 Second Quarter Performance Measure

    Energy Technology Data Exchange (ETDEWEB)

    Scheibe, Timothy D.

    2011-03-31

    The Subsurface Biogeochemical Research (SBR) Long Term Measure for 2011 under the Performance Assessment Rating Tool (PART) measure is to "Refine subsurface transport models by developing computational methods to link important processes impacting contaminant transport at smaller scales to the field scale." The second quarter performance measure is to "Provide a report on computational methods linking genome-enabled understanding of microbial metabolism with reactive transport models to describe processes impacting contaminant transport in the subsurface." Microorganisms such as bacteria are by definition small (typically on the order of a micron in size), and their behavior is controlled by their local biogeochemical environment (typically within a single pore or a biofilm on a grain surface, on the order of tens of microns in size). However, their metabolic activity exerts strong influence on the transport and fate of groundwater contaminants of significant concern at DOE sites, in contaminant plumes with spatial extents of meters to kilometers. This report describes progress and key findings from research aimed at integrating models of microbial metabolism based on genomic information (small scale) with models of contaminant fate and transport in aquifers (field scale).

  17. Alzheimer Disease Biomarkers as Outcome Measures for Clinical Trials in MCI.

    Science.gov (United States)

    Caroli, Anna; Prestia, Annapaola; Wade, Sara; Chen, Kewei; Ayutyanont, Napatkamon; Landau, Susan M; Madison, Cindee M; Haense, Cathleen; Herholz, Karl; Reiman, Eric M; Jagust, William J; Frisoni, Giovanni B

    2015-01-01

    The aim of this study was to compare the performance and power of the best-established diagnostic biological markers as outcome measures for clinical trials in patients with mild cognitive impairment (MCI). Magnetic resonance imaging, F-18 fluorodeoxyglucose positron emission tomography markers, and Alzheimer's Disease Assessment Scale-cognitive subscale were compared in terms of effect size and statistical power over different follow-up periods in 2 MCI groups, selected from Alzheimer's Disease Neuroimaging Initiative data set based on cerebrospinal fluid (abnormal cerebrospinal fluid Aβ1-42 concentration-ABETA+) or magnetic resonance imaging evidence of Alzheimer disease (positivity to hippocampal atrophy-HIPPO+). Biomarkers progression was modeled through mixed effect models. Scaled slope was chosen as measure of effect size. Biomarkers power was estimated using simulation algorithms. Seventy-four ABETA+ and 51 HIPPO+ MCI patients were included in the study. Imaging biomarkers of neurodegeneration, especially MR measurements, showed highest performance. For all biomarkers and both MCI groups, power increased with increasing follow-up time, irrespective of biomarker assessment frequency. These findings provide information about biomarker enrichment and outcome measurements that could be employed to reduce MCI patient samples and treatment duration in future clinical trials.

  18. Evaluation of a device for standardized measurements of reading performance in a prepresbyopic population.

    Science.gov (United States)

    Arad, Tschingis; Baumeister, Martin; Bühren, Jens; Kohnen, Thomas

    2017-04-20

    Automated measurements of reading performance are required for clinical trials involving presbyopia-correcting surgery options. Repeatability of a testing device for reading (Salzburg Reading Desk) was evaluated in a prepresbyopic population. Subjective reading performance of 50 subjects divided into 2 age groups (23-30 years and 38-49 years) with distance-corrected eyes was investigated with different log-scaled reading charts. At study entry, refractive parameters were measured and distance visual acuity assessed. Two standardized binocular measurements were performed for each subject (32.24 ± 9.87 days apart [mean ± SD]). The repeatability of the tests was estimated using correlation coefficients, Wilcoxon signed-rank test, and Bland-Altman method. The test parameters at both maximum reading rate (MRR) measurements demonstrate a strong relationship of age group 2 subjects (correlation coefficient [r] = 0.74 p = 10-4) and of younger subjects (age group 1: r = 0.69, p = 10-4). Prepresbyopic subjects of age group 2 showed moderate results for near reading distance (r = 0.67, p = 10-4); by contrast, younger subjects had poorer results (r = 0.55, p = 10-3). The Wilcoxon signed-rank test revealed agreement between measurements and Bland-Altman plots showed a wide data spread for MRR and near reading distance in both groups. The device measures repeatedly selected reading performance parameters of near real world conditions, such as MRR, in prepresbyopic populations if several factors are taken into account. The option to choose preferred distance leads to more variance in measuring repeated reading performance. German Clinical Trials Register (DRKS) registration reference number: DRKS00000784.

  19. 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.

  20. Clinical performance improvement series. Classic CQI integrated with comprehensive disease management as a model for performance improvement.

    Science.gov (United States)

    Joshi, M S; Bernard, D B

    1999-08-01

    In recent years, health and disease management has emerged as an effective means of delivering, integrating, and improving care through a population-based approach. Since 1997 the University of Pennsylvania Health System (UPHS) has utilized the key principles and components of continuous quality improvement (CQI) and disease management to form a model for health care improvement that focuses on designing best practices, using best practices to influence clinical decision making, changing processes and systems to deploy and deliver best practices, and measuring outcomes to improve the process. Experience with 28 programs and more than 14,000 patients indicates significant improvement in outcomes, including high physician satisfaction, increased patient satisfaction, reduced costs, and improved clinical process and outcome measures across multiple diseases. DIABETES DISEASE MANAGEMENT: In three months a UPHS multidisciplinary diabetes disease management team developed a best practice approach for the treatment of all patients with diabetes in the UPHS. After the program was pilot tested in three primary care physician sites, it was then introduced progressively to additional practice sites throughout the health system. The establishment of the role of the diabetes nurse care managers (certified diabetes educators) was central to successful program deployment. Office-based coordinators ensure incorporation of the best practice protocols into routine flow processes. A disease management intranet disseminates programs electronically. Outcomes of the UPHS health and disease management programs so far demonstrate success across multiple dimensions of performance-service, clinical quality, access, and value. The task of health care leadership today is to remove barriers and enable effective implementation of key strategies, such as health and disease management. Substantial effort and resources must be dedicated to gain physician buy-in and achieve compliance. The