Does the EUA Institutional Evaluation Programme Contribute to Quality Improvement?

Science.gov (United States)

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

2010-01-01

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

European guidelines for quality assurance in colorectal cancer screening and diagnosis

DEFF Research Database (Denmark)

von Karsa, L; Patnick, J; Segnan, N

2013-01-01

-based guidelines for quality assurance in CRC screening and diagnosis have been developed by experts in a project co-financed by the European Union. The 450-page guidelines were published in book format by the European Commission in 2010.  They include 10 chapters and over 250 recommendations, individually graded......Population-based screening for early detection and treatment of colorectal cancer (CRC) and precursor lesions, using evidence-based methods, can be effective in populations with a significant burden of the disease provided the services are of high quality. Multidisciplinary, evidence...... according to the strength of the recommendation and the supporting evidence. Adoption of the recommendations can improve and maintain the quality and effectiveness of an entire screening process, including identification and invitation of the target population, diagnosis and management of the disease...

Managerialism, organisational commitment, and quality of job performances among European university employees

NARCIS (Netherlands)

Smeenk, S.; Teelken, J.C.; Doorewaard, H.; Eisinga, R.

2009-01-01

To achieve efficient and effective quality improvement, European universities have gradually adopted organizational strategies, structures, technologies, management instruments, and values that are commonly found in the private business sector. Whereas some studies have shown that such managerialism

Managerialism, Organizational Commitment, and Quality of Job Performances among European University Employees

NARCIS (Netherlands)

Smeenk, S.G.A.; Teelken, J.C.; Eisinga, R.N.; Doorewaard, J.A.C.M.

2009-01-01

To achieve efficient and effective quality improvement, European universities have gradually adopted organizational strategies, structures, technologies, management instruments, and values that are commonly found in the private business sector. Whereas some studies have shown that such managerialism

Managerialism, organizational commitment and quality of job performances among European university employees

NARCIS (Netherlands)

Smeenk, S.; Teelken, Ch.; Eisinga, R.; Doorewaard, R.

2009-01-01

To achieve efficient and effective quality improvement, European universities have gradually adopted organizational strategies, structures, technologies, management instruments, and values that are commonly found in the private business sector. Whereas some studies have shown that such managerialism

CARE - curriculum quality analysis and impact review of European ECEC

DEFF Research Database (Denmark)

Jensen, Bente; Iannone, Rosa Lisa

to child outcomes including cognitive, language, social and emotional and educational development, as well as more general indicators of leaning and well-being. Research, mostly from the US, suggests that life-chances and child development are dependent on the quality of educational opportunities available...... that it is possible to identify different ways for improving ECEC quality, both structurally and processually. We know from research, that processual quality, e.g. positive interactions between children and adults, is the most important factor to improving child outcomes in general and for socially disadvantaged......There are considerable variations in patterns of professional development among ECEC practioners in European countries with regard to both pre-service and in-service education and training. There exists a substantial body of literature and ongoing studies linking aspects of professional development...

Quality assurance in European pharmacy education and training

Directory of Open Access Journals (Sweden)

Guimarães Morais JA

2011-12-01

Full Text Available A survey of quality assurance (QA systems in European faculties of pharmacy was carried out under the auspices of the European Association of Faculties of Pharmacy PHARMINE consortium. A questionnaire based on the quality criteria of the International Pharmaceutical Federation and the Accreditation Council for Pharmacy Education (USA was sent out to European faculties. Replies were obtained from 28 countries. Just above half has a working QA system. QA scores were high concerning matters such as complete curriculum and training, use of European Credit Transfer System, students’ representation and promotion of professional behavior. QA scores were low concerning matters such as evaluation of achievement of mission and goals, and financial resources. The PHARMINE consortium now has a basis upon which to elaborate and promote QA in European pharmacy faculties.

ANALISIS PERBANDINGAN PENGHARGAAN KUALITAS MALCOLM BALDRIGE NATIONAL QUALITY AWARD DENGAN EUROPEAN QUALITY AWARD (MBNQA vs EQA

Directory of Open Access Journals (Sweden)

Arfan Bakhtiar Amalia

2012-02-01

Full Text Available Persaingan bisnis global saat ini makin ketat. Dengan adanya Malcolm Baldrige National Quality Award (MBNQA dan juga European Quality Award (EQA diharapkan mampu mendorong dan memotivasi perusahaan-perusahaan, baik yang sudah sukses maupun yang sedang berkembang, untuk selalu meningkatkan mutu dan kinerja, serta sebagai kunci daya saing. Dalam makalah ini, kita akan membahas penghargaan kualitas mengenai tujuan, manfaat dan perkembangan, dan trend saat ini, terutama untuk MBNQA dan EQM (European Quality Model. Kita akan membandingkan antara MBNQA dan EQM melalui pengertian, latar belakang, metode-metode, dan kriteria-kriteria, serta aplikasinya, sehingga dapat kita lakukan analisa perbandingan untuk keduanya. Kata Kunci  : Penghargaan Kualitas, Malcolm Baldrige National Quality Award (MBNQA, European Quality Award (EQA   Emulation of global business in this time more and more to tighten. With existence of Malcolm Baldrige National Quality Award (MBNQA as well as European Quality Award (EQA expected can push and motivate companies, both for have successful and also which is expanding, to always increase the quality and performance, and also as competitiveness key. In this paper, we will discuss about national quality award concerning target, benefit, growth, and trend in this time, especially MBNQA and EQM (European Quality Model. We will compare between MBNQA and EQM through congeniality, background, method, and criterions, and also its application,  so that earn us to analyse comparison to both of its. Keyword        : Quality Award, Malcolm Baldrige National Quality Award (MBNQA, European Quality Award (EQA

Organ Donation European Quality System: ODEQUS project methodology.

Science.gov (United States)

Manyalich, M; Guasch, X; Gomez, M P; Páez, G; Teixeira, L

2013-01-01

Differences in the number of organ donors among hospitals cannot be explained only by the number of intensive care unit beds used or neurologic patients treated. The figures obtained are influenced by the organizational structure of the donation process and how efficient it is. The Organ Donation European Quality System (ODEQUS) is a 3-year project (from October 2010 to September 2013) co-financed by the European Agency for Health and Consumers (EAHC20091108) which aims to define a methodology to evaluate organ procurement performance at the hospital level. ODEQUS's specific objectives are to identify quality criteria and to develop quality indicators in three types of organ donation (after brain death, after cardiac death, and living donation). Those tools will be useful for hospitals' self-assessment as well as for developing an international auditing model. A consortium has been established involving 14 associated partners from Austria, Croatia, France, Germany, Italy, Poland, Portugal, Romania, Spain, Sweden, and the United Kingdom, as well as five collaborating partners from Greece, Hungary, Malta, Slovenia, and Turkey. The project has been established in three steps: 1) Design of a survey about the use of quality tools in a wide sample of European hospitals; 2) Development of quality criteria and quality indicators by the project experts. The main fields considered have been organizational structures, clinical procedures, and outcomes; and 3) Elaboration of an evaluation system to test the quality indicators in 11 European hospitals. Two types of training have been designed and performed: one concerns the development of quality criteria and quality indicators, whereas another is focused on how to use evaluation tools. Following this methodology, the project has so far identified 131 quality criteria and developed 31 quality indicators. Currently, the quality indicators are being tested in 11 selected hospitals. Copyright © 2013 Elsevier Inc. All rights

The european approach to quality assurance in diagnostic radiology

International Nuclear Information System (INIS)

Benini, A.

1997-01-01

The european and increasingly the international organizations are emphasizing the importance of appropriate quality assurance programmes in diagnostic radiology. The European Directive (particularly the directive 84/466/EURATOM). the various publications of the International Commission for radiation protection (ICRP), related to protection of the patients and workers and the Basic Safety Standards of the International Atomic Energy Agency (IAEA) might be considered the landmarks of the new approach to the problems of dose reduction and quality in diagnostic radiology. In particular ICRP maintains a watching brief on all aspects related to radiation protection and makes recommendations concerning basic principles. Since ICRP 26 (1977), several ICRP publications have dealt with all the principal fields of diagnostic radiology. The IAEA has recently published the new Basic Safety Standards including guidance levels for the most common diagnostic investigations.Within the European countries the European Union and the European legislation have strong influence of the implementation of radiation protection and Q A at a national level. This has led to a substantial effort in the european countries to establish national standards and basic quality requirements. (author)

Quality measurement and improvement in liver transplantation.

Science.gov (United States)

Mathur, Amit K; Talwalkar, Jayant

2018-06-01

There is growing interest in the quality of health care delivery in liver transplantation. Multiple stakeholders, including patients, transplant providers and their hospitals, payers, and regulatory bodies have an interest in measuring and monitoring quality in the liver transplant process, and understanding differences in quality across centres. This article aims to provide an overview of quality measurement and regulatory issues in liver transplantation performed within the United States. We review how broader definitions of health care quality should be applied to liver transplant care models. We outline the status quo including the current regulatory agencies, public reporting mechanisms, and requirements around quality assurance and performance improvement (QAPI) activities. Additionally, we further discuss unintended consequences and opportunities for growth in quality measurement. Quality measurement and the integration of quality improvement strategies into liver transplant programmes hold significant promise, but multiple challenges to successful implementation must be addressed to optimise value. Copyright © 2018 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

From Quality Assurance to Quality Enhancement in the European Higher Education Area

Science.gov (United States)

Gvaramadze, Irakli

2008-01-01

This article focuses on recent trends in quality assurance initiatives, analyses how the European Higher Education Area promotes quality enhancement mechanisms and their implications for quality cultures in universities. It presents and discusses two approaches towards quality enhancement both at the institutional and programme level: 1. Quality…

Quality and quantity: Can we have both within the European patent system?

DEFF Research Database (Denmark)

Elsmore, Matthew J.

2009-01-01

Scrutiny of patent systems is never far away. The European Patent Office has long faced rising levels of 'inventive activity'. Fast, fluid technologies and strategic firm behavior add to the difficulties faced in trying to reward inventions with commensurate rights. Analysis suggests stronger...... patent protection does not necessarily equate with more innovation and greater diffusion of knowledge; nor do more patents lead to or reflect more innovation. This article focuses on improving the fundamental workings of the European system as is stands, and proposes a focus on quality and patent...

Securing Quality in Journalism on a European Scale. An Infrastructure Analysis.

OpenAIRE

Anger, Heike

2010-01-01

The study at hand shows that in the course of European integration not only politics have been transnationalised and Europeanised but also the infrastructures securing quality in journalism. Infrastructures in journalism can be defined as those institutions and initiatives whose activities are shaping journalism regarding its quality without directly being a part of the media production: European journalism training, European media industry and trade associations and European associations of ...

The European initiative for quality management in lung cancer care

DEFF Research Database (Denmark)

Blum, Torsten G; Rich, Anna; Baldwin, David

2014-01-01

. The Task Force undertook four projects: 1) a narrative literature search on quality management of lung cancer; 2) a survey of national and local infrastructure for lung cancer care in Europe; 3) a benchmarking project on the quality of (inter)national lung cancer guidelines in Europe; and 4) a feasibility...... study of prospective data collection in a pan-European setting. There is little peer-reviewed literature on quality management in lung cancer care. The survey revealed important differences in the infrastructure of lung cancer care in Europe. The European guidelines that were assessed displayed wide...... countries. The European Initiative for Quality Management in Lung Cancer Care has provided the first comprehensive snapshot of lung cancer care in Europe....

Talking about quality: exploring how 'quality' is conceptualized in European hospitals and healthcare systems.

Science.gov (United States)

Wiig, Siri; Aase, Karina; von Plessen, Christian; Burnett, Susan; Nunes, Francisco; Weggelaar, Anne Marie; Anderson-Gare, Boel; Calltorp, Johan; Fulop, Naomi

2014-10-11

Conceptualization of quality of care - in terms of what individuals, groups and organizations include in their meaning of quality, is an unexplored research area. It is important to understand how quality is conceptualised as a means to successfully implement improvement efforts and bridge potential disconnect in language about quality between system levels, professions, and clinical services. The aim is therefore to explore and compare conceptualization of quality among national bodies (macro level), senior hospital managers (meso level), and professional groups within clinical micro systems (micro level) in a cross-national study. This cross-national multi-level case study combines analysis of national policy documents and regulations at the macro level with semi-structured interviews (383) and non-participant observation (803 hours) of key meetings and shadowing of staff at the meso and micro levels in ten purposively sampled European hospitals (England, the Netherlands, Portugal, Sweden, and Norway). Fieldwork at the meso and micro levels was undertaken over a 12-month period (2011-2012) and different types of micro systems were included (maternity, oncology, orthopaedics, elderly care, intensive care, and geriatrics). The three quality dimensions clinical effectiveness, patient safety, and patient experience were incorporated in macro level policies in all countries. Senior hospital managers adopted a similar conceptualization, but also included efficiency and costs in their conceptualization of quality. 'Quality' in the forms of measuring indicators and performance management were dominant among senior hospital managers (with clinical and non-clinical background). The differential emphasis on the three quality dimensions was strongly linked to professional roles, personal ideas, and beliefs at the micro level. Clinical effectiveness was dominant among physicians (evidence-based approach), while patient experience was dominant among nurses (patient

ISO certification pays off in quality improvement

International Nuclear Information System (INIS)

Vermeer, F.J.G.

1992-01-01

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

Current Trends in European Quality Assurance. ENQA Workshop Report 8

Science.gov (United States)

Bozo, Dhurata; Damian, Radu; Gonzalez, Cecilia de la Rosa; Helle, Emmi; Imoda, Franco; Kohler, Alexander; Papazoglou, Vassilios J.; Dalmau, Gemma Rauret; Shopov, Todor

2009-01-01

The present report is a product of two ENQA (European Association for Quality Assurance in Higher Education) seminars, held in 2007, on current trends in European Quality Assurance. The first seminar, hosted by the Bulgarian National Evaluation and Accreditation Agency (NEAA), examined the situation in South-Eastern Europe. The second seminar…

Quality standards of the European Pharmacopoeia.

Science.gov (United States)

Bouin, Anne-Sophie; Wierer, Michael

2014-12-02

The European Pharmacopoeia (Ph. Eur.) provides a legal and scientific reference for the quality control of medicines. It is legally binding in the 38 signatory parties of the Convention on the elaboration of a European Pharmacopoeia (37 member states and the European Union). The requirements for a specific herbal drug are prescribed in the corresponding individual monograph and the relevant general monographs. Criteria for pesticides and heavy metals for example are defined in the general monograph on Herbal drugs. The Ph. Eur. also provides general methods including methods for determination of aflatoxins B1 and ochratoxin A. Screening methods for aristolochic acids are applied for herbal drugs that may be subject to adulteration or substitution with plant material containing aristolochic acids. The Ph. Eur. collaborate in many areas with the European Medicines Agency (EMA) to ensure close collaboration as regards the respective work programmes and approach. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

A roadmap to improve the quality of atrial fibrillation management

DEFF Research Database (Denmark)

Kirchhof, Paulus; Breithardt, Günter; Bax, Jeroen

2016-01-01

. Hence, there are important unmet clinical and research needs in the evaluation and management of AF patients. The ensuing needs and opportunities for improving the quality of AF care were discussed during the fifth Atrial Fibrillation Network/European Heart Rhythm Association consensus conference...

The impact of European legislative and technology measures to reduce air pollutants on air quality, human health and climate

International Nuclear Information System (INIS)

Turnock, S T; Butt, E W; Richardson, T B; Mann, G W; Reddington, C L; Forster, P M; Carslaw, K S; Spracklen, D V; Haywood, J; Johnson, C E; Crippa, M; Janssens-Maenhout, G; Bellouin, N

2016-01-01

European air quality legislation has reduced emissions of air pollutants across Europe since the 1970s, affecting air quality, human health and regional climate. We used a coupled composition-climate model to simulate the impacts of European air quality legislation and technology measures implemented between 1970 and 2010. We contrast simulations using two emission scenarios; one with actual emissions in 2010 and the other with emissions that would have occurred in 2010 in the absence of technological improvements and end-of-pipe treatment measures in the energy, industrial and road transport sectors. European emissions of sulphur dioxide, black carbon (BC) and organic carbon in 2010 are 53%, 59% and 32% lower respectively compared to emissions that would have occurred in 2010 in the absence of legislative and technology measures. These emission reductions decreased simulated European annual mean concentrations of fine particulate matter (PM 2.5 ) by 35%, sulphate by 44%, BC by 56% and particulate organic matter by 23%. The reduction in PM 2.5 concentrations is calculated to have prevented 80 000 (37 000–116 000, at 95% confidence intervals) premature deaths annually across the European Union, resulting in a perceived financial benefit to society of US$232 billion annually (1.4% of 2010 EU GDP). The reduction in aerosol concentrations due to legislative and technology measures caused a positive change in the aerosol radiative effect at the top of atmosphere, reduced atmospheric absorption and also increased the amount of solar radiation incident at the surface over Europe. We used an energy budget approximation to estimate that these changes in the radiative balance have increased European annual mean surface temperatures and precipitation by 0.45 ± 0.11 °C and by 13 ± 0.8 mm yr −1 respectively. Our results show that the implementation of European legislation and technological improvements to reduce the emission of air pollutants has improved air quality

Implementation and translation: from European standards and guidelines for quality assurance to education quality work in higher education institutions

NARCIS (Netherlands)

Westerheijden, Donald F.; Kohoutek, Jan; Eggins, Heather

2014-01-01

The Standards and Guidelines for Quality Assurance in the European Higher Education Area (ESG for short) have been part of the regulative infrastructure of the European Higher Education Area (EHEA) since 2005 (European Association for Quality Assurance in Higher Education, 2009).

Improving the quality of pork and pork products (EU project)

DEFF Research Database (Denmark)

Christensen, Mette; Grunert, Klaus G.; Bonneau, M.

2008-01-01

demands. A large EU-project (Q-PorkChains) funded by EU 6th framework programme was initiated in January 2007. The aim of Q-PorkChains is to improve the quality of pork and its products for the consumer and to develop innovative, integrated and sustainable food production chains with low environmental....... The European Unions self-sufficiency and leading position in the global market for pork and pork products is challenged by a number of non-European countries. Therefore, there is a need for developing innovative, integrated, and sustainable food production chains of high quality pork products matching consumer...... impact. Q-PorkChains is composed of six research modules (consumer and citizen demands, pig production, product development, pork chain management, molecular quality control and knowledge synthesis) and two horizontal modules focusing on implementation of obtained knowledge in pilot and demonstration...

Deepening our understanding of quality improvement in Europe (DUQuE): overview of a study of hospital quality management in seven countries

NARCIS (Netherlands)

Secanell, Mariona; Groene, Oliver; Arah, Onyebuchi A.; Lopez, Maria Andrée; Kutryba, Basia; Pfaff, Holger; Klazinga, Niek; Wagner, Cordula; Kristensen, Solvejg; Bartels, Paul Daniel; Garel, Pascal; Bruneau, Charles; Escoval, Ana; França, Margarida; Mora, Nuria; Suñol, Rosa; Kringos, D. S.; Lombarts, M. J. M. H.; Plochg, T.; Lopez, M. A.; Secanell, M.; Sunol, R.; Vallejo, P.; Bartels, P.; Kristensen, S.; Michel, P.; Saillour-Glenisson, F.; Vlcek, F.; Car, M.; Jones, S.; Klaus, E.; Bottaro, S.; Garel, P.; Saluvan, M.; Bruneau, C.; Depaigne-Loth, A.; Shaw, C.; Hammer, A.; Ommen, O.; Pfaff, H.; Groene, O.; Botje, D.; Wagner, C.; Kutaj-Wasikowska, H.; Kutryba, B.; Escoval, A.; Lívio, A.; Eiras, M.; Franca, M.; Leite, I.

2014-01-01

This paper provides an overview of the DUQuE (Deepening our Understanding of Quality Improvement in Europe) project, the first study across multiple countries of the European Union (EU) to assess relationships between quality management and patient outcomes at EU level. The paper describes the

Deepening our understanding of quality improvement in Europe (DUQuE): overview of a study of hospital quality management in seven countries.

NARCIS (Netherlands)

Secanell, M.; Groene, O.; Arah, O.A.; Lopez, M.A.; Kutryba, B.; Pfaff, H.; Klazinga, N.; Wagner, C.; Kristensen, S.; Bartels, P.D.; Garel, P.; Bruneau, C.; Escoval, A.; França, M.; Mora, N.; Suñol, R.

2014-01-01

Introduction and Objective: This paper provides an overview of the DUQuE (Deepening our Understanding of Quality Improvement in Europe) project, the first study across multiple countries of the European Union (EU) to assess relationships between quality management and patient outcomes at EU level.

Quality of care in European home care programs using the second generation interRAI Home Care Quality Indicators (HCQIs).

Science.gov (United States)

Foebel, Andrea D; van Hout, Hein P; van der Roest, Henriëtte G; Topinkova, Eva; Garms-Homolova, Vjenka; Frijters, Dinnus; Finne-Soveri, Harriet; Jónsson, Pálmi V; Hirdes, John P; Bernabei, Roberto; Onder, Graziano

2015-11-14

Evaluating the quality of care provided to older individuals is a key step to ensure that needs are being met and to target interventions to improve care. To this aim, interRAI's second-generation home care quality indicators (HCQIs) were developed in 2013. This study assesses the quality of home care services in six European countries using these HCQIs as well as the two derived summary scales. Data for this study were derived from the Aged in Home Care (AdHOC) study - a cohort study that examined different models of community care in European countries. The current study selected a sub-sample of the AdHOC cohort from six countries whose follow-up data were complete (Czech Republic, Denmark, Finland, Germany, Italy and the Netherlands). Data were collected from the interRAI Home Care instrument (RAI-HC) between 2000 and 2002. The 23 HCQIs of interest were determined according to previously established methodology, including risk adjustment. Two summary measures, the Clinical Balance Scale and Independence Quality Scale were also determined using established methodology. A total of 1,354 individuals from the AdHOC study were included in these analyses. Of the 23 HCQIs that were measured, the highest proportion of individuals experienced declines in Instrumental Activities of Daily Living (IADLs) (48.4 %). Of the clinical quality indicators, mood decline was the most prevalent (30.0 %), while no flu vaccination and being alone and distressed were the most prevalent procedural and social quality indicators, respectively (33.4 and 12.8 %). Scores on the two summary scales varied by country, but were concentrated around the median mark. The interRAI HCQIs can be used to determine the quality of home care services in Europe and identify areas for improvement. Our results suggest functional declines may prove the most beneficial targets for interventions.

The European Urology Residents Education Programme Hands-on Training Format: 4 Years of Hands-on Training Improvements from the European School of Urology.

Science.gov (United States)

Somani, Bhaskar K; Van Cleynenbreugel, Ben; Gozen, Ali; Palou, Jaun; Barmoshe, Sas; Biyani, Shekhar; Gaya, Josep M; Hellawell, Giles; Pini, Gio; Oscar, Faba R; Sanchez Salas, Rafael; Macek, Petr; Skolarikos, Andreas; Wagner, Christian; Eret, Viktor; Haensel, Stephen; Siena, Giampaolo; Schmidt, Marek; Klitsch, Max; Vesely, Stepan; Ploumidis, Achilles; Proietti, Silvia; Kamphuis, Guido; Tokas, Theodore; Geraghty, Rob; Veneziano, Dominico

2018-03-14

The European School of Urology (ESU) started the European Urology Residents Education Programme (EUREP) in 2003 for final year urology residents, with hands-on training (HOT) added later in 2007. To assess the geographical reach of EUREP, trainee demographics, and individual quality feedback in relation to annual methodology improvements in HOT. From September 2014 to October 2017 (four EUREP courses) several new features have been applied to the HOT format of the EUREP course: 1:1 training sessions (2015), fixed 60-min time slots (2016), and standardised teaching methodology (2017). The resulting EUREP HOT format was verified by collecting and prospectively analysing the following data: total number of participants attending different HOT courses; participants' age; country of origin; and feedback obtained annually. A total of 796 participants from 54 countries participated in 1450 HOT sessions over the last 4 yr. This included 294 (20%) ureteroscopy (URS) sessions, 237 (16.5%) transurethral resection (TUR) sessions, 840 (58%) basic laparoscopic sessions, and 79 (5.5%) intermediate laparoscopic sessions. While 712 residents (89%) were from Europe, 84 (11%) were from non-European nations. Of the European residents, most came from Italy (16%), Germany (15%), Spain (15%), and Romania (8%). Feedback for the basic laparoscopic session showed a constant improvement in scores over the last 4 yr, with the highest scores achieved last year. This included feedback on improvements in tutor rating (p=0.017), organisation (ptraining curriculum with wet laboratory or cadaveric courses in this format, although these could be performed in other training centres in conjunction with EUREP. The EUREP trainee demographics show that the purpose of the course is being achieved, with excellent feedback reported. While European trainees dominate the demographics, participation from a number of non-European countries suggests continued ESU collaboration with other national societies and

Russian Higher Education and European Standards of Quality Assurance

Science.gov (United States)

Motova, Galina; Pykko, Ritta

2012-01-01

This article considers the relevance and implementation of European approaches to quality assurance in the context of the Russian educational system. It covers the issues of transformation of the higher education system during the post-Soviet period, specific features of the state accreditation system, the impact of the European Standards and…

The National System for quality control and the European experience

International Nuclear Information System (INIS)

Dimov, A.; Vassileva, J.; Ingilizova, K.; Slavchev, A. and others

2003-01-01

Objective: The aim of the work is to present the structure and functions of the National System for quality control (NSQC) in the medical irradiation, created to guarantee the safety and the safe use of the radiological equipment. Material and method: The approaches are studies in the development of the NSQC, applied in Bulgaria and some European Union members - such as Germany and Great Britain - and the specifics of the way in which the Directive for medical irradiation EURATOM 97/43 is implemented in national legislations. Results: The advantages and disadvantages of Bulgarian NSQC are analysed and some ideas for tis improvement are suggested. Conclusions: The developed draft NSQC for medical irradiation is in compliance with the requirement of the European Directive. The real advantages and disadvantages of the NSQC will show after its implementation in the practical radiation protection and control in the country

How to develop a patient and carer advisory group in a quality improvement study.

Science.gov (United States)

Loud, Fiona; Jain, Neerja; Thomas, Nicola

2013-09-01

This paper explores how a group of people with renal or other vascular conditions collaborated with renal practitioners in undertaking a quality improvement project, the aim of which was to reduce variation in care for people with Stages 3-4 chronic kidney disease. The patient advisory group supporting the project took a decisive and leading role in the creation of self-management materials and subsequent training for healthcare professionals and patients. The role of the patient advisory group was evaluated informally throughout the project. Confidence amongst the patient advisory group members grew as the project developed. Clinicians are often unclear on how to involve patients and carers in quality improvement projects, yet it is increasingly recognised as important. In practice, patients with experience of long-term conditions can co-lead quality improvement projects. It is recommended that further evaluation of the role of advisory groups is warranted. © 2013 European Dialysis and Transplant Nurses Association/European Renal Care Association.

[Quality assurance and quality improvement in medical practice. Part 1. Definition and importance of quality in medical practice].

Science.gov (United States)

Godény, Sándor

2012-01-22

In Hungary, financing of healthcare has decreased relative to the GDP, while the health status of the population is still ranks among the worst in the European Union. Since healthcare financing is not expected to increase, the number of practicing doctors per capita is continuously decreasing. In the coming years, it is an important question that in this situation what methods can be used to prevent further deterioration of the health status of the Hungarian population, and within this is the role of the quality approach, and different methods of quality management. In the present and the forthcoming two articles those standpoints will be summarized which support the need for the integration of quality assurance in the everyday medical practice. In the first part the importance of quality thinking, quality management, quality assurance, necessity of quality measurement and improvement, furthermore, advantages of the quality systems will be discussed.

Quantitative research versus quality assurance, quality improvement, total quality management, and continuous quality improvement.

Science.gov (United States)

Vogelsang, J

1999-04-01

The purpose of this report is to provide a review of the scientific method used in the quantitative research studies for consumers, evaluators, and applied nurse researchers. The fundamental characteristics of the problem-solving/ performance-improvement processes of quality assurance, quality improvement, total quality management, and continuous quality improvement are described. Research is compared with these processes, and is followed by a discussion about the publication of quantitative research findings.

European Society of Gynaecologic Oncology Quality Indicators for Advanced Ovarian Cancer Surgery.

Science.gov (United States)

Querleu, Denis; Planchamp, François; Chiva, Luis; Fotopoulou, Christina; Barton, Desmond; Cibula, David; Aletti, Giovanni; Carinelli, Silvestro; Creutzberg, Carien; Davidson, Ben; Harter, Philip; Lundvall, Lene; Marth, Christian; Morice, Philippe; Rafii, Arash; Ray-Coquard, Isabelle; Rockall, Andrea; Sessa, Cristiana; van der Zee, Ate; Vergote, Ignace; du Bois, Andreas

2016-09-01

The surgical management of advanced ovarian cancer involves complex surgery. Implementation of a quality management program has a major impact on survival. The goal of this work was to develop a list of quality indicators (QIs) for advanced ovarian cancer surgery that can be used to audit and improve the clinical practice. This task has been carried out under the auspices of the European Society of Gynaecologic Oncology (ESGO). Quality indicators were based on scientific evidence and/or expert consensus. A 4-step evaluation process included a systematic literature search for the identification of potential QIs and the documentation of scientific evidence, physical meetings of an ad hoc multidisciplinarity International Development Group, an internal validation of the targets and scoring system, and an external review process involving physicians and patients. Ten structural, process, or outcome indicators were selected. Quality indicators 1 to 3 are related to achievement of complete cytoreduction, caseload in the center, training, and experience of the surgeon. Quality indicators 4 to 6 are related to the overall management, including active participation to clinical research, decision-making process within a structured multidisciplinary team, and preoperative workup. Quality indicator 7 addresses the high value of adequate perioperative management. Quality indicators 8 to 10 highlight the need of recording pertinent information relevant to improvement of quality. An ESGO-approved template for the operative report has been designed. Quality indicators were described using a structured format specifying what the indicator is measuring, measurability specifications, and targets. Each QI was associated with a score, and an assessment form was built. The ESGO quality criteria can be used for self-assessment, for institutional or governmental quality assurance programs, and for the certification of centers. Quality indicators and corresponding targets give

European demands for food quality and safety

OpenAIRE

Bulatsyk, Sofiya; Yavorska, Nadiya

2017-01-01

In this article was investigated regulations and other normative documents of the European Union concerning food quality and safety and was arranged EU demands regards to food safety. There were determined the basic business concerns of the domestic enterprises in the process of manufacturing and marketing food products

Air quality continued to improve in 2014, but progress are still needed

International Nuclear Information System (INIS)

Le Moullec, Aurelie

2015-09-01

The improvement in air quality that began some years ago continued. Average concentrations of pollutants decreased and exceedance of thresholds for protection of health was observed in fewer areas. Progress was, notably, the result of efforts made to reduce emissions, something made more difficult by the number and variety of sources of pollution. These improvements were, however, fragile as they were partially dependent on weather conditions. 2014 was, thus, marked by an important episode of particulate pollution. In addition, the progress made was not sufficient to bring France into full compliance with European standards, as was also the case for other European countries. (author)

Is Finland different? Quality of Work Among Finnish and European Employees

OpenAIRE

Hartikainen, Armi; Anttila, Timo; Oinas, Tomi; Nätti, Jouko

2010-01-01

The issue of the quality of work-life has risen in popularity due to concerns about the economic and social sustainability of European societies. Throughout the continent, global competition, technological change and the intensification of work are common developments which are seen to a ect the well-being of the workforce. Nevertheless, European countries di er substantially in terms of job quality. According to earlier research, employees in Sweden and Denmark (and to lesser ...

Evaluating the quality of sampling frames used in European cross-national surveys

NARCIS (Netherlands)

Maineri, A.M.; Scherpenzeel, A.; Bristle, Johanna; Pflüger, Senta-Melissa; Butt, Sarah; Zins, Stefan; Emery, Tom; Luijkx, R.

This report addresses the quality of the population registers which are currently being used as sampling frames in countries participating in the four cross-European surveys cooperating in SERISS: the European Social Survey (ESS), the European Values Study (EVS), the Gender and Generations Program

E-MSD: improving data deposition and structure quality.

Science.gov (United States)

Tagari, M; Tate, J; Swaminathan, G J; Newman, R; Naim, A; Vranken, W; Kapopoulou, A; Hussain, A; Fillon, J; Henrick, K; Velankar, S

2006-01-01

The Macromolecular Structure Database (MSD) (http://www.ebi.ac.uk/msd/) [H. Boutselakis, D. Dimitropoulos, J. Fillon, A. Golovin, K. Henrick, A. Hussain, J. Ionides, M. John, P. A. Keller, E. Krissinel et al. (2003) E-MSD: the European Bioinformatics Institute Macromolecular Structure Database. Nucleic Acids Res., 31, 458-462.] group is one of the three partners in the worldwide Protein DataBank (wwPDB), the consortium entrusted with the collation, maintenance and distribution of the global repository of macromolecular structure data [H. Berman, K. Henrick and H. Nakamura (2003) Announcing the worldwide Protein Data Bank. Nature Struct. Biol., 10, 980.]. Since its inception, the MSD group has worked with partners around the world to improve the quality of PDB data, through a clean up programme that addresses inconsistencies and inaccuracies in the legacy archive. The improvements in data quality in the legacy archive have been achieved largely through the creation of a unified data archive, in the form of a relational database that stores all of the data in the wwPDB. The three partners are working towards improving the tools and methods for the deposition of new data by the community at large. The implementation of the MSD database, together with the parallel development of improved tools and methodologies for data harvesting, validation and archival, has lead to significant improvements in the quality of data that enters the archive. Through this and related projects in the NMR and EM realms the MSD continues to improve the quality of publicly available structural data.

Learning from MARQuIS: future direction of quality and safety in hospital care in the European Union

NARCIS (Netherlands)

Groene, O.; Klazinga, N.; Walshe, K.; Cucic, C.; Shaw, C. D.; Suñol, R.

2009-01-01

This article summarises the significant lessons to be drawn from, and the policy implications of, the findings of the Methods of Assessing Response to Quality Improvement Strategies (MARQuIS) project-a part of the suite of research projects intended to support policy established by the European

European wind turbine testing procedure developments. Task 2: Power quality

DEFF Research Database (Denmark)

Sørensen, Poul Ejnar; Friis Pedersen, Troels; Gerdes, G.

2001-01-01

The present report describes the work done in the power quality subtask of the European Wind Turbine Testing Procedure Developments project funded by the EU SMT program. The objective of the power quality subtask has been to make recommendations andprovide background for new standards...... for measurement and testing of wind turbine power quality. The focus in the work has been to support the ongoing standardisation work in IEC with a new standard IEC61400-21 for measurement and assessment of powerquality characteristics of grid connected wind turbines. The work has also been based on the power...... quality measuremnet procedure in the Measnet cooperation of European test stations for wind turbines. The first working item of the project has been toverify the state of the art of the measurement procedures by analyses and comparisons of the measurements and data processing software of the participating...

Collaborative quality improvement.

Science.gov (United States)

Luckenbaugh, Amy N; Miller, David C; Ghani, Khurshid R

2017-07-01

Quality improvement collaboratives were developed in many medical and surgical disciplines with the goal of measuring and improving the quality of care provided to patients. The aim of this review is to provide an overview of surgical quality improvement collaboratives, and in particular those aimed at improving urological care. Quality improvement collaboratives collect high-quality data using standardized methodologies, and use the data to provide feedback to physicians and practices, and then implement processes to improve patient outcomes. The largest regional collaborative in urology is the Michigan Urological Surgery Improvement Collaborative (MUSIC). Recent efforts by this group have been focused at understanding variation in care, improving patient selection for treatment, reducing treatment morbidity and measuring and optimizing technical skill. The American Urological Association has also recently launched a national quality registry (AQUA), with an initial focus on prostate cancer care. By understanding factors that result in exemplary performance, quality improvement collaboratives are able to develop best practices around areas of care with high variation that have the potential to improve outcomes and reduce costs. These developments have been made possible by the unique model offered by the collaborative structure with the goal of improving patient care at a population level.

The EFQM excellence model: European and Dutch experiences with the EFQM approach in health care. European Foundation for Quality Management

NARCIS (Netherlands)

Nabitz, U.; Klazinga, N.; Walburg, J.

2000-01-01

One way to meet the challenges in creating a high performance organization in health care is the approach of the European Foundation for Quality Management (EFQM). The Foundation is in the tradition of the American Malcolm Baldrige Award and was initiated by the European Commission and 14 European

A longitudinal, multi-level comparative study of quality and safety in European hospitals: the QUASER study protocol

Directory of Open Access Journals (Sweden)

Weggelaar Anne-Marie

2011-10-01

Full Text Available Abstract Background although there is a wealth of information available about quality improvement tools and techniques in healthcare there is little understanding about overcoming the challenges of day-to-day implementation in complex organisations like hospitals. The 'Quality and Safety in Europe by Research' (QUASER study will investigate how hospitals implement, spread and sustain quality improvement, including the difficulties they face and how they overcome them. The overall aim of the study is to explore relationships between the organisational and cultural characteristics of hospitals and how these impact on the quality of health care; the findings will be designed to help policy makers, payers and hospital managers understand the factors and processes that enable hospitals in Europe to achieve-and sustain-high quality services for their patients. Methods/design in-depth multi-level (macro, meso and micro-system analysis of healthcare quality policies and practices in 5 European countries, including longitudinal case studies in a purposive sample of 10 hospitals. The project design has three major features: • a working definition of quality comprising three components: clinical effectiveness, patient safety and patient experience • a conceptualisation of quality as a human, social, technical and organisational accomplishment • an emphasis on translational research that is evidence-based and seeks to provide strategic and practical guidance for hospital practitioners and health care policy makers in the European Union. Throughout the study we will adopt a mixed methods approach, including qualitative (in-depth, narrative-based, ethnographic case studies using interviews, and direct non-participant observation of organisational processes and quantitative research (secondary analysis of safety and quality data, for example: adverse incident reporting; patient complaints and claims. Discussion the protocol is based on the premise that

The European Foundation for Quality Management (EFQM Excellence Model in a Low Voltage Switchgear Compan

Directory of Open Access Journals (Sweden)

Özgür Özmen

2017-11-01

Full Text Available The Turkish low voltage switchgear sector is made up of several local and international companies. Generally, local companies operating in this sector try to get a competitive advantage by fabricating cheap products, in order to cope with the competition that focuses more on quality. What’s more, international corporations perform quality activities under the organization and control of their top-managements from abroad. Although VIKO is a local producer, it is a company willing to invest more in quality, as well as in research and development. VIKO company is the focus of this self-assessment study, since it lies at the conjunction of companies operating in this sector, it being a local company performing various quality enhancement activities. Simultaneously, the authors consider that this study shall prove useful to create an overview over the entire Turkish low voltage switchgear sector. The evaluation of the company and its core-activities was based upon nine criteria of the European Foundation for Quality Management (EFQM Excellence Model, in order to identify the strengths, the weaknesses and aspects that require improvements. This is the first study worldwide performed in the low voltage switchgear sector and it is aimed at motivating other Turkish companies that operate in this sector to implement The European Foundation for Quality Management (EFQM Excellence Model in their TQM activities (Total Quality Management.

[The "Hersbruck Model". Application and integration of the DIN EN ISO 9001 quality norms with criteria of the European Foundation for Quality Management in a clinic].

Science.gov (United States)

Fritze, B; Amon, U

1999-11-01

The german health system has dramatically changed and still continues to do so. Modified aspects concerning economy, customer orientation, competition, quality assurance and quality management seem to be increasingly important. Appropriate response to this challenge demands a relevant adjustment of a quality "philosophy" within a hospital. The "Hersbruck Model" has proven to be a suitable approach: on the basis of a quality management system--established and certified according to DIN EN ISO 9001--it implements all components of the model of the European Foundation for Quality Management. The modern quality tools as Total Quality Management and continuous quality improvement allow a permanent increase of customer/patient satisfaction.

Antifungal therapy in European hospitals

DEFF Research Database (Denmark)

Zarb, P; Amadeo, B; Muller, A

2012-01-01

The study aimed to identify targets for quality improvement in antifungal use in European hospitals and determine the variability of such prescribing. Hospitals that participated in the European Surveillance of Antimicrobial Consumption Point Prevalence Surveys (ESAC-PPS) were included. The WHO...

The impact of international shipping on European air quality and climate forcing

Energy Technology Data Exchange (ETDEWEB)

van Aardenne, J. [European Environment Agency (EEA), Copenhagen (Denmark); Colette, A. [INERIS (France); Degraeuwe, B.; de Vlieger, I. [VITO (Belgium); Hammingh, P. [PBL Netherlands Environmental Assessment Agency (Netherlands); Viana, M. [CSIC (Spain)

2013-03-15

This EEA Technical report provides an overview on the state of knowledge on the impact of international shipping in European waters to air quality and climate change. Based on literature review and model assessment studies information is provided on past and future emissions of air pollutants and greenhouse gases, monitoring of ship emissions, emission mitigation policies and impact on European air quality and radiative forcing. (Author)

Using institutional theory to analyse hospital responses to external demands for finance and quality in five European countries

Science.gov (United States)

Mendel, Peter; Nunes, Francisco; Wiig, Siri; van den Bovenkamp, Hester; Karltun, Anette; Robert, Glenn; Anderson, Janet; Vincent, Charles; Fulop, Naomi

2015-01-01

Objectives Given the impact of the global economic crisis, delivering better health care with limited finance grows more challenging. Through the lens of institutional theory, this paper explores pressures experienced by hospital leaders to improve quality and constrain spending, focusing on how they respond to these often competing demands. Methods An in-depth, multilevel analysis of health care quality policies and practices in five European countries including longitudinal case studies in a purposive sample of ten hospitals. Results How hospitals responded to the financial and quality challenges was dependent upon three factors: the coherence of demands from external institutions; managerial competence to align external demands with an overall quality improvement strategy, and managerial stability. Hospital leaders used diverse strategies and practices to manage conflicting external pressures. Conclusions The development of hospital leaders’ skills in translating external requirements into implementation plans with internal support is a complex, but crucial, task, if quality is to remain a priority during times of austerity. Increasing quality improvement skills within a hospital, developing a culture where quality improvement becomes embedded and linking cost reduction measures to improving care are all required. PMID:26683885

Using institutional theory to analyse hospital responses to external demands for finance and quality in five European countries.

Science.gov (United States)

Burnett, Susan; Mendel, Peter; Nunes, Francisco; Wiig, Siri; van den Bovenkamp, Hester; Karltun, Anette; Robert, Glenn; Anderson, Janet; Vincent, Charles; Fulop, Naomi

2016-04-01

Given the impact of the global economic crisis, delivering better health care with limited finance grows more challenging. Through the lens of institutional theory, this paper explores pressures experienced by hospital leaders to improve quality and constrain spending, focusing on how they respond to these often competing demands. An in-depth, multilevel analysis of health care quality policies and practices in five European countries including longitudinal case studies in a purposive sample of ten hospitals. How hospitals responded to the financial and quality challenges was dependent upon three factors: the coherence of demands from external institutions; managerial competence to align external demands with an overall quality improvement strategy, and managerial stability. Hospital leaders used diverse strategies and practices to manage conflicting external pressures. The development of hospital leaders' skills in translating external requirements into implementation plans with internal support is a complex, but crucial, task, if quality is to remain a priority during times of austerity. Increasing quality improvement skills within a hospital, developing a culture where quality improvement becomes embedded and linking cost reduction measures to improving care are all required. © The Author(s) 2015.

Teaching quality improvement.

Science.gov (United States)

Murray, Marry Ellen; Douglas, Stephen; Girdley, Diana; Jarzemsky, Paula

2010-08-01

Practicing nurses are required to engage in quality improvement work as a part of their clinical practice, but few undergraduate nursing education programs offer course work and applied experience in this area. This article presents a description of class content and teaching strategies, assignments, and evaluation strategies designed to achieve the Quality and Safety Education in Nursing competencies related to quality improvement and interdisciplinary teams. Students demonstrate their application of the quality improvement process by designing and implementing a small-scale quality improvement project that they report in storyboard format on a virtual conference Web site.

Desk-study on habitat quality for the European Sturgeon in the Dutch Rhine and southern North Sea

NARCIS (Netherlands)

Winter, H.V.; Teal, L.R.; Wolfshaar, van de K.E.; Griffioen, A.B.; Houben, B.; Breve, N.W.P.

2015-01-01

One of the most endangered fish species worldwide is the European sturgeon Acipenser sturio. The River Rhine was home to an important sturgeon population that went locally extinct in the first half of the 20th century. In recent decades, many improvements of the ecological quality of the Rhine have

Does real-time objective feedback and competition improve performance and quality in manikin CPR training--a prospective observational study from several European EMS.

Science.gov (United States)

Smart, J R; Kranz, K; Carmona, F; Lindner, T W; Newton, A

2015-10-15

Previous studies have reported that the quality of cardiopulmonary resuscitation (CPR) is important for patient survival. Real time objective feedback during manikin training has been shown to improve CPR performance. Objective measurement could facilitate competition and help motivate participants to improve their CPR performance. The aims of this study were to investigate whether real time objective feedback on manikins helps improve CPR performance and whether competition between separate European Emergency Medical Services (EMS) and between participants at each EMS helps motivation to train. Ten European EMS took part in the study and was carried out in two stages. At Stage 1, each EMS provided 20 pre-hospital professionals. A questionnaire was completed and standardised assessment scenarios were performed for adult and infant out of hospital cardiac arrest (OHCA). CPR performance was objectively measured and recorded but no feedback given. Between Stage 1 and 2, each EMS was given access to manikins for 6 months and instructed on how to use with objective real-time CPR feedback available. Stage 2 was undertaken and was a repeat of Stage 1 with a questionnaire with additional questions relating to usefulness of feedback and the competition nature of the study (using a 10 point Likert score). The EMS that improved the most from Stage 1 to Stage 2 was declared the winner. An independent samples Student t-test was used to analyse the objective CPR metrics with the significance level taken as p Competition between EMS organisations recorded a mean score of 5.8 and competition between participants recorded a mean score of 6.0. The results suggest that the use of real time objective feedback can significantly help improve CPR performance. Competition, especially between participants, appeared to encourage staff to practice and this study suggests that competition might have a useful role to help motivate staff to perform CPR training.

Air quality comparison between two European ceramic tile clusters

Science.gov (United States)

Minguillón, M. C.; Monfort, E.; Escrig, A.; Celades, I.; Guerra, L.; Busani, G.; Sterni, A.; Querol, X.

2013-08-01

The European ceramic tile industry is mostly concentrated in two clusters, one in Castelló (Spain) and another one in Modena (Italy). Industrial clusters may have problems to accomplish the EU air quality regulations because of the concentration of some specific pollutants and, hence, the feasibility of the industrial clusters can be jeopardised. The present work assesses the air quality in these ceramic clusters in 2008, when the new EU emission regulations where put into force. PM10 samples were collected at two sampling sites in the Modena ceramic cluster and one sampling site in the Castelló ceramic cluster. PM10 annual average concentrations were 12-14 μg m-3 higher in Modena than in Castelló, and were close to or exceeded the European limit. Air quality in Modena was mainly influenced by road traffic and, in a lower degree, the metalmechanical industry, as evidenced by the high concentrations of Mn, Cu, Zn, Sn and Sb registered. The stagnant weather conditions from Modena hindering dispersion of pollutants also contributed to the relatively high pollution levels. In Castelló, the influence of the ceramic industry is evidenced by the high concentrations of Ti, Se, Tl and Pb, whereas this influence is not seen in Modena. The difference in the impact of the ceramic industry on the air quality in the two areas was attributed to: better abatement systems in the spray-drier facilities in Modena, higher coverage of the areas for storage and handling of dusty raw materials in Modena, presence of two open air quarries in the Castelló region, low degree of abatement systems in the ceramic tile kilns in Castelló, and abundance of ceramic frit, glaze and pigment manufacture in Castelló as opposed to scarce manufacture of these products in Modena. The necessity of additional measures to fulfil the EU air quality requirements in the Modena region is evidenced, despite the high degree of environmental measures implemented in the ceramic industry. The Principal

Quality control in mutation analysis: the European Molecular Genetics Quality Network (EMQN).

Science.gov (United States)

Müller, C R

2001-08-01

The demand for clinical molecular genetics testing has steadily grown since its introduction in the 1980s. In order to reach and maintain the agreed quality standards of laboratory medicine, the same internal and external quality assurance (IQA/EQA) criteria have to be applied as for "conventional" clinical chemistry or pathology. In 1996 the European Molecular Genetics Quality Network (EMQN) was established in order to spread QA standards across Europe and to harmonise the existing national activities. EMQN is operated by a central co-ordinator and 17 national partners from 15 EU countries; since 1998 it is being funded by the EU commission for a 3-year period. EMQN promotes QA by two tools: by providing disease-specific best practice meetings (BPM) and EQA schemes. A typical BPM is focussed on one disease or group of related disorders. International experts report on the latest news of gene characterisation and function and the state-of-the-art techniques for mutation detection. Disease-specific EQA schemes are provided by experts in the field. DNA samples are sent out together with mock clinical referrals and a diagnostic question is asked. Written reports must be returned which are marked for genotyping and interpretation. So far, three BPMs have been held and six EQA schemes are in operation at various stages. Although mutation types and diagnostic techniques varied considerably between schemes, the overall technical performance showed a high diagnostic standard. Nevertheless, serious genotyping errors have been occurred in some schemes which underline the necessity of quality assurance efforts. The European Molecular Genetics Quality Network provides a necessary platform for the internal and external quality assurance of molecular genetic testing.

Comprehensive Clinical Audits of Diagnostic Radiology Practices: A Tool for Quality Improvement. Quality Assurance Audit for Diagnostic Radiology Improvement and Learning (QUAADRIL)

International Nuclear Information System (INIS)

2011-01-01

Interest in quality assurance processes and quality improvement in diagnostic radiology is being driven by a number of factors. These include the high cost and complexity of radiological equipment, acknowledgement of the possibility of increasing doses to patients, and the importance of radiological diagnosis to patient management within the health care environment. To acknowledge these interests, clinical audits have been introduced and, in Europe, mandated under a European Directive (Council Directive 97/47/EURATOM). Comprehensive clinical audits focus on clinical management and infrastructure, patient related and technical procedures, and education and research. This publication includes a structured set of standards appropriate for diagnostic radiology, an audit guide to their clinical review, and data collection sheets for the rapid production of reports in audit situations. It will be a useful guide for diagnostic radiology facilities wishing to improve their service to patients through timely diagnosis with minimal radiation dose.

Comprehensive Clinical Audits of Diagnostic Radiology Practices: A Tool for Quality Improvement. Quality Assurance Audit for Diagnostic Radiology Improvement and Learning (QUAADRIL)

International Nuclear Information System (INIS)

2010-01-01

Interest in quality assurance processes and quality improvement in diagnostic radiology is being driven by a number of factors. These include the high cost and complexity of radiological equipment, acknowledgement of the possibility of increasing doses to patients, and the importance of radiological diagnosis to patient management within the health care environment. To acknowledge these interests, clinical audits have been introduced and, in Europe, mandated under a European Directive (Council Directive 97/47/EURATOM). Comprehensive clinical audits focus on clinical management and infrastructure, patient related and technical procedures, and education and research. This publication includes a structured set of standards appropriate for diagnostic radiology, an audit guide to their clinical review, and data collection sheets for the rapid production of reports in audit situations. It will be a useful guide for diagnostic radiology facilities wishing to improve their service to patients through timely diagnosis with minimal radiation dose.

Quality management and perceptions of teamwork and safety climate in European hospitals.

Science.gov (United States)

Kristensen, Solvejg; Hammer, Antje; Bartels, Paul; Suñol, Rosa; Groene, Oliver; Thompson, Caroline A; Arah, Onyebuchi A; Kutaj-Wasikowska, Halina; Michel, Philippe; Wagner, Cordula

2015-12-01

This study aimed to investigate the associations of quality management systems with teamwork and safety climate, and to describe and compare differences in perceptions of teamwork climate and safety climate among clinical leaders and frontline clinicians. We used a multi-method, cross-sectional approach to collect survey data of quality management systems and perceived teamwork and safety climate. Our data analyses included descriptive and multilevel regression methods. Data on implementation of quality management system from seven European countries were evaluated including patient safety culture surveys from 3622 clinical leaders and 4903 frontline clinicians. Perceived teamwork and safety climate. Teamwork climate was reported as positive by 67% of clinical leaders and 43% of frontline clinicians. Safety climate was perceived as positive by 54% of clinical leaders and 32% of frontline clinicians. We found positive associations between implementation of quality management systems and teamwork and safety climate. Our findings, which should be placed in a broader clinical quality improvement context, point to the importance of quality management systems as a supportive structural feature for promoting teamwork and safety climate. To gain a deeper understanding of this association, further qualitative and quantitative studies using longitudinally collected data are recommended. The study also confirms that more clinical leaders than frontline clinicians have a positive perception of teamwork and safety climate. Such differences should be accounted for in daily clinical practice and when tailoring initiatives to improve teamwork and safety climate. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

EUROPEAN POLICY CONCERNING THE PROTECTION OF THE QUALITY OF THE ENVIRONMENTAL FACTOR - WATER

Directory of Open Access Journals (Sweden)

FLORICA BRASOVEANU

2012-05-01

Full Text Available European Union environmental policy, as was established in the EC Treaty aims at ensuring environmental sustainability activities through its inclusion in EU sectoral policies, by developing measures to prevent by following the basic principles of sustainable development and by taking joint responsibilities. Environmental legislation is one of those tools that combine management of natural resources with the prevention and control of the pollution. These laws attempt to prevent, or at least limit the effects of environmental degradation caused by the phenomenon of pollution. Environmental legislation should primarily be flexible in the sense to allow the fulfillment of current and the future goals in order to stimulate sustainable development concept and to base on general criteria for the purposes of allowing the extension to complex environmental problems. The environmental legislation is due to focus on integrating the source - effect policy, that is to focus on regulations for issuing permits for pollution, but also the responsibility of companies and citizens.Despite the significant improvements that have occurred especially in reducing air and water pollution, European legislation should be developed further. It is true that there are still many points that require completion and perfection, but the path followed is the best. In the European Union the process of implementation and adoption of new regulations on environmental protection (regulations, directives, decisions,recommendations to combat the causes of degradation of environmental quality and life quality time with them continues.

Design of a dynamic model for nuclear energy management based on European Foundation for Quality Management

International Nuclear Information System (INIS)

Fam, I. M.; Shekari, A.

2008-01-01

The Business excellence model has been developed to improve and promote business levels. In business excellence model such as European Foundation for Quality Management model, the important role of resource management is emphasizes. In this paper, we have tried with consideration to tendency progressive concepts of nuclear energy management; a dynamic model has been presented for energy management within the scope of European Foundation for Quality Management model. Population growth could cause increasing of the level of energy demands. No doubt, the confidence of this developed phenomenon with the limits of environment will create greater challenges for the world and its inhabitants. Considering the shortage of energy supply all over the world, nuclear energy management has been studied with a view to fourth and fifth criterions included in European Foundation for Quality Management model (Partnership and resource and Process criteria's). In addition to it, a dynamic model has been presented for nuclear energy management within the scope of European Foundation for Quality Management model. In this dynamic model, with differential equation definition for each of the presented communications of defined causal model, input variable impacts on output ones have been determined and considered. They can be reviewed, based on six scenario plans, the importance of nuclear energy management of a business has been properly shown, and similarly the rate of investment on systems as a factor affecting the level of attention paid to the future of business enterprises, has been specified. This paper conceives nuclear energy management as an instrument to contribute to the growth and fall of a business. It is therefore, imperative to attach more importance at nuclear energy demand management in the business and an attempt should be made to keep it under our control

A longitudinal, multi-level comparative study of quality and safety in European hospitals

DEFF Research Database (Denmark)

Robert, Glenn B; Anderson, Janet E; Burnett, Susan J

2011-01-01

makers in the European Union. Throughout the study we will adopt a mixed methods approach, including qualitative (in-depth, narrative-based, ethnographic case studies using interviews, and direct non-participant observation of organisational processes) and quantitative research (secondary analysis......, patient safety and patient experience • a conceptualisation of quality as a human, social, technical and organisational accomplishment • an emphasis on translational research that is evidence-based and seeks to provide strategic and practical guidance for hospital practitioners and health care policy...... by Research' (QUASER) study will investigate how hospitals implement, spread and sustain quality improvement, including the difficulties they face and how they overcome them. The overall aim of the study is to explore relationships between the organisational and cultural characteristics of hospitals and how...

Opioid Maintenance Treatment--A Call for a Joint European Quality Care Approach.

Science.gov (United States)

Brandt, Laura; Unger, Annemarie; Moser, Laura; Fischer, Gabriele; Jagsch, Reinhold

2016-01-01

The aim of this exploratory analysis of European Quality Audit of Opioid Treatment data was to identify areas of improvement for current opioid maintenance treatment (OMT) approaches. Factors facilitating treatment entry, retention and refusal were compared between 8 European countries and between OMT patient (OMT-P) and active opioid user (AOU) sample groups. Both groups were divided into those who had never had OMT before (un-experienced OMT-P (n = 573) and AOU (n = 360)) and those who had been maintained at least once prior to this investigation (experienced OMT-P (n = 746) and AOU (n = 377)). The European comparison showed that motives for starting OMT vary distinctly between countries (p ≤ 0.001). Transnationally, experienced AOU reported concerns about their ability to follow treatment rules and negative treatment experiences as decisive reasons for staying out of OMT. Greater flexibility, less pressure to reduce their treatment dose and greater treatment structure were ranked significantly higher by experienced compared to un-experienced OMT-P as factors that might facilitate treatment retention (p ≤ 0.05). Increasing awareness of potential shortcomings of OMT delivery systems is crucial to optimally match treatment approaches to patient needs and also to reduce the considerable economic burden of addiction to society. © 2015 S. Karger AG, Basel.

The legal framework governing the quality of (traditional) herbal medicinal products in the European Union.

Science.gov (United States)

Kroes, Burt H

2014-12-02

In the European Union a complex regulatory framework is in place for the regulation of (traditional) herbal medicinal products. It is based on the principle that a marketing authorisation granted by the competent authorities is required for placing medicinal products on the market. The requirements and procedures for acquiring such a marketing authorisation are laid down in regulations, directives and scientific guidelines. This paper gives an overview of the quality requirements for (traditional) herbal medicinal products that are contained in European pharmaceutical legislation. Pharmaceutical quality of medicinal product is the basis for ensuring safe and effective medicines. The basic principles governing the assurance of the quality of medicinal products in the European Union are primarily defined in the amended Directive 2001/83/EC and Directive 2003/63/EC. Quality requirements of herbal medicinal products are also laid down in scientific guidelines. Scientific guidelines provide a basis for practical harmonisation of how the competent authorities of EU Member States interpret and apply the detailed requirements for the demonstration of quality laid down in regulations and directives. Detailed quality requirements for herbal medicinal products on the European market are contained in European Union (EU) pharmaceutical legislation. They include a system of manufacturing authorisations which ensures that all herbal medicinal products on the European market are manufactured/imported only by authorised manufacturers, whose activities are regularly inspected by the competent authorities. Additionally, as starting materials only active substances are allowed which have been manufactured in accordance with the GMP for starting materials as adopted by the Community. The European regulatory framework encompasses specific requirements for herbal medicinal products. These requirements are independent from the legal status. Thus, the same quality standards equally apply

Monitoring of environmental radioactivity in the European Communities inventory of methods and development of data quality objectives

International Nuclear Information System (INIS)

Raes, F.

1991-01-01

A review is given of the procedures for environmental monitoring in the 12 Member States of the European Community. Detailed information of sampling and measuring methods for radioactivity in air, deposition, water, milk and for ambient gamma dose rate are presented in tables and figures. Some sample results of environmental radioactivity monitoring indicate problems with intercomparability of data reported by different EC countries. A review is given of international and national programmes and proposals for Quality Assurance and Control. There is a large but rather uncoordinated activity in this field; only a few countries within the EC have a well structured and comprehensive approach to QA and regularly join international programmes. Data Quality Objectives (DQOs) are developed for environmental radioactivity monitoring. They include the definition of the accuracy and repeatability of the measurements, and the definition of recording and detection levels. The recording levels, are based on a de minimis annual dose of 0.005 mSv. Based on these DQO's, the current problems with intercomparability are put into perspective, and proposals for future integration of national data into an overall European picture made. There is a need to improve quality of environmental monitoring in order to arrive at a meaningful and transparent picture of the overall radiological situation in the EC. Proposals are made for CEC initiatives in the field of QA/QC. The three most important deal with: - reporting of national data in a European context, - intercomparisons of analytical techniques among the 12 EC countries, - organization of a European network for monitoring levels actually prevailing in the environment

Development of a Competency Framework for Quality Improvement in Family Medicine: A Qualitative Study

Science.gov (United States)

Czabanowska, Katarzyna; Klemenc-Ketis, Zalika; Potter, Amanda; Rochfort, Andree; Tomasik, Tomasz; Csiszar, Judit; Van den Bussche, Piet

2012-01-01

Objective: The aim of this study was to develop a comprehensive framework of quality improvement competencies for use in continuing professional development (CPD) and continuing medical education (CME) for European general practice/family medicine physicians (GPs/FDs). Methods: The study was carried out in three phases: literature review,…

Continuous quality improvement

International Nuclear Information System (INIS)

Bourne, P.B.

1985-01-01

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

The relationship between social capital and quality management systems in European hospitals: a quantitative study.

Science.gov (United States)

Hammer, Antje; Arah, Onyebuchi A; Dersarkissian, Maral; Thompson, Caroline A; Mannion, Russell; Wagner, Cordula; Ommen, Oliver; Sunol, Rosa; Pfaff, Holger

2013-01-01

Strategic leadership is an important organizational capability and is essential for quality improvement in hospital settings. Furthermore, the quality of leadership depends crucially on a common set of shared values and mutual trust between hospital management board members. According to the concept of social capital, these are essential requirements for successful cooperation and coordination within groups. We assume that social capital within hospital management boards is an important factor in the development of effective organizational systems for overseeing health care quality. We hypothesized that the degree of social capital within the hospital management board is associated with the effectiveness and maturity of the quality management system in European hospitals. We used a mixed-method approach to data collection and measurement in 188 hospitals in 7 European countries. For this analysis, we used responses from hospital managers. To test our hypothesis, we conducted a multilevel linear regression analysis of the association between social capital and the quality management system score at the hospital level, controlling for hospital ownership, teaching status, number of beds, number of board members, organizational culture, and country clustering. The average social capital score within a hospital management board was 3.3 (standard deviation: 0.5; range: 1-4) and the average hospital score for the quality management index was 19.2 (standard deviation: 4.5; range: 0-27). Higher social capital was associated with higher quality management system scores (regression coefficient: 1.41; standard error: 0.64, p=0.029). The results suggest that a higher degree of social capital exists in hospitals that exhibit higher maturity in their quality management systems. Although uncontrolled confounding and reverse causation cannot be completely ruled out, our new findings, along with the results of previous research, could have important implications for the work of

The European Gonococcal Antimicrobial Surveillance Programme (Euro-GASP)--a sentinel approach in the European Union (EU)/European Economic Area (EEA).

Science.gov (United States)

Spiteri, Gianfranco; Cole, Michelle; Unemo, Magnus; Hoffmann, Steen; Ison, Catherine; van de Laar, Marita

2013-12-01

Antimicrobial resistance in Neisseria gonorrhoeae is monitored in the European Union/European Economic Area through the European Gonococcal Antimicrobial Surveillance Programme (Euro-GASP) coordinated by the European Centre for Disease Prevention and Control. Euro-GASP includes a sentinel surveillance programme which aims to detect in a timely manner changes in resistance patterns and inform treatment guidelines. The programme aims to test a representative number of isolates from each European Union/European Economic Area member state per year for a range of therapeutically relevant antimicrobials through a biannual hybrid centralised/decentralised system. Testing is supported by an External Quality Assurance programme and a laboratory training programme. Participation in the programme has increased to 21 countries in 2012. Euro-GASP has been able to detect the rapid spread of isolates with decreased susceptibility to cefixime across Europe in 2010 and 2011. Results from the programme have informed changes in European treatment guidelines for gonorrhoea and led to the development of the 'Response plan to control and manage the threat of multidrug resistant gonorrhoea in Europe'. Future challenges for Euro-GASP include supporting countries to participate in Euro-GASP through decentralised testing, improving timeliness and epidemiological data quality, and increasing participation from Eastern Europe.

Quality improvement - the future begins

International Nuclear Information System (INIS)

Boissy, G.J.

1987-01-01

The comprehensive quality improvement program of the Florida Power and Light Co. is described: management commitment, quality improvement process, quality improvement teams, policy development, and quality in daily work are discussed

European specialist porphyria laboratories: diagnostic strategies, analytical quality, clinical interpretation, and reporting as assessed by an external quality assurance program.

Science.gov (United States)

Aarsand, Aasne K; Villanger, Jørild H; Støle, Egil; Deybach, Jean-Charles; Marsden, Joanne; To-Figueras, Jordi; Badminton, Mike; Elder, George H; Sandberg, Sverre

2011-11-01

The porphyrias are a group of rare metabolic disorders whose diagnosis depends on identification of specific patterns of porphyrin precursor and porphyrin accumulation in urine, blood, and feces. Diagnostic tests for porphyria are performed by specialized laboratories in many countries. Data regarding the analytical and diagnostic performance of these laboratories are scarce. We distributed 5 sets of multispecimen samples from different porphyria patients accompanied by clinical case histories to 18-21 European specialist porphyria laboratories/centers as part of a European Porphyria Network organized external analytical and postanalytical quality assessment (EQA) program. The laboratories stated which analyses they would normally have performed given the case histories and reported results of all porphyria-related analyses available, interpretative comments, and diagnoses. Reported diagnostic strategies initially showed considerable diversity, but the number of laboratories applying adequate diagnostic strategies increased during the study period. We found an average interlaboratory CV of 50% (range 12%-152%) for analytes in absolute concentrations. Result normalization by forming ratios to the upper reference limits did not reduce this variation. Sixty-five percent of reported results were within biological variation-based analytical quality specifications. Clinical interpretation of the obtained analytical results was accurate, and most laboratories established the correct diagnosis in all distributions. Based on a case-based EQA scheme, variations were apparent in analytical and diagnostic performance between European specialist porphyria laboratories. Our findings reinforce the use of EQA schemes as an essential tool to assess both analytical and diagnostic processes and thereby to improve patient care in rare diseases.

European Interoperability Assets Register and Quality Framework Implementation.

Science.gov (United States)

Moreno-Conde, Alberto; Thienpont, Geert; Lamote, Inge; Coorevits, Pascal; Parra, Carlos; Kalra, Dipak

2016-01-01

Interoperability assets is the term applied to refer to any resource that can support the design, implementation and successful adoption of eHealth services that can exchange data meaningfully. Some examples may include functional requirements, specifications, standards, clinical models and term lists, guidance on how standards may be used concurrently, implementation guides, educational resources, and other resources. Unfortunately, these are largely accessible in ad hoc ways and result in scattered fragments of a solution space that urgently need to be brought together. At present, it is well known that new initiatives and projects will reinvent assets of which they were unaware, while those assets which were potentially of great value are forgotten, not maintained and eventually fall into disuse. This research has defined a quality in use model and assessed the suitability of this quality framework based on the feedback and opinion of a representative sample of potential end users. This quality framework covers the following domains of asset development and adoption: (i) Development process, (ii) Maturity level, (iii) Trustworthiness, (iv) Support & skills, (v) Sustainability, (vi) Semantic interoperability, (vii) Cost & effort of adoption (viii) Maintenance. When participants were requested to evaluate how the overall quality in use framework, 70% would recommend using the register to their colleagues, 70% felt that it could provide relevant benefits for discovering new assets, and 50% responded that it would support their decision making about the recommended asset to adopt or implement in their organisation. Several European projects have expressed interest in using the register, which will now be sustained and promoted by the the European Institute for Innovation through Health Data.

Quality Assurance in the European Higher Education Area: The Emergence of a German Market for Quality Assurance Agencies

Science.gov (United States)

Serrano-Velarde, Kathia E.

2008-01-01

Most European countries have introduced systematic quality assurance as part of an overall governance reform aimed at enhancing universities' autonomy. Researchers and economic entrepreneurs tend, however, to underestimate the political dimension of accreditation and evaluation when they consider the contribution of quality assurance to the…

Nuclear power and European Union enlargement challenge

International Nuclear Information System (INIS)

Chirica, T.; Bilegan, C.; Pall, S.; Sandru, P.

2000-01-01

In the nuclear power sector, the main concern for the candidate countries entering the European Union, remains the nuclear safety. New standards and regulation will be issued for improving the general quality of life in a sound environment. For the candidate countries entering the European Union, this situation represents a real challenge. Their national legislation must be improved to meet the European standards. The conditions are different from country to country, and more difficult for those, which operate ''non west European reactor type''. The paper also present the actual status of the Romanian legislation related to nuclear power and environment. There are presented the principles, terms and responsibilities contained in this legislation. The authors discuss some aspects related to the possibilities to improve the national legislation to meet the actual European Commission or EURATOM standards. (author)

The ENDOCARE questionnaire guides European endometriosis clinics to improve the patient-centeredness of their care.

Science.gov (United States)

Dancet, E A F; Apers, S; Kluivers, K B; Kremer, J A M; Sermeus, W; Devriendt, C; Nelen, W L D M; D'Hooghe, T M

2012-11-01

How patient-centered are two included specialized endometriosis clinics relative to each other and how can they improve the patient-centeredness of their care? The validated ENDOCARE questionnaire (ECQ) reliably concluded that the adjusted overall patient-centeredness did not differ between the clinics, that each clinic was significantly more patient-centered for 2 out of 10 dimensions of patient-centered endometriosis care and that clinics 1 and 2 had to improve 8 and 13 specific care aspects, respectively. Patient-centered endometriosis care is essential to high-quality care and is defined by 10 dimensions. The ECQ was developed, validated and proved to be reliable in a European setting of self-reported endometriosis patients but had not yet been used at a clinic level for quality management. A cross-sectional survey was disseminated in 2011 to all 514 women diagnosed with endometriosis during a laparoscopy indicated for pain and/or infertility during a retrospective 2-year period (2009-2010) in two university clinics from two different European countries. In total 337 patients completed the ECQ (216 and 121 per clinic). Respondents had a mean age of 34.3 years. Three in four reported a surgical diagnosis of moderate or severe endometriosis and the majority reported surgical treatment by a multidisciplinary team. The ECQ assessed the 10 dimensions of patient-centeredness, more specifically whether the health-care performance, as perceived by patients, measured up to what is important to patients in general. The ECQ was completed by 337 respondents (response rate = 65.6%). Reliability and validity of the ECQ for use on clinic level were confirmed. Clinics did not differ in overall mean importance scores; importance rankings of the ECQ dimensions were almost identical. The overall patient-centeredness scores (PCS), adjusted for education level, did not discriminate between the clinics. However, the adjusted PCS for the dimensions 'clinic staff' and 'technical

Assessing quality in European educational research indicators and approaches

CERN Document Server

Åström, Fredrik; Hansen, Antje

2014-01-01

Competition-based models for research policy and management have an increasing influence throughout the research process, from attracting funding to publishing results. The introduction of quality control methods utilizing various forms of performance indicators is part of this development. The authors presented in this volume deal with the following questions: What counts as ‘quality’ and how can this be assessed? What are the possible side effects of current quality control systems on research conducted in the European Research Area, especially in the social sciences and the humanities?

A cluster-randomised quality improvement study to improve two inpatient stroke quality indicators.

Science.gov (United States)

Williams, Linda; Daggett, Virginia; Slaven, James E; Yu, Zhangsheng; Sager, Danielle; Myers, Jennifer; Plue, Laurie; Woodward-Hagg, Heather; Damush, Teresa M

2016-04-01

Quality indicator collection and feedback improves stroke care. We sought to determine whether quality improvement training plus indicator feedback was more effective than indicator feedback alone in improving inpatient stroke indicators. We conducted a cluster-randomised quality improvement trial, randomising hospitals to quality improvement training plus indicator feedback versus indicator feedback alone to improve deep vein thrombosis (DVT) prophylaxis and dysphagia screening. Intervention sites received collaborative-based quality improvement training, external facilitation and indicator feedback. Control sites received only indicator feedback. We compared indicators pre-implementation (pre-I) to active implementation (active-I) and post-implementation (post-I) periods. We constructed mixed-effect logistic models of the two indicators with a random intercept for hospital effect, adjusting for patient, time, intervention and hospital variables. Patients at intervention sites (1147 admissions), had similar race, gender and National Institutes of Health Stroke Scale scores to control sites (1017 admissions). DVT prophylaxis improved more in intervention sites during active-I period (ratio of ORs 4.90, pimproved similarly in both groups during active-I, but control sites improved more in post-I period (ratio of ORs 0.67, p=0.04). In logistic models, the intervention was independently positively associated with DVT performance during active-I period, and negatively associated with dysphagia performance post-I period. Quality improvement training was associated with early DVT improvement, but the effect was not sustained over time and was not seen with dysphagia screening. External quality improvement programmes may quickly boost performance but their effect may vary by indicator and may not sustain over time. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

ENQA: 10 Years (2000-2010): A Decade of European Co-Operation in Quality Assurance in Higher Education

Science.gov (United States)

Crozier, Fiona, Ed.; Costes, Nathalie, Ed.; Ranne, Paula, Ed.; Stalter, Maria, Ed.

2010-01-01

The history of ENQA (European Association for Quality Assurance in Higher Education) arises in the late 1990s when the first formal procedures for quality assurance begun to stabilize on a national level. As a result of the European Pilot Projects in the field of external quality assurance during the nineties, participants felt the need for…

[European community guidelines and standards in indoor air quality: what proposals for Italy].

Science.gov (United States)

Settimo, Gaetano; D'Alessandro, Daniela

2014-01-01

Indoor air quality is an issue on which to focus because of the increasing number of exposed population and in view of the strong public feeling on this issue. This paper reports the rules of EU and several European countries about indoor air quality, focusing on the initiatives performed in Italy to respond to WHO recommendations. Several EU countries have introduced in their legislation rules relating to indoor air quality. At the moment, in Italy, a reference rule has not been issued. For this reason, up to date main informations concerning some guidelines or reference values in indoor air, to be used for a first comparison, are those obtained by the scientific literature, or by the guidelines issued by other European countries or, for analogy, by other standard values such as limit or reference values regarding outdoor air. Even the EU, while reaffirming the priority of energy efficiency measures, recommends healthier indoor environments and the development of a specific European strategy on the issue of indoor air quality. The National Study Group on indoor pollution of the Italian National Health Institute (ISS), is working for the development of shared technical and scientific documents, in order to provide greater uniformity of actions at national level, waiting for a legal framework for indoor air quality, in the light of the indication already produced by the WHO.

Improvement of the European thermodynamic database NUCLEA

Energy Technology Data Exchange (ETDEWEB)

Brissoneau, L.; Journeau, C.; Piluso, P. [CEA Cadarache, DEN, F-13108 St Paul Les Durance (France); Bakardjieva, S. [Acad Sci Czech Republic, Inst Inorgan Chem, CZ-25068 Rez (Czech Republic); Barrachin, M. [Inst Radioprotect and Surete Nucl, St Paul Les Durance (France); Bechta, S. [NITI, Aleksandrov Res Inst Technol, Sosnovyi Bor (Russian Federation); Bottomley, D. [Commiss European Communities, Joint Res Ctr, Inst Transuranium Elements, D-76125 Karlsruhe (Germany); Cheynet, B.; Fischer, E. [Thermodata, F-38400 St Martin Dheres (France); Kiselova, M. [Nucl Res Inst UJV, Rez 25068 (Czech Republic); Mezentseva, L. [Russian Acad Sci, Inst Silicate Chem, St Petersburg (Russian Federation)

2010-07-01

Modelling of corium behaviour during a severe accident requires knowledge of the phases present at equilibrium for a given corium composition, temperature and pressure. The thermodynamic database NUCLEA in combination with a Gibbs Energy minimizer is the European reference tool to achieve this goal. This database has been improved thanks to the analysis of bibliographical data and to EU-funded experiments performed within the SARNET network, PLINIUS as well as the ISTC CORPHAD and EVAN projects. To assess the uncertainty range associated with Energy Dispersive X-ray analyses, a round-robin exercise has been launched in which a UO{sub 2}-containing corium-concrete interaction sample from VULCANO has been analyzed by three European laboratories with satisfactorily small differences. (authors)

Is having quality as an item on the executive board agenda associated with the implementation of quality management systems in European hospitals: a quantitative analysis

NARCIS (Netherlands)

Botje, D.; Klazinga, N.S.; Sunol, R.; Groene, O.; Pfaff, H.; Mannion, R.; Depaigne-Loth, A.; Arah, O.A.; DerSarkissian, M.; Wagner, C.

2014-01-01

Objective: To assess whether there is a relationship between having quality as an item on the board's agenda, perceived external pressure (PEP) and the implementation of quality management in European hospitals. Design: A quantitative, mixed method, cross-sectional study in seven European countries

From intermittent antibiotic point prevalence surveys to quality improvement: experience in Scottish hospitals

Directory of Open Access Journals (Sweden)

Malcolm William

2013-01-01

Full Text Available Abstract Background In 2008, the Scottish Antimicrobial Prescribing Group (SAPG was established to coordinate a national antimicrobial stewardship programme. In 2009 SAPG led participation in a European point prevalence survey (PPS of hospital antibiotic use. We describe how SAPG used this baseline PPS as the foundation for implementation of measures for improvement in antibiotic prescribing. Methods In 2009 data for the baseline PPS were collected in accordance with the European Surveillance of Antimicrobial Consumption [ESAC] protocol. This informed the development of two quality prescribing indicators: compliance with antibiotic policy in acute admission units and duration of surgical prophylaxis. From December 2009 clinicians collected these data on a monthly basis. The prescribing indicators were reviewed and further modified in March 2011. Data for the follow up PPS in September 2011 were collected as part of a national PPS of healthcare associated infection and antimicrobial use developed using ECDC protocols. Results In the baseline PPS data were collected in 22 (56% acute hospitals. The frequency of recording the reason for treatment in medical notes was similar in Scotland (75.9% and Europe (75.7%. Compliance with policy (81.0% was also similar to Europe (82.5% but duration of surgical prophylaxis Conclusions The baseline PPS identified priorities for quality improvement. SAPG has demonstrated that implementation of regularly reviewed national prescribing indicators, acceptable to clinicians, implemented through regular systematic measurement can drive improvement in quality of antibiotic use in key clinical areas. However, our data also show that the ESAC PPS method may underestimate the proportion of surgical prophylaxis with duration

High Resolution Air Quality Forecasts in the Western Mediterranean area within the MACC, MACC-II and MACC-III European projects

Energy Technology Data Exchange (ETDEWEB)

Cansado, A.; Martinez, I.; Morales, T.

2015-07-01

The European Earth observation programme Copernicus, formerly known as GMES (Global Monitoring for Environment and Security) is establishing a core global and regional environmental atmospheric service as a component of the Europes Copernicus/GMES initiative through successive R and D projects led by ECMWF (European Center for Medium-range Weather Forecasting) and funded by the 6th and 7th European Framework Programme for Research and Horizon 2020 Programme: GEMS, MACC, MACC-II and MACC-III. AEMET (Spanish State Meteorological Agency) has participated in the projects MACC and MACC-II and continues participating in MACC-III (http://atmosphere.copernicus.eu). AEMET has contributed to those projects by generating highresolution (0.05 degrees) daily air-quality forecasts for the Western Mediterranean up to 48 hours aiming to analyse the dependence of the quality of forecasts on resolution. We monitor the evolution of different chemical species such as NO{sub 2}, O{sub 3}, CO y SO{sub 2} at surface and different vertical levels using the global model MOCAGE and the MACC Regional Ensemble forecasts as chemical boundary conditions. We will show different case-studies, where the considered chemical species present high values and will show a validation of the air-quality by comparing to some of the available air-quality observations (EMEP/GAW, regional -autonomous communities- and local -city councils- air-quality monitoring networks) over the forecast domain. The aim of our participation in these projects is helping to improve the understanding of the processes involved in the air-quality forecast in the Mediterranean where special factors such as highly populated areas together with an intense solar radiation make air-quality forecasting particularly challenging. (Author)

High Resolution Air Quality Forecasts in the Western Mediterranean area within the MACC, MACC-II and MACC-III European projects

Energy Technology Data Exchange (ETDEWEB)

Cansado, A.; Martinez, I.; Morales, T.

2015-07-01

The European Earth observation programme Copernicus, formerly known as GMES (Global Monitoring for Environment and Security) is establishing a core global and regional environmental atmospheric service as a component of the Europe’s Copernicus/GMES initiative through successive R&D projects led by ECMWF (European Center for Medium-range Weather Forecasting) and funded by the 6th and 7th European Framework Programme for Research and Horizon 2020 Programme: GEMS, MACC, MACC-II and MACC-III. AEMET (Spanish State Meteorological Agency) has participated in the projects MACC and MACC-II and continues participating in MACC-III (http://atmosphere.copernicus.eu). AEMET has contributed to those projects by generating highresolution (0.05 degrees) daily air-quality forecasts for the Western Mediterranean up to 48 hours aiming to analyse the dependence of the quality of forecasts on resolution. We monitor the evolution of different chemical species such as NO2, O3, CO y SO2 at surface and different vertical levels using the global model MOCAGE and the MACC Regional Ensemble forecasts as chemical boundary conditions. We will show different case-studies, where the considered chemical species present high values and will show a validation of the air-quality by comparing to some of the available air-quality observations (EMEP/GAW, regional -autonomous communities- and local -city councils- air-quality monitoring networks) over the forecast domain. The aim of our participation in these projects is helping to improve the understanding of the processes involved in the air-quality forecast in the Mediterranean where special factors such as highly populated areas together with an intense solar radiation make air-quality forecasting particularly challenging. (Author)

Does quality improvement work in neonatology improve clinical outcomes?

Science.gov (United States)

Ellsbury, Dan L; Clark, Reese H

2017-04-01

Quality improvement initiatives in neonatology have been promoted as an important way of improving outcomes of newborns. The purpose of this review is to examine the effectiveness of recent quality improvement work in improving the outcomes of infants requiring neonatal intensive care. Quality improvement collaboratives and single-center projects demonstrate improvement of clinical processes and outcomes in neonatology that impact both preterm and term infants. Declines in morbidities, resource use, and length of stay have been associated with reductions in healthcare costs. Recent quality improvement work has shown evidence of improvement in clinical outcomes in neonatal intensive care patients. These improvements have important implications for the reduction of healthcare costs in this population.

Quality improvement: the nurse's role.

Science.gov (United States)

Moran, M J; Johnson, J E

1992-06-01

Continuous quality improvement is a concept which includes: Quality assurance--the provision of services that meet an appropriate standard. Problem resolution--including all departments involved in the issue at hand. Quality improvement--a continuous process involving all levels of the organization working together across departmental lines to produce better services for health care clients. Deming (1982b) and others have espoused total system reform to achieve quality improvement--not merely altering the current system, but radically changing it. It must be assumed that those who provide services at the staff level are acting in good faith and are not willfully failing to do what is correct (Berwick, 1991). Those who perform direct services are in an excellent position to identify the need for change in service delivery processes. Based on this premise, the staff nurse--who is at the heart of the system--is the best person to assess the status of health care services and to work toward improving the processes by which these services are provided to clients in the health care setting. The nurse manager must structure the work setting to facilitate the staff nurse's ability to undertake constructive action for improving care. The use of quality circles, quality councils, or quality improvement forums to facilitate the coordination of quality improvement efforts is an effective way to achieve success. The QA coordinator assists departments in documenting that the quality improvement efforts are effective across all departments of the organization, and aggregates data to demonstrate that they meet the requirements of external regulatory agencies, insurers, and professional standards. The nurse executive provides the vision and secures the necessary resources to ensure that the organization's quality improvement efforts are successful. By inspiring and empowering the staff in their efforts to improve the process by which health care is provided, nurse managers

The Relationship between Social Capital and Quality Management Systems in European Hospitals: A Quantitative Study

Science.gov (United States)

Hammer, Antje; Arah, Onyebuchi A.; DerSarkissian, Maral; Thompson, Caroline A.; Mannion, Russell; Wagner, Cordula; Ommen, Oliver; Sunol, Rosa; Pfaff, Holger

2013-01-01

Background Strategic leadership is an important organizational capability and is essential for quality improvement in hospital settings. Furthermore, the quality of leadership depends crucially on a common set of shared values and mutual trust between hospital management board members. According to the concept of social capital, these are essential requirements for successful cooperation and coordination within groups. Objectives We assume that social capital within hospital management boards is an important factor in the development of effective organizational systems for overseeing health care quality. We hypothesized that the degree of social capital within the hospital management board is associated with the effectiveness and maturity of the quality management system in European hospitals. Methods We used a mixed-method approach to data collection and measurement in 188 hospitals in 7 European countries. For this analysis, we used responses from hospital managers. To test our hypothesis, we conducted a multilevel linear regression analysis of the association between social capital and the quality management system score at the hospital level, controlling for hospital ownership, teaching status, number of beds, number of board members, organizational culture, and country clustering. Results The average social capital score within a hospital management board was 3.3 (standard deviation: 0.5; range: 1-4) and the average hospital score for the quality management index was 19.2 (standard deviation: 4.5; range: 0-27). Higher social capital was associated with higher quality management system scores (regression coefficient: 1.41; standard error: 0.64, p=0.029). Conclusion The results suggest that a higher degree of social capital exists in hospitals that exhibit higher maturity in their quality management systems. Although uncontrolled confounding and reverse causation cannot be completely ruled out, our new findings, along with the results of previous research, could

Development of a water quality index based on a European ...

African Journals Online (AJOL)

This index has advantages over pre-existing indices by reflecting the appropriateness of water for specific use, e.g. drinking water supply rather than general supply, and has been developed by studying the supranational standard, i.e. the European Community Standard. Three classification schemes for water quality are ...

Quality health care in the European Union thanks to competition law.

Science.gov (United States)

Fornaciari, Diego

2010-01-01

There are many biases concerning the application of competition law in health care. Quality concerns can however be integrated into competition law analysis. The aim of this paper is to identify the links between the application of competition law in the European Union and the right to quality health care and to point out the problems that arise when integrating quality concerns in competition law analysis. Guidelines must be issued and competition authorities must work together with institutions that have expertise in the field of health care quality measurement in order to integrate these dimensions in competition practice.

Quality Health Care in the European Union Thanks to Competition Law

Science.gov (United States)

Fornaciari, Diego

2010-01-01

There are many biases concerning the application of competition law in health care. Quality concerns can however be integrated into competition law analysis. The aim of this paper is to identify the links between the application of competition law in the European Union and the right to quality health care and to point out the problems that arise when integrating quality concerns in competition law analysis. Guidelines must be issued and competition authorities must work together with institutions that have expertise in the field of health care quality measurement in order to integrate these dimensions in competition practice. PMID:20195428

Using Lean to Advance Quality Improvement Research.

Science.gov (United States)

Blackmore, Christopher Craig; Williams, Barbara L; Ching, Joan M; Chafetz, Lynne A; Kaplan, Gary S

2016-01-01

Quality improvement research skills are not commonplace among quality improvement practitioners, and research on the effectiveness of quality improvement has not always kept pace with improvement innovation. However, the Lean tools applied to quality improvement should be equally relevant to the advancement of quality improvement research. We applied the Lean methods to develop a simplified quality improvement publication pathway enabling a small research methodology group to increase quality improvement research throughout the institution. The key innovations of the pathway are horizontal integration of the quality improvement research methods group across the institution, implementation of a Lean quality improvement research pathway, and application of a just-in-time quality improvement research toolkit. This work provides a road map and tools for the acceleration of quality improvement research. At our institution, the Lean quality improvement research approach was associated with statistically significant increases in the number (annual mean increase from 3.0 to 8.5, p = .03) and breadth of published quality improvement research articles, and in the number of quality improvement research projects currently in process. Application of Lean methods to the quality improvement research process can aid in increasing publication of quality improvement articles from across the institution.

Applying different quality and safety models in healthcare improvement work: Boundary objects and system thinking

International Nuclear Information System (INIS)

Wiig, Siri; Robert, Glenn; Anderson, Janet E.; Pietikainen, Elina; Reiman, Teemu; Macchi, Luigi; Aase, Karina

2014-01-01

A number of theoretical models can be applied to help guide quality improvement and patient safety interventions in hospitals. However there are often significant differences between such models and, therefore, their potential contribution when applied in diverse contexts. The aim of this paper is to explore how two such models have been applied by hospitals to improve quality and safety. We describe and compare the models: (1) The Organizing for Quality (OQ) model, and (2) the Design for Integrated Safety Culture (DISC) model. We analyze the theoretical foundations of the models, and show, by using a retrospective comparative case study approach from two European hospitals, how these models have been applied to improve quality and safety. The analysis shows that differences appear in the theoretical foundations, practical approaches and applications of the models. Nevertheless, the case studies indicate that the choice between the OQ and DISC models is of less importance for guiding the practice of quality and safety improvement work, as they are both systemic and share some important characteristics. The main contribution of the models lay in their role as boundary objects directing attention towards organizational and systems thinking, culture, and collaboration

Is patient-centredness in European hospitals related to existing quality improvement strategies? Analysis of a cross-sectional survey (MARQuIS study)

NARCIS (Netherlands)

Groene, O.; Lombarts, M. J. M. H.; Klazinga, N.; Alonso, J.; Thompson, A.; Suñol, R.

2009-01-01

Background: There is growing recognition of patients' contributions to setting objectives for their own care, improving health outcomes and evaluating care. Objective: To quantify the extent to which European hospitals have implemented strategies to promote a patient-centred approach, and to assess

Quality assurance and benchmarking: an approach for European dental schools.

NARCIS (Netherlands)

Jones, M.L.; Hobson, R.S.; Plasschaert, A.J.M.; Gundersen, S.; Dummer, P.; Roger-Leroi, V.; Sidlauskas, A.; Hamlin, J.

2007-01-01

This document was written by Task Force 3 of DentEd III, which is a European Union funded Thematic Network working under the auspices of the Association for Dental Education in Europe (ADEE). It provides a guide to assist in the harmonisation of Dental Education Quality Assurance (QA) systems across

Accelerate Water Quality Improvement

Science.gov (United States)

EPA is committed to accelerating water quality improvement and minimizing negative impacts to aquatic life from contaminants and other stressors in the Bay Delta Estuary by working with California Water Boards to strengthen water quality improvement plans.

Quality management in European screening laboratories in blood establishments: A view of current approaches and trends.

Science.gov (United States)

Pereira, Paulo; Westgard, James O; Encarnação, Pedro; Seghatchian, Jerard; de Sousa, Gracinda

2015-04-01

The screening laboratory has a critical role in the post-transfusion safety. The success of its targets and efficiency depends on the management system used. Even though the European Union directive 2002/98/EC requires a quality management system in blood establishments, its requirements for screening laboratories are generic. Complementary approaches are needed to implement a quality management system focused on screening laboratories. This article briefly discusses the current good manufacturing practices and good laboratory practices, as well as the trends in quality management system standards. ISO 9001 is widely accepted in some European Union blood establishments as the quality management standard, however this is not synonymous of its successful application. The ISO "risk-based thinking" is interrelated with the quality risk-management process of the EuBIS "Standards and criteria for the inspection of blood establishments". ISO 15189 should be the next step on the quality assurance of a screening laboratory, since it is focused on medical laboratory. To standardize the quality management systems in blood establishments' screening laboratories, new national and European claims focused on technical requirements following ISO 15189 is needed. Copyright © 2015 Elsevier Ltd. All rights reserved.

[Real-time feedback systems for improvement of resuscitation quality].

Science.gov (United States)

Lukas, R P; Van Aken, H; Engel, P; Bohn, A

2011-07-01

The quality of chest compression is a determinant of survival after cardiac arrest. Therefore, the European Resuscitation Council (ERC) 2010 guidelines on resuscitation strongly focus on compression quality. Despite its impact on survival, observational studies have shown that chest compression quality is not reached by professional rescue teams. Real-time feedback devices for resuscitation are able to measure chest compression during an ongoing resuscitation attempt through a sternal sensor equipped with a motion and pressure detection system. In addition to the electrocardiograph (ECG) ventilation can be detected by transthoracic impedance monitoring. In cases of quality deviation, such as shallow chest compression depth or hyperventilation, feedback systems produce visual or acoustic alarms. Rescuers can thereby be supported and guided to the requested quality in chest compression and ventilation. Feedback technology is currently available both as a so-called stand-alone device and as an integrated feature in a monitor/defibrillator unit. Multiple studies have demonstrated sustainable enhancement in the education of resuscitation due to the use of real-time feedback technology. There is evidence that real-time feedback for resuscitation combined with training and debriefing strategies can improve both resuscitation quality and patient survival. Chest compression quality is an independent predictor for survival in resuscitation and should therefore be measured and documented in further clinical multicenter trials.

Quality - a Factor for Competitiveness Improvement for Small and Medium Enterprises

Directory of Open Access Journals (Sweden)

Ion IONITA

2009-01-01

Full Text Available The impact of quality management on microeconomic systems is major. Theintegration into the European Economic Area requires a comprehensive processof compliance to European policies and practices, including implementation ofquality management system. The dominance of the small and mediumenterprises sector in the economy requires a specific action framework, thequality having a fundamental role. Only those operators who have implementedand certified a quality management system can valorize on their goods andservices in the European market. Acting on the potentials` sphere, qualitybecomes a crucial resource for economic success. In this context, the authorsaim to analyze the impact of implementation and certification of qualitymanagement on the progress of Romania small and medium enterprises in thecontext of diversification and globalization of the emphasis of European andworld markets.

"Rheum to Improve": Quality Improvement in Outpatient Rheumatology.

Science.gov (United States)

Chow, Shirley L; Shojania, Kaveh G

2017-09-01

The commitment to improve care processes and patient outcomes is a professional mandate for clinicians and is also seen as an operational priority for institutions. Quality improvement now figures in the accreditation of training programs, specialty examinations, and hospital scorecards. Rheumatologists have traditionally focused primarily on quality problems such as guideline adherence; however, improvement goals should also include other aspects of care that are helpful to patients and are professionally rewarding for practitioners. This review makes use of improvement projects in outlining tangible tools rheumatologists can use to resolve quality concerns in their practices.

Can we import quality tools? a feasibility study of European practice assessment in a country with less organised general practice

Directory of Open Access Journals (Sweden)

Pestiaux Dominique

2009-10-01

Full Text Available Abstract Background Quality is on the agenda of European general practice (GP. European researchers have, in collaboration, developed tools to assess quality of GPs. In this feasibility study, we tested the European Practice Assessment (EPA in a one-off project in Belgium, where general practice has a low level of GP organisation. Methods A framework for feasibility analysis included describing the recruiting of participants, a brief telephone study survey among non-responders, organisational and logistic problems. Using field notes and focus groups, we studied the participants' opinions. Results In this study, only 36 of 1000 invited practices agreed to participate. Co-ordination, administrative work, practice visits and organisational problems required several days per practice. The researchers further encountered technical problems, for instance when entering the data and uploading to the web-based server. In subsequent qualitative analysis using two focus groups, most participant GPs expressed a positive feeling after the EPA procedure. In the short period of follow-up, only a few GPs reported improvements after the visit. The participant GPs suggested that follow-up and coaching would probably facilitate the implementation of changes. Conclusion This feasibility study shows that prior interest in EPA is low in the GP community. We encountered a number of logistic and organisational problems. It proved attractive to participants, but it can be augmented by coaching of participants in more than a one-off project to identify and achieve targets for quality improvement. In the absence of commitment of the government, a network of universities and one scientific organisation will offer EPA as a service to training practices.

Challenges in Constructing a Multi-dimensional European Job Quality Index

DEFF Research Database (Denmark)

Leschke, Janine; Watt, Andrew

2014-01-01

quality performances and the outcomes in six sub-dimensions of job quality and compare them with each other, across gender and over time. At the same time, the limitations of such a composite index need to be borne in mind. The most important challenges are the availability (over time), timeliness......There are few attempts to benchmark job quality in a multi-dimensional perspective across Europe. Against this background, we have created a synthetic job quality index (JQI) for the EU27 countries in an attempt to shed light on the question of how European countries compare with each other and how...... they are developing over time in terms of job quality. Taking account of the multi-faceted nature of job quality, the JQI is compiled on the basis of six sub-indices which cover the most important dimensions of job quality as identified in the literature. The paper addresses the methods used to construct the JQI...

The Impact of ERASMUS on European Higher Education: Quality, Openness and Internationalisation; Final Report by the consortium of CHEPS, INCHER-Kassel and ECOTEC

NARCIS (Netherlands)

Vossensteyn, Johan J.; Beerkens-Soo, M.; Cremonini, Leon; Antonowitsch, Dominic; Epping, Elisabeth

2008-01-01

This study explores the impact of the ERASMUS programme on quality improvement in European higher education in particular in the areas of teaching, research, student services and the openness to society with a focus at the institutional and system level. The study puts an emphasis on the

COWAM 2 : A European Contribution to the Improvement of Governance in the Field of Radioactive Waste Management

International Nuclear Information System (INIS)

Heriard Dubreuil, Gilles

2006-01-01

The quality of decision-making processes in radioactive waste management (RWM) was explored within the European 5th Framework Research Programme, through a Concerted Action project known as COWAM (Community Waste Management). COWAM (2000-2003) was established as a network, gathering European local communities, together with representatives of regulators, implementers and experts. The project made a major contribution to framing the governance of radioactive waste management by identifying key needs: early involvement of local stakeholders in the decision making processes on radioactive waste management; effective implementation of local democracy; access to expertise; influence of local actors on a defined national framework for radioactive waste management; and sustainable regional development of communities hosting radioactive waste management facilities. As a follow-on project from COWAM, COWAM 2 has been established within the European 6th Framework Research Programme. COWAM 2 started in January 2004 and will be completed at the end of 2006. The project format evolved from that of a network for collective reflection into a pluralistic research partnership, aimed at practical implementation. The involvement of stakeholders continues to be an essential element of the project, in terms of the quality, legitimacy and robustness of the results. Representatives of local communities and NGOs as well as institutional stakeholders contribute expertise on issues with which they are directly concerned, working in conjunction with specialists from various fields of study relevant to the governance of radioactive waste management. A stakeholder Steering Committee oversees the project. The objective of COWAM 2 is to contribute to a concrete improvement in RWM governance, by: better identifying and understanding societal expectations, needs and concerns as regards decision-making processes, notably at the local and regional levels, taking into account past and ongoing

COWAM 2 : A European Contribution to the Improvement of Governance in the Field of Radioactive Waste Management

Energy Technology Data Exchange (ETDEWEB)

Heriard Dubreuil, Gilles [MUTADIS, Paris (FR)] (and others)

2006-09-15

The quality of decision-making processes in radioactive waste management (RWM) was explored within the European 5th Framework Research Programme, through a Concerted Action project known as COWAM (Community Waste Management). COWAM (2000-2003) was established as a network, gathering European local communities, together with representatives of regulators, implementers and experts. The project made a major contribution to framing the governance of radioactive waste management by identifying key needs: early involvement of local stakeholders in the decision making processes on radioactive waste management; effective implementation of local democracy; access to expertise; influence of local actors on a defined national framework for radioactive waste management; and sustainable regional development of communities hosting radioactive waste management facilities. As a follow-on project from COWAM, COWAM 2 has been established within the European 6th Framework Research Programme. COWAM 2 started in January 2004 and will be completed at the end of 2006. The project format evolved from that of a network for collective reflection into a pluralistic research partnership, aimed at practical implementation. The involvement of stakeholders continues to be an essential element of the project, in terms of the quality, legitimacy and robustness of the results. Representatives of local communities and NGOs as well as institutional stakeholders contribute expertise on issues with which they are directly concerned, working in conjunction with specialists from various fields of study relevant to the governance of radioactive waste management. A stakeholder Steering Committee oversees the project. The objective of COWAM 2 is to contribute to a concrete improvement in RWM governance, by: better identifying and understanding societal expectations, needs and concerns as regards decision-making processes, notably at the local and regional levels, taking into account past and ongoing

Quality assurance systems of higher education - The case of european institutions: origin, evolution and trends

Directory of Open Access Journals (Sweden)

Ángela Corengia

2014-11-01

Full Text Available http://dx.doi.org/10.5007/1983-4535.2014v7n3p61 The purpose of this research is to analyze the origin, evolution, performance and trends of higher education quality assurance systems in the following European countries: Denmark, Norway, Sweden, Finland, Austria, Italy, Switzerland, Germany, Netherlands, United Kingdom and France. It also studies the performance and impact of the organizations that join the European Quality Assurance Agencies together. The main sources of data collection were in situ semi-structured interviews to members of these agencies. It was found that in higher education institutions there is a strong trend towards the development of ‘internal quality assurance systems' in response to the public policies known as 'quality audits'. This overview about what is taking place in Europe may provide innovative instruments that could be considered for higher education quality evaluation and accreditation in Latin-American countries: quality audits, disciplinary agencies, evaluation of the quality assurance agencies, among others.

Recommendations for quality improvement in genetic testing for cystic fibrosis European Concerted Action on Cystic Fibrosis

NARCIS (Netherlands)

Dequeker, E; Cuppens, H; Dodge, J; Estivill, [No Value; Goossens, M; Pignatti, PF; Scheffer, H; Schwartz, M; Schwarz, M; Tummler, B; Cassiman, JJ

These recommendations for quality improvement of cystic fibrosis genetic diagnostic testing provide general guidelines for the molecular genetic testing of cystic fibrosis in patients/individuals. General strategies for testing as well as guidelines for laboratory procedures, internal and external

Consumers’ Awareness and Attitudinal Determinants of European Union Quality Label Use on Traditional Foods

Directory of Open Access Journals (Sweden)

Wim Verbeke

2012-11-01

Full Text Available This study analyses European consumers’ awareness and determinants of use of PDO, PGI and TSG labels in six European countries (Italy, Spain, France, Bel- gium, Norway and Poland using data from a cross-sectional survey with 4,828 participants. The study confirms a higher awareness of PDO (68.1% as compared to PGI (36.4% and TSG (25.2%. Awareness is higher among men and people aged above 50 years. Consumers’ use of a PDO, PGI or TSG label is triggered by the belief that the label signals better product quality. Quality beliefs are shaped by an interest in getting information about product quality through the quality label. Interest in the origin of foods is a stronger direct and indirect driver of label use than interest in support for the local economy, but both motivations are not directly related to TSG-label use. Differences in the role of determinants are small between the three labelling schemes and between countries with versus without a strong tradition of quality labels in their agri- cultural and food quality policies. Apart from building general awareness and favourable quality perceptions of the quality schemes and their respective labels, efforts to stimulate consumers’ interest in origin and getting information about product quality through EU quality labels are recommended.

General overview: European Integrated project on Aerosol Cloud Climate and Air Quality interactions (EUCAARI – integrating aerosol research from nano to global scales

Directory of Open Access Journals (Sweden)

D. Simpson

2011-12-01

Full Text Available In this paper we describe and summarize the main achievements of the European Aerosol Cloud Climate and Air Quality Interactions project (EUCAARI. EUCAARI started on 1 January 2007 and ended on 31 December 2010 leaving a rich legacy including: (a a comprehensive database with a year of observations of the physical, chemical and optical properties of aerosol particles over Europe, (b comprehensive aerosol measurements in four developing countries, (c a database of airborne measurements of aerosols and clouds over Europe during May 2008, (d comprehensive modeling tools to study aerosol processes fron nano to global scale and their effects on climate and air quality. In addition a new Pan-European aerosol emissions inventory was developed and evaluated, a new cluster spectrometer was built and tested in the field and several new aerosol parameterizations and computations modules for chemical transport and global climate models were developed and evaluated. These achievements and related studies have substantially improved our understanding and reduced the uncertainties of aerosol radiative forcing and air quality-climate interactions. The EUCAARI results can be utilized in European and global environmental policy to assess the aerosol impacts and the corresponding abatement strategies.

European working environment in figures : availability and quality of occupational health and safety data in sixteen European countries

NARCIS (Netherlands)

Nossent, S.; Groot, B. de; Verboom, F.; Pantry, S.

1996-01-01

This report by the European Foundation for the Improvement of Living and Working Conditions shows that information is essential to pinpoint risk factors in the workplace, and is a crucial starting point for the preparation of efficient measures to improve the working environment. To this end, most

Structured data quality reports to improve EHR data quality.

Science.gov (United States)

Taggart, Jane; Liaw, Siaw-Teng; Yu, Hairong

2015-12-01

To examine whether a structured data quality report (SDQR) and feedback sessions with practice principals and managers improve the quality of routinely collected data in EHRs. The intervention was conducted in four general practices participating in the Fairfield neighborhood electronic Practice Based Research Network (ePBRN). Data were extracted from their clinical information systems and summarised as a SDQR to guide feedback to practice principals and managers at 0, 4, 8 and 12 months. Data quality (DQ) metrics included completeness, correctness, consistency and duplication of patient records. Information on data recording practices, data quality improvement, and utility of SDQRs was collected at the feedback sessions at the practices. The main outcome measure was change in the recording of clinical information and level of meeting Royal Australian College of General Practice (RACGP) targets. Birth date was 100% and gender 99% complete at baseline and maintained. DQ of all variables measured improved significantly (pImprovement was greatest with allergies. There was no significant change in duplicate records. SDQRs and feedback sessions support general practitioners and practice managers to focus on improving the recording of patient information. However, improved practice DQ, was not sufficient to meet RACGP targets. Randomised controlled studies are required to evaluate strategies to improve data quality and any associated improved safety and quality of care. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

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

Science.gov (United States)

Roche, B G; Sommer, C

1995-01-01

In may 1994 we were selected by the surgical Swiss association to make a study about quality in USA. During our travel we visited 3 types of institutions: Hospitals, National Institute of standard and Technology, Industry, Johnson & Johnson. We appreciate to compare 2 types of quality programs: Quality Assurance (QA) and Continuous Quality Improvement (CQI). In traditional healthcare circles, QA is the process established to meet external regulatory requirements and to assure that patient care is consistent with established standards. In a modern quality terms, QA outside of healthcare means designing a product or service, as well as controlling its production, so well that quality is inevitable. The ideas of W. Edward Deming is that there is never improvement just by inspection. He developed a theory based on 14 principles. A productive work is accomplished through processes. Understanding the variability of processes is a key to improve quality. Quality management sees each person in an organisation as part of one or more processes. The job of every worker is to receive the work of others, add value to that work, and supply it to the next person in the process. This is called the triple role the workers as customer, processor, and supplier. The main source of quality defects is problems in the process. The old assumption is that quality fails when people do the right thing wrong; the new assumption is that, more often, quality failures arise when people do the wrong think right. Exhortation, incentives and discipline of workers are unlikely to improve quality. If quality is failing when people do their jobs as designed, then exhorting them to do better is managerial nonsense. Modern quality theory is customer focused. Customers are identified internally and externally. The modern approach to quality is thoroughly grounded in scientific and statistical thinking. Like in medicine, the symptom is a defect in quality. The therapist of process must perform diagnostic

From sensor output to improved product quality

NARCIS (Netherlands)

Hertog, M.L.A.T.M.; Vollebregt, Martijntje; Unzueta, I.; Hoofman, R.J.O.M.; Lammertyn, J.

2015-01-01

The research conducted in the European PASTEUR project focussed on perishables monitoring through smart tracking of lifetime and quality. The aim was to develop a wireless sensor platform to monitor the environmental conditions of perishable goods in the supply chain between producer and

Third European Company Survey: Workplace innovation in European companies

OpenAIRE

Oeij, P.; Žiauberyté-Jakštiené, R.; Dhondt, S.; Corral, A.; Totterdill, P.; Preenen, P.

2015-01-01

Workplace innovation (WPI) is a developed and implemented practice or combination of practices which enables employees to participate in organisational change and renewal and hence improve the quality of working life and organisational performance. This report looks at reasons for enabling WPI, adoption and implementation, and impact on organisation and management, employees and employee representatives. The research is based on 51 companies identified in Eurofound’s third European Company Su...

Solutions to Improve Educational Management Quality

OpenAIRE

Ramezan Jahanian; Masoomeh Motahari

2013-01-01

Nowadays, enhancing the quality in educational systems of different countries has gained especial importance and stand. Improving utilizing and increasing the quality in our country’s educational system is felt too. One of the utilizing factors in education system is to improve the educational management quality.In this article, effective factors in educational management quality and one of its improving solutions, thorough management quality, is analyzed.

Benchmarking as an Instrument for Improvement of Quality Management in Higher Education

Directory of Open Access Journals (Sweden)

Narimantas Kazimieras Paliulis

2015-06-01

Full Text Available Conditioned by globalisation and constant change, higher education institutions (HEIs are forced to pursue new instruments for quality assurance in higher education. States seem to pursue this aim by attempting to create an efficiently operating system of higher education that satisfies needs of diverse societal groups. Quality dimension is the most important element of efficient and effective higher education. From the perspective of a state, assessment and monitoring of quality are instruments for the management of processes of higher education. The article substantiates these statements using the evolution of the dimension of quality in the European and Lithuanian higher education in the course of the Bologna Process. The article also presents a benchmarking method and discusses its development and application tendencies in business organisations. Also, it looks at possibilities to apply this method in higher education. The main aim of this article is to explore benchmarking as an effective instrument for the improvement of performance quality in HEIs and complement the already implemented quality management systems. Another aim is to suggest this method to national agencies for quality assurance in higher education for monitoring and analysis of qualitative changes on the systematic level. The object of the article is the improvement of performance quality in HEIs. Benchmarking is proposed for the use in higher education on the institutional level as an instrument that complements presently introduced quality management systems in Lithuanian HEIs. This way, it will contribute to the formation of the culture of quality in higher education.

Improving Access to European E-theses: the DART-Europe Programme

Directory of Open Access Journals (Sweden)

Martin Moyle

2008-11-01

Full Text Available DART-Europe (Digital Access to Research Theses - Europe is a partnership of research libraries and library consortia who are working together to improve global access to European research theses. The Programme is endorsed by LIBER (Ligue des Bibliothèques Européennes de Recherche as part of the work of the LIBER Access Division, and it is the European Working Group of the NDLTD (Networked Digital Library of Theses and Dissertations. DART-Europe serves as a European networking forum on issues relating to electronic theses. The DART-Europe partners share an enthusiasm for open access to research theses, and they have helped to provide researchers with the DART-Europe E-theses Portal, a service which enables the discovery of the open access research-level e-theses offered by institutions and consortia from a growing number of European countries. This article gives an overview of DART-Europe, its progress and its future plans, with particular reference to the DART-Europe E-theses Portal.

How to Improve the Quality of Screening Endoscopy in Korea: National Endoscopy Quality Improvement Program.

Science.gov (United States)

Cho, Yu Kyung

2016-07-01

In Korea, gastric cancer screening, either esophagogastroduodenoscopy or upper gastrointestinal series (UGIS), is performed biennially for adults aged 40 years or older. Screening endoscopy has been shown to be associated with localized cancer detection and better than UGIS. However, the diagnostic sensitivity of detecting cancer is not satisfactory. The National Endoscopy Quality Improvement (QI) program was initiated in 2009 to enhance the quality of medical institutions and improve the effectiveness of the National Cancer Screening Program (NCSP). The Korean Society of Gastrointestinal Endoscopy developed quality standards through a broad systematic review of other endoscopic quality guidelines and discussions with experts. The standards comprise five domains: qualifications of endoscopists, endoscopic unit facilities and equipment, endoscopic procedure, endoscopy outcomes, and endoscopic reprocessing. After 5 years of the QI program, feedback surveys showed that the perception of QI and endoscopic practice improved substantially in all domains of quality, but the quality standards need to be revised. How to avoid missing cancer in endoscopic procedures in daily practice was reviewed, which can be applied to the mass screening endoscopy. To improve the quality and effectiveness of NCSP, key performance indicators, acceptable quality standards, regular audit, and appropriate reimbursement are necessary.

Quality control for diagnostic oral microbiology laboratories in European countries

Directory of Open Access Journals (Sweden)

Andrew J. Smith

2011-11-01

Full Text Available Participation in diagnostic microbiology internal and external quality control (QC processes is good laboratory practice and an essential component of a quality management system. However, no QC scheme for diagnostic oral microbiology existed until 2009 when the Clinical Oral Microbiology (COMB Network was created. At the European Oral Microbiology Workshop in 2008, 12 laboratories processing clinical oral microbiological samples were identified. All these were recruited to participate into the study and six laboratories from six European countries completed both the online survey and the first QC round. Three additional laboratories participated in the second round. Based on the survey, European oral microbiology laboratories process a significant (mean per laboratory 4,135 number of diagnostic samples from the oral cavity annually. A majority of the laboratories did not participate in any internal or external QC programme and nearly half of the laboratories did not have standard operating procedures for the tests they performed. In both QC rounds, there was a large variation in the results, interpretation and reporting of antibiotic susceptibility testing among the laboratories. In conclusion, the results of this study demonstrate the need for harmonisation of laboratory processing methods and interpretation of results for oral microbiology specimens. The QC rounds highlighted the value of external QC in evaluating the efficacy and safety of processes, materials and methods used in the laboratory. The use of standardised methods is also a prerequisite for multi-centre epidemiological studies that can provide important information on emerging microbes and trends in anti-microbial susceptibility for empirical prescribing in oro-facial infections.

Workers' Objectives in Quality Improvement.

Science.gov (United States)

Brossard, Michel

1990-01-01

A case study of quality circles in an appliance factory found that circle members and nonmembers obtained better working conditions by improving quality through the direct impact of their work on the company's market position. The study of the quality improvement process shows that workers seek more than psychological rewards for their…

Towards an integrative approach of improving indoor air quality

Energy Technology Data Exchange (ETDEWEB)

Bluyssen, Philomena M. [TNO Built Environment and Geosciences, P.O. Box 49, 2600 AA Delft (Netherlands)

2009-09-15

There seems to be a discrepancy between current Indoor Air Quality standards and end-users wishes and demands. Indoor air quality can be approached from three points of view: the human, the indoor air of the space and the sources contributing to indoor air pollution. Standards currently in use mainly address the indoor air of the space. ''Other or additional'' recommendations and guidelines are required to improve indoor air quality. Even though we do not fully understand the mechanisms behind the physical, chemical, physiological and psychological processes, it is still possible to identify the different ways to be taken regulatory, politically-socially (awareness), technically (process and product) and scientifically. Besides the fact that there is an urgent need to involve medicine and neuro-psychology in research to investigate the mechanisms behind dose-response, health effects and interactions between and with the other factors and parameters of the indoor environment and the human body and mind, a holistic approach is required including the sources, the air and last but not least the human beings (occupants) themselves. This paper mainly focuses on the European situation. (author)

The Professional Doctorate: From Anglo-Saxon to European Challenges

Science.gov (United States)

Huisman, Jeroen; Naidoo, Rajani

2006-01-01

This paper addresses the debate on the third cycle of European higher education. Currently, much attention is paid to improving the structure and quality of doctorate education in the European context of the Bologna process and the Lisbon objectives. However, alternatives to the traditional doctorate are hardly addressed in the policy documents of…

Creating Quality Improvement Culture in Public Health Agencies

Science.gov (United States)

Mahanna, Elizabeth; Joly, Brenda; Zelek, Michael; Riley, William; Verma, Pooja; Fisher, Jessica Solomon

2014-01-01

Objectives. We conducted case studies of 10 agencies that participated in early quality improvement efforts. Methods. The agencies participated in a project conducted by the National Association of County and City Health Officials (2007–2008). Case study participants included health directors and quality improvement team leaders and members. We implemented multiple qualitative analysis processes, including cross-case analysis and logic modeling. We categorized agencies according to the extent to which they had developed a quality improvement culture. Results. Agencies were conducting informal quality improvement projects (n = 4), conducting formal quality improvement projects (n = 3), or creating a quality improvement culture (n = 4). Agencies conducting formal quality improvement and creating a quality improvement culture had leadership support for quality improvement, participated in national quality improvement initiatives, had a greater number of staff trained in quality improvement and quality improvement teams that met regularly with decision-making authority. Agencies conducting informal quality improvement were likely to report that accreditation is the major driver for quality improvement work. Agencies creating a quality improvement culture were more likely to have a history of evidence-based decision-making and use quality improvement to address emerging issues. Conclusions. Our findings support previous research and add the roles of national public health accreditation and emerging issues as factors in agencies’ ability to create and sustain a quality improvement culture. PMID:24228680

Creating quality improvement culture in public health agencies.

Science.gov (United States)

Davis, Mary V; Mahanna, Elizabeth; Joly, Brenda; Zelek, Michael; Riley, William; Verma, Pooja; Fisher, Jessica Solomon

2014-01-01

We conducted case studies of 10 agencies that participated in early quality improvement efforts. The agencies participated in a project conducted by the National Association of County and City Health Officials (2007-2008). Case study participants included health directors and quality improvement team leaders and members. We implemented multiple qualitative analysis processes, including cross-case analysis and logic modeling. We categorized agencies according to the extent to which they had developed a quality improvement culture. Agencies were conducting informal quality improvement projects (n = 4), conducting formal quality improvement projects (n = 3), or creating a quality improvement culture (n = 4). Agencies conducting formal quality improvement and creating a quality improvement culture had leadership support for quality improvement, participated in national quality improvement initiatives, had a greater number of staff trained in quality improvement and quality improvement teams that met regularly with decision-making authority. Agencies conducting informal quality improvement were likely to report that accreditation is the major driver for quality improvement work. Agencies creating a quality improvement culture were more likely to have a history of evidence-based decision-making and use quality improvement to address emerging issues. Our findings support previous research and add the roles of national public health accreditation and emerging issues as factors in agencies' ability to create and sustain a quality improvement culture.

FLEXIBLE AND IMPROVED IMPLEMENTATION OF THE EUROPEAN NEIGHBOURHOOD POLICY

Directory of Open Access Journals (Sweden)

Marcela SLUSARCIUC

2014-10-01

Full Text Available The European Neighbourhood Policy is at crossroads meaning that the actual frame of geopolitical movements imposes a new reshaping mainly on the Eastern side caused by the Ukraine issue. The implementation of the ENP through the European Neighbourhood Partnership Instrument, financial umbrella for the Joint Operational Programmes (JOPs, is already a challenging exercise for the Member States working together with the Partner Countries in order to develop an area of prosperity and good neighbourliness. This paper proposes a pack of features and recommendations arisen from the experiences gained by the implementation bodies of the JOPs along the European Union Eastern border, beneficiaries and other experts in cross-border cooperation. The main issues approached aim the improvement of the future cross-border programmes in terms of flexibility, transparency and efficiency: stakeholders consultation all along the programme cycle, a new mix of funding sources, gradual involvement of new types of beneficiaries and programme evaluation.

Constructing an Efficient and Balanced European Patent System: “Muddling through”

DEFF Research Database (Denmark)

Schovsbo, Jens Hemmingsen

2011-01-01

The paper discusses ways to construct a more efficient and balanced European patent system. It identifies and describes challenges relating to innovation, to non-economic issues and to governance. In order to improve the patent system, a cautious approach of “Muddling through” is recommended. More...... concretely, the paper puts forward some of the solutions proposed in the STOA Report to the European Parliament on “Policy options for the improvement of the European patent system” and suggest initiatives such as the insertion of a mission statement in the EPC, improvement of patent quality, increasing...... access to patented inventions and enhancement of governance....

Do Clinical Practice Guidelines Improve Quality?

Science.gov (United States)

Baldassari, Cristina M

2017-07-01

Controversy exists surrounding how to best define and assess quality in the health care setting. Clinical practice guidelines (CPGs) have been developed to improve the quality of medical care by highlighting key clinical recommendations based on recent evidence. However, data linking CPGs to improvements in outcomes in otolaryngology are lacking. Numerous barriers contribute to difficulties in translating CPGs to improvements in quality. Future initiatives are needed to improve CPG adherence and define the impact of CPG recommendations on the quality of otolaryngologic care provided to our patients.

Comprehensive audits of radiotherapy practices: A tool for quality improvement: Quality Assurance Team for Radiation Oncology (QUATRO)

International Nuclear Information System (INIS)

2007-10-01

As part of a comprehensive approach to quality assurance (QA) in the treatment of cancer by radiation, an independent external audit (peer review) is important to ensure adequate quality of practice and delivery of treatment. Quality audits can be of various types and at various levels, either reviewing critical parts of the radiotherapy process (partial audits) or assessing the whole process (comprehensive audits). The IAEA has a long history of providing assistance for dosimetry (partial) audits in radiotherapy to its Member States. Together with the World Health Organization (WHO), it has operated postal audit programmes using thermoluminescence dosimetry (TLD) to verify the calibration of radiotherapy beams since 1969. Furthermore, it has developed a set of procedures for experts undertaking missions to radiotherapy hospitals in Member States for on-site review of dosimetry equipment, data and techniques, measurements and training of local staff. This methodology involves dosimetry and medical radiation physics aspects of the radiotherapy process without entering into clinical areas. The IAEA, through its technical cooperation programme, has received numerous requests from developing countries to perform comprehensive audits of radiotherapy programmes to assess the whole process. including aspects such as organization, infrastructure, and clinical and medical physics components. The objective of a comprehensive clinical audit is to review and evaluate thc quality of all of the components of the practice of radiotherapy at an institution, including its professional competence, with a view to quality improvement. A multidisciplinary team, comprising a radiation oncologist, a medical physicist and a radiotherapy technologist, carries out the audit. The present publication has been field tested by IAEA teams performing audits in radiotherapy programmes in hospitals in Africa, Asia, Europe and Latin America. Their comments, corrections and feedback have been taken

Comprehensive audits of radiotherapy practices: A tool for quality improvement: Quality Assurance Team for Radiation Oncology (QUATRO)

International Nuclear Information System (INIS)

2008-08-01

As part of a comprehensive approach to quality assurance (QA) in the treatment of cancer by radiation, an independent external audit (peer review) is important to ensure adequate quality of practice and delivery of treatment. Quality audits can be of various types and at various levels, either reviewing critical parts of the radiotherapy process (partial audits) or assessing the whole process (comprehensive audits). The IAEA has a long history of providing assistance for dosimetry (partial) audits in radiotherapy to its Member States. Together with the World Health Organization (WHO), it has operated postal audit programmes using thermoluminescence dosimetry (TLD) to verify the calibration of radiotherapy beams since 1969. Furthermore, it has developed a set of procedures for experts undertaking missions to radiotherapy hospitals in Member States for on-site review of dosimetry equipment, data and techniques, measurements and training of local staff. This methodology involves dosimetry and medical radiation physics aspects of the radiotherapy process without entering into clinical areas. The IAEA, through its technical cooperation programme, has received numerous requests from developing countries to perform comprehensive audits of radiotherapy programmes to assess the whole process. including aspects such as organization, infrastructure, and clinical and medical physics components. The objective of a comprehensive clinical audit is to review and evaluate thc quality of all of the components of the practice of radiotherapy at an institution, including its professional competence, with a view to quality improvement. A multidisciplinary team, comprising a radiation oncologist, a medical physicist and a radiotherapy technologist, carries out the audit. The present publication has been field tested by IAEA teams performing audits in radiotherapy programmes in hospitals in Africa, Asia, Europe and Latin America. Their comments, corrections and feedback have been taken

SQIMSO: Quality Improvement for Small Software Organizations

OpenAIRE

Rabih Zeineddine; Nashat Mansour

2005-01-01

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

A European Quality Control Programme as a cooperative tool between users and a diagnostic company.

Science.gov (United States)

Costongs, G M; Janson, P C

1993-12-01

Achievement of appropriate precision is a major challenge for the clinical laboratory, particularly in specialized fields such as enzymology and immunochemistry. Especially in immunochemistry, where accuracy can only poorly be checked because of a lack of reference methods and a multitude of detectable epitopes, precision remains an important index of quality. In immunochemical methods there are three main sources of variation: differences in methodology, lot-to-lot variation and performance of the assay, the latter including the skill of the technicians and instrument performance. The results of a European Quality Control Programme for the users of one type of automated immunoassay analyser were compared with a similar Italian Quality Control Programme for users of different immunometric techniques. The precisions (%CV) of the two programmes were compared, as well as the number of values lying within one half of the biological variation of the analysed serum components. Feedback between users and manufacturers leads to a clear improvement in analysis performance, so that most of the considered values come to lie within the acceptable limits of 1/2 of the biological variation. It is concluded that both national and international quality control programmes are very useful for indicating the intrinsic quality of the quantities used in the clinical laboratory.

European Society of Gynaecological Oncology (ESGO) Guidelines for Ovarian Cancer Surgery

NARCIS (Netherlands)

Querleu, Denis; Planchamp, Francois; Chiva, Luis; Fotopoulou, Christina; Barton, Desmond; Cibula, David; Aletti, Giovanni; Carinelli, Silvestro; Creutzberg, Carien; Davidson, Ben; Harter, Philip; Lundvall, Lene; Marth, Christian; Morice, Philippe; Rafii, Arash; Ray-Coquard, Isabelle; Rockall, Andrea; Sessa, Christiana; van der Zee, Ate; Vergote, Ignace; duBois, Andreas

Objective The aim of this study was to develop clinically relevant and evidence-based guidelines as part of European Society of Gynaecological Oncology's mission to improve the quality of care for women with gynecological cancers across Europe. Methods The European Society of Gynaecological Oncology

European guidelines for quality assurance in colorectal cancer screening and diagnosis: Overview and introduction to the full Supplement publication

Science.gov (United States)

von Karsa, L.; Patnick, J.; Segnan, N.; Atkin, W.; Halloran, S.; Lansdorp-Vogelaar, I.; Malila, N.; Minozzi, S.; Moss, S.; Quirke, P.; Steele, R. J.; Vieth, M.; Aabakken, L.; Altenhofen, L.; Ancelle-Park, R.; Antoljak, N.; Anttila, A.; Armaroli, P.; Arrossi, S.; Austoker, J.; Banzi, R.; Bellisario, C.; Blom, J.; Brenner, H.; Bretthauer, M.; Camargo Cancela, M.; Costamagna, G.; Cuzick, J.; Dai, M.; Daniel, J.; Dekker, E.; Delicata, N.; Ducarroz, S.; Erfkamp, H.; Espinàs, J. A.; Faivre, J.; Faulds Wood, L.; Flugelman, A.; Frkovic-Grazio, S.; Geller, B.; Giordano, L.; Grazzini, G.; Green, J.; Hamashima, C.; Herrmann, C.; Hewitson, P.; Hoff, G.; Holten, I.; Jover, R.; Kaminski, M. F.; Kuipers, E. J.; Kurtinaitis, J.; Lambert, R.; Launoy, G.; Lee, W.; Leicester, R.; Leja, M.; Lieberman, D.; Lignini, T.; Lucas, E.; Lynge, E.; Mádai, S.; Marinho, J.; Maučec Zakotnik, J.; Minoli, G.; Monk, C.; Morais, A.; Muwonge, R.; Nadel, M.; Neamtiu, L.; Peris Tuser, M.; Pignone, M.; Pox, C.; Primic-Zakelj, M.; Psaila, J.; Rabeneck, L.; Ransohoff, D.; Rasmussen, M.; Regula, J.; Ren, J.; Rennert, G.; Rey, J.; Riddell, R. H.; Risio, M.; Rodrigues, V.; Saito, H.; Sauvaget, C.; Scharpantgen, A.; Schmiegel, W.; Senore, C.; Siddiqi, M.; Sighoko, D.; Smith, R.; Smith, S.; Suchanek, S.; Suonio, E.; Tong, W.; Törnberg, S.; Van Cutsem, E.; Vignatelli, L.; Villain, P.; Voti, L.; Watanabe, H.; Watson, J.; Winawer, S.; Young, G.; Zaksas, V.; Zappa, M.; Valori, R.

2015-01-01

Population-based screening for early detection and treatment of colorectal cancer (CRC) and precursor lesions, using evidence-based methods, can be effective in populations with a significant burden of the disease provided the services are of high quality. Multidisciplinary, evidence-based guidelines for quality assurance in CRC screening and diagnosis have been developed by experts in a project co-financed by the European Union. The 450-page guidelines were published in book format by the European Commission in 2010.They include 10 chapters and over 250 recommendations, individually graded according to the strength of the recommendation and the supporting evidence. Adoption of the recommendations can improve and maintain the quality and effectiveness of an entire screening process, including identification and invitation of the target population, diagnosis and management of the disease and appropriate surveillance in people with detected lesions. To make the principles, recommendations and standards in the guidelines known to a wider professional and scientific community and to facilitate their use in the scientific literature, the original content is presented in journal format in an open-access Supplement of Endoscopy. The editors have prepared the present overview to inform readers of the comprehensive scope and content of the guidelines. PMID:23212726

Quality Procedures in the European Higher Education Area and Beyond--Visions for the Future: Third ENQA Survey. ENQA Occasional Papers 18

Science.gov (United States)

Grifoll, Josep; Hopbach, Achim; Kekalainen, Helka; Lugano, Nathalie; Rozsnyai, Christina; Shopov, Todor

2012-01-01

Higher education reforms over the last decade, resulting in the establishment of the European Higher Education Area, with new social demands and expectations, have greatly impacted quality assurance in higher education. As a follow-up activity to two previous surveys on external quality procedures, the European Association for Quality Assurance in…

Quality improvement education to improve performance on ulcerative colitis quality measures and care processes aligned with National Quality Strategy priorities.

Science.gov (United States)

Greene, Laurence; Moreo, Kathleen

2015-01-01

Studies on inflammatory bowel disease (IBD) have reported suboptimal approaches to patient care. In the United States, the findings have motivated leading gastroenterology organizations to call for initiatives that support clinicians in aligning their practices with quality measures for IBD and priorities of the National Quality Strategy (NQS). We designed and implemented a quality improvement (QI) education program on ulcerative colitis in which patient charts were audited for 30 gastroenterologists before (n = 300 charts) and after (n = 290 charts) they participated in QI-focused educational activities. Charts were audited for nine measures, selected for their alignment with four NQS priorities: making care safer, ensuring patient engagement, promoting communication, and promoting effective treatment practices. Four of the measures, including guideline-directed vaccinations and assessments of disease type and activity, were part of the CMS Physician Quality Reporting System (PQRS). The other five measures involved counseling patients on various topics in ulcerative colitis management, documentation of side effects, assessment of adherence status, and simplification of dosing. The gastroenterologists also completed baseline and post-education surveys designed to assess qualitative outcomes. One of the educational interventions was a private audit feedback session conducted for each gastroenterologist. The sessions were designed to support participants in identifying measures reflecting suboptimal care quality and developing action plans for improvement. In continuous improvement cycles, follow-up interventions included QI tools and educational monographs. Across the nine chart variables, post-education improvements ranged from 0% to 48%, with a mean improvement of 15.9%. Survey findings revealed improvements in self-reported understanding of quality measures and intentions to apply them to practice, and lower rates of perceived significant barriers to high-quality

Penerapan european foundation for quality management’s (efqm excellence model pada sistem pengukuran kinerja jurusan Teknik Mesin Universitas Udayana

Directory of Open Access Journals (Sweden)

I Made Dwi Budiana Penindra

2018-01-01

, dari 40 stakeholder requirement dijabarkan menjadi 15 KPI. Implementasi pada semester genap 2014/2015 menunjukkan peningkatan sebesar 83,92 % dari periode sebelumnya dengan Indeks Performance Indicator sebesar 773,35. Kata kunci: Pengukuran kinerja, European Foundation for Quality Management’s (EFQM Execellence Model, Metode Objectives Matrix (OMAX, Integrated Performance Measurement Systems (IPMS, dan Analytical Hierarcy Process (AHP Abstract Globalization is a phenomenon that can not be avoided in the governance of our lives where competition between countries become more open, especially in the field of human resources. To deal with the situation, the college is expected to be the center of the implementation and development of higher education that generate benefits and improve the quality of life of society, nation and state. Department of Mechanical Engineering is one of the departments that have earned accreditation from BAN PT where currently only 20% of accredited departments in the university. In order to improve its performance, it would need to design an integrated performance measurement system which is now the Department of Mechanical Engineering has not had a good performance measurement system yet. Enhancing performance measurement systems that already exist, analysis, design and implementation of performance measurement system will be done with the European Foundation for Quality Management's (EFQM excellence model wherein the method is integrated by several methods, namely Methods Objectives Matrix (OMAX, Integrated Performance Measurement Systems (IPMS, and Hierarcy Analytical Process (AHP in the Department of Mechanical Engineering University of Udayana. Steps or details of the research methods to be expected is as following steps: Selection Method of Measuring Productivity, Types and Data Collection Methods, Identification Indicators or the Criterion productivity will be measured, Giving Weights From Each KPI The Measured, Data Processing or

Predicting Hybrid Performances for Quality Traits through Genomic-Assisted Approaches in Central European Wheat

KAUST Repository

Liu, Guozheng

2016-07-06

Bread-making quality traits are central targets for wheat breeding. The objectives of our study were to (1) examine the presence of major effect QTLs for quality traits in a Central European elite wheat population, (2) explore the optimal strategy for predicting the hybrid performance for wheat quality traits, and (3) investigate the effects of marker density and the composition and size of the training population on the accuracy of prediction of hybrid performance. In total 135 inbred lines of Central European bread wheat (Triticum aestivum L.) and 1,604 hybrids derived from them were evaluated for seven quality traits in up to six environments. The 135 parental lines were genotyped using a 90k single-nucleotide polymorphism array. Genome-wide association mapping initially suggested presence of several quantitative trait loci (QTLs), but cross-validation rather indicated the absence of major effect QTLs for all quality traits except of 1000-kernel weight. Genomic selection substantially outperformed marker-assisted selection in predicting hybrid performance. A resampling study revealed that increasing the effective population size in the estimation set of hybrids is relevant to boost the accuracy of prediction for an unrelated test population.

Predicting Hybrid Performances for Quality Traits through Genomic-Assisted Approaches in Central European Wheat.

Directory of Open Access Journals (Sweden)

Guozheng Liu

Full Text Available Bread-making quality traits are central targets for wheat breeding. The objectives of our study were to (1 examine the presence of major effect QTLs for quality traits in a Central European elite wheat population, (2 explore the optimal strategy for predicting the hybrid performance for wheat quality traits, and (3 investigate the effects of marker density and the composition and size of the training population on the accuracy of prediction of hybrid performance. In total 135 inbred lines of Central European bread wheat (Triticum aestivum L. and 1,604 hybrids derived from them were evaluated for seven quality traits in up to six environments. The 135 parental lines were genotyped using a 90k single-nucleotide polymorphism array. Genome-wide association mapping initially suggested presence of several quantitative trait loci (QTLs, but cross-validation rather indicated the absence of major effect QTLs for all quality traits except of 1000-kernel weight. Genomic selection substantially outperformed marker-assisted selection in predicting hybrid performance. A resampling study revealed that increasing the effective population size in the estimation set of hybrids is relevant to boost the accuracy of prediction for an unrelated test population.

Predicting Hybrid Performances for Quality Traits through Genomic-Assisted Approaches in Central European Wheat

KAUST Repository

Liu, Guozheng; Zhao, Yusheng; Gowda, Manje; Longin, C. Friedrich H.; Reif, Jochen C.; Mette, Michael F.

2016-01-01

Bread-making quality traits are central targets for wheat breeding. The objectives of our study were to (1) examine the presence of major effect QTLs for quality traits in a Central European elite wheat population, (2) explore the optimal strategy for predicting the hybrid performance for wheat quality traits, and (3) investigate the effects of marker density and the composition and size of the training population on the accuracy of prediction of hybrid performance. In total 135 inbred lines of Central European bread wheat (Triticum aestivum L.) and 1,604 hybrids derived from them were evaluated for seven quality traits in up to six environments. The 135 parental lines were genotyped using a 90k single-nucleotide polymorphism array. Genome-wide association mapping initially suggested presence of several quantitative trait loci (QTLs), but cross-validation rather indicated the absence of major effect QTLs for all quality traits except of 1000-kernel weight. Genomic selection substantially outperformed marker-assisted selection in predicting hybrid performance. A resampling study revealed that increasing the effective population size in the estimation set of hybrids is relevant to boost the accuracy of prediction for an unrelated test population.

Predicting Hybrid Performances for Quality Traits through Genomic-Assisted Approaches in Central European Wheat

Science.gov (United States)

Liu, Guozheng; Zhao, Yusheng; Gowda, Manje; Longin, C. Friedrich H.; Reif, Jochen C.; Mette, Michael F.

2016-01-01

Bread-making quality traits are central targets for wheat breeding. The objectives of our study were to (1) examine the presence of major effect QTLs for quality traits in a Central European elite wheat population, (2) explore the optimal strategy for predicting the hybrid performance for wheat quality traits, and (3) investigate the effects of marker density and the composition and size of the training population on the accuracy of prediction of hybrid performance. In total 135 inbred lines of Central European bread wheat (Triticum aestivum L.) and 1,604 hybrids derived from them were evaluated for seven quality traits in up to six environments. The 135 parental lines were genotyped using a 90k single-nucleotide polymorphism array. Genome-wide association mapping initially suggested presence of several quantitative trait loci (QTLs), but cross-validation rather indicated the absence of major effect QTLs for all quality traits except of 1000-kernel weight. Genomic selection substantially outperformed marker-assisted selection in predicting hybrid performance. A resampling study revealed that increasing the effective population size in the estimation set of hybrids is relevant to boost the accuracy of prediction for an unrelated test population. PMID:27383841

Cortisol-binding globulin and meat quality in five European lines of pigs

NARCIS (Netherlands)

Geverink, N.A.; Foury, A.; Plastow, G.S.; Gil, L.; Gispert, M.; Hortós, M.; Font I Furnols, M.; Gort, G.; Moisan, M.P.; Mormède, P.

2006-01-01

The gene (Cbg) encoding cortisol-binding globulin (CBG) has been proposed as a candidate gene to explain genetic variation in cortisol secretion and carcass composition in pigs. The objective of this study was to evaluate the association between CBG and pork quality in 5 European breeding lines,

Quality improvement and emerging global health priorities

Science.gov (United States)

Mensah Abrampah, Nana; Syed, Shamsuzzoha Babar; Hirschhorn, Lisa R; Nambiar, Bejoy; Iqbal, Usman; Garcia-Elorrio, Ezequiel; Chattu, Vijay Kumar; Devnani, Mahesh; Kelley, Edward

2018-01-01

Abstract Quality improvement approaches can strengthen action on a range of global health priorities. Quality improvement efforts are uniquely placed to reorient care delivery systems towards integrated people-centred health services and strengthen health systems to achieve Universal Health Coverage (UHC). This article makes the case for addressing shortfalls of previous agendas by articulating the critical role of quality improvement in the Sustainable Development Goal era. Quality improvement can stimulate convergence between health security and health systems; address global health security priorities through participatory quality improvement approaches; and improve health outcomes at all levels of the health system. Entry points for action include the linkage with antimicrobial resistance and the contentious issue of the health of migrants. The work required includes focussed attention on the continuum of national quality policy formulation, implementation and learning; alongside strengthening the measurement-improvement linkage. Quality improvement plays a key role in strengthening health systems to achieve UHC. PMID:29873793

Exercise-based cardiac rehabilitation in twelve European countries results of the European cardiac rehabilitation registry

DEFF Research Database (Denmark)

Benzer, Werner; Rauch, Bernhard; Schmid, Jean-Paul

2017-01-01

AIM: Results from EuroCaReD study should serve as a benchmark to improve guideline adherence and treatment quality of cardiac rehabilitation (CR) in Europe. METHODS AND RESULTS: Data from 2.054 CR patients in 12 European countries were derived from 69 centres. 76% were male. Indication for CR...

How to Begin a Quality Improvement Project.

Science.gov (United States)

Silver, Samuel A; Harel, Ziv; McQuillan, Rory; Weizman, Adam V; Thomas, Alison; Chertow, Glenn M; Nesrallah, Gihad; Bell, Chaim M; Chan, Christopher T

2016-05-06

Quality improvement involves a combined effort among health care staff and stakeholders to diagnose and treat problems in the health care system. However, health care professionals often lack training in quality improvement methods, which makes it challenging to participate in improvement efforts. This article familiarizes health care professionals with how to begin a quality improvement project. The initial steps involve forming an improvement team that possesses expertise in the quality of care problem, leadership, and change management. Stakeholder mapping and analysis are useful tools at this stage, and these are reviewed to help identify individuals who might have a vested interest in the project. Physician engagement is a particularly important component of project success, and the knowledge that patients/caregivers can offer as members of a quality improvement team should not be overlooked. After a team is formed, an improvement framework helps to organize the scientific process of system change. Common quality improvement frameworks include Six Sigma, Lean, and the Model for Improvement. These models are contrasted, with a focus on the Model for Improvement, because it is widely used and applicable to a variety of quality of care problems without advanced training. It involves three steps: setting aims to focus improvement, choosing a balanced set of measures to determine if improvement occurs, and testing new ideas to change the current process. These new ideas are evaluated using Plan-Do-Study-Act cycles, where knowledge is gained by testing changes and reflecting on their effect. To show the real world utility of the quality improvement methods discussed, they are applied to a hypothetical quality improvement initiative that aims to promote home dialysis (home hemodialysis and peritoneal dialysis). This provides an example that kidney health care professionals can use to begin their own quality improvement projects. Copyright © 2016 by the American

IMPROVING CONCEPTUAL DESIGN QUALITY

DEFF Research Database (Denmark)

Bush, Stuart; Robotham, Antony John

1999-01-01

designer to identify clear targets for design improvement and to measure the effectiveness of any new solution, whilst attention to QFD ensures customer requirements are still being satisfied.Often, SME's are not aware of many of the best design practices and so are not able to meet the demand......This paper will consider how Quality Function Deployment (QFD) and Design for Manufacture and Assembly (DFMA) processes can be used to improve the design quality of products at the concept stage. We appreciate that both QFD and DFMA are techniques that have been used for some time by mature product...... quality is maintained in design project work. The projects described have been carried out with products manufactured by small to medium sized enterprises (SME's), where we have found significant opportunities for product improvement. The quantitative nature of DFMA analysis results allows the novice...

The distribution of chydorids (Branchiopoda, Anomopoda)in European shallow lakes and its application to ecological quality monitoring

NARCIS (Netherlands)

Eyto, de E.; Irvine, K.; Garcia-Criado, F.; Gyllström, M.; Jeppesen, E.; Kornijow, R.; Miracle, M.R.; Nykänen, M.; Bareiss, C.; Cerbin, S.; Salujoe, J.; Franken, R.J.M.; Stephens, D.; Moss, B.

2003-01-01

This study describes the chydorid (Branchiopoda, Anomopoda) assemblages from 66 European shallow lakes, and presents data relating the assemblages to lake type and ecological quality
This study describes the chydorid (Branchiopoda, Anomopoda) assemblages from 66 European shallow lakes, and

Power quality improvements of wind farms

Energy Technology Data Exchange (ETDEWEB)

Soebrink, Kent H. [Eltra (Denmark); Stoeber, Ralf; Schettler, Frank; Bergmann, Klaus [Siemens (Germany); Jenkins, Nicholas; Ekanayake, Janaka; Saad-Saoud, Zouhir; Liboa, Maria Luiza; Strbac, Goran [UMIST (United Kingdom); Kaas Pedersen, Joergen; Helgesen Pedersen, Knud Ole [Technical Univ. of Denmark (Denmark)

1998-06-01

The main objective of the project was to investigate how the power quality of the electrical output of wind farms could be improved by the use of modern high power electronic technology. Although the research is of direct application to wind energy it will also be relevant to many other types of small-scale generation embedded in utility distribution networks. The operation of wind turbines with asynchronous generators requires reactive power which, if supplied form the network, leads to low voltages and increased losses. In order to improve the power factor of the generation, fixed capacitors are usually used to provide reactive power. However, if they are sized for the full requirement of the wind farm, they can cause self-excitation and potentially damaging and hazardous overvoltages if the wind turbines` connection with the network is interrupted and they become islanded. An advanced Static VAr Compensator (ASVC) uses a power electronic converter to generate or absorb reactive power. They can be used to provide reactive power with rapid control and with only modestly sized passive components (i.e. small capacitors and reactors). The objective of the project was to combine research and development of this novel form of electronic equipment with its application to increase the use of renewable energy, and wind power in particular, in the European Union. (EG) 19 refs.

Continuous quality improvement

NARCIS (Netherlands)

Rohlin, Madeleine; Schaub, Rob M.H.; Holbrook, Peter; Leibur, Edvitar; Lévy, Gérard; Roubalikova, Lenka; Nilner, Maria; Roger-Leroi, Valerie; Danner, Gunter; Iseri, Haluk; Feldman, Cecile

2002-01-01

Versch. in: Eur J Dent Educ; 6 (Suppl. 3): 67–77 Continuous quality improvement (CQI) can be envisaged as a circular process of goal-setting, followed by external and internal evaluations resulting in improvements that can serve as goals for a next cycle. The need for CQI is apparent, because of

European guidelines for quality assurance in colorectal cancer screening and diagnosis. First Edition--Quality assurance in pathology in colorectal cancer screening and diagnosis.

Science.gov (United States)

Quirke, P; Risio, M; Lambert, R; von Karsa, L; Vieth, M

2012-09-01

Multidisciplinary, evidence-based guidelines for quality assurance in colorectal cancer screening and diagnosis have been developed by experts in a project coordinated by the International Agency for Research on Cancer. The full guideline document covers the entire process of population-based screening. It consists of 10 chapters and over 250 recommendations, graded according to the strength of the recommendation and the supporting evidence. The 450-page guidelines and the extensive evidence base have been published by the European Commission. The chapter on quality assurance in pathology in colorectal cancer screening and diagnosis includes 23 graded recommendations. The content of the chapter is presented here to promote international discussion and collaboration by making the principles and standards recommended in the new EU Guidelines known to a wider professional and scientific community. Following these recommendations has the potential to enhance the control of colorectal cancer through improvement in the quality and effectiveness of the screening process, including multi-disciplinary diagnosis and management of the disease. © Georg Thieme Verlag KG Stuttgart · New York.

Material and Non-material Determinants of European Youth's Life Quality

OpenAIRE

Gawlik, Remigiusz

2013-01-01

The paper confronts chosen approaches to quality of life studies with recent changes in post-crisis socio-economic environment. The focus is on European Youth at verge of entry into adult life. Presented research is a preliminary study for “The Application of Artificial Intelligence Methods for Analyzing Material and Non-material Determinants of Life Satisfaction between Young People from Developing Countries” project. Identifying and grouping the determinants of their life satisfaction could...

Improving quality of life in ageing populations: what can volunteering do?

Science.gov (United States)

Cattan, Mima; Hogg, Eddy; Hardill, Irene

2011-12-01

The year 2011 was declared the 'European Year of Volunteering' to recognise the contribution volunteers make to society. Such cross-national events reflect the high profile of volunteering and political imperatives to promote it. The purpose of this review is to provide a comprehensive review of current knowledge (articles published between 2005 and 2011) regarding the role of volunteering in improving older people's quality of life (QoL) and to identify areas requiring further research. Volunteering was defined as an activity that is freely chosen, does not involve remuneration and helps or benefits those beyond an individual's immediate family. Our search identified 22 studies and 5 review articles that addressed the benefits of volunteering on older people's quality of life. Most of the research had been conducted in the United States, Canada and Australia using data from longitudinal studies. The majority of the studies concluded that there is a positive association between older people's quality of life and engagement in volunteering. Due to the study designs and the heterogeneity of the research, causality is difficult to demonstrate and the knowledge the studies bring to the subject is variable. This review shows that volunteering may help to maintain and possibly improve some older adults' quality of life. However, there are still major gaps in our understanding of who actually benefits, the social and cultural context of volunteering and its role in reducing health and social inequalities. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Does competition improve health care quality?

Science.gov (United States)

Scanlon, Dennis P; Swaminathan, Shailender; Lee, Woolton; Chernew, Michael

2008-12-01

To identify the effect of competition on health maintenance organizations' (HMOs) quality measures. Longitudinal analysis of a 5-year panel of the Healthcare Effectiveness Data and Information Set (HEDIS) and Consumer Assessment of Health Plans Survey(R) (CAHPS) data (calendar years 1998-2002). All plans submitting data to the National Committee for Quality Assurance (NCQA) were included regardless of their decision to allow NCQA to disclose their results publicly. NCQA, Interstudy, the Area Resource File, and the Bureau of Labor Statistics. Fixed-effects models were estimated that relate HMO competition to HMO quality controlling for an unmeasured, time-invariant plan, and market traits. Results are compared with estimates from models reliant on cross-sectional variation. Estimates suggest that plan quality does not improve with increased levels of HMO competition (as measured by either the Herfindahl index or the number of HMOs). Similarly, increased HMO penetration is generally not associated with improved quality. Cross-sectional models tend to suggest an inverse relationship between competition and quality. The strategies that promote competition among HMOs in the current market setting may not lead to improved HMO quality. It is possible that price competition dominates, with purchasers and consumers preferring lower premiums at the expense of improved quality, as measured by HEDIS and CAHPS. It is also possible that the fragmentation associated with competition hinders quality improvement.

Towards European urinalysis guidelines. Introduction of a project under European Confederation of Laboratory Medicine.

Science.gov (United States)

Kouri, T T; Gant, V A; Fogazzi, G B; Hofmann, W; Hallander, H O; Guder, W G

2000-07-01

Improved standardized performance is needed because urinalysis continues to be one of the most frequently requested laboratory tests. Since 1997, the European Confederation of Laboratory Medicine (ECLM) has been supporting an interdisciplinary project aiming to produce European urinalysis guidelines. More than seventy clinical chemists, microbiologists and ward-based clinicians, as well as representatives of manufacturers are taking part. These guidelines aim to improve the quality and consistency of chemical urinalysis, particle counting and bacterial culture by suggesting optimal investigative processes that could be applied in Europe. The approach is based on medical needs for urinalysis. The importance of the pre-analytical stage for total quality is stressed by detailed illustrative advice for specimen collection. Attention is also given to emerging automated technology. For cost containment reasons, both optimum (ideal) procedures and minimum analytical approaches are suggested. Since urinalysis mostly lacks genuine reference methods (primary reference measurement procedures; Level 4), a novel classification of the methods is proposed: comparison measurement procedures (Level 3), quantitative routine procedures (Level 2), and ordinal scale examinations (Level 1). Stepwise strategies are suggested to save costs, applying different rules for general and specific patient populations. New analytical quality specifications have been created. After a consultation period, the final written text will be published in full as a separate document.

PUBLIC POLICY, QUALITY OF INTITUTION AND ECONOMIC GROWTH IN CENTRAL AND EASTERN EUROPEAN COUNTRIES

Directory of Open Access Journals (Sweden)

DOGARU DORIN-MADALIN

2015-04-01

, international exchange, freedom of exchange in capital and financial markets on economic growth is far from being negligible. Hence, the Central and Eastern European countries joining the EU should implement policies strength their institutions and to improve the quality of public decisions.

Moving up the Ladder: How Do States Deliver Quality Improvement Supports within Their Quality Rating and Improvement Systems? Brief

Science.gov (United States)

Holod, Aleksandra; Faria, Ann-Marie; Weinberg, Emily; Howard, Eboni

2015-01-01

As national attention has increasingly focused on the potential for high-quality early childhood education (ECE) to improve children's school readiness, states have developed quality rating and improvement systems (QRISs) to document the quality of ECE programs, support systematic quality improvement, and provide clear information to families…

Do private hospitals outperform public hospitals regarding efficiency, accessibility, and quality of care in the European Union? A literature review.

Science.gov (United States)

Kruse, Florien M; Stadhouders, Niek W; Adang, Eddy M; Groenewoud, Stef; Jeurissen, Patrick P T

2018-03-02

European countries have enhanced the scope of private provision within their health care systems. Privatizing services have been suggested as a means to improve access, quality, and efficiency in health care. This raises questions about the relative performance of private hospitals compared with public hospitals. Most systematic reviews that scrutinize the performance of the private hospitals originate from the United States. A systematic overview for Europe is nonexisting. We fill this gap with a systematic realist review comparing the performance of public hospitals to private hospitals on efficiency, accessibility, and quality of care in the European Union. This review synthesizes evidence from Italy, Germany, the United Kingdom, France, Greece, Austria, Spain, and Portugal. Most evidence suggests that public hospitals are at least as efficient as or are more efficient than private hospitals. Accessibility to broader populations is often a matter of concern in private provision: Patients with higher social-economic backgrounds hold better access to private hospital provision, especially in private parallel systems such as the United Kingdom and Greece. The existing evidence on quality of care is often too diverse to make a conclusive statement. In conclusion, the growth in private hospital provision seems not related to improvements in performance in Europe. Our evidence further suggests that the private (for-profit) hospital sector seems to react more strongly to (financial) incentives than other provider types. In such cases, policymakers either should very carefully develop adequate incentive structures or be hesitant to accommodate the growth of the private hospital sector. Copyright © 2018 John Wiley & Sons, Ltd.

Using Quality Tools and Methodologies to Improve a Hospital's Quality Position.

Science.gov (United States)

Branco, Daniel; Wicks, Angela M; Visich, John K

2017-01-01

The authors identify the quality tools and methodologies most frequently used by quality-positioned hospitals versus nonquality hospitals. Northeastern U.S. hospitals in both groups received a brief, 12-question survey. The authors found that 93.75% of the quality hospitals and 81.25% of the nonquality hospitals used some form of process improvement methodologies. However, there were significant differences between the groups regarding the impact of quality improvement initiatives on patients. The findings indicate that in quality hospitals the use of quality improvement initiatives had a significantly greater positive impact on patient satisfaction and patient outcomes when compared to nonquality hospitals.

The impact of leadership qualities on quality management improvement

Directory of Open Access Journals (Sweden)

Ph. D. Radoslaw Wolniak

2011-05-01

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

The impact of leadership qualities on quality management improvement

Directory of Open Access Journals (Sweden)

Radoslaw Wolniak

2011-12-01

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

Achieving Improvement Through Nursing Home Quality Measurement

OpenAIRE

Harris, Yael; Clauser, Steven B.

2002-01-01

CMS has initiated the Nursing Home Quality Initiative (NHQI) to improve the quality of nursing home care. Central to the NHQI is the public reporting of nursing home quality measures that serve as the basis for the Initiative's communication and quality improvement program. This article provides an overview of the NHQI, focusing on the role of nursing home quality measures in achieving improvements in nursing home care. We also describe the evolution of quality measurement in nursing homes, a...

European Network of Bipolar Research Expert Centre (ENBREC)

DEFF Research Database (Denmark)

Henry, Chantal; Andreassen, Ole A; Barbato, Angelo

2013-01-01

Bipolar disorders rank as one of the most disabling illnesses in working age adults worldwide. Despite this, the quality of care offered to patients with this disorder is suboptimal, largely due to limitations in our understanding of the pathology. Improving this scenario requires the development...... centres across Europe can collaborate on a wide range of basic science and clinical programmes using shared protocols. This paper is to describe the network and how it aims to improve the quality and effectiveness of research in a neglected priority area....... of a critical mass of expertise and multicentre collaborative projects. Within the framework of the European FP7 programme, we developed a European Network of Bipolar Research Expert Centres (ENBREC) designed specifically to facilitate EU-wide studies. ENBREC provides an integrated support structure...... facilitating research on disease mechanisms and clinical outcomes across six European countries (France, Germany, Italy, Norway, Spain and the UK). The centres are adopting a standardised clinical assessment that explores multiple aspects of bipolar disorder through a structured evaluation designed to inform...

European intercomparison workshops on air quality monitoring. Vol. 4. Measuring NO, NO{sub 2}, O{sub 3} and SO{sub 2}

Energy Technology Data Exchange (ETDEWEB)

Muecke, H.G.; Kollar, M. [Umweltbundesamt, Berlin (Germany). WHO-Zentrum zur Ueberwachung der Luftguete und Bekaempfung der Luftverschmutzung; Kratz, M.; Medem, A.; Rudolf, W.; Stummer, V.; Sukale, G. [Umweltbundesamt, Langen (Germany). UBA Pilotstation

2000-07-01

This report presents the results of two European Intercomparison Workshops on Air Quality Monitoring (NO, NO{sub 2}, O{sub 3}, and SO{sub 2}). The Workshops were a contribution to continuing quality assurance and quality control activities on air quality monitoring for Member States of the WHO European Region. Fourteen institutes mainly from Central and Eastern Europe used the opportunity to compare their measurement methods (15 manual methods and 24 monitors) and standards. (orig.)

Multiple case study in seven European countries regarding culture-sensitive classroom quality assessment

OpenAIRE

Slot, P.L.; Cadima, Joana; Salminen, Jenni; Pastori, Giulia; Lerkkanen, Marja-Kristiina

2016-01-01

This report presents the findings of a multiple case study, conducted in seven European countries to examine common and culturally differing aspects of curriculum, pedagogy, and quality of Early Childhood Education and Care (ECEC) provisions in Europe. This multiple case study involved intensive data collection on structural characteristics, process quality, implemented curricula and pedagogical approaches in four ECEC centers in each of the seven countries that were considered examples of ‘g...

Multiple case study in seven European countries regarding culture-sensitive classroom quality assessment

NARCIS (Netherlands)

Slot, P.L.|info:eu-repo/dai/nl/328192694; Cadima, Joana; Salminen, Jenni; Pastori, Giulia; Lerkkanen, Marja-Kristiina

This report presents the findings of a multiple case study, conducted in seven European countries to examine common and culturally differing aspects of curriculum, pedagogy, and quality of Early Childhood Education and Care (ECEC) provisions in Europe. This multiple case study involved intensive

EQUIP: A European Survey of Quality Criteria for the Evaluation of Databases.

Science.gov (United States)

Wilson, T. D.

1998-01-01

Reports on two stages of an investigation into the perceived quality of online databases. Presents data from 989 questionnaires from 600 database users in 12 European and Scandinavian countries and results of a test of the SERVQUAL methodology for identifying user expectations about database services. Lists statements used in the SERVQUAL survey.…

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

Directory of Open Access Journals (Sweden)

Cathy Kande

2014-01-01

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

Practical Approaches to Quality Improvement for Radiologists.

Science.gov (United States)

Kelly, Aine Marie; Cronin, Paul

2015-10-01

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

Quality of Care and Job Satisfaction in the European Home Care Setting: Research Protocol

Science.gov (United States)

van der Roest, Henriëtte; van Hout, Hein; Declercq, Anja

2016-01-01

Introduction: Since the European population is ageing, a growing number of elderly will need home care. Consequently, high quality home care for the elderly remains an important challenge. Job satisfaction among care professionals is regarded as an important aspect of the quality of home care. Aim: This paper describes a research protocol to identify elements that have an impact on job satisfaction among care professionals and on quality of care for older people in the home care setting of six European countries. Methods: Data on elements at the macro-level (policy), meso-level (care organisations) and micro-level (clients) are of importance in determining job satisfaction and quality of care. Macro-level indicators will be identified in a previously published literature review. At meso- and micro-level, data will be collected by means of two questionnaires utilsed with both care organisations and care professionals, and by means of interRAI Home Care assessments of clients. The client assessments will be used to calculate quality of care indicators. Subsequently, data will be analysed by means of linear and stepwise multiple regression analyses, correlations and multilevel techniques. Conclusions and Discussion: These results can guide health care policy makers in their decision making process in order to increase the quality of home care in their organisation, in their country or in Europe. PMID:28435423

Quality of Care and Job Satisfaction in the European Home Care Setting: Research Protocol

Directory of Open Access Journals (Sweden)

Liza Van Eenoo

2016-08-01

Full Text Available Introduction: Since the European population is ageing, a growing number of elderly will need home care. Consequently, high quality home care for the elderly remains an important challenge. Job satisfaction among care professionals is regarded as an important aspect of the quality of home care. Aim: This paper describes a research protocol to identify elements that have an impact on job satisfaction among care professionals and on quality of care for older people in the home care setting of six European countries. Methods: Data on elements at the macro-level (policy, meso-level (care organisations and micro-level (clients are of importance in determining job satisfaction and quality of care. Macro-level indicators will be identified in a previously published literature review. At meso- and micro-level, data will be collected by means of two questionnaires utilsed with both care organisations and care professionals, and by means of interRAI Home Care assessments of clients. The client assessments will be used to calculate quality of care indicators. Subsequently, data will be analysed by means of linear and stepwise multiple regression analyses, correlations and multilevel techniques. Conclusions and Discussion: These results can guide health care policy makers in their decision making process in order to increase the quality of home care in their organisation, in their country or in Europe.

European guidelines for quality assurance in cervical cancer screening. Summary of the supplements on HPV screening and vaccination

Directory of Open Access Journals (Sweden)

Lawrence von Karsa

2015-12-01

Full Text Available In a project coordinated by the International Agency for Research on Cancer (IARC 31 experts from 11 European countries and IARC have developed supplements to the current European guidelines for quality assurance in cervical cancer screening. The supplements take into account the potential of primary testing for human papillomavirus (HPV and vaccination against HPV infection to improve cervical cancer prevention and control and will be published by the European Commission in book format. They include 62 recommendations or conclusions for which the strength of the evidence and the respective recommendations is graded. While acknowledging the available evidence for more efficacious screening using HPV primary testing compared to screening based on cytology, the authors and editors of the supplements emphasize that appropriate policy and programme organization remain essential to achieve an acceptable balance between benefit and harm of any screening or vaccination programme. A summary of the supplements and all of the graded recommendations are presented here in journal format to make key aspects of the updated and expanded guidelines known to a wider professional and scientific community. Keywords: Mass screening, Vaccination, Cervical neoplasms, Human papillomavirus, Evidence-based guidelines, Population-based programme

European Guidelines for Quality Assurance in Cervical Cancer Screening. Second edition--summary document.

Science.gov (United States)

Arbyn, M; Anttila, A; Jordan, J; Ronco, G; Schenck, U; Segnan, N; Wiener, H; Herbert, A; von Karsa, L

2010-03-01

European Guidelines for Quality Assurance in Cervical Cancer Screening have been initiated in the Europe Against Cancer Programme. The first edition established the principles of organised population-based screening and stimulated numerous pilot projects. The second multidisciplinary edition was published in 2008 and comprises approximately 250 pages divided into seven chapters prepared by 48 authors and contributors. Considerable attention has been devoted to organised, population-based programme policies which minimise adverse effects and maximise benefits of screening. It is hoped that this expanded guidelines edition will have a greater impact on countries in which screening programmes are still lacking and in which opportunistic screening has been preferred in the past. Other methodological aspects such as future prospects of human papillomavirus testing and vaccination in cervical cancer control have also been examined in the second edition; recommendations for integration of the latter technologies into European guidelines are currently under development in a related project supported by the European Union Health Programme. An overview of the fundamental points and principles that should support any quality-assured screening programme and key performance indicators are presented here in a summary document of the second guidelines edition in order to make these principles and standards known to a wider scientific community.

Nordic air quality co-benefits from European post-2012 climate policies

International Nuclear Information System (INIS)

Rypdal, Kristin; Rive, Nathan; Astroem, Stefan; Karvosenoja, Niko; Aunan, Kristin; Bak, Jesper L.; Kupiainen, Kaarle; Kukkonen, Jaakko

2007-01-01

Although climate policies target primarily CO 2 , they may indirectly have an impact on air pollutants and thus on air quality. Here we look specifically at the co-benefits of various European post-2012 climate policy scenarios related to air quality in the Nordic region. We analyse how caps on emissions, expansion of the European Union (EU) Emissions Trading System, carbon taxes, and Russian and non-EU Eastern Europe participation after 2012 will influence emissions, air quality, avoided abatement costs, welfare effects, the regional environment and human exposure to particulate matter in the Nordic countries. We find that stricter targets will contribute to reduced emissions of air pollutants, and benefits to ecosystems and human health, which would have required substantial abatement costs if achieved by application of 'end-of-pipe' measures. Due to the assumed use of the flexibility mechanisms, reductions in emissions in the Nordic countries are smaller than in other regions, but the Nordic countries benefit from reductions in emissions in nearby regions. The more sectors that are included in the emissions trading scheme, the greater the emission of air pollutants. If Eastern Europe and Russia were to abandon participation in a climate agreement, the EU and Norway would have to undertake more emission cuts at home in order to meet the same targets. This would benefit ecosystems in southern Scandinavia, but acidification would increase in the north because of increased emissions in Russia

Quality Improvement Initiatives in Inflammatory Bowel Disease.

Science.gov (United States)

Berry, Sameer K; Siegel, Corey A; Melmed, Gil Y

2017-08-01

This article serves as an overview of several quality improvement initiatives in inflammatory bowel disease (IBD). IBD is associated with significant variation in care, suggesting poor quality of care. There have been several efforts to improve the quality of care for patients with IBD. Quality improvement (QI) initiatives in IBD are intended to be patient-centric, improve outcomes for individuals and populations, and reduce costs-all consistent with "the triple aim" put forth by the Institute for Healthcare Improvement (IHI). Current QI initiatives include the development of quality measure sets to standardize processes and outcomes, learning health systems to foster collaborative improvement, and patient-centered medical homes specific to patients with IBD in shared risk models of care. Some of these programs have demonstrated early success in improving patient outcomes, reducing costs, improving patient satisfaction, and facilitating patient engagement. However, further studies are needed to evaluate and compare the effects of these programs over time on clinical outcomes in order to demonstrate long-term value and sustainability.

Improving quality of care in inflammatory bowel disease: what changes can be made today?

Science.gov (United States)

Panés, Julián; O'Connor, Marian; Peyrin-Biroulet, Laurent; Irving, Peter; Petersson, Joel; Colombel, Jean-Frédéric

2014-09-01

There are a number of gaps in our current quality of care for patients with inflammatory bowel diseases. This review proposes changes that could be made now to improve inflammatory bowel disease care. Evidence from the literature and clinical experience are presented that illustrate best practice for improving current quality of care of patients with inflammatory bowel diseases. Best care for inflammatory bowel disease patients will involve services provided by a multidisciplinary team, ideally delivered at a centre of excellence and founded on current guidelines. Dedicated telephone support lines, virtual clinics and networking may also provide models through which to deliver high-quality, expert integrated patient care. Improved physician-patient collaboration may improve treatment adherence, producing tangible improvements in disease outcomes, and may also allow patients to better understand the benefits and risks of a disease management plan. Coaching programmes and tools that improve patient self-management and empowerment are likely to be supported by payers if these can be shown to reduce long-term disability. Halting disease progression before there is widespread bowel damage and disability are ideal goals of inflammatory bowel disease management. Improving patient-physician communication and supporting patients in their understanding of the evidence base are vital for ensuring patient commitment and involvement in the long-term management of their condition. Furthermore, there is a need to create more centres of excellence and to develop inflammatory bowel disease networks to ensure a consistent level of care across different settings. Copyright © 2014 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

Process safety improvement-Quality and target zero

Energy Technology Data Exchange (ETDEWEB)

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

2008-11-15

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

Process safety improvement-Quality and target zero

International Nuclear Information System (INIS)

Van Scyoc, Karl

2008-01-01

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

Process safety improvement--quality and target zero.

Science.gov (United States)

Van Scyoc, Karl

2008-11-15

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

Clinical quality standards for radiotherapy

Science.gov (United States)

2012-01-01

Aim of the study The technological progress that is currently being witnessed in the areas of diagnostic imaging, treatment planning systems and therapeutic equipment has caused radiotherapy to become a high-tech and interdisciplinary domain involving staff of various backgrounds. This allows steady improvement in therapy results, but at the same time makes the diagnostic, imaging and therapeutic processes more complex and complicated, requiring every stage of those processes to be planned, organized, controlled and improved so as to assure high quality of services provided. The aim of this paper is to present clinical quality standards for radiotherapy as developed by the author. Material and methods In order to develop the quality standards, a comparative analysis was performed between European and Polish legal acts adopted in the period of 1980-2006 and the universal industrial ISO 9001:2008 standard, defining requirements for quality management systems, and relevant articles published in 1984-2009 were reviewed, including applicable guidelines and recommendations of American, international, European and Polish bodies, such as the American Association of Physicists in Medicine (AAPM), the European Society for Radiotherapy & Oncology (ESTRO), the International Atomic Energy Agency (IAEA), and the Organisation of European Cancer Institutes (OECI) on quality assurance and management in radiotherapy. Results As a result, 352 quality standards for radiotherapy were developed and categorized into the following three groups: 1 – organizational standards; 2 – physico-technical standards and 3 – clinical standards. Conclusion Proposed clinical quality standards for radiotherapy can be used by any institution using ionizing radiation for medical purposes. However, standards are of value only if they are implemented, reviewed, audited and improved, and if there is a clear mechanism in place to monitor and address failure to meet agreed standards. PMID:23788854

Ozone concentrations and damage for realistic future European climate and air quality scenarios

NARCIS (Netherlands)

Hendriks, C.; Forsell, N.; Kiesewetter, G.; Schaap, M.; Schöpp, W.

2016-01-01

Ground level ozone poses a significant threat to human health from air pollution in the European Union. While anthropogenic emissions of precursor substances (NOx, NMVOC, CH4) are regulated by EU air quality legislation and will decrease further in the future, the emissions of biogenic NMVOC (mainly

Quality Improvement and Learning in Productive Systems

OpenAIRE

Charles H. Fine

1986-01-01

Recent interest in product quality suggests that effort devoted to improving the quality of manufactured products may reduce unit costs. This conjecture---that improving quality can lower costs---challenges the traditional assumption that unit costs increase with increased quality assurance activities and has significant implications for quality management. By introducing the idea of a quality-based learning curve, this paper links the previously disjoint literatures of quality control and le...

Assessment of the effectiveness of European air quality policies and measures. Final report on Task 3.3. Survey to access successes and failures of the EU Air Quality Policies

International Nuclear Information System (INIS)

2004-01-01

The main objective of Task 3.3 of the title project was to survey the views of European policy makers and other stakeholders directly involved in air quality policy development and implementation on the successes and failures of the present European air quality policies. The survey also included several decisionmakers from the USA, Japan and Switzerland to learn about these countries' experiences with specific air quality policies. A list of approximately 90 people to be surveyed during the project was developed. The list included representatives from the European Commission, the European Parliament, national-level representatives from the Member States, including those designated by the CAFE Steering Group, along with representatives of local authorities, NGOs, industry and academia. The survey was conducted through a questionnaire and follow-up interviews. The questionnaire consists of four major parts. Part 1 includes questions about the impact of EU legislation on air quality. Part 2 is designed to learn about stakeholder opinions on the adequacy of Community-level measures with respect to air quality protection. Part 3 asks for opinions about various measures used in Community-level legislation on air quality as well as ideas for new or modified measures that could be effective in achieving better air quality in the EU. Part 4 includes questions about stakeholder involvement and transparency and was designed to assist with the implementation of Task 3.4 (on public participation and transparency) of the project. The analysis of responses for this part of the questionnaire is presented in the parallel Report for Task 3.4. The final version of the questionnaire used to interview European stakeholders is attached as Appendix II. For the decision-makers from the USA, Switzerland, and Japan a separate questionnaire was developed, and is attached as Appendix III. In all, the team received 49 responses from the 90 enquiries.

Improving care at cystic fibrosis centers through quality improvement.

Science.gov (United States)

Kraynack, Nathan C; McBride, John T

2009-10-01

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

Statistical methods for quality improvement

National Research Council Canada - National Science Library

Ryan, Thomas P

2011-01-01

...."-TechnometricsThis new edition continues to provide the most current, proven statistical methods for quality control and quality improvementThe use of quantitative methods offers numerous benefits...

Quality improvement in neurological surgery graduate medical education.

Science.gov (United States)

Parker, Scott L; McGirt, Matthew J; Asher, Anthony L; Selden, Nathan R

2015-04-01

There has been no formal, standardized curriculum for neurosurgical resident education in quality improvement. There are at least 2 reasons to integrate a formalized quality improvement curriculum into resident education: (1) increased emphasis on the relative quality and value (cost-effectiveness) of health care provided by individual physicians, and (2) quality improvement principles empower broader lifelong learning. An integrated quality improvement curriculum should comprise specific goals and milestones at each level of residency training. This article discusses the role and possible implementation of a national program for quality improvement in neurosurgical resident education. Copyright © 2015 Elsevier Inc. All rights reserved.

Indicators of prescribing quality in drug utilisation research : report of a European meeting (DURQUIM, 13-15 May 2004)

NARCIS (Netherlands)

Hoven, JL; Haaijer-Ruskamp, FM; Vander Stichele, RH

An invitational expert meeting on indicators of prescribing quality was held on 13-15 May 2004, bringing together-from 19 European countries, the US, Canada, and Australia-40 researchers specialized in the development and application of indicators. The meeting was organized by the European Drug

European Educational Research Quality Indicators (EERQI): A first prototype framework of intrinsic and extrinsic indicators

NARCIS (Netherlands)

Mooij, Ton

2011-01-01

Mooij, T. (2011, 15-16 March). European Educational Research Quality Indicators (EERQI): A first prototype framework of intrinsic and extrinsic indicators. Paper presented at the final EERQI conference, Brussels, University Foundation.

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

Science.gov (United States)

Jardim, Kevin P.

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

The effect of certification and accreditation on quality management in 4 clinical services in 73 European hospitals.

NARCIS (Netherlands)

Shaw, C.D.; Groene, O.; Botje, D.; Suñol, R.; Kutryba, B.; Klazinga, N.; Bruneau, C.; Hammer, A.; Wang, A.; Arah, O.A.; Wagner, C.

2014-01-01

Objective: To investigate the relationship between ISO 9001 certification, healthcare accreditation and quality management in European hospitals. Design: A mixed method multi-level cross-sectional design in seven countries. External teams assessed clinical services on the use of quality management

European supply chain for valve springs

Energy Technology Data Exchange (ETDEWEB)

Barthold, G. [Scherdel GmbH, Marktredwitz (Germany); Thureborn, D.; Hallberg, M. [Haldex Garphyttan AB (Sweden); Janssen, P. [Mittal Steel Ruhrort GmbH / Mittal Steel Hochfeld GmbH (Germany)

2005-07-01

Forced by the Kobe earthquake in 1995 and the lack of valve spring steel on the world market due to damages of the Kobe steel plant, the development of a European supply chain has been sped up. End of 1994 a super clean valve spring steel with a reasonable quality from a European source was available. A strong relationship between the steel producer (Mittal), the wire manufacturer (Haldex Garphyttan) and the spring maker (Scherdel) was established. A working group of the three companies holds meetings on a regular basis to discuss quality and development issues. Over the last years the supply chain has achieved significant improvements in terms of cleanliness and decarburisation of the wire rod. The continuous common advancement of the valve spring quality has enabled the valve spring failures in the field to be reduced to < 0.1 ppm. The development and market launch of new grades has been prepared. (orig.)

European beef consumers' interest in a beef eating-quality guarantee

DEFF Research Database (Denmark)

Verbeke, Wim; Van Wezemael, Lyn; de Barcellos, Marcia Dutra

2010-01-01

and Germany to assess their opinions about beef muscle profiling and their interest in a beef eating-quality guarantee. Findings indicate that both concepts are well accepted by European beef consumers, although not unconditional. Besides acknowledging the opportunity to purchase beef with guaranteed...... tenderness, consumers express some reserve related to the possible upgrading of lower value cuts, too much standardisation, and the fact that tenderness is to some extent subjective. They further require the system to be simple, sufficiently documented and independent-party controlled. The insights obtained...

Quality of life in patients with schizophrenia in five European countries: the EPSILON study

NARCIS (Netherlands)

Gaite, L.; Vázquez-Barquero, J. L.; Borra, C.; Ballesteros, J.; Schene, A.; Welcher, B.; Thornicroft, G.; Becker, T.; Ruggeri, M.; Herrán, A.

2002-01-01

Objective: To compare subjective quality of life (QOL) and objective, QOL indicators in patients with schizophrenia from five European sites: Amsterdam, Copenhagen, London, Santander and Verona. Method: A representative sample of 404 patients with schizophrenia, in contact with mental health

Improving Family Meetings in Intensive Care Units: A Quality Improvement Curriculum.

Science.gov (United States)

Gruenewald, David A; Gabriel, Michelle; Rizzo, Dorothy; Luhrs, Carol A

2017-07-01

Family meetings in the intensive care unit are associated with beneficial outcomes for patients, their families, and health care systems, yet these meetings often do not occur in a timely, effective, reliable way. The Department of Veterans Affairs Comprehensive End-of-Life Care Implementation Center sponsored a national initiative to improve family meetings in Veterans Affairs intensive care units across the United States. Process measures of success for the initiative were identified, including development of a curriculum to support facility-based quality improvement projects to implement high-quality family meetings. Identified curriculum requirements included suitability for distance learning and applicability to many clinical intensive care units. Curriculum modules were cross-mapped to the "Plan-Do-Study-Act" model to aid in planning quality improvement projects. A questionnaire was e-mailed to users to evaluate the curriculum's effectiveness. Users rated the curriculum's effectiveness in supporting and achieving aims of the initiative as 3.6 on a scale of 0 (not effective) to 4 (very effective). Users adapted the curriculum to meet local needs. The number of users increased from 6 to 17 quality improvement teams in 2 years. All but 3 teams progressed to implementation of an action plan. Users were satisfied with the effectiveness and adaptability of a family-meeting quality improvement curriculum to support implementation of a quality improvement project in Veterans Affairs intensive care units. This tool may be useful in facilitating projects to improve the quality of family meetings in other intensive care units. ©2017 American Association of Critical-Care Nurses.

The information system of learning quality control in higher education institutions: achievements and problems of European universities

Directory of Open Access Journals (Sweden)

Orekhova Elena

2016-01-01

Full Text Available The article deals with the main trends in the development of the system of learning quality control connected with the European integration of higher education and the democratization of education. The authors analyze the state of information systems of learning quality control existing in European higher education and identify their strong and weak points. The authors show that in the learning process universities actively use innovative analytic methods as well as modern means of collecting, storing and transferring information that ensure the successful management of such a complex object as the university of the 21st century.

Human Capital Questionnaire: Assessment of European nurses' perceptions as indicators of human capital quality.

Science.gov (United States)

Yepes-Baldó, Montserrat; Romeo, Marina; Berger, Rita

2013-06-01

Healthcare accreditation models generally include indicators related to healthcare employees' perceptions (e.g. satisfaction, career development, and health safety). During the accreditation process, organizations are asked to demonstrate the methods with which assessments are made. However, none of the models provide standardized systems for the assessment of employees. In this study, we analyzed the psychometric properties of an instrument for the assessment of nurses' perceptions as indicators of human capital quality in healthcare organizations. The Human Capital Questionnaire was applied to a sample of 902 nurses in four European countries (Spain, Portugal, Poland, and the UK). Exploratory factor analysis identified six factors: satisfaction with leadership, identification and commitment, satisfaction with participation, staff well-being, career development opportunities, and motivation. The results showed the validity and reliability of the questionnaire, which when applied to healthcare organizations, provide a better understanding of nurses' perceptions, and is a parsimonious instrument for assessment and organizational accreditation. From a practical point of view, improving the quality of human capital, by analyzing nurses and other healthcare employees' perceptions, is related to workforce empowerment. © 2012 Wiley Publishing Asia Pty Ltd.

Modern European monographs for quality control of Chinese herbs.

Science.gov (United States)

Bauer, Rudolf; Franz, Gerhard

2010-12-01

The actual concern about the safety and efficacy of herbal drugs originating from traditional Chinese medicine (TCM) is based on observations that these medicinal plants may have a high risk potential due to insufficient definitions, problems with identity, purity and falsifications. No uniform legal status for these groups of herbal drugs currently exists in the European Union. For quality control, monographs for TCM herbs can mainly be found in the Pharmacopoeia of the Peoples Republic of China. Based on these facts the Commission of the European Pharmacopoeia decided in 2005 to establish TCM-herbal drug monographs for the most important medicinal plants imported from Far East. These new monographs had to be established and evaluated on the basis of existing monographs in the Chinese Pharmacopoeia (ChP), English edition 2005. Due to important differences in the overall features of EP and ChP, a simple adapt/adopt procedure was not feasible. Therefore, specialist groups were mandated with a corresponding working programme. Some results and actual problems related to this working programme will be presented and discussed. © Georg Thieme Verlag KG Stuttgart · New York.

European Society of Gynaecological Oncology Guidelines for the Management of Patients With Vulvar Cancer

NARCIS (Netherlands)

Oonk, Maaike H. M.; Planchamp, Francois; Baldwin, Peter; Bidzinski, Mariusz; Brannstrom, Mats; Landoni, Fabio; Mahner, Sven; Mahantshetty, Umesh; Mirza, Mansoor; Petersen, Cordula; Querleu, Denis; Regauer, Sigrid; Rob, Lukas; Rouzier, Roman; Ulrikh, Elena; van der Velden, Jacobus; Vergote, Ignace; Woelber, Linn; van der Zee, Ate G. J.

Objective The aim of this study was to develop clinically relevant and evidence-based guidelines as part of European Society of Gynaecological Oncology's mission to improve the quality of care for women with gynecologic cancers across Europe. Methods The European Society of Gynaecological Oncology

European Society of Gynaecological Oncology Guidelines for the Management of Patients With Vulvar Cancer

NARCIS (Netherlands)

Oonk, Maaike H. M.; Planchamp, François; Baldwin, Peter; Bidzinski, Mariusz; Brännström, Mats; Landoni, Fabio; Mahner, Sven; Mahantshetty, Umesh; Mirza, Mansoor; Petersen, Cordula; Querleu, Denis; Regauer, Sigrid; Rob, Lukas; Rouzier, Roman; Ulrikh, Elena; van der Velden, Jacobus; Vergote, Ignace; Woelber, Linn; van der Zee, Ate G. J.

2017-01-01

The aim of this study was to develop clinically relevant and evidence-based guidelines as part of European Society of Gynaecological Oncology's mission to improve the quality of care for women with gynecologic cancers across Europe. The European Society of Gynaecological Oncology Council nominated

Quality improvement through multiple response optimization

International Nuclear Information System (INIS)

Noorossana, R.; Alemzad, H.

2003-01-01

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

The implications of economic development, climate change and European Water Policy on surface water quality threats

Directory of Open Access Journals (Sweden)

Jolanta Dąbrowska

2017-06-01

Full Text Available The paper presents historical background, up-to-date situation and future perspectives for the development of nutrient pollution threats to European surface water quality, as well as the evolution of the approach to water pollution. Utilized agricultural area in European countries is slightly diminishing, however the consumption of mineral fertilisers is steadily increasing. The consumption in Europe in the years 2015–2030 is projected to increase by 10%, and in the world by 20%. Both climate changes leading to the increase of temperature even of ca. 6°C (in comparison to the pre-industrial period and accelerated soil erosion due to high intensity rainfall cause increased productivity of water ecosystems. Those aspects have to be taken into consideration in water management. Due to legal regulations introduced in the last twenty years, wastewater treatment has been made more effective and population connected to wastewater treatment systems has increased. The improvement has been seen mainly in eastern and southern parts of Europe. After the implementation of Water Framework Directive theories regarding modern water management have been developed, with the aim to increase the ecosystem’s capacity and its resilience to climate changes and anthropopressure.

Preanalytical quality improvement : in quality we trust

OpenAIRE

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

2013-01-01

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

Methodology for Evaluating Quality and Reusability of Learning Objects

Science.gov (United States)

Kurilovas, Eugenijus; Bireniene, Virginija; Serikoviene, Silvija

2011-01-01

The aim of the paper is to present the scientific model and several methods for the expert evaluation of quality of learning objects (LOs) paying especial attention to LOs reusability level. The activities of eQNet Quality Network for a European Learning Resource Exchange (LRE) aimed to improve reusability of LOs of European Schoolnet's LRE…

Health-related quality of life in European women following myocardial infarction: a cross-sectional study.

Science.gov (United States)

Lidell, Evy; Höfer, Stefan; Saner, Hugo; Perk, Joep; Hildingh, Cathrine; Oldridge, Neil

2015-08-01

Coronary heart disease is a major contributor to women's health problems. Self-perceived social support, well-being and health-related quality of life (HRQL) were documented in the cross-sectional HeartQoL survey of European women one and six months after a myocardial infarction. European women were recruited in 18 European countries and grouped into four geographical regions (Southern Europe, Northern Europe, Western Europe and Eastern Europe). Continuous socio-demographic variables and categorical variables were compared by age and region with ANOVA and χ(2), respectively; multiple regression models were used to identify predictors of social support, well-being and HRQL. Women living in the Eastern European region rated social support, well-being and HRQL significantly lower than women in the other regions. Older women had lower physical HRQL scores than younger women. Eastern European women rated social support, well-being and HRQL significantly lower than women in the other regions. Prediction of the dependent variables (social support, well-being and HRQL) by socio-demographic factors varied by total group, in the older age group, and by region; body mass index and managerial responsibility were the most consistent significant predictors. © The European Society of Cardiology 2014.

Quality improvement in pediatrics: past, present, and future.

Science.gov (United States)

Schwartz, Stephanie P; Rehder, Kyle J

2017-01-01

Almost two decades ago, the landmark report "To Err is Human" compelled healthcare to address the large numbers of hospitalized patients experiencing preventable harm. Concurrently, it became clear that the rapidly rising cost of healthcare would be unsustainable in the long-term. As a result, quality improvement methodologies initially rooted in other high-reliability industries have become a primary focus of healthcare. Multiple pediatric studies demonstrate remarkable quality and safety improvements in several domains including handoffs, catheter-associated blood stream infections, and other serious safety events. While both quality improvement and research are data-driven processes, significant differences exist between the two. Research utilizes a hypothesis driven approach to obtain new knowledge while quality improvement often incorporates a cyclic approach to translate existing knowledge into clinical practice. Recent publications have provided guidelines and methods for effectively reporting quality and safety work and improvement implementations. This review examines not only how quality improvement in pediatrics has led to improved outcomes, but also looks to the future of quality improvement in healthcare with focus on education and collaboration to ensure best practice approaches to caring for children.

Comparative Analysis of the Specifications on the Power Quality of the European Union and the Russian Federation

Science.gov (United States)

Ded, A. V.; Maltsev, V. N.; Sikorski, S. P.

2018-04-01

Since July 2014 the interstate standard GOST 32144-2013 is the only document that defines standard requirements for the power quality in the territory of the Russian Federation. The new standard preamble specifies that this document considers the requirements of the European regional standard EN 50160-2010. However, GOST authors established the degree of standards conformity as nonequivalent. In connection with Russia's accession to the World Trade Organization (WTO) all requirements for goods including electric energy should correspond the international standard requirements. The article analyzes the above standard requirements and assesses the requirements for the power quality standards used in the European Union and in the Russian Federation.

E-CUSTOMS PROGRAMME - NEW QUALITY OF SERVICES PROVIDED BY CUSTOMS ADMINISTRATIONS TO EUROPEAN BUSINESS

Directory of Open Access Journals (Sweden)

Małgorzata Czermińska

2016-09-01

Full Text Available E-Customs initiative includes a number of IT projects, organizational and legal measures. They are designed to creation of a simple and paperless environment for trade and customs, to short the duration of customs clearance and to ensure an appropriate level of security of commercial transactions. Modern customs administration must operate on the basis of advanced infrastructure in the field of information and communication technologies. Only then will it be able to provide cheaper and more efficient customs services. Therefore, the greatest challenge and the main goal of the e-Customs programme is to harmonize customs procedures and systems in the 28 Member States. The article describes the assumptions and objectives of the e-Customs, presents its genesis and evolution. Particular attention was paid to the activities that are aimed at improving the quality of customs services provided to European companies.

Integration of quality improvement and cost-efficiency through industrial improvement techniques

Directory of Open Access Journals (Sweden)

Vink JP

2016-06-01

Full Text Available Jasper P Vink,1 Maxime T Rigaudy,1,2 Karl O Elmqvist11Imperial College Business School, Imperial College London, London, 2Hull York Medical School, York, UKIn this journal, Crema and Verbano1 discussed the importance of defining quality of health care and how quality can be improved through various industrial instruments and techniques. Quality of health care is a heavily debated topic that requires a wide scope of considerations across the many stakeholders of the health system. We acknowledge Crema and Verbano’s arguments that patient safety is a basic pillar of quality, upon which we would like to expand by highlighting the clinical effectiveness and patient-reported outcomes, which are the two further crucial components of quality. The arguments made regarding quality improvement techniques and cost efficiency in health care provision are insightful, yet appear to make a distinction between efforts to improve quality, eliminate waste from processes, and cut costs in health care provision. We would argue that in fact these achievements are all closely related and can be achieved simultaneously, if the industrial techniques of quality management are applied adequately.View the original paper by Crema and Verbano.

Towards a Diagnostic Instrument to Identify Improvement Opportunities for Quality Controlled Logistics in Agrifood Supply Chain Networks

Directory of Open Access Journals (Sweden)

Jack G.A.J. van der Vorst

2011-10-01

Full Text Available  Western-European consumers have become not only more demanding on product availability in retail outlets but also on other food attributes such as quality, integrity, and safety. When (redesigning food supply-chain networks, from a logistics point of view, one has to consider these demands next to traditional efficiency and responsiveness requirements. The concept ‘quality controlled logistics’ (QCL hypothesizes that if product quality in each step of the supply chain can be predicted in advance, goods flows can be controlled in a pro-active manner and better chain designs can be established resulting in higher product availability, constant quality, and less product losses. The paper discusses opportunities of using real-time product quality information for improvement of the design and management of ‘AgriFood Supply Chain Networks’, and presents a preliminary diagnostic instrument for assessment of ‘critical quality’ and ‘logistics control’ points in the supply chain network. Results of a tomato-chain case illustrate the added value of the QCL concept for identifying improvement opportunities in the supply chain as to increase both product availability and quality. Future research aims for the further development of the diagnostic instrument and the quantification of costs and benefits of QCL scenarios.

Improving and monitoring air quality.

Science.gov (United States)

DuPont, André

2018-05-01

Since the authorization of the Clean Air Act Amendments of 1990, the air quality in the USA has significantly improved because of strong public support. The lessons learned over the last 25 years are being shared with the policy analysts, technical professionals, and scientist who endeavor to improve air quality in their communities. This paper will review how the USA has achieved the "high" standard of air quality that was envisioned in the early 1990s. This document will describe SO 2 gas emission reduction technology and highlight operation of emission monitoring technology. This paper describes the basic process operation of an air pollution control scrubber. A technical review of measures required to operate and maintain a large-scale pollution control system will be described. Also, the author explains how quality assurance procedures in performance of continuous emission monitoring plays a significant role in reducing air pollution.

Professional Training of Junior Medical Staff: European Experience

Science.gov (United States)

Iliasova, Yuliia

2017-01-01

The article covers current problems of professional training of junior medical staff. The main disadvantages of Ukrainian system of medical education that impede the intention of improving quality of professional training of junior medical staff have been analyzed. European experience in organizing medical education, namely, in Great Britain,…

[QUIPS: quality improvement in postoperative pain management].

Science.gov (United States)

Meissner, Winfried

2011-01-01

Despite the availability of high-quality guidelines and advanced pain management techniques acute postoperative pain management is still far from being satisfactory. The QUIPS (Quality Improvement in Postoperative Pain Management) project aims to improve treatment quality by means of standardised data acquisition, analysis of quality and process indicators, and feedback and benchmarking. During a pilot phase funded by the German Ministry of Health (BMG), a total of 12,389 data sets were collected from six participating hospitals. Outcome improved in four of the six hospitals. Process indicators, such as routine pain documentation, were only poorly correlated with outcomes. To date, more than 130 German hospitals use QUIPS as a routine quality management tool. An EC-funded parallel project disseminates the concept internationally. QUIPS demonstrates that patient-reported outcomes in postoperative pain management can be benchmarked in routine clinical practice. Quality improvement initiatives should use outcome instead of structural and process parameters. The concept is transferable to other fields of medicine. Copyright © 2011. Published by Elsevier GmbH.

Deepening our understanding of quality improvement in Europe (DUQuE): overview of a study of hospital quality management in seven countries.

Science.gov (United States)

Secanell, Mariona; Groene, Oliver; Arah, Onyebuchi A; Lopez, Maria Andrée; Kutryba, Basia; Pfaff, Holger; Klazinga, Niek; Wagner, Cordula; Kristensen, Solvejg; Bartels, Paul Daniel; Garel, Pascal; Bruneau, Charles; Escoval, Ana; França, Margarida; Mora, Nuria; Suñol, Rosa

2014-04-01

This paper provides an overview of the DUQuE (Deepening our Understanding of Quality Improvement in Europe) project, the first study across multiple countries of the European Union (EU) to assess relationships between quality management and patient outcomes at EU level. The paper describes the conceptual framework and methods applied, highlighting the novel features of this study. DUQuE was designed as a multi-level cross-sectional study with data collection at hospital, pathway, professional and patient level in eight countries. We aimed to collect data for the assessment of hospital-wide constructs from up to 30 randomly selected hospitals in each country, and additional data at pathway and patient level in 12 of these 30. A comprehensive conceptual framework was developed to account for the multiple levels that influence hospital performance and patient outcomes. We assessed hospital-specific constructs (organizational culture and professional involvement), clinical pathway constructs (the organization of care processes for acute myocardial infarction, stroke, hip fracture and deliveries), patient-specific processes and outcomes (clinical effectiveness, patient safety and patient experience) and external constructs that could modify hospital quality (external assessment and perceived external pressure). Data was gathered from 188 hospitals in 7 participating countries. The overall participation and response rate were between 75% and 100% for the assessed measures. This is the first study assessing relation between quality management and patient outcomes at EU level. The study involved a large number of respondents and achieved high response rates. This work will serve to develop guidance in how to assess quality management and makes recommendations on the best ways to improve quality in healthcare for hospital stakeholders, payers, researchers, and policy makers throughout the EU.

Searching for (un)sustainabilty in pangasius aquaculture: A political economy of quality in European retail

NARCIS (Netherlands)

Bush, S.R.; Duijf, M.

2011-01-01

Drawing on a political economy of food quality, this paper investigates the main sources of uncertainty over the environmental sustainability of Vietnamese pangasius catfish in European markets and how retailers subsequently respond to these uncertainties. Based on media survey and interviews with

42 CFR 441.474 - Quality assurance and improvement plan.

Science.gov (United States)

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Quality assurance and improvement plan. 441.474... improvement plan. (a) The State must provide a quality assurance and improvement plan that describes the State... pursue opportunities for system improvement. (b) The quality assurance and improvement plan shall also...

Influence of the water quality improvement on fish population in the Seine River (Paris, France) over the 1990-2013 period.

Science.gov (United States)

Azimi, Sam; Rocher, Vincent

2016-01-15

Over the past 20 years, rules concerning wastewater treatment and quality of water discharged into the environment have changed considerably. Huge investments have been made in Paris conurbation to improve waste water treatment processes in accordance with the European Water Framework Directive. The interdepartmental association for sewage disposal in Paris conurbation (SIAAP) carried out a monitoring of both fish assemblages and water quality in the Seine River around the Paris conurbation (France) since the early 90's. The main goal of this study was to estimate the influence of the water quality improvement on fish. On one hand, the study confirmed the improvement of the water quality (dissolved oxygen, ammonia nitrogen, organic matter) in the Seine River, mostly focused downstream of Paris conurbation. On the other hand, an increase of the number of species occurred from 1990 (14) to 2013 (21). Moreover, changes in the river Seine assemblages happened over that 23-year period with emergence of sensitive species (ruffe, scalpin and pike-perch). The improvement of the water quality was also reported with respect to the Index of Biotic Integrity (IBI). However, no variation of pollutant concentrations in roach, eel and chub muscles has been observed. An exceedance of the environmental quality standards have even been reported all over this period as regards mercury and organochlorine.

European commission contribution to improving off-site emergency preparedness

International Nuclear Information System (INIS)

Kelly, G.N.

1996-01-01

Increasing attention is being given by the European Commission to off-site emergency preparedness as part of its broader contribution to improving nuclear safety in Eastern Europe. The main initiatives being taken or planned by the Commission in this area are summarized. Particular attention is given to two topics: firstly, the development of the RODOS (Real-time On-line Decision Support) system for supporting off-site emergency management in the event of a nuclear accident; and, secondly, the work of an Inter-Service Group on nuclear Off-Site Emergency Preparedness (OSEP) in Eastern Europe that has recently been established within the Commission. The contribution that each is making to improving emergency preparedness, both in Eastern Europe and in Europe more widely, is described

Methodology of quality improvement projects for the Texas Medicare population.

Science.gov (United States)

Pendergrass, P W; Abel, R L; Bing, M; Vaughn, R; McCauley, C

1998-07-01

The Texas Medical Foundation, the quality improvement organization for the state of Texas, develops local quality improvement projects for the Medicare population. These projects are developed as part of the Health Care Quality Improvement Program undertaken by the Health Care Financing Administration. The goal of a local quality improvement project is to collaborate with providers to identify and reduce the incidence of unintentional variations in the delivery of care that negatively impact outcomes. Two factors are critical to the success of a quality improvement project. First, as opposed to peer review that is based on implicit criteria, quality improvement must be based on explicit criteria. These criteria represent key steps in the delivery of care that have been shown to improve outcomes for a specific disease. Second, quality improvement must be performed in partnership with the health care community. As such, the health care community must play an integral role in the design and evaluation of a quality improvement project and in the design and implementation of the resulting quality improvement plan. Specifically, this article provides a historical perspective for the transition from peer review to quality improvement. It discusses key steps used in developing and implementing local quality improvement projects including topic selection, quality indicator development, collaborator recruitment, and measurement of performance/improvement. Two Texas Medical Foundation projects are described to highlight the current methodology and to illustrate the impact of quality improvement projects.

25 years of European Union (EU) quality schemes for agricultural products and foodstuffs across EU Member States.

Science.gov (United States)

Albuquerque, Tânia G; Oliveira, M Beatriz Pp; Costa, Helena S

2018-05-01

Consumers are increasingly turning their attention to the quality and origin of products that they consume. European Union (EU) quality schemes are associated with a label, which was introduced to allow consumers to perform an informed choice and to protect producers from unfair practices. This present study provides an overview of the last 25 years of EU quality schemes [Protected Designations of Origin (PDO), Protected Geographical Indications (PGI) and Traditional Specialities Guaranteed (TSG)] on agricultural products and foodstuffs across the 28 EU Member States. According to the results, it was possible to conclude that Southern European countries have the highest number of registered products. The most used EU quality scheme is PGI, followed by PDO. Concerning the analysis of the evolution in the last 25 years, the number of registered products among EU Member States has increased significantly. The fruit, vegetables and cereals (fresh or processed) category is the one that accounts for the highest percentage (26.8%) of registered products, followed by cheeses and meat products (cooked, salted, smoked) categories, with 17.2% and 13.5%, respectively. Further investigations should address consumer preferences, knowledge and attitudes, especially Northern European countries with a lower number of registered products. Moreover, the investigation and registration of products should be encouraged among all EU Member States to allow the maintenance of important elements of the history, culture and heritage of the local areas, regions and countries. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

[General practice has to contribute to the continuous improvement of quality of care and integrate health promotion].

Science.gov (United States)

Vanmeerbeek, Marc

2009-09-01

Quality of care in general practice is mainly based on effectiveness of clinical and inter-personal care, and access to care. Assessment has to focus on structures and processes, more than on outcomes. The sets of clinical indicators used in some european countries, though good starting points are still incomplete to encompass the complexity of activity. Assessment of care quality by the public authorities must be acceptable to the doctors who are the object of this assessment; otherwise its conclusions will be rejected. Continuous quality improvement can maintain quality of care at a high level and maintain costs under control. Health has to be managed, and doctors have a collective responsibility towards their patients. The procedures of the quality cycle are applicable in general practice for the development of community-based projects of health promotion, within the network of care. The discipline can find in it a new lease of life and perhaps curb the loss of interest among young doctors.

[European Union regulatory and quality requirements for botanical drugs and their implications for Chinese herbal medicinal products development].

Science.gov (United States)

Zhu, You-Ping

2017-06-01

This paper introduces regulatory pathways and characteristic quality requirements for marketing authorization of herbal medicinal products in the European Union（EU）, and the legal status and applications of "European Union list of herbal substances, preparations and combinations" and "European Union herbal monographs". Also introduced are Chinese herbs that have been granted the EU list entry, those with EU herbal monographs, and registered EU traditional herbal medicinal products with Chinese herbs as active ingredients. Special attention is paid to the technical details of three authorized EU herbal medicinal products (Veregen, Sativex and Episalvan) in comparison with Andrographis paniculata extract HMPL-004 that failed the phase Ⅲ clinical trial for ulcerative colitis. The paper further emphasizes the importance of enriching active fractions of herbal extracts and taking regulatory and quality considerations into account in early stage of botanical drug development. Copyright© by the Chinese Pharmaceutical Association.

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

Science.gov (United States)

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

1995-01-01

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

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

Science.gov (United States)

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

2013-01-01

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

Improving Indoor Air Quality

Science.gov (United States)

Usually the most effective way to improve indoor air quality is to eliminate individual sources of pollution or to reduce their emissions. Some sources, like those that contain asbestos, can be sealed or enclosed.

Providing Quality Therapeutics in Switzerland: Role of the Stakeholders and Recent Incentives for Further Improvements.

Science.gov (United States)

Besson, Marie; Samer, Caroline; Rollason, Victoria; Dayer, Pierre; Desmeules, Jules

2015-07-01

Quality therapeutics play an important role in Switzerland's health care and economy. Switzerland holds a key position in the world of research and development, as well as in drug production. Recently, new emphasis has been placed on promoting clinical research and maintaining Switzerland's position as a center of excellence in the field. Recent revisions to the law regarding medical trials in human research allow for better allocation of regulatory resources and simplified procedures for drugs already authorized in Switzerland. The country has its own regulatory agency, the Swiss Agency for Therapeutic Products (Swissmedic), which is a public institution of the Swiss government. Swissmedic is responsible for ensuring safety in medicines, particularly regarding authorizations and market surveillance in the sector of medicinal products and medical devices. Although the centralized authorization procedure of the European Union for medicines does not apply to Switzerland, there are mutual recognition mechanisms between the Swiss medicine regulatory authority and the European Medicines Agency. Swissmedic is also in charge of postmarketing safety and oversees the national pharmacovigilance center, which collaborates closely with the World Health Organization center in Uppsala. In addition, university hospital-based clinical pharmacologists, who are involved in basic science and clinical research, regulatory affairs, ethics committees, and pharmacovigilance, promote quality therapeutics. This article discusses the role of the various stakeholders and the recent efforts made to provide a better allocation of resources aimed at further improving quality therapeutics in Switzerland. Copyright © 2015 Elsevier HS Journals, Inc. All rights reserved.

Improving PSA quality of KSNP PSA model

International Nuclear Information System (INIS)

Yang, Joon Eon; Ha, Jae Joo

2004-01-01

In the RIR (Risk-informed Regulation), PSA (Probabilistic Safety Assessment) plays a major role because it provides overall risk insights for the regulatory body and utility. Therefore, the scope, the level of details and the technical adequacy of PSA, i.e. the quality of PSA is to be ensured for the successful RIR. To improve the quality of Korean PSA, we evaluate the quality of the KSNP (Korean Standard Nuclear Power Plant) internal full-power PSA model based on the 'ASME PRA Standard' and the 'NEI PRA Peer Review Process Guidance.' As a working group, PSA experts of the regulatory body and industry also participated in the evaluation process. It is finally judged that the overall quality of the KSNP PSA is between the ASME Standard Capability Category I and II. We also derive some items to be improved for upgrading the quality of the PSA up to the ASME Standard Capability Category II. In this paper, we show the result of quality evaluation, and the activities to improve the quality of the KSNP PSA model

Modalities of hemodialysis: Quality improvement

Directory of Open Access Journals (Sweden)

Ayman Karkar

2012-01-01

Full Text Available Hemodialysis (HD treatment had, over many years, improved the survival rate of patients with end-stage renal disease. However, standard or conventional HD prescription is far from being optimal in replacing the function of normal kidneys. Its unphysiologic clearance pattern and inability to remove all types and sizes of uremic toxins results in inter- and intra-dialysis complications and an unacceptably high rate of cardiovascular morbidity and mortality. Efficiency of HD can be improved by increasing blood and dialysate flow rates, dialyzer size and surface area and duration and frequency of dialysis sessions. Home HD, where short daily or long slow nocturnal HD sessions can conveniently be performed, provides an excellent option for quality of life improvement and reduction in morbidity and mortality. Recent innovations in the specifications of HD machines and improvement in dialysis membranes characteristics and water treatment technology paved the way for achieving quality HD. These advancements have resulted in efficient implementation of adsorption, diffusion and/or convection principles using adsorption HD, hemofiltration, hemodiafiltration (HDF and online HDF modalities in order to achieve optimum HD. Implementation of these innovations resulted in better quality care achievements in clinical practice and reduction in morbidity and mortality rates among HD patients.

Can traceability improve consumers' confidence in food quality and safety?

NARCIS (Netherlands)

Rijswijk, van W.; Cornelisse-Vermaat, J.R.; Frewer, L.J.

2006-01-01

Abstract This paper investigates whether the implementation of traceability systems in line with the European General Food Law as well as food labelling laws related to allergens can impact on consumer confidence in food quality and safety. It aims to give insight into consumer demands regarding

A quality improvement management model for renal care.

Science.gov (United States)

Vlchek, D L; Day, L M

1991-04-01

The purpose of this article is to explore the potential for applying the theory and tools of quality improvement (total quality management) in the renal care setting. We believe that the coupling of the statistical techniques used in the Deming method of quality improvement, with modern approaches to outcome and process analysis, will provide the renal care community with powerful tools, not only for improved quality (i.e., reduced morbidity and mortality), but also for technology evaluation and resource allocation.

45 CFR 1304.60 - Deficiencies and quality improvement plans.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Deficiencies and quality improvement plans. 1304... must correct the deficiency either immediately or pursuant to a Quality Improvement Plan. (c) An Early... Improvement Plan must submit to the responsible HHS official a Quality Improvement Plan specifying, for each...

Improving patient safety through quality assurance.

Science.gov (United States)

Raab, Stephen S

2006-05-01

Anatomic pathology laboratories use several quality assurance tools to detect errors and to improve patient safety. To review some of the anatomic pathology laboratory patient safety quality assurance practices. Different standards and measures in anatomic pathology quality assurance and patient safety were reviewed. Frequency of anatomic pathology laboratory error, variability in the use of specific quality assurance practices, and use of data for error reduction initiatives. Anatomic pathology error frequencies vary according to the detection method used. Based on secondary review, a College of American Pathologists Q-Probes study showed that the mean laboratory error frequency was 6.7%. A College of American Pathologists Q-Tracks study measuring frozen section discrepancy found that laboratories improved the longer they monitored and shared data. There is a lack of standardization across laboratories even for governmentally mandated quality assurance practices, such as cytologic-histologic correlation. The National Institutes of Health funded a consortium of laboratories to benchmark laboratory error frequencies, perform root cause analysis, and design error reduction initiatives, using quality assurance data. Based on the cytologic-histologic correlation process, these laboratories found an aggregate nongynecologic error frequency of 10.8%. Based on gynecologic error data, the laboratory at my institution used Toyota production system processes to lower gynecologic error frequencies and to improve Papanicolaou test metrics. Laboratory quality assurance practices have been used to track error rates, and laboratories are starting to use these data for error reduction initiatives.

The European Cancer Patient’s Bill of Rights, update and implementation 2016

Science.gov (United States)

Højgaard, Liselotte; Löwenberg, Bob; Selby, Peter; Lawler, Mark; Banks, Ian; Law, Kate; Albreht, Tit; Armand, Jean-Pierre; Barbacid, Mariano; Barzach, Michèle; Bergh, Jonas; Cameron, David; Conte, Pierfranco; de Braud, Filippo; de Gramont, Aimery; De Lorenzo, Francesco; Diehl, Volker; Diler, Sarper; Erdem, Sema; Geissler, Jan; Gore-Booth, Jola; Henning, Geoffrey; Horgan, Denis; Jassem, Jacek; Johnson, Peter; Kaasa, Stein; Kapitein, Peter; Karjalainen, Sakari; Kelly, Joan; Kienesberger, Anita; La Vecchia, Carlo; Lacombe, Denis; Lindahl, Tomas; Luzzatto, Lucio; Malby, Rebecca; Mastris, Ken; Meunier, Françoise; Murphy, Martin; Naredi, Peter; Nurse, Paul; Oliver, Kathy; Pearce, Jonathan; Pelouchov, Jana; Piccart, Martine; Pinedo, Bob; Spurrier-Bernard, Gilly; Sullivan, Richard; Tabernero, Josep; Van de Velde, Cornelis; van Herk, Bert; Vedsted, Peter; Waldmann, Anita; Weller, David; Wilking, Nils; Wilson, Roger; Yared, Wendy; Zielinski, Christoph; zur Hausen, Harald; Le Chevalier, Thierry; Johnston, Patrick

2016-01-01

Abstract In this implementation phase of the European Cancer Patient’s Bill of Rights (BoR), we confirm the following three patient-centred principles that underpin this initiative:The right of every European citizen to receive the most accurate information and to be proactively involved in his/her care.The right of every European citizen to optimal and timely access to a diagnosis and to appropriate specialised care, underpinned by research and innovation.The right of every European citizen to receive care in health systems that ensure the best possible cancer prevention, the earliest possible diagnosis of their cancer, improved outcomes, patient rehabilitation, best quality of life and affordable health care. The key aspects of working towards implementing the BoR are:Agree our high-level goal. The vision of 70% long-term survival for patients with cancer in 2035, promoting cancer prevention and cancer control and the associated progress in ensuring good patient experience and quality of life.Establish the major mechanisms to underpin its delivery. (1) The systematic and rigorous sharing of best practice between and across European cancer healthcare systems and (2) the active promotion of Research and Innovation focused on improving outcomes; (3) Improving access to new and established cancer care by sharing best practice in the development, approval, procurement and reimbursement of cancer diagnostic tests and treatments.Work with other organisations to bring into being a Europe based centre that will (1) systematically identify, evaluate and validate and disseminate best practice in cancer management for the different countries and regions and (2) promote Research and Innovation and its translation to maximise its impact to improve outcomes. PMID:28848664

The effectiveness of the European agricultural quality policy: a price analysis

Energy Technology Data Exchange (ETDEWEB)

Bardaji, I.; Iraizoz, B.; Rapun, M.

2009-07-01

The European rural development policy, the second pillar of the Common Agricultural Policy, is currently playing an increasing role. One of its key instruments is the support for quality standards through Protected Geographical Indications (PGI). The analysis presented in this article investigates prices for two varieties of beef (PGI and non- PGI). The research setting is a specific area in northern Spain, where Ternera de Navarra (Navarra beef) is produced. The results show that quality production systems achieve higher and more stable prices in the long term. Another major point emerging from the analysis, given the nature of the beef production sector, is that the PGI product is better able to stand up to consumer confidence crises, such as that triggered by the bovine spongiform encephalopathy outbreak. Additional key words: prices, protected geographical indication, rural development. (Author) 40 refs.

Improving organizational climate for quality and quality of care: does membership in a collaborative help?

Science.gov (United States)

Nembhard, Ingrid M; Northrup, Veronika; Shaller, Dale; Cleary, Paul D

2012-11-01

The lack of quality-oriented organizational climates is partly responsible for deficiencies in patient-centered care and poor quality more broadly. To improve their quality-oriented climates, several organizations have joined quality improvement collaboratives. The effectiveness of this approach is unknown. To evaluate the impact of collaborative membership on organizational climate for quality and service quality. Twenty-one clinics, 4 of which participated in a collaborative sponsored by the Institute for Clinical Systems Improvement. Pre-post design. Preassessments occurred 2 months before the collaborative began in January 2009. Postassessments of service quality and climate occurred about 6 months and 1 year, respectively, after the collaborative ended in January 2010. We surveyed clinic employees (eg, physicians, nurses, receptionists, etc.) about the organizational climate and patients about service quality. Prioritization of quality care, high-quality staff relationships, and open communication as indicators of quality-oriented climate and timeliness of care, staff helpfulness, doctor-patient communication, rating of doctor, and willingness to recommend doctor's office as indicators of service quality. There was no significant effect of collaborative membership on quality-oriented climate and mixed effects on service quality. Doctors' ratings improved significantly more in intervention clinics than in control clinics, staff helpfulness improved less, and timeliness of care declined more. Ratings of doctor-patient communication and willingness to recommend doctor were not significantly different between intervention and comparison clinics. Membership in the collaborative provided no significant advantage for improving quality-oriented climate and had equivocal effects on service quality.

Electronic health records improve clinical note quality.

Science.gov (United States)

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

2015-01-01

The clinical note documents the clinician's information collection, problem assessment, clinical management, and its used for administrative purposes. Electronic health records (EHRs) are being implemented in clinical practices throughout the USA yet it is not known whether they improve the quality of clinical notes. The goal in this study was to determine if EHRs improve the quality of outpatient clinical notes. A five and a half year longitudinal retrospective multicenter quantitative study comparing the quality of handwritten and electronic outpatient clinical visit notes for 100 patients with type 2 diabetes at three time points: 6 months prior to the introduction of the EHR (before-EHR), 6 months after the introduction of the EHR (after-EHR), and 5 years after the introduction of the EHR (5-year-EHR). QNOTE, a validated quantitative instrument, was used to assess the quality of outpatient clinical notes. Its scores can range from a low of 0 to a high of 100. Sixteen primary care physicians with active practices used QNOTE to determine the quality of the 300 patient notes. The before-EHR, after-EHR, and 5-year-EHR grand mean scores (SD) were 52.0 (18.4), 61.2 (16.3), and 80.4 (8.9), respectively, and the change in scores for before-EHR to after-EHR and before-EHR to 5-year-EHR were 18% (pquality scores significantly improved over the 5-year time interval. The EHR significantly improved the overall quality of the outpatient clinical note and the quality of all its elements, including the core and non-core elements. To our knowledge, this is the first study to demonstrate that the EHR significantly improves the quality of clinical notes. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association.

How Quality Improvement Practice Evidence Can Advance the Knowledge Base.

Science.gov (United States)

OʼRourke, Hannah M; Fraser, Kimberly D

2016-01-01

Recommendations for the evaluation of quality improvement interventions have been made in order to improve the evidence base of whether, to what extent, and why quality improvement interventions affect chosen outcomes. The purpose of this article is to articulate why these recommendations are appropriate to improve the rigor of quality improvement intervention evaluation as a research endeavor, but inappropriate for the purposes of everyday quality improvement practice. To support our claim, we describe the differences between quality improvement interventions that occur for the purpose of practice as compared to research. We then carefully consider how feasibility, ethics, and the aims of evaluation each impact how quality improvement interventions that occur in practice, as opposed to research, can or should be evaluated. Recommendations that fit the evaluative goals of practice-based quality improvement interventions are needed to support fair appraisal of the distinct evidence they produce. We describe a current debate on the nature of evidence to assist in reenvisioning how quality improvement evidence generated from practice might complement that generated from research, and contribute in a value-added way to the knowledge base.

Data Quality Assessment and Recommendations to Improve the Quality of Hemodialysis Database

Directory of Open Access Journals (Sweden)

Neda Firouraghi

2018-01-01

Full Text Available Introduction: Since clinical data contain abnormalities, quality assessment and reporting of data errors are necessary. Data quality analysis consists of developing strategies, making recommendations to avoid future errors and improving the quality of data entry by identifying error types and their causes. Therefore, this approach can be extremely useful to improve the quality of the databases. The aim of this study was to analyze hemodialysis (HD patients’ data in order to improve the quality of data entry and avoid future errors. Method: The study was done on Shiraz University of Medical Sciences HD database in 2015. The database consists of 2367 patients who had at least 12 months follow up (22.34±11.52 months in 2012-2014. Duplicated data were removed; outliers were detected based on statistical methods, expert opinion and the relationship between variables; then, the missing values were handled in 72 variables by using IBM SPSS Statistics 22 in order to improve the quality of the database. According to the results, some recommendations were given to improve the data entry process. Results: The variables had outliers in the range of 0-9.28 percent. Seven variables had missing values over 20 percent and in the others they were between 0 and 19.73 percent. The majority of missing values belong to serum alkaline phosphatase, uric acid, high and low density lipoprotein, total iron binding capacity, hepatitis B surface antibody titer, and parathyroid hormone. The variables with displacement (the values of two or more variables were recorded in the wrong attribute were weight, serum creatinine, blood urea nitrogen, systolic and diastolic blood pressure. These variables may lead to decreased data quality. Conclusion: According to the results and expert opinion, applying some data entry principles, such as defining ranges of values, using the relationship between hemodialysis features, developing alert systems about empty or duplicated data and

Continuous quality improvement in the ambulatory endoscopy center.

Science.gov (United States)

Johanson, John F

2002-04-01

What does quality assessment have to do with the practicing gastroenterologist? Why should one spend the time and effort to incorporate CQI activities into an already busy practice? First and foremost, quality improvement should directly benefit the patient by ensuring that they receive the highest quality of care possible. For example, comparing endoscopic use or outcomes, such as procedure success or complications, with national standards or other endoscopists in the same community may identify physicians who could benefit from additional training. Similar analyses may likewise identify outstanding physicians who might serve as resources for other physicians. Surveys of patient satisfaction may reveal deficiencies, which might be unknown to a physician who is otherwise technically excellent; deficiencies that would never have been uncovered by traditional measures of quality. Second, applying the techniques of CQI to study one's own practice can provide a competitive edge when vying for managed care or corporate contracts. In this regard, CQI can be used to document physician or practice performance through tracking of endoscopic use, procedure success and complication rates, and patient satisfaction. Finally, the rising concern among various patient advocacy groups has led to an increased emphasis on quality improvement, and in most cases it is a required activity as part of the accreditation process. Steps to quality improvement There is more to quality improvement than simply selecting and implementing a performance improvement plan. A number of steps have been suggested to achieve fundamental improvement in the quality of medical care [3]. The first is to use outcomes management for improvement rather than for judgment. One of the major criticisms of QA is that it will be used to judge physicians providing care. It is feared that CQI will be used to identify poor performers who will then be punished. This strategy leads to fear and inhibits an honest pursuit

Technological measures to improve automotive product quality

OpenAIRE

Gladkov, V.; Kruglov, S.

2010-01-01

The paper examines the basic technological measures aimed at improving product quality in automotive industry. While paying due attention to solving organizational and technological problems, including the development of certification systems for production processes, it is also necessary to improve the technical standards of specific technologies, equipment and materials as they largely determine product quality. Special emphasis is given to the importance of improving the production of auto...

Framing quality improvement tools and techniques in healthcare the case of improvement leaders' guides.

Science.gov (United States)

Millar, Ross

2013-01-01

The purpose of this paper is to present a study of how quality improvement tools and techniques are framed within healthcare settings. The paper employs an interpretive approach to understand how quality improvement tools and techniques are mobilised and legitimated. It does so using a case study of the NHS Modernisation Agency Improvement Leaders' Guides in England. Improvement Leaders' Guides were framed within a service improvement approach encouraging the use of quality improvement tools and techniques within healthcare settings. Their use formed part of enacting tools and techniques across different contexts. Whilst this enactment was believed to support the mobilisation of tools and techniques, the experience also illustrated the challenges in distributing such approaches. The paper provides an important contribution in furthering our understanding of framing the "social act" of quality improvement. Given the ongoing emphasis on quality improvement in health systems and the persistent challenges involved, it also provides important information for healthcare leaders globally in seeking to develop, implement or modify similar tools and distribute leadership within health and social care settings.

QUALITY IMPROVEMENT MODEL AT THE MANUFACTURING PROCESS PREPARATION LEVEL

Directory of Open Access Journals (Sweden)

Dusko Pavletic

2009-12-01

Full Text Available The paper expresses base for an operational quality improvement model at the manufacturing process preparation level. A numerous appropriate related quality assurance and improvement methods and tools are identified. Main manufacturing process principles are investigated in order to scrutinize one general model of manufacturing process and to define a manufacturing process preparation level. Development and introduction of the operational quality improvement model is based on a research conducted and results of methods and tools application possibilities in real manufacturing processes shipbuilding and automotive industry. Basic model structure is described and presented by appropriate general algorithm. Operational quality improvement model developed lays down main guidelines for practical and systematic application of quality improvements methods and tools.

Bringing quality improvement into the intensive care unit.

Science.gov (United States)

McMillan, Tracy R; Hyzy, Robert C

2007-02-01

During the last several years, many governmental and nongovernmental organizations have championed the application of the principles of quality improvement to the practice of medicine, particularly in the area of critical care. To review the breadth of approaches to quality improvement in the intensive care unit, including measures such as mortality and length of stay, and the use of protocols, bundles, and the role of large, multiple-hospital collaboratives. Several agencies have participated in the application of the quality movement to medicine, culminating in the development of standards such as the intensive care unit core measures of the Joint Commission on Accreditation of Healthcare Organizations. Although "zero defects" may not be possible in all measurable variables of quality in the intensive care unit, several measures, such as catheter-related bloodstream infections, can be significantly reduced through the implementation of improved processes of care, such as care bundles. Large, multiple-center, quality improvement collaboratives, such as the Michigan Keystone Intensive Care Unit Project, may be particularly effective in improving the quality of care by creating a "bandwagon effect" within a geographic region. The quality revolution is having a significant effect in the critical care unit and is likely to be facilitated by the transition to the electronic medical record.

Integrating empowerment evaluation and quality improvement to achieve healthcare improvement outcomes

Science.gov (United States)

Wandersman, Abraham; Alia, Kassandra Ann; Cook, Brittany; Ramaswamy, Rohit

2015-01-01

While the body of evidence-based healthcare interventions grows, the ability of health systems to deliver these interventions effectively and efficiently lags behind. Quality improvement approaches, such as the model for improvement, have demonstrated some success in healthcare but their impact has been lessened by implementation challenges. To help address these challenges, we describe the empowerment evaluation approach that has been developed by programme evaluators and a method for its application (Getting To Outcomes (GTO)). We then describe how GTO can be used to implement healthcare interventions. An illustrative healthcare quality improvement example that compares the model for improvement and the GTO method for reducing hospital admissions through improved diabetes care is described. We conclude with suggestions for integrating GTO and the model for improvement. PMID:26178332

The ReACH Collaborative--improving quality home care.

Science.gov (United States)

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

2007-08-01

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

[Quality assurance and quality improvement in medical practice. Part 3: Clinical audit in medical practice].

Science.gov (United States)

Godény, Sándor

2012-02-05

The first two articles in the series were about the definition of quality in healthcare, the quality approach, the importance of quality assurance, the advantages of quality management systems and the basic concepts and necessity of evidence based medicine. In the third article the importance and basic steps of clinical audit are summarised. Clinical audit is an integral part of quality assurance and quality improvement in healthcare, that is the responsibility of any practitioner involved in medical practice. Clinical audit principally measures the clinical practice against clinical guidelines, protocols and other professional standards, and sometimes induces changes to ensure that all patients receive care according to principles of the best practice. The clinical audit can be defined also as a quality improvement process that seeks to identify areas for service improvement, develop and carry out plans and actions to improve medical activity and then by re-audit to ensure that these changes have an effect. Therefore, its aims are both to stimulate quality improvement interventions and to assess their impact in order to develop clinical effectiveness. At the end of the article key points of quality assurance and improvement in medical practice are summarised.

A Simulation-Based Quality Improvement Initiative Improves Pediatric Readiness in Community Hospitals.

Science.gov (United States)

Whitfill, Travis; Gawel, Marcie; Auerbach, Marc

2017-07-17

The National Pediatric Readiness Project Pediatric Readiness Survey (PRS) measured pediatric readiness in 4149 US emergency departments (EDs) and noted an average score of 69 on a 100-point scale. This readiness score consists of 6 domains: coordination of pediatric patient care (19/100), physician/nurse staffing and training (10/100), quality improvement activities (7/100), patient safety initiatives (14/100), policies and procedures (17/100), and availability of pediatric equipment (33/100). We aimed to assess and improve pediatric emergency readiness scores across Connecticut's hospitals. The aim of this study was to compare the National Pediatric Readiness Project readiness score before and after an in situ simulation-based assessment and quality improvement program in Connecticut hospitals. We leveraged in situ simulations to measure the quality of resuscitative care provided by interprofessional teams to 3 simulated patients (infant septic shock, infant seizure, and child cardiac arrest) presenting to their ED resuscitation bay. Assessments of EDs were made based on a composite quality score that was measured as the sum of 4 distinct domains: (1) adherence to sepsis guidelines, (2) adherence to cardiac arrest guidelines, (3) performance on seizure resuscitation, and (4) teamwork. After the simulation, a detailed report with scores, comparisons to other EDs, and a gap analysis were provided to sites. Based on this report, a regional children's hospital team worked collaboratively with each ED to develop action items and a timeline for improvements. The National Pediatric Readiness Project PRS scores, the primary outcome of this study, were measured before and after participation. Twelve community EDs in Connecticut participated in this project. The PRS scores were assessed before and after the intervention (simulation-based assessment and gap analysis/report-out). The average time between PRS assessments was 21 months. The PRS scores significantly improved 12

Quality Rating and Improvement System State Evaluations and Research

Science.gov (United States)

Ferguson, Daniel

2016-01-01

A quality rating and improvement system (QRIS) is a method used by states and local jurisdictions to assess the level of quality of child care and early education programs, improve quality, and convey quality ratings to parents and other consumers. A typical QRIS incorporates the following components: quality standards for participating providers;…

Nationwide quality improvement in lung cancer care

DEFF Research Database (Denmark)

Jakobsen, Erik Winther; Green, Anders; Oesterlind, Kell

2013-01-01

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

Improving the explanatory power of bargaining models - New evidence from European Union studies

NARCIS (Netherlands)

Selck, TJ

Focusing on recent studies of European Union legislative decision-making, this research note evaluates the current literature that attempts to improve the explanatory power of bargaining models by integrating game-theoretic spatial models with micro-level data gained from expert interviews or from

Laboratory quality improvement in Thailand's northernmost provinces.

Science.gov (United States)

Kanitvittaya, S; Suksai, U; Suksripanich, O; Pobkeeree, V

2010-01-01

In Thailand nearly 1000 public health laboratories serve 65 million people. A qualified indicator of a good quality laboratory is Thailand Medical Technology Council certification. Consequently, Chiang Rai Regional Medical Sciences Center established a development program for laboratory certification for 29 laboratories in the province. This paper seeks to examine this issue. The goal was to improve laboratory service quality by voluntary participation, peer review, training and compliance with standards. The program consisted of specific activities. Training and workshops to update laboratory staffs' quality management knowledge were organized. Staff in each laboratory performed a self-assessment using a standard check-list to evaluate ten laboratory management areas. Chiang Rai Regional Medical Sciences Center staff supported the distribution of quality materials and documents. They provided calibration services for laboratory equipment. Peer groups performed an internal audit and successful laboratories received Thailand Medical Technology Council certification. By December 2007, eight of the 29 laboratories had improved quality sufficiently to be certified. Factors that influenced laboratories' readiness for quality improvement included the number of staff, their knowledge, budget and staff commitment to the process. Moreover, the support of each hospital's laboratory working group or network was essential for success. There was no clear policy for supporting the program. Laboratories voluntarily conducted quality management using existing resources. A bottom-up approach to this kind of project can be difficult to accomplish. Laboratory professionals can work together to illustrate and highlight outcomes for top-level health officials. A top-down, practical approach would be much less difficult to implement. Quality certification is a critical step for laboratory staff, which also encourages them to aspire to international quality standards like ISO. The

Key interventions and quality indicators for quality improvement of STEMI care: a RAND Delphi survey.

Science.gov (United States)

Aeyels, Daan; Sinnaeve, Peter R; Claeys, Marc J; Gevaert, Sofie; Schoors, Danny; Sermeus, Walter; Panella, Massimiliano; Coeckelberghs, Ellen; Bruyneel, Luk; Vanhaecht, Kris

2017-12-13

Identification, selection and validation of key interventions and quality indicators for improvement of in hospital quality of care for ST-elevated myocardial infarction (STEMI) patients. A structured literature review was followed by a RAND Delphi Survey. A purposively selected multidisciplinary expert panel of cardiologists, nurse managers and quality managers selected and validated key interventions and quality indicators prior for quality improvement for STEMI. First, 34 experts (76% response rate) individually assessed the appropriateness of items to quality improvement on a nine point Likert scale. Twenty-seven key interventions, 16 quality indicators at patient level and 27 quality indicators at STEMI care programme level were selected. Eighteen additional items were suggested. Experts received personal feedback, benchmarking their score with group results (response rate, mean, median and content validity index). Consequently, 32 experts (71% response rate) openly discussed items with an item-content validity index above 75%. By consensus, the expert panel validated a final set of 25 key interventions, 13 quality indicators at patient level and 20 quality indicators at care programme level prior for improvement of in hospital care for STEMI. A structured literature review and multidisciplinary expertise was combined to validate a set of key interventions and quality indicators prior for improvement of care for STEMI. The results allow researchers and hospital staff to evaluate and support quality improvement interventions in a large cohort within the context of a health care system.

Quality Function Deployment Application for Improving Quality of Education in Business Schools

Science.gov (United States)

Sagnak, Muhittin; Ada, Nesrin; Kazancoglu, Yigit; Tayaksi, Cansu

2017-01-01

There is an increasing competition between universities globally to attract students. At this point, to compete, it is imperative for the universities to improve the quality of education provided for their stakeholders, including students, parents, and employers. For improving the quality of education, first of all, the universities should make…

IMPROVING QUALITY MANAGEMENT IN PANIFICATION

Directory of Open Access Journals (Sweden)

Cornelia Petroman

2010-12-01

Full Text Available Consumers of panification products (as well as consumers of any other type of product or service are concerned about the quality of the products they purchase. Implementing the quality management system in the food industry is not compulsory, but it can bring about numerous, palpable benefits, particularly in reducing the amount of acryl amide. It is a modern system allowing the management analysis aiming at checking and reaching the goals to define new objectives, and the continuous improvement of the quality of processes and products.

Teaching Quality Improvement Through a Book Club

Directory of Open Access Journals (Sweden)

Benjamin Doolittle

2015-12-01

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

Title IV Quality Control Project, Stage II. Management Option II: Delivery System Quality Improvements.

Science.gov (United States)

Advanced Technology, Inc., Reston, VA.

Stage Two of the Title IV Quality Control Project is an integrated study of quality in five related Federal financial aid programs for postsecondary students. Section 1 of the paper establishes a framework for defining quality improvements, in order to identify the types of changes that would tend to improve quality across all facets of the…

Using quality measures for quality improvement: the perspective of hospital staff.

Directory of Open Access Journals (Sweden)

Asgar Aghaei Hashjin

Full Text Available RESEARCH OBJECTIVE: This study examines the perspectives of a range of key hospital staff on the use, importance, scientific background, availability of data, feasibility of data collection, cost benefit aspects and availability of professional personnel for measurement of quality indicators among Iranian hospitals. The study aims to facilitate the use of quality indicators to improve quality of care in hospitals. STUDY DESIGN: A cross-sectional study was conducted over the period 2009 to 2010. Staff at Iranian hospitals completed a self-administered questionnaire eliciting their views on organizational, clinical process, and outcome (clinical effectiveness, patient safety and patient centeredness indicators. POPULATION STUDIED: 93 hospital frontline staff including hospital/nursing managers, medical doctors, nurses, and quality improvement/medical records officers in 48 general and specialized hospitals in Iran. PRINCIPAL FINDINGS: On average, only 69% of respondents reported using quality indicators in practice at their affiliated hospitals. Respondents varied significantly in their reported use of organizational, clinical process and outcome quality indicators. Overall, clinical process and effectiveness indicators were reported to be least used. The reported use of indicators corresponded with their perceived level of importance. Quality indicators were reported to be used among clinical staff significantly more than among managerial staff. In total, 74% of the respondents reported to use obligatory indicators, while this was 68% for voluntary indicators (p<0.05. CONCLUSIONS: There is a general awareness of the importance and usability of quality indicators among hospital staff in Iran, but their use is currently mostly directed towards external accountability purposes. To increase the formative use of quality indicators, creation of a common culture and feeling of shared ownership, alongside an increased uptake of clinical process and

Engaging Clinical Nurses in Quality Improvement Projects.

Science.gov (United States)

Moore, Susan; Stichler, Jaynelle F

2015-10-01

Clinical nurses have the knowledge and expertise required to provide efficient and proficient patient care. Time and knowledge deficits can prevent nurses from developing and implementing quality improvement or evidence-based practice projects. This article reviews a process for professional development of clinical nurses that helped them to define, implement, and analyze quality improvement or evidence-based practice projects. The purpose of this project was to educate advanced clinical nurses to manage a change project from inception to completion, using the Six Sigma DMAIC (Define, Measure, Analyze, Improve, Control) Change Acceleration Process as a framework. One-to-one mentoring and didactic in-services advanced the knowledge, appreciation, and practice of advanced practice clinicians who completed multiple change projects. The projects facilitated clinical practice changes, with improved patient outcomes; a unit cultural shift, with appreciation of quality improvement and evidence-based projects; and engagement with colleagues. Project outcomes were displayed in poster presentations at a hospital exposition for knowledge dissemination. Copyright 2015, SLACK Incorporated.

40 CFR 63.175 - Quality improvement program for valves.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 9 2010-07-01 2010-07-01 false Quality improvement program for valves... alternative quality improvement programs specified in paragraphs (d) and (e) of this section. The decision to... § 63.168 and § 63.175. (1) If the owner or operator elects to continue the quality improvement program...

Increased office productivity through improved indoor air quality

DEFF Research Database (Denmark)

Fanger, Povl Ole

2002-01-01

Control of indoor pollution sources and ventilation are both means of improving indoor air quality. Three independent experiments have recently documented that removing a pollution source or increasing the ventilation rate will improve perceived air quality, reduce the intensity of several Sick...... with the air quality was reduced by either measure. The quantitative relationsh8ip was 1.1% change in performance per 10% dissatisfied, in the range 25-70% dissatisifed, or 0.5% change in performance per 1 decipol (dp), in the range 2-13 dp. Significant improvements in performance occurred only when......, future developments in HVCAC technology may include "personalized air ", new ways of improving the quality of supply air (e.g., by filtration), more extensive use of heat recovery from exhaust air and systematic selection of low-polluting building and furnishing materials....

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

Science.gov (United States)

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

2014-08-01

Colorectal cancer is one of the most common cancers in Europe. Over the past few decades, important advances have been made in screening, staging and treatment of colorectal cancer. However, considerable variation between and within European countries remains, which implies that further improvements are possible. The most important remaining question now is: when are we, health care professionals, delivering the best available care to patients with colon or rectal cancer? Currently, quality assurance is a major issue in colorectal cancer care and quality assurance awareness is developing in almost all disciplines involved in the treatment of colorectal cancer patients. Quality assurance has shown to be effective in clinical trials. For example, standardisation and quality control were introduced in the Dutch TME trial and led to marked improvements of local control and survival in rectal cancer patients. Besides, audit structures can also be very effective in monitoring cancer management and national audits showed to further improve outcome in colorectal cancer patients. To reduce the differences between European countries, an international, multidisciplinary, outcome-based quality improvement programme, European Registration of Cancer Care (EURECCA), has been initiated. In the near future, the EURECCA dataset will perform research on subgroups as elderly patients or patients with comorbidities, which are often excluded from trials. For optimal colorectal cancer care, quality assurance in guideline formation and in multidisciplinary team management is also of great importance. The aim of this review was to create greater awareness and to give an overview of quality assurance in the management of colorectal cancer. © The Author 2014. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Evaluation of a Quality Improvement Resource for Public Health Practitioners.

Science.gov (United States)

Porterfield, Deborah S; Marcial, Laura H; Brown, Stephen; Throop, Cynthia; Pina, Jamie

Quality improvement is a critical mechanism to manage public health agency performance and to strengthen accountability for public funds. The objective of this study was to evaluate a relatively new quality improvement resource, the Public Health Quality Improvement Exchange (PHQIX), a free online communication platform dedicated to making public health quality improvement information accessible to practitioners. We conducted an internet-based survey of registered PHQIX users (n = 536 respondents) in 2013 and key informant interviews with PHQIX frequent users (n = 21) in 2014, in the United States. We assessed use of the PHQIX website, user engagement and satisfaction, communication and knowledge exchange, use of information, and impact on quality improvement capacity and accreditation readiness. Of 462 respondents, 369 (79.9%) browsed quality improvement initiatives, making it the most commonly used site feature, and respondents described PHQIX as a near-unique source for real-world quality improvement examples. Respondents were satisfied with the quality and breadth of topics and relevance to their settings (average satisfaction scores, 3.9-4.1 [where 5 was the most satisfied]). Of 407 respondents, 237 (58.2%) said that they had put into practice information learned on PHQIX, and 209 of 405 (51.6%) said that PHQIX had helped to improve quality improvement capacity. Fewer than half of respondents used the commenting function, the Community Forum, and the Ask an Expert feature. Findings suggest that PHQIX, particularly descriptions of the quality improvement initiatives, is a valued resource for public health practitioners. Users reported sharing information with colleagues and applying what they learned to their own work. These findings may relate to other efforts to disseminate quality improvement knowledge.

Joint Efforts Towards European HF Radar Integration

Science.gov (United States)

Rubio, A.; Mader, J.; Griffa, A.; Mantovani, C.; Corgnati, L.; Novellino, A.; Schulz-Stellenfleth, J.; Quentin, C.; Wyatt, L.; Ruiz, M. I.; Lorente, P.; Hartnett, M.; Gorringe, P.

2016-12-01

During the past two years, significant steps have been made in Europe for achieving the needed accessibility to High Frequency Radar (HFR) data for a pan-European use. Since 2015, EuroGOOS Ocean Observing Task Teams (TT), such as HFR TT, are operational networks of observing platforms. The main goal is on the harmonization of systems requirements, systems design, data quality, improvement and proof of the readiness and standardization of HFR data access and tools. Particular attention is being paid by HFR TT to converge from different projects and programs toward those common objectives. First, JERICO-NEXT (Joint European Research Infrastructure network for Coastal Observatory - Novel European eXpertise for coastal observaTories, H2020 2015 Programme) will contribute on describing the status of the European network, on seeking harmonization through exchange of best practices and standardization, on developing and giving access to quality control procedures and new products, and finally on demonstrating the use of such technology in the general scientific strategy focused by the Coastal Observatory. Then, EMODnet (European Marine Observation and Data Network) Physics started to assemble HF radar metadata and data products within Europe in a uniform way. This long term program is providing a combined array of services and functionalities to users for obtaining free of charge data, meta-data and data products on the physical conditions of European sea basins and oceans. Additionally, the Copernicus Marine Environment Monitoring Service (CMEMS) delivers from 2015 a core information service to any user related to 4 areas of benefits: Maritime Safety, Coastal and Marine Environment, Marine Resources, and Weather, Seasonal Forecasting and Climate activities. INCREASE (Innovation and Networking for the integration of Coastal Radars into EuropeAn marine SErvices - CMEMS Service Evolution 2016) will set the necessary developments towards the integration of existing European

EMPRESS: A European Project to Enhance Process Control Through Improved Temperature Measurement

Science.gov (United States)

Pearce, J. V.; Edler, F.; Elliott, C. J.; Rosso, L.; Sutton, G.; Andreu, A.; Machin, G.

2017-08-01

A new European project called EMPRESS, funded by the EURAMET program `European Metrology Program for Innovation and Research,' is described. The 3 year project, which started in the summer of 2015, is intended to substantially augment the efficiency of high-value manufacturing processes by improving temperature measurement techniques at the point of use. The project consortium has 18 partners and 5 external collaborators, from the metrology sector, high-value manufacturing, sensor manufacturing, and academia. Accurate control of temperature is key to ensuring process efficiency and product consistency and is often not achieved to the level required for modern processes. Enhanced efficiency of processes may take several forms including reduced product rejection/waste; improved energy efficiency; increased intervals between sensor recalibration/maintenance; and increased sensor reliability, i.e., reduced amount of operator intervention. Traceability of temperature measurements to the International Temperature Scale of 1990 (ITS-90) is a critical factor in establishing low measurement uncertainty and reproducible, consistent process control. Introducing such traceability in situ (i.e., within the industrial process) is a theme running through this project.

Improving Power Quality in AC Supply Grids

Directory of Open Access Journals (Sweden)

Piotr Fabijański

2015-12-01

Full Text Available This paper describes a digital and actual model of the UPQC (Unified Power Quality Conditioner integrated system for power quality improvement. The UPQC’s design and its connection to an AC supply grid, 1-phase and 3-phase alike, provide effective compensation of unwanted interferences in the waveforms of load supply voltages and non-linear load currents. This article presents an overview of topologies and control strategies. The study of the UPQC confirmed its positive impact on the power quality. The electricity parameters were significantly improved. Total harmonic distortion in supply voltage THDu decreased six-fold to 1.89%, and total harmonic distortion in load current THDi decreased more than ten-fold to 2.38% for a non-linear load (uncontrolled bridge rectifier with load L. Additionally, symmetrisation of supply voltages and reactive power compensation Q of linear load was obtained. The UPQC integrated system for power quality improvement can be used wherever high-quality and PN-EN 50160 standard – compliant electricity is required.

Validation of quality indicators for the organization of palliative care: a modified RAND Delphi study in seven European countries (the Europall project).

Science.gov (United States)

Woitha, Kathrin; Van Beek, Karen; Ahmed, Nisar; Jaspers, Birgit; Mollard, Jean M; Ahmedzai, Sam H; Hasselaar, Jeroen; Menten, Johan; Vissers, Kris; Engels, Yvonne

2014-02-01

Validated quality indicators can help health-care professionals to evaluate their medical practices in a comparative manner to deliver optimal clinical care. No international set of quality indicators to measure the organizational aspects of palliative care settings exists. To develop and validate a set of structure and process indicators for palliative care settings in Europe. A two-round modified RAND Delphi process was conducted to rate clarity and usefulness of a previously developed set of 110 quality indicators. In total, 20 multi-professional palliative care teams of centers of excellence from seven European countries. In total, 56 quality indicators were rated as useful. These valid quality indicators concerned the following domains: the definition of a palliative care service (2 quality indicators), accessibility to palliative care (16 quality indicators), specific infrastructure to deliver palliative care (8 quality indicators), symptom assessment tools (1 quality indicator), specific personnel in palliative care services (9 quality indicators), documentation methodology of clinical data (14 quality indicators), evaluation of quality and safety procedures (1 quality indicator), reporting of clinical activities (1 quality indicator), and education in palliative care (4 quality indicator). The modified RAND Delphi process resulted in 56 international face-validated quality indicators to measure and compare organizational aspects of palliative care. These quality indicators, aimed to assess and improve the organization of palliative care, will be pilot tested in palliative care settings all over Europe and be used in the EU FP7 funded IMPACT project.

Fostering evidence-based quality improvement for patient-centered medical homes: Initiating local quality councils to transform primary care.

Science.gov (United States)

Stockdale, Susan E; Zuchowski, Jessica; Rubenstein, Lisa V; Sapir, Negar; Yano, Elizabeth M; Altman, Lisa; Fickel, Jacqueline J; McDougall, Skye; Dresselhaus, Timothy; Hamilton, Alison B

Although the patient-centered medical home endorses quality improvement principles, methods for supporting ongoing, systematic primary care quality improvement have not been evaluated. We introduced primary care quality councils at six Veterans Health Administration sites as an organizational intervention with three key design elements: (a) fostering interdisciplinary quality improvement leadership, (b) establishing a structured quality improvement process, and (c) facilitating organizationally aligned frontline quality improvement innovation. Our evaluation objectives were to (a) assess design element implementation, (b) describe implementation barriers and facilitators, and (c) assess successful quality improvement project completion and spread. We analyzed administrative records and conducted interviews with 85 organizational leaders. We developed and applied criteria for assessing design element implementation using hybrid deductive/inductive analytic techniques. All quality councils implemented interdisciplinary leadership and a structured quality improvement process, and all but one completed at least one quality improvement project and a toolkit for spreading improvements. Quality councils were perceived as most effective when service line leaders had well-functioning interdisciplinary communication. Matching positions within leadership hierarchies with appropriate supportive roles facilitated frontline quality improvement efforts. Two key resources were (a) a dedicated internal facilitator with project management, data collection, and presentation skills and (b) support for preparing customized data reports for identifying and addressing practice level quality issues. Overall, quality councils successfully cultivated interdisciplinary, multilevel primary care quality improvement leadership with accountability mechanisms and generated frontline innovations suitable for spread. Practice level performance data and quality improvement project management support

Women's job quality across family life stages: An analysis of female employees across 27 European countries

OpenAIRE

Piasna, A.; Plagnol, A.

2017-01-01

There is little empirical evidence on how working conditions affect women’s employment and fertility choices, despite a number of studies on the impact of individual-level and institutional factors. The article addresses this gap by examining how family life stages are related to particular aspects of job quality among employed women in 27 European countries. The central argument of the analysis is that high-quality jobs are conducive to both transitions to motherhood and employment after chi...

Improvements in geomagnetic observatory data quality

DEFF Research Database (Denmark)

Reda, Jan; Fouassier, Danielle; Isac, Anca

2011-01-01

between observatories and the establishment of observatory networks has harmonized standards and practices across the world; improving the quality of the data product available to the user. Nonetheless, operating a highquality geomagnetic observatory is non-trivial. This article gives a record...... of the current state of observatory instrumentation and methods, citing some of the general problems in the complex operation of geomagnetic observatories. It further gives an overview of recent improvements of observatory data quality based on presentation during 11th IAGA Assembly at Sopron and INTERMAGNET...

PROCESS VARIABILITY REDUCTION THROUGH STATISTICAL PROCESS CONTROL FOR QUALITY IMPROVEMENT

Directory of Open Access Journals (Sweden)

B.P. Mahesh

2010-09-01

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

Physical Activity Improves Quality of Life

Science.gov (United States)

... It Works Healthy Workplace Food and Beverage Toolkit Physical activity improves quality of life Updated:Mar 2,2015 ... proven to improve both mental and physical health. Physical activity boosts mental wellness. Regular physical activity can relieve ...

Quality assurance network: The European pilot study

Energy Technology Data Exchange (ETDEWEB)

Chavaudra, J; Derreumaux, S; Brider, A [Institut Gustave Roussa, Villejuif (France). Service de Physique; Dutreix, A; Schueren, E van der [University Hospital, Leuven (Belgium)

1996-08-01

Based on the IAEA/WHO experience in mailed dosimetry, a Quality Assurance (QA) Network, sponsored by the EC committee ``Europe against Cancer``, has been set up in 1991 for all European centres. Besides a survey of radiotherapy infrastructure, the project includes three measurement steps: primarily, a check of beam output and quality in reference conditions with a mailed TLD-procedure, in a second step, the mailed verification of other beam data and dose calculation procedures with multipurpose phantom, and finally in vivo dosimetry at the individual patient levels with mailed dosimeters. The results concerning 162 beams from 85 centres are analysed (58 {sup 60}Co beams and 104 X-ray beams). 27 beams present minor deviations (3 to 6%) and 15 beams (4/58 {sup 60}Co beams and 11/104 X-ray beams) from 11 centres present major deviations ({>=} 6%). The analysis shows that 17/27 minor deviations and all major deviations have been detected in centres which have not benefited from an external check during the last five years; in 14 out of 15 large deviations, the measured dose is smaller than the stated dose. In most centres with major deviation, the physicists did not have the necessary experience and did not calibrate regularly the beams. In 6 centres out of 11 there was no dosimeter or the dosimeter available has not been calibrated recently. In 3 centres, the physicist did not give any explanations. The conclusions concerning the second step (multipurpose phantom), outline the larger magnitude of the deviations for off axis points, oblique surface and the use of wedge filters. (author). 32 refs, 7 figs, 2 tabs.

Quality assurance network: The European pilot study

International Nuclear Information System (INIS)

Chavaudra, J.; Derreumaux, S.; Brider, A.

1996-01-01

Based on the IAEA/WHO experience in mailed dosimetry, a Quality Assurance (QA) Network, sponsored by the EC committee ''Europe against Cancer'', has been set up in 1991 for all European centres. Besides a survey of radiotherapy infrastructure, the project includes three measurement steps: primarily, a check of beam output and quality in reference conditions with a mailed TLD-procedure, in a second step, the mailed verification of other beam data and dose calculation procedures with multipurpose phantom, and finally in vivo dosimetry at the individual patient levels with mailed dosimeters. The results concerning 162 beams from 85 centres are analysed (58 60 Co beams and 104 X-ray beams). 27 beams present minor deviations (3 to 6%) and 15 beams (4/58 60 Co beams and 11/104 X-ray beams) from 11 centres present major deviations (≥ 6%). The analysis shows that 17/27 minor deviations and all major deviations have been detected in centres which have not benefited from an external check during the last five years; in 14 out of 15 large deviations, the measured dose is smaller than the stated dose. In most centres with major deviation, the physicists did not have the necessary experience and did not calibrate regularly the beams. In 6 centres out of 11 there was no dosimeter or the dosimeter available has not been calibrated recently. In 3 centres, the physicist did not give any explanations. The conclusions concerning the second step (multipurpose phantom), outline the larger magnitude of the deviations for off axis points, oblique surface and the use of wedge filters. (author). 32 refs, 7 figs, 2 tabs

Quality improvement in neurology: AAN Parkinson disease quality measures

Science.gov (United States)

Cheng, E.M.; Tonn, S.; Swain-Eng, R.; Factor, S.A.; Weiner, W.J.; Bever, C.T.

2010-01-01

Background: Measuring the quality of health care is a fundamental step toward improving health care and is increasingly used in pay-for-performance initiatives and maintenance of certification requirements. Measure development to date has focused on primary care and common conditions such as diabetes; thus, the number of measures that apply to neurologic care is limited. The American Academy of Neurology (AAN) identified the need for neurologists to develop measures of neurologic care and to establish a process to accomplish this. Objective: To adapt and test the feasibility of a process for independent development by the AAN of measures for neurologic conditions for national measurement programs. Methods: A process that has been used nationally for measure development was adapted for use by the AAN. Topics for measure development are chosen based upon national priorities, available evidence base from a systematic literature search, gaps in care, and the potential impact for quality improvement. A panel composed of subject matter and measure development methodology experts oversees the development of the measures. Recommendation statements and their corresponding level of evidence are reviewed and considered for development into draft candidate measures. The candidate measures are refined by the expert panel during a 30-day public comment period and by review by the American Medical Association for Current Procedural Terminology (CPT) II codes. All final AAN measures are approved by the AAN Board of Directors. Results: Parkinson disease (PD) was chosen for measure development. A review of the medical literature identified 258 relevant recommendation statements. A 28-member panel approved 10 quality measures for PD that included full specifications and CPT II codes. Conclusion: The AAN has adapted a measure development process that is suitable for national measurement programs and has demonstrated its capability to independently develop quality measures. GLOSSARY

European Home Energy

DEFF Research Database (Denmark)

Tommerup, Henrik M.

2009-01-01

An important aim of the european energy performance of buildings directive is to improve the overall energy efficiency of new homes......An important aim of the european energy performance of buildings directive is to improve the overall energy efficiency of new homes...

Image quality in conventional chest radiography. Evaluation using the postprocessing tool Diamond View

International Nuclear Information System (INIS)

Niemann, Tilo; Reisinger, Clemens; Rau, Philipp; Schwarz, Jochen; Ruis-Lopez, Laura; Bongartz, Georg

2010-01-01

The objective of this work was to evaluate the influence of the postprocessing tool Diamond View (Siemens AG Medical Solutions, Germany) on image quality in conventional chest radiography. Evaluation of image quality remains a challenge in conventional radiography. Based on the European Commission quality criteria we evaluated the improvement of image quality when applying the new postprocessing tool Diamond View (Siemens AG Medical solutions, Germany) to conventional chest radiographs. Three different readers prospectively evaluated 102 digital image pairs of chest radiographs. Statistical analysis was performed with a p value <0.05 considered as significant. Images were evaluated on basis of the modified imaging Quality Criteria by the Commission of the European Communities. Each of the 11 image quality criteria was evaluated separately using a five point classification. Statistical analysis showed an overall tendency for improved image quality for Diamond View (DV) for all criteria. Significant differences could be found in most of the criteria. In conclusion DV improves image quality in conventional chest radiographs.

Ninety to Nothing: a PDSA quality improvement project.

Science.gov (United States)

Prybutok, Gayle Linda

2018-05-14

Purpose The purpose of this paper is to present a case study of a successful quality improvement project in an acute care hospital focused on reducing the time of the total patient visit in the emergency department. Design/methodology/approach A multidisciplinary quality improvement team, using the PDSA (Plan, Do, Study, Act) Cycle, analyzed the emergency department care delivery process and sequentially made process improvements that contributed to project success. Findings The average turnaround time goal of 90 minutes or less per visit was achieved in four months, and the organization enjoyed significant collateral benefits both internal to the organization and for its customers. Practical implications This successful PDSA process can be duplicated by healthcare organizations of all sizes seeking to improve a process related to timely, high-quality patient care delivery. Originality/value Extended wait time in hospital emergency departments is a universal problem in the USA that reduces the quality of the customer experience and that delays necessary patient care. This case study demonstrates that a structured quality improvement process implemented by a multidisciplinary team with the authority to make necessary process changes can successfully redefine the norm.

Using Quality Improvement to Improve Internal and External Coordination and Referrals.

Science.gov (United States)

Cain, Katherine L; Collins, Ragan P

As part of accreditation, Public Health Accreditation Board site visitors recommended that the New Orleans Health Department strengthen its quality improvement program. With support from the Public Health Accreditation Board, the New Orleans Health Department subsequently embarked on a data-driven planning process through which it prioritized quality improvement projects for 2016. One of these projects aimed to improve referrals to New Orleans Health Department's direct services programs from local clinics and hospitals to better provide our most vulnerable residents with a continuum of care. After completing a cause-and-effect analysis, we implemented a solution involving increased outreach to health care institutions and saw annual participation increase in 3 out of 4 of our programs. We leveraged this work to successfully apply for funding to create a centralized referral system, which will facilitate partnerships among local health and human service agencies and improve access to services. This is one example of how accreditation has benefited our health department and our community. We have found that the accreditation process promotes a culture of quality and helps health departments identify and address areas for improvement.

Clinical audits: who does control what? European guide lines

International Nuclear Information System (INIS)

Jarvinen, H.

2009-01-01

The E.C. directive 97/43/EURATOM (M.E.D.-directive) introduced the concept of Clinical Audit for the assessment of medical radiological practices (diagnostic radiology, nuclear medicine and radiotherapy). The European Commission started in June 2007 a special project to review in detail the status of implementation of Clinical audits in Member States and to prepare European Guidance on Clinical Audits for diagnostic radiology, nuclear medicine and radiotherapy. The purpose of this E.C. project is to provide clear and comprehensive information and guidance on the procedures and criteria for clinical audits in all radiological practices, in order to improve the implementation of Article 6.4 of the M.E.D.-directive. The guidance should be flexible and enable the member States to adopt the model of clinical audit with respect to their national legislation and administrative provisions. By definition, clinical audit is a systematic examination or review of medical radiological procedures. It seeks to improve the quality and the outcome of patient care through structured review whereby radiological practices, procedures and results are examined against agreed standards for good medical radiological procedures. Modifications of the practices are implemented where indicated and new standards applied if necessary. The general objectives of clinical audit should be: to improve the quality of patient care, to promote the effective use of resources, to enhance the provision and organization of clinical services, to further professional education and training. Clinical audits must be at the same time internal (set by the management of the department) and external (set by external auditors at the department). It must not be confused with other evaluation activities such inspections, accreditation or quality system certifications. Clinical audits should address structure, process and outcome such the unit mission, quality assurance, dosimetry and treatments follow-up. The recent

Fifty years of fuel quality and vehicle emissions

Energy Technology Data Exchange (ETDEWEB)

Rose, K. [CONCAWE, Brussels (Belgium)

2013-04-01

In the late 1970s, with growing emphasis on urban air quality in Europe, CONCAWE embarked on new research related to fuels and vehicles. After only a few years, it became clear that fuel properties and specifications would be increasingly important to the future of the European refining industry, and considerable research was completed in the 1970s to better understand the impact of fuel composition on vehicle performance and emissions. This early work led to the formation of the first Fuels and Emissions Management Group (FEMG) in 1982, almost 20 years after the formation of the CONCAWE Association. Since these early days, FEMG has been responsible for ensuring CONCAWE's strategic outlook on future vehicle and fuel developments, monitoring regulatory and vehicle developments, and overseeing a diverse portfolio of fuel quality and vehicle emissions research. Since the 1980s, tremendous progress has been made in improving European air quality, in part by reducing emissions from road transport and other sectors, and major improvements in European fuel qualities have contributed to these reductions. Nevertheless, many challenges are still ahead, especially further reductions in pollutant emissions from vehicles while also reducing greenhouse gas (GHG) emissions from transport. In the near-term, these GHG reductions will largely come from improvements in engine and vehicle fuel consumption and by blending of GHG-reducing bio-blending components. Dealing with these challenges to fuel quality and performance will require a continuing focus on CONCAWE's founding principles: sound science, cost effectiveness and transparency.

Students as Stakeholders in the Policy Context of the European Standards and Guidelines for Quality Assurance in Higher Education Institutions

NARCIS (Netherlands)

Logermann, Frauke; Leisyte, Liudvika; Curaj, Adrian; Matei, Liviu; Pricopie, Remus; Salmi, Jamil; Scott, Peter

2015-01-01

The European Standard and Guidelines for Quality Assurance (ESG) of 2005 can be defined as one of the major Bologna documents aimed at furthering the role of students as stakeholders in internal quality assurance processes at higher education institutions (HEIs). Still little is known about

Prioritizing quality improvement in general surgery.

Science.gov (United States)

Schilling, Peter L; Dimick, Justin B; Birkmeyer, John D

2008-11-01

Despite growing interest in quality improvement, uncertainty remains about which procedures offer the most room for improvement in general surgery. In this context, we sought to describe the relative contribution of different procedures to overall morbidity, mortality, and excess length of stay in general surgery. Using data from the American College of Surgeons' National Surgery Quality Improvement Program (ACS-NSQIP), we identified all patients undergoing a general surgery procedure in 2005 and 2006 (n=129,233). Patients were placed in 36 distinct procedure groups based on Current Procedural Terminology codes. We first examined procedure groups according to their relative contribution to overall morbidity and mortality. We then assessed procedure groups according to their contribution to overall excess length of stay. Ten procedure groups alone accounted for 62% of complications and 54% of excess hospital days. Colectomy accounted for the greatest share of adverse events, followed by small intestine resection, inpatient cholecystectomy, and ventral hernia repair. In contrast, several common procedures contributed little to overall morbidity and mortality. For example, outpatient cholecystectomy, breast procedures, thyroidectomy, parathyroidectomy, and outpatient inguinal hernia repair together accounted for 34% of procedures, but only 6% of complications (and only 4% of major complications). These same procedures accounted for surgery. Focusing quality improvement efforts on these procedures may be an effective strategy for improving patient care and reducing cost.

The quality improvement attitude survey: Development and preliminary psychometric characteristics.

Science.gov (United States)

Dunagan, Pamela B

2017-12-01

To report the development of a tool to measure nurse's attitudes about quality improvement in their practice setting and to examine preliminary psychometric characteristics of the Quality Improvement Nursing Attitude Scale. Human factors such as nursing attitudes of complacency have been identified as root causes of sentinel events. Attitudes of nurses concerning use of Quality and Safety Education for nurse's competencies can be most challenging to teach and to change. No tool has been developed measuring attitudes of nurses concerning their role in quality improvement. A descriptive study design with preliminary psychometric evaluation was used to examine the preliminary psychometric characteristics of the Quality Improvement Nursing Attitude Scale. Registered bedside clinical nurses comprised the sample for the study (n = 57). Quantitative data were analysed using descriptive statistics and Cronbach's alpha reliability. Total score and individual item statistics were evaluated. Two open-ended items were used to collect statements about nurses' feelings regarding their experience in quality improvement efforts. Strong support for the internal consistency reliability and face validity of the Quality Improvement Nursing Attitude Scale was found. Total scale scores were high indicating nurse participants valued Quality and Safety Education for Nurse competencies in practice. However, item-level statistics indicated nurses felt powerless when other nurses deviate from care standards. Additionally, the sample indicated they did not consistently report patient safety issues and did not have a feeling of value in efforts to improve care. Findings suggested organisational culture fosters nurses' reporting safety issues and feeling valued in efforts to improve care. Participants' narrative comments and item analysis revealed the need to generate new items for the Quality Improvement Nursing Attitude Scale focused on nurses' perception of their importance in quality and

The European Narcolepsy Network (EU-NN) database

DEFF Research Database (Denmark)

Khatami, Ramin; Luca, Gianina; Baumann, Christian R

2016-01-01

Narcolepsy with cataplexy is a rare disease with an estimated prevalence of 0.02% in European populations. Narcolepsy shares many features of rare disorders, in particular the lack of awareness of the disease with serious consequences for healthcare supply. Similar to other rare diseases, only a ......, identification of post-marketing medication side-effects, and will contribute to improve clinical trial designs and provide facilities to further develop phase III trials....... Narcolepsy Network is introduced. The database structure, standardization of data acquisition and quality control procedures are described, and an overview provided of the first 1079 patients from 18 European specialized centres. Due to its standardization this continuously increasing data pool is most...

An integrated approach to hospital strategic planning, quality assurance, and continuous quality improvement.

Science.gov (United States)

Day, G; Gardner, S; Herba, C

1995-01-01

Like many other healthcare organizations today, the authors' facility, a 306-bed acute care community hospital in Michigan, strives to visualize and make a transition from traditional quality assurance to continuous quality improvement. The Juran Trilogy provided the insight that strategic planning, measurement, and continuous improvement must exist side by side. At the authors' facility, this realization resulted in the hospital quality plan, which treats each of these components as part of the foundation for quality. The authors explain this model and the reporting and communication mechanisms that support it.

Context in Quality of Care: Improving Teamwork and Resilience.

Science.gov (United States)

Tawfik, Daniel S; Sexton, John Bryan; Adair, Kathryn C; Kaplan, Heather C; Profit, Jochen

2017-09-01

Quality improvement in health care is an ongoing challenge. Consideration of the context of the health care system is of paramount importance. Staff resilience and teamwork climate are key aspects of context that drive quality. Teamwork climate is dynamic, with well-established tools available to improve teamwork for specific tasks or global applications. Similarly, burnout and resilience can be modified with interventions such as cultivating gratitude, positivity, and awe. A growing body of literature has shown that teamwork and burnout relate to quality of care, with improved teamwork and decreased burnout expected to produce improved patient quality and safety. Copyright © 2017 Elsevier Inc. All rights reserved.

Psychometric validation of the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Endometrial Cancer Module (EORTC QLQ-EN24)

DEFF Research Database (Denmark)

Greimel, Elfriede; Nordin, Andy; Lanceley, Anne

2011-01-01

A validation study was conducted to evaluate the psychometric properties of the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Endometrial Cancer Module (EORTC QLQ-EN24). This module was designed to assess disease and treatment specific aspects of...... of the quality of life (QoL) of patients with endometrial cancer.......A validation study was conducted to evaluate the psychometric properties of the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Endometrial Cancer Module (EORTC QLQ-EN24). This module was designed to assess disease and treatment specific aspects...

Quality improvement teaching at medical school: a student perspective

OpenAIRE

Nair, Pooja; Barai, Ishani; Prasad, Sunila; Gadhvi, Karishma

2016-01-01

Pooja Nair, Ishani Barai, Sunila Prasad, Karishma Gadhvi Department of Medicine, Imperial College School of Medicine, Imperial College London, London, UK Abstract: Guidelines in the UK require all doctors to actively take part in quality improvement. To ease future doctors into the process, formal quality improvement teaching can be delivered during medical school. Keywords: quality improvement, medical school, patient safety, patient satisfaction, medical student, clinical audit

How to Sustain Change and Support Continuous Quality Improvement.

Science.gov (United States)

Silver, Samuel A; McQuillan, Rory; Harel, Ziv; Weizman, Adam V; Thomas, Alison; Nesrallah, Gihad; Bell, Chaim M; Chan, Christopher T; Chertow, Glenn M

2016-05-06

To achieve sustainable change, quality improvement initiatives must become the new way of working rather than something added on to routine clinical care. However, most organizational change is not maintained. In this next article in this Moving Points in Nephrology feature on quality improvement, we provide health care professionals with strategies to sustain and support quality improvement. Threats to sustainability may be identified both at the beginning of a project and when it is ready for implementation. The National Health Service Sustainability Model is reviewed as one example to help identify issues that affect long-term success of quality improvement projects. Tools to help sustain improvement include process control boards, performance boards, standard work, and improvement huddles. Process control and performance boards are methods to communicate improvement results to staff and leadership. Standard work is a written or visual outline of current best practices for a task and provides a framework to ensure that changes that have improved patient care are consistently and reliably applied to every patient encounter. Improvement huddles are short, regular meetings among staff to anticipate problems, review performance, and support a culture of improvement. Many of these tools rely on principles of visual management, which are systems transparent and simple so that every staff member can rapidly distinguish normal from abnormal working conditions. Even when quality improvement methods are properly applied, the success of a project still depends on contextual factors. Context refers to aspects of the local setting in which the project operates. Context affects resources, leadership support, data infrastructure, team motivation, and team performance. For these reasons, the same project may thrive in a supportive context and fail in a different context. To demonstrate the practical applications of these quality improvement principles, these principles are

The process of managerial control in quality improvement initiatives.

Science.gov (United States)

Slovensky, D J; Fottler, M D

1994-11-01

The fundamental intent of strategic management is to position an organization with in its market to exploit organizational competencies and strengths to gain competitive advantage. Competitive advantage may be achieved through such strategies as low cost, high quality, or unique services or products. For health care organizations accredited by the Joint Commission on Accreditation of Healthcare Organizations, continually improving both processes and outcomes of organizational performance--quality improvement--in all operational areas of the organization is a mandated strategy. Defining and measuring quality and controlling the quality improvement strategy remain problematic. The article discusses the nature and processes of managerial control, some potential measures of quality, and related information needs.

Strategies to improve quality of childbirth care

Directory of Open Access Journals (Sweden)

farahnaz Changaee

2015-01-01

Full Text Available Background: Access to affordable and quality health care is one of the most important ways for reducing maternal and child mortality. The purpose of this study was to provide strategies to promote the quality of care during childbirth in Lorestan province in 2011. Materials and Methods: This research was a mixed method (quantitative, qualitative, study in which quality of 200 care during childbirth in hospitals of Lorestan Province were evaluated. Data gathered through self-made tools (Checklists prepared according to the guidelines of the ministry of health. Descriptive statistics and SPSS software were used to data analysis.In the second part of the study which was qualitative, interview with service providers, hospital officials and high-ranking officials of Lorestan university of medical sciences (decision makers was used to discuss strategies to improve the quality of care. Results: The results showed that the care of the first stage delivery in %54.5, second stage %57 and third stage 66% were in accordance with the desired status and care in this three stages was of moderate quality. Based on the interviews, the officials who are in charge of Lorestan university of medical sciences, proposed strategies such as financial incentives and in-service training of midwives as suitable strategies to improve quality of services. Conclusion: According to the results, strategies such as financial incentives, increased use of private sector services to reduce the workload of the public sector and increase of quality and use of more in-service training, to improve the quality of services, are recommended.

European Patient Summary Guideline: Focus on Greece.

Science.gov (United States)

Berler, Alexander; Tagaris, Anastassios; Chronaki, Catherine

2016-01-01

The European Patient Summary (PS) guideline specifies a minimal dataset of essential and important information for unplanned or emergency care initially defined in the epSOS project with aim to improve patients' safety and quality of Care. The eHealth Network of European Union (EU) Member State (MS) representatives established under Article 14 of the EU directive 2011/24 on patient rights to cross-border healthcare adopted PS guideline in November 2013 and since then the guideline has been part of MS strategic eHealth implementation plans, standardization efforts, and concrete regional, national, European and international projects. This paper reviews implementation efforts for the implementation of an operational patient summary service in Greece drawing on challenges and lessons learned for sustainable standards-based large scale eHealth deployment in Europe and abroad, as well as the reuse of best practices from international standards and integration profiles.

Does Medical Malpractice Law Improve Health Care Quality?

Science.gov (United States)

Frakes, Michael; Jena, Anupam B.

2016-01-01

We assess the potential for medical liability forces to deter medical errors and improve health care treatment quality, identifying liability’s influence by drawing on variations in the manner by which states formulate the negligence standard facing physicians. Using hospital discharge records from the National Hospital Discharge Survey and clinically-validated quality metrics inspired by the Agency for Health Care Research and Quality, we find evidence suggesting that treatment quality may improve upon reforms that expect physicians to adhere to higher quality clinical standards. We do not find evidence, however, suggesting that treatment quality may deteriorate following reforms to liability standards that arguably condone the delivery of lower quality care. Similarly, we do not find evidence of deterioration in health care quality following remedy-focused liability reforms such as caps on non-economic damages awards. PMID:28479642

Towards a chain coordination model for quality management strategies to strengthen the competition of European pork producers

NARCIS (Netherlands)

Brinkmann, D.; Lang, J.; Petersen, B.; Wognum, P.M.; Trienekens, J.H.

2011-01-01

This paper presents a new chain coordination model for quality management strategies of European pork supply chains. It is a result of qualitative research into intensive and extensive pork production in seven selected countries consisting of a literature review, country-specific expert interviews

Governmental point of view on the Dutch National Cooperative Programme for Air Quality

International Nuclear Information System (INIS)

2008-06-01

Dutch air quality does not yet meet the European standards throughout the Netherlands. The Dutch National Cooperative Programme for Air Quality (NSL) is expected to realize improvements. This publication explains the Dutch plans for meeting the European standards for air quality in the coming years. It addresses the following subjects: the Dutch National Cooperative Programme for Air Quality (NSL); legal framework; historical development; current situation and autonomous development for PM10 and NO2; spatial projects; measure packages and financial means. [mk] [nl

Quality improvement teaching at medical school: a student perspective

Directory of Open Access Journals (Sweden)

Nair P

2016-03-01

Full Text Available Pooja Nair, Ishani Barai, Sunila Prasad, Karishma Gadhvi Department of Medicine, Imperial College School of Medicine, Imperial College London, London, UK Abstract: Guidelines in the UK require all doctors to actively take part in quality improvement. To ease future doctors into the process, formal quality improvement teaching can be delivered during medical school. Keywords: quality improvement, medical school, patient safety, patient satisfaction, medical student, clinical audit

Quality Improvement Processes in Obesity Surgery Lead to Higher Quality and Value, Lower Costs.

Science.gov (United States)

Brousseau, Holli; Pohl, Dieter

2017-03-01

In the era of changes in the evaluation of medical services and performance, the Centers for Medicare and Medicaid Services (CMS) has determined that the key components are quality, value, and clinical practice improvement (MACRA). Weight Loss Surgery, also called Bariatric or Obesity Surgery, has been at the forefront of quality improvement and quality reporting through the Center of Excellence Program since 2005. As a result, weight loss surgery is now as safe as gallbladder surgery.1 Even within this culture of quality and safety, improvements are still possible, as described in this article. [Full article available at http://rimed.org/rimedicaljournal-2017-03.asp].

Integrating empowerment evaluation and quality improvement to achieve healthcare improvement outcomes.

Science.gov (United States)

Wandersman, Abraham; Alia, Kassandra Ann; Cook, Brittany; Ramaswamy, Rohit

2015-10-01

While the body of evidence-based healthcare interventions grows, the ability of health systems to deliver these interventions effectively and efficiently lags behind. Quality improvement approaches, such as the model for improvement, have demonstrated some success in healthcare but their impact has been lessened by implementation challenges. To help address these challenges, we describe the empowerment evaluation approach that has been developed by programme evaluators and a method for its application (Getting To Outcomes (GTO)). We then describe how GTO can be used to implement healthcare interventions. An illustrative healthcare quality improvement example that compares the model for improvement and the GTO method for reducing hospital admissions through improved diabetes care is described. We conclude with suggestions for integrating GTO and the model for improvement. 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.

Approaching the Practice Quality Improvement Project in Interventional Radiology.

Science.gov (United States)

Reis, Stephen P; White, Benjamin; Sutphin, Patrick D; Pillai, Anil K; Kalva, Sanjeeva P; Toomay, Seth M

2015-12-01

An important component of maintenance of certification and quality improvement in radiology is the practice quality improvement (PQI) project. In this article, the authors describe several methodologies for initiating and completing PQI projects. Furthermore, the authors illustrate several tools that are vital in compiling, analyzing, and presenting data in an easily understandable and reproducible manner. Last, they describe two PQI projects performed in an interventional radiology division that have successfully improved the quality of care for patients. Using the DMAIC (define, measure, analyze, improve, control) quality improvement framework, interventional radiology throughput has been increased, to lessen mediport wait times from 43 to 8 days, and mediport infection rates have decreased from more than 2% to less than 0.4%. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

A Novel Mesh Quality Improvement Method for Boundary Elements

Directory of Open Access Journals (Sweden)

Hou-lin Liu

2012-01-01

Full Text Available In order to improve the boundary mesh quality while maintaining the essential characteristics of discrete surfaces, a new approach combining optimization-based smoothing and topology optimization is developed. The smoothing objective function is modified, in which two functions denoting boundary and interior quality, respectively, and a weight coefficient controlling boundary quality are taken into account. In addition, the existing smoothing algorithm can improve the mesh quality only by repositioning vertices of the interior mesh. Without destroying boundary conformity, bad elements with all their vertices on the boundary cannot be eliminated. Then, topology optimization is employed, and those elements are converted into other types of elements whose quality can be improved by smoothing. The practical application shows that the worst elements can be eliminated and, with the increase of weight coefficient, the average quality of boundary mesh can also be improved. Results obtained with the combined approach are compared with some common approach. It is clearly shown that it performs better than the existing approach.

"Quality Handling" a training program to reduce fear and stress in farm animals

NARCIS (Netherlands)

Boivin, X.; Ruis, M.A.W.

2011-01-01

Research programs such as the European Welfare Quality® program, have attempted to improve animal welfare by developing training programs for improving stockperson behaviour towards the animals. The authors will illustrate different approches in this paper, with a special focus on the Quality

Systematic Quality Improvement in Medicine: Everyone Can Do It

Directory of Open Access Journals (Sweden)

Mark L. Zeidel

2011-07-01

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

Systematic quality improvement in medicine: everyone can do it.

Science.gov (United States)

Zeidel, Mark L

2011-07-01

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

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

Science.gov (United States)

Pflueger, Dane

2015-04-23

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

Replanning During Intensity Modulated Radiation Therapy Improved Quality of Life in Patients With Nasopharyngeal Carcinoma

International Nuclear Information System (INIS)

Yang Haihua; Hu Wei; Wang Wei; Chen Peifang; Ding Weijun; Luo Wei

2013-01-01

Purpose: Anatomic and dosimetric changes have been reported during intensity modulated radiation therapy (IMRT) in patients with nasopharyngeal carcinoma (NPC). The purpose of this study was to evaluate the effects of replanning on quality of life (QoL) and clinical outcomes during the course of IMRT for NPC patients. Methods and Materials: Between June 2007 and August 2011, 129 patients with NPC were enrolled. Forty-three patients received IMRT without replanning, while 86 patients received IMRT replanning after computed tomography (CT) images were retaken part way through therapy. Chinese versions of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 and Head and Neck Quality of Life Questionnaire 35 were completed before treatment began and at the end of treatment and at 1, 3, 6, and 12 months after the completion of treatment. Overall survival (OS) data were compared using the Kaplan-Meier method. Results: IMRT replanning had a profound impact on the QoL of NPC patients, as determined by statistically significant changes in global QoL and other QoL scales. Additionally, the clinical outcome comparison indicates that replanning during IMRT for NPC significantly improved 2-year local regional control (97.2% vs 92.4%, respectively, P=.040) but did not improve 2-year OS (89.8% vs 82.2%, respectively, P=.475). Conclusions: IMRT replanning improves QoL as well as local regional control in patients with NPC. Future research is needed to determine the criteria for replanning for NPC patients undergoing IMRT.

40 CFR 64.8 - Quality improvement plan (QIP) requirements.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Quality improvement plan (QIP... PROGRAMS (CONTINUED) COMPLIANCE ASSURANCE MONITORING § 64.8 Quality improvement plan (QIP) requirements. (a.... (iii) Appropriate improvements to control methods. (iv) Other steps appropriate to correct control...

Improving embryo quality in assisted reproduction

NARCIS (Netherlands)

Mantikou, E.

2013-01-01

The goal of this thesis was to improve embryo quality in assisted reproductive technologies by gaining more insight into human preimplantation embryo development and by improving in vitro culture conditions. To do so, we investigated an intriguing feature of the human preimplantation embryo, i.e.

New approaches to improving the quality of administrative services in the modernization of public administration in Ukraine

Directory of Open Access Journals (Sweden)

D. Y. Zapysnyy

2016-06-01

Full Text Available The benefit of the study is to highlight the issues of the administrative (municipal services by Ukrainian public authorities as a priority of the on-going decentralization and administrative reforms in Ukraine. Consequently, provision of the high quality services to the citizens became a main mission of all public authorities (State bodies, regional authorities, local self-government bodies in the framework of the implementation of the new public management and good governance standards on all levels – national, regional and local. It reflects also the main European tendencies in the field of public administration reform which are fixed in the documents of the international organizations (Council of Europe, European Union, OECD/ SIGMA etc.. For example, the European Strategy on Innovation and Good Governance on Local Level which was adopted by the Council of Europe Committee of Ministers in 2008 fixed the principle of the ability to provide high quality services to the citizens as one of its twelve main principles of good governance on local level. This study tested the key issues of increasing the quality of the services which are provided to the citizens by the State bodies and the local self-government bodies. Moreover the study pointed out the main tendencies in the realization of the State policy in the field of the improvement of the quality of the administrative (municipal services (in the context of the on-going large-scaled decentralization reform in Ukraine as well as the main direction for its further modernization. The questions concerning the quality standards in the activity of the State bodies and LSG bodies are highlighted in order to increase the quality of the services to be provided to the citizens. Besides, the study emphasized the issues related to ensuring the transparency of the activity of the State bodies as well as the regional and the local authorities, in the field of the provision of the administrative (municipal

Sleep Quality Improvement During Cognitive Behavioral Therapy for Anxiety Disorders.

Science.gov (United States)

Ramsawh, Holly J; Bomyea, Jessica; Stein, Murray B; Cissell, Shadha H; Lang, Ariel J

2016-01-01

Despite the ubiquity of sleep complaints among individuals with anxiety disorders, few prior studies have examined whether sleep quality improves during anxiety treatment. The current study examined pre- to posttreatment sleep quality improvement during cognitive behavioral therapy (CBT) for panic disorder (PD; n = 26) or generalized anxiety disorder (GAD; n = 24). Among sleep quality indices, only global sleep quality and sleep latency improved significantly (but modestly) during CBT. Sleep quality improvement was greater for treatment responders, but did not vary by diagnosis. Additionally, poor baseline sleep quality was independently associated with worse anxiety treatment outcome, as measured by higher intolerance of uncertainty. Additional intervention targeting sleep prior to or during CBT for anxiety may be beneficial for poor sleepers.

Voltage Quality Improvement Using Solar Photovoltaic Systems

Directory of Open Access Journals (Sweden)

Denisa Galzina

2015-06-01

This paper briefly shows the methods of power quality improvement, and then the results of on-site power quality measurements in the grid before and after the connection of the solar photovoltaic system.

Improved prediction of vegetation composition in NW European softwater lakes by combining location, water and sediment chemistry

DEFF Research Database (Denmark)

Pulido Pérez, Cristina; Jensen, Kaj Sand; Lucassen, Esther C.H.E.T.

2012-01-01

Isoetids, as indicators of near-pristine softwater lakes, have a high priority in national and international (European Water Directive Framework) assessments of ecological lake quality. Our main goal was to identify the most important environmental factors that influence the composition of plant...

Dietary quality and lifestyle factors in relation to 10-year mortality in older Europeans - The SENECA study

NARCIS (Netherlands)

Haveman-Nies, A.; Groot, de C.P.G.M.; Burema, J.; Amorim Cruz, J.A.; Osler, M.; Staveren, van W.A.

2002-01-01

The single and combined effects of three healthy lifestyle behaviors—nonsmoking, being physically active, and having a high-quality diet—on survival were investigated among older people in the SENECA Study. This European longitudinal study started with baseline measurements in 1988–1989 and lasted

Quality improvement in clinical documentation: does clinical governance work?

Directory of Open Access Journals (Sweden)

Dehghan M

2013-12-01

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

Quality improvement tools and processes.

Science.gov (United States)

Lau, Catherine Y

2015-04-01

The Model for Improvement and the Plan-Do-Study-Act cycle is a popular quality improvement (QI) tool for health care providers to successfully lead QI projects and redesign care processes. This tool has several distinct components that must be addressed in sequence to organize and critically evaluate improvement activities. Unlike other health sciences clinical research, QI projects and research are based on dynamic hypotheses that develop into observable, serial tests of change with continuous collection and feedback of performance data to stakeholders. Copyright © 2015 Elsevier Inc. All rights reserved.

Cost-Effective Adjustments to Nursing Home Staffing to Improve Quality.

Science.gov (United States)

Bowblis, John R; Roberts, Amy Restorick

2018-06-01

Health care providers face fixed reimbursement rates from government sources and need to carefully adjust staffing to achieve the highest quality within a given cost structure. With data from the Certification and Survey Provider Enhanced Reports (1999-2015), this study holistically examined how staffing levels affect two publicly reported measures of quality in the nursing home industry, the number of deficiency citations and the deficiency score. While higher staffing consistently yielded better quality, the largest quality improvements resulted from increasing administrative registered nurses and social service staffing. After adjusting for wages, the most cost-effective investment for improving overall deficiency outcomes was increasing social services. Deficiencies related to quality of care were improved most by increasing administrative nursing and social service staff. Quality of life deficiencies were improved most by increasing social service and activities staff. Approaches to improve quality through staffing adjustments should target specific types of staff to maximize return on investment.

Quality Improvement in Athletic Health Care.

Science.gov (United States)

Lopes Sauers, Andrea D; Sauers, Eric L; Valier, Alison R Snyder

2017-11-01

  Quality improvement (QI) is a health care concept that ensures patients receive high-quality (safe, timely, effective, efficient, equitable, patient-centered) and affordable care. Despite its importance, the application of QI in athletic health care has been limited.   To describe the need for and define QI in health care, to describe how to measure quality in health care, and to present a QI case in athletic training.   As the athletic training profession continues to grow, a widespread engagement in QI efforts is necessary to establish the value of athletic training services for the patients that we serve. A review of the importance of QI in health care, historical perspectives of QI, tools to drive QI efforts, and examples of common QI initiatives is presented to assist clinicians in better understanding the value of QI for advancing athletic health care and the profession. Clinical and Research Advantages:  By engaging clinicians in strategies to measure outcomes and improve their patient care services, QI practice can help athletic trainers provide high-quality and affordable care to patients.

Transferring skills in quality collaboratives focused on improving patient logistics

NARCIS (Netherlands)

J.W.M. Weggelaar-Jansen (Anne Marie); J.D.H. van Wijngaarden (Jeroen)

2018-01-01

textabstractA quality improvement collaborative, often used by the Institute for Healthcare Improvement, is used to educate healthcare professionals and improve healthcare at the same time. Our research focused on quality improvement collaboratives aiming to improve patient logistics and tried to

Allergens in law - European legislation assessed against the preferences of food allergic consumers

NARCIS (Netherlands)

Hendriks, M.J.; Frewer, L.J.; Meulen, van der B.M.J.

2011-01-01

This article reviews current European legislation concerning allergens and their labelling, in particular in relation to the need to optimise consumer protection and improve the quality of life of food allergic consumers. Adequate communication concerning the presence of (potentially) allergenic

Room for improvement? Leadership, innovation culture and uptake of quality improvement methods in general practice.

Science.gov (United States)

Apekey, Tanefa A; McSorley, Gerry; Tilling, Michelle; Siriwardena, A Niroshan

2011-04-01

Leadership and innovation are currently seen as essential elements for the development and maintenance of high-quality care. Little is known about the relationship between leadership and culture of innovation and the extent to which quality improvement methods are used in general practice. This study aimed to assess the relationship between leadership behaviour, culture of innovation and adoption of quality improvement methods in general practice. Self-administered postal questionnaires were sent to general practitioner quality improvement leads in one county in the UK between June and December 2007. The questionnaire consisted of background information, a 12-item scale to assess leadership behaviour, a seven-dimension self-rating scale for culture of innovation and questions on current use of quality improvement tools and techniques. Sixty-three completed questionnaires (62%) were returned. Leadership behaviours were not commonly reported. Most practices reported a positive culture of innovation, featuring relationship most strongly, followed by targets and information but rated lower on other dimensions of rewards, risk and resources. There was a significant positive correlation between leadership behaviour and the culture of innovation (r = 0.57; P improvement methods were not adopted by most participating practices. Leadership behaviours were infrequently reported and this was associated with a limited culture of innovation in participating general practices. There was little use of quality improvement methods beyond clinical and significant event audit. Practices need support to enhance leadership skills, encourage innovation and develop quality improvement skills if improvements in health care are to accelerate. © 2010 Blackwell Publishing Ltd.

Leadership, safety climate, and continuous quality improvement: impact on process quality and patient safety.

Science.gov (United States)

McFadden, Kathleen L; Stock, Gregory N; Gowen, Charles R

2014-10-01

Successful amelioration of medical errors represents a significant problem in the health care industry. There is a need for greater understanding of the factors that lead to improved process quality and patient safety outcomes in hospitals. We present a research model that shows how transformational leadership, safety climate, and continuous quality improvement (CQI) initiatives are related to objective quality and patient safety outcome measures. The proposed framework is tested using structural equation modeling, based on data collected for 204 hospitals, and supplemented with objective outcome data from the Centers for Medicare and Medicaid Services. The results provide empirical evidence that a safety climate, which is connected to the chief executive officer's transformational leadership style, is related to CQI initiatives, which are linked to improved process quality. A unique finding of this study is that, although CQI initiatives are positively associated with improved process quality, they are also associated with higher hospital-acquired condition rates, a measure of patient safety. Likewise, safety climate is directly related to improved patient safety outcomes. The notion that patient safety climate and CQI initiatives are not interchangeable or universally beneficial is an important contribution to the literature. The results confirm the importance of using CQI to effectively enhance process quality in hospitals, and patient safety climate to improve patient safety outcomes. The overall pattern of findings suggests that simultaneous implementation of CQI initiatives and patient safety climate produces greater combined benefits.

Quality Improvement of Liver Ultrasound Images Using Fuzzy Techniques.

Science.gov (United States)

Bayani, Azadeh; Langarizadeh, Mostafa; Radmard, Amir Reza; Nejad, Ahmadreza Farzaneh

2016-12-01

Liver ultrasound images are so common and are applied so often to diagnose diffuse liver diseases like fatty liver. However, the low quality of such images makes it difficult to analyze them and diagnose diseases. The purpose of this study, therefore, is to improve the contrast and quality of liver ultrasound images. In this study, a number of image contrast enhancement algorithms which are based on fuzzy logic were applied to liver ultrasound images - in which the view of kidney is observable - using Matlab2013b to improve the image contrast and quality which has a fuzzy definition; just like image contrast improvement algorithms using a fuzzy intensification operator, contrast improvement algorithms applying fuzzy image histogram hyperbolization, and contrast improvement algorithms by fuzzy IF-THEN rules. With the measurement of Mean Squared Error and Peak Signal to Noise Ratio obtained from different images, fuzzy methods provided better results, and their implementation - compared with histogram equalization method - led both to the improvement of contrast and visual quality of images and to the improvement of liver segmentation algorithms results in images. Comparison of the four algorithms revealed the power of fuzzy logic in improving image contrast compared with traditional image processing algorithms. Moreover, contrast improvement algorithm based on a fuzzy intensification operator was selected as the strongest algorithm considering the measured indicators. This method can also be used in future studies on other ultrasound images for quality improvement and other image processing and analysis applications.

How to Measure and Interpret Quality Improvement Data.

Science.gov (United States)

McQuillan, Rory Francis; Silver, Samuel Adam; Harel, Ziv; Weizman, Adam; Thomas, Alison; Bell, Chaim; Chertow, Glenn M; Chan, Christopher T; Nesrallah, Gihad

2016-05-06

This article will demonstrate how to conduct a quality improvement project using the change idea generated in "How To Use Quality Improvement Tools in Clinical Practice: How To Diagnose Solutions to a Quality of Care Problem" by Dr. Ziv Harel and colleagues in this Moving Points feature. This change idea involves the introduction of a nurse educator into a CKD clinic with a goal of increasing rates of patients performing dialysis independently at home (home hemodialysis or peritoneal dialysis). Using this example, we will illustrate a Plan-Do-Study-Act (PDSA) cycle in action and highlight the principles of rapid cycle change methodology. We will then discuss the selection of outcome, process, and balancing measures, and the practicalities of collecting these data in the clinic environment. We will also introduce the PDSA worksheet as a practical way to oversee the progress of a quality improvement project. Finally, we will demonstrate how run charts are used to visually illustrate improvement in real time, and how this information can be used to validate achievement, respond appropriately to challenges the project may encounter, and prove the significance of results. This article aims to provide readers with a clear and practical framework upon which to trial their own ideas for quality improvement in the clinical setting. Copyright © 2016 by the American Society of Nephrology.

Muskuloskeletal radiography as a specialty. A quality improvement project on positioning of musculoskeletal x-rays with a multimethodology and multidisciplinary approach

DEFF Research Database (Denmark)

Jensen, Janni; Torfing, Trine

treatment and/or unfavorable outcome for the patient. Guidelines developed by “European Guidelines on Quality Criteria for Diagnostic Radiographic Images” provide quality assessment tools regarding the technical aspect of x-rays (i.e. noise and resolution). One could argue what the quality of a perfectly......, i.e. the radiographers working with muskuloskeletal x-rays are specialized within this field. The primary purposes of this project are to perform continuous quantitative quality assessment and improvement of positioning of muskuloskeletal x-rays. Methods It has not yet been possible to find any...... of muskuloskeletal x-rays held by a radiologist, a reporting radiographer and an orthopedic surgeon, all from OUH • Radiographers are offered one-hour individual sessions with a reporting radiographer reviewing their own X-rays discussing positioning and pathology focusing on the association between positioning...

Internal Resources to Improve the Quality of Higher Education

Directory of Open Access Journals (Sweden)

Tatyana V. Zak

2016-03-01

Full Text Available The article deals with the situation in the Russian higher education system. The factors affecting the improvement of the quality of higher education are analyzed. The emphasis is on mass universities. The main obstacles to improving the quality of education in these institutions are the Institute of collective reputation and the high costs of the struggle for improving the quality of education.The necessity of focusing on the actuation of the internal resources to improve the quality associated with the change in the educational process: giving students the right to choose the timing exams and training period at university. The implementation of the proposed measures will reduce the opportunity costs associated with quality improvement activities. The proposed change in the organization of the learning process opens the possibility to estimate the activity of universities in terms of medium-term implementation of educational programs. The use of this indicator will not only combine the two different targets of universities, but also to minimize the costs of opportunistic behavior of teachers and management.

Lower- Versus Higher-Income Populations In The Alternative Quality Contract: Improved Quality And Similar Spending.

Science.gov (United States)

Song, Zirui; Rose, Sherri; Chernew, Michael E; Safran, Dana Gelb

2017-01-01

As population-based payment models become increasingly common, it is crucial to understand how such payment models affect health disparities. We evaluated health care quality and spending among enrollees in areas with lower versus higher socioeconomic status in Massachusetts before and after providers entered into the Alternative Quality Contract, a two-sided population-based payment model with substantial incentives tied to quality. We compared changes in process measures, outcome measures, and spending between enrollees in areas with lower and higher socioeconomic status from 2006 to 2012 (outcome measures were measured after the intervention only). Quality improved for all enrollees in the Alternative Quality Contract after their provider organizations entered the contract. Process measures improved 1.2 percentage points per year more among enrollees in areas with lower socioeconomic status than among those in areas with higher socioeconomic status. Outcome measure improvement was no different between the subgroups; neither were changes in spending. Larger or comparable improvements in quality among enrollees in areas with lower socioeconomic status suggest a potential narrowing of disparities. Strong pay-for-performance incentives within a population-based payment model could encourage providers to focus on improving quality for more disadvantaged populations. Project HOPE—The People-to-People Health Foundation, Inc.

Validation of the European Proxy KIDSCREEN-52 Pilot Test Health-Related Quality of Life Questionnaire: First Results

NARCIS (Netherlands)

Robitail, S.; Simeoni, M.-C.; Erhart, M.; Ravens-Sieberer, U.; Bruil, J.; Auquier, P.

2006-01-01

Purpose: The KIDSCREEN project aims to develop a European cross-cultural generic self-administered Health-Related Quality of Life (HRQoL) instrument for children and adolescents. Proxy measures HRQoL should be a useful and practical alternative to assess children's HRQoL. The KIDSCREEN pilot study

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

Science.gov (United States)

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Use of quality improvement organization review... HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Quality Improvement § 422.153 Use of quality improvement organization review information. CMS will acquire from quality...

Discourses of crises and the European Union as a community without qualities: A view from the literary history

Directory of Open Access Journals (Sweden)

Đerić Gordana

2014-01-01

Full Text Available Proceeding from the assumption that meanings and perceptions of social reality are generated by means of public language, or in other words, from the belief that the role of public language is more that of shaping the social reality, rather than description or detection of problems, the authors assume a reserved approach to contemporary discourses on the crises of the European Union. Such approach is explained by the vagueness and deprival of meaning of the term crises, as it is typically used in current political discourses. By pointing out to a loss of the semantic core of the term, caused by its inconsistent usage and longevity of the condition termed 'crisis', they also express doubts concerning its analytical operativeness. In the authors' opinion, this 'profaned' term has become a performative representation of simulation - sort of crisis, which has, either as a justification, necessity or a pretext, created numerous effects in recent years. The assumption that simulation - seen as the absence of the reality rather than its disguise (Jean Baudrillard - represents a leading principle of our age is examined through the concept of continued effect of literature and corroborated by the authors' interpretation of Robert Musil's novel 'Man Without Qualities', as a mythopoetic framework of the analysis and reflections of high art in the contemporary age. In the first part of the text, the authors point out to Musil's poetic anticipation of the direction taken by the European society, that is, the cultural climate and conditions favouring development of man without qualities. In the absence of these qualities and, especially, in preference given to Musil's category 'sense of possibility'over the 'sense of reality', the authors recognise the interpretative basis for the analysis of Community without qualities, as another name for the European Union. From that point of view, which, in addition to loss of specific qualities, also involves deprival of

Cryosat Level1b SAR/Sarin: Improving the Quality of the Baseline C Products

Science.gov (United States)

Scagliola, M.; Fornari, M.; Tagliani, N.; Frommknecht, B.; Bouffard, J.; Parrinello, T.

2014-12-01

CryoSat was launched on the 8th April 2010 and it is the first European ice mission dedicated to monitoring precise changes in the thickness of polar ice sheets and floating sea ice over a 3-year period. Cryosat carries an innovative radar altimeter called the Synthetic Aperture Interferometric Altimeter (SIRAL), that transmits pulses at a high pulse repetition frequency thus making the received echoes phase coherent and suitable for azimuth processing. This allows to reach a significantly improved along track resolution with respect to traditional pulse-width limited altimeters. CryoSat is the first altimetry mission operating in SAR mode and continuous improvement in the Level1 Instrument Processing Facility (IPF1) are being identified, tested and validated in order to improve the quality of the Level1b products. Towards the release of the BaselineC of the CryoSat Level1b SAR/SARin products, that is expected at the end of 2014, several improvements have been identified: a datation bias of about -0.5195 ms will be corrected a range bias of about 0.6730 m will be corrected The range window size will be doubled with respect to BaselineB, so that the in Level1b products the waveforms will be doubled too Improved processing for 1Hz echoes to have sharper waveforms Surface sample stack weighting to filter out the single look echoes acquired at highest look angle, that results in a sharpening of the 20Hz waveforms Additional auxiliary information related to the mispointing angles of the instrument as well as to the stacks of single look echoes will be added This poster details the main quality improvements that are foreseen to be included in the CryoSat Level1b SAR/SARin products in BaselineC.

San Francisco Bay Water Quality Improvement Fund

Science.gov (United States)

EPAs grant program to protect and restore San Francisco Bay. The San Francisco Bay Water Quality Improvement Fund (SFBWQIF) has invested in 58 projects along with 70 partners contributing to restore wetlands, water quality, and reduce polluted runoff.,

MODERN CONCEPTS OF THE SIX SIGMA METHODOLOGY FOR IMPROVING THE QUALITY

Directory of Open Access Journals (Sweden)

MARGARITA JANESKA

2018-02-01

Full Text Available Product quality is generally accepted as being crucial in today’s industrial business. The traditional aspects of product quality are connected to product design (translating customer demands into attractive features and technical specifications and to the design and specification of high performance production processes with low defect rates. Quality management is the general expression for all actions leading to quality. Quality management is focused on improving customer satisfaction through continuous improvement of processes including the removal of uncertain activities, and continuous improvement of the quality of processes, products and services. The quality management includes four key processes, such as quality planning, quality assurance, quality control and quality costs. The main accent in this paper will be on quality control and the application of one of the quality control tools in order to improve it. Six Sigma is different from other quality improvement concepts in that its framework is comprised of many principles, tools and techniques, which, together with experience, are all integrated and translated into best practices. Bearing in mind that the goal of every company is to work effectively and effectively in the long run, this paper focuses on Six Sigma as a way to continuously improve quality. Namely, this paper emphasizes the key features of the quality of products / services, the Need for the application of Six Sigma for quality assurance, and also a detailed list of tools and techniques that can be used during the implementation of Six Sigma.

SF Bay Water Quality Improvement Fund: Projects and Accomplishments

Science.gov (United States)

San Francisco Bay Water Quality Improvement Fund (SFBWQIF) projects listed here are part of an EPA competitive grant program to improve SF Bay water quality focused on restoring impaired waters and enhancing aquatic resources.

Infrastructure for large-scale quality-improvement projects: early lessons from North Carolina Improving Performance in Practice.

Science.gov (United States)

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

2010-01-01

Little is known regarding how to accomplish large-scale health care improvement. Our goal is to improve the quality of chronic disease care in all primary care practices throughout North Carolina. Methods for improvement include (1) common quality measures and shared data system; (2) rapid cycle improvement principles; (3) quality-improvement consultants (QICs), or practice facilitators; (4) learning networks; and (5) alignment of incentives. We emphasized a community-based strategy and developing a statewide infrastructure. Results are reported from the first 2 years of the North Carolina Improving Performance in Practice (IPIP) project. A coalition was formed to include professional societies, North Carolina AHEC, Community Care of North Carolina, insurers, and other organizations. Wave One started with 18 practices in 2 of 9 regions of the state. Quality-improvement consultants recruited practices. Over 80 percent of practices attended all quarterly regional meetings. In 9 months, almost all diabetes measures improved, and a bundled asthma measure improved from 33 to 58 percent. Overall, the magnitude of improvement was clinically and statistically significant (P = .001). Quality improvements were maintained on review 1 year later. Wave Two has spread to 103 practices in all 9 regions of the state, with 42 additional practices beginning the enrollment process. Large-scale health care quality improvement is feasible, when broadly supported by statewide leadership and community infrastructure. Practice-collected data and lack of a control group are limitations of the study design. Future priorities include maintaining improved sustainability for practices and communities. Our long-term goal is to transform all 2000 primary-care practices in our state.

Quality improvement process pilot project at Gallagher station

International Nuclear Information System (INIS)

Vondielingen, D.E.

1992-01-01

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

Quality of life in children and adolescents: a European public health perspective.

Science.gov (United States)

Ravens-Sieberer, U; Gosch, A; Abel, T; Auquier, P; Bellach, B M; Bruil, J; Dür, W; Power, M; Rajmil, L

2001-01-01

The measurement of health-related quality of life (HRQOL) is increasingly important as a means of monitoring population health status over time, of detecting sub-groups within the general population with poor HRQOL, and of assessing the impact of public health interventions within a given population. At present, no standardised instrument exists which can be applied with equal relevance in pediatric populations in different European populations. The collaborative European KIDSCREEN project aims to develop a standardised screening instrument for children's quality of life which will be used in representative national and European health surveys. Participants of the project are centres from Austria, France, Germany, Netherlands, Spain, Switzerland, and United Kingdom. By including the instrument in health services research and health reporting, it also aims at identifying children at risk in terms of their subjective health, thereby allowing the possibility of early intervention. Instrument development will be based on constructing a psychometrically sound HRQOL instrument taking into account the existing state of the art. Development will centre on literature searches, expert consultation (Delphi Methods) and focus groups with children and adolescents (8-17 years). According to international guidelines, items will be translated into the languages of the seven participating countries for a pilot test with 2,100 children and their parents in Europe. The final instrument will be used in representative mail and telephone surveys of HRQOL in 1,800 children and their parents per country (total n = 25,200) and normative data will be produced. The potential for implementing the measurement tool in health services and health reporting will also be evaluated in several different research and public health settings. The final analysis will involve national and cross cultural-analysis of the instrument. The international, collaborative nature of the KIDSCREEN project means it

Quality uncertainty and allocation of decision rights in the European protected designation of origin

Directory of Open Access Journals (Sweden)

Gaetano Martino

2013-06-01

Full Text Available The paper considers some issue in the governance of the European Protected Designation of Origin (PDO. The PDO systems are the outcomes of both farmers and consumers expectations and connect the valorisation of the agricultural and rural resources of given territories to the quality of typical products. A critical point in the governance of the PDO systems is represented by the connection between the quality strategies and the uncertainty. The paper argues that the PDO systems can be thought of as strictly coordinated subsystems in which the ex post governance play a critical role in coping with quality uncertainty. The study suggests that the society's inducements given raise to complex organizational systems in which the allocation of decision rights to PDO collective organizations play a major role. The empirical analysis is carried out by examining ten Italian PDO systems in order to identify the decision rights allocated.

Ozone concentrations and damage for realistic future European climate and air quality scenarios

Science.gov (United States)

Hendriks, Carlijn; Forsell, Nicklas; Kiesewetter, Gregor; Schaap, Martijn; Schöpp, Wolfgang

2016-11-01

Ground level ozone poses a significant threat to human health from air pollution in the European Union. While anthropogenic emissions of precursor substances (NOx, NMVOC, CH4) are regulated by EU air quality legislation and will decrease further in the future, the emissions of biogenic NMVOC (mainly isoprene) may increase significantly in the coming decades if short-rotation coppice plantations are expanded strongly to meet the increased biofuel demand resulting from the EU decarbonisation targets. This study investigates the competing effects of anticipated trends in land use change, anthropogenic ozone precursor emissions and climate change on European ground level ozone concentrations and related health and environmental impacts until 2050. The work is based on a consistent set of energy consumption scenarios that underlie current EU climate and air quality policy proposals: a current legislation case, and an ambitious decarbonisation case. The Greenhouse Gas-Air Pollution Interactions and Synergies (GAINS) integrated assessment model was used to calculate air pollutant emissions for these scenarios, while land use change because of bioenergy demand was calculated by the Global Biosphere Model (GLOBIOM). These datasets were fed into the chemistry transport model LOTOS-EUROS to calculate the impact on ground level ozone concentrations. Health damage because of high ground level ozone concentrations is projected to decline significantly towards 2030 and 2050 under current climate conditions for both energy scenarios. Damage to plants is also expected to decrease but to a smaller extent. The projected change in anthropogenic ozone precursor emissions is found to have a larger impact on ozone damage than land use change. The increasing effect of a warming climate (+2-5 °C across Europe in summer) on ozone concentrations and associated health damage, however, might be higher than the reduction achieved by cutting back European ozone precursor emissions. Global

Legal requirements for the quality of herbal substances and herbal preparations for the manufacturing of herbal medicinal products in the European union.

Science.gov (United States)

Vlietinck, Arnold; Pieters, Luc; Apers, Sandra

2009-06-01

In the European Union (EU) herbal medicinal products have become increasingly important. This is, for instance, underlined by the recent introduction of a simplified procedure in the Member States of the EU allowing the registration of herbal medicinal products which fulfill the criteria of a traditional herbal medicinal product, i.e., sufficient evidence of its medicinal use throughout a period of at least 30 years for products in the EU and at least 15 years within the EU and 15 years elsewhere for products outside the EU. With regard to the manufacturing of these products and their quality, applications of traditional herbal medicinal products have to fulfil the same requirements as applications for a marketing authorization. The quality of herbal substances as well as herbal preparations will be determined by the availability of modern science-based public monographs in the European Pharmacopoeia and their equivalents developed by the pharmaceutical industry. The standards put forward in these monographs must allow us not only to define the quality of these products, but also to eliminate dangerous counterfeit, substandard, adulterated and contaminated (traditional) herbal medicinal products. The usefulness of these monographs to implement the criteria on quality and specifications put forward for these products in the different guidelines of the European Medicines Agency (EMEA) is discussed.

Coaching and Quality Assistance in Quality Rating Improvement Systems: Approaches Used by TA Providers to Improve Quality in Early Care and Education Programs and Home-Based Settings

Science.gov (United States)

Smith, Sheila; Robbins, Taylor; Schneider, Will; Kreader, J. Lee; Ong, Christine

2012-01-01

Quality Rating Improvement Systems (QRISs) commonly offer on-site technical assistance (TA) and coaching to help early care and education settings achieve quality improvements and a higher QRIS rating. In surveys of administrators overseeing statewide QRISs, almost all states reported the use of on-site TA and coaching in both center-based and…

Using complaints to enhance quality improvement: developing an analytical tool.

Science.gov (United States)

Hsieh, Sophie Yahui

2012-01-01

This study aims to construct an instrument for identifying certain attributes or capabilities that might enable healthcare staff to use complaints to improve service quality. PubMed and ProQuest were searched, which in turn expanded access to other literature. Three paramount dimensions emerged for healthcare quality management systems: managerial, operational, and technical (MOT). The paper reveals that the managerial dimension relates to quality improvement program infrastructure. It contains strategy, structure, leadership, people and culture. The operational dimension relates to implementation processes: organizational changes and barriers when using complaints to enhance quality. The technical dimension emphasizes the skills, techniques or information systems required to achieve successfully continuous quality improvement. The MOT model was developed by drawing from the relevant literature. However, individuals have different training, interests and experiences and, therefore, there will be variance between researchers when generating the MOT model. The MOT components can be the guidelines for examining whether patient complaints are used to improve service quality. However, the model needs testing and validating by conducting further research before becoming a theory. Empirical studies on patient complaints did not identify any analytical tool that could be used to explore how complaints can drive quality improvement. This study developed an instrument for identifying certain attributes or capabilities that might enable healthcare professionals to use complaints and improve service quality.

Talking about quality

DEFF Research Database (Denmark)

Wiig, Siri; Aase, Karina; von Plessen, Christian

2014-01-01

and bridge potential disconnect in language about quality between system levels, professions, and clinical services. The aim is therefore to explore and compare conceptualization of quality among national bodies (macro level), senior hospital managers (meso level), and professional groups within clinical...... depending on the type of services provided. CONCLUSION: The quality conceptualization differed across system levels (macro-meso-micro), among professional groups (nurses, doctors, managers), and between the studied micro systems in our ten sampled European hospitals. This entails a managerial alignment......BACKGROUND: Conceptualization of quality of care - in terms of what individuals, groups and organizations include in their meaning of quality, is an unexplored research area. It is important to understand how quality is conceptualised as a means to successfully implement improvement efforts...

Designing a Clinical Data Warehouse Architecture to Support Quality Improvement Initiatives.

Science.gov (United States)

Chelico, John D; Wilcox, Adam B; Vawdrey, David K; Kuperman, Gilad J

2016-01-01

Clinical data warehouses, initially directed towards clinical research or financial analyses, are evolving to support quality improvement efforts, and must now address the quality improvement life cycle. In addition, data that are needed for quality improvement often do not reside in a single database, requiring easier methods to query data across multiple disparate sources. We created a virtual data warehouse at NewYork Presbyterian Hospital that allowed us to bring together data from several source systems throughout the organization. We also created a framework to match the maturity of a data request in the quality improvement life cycle to proper tools needed for each request. As projects progress in the Define, Measure, Analyze, Improve, Control stages of quality improvement, there is a proper matching of resources the data needs at each step. We describe the analysis and design creating a robust model for applying clinical data warehousing to quality improvement.

On relations between quality management, doing business and life quality (a comparative analysis of Balkans with western European countries)

OpenAIRE

CEKO ENRIKO

2016-01-01

The purpose of research: Determination of relations between quality management, doing business and life quality and giving some thoughts to improve the situation regarding the quality institutions and quality infrastructure parallel with doing business climate and life quality. Methods: Collection of information, data and facts for quality management, doing business and life quality mainly from primary sources, comparing the information, data and facts gathered, conducting relevant analysis a...

The European Cancer Patient's Bill of Rights, update and implementation 2016

DEFF Research Database (Denmark)

Højgaard, Liselotte; Löwenberg, Bob; Selby, Peter

2016-01-01

.The right of every European citizen to optimal and timely access to a diagnosis and to appropriate specialised care, underpinned by research and innovation.The right of every European citizen to receive care in health systems that ensure the best possible cancer prevention, the earliest possible diagnosis...... of their cancer, improved outcomes, patient rehabilitation, best quality of life and affordable health care. The key aspects of working towards implementing the BoR are:Agree our high-level goal. The vision of 70% long-term survival for patients with cancer in 2035, promoting cancer prevention and cancer control...... on improving outcomes; (3) Improving access to new and established cancer care by sharing best practice in the development, approval, procurement and reimbursement of cancer diagnostic tests and treatments.Work with other organisations to bring into being a Europe based centre that will (1) systematically...

Performance Evaluation of Qom Shahid Beheshti Hospital based on EFQM (European Foundation for Quality Management

Directory of Open Access Journals (Sweden)

Mahmoud Parham

2013-07-01

Full Text Available Background and Objectives: performance evaluation is an important tool for measuring achievement of an organization’ quality objectives and performance excellence. Among the models of organizational excellence currently used to evaluate the quality of services in hospitals, European Foundation for Quality Management (EFQM have been more welcoming in hospitals. This study was done with the aim of evaluating the performance of Qom shahid beheshti hospital based on EFQM excellence model and identification of strengths and areas in need of improvement.Methods: This study was conducted using cross-sectional method during summer 2011. The Tool for data gathering was a standard self-assessment questionnaire based on EFQM excellence model. The study population was staff managers of Qom shahid beheshti hospital, who were selected through census method. Data were collected in the form of nonuplet criteria of EFQM model, and analyzed by descriptive tests.Result: The scores that were obtained based on nonuplet criteria of EFQM were as follows: 48.4% for leadership, 44.9% for policy and strategy, 48.6% for employees, 49.5% for resources and contributions, 46.4% for processes, 42.1% for the results of customer, 38.6% for the results of employees, 44% for society results, and 42.4% for key performance results. The highest and lowest scores were related to resources and contributions and results of employees, respectively. Total scores of the hospital were 447 out of 1000.Conclusion: Considering that the assessment process of board of trustees hospitals is using EFQM evaluation model in addition to accreditation standards, therefore, in this research, the strengths and weaknesses were identified using this model and some recommendations were given to the hospital.

Quality Improvement with Trustee Commitment.

Science.gov (United States)

Chaffee, Ellen Earle; Seymour, Daniel

1991-01-01

Total Quality Management is a comprehensive system for developing organizationwide participation in planning for and implementing continuous improvement in critical processes. In colleges, trustees can be central to the success of the method through their commitment and the development of supportive policy and procedures. (MSE)

Evolution and outcomes of a quality improvement program.

Science.gov (United States)

Thor, Johan; Herrlin, Bo; Wittlöv, Karin; Øvretveit, John; Brommels, Mats

2010-01-01

The purpose of this paper is to examine the outcomes and evolution over a five-year period of a Swedish university hospital quality improvement program in light of enduring uncertainty regarding the effectiveness of such programs in healthcare and how best to evaluate it. The paper takes the form of a case study, using data collected as part of the program, including quality indicators from clinical improvement projects and participants' program evaluations. Overall, 58 percent of the program's projects (39/67) demonstrated success. A greater proportion of projects led by female doctors demonstrated success (91 percent, n=11) than projects led by male doctors (51 percent, n=55). Facilitators at the hospital continuously adapted the improvement methods to the local context. A lack of dedicated time for improvement efforts was the participants' biggest difficulty. The dominant benefits included an increased ability to see the "bigger picture" and the improvements achieved for patients and employees. Quality measurement, which is important for conducting and evaluating improvement efforts, was weak with limited reliability. Nevertheless, the present study adds evidence about the effectiveness of healthcare improvement programs. Gender differences in improvement team leadership merit further study. Improvement program evaluation should assess the extent to which improvement methods are locally adapted and applied. This case study reports the outcomes of all improvement projects undertaken in one healthcare organization over a five-year period and provides in-depth insight into an improvement program's changeable nature.

Formalising medical quality indicators to improve guidelines

NARCIS (Netherlands)

Van Gendt, Marjolein; Ten Teije, Annette; Serban, Radu; Van Harmelen, Frank

2005-01-01

Medical guidelines can significantly improve quality of medical care and reduce costs. But how do we get sound and well-structured guidelines? This paper investigates the use of quality indicators that are formulated by medical institutions to evaluate medical care. The main research questions are

Systematic Review of International Colposcopy Quality Improvement Guidelines.

Science.gov (United States)

Mayeaux, Edward J; Novetsky, Akiva P; Chelmow, David; Choma, Kim; Garcia, Francisco; Liu, Angela H; Papasozomenos, Theognosia; Einstein, Mark H

2017-10-01

The American Society for Colposcopy and Cervical Pathology Colposcopy Standards Committee organized multiple working groups to draft colposcopy standards for the United States. As part of this project, international quality assurance and improvement measures were examined. The quality improvement working group performed a systematic review of the literature to collate international guidelines related to quality improvement. Source guidelines were collected using searches in Medline, Google Scholar, the International Federation of Cervical Pathology and Colposcopy Web site, other regional colposcopy group's Web sites, and communications with International Federation of Cervical Pathology and Colposcopy board of directors' members and other expert members of various national groups. Once identified, the sources were reviewed by multiple workgroup members for potential guideline materials. Fifty-six unique documents were identified, of which 18 met inclusion criteria and contributed data to the analysis. Information was abstracted and grouped by related subject. Wide variation exists in colposcopy guidance and quality indicators from regional and national colposcopy societies. Abstracted international guidelines are presented.

Continuous improvement of software quality

International Nuclear Information System (INIS)

Sivertsen, Terje

1999-04-01

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

Influence of parental socio-economic status on diet quality of European adolescents: results from the HELENA study.

Science.gov (United States)

Béghin, L; Dauchet, L; De Vriendt, Tineke; Cuenca-García, M; Manios, Y; Toti, E; Plada, M; Widhalm, K; Repasy, J; Huybrechts, I; Kersting, M; Moreno, L A; Dallongeville, J

2014-04-14

Diet quality is influenced by socio-economic and geographical factors. The present study sought to assess whether adolescents' diet quality is affected by their parents' socio-economic status and whether the relationship between these factors is similar in northern and southern Europe. Data collected in the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study in eight European countries were analysed. Dietary intake data were recorded via repeated 24 h recalls (using specifically developed HELENA Dietary Intake Assessment Tool software) and converted into an adolescent-specific Diet Quality Index (DQI-AM). Socio-economic status was estimated through parental educational level (Par-Educ-Lev) and parental occupation level (Par-Occ-Lev) as reported by the adolescents in a specific questionnaire. The DQI-AM data were then analysed as a function of Par-Educ-Lev and Par-Occ-Lev in northern European countries (Austria, Belgium, France, Germany and Sweden) and southern European countries (Greece, Italy and Spain). We studied a total of 1768 adolescents (age 14.7 (SD 1.3) years; percentage of girls: 52.8%; 1135 and 633 subjects from northern and southern Europe, respectively). On average, the DQI-AM score was higher in southern Europe than in northern Europe (69.1 (SD 0.1) v. 60.4 (SD 2.8), respectively; P < 0.001; Δ = 12.6%). The DQI was positively correlated with both paternal and maternal Par-Educ-Lev. However, this association was more pronounced in northern Europe than in southern Europe (P interaction = 0.004 for the mother and 0.06 for the father). The DQI was also positively correlated with Par-Occ-Lev (all P trends < 0.01), but this correlation was independent of the geographical area (P interaction = 0.51 for the mother and 0.50 for the father). In conclusion, Par-Educ-Lev and Par-Occ-Lev are associated with diet quality in adolescents in Europe. However, this association differs between northern Europe and southern Europe.

Application of improved quality control technology to pressure vessels

International Nuclear Information System (INIS)

Kriedt, F.

1985-01-01

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

International Accreditations as Drivers of Business School Quality Improvement

Science.gov (United States)

Bryant, Michael

2013-01-01

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

Combining clinical microsystems and an experiential quality improvement curriculum to improve residency education in internal medicine.

Science.gov (United States)

Tess, Anjala V; Yang, Julius J; Smith, C Christopher; Fawcett, Caitlin M; Bates, Carol K; Reynolds, Eileen E

2009-03-01

Beth Israel Deaconess Medical Center's internal medicine residency program was admitted to the new Education Innovation Project accreditation pathway of the Accreditation Council of Graduate Medical Education to begin in July 2006. The authors restructured the inpatient medical service to create clinical microsystems in which residents practice throughout residency. Program leadership then mandated an active curriculum in quality improvement based in those microsystems. To provide the experience to every graduating resident, a core faculty in patient safety was trained in the basics of quality improvement. The authors hypothesized that such changes would increase the number of residents participating in quality improvement projects, improve house officer engagement in quality improvement work, enhance the culture of safety the residents perceive in their training environment, improve work flow on the general medicine ward rotations, and improve the overall educational experience for the residents on ward rotations.The authors describe the first 18 months of the intervention (July 2006 to January 2008). The authors assessed attitudes and the educational experience with surveys and evaluation forms. After the intervention, the authors documented residents' participation in projects that overlapped with hospital priorities. More residents reported roles in designing and implementing quality improvement changes. Residents also noted greater satisfaction with the quality of care they deliver. Fewer residents agreed or strongly agreed that the new admitting system interfered with communication. Ongoing residency program assessment showed an improved perception of workload, and educational ratings of rotations improved. The changes required few resources and can be transported to other settings.

Improved GMP-compliant multi-dose production and quality control of 6-[18F]fluoro-L-DOPA.

Science.gov (United States)

Luurtsema, G; Boersma, H H; Schepers, M; de Vries, A M T; Maas, B; Zijlma, R; de Vries, E F J; Elsinga, P H

2017-01-01

6-[ 18 F]Fluoro-L-3,4-dihydroxyphenylalanine (FDOPA) is a frequently used radiopharmaceutical for detecting neuroendocrine and brain tumors and for the differential diagnosis of Parkinson's disease. To meet the demand for FDOPA, a high-yield GMP-compliant production method is required. Therefore, this study aimed to improve the FDOPA production and quality control procedures to enable distribution of the radiopharmaceutical over distances.FDOPA was prepared by electrophilic fluorination of the trimethylstannyl precursor with [ 18 F]F 2 , produced from [ 18 O] 2 via the double-shoot approach, leading to FDOPA with higher specific activity as compared to FDOPA which was synthesized, using [ 18 F]F 2 produced from 20 Ne, leading to FDOPA with a lower specific activity. The quality control of the product was performed using a validated UPLC system and compared with quality control with a conventional HPLC system. Impurities were identified using UPLC-MS. The [ 18 O] 2 double-shoot radionuclide production method yielded significantly more [ 18 F]F 2 with less carrier F 2 than the conventional method starting from 20 Ne. After adjustment of radiolabeling parameters substantially higher amounts of FDOPA with higher specific activity could be obtained. Quality control by UPLC was much faster and detected more side-products than HPLC. UPLC-MS showed that the most important side-product was FDOPA-quinone, rather than 6-hydroxydopa as suggested by the European Pharmacopoeia. The production and quality control of FDOPA were significantly improved by introducing the [ 18 O] 2 double-shoot radionuclide production method, and product analysis by UPLC, respectively. As a result, FDOPA is now routinely available for clinical practice and for distribution over distances.

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.

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

Science.gov (United States)

Tout, Kathryn; Isner, Tabitha; Zaslow, Martha

2011-01-01

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

European Master of Science in Nuclear Engineering

International Nuclear Information System (INIS)

Moons, Frans; Safieh, Joseph; Giot, Michel; Mavko, Borut; Sehgal, Bal Raj; Schaefer, Anselm; Goethem, Georges van; D'Haeseleer, William

2005-01-01

The need to preserve, enhance or strengthen nuclear knowledge is worldwide recognised since a couple of years. Among others, 'networking to maintain nuclear competence through education and training', was recommended in 2001 by an expert panel to the European Commission [EUR, 19150 EN, Strategic issues related to a 6th Euratom Framework Programme (2002-2006). Scientific and Technical Committee Euratom, pp. 14]. It appears that within the European University education and training framework, nuclear engineering is presently still sufficiently covered, although somewhat fragmented. However, it has been observed that several areas are at risk in the very near future including safety relevant fields such as reactor physics and nuclear thermal-hydraulics. Furthermore, in some countries deficiencies have been identified in areas such as the back-end of the nuclear fuel cycle, waste management and decommissioning. To overcome these risks and deficiencies, it is of very high importance that European countries work more closely together. Harmonisation and improvement of the nuclear education and training have to take place at an international level in order to maintain the knowledge properly and to transfer it throughout Europe for the safe and economic design, operation and dismantling of present and future nuclear systems. To take up the challenges of offering top quality, new, attractive and relevant curricula, higher education institutions should cooperate with industry, regulatory bodies and research centres, and more appropriate funding from public and private sources. In addition, European nuclear education and training should benefit from links with international organisations like IAEA, OECD-NEA and others, and should include worldwide cooperation with academic institutions and research centres. The first and central issue is to establish a European Master of Science in Nuclear Engineering. The concept envisaged is compatible with the projected harmonised European

Reaching Rural Mammographers for Quality Improvement

National Research Council Canada - National Science Library

Urban, Nicole

1997-01-01

The Fred Hutchinson Cancer Research Center, the University of Washington, and the Washington State Department of Health are collaborating to develop and implement a mammography quality improvement program (MQIP...

Reaching Rural Mammographers for Quality Improvement

National Research Council Canada - National Science Library

Urban, Nicole

1998-01-01

The Fred Hutchinson Cancer Research Center, the University of Washington, and the Washington State Department of Health are collaborating to develop and implement a mammography quality improvement. program (MQIP...

Reaching Rural Mammographers for Quality Improvement

National Research Council Canada - National Science Library

Urban, Nicole

1999-01-01

The Fred Hutchinson Cancer Research Center, the University of Washington, and the Washington State Department of Health are collaborating to develop and implement a mammography quality improvement program (MQIP...

The European Hematology Association Roadmap for European Hematology Research

DEFF Research Database (Denmark)

Engert, Andreas; Balduini, Carlo; Brand, Anneke

2016-01-01

The European Hematology Association (EHA) Roadmap for European Hematology Research highlights major achievements in diagnosis and treatment of blood disorders and identifies the greatest unmet clinical and scientific needs in those areas to enable better funded, more focused European hematology...... research. Initiated by the EHA, around 300 experts contributed to the consensus document, which will help European policy makers, research funders, research organizations, researchers, and patient groups make better informed decisions on hematology research. It also aims to raise public awareness...... of the burden of blood disorders on European society, which purely in economic terms is estimated at €23 billion per year, a level of cost that is not matched in current European hematology research funding. In recent decades, hematology research has improved our fundamental understanding of the biology...

First Central and Eastern European Workshop on Quality control, patient dosimetry and radiation protection in diagnostic and interventional radiology and nuclear medicine

International Nuclear Information System (INIS)

National Frederic Joliot-Curie Research Institute for Radiobiology and Radiohygiene

2007-01-01

First Central and Eastern European Workshop on Quality Control, Patient Dosimetry and Radiation Protection in Diagnostic and Interventional Radiology and Nuclear Medicine, scientifically supported and accredited as a CPD event for medical physicists by EFOMP, National 'Frederic Joliot-Curie' Research Institute for Radiobiology and Radiohygiene (NRIRR), Budapest, Hungary, April 25-28, 2007. Topics of the meeting included all areas of medical radiation physics except radiation therapy. A unique possibility was realized by inviting four European manufacturers of quality control instrumentation, not only for exhibiting but they also had 45 minutes individual presentations about each manufacturer's product scale and conception. Further sessions dealt with dosimetry, optimization, quality control and testing, radiation protection and standardization, computed tomography and nuclear medicine, in 29 oral presentations and 1 poster of the participants. (S.I.)

Interventions to improve water quality for preventing diarrhoea.

Science.gov (United States)

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

2015-10-20

Diarrhoea is a major cause of death and disease, especially among young children in low-income countries. In these settings, many infectious agents associated with diarrhoea are spread through water contaminated with faeces.In remote and low-income settings, source-based water quality improvement includes providing protected groundwater (springs, wells, and bore holes), or harvested rainwater as an alternative to surface sources (rivers and lakes). Point-of-use water quality improvement interventions include boiling, chlorination, flocculation, filtration, or solar disinfection, mainly conducted at home. To assess the effectiveness of interventions to improve water quality for preventing diarrhoea. We searched the Cochrane Infectious Diseases Group Specialized Register (11 November 2014), CENTRAL (the Cochrane Library, 7 November 2014), MEDLINE (1966 to 10 November 2014), EMBASE (1974 to 10 November 2014), and LILACS (1982 to 7 November 2014). We also handsearched relevant conference proceedings, contacted researchers and organizations working in the field, and checked references from identified studies through 11 November 2014. Randomized controlled trials (RCTs), quasi-RCTs, and controlled before-and-after studies (CBA) comparing interventions aimed at improving the microbiological quality of drinking water with no intervention in children and adults. Two review authors independently assessed trial quality and extracted data. We used meta-analyses to estimate pooled measures of effect, where appropriate, and investigated potential sources of heterogeneity using subgroup analyses. We assessed the quality of evidence using the GRADE approach. Forty-five cluster-RCTs, two quasi-RCTs, and eight CBA studies, including over 84,000 participants, met the inclusion criteria. Most included studies were conducted in low- or middle-income countries (LMICs) (50 studies) with unimproved water sources (30 studies) and unimproved or unclear sanitation (34 studies). The primary

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