Improving Health Promotion Using Quality Improvement Techniques in Australian Indigenous Primary Health Care

Science.gov (United States)

Percival, Nikki; O’Donoghue, Lynette; Lin, Vivian; Tsey, Komla; Bailie, Ross Stewart

2016-01-01

Although some areas of clinical health care are becoming adept at implementing continuous quality improvement (CQI) projects, there has been limited experimentation of CQI in health promotion. In this study, we examined the impact of a CQI intervention on health promotion in four Australian Indigenous primary health care centers. Our study objectives were to (a) describe the scope and quality of health promotion activities, (b) describe the status of health center system support for health promotion activities, and (c) introduce a CQI intervention and examine the impact on health promotion activities and health centers systems over 2 years. Baseline assessments showed suboptimal health center systems support for health promotion and significant evidence-practice gaps. After two annual CQI cycles, there were improvements in staff understanding of health promotion and systems for planning and documenting health promotion activities had been introduced. Actions to improve best practice health promotion, such as community engagement and intersectoral partnerships, were inhibited by the way health center systems were organized, predominately to support clinical and curative services. These findings suggest that CQI can improve the delivery of evidence-based health promotion by engaging front line health practitioners in decision-making processes about the design/redesign of health center systems to support the delivery of best practice health promotion. However, further and sustained improvements in health promotion will require broader engagement of management, senior staff, and members of the local community to address organizational and policy level barriers. PMID:27066470

Improving health promotion using quality improvement techniques in Australian Indigenous primary health care

Directory of Open Access Journals (Sweden)

Nikki ePercival

2016-03-01

Full Text Available While some areas of clinical health care are becoming adept at implementing continuous quality improvement (CQI projects, there has been limited experimentation of CQI in health promotion. In this study, we examined the impact of a CQI intervention on health promotion in four Australian Indigenous primary health care centres. Our study objectives were to: (a describe the scope and quality of health promotion activities; (b describe the status of health centre system support for health promotion activities; and (c introduce a CQI intervention and examine the impact on health promotion activities and health centres systems over two years. Baseline assessments showed sub-optimal health centre systems support for health promotion and significant evidence-practice gaps. After two annual CQI cycles, there were improvements in staff understanding of health promotion and systems for planning and documenting health promotion activities had been introduced. Actions to improve best practice health promotion, such as community engagement and intersectoral partnerships, were inhibited by the way health centre systems were organized, predominately to support clinical and curative services. These findings suggest that CQI can improve the delivery of evidence based health promotion by engaging front line health practitioners in decision making processes about the design/redesign of health centre systems to support the delivery of best practice health promotion. However, further and sustained improvements in health promotion will require broader engagement of management, senior staff and members of the local community to address organisational and policy level barriers.

Improving Health Promotion Using Quality Improvement Techniques in Australian Indigenous Primary Health Care.

Science.gov (United States)

Percival, Nikki; O'Donoghue, Lynette; Lin, Vivian; Tsey, Komla; Bailie, Ross Stewart

2016-01-01

Although some areas of clinical health care are becoming adept at implementing continuous quality improvement (CQI) projects, there has been limited experimentation of CQI in health promotion. In this study, we examined the impact of a CQI intervention on health promotion in four Australian Indigenous primary health care centers. Our study objectives were to (a) describe the scope and quality of health promotion activities, (b) describe the status of health center system support for health promotion activities, and (c) introduce a CQI intervention and examine the impact on health promotion activities and health centers systems over 2 years. Baseline assessments showed suboptimal health center systems support for health promotion and significant evidence-practice gaps. After two annual CQI cycles, there were improvements in staff understanding of health promotion and systems for planning and documenting health promotion activities had been introduced. Actions to improve best practice health promotion, such as community engagement and intersectoral partnerships, were inhibited by the way health center systems were organized, predominately to support clinical and curative services. These findings suggest that CQI can improve the delivery of evidence-based health promotion by engaging front line health practitioners in decision-making processes about the design/redesign of health center systems to support the delivery of best practice health promotion. However, further and sustained improvements in health promotion will require broader engagement of management, senior staff, and members of the local community to address organizational and policy level barriers.

The National Heart Failure Project: a health care financing administration initiative to improve the care of Medicare beneficiaries with heart failure.

Science.gov (United States)

Masoudi, F A; Ordin, D L; Delaney, R J; Krumholz, H M; Havranek, E P

2000-01-01

This is the second in a series describing Health Care Financing Administration (HCFA) initiatives to improve care for Medicare beneficiaries with heart failure. The first article outlined the history of HCFA quality-improvement projects and current initiatives to improve care in six priority areas: heart failure, acute myocardial infarction, stroke, pneumonia, diabetes, and breast cancer. This article details the objectives and design of the Medicare National Heart Failure Quality Improvement Project (NHF), which has as its goal the improvement of inpatient heart failure care. (c)2000 by CHF, Inc.

CQI project improves discharge process.

Science.gov (United States)

1998-08-01

At Gibson Rehab Center in Williamsport, PA, a continuous quality improvement project to bolster the institution's discharge planning process has resulted in increased satisfaction and an award for quality. The 15-month project was spearheaded by a multidisciplinary team charged with identifying areas that had a significant impact on customer service and suggesting better ways of delivering that service. Among the changes the group suggested were establishing a weekly discharge planning group for new neuro patients, assigning a discharge coordinator for each treatment team, and creating an interdisciplinary communication sheet for the home health therapy staff.

Umbrella project for Bangladesh: strengthening NGO capacity and linkages to improve reproductive health service and information. RAS/98/P55.

Science.gov (United States)

1999-06-01

In Bangladesh, the UN Population Fund is working to strengthen nongovernmental organization (NGO) capacity and linkages to improve reproductive health services and information. Specifically, the aim is to strengthen the technical and human resource capacity of participating NGOs and the functional linkages between national NGOs and relevant government agencies to help harmonize and standardize the delivery of reproductive health information and services. This umbrella project collaborates with RHI-participating NGOs in a policy paper on adolescent reproductive health, and will maintain contact with the regional dimension project to collaborate its activities. Programs implemented by partner NGOs are being reviewed and monitored, and linkages among national NGOs and government agencies are being developed. The main activities of the project are enumerated.

Comprehensive review of the evidence regarding the effectiveness of community-based primary health care in improving maternal, neonatal and child health: 7. shared characteristics of projects with evidence of long-term mortality impact.

Science.gov (United States)

Perry, Henry B; Rassekh, Bahie M; Gupta, Sundeep; Freeman, Paul A

2017-06-01

There is limited evidence about the long-term effectiveness of integrated community-based primary health care (CBPHC) in improving maternal, neonatal and child health. However, the interventions implemented and the approaches used by projects with such evidence can provide guidance for ending preventable child and maternal deaths by the year 2030. A database of 700 assessments of the effectiveness of CBPHC in improving maternal, neonatal and child health has been assembled, as described elsewhere in this series. A search was undertaken of these assessments of research studies, field project and programs (hereafter referred to as projects) with more than a single intervention that had evidence of mortality impact for a period of at least 10 years. Four projects qualified for this analysis: the Matlab Maternal Child Health and Family Planning (MCH-FP) P in Bangladesh; the Hôpital Albert Schweitzer in Deschapelles, Haiti; the Comprehensive Rural Health Project (CRHP) in Jamkhed, India; and the Society for Education, Action and Research in Community Health (SEARCH) in Gadchiroli, India. These four projects have all been operating for more than 30 years, and they all have demonstrated reductions in infant mortality, 1- to 4-year mortality, or under-5 mortality for at least 10 years. They share a number of characteristics. Among the most notable of these are: they provide comprehensive maternal, child health and family planning services, they have strong community-based programs that utilize community health workers who maintain regular contact with all households, they have develop strong collaborations with the communities they serve, and they all have strong referral capabilities and provide first-level hospital care. The shared features of these projects provide guidance for how health systems around the world might improve their effectiveness in improving maternal, neonatal and child health. Strengthening these features will contribute to achieving the goal of

Improving a health information system for real-time data entries: An action research project using socio-technical systems theory.

Science.gov (United States)

Adaba, Godfried Bakiyem; Kebebew, Yohannes

2018-03-01

This paper presents the findings of an action research (AR) project to improve a health information system (HIS) at the Operating Theater Department (OTD) of a National Health Service (NHS) hospital in South East England, the UK. Informed by socio-technical systems (STS) theory, AR was used to design an intervention to enhance an existing patient administration system (PAS) to enable data entries in real time while contributing to the literature. The study analyzed qualitative data collected through interviews, participant observations, and document reviews. The study found that the design of the PAS was unsuitable to the work of the three units of the OTD. Based on the diagnoses and STS theory, the project developed and implemented a successful intervention to enhance the legacy system for data entries in real time. The study demonstrates the value of AR from a socio-technical perspective for improving existing systems in healthcare settings. The steps adopted in this study could be applied to improve similar systems. A follow-up study will be essential to assess the sustainability of the improved system.

Improving mental health knowledge of the Charedi Orthodox Jewish Community in North London: A partnership project.

Science.gov (United States)

Perry, Aradhana; Gardener, Chelsea; Dove, Jonathan; Eiger, Yocheved; Loewenthal, Kate

2018-05-01

This article describes a successful community-based partnership project between statutory and third-sector services targeting the strictly Orthodox Jewish community (OJC). The City and Hackney Black and Minority Ethnic (BME) Access Service (East London NHS Foundation Trust (ELFT)) collaborated with Bikur Cholim, a local third-sector organisation based in the heart of a north London Charedi OJC, to develop a brief culturally tailored psychoeducational group intervention focusing on mental health promotion and prevention. In total, 34 carers in the Charedi OJC were provided with general information on mental health, the availability of support services and self-care. Overall improvements in well-being, increased intentions to access services, particularly talking therapies, and qualitative feedback indicated that the group was very well received. The project endorses the value of culturally relevant psychoeducation, enabling suggestions for culturally appropriate service development.

An improvement project within urological care.

Science.gov (United States)

Khatami, Annelie; Rosengren, Kristina

2015-01-01

The purpose of this paper is to describe staff experiences in an on-going improvement project regarding patients with ureteral stones. A qualitative descriptive study based on eight group interviews and 48 narratives, was performed. Data were analysed using qualitative content analysis. Trustworthiness was ensured by using a well-documented improvement process method during six months. The results formed three categories: an absent comprehensive view; complexity; and vulnerability within the organisation. A holistic perspective regarding urological care at the micro-, meso- and macro-levels is needed to improve planning and caring processes. This study includes one team (six members, different health professionals) within the same urology department. Results show that staff need information, such as guidelines and support throughout the improvement work to deliver high-quality care. Moreover, there is a need for evidence-based guidelines at national level to support improvement work. Healthcare staff need to pay attention to all team member needs to improve urological care. Organisational and managerial aspect are needed to support clear and common goals regarding healthcare improvement work. Urological improvement projects, generally, are lacking, which is why this study is important to improve nephrolithiasis patient care.

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.

The Perinatal Mental Health and Wellness Project: Improving perinatal mental health outcomes by working together across sectors

OpenAIRE

Herde, Emily Louise

2018-01-01

This paper reports on the Perinatal Mental Health and Wellness Project which aimed to develop and evaluate a collaborative model for mental health promotion, illness prevention and early intervention in the perinatal period. The project took on a place-based action research approach, developing and trialling the model with expectant parents (n=537) engaged with Redcliffe Hospital Maternity Services in the Metro North Hospital and Health Service in Queensland, Australia, from 2015 – 2017.In Au...

Indigenous health: effective and sustainable health services through continuous quality improvement.

Science.gov (United States)

Bailie, Ross S; Si, Damin; O'Donoghue, Lyn; Dowden, Michelle

2007-05-21

The Australian government's Healthy for Life program is supporting capacity development in Indigenous primary care using continuous quality improvement (CQI) techniques. An important influence on the Healthy for Life program has been the ABCD research project. The key features contributing to the success of the project are described. The ABCD research project: uses a CQI approach, with an ongoing cycle of gathering data on how well organisational systems are functioning, and developing and then implementing improvements; is guided by widely accepted principles of community-based research, which emphasise participation; and adheres to the principles and values of Indigenous health research and service delivery. The potential for improving health outcomes in Aboriginal and Torres Strait Islander communities using a CQI approach should be strengthened by clear clinical and managerial leadership, supporting service organisations at the community level, and applying participatory-action principles.

A practical guide to applying lean tools and management principles to health care improvement projects.

Science.gov (United States)

Simon, Ross W; Canacari, Elena G

2012-01-01

Manufacturing organizations have used Lean management principles for years to help eliminate waste, streamline processes, and cut costs. This pragmatic approach to structured problem solving can be applied to health care process improvement projects. Health care leaders can use a step-by-step approach to document processes and then identify problems and opportunities for improvement using a value stream process map. Leaders can help a team identify problems and root causes and consider additional problems associated with methods, materials, manpower, machinery, and the environment by using a cause-and-effect diagram. The team then can organize the problems identified into logical groups and prioritize the groups by impact and difficulty. Leaders must manage action items carefully to instill a sense of accountability in those tasked to complete the work. Finally, the team leaders must ensure that a plan is in place to hold the gains. Copyright © 2012 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Towards a Unified Taxonomy of Health Indicators: Academic Health Centers and Communities Working Together to Improve Population Health

Science.gov (United States)

Ahmed, Syed; Franco, Zeno; Kissack, Anne; Gabriel, Davera; Hurd, Thelma; Ziegahn, Linda; Bates, Nancy J.; Calhoun, Karen; Carter-Edwards, Lori; Corbie-Smith, Giselle; Eder, Milton “Mickey”; Ferrans, Carol; Hacker, Karen; Rumala, Bernice B.; Strelnick, A. Hal; Wallerstein, Nina

2014-01-01

The Clinical and Translational Science Awards (CTSA) program represents a significant public investment. To realize its major goal of improving the public’s health and reducing health disparities, the CTSA Consortium’s Community Engagement Key Function Committee has undertaken the challenge of developing a taxonomy of community health indicators. The objective is to initiate a unified approach for monitoring progress in improving population health outcomes. Such outcomes include, importantly, the interests and priorities of community stakeholders, plus the multiple, overlapping interests of universities and of the public health and health care professions involved in the development and use of local health care indicators. The emerging taxonomy of community health indicators that the authors propose supports alignment of CTSA activities and facilitates comparative effectiveness research across CTSAs, thereby improving the health of communities and reducing health disparities. The proposed taxonomy starts at the broadest level, determinants of health; subsequently moves to more finite categories of community health indicators; and, finally, addresses specific quantifiable measures. To illustrate the taxonomy’s application, the authors have synthesized 21 health indicator projects from the literature and categorized them into international, national, or local/special jurisdictions. They furthered categorized the projects within the taxonomy by ranking indicators with the greatest representation among projects and by ranking the frequency of specific measures. They intend for the taxonomy to provide common metrics for measuring changes to population health and, thus, extend the utility of the CTSA Community Engagement Logic Model. The input of community partners will ultimately improve population health. PMID:24556775

The use of process mapping in healthcare quality improvement projects.

Science.gov (United States)

Antonacci, Grazia; Reed, Julie E; Lennox, Laura; Barlow, James

2018-05-01

Introduction Process mapping provides insight into systems and processes in which improvement interventions are introduced and is seen as useful in healthcare quality improvement projects. There is little empirical evidence on the use of process mapping in healthcare practice. This study advances understanding of the benefits and success factors of process mapping within quality improvement projects. Methods Eight quality improvement projects were purposively selected from different healthcare settings within the UK's National Health Service. Data were gathered from multiple data-sources, including interviews exploring participants' experience of using process mapping in their projects and perceptions of benefits and challenges related to its use. These were analysed using inductive analysis. Results Eight key benefits related to process mapping use were reported by participants (gathering a shared understanding of the reality; identifying improvement opportunities; engaging stakeholders in the project; defining project's objectives; monitoring project progress; learning; increased empathy; simplicity of the method) and five factors related to successful process mapping exercises (simple and appropriate visual representation, information gathered from multiple stakeholders, facilitator's experience and soft skills, basic training, iterative use of process mapping throughout the project). Conclusions Findings highlight benefits and versatility of process mapping and provide practical suggestions to improve its use in practice.

Impact of a quality improvement project to strengthen infection ...

African Journals Online (AJOL)

Impact of a quality improvement project to strengthen infection prevention and control training at rural healthcare facilities. ... African Journal of Health Professions Education. Journal Home · ABOUT THIS JOURNAL · Advanced Search ...

Lessons learnt from a primary care asthma improvement project.

Science.gov (United States)

Lenney, Warren; Clayton, Sadie; Gilchrist, Francis J; Price, David; Small, Iain; Smith, Judy; Sutton, Emma J

2016-01-07

Asthma is a very common disease that can occur at any age. In the UK and in many other countries it is mainly managed in primary care. The published evidence suggests that the key to improving diagnosis and management lies in better training and education rather than in the discovery of new medications. An asthma improvement project managed through the British Lung Foundation is attempting to do this. The project has three pilot sites: two in England supported by the Department of Health and one in Scotland supported by the Scottish Government. If the project is successful it will be rolled out to other health areas within the UK. The results of this project are not yet available. This article highlights the challenges encountered in setting up the project and may well be applicable to other areas in the UK and to other countries where similar healthcare systems exist. The encountered challenges reflect the complex nature of healthcare systems and electronic data capture in primary care. We discuss the differences between general practices in their ability and willingness to support the project, the training and education of their staff on asthma management, governance issues in relation to information technology systems, and the quality of data capture. Virtually all the challenges have now been overcome, but discussing them should ensure that others become aware of them at an early stage should they wish to undertake similar projects in the future.

National health expenditure projections, 2013-23: faster growth expected with expanded coverage and improving economy.

Science.gov (United States)

Sisko, Andrea M; Keehan, Sean P; Cuckler, Gigi A; Madison, Andrew J; Smith, Sheila D; Wolfe, Christian J; Stone, Devin A; Lizonitz, Joseph M; Poisal, John A

2014-10-01

In 2013 health spending growth is expected to have remained slow, at 3.6 percent, as a result of the sluggish economic recovery, the effects of sequestration, and continued increases in private health insurance cost-sharing requirements. The combined effects of the Affordable Care Act's coverage expansions, faster economic growth, and population aging are expected to fuel health spending growth this year and thereafter (5.6 percent in 2014 and 6.0 percent per year for 2015-23). However, the average rate of increase through 2023 is projected to be slower than the 7.2 percent average growth experienced during 1990-2008. Because health spending is projected to grow 1.1 percentage points faster than the average economic growth during 2013-23, the health share of the gross domestic product is expected to rise from 17.2 percent in 2012 to 19.3 percent in 2023. Project HOPE—The People-to-People Health Foundation, Inc.

Designing and Conducting Health Systems Research Projects ...

International Development Research Centre (IDRC) Digital Library (Canada)

Home · Resources · Publications. Designing and Conducting Health Systems Research Projects Volume 1: Proposal Development and Fieldwork ... IDRC and the United Kingdom's Global AMR Innovation Fund—managed by the ... New website will help record vital life events to improve access to services for all.

Selecting Health Care Improvement Projects: A Methodology Integrating Cause-and-Effect Diagram and Analytical Hierarchy Process.

Science.gov (United States)

Testik, Özlem Müge; Shaygan, Amir; Dasdemir, Erdi; Soydan, Guray

It is often vital to identify, prioritize, and select quality improvement projects in a hospital. Yet, a methodology, which utilizes experts' opinions with different points of view, is needed for better decision making. The proposed methodology utilizes the cause-and-effect diagram to identify improvement projects and construct a project hierarchy for a problem. The right improvement projects are then prioritized and selected using a weighting scheme of analytical hierarchy process by aggregating experts' opinions. An approach for collecting data from experts and a graphical display for summarizing the obtained information are also provided. The methodology is implemented for improving a hospital appointment system. The top-ranked 2 major project categories for improvements were identified to be system- and accessibility-related causes (45%) and capacity-related causes (28%), respectively. For each of the major project category, subprojects were then ranked for selecting the improvement needs. The methodology is useful in cases where an aggregate decision based on experts' opinions is expected. Some suggestions for practical implementations are provided.

Can action research strengthen district health management and improve health workforce performance? A research protocol.

Science.gov (United States)

Mshelia, C; Huss, R; Mirzoev, T; Elsey, H; Baine, S O; Aikins, M; Kamuzora, P; Bosch-Capblanch, X; Raven, J; Wyss, K; Green, A; Martineau, T

2013-08-30

The single biggest barrier for countries in sub-Saharan Africa (SSA) to scale up the necessary health services for addressing the three health-related Millennium Development Goals and achieving Universal Health Coverage is the lack of an adequate and well-performing health workforce. This deficit needs to be addressed both by training more new health personnel and by improving the performance of the existing and future health workforce. However, efforts have mostly been focused on training new staff and less on improving the performance of the existing health workforce. The purpose of this paper is to disseminate the protocol for the PERFORM project and reflect on the key challenges encountered during the development of this methodology and how they are being overcome. The overall aim of the PERFORM project is to identify ways of strengthening district management in order to address health workforce inadequacies by improving health workforce performance in SSA. The study will take place in three districts each in Ghana, Tanzania and Uganda using an action research approach. With the support of the country research teams, the district health management teams (DHMTs) will lead on planning, implementation, observation, reflection and redefinition of the activities in the study. Taking into account the national and local human resource (HR) and health systems (HS) policies and practices already in place, 'bundles' of HR/HS strategies that are feasible within the context and affordable within the districts' budget will be developed by the DHMTs to strengthen priority areas of health workforce performance. A comparative analysis of the findings from the three districts in each country will add new knowledge on the effects of these HR/HS bundles on DHMT management and workforce performance and the impact of an action research approach on improving the effectiveness of the DHMTs in implementing these interventions. Different challenges were faced during the development of

[Outcomes evaluation of the school staff health promotion project].

Science.gov (United States)

Woynarowska-Sołdan, Magdalena

This article presents selected outcomes of a 3-year project "Health promotion of school staff in health-promoting schools," as well as the achievements and difficulties in its implementation. The research was conducted on 644 teachers and 226 members of non-teaching staff in 21 schools. The method involved opinion poll and authored questionnaires. A 2-part model of outcome evaluation was developed. Most participants appreciated the changes that took place within the 3 years of the project implementation. These included the improved level of their knowledge about health, health-conducive behaviors (62-93%) and the physical and social environment of the school (50-92%). Changes were more frequently acknowledged by teachers. About 80% of the participants had a positive attitude to the project, but only 20% assessed their involvement as considerable. About 90% believed that health promotion activities should be continued. According to the project leaders, insufficient support and financial resources, and difficulties in motivating school employees, particularly the nonteaching staff, to undertake health-promotion activities were the major handicaps in the project implementation. The project outcomes can be assessed as satisfying. They revealed that it is posssible to initiate health promotion among school staff. This can be effective on condition that participants are motivated, actively engaged in the project and supported by the head teacher and the local community. Necessarily, school leaders should be prepared to promote health among adults and to gain support from school policy decision makers, school administration, trade unions and universities involved in teacher training. Med Pr 2016;67(2):187-200. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Outcomes evaluation of the school staff health promotion project

Directory of Open Access Journals (Sweden)

Magdalena Woynarowska-Sołdan

2016-04-01

Full Text Available Background: This article presents selected outcomes of a 3-year project “Health promotion of school staff in health-promoting schools,” as well as the achievements and difficulties in its implementation. Material and Methods: The research was conducted on 644 teachers and 226 members of non-teaching staff in 21 schools. The method involved opinion poll and authored questionnaires. A 2-part model of outcome evaluation was developed. Results: Most participants appreciated the changes that took place within the 3 years of the project implementation. These included the improved level of their knowledge about health, health-conducive behaviors (62–93% and the physical and social environment of the school (50–92%. Changes were more frequently acknowledged by teachers. About 80% of the participants had a positive attitude to the project, but only 20% assessed their involvement as considerable. About 90% believed that health promotion activities should be continued. According to the project leaders, insufficient support and financial resources, and difficulties in motivating school employees, particularly the nonteaching staff, to undertake health-promotion activities were the major handicaps in the project implementation. Conclusions: The project outcomes can be assessed as satisfying. They revealed that it is posssible to initiate health promotion among school staff. This can be effective on condition that participants are motivated, actively engaged in the project and supported by the head teacher and the local community. Necessarily, school leaders should be prepared to promote health among adults and to gain support from school policy decision makers, school administration, trade unions and universities involved in teacher training. Med Pr 2016;67(2:187–200

Air quality environmental assessment of the Horseshoe Bay Terminal Improvement Project

Energy Technology Data Exchange (ETDEWEB)

NONE

2001-09-01

The proposed improvement project for British Columbia's Horseshoe Bay Ferry Terminal incorporates specific measures to protect the air quality of the area, the environment and public health. The ferry terminal handles over 2.5 million vehicles and 7 million passengers per year. The upgrades are intended to improve terminal operations, increase safety and reduce traffic congestion through residential and commercial portions of the Horseshoe Bay area as well as Highway 99 traffic. The toll booths will be relocated about 25 m further away from the nearby elementary school to further protect air quality at the school. A study was conducted in which vehicular emissions from the operation of the ferry terminal prior to the proposed improvement project were modelled to predict the effect of vehicular emissions on ambient air quality levels in the area and to ensure that maximum acceptable objectives are met for gaseous air pollutants, including carbon monoxide, carbon dioxide, nitrous oxides, as well as inhalable and fine particulates. The British Columbia Ferry Corp. will work jointly with the Greater Vancouver Regional District to install continuous monitors for at least one year after the project is completed. Based on the analysis of the report, the air quality in the Horseshoe Bay area would not suffer major adverse environmental or public health affects from the proposed improvement project.

Special Project Grants Awarded for Improvement in Nurse Training. A Listing.

Science.gov (United States)

National Institutes of Health (DHEW), Bethesda, MD. Div. of Nursing.

This current directory lists alphabetically by state, special projects funded by the Title II Nurse Training Act of the Health Manpower Act of 1968, which are awarded for improvement programs in nurse training. Projects funded through June 1971 are listed and briefly annotated, including planning grants awarded for the first time during the fiscal…

The health terminology project glossaries` structure

Directory of Open Access Journals (Sweden)

Sátia Marini

2014-04-01

Full Text Available Current paper was motivated by a Master´s degree in Translation Studies on one of the glossaries of the Health Terminology Project (PTS of the Ministry of Health (MS inBrazil, by which the products developed by the project were analyzed. The authors would like to forward their experience earned from the development of these instruments and from the evolution of the glossary´s layout and structure. Although within the same institution, each instrument is made suitable to the specific purpose of each area and the terminology project accumulates experience by the constant improvement of previously developed glossaries (adding new terms; providing the equivalent word in other languages for terms already defined and by the establishment of new ones. The evolution of the structure of the glossaries was qualitatively analyzed; remarks on the types of cross references were made; a quantitative survey of their main features was undertaken. Finally, the importance of this type of work should be underscored either within the government, or in the academy or in private companies, for the sharing of intellectual knowledge.

Steam Pressure-Reducing Station Safety and Energy Efficiency Improvement Project

Energy Technology Data Exchange (ETDEWEB)

Lower, Mark D [ORNL; Christopher, Timothy W [ORNL; Oland, C Barry [ORNL

2011-06-01

The Facilities and Operations (F&O) Directorate is sponsoring a continuous process improvement (CPI) program. Its purpose is to stimulate, promote, and sustain a culture of improvement throughout all levels of the organization. The CPI program ensures that a scientific and repeatable process exists for improving the delivery of F&O products and services in support of Oak Ridge National Laboratory (ORNL) Management Systems. Strategic objectives of the CPI program include achieving excellence in laboratory operations in the areas of safety, health, and the environment. Identifying and promoting opportunities for achieving the following critical outcomes are important business goals of the CPI program: improved safety performance; process focused on consumer needs; modern and secure campus; flexibility to respond to changing laboratory needs; bench strength for the future; and elimination of legacy issues. The Steam Pressure-Reducing Station (SPRS) Safety and Energy Efficiency Improvement Project, which is under the CPI program, focuses on maintaining and upgrading SPRSs that are part of the ORNL steam distribution network. This steam pipe network transports steam produced at the ORNL steam plant to many buildings in the main campus site. The SPRS Safety and Energy Efficiency Improvement Project promotes excellence in laboratory operations by (1) improving personnel safety, (2) decreasing fuel consumption through improved steam system energy efficiency, and (3) achieving compliance with applicable worker health and safety requirements. The SPRS Safety and Energy Efficiency Improvement Project being performed by F&O is helping ORNL improve both energy efficiency and worker safety by modifying, maintaining, and repairing SPRSs. Since work began in 2006, numerous energy-wasting steam leaks have been eliminated, heat losses from uninsulated steam pipe surfaces have been reduced, and deficient pressure retaining components have been replaced. These improvements helped ORNL

Improving asthma-related health outcomes among low-income, multiethnic, school-aged children: results of a demonstration project that combined continuous quality improvement and community health worker strategies.

Science.gov (United States)

Fox, Patrick; Porter, Patricia G; Lob, Sibylle H; Boer, Jennifer Holloman; Rocha, David A; Adelson, Joel W

2007-10-01

The purpose of this work was to improve asthma-related health outcomes in an ethnically and geographically disparate population of economically disadvantaged school-aged children by using a team-based approach using continuous quality improvement and community health workers. A demonstration project was conducted with 7 community clinics treating approximately 3000 children with asthma 5 to 18 years of age. The overall clinic population with asthma was assessed for care-process changes through random cross-sectional chart reviews at baseline and 24 months (N = 560). A subset of patients with either moderate or severe persistent asthma or poorly controlled asthma (N = 405) was followed longitudinally for specific asthma-related clinical outcomes, satisfaction with care, and confidence managing asthma by family interview at baseline and at 12 or 24 months. Patient-centered and care-process outcomes included patient/parent assessment of quality of care and confidence in self-management, asthma action plan review, and documentation of guideline-based indicators of quality of care. Direct clinical outcomes included daytime and nighttime symptoms, use of rescue medications, acute care and emergency department visits, hospitalizations, and missed school days. Each clinic site's degree of adherence to the intervention model was evaluated and ranked to examine the correlation between model adherence and outcomes. Cross-sectional data showed clinic-wide improvements in the documentation of asthma severity, review of action plans, health services use, and asthma symptoms. At follow-up in the longitudinal sample, fewer patients reported acute visits, emergency department visits, hospitalizations, frequent daytime and nighttime symptoms, and missed school days compared with baseline. More patients reported excellent or very good quality of care and confidence in asthma self-management. Linear regression analysis of the clinical sites' model adherence ranks against site

Managing clinical improvement projects.

Science.gov (United States)

Phillips, Joanna; Simmonds, Lorraine

This paper, the second of a three-part series looking at change management tools, provides a practical guide on how to use common project management principles in practice. Much of the literature on project management focuses on the business arena, with little reference to clinical settings. Identifying this literature and understanding its relevance to managing projects in healthcare can be difficult. This article provides a practical guide to identifying the key principles of good project management and applying these in health settings.

Quality Improvement Project to Improve Patient Satisfaction With Pain Management: Using Human-Centered Design.

Science.gov (United States)

Trail-Mahan, Tracy; Heisler, Scott; Katica, Mary

2016-01-01

In this quality improvement project, our health system developed a comprehensive, patient-centered approach to improving inpatient pain management and assessed its impact on patient satisfaction across 21 medical centers. Using human-centered design principles, a bundle of 6 individual and team nursing practices was developed. Patient satisfaction with pain management, as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems pain composite score, increased from the 25th to just under the 75th national percentile.

Researchers' experience with project management in health and medical research: Results from a post-project review

Science.gov (United States)

2011-01-01

Background Project management is widely used to deliver projects on time, within budget and of defined quality. However, there is little published information describing its use in managing health and medical research projects. We used project management in the Alcohol and Pregnancy Project (2006-2008) http://www.ichr.uwa.edu.au/alcoholandpregnancy and in this paper report researchers' opinions on project management and whether it made a difference to the project. Methods A national interdisciplinary group of 20 researchers, one of whom was the project manager, formed the Steering Committee for the project. We used project management to ensure project outputs and outcomes were achieved and all aspects of the project were planned, implemented, monitored and controlled. Sixteen of the researchers were asked to complete a self administered questionnaire for a post-project review. Results The project was delivered according to the project protocol within the allocated budget and time frame. Fifteen researchers (93.8%) completed a questionnaire. They reported that project management increased the effectiveness of the project, communication, teamwork, and application of the interdisciplinary group of researchers' expertise. They would recommend this type of project management for future projects. Conclusions Our post-project review showed that researchers comprehensively endorsed project management in the Alcohol and Pregnancy Project and agreed that project management had contributed substantially to the research. In future, we will project manage new projects and conduct post-project reviews. The results will be used to encourage continuous learning and continuous improvement of project management, and provide greater transparency and accountability of health and medical research. The use of project management can benefit both management and scientific outcomes of health and medical research projects. PMID:21635721

Improving hearing health for farming families.

Science.gov (United States)

Lower, Tony; Fragar, Lyn; Depcynzksi, Julie; Challinor, Kathy; Mills, Jan; Williams, Warwick

2010-01-01

Occupational noise injury and hearing loss are common features of agricultural workforces internationally. Farmsafe Australia has identified hearing health as one of its 4 key priority goals and targets. Currently, approximately 60-70% of Australian farmers have measurable hearing loss, compared with 27% of those in the general Australian community. This article describes the findings of a community based demonstration project to address hearing health issues conducted in the Australian state of New South Wales. This program sought to implement local demonstration projects in 3 communities to identify what works well in hearing health promotion with farmers and what could be applied more broadly throughout Australia. Local advisory groups were established in each community to guide project development and implementation. Project implementation focused on 3 major aspects: (1) increasing awareness of priority noise injury prevention and hearing health practices; (2) improving access to hearing health services; and (3) networking services in local communities. Area-specific training was undertaken for stakeholders to maximize local information links. Service utilization data were monitored and analysed. There was variability among sites; however in general there was an increased awareness of hearing health issues by farming families and expanded opportunities for farmers to access screening services. Utilization rates of hearing services also increased markedly in one community. Local hearing health networks were strengthened by linkages to key stakeholders outside the health sector. Previously unidentified methods of promoting hearing health (eg using agricultural retail outlets that supply hearing protection equipment and are accepted by farmers as an information source) were identified and utilized. Hearing health promotion with farmers in local communities can be enhanced through utilization and strengthening of local networks. Integration of hearing health

Unlocking community capabilities for improving maternal and newborn health: participatory action research to improve birth preparedness, health facility access, and newborn care in rural Uganda

Directory of Open Access Journals (Sweden)

Elizabeth Ekirapa-Kiracho

2016-11-01

Full Text Available Abstract Background Community capacities and resources must be harnessed to complement supply side initiatives addressing high maternal and neonatal mortality rates in Uganda. This paper reflects on gains, challenges and lessons learnt from working with communities to improve maternal and newborn health in rural Uganda. Methods A participatory action research project was supported from 2012 to 2015 in three eastern districts. This project involved working with households, saving groups, sub county and district leaders, transporters and village health teams in diagnosing causes of maternal and neonatal mortality and morbidity, developing action plans to address these issues, taking action and learning from action in a cyclical manner. This paper draws from project experience and documentation, as well as thematic analysis of 20 interviews with community and district stakeholders and 12 focus group discussions with women who had recently delivered and men whose wives had recently delivered. Results Women and men reported increased awareness about birth preparedness, improved newborn care practices and more male involvement in maternal and newborn health. However, additional direct communication strategies were required to reach more men beyond the minority who attended community dialogues and home visits. Saving groups and other saving modalities were strengthened, with money saved used to meet transport costs, purchase other items needed for birth and other routine household needs. However saving groups required significant support to improve income generation, management and trust among members. Linkages between savings groups and transport providers improved women’s access to health facilities at reduced cost. Although village health teams were a key resource for providing information, their efforts were constrained by low levels of education, inadequate financial compensation and transportation challenges. Ensuring that the village health

Public Health Nurses in Israel: A Case Study on a Quality Improvement Project of Nurse's Work Life.

Science.gov (United States)

Kagan, Ilya; Shachaf, Sara; Rapaport, Zofia; Livne, Tzipi; Madjar, Batya

2017-01-01

Public health nurses (PHNs) working in Well Baby Clinic in Israel's Haifa district were voicing great distress to inspectors-the impossibility of meeting their workload, feeling overwhelmed, poor physical, and technological conditions. They were feeling tired and frustrated and burn-out was rising. The district's nursing management took the decision, together with Tel Aviv University's nursing research unit, to conduct a quality improvement project based on issues that arose from meetings with focus groups on the nurses' difficulties. This paper is a case study of a quality improvement project targeting nurses daily working life. One of its chief contributions is as a study of meeting PHNs' frustration by integrating focus groups and round-table brainstorming (involving nurses, clinic managers and nursing inspectors) in order to identify targets for practical intervention. This strategy has been very successful. It has provided the district's nursing management a battery of forcefully argued and realistically grounded proposals for making the work of Well Baby clinics more relevant to their communities and giving nurses (a) the conditions to meet their assignments and (b) greater professional self-respect. © 2016 Wiley Periodicals, Inc.

The utah beacon experience: integrating quality improvement, health information technology, and practice facilitation to improve diabetes outcomes in small health care facilities.

Science.gov (United States)

Tennison, Janet; Rajeev, Deepthi; Woolsey, Sarah; Black, Jeff; Oostema, Steven J; North, Christie

2014-01-01

The Utah Improving Care through Connectivity and Collaboration (IC3) Beacon community (2010-2013) was spearheaded by HealthInsight, a nonprofit, community-based organization. One of the main objectives of IC(3) was to improve health care provided to patients with diabetes in three Utah counties, collaborating with 21 independent smaller clinics and two large health care enterprises. This paper will focus on the use of health information technology (HIT) and practice facilitation to develop and implement new care processes to improve clinic workflow and ultimately improve patients' diabetes outcomes at 21 participating smaller, independent clinics. Early in the project, we learned that most of the 21 clinics did not have the resources needed to successfully implement quality improvement (QI) initiatives. IC(3) helped clinics effectively use data generated from their electronic health records (EHRs) to design and implement interventions to improve patients' diabetes outcomes. This close coupling of HIT, expert practice facilitation, and Learning Collaboratives was found to be especially valuable in clinics with limited resources. Through this process we learned that (1) an extensive readiness assessment improved clinic retention, (2) clinic champions were important for a successful collaboration, and (3) current EHR systems have limited functionality to assist in QI initiatives. In general, smaller, independent clinics lack knowledge and experience with QI and have limited HIT experience to improve patient care using electronic clinical data. Additionally, future projects like IC(3) Beacon will be instrumental in changing clinic culture so that QI is integrated into routine workflow. Our efforts led to significant changes in how practice staff optimized their EHRs to manage and improve diabetes care, while establishing the framework for sustainability. Some of the IC(3) Beacon practices are currently smoothly transitioning to new models of care such as Patient

Protocol for project IMPACT (improving millions hearts for provider and community transformation): a quasi-experimental evaluation of an integrated electronic health record and community health worker intervention study to improve hypertension management among South Asian patients.

Science.gov (United States)

Lopez, Priscilla M; Zanowiak, Jennifer; Goldfeld, Keith; Wyka, Katarzyna; Masoud, Ahmad; Beane, Susan; Kumar, Rashi; Laughlin, Phoebe; Trinh-Shevrin, Chau; Thorpe, Lorna; Islam, Nadia

2017-12-06

The Million Hearts® initiative aims to prevent heart disease and stroke in the United States by mobilizing public and private sectors around a core set of objectives, with particular attention on improving blood pressure control. South Asians in particular have disproportionately high rates of hypertension and face numerous cultural, linguistic, and social barriers to accessing healthcare. Interventions utilizing Health information technology (HIT) and community health worker (CHW)-led patient coaching have each been demonstrated to be effective at advancing Million Hearts® goals, yet few studies have investigated the potential impact of integrating these strategies into a clinical-community linkage initiative. Building upon this initiative, we present the protocol and preliminary results of a research study, Project IMPACT, designed to fill this gap in knowledge. Project IMPACT is a stepped wedge quasi-experimental study designed to test the feasibility, adoption, and impact of integrating CHW-led health coaching with electronic health record (EHR)-based interventions to improve hypertension control among South Asian patients in New York City primary care practices. EHR intervention components include the training and implementation of hypertension-specific registry reports, alerts, and order sets. Fidelity to the EHR intervention is assessed by collecting the type, frequency, and utilization of intervention components for each practice. CHW intervention components consist of health coaching sessions on hypertension and related risk factors for uncontrolled hypertensive patients. The outcome, hypertension control (informs the effectiveness of these interventions in team-based care approaches, thereby, helping to develop relevant sustainability strategies for improving hypertension control among targeted racial/ethnic minority populations at small primary care practices. This study protocol has been approved and is made available on Clinicaltrials.gov by NCT

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

Science.gov (United States)

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

2011-01-01

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

Performance improvement with ISO 9001:2000: a case of PKOC-II project

Energy Technology Data Exchange (ETDEWEB)

Behera, U.K.; Prasad, K.S.N. [Singareni Collieries Co. Ltd. (India)

2006-07-01

The present study is limited to the study of main step towards ISO 9001:2000 (QMS) development, implementation and improvements of PKOC-II project and the same are discussed. In line with increasing global concern for quality, environmental protection and occupational health and safety, Singareni Collieries Co. Ltd (SCCL) has taken the strategic decision to implement ISO 9001:2000 (QMS), ISO 14001:2004 EMS (environmental management system) and occupational health and safety assessment series 18001:1999 (OHSAS) at the PK OC-II project. This is the first project to implement all three management systems QMS, OHSAS, and EMS, in the Indian coal industry. 25 refs., 12 figs., 2 tabs.

Strengthening global health security capacity--Vietnam demonstration project, 2013.

Science.gov (United States)

Tran, Phu Dac; Vu, Long Ngoc; Nguyen, Hien Tran; Phan, Lan Trong; Lowe, Wayne; McConnell, Michelle S; Iademarco, Michael F; Partridge, Jeffrey M; Kile, James C; Do, Trang; Nadol, Patrick J; Bui, Hien; Vu, Diep; Bond, Kyle; Nelson, David B; Anderson, Lauren; Hunt, Kenneth V; Smith, Nicole; Giannone, Paul; Klena, John; Beauvais, Denise; Becknell, Kristi; Tappero, Jordan W; Dowell, Scott F; Rzeszotarski, Peter; Chu, May; Kinkade, Carl

2014-01-31

Over the past decade, Vietnam has successfully responded to global health security (GHS) challenges, including domestic elimination of severe acute respiratory syndrome (SARS) and rapid public health responses to human infections with influenza A(H5N1) virus. However, new threats such as Middle East respiratory syndrome coronavirus (MERS-CoV) and influenza A(H7N9) present continued challenges, reinforcing the need to improve the global capacity to prevent, detect, and respond to public health threats. In June 2012, Vietnam, along with many other nations, obtained a 2-year extension for meeting core surveillance and response requirements of the 2005 International Health Regulations (IHR). During March-September 2013, CDC and the Vietnamese Ministry of Health (MoH) collaborated on a GHS demonstration project to improve public health emergency detection and response capacity. The project aimed to demonstrate, in a short period, that enhancements to Vietnam's health system in surveillance and early detection of and response to diseases and outbreaks could contribute to meeting the IHR core capacities, consistent with the Asia Pacific Strategy for Emerging Diseases. Work focused on enhancements to three interrelated priority areas and included achievements in 1) establishing an emergency operations center (EOC) at the General Department of Preventive Medicine with training of personnel for public health emergency management; 2) improving the nationwide laboratory system, including enhanced testing capability for several priority pathogens (i.e., those in Vietnam most likely to contribute to public health emergencies of international concern); and 3) creating an emergency response information systems platform, including a demonstration of real-time reporting capability. Lessons learned included awareness that integrated functions within the health system for GHS require careful planning, stakeholder buy-in, and intradepartmental and interdepartmental coordination and

Delivery improvements for CANDU projects

International Nuclear Information System (INIS)

Stephen Yu; Ken Hedges

1998-01-01

Future CANDU design will continue to meet emerging design and performance requirements as expected by the operating utilities, and will integrate new technologies into both the product features and work processes. Elements of this risk reduction strategy include feedback of lessons learned from operating plants, project experiences from previous projects, and replication of successful systems and equipment. Project implementation risk is minimized by up-front engineering and licensing prior to contract start. Enhanced competitiveness of the CANDU products is ensured by incorporating improvements based on updated technology. This paper summarizes the strategy used to enhance competitiveness of the CANDU products and the measures introduced to minimize risk during project implementation. This strategy provides a balance between innovation and proven designs; and between the desire for safety and operational improvements and the cost to achieve the improvements

A structured women's preventive health clinic for residents: a quality improvement project designed to meet training needs and improve cervical cancer screening rates.

Science.gov (United States)

Singh, Mamta K; Einstadter, Douglas; Lawrence, Renee

2010-10-01

Multiple resident-related factors contribute to 'missed opportunities' in providing comprehensive preventive care for female patients, including comfort level, knowledge and experience--all of which are compounded by resident turnover rates. Of particular concern among Internal Medicine (IM) residents is their knowledge and comfort level in performing pelvic exams. To evaluate the impact of a quality improvement project of implementing a Women's Preventive Health Clinic (WPHC) on addressing gaps identified by needs assessments: residents' comfort and knowledge with female preventive care and cervical cancer screening. The WPHC, a multidisciplinary weekly clinic, focused on preventive services for women with chronic conditions. The alternating didactic and clinic sessions emphasised women's preventive health topics for IM residents. Sixty-three IM residents participated in WPHC between 2002 and 2005. Pre- and post-test design was used to assess resident knowledge and comfort levels. Cervical cancer screening rates of residents' patients were assessed pre- and post-WPHC initiation. There was a significant improvement in general knowledge (64% correct at pretest vs 73% at post-test, p=0.0002), resident comfort level in discussing women's health topics and performing gynaecological exams (p<0.0002). Cervical cancer screening rates among IM residents' patients improved from 54% (pre-WPHC initiation) to 65% (post-WPHC initiation period). The results indicate that a focused resident preventive programme can meet gaps identified by education and needs assessments, and simultaneously have a positive impact on cervical cancer screening rates and thus may serve as a model for other residency programmes.

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.

Health System Measurement Project

Data.gov (United States)

U.S. Department of Health & Human Services — The Health System Measurement Project tracks government data on critical U.S. health system indicators. The website presents national trend data as well as detailed...

Obstacles to implementation of an intervention to improve surgical services in an Ethiopian hospital: a qualitative study of an international health partnership project.

Science.gov (United States)

Aveling, Emma-Louise; Zegeye, Desalegn Tegabu; Silverman, Michael

2016-08-17

Access to safe surgical care represents a critical gap in healthcare delivery and development in many low- and middle-income countries, including Ethiopia. Quality improvement (QI) initiatives at hospital level may contribute to closing this gap. Many such quality improvement initiatives are carried out through international health partnerships. Better understanding of how to optimise quality improvement in low-income settings is needed, including through partnership-based approaches. Drawing on a process evaluation of an intervention to improve surgical services in an Ethiopian hospital, this paper offers lessons to help meet this need. We conducted a qualitative process evaluation of a quality improvement project which aimed to improve access to surgical services in an Ethiopian referral hospital through better management. Data was collected longitudinally and included: 66 in-depth interviews with surgical staff and project team members; observation (135 h) in the surgery department and of project meetings; project-related documentation. Thematic analysis, guided by theoretical constructs, focused on identifying obstacles to implementation. The project largely failed to achieve its goals. Key barriers related to project design, partnership working and the implementation context, and included: confusion over project objectives and project and partner roles and responsibilities; logistical challenges concerning overseas visits; difficulties in communication; gaps between the time and authority team members had and that needed to implement and engage other staff; limited strategies for addressing adaptive-as opposed to technical-challenges; effects of hierarchy and resource scarcity on QI efforts. While many of the obstacles identified are common to diverse settings, our findings highlight ways in which some features of low-income country contexts amplify these common challenges. We identify lessons for optimising the design and planning of quality improvement

Engaging clinicians in health informatics projects.

Science.gov (United States)

Caballero Muñoz, Erika; Hullin Lucay Cossio, Carola M

2010-01-01

This chapter gives an educational overview of: * The importance of the engagement of clinicians within a health informatics project * Strategies required for an effective involvement of clinicians throughout a change management process within a clinical context for the implementation of a health informatics project * The critical aspects for a successful implementation of a health informatics project that involves clinicians as end users * Key factors during the administration of changes during the implementation of an informatics project for an information system in clinical practice.

Health improvement of domestic hot tap water supply Gusev, Kaliningrad Region, Russia. Make-up water tank project. Final report

Energy Technology Data Exchange (ETDEWEB)

Aagaard, Joergen

1998-07-01

This report describes the project `Health Improvement of Domestic Hot Tap Water Supply, Gusev, Kaliningrad, Russia`, which was carried out in the autumn of 1996 and financed by the Danish Environmental Protection Agency, the Danish Energy Agency and Gusev Municipality. The project proposal and application outlined the following objectives: Erection of system so that hot tap water, which is tapped directly from the district heating system, obtains an acceptable quality in health terms; Complete training and education, so that the plant can be operated and maintained by the power station`s staff and rehabilitation projects within supply of domestic water and district heating can be promoted to the greatest possible extent; Systems for heat treatment of make-up water were implemented in less than three months; The project was carried out in close Danish-Russian co-operation from the beginning of engineering to the commissioning and resulted in transfer and demonstration of know-how and technology; Information was recorded on the existing domestic water and heat supply systems as well as on the treatment of sewage, and recommendations for rehabilitation projects were made. Previously, when the temperature in the district heating system was relatively high, a heat treatment apparently took place in the district heating system. However, due to the current poor economic situation there are no means with which to buy the fuel quantities necessary to maintain the previously normal district heating temperature. In the new concept the cold make-up water is heated to >80 deg. C as required by the health authorities before it is led to the district heating return system and subsequently heated to the actual supply temperature of 50-60 deg. C. The energy consumption in the two concepts is approximately the same. A 1,000 m{sup 3} tank with heating coils was erected between the make-up water system and the district heating system. The tank should equalise the daily capacity

University of Michigan Comprehensive Cancer Center opportunities for improvement project.

Science.gov (United States)

Breslin, Tara M; Waldinger, Marcy; Silver, Samuel M

2014-02-01

The University of Michigan Comprehensive Cancer Center (UMCCC) Opportunities for Improvement project involved a detailed patient-level medical record review, feedback to medical providers and clinical leadership, and discussion of potential predictors of discordant or delayed care. The medical record review revealed that reasons for discordant or delayed care were well documented by clinical providers, and medical comorbidity was the most common predisposing factor. Another common theme was the difficulty in obtaining treatment records for patients who received a portion of their care outside UMCCC. The project provided a valuable opportunity to examine established processes of care and data collection and consider how the newly implemented electronic health record might support future efforts aimed at improving efficiency and communication among providers.

Incorporation of project-based learning into an occupational health course.

Science.gov (United States)

Dehdashti, Alireza; Mehralizadeh, Semira; Kashani, Masoud Motalebi

2013-01-01

Use of an appropriate teaching approach is a major concern for faculty members who are involved in occupational health and safety academic education. The challenge is to explore teaching tools to equip students with knowledge and skills to prepare them for their practices, in which they will encounter occupational health and safety issues in various occupational settings. The current study presents the design and implementation of a team project-based learning approach for undergraduate occupational health students to examine the appropriateness and perceptions of students and educators with regard to such a learning experience. Steps were taken to guide the educators and students through the learning process based on projects completed in teams. The research tools for collecting data were a questionnaire and semi-structured interviews with participants. The results illustrated that use of the proposed teaching approach as part of occupational health education may have the potential to motivate and enhance the active roles of educators and students in the learning process, and improve students' technical and social skills that are crucial for practice in the occupational health field. The study findings showed that project-based learning may provide a promising teaching strategy in the education and training of occupational health students. In addition, academic institutions should encourage educators to plan, introduce and evaluate the effectiveness of project-based learning.

Improving Perinatal Mental Health Care for Women Veterans: Description of a Quality Improvement Program.

Science.gov (United States)

Katon, Jodie G; Lewis, Lacey; Hercinovic, Selma; McNab, Amanda; Fortney, John; Rose, Susan M

2017-08-01

Purpose We describe results from a quality improvement project undertaken to address perinatal mental healthcare for women veterans. Description This quality improvement project was conducted in a single VA healthcare system between 2012 and 2015 and included screening for depressive symptoms with the Edinburgh Postnatal Depression Scale (EPDS) three times during the perinatal period, a dedicated maternity care coordinator (MCC), an on-site clinical social worker, and an on-site obstetrician/gynecologist (Ob/gyn). Information on prior mental health diagnosis was collected by the MCC or Ob/gyn. The prevalence of perinatal depressive symptoms and receipt of mental healthcare among those with such symptoms are reported by presence of a pre-pregnancy mental health diagnosis. Assessment Of the 199 women who used VA maternity benefits between 2012 and 2015, 56% (n = 111) had at least one pre-pregnancy mental health diagnosis. Compared to those without a pre-pregnancy mental health diagnosis, those with such a diagnosis were more likely to be screened for perinatal depressive symptoms at least once (61.5% vs. 46.8%, p = 0.04). Prevalence of depressive symptoms was 46.7% among those with a pre-pregnancy mental health diagnosis and 19.2% among those without. Among those with a pre-pregnancy mental health diagnosis and depressive symptoms (n = 35), 88% received outpatient mental healthcare and 77% met with the clinical social worker. Among those without a pre-pregnancy mental health diagnosis and depressive symptoms (n = 8), none received outpatient mental healthcare, but 77.8% met with the clinical social worker. Conclusion Improving perinatal mental healthcare for women veterans requires a multidisciplinary approach, including on-site integrated mental healthcare.

Faculty development projects for international health professions educators: Vehicles for institutional change?

Science.gov (United States)

Burdick, William P; Friedman, Stacey R; Diserens, Deborah

2012-01-01

Projects are an important tool in faculty development, and project emphasis may offer insights into perceived education priorities. Impact of projects has been focused on individuals, not institutions or health. Education innovation projects of Fellows in an international faculty development program were examined to better understand perceived needs in health professions education and institutional impact of projects. Four hundred and thirty-five projects were analyzed to identify focus areas. Fellows were asked to identify changes in their schools and communities resulting from their projects. New education methods and curriculum change were common project focus areas. Regional differences were evident with a higher percentage of education methods projects by Fellows residing in India (52%), compared with South Africa (25%) and Brazil (24%). Fifty-six percent of projects were incorporated into the curriculum and/or incorporated as institutional policy. One-third to two-thirds of respondents noted improved teaching quality, collaboration, education research interest, assessment, student performance, and curriculum alignment with community health needs. National differences in project focus may offer insight into local conditions and needs. High rates of diffusion of projects and impact on faculty, students, and curriculum suggest that faculty development projects may be a strategy for institutional change in resource limited environments.

Improvement of maternal health services through the use of mobile phones.

Science.gov (United States)

Noordam, A Camielle; Kuepper, Barbara M; Stekelenburg, Jelle; Milen, Anneli

2011-05-01

To analyse, on the basis of the literature, the potential of mobile phones to improve maternal health services in Low and Middle Income Countries (LMIC). Wide search for scientific and grey literature using various terms linked to: maternal health, mobile telecommunication and LMIC. Applications requiring an internet connection were excluded as this is not widely available in LMIC yet. Few projects exist in this field and little evidence is available as yet on the impact of mobile phones on the quality of maternal health services. Projects focus mainly on the delay in receiving care--that is in recognizing the need and making the decision to seek care--and the delay in arriving at the health facility. This is achieved by connecting lesser trained health workers to specialists and coordination of referrals. Ongoing projects focus on empowering women to seek health care. There is broad agreement that access to communication is one of several essential components to improve maternal health services and hence the use of mobile phones has much potential. However, there is a need for robust evidence on constraints and impacts, especially when financial and human resources will be invested. Concurrently, other ways in which mobile phones can be used to benefit maternal health services need to be further explored, taking into consideration privacy and confidentiality. © 2011 Blackwell Publishing Ltd.

Perceptions of community participation and health gain in a community project for the South Asian population: a qualitative study.

Science.gov (United States)

Bandesha, G; Litva, A

2005-09-01

The new public health rejects old individualist attempts at improving health and embraces community-based approaches in reducing health inequalities. Primary Care Trusts in England face the challenge of converting community participation in health into reality. This study explores differences in perception of participation between lay and professional stakeholders of a community health project for a South Asian population in Greater Manchester. In-depth interviews and focus groups were used to explore the views of professional and lay stakeholders. All data were audio-taped, transcribed and analysed for emerging themes using a qualitative framework. Professionals talked of working in partnership with the community but lay stakeholders did not feel that they had control over the project. There were problems in engaging the community and local health professionals in the project. Lack of cultural awareness hampered participation in the project. There was agreement that the project improved the self-confidence of participants and created a more informed population. However, there was little support for claims of improvements in social cohesion and changes in lifestyle directly as a result of the project. Converting the rhetoric of community participation in health into reality is a greater challenge than was envisaged by policy makers. Marginalized communities may not be willing participants and issues of language and cultural sensitivity are important. Project outcomes need to be agreed to ensure projects are evaluated appropriately. Projects with South Asian communities should not be seen to be dealing with all 'ethnic health' issues without addressing changes in statutory organizations and other wider social determinants of health.

[RIU project: perceived changes by health agents and professionals after a health intervention in an urban area of socioeconomic disadvantage].

Science.gov (United States)

Aviñó, Dory; Paredes-Carbonell, Joan J; Peiró-Pérez, Rosana; La Parra Casado, Daniel; Álvarez-Dardet, Carlos

2014-12-01

To describe how health agents and professionals working in a community project perceive the changes related to the population health status and their use of health-care services after the RIU intervention in an urban area of socioeconomic disadvantage. A qualitative descriptive study based on individual and group interviews and participant observation conducted between October 2008-July 2009. Raval (Algemesí-Valencia) We selected by purposive sample 7 women health agents, all persons who completed the intervention, and 10 professionals for their involvement in the intervention. We conducted a group interview with the women at 6 months and a group and 7 individuals interviews both at 9 months of intervention. We realized a thematic descriptive analysis from health promotion framework. We used participant observation in a meeting with professionals at 9 months and analyzed field notes as: appraisal project, detected changes, challenges and recommendations. Women acquired information about health, contraception, pregnancy and heath services; they noted changes in self-care and social skills and leadership; they internalized the role of health worker disseminating what they learned and showed improvement in self-esteem and social recognition. They caused changes in the people related on health care and access to services. Professionals didn't incorporate at their work the community perspective; they valued positively the project; professionals and women agreed on improving access and use of services and closeness population-professionals. RIU increases the capabilities of the participants, their social recognition and improves access and use of health services. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

GP's consult and health behaviour change project. Developing a programme to train GPs in communication skills to achieve lifestyle improvements.

Science.gov (United States)

Thijs, G A

2007-08-01

The European definition of General Practice states that GPs should use their core competence, amongst others, in their communication with patients. Their communication skills are particularly challenged in the field of lifestyle improvements. Most GPs feel they lack efficacy in achieving lifestyle changes. In November 2002 the Prevention Department of the Scientific Society of Flemish GPs (now Domus Medica) decided to start a project "consulting & behaviour change". Under this project, every Flemish GP should by the year 2007, have (amongst others things) a basic knowledge of the principles of lifestyle improvements and should be able to give a short advice to high risk patients. A literature search was conducted to make an inventory of models that could be used to train GPs. Experts at specific methods and topics were consulted to get acquainted with their specific approaches. Experts in the field of CME were gathered to discuss barriers and solutions to these barriers. During steering group meetings, several possible solutions were discussed. The Trans Theoretical Model (TTM-as theoretical framework) and brief motivational interviews (MI-as communication skill) were evaluated as offering the best opportunities for adapting the work situation of the GP. We promoted this approach to the GPs as an ABC concept (Anamnesis/Ask; Be the guide/Decision tree ("Beslissingsboom" in Dutch); Continuity) applied on different topics (smoke stop, alcohol, healthy food, physical activity). In our guidelines we pay more attention to brief motivational interviews for health behaviour changes. Recently we started developing an e-learning website as part of a larger learning project, this in cooperaion with different Flemish partners and disciplines. The Trans Theoretical Model and the brief motivational interviewing approach seem to be accepted by health care, educational and scientific organisations. The process of integrating this approach in the GP's daily practice has to be

Waste Management Process Improvement Project

International Nuclear Information System (INIS)

Atwood, J.; Borden, G.; Rangel, G. R.

2002-01-01

The Bechtel Hanford-led Environmental Restoration Contractor team's Waste Management Process Improvement Project is working diligently with the U.S. Department of Energy's (DOE) Richland Operations Office to improve the waste management process to meet DOE's need for an efficient, cost-effective program for the management of dangerous, low-level and mixed-low-level waste. Additionally the program must meet all applicable regulatory requirements. The need for improvement was highlighted when a change in the Groundwater/Vadose Zone Integration Project's waste management practices resulted in a larger amount of waste being generated than the waste management organization had been set up to handle

[A project to reduce the incidence of intubation care errors among foreign health aides].

Science.gov (United States)

Chen, Mei-Ju; Lu, Yu-Hua; Chen, Chiu-Chun; Li, Ai-Cheng

2014-08-01

Foreign health aides are the main providers of care for the elderly and the physically disabled in Taiwan. Correct care skills improve patient safety. In 2010, the incidence of mistakes among foreign health aides in our hospital unit was 58% for nasogastric tube care and 57% for tracheostomy tube care. A survey of foreign health aides and nurses in the unit identified the main causes of these mistakes as: communication difficulties, inaccurate instructions given to patients, and a lack of standard operating procedures given to the foreign health aides. This project was designed to reduce the rates of improper nasogastric tube care and improper tracheostomy tube care to 20%, respectively. This project implemented several appropriate measures. We produced patient instruction hand-outs in Bahasa Indonesia, established a dedicated file holder for Bahasa Indonesian tube care reference information, produced Bahasa Indonesian tube-care-related posters, produced a short film about tube care in Bahasa Indonesian, and established a standardized operating procedure for tube care in our unit. Between December 15th and 31st, 2011, we audited the performance of a total of 32 foreign health aides for proper execution of nasogastric tube care (21 aides) and of proper execution of tracheostomy tube care (11 aides). Patients with concurrent nasogastric and tracheostomy tubes were inspected separately for each care group. The incidence of improper care decreased from 58% to 18% nasogastric intubation and 57% to 18% for tracheostomy intubation. This project decreased significantly the incidence of improper tube care by the foreign health aides in our unit. Furthermore, the foreign health aides improved their tube nursing care skills. Therefore, this project improved the quality of patient care.

Value propositions of mHealth projects.

Science.gov (United States)

Gorski, Irena; Bram, Joshua T; Sutermaster, Staci; Eckman, Molly; Mehta, Khanjan

While mHealth holds great potential for addressing global health disparities, a majority of the initiatives never proceed beyond the pilot stage. One fundamental concern is that mHealth projects are seldom designed from the customer's perspective to address their specific problems and/or create appreciable value. A customer-centric view, where direct tangible benefits of interventions are identified and communicated effectively, can drive customer engagement and advance projects toward self-sustaining business models. This article reviews the business models of 234 mHealth projects to identify nine distinct value propositions that solve specific problems for customers. Each of these value propositions is discussed with real-world examples, analyses of their design approaches and business strategies, and common enablers as well as hurdles to surviving past the pilot stage. Furthermore, a deeper analysis of 42 mHealth ventures that have achieved self-sustainability through project revenue provides a host of practical and poignant insights into the design of systems that can fulfil mHealth's promise to address healthcare challenges in the long term.

Steam generator reliability improvement project

International Nuclear Information System (INIS)

Blomgren, J.C.; Green, S.J.

1987-01-01

Upon successful completion of its research and development technology transfer program, the Electric Power Research Institute's Steam Generator Owners Group (SGOG II) will disband in December 1986 and be replaced in January 1987 by a successor project, the Steam Generator Reliability Project (SGRP). The new project, funded in the EPRI base program, will continue the emphasis on reliability and life extension that was carried forward by SGOG II. The objectives of SGOG II have been met. Causes and remedies have been identified for tubing corrosion problems, such as stress corrosion cracking and pitting, and steam generator technology has been improved in areas such as tube wear prediction and nondestructive evaluation (NDE). These actions have led to improved reliability of steam generators. Now the owners want to continue with a centrally managed program that builds on what has been learned. The goal is to continue to improve steam generator reliability and solve small problems before they become large problems

Steam generator reliability improvement project

International Nuclear Information System (INIS)

Blomgren, J.C.; Green, S.J.

1987-01-01

Upon successful completion of its research and development technology transfer program, the Electric Power Research Institute's (EPRI's) Steam Generator Owners Group (SGOG II) will disband in December 1986, and be replaced in January 1987, by a successor project, the Steam Generator Reliability Project (SGRP). The new project, funded in the EPRI base program, will continue to emphasize reliability and life extension, which were carried forward by SGOG II. The objectives of SGOG II have been met. Causes and remedies have been identified for tubing corrosion problems such as stress corrosion cracking and pitting, and steam generator technology has been improved in areas such as tube wear prediction and nondestructive evaluation. These actions have led to improved reliability of steam generators. Now the owners want to continue with a centrally managed program that builds on what has been learned. The goal is to continue to improve steam generator reliability and to solve small problems before they become large problems

Improving Project Manufacturing Coordination

Directory of Open Access Journals (Sweden)

Korpivaara Ville

2014-09-01

Full Text Available The objective of this research is to develop firms’ project manufacturing coordination. The development will be made by centralizing the manufacturing information flows in one system. To be able to centralize information, a deep user need assessment is required. After user needs have been identified, the existing system will be developed to match these needs. The theoretical background is achieved through exploring the literature of project manufacturing, development project success factors and different frameworks and tools for development project execution. The focus of this research is rather in customer need assessment than in system’s technical expertise. To ensure the deep understanding of customer needs this study is executed by action research method. As a result of this research the information system for project manufacturing coordination was developed to respond revealed needs of the stakeholders. The new system improves the quality of the manufacturing information, eliminates waste in manufacturing coordination processes and offers a better visibility to the project manufacturing. Hence it provides a solid base for the further development of project manufacturing.

Project Hanford management contract quality improvement project management plan; TOPICAL

International Nuclear Information System (INIS)

ADAMS, D.E.

1999-01-01

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

Managing project complexity : A study into adapting early project phases to improve project performance in large engineering projects

NARCIS (Netherlands)

Bosch-Rekveldt, M.G.C.

2011-01-01

Engineering projects become increasingly more complex and project complexity is assumed to be one of the causes for projects being delivered late and over budget. However, what this project complexity actually comprised of was unclear. To improve the overall project performance, this study focuses

Project CHERISH (Children in Home Environments: Regulation To Improve Safety and Health). Final Report.

Science.gov (United States)

Grubb, Paul Dallas

In 1990, Project CHERISH (Children in Home Environments: Regulation to Increase Safety and Health) enabled the Texas Department of Human Services to implement and evaluate several innovative strategies to strengthen regulation of family day care homes. This report contains descriptions of those strategies, an evaluation of their efficacy, and…

Using Focused Laboratory Management and Quality Improvement Projects to Enhance Resident Training and Foster Scholarship

Science.gov (United States)

Ford, Bradley A.; Klutts, J. Stacey; Jensen, Chris S.; Briggs, Angela S.; Robinson, Robert A.; Bruch, Leslie A.; Karandikar, Nitin J.

2017-01-01

Training in patient safety, quality, and management is widely recognized as an important element of graduate medical education. These concepts have been intertwined in pathology graduate medical education for many years, although training programs face challenges in creating explicit learning opportunities in these fields. Tangibly involving pathology residents in management and quality improvement projects has the potential to teach and reinforce key concepts and further fulfill Accreditation Council for Graduate Medical Education goals for pursuing projects related to patient safety and quality improvement. In this report, we present our experience at a pathology residency program (University of Iowa) in engaging pathology residents in projects related to practical issues of laboratory management, process improvement, and informatics. In this program, at least 1 management/quality improvement project, typically performed during a clinical chemistry/management rotation, was required and ideally resulted in a journal publication. The residency program also initiated a monthly management/informatics series for pathology externs, residents, and fellows that covers a wide range of topics. Since 2010, all pathology residents at the University of Iowa have completed at least 1 management/quality improvement project. Many of the projects involved aspects of laboratory test utilization, with some projects focused on other areas such as human resources, informatics, or process improvement. Since 2012, 31 peer-reviewed journal articles involving effort from 26 residents have been published. Multiple projects resulted in changes in ongoing practice, particularly within the hospital electronic health record. Focused management/quality improvement projects involving pathology residents can result in both meaningful quality improvement and scholarly output. PMID:28913416

Using Focused Laboratory Management and Quality Improvement Projects to Enhance Resident Training and Foster Scholarship.

Science.gov (United States)

Krasowski, Matthew D; Ford, Bradley A; Klutts, J Stacey; Jensen, Chris S; Briggs, Angela S; Robinson, Robert A; Bruch, Leslie A; Karandikar, Nitin J

2017-01-01

Training in patient safety, quality, and management is widely recognized as an important element of graduate medical education. These concepts have been intertwined in pathology graduate medical education for many years, although training programs face challenges in creating explicit learning opportunities in these fields. Tangibly involving pathology residents in management and quality improvement projects has the potential to teach and reinforce key concepts and further fulfill Accreditation Council for Graduate Medical Education goals for pursuing projects related to patient safety and quality improvement. In this report, we present our experience at a pathology residency program (University of Iowa) in engaging pathology residents in projects related to practical issues of laboratory management, process improvement, and informatics. In this program, at least 1 management/quality improvement project, typically performed during a clinical chemistry/management rotation, was required and ideally resulted in a journal publication. The residency program also initiated a monthly management/informatics series for pathology externs, residents, and fellows that covers a wide range of topics. Since 2010, all pathology residents at the University of Iowa have completed at least 1 management/quality improvement project. Many of the projects involved aspects of laboratory test utilization, with some projects focused on other areas such as human resources, informatics, or process improvement. Since 2012, 31 peer-reviewed journal articles involving effort from 26 residents have been published. Multiple projects resulted in changes in ongoing practice, particularly within the hospital electronic health record. Focused management/quality improvement projects involving pathology residents can result in both meaningful quality improvement and scholarly output.

Development of a Multi-Domain Assessment Tool for Quality Improvement Projects.

Science.gov (United States)

Rosenbluth, Glenn; Burman, Natalie J; Ranji, Sumant R; Boscardin, Christy K

2017-08-01

Improving the quality of health care and education has become a mandate at all levels within the medical profession. While several published quality improvement (QI) assessment tools exist, all have limitations in addressing the range of QI projects undertaken by learners in undergraduate medical education, graduate medical education, and continuing medical education. We developed and validated a tool to assess QI projects with learner engagement across the educational continuum. After reviewing existing tools, we interviewed local faculty who taught QI to understand how learners were engaged and what these faculty wanted in an ideal assessment tool. We then developed a list of competencies associated with QI, established items linked to these competencies, revised the items using an iterative process, and collected validity evidence for the tool. The resulting Multi-Domain Assessment of Quality Improvement Projects (MAQIP) rating tool contains 9 items, with criteria that may be completely fulfilled, partially fulfilled, or not fulfilled. Interrater reliability was 0.77. Untrained local faculty were able to use the tool with minimal guidance. The MAQIP is a 9-item, user-friendly tool that can be used to assess QI projects at various stages and to provide formative and summative feedback to learners at all levels.

Framework to Define Structure and Boundaries of Complex Health Intervention Systems: The ALERT Project

Directory of Open Access Journals (Sweden)

Elena Boriani

2017-07-01

Full Text Available Health intervention systems are complex and subject to multiple variables in different phases of implementation. This constitutes a concrete challenge for the application of translational science in real life. Complex systems as health-oriented interventions call for interdisciplinary approaches with carefully defined system boundaries. Exploring individual components of such systems from different viewpoints gives a wide overview and helps to understand the elements and the relationships that drive actions and consequences within the system. In this study, we present an application and assessment of a framework with focus on systems and system boundaries of interdisciplinary projects. As an example on how to apply our framework, we analyzed ALERT [an integrated sensors and biosensors’ system (BEST aimed at monitoring the quality, health, and traceability of the chain of the bovine milk], a multidisciplinary and interdisciplinary project based on the application of measurable biomarkers at strategic points of the milk chain for improved food security (including safety, human, and ecosystem health (1. In fact, the European food safety framework calls for science-based support to the primary producers’ mandate for legal, scientific, and ethical responsibility in food supply. Because of its multidisciplinary and interdisciplinary approach involving human, animal, and ecosystem health, ALERT can be considered as a One Health project. Within the ALERT context, we identified the need to take into account the main actors, interactions, and relationships of stakeholders to depict a simplified skeleton of the system. The framework can provide elements to highlight how and where to improve the project development when project evaluations are required.

Integrating Public Health and Health Promotion Practice in the Medical Curriculum: A Self-Directed Team-Based Project Approach

Directory of Open Access Journals (Sweden)

Geraldine Kershaw

2017-08-01

Full Text Available Preparing health professionals in health promotion (HP and disease prevention is essential for improvement of population health, community HP, and better health care for individuals. The aim of this article is to describe an HP project in the form of a major self-directed project-based learning task integrated within the curriculum in the second year of the medical degree program at United Arab Emirates University. The project introduces students to public health and HP practice and develops students’ literature searching, writing, presentation skills, and team work. Students learn the principles underlying behavioral change, and the design of HP programs and materials, through a lecture format. Small groups of students each choose a specific health topic for their project. Over 11 weeks, students obtain information about their topic from appropriate sources (library, PubMed, Google Scholar, credible health sources such as World Health Organization. Using the principles learned in the lectures, they develop appropriate materials for their target audience: for example, posters, a pamphlet, social media content, or a video or radio message. Students seek advice from specialist faculty as needed. In week 12, each team presents their project background, rationale, and materials to their colleagues in a seminar format open to all faculty. They then submit the materials they developed for assessment. Group marks are assigned for presentations and materials. Key concepts are assessed by multiple choice questions in comprehensive course examinations. By participation in the HP project, many students develop a solid background in prevention. The information retrieval, writing, and presentation skills, as well as experience of team work, are valuable both for the remaining years of their training and their future careers.

Competitiveness Improvement Project Informational Workshop

Energy Technology Data Exchange (ETDEWEB)

Sinclair, Karin C [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Preus, Robert W [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Dana, Scott [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Van Dam, Jeroen J [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Damiani, Rick R [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Jackson, Kyndall R [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Baring-Gould, Edward I [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Jain, Anant [Intertek

2018-02-27

This presentation was given at the Competitiveness Improvement Project (CIP) Informational Workshop on December 6, 2017. Topics covered during the workshop include an overview of the CIP, past projects, scoring criteria, technical support opportunities, certification body requirements, standards applicable to distributed wind generators, information on the National Electric Code, certification testing requirements, test site requirements, National Environmental Policy Act, design review, levelized cost of energy, procurement/contracting, project management/deliverables, and outreach materials.

Design of the DIRECT-project: interventions to increase job resources and recovery opportunities to improve job-related health, well-being, and performance outcomes in nursing homes.

Science.gov (United States)

Spoor, Ellen; de Jonge, Jan; Hamers, Jan P H

2010-05-28

Because of high demands at work, nurses are at high risk for occupational burnout and physical complaints. The presence of job resources (such as job autonomy or social support) and recovery opportunities could counteract the adverse effect of high job demands. However, it is still unclear how job resources and recovery opportunities can be translated into effective workplace interventions aiming to improve employee health, well-being, and performance-related outcomes. The aim of the current research project is developing and implementing interventions to optimize job resources and recovery opportunities, which may lead to improved health, well-being and performance of nurses. The DIRECT-project (DIsc Risk Evaluating Controlled Trial) is a longitudinal, quasi-experimental field study. Nursing home staff of 4 intervention wards and 4 comparison wards will be involved. Based on the results of a base-line survey, interventions will be implemented to optimize job resources and recovery opportunities. After 12 and 24 month the effect of the interventions will be investigated with follow-up surveys. Additionally, a process evaluation will be conducted to map factors that either stimulated or hindered successful implementation as well as the effectiveness of the interventions. The DIRECT-project fulfils a strong need for intervention research in the field of work, stress, performance, and health. The results could reveal (1) how interventions can be tailored to optimize job resources and recovery opportunities, in order to counteract job demands, and (2) what the effects of these interventions will be on health, well-being, and performance of nursing staff.

Design of the DIRECT-project: interventions to increase job resources and recovery opportunities to improve job-related health, well-being, and performance outcomes in nursing homes

Directory of Open Access Journals (Sweden)

Hamers Jan PH

2010-05-01

Full Text Available Abstract Background Because of high demands at work, nurses are at high risk for occupational burnout and physical complaints. The presence of job resources (such as job autonomy or social support and recovery opportunities could counteract the adverse effect of high job demands. However, it is still unclear how job resources and recovery opportunities can be translated into effective workplace interventions aiming to improve employee health, well-being, and performance-related outcomes. The aim of the current research project is developing and implementing interventions to optimize job resources and recovery opportunities, which may lead to improved health, well-being and performance of nurses. Methods/design The DIRECT-project (DIsc Risk Evaluating Controlled Trial is a longitudinal, quasi-experimental field study. Nursing home staff of 4 intervention wards and 4 comparison wards will be involved. Based on the results of a base-line survey, interventions will be implemented to optimize job resources and recovery opportunities. After 12 and 24 month the effect of the interventions will be investigated with follow-up surveys. Additionally, a process evaluation will be conducted to map factors that either stimulated or hindered successful implementation as well as the effectiveness of the interventions. Discussion The DIRECT-project fulfils a strong need for intervention research in the field of work, stress, performance, and health. The results could reveal (1 how interventions can be tailored to optimize job resources and recovery opportunities, in order to counteract job demands, and (2 what the effects of these interventions will be on health, well-being, and performance of nursing staff.

Including Health in Environmental Assessments of Major Transport Infrastructure Projects: A Documentary Analysis.

Science.gov (United States)

Riley, Emily; Harris, Patrick; Kent, Jennifer; Sainsbury, Peter; Lane, Anna; Baum, Fran

2018-05-10

Transport policy and practice impacts health. Environmental Impact Assessments (EIAs) are regulated public policy mechanisms that can be used to consider the health impacts of major transport projects before they are approved. The way health is considered in these environmental assessments (EAs) is not well known. This research asked: How and to what extent was human health considered in EAs of four major transport projects in Australia. We developed a comprehensive coding framework to analyse the Environmental Impact Statements (EISs) of four transport infrastructure projects: three road and one light rail. The coding framework was designed to capture how health was directly and indirectly included. We found that health was partially considered in all four EISs. In the three New South Wales (NSW) projects, but not the one South Australian project, this was influenced by the requirements issued to proponents by the government which directed the content of the EIS. Health was assessed using human health risk assessment (HHRA). We found this to be narrow in focus and revealed a need for a broader social determinants of health approach, using multiple methods. The road assessments emphasised air quality and noise risks, concluding these were minimal or predicted to improve. The South Australian project was the only road project not to include health data explicitly. The light rail EIS considered the health benefits of the project whereas the others focused on risk. Only one project considered mental health, although in less detail than air quality or noise. Our findings suggest EIAs lag behind the known evidence linking transport infrastructure to health. If health is to be comprehensively included, a more complete model of health is required, as well as a shift away from health risk assessment as the main method used. This needs to be mandatory for all significant developments. We also found that considering health only at the EIA stage may be a significant

Realizing universal health coverage for maternal health services in the Republic of Guinea: the use of workforce projections to design health labor market interventions

Directory of Open Access Journals (Sweden)

Jansen C

2014-11-01

Full Text Available Christel Jansen,1 Laurence Codjia,2 Giorgio Cometto,3 Mohamed Lamine Yansané,4 Marjolein Dieleman1 1Health Unit, Royal Tropical Institute, Amsterdam, the Netherlands; 2Health Workforce, World Health Organization, Geneva, Switzerland; 3Global Health Workforce Alliance, World Health Organization, Geneva, Switzerland; 4Health Focus GmbH, Conakry, Guinea Background: Universal health coverage requires a health workforce that is available, accessible, and well-performing. This article presents a critical analysis of the health workforce needs for the delivery of maternal and neonatal health services in Guinea, and of feasible and relevant interventions to improve the availability, accessibility, and performance of the health workforce in the country. Methods: A needs-based approach was used to project human resources for health (HRH requirements. This was combined with modeling of future health sector demand and supply. A baseline scenario with disaggregated need and supply data for the targeted health professionals per region and setting (urban or rural informed the identification of challenges related to the availability and distribution of the workforce between 2014 and 2024. Subsequently, the health labor market framework was used to identify interventions to improve the availability and distribution of the health workforce. These interventions were included in the supply side modeling, in order to create a “policy rich” scenario B which allowed for analysis of their potential impact. Results: In the Republic of Guinea, only 44% of the nurses and 18% of the midwives required for maternal and neonatal health services are currently available. If Guinea continues on its current path without scaling up recruitment efforts, the total stock of HRH employed by the public sector will decline by 15% between 2014 and 2024, while HRH needs will grow by 22% due to demographic trends. The high density of HRH in urban areas and the high number of auxiliary

Parents as Teachers Health Literacy Demonstration project: integrating an empowerment model of health literacy promotion into home-based parent education.

Science.gov (United States)

Carroll, Lauren N; Smith, Sandra A; Thomson, Nicole R

2015-03-01

The Parents as Teachers (PAT) Health Literacy Demonstration project assessed the impact of integrating data-driven reflective practices into the PAT home visitation model to promote maternal health literacy. PAT is a federally approved Maternal, Infant, Early Childhood Home Visiting program with the goal of promoting school readiness and healthy child development. This 2-year demonstration project used an open-cohort longitudinal design to promote parents' interactive and reflective skills, enhance health education, and provide direct assistance to personalize and act on information by integrating an empowerment paradigm into PAT's parent education model. Eight parent educators used the Life Skills Progression instrument to tailor the intervention to each of 103 parent-child dyads. Repeated-measures analysis of variance, paired t tests, and logistic regression combined with qualitative data demonstrated that mothers achieved overall significant improvements in health literacy, and that home visitors are important catalysts for these improvements. These findings support the use of an empowerment model of health education, skill building, and direct information support to enable parents to better manage personal and child health and health care. © 2014 Society for Public Health Education.

A pilot project to improve access to telepsychotherapy at rural clinics.

Science.gov (United States)

Adler, Geri; Pritchett, Lonique R; Kauth, Michael R; Nadorff, Danielle

2014-01-01

The U.S. Department of Veterans Affairs (VA) has pioneered telemental health (TMH) with over 500,000 TMH encounters over the past decade. VA community-based outpatient clinics were established to improve accessibility of mental healthcare for rural Veterans. Despite these clinics clinics and increased availability of TMH, many rural Veterans have difficulty receiving mental healthcare, particularly psychotherapy. Twelve therapists participated in a pilot project using TMH technologies to improve mental healthcare service delivery to rural Veterans treated at six community clinics. Therapists completed online training, and study staff communicated with them monthly and clinical leaders every other month. Therapists completed two questionnaires: before training and 10 months later. This article describes barriers and facilitators to the implementation of the project, as well as therapists' knowledge, confidence, and motivation regarding TMH. Two clinicians were offering telepsychotherapy after 10 months. At all six sites, unanticipated organizational constraints and administrative barriers delayed implementation; establishing organizational practices and therapists' motivation helped facilitate the process. Adopters of the project reported more positive views of the modality and did not worry about staffing, a concern of nonadopters. Despite barriers to implementation, lessons learned from this pilot project have led to improvements and changes in TMH processes. Results from the pilot showed that therapists providing telepsychotherapy had increased confidence, knowledge, and motivation. As TMH continues to expand, formalized decision-making with clinical leaders regarding project goals, better matching of therapists with this modality, and assessment of medical center and clinic readiness are recommended.

Needs assessment in health research projects: a new approach to project management in iran.

Science.gov (United States)

Peykari, Niloofar; Owlia, Parviz; Malekafzali, Hossein; Ghanei, Mostafa; Babamahmoodi, Abdolreza; Djalalinia, Shirin

2013-01-01

The science and technology health plan has defined the outline of health research to the national vision of Iran by 2025. The aim of this study was to focus on the process of needs assessment of health research projects also health research priority setting in Iran. THE PROJECT MANAGEMENT LIFE CYCLE HAS FOUR PHASES: Initiation, Planning, Execution and Closure. Based on abovementioned points we conducted the study. Focusing on the needs assessment led to systematic implementation of needs assessment of health project in all of the medical sciences universities. Parallel with this achieved strategies health research priority setting was followed through specific process from empowerment to implementation. We should adopt with more systematic progressive methods of health project managements for both our national convenience as well as our international health research programs.

Improving the physical health in long-term psychiatric inpatients

DEFF Research Database (Denmark)

Hjorth, Peter; Davidsen, A.S.; Killian, R.

2014-01-01

programme to improve physical health is effective. METHODS: An extension of the European Network for Promoting the Health of Residents in Psychiatric and Social Care Institutions (HELPS) project further developed as a 12-month controlled cluster-randomized intervention study in the Danish centre. Waist......, but not significant, reduction in waist circumference, while participants in the control group showed a significant increase in waist circumference. CONCLUSIONS: The intervention had a positive effect on the physical health of the patients measured by a reduction in the increase of waist circumference....

Impact assessment of a maternal health project in a megacity, Nigeria: toward a future with more demand for maternal health services.

Science.gov (United States)

Matsuoka, Sadatoshi; Koga, Sumiko; Suzui, Emiko; Tsukada, Yoshiko; Ohashi, Kazutomo; Johnson, Taiwo

2017-10-01

To improve the quantity and quality of maternal health services in Lagos State, Nigeria having a maternal mortality ratio of 555 per 100 000 live births, a four-year project was implemented since February 2010. The major activity of the project was training for both the service supply and demand sides. This study aimed to examine the impact of the project on coverages and quality of the services in target areas, and guide statewide policies. The Cochran-Armitage test for trend was applied to understand trends in the service coverages during 2009-2013. The same test was performed to analyse trends in the proportions of perineal conditions (i.e. intact or tear) and to evaluate variations in midwives' snkill during 2011-2013. The paired t-test was used to analyse changes in midwives' knowledge. The project interventions contributed to a significant increase in the overall service coverages, including improvements in midwifery knowledge and possibly in their skills. However, the service coverage was still limited as of the termination of the project. To instal the interventions and maximise the effect of them state-wide, it is recommended to undertake five tasks: (i) establishment of public primary health centres offering 24-h maternal health services; (ii) redeployment and recruitment of public health personnel; (iii) expansion of midwifery trainings and continuous education by the local trainers; (iv) review of grass-roots level activities; and (v) scrutiny of barriers to maternal health services. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Factors of human capital related to project success in health care work units.

Science.gov (United States)

Suhonen, Marjo; Paasivaara, Leena

2011-03-01

To explore factors of human capital related to project success that employees expect from nurse managers. Human capital refers to those resources that managers working with projects possess, such as abilities, knowledge and qualities of character. The data were collected by open interviews (n=14) with nurses, public health nurses and nurse managers working in primary health care and a hospital. Data analysis was carried out using qualitative content analysis. The main factors of human capital related to project success proved to be as follows: (1) management of enthusiastic project culture, (2) management of regeneration and (3) management of emotional intelligence. Future research is needed on the kind of means nurse managers use in human capital management in projects and how they see their possibilities in managing human capital. Human capital management skills should be underlined as an important competence area when recruiting a nurse manager. The success of health care projects cannot be improved only through education or by training of nurse managers; in addition, projects need nurse managers who understand workplace spirituality and have high emotional intelligence. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.

Lessons Learned From the Environmental Public Health Tracking Sub-County Data Pilot Project.

Science.gov (United States)

Werner, Angela K; Strosnider, Heather; Kassinger, Craig; Shin, Mikyong

2017-12-07

Small area data are key to better understanding the complex relationships between environmental health, health outcomes, and risk factors at a local level. In 2014, the Centers for Disease Control and Prevention's National Environmental Public Health Tracking Program (Tracking Program) conducted the Sub-County Data Pilot Project with grantees to consider integration of sub-county data into the National Environmental Public Health Tracking Network (Tracking Network). The Tracking Program and grantees developed sub-county-level data for several data sets during this pilot project, working to standardize processes for submitting data and creating required geographies. Grantees documented challenges they encountered during the pilot project and documented decisions. This article covers the challenges revealed during the project. It includes insights into geocoding, aggregation, population estimates, and data stability and provides recommendations for moving forward. National standards for generating, analyzing, and sharing sub-county data should be established to build a system of sub-county data that allow for comparison of outcomes, geographies, and time. Increasing the availability and accessibility of small area data will not only enhance the Tracking Network's capabilities but also contribute to an improved understanding of environmental health and informed decision making at a local level.

Improving employee productivity through improved health.

Science.gov (United States)

Mitchell, Rebecca J; Ozminkowski, Ronald J; Serxner, Seth

2013-10-01

The objective of this study was to estimate productivity-related savings associated with employee participation in health promotion programs. Propensity score weighting and multiple regression techniques were used to estimate savings. These techniques were adjusted for demographic and health status differences between participants who engaged in one or more telephonic health management programs and nonparticipants who were eligible for but did not engage in these programs. Employees who participated in a program and successfully improved their health care or lifestyle showed significant improvements in lost work time. These employees saved an average of $353 per person per year. This reflects about 10.3 hours in additional productive time annually, compared with similar, but nonparticipating employees. Participating in health promotion programs can help improve productivity levels among employees and save money for their employers.

Articulating current service development practices: a qualitative analysis of eleven mental health projects.

Science.gov (United States)

Jun, Gyuchan Thomas; Morrison, Cecily; Clarkson, P John

2014-01-17

The utilisation of good design practices in the development of complex health services is essential to improving quality. Healthcare organisations, however, are often seriously out of step with modern design thinking and practice. As a starting point to encourage the uptake of good design practices, it is important to understand the context of their intended use. This study aims to do that by articulating current health service development practices. Eleven service development projects carried out in a large mental health service were investigated through in-depth interviews with six operation managers. The critical decision method in conjunction with diagrammatic elicitation was used to capture descriptions of these projects. Stage-gate design models were then formed to visually articulate, classify and characterise different service development practices. Projects were grouped into three categories according to design process patterns: new service introduction and service integration; service improvement; service closure. Three common design stages: problem exploration, idea generation and solution evaluation - were then compared across the design process patterns. Consistent across projects were a top-down, policy-driven approach to exploration, underexploited idea generation and implementation-based evaluation. This study provides insight into where and how good design practices can contribute to the improvement of current service development practices. Specifically, the following suggestions for future service development practices are made: genuine user needs analysis for exploration; divergent thinking and innovative culture for idea generation; and fail-safe evaluation prior to implementation. Better training for managers through partnership working with design experts and researchers could be beneficial.

Distributed Wind Competitiveness Improvement Project

Energy Technology Data Exchange (ETDEWEB)

2018-02-27

The Competitiveness Improvement Project (CIP) is a periodic solicitation through the U.S. Department of Energy and its National Renewable Energy Laboratory. The Competitiveness Improvement Project (CIP) is a periodic solicitation through the U.S. Department of Energy and its National Renewable Energy Laboratory. Manufacturers of small and medium wind turbines are awarded cost-shared grants via a competitive process to optimize their designs, develop advanced manufacturing processes, and perform turbine testing. The goals of the CIP are to make wind energy cost competitive with other distributed generation technology and increase the number of wind turbine designs certified to national testing standards. This fact sheet describes the CIP and funding awarded as part of the project.ufacturers of small and medium wind turbines are awarded cost-shared grants via a competitive process to optimize their designs, develop advanced manufacturing processes, and perform turbine testing. The goals of the CIP are to make wind energy cost competitive with other distributed generation technology and increase the number of wind turbine designs certified to national testing standards. This fact sheet describes the CIP and funding awarded as part of the project.

Framework to Define Structure and Boundaries of Complex Health Intervention Systems: The ALERT Project

DEFF Research Database (Denmark)

Boriani, Elena; Esposito, Roberto; Frazzoli, Chiara

2017-01-01

of a framework with focus on systems and system boundaries of interdisciplinary projects. As an example on how to apply our framework, we analyzed ALERT [an integrated sensors and biosensors’ system (BEST) aimed at monitoring the quality, health, and traceability of the chain of the bovine milk......], a multidisciplinary and interdisciplinary project based on the application of measurable biomarkers at strategic points of the milk chain for improved food security (including safety), human, and ecosystem health (1). In fact, the European food safety framework calls for science-based support to the primary producers......’ mandate for legal, scientific, and ethical responsibility in food supply. Because of its multidisciplinary and interdisciplinary approach involving human, animal, and ecosystem health, ALERT can be considered as a One Health project. Within the ALERT context, we identified the need to take into account...

Commentary - Advancing health equity to improve health: the time is now

Directory of Open Access Journals (Sweden)

B. Jackson

2016-02-01

Full Text Available Health inequities, or avoidable inequalities in health between groups of people, are increasingly recognized and tackled to improve public health. Canada’s interest in health inequities goes back over 40 years, with the landmark 1974 Lalonde report, and continues with the 2011 Rio Political Declaration on Social Determinants of Health, which affirmed a global political commitment to implementing a social determinants of health approach to reducing health inequities. Research in this area includes documenting and tracking health inequalities, exploring their multidimensional causes, and developing and evaluating ways to address them. Inequalities can be observed in who is vulnerable to infectious and chronic diseases, the impact of health promotion and disease prevention efforts, how disease progresses, and the outcomes of treatment. Many programs, policies and projects with potential impacts on health equity and determinants of health have been implemented across Canada. Recent theoretical and methodological advances in the areas of implementation science and population health intervention research have strengthened our capacity to develop effective interventions. With the launch of a new health equity series this month, the journals Canada Communicable Disease Report and Health Promotion and Chronic Disease Prevention in Canada will continue to reflect and foster analysis of social determinants of health and focus on intervention studies that advance health equity.

Improving Climate Projections Using "Intelligent" Ensembles

Science.gov (United States)

Baker, Noel C.; Taylor, Patrick C.

2015-01-01

Recent changes in the climate system have led to growing concern, especially in communities which are highly vulnerable to resource shortages and weather extremes. There is an urgent need for better climate information to develop solutions and strategies for adapting to a changing climate. Climate models provide excellent tools for studying the current state of climate and making future projections. However, these models are subject to biases created by structural uncertainties. Performance metrics-or the systematic determination of model biases-succinctly quantify aspects of climate model behavior. Efforts to standardize climate model experiments and collect simulation data-such as the Coupled Model Intercomparison Project (CMIP)-provide the means to directly compare and assess model performance. Performance metrics have been used to show that some models reproduce present-day climate better than others. Simulation data from multiple models are often used to add value to projections by creating a consensus projection from the model ensemble, in which each model is given an equal weight. It has been shown that the ensemble mean generally outperforms any single model. It is possible to use unequal weights to produce ensemble means, in which models are weighted based on performance (called "intelligent" ensembles). Can performance metrics be used to improve climate projections? Previous work introduced a framework for comparing the utility of model performance metrics, showing that the best metrics are related to the variance of top-of-atmosphere outgoing longwave radiation. These metrics improve present-day climate simulations of Earth's energy budget using the "intelligent" ensemble method. The current project identifies several approaches for testing whether performance metrics can be applied to future simulations to create "intelligent" ensemble-mean climate projections. It is shown that certain performance metrics test key climate processes in the models, and

Improving pediatric immunization rates: description of a resident-led clinical continuous quality improvement project.

Science.gov (United States)

Jones, Kyle Bradford; Gren, Lisa H; Backman, Richard

2014-09-01

Increased emphasis is being placed on the continuous quality improvement (CQI) education of residents of all specialties. This article describes a resident-led continuous quality improvement (CQI) project, based on a novel curriculum, to improve the immunization rates of children under 2 years old at the Madsen Family Health Center (MHC). All third-year residents were trained in the FOCUS-PDSA CQI methodology through concurrent didactic lectures and experience leading the CQI team. The CQI team included clinical staff led by a third-year family medicine resident and mentored by a member of the family medicine faculty. Immunization records were distributed to provider-medical assistant teamlets daily for each pediatric patient scheduled in clinic as the intervention. Compliance with the intervention (process measure), as well as immunization rates at 2 and 5 months post-intervention (outcome measure), were monitored. Immunization records were printed on 84% of clinic days from October 24, 2011 to March 31, 2012. The percentage of patients immunized at baseline was 66%. The percentage immunized as of December 31, 2011 was 96% and was 91% as of March 31, 2012. An important educational experience was organized for third-year family medicine residents through learning CQI skills, leading a CQI team, and directing a CQI project to completion. Significant improvement in the percentage of patients under 2 years old immunized at the MHC was achieved by presenting provider-medical assistant teamlets with immunization records of all pediatric patients on the daily clinic schedule.

Project Access: Strategies to improve care for children and youth with epilepsy: illustrations of recommendations in the IOM report on the epilepsies.

Science.gov (United States)

Wagner, Janelle L; Levisohn, Paul M; Onufer, Charles N; Uchegbu, Gloria C; Fletcher, Linda; Zupanc, Mary; Browne, Mimi

2013-10-01

Project Access (PA), funded by the Maternal and Child Health Bureau (MCHB) of the Health Resources and Services Administration (HRSA), provided grants to state and local agencies to improve awareness, provide education, design, test, pilot and evaluate system changes, and improve quality of services and access to early diagnosis and comprehensive, coordinated health care and related services for children and youth with epilepsy residing in rural and medically underserved areas. In 2011, the Institute of Medicine of the National Academies (IOM) published a series of 13 recommendations addressing unmet psychosocial, medical, and public health needs of individuals with epilepsy, including children and youth. This paper examines the synergy between these two projects showing how the strategies utilized in the PA demonstration projects can address the IOM recommendations and how these recommendations can inform future initiatives for improving care for children and youth with epilepsy. © 2013.

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.

Impact of Construction Health & Safety Regulations on Project ...

African Journals Online (AJOL)

Impact of Construction Health & Safety Regulations on Project Parameters in Nigeria: Consultants and Contractors View. ... The study recommends that better attention is given to health and safety should as a project parameter and that related practice notes and guidelines should be evolved for all project stakeholders.

UMTRA Project-Level Cost Reduction/Productivity Improvement Program manual

International Nuclear Information System (INIS)

1995-06-01

Mission of the Uranium Mill Tailings Remedial Action (UMTRA) Project Cost Reduction/Productivity Improvement Program (CR/PIP) is to contribute to the UMTRA Project's environmental restoration mission by providing the means to achieve and recognize continuous improvements and cost savings. This manual includes program definition, description of UMTRA project organizational responsibilities and interfaces with existing project functions, guidance to contractors, and definition of project-level functions

Guide for prioritizing power plant productivity improvement projects: handbook of availability improvement methodology

International Nuclear Information System (INIS)

1981-01-01

As part of its program to help improve electrical power plant productivity, the Department of Energy (DOE) has developed a methodology for evaluating productivity improvement projects. This handbook presents a simplified version of this methodology called the Availability Improvement Methodology (AIM), which provides a systematic approach for prioritizing plant improvement projects. Also included in this handbook is a description of data taking requirements necessary to support the AIM methodology, benefit/cost analysis, and root cause analysis for tracing persistent power plant problems. In applying the AIM methodology, utility engineers should be mindful that replacement power costs are frequently greater for forced outages than for planned outages. Equivalent availability includes both. A cost-effective ranking of alternative plant improvement projects must discern between those projects which will reduce forced outages and those which might reduce planned outages. As is the case with any analytical procedure, engineering judgement must be exercised with respect to results of purely mathematical calculations

SNF project engineering process improvement plan

International Nuclear Information System (INIS)

KELMENSON, R.L.

1999-01-01

This Engineering Process Improvement Plan documents the activities and plans to be taken by the SNF Project (the Project) to support its engineering process and to produce a consolidated set of engineering procedures that are fully compliant with the requirements of HNF-PRO-1819 (1819). These requirements are imposed on all engineering activities performed for the Project and apply to all life-cycle stages of the Project's systems, structures and components (SSCs). This Plan describes the steps that will be taken by the Project during the transition period to ensure that new procedures are effectively integrated into the Project's work process as these procedures are issued. The consolidated procedures will be issued and implemented by September 30, 1999

Physicians' accounts of frontline tensions when implementing pilot projects to improve primary care.

Science.gov (United States)

Mansfield, Elizabeth; Bhattacharyya, Onil; Christian, Jennifer; Naglie, Gary; Steriopoulos, Vicky; Webster, Fiona

2018-03-19

Purpose Canada's primary care system has been described as "a culture of pilot projects" with little evidence of converting successful initiatives into funded, permanent programs or sharing project outcomes and insights across jurisdictions. Health services pilot projects are advocated as an effective strategy for identifying promising models of care and building integrated care partnerships in local settings. In the qualitative study reported here, the purpose of this paper is to investigate the strengths and challenges of this approach. Design/methodology/approach Semi-structured interviews were conducted with 34 primary care physicians who discussed their experiences as pilot project leads. Following thematic analysis methods, broad system issues were captured as well as individual project information. Findings While participants often portrayed themselves as advocates for vulnerable patients, mobilizing healthcare organizations and providers to support new models of care was discussed as challenging. Competition between local healthcare providers and initiatives could impact pilot project success. Participants also reported tensions between their clinical, project management and research roles with additional time demands and skill requirements interfering with the work of implementing and evaluating service innovations. Originality/value Study findings highlight the complexity of pilot project implementation, which encompasses physician commitment to addressing care for vulnerable populations through to the need for additional skill set requirements and the impact of local project environments. The current pilot project approach could be strengthened by including more multidisciplinary collaboration and providing infrastructure supports to enhance the design, implementation and evaluation of health services improvement initiatives.

Process evaluation of Project WebHealth: a nondieting Web-based intervention for obesity prevention in college students.

Science.gov (United States)

Dour, Colleen A; Horacek, Tanya M; Schembre, Susan M; Lohse, Barbara; Hoerr, Sharon; Kattelmann, Kendra; White, Adrienne A; Shoff, Suzanne; Phillips, Beatrice; Greene, Geoffrey

2013-01-01

To evaluate the motivational effect of the Project WebHealth study procedures and intervention components on weight-related health behavior changes in male and female college students. Process evaluation. Eight universities in the United States. Project WebHealth participants (n = 653; 29% men). Participants rated motivational effects of study procedures and intervention components. Participants were grouped into outcome-based health behavior categories based on achievement of desired targets for fruit and vegetable intake, physical activity, and/or body weight. Differences in motivation from each procedure and component were analyzed by gender- and outcome-based health behavior category. Women were generally more motivated than men. Compared to those who did not meet any target health behaviors, men with improved health outcomes (68%) were significantly more motivated by the skills to fuel the body lesson, goal setting, and research snippets. Their female counterparts (63%) were significantly more motivated by the lessons on body size and eating enjoyment, and by the suggested weekly activities. Specific study procedures and components of Project WebHealth motivated study participants to improve their weight-related health behaviors, and they differed by gender. Findings support the need for gender-tailored interventions in this population. Copyright © 2013 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Improving Maternal and Child Health in Underserved Rural Areas of ...

International Development Research Centre (IDRC) Digital Library (Canada)

Maternal and child health is a priority for Nigeria, but there are significant challenges and opportunities at state levels that influence efforts to reduce deaths. This project will contribute to government efforts in Delta State to improve delivery and use of maternal and child healthcare services in three marginalized rural ...

Elementary and middle school science improvement project

Science.gov (United States)

Mcguire, Saundra Y.

1989-01-01

The Alabama A and M University Elementary and Middle School Science Improvement Project (Project SIP) was instituted to improve the science knowledge of elementary and middle school teachers using the experimental or hands-on approach. Summer workshops were conducted during the summers of 1986, 1987, and 1988 in the areas of biology, chemistry, physics, and electricity, and magnetism. Additionally, a manual containing 43 lessons which included background information, experiments and activities for classroom and home use was provided to each teacher. During the course of the project activities, the teachers interacted with various university faculty members, scientists, and NASA staff. The administrative aspects of the program, the delivery of the services to participating teachers, and the project outcome are addressed.

ELECTRICAL SAFETY IMPROVEMENT PROJECT A COMPLEX WIDE TEAMING INITIATIVE

Energy Technology Data Exchange (ETDEWEB)

GRAY BJ

2007-11-26

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

Improvement of Construction Project Management Processes

Directory of Open Access Journals (Sweden)

Nazarko, J.

2017-07-01

Full Text Available The common denominator of the five papers published in the current edition of the Journal of Engineering, Project, and Production Management is the improvement of construction project management processes for effective use of resources. Execution of proper project management processes is widely recognized as a key success factor influencing likelihood of project success (Alleman, 2014. It is noticeable that four out of five papers in this issue of the Journal are authored or co-authored by Iranian researchers from the same Institute but their conclusions bear importance that cannot be limited to the authors’ region.

Construction Project Performance Improvement through Radio Frequency Identification Technology Application on a Project Supply Chain

Science.gov (United States)

Wang, Heng

2017-01-01

Construction project productivity typically lags other industries and it has been the focus of numerous studies in order to improve the project performance. This research investigated the application of Radio Frequency Identification (RFID) technology on construction projects' supply chain and determined that RFID technology can improve the…

A quality improvement project to improve admission temperatures in very low birth weight infants.

Science.gov (United States)

Lee, H C; Ho, Q T; Rhine, W D

2008-11-01

To review the results of a quality improvement (QI) project to improve admission temperatures of very low birth weight inborn infants. The neonatal intensive care unit at Lucile Packard Children's Hospital underwent a QI project to address hypothermic preterm newborns by staff education and implementing processes such as polyethylene wraps and chemical warming mattresses. We performed retrospective chart review of all inborn infants with birth weight project. The improvement was consistent and persisted over a 15-month period. After risk adjustment, the strongest predictor of hypothermia was being born in the period before implementation of the QI project (odds ratio 8.12, 95% confidence interval 4.63, 14.22). Although cesarean delivery was a strong risk factor for hypothermia prior to the project, it was no longer significant after the project. There was no significant difference in death or intraventricular hemorrhage detected between periods. There was a significant improvement in admission temperatures after a QI project, which persisted beyond the initial implementation period. Although there was no difference in mortality or intraventricular hemorrhage rates, we did not have sufficient power to detect small differences in these outcomes.

Health Care Employee Perceptions of Patient-Centered Care: A Photovoice Project

Science.gov (United States)

Balbale, Salva Najib; Turcios, Stephanie; LaVela, Sherri L.

2015-01-01

Given the importance of health care employees in the delivery of patient-centered care, understanding their unique perspective is essential for quality improvement. The purpose of this study was to use photovoice to evaluate perceptions and experiences around patient-centered care among Veterans Affairs (VA) health care employees. We asked participants to take photographs of salient features in their environment related to patient-centered care. We used the photographs to facilitate dialogue during follow-up interviews. Twelve VA health care employees across two VA sites participated in the project. Although most participants felt satisfied with their work environment and experiences at the VA, several areas for improvement were identified. These included a need for more employee health and wellness initiatives and a need for enhanced opportunities for training and professional growth. Application of photovoice enabled us to learn about employees' unique perspectives around patient-centered care while engaging them in an evaluation of care delivery. PMID:25274626

Accredited Health Department Partnerships to Improve Health: An Analysis of Community Health Assessments and Improvement Plans.

Science.gov (United States)

Kronstadt, Jessica; Chime, Chinecherem; Bhattacharya, Bulbul; Pettenati, Nicole

The Public Health Accreditation Board (PHAB) Standards & Measures require the development and updating of collaborative community health assessments (CHAs) and community health improvement plans (CHIPs). The goal of this study was to analyze the CHAs and CHIPs of PHAB-accredited health departments to identify the types of partners engaged, as well as the objectives selected to measure progress toward improving community health. The study team extracted and coded data from documents from 158 CHA/CHIP processes submitted as part of the accreditation process. Extracted data included population size, health department type, data sources, and types of partner organizations. Health outcome objectives were categorized by Healthy People 2020 Leading Health Indicator (LHI), as well as by the 7 broad areas in the PHAB reaccreditation framework for population health outcomes reporting. Participants included health departments accredited between 2013 and 2016 that submitted CHAs and CHIPs to PHAB, including 138 CHAs/CHIPs from local health departments and 20 from state health departments. All the CHAs/CHIPs documented collaboration with a broad array of partners, with hospitals and health care cited most frequently (99.0%). Other common partners included nonprofit service organizations, education, business, and faith-based organizations. Small health departments more frequently listed many partner types, including law enforcement and education, compared with large health departments. The majority of documents (88.6%) explicitly reference Healthy People 2020 goals, with most addressing the LHIs nutrition/obesity/physical activity and access to health services. The most common broad areas from PHAB's reaccreditation framework were preventive health care and individual behavior. This study demonstrates the range of partners accredited health departments engage with to collaborate on improving their communities' health as well as the objectives used to measure community health

EmERGE project: Evaluating mHealth technology in HIV to improve Empowerment and healthcare utilisation

Energy Technology Data Exchange (ETDEWEB)

Chausa, P.; Gomez, A.J.; Apers, L.; Henwood, F.; Mandalia, S.; Wallitt, E.; Leon, A.; Begovac, J.; Borges, M.; Brown, A.; Block, K.; Glaysher, B.; Whetham, J.

2016-07-01

The EmERGE project (http://www.emergeproject.eu/) will develop a mHealth platform to enable self-management of HIV in patients with stable disease. The platform will build upon and integrate the existing mHealth solutions operated by pioneering healthcare providers in the UK and Spain and apply a rigorous co-design approach to ensure patient and clinician input to the solution. The platform will provide users with web based (clinicians) and mobile device applications (patients) which interface securely with relevant medical data and facilitate remote access to key healthcare providers. EATG, the leading European HIV patient organisation, will provide a direct and deep interaction with representative patients and clinicians from 5 EU countries. The platform and interfaces will be validated in a large study of 3900 patients using a tailored Health Technology Assessment process: the Model for Assessment of Telemedicine applications, specifically developed for the assessment of mHealth solutions including translatability as a key factor. (Author)

Information and Communications Technologies Health Projects in Panama: A Systematic Review and their Relation with Public Policies.

Science.gov (United States)

Sánchez, Gema Anabel Castillo; Berbey, Aranzazu; de la Torre-Díez, Isabel; López-Coronado, Miguel

2017-07-01

This paper presents a review about Information and Communications Technologies (ICTs) health projects in Panama. The main contribution is to provide a vision of the situation in Panama, allowing an understanding of the dynamics of health policies and how they have affected the implementation of ICT's Projects to improve the health of Panamanians. We analyze the projects found with ICT's in health of Panama, which allow us to see a perspective of projects information is obtained from 2000 to 2016, however it is important to highlight that there may be other projects that we do not know because we did not find enough information or evidence of the same. That is why this review has interviews with key personnel, who have guided us with the search for information. 56% of technology projects are concentrated in the capital city and only 16% in the province of Chiriquí. 64% of these projects are focused on the development of information systems, mainly focused on electronic patient registration. And 60% refers to projects related to primary health care. The MINSA and CSS both with a 20% participation in ICT project, in addition we can notice the dispersion of projects for hospitals, where each one is developing programs per their needs or priorities. The national information about ICT projects of Health, it has been notorious the state of dispersion and segmented of public health information. We consider that it is a natural consequence of Policy in Panamanian Health System. This situation limits the information retrieval and knowledge of ICT in Health of Panama. To stakeholders, this information is directed so that health policies are designed towards a more effective and integral management, administering the ICT's as tools for the well-being of most the Panamanian population, including indigenous group.

Implementing practice management strategies to improve patient care: the EPIC project.

Science.gov (United States)

Attwell, David; Rogers-Warnock, Leslie; Nemis-White, Joanna

2012-01-01

Healthcare gaps, the difference between usual care and best care, are evident in Canada, particularly with respect to our aging, ailing population. Primary care practitioners are challenged to identify, prevent and close care gaps in their practice environment given the competing demands of informed, litigious patients with complex medical needs, ever-evolving scientific evidence with new treatment recommendations across many disciplines and an enhanced emphasis on quality and accountability in healthcare. Patient-centred health and disease management partnerships using measurement, feedback and communication of practice patterns and outcomes have been shown to narrow care gaps. Practice management strategies such as the use of patient registries and recall systems have also been used to help practitioners better understand, follow and proactively manage populations of patients in their practice. The Enhancing Practice to Improve Care project was initiated to determine the impact of a patient-centred health and disease management partnership using practice management strategies to improve patient care and outcomes for patients with chronic kidney disease (CKD). Forty-four general practices from four regions of British Columbia participated and, indeed, demonstrated that care and outcomes for patients with CKD could be improved via the implementation of practice management strategies in a patient-centred partnership measurement model of health and disease management.

Uranium Mill Tailings Remedial Action Project: Cost Reduction and Productivity Improvement Program Project Plan

International Nuclear Information System (INIS)

1991-11-01

The purpose of the Cost Reduction/Productivity Improvement Program Plan is to formalize and improve upon existing efforts to control costs which have been underway since project inception. This program plan has been coordinated with the Department of Energy (DOE) Office of Environmental Management (EM) and the DOE Field Office, Albuquerque (AL). It incorporates prior Uranium Mill Tallings Remedial Action (UMTRA) Project Office guidance issued on the subject. The opportunities for reducing cosh and improving productivity are endless. The CR/PIP has these primary objectives: Improve productivity and quality; heighten the general cost consciousness of project participants, at all levels of their organizations; identify and implement specific innovative employee ideas that extend beyond what is required through existing processes and procedures; emphasize efforts that create additional value for the money spent by maintaining the project Total Estimated Cost (TEC) at the lowest possible level

Health system and societal barriers for gestational diabetes mellitus (GDM) services - lessons from World Diabetes Foundation supported GDM projects

DEFF Research Database (Denmark)

Nielsen, Karoline Kragelund; de Courten, Maximilian; Kapur, Anil

2012-01-01

for the offspring. A better understanding of the barriers hindering detection and treatment of GDM is needed. Based on experiences from World Diabetes Foundation (WDF) supported GDM projects this paper seeks to investigate societal and health system barriers to such efforts. Methods Questionnaires were filled out...... by 10 WDF supported GDM project partners implementing projects in eight different LMIC. In addition, interviews were conducted with the project partners. The interviews were analysed using content analysis. Results Barriers to improving maternal health related to GDM nominated by project implementers...

A continuous quality improvement project to reduce medication error in the emergency department.

Science.gov (United States)

Lee, Sara Bc; Lee, Larry Ly; Yeung, Richard Sd; Chan, Jimmy Ts

2013-01-01

Medication errors are a common source of adverse healthcare incidents particularly in the emergency department (ED) that has a number of factors that make it prone to medication errors. This project aims to reduce medication errors and improve the health and economic outcomes of clinical care in Hong Kong ED. In 2009, a task group was formed to identify problems that potentially endanger medication safety and developed strategies to eliminate these problems. Responsible officers were assigned to look after seven error-prone areas. Strategies were proposed, discussed, endorsed and promulgated to eliminate the problems identified. A reduction of medication incidents (MI) from 16 to 6 was achieved before and after the improvement work. This project successfully established a concrete organizational structure to safeguard error-prone areas of medication safety in a sustainable manner.

Using adapted quality-improvement approaches to strengthen community-based health systems and improve care in high HIV-burden sub-Saharan African countries.

Science.gov (United States)

Horwood, Christiane M; Youngleson, Michele S; Moses, Edward; Stern, Amy F; Barker, Pierre M

2015-07-01

Achieving long-term retention in HIV care is an important challenge for HIV management and achieving elimination of mother-to-child transmission. Sustainable, affordable strategies are required to achieve this, including strengthening of community-based interventions. Deployment of community-based health workers (CHWs) can improve health outcomes but there is a need to identify systems to support and maintain high-quality performance. Quality-improvement strategies have been successfully implemented to improve quality and coverage of healthcare in facilities and could provide a framework to support community-based interventions. Four community-based quality-improvement projects from South Africa, Malawi and Mozambique are described. Community-based improvement teams linked to the facility-based health system participated in learning networks (modified Breakthrough Series), and used quality-improvement methods to improve process performance. Teams were guided by trained quality mentors who used local data to help nurses and CHWs identify gaps in service provision and test solutions. Learning network participants gathered at intervals to share progress and identify successful strategies for improvement. CHWs demonstrated understanding of quality-improvement concepts, tools and methods, and implemented quality-improvement projects successfully. Challenges of using quality-improvement approaches in community settings included adapting processes, particularly data reporting, to the education level and first language of community members. Quality-improvement techniques can be implemented by CHWs to improve outcomes in community settings but these approaches require adaptation and additional mentoring support to be successful. More research is required to establish the effectiveness of this approach on processes and outcomes of care.

Unmet Need: Improving mHealth Evaluation Rigor to Build the Evidence Base.

Science.gov (United States)

Mookherji, Sangeeta; Mehl, Garrett; Kaonga, Nadi; Mechael, Patricia

2015-01-01

mHealth-the use of mobile technologies for health-is a growing element of health system activity globally, but evaluation of those activities remains quite scant, and remains an important knowledge gap for advancing mHealth activities. In 2010, the World Health Organization and Columbia University implemented a small-scale survey to generate preliminary data on evaluation activities used by mHealth initiatives. The authors describe self-reported data from 69 projects in 29 countries. The majority (74%) reported some sort of evaluation activity, primarily nonexperimental in design (62%). The authors developed a 6-point scale of evaluation rigor comprising information on use of comparison groups, sample size calculation, data collection timing, and randomization. The mean score was low (2.4); half (47%) were conducting evaluations with a minimum threshold (4+) of rigor, indicating use of a comparison group, while less than 20% had randomized the mHealth intervention. The authors were unable to assess whether the rigor score was appropriate for the type of mHealth activity being evaluated. What was clear was that although most data came from mHealth projects pilots aimed for scale-up, few had designed evaluations that would support crucial decisions on whether to scale up and how. Whether the mHealth activity is a strategy to improve health or a tool for achieving intermediate outcomes that should lead to better health, mHealth evaluations must be improved to generate robust evidence for cost-effectiveness assessment and to allow for accurate identification of the contribution of mHealth initiatives to health systems strengthening and the impact on actual health outcomes.

African refugee and immigrant health needs: report from a community-based house meeting project.

Science.gov (United States)

Boise, Linda; Tuepker, Anais; Gipson, Teresa; Vigmenon, Yves; Soule, Isabelle; Onadeko, Sade

2013-01-01

As in other communities in the United States, information is lacking about the health needs of Africans refugees and immigrants living in Portland, Oregon. In 2008, the African Partnership for Health coalition (APH) was formed to carry out research, advocacy and education to improve the health and well-being of Africans in Oregon. This was APH's initial project. The purposes of this study were to gather data about the perceived health needs and barriers to health care Africans encounter, and lay the foundation for a program of action to guide APH's future work. Community-based participatory research (CBPR) methods were used to collect data on how to improve the health of the African community in the Portland area and define an agenda for future projects. Popular education principles guided the engagement and training of African community members, who conducted nine house meetings with 56 Africans from 14 countries. The results were analyzed by African community members and researchers and prioritized at a community meeting. Three themes emerged: The stressfulness of life in America, the challenges of gaining access to health care, and the pervasive feelings of disrespect and lack of understanding of Africans' health needs, culture, and life experiences by health providers and staff members. Using CBPR methods, we identified and prioritized the needs of the African community. This information provides a framework for future work of the African Partnership for Health and other service and advocacy groups.

Study protocol: national research partnership to improve primary health care performance and outcomes for Indigenous peoples

Directory of Open Access Journals (Sweden)

McDermott Robyn

2010-05-01

Full Text Available Abstract Background Strengthening primary health care is critical to reducing health inequity between Indigenous and non-Indigenous Australians. The Audit and Best practice for Chronic Disease Extension (ABCDE project has facilitated the implementation of modern Continuous Quality Improvement (CQI approaches in Indigenous community health care centres across Australia. The project demonstrated improvements in health centre systems, delivery of primary care services and in patient intermediate outcomes. It has also highlighted substantial variation in quality of care. Through a partnership between academic researchers, service providers and policy makers, we are now implementing a study which aims to 1 explore the factors associated with variation in clinical performance; 2 examine specific strategies that have been effective in improving primary care clinical performance; and 3 work with health service staff, management and policy makers to enhance the effective implementation of successful strategies. Methods/Design The study will be conducted in Indigenous community health centres from at least six States/Territories (Northern Territory, Western Australia, New South Wales, South Australia, Queensland and Victoria over a five year period. A research hub will be established in each region to support collection and reporting of quantitative and qualitative clinical and health centre system performance data, to investigate factors affecting variation in quality of care and to facilitate effective translation of research evidence into policy and practice. The project is supported by a web-based information system, providing automated analysis and reporting of clinical care performance to health centre staff and management. Discussion By linking researchers directly to users of research (service providers, managers and policy makers, the partnership is well placed to generate new knowledge on effective strategies for improving the quality of primary

Cervical Spine Collar Removal by Emergency Room Nurses: A Quality Improvement Project.

Science.gov (United States)

Fontaine, Guillaume; Forgione, Massimo; Lusignan, Francis; Lanoue, Marc-André; Drouin, Simon

2018-05-01

The Canadian C-Spine Rule (CCR) is a clinical decision aid to facilitate the safe removal of cervical collars in the alert, orientated, low-risk adult trauma patient. Few health care settings have assessed initiatives to train charge nurses to use the CCR. This practice improvement project conducted in a secondary trauma center in Canada aimed to (1) train charge nurses of the emergency room to use the CCR, (2) monitor its use throughout the project period, and (3) compare the assessments of the charge nurses with those of emergency physicians. The project began with the creation of an interdisciplinary team. Clinical guidelines were established by the interdisciplinary project team. Nine charge nurses of the emergency room were then trained to use the CCR (3 on each 8-hour shift). The use of the CCR was monitored throughout the project period, from June 1 to October 5, 2016. The 3 aims of this practice improvement project were attained successfully. Over a 5-month period, 114 patients were assessed with the CCR. Charge nurses removed the cervical collars for 54 of 114 patients (47%). A perfect agreement rate (114 of 114 patients, 100%) was attained between the assessments of the nurses and those of physicians. This project shows that the charge nurses of a secondary trauma center can use the CCR safely on alert, orientated, and low-risk adult trauma patients as demonstrated by the agreement in the assessments of emergency room nurses and physicians. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

User Participation in Coproduction of Health Innovation: Proposal for a Synergy Project.

Science.gov (United States)

Nygren, Jens; Zukauskaite, Elena; Westberg, Niklas

2018-05-09

This project concerns advancing knowledge, methods, and logic for user participation in coproduction of health innovations. Such advancement is vital for several reasons. From a user perspective, participation in coproduction provides an opportunity to gain real influence over goal definition, design, and implementation of health innovations, ensuring that the solution developed solves real problems in right ways. From a societal perspective, it's a mean to improve the efficiency of health care and the implementation of the Patient Act. As for industry, frameworks and knowledge of coproduction offer tools to operate in a complex sector, with great potential for innovation of services and products. The fundamental objective of this project is to advance knowledge and methods of how user participation in the coproduction of health innovations can be applied in order to benefit users, industry, and public sector. This project is a synergy project, which means that the objective will be accomplished through collaboration and meta-analysis between three subprojects that address different user groups, apply different strategies to promote human health, and relate to different parts of the health sector. Furthermore, subprojects focus on distinctive stages in the spectrum of innovation, with the objective to generate knowledge of the innovation process as a whole. The project is organized around three work packages related to three challenges-coproduction, positioning, and realization. Each subproject is designed such that it has its own field of study with clearly identified objectives but also targets work packages to contribute to the project as a whole. The work on the work packages will use case methodology for data collection and analysis based on the subprojects as data sources. More concretely, logic of multiple case studies will be applied with each subproject representing a separate case which is similar to each other in its attention to user participation in

Promoting Health Literacy through the Health Education Assessment Project

Science.gov (United States)

Marx, Eva; Hudson, Nancy; Deal, Tami B.; Pateman, Beth; Middleton, Kathleen

2007-01-01

Background: The Council of Chief State School Officers' State Collaborative on Assessment and Student Standards Health Education Assessment Project (SCASS-HEAP) allows states to pool financial and human resources to develop effective ready-to-use health education assessment resources through a collaborative process. The purpose of this article is…

A portfolio evaluation framework for air transportation improvement projects

Science.gov (United States)

Baik, Hyeoncheol

This thesis explores the application of portfolio theory to the Air Transportation System (ATS) improvement. The ATS relies on complexly related resources and different stakeholder groups. Moreover, demand for air travel is significantly increasing relative to capacity of air transportation. In this environment, improving the ATS is challenging. Many projects, which are defined as technologies or initiatives, for improvement have been proposed and some have been demonstrated in practice. However, there is no clear understanding of how well these projects work in different conditions nor of how they interact with each other or with existing systems. These limitations make it difficult to develop good project combinations, or portfolios that maximize improvement. To help address this gap, a framework for identifying good portfolios is proposed. The framework can be applied to individual projects or portfolios of projects. Projects or portfolios are evaluated using four different groups of factors (effectiveness, time-to-implement, scope of applicability, and stakeholder impacts). Portfolios are also evaluated in terms of interaction-determining factors (prerequisites, co-requisites, limiting factors, and amplifying factors) because, while a given project might work well in isolation, interdependencies between projects or with existing systems could result in lower overall performance in combination. Ways to communicate a portfolio to decision makers are also introduced. The framework is unique because (1) it allows using a variety of available data, and (2) it covers diverse benefit metrics. For demonstrating the framework, an application to ground delay management projects serves as a case study. The portfolio evaluation approach introduced in this thesis can aid decision makers and researchers at universities and aviation agencies such as Federal Aviation Administration (FAA), National Aeronautics and Space Administration (NASA), and Department of Defense (DoD), in

UMTRA Project environmental, health, and safety plan

International Nuclear Information System (INIS)

1989-02-01

The basic health and safety requirements established in this plan are designed to provide guidelines to be applied at all Uranium Mill Tailings Remedial Action (UMTRA) Project sites. Specific restrictions are given where necessary. However, an attempt has been made to provide guidelines which are generic in nature, and will allow for evaluation of site-specific conditions. Health and safety personnel are expected to exercise professional judgment when interpreting these guidelines to ensure the health and safety of project personnel and the general population. This UMTRA Project Environmental, Health, and Safety (EH ampersand S) Plan specifies the basic Federal health and safety standards and special DOE requirements applicable to this program. In addition, responsibilities in carrying out this plan are delineated. Some guidance on program requirements and radiation control and monitoring is also included. An Environmental, Health, and Safety Plan shall be developed as part of the remedial action plan for each mill site and associated disposal site. Special conditions at the site which may present potential health hazards will be described, and special areas that should should be addressed by the Remedial Action Contractor (RAC) will be indicated. Site-specific EH ampersand S concerns will be addressed by special contract conditions in RAC subcontracts. 2 tabs

Listening to parents to improve health visiting practice.

Science.gov (United States)

Morton, Alison; Hargreaves, Sharon; Taylor, Liz

2015-05-01

Listening to the "voice" of the service user is now widely accepted as central to the delivery of high quality healthcare. This paper presents an overview of the importance of service user engagement and personalised care in health visiting with a brief review of recent policy and research. A personalised approach to health visiting practice is recommended to improve service user experience and uptake of the health visiting service offer and this is considered most significant when engaging "hard to reach" groups. A project report on a service user experience strategy within the 0-19 service of a NHS Trust in England is presented which describes initiatives to develop a health visiting and school nursing service that listens to service users. A cyclical service user engagement model which incorporates continuous reviews and service reconfiguration is described with examples of service changes in response to expressed local needs.

Community participation in primary health care projects of the Muldersdrift Health and Development Programme

Directory of Open Access Journals (Sweden)

M. Barker

2007-09-01

Full Text Available After numerous teething problems (1974-1994, the Department of Nursing Education of WITS University took responsibility for the Muldersdrift Health and Development Programme (MHDP. The nursing science students explored and implemented an empowerment approach to community participation. The students worked with MHDP health workers to improve health through community participation, in combination with primary health care (PHC activities and the involvement of a variety of community groups. As the PHC projects evolved overtime, the need arose to evaluate the level of community participation and how much community ownership was present over decision-making and resources. This led to the question “What was the level of community participation in PHC projects of the MHDP?” Based on the question the following objectives were set, i.e. i to evaluate the community participation in PHC initiatives; ii to provide the project partners with motivational affirmation on the level of community participation criteria thus far achieved; iii to indicate to participants the mechanisms that should still be implemented if they wanted to advance to higher levels of community participation; iv to evaluate the MHDP’s implementation of a people-centred approach to community participation in PHC; and v the evaluation of the level of community participation in PHC projects in the MHDP. An evaluative, descriptive, contextual and quantitative research design was used. Ethical standards were adhered to throughout the study. The MHDP had a study population of twentythree (N=23 PHC projects. A purposive sample of seven PHC initiatives was chosen according to specific selection criteria and evaluated according to the “Criteria to evaluate community participation in PHC projects” instrument (a quantitative tool. Structured group interviews were done with PHC projects’ executive committee members. The Joint Management Committee’s data was collected through mailed

Improving the Health of Cambodian Americans: Grassroots Approaches and Root Causes.

Science.gov (United States)

Lee, Juliet P; Kirkpatrick, Sean; Rojas-Cheatham, Ann; Sin, Talaya; Moore, Roland S; Tan, Sotheavy; Godoy, Shadia; Ercia, Angelo

2016-01-01

Cambodian Americans experience great disparities in health compared to other Americans, yet may be underserved by conventional healthcare systems. Community-based participatory research (CBPR) is a means to engage underserved communities in health research and programming. We describe results of our efforts to engage the Cambodian grassroots members as well as formal leaders in Oakland, California. In addition to a community advisory group, we convened a Community Work Group (CWG), composed of 10 grassroots community women of varying ages and backgrounds. The project aimed to leverage the lived experiences of these women and their understandings of health and wellness in identifying specific health issues and developing culturally resonant strategies. The CWG met weekly with staff facilitators using methods for collective analysis including theater, body mapping, and other expressive arts. The approach proved logistically challenging, but resulted in novel analyses and strategies. The group identified trauma, along with poor access to education, unemployment and underemployment, social isolation, and generation gap, together with community violence, as root causes of key behavioral health issues, namely, alcohol abuse, gambling, prescription drug misuse, and domestic violence. Strategies proposed and implemented by the group and project staff were a community garden, Cambodian New Year's celebrations, and a museum exhibit on the Cambodian refugee experiences. Grassroots community engagement can support projects in identifying social determinants of health and developing the capacities of community members to conduct research and actions to improve health.

The WAMI Rural Hospital Project. Part 3: Building health care leadership in rural communities.

Science.gov (United States)

Elder, W G; Amundson, B A

1991-01-01

The WAMI Rural Hospital Project (RHP) intervention combined aspects of community development, strategic planning and organizational development to address the leadership issues in six Northwest rural hospitals. Hospitals and physicians, other community health care providers and local townspeople were involved in this intervention, which was accomplished in three phases. In the first phase, extensive information about organizational effectiveness was collected at each site. Phase two consisted of 30 hours of education for the physician, board, and hospital administrator community representatives covering management, hospital board governance, and scope of service planning. In the third phase, each community worked with a facilitator to complete a strategic plan and to resolve conflicts addressed in the management analyses. The results of the evaluation demonstrated that the greatest change noted among RHP hospitals was improvement in the effectiveness of their governing boards. All boards adopted some or all of the project's model governance plan and had successfully completed considerable portions of their strategic plans by 1989. Teamwork among the management triad (hospital, board, and medical staff) was also substantially improved. Other improvements included the development of marketing plans for the three hospitals that did not initially have them and more effective use of outside consultants. The project had less impact on improving the functioning of the medical chief of staff, although this was not a primary target of the intervention. There was also relatively less community interest in joining regional health care associations. The authors conclude that an intervention program tailored to address specific community needs and clearly identified leadership deficiencies can have a positive effect on rural health care systems.

A Pilot for Improving Depression Care on College Campuses: Results of the College Breakthrough Series-Depression (CBS-D) Project

Science.gov (United States)

Chung, Henry; Klein, Michael C.; Silverman, Daniel; Corson-Rikert, Janet; Davidson, Eleanor; Ellis, Patricia; Kasnakian, Caroline

2011-01-01

Objective: To implement a pilot quality improvement project for depression identification and treatment in college health. Participants: Eight college health center teams composed primarily of primary care and counseling service directors and clinicians. Methods: Chronic (Collaborative) Care Model (CCM) used with standardized screening to…

Workplace health improvement: perspectives of environmental health officers.

Science.gov (United States)

Reynolds, J; Wills, J

2012-01-01

Environmental health practice in the field of occupational health and safety is traditionally concerned with protecting health relating to the workplace. However, little is currently known about environmental health officers' (EHOs) perceptions of their role in workplace health improvement, a pertinent topic in light of the recent government agenda for improving the health of the workforce in the UK. To explore how EHOs perceive workplace health improvement and its relevance to their professional role. A qualitative methodology was employed, using a case-study design with thematic analysis of 15 transcripts of in-depth telephone interviews with EHOs working in London, UK. EHOs view themselves primarily as enforcement officers, with legislation guiding their understandings of workplace health. Many interpret work-related ill health in terms of safety and physical injury and do not feel competent in assessing broader psychosocial elements of ill health. However, a few EHOs welcomed the opportunity to promote health in the workplace, recognizing the importance of prevention. This study indicates a gap between the contemporary EHO role framed by professional bodies as holistic and contributing to public health goals and the role perceived by EHOs 'on the ground'. A more traditional, protective and enforcement-based approach persists among EHOs in this sample, and few feel they have skills to address determinants beyond physical hazards to health. Yet, a minority of EHOs adopted a more health-promoting approach, suggesting that the potential contribution of EHOs to the workplace health improvement agenda should be explored further.

Internal evaluation of the European network for health technology assessment project.

Science.gov (United States)

Håheim, Lise Lund; Imaz, Iñaki; Loud, Marlène Läubli; Gasparetto, Teresa; González-Enriquez, Jesús; Dahlgren, Helena; Trofimovs, Igor; Berti, Elena; Mørland, Berit

2009-12-01

The internal evaluation studied the development of the European network for Health Technology Assessment (EUnetHTA) Project in achieving the general objective of establishing an effective and a sustainable network of health technology assessment (HTA) in Europe. The Work Package 3 group was dedicated to this task and performed the work. Information on activities during the project was collected from three sources. First, three yearly cross-sectional studies surveyed the participants' opinions. Responses were by individuals or by institutions. The last round included surveys to the Steering Committee, the Stakeholder Forum, and the Secretariat. Second, the Work Package Lead Partners were interviewed bi-annually, five times in total, to update the information on the Project's progress. Third, additional information was sought in available documents. The organizational structure remained stable. The Project succeeded in developing tools aimed at providing common methodology with intent to establish a standard of conducting and reporting HTA and to facilitate greater collaboration among agencies. The participants/agencies expressed their belief in a network and in maintaining local/national autonomy. The Work Package Leaders expressed a strong belief in the solid base of the Project for a future network on which to build, but were aware of the need for funding and governmental support. Participants and Work Package Leaders have expressed support for a future network that will improve national and international collaboration in HTA based on the experience from the EUnetHTA project.

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.

eHealth for Remote Regions: Findings from Central Asia Health Systems Strengthening Project.

Science.gov (United States)

Sajwani, Afroz; Qureshi, Kiran; Shaikh, Tehniat; Sayani, Saleem

2015-01-01

Isolated communities in remote regions of Afghanistan, Kyrgyz Republic, Pakistan and Tajikistan lack access to high-quality, low-cost health care services, forcing them to travel to distant parts of the country, bearing an unnecessary financial burden. The eHealth Programme under Central Asia Health Systems Strengthening (CAHSS) Project, a joint initiative between the Aga Khan Foundation, Canada and the Government of Canada, was initiated in 2013 with the aim to utilize Information and Communication Technologies to link health care institutions and providers with rural communities to provide comprehensive and coordinated care, helping minimize the barriers of distance and time. Under the CAHSS Project, access to low-cost, quality health care is provided through a regional hub and spoke teleconsultation network of government and non-government health facilities. In addition, capacity building initiatives are offered to health professionals. By 2017, the network is expected to connect seven Tier 1 tertiary care facilities with 14 Tier 2 secondary care facilities for teleconsultation and eLearning. From April 2013 to September 2014, 6140 teleconsultations have been provided across the project sites. Additionally, 52 new eLearning sessions have been developed and 2020 staff members have benefitted from eLearning sessions. Ethics and patient rights are respected during project implementation.

The SUSTAIN Project: A European Study on Improving Integrated Care for Older People Living at Home

Science.gov (United States)

Stoop, Annerieke; Billings, Jenny; Leichsenring, Kai; Ruppe, Georg; Tram, Nhu; Barbaglia, María Gabriela; Ambugo, Eliva A.; Zonneveld, Nick; Paat-Ahi, Gerli; Hoffmann, Henrik; Khan, Usman; Stein, Viktoria; Wistow, Gerald; Lette, Manon; Jansen, Aaltje P.D.; Nijpels, Giel; Baan, Caroline A.

2018-01-01

Introduction: Integrated care programmes are increasingly being put in place to provide care to older people who live at home. Knowledge of how to further develop integrated care and how to transfer successful initiatives to other contexts is still limited. Therefore, a cross-European research project, called Sustainable Tailored Integrated Care for Older People in Europe (SUSTAIN), has been initiated with a twofold objective: 1. to collaborate with local stakeholders to support and monitor improvements to established integrated care initiatives for older people with multiple health and social care needs. Improvements focus on person-centredness, prevention orientation, safety and efficiency; 2. to make these improvements applicable and adaptable to other health and social care systems, and regions in Europe. This paper presents the overall structure and approach of the SUSTAIN project. Methods: SUSTAIN uses a multiple embedded case study design. In three phases, SUSTAIN partners: (i) conduct interviews and workshops with stakeholders from fourteen established integrated care initiatives to understand where they would prefer improvements to existing ways of working; (ii) collaborate with local stakeholders to support the design and implementation of improvement plans, evaluate implementation progress and outcomes per initiative, and carry out overarching analyses to compare the different initiatives, and; (iii) translate knowledge and experience to an online roadmap. Discussion: SUSTAIN aims to generate evidence on how to improve integrated care, and apply and transfer the knowledge gained to other health and social care systems, and regions. Lessons learned will be brought together in practical tools to inform and support policy-makers and decision-makers, as well as other stakeholders involved in integrated care, to manage and improve care for older people living at home. PMID:29632456

Project-induced displacement, secondary stressors, and health.

Science.gov (United States)

Cao, Yue; Hwang, Sean-Shong; Xi, Juan

2012-04-01

It has been estimated that about 15 million people are displaced by development projects around the world each year. Despite the magnitude of people affected, research on the health and other impacts of project-induced displacement is rare. This study extends existing knowledge by exploring the short-term health impact of a large scale population displacement resulting from China's Three Gorges Dam Project. The study is theoretically guided by the stress process model, but we supplement it with Cernea's impoverishment risks and reconstruction (IRR) model widely used in displacement literature. Our panel analysis indicates that the displacement is associated positively with relocatees' depression level, and negatively with their self-rated health measured against a control group. In addition, a path analysis suggests that displacement also affects depression and self-rated health indirectly by changing social integration, socioeconomic status, and community resources. The importance of social integration as a protective mechanism, a factor that has been overlooked in past studies of population displacement, is highlighted in this study. Published by Elsevier Ltd.

The integrated project: a promising promotional strategy for primary health care.

Science.gov (United States)

Daniel, C; Mora, B

1985-10-01

The integrated project using parasite control and nutrition as entry points for family planning practice has shown considerable success in promoting health consciousness among health workers and project beneficiaries. This progress is evident in the Family Planning, Parasite Control and Nutrition (FAPPCAN) areas. The project has also mobilized technical and financial support from the local government as well as from private and civic organizations. The need for integration is underscored by the following considerations: parasite control has proved to be effective for preventive health care; the integrated project uses indigenous community health workers to accomplish its objectives; the primary health care (PHC) movement depends primarily on voluntary community participation and the integrated project has shown that it can elicit this participation. The major health problems in the Philippines are: a prevalence of communicable and other infectious diseases; poor evironmental sanitation; malnutrition; and a rapid population growth rate. The integrated program utilizes the existing village health workers in identifying problems related to family planning, parasite control and nutrition and integrates these activities into the health delivery system; educates family members on how to detect health and health-related problems; works out linkages with government agencies and the local primary health care committee in defining the scope of health-related problems; mobilizes community members to initiate their own projects; gets the commitment of village officials and committe members. The integrated project operates within the PHC. A health van with a built-in video playback system provides educational and logistical support to the village worker. The primary detection and treatment of health problems are part of the village health workers' responsibilities. Research determines the project's capability to reactivate the village primary health care committees and sustain

Project 11. Cowpea - Cereals Systems Improvement in the Dry Savannas

International Nuclear Information System (INIS)

1998-01-01

The research agenda of the IITA is subdivided into a portfolio of 16 projects (Annex 1), around which these annual reports are prepared. These projects address different aspects of attaining sustainable increases in productivity of dominant farming systems and utilization practices in the various agroecologies of Sub-Saharan Africa (SSA). Research and training activities carried out in the 16 projects are being implemented together with national program partners in order to increase the well-being of poor people in SSA through higher levels of food production, better income and nutritional status, and reduced drudgery - particularly for women. Additionally IITA serves as the convening centre for the Ecoregional Program for the Humid and Sub Humid Tropics of Sub-Saharan Africa (EPHTA) and the Systemwide Project on Integrated Pest Management (SP-IPM). The institute-wide log frame (Annex 2) shows the expected contribution of each project to the overall institute goal, with the specific project log frame presented in Annex 3. Highlights from all these projects can be found in Annex 4, which thus provides an illustrative overview of IITA's research activities and achievements of the year. Annex 5 shows all the agroecological zones of sub-saharan Africa in which IITA conducts research. The project management arrangement for implementing IITA's research agenda is relatively new, and continues to evolve from a divisional/program structure. In earlier years, detailed research outputs and achievements were reported in divisional reports; this is the third year that implementation of IITA's research agenda is being presented in individual project reports. To satisfy the continuing needs of disciplinary groups in partner and other interested institutions, portions from the individual project reports will be collated into subject matter reports corresponding to current research divisions -Crop improvement, Plant Health Management, and Resource and Crop Management

Transforming community members into diabetes cultural health brokers: the Neighborhood Health Talker project.

Science.gov (United States)

Cadzow, Renee B; Craig, Mary; Rowe, Jimmy; Kahn, Linda S

2013-01-01

The purpose of this study was to evaluate a community-based diabetes education pilot project. The Neighborhood Health Talker project aimed to train and implement cultural health brokers primarily targeting communities of color to improve community members' diabetes knowledge and diabetes self-management skills. A secondary aim was to establish diabetes resource libraries accessible to communities that normally experience barriers to these resources. Recruited community members completed 1 week of formal training developed by a multidisciplinary team in Buffalo, NY. The effect of training was evaluated through the use of baseline surveys, a pretest/posttest covering all training content, and daily quizzes evaluating knowledge relevant to each of the five training modules. Trained NHTs then held at least five community conversations in various locations and administered anonymous postconversation surveys to participants. Descriptive statistics and qualitative analysis techniques were used to summarize test, quiz, and survey results. Twelve women and 1 man completed the training program. Working alone as well as in pairs, each held at least five community conversations reaching over 700 community members of all ages over 3 months and established 8 diabetes resource libraries in the community. All trainees increased their diabetes knowledge and confidence as well as their abilities to perform the tasks of a cultural health broker. Trainees also indicated that the goals they set at training initiation were met. The training was successful in increasing trainee knowledge and confidence about diabetes prevention and self-management. Participants not only developed proficiency in discussing diabetes, they also made important lifestyle changes that demonstrated their commitment to the cause and the project. Low-cost initiatives like this are easily reproducible in other communities of color and could be modified to meet the needs of other communities as well.

Outreach nurses in Harm Reduction projects: improving acceptability and availability of medical care to drug users

Directory of Open Access Journals (Sweden)

Dvinskykh, Natalya

2012-07-01

Full Text Available BACKGROUND: Injection drug users (IDU remain one of the most vulnerable population segments in Ukraine, with HIV prevalence up to 22% among this group. At the same time, drug users lack access to basic health care and reportedly face stigma and discrimination from medical workers. Harm reduction projects in Ukraine partially address this problem by providing regular HIV and STI testing for their clients, and by referring them to medical institutions, where IDU can get free treatment for STI, TB, and ARV therapy for HIV. However, issues of acceptability and availability of medical care for drug users are far from being resolved. METHODS: During 2011, the new approach of ‘outreach nurses’ was piloted by All Ukrainian Harm Reduction Association (UHRA with support from ICF “International HIV/AIDS Alliance in Ukraine”. The aim of the project was to bring medical services closer to IDU by integrating work of medical professionals into a comprehensive package of Harm Reduction project services. The project employed fifteen nurses from five regions of Ukraine. During the project, nurses provided basic medical services, consultations on health improvement issues and referrals. The services were provided at the places convenient for clients: syringe exchange points, community centers, mobile clinics, and at home. RESULTS: The services of the project were well accepted by the clients. From June till December 2011 the project reached 1703 unique clients, with a total of 4525 visits (300 visits per nurse on average. For comparison, in the HR projects that employed surgeons, on average there were 58 visits per doctor (from 30 to 93 during the same period of time. CONCLUSIONS: To improve access to medical care for the drug using population Harm Reduction projects should consider including work of ‘outreach nurses’ to the package of services they provide.

Mentorship and coaching to support strengthening healthcare systems: lessons learned across the five Population Health Implementation and Training partnership projects in sub-Saharan Africa.

Science.gov (United States)

Manzi, Anatole; Hirschhorn, Lisa R; Sherr, Kenneth; Chirwa, Cindy; Baynes, Colin; Awoonor-Williams, John Koku

2017-12-21

Despite global efforts to increase health workforce capacity through training and guidelines, challenges remain in bridging the gap between knowledge and quality clinical practice and addressing health system deficiencies preventing health workers from providing high quality care. In many developing countries, supervision activities focus on data collection, auditing and report completion rather than catalyzing learning and supporting system quality improvement. To address this gap, mentorship and coaching interventions were implemented in projects in five African countries (Ghana, Mozambique, Rwanda, Tanzania, and Zambia) as components of health systems strengthening (HSS) strategies funded through the Doris Duke Charitable Foundation's African Health Initiative. We report on lessons learned from a cross-country evaluation. The evaluation was designed based on a conceptual model derived from the project-specific interventions. Semi-structured interviews were administered to key informants to capture data in six categories: 1) mentorship and coaching goals, 2) selection and training of mentors and coaches, 3) integration with the existing systems, 4) monitoring and evaluation, 5) reported outcomes, and 6) challenges and successes. A review of project-published articles and technical reports from the individual projects supplemented interview information. Although there was heterogeneity in the approaches to mentorship and coaching and targeted areas of the country projects, all led to improvements in core health system areas, including quality of clinical care, data-driven decision making, leadership and accountability, and staff satisfaction. Adaptation of approaches to reflect local context encouraged their adoption and improved their effectiveness and sustainability. We found that incorporating mentorship and coaching activities into HSS strategies was associated with improvements in quality of care and health systems, and mentorship and coaching represents an

Improving the production of applied health research findings: insights from a qualitative study of operational research.

Science.gov (United States)

Crowe, Sonya; Turner, Simon; Utley, Martin; Fulop, Naomi J

2017-09-08

Knowledge produced through applied health research is often of a form not readily accessible to or actionable by policymakers and practitioners, which hinders its implementation. Our aim was to identify research activities that can support the production of knowledge tailored to inform policy and practice. To do this, we studied an operational research approach to improving the production of applied health research findings. A 2-year qualitative study was conducted of the operational research contribution to a multidisciplinary applied health research project that was successful in rapidly informing national policy. Semi-structured interviews (n = 20) were conducted with all members of the project's research team and advisory group (patient and health professional representatives and academics). These were augmented by participant (> 150 h) and non-participant (> 15 h) observations focusing on the process and experience of attempting to support knowledge production. Data were analysed thematically using QSR NVivo software. Operational research performed a knowledge mediation role shaped by a problem-focused approach and an intent to perform those tasks necessary to producing readily implementable knowledge but outwith the remit of other disciplinary strands of the project. Three characteristics of the role were found to support this: engaging and incorporating different perspectives to improve services by capturing a range of health professional and patient views alongside quantitative and qualitative research evidence; rendering data meaningful by creating and presenting evidence in forms that are accessible to and engage different audiences, enabling them to make sense of it for practical use; and maintaining perceived objectivity and rigour by establishing credibility, perceived neutrality and confidence in the robustness of the research in order to unite diverse professionals in thinking creatively about system-wide service improvement. Our study

Sexual health promotion on social networking sites: a process evaluation of The FaceSpace Project.

Science.gov (United States)

Nguyen, Phuong; Gold, Judy; Pedrana, Alisa; Chang, Shanton; Howard, Steve; Ilic, Olivia; Hellard, Margaret; Stoove, Mark

2013-07-01

This article reports findings from an evaluation of reach and engagement of The FaceSpace Project, a novel sexual health promotion project delivered through social networking sites that targeted young people aged 16-29 years. Multiple methods were used to evaluate project reach and engagement. The evaluation focussed on quantitative data (online usage statistics, online surveys), complemented by available qualitative data (project team meeting notes). The project reached 900 fans who were mostly between 18 and 34 years of age. The most successful ways of increasing audience reach were via Facebook advertisements and tagging photos of young people attending a music festival on the project Facebook page. Peaks in Facebook page interactions (comments and "likes") coincided with recruitment peaks and when videos were posted. However, video views varied greatly between postings. Feedback from the project team for increasing engagement in future social networking site interventions included having one centralized Facebook page and using episodic videos. This evaluation is among the first to assess the use of social networking sites for sexual health promotion and provides information to inform the implementation and evaluation of future projects using new media. Social networking sites offer great potential to reach and engage young people for sexual health promotion. However, further work is required to improve implementation and promote audience reach and engagement as well as to determine effectiveness of social networking sites in changing knowledge, attitudes, and behaviors. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Design of the DISCovery project: tailored work-oriented interventions to improve employee health, well-being, and performance-related outcomes in hospital care

Directory of Open Access Journals (Sweden)

Niks Irene MW

2013-02-01

Full Text Available Abstract Background It is well-known that health care workers in today’s general hospitals have to deal with high levels of job demands, which could have negative effects on their health, well-being, and job performance. A way to reduce job-related stress reactions and to optimize positive work-related outcomes is to raise the level of specific job resources and opportunities to recover from work. However, the question remains how to translate the optimization of the balance between job demands, job resources, and recovery opportunities into effective workplace interventions. The aim of the DISCovery project is to develop and implement tailored work-oriented interventions to improve health, well-being, and performance of health care personnel. Methods/Design A quasi-experimental field study with a non-equivalent control group pretest-posttest design will be conducted in a top general hospital. Four existing organizational departments will provide both an intervention and a comparison group. Two types of research methods are used: (1 a longitudinal web-based survey study, and (2 a longitudinal daily diary study. After base-line measures of both methods, existing and yet to be developed interventions will be implemented within the experimental groups. Follow-up measurements will be taken one and two years after the base-line measures to analyze short-term and long-term effects of the interventions. Additionally, a process evaluation and a cost-effectiveness analysis will be carried out. Discussion The DISCovery project fulfills a strong need for theory-driven and scientifically well-performed research on job stress and performance interventions. It will provide insight into (1 how a balance between job demands, job resources, and recovery from work can be optimized, (2 the short-term and long-term effects of tailored work-oriented effects, and (3 indicators for successful or unsuccessful implementation of interventions.

Design of the DISCovery project: tailored work-oriented interventions to improve employee health, well-being, and performance-related outcomes in hospital care.

Science.gov (United States)

Niks, Irene M W; de Jonge, Jan; Gevers, Josette M P; Houtman, Irene L D

2013-02-19

It is well-known that health care workers in today's general hospitals have to deal with high levels of job demands, which could have negative effects on their health, well-being, and job performance. A way to reduce job-related stress reactions and to optimize positive work-related outcomes is to raise the level of specific job resources and opportunities to recover from work. However, the question remains how to translate the optimization of the balance between job demands, job resources, and recovery opportunities into effective workplace interventions. The aim of the DISCovery project is to develop and implement tailored work-oriented interventions to improve health, well-being, and performance of health care personnel. A quasi-experimental field study with a non-equivalent control group pretest-posttest design will be conducted in a top general hospital. Four existing organizational departments will provide both an intervention and a comparison group. Two types of research methods are used: (1) a longitudinal web-based survey study, and (2) a longitudinal daily diary study. After base-line measures of both methods, existing and yet to be developed interventions will be implemented within the experimental groups. Follow-up measurements will be taken one and two years after the base-line measures to analyze short-term and long-term effects of the interventions. Additionally, a process evaluation and a cost-effectiveness analysis will be carried out. The DISCovery project fulfills a strong need for theory-driven and scientifically well-performed research on job stress and performance interventions. It will provide insight into (1) how a balance between job demands, job resources, and recovery from work can be optimized, (2) the short-term and long-term effects of tailored work-oriented effects, and (3) indicators for successful or unsuccessful implementation of interventions.

Improved Prioritization Criteria for Road Infrastructure Projects

Directory of Open Access Journals (Sweden)

Ionescu Heroiu Marcel

2016-12-01

Full Text Available This report’s main aim is to propose a methodology for assessing state-budget-funded projects based on a rigorous selection model, including clear and effective prioritization criteria. This report first argues that project prioritization and selection should be optimized against four dimensions: absorption, impact, legitimacy, and capacity. Second, it provides a diagnostic of the National Program for Local Development (PNDL, managed by the Ministry of Regional Development and Public Administration (MRDPA, as the most significant source of state-budget funding for local infrastructure projects. The PNDL’s current design and implementation leaves room for improvement, as reflected by the lack of strategic direction in allocating funds and the continued rise in the number of projects that get started without a feasible timeline for their completion. Further, this report makes recommendations for improvement of project evaluation and selection procedures for local infrastructure development projects, with a special focus on prioritization criteria and viable funding sources for each type of investment. The practical purpose is to enhance the efficiency and effectiveness of proposed investments, maximizing impact in the context of inherently limited available financial resources. A complementary focus is on opportunities for harmonizing and better coordinating investments across various sources of funding, in the context of nearly EUR 40 billion available to Romania from the EU for the 2014-2020 programming period.

Continued multidisciplinary project-based learning - implementation in health informatics.

Science.gov (United States)

Wessel, C; Spreckelsen, C

2009-01-01

Problem- and project-based learning are approved methods to train students, graduates and post-graduates in scientific and other professional skills. The students are trained on realistic scenarios in a broader context. For students specializing in health informatics we introduced continued multidisciplinary project-based learning (CM-PBL) at a department of medical informatics. The training approach addresses both students of medicine and students of computer science. The students are full members of an ongoing research project and develop a project-related application or module, or explore or evaluate a sub-project. Two teachers guide and review the students' work. The training on scientific work follows a workflow with defined milestones. The team acts as peer group. By participating in the research team's work the students are trained on professional skills. A research project on a web-based information system on hospitals built the scenario for the realistic context. The research team consisted of up to 14 active members at a time, who were scientists and students of computer science and medicine. The well communicated educational approach and team policy fostered the participation of the students. Formative assessment and evaluation showed a considerable improvement of the students' skills and a high participant satisfaction. Alternative education approaches such as project-based learning empower students to acquire scientific knowledge and professional skills, especially the ability of life-long learning, multidisciplinary team work and social responsibility.

The Environmental Health/Home Safety Education Project: a successful and practical U.S.-Mexico border initiative.

Science.gov (United States)

Forster-Cox, Susan C; Mangadu, Thenral; Jacquez, Benjamín; Fullerton, Lynne

2010-05-01

The Environmental Health/Home Safety Education Project (Proyecto de Salud Ambiental y Seguridad en el Hogar) has been developed in response to a wide array of severe and often preventable environmental health issues occurring in and around homes on the U.S.-Mexico border. Utilizing well-trained community members, called promotoras , homes are visited and assessed for potential environmental hazards, including home fire and food safety issues. Data analyzed from project years 2002 to 2005 shows a significant impact in knowledge levels and initial behavior change among targeted participants as it relates to fire and food safety issues. Since the initiation of the project in 1999, hundreds of participants have improved their quality of life by making their homes safer. The project has proven to be sustainable, replicable, flexible, and attractive to funders.

Hong Kong's health spending projections through 2033.

Science.gov (United States)

Leung, Gabriel M; Tin, Keith Y K; Chan, Wai-Sum

2007-04-01

To derive actuarial projection estimates of Hong Kong's total domestic health expenditure to the year 2033. Disaggregating health expenditure by age, sex, unit cost and utilisation level, we estimated future health spending by projecting utilisation (by public/private, inpatient/outpatient care) to reflect demographic changes and associated increase in demand (from higher expectations and greater intensity of care), and then multiplying such by the projected unit costs (incorporating the impact of key cost drivers such as public expectations, technological changes and potential productivity gains) to obtain total expenditure estimates. The model was most sensitive to the excess health care price inflation rate, i.e. the annual price/cost growth of medical goods and services over and above per capita GDP growth. Population ageing and growth per se, without taking into account related technologic innovation for chronic conditions that particularly afflict older adults, contribute relatively little to overall spending growth. Given the model assumptions, it is possible to limit total health spending to below 10% of GDP by 2033, where the public share would gradually decline from the current 57% to between 46% and 49%. Expenditure control through global budgeting, technology assessment and demand-side constraints should be considered although their effectiveness remains inconclusive.

Telemedicine and primary health: The virtual doctor project Zambia

OpenAIRE

Mupela, Evans; Mustarde, Paul; Jones, Huw

2011-01-01

This paper is a commentary on a project application of telemedicine to alleviate primary health care problems in Lundazi district in the Eastern province of Zambia. The project dubbed 'The Virtual Doctor Project' will use hard body vehicles fitted with satellite communication devices and modern medical equipment to deliver primary health care services to some of the neediest areas of the country. The relevance and importance of the project lies in the fact that these areas are hard-to-reach d...

Projection models for health-effects assessment in populations exposed to radioactive and nonradioactive pollutants. Volume I. Introduction to the SPAHR demographic model for health risk

Energy Technology Data Exchange (ETDEWEB)

Collins, J.J.; Lundy, R.T.; Grahn, D.; Ginevan, M.E.

1982-09-01

The Simulation Package for the Analysis of Health Risk (SPAHR) is a computer software package based upon a demographic model for health risk projections. The model extends several health risk projection models by making realistic assumptions about the population at risk, and thus represents a distinct improvement over previous models. Complete documentation for use of SPAHR is contained in this five-volume publication. The demographic model in SPAHR estimates population response to environmental toxic exposures. Latency of response, changing dose level over time, competing risks from other causes of death, and population structure can be incorporated into SPAHR to project health risks. Risks are measured by morbid years, number of deaths, and loss of life expectancy. Comparisons of estimates of excess deaths demonstrate that previous health risk projection models may have underestimated excess deaths by a factor of from 2 to 10, depending on the pollutant and the exposure scenario. The software supporting the use of the demographic model is designed to be user oriented. Complex risk projections are made by responding to a series of prompts generated by the package. The flexibility and ease of use of SPAHR make it an important contribution to existing models and software packages. The first volume presents the theory behind the SPAHR health risk projection model and several applications of the model to actual pollution episodes. The elements required for an effective health risk projection model are specified, and the models that have been used to date in health risk projections are outlined. These are compared with the demographic model, whose formulation is described in detail. Examples of the application of air pollution and radiation dose-response functions are included in order to demonstrate the estimation of future mortality and morbidity levels and the range of variation in excess deaths that occurs when populations structure is changed.

Projection models for health-effects assessment in populations exposed to radioactive and nonradioactive pollutants. Volume I. Introduction to the SPAHR demographic model for health risk

International Nuclear Information System (INIS)

Collins, J.J.; Lundy, R.T.; Grahn, D.; Ginevan, M.E.

1982-09-01

The Simulation Package for the Analysis of Health Risk (SPAHR) is a computer software package based upon a demographic model for health risk projections. The model extends several health risk projection models by making realistic assumptions about the population at risk, and thus represents a distinct improvement over previous models. Complete documentation for use of SPAHR is contained in this five-volume publication. The demographic model in SPAHR estimates population response to environmental toxic exposures. Latency of response, changing dose level over time, competing risks from other causes of death, and population structure can be incorporated into SPAHR to project health risks. Risks are measured by morbid years, number of deaths, and loss of life expectancy. Comparisons of estimates of excess deaths demonstrate that previous health risk projection models may have underestimated excess deaths by a factor of from 2 to 10, depending on the pollutant and the exposure scenario. The software supporting the use of the demographic model is designed to be user oriented. Complex risk projections are made by responding to a series of prompts generated by the package. The flexibility and ease of use of SPAHR make it an important contribution to existing models and software packages. The first volume presents the theory behind the SPAHR health risk projection model and several applications of the model to actual pollution episodes. The elements required for an effective health risk projection model are specified, and the models that have been used to date in health risk projections are outlined. These are compared with the demographic model, whose formulation is described in detail. Examples of the application of air pollution and radiation dose-response functions are included in order to demonstrate the estimation of future mortality and morbidity levels and the range of variation in excess deaths that occurs when populations structure is changed

Using design science and artificial intelligence to improve health communication: ChronologyMD case example.

Science.gov (United States)

Neuhauser, Linda; Kreps, Gary L; Morrison, Kathleen; Athanasoulis, Marcos; Kirienko, Nikolai; Van Brunt, Deryk

2013-08-01

This paper describes how design science theory and methods and use of artificial intelligence (AI) components can improve the effectiveness of health communication. We identified key weaknesses of traditional health communication and features of more successful eHealth/AI communication. We examined characteristics of the design science paradigm and the value of its user-centered methods to develop eHealth/AI communication. We analyzed a case example of the participatory design of AI components in the ChronologyMD project intended to improve management of Crohn's disease. eHealth/AI communication created with user-centered design shows improved relevance to users' needs for personalized, timely and interactive communication and is associated with better health outcomes than traditional approaches. Participatory design was essential to develop ChronologyMD system architecture and software applications that benefitted patients. AI components can greatly improve eHealth/AI communication, if designed with the intended audiences. Design science theory and its iterative, participatory methods linked with traditional health communication theory and methods can create effective AI health communication. eHealth/AI communication researchers, developers and practitioners can benefit from a holistic approach that draws from theory and methods in both design sciences and also human and social sciences to create successful AI health communication. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Using the Neptune project to benefit Australian aquatic animal health research.

Science.gov (United States)

McNamara, M; Ernst, I; Adlard, R D

2015-06-29

Diseases of aquatic animals have had, and continue to have, a significant impact on aquatic animal health. In Australia, where fisheries and aquaculture are important industries, aquatic species have been subject to serious disease outbreaks, including pilchard herpesvirus, the cause of one of the largest wild fish kills ever recorded. At the same time, there is a consensus that Australia's parasite fauna are largely unknown, and that aquatic animal health information is difficult to access. Managing aquatic animal diseases is challenging because they may be entirely new, their hosts may be new to aquaculture, and specialist expertise and basic diagnostic tools may be lacking or absent. The Neptune project was created in response to these challenges, and it aims to increase awareness of aquatic animal diseases, improve disease management, and promote communication between aquatic animal health professionals in Australia. The project consists of an online database, a digital microscopy platform containing a whole-slide image library, a community space, and online communications technology. The database contains aquatic animal health information from published papers, government reports, and other sources, while the library contains slides of key diseases both endemic and exotic to Australia. These assets make Neptune a powerful resource for researchers, students, and biosecurity officials.

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

Project HealthDesign: enhancing action through information.

Science.gov (United States)

Brennan, Patricia Flatley; Casper, Gail; Downs, Stephen; Aulahk, Veenu

2009-01-01

Project HealthDesign is a country-wide initiative in the United States designed to stimulate innovation in personal health records (PHRs). Nine grantee teams engaged in an 18-month long design and prototyping process. Two teams addressed the needs of children and adolescents; three created novel approaches to help adults prevent or manage metabolic syndrome; three groups employed interface innovations to assist patients with chronic care management and one team devised a novel calendaring system to assist patients undergoing complex medical/surgical treatments to integrate care processes into their daily lives. These projects not only included development and testing of novel personal health records applications, but also served as the starting point to specify and implement a common technical core platform. The project advanced PHR development in two key ways: intensive user-centered design and a development architecture that separates applications of PHRs from the infrastructure that supports them. The initiative also allowed systematic investigation of significant ethical, legal and social issues, including how privacy considerations are changed when information technology innovations are used in the home and the rebalancing of the authority structure of health care decision making when patient-centered approaches guide the design of PHRs.

Air Pollution and Climate Change Health Impact Assessment. The ACHIA Project

International Nuclear Information System (INIS)

Kinney, P.L.

2013-01-01

Climate change may affect human health via interactions with air pollutants such as ozone and PM 2.5 . These air pollutants are linked to climate because they can be both affected by and have effects on climate. In coming decades, substantial, cost-effective improvements in public health may be achieved with well-planned strategies to mitigate climate impacts while also reducing health effects of ozone and PM 2.5 . Climate mitigation actions affect greenhouse pollutant emissions, including methane and black carbon, but also may affect other key air pollution precursors such as NOx, CO, and SOx. To better understand the potential of such strategies, studies are needed that assess possible future health impacts under alternative assumptions about future emissions and climate across multiple spatial scales. The overall objective of this project is to apply state of the art climate, air quality, and health modelling tools to assess future health impacts of ozone and PM 2.5 under different IPCCs scenario of climate change, focusing specifically on pollution-related health co-benefits which could be achieved under alternative climate mitigation pathways in the period 2030-2050. This question will be explored at three spatial scales: global, regional (Europe), and urban (Paris). ACHIA is comprised of an integrated set of four work packages: WP1. Global Climate and Air Pollution Impacts of Alternative Emissions Pathways; WP2. Climate and Air Quality at Regional and Urban Scales: Results for Europe and Paris; WP3. Health Impact Assessment; WP4. Dissemination, Evaluation, Management. ACHIA is designed to create an interdisciplinary approach to the impacts of climate change on health through air quality changes, and to start longer-term collaborations between communities. We expect the project to advance state of art across all WPs, with important implications for research groups around the world. A particular innovation of the project is the multi-scale aspect, i.e., the

MDSplus quality improvement project

Energy Technology Data Exchange (ETDEWEB)

Fredian, Thomas W., E-mail: twf@psfc.mit.edu [Massachusetts Institute of Technology, 175 Albany Street, Cambridge, MA 02139 (United States); Stillerman, Joshua [Massachusetts Institute of Technology, 175 Albany Street, Cambridge, MA 02139 (United States); Manduchi, Gabriele; Rigoni, Andrea [Consorzio RFX, Euratom-ENEA Association, Corso Stati Uniti 4, Padova 35127 (Italy); Erickson, Keith [Princeton Plasma Physics Laboratory, Princeton, NJ 08543 (United States)

2016-11-15

Highlights: • Project to improve the quality of the MDSplus software package. • Use of modern software technology, compiler options, automake. • Refactoring of older code. • Use of testing tools. - Abstract: MDSplus is a data acquisition and analysis system used worldwide predominantly in the fusion research community. Development began 29 years ago on the OpenVMS operating system. Since that time there have been many new features added and the code has been ported to many different operating systems. There have been contributions to the MDSplus development from the fusion community in the way of feature suggestions, feature implementations, documentation and porting to different operating systems. The bulk of the development and support of MDSplus, however, has been provided by a relatively small core developer group of three or four members. Given the size of the development team and the large number of users much more effort was focused on providing new features for the community than on keeping the underlying code and documentation up to date with the evolving software development standards. To ensure that MDSplus will continue to provide the needs of the community in the future, the MDSplus development team along with other members of the MDSplus user community has commenced on a major quality improvement project. The planned improvements include changes to software build scripts to better use GNU Autoconf and Automake tools, refactoring many of the source code modules using new language features available in modern compilers, using GNU MinGW-w64 to create MS Windows distributions, migrating to a more modern source code management system, improvement of source documentation as well as improvements to the (www.mdsplus.org) web site documentation and layout, and the addition of more comprehensive test suites to apply to MDSplus code builds prior to releasing installation kits to the community. This work should lead to a much more robust product and

MDSplus quality improvement project

International Nuclear Information System (INIS)

Fredian, Thomas W.; Stillerman, Joshua; Manduchi, Gabriele; Rigoni, Andrea; Erickson, Keith

2016-01-01

Highlights: • Project to improve the quality of the MDSplus software package. • Use of modern software technology, compiler options, automake. • Refactoring of older code. • Use of testing tools. - Abstract: MDSplus is a data acquisition and analysis system used worldwide predominantly in the fusion research community. Development began 29 years ago on the OpenVMS operating system. Since that time there have been many new features added and the code has been ported to many different operating systems. There have been contributions to the MDSplus development from the fusion community in the way of feature suggestions, feature implementations, documentation and porting to different operating systems. The bulk of the development and support of MDSplus, however, has been provided by a relatively small core developer group of three or four members. Given the size of the development team and the large number of users much more effort was focused on providing new features for the community than on keeping the underlying code and documentation up to date with the evolving software development standards. To ensure that MDSplus will continue to provide the needs of the community in the future, the MDSplus development team along with other members of the MDSplus user community has commenced on a major quality improvement project. The planned improvements include changes to software build scripts to better use GNU Autoconf and Automake tools, refactoring many of the source code modules using new language features available in modern compilers, using GNU MinGW-w64 to create MS Windows distributions, migrating to a more modern source code management system, improvement of source documentation as well as improvements to the (www.mdsplus.org) web site documentation and layout, and the addition of more comprehensive test suites to apply to MDSplus code builds prior to releasing installation kits to the community. This work should lead to a much more robust product and

Management Systems for Organic EggProduction - Aiming to Improve AnimalHealth and Welfare

DEFF Research Database (Denmark)

Hegelund, Lene

one production period. In the second part of the project a generic HACCP system was developed, using an expert panel analysis. The two management tools have very different approaches to improving animal health and welfare, and subsequently different methods, cost and advantages. This makes them...

[Evaluation of 12 pilot projects to improve outpatient palliative care].

Science.gov (United States)

Schmidt-Wolf, G; Elsner, F; Lindena, G; Hilgers, R-D; Heussen, N; Rolke, R; Ostgathe, C; Radbruch, L

2013-12-01

With a priority programme the German Cancer Aid supported the development of quality-assured outpatient palliative care to cover the whole country. The 12 regional pilot projects funded with the aim to improve outpatient palliative care in different models and different frameworks were concurrently monitored and evaluated. The supported projects, starting and ending individually, documented all patients who were cared for using HOPE (Hospice and palliative care evaluation) and MIDOS (Minimal documentation system for palliative patients). Total data were analyzed for 3239 patients decriptively. In addition to the quantitative data the experiences of the projects were recorded in a number of workshops (2008, 2009, 2010, and 2012). In particular, the experiences reported in the final meeting in July 2012 were considered for this article as well as the final reports for the German Cancer Aid. In the quantitative evaluation 85.6% of 3239 palliative care patients had a cancer diagnosis. In all model projects the goal of a network with close cooperation of primary providers, social support, and outpatient and inpatient specialist services has been achieved. For all projects, the initial financing of the German Cancer Aid was extremely important, because contracts with health insurance funds were negotiated slowly, and could then be built on the experiences with the projects. The participants of the project-completion meeting emphasized the need to carry out a market analysis before starting palliative care organizations considering the different regional structures and target groups of patients. Education, training and continuing education programs contribute significantly to the network. A reliably funded coordination center/case management across all institutions is extremely important. © Georg Thieme Verlag KG Stuttgart · New York.

Health Activities Project (HAP), Trial Edition III.

Science.gov (United States)

Buller, Dave; And Others

Contained within this Health Activities Project (HAP) trial edition (set III) are a teacher information folio and numerous student activity folios which center around the idea that students in grades 5-8 can control their own health and safety. Each student folio is organized into an Overview, Health Background, Materials, Setting Up, and…

Improving the quality of the evidence base of health informatics.

Science.gov (United States)

Talmon, Jan

2008-11-06

Evaluation of health informatics technology has had attention from quite a few researchers in health informatics in the last few decades. In the early nineties of the past century several working groups and research projects have discussed evaluation methods and methodologies. Despite these activities, evaluation of health informatics has not received the recognition it deserves. In this presentation we will reiterate the arguments put forward in the Declaration of Innsbruck to consider evaluation an essential element of the evidence base of health informatics. Not only are evaluation studies essential, it is also required that such studies are properly reported. A joint effort of the IMIA, EFMI and AMIA working groups on evaluation has resulted in a guideline for reporting the results of evaluation studies of health informatics applications (STARE-HI). STARE-HI is currently endorsed by EFMI. The general assembly of IMIA has adopted STARE-HI as an official IMIA document. Endorsement from AMIA is being sought. A pilot study in which STARE-HI was applied to assess the quality of current reporting clearly indicates that there is quite some room for improvement. Application of guidelines such as STARE-HI would contribute to a further improvement of the evidence base of health informatics and would open the road for high quality reviews and meta-analyses.

The Utrecht Health Project: Optimization of routine healthcare data for research

International Nuclear Information System (INIS)

Grobbee, Diederick E.; Hoes, Arno W.; Verheij, Theo J. M.; Schrijvers, Augustinus J. P.; Ameijden, Erik J. C. van; Numans, Mattijs E.

2005-01-01

Background. Research on the impact of changes in healthcare policy, developments in community and public health and determinants of health and disease during lifetime may effectively make use of routine healthcare data. These data, however, need to meet minimal criteria for quality and completeness. Research opportunities are further improved when routine data are supplemented with a standardized 'baseline' assessment of the full population. This formed the basis for a new study initiated in a newly developed large residential area in Leidsche Rijn, part of the city of Utrecht, the Netherlands.Methods. All new inhabitants are invited by their general practitioner to participate in the Utrecht Health Project (UHP). Informed consent is obtained and an individual health profile (IHP) is made by dedicated research nurses. The IHP is the starting point for the UHP research database as well as for the primary care electronic medical records. Follow-up data are collected through continuous linkage with the computerized medical files recorded by the general practitioners. UHP staff in each practice takes care of quality management of registration as well as data handling.Results. Currently, over 60 of invited new residents in the area have given informed consent with participation steadily increasing. Discussion. The Utrecht Health Project combines key elements of traditional epidemiologic cohort studies with the current power of routine electronic medical record keeping in primary care. The research approach optimizes routine health care data for use in scientific research

Mental health promotion in a school community by using the results from the Well-being Profile: an action research project.

Science.gov (United States)

Puolakka, Kristiina; Haapasalo-Pesu, Kirsi-Maria; Konu, Anne; Astedt-Kurki, Päivi; Paavilainen, Eija

2014-01-01

This article presents an action research project as a method to combine science and practical expertise in order to develop the practices of the health care system. The project aimed at developing mental health promotion in the school community in general and at finding tools for timely help when mental health is at risk. The underlying idea is that mental health is an integral part of health and by promoting general well-being it is also possible to promote and ensure mental health at school. The study was conducted in a Finnish lower secondary school of 446 pupils where the pupils are aged between 12 and 15 years. The initial survey was conducted using the School Well-being Profile, a tool developed by Anne Konu. A well-being questionnaire was used to identify the areas in need of improvement, providing the basis for planning and implementing development measures together with the local actors. The instrument proved to be a usable way of collecting feedback of the well-being of the school environment. As a result of the action research project, the school's physical conditions and social relationships improved and appropriate practices for future problem situations were set.

Medico-ecological study and health impact assessment of hydro-electric projects in Malaysia

Energy Technology Data Exchange (ETDEWEB)

Lai, Karen [Institute for Medical Research, Kuala Lumpur (Malaysia)

1997-12-31

The objectives of this studies were to determine i) if there was any potential health risks in terms of spread of vector-borne and other communicable diseases resulting from the changes in the environment due to creation of large bodies of water as consequence of the construction of dams, ii) diseases of public health importance in populations affected by such projects. Nine pre-impoundment studies had been carried out and potential impact of the change in environment on discases and health of the affected populations in each areas was evaluated. Risk of infections to the dam construction workers also assessed. Recommendations on mitigation measures were made for each situation so that adequate provisions could be made to improve the health conditions of these populations especially those who would be resettled as a result of impoundment . Prevention and control measures on transmission of infection, including vector control were proposed. The potential medico-ecological hazards encountered by immigrants and visitors to the area on completion of the hydro project were also envisaged.

Medico-ecological study and health impact assessment of hydro-electric projects in Malaysia

International Nuclear Information System (INIS)

Karen Lai

1996-01-01

The objectives of this studies were to determine i) if there was any potential health risks in terms of spread of vector-borne and other communicable diseases resulting from the changes in the environment due to creation of large bodies of water as consequence of the construction of dams, ii) diseases of public health importance in populations affected by such projects. Nine pre-impoundment studies had been carried out and potential impact of the change in environment on discases and health of the affected populations in each areas was evaluated. Risk of infections to the dam construction workers also assessed. Recommendations on mitigation measures were made for each situation so that adequate provisions could be made to improve the health conditions of these populations especially those who would be resettled as a result of impoundment . Prevention and control measures on transmission of infection, including vector control were proposed. The potential medico-ecological hazards encountered by immigrants and visitors to the area on completion of the hydro project were also envisaged

Health Activities Project (HAP), Trial Edition II.

Science.gov (United States)

Buller, Dave; And Others

Contained within this Health Activities Project (HAP) trial edition (set II) are a teacher information folio and numerous student activity folios which center around the idea that students in grades 5-8 can control their own health and safety. Each student folio is organized into a Synopsis, Health Background, Materials, Setting Up, and Activities…

Diagnostic framework and health check tool for engineering and technology projects

Directory of Open Access Journals (Sweden)

Simon P Philbin

2014-10-01

Full Text Available Purpose: Development of a practitioner oriented diagnostic framework and health check tool to support the robust assessment of engineering and technology projects.Design/methodology/approach: The research is based on a literature review that draws together insights on project assessment and critical success factors to establish an integrated systems view of projects. This is extended to allow a comprehensive diagnostic framework to be developed along with a high-level health check tool that can be readily deployed on projects. The utility of the diagnostic framework and health check tool are explored through three illustrative case studies, with two from Canada and one from the United Kingdom. Findings andOriginality/value: The performance of engineering and technology projects can be viewed through a systems perspective and being a function of six sub-systems that are: process, technology, resources, impact, knowledge and culture. The diagnostic framework that is developed through this research integrates these sub-systems to provide a comprehensive assessment methodology for projects, which is linked to existing best practice for project reviews, performance management and maturity models. The case studies provide managerial insights that are related to the diagnostic framework but crucially also position the approach in the context of industrial applications for construction engineering and technology management.Research limitations/implications: The case study approach includes two case studies from the construction and facilities development sector with the third case study from the research and technology sector. Further work is required to investigate the use of the diagnostic framework and health check tool in other sectors.Practical implications: The health check tool will be of practical benefit to new projects managers that require access to a robust and convenient project review methodology for assessing the status and health of a

Strengthening public health research for improved health

Directory of Open Access Journals (Sweden)

Enrique Gea-Izquierdo

2012-08-01

Full Text Available Research in public health is a range that includes from fundamental research to research in clinical practice, including novel advances, evaluation of results and their spreading. Actually, public health research is considered multidisciplinary incorporating numerous factors in its development. Establishing as a mainstay the scientific method, deepens in basic research, clinical epidemiological research and health services. The premise of quality and relevance is reflected in international scientific research, and in the daily work and good biomedical practices that should be included in the research as a common task. Therefore, the research must take a proactive stance of inquiry, integrating a concern planned and ongoing development of knowledge. This requires improve international coordination, seeking a balance between basic and applied research as well as science and technology. Thus research cannot be considered without innovation, weighing up the people and society needs. Acting on knowledge of scientific production processes requires greater procedures thoroughness and the effective expression of the results. It is noted as essential to establish explicit principles in review and evaluation of the adjustments of actions, always within the standards of scientific conduct and fairness of the research process. In the biomedical scientific lines it have to be consider general assessments that occur related to the impact and quality of health research, mostly leading efforts to areas that require further attention. However, other subject areas that may be deficient or with lower incidence in the population should not be overlook. Health research as a source of new applications and development provides knowledge, improving well-being. However, it is understandable without considering the needs and social demands. Therefore, in public health research and to improve the health of the population, we must refine and optimize the prevention and

Experiences of Social Inclusion and Employment of Mental Health Service Users in a European Union Project

DEFF Research Database (Denmark)

Nieminen, Irja; Ramon, Shulamit; Dawson, Ian

2012-01-01

users experienced improvement in their social life. Employment and participation in meaningful activities continued to improve to the end of the EMILIA project, although at a slower pace. In addition, users were motivated for work and actively searched for employment. Having a mental illness, stigma......, and discrimination were reported to be obstacles to social inclusion. The difficulties identified in social relationships continued to exist. Conclusions: Train- ing intervention impact positively on mental health service users’ social inclusion and employment. However stigma, discrimination, and having a mental......ABSTRACT: Aims: The aim of this study is to describe how the mental health service users experienced social inclusion and employment in the EU EMILIA project. Methods: The study design is an intervention group follow-up study, with data collection at three points: baseline (T0), at 10-month follow...

Improvement of tuberculosis laboratory capacity on Pemba Island, Zanzibar: a health cooperation project.

Directory of Open Access Journals (Sweden)

Maria G Paglia

Full Text Available Low-income countries with high Tuberculosis burden have few reference laboratories able to perform TB culture. In 2006, the Zanzibar National TB Control Programme planned to decentralize TB diagnostics. The Italian Cooperation Agency with the scientific support of the "L. Spallanzani" National Institute for Infectious Diseases sustained the project through the implementation of a TB reference laboratory in a low-income country with a high prevalence of TB. The implementation steps were: 1 TB laboratory design according to the WHO standards; 2 laboratory equipment and reagent supplies for microscopy, cultures, and identification; 3 on-the-job training of the local staff; 4 web- and telemedicine-based supervision. From April 2007 to December 2010, 921 sputum samples were received from 40 peripheral laboratories: 120 TB cases were diagnosed. Of all the smear-positive cases, 74.2% were culture-positive. During the year 2010, the smear positive to culture positive rate increased up to 100%. In March 20, 2010 the Ministry of Health and Social Welfare of Zanzibar officially recognized the Public Health Laboratory- Ivo de Carneri as the National TB Reference Laboratory for the Zanzibar Archipelago. An advanced TB laboratory can represent a low cost solution to strengthen the TB diagnosis, to provide capacity building and mid-term sustainability.

Working towards Men's Health: Findings from the Sefton Men's Health Project

Science.gov (United States)

Robinson, Mark; Robertson, Steve; McCullagh, Jo; Hacking, Sue

2010-01-01

Objective: To evaluate a health improvement initiative aimed at enhancing the health of men in deprived areas. Design: A healthy lifestyle programme was undertaken with men to increase their health knowledge, and encourage behaviour modification and access to health improvement services. A peer mentoring programme was implemented and a training…

Self-management support and training for patients with chronic and complex conditions improves health-related behaviour and health outcomes.

Science.gov (United States)

Harvey, Peter W; Petkov, John N; Misan, Gary; Fuller, Jeffrey; Battersby, Malcolm W; Cayetano, Teofilo N; Warren, Kate; Holmes, Paul

2008-05-01

The Sharing Health Care SA chronic disease self-management (CDSM) project in rural South Australia was designed to assist patients with chronic and complex conditions (diabetes, cardiovascular disease and arthritis) to learn how to participate more effectively in the management of their condition and to improve their self-management skills. Participants with chronic and complex conditions were recruited into the Sharing Health Care SA program and offered a range of education and support options (including a 6-week peer-led chronic disease self-management program) as part of the Enhanced Primary Care care planning process. Patient self-reported data were collected at baseline and subsequent 6-month intervals using the Partners in Health (PIH) scale to assess self-management skill and ability for 175 patients across four data collection points. Health providers also scored patient knowledge and self-management skills using the same scale over the same intervals. Patients also completed a modified Stanford 2000 Health Survey for the same time intervals to assess service utilisation and health-related lifestyle factors. Results show that both mean patient self-reported PIH scores and mean health provider PIH scores for patients improved significantly over time, indicating that patients demonstrated improved understanding of their condition and improved their ability to manage and deal with their symptoms. These results suggest that involvement in peer-led self-management education programs has a positive effect on patient self-management skill, confidence and health-related behaviour.

Improvement of the cost-benefit analysis algorithm for high-rise construction projects

Directory of Open Access Journals (Sweden)

Gafurov Andrey

2018-01-01

Full Text Available The specific nature of high-rise investment projects entailing long-term construction, high risks, etc. implies a need to improve the standard algorithm of cost-benefit analysis. An improved algorithm is described in the article. For development of the improved algorithm of cost-benefit analysis for high-rise construction projects, the following methods were used: weighted average cost of capital, dynamic cost-benefit analysis of investment projects, risk mapping, scenario analysis, sensitivity analysis of critical ratios, etc. This comprehensive approach helped to adapt the original algorithm to feasibility objectives in high-rise construction. The authors put together the algorithm of cost-benefit analysis for high-rise construction projects on the basis of risk mapping and sensitivity analysis of critical ratios. The suggested project risk management algorithms greatly expand the standard algorithm of cost-benefit analysis in investment projects, namely: the “Project analysis scenario” flowchart, improving quality and reliability of forecasting reports in investment projects; the main stages of cash flow adjustment based on risk mapping for better cost-benefit project analysis provided the broad range of risks in high-rise construction; analysis of dynamic cost-benefit values considering project sensitivity to crucial variables, improving flexibility in implementation of high-rise projects.

Improvement of the cost-benefit analysis algorithm for high-rise construction projects

Science.gov (United States)

Gafurov, Andrey; Skotarenko, Oksana; Plotnikov, Vladimir

2018-03-01

The specific nature of high-rise investment projects entailing long-term construction, high risks, etc. implies a need to improve the standard algorithm of cost-benefit analysis. An improved algorithm is described in the article. For development of the improved algorithm of cost-benefit analysis for high-rise construction projects, the following methods were used: weighted average cost of capital, dynamic cost-benefit analysis of investment projects, risk mapping, scenario analysis, sensitivity analysis of critical ratios, etc. This comprehensive approach helped to adapt the original algorithm to feasibility objectives in high-rise construction. The authors put together the algorithm of cost-benefit analysis for high-rise construction projects on the basis of risk mapping and sensitivity analysis of critical ratios. The suggested project risk management algorithms greatly expand the standard algorithm of cost-benefit analysis in investment projects, namely: the "Project analysis scenario" flowchart, improving quality and reliability of forecasting reports in investment projects; the main stages of cash flow adjustment based on risk mapping for better cost-benefit project analysis provided the broad range of risks in high-rise construction; analysis of dynamic cost-benefit values considering project sensitivity to crucial variables, improving flexibility in implementation of high-rise projects.

Development and experimental study of mental health app for University students: Improving the app through log analysis and questionnaire

OpenAIRE

梶谷, 康介; 東島, 育美; 金子, 晃介; 松下, 智子; 福盛, 英明; 金, 大雄

2018-01-01

The survey by the Ministry of Health, Labour and Welfare showed suicide to be the leading cause of death for Japanese in their 20s, and enacting mental health measures for young people such as university students is an urgent issue. As a mental health measure aimed at the youth, we have launched the project entitled “the empirical study on the improvement in mental health of university students using a smartphone app”. In this project, we first conducted a questionnaire survey about healthcar...

Improving Environmental Literacy through GO3 Citizen Science Project

Science.gov (United States)

Wilkening, B.

2011-12-01

In the Global Ozone (GO3) Project students measure ground-level ozone on a continuous basis and upload their results to a global network used by atmospheric scientists and schools. Students learn important concepts such as chemical measurement methods; instrumentation; calibration; data acquisition using computers; data quality; statistics; data analysis and graphing; posting of data to the web; the chemistry of air pollution; stratospheric ozone depletion and global climate change. Students collaborate with researchers and other students globally in the GO3 network. Wilson K-8 School is located in a suburban area in Pima County, Arizona. Throughout the year we receive high ozone alert days. Prior to joining the GO3 project, my students were unaware of air pollution alerts, risks and causes. In the past when Pima County issued alerts to the school, they were posted on signs around the school. No explanation was provided to the students and the signs were often left up for days. This discounted the potential health effects of the situation, resulting in the alerts effectively being ignored. The GO3 project is transforming both my students and our school community. Now my students are: Performing science research Utilizing technology and increasing their skills Collaborating in a responsible manner on the global GO3 social network Communicating their work to the community Issuing their own ozone alerts to their school Advocating for actions that will improve air quality My students participation in this citizen science project is creating a more cognizant and active community in regards to air pollution.

Improving data quality across 3 sub-Saharan African countries using the Consolidated Framework for Implementation Research (CFIR): results from the African Health Initiative.

Science.gov (United States)

Gimbel, Sarah; Mwanza, Moses; Nisingizwe, Marie Paul; Michel, Cathy; Hirschhorn, Lisa

2017-12-21

High-quality data are critical to inform, monitor and manage health programs. Over the seven-year African Health Initiative of the Doris Duke Charitable Foundation, three of the five Population Health Implementation and Training (PHIT) partnership projects in Mozambique, Rwanda, and Zambia introduced strategies to improve the quality and evaluation of routinely-collected data at the primary health care level, and stimulate its use in evidence-based decision-making. Using the Consolidated Framework for Implementation Research (CFIR) as a guide, this paper: 1) describes and categorizes data quality assessment and improvement activities of the projects, and 2) identifies core intervention components and implementation strategy adaptations introduced to improve data quality in each setting. The CFIR was adapted through a qualitative theme reduction process involving discussions with key informants from each project, who identified two domains and ten constructs most relevant to the study aim of describing and comparing each country's data quality assessment approach and implementation process. Data were collected on each project's data quality improvement strategies, activities implemented, and results via a semi-structured questionnaire with closed and open-ended items administered to health management information systems leads in each country, with complementary data abstraction from project reports. Across the three projects, intervention components that aligned with user priorities and government systems were perceived to be relatively advantageous, and more readily adapted and adopted. Activities that both assessed and improved data quality (including data quality assessments, mentorship and supportive supervision, establishment and/or strengthening of electronic medical record systems), received higher ranking scores from respondents. Our findings suggest that, at a minimum, successful data quality improvement efforts should include routine audits linked to

Performance excellence: using Lean Six Sigma tools to improve the US Army behavioral health surveillance process, boost team morale, and maximize value to customers and stakeholders.

Science.gov (United States)

Watkins, Eren Youmans; Kemeter, Dave M; Spiess, Anita; Corrigan, Elizabeth; Kateley, Keri; Wills, John V; Mancha, Brent Edward; Nichols, Jerrica; Bell, Amy Millikan

2014-01-01

Lean Six Sigma (LSS) is a process improvement, problem-solving methodology used in business and manufacturing to improve the speed, quality, and cost of products. LSS can also be used to improve knowledge-based products integral to public health surveillance. An LSS project by the Behavioral Social Health Outcomes Program of the Army Institute of Public Health reduced the number of labor hours spent producing the routine surveillance of suicidal behavior publication. At baseline, the total number of labor hours was 448; after project completion, total labor hours were 199. Based on customer feedback, publication production was reduced from quarterly to annually. Process improvements enhanced group morale and established best practices in the form of standard operating procedures and business rules to ensure solutions are sustained. LSS project participation also fostered a change in the conceptualization of tasks and projects. These results demonstrate that LSS can be used to inform the public health process and should be considered a viable method of improving knowledge-based products and processes.

Implementation of municipal health promoting projects in primary schools: teachers perspective

DEFF Research Database (Denmark)

Nordin, Lone Lindegard

2013-01-01

. The project is funded by the Danish Ministry of Science, University of Aarhus and Silkeborg municipality, and involves 5 primary schools, 23 teachers and 233 pupils from 7th to 9 class. The project is positioned within the critical approach to school health education and health promotion, developed......Implementation of municipally health promoting projects' in primary schools: teachers perspective Research question This paper discusses the findings from a qualitative research, that aimed to investigate how teachers in primary schools implemented municipal health promoting projects focusing...... that there is a “gap” between policy and practice according to aim, content and methods, and that teachers practice can be explained as coping mechanism. The key findings include: • Teachers practice is closer to traditional health education than critical health education. • Teachers priorities the mandatory teaching...

Establishing a portfolio of quality-improvement projects in pediatric surgery through advanced improvement leadership systems.

Science.gov (United States)

Gerrein, Betsy T; Williams, Christina E; Von Allmen, Daniel

2013-01-01

Formal quality-improvement (QI) projects require that participants are educated in QI methods to provide them with the capability to carry out successful, meaningful work. However, orchestrating a portfolio of projects that addresses the strategic mission of the institution requires an extension of basic QI training to provide the division or business unit with the capacity to successfully develop and manage the portfolio. Advanced Improvement Leadership Systems is a program to help units create a meaningful portfolio. This program, used by the Division of Pediatric General and Thoracic Surgery at Cincinnati Children's Hospital Medical Center, helped establish a portfolio of targeted QI projects designed to achieve outstanding outcomes at competitive costs in multiple clinical areas aligned with the institution's strategic goals (improve disease-based outcomes, patient safety, flow, and patient and family experience). These objectives are addressed in an institutional strategic plan built around 5 core areas: Safety, Productivity, Care Coordination and Outcomes, Patient and Family Experience, and Value. By combining the portfolio of QI projects with improvements in the divisional infrastructure, effective improvement efforts were realized throughout the division. In the 9 months following the program, divisional capability resulted in a 16.5% increase (5.7% to 22.2%) of formally trained staff working on 10 QI teams. Concurrently, a leadership team, designed to coordinate projects, remove barriers, and provide technical support, provided the capacity to pursue this ongoing effort. The Advanced Improvement Leadership Systems program increased the Division's efficiency and effectiveness in pursing the QI mission that is integral at our hospital.

Establishing a Portfolio of Quality-Improvement Projects in Pediatric Surgery through Advanced Improvement Leadership Systems

Science.gov (United States)

Gerrein, Betsy T; Williams, Christina E; von Allmen, Daniel

2013-01-01

Formal quality-improvement (QI) projects require that participants are educated in QI methods to provide them with the capability to carry out successful, meaningful work. However, orchestrating a portfolio of projects that addresses the strategic mission of the institution requires an extension of basic QI training to provide the division or business unit with the capacity to successfully develop and manage the portfolio. Advanced Improvement Leadership Systems is a program to help units create a meaningful portfolio. This program, used by the Division of Pediatric General and Thoracic Surgery at Cincinnati Children’s Hospital Medical Center, helped establish a portfolio of targeted QI projects designed to achieve outstanding outcomes at competitive costs in multiple clinical areas aligned with the institution’s strategic goals (improve disease-based outcomes, patient safety, flow, and patient and family experience). These objectives are addressed in an institutional strategic plan built around 5 core areas: Safety, Productivity, Care Coordination and Outcomes, Patient and Family Experience, and Value. By combining the portfolio of QI projects with improvements in the divisional infrastructure, effective improvement efforts were realized throughout the division. In the 9 months following the program, divisional capability resulted in a 16.5% increase (5.7% to 22.2%) of formally trained staff working on 10 QI teams. Concurrently, a leadership team, designed to coordinate projects, remove barriers, and provide technical support, provided the capacity to pursue this ongoing effort. The Advanced Improvement Leadership Systems program increased the Division’s efficiency and effectiveness in pursing the QI mission that is integral at our hospital. PMID:24361020

Poster project to emphasize public health in the pharmacy curriculum.

Science.gov (United States)

Kelsch, Michael P; Werremeyer, Amy B

2011-02-10

To implement and assess a required public health poster project in a doctor of pharmacy (PharmD) program. Third-year PharmD students collaborated in pairs to research a public health topic relating to pharmacy practice. Each student group prepared an informational poster, while receiving feedback from a faculty mentor at each stage of the project. The students presented their completed posters at a statewide pharmacy conference. Faculty members evaluated the posters with a grading rubric, and students completed a survey instrument that assessed the overall experience. In general, faculty members rated the class highly across all domains of the grading rubric. The class generally agreed that the poster project increased their awareness of public health issues related to pharmacy practice, overall knowledge of public health, and presentation skills. The implementation of a poster project was well received by students and faculty members as an effective method for enhancing public health instruction in the PharmD program at North Dakota State University.

Interstate Electrification Improvement Project

Energy Technology Data Exchange (ETDEWEB)

Puckette, Margaret [Shorepower Technologies, Hillsboro, OR (United States); Kim, Jeff [Shorepower Technologies, Hillsboro, OR (United States)

2015-07-01

The Interstate Electrification Improvement Project, publicly known as the Shorepower Truck Electrification Project (STEP), started in May 2011 and ended in March 2015. The project grant was awarded by the Department of Energy’s Vehicles Technology Office in the amount of $22.2 million. It had three overarching missions: 1. Reduce the idling of Class 8 tractors when parked at truck stops, to reduce diesel fuel consumption and thus U.S. dependence on foreign petroleum; 2. Stimulate job creation and economic activity as part of the American Reinvestment and Recovery Act of 2009; 3. Reduce greenhouse gas emissions (GHG) from diesel combustion and the carbon footprint of the truck transportation industry. The project design was straightforward. First, build fifty Truck Stop Electrification (TSE) facilities in truck stop parking lots across the country so trucks could plug-in to 110V, 220V, or 480VAC, and shut down the engine instead of idling. These facilities were strategically located at fifty truck stops along major U.S. Interstates with heavy truck traffic. Approximately 1,350 connection points were installed, including 150 high-voltage electric standby Transport Refrigeration Unit (eTRU) plugs--eTRUs are capable of plugging in to shore power1 to cool the refrigerated trailer for loads such as produce, meats and ice cream. Second, the project provided financial incentives on idle reduction equipment to 5,000 trucks in the form of rebates, to install equipment compatible with shore power. This equipment enables drivers to shut down the main engine when parked, to heat or cool their cab, charge batteries, or use other household appliances without idling—a common practice that uses approximately 1 gallon of diesel per hour. The rebate recipients were intended to be the first fleets to plug into Shorepower to save diesel fuel and ensure there is significant population of shore power capable trucks. This two part project was designed to complement each other by

Summary of EPRI projects for improving power plant maintenance and maintainability

International Nuclear Information System (INIS)

Shugars, H.G.; Poole, D.N.; Pack, R.W.

1979-01-01

The Electric Power Research Institute is sponsoring projects to improve power plant maintenance and maintainability. Areas presently being emphasized are improvements in plant design for maintainability, improvements in performing nuclear plant refuelings, and development of on-line monitoring and diagnostic systems for various plant components. The seven projects are reviewed. They are: (1) human factors review of power plant maintainability; (2) refueling outage improvement; (3) on-line monitoring and diagnostics for power plant machinery; (4) acoustic emission and vibrati1on signature analysis of fossil fuel plant components; (5) acoustic monitoring of power plant valves; (6) on-line monitoring and diagnostics for generators; and (7) detection of water induction in steam turbines. Each project contractor and the project manager are listed for reference. 8 references

"Sitting in different chairs:" roles of the community health workers in the Poder es Salud/Power for Health Project.

Science.gov (United States)

Farquhar, S A; Wiggins, N; Michael, Y L; Luhr, G; Jordan, J; Lopez, A

2008-07-01

Evaluations of Community Health Worker programs consistently document improvements in health, yet few articles clearly describe the roles of Community Health Workers (CHWs) from the CHWs' perspective. This article presents the CHWs' points of view regarding the various roles they played in a community-based participatory research (CBPR) project, Poder es Salud/Power for Health in Portland, Oregon, including their roles as community organizers and co-researchers. Authors draw from an analysis of transcript data from in-depth interviews conducted with CHWs to present a description of the strategies employed by the CHWs to build leadership skills and knowledge among community members. CHWs also discuss their own personal and professional development. The analysis of the interviews suggests that CHWs valued their multiple roles with Poder es Salud/Power for Health and their participation on the project's Steering Committee. Based on CHWs' descriptions of their work, this type of involvement appears to build the CHWs' leadership skills and sense of efficacy to create change in their communities. By serving as community organizers and participating as producers of research, rather than acting merely as a deliverer of the intervention activities, the CHWs were able to build skills that make them more successful as CHWs.

Improving Project Management Using Formal Models and Architectures

Science.gov (United States)

Kahn, Theodore; Sturken, Ian

2011-01-01

This talk discusses the advantages formal modeling and architecture brings to project management. These emerging technologies have both great potential and challenges for improving information available for decision-making. The presentation covers standards, tools and cultural issues needing consideration, and includes lessons learned from projects the presenters have worked on.

A developmental evaluation to enhance stakeholder engagement in a wide-scale interactive project disseminating quality improvement data: study protocol for a mixed-methods study.

Science.gov (United States)

Laycock, Alison; Bailie, Jodie; Matthews, Veronica; Cunningham, Frances; Harvey, Gillian; Percival, Nikki; Bailie, Ross

2017-07-13

Bringing together continuous quality improvement (CQI) data from multiple health services offers opportunities to identify common improvement priorities and to develop interventions at various system levels to achieve large-scale improvement in care. An important principle of CQI is practitioner participation in interpreting data and planning evidence-based change. This study will contribute knowledge about engaging diverse stakeholders in collaborative and theoretically informed processes to identify and address priority evidence-practice gaps in care delivery. This paper describes a developmental evaluation to support and refine a novel interactive dissemination project using aggregated CQI data from Aboriginal and Torres Strait Islander primary healthcare centres in Australia. The project aims to effect multilevel system improvement in Aboriginal and Torres Strait Islander primary healthcare. Data will be gathered using document analysis, online surveys, interviews with participants and iterative analytical processes with the research team. These methods will enable real-time feedback to guide refinements to the design, reports, tools and processes as the interactive dissemination project is implemented. Qualitative data from interviews and surveys will be analysed and interpreted to provide in-depth understanding of factors that influence engagement and stakeholder perspectives about use of the aggregated data and generated improvement strategies. Sources of data will be triangulated to build up a comprehensive, contextualised perspective and integrated understanding of the project's development, implementation and findings. The Human Research Ethics Committee (HREC) of the Northern Territory Department of Health and Menzies School of Health Research (Project 2015-2329), the Central Australian HREC (Project 15-288) and the Charles Darwin University HREC (Project H15030) approved the study. Dissemination will include articles in peer-reviewed journals, policy

Using implementation tools to design and conduct quality improvement projects for faster and more effective improvement.

Science.gov (United States)

Ovretveit, John; Mittman, Brian; Rubenstein, Lisa; Ganz, David A

2017-10-09

Purpose The purpose of this paper is to enable improvers to use recent knowledge from implementation science to carry out improvement changes more effectively. It also highlights the importance of converting research findings into practical tools and guidance for improvers so as to make research easier to apply in practice. Design/methodology/approach This study provides an illustration of how a quality improvement (QI) team project can make use of recent findings from implementation research so as to make their improvement changes more effective and sustainable. The guidance is based on a review and synthesis of improvement and implementation methods. Findings The paper illustrates how research can help a quality project team in the phases of problem definition and preparation, in design and planning, in implementation, and in sustaining and spreading a QI. Examples of the use of different ideas and methods are cited where they exist. Research limitations/implications The example is illustrative and there is little limited experimental evidence of whether using all the steps and tools in the one approach proposed do enable a quality team to be more effective. Evidence supporting individual guidance proposals is cited where it exists. Practical implications If the steps proposed and illustrated in the paper were followed, it is possible that quality projects could avoid waste by ensuring the conditions they need for success are in place, and sustain and spread improvement changes more effectively. Social implications More patients could benefit more quickly from more effective implementation of proven interventions. Originality/value The paper is the first to describe how improvement and implementation science can be combined in a tangible way that practical improvers can use in their projects. It shows how QI project teams can take advantage of recent advances in improvement and implementation science to make their work more effective and sustainable.

The Current and Projected Taxpayer Shares of US Health Costs.

Science.gov (United States)

Himmelstein, David U; Woolhandler, Steffie

2016-03-01

We estimated taxpayers' current and projected share of US health expenditures, including government payments for public employees' health benefits as well as tax subsidies to private health spending. We tabulated official Centers for Medicare and Medicaid Services figures on direct government spending for health programs and public employees' health benefits for 2013, and projected figures through 2024. We calculated the value of tax subsidies for private spending from official federal budget documents and figures for state and local tax collections. Tax-funded health expenditures totaled $1.877 trillion in 2013 and are projected to increase to $3.642 trillion in 2024. Government's share of overall health spending was 64.3% of national health expenditures in 2013 and will rise to 67.1% in 2024. Government health expenditures in the United States account for a larger share of gross domestic product (11.2% in 2013) than do total health expenditures in any other nation. Contrary to public perceptions and official Centers for Medicare and Medicaid Services estimates, government funds most health care in the United States. Appreciation of government's predominant role in health funding might encourage more appropriate and equitable targeting of health expenditures.

Strengthening government health and family planning programs: findings from an action research project in rural Bangladesh.

Science.gov (United States)

Simmons, R; Phillips, J F; Rahman, M

1984-01-01

An ongoing study at the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) is based on the premise that public sector health and family planning programs can be improved through an assessment of the dysfunctional aspects of their operations, the development of problem-solving capabilities, and the transfer of strategies successfully tested in a small-scale pilot project. This paper reports findings from a field trial implemented in a subunit of the project area at an early stage of the project. Operational barriers to public sector program implementation are discussed with regard to the quantity of work, the quality of work, supplies and facilities, integration of health and family planning, and leadership, supervision, and decision making. Initial results of the ICDDR,B intervention on these managerial processes are also indicated.

Improving immunization delivery using an electronic health record: the ImmProve project.

Science.gov (United States)

Bundy, David G; Persing, Nichole M; Solomon, Barry S; King, Tracy M; Murakami, Peter N; Thompson, Richard E; Engineer, Lilly D; Lehmann, Christoph U; Miller, Marlene R

2013-01-01

Though an essential pediatric preventive service, immunizations are challenging to deliver reliably. Our objective was to measure the impact on pediatric immunization rates of providing clinicians with electronic health record-derived immunization prompting. Operating in a large, urban, hospital-based pediatric primary care clinic, we evaluated 2 interventions to improve immunization delivery to children ages 2, 6, and 13 years: point-of-care, patient-specific electronic clinical decision support (CDS) when children overdue for immunizations presented for care, and provider-specific bulletins listing children overdue for immunizations. Overall, the proportion of children up to date for a composite of recommended immunizations at ages 2, 6, and 13 years was not different in the intervention (CDS active) and historical control (CDS not active) periods; historical immunization rates were high. The proportion of children receiving 2 doses of hepatitis A immunization before their second birthday was significantly improved during the intervention period. Human papillomavirus (HPV) immunization delivery was low during both control and intervention periods and was unchanged for 13-year-olds. For 14-year-olds, however, 4 of the 5 highest quarterly rates of complete HPV immunization occurred in the final year of the intervention. Provider-specific bulletins listing children overdue for immunizations increased the likelihood of identified children receiving catch-up hepatitis A immunizations (hazard ratio 1.32; 95% confidence interval 1.12-1.56); results for HPV and the composite of recommended immunizations were of a similar magnitude but not statistically significant. In our patient population, with high baseline uptake of recommended immunizations, electronic health record-derived immunization prompting had a limited effect on immunization delivery. Benefit was more clearly demonstrated for newer immunizations with lower baseline uptake. Copyright © 2013 Academic

Improving food and agricultural production. Thailand. Project findings and recommendations

International Nuclear Information System (INIS)

1992-01-01

This document is the terminal report of a United Nations Development Program project to improve food and agricultural production in Thailand by means of nuclear and related technology. The project resulted in improved mutant material to be made available to plant breeders as well as in reports and recommendations on soil-water-plant management practices and livestock management. An additional benefit has been the specialized training that has been provided to many researchers in the country through the project

Health information systems to improve health care: A telemedicine case study

Directory of Open Access Journals (Sweden)

Liezel Cilliers

2013-03-01

Full Text Available Background: E-health has been identified as an integral part of the future of South African public healthcare. Telemedicine was first introduced in South Africa in 1997 and since then the cost of running the Telemedicine projects has increased substantially. Despite these efforts to introduce the system, only 34% of the Telemedicine sites in South Africa are functional at present. Objectives: Literature has suggested that one of the barriers to the successful implementation of health information systems is the user acceptance by health care workers of systems such as Telemedicine. This study investigated the user acceptance of Telemedicine in the public health care system in the Eastern Cape Province, making use of the Unified Theory of the Use and Acceptance of Technology. Method: The study employed a quantitative survey approach. A questionnaire was developed making use of existing literature and was distributed to various clinics around the province where Telemedicine has been implemented. Statistics were produced making use of Statistical Package for the Social Sciences (SPSS. Results: In general, the health care workers did understand the value and benefit of health information systems to improve the effectiveness and efficiency of the health care system. The barriers to the effective implementation of a health information system include the lack of knowledge and the lack of awareness regarding the Telemedicine system. This in turn means that the user is apprehensive when making use of the system thus contributing to less frequent usage. Conclusion: Health care workers do acknowledge that information systems can help to increase the effectiveness of the health care system. In general, the acceptance of Telemedicine in the Eastern Cape Department of Health is positive, but in order to integrate it into standard work practices, more must be done with regards to the promotion and education of telemedicine.

Pay For Success And Population Health: Early Results From Eleven Projects Reveal Challenges And Promise.

Science.gov (United States)

Lantz, Paula M; Rosenbaum, Sara; Ku, Leighton; Iovan, Samantha

2016-11-01

Pay for success (PFS) is a type of social impact investing that uses private capital to finance proven prevention programs that help a government reduce public expenditures or achieve greater value. We conducted an analysis of the first eleven PFS projects in the United States to investigate the potential of PFS as a strategy for financing and disseminating interventions aimed at improving population health and health equity. The PFS approach has significant potential for bringing private-sector resources to interventions regarding social determinants of health. Nonetheless, a number of challenges remain, including structuring PFS initiatives so that optimal prevention benefits can be achieved and ensuring that PFS interventions and evaluation designs are based on rigorous research principles. In addition, increased policy attention regarding key PFS payout issues is needed, including the "wrong pockets" problem and legal barriers to using federal Medicaid funds as an investor payout source. Project HOPE—The People-to-People Health Foundation, Inc.

Evaluation of Health Equity Impact of Structural Policies: Overview of Research Methods Used in the SOPHIE Project.

Science.gov (United States)

Kunst, Anton E

2017-07-01

This article briefly assesses the research methods that were applied in the SOPHIE project to evaluate the impact of structural policies on population health and health inequalities. The evaluation of structural policies is one of the key methodological challenges in today's public health. The experience in the SOPHIE project was that mixed methods are essential to identify, understand, and predict the health impact of structural policies. On the one hand, quantitative studies that included spatial comparisons or time trend analyses, preferably in a quasi-experimental design, showed that some structural policies were associated with improved population health and smaller health inequalities. On the other hand, qualitative studies, often inspired by realist approaches, were important to understand how these policies could have achieved the observed impact and why they would succeed in some settings but fail in others. This review ends with five recommendations for future studies that aim to evaluate, understand, and predict how health inequalities can be reduced through structural policies.

Using and interpreting mental health measures in the National Social Life, Health, and Aging Project.

Science.gov (United States)

Payne, Carolyn; Hedberg, E C; Kozloski, Michael; Dale, William; McClintock, Martha K

2014-11-01

National Social Life, Health, and Aging Project (NSHAP) included five unique mental health measures in Waves 1 and 2 that researchers can use to measure the overall emotional health of participants: depressive symptoms, happiness-unhappiness, anxiety symptoms, perceived stress, and felt loneliness. For each, we detail the rationale for its development and explain how to score, analyze, and interpret results. NSHAP developed its measures by modifying traditional short-form scales to improve response efficiency and reduce respondent burden. Scoring protocols and interpretations were developed for each measure. U.S. population estimates for older adults born between 1920 and 1947 were generated using age-eligible samples from Waves 1 and 2. NSHAP's protocols yielded U.S. prevalence rates similar to other nationally representative studies of older adults and comparable between waves. Higher estimates of anxiety symptoms and perceived stress in Wave 2 compared with Wave 1 were explained by age, administration mode, and time period. Analytic strategies for longitudinal analyses are provided. In Wave 2, mental health generally was worse at older ages, with women having more symptoms at younger ages than men. Women had fewer anxiety symptoms at the oldest ages. NSHAP's mental health measures were successfully integrated into the project's survey and showed acceptable external reliability as well as moderately stable individual characteristics across the 5 years between Waves 1 and 2. Depressive symptoms and unhappiness may form a mental health cluster in the elderly, distinct from anxiety symptoms, perceived stress, and felt loneliness. Gender differences in age-specific patterns of mental health were evident using the exact age of participants rather than the traditional decade groupings. Administration mode and time period (between 2005-2006 and 2010-2011) were determined to be potential confounds that need to be accommodated in longitudinal analyses of aging, whereas

Project (inverted exclamation mark)EXITO!: success through diversity and universality for outcomes improvement among Hispanic home care patients.

Science.gov (United States)

Woerner, Louise; Espinosa, Javier; Bourne, Susan; O'Toole, Marie; Ingersoll, Gail L

2009-01-01

The National Health Disparities Report notes that Hispanics have poorer quality of care in 23 of 38 core measures. The result of this disparity is great personal and health system costs, which could be reduced. Prior studies have focused on access and language. We studied outcomes improvement. The purpose of this project was to develop a replicable theory-based outcomes improvement model for delivery of nursing care to Hispanic patients. The Leininger Sunrise Enabler approach was used to design a program specific to the cultural needs of a home care population. Outcome and Assessment Information Set (OASIS) data from 125 unduplicated home care patients were tracked. Nursing care delivery was analyzed using ethnographic research techniques. Delivery of nursing care using a culturally congruent approach reduced acute hospitalization and emergent care visits. Medication management and customer and nursing satisfaction also improved. National standards for culturally and linguistically appropriate services in health care help reduce healthcare disparities, but improving Hispanic outcomes requires moving beyond symptoms and symptom management to transcultural care. The estimated savings to the health care system are significant.

Copenhagen infant mental health project

DEFF Research Database (Denmark)

Væver, Mette Skovgaard; Smith-Nielsen, Johanne; Lange, Theis

2016-01-01

such as physical and mental health, educational and labor market success, social network and establishing of family. Secure attachment is associated with optimal outcomes in all developmental domains in childhood, and both insecure and disorganized attachment are associated with a range of later problems......Background: Infant mental health is a significant public health issue as early adversity and exposure to early childhood stress are significant risk factors that may have detrimental long-term developmental consequences for the affected children. Negative outcomes are seen on a range of areas...... in the City of Copenhagen, Denmark. During the project a general population of an estimated 17.600 families with an infant aged 2–12 months are screened for two known infant mental health risks, maternal postnatal depression and infant social withdrawal. Eligible families (N = 314), who agree to participate...

Cell phone–based health education messaging improves health ...

African Journals Online (AJOL)

SMS), provides new and innovative opportunities for disease prevention and health education. Objective: To explore the use of cell phone–based health education SMS to improve the health literacy of community residents in China. Methods: ...

North-south collaboration and capacity development in global health research in low- and middle-income countries - the ARCADE projects.

Science.gov (United States)

Atkins, Salla; Marsden, Sophie; Diwan, Vishal; Zwarenstein, Merrick

2016-01-01

Research capacity enhancement is needed in low- and middle-income countries (LMICs) for improved health, wellbeing, and health systems' development. In this article, we discuss two capacity-building projects, the African/Asian Regional Capacity Development (ARCADE) in Health Systems and Services Research (HSSR) and Research on Social Determinants of Health (RSDH), implemented from 2011 to 2015. The two projects focussed on providing courses in HSSR and social determinants of health research, and on developing collaborations between universities, along with capacity in LMIC universities to manage research grant submissions, financing, and reporting. Both face-to-face and sustainable online teaching and learning resources were used in training at higher postgraduate levels (Masters and Doctoral level). We collated project meeting and discussion minutes along with project periodic reports and deliverables. We extracted key outcomes from these, reflected on these in discussions, and summarised them for this paper. Nearly 55 courses and modules were developed that were delivered to over 920 postgraduate students in Africa, Asia, and Europe. Junior researchers were mentored in presenting, developing, and delivering courses, and in preparing research proposals. In total, 60 collaborative funding proposals were prepared. The consortia also developed institutional capacity in research dissemination and grants management through webinars and workshops. ARCADE HSSR and ARCADE RSDH were comprehensive programmes, focussing on developing the research skills, knowledge, and capabilities of junior researchers. One of the main strengths of these programmes was the focus on network building amongst the partner institutions, where each partner brought skills, expertise, and diverse work cultures into the consortium. Through these efforts, the projects improved both the capacity of junior researchers and the research environment in Africa, Asia, and Europe.

Improving Immunization Rates Using Lean Six Sigma Processes: Alliance of Independent Academic Medical Centers National Initiative III Project.

Science.gov (United States)

Hina-Syeda, Hussaini; Kimbrough, Christina; Murdoch, William; Markova, Tsveti

2013-01-01

hospital has completed quality improvement projects in the past; however, this project was the first in which residents were actively involved. The didactic components and experiential learning were powerfully synergistic. This and similar projects can have far-reaching implications in terms of promoting patient health and improving the quality of care delivered by the healthcare systems and teaching hospitals.

The HANS KAI Project: a community-based approach to improving health and well-being through peer support

Directory of Open Access Journals (Sweden)

Alexandra Henteleff

2018-03-01

Full Text Available Introduction: HANS KAI is a unique health promotion intervention to improve participants’ health by focussing on interrelated chronic disease prevention behaviours through peer support and strengthening of social support networks. The study objective was to determine the effectiveness of HANS KAI in an urban Canadian setting. Methods: We used a mixed methods intervention research design that involved multiple sites from November 2010 to April 2015. Data was obtained from participant surveys as well as in-person interviews at zero, 6, 12 and 24 months. Participants met in groups at least once a month during the research period, to self-monitor health indicators, prepare and share a healthy snack, participate in a physical activity, set a healthy lifestyle goal (optional and socialize. Results: There were statistically significant mental health improvements from pre- to post-program, and 66% of the participants described specific behaviour changes as a result of HANS KAI participation. Additional positive health impacts included peer support; acquiring specific health knowledge; inspiration, motivation or accountability; the empowering effect of monitoring one’s own health indicators; overcoming social isolation and knowing how to better access services. Conclusion: The need to identify innovative ways to address chronic disease prevention and management has been the driver for implementing and evaluating HANS KAI. While further research will be required to validate the present findings, it appears that HANS KAI may be an effective approach to create environments that empower community members to support each other while promoting healthy lifestyle choices and detecting early changes in health status.

Improving patient care through student leadership in team quality improvement projects.

Science.gov (United States)

Tschannen, Dana; Aebersold, Michelle; Kocan, Mary Jo; Lundy, Francene; Potempa, Kathleen

2015-01-01

In partnership with a major medical center, senior-level nursing students completed a root cause analysis and implementation plan to address a unit-specific quality issue. To evaluate the project, unit leaders were asked their perceptions of the value of the projects and impact on patient care, as well as to provide exemplars depicting how the student root cause analysis work resulted in improved patient outcome and/or unit processes. Liaisons noted benefits of having an RCA team, with positive impact on patient outcomes and care processes.

A quality improvement project using statistical process control methods for type 2 diabetes control in a resource-limited setting.

Science.gov (United States)

Flood, David; Douglas, Kate; Goldberg, Vera; Martinez, Boris; Garcia, Pablo; Arbour, MaryCatherine; Rohloff, Peter

2017-08-01

Quality improvement (QI) is a key strategy for improving diabetes care in low- and middle-income countries (LMICs). This study reports on a diabetes QI project in rural Guatemala whose primary aim was to improve glycemic control of a panel of adult diabetes patients. Formative research suggested multiple areas for programmatic improvement in ambulatory diabetes care. This project utilized the Model for Improvement and Agile Global Health, our organization's complementary healthcare implementation framework. A bundle of improvement activities were implemented at the home, clinic and institutional level. Control charts of mean hemoglobin A1C (HbA1C) and proportion of patients meeting target HbA1C showed improvement as special cause variation was identified 3 months after the intervention began. Control charts for secondary process measures offered insights into the value of different components of the intervention. Intensity of home-based diabetes education emerged as an important driver of panel glycemic control. Diabetes QI work is feasible in resource-limited settings in LMICs and can improve glycemic control. Statistical process control charts are a promising methodology for use with panels or registries of diabetes patients. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Modeled effects of an improved building insulation scenario in Europe on air pollution, health and societal costs

DEFF Research Database (Denmark)

Bønløkke, Jakob Hjort; Holst, Gitte Juel; Sigsgaard, Torben

2015-01-01

scenario in Europe would have substantial benefits on health through improvements in air pollution. Health effects and societal cost savings may significantly counterbalance investment costs and should be taken into account when evaluating strategies for mitigation of global warming....... with extensions. Mean annual changes in the main air pollutants were derived for each country. World Health Organization (WHO) and European Union (EU) data on populations and on impacts of pollutants were used to derive health effects and costs. Effects on indoor air quality were not assessed. Results: Projected...... 78678 LY in Europe. A total of 7173 cases of persistent chronic bronchitis could be avoided annually. Several other health outcomes improved similarly. The saved societal costs totaled 6.64 billion € annually. Conclusions: In addition to carbon emission reductions, an improved building insulation...

Participatory science and innovation for improved sanitation and hygiene: process and outcome evaluation of project SHINE, a school-based intervention in Rural Tanzania

Directory of Open Access Journals (Sweden)

Erin Hetherington

2017-02-01

Full Text Available Abstract Background Diarrheal disease is a major cause of mortality and morbidity in low and middle income countries with children being disproportionately affected. Project SHINE (Sanitation & Hygiene INnovation in Education is a grassroots participatory science education and social entrepreneurship model to engage youth and the wider community in the development of sustainable strategies to improve sanitation and hygiene. Methods Based in rural and remote Tanzania, this pilot study engaged pastoralist high-school students and communities in the development and evaluation of culturally and contextually relevant strategies to improve sanitation and hygiene. Using a train-the-trainer approach, key activities included teacher workshops, school-based lessons, extra-curricular activities, community events and a One Health sanitation science fair which showcased projects related to water, sanitation and hygiene in relation to human and animal health. The process and outcome of the study were evaluated through qualitative interviews and focus group discussions with diverse project participants, as well as pre- and post- questionnaires completed by students on knowledge, attitudes and practices concerning sanitation and hygiene. Results The questionnaire results at baseline and follow-up showed statistically significant improvements on key measures including a decrease in unhygienic behaviors, an increase in the perceived importance of handwashing and intention to use the toilet, and increased communication in the social network about the importance of clean water and improved sanitation and hygiene practices, however there were no significant changes in sanitation related knowledge. Qualitative data highlighted strong leadership emerging from youth and enthusiasm from teachers and students concerning the overall approach in the project, including the use of participatory methods. There was a high degree of community engagement with hundreds of

Participatory science and innovation for improved sanitation and hygiene: process and outcome evaluation of project SHINE, a school-based intervention in Rural Tanzania.

Science.gov (United States)

Hetherington, Erin; Eggers, Matthijs; Wamoyi, Joyce; Hatfield, Jennifer; Manyama, Mange; Kutz, Susan; Bastien, Sheri

2017-02-07

Diarrheal disease is a major cause of mortality and morbidity in low and middle income countries with children being disproportionately affected. Project SHINE (Sanitation & Hygiene INnovation in Education) is a grassroots participatory science education and social entrepreneurship model to engage youth and the wider community in the development of sustainable strategies to improve sanitation and hygiene. Based in rural and remote Tanzania, this pilot study engaged pastoralist high-school students and communities in the development and evaluation of culturally and contextually relevant strategies to improve sanitation and hygiene. Using a train-the-trainer approach, key activities included teacher workshops, school-based lessons, extra-curricular activities, community events and a One Health sanitation science fair which showcased projects related to water, sanitation and hygiene in relation to human and animal health. The process and outcome of the study were evaluated through qualitative interviews and focus group discussions with diverse project participants, as well as pre- and post- questionnaires completed by students on knowledge, attitudes and practices concerning sanitation and hygiene. The questionnaire results at baseline and follow-up showed statistically significant improvements on key measures including a decrease in unhygienic behaviors, an increase in the perceived importance of handwashing and intention to use the toilet, and increased communication in the social network about the importance of clean water and improved sanitation and hygiene practices, however there were no significant changes in sanitation related knowledge. Qualitative data highlighted strong leadership emerging from youth and enthusiasm from teachers and students concerning the overall approach in the project, including the use of participatory methods. There was a high degree of community engagement with hundreds of community members participating in school-based events

Can model weighting improve probabilistic projections of climate change?

Energy Technology Data Exchange (ETDEWEB)

Raeisaenen, Jouni; Ylhaeisi, Jussi S. [Department of Physics, P.O. Box 48, University of Helsinki (Finland)

2012-10-15

Recently, Raeisaenen and co-authors proposed a weighting scheme in which the relationship between observable climate and climate change within a multi-model ensemble determines to what extent agreement with observations affects model weights in climate change projection. Within the Third Coupled Model Intercomparison Project (CMIP3) dataset, this scheme slightly improved the cross-validated accuracy of deterministic projections of temperature change. Here the same scheme is applied to probabilistic temperature change projection, under the strong limiting assumption that the CMIP3 ensemble spans the actual modeling uncertainty. Cross-validation suggests that probabilistic temperature change projections may also be improved by this weighting scheme. However, the improvement relative to uniform weighting is smaller in the tail-sensitive logarithmic score than in the continuous ranked probability score. The impact of the weighting on projection of real-world twenty-first century temperature change is modest in most parts of the world. However, in some areas mainly over the high-latitude oceans, the mean of the distribution is substantially changed and/or the distribution is considerably narrowed. The weights of individual models vary strongly with location, so that a model that receives nearly zero weight in some area may still get a large weight elsewhere. Although the details of this variation are method-specific, it suggests that the relative strengths of different models may be difficult to harness by weighting schemes that use spatially uniform model weights. (orig.)

The safe home project.

Science.gov (United States)

Arphorn, Sara; Jiraniratisai, Sopaphan; Rungtakul, Rungsri; Phutta, Nikom

2011-12-01

The Thai Health Promotion Foundation supported the Improvement of Quality of Life of Informal Workers project in Ban Luang District, Amphur Photaram, Ratchaburi Province. There were many informal workers in Ban Luang District. Sweet-crispy fish producers in Ban Luang were the largest group among the sweet-crispy fish producers in Thailand. This project was aimed at improving living and working conditions of informal workers, with a focus on the sweet-crispy fish group. Good practices of improved living and working conditions were used to help informal workers build safe, healthy and productive work environments. These informal workers often worked in substandard conditions and were exposed to various hazards in the working area. These hazards included risk of exposure to hot work environment, ergonomics-related injuries, chemical hazards, electrical hazards etc. Ergonomics problems were commonly in the sweet-crispy fish group. Unnatural postures such as prolonged sitting were performed dominantly. One hundred and fifty informal workers participated in this project. Occupational health volunteers were selected to encourage occupational health and safety in four groups of informal workers in 2009. The occupational health volunteers trained in 2008 were farmers, beauty salon workers and doll makers. The occupational health and safety knowledge is extended to a new informal worker group: sweet-crispy fish producer, in 2009. The occupational health and safety training for sweet-crispy fish group is conducted by occupational health volunteers. The occupational health volunteers increased their skills and knowledge assist in to make safe home and safe community through participatory oriented training. The improvement of living and working condition is conducted by using a modified WISH, Work Improvement for Safe Home, checklist. The plans of improvement were recorded. The informal workers showed improvement mostly on material handling and storage. The safe uses and safe

Environmental handling in the Japan: Project of improvement of lands

International Nuclear Information System (INIS)

Tascon Carvajal, R.

1993-01-01

Some administrative aspects, politicians and strategies are described continued by the Japan to protect the environment in the agrarian sector. It is analyzed the project of improvement of lands, their objectives and functions and the operative mark inside which is unwrapped, their procedures for the implementation as sampling and planning, definitive design and construction. Equally the projects of improvement of lands of reduced reach are discussed, in what concerns to irrigation and drainage, consolidation of lands, prevention of disasters and development of the community. The perspectives of the projects of development of lands of long reach are mentioned inside a general strategy of productivity, sustainability, justness and improvement of the level of life

Gender Policies and Gender Inequalities in Health in Europe: Results of the SOPHIE Project.

Science.gov (United States)

Palència, Laia; De Moortel, Deborah; Artazcoz, Lucía; Salvador-Piedrafita, María; Puig-Barrachina, Vanessa; Hagqvist, Emma; Pérez, Glòria; Ruiz, Marisol E; Trujillo-Alemán, Sara; Vanroelen, Christophe; Malmusi, Davide; Borrell, Carme

2017-01-01

The aim of this article is to explain the results of the SOPHIE project regarding the effect of gender policies on gender inequalities in health in Europe. We start with the results of a systematic review on how gender regimes and gender equality policies at the country level impact women's health and gender inequalities in health. Then, we report on three empirical analyses on the relationship between different family policy models existing in Europe and gender inequalities in health. Finally we present four case studies on specific examples of gender policies or determinants of gender inequalities in health. The results show that policies that support women's participation in the labor force and decrease their burden of care, such as public services and support for families and entitlements for fathers, are related to lower levels of gender inequality in terms of health. In addition, public services and benefits for disabled and dependent people can reduce the burden placed on family caregivers and hence improve their health. In the context of the current economic crisis, gender equality policies should be maintained or improved. © The Author(s) 2016.

How to improve eHealth interventions in Health Psychology and Behavioral Medicine

NARCIS (Netherlands)

van Gemert-Pijnen, Julia E.W.C.; Kulyk, Olga Anatoliyivna; Wentzel, M.J.; Sieverink, Floor; Beerlage-de Jong, Nienke; Kelders, Saskia Marion

2014-01-01

Introduction: eHealth is gaining more and more ground in health psychology and behavioural medicine to support wellbeing, a healthier lifestyle or adherence to medications. Despite the large number of eHealth projects to date, the actual use of eHealth interventions is lower than expected. Many

Implementation of occupational health service improvements through application of total quality management processes.

Science.gov (United States)

Thomas, Elizabeth Anne

2011-06-01

The occupational health services department for a manufacturing division of a high-technology firm was redesigned from an outsourced model, in which most services were provided by an outside clinic vendor, to an in-house service model, in which services were provided by an on-site nurse practitioner. The redesign and implementation, accomplished by a cross-functional team using Total Quality Management processes, resulted in a comprehensive occupational health services department that realized significant cost reduction, increased compliance with regulatory and company requirements, and improved employee satisfaction. Implications of this project for occupational health nurses are discussed.

Reducing Health Disparities and Improving Health Equity in Saint Lucia

Directory of Open Access Journals (Sweden)

Kisha Holden

2015-12-01

Full Text Available St. Lucia is an island nation in the Eastern Caribbean, with a population of 179,000 people, where chronic health conditions, such as hypertension and diabetes, are significant. The purpose of this pilot study is to create a model for community health education, tracking, and monitoring of these health conditions, research training, and policy interventions in St. Lucia, which may apply to other Caribbean populations, including those in the U.S. This paper reports on phase one of the study, which utilized a mixed method analytic approach. Adult clients at risk for, or diagnosed with, diabetes (n = 157, and health care providers/clinic administrators (n = 42, were recruited from five healthcare facilities in St. Lucia to assess their views on health status, health services, and improving health equity. Preliminary content analyses indicated that patients and providers acknowledge the relatively high prevalence of diabetes and other chronic illnesses, recognize the impact that socioeconomic status has on health outcomes, and desire improved access to healthcare and improvements to healthcare infrastructures. These findings could inform strategies, such as community education and workforce development, which may help improve health outcomes among St. Lucians with chronic health conditions, and inform similar efforts among other selected populations.

Reducing Health Disparities and Improving Health Equity in Saint Lucia.

Science.gov (United States)

Holden, Kisha; Charles, Lisa; King, Stephen; McGregor, Brian; Satcher, David; Belton, Allyson

2015-12-22

St. Lucia is an island nation in the Eastern Caribbean, with a population of 179,000 people, where chronic health conditions, such as hypertension and diabetes, are significant. The purpose of this pilot study is to create a model for community health education, tracking, and monitoring of these health conditions, research training, and policy interventions in St. Lucia, which may apply to other Caribbean populations, including those in the U.S. This paper reports on phase one of the study, which utilized a mixed method analytic approach. Adult clients at risk for, or diagnosed with, diabetes (n = 157), and health care providers/clinic administrators (n = 42), were recruited from five healthcare facilities in St. Lucia to assess their views on health status, health services, and improving health equity. Preliminary content analyses indicated that patients and providers acknowledge the relatively high prevalence of diabetes and other chronic illnesses, recognize the impact that socioeconomic status has on health outcomes, and desire improved access to healthcare and improvements to healthcare infrastructures. These findings could inform strategies, such as community education and workforce development, which may help improve health outcomes among St. Lucians with chronic health conditions, and inform similar efforts among other selected populations.

Health Activities Project (HAP): Breathing Fitness Module.

Science.gov (United States)

Buller, Dave; And Others

Contained within this Health Activities Project (HAP) learning packet are activities for children in grades 5-8. Design of the activities centers around the idea that students can control their own health and safety. Within this module are teacher and student folios describing four activities which involve students in learning how to measure their…

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.

SNF project engineering process improvement plan

International Nuclear Information System (INIS)

DESAI, S.P.

1999-01-01

This Engineering Process Improvement Plan documents the activities and plans to be taken by the SNF Project to support its engineering process and to produce a consolidated set of engineering procedures that are fully compliant with the requirements of HNF-PRO-1819. All new procedures will be issued and implemented by September 30, 1999

Education projects: an opportunity for student fieldwork in global health academic programs.

Science.gov (United States)

Fyfe, Molly V

2012-01-01

Universities, especially in higher-income countries, increasingly offer programs in global health. These programs provide different types of fieldwork projects, at home and abroad, including: epidemiological research, community health, and clinical electives. I illustrate how and why education projects offer distinct learning opportunities for global health program fieldwork. As University of California students, we partnered in Tanzania with students from Muhimbili University of Health and Allied Science (MUHAS) to assist MUHAS faculty with a curricular project. We attended classes, clinical rounds, and community outreach sessions together, where we observed teaching, materials used, and the learning environment; and interviewed and gathered data from current students, alumni, and health professionals during a nationwide survey. We learned together about education of health professionals and health systems in our respective institutions. On the basis of this experience, I suggest some factors that contribute to the productivity of educational projects as global health fieldwork.

[Evaluation of the effect of the health education intervention project "Healthy School"].

Science.gov (United States)

Zivković, M; Bjegović, V; Vuković, D; Marinković, J

1998-01-01

Contemporary health-education intervention programs are increasingly used as a tool for improving health of school children [1-4]. Since 1992 a Network of 13 elementary Health Promoting Schools established in Yugoslavia (though not yet admitted to the European Network) has been operational. The Project was approved by the Ministries of Health, Education and Ecology from the very beginning, and financially supported by the Government of Serbia since 1995. The team of up to 40 health professionals, school principals and school project managers worked together for four years to change the working conditions in schools knowledge, attitudes and behaviour of school children and staff in order to improve their health [5]. The goal of this paper is to present results of health education intervention in changing of hygienic conditions in schools, as well as some of the attitudes, behaviour and knowledge of pupils and their parents. The study took place before and after the intervention--at two points in time--during 1993 and 1996. The tri-angular approach including (1) pupils, (2) schools (teachers, school environment), and (3) parents, was used. A random pretest and post-test study design with control group (12 experimental and two control schools) has been implemented. The multiphase cluster sample was employed in order to represent all of the country typical regions. Six types of especially designed questionnaires were used to provide comparable variables in the sample of pupils, their parents and teachers. Exception were 1st-graders and 4th-graders for whom information were gathered by means of a "draw-and-write" investigation technique [6]. The response rate was 88.70% before and 98.28% after intervention. Data were analyzed by descriptive and inferential statistics using SPSS/PC software. Schools are somewhat less overcrowded, much cleaner and better maintained after the four-year intervention. Toilets are in a better condition, but there is still much more to be done

WHO Better Outcomes in Labour Difficulty (BOLD) project: innovating to improve quality of care around the time of childbirth.

Science.gov (United States)

Oladapo, Olufemi T; Souza, João Paulo; Bohren, Meghan A; Tunçalp, Özge; Vogel, Joshua P; Fawole, Bukola; Mugerwa, Kidza; Gülmezoglu, A Metin

2015-05-26

As most pregnancy-related deaths and morbidities are clustered around the time of childbirth, quality of care during this period is critical to the survival of pregnant women and their babies. Despite the wide acceptance of partograph as the central tool to optimize labour outcomes for over 40 years, its use has not successfully improved outcomes in many settings for several reasons. There are also increasing questions about the validity and applicability of its central feature - "the alert line" - to all women regardless of their labour characteristics. Apart from the known deficiencies in labour care, attempts to improve quality of care in low resource settings have also failed to address and integrate women's birth experience into quality improvement processes. It was against this background that the World Health Organization (WHO) embarked on the Better Outcomes in Labour Difficulty (BOLD) project to improve the quality of intrapartum care in low- and middle-income countries. The main goal of the BOLD project is to reduce intrapartum-related stillbirths, maternal and newborn mortalities and morbidities by addressing the critical barriers to the process of good quality intrapartum care and enhancing the connection between health systems and communities. The project seeks to achieve this goal by (1) developing an evidence-based, easy to use, labour monitoring-to-action decision-support tool (currently termed Simplified, Effective, Labour Monitoring-to-Action - SELMA); and (2) by developing innovative service prototypes/tools, co-designed with users of health services (women, their families and communities) and health providers, to promote access to respectful, dignified and emotionally supportive care for pregnant women and their companions at the time of birth ("Passport to Safer Birth"). This two-pronged approach is expected to positively impact on important domains of quality of care relating to both provision and experience of care. In this paper, we briefly

Experiences from three community health promotion projects in Greenland

DEFF Research Database (Denmark)

Curtis, Tine; Olesen, Ingelise; Kjeldsen, Ann B

2005-01-01

OBJECTIVES AND METHODS: Three community health promotion projects have been implemented in Greenland in the municipalities of Upernavik, Ittoqqortoormiit and Qasigiannguit. Based on project reports and other written material, this paper describes experiences from the three projects and discusses...... with strong leadership and a central organisation, whereas the Qasigiannguit project was designed as a community project with population participation in all phases of the project. The two former projects have probably had a greater direct change impact on the community, whereas the latter has strengthened...

Evaluation of regional project to strengthen national health research systems in four countries in West Africa: lessons learned.

Science.gov (United States)

Sombié, Issiaka; Aidam, Jude; Montorzi, Gabriela

2017-07-12

Since the Commission on Health Research for Development (COHRED) published its flagship report, more attention has been focused on strengthening national health research systems (NHRS). This paper evaluates the contribution of a regional project that used a participatory approach to strengthen NHRS in four post-conflict West African countries - Guinea-Bissau, Liberia, Sierra Leone and Mali. The data from the situation analysis conducted at the start of the project was compared to data from the project's final evaluation, using a hybrid conceptual framework built around four key areas identified through the analysis of existing frameworks. The four areas are governance and management, capacities, funding, and dissemination/use of research findings. The project helped improve the countries' governance and management mechanisms without strengthening the entire NHRS. In the four countries, at least one policy, plan or research agenda was developed. One country put in place a national health research ethics committee, while all four countries could adopt a research information management system. The participatory approach and support from the West African Health Organisation and COHRED were all determining factors. The lessons learned from this project show that the fragile context of these countries requires long-term engagement and that support from a regional institution is needed to address existing challenges and successfully strengthen the entire NHRS.

[Subtainable health promotion via organisational development--a model project for teachers in professional training schools].

Science.gov (United States)

Schumacher, L; Nieskens, B; Bräuer, H; Sieland, B

2005-02-01

The goal of this project is the development, implementation and evaluation of a concept designed for sustainable health promotion among occupational and trade school teachers. We assume that for sustainable health promotion -- along with a behavioral prevention program -- a change is necessary in the structure, as well as, the working and communication processes within schools. The realization of early teacher participation and self regulated cooperative groups initiates comprehensive and goal-oriented developmental processes in the project schools. The organizational development process was accomplished in the following way: At the beginning we conducted a diagnosis of school-specific and individual health risks and the resources available to the project schools. The results were reported for both the individual and for the teacher group. This was intended to clarify the potential for improvement and, thus, strengthen the teachers' motivation toward processes of change. Following the diagnosis, the teachers chose areas of stress-related strain and then worked in groups to develop and implement behaviour and working condition-oriented intervention strategies for health promotion. The diagnosis results confirm the necessity of school-specific health promotion: the schools demonstrate very different demand and resource profiles. Furthermore, is has become evident that the central success factor for health promotion in schools is the teachers' willingness for change. The individual and group reports of the diagnosis results seem to have made clear how essential individual and organisational changes are.

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.

Improving family planning services delivery and uptake: experiences from the "Reversing the Stall in Fertility Decline in Western Kenya Project".

Science.gov (United States)

Amo-Adjei, Joshua; Mutua, Michael; Athero, Sherine; Izugbara, Chimaraoke; Ezeh, Alex

2017-10-10

In this paper, we reflect on our experiences of implementing a multipronged intervention to improve sexual and reproductive health outcomes. The project used family planning as its entry point and was implemented in two high fertility counties-Busia and Siaya in Kenya. The intervention, implemented by a seven-member consortium, involved: family planning services delivery; regular training of service providers to deliver high quality services; monitoring and evaluation; strengthening of commodity chain delivery and forecasting; school-based and out-of-school based sexuality education; and advocacy and stakeholder engagements at the community, county and national levels. Over a 5-year period, the project contributed to raising demand for family planning considerably, evidenced in fertility decline. It also improved the capacity of family planning services providers, increased commitment and awareness of county government and other community stakeholders on the importance of investments in family planning. Our collaborations with organisations interested in sexual and reproductive health issues substantially enhanced the consortium's ability to increase demand for, and supply of family planning commodities. These collaborations are proving useful in the continuity and sustainability of project achievements.

Sexual and reproductive health in Greenland: evaluation of implementing sexual peer-to-peer education in Greenland (the SexInuk project).

Science.gov (United States)

Homøe, Anne-Sophie; Knudsen, Ane-Kersti Skaarup; Nielsen, Sigrid Brisson; Grynnerup, Anna Garcia-Alix

2015-01-01

For decades, the rates of sexually transmitted infections (STIs), such as gonorrhoea, chlamydia and syphilis, have increased in Greenland, especially within the young age groups (15-29 years). From 2006 to 2013, the number of abortions has been consistent with approximately 800-900 abortions per year in Greenland, which is nearly as high as the total number of births during the same period. Previous studies in Greenland have reported that knowledge about sexual health is important, both as prevention and as facilitator to stop the increasing rates of STIs. A peer-to-peer education programme about sexual health requires adaption to cultural values and acceptance among the population and government in order to be sustainable. Formative evaluation of a voluntary project (SexInuk), in relation to peer-to-peer education with focus on sexual health. Two workshops were conducted in Nuuk, Greenland, to recruit Greenlandic students. Qualitative design with focus group interviews (FGIs) to collect qualitative feedback on feasibility and implementation of the project. Supplemented with a brief questionnaire regarding personal information (gender, age, education) and questions about the educational elements in the SexInuk project. Eight Greenlandic students, who had completed one or two workshops, were enrolled. The FGIs showed an overall consensus regarding the need for improving sexual health education in Greenland. The participants requested more voluntary educators, to secure sustainability. The articulation of taboo topics in the Greenlandic society appeared very important. The participants suggested more awareness by promoting the project. Cultural values and language directions were important elements in the FGIs. To our knowledge, voluntary work regarding peer-to-peer education and sexual health has not been structurally evaluated in Greenland before. To achieve sustainability, the project needs educators and financial support. Further research is needed to investigate

Electronic Health Record Tools to Care for At-Risk Older Drivers: A Quality Improvement Project.

Science.gov (United States)

Casey, Colleen M; Salinas, Katherine; Eckstrom, Elizabeth

2015-06-01

Evaluating driving safety of older adults is an important health topic, but primary care providers (PCP) face multiple barriers in addressing this issue. The study's objectives were to develop an electronic health record (EHR)-based Driving Clinical Support Tool, train PCPs to perform driving assessments utilizing the tool, and systematize documentation of assessment and management of driving safety issues via the tool. The intervention included development of an evidence-based Driving Clinical Support Tool within the EHR, followed by training of internal medicine providers in the tool's content and use. Pre- and postintervention provider surveys and chart review of driving-related patient visits were conducted. Surveys included self-report of preparedness and knowledge to evaluate at-risk older drivers and were analyzed using paired t-test. A chart review of driving-related office visits compared documentation pre- and postintervention including: completeness of appropriate focused history and exam, identification of deficits, patient education, and reporting to appropriate authorities when indicated. Data from 86 providers were analyzed. Pre- and postintervention surveys showed significantly increased self-assessed preparedness (p < .001) and increased driving-related knowledge (p < .001). Postintervention charts showed improved documentation of correct cognitive testing, more referrals/consults, increased patient education about community resources, and appropriate regulatory reporting when deficits were identified. Focused training and an EHR-based clinical support tool improved provider self-reported preparedness and knowledge of how to evaluate at-risk older drivers. The tool improved documentation of driving-related issues and led to improved access to interdisciplinary care coordination. Published by Oxford University Press on behalf of the Gerontological Society of America 2015.

How can innovative project delivery systems improve the overall efficiency of GDOT in transportation project delivery?

Science.gov (United States)

2013-04-01

The USDOT and Federal Highway Administration (FHWA) recommend the smart use of innovative project : delivery systems, such as design-build, to improve efficiency and effectiveness of developing transportation : projects. Although design-build provide...

Improving district level health planning and priority setting in Tanzania through implementing accountability for reasonableness framework

DEFF Research Database (Denmark)

Maluka, Stephen; Kamuzora, Peter; Sebastián, Miguel San

2010-01-01

In 2006, researchers and decision-makers launched a five-year project - Response to Accountable Priority Setting for Trust in Health Systems (REACT) - to improve planning and priority-setting through implementing the Accountability for Reasonableness framework in Mbarali District, Tanzania...

Measures to improve nuclear power project management

International Nuclear Information System (INIS)

Ma Xinchao

2012-01-01

Focusing on correct application of ability level principle in setting organizational structure, the effective management system has been established, and 8 practical management regimes have been developed. Personnel training and management work shall be well done and enhanced. Experience feedback in construction management shall be well done for all systems. Exchange of construction and management techniques shall be actively carried out. All staff shall participate in safety management. KPI system is adopted for assessing stakeholders' project management method, and PDCA cycle is adopted for continued improved. Management level upgrading measures are proposed to ensure the smooth construction of nuclear power project. Setting forth and popularizing management theory can provide reference for and promote the smooth progress of various nuclear power projects. (author)

Improving the attractiveness of CDM projects through allowing and incorporating options

International Nuclear Information System (INIS)

Carmichael, David G.; Ballouz, Joseph J.; Balatbat, Maria C.A.

2015-01-01

The paper puts forward a proposal that, within Clean Development Mechanism (CDM) projects, investors be allowed to benefit from options; this will require a CDM rule change. Through the presence of options, the downside risk resulting from low carbon prices and/or low achieved emission reductions on projects can be limited, while any upside resulting from high carbon prices and/or high achieved emission reductions can be taken advantage of. It is demonstrated that the presence of options improves the financial attractiveness of CDM projects, and this is at no detriment to any stakeholder. The flow-on from the proposal is that more CDM projects should be realisable if options are available, and this in turn will lead to reduced global emissions and improved sustainability. The proposal is supported by the necessary theory and is demonstrated on two registered CDM projects, one on hydropower and one on wind power. - Highlights: • The paper proposes that options be allowed within CDM projects. • Introducing options will require a CDM rule change. • Options improve the financial attractiveness of CDM projects. • Allowing options comes at no cost or detriment to any party. • Allowing options is a win–win situation to both society and the project proponent.

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.

Health Impact Assessment of an oil drilling project in California

Directory of Open Access Journals (Sweden)

Lindsay C. McCallum

2016-04-01

Full Text Available Objectives: The Health Impact Assessment (HIA was conducted to evaluate the potential community health implications of a proposed oil drilling and production project in Hermosa Beach, California. The HIA considered 17 determinants of health that fell under 6 major categories (i.e., air quality, water and soil quality, upset conditions, noise and light emissions, traffic, and community livability. Material and Methods: This paper attempts to address some of the gaps within the HIA practice by presenting the methodological approach and results of this transparent, comprehensive HIA; specifically, the evaluation matrix and decision-making framework that have been developed for this HIA and form the basis of the evaluation and allow for a clear conclusion to be reached in respect of any given health determinant (i.e., positive, negative, neutral. Results: There is a number of aspects of the project that may positively influence health (e.g., increased education funding, ability to enhance green space, and at the same time there have been potential negative effects identified (e.g., odor, blowouts, property values. Except for upset conditions, the negative health outcomes have been largely nuisance-related (e.g., odor, aesthetics without irreversible health impacts. The majority of the health determinants, that had been examined, have revealed that the project would have no substantial effect on the health of the community. Conclusions: Using the newly developed methodology and based on established mitigation measures and additional recommendations provided in the HIA, the authors have concluded that the project will have no substantial effect on community health. This approach and methodology will assist practitioners, stakeholders and decision-makers in advancing the HIA as a useful, reproducible, and informative tool.

Avoiding failure: tools for successful and sustainable quality-improvement projects

International Nuclear Information System (INIS)

Donnelly, Lane F.

2017-01-01

Involvement in successful and sustained quality improvement can be a very rewarding experience. However, it can be very difficult work. Up to 70% of attempted organizational change is not sustained. There are many reasons why quality-improvement projects might not be successful. In this article, the author reviews items associated with an increased or decreased likelihood of success. Such items have been categorized as structural issues, human issues and environmental context. This paper is intended to serve those embarking on quality-improvement projects as a resource to help position them for success. (orig.)

Avoiding failure: tools for successful and sustainable quality-improvement projects

Energy Technology Data Exchange (ETDEWEB)

Donnelly, Lane F. [Texas Children' s Hospital, Department of Radiology, Houston, TX (United States)

2017-06-15

Involvement in successful and sustained quality improvement can be a very rewarding experience. However, it can be very difficult work. Up to 70% of attempted organizational change is not sustained. There are many reasons why quality-improvement projects might not be successful. In this article, the author reviews items associated with an increased or decreased likelihood of success. Such items have been categorized as structural issues, human issues and environmental context. This paper is intended to serve those embarking on quality-improvement projects as a resource to help position them for success. (orig.)

Avoiding failure: tools for successful and sustainable quality-improvement projects.

Science.gov (United States)

Donnelly, Lane F

2017-06-01

Involvement in successful and sustained quality improvement can be a very rewarding experience. However, it can be very difficult work. Up to 70% of attempted organizational change is not sustained. There are many reasons why quality-improvement projects might not be successful. In this article, the author reviews items associated with an increased or decreased likelihood of success. Such items have been categorized as structural issues, human issues and environmental context. This paper is intended to serve those embarking on quality-improvement projects as a resource to help position them for success.

The TackSHS project - a collaborative H2020 project

Directory of Open Access Journals (Sweden)

Esteve Fernandez

2016-03-01

Full Text Available TackSHS is a new research project funded by the European Union’s Horizon 2020 Research and Innovation Programme. It aims to improve our understanding of second-hand tobacco smoke and e-cigarette emissions and find ways of tackling the health burden caused by exposure to them. Within a fast changing environment, the project will try to elucidate the comprehensive impact that SHS and e-cigarette aerosols have on respiratory health of the European population and how health impacts vary according to socio-economic parameters with particular emphasis on specific vulnerable groups such as patients suffering from chronic lung diseases.

Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health Outcomes.

Science.gov (United States)

McCalman, Janya; Bailie, Ross; Bainbridge, Roxanne; McPhail-Bell, Karen; Percival, Nikki; Askew, Deborah; Fagan, Ruth; Tsey, Komla

2018-01-01

Continuous quality improvement (CQI) processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10-20% of gain in health outcomes is contributed by health-care services; a much larger share is determined by social and cultural factors. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. Referring to the Aboriginal and Torres Strait Islander Australian context as an example, the authors provide a systems framework that includes strategies and conditions to facilitate evidence-based and local decision making by primary health-care services. The framework describes the integration of CQI vertically to improve linkages with governments and community members and horizontally with other sectors to influence the social and cultural determinants of health. Further, government and primary health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally.

Assessing local resources and culture before instituting quality improvement projects.

Science.gov (United States)

Hawkins, C Matthew

2014-12-01

The planning phases of quality improvement projects are commonly overlooked. Disorganized planning and implementation can escalate chaos, intensify resistance to change, and increase the likelihood of failure. Two important steps in the planning phase are (1) assessing local resources available to aid in the quality improvement project and (2) evaluating the culture in which the desired change is to be implemented. Assessing local resources includes identifying and engaging key stakeholders and evaluating if appropriate expertise is available for the scope of the project. This process also involves engaging informaticists and gathering available IT tools to plan and automate (to the extent possible) the data-gathering, analysis, and feedback steps. Culture in a department is influenced by the ability and willingness to manage resistance to change, build consensus, span boundaries between stakeholders, and become a learning organization. Allotting appropriate time to perform these preparatory steps will increase the odds of successfully performing a quality improvement project and implementing change. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Leadership for health improvement--implementation and evaluation.

Science.gov (United States)

Carr, Susan M; Carr, Sue; Lhussier, Monique; Reynolds, Joanna; Hunter, David J; Hannaway, Catherine

2009-01-01

The purpose of this paper is to present a co-authored reflection on the health improvement leadership development programme and the key evaluation messages derived from piloting in an English National Health Service region. It highlights the specific attributes of this approach to health improvement leadership development and clarifies health improvement development issues. Appreciative inquiry and soft systems methodology are combined in an evaluation approach designed to capture individual as well as organisation learning and how it impacts on leadership in specific contexts. The evaluation exposes the health improvement leadership needs of a multi-organisation cohort, offers some explanations for successful achievement of learning needs while also exposing of the challenges and paradoxes faced in this endeavour. There are limited reported templates of how to develop leadership for health improvement. This paper details a whole systems approach, acknowledging the impact of context on leadership and an approach to evaluating such complex initiatives.

The Torres Indigenous Hip Hop Project: evaluating the use of performing arts as a medium for sexual health promotion.

Science.gov (United States)

McEwan, Alexandra; Crouch, Alan; Robertson, Heather; Fagan, Patricia

2013-08-01

The Torres Indigenous Hip Hop Project (the Project) was conducted in the Torres and Northern Peninsula Area of Queensland during early 2010. This paper provides a critical analysis of project outcomes and identifies criteria that may form a suitable framework for the assessment of proposals for sexual health promotion using performing arts-based approaches in Aboriginal and Torres Strait Islander settings. A case study method was used. The first phase of analysis assessed whether project objectives were met using data collected during project planning and implementation. The second phase used these findings, augmented by interviews with key personnel, to respond to the question 'How could this be done better?'. The Project required significant human and organisational implementation support. The project was successful in facilitating event-specific community mobilisation. It raised awareness of sexual health disadvantage and engaged effectively with the target group. It laid important groundwork to progress school-based and community mechanisms to address regional youth disadvantage. Against these benefits are issues of opportunity cost and the need for ongoing resources to capitalise on the opportunities created. With substantial support and planning, such approaches can play an important role in engaging young people and bridging the gap between clinical interventions and improvements in health deriving from community-driven strategies. SO WHAT? This paper contributes to existing literature by identifying key elements of an effective approach to using performing arts in sexual health promotion in Aboriginal and Torres Strait Islander settings. It also provides guidance when consideration is being given to investment in resource-intensive health promotion initiatives.

Harnessing and blending the power of two research networks to improve prevention science and public health practice

Science.gov (United States)

Vanderpool, Robin C.; Brownson, Ross C.; Mays, Glen P.; Crosby, Richard A.; Wyatt, Stephen W.

2015-01-01

Strategic collaborations are essential in moving public health research and practice forward1, particularly in light of escalating fiscal and environmental challenges facing the public health community. This commentary provides background and context for an emerging partnership between two national networks, Prevention Research Centers (PRCs) and Public Health Practice-Based Research Networks (PBRNs), to impact public health practice. Supported by CDC, PRCs are celebrating over 25 years of transdisciplinary applied prevention research grounded in community and stakeholder engagement. Public Health PBRNs, funded by the Robert Wood Johnson Foundation, conduct innovative public health services and systems research with public health agencies and community partners to improve public health decision-making. By utilizing each of the networks’ respective strengths and resources, collaborative ventures between PRCs and Public Health PBRNs can enhance the translation of applied prevention research to evidence-based practice and empirically investigate novel public health practices developed in the field. Three current PRC-Public Health PBRNs projects are highlighted and future research directions are discussed. Improving the interconnectedness of prevention research and public health practice is essential to improve the health of the Nation. PMID:24237918

Health Impact Assessment of an oil drilling project in California.

Science.gov (United States)

McCallum, Lindsay C; Souweine, Kathleen; McDaniel, Mary; Koppe, Bart; McFarland, Christine; Butler, Katherine; Ollson, Christopher A

2016-01-01

The Health Impact Assessment (HIA) was conducted to evaluate the potential community health implications of a proposed oil drilling and production project in Hermosa Beach, California. The HIA considered 17 determinants of health that fell under 6 major categories (i.e., air quality, water and soil quality, upset conditions, noise and light emissions, traffic, and community livability). This paper attempts to address some of the gaps within the HIA practice by presenting the methodological approach and results of this transparent, comprehensive HIA; specifically, the evaluation matrix and decision-making framework that have been developed for this HIA and form the basis of the evaluation and allow for a clear conclusion to be reached in respect of any given health determinant (i.e., positive, negative, neutral). There is a number of aspects of the project that may positively influence health (e.g., increased education funding, ability to enhance green space), and at the same time there have been potential negative effects identified (e.g., odor, blowouts, property values). Except for upset conditions, the negative health outcomes have been largely nuisance-related (e.g., odor, aesthetics) without irreversible health impacts. The majority of the health determinants, that had been examined, have revealed that the project would have no substantial effect on the health of the community. Using the newly developed methodology and based on established mitigation measures and additional recommendations provided in the HIA, the authors have concluded that the project will have no substantial effect on community health. This approach and methodology will assist practitioners, stakeholders and decision-makers in advancing the HIA as a useful, reproducible, and informative tool. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Using SQUIRE 2.0 as a Guide for Planning Your Quality Improvement Project.

Science.gov (United States)

Stausmire, Julie M; Ulrich, Charla

2017-12-01

This article is the third of a 4-part quality improvement resource series for critical care nurses interested in implementing system process or performance improvement projects. Part 1 defined the differences between research and quality improvement. Part 2 discussed how nurses and managers could identify meaningful quality improvement projects that will make a real difference in their critical care unit while fitting within their time constraints and resources. Part 3 uses the recently revised Standards for Quality Improvement Reporting Excellence guidelines as a basis for designing, implementing, documenting, and publishing quality improvement projects. © 2017 American Association of Critical-Care Nurses.

Improving global health: counting reasons why.

Science.gov (United States)

Selgelid, Michael J

2008-08-01

This paper examines cumulative ethical and self-interested reasons why wealthy developed nations should be motivated to do more to improve health care in developing countries. Egalitarian and human rights reasons why wealthy nations should do more to improve global health are that doing so would (1) promote equality of opportunity (2) improve the situation of the worst-off, (3) promote respect of the human right to have one's most basic needs met, and (4) reduce undeserved inequalities in well-being. Utilitarian reasons for improving global health are that this would (5) promote the greater good of humankind, and (6) achieve enormous benefits while requiring only small sacrifices. Libertarian reasons are that this would (7) amend historical injustices and (8) meet the obligation to amend injustices that developed world countries have contributed to. Self-interested reasons why wealthy nations should do more to improve global health are that doing so would (9) reduce the threat of infectious diseases to developed countries, (10) promote developed countries' economic interests, and (11) promote global security. All of these reasons count, and together they add up to make an overwhelmingly powerful case for change. Those opposed to wealthy government funding of developing world health improvement would most likely appeal, implicitly or explicitly to the idea that coercive taxation for redistributive purposes would violate the right of an individual to keep his hard-earned income. The idea that this reason not to improve global health should outweigh the combination of rights and values embodied in the eleven reasons enumerated above, however is implausibly extreme, morally repugnant and perhaps imprudent.

Field review of fish habitat improvement projects in central Idaho

International Nuclear Information System (INIS)

Beschta, R.L.; Griffith, J.; Wesche, T.A.

1993-05-01

The goal of this field review was to provide information to the Bonneville Power Administration (BPA) regarding previous and ongoing fish habitat improvement projects in central Idaho. On July 14, 1992, the review team met at the Sawtooth National Recreation Area office near Ketchum, Idaho, for a slide presentation illustrating several habitat projects during their construction phases. Following the slide presentation, the review team inspected fish habitat projects that have been implemented in the last several years in the Stanley Basin and adjacent valleys. At each site the habitat project was described to the field team and a brief period for project inspection followed. The review team visited approximately a dozen sites on the Challis, Sawtooth, and Boise National Forests over a period of approximately two and a half days. There are two objectives of this review namely to summarize observations for specific field sites and to provide overview commentary regarding the BPA habitat improvement program in central Idaho

Building a partnership to evaluate school-linked health services: the Cincinnati School Health Demonstration Project.

Science.gov (United States)

Rose, Barbara L; Mansour, Mona; Kohake, Kelli

2005-12-01

The Cincinnati School Health Demonstration Project was a 3-year collaboration that evaluated school-linked health services in 6 urban elementary (kindergarten to eighth grade) schools. Partners from the Cincinnati Health Department, Cincinnati Public Schools, Cincinnati Children's Hospital Medical Center, and The Health Foundation of Greater Cincinnati wanted to determine if levels of school-linked care made a difference in student quality of life, school connectedness, attendance, emergency department use, and volume of referrals to health care specialists. School nurses, principals and school staff, parents and students, upper-level managers, and health service researchers worked together over a 2.5-year period to learn about and use new technology to collect information on student health, well-being, and outcome measures. Varying levels of school health care intervention models were instituted and evaluated. A standard model of care was compared with 2 models of enhanced care and service. The information collected from students, parents, nurses, and the school system provided a rich database on the health of urban children. School facilities, staffing, and computer technology, relationship building among stakeholders, extensive communication, and high student mobility were factors that influenced success and findings of the project. Funding for district-wide computerization and addition of school health staff was not secured by the end of the demonstration project; however, relationships among the partners endured and paved the way for future collaborations designed to better serve urban school children in Cincinnati.

Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health Outcomes

Directory of Open Access Journals (Sweden)

Janya McCalman

2018-03-01

Full Text Available Continuous quality improvement (CQI processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10–20% of gain in health outcomes is contributed by health-care services; a much larger share is determined by social and cultural factors. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. Referring to the Aboriginal and Torres Strait Islander Australian context as an example, the authors provide a systems framework that includes strategies and conditions to facilitate evidence-based and local decision making by primary health-care services. The framework describes the integration of CQI vertically to improve linkages with governments and community members and horizontally with other sectors to influence the social and cultural determinants of health. Further, government and primary health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally.

Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health Outcomes

Science.gov (United States)

McCalman, Janya; Bailie, Ross; Bainbridge, Roxanne; McPhail-Bell, Karen; Percival, Nikki; Askew, Deborah; Fagan, Ruth; Tsey, Komla

2018-01-01

Continuous quality improvement (CQI) processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10–20% of gain in health outcomes is contributed by health-care services; a much larger share is determined by social and cultural factors. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. Referring to the Aboriginal and Torres Strait Islander Australian context as an example, the authors provide a systems framework that includes strategies and conditions to facilitate evidence-based and local decision making by primary health-care services. The framework describes the integration of CQI vertically to improve linkages with governments and community members and horizontally with other sectors to influence the social and cultural determinants of health. Further, government and primary health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally. PMID:29623271

North–south collaboration and capacity development in global health research in low- and middle-income countries – the ARCADE projects

Directory of Open Access Journals (Sweden)

Salla Atkins

2016-10-01

Full Text Available Background: Research capacity enhancement is needed in low- and middle-income countries (LMICs for improved health, wellbeing, and health systems’ development. In this article, we discuss two capacity-building projects, the African/Asian Regional Capacity Development (ARCADE in Health Systems and Services Research (HSSR and Research on Social Determinants of Health (RSDH, implemented from 2011 to 2015. The two projects focussed on providing courses in HSSR and social determinants of health research, and on developing collaborations between universities, along with capacity in LMIC universities to manage research grant submissions, financing, and reporting. Both face-to-face and sustainable online teaching and learning resources were used in training at higher postgraduate levels (Masters and Doctoral level. Design: We collated project meeting and discussion minutes along with project periodic reports and deliverables. We extracted key outcomes from these, reflected on these in discussions, and summarised them for this paper. Results: Nearly 55 courses and modules were developed that were delivered to over 920 postgraduate students in Africa, Asia, and Europe. Junior researchers were mentored in presenting, developing, and delivering courses, and in preparing research proposals. In total, 60 collaborative funding proposals were prepared. The consortia also developed institutional capacity in research dissemination and grants management through webinars and workshops. Discussion: ARCADE HSSR and ARCADE RSDH were comprehensive programmes, focussing on developing the research skills, knowledge, and capabilities of junior researchers. One of the main strengths of these programmes was the focus on network building amongst the partner institutions, where each partner brought skills, expertise, and diverse work cultures into the consortium. Through these efforts, the projects improved both the capacity of junior researchers and the research

An educational approach to improve outcomes in acute kidney injury (AKI): report of a quality improvement project.

Science.gov (United States)

Xu, Gang; Baines, Richard; Westacott, Rachel; Selby, Nick; Carr, Susan

2014-03-20

To assess the impact of a quality improvement project that used a multifaceted educational intervention on how to improve clinician's knowledge, confidence and awareness of acute kidney injury (AKI). 2 large acute teaching hospitals in England, serving a combined population of over 1.5 million people. All secondary care clinicians working in the clinical areas were targeted, with a specific focus on clinicians working in acute admission areas. A multifaceted educational intervention consisting of traditional didactic lectures, case-based teaching in small groups and an interactive web-based learning resource. We assessed clinicians' knowledge of AKI and their self-reported clinical behaviour using an interactive questionnaire before and after the educational intervention. Secondary outcome measures included clinical audit of patient notes before and after the intervention. 26% of clinicians reported that they were aware of local AKI guidelines in the preintervention questionnaire compared to 64% in the follow-up questionnaire (χ²=60.2, pquality improvement project utilising a multifaceted educational intervention improved awareness of AKI as demonstrated by changes in the clinician's self-reported management of patients with AKI. Elements of the project have been sustained beyond the project period, and demonstrate the power of quality improvement projects to help initiate changes in practice. Our findings are limited by confounding factors and highlight the need to carry out formal randomised studies to determine the impact of educational initiatives in the clinical setting.

Working with Climate Projections to Estimate Disease Burden: Perspectives from Public Health

Directory of Open Access Journals (Sweden)

Kathryn C. Conlon

2016-08-01

Full Text Available There is interest among agencies and public health practitioners in the United States (USA to estimate the future burden of climate-related health outcomes. Calculating disease burden projections can be especially daunting, given the complexities of climate modeling and the multiple pathways by which climate influences public health. Interdisciplinary coordination between public health practitioners and climate scientists is necessary for scientifically derived estimates. We describe a unique partnership of state and regional climate scientists and public health practitioners assembled by the Florida Building Resilience Against Climate Effects (BRACE program. We provide a background on climate modeling and projections that has been developed specifically for public health practitioners, describe methodologies for combining climate and health data to project disease burden, and demonstrate three examples of this process used in Florida.

UMTRA Project: Environment, Safety, and Health Plan

International Nuclear Information System (INIS)

1995-02-01

The US Department of Energy has prepared this UMTRA Project Environment, Safety, and Health (ES and H) Plan to establish the policy, implementing requirements, and guidance for the UMTRA Project. The requirements and guidance identified in this plan are designed to provide technical direction to UMTRA Project contractors to assist in the development and implementation of their ES and H plans and programs for UMTRA Project work activities. Specific requirements set forth in this UMTRA Project ES and H Plan are intended to provide uniformity to the UMTRA Project's ES and H programs for processing sites, disposal sites, and vicinity properties. In all cases, this UMTRA Project ES and H Plan is intended to be consistent with applicable standards and regulations and to provide guidance that is generic in nature and will allow for contractors' evaluation of site or contract-specific ES and H conditions. This plan specifies the basic ES and H requirements applicable to UMTRA Project ES and H programs and delineates responsibilities for carrying out this plan. DOE and contractor ES and H personnel are expected to exercise professional judgment and apply a graded approach when interpreting these guidelines, based on the risk of operations

Advances in public health accreditation readiness and quality improvement: evaluation findings from the National Public Health Improvement Initiative.

Science.gov (United States)

McLees, Anita W; Thomas, Craig W; Nawaz, Saira; Young, Andrea C; Rider, Nikki; Davis, Mary

2014-01-01

Continuous quality improvement is a central tenet of the Public Health Accreditation Board's (PHAB) national voluntary public health accreditation program. Similarly, the Centers for Disease Control and Prevention launched the National Public Health Improvement Initiative (NPHII) in 2010 with the goal of advancing accreditation readiness, performance management, and quality improvement (QI). Evaluate the extent to which NPHII awardees have achieved program goals. NPHII awardees responded to an annual assessment and program monitoring data requests. Analysis included simple descriptive statistics. Seventy-four state, tribal, local, and territorial public health agencies receiving NPHII funds. NPHII performance improvement managers or principal investigators. Development of accreditation prerequisites, completion of an organizational self-assessment against the PHAB Standards and Measures, Version 1.0, establishment of a performance management system, and implementation of QI initiatives to increase efficiency and effectiveness. Of the 73 responding NPHII awardees, 42.5% had a current health assessment, 26% had a current health improvement plan, and 48% had a current strategic plan in place at the end of the second program year. Approximately 26% of awardees had completed an organizational PHAB self-assessment, 72% had established at least 1 of the 4 components of a performance management system, and 90% had conducted QI activities focused on increasing efficiencies and/or effectiveness. NPHII appears to be supporting awardees' initial achievement of program outcomes. As NPHII enters its third year, there will be additional opportunities to advance the work of NPHII, compile and disseminate results, and inform a vision of high-quality public health necessary to improve the health of the population.

The Comprehensive Health Education Workers Project and Caring Professionals as Asset-Builders

Science.gov (United States)

Lévesque, Michel

2017-01-01

The Comprehensive Health Education Workers (CHEW) Project is a community-based initiative that educates sexual and gender minority (SGM or LGBTQ) young people about comprehensive--mental, physical, sexual, and social--health and that supports their comprehensive health needs with other services. Since October 2014, CHEW Project staff have served…

Improving Sustainability Performance for Public-Private-Partnership (PPP Projects

Directory of Open Access Journals (Sweden)

Liyin Shen

2016-03-01

Full Text Available Improving sustainability performance in developing infrastructure projects is an important strategy for pursuing the mission of sustainable development. In recent years, the business model of public-private-partnership (PPP is promoted as an effective approach in developing infrastructure projects. It is considered that the distribution of the contribution on project investment between private and public sectors is one of the key variables affecting sustainability performance of PPP-type projects. This paper examines the impacts of the contribution distribution between public and private sectors on project sustainability performance. A model named the sustainability performance-based evaluation model (SPbEM is developed for assisting the assessment of the level of sustainability performance of PPP projects. The study examines the possibility of achieving better sustainability through proper arrangement of the investment distribution between the two primary sectors in developing PPP-type infrastructure projects.

Improving primary health care facility performance in Ghana: efficiency analysis and fiscal space implications.

Science.gov (United States)

Novignon, Jacob; Nonvignon, Justice

2017-06-12

Health centers in Ghana play an important role in health care delivery especially in deprived communities. They usually serve as the first line of service and meet basic health care needs. Unfortunately, these facilities are faced with inadequate resources. While health policy makers seek to increase resources committed to primary healthcare, it is important to understand the nature of inefficiencies that exist in these facilities. Therefore, the objectives of this study are threefold; (i) estimate efficiency among primary health facilities (health centers), (ii) examine the potential fiscal space from improved efficiency and (iii) investigate the efficiency disparities in public and private facilities. Data was from the 2015 Access Bottlenecks, Cost and Equity (ABCE) project conducted by the Institute for Health Metrics and Evaluation. The Stochastic Frontier Analysis (SFA) was used to estimate efficiency of health facilities. Efficiency scores were then used to compute potential savings from improved efficiency. Outpatient visits was used as output while number of personnel, hospital beds, expenditure on other capital items and administration were used as inputs. Disparities in efficiency between public and private facilities was estimated using the Nopo matching decomposition procedure. Average efficiency score across all health centers included in the sample was estimated to be 0.51. Also, average efficiency was estimated to be about 0.65 and 0.50 for private and public facilities, respectively. Significant disparities in efficiency were identified across the various administrative regions. With regards to potential fiscal space, we found that, on average, facilities could save about GH₵11,450.70 (US$7633.80) if efficiency was improved. We also found that fiscal space from efficiency gains varies across rural/urban as well as private/public facilities, if best practices are followed. The matching decomposition showed an efficiency gap of 0.29 between private

State partnership in environmental health and safety phase of Plowshare projects

Energy Technology Data Exchange (ETDEWEB)

Kinsman, S [California State Department of Public Health, Berkeley, CA (United States)

1969-07-01

When experiments on projects involving Plowshare devices are conceived, the state chosen for the project should be invited to participate in planning the health and safety aspects and be prepared to actively participate in the D-Day phase as well as the post-detonation activity. In California nuclear science technology and competence have preceded the social acceptance and use of nuclear devices for large scale Plowshare projects. However, the environmental surveillance program of the Bureau of Radiological Health in the State Department of Public Health has established an operative program which will be ready and able to function as an active participant or in a support role in environmental health phases of nuclear projects scheduled in the State. A description of our present program will be included in this paper. This will enable the attendees and readers to realize capabilities which will be activated for participation and/or support roles during Plowshare activities in the State or in a neighboring state if the need arises. (author)

State partnership in environmental health and safety phase of Plowshare projects

International Nuclear Information System (INIS)

Kinsman, S.

1969-01-01

When experiments on projects involving Plowshare devices are conceived, the state chosen for the project should be invited to participate in planning the health and safety aspects and be prepared to actively participate in the D-Day phase as well as the post-detonation activity. In California nuclear science technology and competence have preceded the social acceptance and use of nuclear devices for large scale Plowshare projects. However, the environmental surveillance program of the Bureau of Radiological Health in the State Department of Public Health has established an operative program which will be ready and able to function as an active participant or in a support role in environmental health phases of nuclear projects scheduled in the State. A description of our present program will be included in this paper. This will enable the attendees and readers to realize capabilities which will be activated for participation and/or support roles during Plowshare activities in the State or in a neighboring state if the need arises. (author)

Developing an action-based health and safety training project in southern China.

Science.gov (United States)

Szudy, Betty; O'Rourke, Dara; Brown, Garrett D

2003-01-01

A project brought together international footwear manufacturers, labor rights groups, local contract factories, and occupational health professionals to strengthen factory health and safety programs in southern China. Steps involved in the two-year project, including needs assessment, interviews and focus groups with workers and supervisors; design and development of a participatory workshop; development of plant-wide health and safety committees in three footwear factories; and evaluation project impact, are discussed. The project significantly increased occupational safety and health knowledge, and hazards in the factories were identified and corrected. Successes and challenges faced by three functioning worker-management health and safety committees are discussed. Key elements to create effective programs with meaningful participation by workers include: 1) developing clear guidelines that enable multi-stakeholder groups to collaborate; 2) obtaining top-level management support; 3) building workers' knowledge and capacity to fully participate; 4) involving local labor rights groups and occupational professionals in support and technical assistance; and 5) connecting project goals to larger issues within a country and the global economy.

Factors related to perceived health among elderly people: the Albertina Project.

Science.gov (United States)

Lindgren, A M; Svärdsudd, K; Tibblin, G

1994-07-01

The Albertina Project is an epidemiological study of the medical, social and economic situation among people aged 75 years or older in Uppsala, Sweden. In this report, health conditions, quality-of-life measures and housing problems affecting it are presented. A postal questionnaire was sent to an 11% random sample (n = 959) of the eligible population out of which 706 (74%) persons responded. Nearly one-third of the elderly people could not read a newspaper with or without glasses, more than one-third had impaired hearing, 47% had some sort of mobility problem and 66% reported some form of sleeping problem. Forty-two per cent felt lonely sometimes or often and 65% were worried, in most cases about the risk of falling. In spite of this, 87% rated their health as good and 79% were content or rather content with their situation. Even though eyesight and hearing problems were common in this study, they did not affect perceived health to any large extent. Mobility problems and sleeping problems had a greater impact. The most important factors related to perceived health were activity score, contentment and mobility problems. Contentment was affected by activity score and loneliness and the latter was in turn affected by age and type of dwelling. The practical implication of these findings is that perhaps more attention should be focused on efforts to improve old people's satisfaction with their life situation rather than on marginal improvements of their medical situation.

Family health nurse project--an education program of the World Health Organization: the University of Stirling experience.

Science.gov (United States)

Murray, Ian

2008-11-01

This article outlines the delivery of the Family Health Nurse Education Programme of the World Health Organization (WHO) at the University of Stirling, Scotland, from 2001 to 2005. The program was part of the WHO European Family Health Nurse pilot project. The curriculum outlined by the WHO Curriculum Planning Group detailed the broad thrust of the Family Health Nurse Education Programme and was modified to be responsive to the context in which it was delivered, while staying faithful to general principles and precepts. The Family Health Nurse Education Programme is described in its evolving format over the two phases of the project; the remote and rural context occurred from 2001 to 2003, and the modification of the program for the urban phase of the project occurred during 2004 and 2005. The conceptual framework that was foundational to the development of the curriculum to prepare family health nurses will be described.

Texas Pulse Oximetry Project: A Multicenter Educational and Quality Improvement Project for Implementation of Critical Congenital Heart Disease Screening Using Pulse Oximetry.

Science.gov (United States)

Guillory, Charleta; Gong, Alice; Livingston, Judith; Creel, Liza; Ocampo, Elena; McKee-Garrett, Tiffany

2017-07-01

Objective  Critical congenital heart disease (CCHD) is a leading cause of death in infants. Newborn screening (NBS) by pulse oximetry allows early identification of CCHD in asymptomatic newborns. To improve readiness of hospital neonatal birthing facilities for mandatory screening in Texas, an educational and quality improvement (QI) project was piloted to identify an implementation strategy for CCHD NBS in a range of birthing hospitals. Study Design  Thirteen Texas hospitals implemented standardized CCHD screening by pulse oximetry. An educational program was devised and a tool kit was created to facilitate education and implementation. Newborn nursery nurses' knowledge was assessed using a pre- and posttest instrument. Results  The nurses' knowledge assessment improved from 71 to 92.5% ( p  educational program, including a tool kit, QI processes, and standardized pulse oximetry CCHD NBS, is applicable for a range of hospital birthing facilities and may facilitate wide-scale implementation, thereby improving newborn health. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Health programmes for school employees: improving quality of life, health and productivity.

Science.gov (United States)

Kolbe, Lloyd J; Tirozzi, Gerald N; Marx, Eva; Bobbitt-Cooke, Mary; Riedel, Sara; Jones, Jack; Schmoyer, Michael

2005-01-01

School health programmes in the 21st century could include eight components: 1) health services; 2) health education; 3) healthy physical and psychosocial environments; 4) psychological, counselling, and social services; 5) physical education and other physical activities; 6) healthy food services; and 7) integrated efforts of schools, families, and communities to improve the health of school students and employees. The eighth component of modern school health programmes, health programmes for school employees, is the focus of this article. Health programmes for school employees could be designed to increase the recruitment, retention, and productivity of school employees by partially focusing each of the preceding seven components of the school health programme on improving the health and quality of life of school employees as well as students. Thus, efforts to improve the quality of life, health, and productivity of school employees may be distinct from, but integrated with, efforts to improve the quality of life, health, and education of students. School employee health programmes can improve employee: 1) recruitment; 2) morale; 3) retention; and 4) productivity. They can reduce employee: 5) risk behaviours (e.g., physical inactivity); 6) risk factors (e.g., stress, obesity, high blood pressure); (7) illnesses; 8) work-related injuries; 9) absentee days; 10) worker compensation and disability claims; and 11) health care and health insurance costs. Further, if we hope to improve our schools' performance and raise student achievement levels, developing effective school employee health programmes can increase the likelihood that employees will: 12) serve as healthy role models for students; 13) implement effective school health programmes for students; and 14) present a positive image of the school to the community. If we are to improve the quality of life, health, and productivity of school employees in the 21st century: school administrators, employees, and

Health Activities Project (HAP): Sight and Sound Module.

Science.gov (United States)

Buller, Dave; And Others

Contained within this Health Activities Project (HAP) learning packet are activities for children in grades 5-8. Design of the activities centers around the idea that students can control their own health and safety. Within this module are teacher and student folios describing six activities which involve students in restricting their vision by…

Child welfare caseworkers as brokers of mental health services: a pilot evaluation of Project Focus Colorado.

Science.gov (United States)

Fitzgerald, Monica M; Torres, Marcela M; Shipman, Kimberly; Gorrono, Jessica; Kerns, Suzanne E U; Dorsey, Shannon

2015-02-01

Youth in the child welfare system (CWS) have substantially higher rates of mental health needs compared to the general population, yet they rarely receive targeted, evidence-based practices (EBPs). Caseworkers play the critically important role of "service broker" for CWS youth and families. This study examines preliminary caseworker-level outcomes of Project Focus Colorado (PF-C), a training and consultation program designed to improve access to EBPs for CWS youth. PF-C evaluation occurred in four child welfare offices (two intervention [n = 16 caseworkers] vs. two practice-as-usual, wait-list control [WLC; n = 12 caseworkers]). Receipt of PF-C was associated with significantly increased caseworker knowledge of (a) EBPs, (b) child mental health problems, (c) evidence-based treatment components targeting mental health problem areas, and (d) mental health screening instruments, compared to WLC. Dose of training and consultation was associated with greater ability to correctly classify mental health problems and match them to EBPs. These preliminary results suggest that targeted training and consultation help to improve caseworker knowledge of children's mental health needs, EBPs for mental health, and mental health screening instruments. © The Author(s) 2014.

SPHERE's 'Dress Sense' a Multi-disciplinary approach to designing wearable technology to improve health

Directory of Open Access Journals (Sweden)

Amelia Martin

2015-10-01

Full Text Available Background Healthcare systems face financial challenges, with a greater number of the population living longer with long term conditions. In order to deliver safe, high quality care within these constraints, we must place more emphasis on preventing illness than treating illness. We can use the science of behaviour change, health, and technology to create solutions to these problems. An example of innovation in this field include SPHERE’s multidisciplinary project entitled ‘Dress Sense’, with the aim to create a piece of wearable technology to improve health. Description This competition was run by SPHERE (Sensor Platform for HEalthcare in a Residential Environment which focuses on developing sensor systems to monitor health and wellbeing in the home. The teams comprised of computer scientists, medical professionals, students and school children, engineers, fashion designers and textile artists. They were provided with a kit including Arduino software, sensors and other items to make wearable computers. There were no constraints on what they could produce, except for a deadline of 3 weeks. The end project was judged according to the innovation and usefulness of the overall concept; the functionality, usability and desirability (aesthetics of the constructed device and the multi-displinary component. The idea was to foster open innovation in order to share ideas between specialities. Conclusions Ideas included tackling diabetic medical adherence through a wearable band to sensors woven into socks to prevent deep vein thrombosis. The winning concept was, ‘Yo’ a support system to aid cognitive behaviour therapy, through wearable products and accessories, to help those who begin CBT, stay motivated to engage effectively with therapy. This project highlighs how through multi-disciplinary collaboration and including the younger generation, innovative effective ideas can be found to harness digital technology to improve health.

76 FR 58840 - Central Valley Project Improvement Act; Refuge Water Management Plans

Science.gov (United States)

2011-09-22

... DEPARTMENT OF THE INTERIOR Bureau of Reclamation Central Valley Project Improvement Act; Refuge Water Management Plans AGENCY: Bureau of Reclamation, Interior. ACTION: Notice of availability. SUMMARY: To meet the requirements of the Central Valley Project Improvement Act of 1992 (CVPIA) and subsequent...

[Health projects managed by Nursing Coordinators: an analysis of contents and degree of success].

Science.gov (United States)

Palese, Alvisa; Bresciani, Federica; Brutti, Caterina; Chiari, Ileana; Fontana, Luciana; Fronza, Ornella; Gasperi, Giuseppina; Gheno, Oscar; Guarese, Olga; Leali, Anna; Mansueti, Nadia; Masieri, Enrico; Messina, Laura; Munaretto, Gabriella; Paoli, Claudia; Perusi, Chiara; Randon, Giulia; Rossi, Gloria; Solazzo, Pasquale; Telli, Debora; Trenti, Giuliano; Veronese, Elisabetta; Saiani, Luisa

2012-01-01

To describe the evolution and results of health projects run in hospitals and managed by Nursing Coordinators. A convenience sample of 13 north Italian hospital, and a sample of 56 Nursing Coordinators with a permanent position from at least 1 year, was contacted. The following information was collected with a structured interview: projects run in 2009, topic, if bottom up or top down, number of staff involved and state (ended, still running, stopped). In 2009 Nursing Coordinators started 114 projects (mean 1.8±1.2 each): 94 (82.5%) were improvement projects, 17 (14.9%) accreditation, and 3 (2.6%) research. The projects involved 2.732 staff members (73.7%; average commitment 84 hours); 55 (48.2%) projects were still running, 52 (45.6%) completed, for 5 (4.4%) there was no assessment and 2 (1.8%) had been stopped. Nurses are regularly involved in several projects. A systematic monitoring of the results obtained and stabilization strategies are scarce. Due to the large number of resources invested, a correct management and the choice of areas relevant for patients' problems and needs are pivotal.

What drives continuous improvement project success in healthcare?

Science.gov (United States)

Stelson, Paul; Hille, Joshua; Eseonu, Chinweike; Doolen, Toni

2017-02-13

Purpose The purpose of this paper is to present findings from a study of factors that affect continuous improvement (CI) project success in hospitals. Design/methodology/approach Quantitative regression analysis was performed on Likert scale survey responses. Qualitative thematic analysis was performed on open-ended survey responses and written reports on CI projects. Findings The paper identifies managerial and employee factors that affect project success. These factors include managerial support, communication, and affective commitment. Affective commitment is the extent to which employees perceive the change as being needed or necessary. Practical implications The results highlight how managerial decisions, approaches to communication - including communication before, during and after CI projects affect project success. The results also show that success depends on the way employees perceive proposed changes. This suggests the need for a more individualized approach to CI, lean, and broader change initiatives. Originality/value This research is the first to fuse project success and sustainability theory to CI projects, beyond Kaizen events, in healthcare environments. The research is particularly important at a time when healthcare organizations are required to make rapid changes with limited resources as they work toward outcome-based assessment and reimbursement rules.

[Effects of community health promotion project for garlic cultivating farmers based on self-efficacy theory and community capacity building framework].

Science.gov (United States)

Kim, Hyang-Sook; Gu, Mee Ock

2011-02-01

This study was conducted to test the effects of a community health promotion project for farmers cultivating garlic. Bandura's self-efficacy theory (1986) and Chaskin's community capacity framework (2001) were used as the theoretical framework. A nonequivalent control group pretest-posttest design was used. Study participants were 72 garlic farmers (intervention: 36, control: 36). The community health promotion project consisted of health promotion program and community capacity building strategies and was provided for 12 weeks (8 during farming off-season and 4 during farming season). Data were collected between February 23 and May 31, 2009 and were analyzed using chi-square test, Fisher's exact test, t-test, and repeated measure ANOVA using SPSS/WIN 12.0. For the experimental group, significant improvement was found for self-efficacy, farming related health behavior, physical fitness (muscle strength, muscle endurance, upper body flexibility, lower body flexibility, cardiovascular endurance, balance, agility), farmer's syndrome, and health related quality of life as compared to the control group. The findings of the study indicate that the community health promotion project for garlic farmers is effective and can be recommended as a nursing intervention for health promotion of garlic cultivating farmers.

Falls prevention in hospitals and mental health units: an extended evaluation of the FallSafe quality improvement project.

Science.gov (United States)

Healey, Frances; Lowe, Derek; Darowski, Adam; Windsor, Julie; Treml, Jonathan; Byrne, Lisa; Husk, Janet; Phipps, Jill

2014-07-01

inpatient falls are a major patient safety issue causing distress, injury and death. Systematic review suggests multifactorial assessment and intervention can reduce falls by 20-30%, but large-scale studies of implementation are few. This paper describes an extended evaluation of the FallSafe quality improvement project, which presented key components of multifactorial assessment and intervention as a care bundle. : data on delivery of falls prevention processes were collected at baseline and for 18 months from nine FallSafe units and nine control units. Data on falls were collected from local risk management systems for 24 months, and data on under-reporting through staff surveys. : in FallSafe units, delivery of seven care bundle components significantly improved; most improvements were sustained after active project support was withdrawn. Twelve-month moving average of reported fall rates showed a consistent downward trend in FallSafe units but not controls. Significant reductions in reported fall rate were found in FallSafe units (adjusted rate ratio (ARR) 0.75, 95% confidence interval (CI) 0.68-0.84 P control units (ARR 0.91, 95% CI 0.81-1.03 P = 0.13). No significant changes in injurious fall rate were found in FallSafe units (ARR 0.86, 95% CI 0.71-1.03 P = 0.11), or controls (ARR 0.88, 95% CI 0.72-1.08 P = 0.13). In FallSafe units, staff certain falls had been reported increased from 60 to 77%. : introducing evidence-based care bundles of multifactorial assessment and intervention using a quality improvement approach resulted in improved delivery of multifactorial assessment and intervention and significant reductions in fall rates, but not in injurious fall rates. © The Author 2013. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Quality improvement primer part 1: Preparing for a quality improvement project in the emergency department.

Science.gov (United States)

Chartier, Lucas B; Cheng, Amy H Y; Stang, Antonia S; Vaillancourt, Samuel

2018-01-01

Emergency medicine (EM) providers work in a fast-paced and often hectic environment that has a high risk for patient safety incidents and gaps in the quality of care. These challenges have resulted in opportunities for frontline EM providers to play a role in quality improvement (QI) projects. QI has developed into a mature field with methodologies that can dramatically improve the odds of having a successful project with a sustainable impact. However, this expertise is not yet commonly taught during professional training. In this first of three articles meant as a QI primer for EM clinicians, we will introduce QI methodology and strategic planning using a fictional case study as an example. We will review how to identify a QI problem, define components of an effective problem statement, and identify stakeholders and core change team members. We will also describe three techniques used to perform root cause analyses-Ishikawa diagrams, Pareto charts and process mapping-and how they relate to preparing for a QI project. The next two papers in this series will focus on the execution of the QI project itself using rapid-cycle testing and on the evaluation and sustainability of QI projects.

The relationship between health policy and public health interventions: a case study of the DRIVE project to "end" the HIV epidemic among people who inject drugs in Haiphong, Vietnam.

Science.gov (United States)

Hammett, Theodore M; Trang, Nguyen Thu; Oanh, Khuat Thi Hai; Huong, Nguyen Thi; Giang, Le Minh; Huong, Duong Thi; Nagot, Nicolas; Des Jarlais, Don C

2018-03-12

We present a case study of the effects of health policies on the implementation and potential outcomes of a public health intervention, using the DRIVE project, that aims to 'end' the HIV epidemic among people who inject drugs in Haiphong, Vietnam. DRIVE's success depends on two policy transitions: (1) integration of donor-funded HIV outpatient clinics into public health clinics and expansion of social health insurance; (2) implementation of a "Renovation Plan" for substance use treatment. Interviews and focus group discussions with key informants and review of policy documents and clinic data reveal that both policy transitions are underway but face challenges. DRIVE promises to show how evolving policy affects health interventions and how advocacy based on project data can improve policy. Broad lessons include the importance of clear and consistent policies, vigorous enforcement, and adequate funding of promulgated policies.

Project monitoring and evaluation: an enhancing method for health research system management.

Science.gov (United States)

Djalalinia, Shirin; Owlia, Parviz; Malekafzali, Hossein; Ghanei, Mostafa; Babamahmoodi, Abdolreza; Peykari, Niloofar

2014-04-01

Planning, organizing, staffing, leading and monitoring are the basic functional component of management. In present article, we aim to define the project monitoring and evaluation in health research system (HRS) considering its success and challenges based on our national experience. IN THIS STUDY BASED ON THE INFORMATION OF ANNUAL MEDICAL SCIENCE UNIVERSITIES EVALUATION DURING THE LAST DECADE THE HRS INDICATORS HAVE BEEN SCORED IN THREE AXES BASED ON HRS FUNCTIONS: Stewardship, capacity building and knowledge production. In this article, we will focus on the results of HRS evaluation from 2002 to 2010, also on its success and challenges. In an overall view, the main results are the experiences of the designing and implantation of such process after pre-project preparation, all parts followed under the whole supervision of the aims of the HRS evaluation. Project management light the way of practical application of knowledge, skills, tools and techniques for better HRS evaluation and management. We concluded that; although monitoring and evaluation as an essential part of HRS Management light the improvement ahead way but we still need to advantage of the new project management advances.

Projection models for health effects assessment in populations exposed to radioactive and nonradioactive pollutants. Volume IV. SPAHR user's guide

International Nuclear Information System (INIS)

Collins, J.J.; Lundy, R.T.

1982-09-01

The Simulation Package for the Analysis of Health Risk (SPAHR) is a computer software package based upon a demographic model for health risk projections. The model extends several health risk projection models by making realistic assumptions about the population at risk, and thus represents a distinct improvement over previous models. Complete documentation for use of SPAHR is contained in this five-volume publication. The demographic model in SPAHR estimates population response to environmental toxic exposures. Latency of response, changing dose level over time, competing risks from other causes of death, and population structure can be incorporated into SPAHR to project health risks. Risks are measured by morbid years, number of deaths, and loss of life expectancy. Comparisons of estimates of excess deaths demonstrate that previous health risk projection models may have underestimated excess deaths by a factor of from 2 to 10, depending on the pollutant and the exposure scenario. The software supporting the use of the demographic model is designed to be user oriented. Complex risk projections are made by responding to a series of prompts generated by the package. The flexibility and ease of use of SPAHR make it an important contribution to existing models and software packages. This volume gives the more advanced user of the SPAHR computer package the information required to create tailor-made programs for addressing specific issues not covered by the three interactive packages. It assumes that the user is familiar with the concepts and terms relating to demography and health risk assessment

Improved Methodology for Benefit Estimation of Preservation Projects

Science.gov (United States)

2018-04-01

This research report presents an improved process for evaluating the benefits and economic tradeoffs associated with a variety of highway preservation projects. It includes a summary of results from a comprehensive phone survey concerning the use and...

Survival of the project: a case study of ICT innovation in health care.

Science.gov (United States)

Andreassen, Hege K; Kjekshus, Lars Erik; Tjora, Aksel

2015-05-01

From twenty years of information and communication technology (ICT) projects in the health sector, we have learned one thing: most projects remain projects. The problem of pilotism in e-health and telemedicine is a growing concern, both in medical literature and among policy makers, who now ask for large-scale implementation of ICT in routine health service delivery. In this article, we turn the question of failing projects upside down. Instead of investigating the obstacles to implementing ICT and realising permanent changes in health care routines, we ask what makes the temporary ICT project survive, despite an apparent lack of success. Our empirical material is based on Norwegian telemedicine. Through a case study, we take an in-depth look into the history of one particular telemedical initiative and highlight how ICT projects matter on a managerial level. Our analysis reveals how management tasks were delegated to the ICT project, which thus contributed to four processes of organisational control: allocating resources, generating and managing enthusiasm, system correction and aligning local practice and national policies. We argue that the innovation project in itself can be considered an innovation that has become normalised in health care, not in clinical, but in management work. In everyday management, the ICT project appears to be a convenient tool suited to ease the tensions between state regulatory practices and claims of professional autonomy that arise in the wake of new public management reforms. Separating project management and funding from routine practice handles the conceptualised heterogeneity between innovation and routine within contemporary health care delivery. Whilst this separation eases the execution of both normal routines and innovative projects, it also delays expected diffusion of technology. Copyright © 2015 Elsevier Ltd. All rights reserved.

Project on School Staff Health Promotion in Poland: The First Experiences

Science.gov (United States)

Woynarowska-Soldan, Magdalena

2015-01-01

Purpose: The purpose of this paper is to present the concept, methods of implementation, results and experiences from the first stage of the three-year project on school staff health promotion carried out within the framework of the health-promoting school (HPS) network in Poland. Design/methodology/approach: The project was implemented in 2012 in…

Cell phone-based health education messaging improves health literacy.

Science.gov (United States)

Zhuang, Runsen; Xiang, Yueying; Han, Tieguang; Yang, Guo-An; Zhang, Yuan

2016-03-01

The ubiquity of cell phones, which allow for short message service (SMS), provides new and innovative opportunities for disease prevention and health education. To explore the use of cell phone-based health education SMS to improve the health literacy of community residents in China. A multi-stage random sampling method was used to select representative study communities and participants ≥ 18 years old. Intervention participants were sent health education SMSs once a week for 1 year and controls were sent conventional, basic health education measures. Health literacy levels of the residents before and after the intervention were evaluated between intervention and control groups. Public health literacy scores increased 1.5 points, from 61.8 to 63.3, after SMS intervention for 1 year (P<0.01); the increase was greater for males than females (2.01 vs. 1.03; P<0.01) and for Shenzhen local residents than non-permanent residents (2.56 vs. 1.14; P<0.01). The frequency of high health literacy scores was greater for the intervention than control group (22.03% to 30.93% vs. 22.07% to 20.82%). With health literacy as a cost-effective index, the cost-effectiveness per intervention was 0.54. SMS may be a useful tool for improving health literacy.

Protocole of a controlled before-after evaluation of a national health information technology-based program to improve healthcare coordination and access to information.

Science.gov (United States)

Saillour-Glénisson, Florence; Duhamel, Sylvie; Fourneyron, Emmanuelle; Huiart, Laetitia; Joseph, Jean Philippe; Langlois, Emmanuel; Pincemail, Stephane; Ramel, Viviane; Renaud, Thomas; Roberts, Tamara; Sibé, Matthieu; Thiessard, Frantz; Wittwer, Jerome; Salmi, Louis Rachid

2017-04-21

Improvement of coordination of all health and social care actors in the patient pathways is an important issue in many countries. Health Information (HI) technology has been considered as a potentially effective answer to this issue. The French Health Ministry first funded the development of five TSN ("Territoire de Soins Numérique"/Digital health territories) projects, aiming at improving healthcare coordination and access to information for healthcare providers, patients and the population, and at improving healthcare professionals work organization. The French Health Ministry then launched a call for grant to fund one research project consisting in evaluating the TSN projects implementation and impact and in developing a model for HI technology evaluation. EvaTSN is mainly based on a controlled before-after study design. Data collection covers three periods: before TSN program implementation, during early TSN program implementation and at late TSN program implementation, in the five TSN projects' territories and in five comparison territories. Three populations will be considered: "TSN-targeted people" (healthcare system users and people having characteristics targeted by the TSN projects), "TSN patient users" (people included in TSN experimentations or using particular services) and "TSN professional users" (healthcare professionals involved in TSN projects). Several samples will be made in each population depending on the objective, axis and stage of the study. Four types of data sources are considered: 1) extractions from the French National Heath Insurance Database (SNIIRAM) and the French Autonomy Personalized Allowance database, 2) Ad hoc surveys collecting information on knowledge of TSN projects, TSN program use, ease of use, satisfaction and understanding, TSN pathway experience and appropriateness of hospital admissions, 3) qualitative analyses using semi-directive interviews and focus groups and document analyses and 4) extractions of TSN

BRONX HEALTH EDUCATION PROJECT FOR WEST AFRICAN IMMIGRANTS.

Science.gov (United States)

Wilson, Rebecca Dover; Elgoghail, Nadia

2016-01-01

The transition from a traditional West African diet and lifestyle to a modern diet has a significant impact on health and the risk of chronic disease. To implement a health education program for West African immigrants in the U.S. to address health risks associated with the modern diet. A health education program model targeted at West African immigrants in the Bronx was determined based on existing health education programs with educational materials, group education sessions, and targeted individual counseling. A health education program was successfully implemented at a clinic comprised of West African immigrant patients in the Bronx. This project demonstrates an example of a targeted health education program for West African immigrants to address health risks related to diet.

Ethical analysis to improve decision-making on health technologies.

Science.gov (United States)

Saarni, Samuli I; Hofmann, Bjørn; Lampe, Kristian; Lühmann, Dagmar; Mäkelä, Marjukka; Velasco-Garrido, Marcial; Autti-Rämö, Ilona

2008-08-01

Health technology assessment (HTA) is the multidisciplinary study of the implications of the development, diffusion and use of health technologies. It supports health-policy decisions by providing a joint knowledge base for decision-makers. To increase its policy relevance, HTA tries to extend beyond effectiveness and costs to also considering the social, organizational and ethical implications of technologies. However, a commonly accepted method for analysing the ethical aspects of health technologies is lacking. This paper describes a model for ethical analysis of health technology that is easy and flexible to use in different organizational settings and cultures. The model is part of the EUnetHTA project, which focuses on the transferability of HTAs between countries. The EUnetHTA ethics model is based on the insight that the whole HTA process is value laden. It is not sufficient to only analyse the ethical consequences of a technology, but also the ethical issues of the whole HTA process must be considered. Selection of assessment topics, methods and outcomes is essentially a value-laden decision. Health technologies may challenge moral or cultural values and beliefs, and their implementation may also have significant impact on people other than the patient. These are essential considerations for health policy. The ethics model is structured around key ethical questions rather than philosophical theories, to be applicable to different cultures and usable by non-philosophers. Integrating ethical considerations into HTA can improve the relevance of technology assessments for health care and health policy in both developed and developing countries.

Improving the use of health data for health system strengthening

Directory of Open Access Journals (Sweden)

Tara Nutley

2013-02-01

Full Text Available Background: Good quality and timely data from health information systems are the foundation of all health systems. However, too often data sit in reports, on shelves or in databases and are not sufficiently utilised in policy and program development, improvement, strategic planning and advocacy. Without specific interventions aimed at improving the use of data produced by information systems, health systems will never fully be able to meet the needs of the populations they serve. Objective: To employ a logic model to describe a pathway of how specific activities and interventions can strengthen the use of health data in decision making to ultimately strengthen the health system. Design: A logic model was developed to provide a practical strategy for developing, monitoring and evaluating interventions to strengthen the use of data in decision making. The model draws on the collective strengths and similarities of previous work and adds to those previous works by making specific recommendations about interventions and activities that are most proximate to affect the use of data in decision making. The model provides an organizing framework for how interventions and activities work to strengthen the systematic demand, synthesis, review, and use of data. Results: The logic model and guidance are presented to facilitate its widespread use and to enable improved data-informed decision making in program review and planning, advocacy, policy development. Real world examples from the literature support the feasible application of the activities outlined in the model. Conclusions: The logic model provides specific and comprehensive guidance to improve data demand and use. It can be used to design, monitor and evaluate interventions, and to improve demand for, and use of, data in decision making. As more interventions are implemented to improve use of health data, those efforts need to be evaluated.

The state and profile of open source software projects in health and medical informatics.

Science.gov (United States)

Janamanchi, Balaji; Katsamakas, Evangelos; Raghupathi, Wullianallur; Gao, Wei

2009-07-01

Little has been published about the application profiles and development patterns of open source software (OSS) in health and medical informatics. This study explores these issues with an analysis of health and medical informatics related OSS projects on SourceForge, a large repository of open source projects. A search was conducted on the SourceForge website during the period from May 1 to 15, 2007, to identify health and medical informatics OSS projects. This search resulted in a sample of 174 projects. A Java-based parser was written to extract data for several of the key variables of each project. Several visually descriptive statistics were generated to analyze the profiles of the OSS projects. Many of the projects have sponsors, implying a growing interest in OSS among organizations. Sponsorship, we discovered, has a significant impact on project success metrics. Nearly two-thirds of the projects have a restrictive license type. Restrictive licensing may indicate tighter control over the development process. Our sample includes a wide range of projects that are at various stages of development (status). Projects targeted towards the advanced end user are primarily focused on bio-informatics, data formats, database and medical science applications. We conclude that there exists an active and thriving OSS development community that is focusing on health and medical informatics. A wide range of OSS applications are in development, from bio-informatics to hospital information systems. A profile of OSS in health and medical informatics emerges that is distinct and unique to the health care field. Future research can focus on OSS acceptance and diffusion and impact on cost, efficiency and quality of health care.

Impact of a quality improvement project on deceased organ donor management

Science.gov (United States)

Olmos, Andrea; Feiner, John; Hirose, Ryutaro; Swain, Sharon; Blasi, Annabel; Roberts, John P.; Niemann, Claus U.

2017-01-01

Context Donors showed poor glucose control in the period between declaration of brain death and organ recovery. The level of hyperglycemia in the donors was associated with a decline in terminal renal function. Objective To determine whether implementation of a quality improvement project improved glucose control and preserved renal function in deceased organ donors. Methods Data collected retrospectively included demographics, medical history, mechanism of death, laboratory values, and data from the United Network for Organ Sharing. Results After implementation of the quality improvement project, deceased donors had significantly lower mean glucose concentrations (mean [SD], 162 [44] vs 212 [42] mg/dL; P donor cohorts from before and after the quality improvement project were analyzed together, mean glucose concentration remained a significant predictor of terminal creatinine level (P donors indicated that higher terminal creatinine level was associated with delayed graft function in recipients (P donor glucose homeostasis, and the data confirm that poor glucose homeostasis is associated with worsening terminal renal function. PMID:26645930

Proposed Casey's Pond Improvement Project, Fermi National Accelerator Laboratory

International Nuclear Information System (INIS)

1995-05-01

The U.S. Department of Energy (DOE) has prepared an Environmental Assessment (EA), evaluating the impacts associated with the proposed Casey's Pond Improvement Project at the Fermi National Accelerator Laboratory (Fermilab) in Batavia, Illinois. The improvement project would maximize the efficiency of the Fermilab Industrial Cooling Water (ICW) distribution system, which removes (via evaporation) the thermal load from experimental and other support equipment supporting the high energy physics program at Fermilab. The project would eliminate the risk of overheating during fixed target experiments, ensure that the Illinois Water Quality Standards are consistently achieved and provide needed additional water storage for fire protection. Based on the analysis in the EA, the DOE has determined that the proposed action does not constitute a major Federal action significantly affecting the quality of the human environment, within the meaning of the National Environmental Policy Act (NEPA) of 1969. Therefore, the preparation of an Environmental Impact Statement is not required

Rural interdisciplinary mental health team building via satellite: a demonstration project.

Science.gov (United States)

Cornish, Peter A; Church, Elizabeth; Callanan, Terrence; Bethune, Cheri; Robbins, Carl; Miller, Robert

2003-01-01

This paper reports on the results of a demonstration project that examined the role of telehealth/telemedicine (hereafter referred to as telehealth) in providing interdisciplinary mental health training and support to health professionals in a rural region of Atlantic Canada. Special emphasis was placed on addressing the question of how training might affect interdisciplinary collaboration among the rural health professionals. Five urban mental health professionals from three disciplines provided training and support via video-satellite and internet, print and video resources to 34 rural health and community professionals. In order to assess the rural community's needs and the impact of the interventions, questionnaires were administered and on-site interviews were conducted before and after the project. Throughout the project, field notes were recorded and satisfaction ratings were obtained. Satisfaction with the video-satellite presentations was high and stable, with the exception of one session when signal quality was very poor. Rural participants were most satisfied with opportunities for interaction and least satisfied with the variable quality of the video transmission signal. High staff turnover among rural professionals resulted in insufficient power to permit statistical analysis. Positive reports of the project impact included expanded knowledge and heightened sensitivity to mental health issues, increased cross-disciplinary connections, and greater cohesion among professionals. The results suggest that, with some refinements, telehealth technology can be used to facilitate mental health training and promote interdisciplinary collaboration among professionals in a rural setting.

A knowledge translation project on community-centred approaches in public health.

Science.gov (United States)

Stansfield, J; South, J

2018-03-01

This article examines the development and impact of a national knowledge translation project aimed at improving access to evidence and learning on community-centred approaches for health and wellbeing. Structural changes in the English health system meant that knowledge on community engagement was becoming lost and a fragmented evidence base was seen to impact negatively on policy and practice. A partnership started between Public Health England, NHS England and Leeds Beckett University in 2014 to address these issues. Following a literature review and stakeholder consultation, evidence was published in a national guide to community-centred approaches. This was followed by a programme of work to translate the evidence into national strategy and local practice.The article outlines the key features of the knowledge translation framework developed. Results include positive impacts on local practice and national policy, for example adoption within National Institute for Health and Care Evidence (NICE) guidance and Local Authority public health plans and utilization as a tool for local audit of practice and commissioning. The framework was successful in its non-linear approach to knowledge translation across a range of inter-connected activity, built on national leadership, knowledge brokerage, coalition building and a strong collaboration between research institute and government agency.

Patient engagement: four case studies that highlight the potential for improved health outcomes and reduced costs.

Science.gov (United States)

Laurance, Jeremy; Henderson, Sarah; Howitt, Peter J; Matar, Mariam; Al Kuwari, Hanan; Edgman-Levitan, Susan; Darzi, Ara

2014-09-01

The energy of patients and members of the public worldwide who care about improving health is a huge, but still largely unrecognized and untapped, resource. The aim of patient engagement is to shift the clinical paradigm from determining "what is the matter?" to discovering "what matters to you?" This article presents four case studies from around the world that highlight the proven and potential abilities of increased patient engagement to improve health outcomes and reduce costs, while extending the reach of treatment and diagnostic programs into the community. The cases are an online mental health community in the United Kingdom, a genetic screening program in the United Arab Emirates, a World Health Organization checklist for new mothers, and a hospital-based patient engagement initiative in the United States. Evidence from these and similar endeavors suggests that closer collaboration on the part of patients, families, health care providers, health care systems, and policy makers at multiple levels could help diverse nations provide more effective and population-appropriate health care with fewer resources. Project HOPE—The People-to-People Health Foundation, Inc.

Systematic review on what works, what does not work and why of implementation of mobile health (mHealth) projects in Africa.

Science.gov (United States)

Aranda-Jan, Clara B; Mohutsiwa-Dibe, Neo; Loukanova, Svetla

2014-02-21

Access to mobile phone technology has rapidly expanded in developing countries. In Africa, mHealth is a relatively new concept and questions arise regarding reliability of the technology used for health outcomes. This review documents strengths, weaknesses, opportunities, and threats (SWOT) of mHealth projects in Africa. A systematic review of peer-reviewed literature on mHealth projects in Africa, between 2003 and 2013, was carried out using PubMed and OvidSP. Data was synthesized using a SWOT analysis methodology. Results were grouped to assess specific aspects of project implementation in terms of sustainability and mid/long-term results, integration to the health system, management process, scale-up and replication, and legal issues, regulations and standards. Forty-four studies on mHealth projects in Africa were included and classified as: "patient follow-up and medication adherence" (n = 19), "staff training, support and motivation" (n = 2), "staff evaluation, monitoring and guidelines compliance" (n = 4), "drug supply-chain and stock management" (n = 2), "patient education and awareness" (n = 1), "disease surveillance and intervention monitoring" (n = 4), "data collection/transfer and reporting" (n = 10) and "overview of mHealth projects" (n = 2). In general, mHealth projects demonstrate positive health-related outcomes and their success is based on the accessibility, acceptance and low-cost of the technology, effective adaptation to local contexts, strong stakeholder collaboration, and government involvement. Threats such as dependency on funding, unclear healthcare system responsibilities, unreliable infrastructure and lack of evidence on cost-effectiveness challenge their implementation. mHealth projects can potentially be scaled-up to help tackle problems faced by healthcare systems like poor management of drug stocks, weak surveillance and reporting systems or lack of resources. mHealth in Africa is an innovative approach

Enhancing system-wide implementation of opioid prescribing guidelines in primary care: protocol for a stepped-wedge quality improvement project.

Science.gov (United States)

Zgierska, Aleksandra E; Vidaver, Regina M; Smith, Paul; Ales, Mary W; Nisbet, Kate; Boss, Deanne; Tuan, Wen-Jan; Hahn, David L

2018-06-05

Systematic implementation of guidelines for opioid therapy management in chronic non-cancer pain can reduce opioid-related harms. However, implementation of guideline-recommended practices in routine care is subpar. The goal of this quality improvement (QI) project is to assess whether a clinic-tailored QI intervention improves the implementation of a health system-wide, guideline-driven policy on opioid prescribing in primary care. This manuscript describes the protocol for this QI project. A health system with 28 primary care clinics caring for approximately 294,000 primary care patients developed and implemented a guideline-driven policy on long-term opioid therapy in adults with opioid-treated chronic non-cancer pain (estimated N = 3980). The policy provided multiple recommendations, including the universal use of treatment agreements, urine drug testing, depression and opioid misuse risk screening, and standardized documentation of the chronic pain diagnosis and treatment plan. The project team drew upon existing guidelines, feedback from end-users, experts and health system leadership to develop a robust QI intervention, targeting clinic-level implementation of policy-directed practices. The resulting multi-pronged QI intervention included clinic-wide and individual clinician-level educational interventions. The QI intervention will augment the health system's "routine rollout" method, consisting of a single educational presentation to clinicians in group settings and a separate presentation for staff. A stepped-wedge design will enable 9 primary care clinics to receive the intervention and assessment of within-clinic and between-clinic changes in adherence to the policy items measured by clinic-level electronic health record-based measures and process measures of the experience with the intervention. Developing methods for a health system-tailored QI intervention required a multi-step process to incorporate end-user feedback and account for the needs of

Managing health care decisions and improvement through simulation modeling.

Science.gov (United States)

Forsberg, Helena Hvitfeldt; Aronsson, Håkan; Keller, Christina; Lindblad, Staffan

2011-01-01

Simulation modeling is a way to test changes in a computerized environment to give ideas for improvements before implementation. This article reviews research literature on simulation modeling as support for health care decision making. The aim is to investigate the experience and potential value of such decision support and quality of articles retrieved. A literature search was conducted, and the selection criteria yielded 59 articles derived from diverse applications and methods. Most met the stated research-quality criteria. This review identified how simulation can facilitate decision making and that it may induce learning. Furthermore, simulation offers immediate feedback about proposed changes, allows analysis of scenarios, and promotes communication on building a shared system view and understanding of how a complex system works. However, only 14 of the 59 articles reported on implementation experiences, including how decision making was supported. On the basis of these articles, we proposed steps essential for the success of simulation projects, not just in the computer, but also in clinical reality. We also presented a novel concept combining simulation modeling with the established plan-do-study-act cycle for improvement. Future scientific inquiries concerning implementation, impact, and the value for health care management are needed to realize the full potential of simulation modeling.

Climate Services to Improve Public Health

Science.gov (United States)

Jancloes, Michel; Thomson, Madeleine; Costa, María Máñez; Hewitt, Chris; Corvalan, Carlos; Dinku, Tufa; Lowe, Rachel; Hayden, Mary

2014-01-01

A high level expert panel discussed how climate and health services could best collaborate to improve public health. This was on the agenda of the recent Third International Climate Services Conference, held in Montego Bay, Jamaica, 4–6 December 2013. Issues and challenges concerning a demand led approach to serve the health sector needs, were identified and analysed. Important recommendations emerged to ensure that innovative collaboration between climate and health services assist decision-making processes and the management of climate-sensitive health risk. Key recommendations included: a move from risk assessment towards risk management; the engagement of the public health community with both the climate sector and development sectors, whose decisions impact on health, particularly the most vulnerable; to increase operational research on the use of policy-relevant climate information to manage climate- sensitive health risks; and to develop in-country capacities to improve local knowledge (including collection of epidemiological, climate and socio-economic data), along with institutional interaction with policy makers. PMID:24776719

Health physics program for the Edgemont Uranium Mill decommissioning project

International Nuclear Information System (INIS)

Polehn, J.L.; Wallace, R.G.; Reed, R.P.; Wilson, G.T.

1986-01-01

The Tennessee Valley Authority (TVA) is actively involved in decommissioning a uranium mill located near the town of Edgemont, South Dakota. The Edgemont Mill Decommissioning Project, which is unique in many respects, will involve dismantlement of the old inactive mill building and excavation and transportation of several million tons of uranium mill tailings to a permanent disposal site. To ensure that workers are adequately protected from radiation exposure during decommissioning operations, a health physics program appropriate for the decommissioning situation was developed. The Edgemont Mill Decommissioning Project Health Physics Manual (HPM) gives the programmatic requirements for worker radiation protection. The requirements of the HPM are implemented by means of detailed onsite operating procedures. The Edgemont project health physics program was developed using currently available regulations and guidance for an operating uranium mill with appropriate modifications for decommissioning. This paper discusses the development, implementation, and documentation of that program

Advertising a "Healthy Lifestyle:" A Cypriot Health Education Project

Science.gov (United States)

Ioannou, Soula

2006-01-01

This paper describes a health education program entitled "Young Consumer" project, financed by the European Union and implemented by the Cyprus Consumer Association between March and June 2004. The aim of the project was to promote a healthy lifestyle among a group of Cypriot primary school pupils (11-12 years old). Participants were…

UMTRA project office federal employee occupational safety and health program plan

International Nuclear Information System (INIS)

1994-06-01

This document establishes the Federal Employee Occupational Safety and Health (FEOSH) Program for the US Department of Energy (DOE) Uranium Mill Tailings Remedial Action (UMTRA) Project Office. This program will ensure compliance with applicable requirements of DOE Order 3790.1B and DOE Albuquerque Operations Office (AL) Order 3790.lA. FEOSH Program responsibilities delegated by the DOE-AL to the UMTRA Project Office by AL Order 3790.1A also are assigned. The UMTRA Project Office has developed the UMTRA Project Environmental, Safety, and Health (ES ampersand H) Plan (DOE, 1992), which establishes the basic programmatic ES ampersand H requirements for all participants on the UMTRA Project. The ES ampersand H plan is designed primarily to cover remedial action activities at UMTRA sites and defines the ES ampersand H responsibilities of both the UMTRA Project Office and its contractors. The UMTRA FEOSH Program described herein is a subset of the overall UMTRA ES ampersand H program and covers only federal employees working on the UMTRA Project

Sustainability in the AAP Bronchiolitis Quality Improvement Project.

Science.gov (United States)

Shadman, Kristin A; Ralston, Shawn L; Garber, Matthew D; Eickhoff, Jens; Mussman, Grant M; Walley, Susan C; Rice-Conboy, Elizabeth; Coller, Ryan J

2017-11-01

Adherence to American Academy of Pediatrics (AAP) bronchiolitis clinical practice guideline recommendations improved significantly through the AAP's multiinstitutional collaborative, the Bronchiolitis Quality Improvement Project (BQIP). We assessed sustainability of improvements at participating institutions for 1 year following completion of the collaborative. Twenty-one multidisciplinary hospital-based teams provided monthly data for key inpatient bronchiolitis measures during baseline and intervention bronchiolitis seasons. Nine sites provided data in the season following completion of the collaborative. Encounters included children younger than 24 months who were hospitalized for bronchiolitis without comorbid chronic illness, prematurity, or intensive care. Changes between baseline-, intervention-, and sustainability-season data were assessed using generalized linear mixed-effects models with site-specific random effects. Differences between hospital characteristics, baseline performance, and initial improvement between sites that did and did not participate in the sustainability season were compared. A total of 2275 discharges were reviewed, comprising 995 baseline, 877 intervention, and 403 sustainability- season encounters. Improvements in all key bronchiolitis quality measures achieved during the intervention season were maintained during the sustainability season, and orders for intermittent pulse oximetry increased from 40.6% (95% confidence interval [CI], 22.8-61.1) to 79.2% (95% CI, 58.0- 91.3). Sites that did and did not participate in the sustainability season had similar characteristics. BQIP participating sites maintained improvements in key bronchiolitis quality measures for 1 year following the project's completion. This approach, which provided an evidence-based best-practice toolkit while building the quality-improvement capacity of local interdisciplinary teams, may support performance gains that persist beyond the active phase of the

Evaluation of an institutional project to improve venous thromboembolism prevention.

Science.gov (United States)

Minami, Christina A; Yang, Anthony D; Ju, Mila; Culver, Eckford; Seifert, Kathryn; Kreutzer, Lindsey; Halverson, Terri; O'Leary, Kevin J; Bilimoria, Karl Y

2016-12-01

Northwestern Memorial Hospital (NMH) was historically a poor performer on the venous thromboembolism (VTE) outcome measure. As this measure has been shown to be flawed by surveillance bias, NMH embraced process-of-care measures to ensure appropriate VTE prophylaxis to assess healthcare-associated VTE prevention efforts. To evaluate the impact of an institution-wide project aimed at improving hospital performance on VTE prophylaxis measures. A retrospective observational study. NMH, an 885-bed academic medical center in Chicago, Illinois PATIENTS: Inpatients admitted to NMH from January 1, 2013 to May 1, 2013 and from October 1, 2014 to April 1, 2015 were eligible for evaluation. Using the define-measure-analyze-improve-control (DMAIC) process-improvement methodology, a multidisciplinary team implemented and iteratively improved 15 data-driven interventions in 4 broad areas: (1) electronic medical record (EMR) alerts, (2) education initiatives, (3) new EMR order sets, and (4) other EMR changes. The Joint Commission's 6 core measures and the Surgical Care Improvement Project (SCIP) SCIP-VTE-2 measure. Based on 3103 observations (1679 from January 1, 2013 to May 1, 2013, and 1424 from October 1, 2014 to April 1, 2015), performance on the core measures improved. Performance on measure 1 (chemoprophylaxis) improved from 82.5% to 90.2% on medicine services, and from 94.4% to 97.6% on surgical services. The largest improvements were seen in measure 4 (platelet monitoring), with a performance increase from 76.7% adherence to 100%, and measure 5 (warfarin discharge instructions), with a performance increase from 27.4% to 88.8%. A systematic hospital-wide DMAIC project improved VTE prophylaxis measure performance. Sustained performance has been observed, and novel control mechanisms for continued performance surveillance have been embedded in the hospital system. Journal of Hospital Medicine 2016;11:S29-S37. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital

Continuous Improvement Implementation in the Nottingham University Hospitals NHS Trust: A Case Study of a Continuous Improvement Programme & Project

OpenAIRE

Velzen, Jeena

2012-01-01

This paper aims at identifying the extent to which the Nottingham University Hospitals NHS Trust has fulfilled literature requirements for successful continuous improvement as exemplified by its Better for You programme and chemotherapy service improvement project. Both the theory and ideals of the continuous improvement programme, along with the actualization of these philosophies and methodologies in the context of the particular project,were compared against a framework for the enabling...

Effectiveness of participatory training on improving occupational health in small and medium enterprises in China.

Science.gov (United States)

Fu, Chuandong; Zhu, Meifeng; Yu, Tak Sun Ignatius; He, Yonghua

2013-01-01

Participatory training on occupational health is widely used in the world. Evaluations of local experiences are necessary to its successful performance. The project evaluated the effectiveness of participatory training on occupational health improvement in small and medium enterprises of China, and explored local practice experiences. Participatory training was provided to 525 welding workers from 25 small and medium enterprises in ship building and machinery manufacturing industries. This training consisted of interactive learning, worksite assessment and group discussion on laws/regulations, safety of machine operation, prevention of slips and trips, fire/explosion prevention, ergonomics, and recognition and prevention of other workplace hazards. Workers completed knowledge, attitude, and practice and worksite assessment questionnaires before and 3 months after intervention. Knowledge, attitude, and practice scores were significantly increased through the training. An inventory of workplace safety modifications was proposed by participants and many were fixed by workers and employers. Health management and personal protective equipment provision/use were most often improved, but improvements in engineering control and health-related accommodations remained unsatisfactory. Workers could recognize and fix workplace hazards after the participatory training. More efficient measures in China are to be explored to improve implementing solutions, especially on preventive engineering and human ergonomics.

Increasing use of mental health services in remote areas using mobile technology: a pre-post evaluation of the SMART Mental Health project in rural India.

Science.gov (United States)

Maulik, Pallab K; Kallakuri, Sudha; Devarapalli, Siddhardha; Vadlamani, Vamsi Krishna; Jha, Vivekanand; Patel, Anushka

2017-06-01

About 25% of the Indian population experience common mental disorders (CMD) but only 15-25% of them receive any mental health care. Stigma, lack of adequate mental health professionals and mental health services account for this treatment gap, which is worse in rural areas. Our project evaluated task shifting and mobile-technology based electronic decision support systems to enhance the ability of primary care health workers to provide evidence-based mental health care for stress, depression, and suicidal risk in 30 remote villages in the state of Andhra Pradesh, India. The Systematic Medical Appraisal Referral and Treatment (SMART) Mental Health project between May 2014 and April 2016 trained lay village health workers (Accredited Social Health Activists - ASHAs) and primary care doctors to screen, diagnose and manage individuals with common mental disorders using an electronic decision support system. An anti-stigma campaign using multi-media approaches was conducted across the villages at the outset of the project. A pre-post evaluation using mixed methods assessed the change in mental health service utilization by screen positive individuals. This paper reports on the quantitative aspects of that evaluation. Training was imparted to 21 ASHAs and 2 primary care doctors. 5007 of 5167 eligible individuals were screened, and 238 were identified as being positive for common mental disorders and referred to the primary care doctors for further management. Out of them, 2 (0.8%) had previously utilized mental health services. During the intervention period, 30 (12.6%) visited the primary care doctor for further diagnosis and treatment, as advised. There was a significant reduction in the depression and anxiety scores between start and end of the intervention among those who had screened positive at the beginning. Stigma and mental health awareness in the broader community improved during the project. The intervention led to individuals being screened for common mental

Increasing use of mental health services in remote areas using mobile technology: a pre–post evaluation of the SMART Mental Health project in rural India

Science.gov (United States)

Maulik, Pallab K; Kallakuri, Sudha; Devarapalli, Siddhardha; Vadlamani, Vamsi Krishna; Jha, Vivekanand; Patel, Anushka

2017-01-01

Background About 25% of the Indian population experience common mental disorders (CMD) but only 15–25% of them receive any mental health care. Stigma, lack of adequate mental health professionals and mental health services account for this treatment gap, which is worse in rural areas. Our project evaluated task shifting and mobile–technology based electronic decision support systems to enhance the ability of primary care health workers to provide evidence–based mental health care for stress, depression, and suicidal risk in 30 remote villages in the state of Andhra Pradesh, India. Methods The Systematic Medical Appraisal Referral and Treatment (SMART) Mental Health project between May 2014 and April 2016 trained lay village health workers (Accredited Social Health Activists – ASHAs) and primary care doctors to screen, diagnose and manage individuals with common mental disorders using an electronic decision support system. An anti–stigma campaign using multi–media approaches was conducted across the villages at the outset of the project. A pre–post evaluation using mixed methods assessed the change in mental health service utilization by screen positive individuals. This paper reports on the quantitative aspects of that evaluation. Results Training was imparted to 21 ASHAs and 2 primary care doctors. 5007 of 5167 eligible individuals were screened, and 238 were identified as being positive for common mental disorders and referred to the primary care doctors for further management. Out of them, 2 (0.8%) had previously utilized mental health services. During the intervention period, 30 (12.6%) visited the primary care doctor for further diagnosis and treatment, as advised. There was a significant reduction in the depression and anxiety scores between start and end of the intervention among those who had screened positive at the beginning. Stigma and mental health awareness in the broader community improved during the project. Conclusions The intervention

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.

The Teen Photovoice Project: A Pilot Study to Promote Health Through Advocacy

Science.gov (United States)

Necheles, Jonathan W.; Chung, Emily Q.; Hawes-Dawson, Jennifer; Ryan, Gery W.; Williams, La’Shield B.; Holmes, Heidi N.; Wells, Kenneth B.; Vaiana, Mary E.; Schuster, Mark A.

2009-01-01

Background Clinicians, public health practitioners, and policymakers would like to understand how youth perceive health issues and how they can become advocates for health promotion in their communities. 1,2 Traditional research methods can be used to capture these perceptions, but are limited in their ability to activate (excite and engage) youth to participate in health promotion activities. Objectives To pilot the use of an adapted version of photovoice as a starting point to engage youth in identifying influences on their health behaviors in a process that encourages the development of health advocacy projects. Methods Application of qualitative and quantitative methods to a participatory research project that teaches youth the photovoice method to identify and address health promotion issues relevant to their lives. Participants included 13 students serving on a Youth Advisory Board (YAB) of the UCLA/RAND Center for Adolescent Health Promotion working in four small groups of two to five participants. Students were from the Los Angeles, California, metropolitan area. Results Results were derived from photograph sorting activities, analysis of photograph narratives, and development of advocacy projects. Youth frequently discussed a variety of topics reflected in their pictures that included unhealthy food choices, inducers of stress, friends, emotions, environment, health, and positive aspects of family. The advocacy projects used social marketing strategies, focusing on unhealthy dietary practices and inducers of stress. The youths’ focus on obesity-related issues have contributed to the center’s success in partnering with the Los Angeles Unified School District on a new community-based participatory research (CBPR) project. Conclusion Youth can engage in a process of identifying community-level health influences, leading to health promotion through advocacy. Participants focused their advocacy work on selected issues addressing the types of unhealthy food

A community based participatory approach to improving health in a Hispanic population

Directory of Open Access Journals (Sweden)

Urquieta de Hernandez Brisa

2011-04-01

Full Text Available Abstract Background The Charlotte-Mecklenburg region has one of the fastest growing Hispanic communities in the country. This population has experienced disparities in health outcomes and diminished ability to access healthcare services. This city is home to an established practice-based research network (PBRN that includes community representatives, health services researchers, and primary care providers. The aims of this project are: to use key principles of community-based participatory research (CBPR within a practice-based research network (PBRN to identify a single disease or condition that negatively affects the Charlotte Hispanic community; to develop a community-based intervention that positively impacts the chosen condition and improves overall community health; and to disseminate findings to all stakeholders. Methods/design This project is designed as CBPR. The CBPR process creates new social networks and connections between participants that can potentially alter patterns of healthcare utilization and other health-related behaviors. The first step is the development of equitable partnerships between community representatives, providers, and researchers. This process is central to the CBPR process and will occur at three levels -- community members trained as researchers and outreach workers, a community advisory board (CAB, and a community forum. Qualitative data on health issues facing the community -- and possible solutions -- will be collected at all three levels through focus groups, key informant interviews and surveys. The CAB will meet monthly to guide the project and oversee data collection, data analysis, participant recruitment, implementation of the community forum, and intervention deployment. The selection of the health condition and framework for the intervention will occur at the level of a community-wide forum. Outcomes of the study will be measured using indicators developed by the participants as well as geospatial

Project Management Life Cycle Models to Improve Management in High-rise Construction

Science.gov (United States)

Burmistrov, Andrey; Siniavina, Maria; Iliashenko, Oksana

2018-03-01

The paper describes a possibility to improve project management in high-rise buildings construction through the use of various Project Management Life Cycle Models (PMLC models) based on traditional and agile project management approaches. Moreover, the paper describes, how the split the whole large-scale project to the "project chain" will create the factor for better manageability of the large-scale buildings project and increase the efficiency of the activities of all participants in such projects.

Project Management Life Cycle Models to Improve Management in High-rise Construction

Directory of Open Access Journals (Sweden)

Burmistrov Andrey

2018-01-01

Full Text Available The paper describes a possibility to improve project management in high-rise buildings construction through the use of various Project Management Life Cycle Models (PMLC models based on traditional and agile project management approaches. Moreover, the paper describes, how the split the whole large-scale project to the "project chain" will create the factor for better manageability of the large-scale buildings project and increase the efficiency of the activities of all participants in such projects.

Environmental health literacy within the Italian Asbestos Project: experience in Italy and Latin American contexts

Directory of Open Access Journals (Sweden)

Daniela Marsili

2015-09-01

Full Text Available The adoption of multidisciplinary approaches to foster scientific research in public health and strengthen its impact on society is nowadays unavoidable. Environmental health literacy (EHL may be defined as the ability to search for, understand, evaluate, and use environmental health information to promote the adoption of informed choices, the reduction of health risks, the improvement of quality of life and the protection of the environment. Both public health and environmental health literacy involve access to and dissemination of scientific information (including research findings, individual and collective decision-making and critical thinking. Specific experiences in environmental health literacy have been developed within the Italian National Asbestos Project (Progetto Amianto in Latin American countries where the use of asbestos is still permitted, and in Italy where a specific effort in EHL has been dedicated to the risks caused by the presence of fluoro-edenite fibers in the town of Biancavilla (Sicily. Taking into account the different geographical and socio-economic contexts, both public health and environmental health literacy were addressed to a wide range of stakeholders, within and outside the health domain.

Innovation in health service management: Adoption of project management offices to support major health care transformation.

Science.gov (United States)

Lavoie-Tremblay, Mélanie; Aubry, Monique; Cyr, Guylaine; Richer, Marie-Claire; Fortin-Verreault, Jean-François; Fortin, Claude; Marchionni, Caroline

2017-11-01

To explore the characteristics that influence project management offices acceptance and adoption in healthcare sector. The creation of project management offices has been suggested as a promising avenue to promote successful organisational change and facilitate evidence-based practice. However, little is known about the characteristics that promote their initial adoption and acceptance in health care sector. This knowledge is important in the context where many organisations are considering implementing project management offices with nurse managers as leaders. A descriptive multiple case study design was used. The unit of analysis was the project management offices. The study was conducted in three university-affiliated teaching hospitals in 2013-14 (Canada). Individual interviews (n = 34) were conducted with senior managers. Results reveal that project management offices dedicated to project and change management constitute an innovation and an added value that addresses tangible needs in the field. Project management offices are an innovation highly compatible with health care managers and their approach has parallels to the process of clinical problem solving and reasoning well-known to adopters. This knowledge is important in a context where many nurses hold various roles in project management offices, such as Director, project manager, clinical expert and knowledge broker. © 2017 John Wiley & Sons Ltd.

SAFETY IMPROVES DRAMATICALLY IN FLUOR HANFORD SOIL AND GROUNDWATER REMEDIATION PROJECT

International Nuclear Information System (INIS)

GERBER MS

2007-01-01

This paper describes dramatic improvements in the safety record of the Soil and Groundwater Remediation Project (SGRP) at the Hanford Site in southeast Washington state over the past four years. During a period of enormous growth in project work and scope, contractor Fluor Hanford reduced injuries, accidents, and other safety-related incidents and enhanced a safety culture that earned the SGRP Star Status in the Department of Energy's (DOE's) Voluntary Protection Program (VPP) in 2007. This paper outlines the complex and multi-faceted work of Fluor Hanford's SGRP and details the steps taken by the project's Field Operations and Safety organizations to improve safety. Holding field safety meetings and walkdowns, broadening safety inspections, organizing employee safety councils, intensively flowing down safety requirements to subcontractors, and adopting other methods to achieve remarkable improvement in safety are discussed. The roles of management, labor and subcontractors are detailed. Finally, SGRP's safety improvements are discussed within the context of overall safety enhancements made by Fluor Hanford in the company's 11 years of managing nuclear waste cleanup at the Hanford Site

A Lean Six Sigma quality improvement project to increase discharge paperwork completeness for admission to a comprehensive integrated inpatient rehabilitation program.

Science.gov (United States)

Neufeld, Nathan J; Hoyer, Erik H; Cabahug, Philippines; González-Fernández, Marlís; Mehta, Megha; Walker, N Colbey; Powers, Richard L; Mayer, R Samuel

2013-01-01

Lean Six Sigma (LSS) process analysis can be used to increase completeness of discharge summary reports used as a critical communication tool when a patient transitions between levels of care. The authors used the LSS methodology as an intervention to improve systems process. Over the course of the project, 8 required elements were analyzed in the discharge paperwork. The authors analyzed the discharge paperwork of patients (42 patients preintervention and 143 patients postintervention) of a comprehensive integrated inpatient rehabilitation program (CIIRP). Prior to this LSS project, 61.8% of required discharge elements were present. The intervention improved the completeness to 94.2% of the required elements. The percentage of charts that were 100% complete increased from 11.9% to 67.8%. LSS is a well-established process improvement methodology that can be used to make significant improvements in complex health care workflow issues. Specifically, the completeness of discharge documentation required for transition of care to CIIRP can be improved.

Implementing service improvement projects within pre-registration nursing education: a multi-method case study evaluation.

Science.gov (United States)

Baillie, Lesley; Bromley, Barbara; Walker, Moira; Jones, Rebecca; Mhlanga, Fortune

2014-01-01

Preparing healthcare students for quality and service improvement is important internationally. A United Kingdom (UK) initiative aims to embed service improvement in pre-registration education. A UK university implemented service improvement teaching for all nursing students. In addition, the degree pathway students conducted service improvement projects as the basis for their dissertations. The study aimed to evaluate the implementation of service improvement projects within a pre-registration nursing curriculum. A multi-method case study was conducted, using student questionnaires, focus groups with students and academic staff, and observation of action learning sets. Questionnaire data were analysed using SPSS v19. Qualitative data were analysed using Ritchie and Spencer's (1994) Framework Approach. Students were very positive about service improvement. The degree students, who conducted service improvement projects in practice, felt more knowledgeable than advanced diploma students. Selecting the project focus was a key issue and students encountered some challenges in practice. Support for student service improvement projects came from action learning sets, placement staff, and academic staff. Service improvement projects had a positive effect on students' learning. An effective partnership between the university and partner healthcare organisations, and support for students in practice, is essential. Copyright © 2013 Elsevier Ltd. All rights reserved.

ISTC projects devoted to improving laser beam quality

Science.gov (United States)

Malakhov, Yu. I.

2007-05-01

Short overview is done about the activity of ISTC in a direction concerned with improving powerful laser beam quality by means of nonlinear and linear adaptive optics methods. Completed projects #0591 and #1929 resulted in the development of a stimulated Brillouin scattering (SBS) phase conjugation mirror of superhigh fidelity employing the kinoform optical elements (rasters of small lenses) of new generation designed for pulsed or pulse-periodic lasers with nanosecond scale pulse duration. Project #2631 is devoted to development of an adaptive optical system for phase registration and correction of laser beams with wave front vortices. The principles of operation of conventional adaptive systems are based on the assumption that the phase is a smooth continuous function in space. Therefore the solution of the Project tasks will assume a new step in adaptive optics.

Systematic review on what works, what does not work and why of implementation of mobile health (mHealth) projects in Africa

Science.gov (United States)

2014-01-01

Background Access to mobile phone technology has rapidly expanded in developing countries. In Africa, mHealth is a relatively new concept and questions arise regarding reliability of the technology used for health outcomes. This review documents strengths, weaknesses, opportunities, and threats (SWOT) of mHealth projects in Africa. Methods A systematic review of peer-reviewed literature on mHealth projects in Africa, between 2003 and 2013, was carried out using PubMed and OvidSP. Data was synthesized using a SWOT analysis methodology. Results were grouped to assess specific aspects of project implementation in terms of sustainability and mid/long-term results, integration to the health system, management process, scale-up and replication, and legal issues, regulations and standards. Results Forty-four studies on mHealth projects in Africa were included and classified as: “patient follow-up and medication adherence” (n = 19), “staff training, support and motivation” (n = 2), “staff evaluation, monitoring and guidelines compliance” (n = 4), “drug supply-chain and stock management” (n = 2), “patient education and awareness” (n = 1), “disease surveillance and intervention monitoring” (n = 4), “data collection/transfer and reporting” (n = 10) and “overview of mHealth projects” (n = 2). In general, mHealth projects demonstrate positive health-related outcomes and their success is based on the accessibility, acceptance and low-cost of the technology, effective adaptation to local contexts, strong stakeholder collaboration, and government involvement. Threats such as dependency on funding, unclear healthcare system responsibilities, unreliable infrastructure and lack of evidence on cost-effectiveness challenge their implementation. mHealth projects can potentially be scaled-up to help tackle problems faced by healthcare systems like poor management of drug stocks, weak surveillance and reporting systems or

A multidisciplinary approach to improving women's health in semi-urban Ecuador.

Science.gov (United States)

Yancon, Andrea R; Kelly, Sean G; Valsangkar, Bina; Iyengar, Preetha; Malani, Preeti N

2009-10-01

To examine women's reasons for seeking care at The Quito Project (TQP), a student-led organization that aims to improve the health, education, and well-being of a semi-urban community in Quito, Ecuador, and to explore the need for additional preventative interventions. An oral survey was administered to 86 adult patients in 2008. We also completed a chart review to evaluate patient demographics and medical conditions. Sixty-three (73.3%) survey respondents were female. Nearly three-quarters of the women reported an income below the minimum wage; 60% reported that the cost of medical care posed a burden. Fifty-two percent sought care at TQP because the services were free. Additionally, 77% of women reported going to the doctor only when ill and did not access preventative services. By offering medical, dental, and tutoring services, along with preventative health workshops, TQP addresses established barriers to achieving adequate women's health. Survey results have reinforced TQP's focus on prevention.

Does a voucher program improve reproductive health service delivery and access in Kenya?

Science.gov (United States)

Njuki, Rebecca; Abuya, Timothy; Kimani, James; Kanya, Lucy; Korongo, Allan; Mukanya, Collins; Bracke, Piet; Bellows, Ben; Warren, Charlotte E

2015-05-23

Current assessments on Output-Based Aid (OBA) programs have paid limited attention to the experiences and perceptions of the healthcare providers and facility managers. This study examines the knowledge, attitudes, and experiences of healthcare providers and facility managers in the Kenya reproductive health output-based approach voucher program. A total of 69 in-depth interviews with healthcare providers and facility managers in 30 voucher accredited facilities were conducted. The study hypothesized that a voucher program would be associated with improvements in reproductive health service provision. Data were transcribed and analyzed by adopting a thematic framework analysis approach. A combination of inductive and deductive analysis was conducted based on previous research and project documents. Facility managers and providers viewed the RH-OBA program as a feasible system for increasing service utilization and improving quality of care. Perceived benefits of the program included stimulation of competition between facilities and capital investment in most facilities. Awareness of family planning (FP) and gender-based violence (GBV) recovery services voucher, however, remained lower than the maternal health voucher service. Relations between the voucher management agency and accredited facilities as well as existing health systems challenges affect program functions. Public and private sector healthcare providers and facility managers perceive value in the voucher program as a healthcare financing model. They recognize that it has the potential to significantly increase demand for reproductive health services, improve quality of care and reduce inequities in the use of reproductive health services. To improve program functioning going forward, there is need to ensure the benefit package and criteria for beneficiary identification are well understood and that the public facilities are permitted greater autonomy to utilize revenue generated from the voucher program.

77 FR 33240 - Central Valley Project Improvement Act, Water Management Plans

Science.gov (United States)

2012-06-05

... Project water conservation best management practices that shall ``develop criteria for evaluating the... DEPARTMENT OF THE INTERIOR Bureau of Reclamation Central Valley Project Improvement Act, Water Management Plans AGENCY: Bureau of Reclamation, Interior. ACTION: Notice of availability. SUMMARY: The...

75 FR 70020 - Central Valley Project Improvement Act, Water Management Plans

Science.gov (United States)

2010-11-16

... office on Central Valley Project water conservation best management practices that shall ``* * * develop... DEPARTMENT OF THE INTERIOR Bureau of Reclamation Central Valley Project Improvement Act, Water Management Plans AGENCY: Bureau of Reclamation, Interior ACTION: Notice of Availability. SUMMARY: The...

76 FR 12756 - Central Valley Project Improvement Act, Water Management Plans

Science.gov (United States)

2011-03-08

... office on Central Valley Project water conservation best management practices that shall ``* * * develop... DEPARTMENT OF THE INTERIOR Bureau of Reclamation Central Valley Project Improvement Act, Water Management Plans AGENCY: Bureau of Reclamation, Interior. ACTION: Notice of availability. SUMMARY: The...

77 FR 64544 - Central Valley Project Improvement Act, Water Management Plans

Science.gov (United States)

2012-10-22

... Central Valley Project water conservation best management practices that shall ``develop criteria for... DEPARTMENT OF THE INTERIOR Bureau of Reclamation Central Valley Project Improvement Act, Water Management Plans AGENCY: Bureau of Reclamation, Interior. ACTION: Notice of availability. SUMMARY: The...

Family Health Services project: the way forward.

Science.gov (United States)

Dabiri, O M

1993-01-01

Nigerians did not readily accept family planning when Family Health Services (FHS) began in 1988. FHS has made much headway in training, IEC (information, education, and communication), and constituency building and advocacy. Its staff have identified obstacles to implementation, especially program sustainability and management structure. Key limits to sustainability of IEC efforts were inadequately trained personnel and inability of trained personnel to apply what they learned at work stations. The Federal Ministry and Social Services' role in the FHS project was not clearly defined. Some private sector factors contributing to a confused management structure were inadequate method mix, high contraceptive cost, poor monitoring of quality of care, and no coordination of family planning training with the public factor. FHS has since decided to focus its efforts on increasing the demand for and availability of modern contraceptives and improving the quality of family planning services of both the public and private sectors. FHS hopes that accomplishing these activities will reduce fertility, morbidity, and mortality. Strategic plans include a regional focus, quality of care, a variety of methods offered, intensification, hospital and clinics, a management information system, contraceptive logistics, distribution regulations, and addressing social, cultural, and behavioral factors. To effectively implement the strategy, USAID and the Federal Ministry held a workshop in 1993 to effect full integration of Nigerian experience in the 2nd phase of the project (FHS II). Participants reviewed the strengths and weaknesses of the first phase and agreed on implementation. For example, nongovernmental organizations should implement FHS II. FHS II includes training, IEC, and commodities/logistics.