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

Science.gov (United States)

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

2015-10-01

While the body of evidence-based healthcare interventions grows, the ability of health systems to deliver these interventions effectively and efficiently lags behind. Quality improvement approaches, such as the model for improvement, have demonstrated some success in healthcare but their impact has been lessened by implementation challenges. To help address these challenges, we describe the empowerment evaluation approach that has been developed by programme evaluators and a method for its application (Getting To Outcomes (GTO)). We then describe how GTO can be used to implement healthcare interventions. An illustrative healthcare quality improvement example that compares the model for improvement and the GTO method for reducing hospital admissions through improved diabetes care is described. We conclude with suggestions for integrating GTO and the model for improvement. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Teaching quality improvement.

Science.gov (United States)

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

2010-08-01

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

Improving a Dental School's Clinic Operations Using Lean Process Improvement.

Science.gov (United States)

Robinson, Fonda G; Cunningham, Larry L; Turner, Sharon P; Lindroth, John; Ray, Deborah; Khan, Talib; Yates, Audrey

2016-10-01

The term "lean production," also known as "Lean," describes a process of operations management pioneered at the Toyota Motor Company that contributed significantly to the success of the company. Although developed by Toyota, the Lean process has been implemented at many other organizations, including those in health care, and should be considered by dental schools in evaluating their clinical operations. Lean combines engineering principles with operations management and improvement tools to optimize business and operating processes. One of the core concepts is relentless elimination of waste (non-value-added components of a process). Another key concept is utilization of individuals closest to the actual work to analyze and improve the process. When the medical center of the University of Kentucky adopted the Lean process for improving clinical operations, members of the College of Dentistry trained in the process applied the techniques to improve inefficient operations at the Walk-In Dental Clinic. The purpose of this project was to reduce patients' average in-the-door-to-out-the-door time from over four hours to three hours within 90 days. Achievement of this goal was realized by streamlining patient flow and strategically relocating key phases of the process. This initiative resulted in patient benefits such as shortening average in-the-door-to-out-the-door time by over an hour, improving satisfaction by 21%, and reducing negative comments by 24%, as well as providing opportunity to implement the electronic health record, improving teamwork, and enhancing educational experiences for students. These benefits were achieved while maintaining high-quality patient care with zero adverse outcomes during and two years following the process improvement project.

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

Science.gov (United States)

Whitfill, Travis; Gawel, Marcie; Auerbach, Marc

2017-07-17

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

76 FR 41246 - Pesticide Program Dialogue Committee, Pesticide Registration Improvement Act Process Improvement...

Science.gov (United States)

2011-07-13

... Committee, Pesticide Registration Improvement Act Process Improvement Workgroup; Notice of Public Meeting...) Process Improvement Work Group. EPA plans to meet its ESA consultation obligations through the pesticide... a pesticide during the registration review process. This meeting of the PRIA Process Improvement...

Non-oblivious Strategy Improvement

Science.gov (United States)

Fearnley, John

We study strategy improvement algorithms for mean-payoff and parity games. We describe a structural property of these games, and we show that these structures can affect the behaviour of strategy improvement. We show how awareness of these structures can be used to accelerate strategy improvement algorithms. We call our algorithms non-oblivious because they remember properties of the game that they have discovered in previous iterations. We show that non-oblivious strategy improvement algorithms perform well on examples that are known to be hard for oblivious strategy improvement. Hence, we argue that previous strategy improvement algorithms fail because they ignore the structural properties of the game that they are solving.

Making process improvement 'stick'.

Science.gov (United States)

Studer, Quint

2014-06-01

To sustain gains from a process improvement initiative, healthcare organizations should: Explain to staff why a process improvement initiative is needed. Encourage leaders within the organization to champion the process improvement, and tie their evaluations to its outcomes. Ensure that both leaders and employees have the skills to help sustain the sought-after process improvements.

Experimental Study on Durability Improvement of Fly Ash Concrete with Durability Improving Admixture

OpenAIRE

Quan, Hong-zhu; Kasami, Hideo

2014-01-01

In order to improve the durability of fly ash concrete, a series of experimental studies are carried out, where durability improving admixture is used to reduce drying shrinkage and improve freezing-thawing resistance. The effects of durability improving admixture, air content, water-binder ratio, and fly ash replacement ratio on the performance of fly ash concrete are discussed in this paper. The results show that by using durability improving admixture in nonair-entraining fly ash concrete,...

CDBG Public Improvements Activity

Data.gov (United States)

Department of Housing and Urban Development — CDBG activity related to public improvements, including senior centers, youth centers, parks, street improvements, water/sewer improvements, child care centers, fire...

Process Improvement Essentials

CERN Document Server

Persse, James R

2006-01-01

Process Improvement Essentials combines the foundation needed to understand process improvement theory with the best practices to help individuals implement process improvement initiatives in their organization. The three leading programs: ISO 9001:2000, CMMI, and Six Sigma--amidst the buzz and hype--tend to get lumped together under a common label. This book delivers a combined guide to all three programs, compares their applicability, and then sets the foundation for further exploration.

Improving fleet performance

International Nuclear Information System (INIS)

Ramjist, S.

2015-01-01

Use Fleet Initiatives to Improve Overall Fleet Performance . Tightly Integrated with Business Planning (Cause & Effect) . Leverage Strength of Broader Organization - Converge on Standard Business Practices . Ancillary Benefit of Improved Agility.

Improving fleet performance

Energy Technology Data Exchange (ETDEWEB)

Ramjist, S. [Ontario Power Generation, Toronto, ON (Canada)

2015-07-01

Use Fleet Initiatives to Improve Overall Fleet Performance . Tightly Integrated with Business Planning (Cause & Effect) . Leverage Strength of Broader Organization - Converge on Standard Business Practices . Ancillary Benefit of Improved Agility.

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

Science.gov (United States)

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

2016-04-01

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

Experimental study on durability improvement of fly ash concrete with durability improving admixture.

Science.gov (United States)

Quan, Hong-zhu; Kasami, Hideo

2014-01-01

In order to improve the durability of fly ash concrete, a series of experimental studies are carried out, where durability improving admixture is used to reduce drying shrinkage and improve freezing-thawing resistance. The effects of durability improving admixture, air content, water-binder ratio, and fly ash replacement ratio on the performance of fly ash concrete are discussed in this paper. The results show that by using durability improving admixture in nonair-entraining fly ash concrete, the compressive strength of fly ash concrete can be improved by 10%-20%, and the drying shrinkage is reduced by 60%. Carbonation resistance of concrete is roughly proportional to water-cement ratio regardless of water-binder ratio and fly ash replacement ratio. For the specimens cured in air for 2 weeks, the freezing-thawing resistance is improved. In addition, by making use of durability improving admixture, it is easier to control the air content and make fly ash concrete into nonair-entraining one. The quality of fly ash concrete is thereby optimized.

The Work Compatibility Improvement Framework: theory and application of improvement action and intervention strategies.

Science.gov (United States)

Genaidy, Ash M; Rinder, Magda M; Sequeira, Reynold; A-Rehim, Amal D

2009-05-01

Challenges facing management of manufacturing firms can be transformed into asset gains by giving careful consideration to the worker-work environment interface. The benefits of a 'healthy' interface may lead to sizable reductions in rising health care costs and retention of highly qualified workers. This paper presents a novel approach for the 'improve' phase of the Work Compatibility Improvement Framework. The work tasks of this research consisted of: (a) fundamentals of cognitive-based improvement action and intervention; (b) design concepts and process of improvement action/intervention generation; (c) assessment model of estimated gains in company's assets; (d) application demonstration in the manufacturing sector. The process of improvement action/intervention generation is described, preceded by a description of the fundamentals of cognitive-based improvement action and intervention and system architecture. This is followed by a documentation of estimated asset gains as a result of the improvement plan. The results showed that expert workers were, on average, 78% in agreement with the algorithm-identified improvement actions. Their knowledge was used to update the recommended actions as well as to detail the multiple strategies required to address the improvement actions. As a result, an integrated improvement plan was developed resulting in estimated asset gains of $1.6 million, which was validated by the general manager. The research reported herein documented the theory and application of the 'improve' phase of the Work Compatibility Improvement Framework. The economic assessment of the suggested improvement is also reported and this has proved to be an important driver to secure the firm collaboration of manufacturing enterprise management. An integrated improvement solution plan backed by a detailed economic assessment of suggested improvements is essential to demonstrate the full potential of workplace micro- and macro-ergonomic interventions.

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

Science.gov (United States)

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

2017-07-01

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

Continuous Improvement in Education. Advancing Teaching--Improving Learning. White Paper

Science.gov (United States)

Park, Sandra; Hironaka, Stephanie; Carver, Penny; Nordstrum, Lee

2013-01-01

In recent years, "continuous improvement" has become a popular catchphrase in the field of education. However, while continuous improvement has become commonplace and well-documented in other industries, such as healthcare and manufacturing, little is known about how this work has manifested itself in education. This white paper attempts…

Implementing a customer focused continual business improvement program to improve the maintenance process

International Nuclear Information System (INIS)

Kharshafdjian, G.; Fisher, C.; Beres, T.; Brooks, S.; Forbes, S.; Krause, M.; McAuley, K.; Wendorf, M.

2006-01-01

Global market pressures and increasing competition demands that successful companies establish a continual business improvement program as part of implementing its business strategy. Such programs must be driven by the definition of quality from the customer's perspective. This customer quality focus often requires a change in all aspects of the business including products, services, processes and culture. This paper will describe how Atomic Energy of Canada Limited implemented a Continual Business Improvement Program in their Nuclear Laboratories Business Unit. In particular, to review how the techniques were applied to improve the maintenance process and the status of the project. Customer (internal users of the processes at CRL) feedback has shown repeatedly there is dissatisfaction of the maintenance process. Customers complain about jobs not getting done to schedule or being deferred. A project has been launched with the following goals: to improve the maintenance process customer satisfaction and increase trades wrench time by 30 minutes / trade / day. DMAIC (Define-Measure-Analyze-Improve-Control) methodology was applied to find out the Root Cause(s) of the problem, provide solutions, and implement improvements. The expected Operational Benefits include: Executing work efficiently to quality standards and business performance of the site, improve maintenance efficiencies, reduce cycle time for maintenance process and improve process yield, and improve customer and employee satisfaction. (author)

Implementing a customer focused continual business improvement program to improve the maintenance process

Energy Technology Data Exchange (ETDEWEB)

Kharshafdjian, G.; Fisher, C.; Beres, T.; Brooks, S.; Forbes, S.; Krause, M.; McAuley, K.; Wendorf, M. [Atomic Energy of Canada Limited, Chalk River, Ontario (Canada)

2006-07-01

Global market pressures and increasing competition demands that successful companies establish a continual business improvement program as part of implementing its business strategy. Such programs must be driven by the definition of quality from the customer's perspective. This customer quality focus often requires a change in all aspects of the business including products, services, processes and culture. This paper will describe how Atomic Energy of Canada Limited implemented a Continual Business Improvement Program in their Nuclear Laboratories Business Unit. In particular, to review how the techniques were applied to improve the maintenance process and the status of the project. Customer (internal users of the processes at CRL) feedback has shown repeatedly there is dissatisfaction of the maintenance process. Customers complain about jobs not getting done to schedule or being deferred. A project has been launched with the following goals: to improve the maintenance process customer satisfaction and increase trades wrench time by 30 minutes / trade / day. DMAIC (Define-Measure-Analyze-Improve-Control) methodology was applied to find out the Root Cause(s) of the problem, provide solutions, and implement improvements. The expected Operational Benefits include: Executing work efficiently to quality standards and business performance of the site, improve maintenance efficiencies, reduce cycle time for maintenance process and improve process yield, and improve customer and employee satisfaction. (author)

Non-oblivious Strategy Improvement

OpenAIRE

Fearnley, John

2010-01-01

We study strategy improvement algorithms for mean-payoff and parity games. We describe a structural property of these games, and we show that these structures can affect the behaviour of strategy improvement. We show how awareness of these structures can be used to accelerate strategy improvement algorithms. We call our algorithms non-oblivious because they remember properties of the game that they have discovered in previous iterations. We show that non-oblivious strategy improvement algorit...

Chirally improving Wilson fermions I. O(a) improvement

International Nuclear Information System (INIS)

Frezzotti, R.; Rossi, G.C.

2004-01-01

We show that it is possible to improve the chiral behaviour and the approach to the continuum limit of correlation functions in lattice QCD with Wilson fermions by taking arithmetic averages of correlators computed in theories regularized with Wilson terms of opposite sign. Improved hadronic masses and matrix elements can be obtained by similarly averaging the corresponding physical quantities separately computed within the two regularizations. To deal with the problems related to the spectrum of the Wilson-Dirac operator, which are particularly worrisome when Wilson and mass terms are such as to give contributions of opposite sign to the real part of the eigenvalues, we propose to use twisted-mass lattice QCD for the actual computation of the quantities taking part to the averages. The choice ±π/2 for the twisting angle is particularly interesting, as O(a) improved estimates of physical quantities can be obtained even without averaging data from lattice formulations with opposite Wilson terms. In all cases little or no extra computing power is necessary, compared to simulations with standard Wilson fermions or twisted-mass lattice QCD. (author)

Maintenance improvement program

International Nuclear Information System (INIS)

Derbonne, D.R.; Plunkett, T.F.; Simpson, J.R.

1989-01-01

During fuel cycle 1 at River Bend station, considerable effort was expended to reduce corrective maintenance work orders (MWOs) to <1,000. This was done by complementing the plant staff with costly contract personnel. Coming out of the first refueling outage, most contract personnel were released. The change in MWO backlog started a steady rise. It became readily apparent that to avoid costly contract staff time, a maintenance improvement program (MIP) was necessary. The MIP Was primarily directed at two areas: crew efficiency improvements and improved preplanned MWO packages. The overall effect of the MIP was to achieve significant productivity improvements with reduced operation and maintenance cost by providing frequent accountability to all levels of maintenance supervision. The MIP also produced a feeling of pride among the maintenance department employees that had not really existed before. This was the best benefit of all

Improving Healthcare Logistics Processes

DEFF Research Database (Denmark)

Feibert, Diana Cordes

logistics processes in hospitals and aims to provide theoretically and empirically based evidence for improving these processes to both expand the knowledge base of healthcare logistics and provide a decision tool for hospital logistics managers to improve their processes. Case studies were conducted...... processes. Furthermore, a method for benchmarking healthcare logistics processes was developed. Finally, a theoretically and empirically founded framework was developed to support managers in making an informed decision on how to improve healthcare logistics processes. This study contributes to the limited...... literature concerned with the improvement of logistics processes in hospitals. Furthermore, the developed framework provides guidance for logistics managers in hospitals on how to improve their processes given the circumstances in which they operate....

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.

Improving palliative care.

LENUS (Irish Health Repository)

Moran, Sue

2009-05-01

Any service improvement project requires planning, action and evaluation. Using a recognised quality improvement framework can offer a structured approach to implementing and assessing changes to patient care. This article describes how use of the Deming Cycle has helped to identify nurses\\' learning needs.

Room for improvement

DEFF Research Database (Denmark)

Sandal, Louise F; Thorlund, Jonas B; Moore, Andrew J

2018-01-01

-reported outcomes and qualitative findings supported the primary finding, while improvements in muscle strength and aerobic capacity did not differ between exercise groups. CONCLUSION: Results suggest that the physical environment contributes to treatment response. Matching patients' preferences to treatment rooms...... significance (p=0.07). Waitlist group reported no improvement (-0.05 95% CI -0.5 to 0.4). In interviews, participants from the standard environment expressed greater social cohesion and feeling at home. Qualitative themes identified; reflection, sense of fellowship and transition. Secondary patient...... may improve patient-reported outcomes. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov identifier: NCT02043613....

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

Science.gov (United States)

Millar, Ross

2013-01-01

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

Genetic improvement of vegetables

International Nuclear Information System (INIS)

Jaramillo Vasquez, J.G.

2001-01-01

Some genetic bases of the improvement of vegetables are given. The objectives of the genetic improvement and the fundamental stages of this process are done. The sources of genetic variation are indicated and they are related the reproduction systems of the main horticultural species. It is analyzed the concept of genetic inheritance like base to determine the procedures more appropriate of improvement. The approaches are discussed, has more than enough phenotypic value, genetic action and genotypic variance; Equally the heredability concepts and value of improvement. The conventional methods of improvement are described, like they are: the introduction of species or varieties, the selection, the pure line, the pedigree method, the selection for families, the recurrent selection, the selection for unique seed, the haploids method, the selection for heterosis and the synthetic varieties

Reference Manual on Making School Climate Improvements. School Climate Improvement Resource Package, 2017

Science.gov (United States)

Yoder, N.; Darling-Churchill, K.; Colombi, G. D.; Ruddy, S.; Neiman, S.; Chagnon, E.; Mayo, R.

2017-01-01

This reference manual identifies five overarching sets of activities for improving school climate, with the goal of improving student outcomes (e.g., achievement, attendance, behaviors, and skills). These sets of activities help to initiate, implement, and sustain school climate improvements. For each activity set, the manual presents a clear…

Continuous Personal Improvement.

Science.gov (United States)

Emiliani, M. L.

1998-01-01

Suggests that continuous improvement tools used in the workplace can be applied to self-improvement. Explains the use of such techniques as one-piece flow, kanban, visual controls, and total productive maintenance. Points out misapplications of these tools and describes the use of fishbone diagrams to diagnose problems. (SK)

Continuous quality improvement

NARCIS (Netherlands)

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

2002-01-01

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

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

Science.gov (United States)

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

2013-01-01

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

Improving School Improvement: Development and Validation of the CSIS-360, a 360-Degree Feedback Assessment for School Improvement Specialists

Science.gov (United States)

McDougall, Christie M.

2013-01-01

The purpose of the mixed methods study was to develop and validate the CSIS-360, a 360-degree feedback assessment to measure competencies of school improvement specialists from multiple perspectives. The study consisted of eight practicing school improvement specialists from a variety of settings. The specialists nominated 23 constituents to…

Continuous quality improvement

International Nuclear Information System (INIS)

Bourne, P.B.

1985-01-01

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

The Relationship of Engagement in Improvement Practices to Outcome Measures in Large-Scale Quality Improvement Initiatives.

Science.gov (United States)

Foster, Gregory L; Kenward, Kevin; Hines, Stephen; Joshi, Maulik S

Hospital engagement networks (HENs) are part of the largest health care improvement initiative ever undertaken. This article explores whether engagement in improvement activities within a HEN affected quality measures. Data were drawn from 1174 acute care hospitals. A composite quality score was created from 10 targeted topic area measures multiplied by the number of qualifying topics. Scores improved from 5.4 (SD = 6.8) at baseline to 4.6 (5.9) at remeasurement; P improvement ( P improvement, whereas hospitals in the West ( P = .0009) did not improve as much as hospitals in other regions. After adjusting for hospital characteristics, hospitals with improvement champions ( P = .008), a higher level of engagement with their state association ( P = .001), and more leadership involvement ( P = .005) in HEN demonstrated greater improvement.

Quality improvement - the future begins

International Nuclear Information System (INIS)

Boissy, G.J.

1987-01-01

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

Ergonomic Improvements for Foundries

Energy Technology Data Exchange (ETDEWEB)

Frank Peters; Patrick Patterson

2002-06-18

The goal of this project was to make improvements to the production systems of the steel casting industry through ergonomic improvements. Because of the wide variety of products, the wide range of product sizes, and the relatively small quantities of any particular product, manual operations remain a vital part of the production systems of the steel casting companies. Ergonomic improvements will assist the operators to more efficiently and consistently produce quality products.

Measure to succeed: How to improve employee participation in continuous improvement

Energy Technology Data Exchange (ETDEWEB)

Jurburg, M.; Viles, E.; Tanco, M.; Mateo, R.; Lleó, A.

2016-07-01

Purpose: Achieving employee participation in continuous improvement (CI) systems is considered as one of the success factors for the sustainability of those systems. Yet, it is also very difficult to obtain because of the interaction of many critical factors that affect employee participation. Therefore, finding ways of measuring all these critical factors can help practitioners manage the employee participation process accordingly. Design/methodology/approach: Based upon the existing literature, this paper presents a 4-Phase (9 steps) diagnostic tool to measure the main determinants associated with the implementation of CI systems affecting employee participation in improvement activities. Findings: The tool showed its usefulness to detect the main weaknesses and improvement opportunities for improving employee participation in CI through the application in two different cases. Practical implications: This diagnostic tool could be particularly interesting for companies adopting CI and other excellence frameworks, which usually include a pillar related to people development inside the organization, but do not include tools to diagnose the state of this pillar. Originality/value: This diagnostic tool presents a user’s perspective approach, ensuring that the weaknesses and improvement opportunities detected during the diagnose come directly from the users of the CI system, which in this case are the employees themselves. Given that the final objective is to identify reasons and problems hindering employee participation, adopting this user’s perspective approach seem more relevant than adopting other more traditional approaches, based on gathering information from the CI system itself or from the CI managers.

Measure to succeed: How to improve employee participation in continuous improvement

International Nuclear Information System (INIS)

Jurburg, M.; Viles, E.; Tanco, M.; Mateo, R.; Lleó, A.

2016-01-01

Purpose: Achieving employee participation in continuous improvement (CI) systems is considered as one of the success factors for the sustainability of those systems. Yet, it is also very difficult to obtain because of the interaction of many critical factors that affect employee participation. Therefore, finding ways of measuring all these critical factors can help practitioners manage the employee participation process accordingly. Design/methodology/approach: Based upon the existing literature, this paper presents a 4-Phase (9 steps) diagnostic tool to measure the main determinants associated with the implementation of CI systems affecting employee participation in improvement activities. Findings: The tool showed its usefulness to detect the main weaknesses and improvement opportunities for improving employee participation in CI through the application in two different cases. Practical implications: This diagnostic tool could be particularly interesting for companies adopting CI and other excellence frameworks, which usually include a pillar related to people development inside the organization, but do not include tools to diagnose the state of this pillar. Originality/value: This diagnostic tool presents a user’s perspective approach, ensuring that the weaknesses and improvement opportunities detected during the diagnose come directly from the users of the CI system, which in this case are the employees themselves. Given that the final objective is to identify reasons and problems hindering employee participation, adopting this user’s perspective approach seem more relevant than adopting other more traditional approaches, based on gathering information from the CI system itself or from the CI managers.

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

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.

Software Process Improvement Defined

DEFF Research Database (Denmark)

Aaen, Ivan

2002-01-01

This paper argues in favor of the development of explanatory theory on software process improvement. The last one or two decades commitment to prescriptive approaches in software process improvement theory may contribute to the emergence of a gulf dividing theorists and practitioners....... It is proposed that this divide be met by the development of theory evaluating prescriptive approaches and informing practice with a focus on the software process policymaking and process control aspects of improvement efforts...

School Climate Improvement Action Guide for Working with Families. School Climate Improvement Resource Package

Science.gov (United States)

National Center on Safe Supportive Learning Environments, 2017

2017-01-01

Improving school climate takes time and commitment from a variety of people in a variety of roles. This document outlines how family members--including guardians of students--can support school climate improvements. Key action steps are provided for the following strategies: (1) Participate in planning for school climate improvements; (2) Engage…

School Climate Improvement Action Guide for Working with Students. School Climate Improvement Resource Package

Science.gov (United States)

National Center on Safe Supportive Learning Environments, 2017

2017-01-01

Improving school climate takes time and commitment from a variety of people in a variety of roles. This document outlines key action steps to engage students in the school climate improvement process. Key action steps are provided for the following strategies: (1) Participate in planning for school climate improvements; (2) Engage stakeholders in…

Improv(ing) the Academy: Applied Improvisation as a Strategy for Educational Development

Science.gov (United States)

Rossing, Jonathan P.; Hoffmann-Longtin, Krista

2016-01-01

Improvisational theater training (or "improv") is a strategy employed by many business leaders and educators to cultivate creativity and collaboration amid change. Drawing on improv principles such as "Yes, And…" and "Make your scene partners look good," we explore the ways in which educational developers might apply…

Documentation of Improvement Competences

DEFF Research Database (Denmark)

Johansen, Jørn; Back, Karsten Kristensen; Korsaa, Morten

2017-01-01

This paper demonstrates how a report used in a Master in Project management and Process improvement training at Roskilde University Denmark can be used to evaluate if a student can pass the ECQA SPI Manager exam. It also demonstrates how the structure of the report addresses all necessary...... Manager job role, which is based on the SPI Manifesto and the ImprovAbilityTM model (part of ISO/IEC 33014 Guideline for Process Improvement) among other types of knowledge and research....... competences, which should or could be brought into play during the project – and therefor also in one way or another addresses the quality of the activated competences in the improvement project – a kind of qualification. The clue is that the structure of the report follows the units and element in the SPI...

Researchers' Roles in Patient Safety Improvement.

Science.gov (United States)

Pietikäinen, Elina; Reiman, Teemu; Heikkilä, Jouko; Macchi, Luigi

2016-03-01

In this article, we explore how researchers can contribute to patient safety improvement. We aim to expand the instrumental role researchers have often occupied in relation to patient safety improvement. We reflect on our own improvement model and experiences as patient safety researchers in an ongoing Finnish multi-actor innovation project through self-reflective narration. Our own patient safety improvement model can be described as systemic. Based on the purpose of the innovation project, our improvement model, and the improvement models of the other actors in the project, we have carried out a wide range of activities. Our activities can be summarized in 8 overlapping patient safety improvement roles: modeler, influencer, supplier, producer, ideator, reflector, facilitator, and negotiator. When working side by side with "practice," researchers are offered and engage in several different activities. The way researchers contribute to patient safety improvement and balance between different roles depends on the purpose of the study, as well as on the underlying patient safety improvement models. Different patient safety research paradigms seem to emphasize different improvement roles, and thus, they also face different challenges. Open reflection on the underlying improvement models and roles can help researchers with different backgrounds-as well as other actors involved in patient safety improvement-in structuring their work and collaborating productively.

Quality improvement: the nurse's role.

Science.gov (United States)

Moran, M J; Johnson, J E

1992-06-01

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

Improving Reference Service: The Case for Using a Continuous Quality Improvement Method.

Science.gov (United States)

Aluri, Rao

1993-01-01

Discusses the evaluation of library reference service; examines problems with past evaluations, including the lack of long-term planning and a systems perspective; and suggests a method for continuously monitoring and improving reference service using quality improvement tools such as checklists, cause and effect diagrams, Pareto charts, and…

35/30 outage improvement project

International Nuclear Information System (INIS)

Clewett, L.

2011-01-01

Outage performance is a significant contributor to the business plan at Bruce Power. A process improvement initiative commenced in 2010-11 to improve outage efficiency and predictability. 12 teams (over 200 people) participated in improvement identification in four areas: Organizational Engagement; Outage Scope; Resources; and, Critical Outage Execution. Out of over 550 initiatives identified, 200 are being incorporated into the Outage Improvement Initiative. Key deliverables include: Development of a long-range 'fleet-level' business strategy to integrate outage duration, outage improvements and unit refurbishments; Development of a 35 day outage schedule template; Determining optimal outage organization to perform outages on an 8-unit site; Improved schedule adherence and productivity; Process to integrate scope needs to support life-cycle and long-range outage needs improvement while meeting near term and regulatory requirements; Consistent methodology in planning of outages to front-end load the high risk work into the outage schedule; Consistent baseline by senior leaders for the expectations of milestone ownership and completion; Consistent framework for milestone compliance and preparation; Communication strategy to educate personnel on the importance of the outage program and nuclear safety, business goals, and budget; and, Suite of metrics based upon industry benchmarks. The Outage Improvement Initiative has a goal of 35 day outages every 30 months. This potentially represents considerable savings to the Bruce Power business plan, both direct revenue savings attributed to reduced outage duration, as well as incremental outage cost savings. Other improvements from the initiative will include personnel radiation exposure and equipment reliability due to decreased outage duration and adherence to scoping, assessing and long lead part milestones. This presentation will describe the outage improvement initiatives to achieve a goal of consistent 35 day outages

35/30 outage improvement project

Energy Technology Data Exchange (ETDEWEB)

Clewett, L. [Bruce Power, Tiverton, Ontario (Canada)

2011-07-01

Outage performance is a significant contributor to the business plan at Bruce Power. A process improvement initiative commenced in 2010-11 to improve outage efficiency and predictability. 12 teams (over 200 people) participated in improvement identification in four areas: Organizational Engagement; Outage Scope; Resources; and, Critical Outage Execution. Out of over 550 initiatives identified, 200 are being incorporated into the Outage Improvement Initiative. Key deliverables include: Development of a long-range 'fleet-level' business strategy to integrate outage duration, outage improvements and unit refurbishments; Development of a 35 day outage schedule template; Determining optimal outage organization to perform outages on an 8-unit site; Improved schedule adherence and productivity; Process to integrate scope needs to support life-cycle and long-range outage needs improvement while meeting near term and regulatory requirements; Consistent methodology in planning of outages to front-end load the high risk work into the outage schedule; Consistent baseline by senior leaders for the expectations of milestone ownership and completion; Consistent framework for milestone compliance and preparation; Communication strategy to educate personnel on the importance of the outage program and nuclear safety, business goals, and budget; and, Suite of metrics based upon industry benchmarks. The Outage Improvement Initiative has a goal of 35 day outages every 30 months. This potentially represents considerable savings to the Bruce Power business plan, both direct revenue savings attributed to reduced outage duration, as well as incremental outage cost savings. Other improvements from the initiative will include personnel radiation exposure and equipment reliability due to decreased outage duration and adherence to scoping, assessing and long lead part milestones. This presentation will describe the outage improvement initiatives to achieve a goal of consistent 35 day

Accelerate Water Quality Improvement

Science.gov (United States)

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

Entropy based software processes improvement

NARCIS (Netherlands)

Trienekens, J.J.M.; Kusters, R.J.; Kriek, D.; Siemons, P.

2009-01-01

Actual results of software process improvement projects show different levels of success. Although many software development organisations have adopted improvement models such as CMMI, it appears to be difficult to improve software development processes in the right way, e.g. tuned to the actual

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

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

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

Science.gov (United States)

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

2012-07-01

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

Improving Banking Supervision

OpenAIRE

Mayes, David G.

1998-01-01

This paper explains how banking supervision within the EU, and in Finland in particular, can be improved by the implementation of greater market discipline and related changes. Although existing EU law, institutions, market structures and practices of corporate governance restrict the scope for change, substantial improvements can be introduced now while there is a window of opportunity for change. The economy is growing H5ly and the consequences of the banking crises of the early 1990s have ...

Using Lean to Advance Quality Improvement Research.

Science.gov (United States)

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

2016-01-01

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

Improving Agile Software Practice

DEFF Research Database (Denmark)

Tjørnehøj, Gitte

2006-01-01

Software process improvement in small and agile organizations is often problematic, but achieving good SPI-assessments can still be necessary to stay in the marked or to meet demands of multinational owners. The traditional norm driven, centralized and control centered improvement approaches has...

Why Process Improvement Training Fails

Science.gov (United States)

Lu, Dawei; Betts, Alan

2011-01-01

Purpose: The purpose of this paper is to explore the underlying reasons why providing process improvement training, by itself, may not be sufficient to achieve the desired outcome of improved processes; and to attempt a conceptual framework of management training for more effective improvement. Design/methodology/approach: Two similar units within…

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

Science.gov (United States)

Vogelsang, J

1999-04-01

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

Improving with Kaizen

OpenAIRE

Dahl, Helene

2016-01-01

Master's thesis in Executive MBA Kaizen is a Japanese word translated to Good Change, but the meaning behind the word is continuous improvement. Kaizen events are a part of the Lean philosophy and developed by Toyota. The event typically takes place during 4-5 days and aims to make significant change by identifying possibilities for improvement. This thesis is a study of one Kaizen event that took place in an American oil-service company in Sandnes, Norway. A case study has been u...

KAIZEN CONTINUOUS IMPROVEMENT

OpenAIRE

Yenque D., Julio; García P., Manuel; Raez G., Luis

2014-01-01

Many times we ask the question why Japanese companies are competitive?, Surely many of the answers to this mystery have support in the Kaizen. And the Kaizen is not a simple concept, it is a whole way of life that involves both managers and workers in the pursuit of progressive improvement of enterprises. In his book Kaizen, The Key to Japanese Competitive Advantage, Masaaki Imai explains in simple terms what is the essence of this philosophy: Kaizen means improvement means further progressiv...

Historical Improvement in Speed Skating Economy

NARCIS (Netherlands)

Noordhof, Dionne A; Tok, Elmy van; Joosten, Florentine S J G M; Hettinga, Florentina J; Hoozemans, Marco J M; Foster Jr., Carl; Koning, Jos J de

Half the improvement in 1500-m speed-skating world records can be explained by technological innovations and the other half by athletic improvement. It is hypothesized that improved skating economy is accountable for much of the athletic improvement. PURPOSE: To determine skating economy in

Improving patient safety culture in Saudi Arabia (2012-2015): trending, improvement and benchmarking.

Science.gov (United States)

Alswat, Khalid; Abdalla, Rawia Ahmad Mustafa; Titi, Maher Abdelraheim; Bakash, Maram; Mehmood, Faiza; Zubairi, Beena; Jamal, Diana; El-Jardali, Fadi

2017-08-02

Measuring patient safety culture can provide insight into areas for improvement and help monitor changes over time. This study details the findings of a re-assessment of patient safety culture in a multi-site Medical City in Riyadh, Kingdom of Saudi Arabia (KSA). Results were compared to an earlier assessment conducted in 2012 and benchmarked with regional and international studies. Such assessments can provide hospital leadership with insight on how their hospital is performing on patient safety culture composites as a result of quality improvement plans. This paper also explored the association between patient safety culture predictors and patient safety grade, perception of patient safety, frequency of events reported and number of events reported. We utilized a customized version of the patient safety culture survey developed by the Agency for Healthcare Research and Quality. The Medical City is a tertiary care teaching facility composed of two sites (total capacity of 904 beds). Data was analyzed using SPSS 24 at a significance level of 0.05. A t-Test was used to compare results from the 2012 survey to that conducted in 2015. Two adopted Generalized Estimating Equations in addition to two linear models were used to assess the association between composites and patient safety culture outcomes. Results were also benchmarked against similar initiatives in Lebanon, Palestine and USA. Areas of strength in 2015 included Teamwork within units, and Organizational Learning-Continuous Improvement; areas requiring improvement included Non-Punitive Response to Error, and Staffing. Comparing results to the 2012 survey revealed improvement on some areas but non-punitive response to error and Staffing remained the lowest scoring composites in 2015. Regression highlighted significant association between managerial support, organizational learning and feedback and improved survey outcomes. Comparison to international benchmarks revealed that the hospital is performing at or

Brunswick improvement program

International Nuclear Information System (INIS)

Howe, P.W.

1985-01-01

The performance of the twin 790-MW Mark-4 boiling water reactors located at the Brunswick steam electric plant has historically been well below average. The plant experienced low availability, low capacity factors, high US Nuclear Regulatory Commission (NRC) violations, excessive radioactive waste generation, excessive licensee event reports (LERs), an unacceptable industrial safety record, poor SALP ratings, and numerous other deficiencies leading to unacceptable performance. In June 1982 it was determined that certain periodic tests (PT) had never been performed. While one unit was down for a refueling/modification outage, Carolina Power and Light (CP and L) elected to bring the other unit off line and perform an extensive self-examination. As a result, a number of needed improvements covering a wide range of plant activities were identified. CP and L elected to consolidate all the elements of the improvement into a single, plant-wide program. The consolidated program, called the Brunswick Improvement Program (BIP), was established. Major objectives of the BIP and measurable results are presented

Improving Loop Dependence Analysis

DEFF Research Database (Denmark)

Jensen, Nicklas Bo; Karlsson, Sven

2017-01-01

Programmers can no longer depend on new processors to have significantly improved single-thread performance. Instead, gains have to come from other sources such as the compiler and its optimization passes. Advanced passes make use of information on the dependencies related to loops. We improve th...

AGS slow extraction improvements

International Nuclear Information System (INIS)

Glenn, J.W.; Smith, G.A.; Sandberg, J.N.; Repeta, L.; Weisberg, H.

1979-01-01

Improvement of the straightness of the F5 copper septum increased the AGS slow extraction efficiency from approx. 80% to approx. 90%. Installation of an electrostatic septum at H2O, 24 betatron wavelengths upstream of F5, further improved the extraction efficiency to approx. 97%

Nuclear safety. Improvement programme

International Nuclear Information System (INIS)

2000-01-01

In this brochure the improvement programme of nuclear safety of the Mochovce NPP is presented in detail. In 1996, a 'Mochovce NPP Nuclear Safety Improvement Programme' was developed in the frame of unit 1 and 2 completion project. The programme has been compiled as a continuous one, with the aim to reach the highest possible safety level at the time of commissioning and to establish good preconditions for permanent safety improvement in future. Such an approach is in compliance with the world's trends of safety improvement, life-time extension, modernisation and nuclear station power increase. The basic document for development of the 'Programme' is the one titled 'Safety Issues and their Ranking for WWER 440/213 NPP' developed by a group of IAEA experts. The following organisations were selected for solution of the safety measures: EUCOM (Consortium of FRAMATOME, France, and SIEMENS, Germany); SKODA Prague, a.s.; ENERGOPROJEKT Prague, a.s. (EGP); Russian organisations associated in ATOMENERGOEXPORT; VUJE Trnava, a.s

Improved radionuclide bone imaging agent injection needle withdrawal method can improve image quality

International Nuclear Information System (INIS)

Qin Yongmei; Wang Laihao; Zhao Lihua; Guo Xiaogang; Kong Qingfeng

2009-01-01

Objective: To investigate the improvement of radionuclide bone imaging agent injection needle withdrawal method on whole body bone scan image quality. Methods: Elbow vein injection syringe needle directly into the bone imaging agent in the routine group of 117 cases, with a cotton swab needle injection method for the rapid pull out the needle puncture point pressing, pressing moment. Improvement of 117 cases of needle injection method to put two needles into the skin swabs and blood vessels, pull out the needle while pressing two or more entry point 5min. After 2 hours underwent whole body bone SPECT imaging plane. Results: The conventional group at the injection site imaging agents uptake rate was 16.24%, improved group was 2.56%. Conclusion: The modified bone imaging agent injection needle withdrawal method, injection-site imaging agent uptake were significantly decreased whole body bone imaging can improve image quality. (authors)

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

Science.gov (United States)

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

2009-03-01

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

Can training improve human performance

International Nuclear Information System (INIS)

Waylett, W.J. Jr.

1986-01-01

The nuclear industry has made a significant commitment to improve training through the implementation of performance-based training programs. Senior management expects that human performance improvement will result from this significant resource allocation. The author examines this hypothesis and discusses other issues that may interfere with enhancing human performance through training. The integration of quality improvement concepts to support training is also discussed by the author, who was a pioneer facilitator during the development of Florida Power and Light Company's Quality Improvement Program. Critical success factors are proposed based on the author's experience as a plant manager, training manager and quality facilitator

IMPROVING PATIENT SAFETY:

DEFF Research Database (Denmark)

Bagger, Bettan; Taylor Kelly, Hélène; Hørdam, Britta

Improving patient safety is both a national and international priority as millions of patients Worldwide suffer injury or death every year due to unsafe care. University College Zealand employs innovative pedagogical approaches in educational design. Regional challenges related to geographic......, social and cultural factors have resulted in a greater emphasis upon digital technology. Attempts to improve patient safety by optimizing students’ competencies in relation to the reporting of clinical errors, has resulted in the development of an interdisciplinary e-learning concept. The program makes...

Automated Student Model Improvement

Science.gov (United States)

Koedinger, Kenneth R.; McLaughlin, Elizabeth A.; Stamper, John C.

2012-01-01

Student modeling plays a critical role in developing and improving instruction and instructional technologies. We present a technique for automated improvement of student models that leverages the DataShop repository, crowd sourcing, and a version of the Learning Factors Analysis algorithm. We demonstrate this method on eleven educational…

Involving patients in care decisions improves satisfaction: an outcomes-based quality improvement project.

Science.gov (United States)

Leff, Ellen W

2004-05-01

A home care agency used quality improvement processes to improve patient satisfaction survey ratings. The focus was on involving patients in decisions about their care. A multidisciplinary team developed creative strategies to increase staff awareness and enhance customer service skills, which had dramatic results.

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.

Improved Fourier-transform profilometry

International Nuclear Information System (INIS)

Mao Xianfu; Chen Wenjing; Su Xianyu

2007-01-01

An improved optical geometry of the projected-fringe profilometry technique, in which the exit pupil of the projecting lens and the entrance pupil of the imaging lens are neither at the same height above the reference plane nor coplanar, is discussed and used in Fourier-transform profilometry. Furthermore, an improved fringe-pattern description and phase-height mapping formula based on the improved geometrical generalization is deduced. Employing the new optical geometry, it is easier for us to obtain the full-field fringe by moving either the projector or the imaging device. Therefore the new method offers a flexible way to obtain reliable height distribution of a measured object

NCCDS configuration management process improvement

Science.gov (United States)

Shay, Kathy

1993-01-01

By concentrating on defining and improving specific Configuration Management (CM) functions, processes, procedures, personnel selection/development, and tools, internal and external customers received improved CM services. Job performance within the section increased in both satisfaction and output. Participation in achieving major improvements has led to the delivery of consistent quality CM products as well as significant decreases in every measured CM metrics category.

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

Science.gov (United States)

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

2011-04-01

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

Improvability of assembly systems II: Improvability indicators and case study

Directory of Open Access Journals (Sweden)

S.-Y. Chiang

2000-01-01

Full Text Available Based on the performance analysis technique developed in Part I, this paper presents improvability indicators for assembly lines with unreliable machines. In particular, it shows that assembly lines are unimprovable with respect to workforce re-distribution if each buffer is, on the average, close to being half full. These lines are unimprovable with respect to buffer capacity re-distribution if each machine is starved and blocked with almost equal frequency. In addition, the paper provides indicators for identification of bottleneck machines and bottleneck buffers. Finally, the paper reports on an application of these improvability indicators in a case study at an automotive components plant.

Improved flywheel materials :

Energy Technology Data Exchange (ETDEWEB)

Boyle, Timothy J.; Bell, Nelson S; Ehlen, Mark Andrew; Anderson, Benjamin John; Miller, William Kenneth

2013-09-01

As alternative energy generating devices (i.e., solar, wind, etc) are added onto the electrical energy grid (AC grid), irregularities in the available electricity due to natural occurrences (i.e., clouds reducing solar input or wind burst increasing wind powered turbines) will be dramatically increased. Due to their almost instantaneous response, modern flywheel-based energy storage devices can act a mechanical mechanism to regulate the AC grid; however, improved spin speeds will be required to meet the necessary energy levels to balance these green energy variances. Focusing on composite flywheels, we have investigated methods for improving the spin speeds based on materials needs. The so-called composite flywheels are composed of carbon fiber (C-fiber), glass fiber, and a glue (resin) to hold them together. For this effort, we have focused on the addition of fillers to the resin in order to improve its properties. Based on the high loads required for standard meso-sized fillers, this project investigated the utility of ceramic nanofillers since they can be added at very low load levels due to their high surface area. The impact that TiO2 nanowires had on the final strength of the flywheel material was determined by a three-point-bend test. The results of the introduction of nanomaterials demonstrated an increase in strength of the flywheels C-fiber-resin moiety, with an upper limit of a 30% increase being reported. An analysis of the economic impact concerning the utilization of the nanowires was undertaken and after accounting for new-technology and additional production costs, return on improved-nanocomposite investment was approximated at 4-6% per year over the 20-year expected service life. Further, it was determined based on the 30% improvement in strength, this change may enable a 20-30% reduction in flywheel energy storage cost ($/kW-h).

School Climate Improvement Action Guide for Community Partners. School Climate Improvement Resource Package

Science.gov (United States)

National Center on Safe Supportive Learning Environments, 2017

2017-01-01

Improving school climate takes time and commitment from a variety of people in a variety of roles. This document outlines how community partners can support school climate improvements. Organizations and individuals can partner with schools in many different ways--from delivering or coordinating direct services to students and families inside or…

School Climate Improvement Action Guide for Instructional Staff. School Climate Improvement Resource Package

Science.gov (United States)

National Center on Safe Supportive Learning Environments, 2017

2017-01-01

Improving school climate takes time and commitment from a variety of people in a variety of roles. This document outlines key action steps that instructional staff--including teachers, paraprofessionals, and others in the classroom who provide instruction or assistance--can take to support school climate improvements. Key action steps are provided…

School Climate Improvement Action Guide for District Leaders. School Climate Improvement Resource Package

Science.gov (United States)

National Center on Safe Supportive Learning Environments, 2017

2017-01-01

Improving school climate takes time and commitment from a variety of people in a variety of roles. This document outlines key action steps that district leaders--including superintendents, assistant superintendents, directors of student support services, or others--can take to support school climate improvements. Key action steps are provided for…

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.

Improving operating room safety

Directory of Open Access Journals (Sweden)

Garrett Jill

2009-11-01

Full Text Available Abstract Despite the introduction of the Universal Protocol, patient safety in surgery remains a daily challenge in the operating room. This present study describes one community health system's efforts to improve operating room safety through human factors training and ultimately the development of a surgical checklist. Using a combination of formal training, local studies documenting operating room safety issues and peer to peer mentoring we were able to substantially change the culture of our operating room. Our efforts have prepared us for successfully implementing a standardized checklist to improve operating room safety throughout our entire system. Based on these findings we recommend a multimodal approach to improving operating room safety.

Improving inferior vena cava filter retrieval rates with the define, measure, analyze, improve, control methodology.

Science.gov (United States)

Sutphin, Patrick D; Reis, Stephen P; McKune, Angie; Ravanzo, Maria; Kalva, Sanjeeva P; Pillai, Anil K

2015-04-01

To design a sustainable process to improve optional inferior vena cava (IVC) filter retrieval rates based on the Define, Measure, Analyze, Improve, Control (DMAIC) methodology of the Six Sigma process improvement paradigm. DMAIC, an acronym for Define, Measure, Analyze, Improve, and Control, was employed to design and implement a quality improvement project to increase IVC filter retrieval rates at a tertiary academic hospital. Retrievable IVC filters were placed in 139 patients over a 2-year period. The baseline IVC filter retrieval rate (n = 51) was reviewed through a retrospective analysis, and two strategies were devised to improve the filter retrieval rate: (a) mailing of letters to clinicians and patients for patients who had filters placed within 8 months of implementation of the project (n = 43) and (b) a prospective automated scheduling of a clinic visit at 4 weeks after filter placement for all new patients (n = 45). The effectiveness of these strategies was assessed by measuring the filter retrieval rates and estimated increase in revenue to interventional radiology. IVC filter retrieval rates increased from a baseline of 8% to 40% with the mailing of letters and to 52% with the automated scheduling of a clinic visit 4 weeks after IVC filter placement. The estimated revenue per 100 IVC filters placed increased from $2,249 to $10,518 with the mailing of letters and to $17,022 with the automated scheduling of a clinic visit. Using the DMAIC methodology, a simple and sustainable quality improvement intervention was devised that markedly improved IVC filter retrieval rates in eligible patients. Copyright © 2015 SIR. Published by Elsevier Inc. All rights reserved.

Improving Indicators in a Brazilian Hospital Through Quality-Improvement Programs Based on STS Database Reports

Directory of Open Access Journals (Sweden)

Pedro Gabriel Melo de Barros e Silva

2015-12-01

Full Text Available ABSTRACT OBJECTIVE: To report the initial changes after quality-improvement programs based on STS-database in a Brazilian hospital. METHODS: Since 2011 a Brazilian hospital has joined STS-Database and in 2012 multifaceted actions based on STS reports were implemented aiming reductions in the time of mechanical ventilation and in the intensive care stay and also improvements in evidence-based perioperative therapies among patients who underwent coronary artery bypass graft surgeries. RESULTS: All the 947 patients submitted to coronary artery bypass graft surgeries from July 2011 to June 2014 were analyzed and there was an improvement in all the three target endpoints after the implementation of the quality-improvement program but the reduction in time on mechanical ventilation was not statistically significant after adjusting for prognostic characteristics. CONCLUSION: The initial experience with STS registry in a Brazilian hospital was associated with improvement in most of targeted quality-indicators.

Model-based software process improvement

Science.gov (United States)

Zettervall, Brenda T.

1994-01-01

The activities of a field test site for the Software Engineering Institute's software process definition project are discussed. Products tested included the improvement model itself, descriptive modeling techniques, the CMM level 2 framework document, and the use of process definition guidelines and templates. The software process improvement model represents a five stage cyclic approach for organizational process improvement. The cycles consist of the initiating, diagnosing, establishing, acting, and leveraging phases.

School Climate Improvement Action Guide for School Leaders. School Climate Improvement Resource Package

Science.gov (United States)

National Center on Safe Supportive Learning Environments, 2017

2017-01-01

Improving school climate takes time and commitment from a variety of people in a variety of roles. This document outlines key action steps that school leaders--including principals, assistant/vice principals, and building leaders--can take to support school climate improvements. Key action steps are provided for the following strategies: (1)…

Inpatient preanalytic process improvements.

Science.gov (United States)

Wagar, Elizabeth A; Phipps, Ron; Del Guidice, Robert; Middleton, Lavinia P; Bingham, John; Prejean, Cheryl; Johnson-Hamilton, Martha; Philip, Pheba; Le, Ngoc Han; Muses, Waheed

2013-12-01

Phlebotomy services are a common target for preanalytic improvements. Many new, quality engineering tools have recently been applied in clinical laboratories. However, data on relatively few projects have been published. This example describes a complete application of current, quality engineering tools to improve preanalytic phlebotomy services. To decrease the response time in the preanalytic inpatient laboratory by 25%, to reduce the number of incident reports related to preanalytic phlebotomy, and to make systematic process changes that satisfied the stakeholders. The Department of Laboratory Medicine, General Services Section, at the University of Texas MD Anderson Cancer Center (Houston) is responsible for inpatient phlebotomy in a 24-hour operation, which serves 689 inpatient beds. The study director was project director of the Division of Pathology and Laboratory Medicine's Quality Improvement Section and was assisted by 2 quality technologists and an industrial engineer from MD Anderson Office of Performance Improvement. After implementing each solution, using well-recognized, quality tools and metrics, the response time for blood collection decreased by 23%, which was close to meeting the original responsiveness goal of 25%. The response time between collection and arrival in the laboratory decreased by 8%. Applicable laboratory-related incident reports were reduced by 43%. Comprehensive application of quality tools, such as statistical control charts, Pareto diagrams, value-stream maps, process failure modes and effects analyses, fishbone diagrams, solution prioritization matrices, and customer satisfaction surveys can significantly improve preset goals for inpatient phlebotomy.

Improving hand hygiene in a paediatric hospital: a multimodal quality improvement approach.

Science.gov (United States)

Jamal, Ahmed; O'Grady, G; Harnett, E; Dalton, D; Andresen, D

2012-02-01

Effective hand hygiene has long been recognised as an important way to reduce the transmission of bacterial and viral pathogens in healthcare settings. However, many studies have shown that adherence to hand hygiene remains low, and improvement efforts have often not delivered sustainable results. The Children's Hospital at Westmead is the largest tertiary paediatric hospital in Sydney, Australia. The hospital participated in a state-wide 'Clean hands save lives' campaign which was initiated in 2006. Strong leadership, good stakeholder engagement, readily accessible alcohol-based hand rub at the point of patient care, a multifaceted education programme, monitoring of staff, adherence to recommended hand hygiene practices and contemporaneous feedback of performance data have significantly improved and maintained compliance with hand hygiene. Hand hygiene compliance has increased from 23% in 2006 to 87% in 2011 (phand hygiene has been evident in the last 4 years. A decline in a set of hospital-acquired infections (including rotavirus, multiresistant organism transmission, and nosocomial bacteraemia) has also been noted as hand hygiene rates have improved. Monthly usage of alcohol-based hand rub has increased from 16 litres/1000 bed days to 51 litres/1000 bed days during this same period. This project has delivered sustained improvement in hand hygiene compliance by establishing a framework of multimodal evidence-based strategies.

Statewide Quality Improvement Initiative to Reduce Early Elective Deliveries and Improve Birth Registry Accuracy.

Science.gov (United States)

Kaplan, Heather C; King, Eileen; White, Beth E; Ford, Susan E; Fuller, Sandra; Krew, Michael A; Marcotte, Michael P; Iams, Jay D; Bailit, Jennifer L; Bouchard, Jo M; Friar, Kelly; Lannon, Carole M

2018-04-01

To evaluate the success of a quality improvement initiative to reduce early elective deliveries at less than 39 weeks of gestation and improve birth registry data accuracy rapidly and at scale in Ohio. Between February 2013 and March 2014, participating hospitals were involved in a quality improvement initiative to reduce early elective deliveries at less than 39 weeks of gestation and improve birth registry data. This initiative was designed as a learning collaborative model (group webinars and a single face-to-face meeting) and included individual quality improvement coaching. It was implemented using a stepped wedge design with hospitals divided into three balanced groups (waves) participating in the initiative sequentially. Birth registry data were used to assess hospital rates of nonmedically indicated inductions at less than 39 weeks of gestation. Comparisons were made between groups participating and those not participating in the initiative at two time points. To measure birth registry accuracy, hospitals conducted monthly audits comparing birth registry data with the medical record. Associations were assessed using generalized linear repeated measures models accounting for time effects. Seventy of 72 (97%) eligible hospitals participated. Based on birth registry data, nonmedically indicated inductions at less than 39 weeks of gestation declined in all groups with implementation (wave 1: 6.2-3.2%, Pinitiative, they saw significant decreases in rates of early elective deliveries as compared with wave 3 (control; P=.018). All waves had significant improvement in birth registry accuracy (wave 1: 80-90%, P=.017; wave 2: 80-100%, P=.002; wave 3: 75-100%, Pinitiative enabled statewide spread of change strategies to decrease early elective deliveries and improve birth registry accuracy over 14 months and could be used for rapid dissemination of other evidence-based obstetric care practices across states or hospital systems.

SQIMSO: Quality Improvement for Small Software Organizations

OpenAIRE

Rabih Zeineddine; Nashat Mansour

2005-01-01

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

Improved performance of the industry

International Nuclear Information System (INIS)

Jeffrey, R.

1994-01-01

The remarkable improvements in the performance of AGR stations is illustrated. The underlying reasons for this improvement are discussed, emphasizing both the operational performance factors which have led to higher sustained output and the managerial and cultural changes which have focused attention at all levels on the need to be competitive. It is concluded that the UK nuclear industry has become world class with more improvements to come, an asset to the UK. (Author)

Ergonomic Improvements for Foundries; FINAL

International Nuclear Information System (INIS)

Frank Peters; Patrick Patterson

2002-01-01

The goal of this project was to make improvements to the production systems of the steel casting industry through ergonomic improvements. Because of the wide variety of products, the wide range of product sizes, and the relatively small quantities of any particular product, manual operations remain a vital part of the production systems of the steel casting companies. Ergonomic improvements will assist the operators to more efficiently and consistently produce quality products

Improving Photosynthesis

Science.gov (United States)

Evans, John R.

2013-01-01

Photosynthesis is the basis of plant growth, and improving photosynthesis can contribute toward greater food security in the coming decades as world population increases. Multiple targets have been identified that could be manipulated to increase crop photosynthesis. The most important target is Rubisco because it catalyses both carboxylation and oxygenation reactions and the majority of responses of photosynthesis to light, CO2, and temperature are reflected in its kinetic properties. Oxygenase activity can be reduced either by concentrating CO2 around Rubisco or by modifying the kinetic properties of Rubisco. The C4 photosynthetic pathway is a CO2-concentrating mechanism that generally enables C4 plants to achieve greater efficiency in their use of light, nitrogen, and water than C3 plants. To capitalize on these advantages, attempts have been made to engineer the C4 pathway into C3 rice (Oryza sativa). A simpler approach is to transfer bicarbonate transporters from cyanobacteria into chloroplasts and prevent CO2 leakage. Recent technological breakthroughs now allow higher plant Rubisco to be engineered and assembled successfully in planta. Novel amino acid sequences can be introduced that have been impossible to reach via normal evolution, potentially enlarging the range of kinetic properties and breaking free from the constraints associated with covariation that have been observed between certain kinetic parameters. Capturing the promise of improved photosynthesis in greater yield potential will require continued efforts to improve carbon allocation within the plant as well as to maintain grain quality and resistance to disease and lodging. PMID:23812345

Improved reaction sintered silicon nitride. [protective coatings to improve oxidation resistance

Science.gov (United States)

Baumgartner, H. R.

1978-01-01

Processing treatments were applied to as-nitrided reaction sintered silicon nitride (RSSN) with the purposes of improving strength after processing to above 350 MN/m2 and improving strength after oxidation exposure. The experimental approaches are divided into three broad classifications: sintering of surface-applied powders; impregnation of solution followed by further thermal processing; and infiltration of molten silicon and subsequent carburization or nitridation of the silicon. The impregnation of RSSN with solutions of aluminum nitrate and zirconyl chloride, followed by heating at 1400-1500 C in a nitrogen atmosphere containing silicon monoxide, improved RSSN strength and oxidation resistance. The room temperature bend strength of RSSN was increased nearly fifty percent above the untreated strength with mean absolute strengths up to 420 MN/m2. Strengths of treated samples that were measured after a 12 hour oxidation exposure in air were up to 90 percent of the original as-nitrided strength, as compared to retained strengths in the range of 35 to 60 percent for untreated RSSN after the same oxidation exposure.

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.

Identifying continuous quality improvement publications: what makes an improvement intervention 'CQI'?

Science.gov (United States)

O'Neill, Sean M; Hempel, Susanne; Lim, Yee-Wei; Danz, Marjorie S; Foy, Robbie; Suttorp, Marika J; Shekelle, Paul G; Rubenstein, Lisa V

2011-12-01

The term continuous quality improvement (CQI) is often used to refer to a method for improving care, but no consensus statement exists on the definition of CQI. Evidence reviews are critical for advancing science, and depend on reliable definitions for article selection. As a preliminary step towards improving CQI evidence reviews, this study aimed to use expert panel methods to identify key CQI definitional features and develop and test a screening instrument for reliably identifying articles with the key features. We used a previously published method to identify 106 articles meeting the general definition of a quality improvement intervention (QII) from 9427 electronically identified articles from PubMed. Two raters then applied a six-item CQI screen to the 106 articles. Per cent agreement ranged from 55.7% to 75.5% for the six items, and reviewer-adjusted intra-class correlation ranged from 0.43 to 0.62. 'Feedback of systematically collected data' was the most common feature (64%), followed by being at least 'somewhat' adapted to local conditions (61%), feedback at meetings involving participant leaders (46%), using an iterative development process (40%), being at least 'somewhat' data driven (34%), and using a recognised change method (28%). All six features were present in 14.2% of QII articles. We conclude that CQI features can be extracted from QII articles with reasonable reliability, but only a small proportion of QII articles include all features. Further consensus development is needed to support meaningful use of the term CQI for scientific communication.

Status of the PSR improvement program

International Nuclear Information System (INIS)

Macek, R.J.; Fitzgerald, D.H.; Hoehn, M.V.; Ryder, R.D.; York, R.L.

1993-01-01

A program of improvements to increase intensity and improve reliability of the Los Alamos Proton Storage Ring (PSR) has been under way for several years. Reduction of stored beam loss rates by a factor of 4.6 since 1987 through exploitation of H 0 injection has allowed the average intensity to increase by a factor of two to 75μA. Reliability of the PSR and associated beam delivery systems has been improved by extensive rework of numerous subsystems. Radiation protection has been improved by additional shielding of Line D and extensive use of relatively fail-safe radiation detectors incorporated into an improved radiation security system

Capital Improvements Business Line

Science.gov (United States)

2012-08-08

NAVFAC Southwest Dan Waid Program & Business Mgmt NAVFAC SW Capital Improvements Business Line NAVFAC SW 8 August 2012 1 Report...REPORT TYPE 3. DATES COVERED 00-00-2012 to 00-00-2012 4. TITLE AND SUBTITLE Capital Improvements Business Line 5a. CONTRACT NUMBER 5b. GRANT...AVAILABILITY STATEMENT Approved for public release; distribution unlimited 13. SUPPLEMENTARY NOTES Presented at the 2012 Navy Gold Coast Small Business

How to Begin a Quality Improvement Project.

Science.gov (United States)

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

2016-05-06

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

Adaptation improves face trustworthiness discrimination

Directory of Open Access Journals (Sweden)

Bruce D Keefe

2013-06-01

Full Text Available Adaptation to facial characteristics, such as gender and viewpoint, has been shown to both bias our perception of faces and improve facial discrimination. In this study, we examined whether adapting to two levels of face trustworthiness improved sensitivity around the adapted level. Facial trustworthiness was manipulated by morphing between trustworthy and untrustworthy prototypes, each generated by morphing eight trustworthy and eight untrustworthy faces respectively. In the first experiment, just-noticeable differences (JNDs were calculated for an untrustworthy face after participants adapted to an untrustworthy face, a trustworthy face, or did not adapt. In the second experiment, the three conditions were identical, except that JNDs were calculated for a trustworthy face. In the third experiment we examined whether adapting to an untrustworthy male face improved discrimination to an untrustworthy female face. In all experiments, participants completed a two-interval forced-choice adaptive staircase procedure, in which they judged which face was more untrustworthy. JNDs were derived from a psychometric function fitted to the data. Adaptation improved sensitivity to faces conveying the same level of trustworthiness when compared to no adaptation. When adapting to and discriminating around a different level of face trustworthiness there was no improvement in sensitivity and JNDs were equivalent to those in the no adaptation condition. The improvement in sensitivity was found to occur even when adapting to a face with different gender and identity. These results suggest that adaptation to facial trustworthiness can selectively enhance mechanisms underlying the coding of facial trustworthiness to improve perceptual sensitivity. These findings have implications for the role of our visual experience in the decisions we make about the trustworthiness of other individuals.

Improving Family Communication.

Science.gov (United States)

Medrano, Vilma; Bonilla, Gladys; Hernández, Ericka; Romanjek, Mariana Harnecker; Gómez, Adriana; Hernández, Jasón; Reyes, Marcela Ríos; Lindenberg, Cathy Strachan

2017-03-01

TeenSmart International harnesses the power and flexibility of technology to empower youth to take personal responsibility for their health and lifestyle choices. Access to the Internet via mobile phones is often cheaper than paying to connect to a wired broadband service, and in rural areas, mobile networks may be the only means of accessing the Internet. This study assessed the feasibility, acceptability, and impact of "cues to action" or brief motivating cell phone text messages to improve adolescent family communication and relationships. A quasi-experimental design using a voluntary sample of 100 Nicaraguan youth at high risk for poor family communication participated. Pre- and posttest quantitative measures using Student t statistical analysis, a focus group, and a participant testimony provided the evaluation evidence. Findings suggest that there are economic and motivational barriers to the use of text messages, but when barriers are eliminated, the behavioral results are positive. Youth who received two weekly text messages over a 6-month period demonstrated statistically significant improvements in family communication perceptions, attitudes, and behaviors, strengthening their family communications and relationships. Brief and personalized text messaging "cues to action" may be a cost-effective intervention to improve adolescent healthy lifestyle behaviors.

Improving patient handover between teams using a business improvement model: PDSA cycle.

Science.gov (United States)

Luther, Vishal; Hammersley, Daniel; Chekairi, Ahmed

2014-01-01

Medical admission units are continuously under pressure to move patients off the unit to outlying medical wards and allow for new admissions. In a typical district general hospital, doctors working in these medical wards reported that, on average, three patients each week arrived from the medical admission unit before any handover was received, and a further two patients arrived without any handover at all. A quality improvement project was therefore conducted using a 'Plan, Do, Study, Act' cycle model for improvement to address this issue. P - Plan: as there was no framework to support doctors with handover, a series of standard handover procedures were designed. D - Do: the procedures were disseminated to all staff, and championed by key stakeholders, including the clinical director and matron of the medical admission unit. S - STUDY: Measurements were repeated 3 months later and showed no change in the primary end points. A - ACT: The post take ward round sheet was redesigned, creating a checkbox for a medical admission unit doctor to document that handover had occurred. Nursing staff were prohibited from moving the patient off the ward until this had been completed. This later evolved into a separate handover sheet. Six months later, a repeat study revealed that only one patient each week was arriving before or without a verbal handover. Using a 'Plan, Do, Study, Act' business improvement tool helped to improve patient care.

Productivity quality improvement at UNC Geotech

International Nuclear Information System (INIS)

Jenkins, W.A.

1987-01-01

The program to improve productivity is presented in a series of view graphs. Key elements of the program are: CEO leadership and commitment; measurable improvements; specific annual goals; system for sharing benefits of improvements; practical training for employees; and intent to institutionalize

Improving requirements engineering by artefact orientation

NARCIS (Netherlands)

Méndez Fernández, Daniel; Wieringa, Roelf J.

2013-01-01

The importance of continuously improving requirements engineering (RE) has been recognised for many years. Similar to available software process improvement approaches, most RE improvement approaches focus on a normative and solution-driven assessment of companies rather than on a problem-driven RE

Turn-around improvements

International Nuclear Information System (INIS)

Redaelli, S.; Venturini Delsolaro, W.

2012-01-01

An efficient turn-around will be an important parameter for the integrated luminosity performance at LHC in 2012, when an operation with steady beam parameters and machine configuration will be achieved at the beginning of the run. Improvements of the operational cycle were already put successfully in place after the 2010 experience but additional ways to reduce the time required to setup collisions are possible. In this paper, the 2011 turn-around performance is reviewed and the benefits of the improvements from 2010 are presented. Phases of the operational cycle when further amelioration is possible are discussed and some proposal for a faster turn-around in 2012 are outlined. (authors)

Three success factors for continual improvement in healthcare: an analysis of the reports of improvement team members.

Science.gov (United States)

Brandrud, Aleidis Skard; Schreiner, Ada; Hjortdahl, Per; Helljesen, Gro Sævil; Nyen, Bjørnar; Nelson, Eugene C

2011-03-01

The objectives of the Breakthrough Series Collaborative are to close the gap between what we know and what we do, and to contribute to continuous quality improvement (CQI) of healthcare through collaborative learning. The improvement efforts are guided by a systematic approach, combining professional and improvement knowledge. To explore what the improvement teams have learnt from participating in the collaborative and from dealing with promoting and inhibiting factors encountered. Qualitative interviews with 19 team members were conducted in four focus groups, using the Critical Incident Technique. A critical incident is one that makes significant contributions, either positively or negatively, to an activity. The elements of a culture of improvement are revealed by the critical incidents, and reflect the eight domains of knowledge, as a product of collaborative learning. The improvement knowledge and skills of individuals are important elements, but not enough to achieve sustainable changes. 90% of the material reflects the need for a system of CQI to solve the problems that organisations experience in trying to make lasting improvements. A pattern of three success factors for CQI emerges: (1) continuous and reliable information, including measurement, about best and current practice; (2) engagement of everybody in all phases of the improvement work: the patient and family, the leadership, the professional environment and the staff; and (3) an infrastructure based on improvement knowledge, with multidisciplinary teams, available coaching, learning systems and sustainability systems.

Historical Improvement in Speed Skating Economy.

Science.gov (United States)

Noordhof, Dionne A; van Tok, Elmy; Joosten, Florentine S J G M; Hettinga, Florentina J; Hoozemans, Marco J M; Foster, Carl; de Koning, Jos J

2017-02-01

Half the improvement in 1500-m speed-skating world records can be explained by technological innovations and the other half by athletic improvement. It is hypothesized that improved skating economy is accountable for much of the athletic improvement. To determine skating economy in contemporary athletes and to evaluate the change in economy over the years. Contemporary skaters of the Dutch national junior team (n = 8) skated 3 bouts of 6 laps at submaximal velocity, from which skating economy was calculated (in mL O 2 ・ kg -1 ・ km -1 ). A literature search provided historic data on skating velocity and submaximal V̇O 2 (in mL ・ kg -1 ・ min -1 ), from which skating economy was determined. The association between year and skating economy was determined using linear-regression analysis. Correcting the change in economy for technological innovations resulted in an estimate of the association between year and economy due to athletic improvement. A mean (± SD) skating economy of 73.4 ± 6.4 mL O 2 ・ kg -1 ・ km -1 was found in contemporary athletes. Skating economy improved significantly over the historical time frame (-0.57 mL O 2 ・ kg -1 ・ km -1 ・ y -1 , 95% confidence interval [-0.84, -0.31]). In the final regression model for the klapskate era, with altitude as confounder, skating economy improved with a nonsignificant -0.58 mL O 2 ・ kg -1 ・ km -1 ・ y -1 ([-1.19, 0.035]). Skating economy was 73.4 ± 6.4 mL O 2 ・ kg -1 ・ km -1 in contemporary athletes and improved over the past ~50 y. The association between year and skating economy due to athletic improvement, for the klapskate era, approached significance, suggesting a possible improvement in economy over these years.

The Gains from Improved Market Efficiency

DEFF Research Database (Denmark)

Persson, Karl Gunnar; Ejrnæs, Mette

faster, violations of the law of one price become smaller and hence less persistent. There were also significant gains from improved market efficiency but that improvement took place after the information ‘regime’ shifted from pre-telegraphic communication to a regime with swift transmission...... of information in an era which developed a sophisticated commercial press and telegraphic communication. Improved market efficiency probably stimulated trade more than falling transport costs......This paper looks at the gains from improved market efficiency in long-distance grain trade in the second half of the 19th century when violations of the law of one price were reduced due to improved information transmission. Two markets, a major export centre, Chicago, and a major importer...

Evaluating Fidelity to a Modified NIATx Process Improvement Strategy for Improving HIV Services in Correctional Facilities.

Science.gov (United States)

Pankow, Jennifer; Willett, Jennifer; Yang, Yang; Swan, Holly; Dembo, Richard; Burdon, William M; Patterson, Yvonne; Pearson, Frank S; Belenko, Steven; Frisman, Linda K

2018-04-01

In a study aimed at improving the quality of HIV services for inmates, an organizational process improvement strategy using change teams was tested in 14 correctional facilities in 8 US states and Puerto Rico. Data to examine fidelity to the process improvement strategy consisted of quantitative ratings of the structural and process components of the strategy and qualitative notes that explicate challenges in maintaining fidelity to the strategy. Fidelity challenges included (1) lack of communication and leadership within change teams, (2) instability in team membership, and (3) issues with data utilization in decision-making to implement improvements to services delivery.

Improving Employees' Safety Awareness in Healthcare Organizations Using the DMAIC Quality Improvement Approach.

Science.gov (United States)

Momani, Amer; Hirzallah, Muʼath; Mumani, Ahmad

Occupational injuries and illnesses in healthcare can cause great human suffering, incur high cost, and have an adverse impact on the quality of patient care. One of the most effective solutions for addressing health and safety issues and improving decisions at the point of care rests in raising employees' safety awareness to recognize, avoid, or respond to potential problems before they arise. In this article, the DMAIC Six Sigma model (Define, Measure, Analyze, Improve, Control) is used as a systematic program to measure, improve, and sustain employees' safety awareness in healthcare organizations. We report on a case study using the model, which was implemented and validated at a local hospital. First, the occupational health and safety knowledge that each job requires was identified. Next, the degree of competence of jobholders to meet these requirements was assessed. Based on the assessment, different awareness-raising efforts were proposed and implemented. The results showed significant improvement in the overall safety awareness compliance assessed: from 74.2% to 84.4% (p < .001) after the intervention. The proposed model ensures that the organization's awareness-raising efforts serve its actual needs and produce optimized and sustained results that eventually lead to safer healthcare service.

Exercises to Improve Gait Abnormalities

Science.gov (United States)

... Articles Directories Videos Resources Contact Exercises to Improve Gait Abnormalities Home » Article Categories » Exercise and Fitness Font Size: A A A A Exercises to Improve Gait Abnormalities Next Page The manner of how a ...

Benchmarking for Cost Improvement. Final report

Energy Technology Data Exchange (ETDEWEB)

1993-09-01

The US Department of Energy`s (DOE) Office of Environmental Restoration and Waste Management (EM) conducted the Benchmarking for Cost Improvement initiative with three objectives: Pilot test benchmarking as an EM cost improvement tool; identify areas for cost improvement and recommend actions to address these areas; provide a framework for future cost improvement. The benchmarking initiative featured the use of four principal methods (program classification, nationwide cost improvement survey, paired cost comparison and component benchmarking). Interested parties contributed during both the design and execution phases. The benchmarking initiative was conducted on an accelerated basis. Of necessity, it considered only a limited set of data that may not be fully representative of the diverse and complex conditions found at the many DOE installations. The initiative generated preliminary data about cost differences and it found a high degree of convergence on several issues. Based on this convergence, the report recommends cost improvement strategies and actions. This report describes the steps taken as part of the benchmarking initiative and discusses the findings and recommended actions for achieving cost improvement. The results and summary recommendations, reported below, are organized by the study objectives.

Memory reactivation improves visual perception.

Science.gov (United States)

Amar-Halpert, Rotem; Laor-Maayany, Rony; Nemni, Shlomi; Rosenblatt, Jonathan D; Censor, Nitzan

2017-10-01

Human perception thresholds can improve through learning. Here we report findings challenging the fundamental 'practice makes perfect' basis of procedural learning theory, showing that brief reactivations of encoded visual memories are sufficient to improve perceptual discrimination thresholds. Learning was comparable to standard practice-induced learning and was not due to short training per se, nor to an epiphenomenon of primed retrieval enhancement. The results demonstrate that basic perceptual functions can be substantially improved by memory reactivation, supporting a new account of perceptual learning dynamics.

Teacher Research as Continuous Process Improvement

Science.gov (United States)

Ellis, Charles; Castle, Kathryn

2010-01-01

Purpose: Teacher research (inquiry) has been characterized as practice improvement, professional development and action research, among numerous names and descriptions. The purpose of this paper is to support the case that teacher research is also a form of quality improvement known as continuous process improvement (CPI).…

IMPACTS OF BUS STOP IMPROVEMENTS

Science.gov (United States)

2018-03-23

Improving bus stops by providing shelters, seating, signage, and sidewalks is relatively inexpensive and popular among riders and local officials. Making such improvements, however, is not often a priority for U.S. transit providers because of compet...

Effectiveness of a quality-improvement program in improving management of primary care practices

Science.gov (United States)

Szecsenyi, Joachim; Campbell, Stephen; Broge, Bjoern; Laux, Gunter; Willms, Sara; Wensing, Michel; Goetz, Katja

2011-01-01

Background: The European Practice Assessment program provides feedback and outreach visits to primary care practices to facilitate quality improvement in five domains (infrastructure, people, information, finance, and quality and safety). We examined the effectiveness of this program in improving management in primary care practices in Germany, with a focus on the domain of quality and safety. Methods: In a before–after study, 102 primary care practices completed a practice assessment using the European Practice Assessment instrument at baseline and three years later (intervention group). A comparative group of 102 practices was included that completed their first assessment using this instrument at the time of the intervention group’s second assessment. Mean scores were based on the proportion of indicators for which a positive response was achieved by all of the practices, on a scale of 0 to 100. Results: We found significant improvements in all domains between the first and second assessments in the intervention group. In the domain of quality and safety, improvements in scores (mean scores were based on the proportion of indicators for which a positive response was achieved by all of the practices, on a scale of 0 to 100) were observed in the following dimensions: complaint management (from a mean score of 51.2 at first assessment to 80.7 at second assessment); analysis of critical incidents (from 79.1 to 89.6); and quality development, quality policy (from 40.7 to 55.6). Overall scores at the time of the second assessment were significantly higher in the intervention group than in the comparative group. Interpretation: Primary care practices that completed the European Practice Assessment instrument twice over a three-year period showed improvements in practice management. Our findings show the value of the quality-improvement cycle in the context of practice assessment and the use of established organizational standards for practice management with the

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

Directory of Open Access Journals (Sweden)

Vink JP

2016-06-01

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

Cadastral Database Positional Accuracy Improvement

Science.gov (United States)

Hashim, N. M.; Omar, A. H.; Ramli, S. N. M.; Omar, K. M.; Din, N.

2017-10-01

Positional Accuracy Improvement (PAI) is the refining process of the geometry feature in a geospatial dataset to improve its actual position. This actual position relates to the absolute position in specific coordinate system and the relation to the neighborhood features. With the growth of spatial based technology especially Geographical Information System (GIS) and Global Navigation Satellite System (GNSS), the PAI campaign is inevitable especially to the legacy cadastral database. Integration of legacy dataset and higher accuracy dataset like GNSS observation is a potential solution for improving the legacy dataset. However, by merely integrating both datasets will lead to a distortion of the relative geometry. The improved dataset should be further treated to minimize inherent errors and fitting to the new accurate dataset. The main focus of this study is to describe a method of angular based Least Square Adjustment (LSA) for PAI process of legacy dataset. The existing high accuracy dataset known as National Digital Cadastral Database (NDCDB) is then used as bench mark to validate the results. It was found that the propose technique is highly possible for positional accuracy improvement of legacy spatial datasets.

Improved flare tip design

Energy Technology Data Exchange (ETDEWEB)

Gogolek, P. [Natural Resources Canada, Ottawa, ON (Canada). CANMET Energy Technology Centre

2004-07-01

This paper discusses the testing procedures and development of an improved flare tip design. Design objectives included performance equal to or better than utility flares at low wind speed; conversion efficiency; fuel slip; smoking; significant improvement at high wind speed; and no increase in trace emissions. A description of the testing facility of the flare tip was provided, with reference to the fact that the facility allowed for realistic near full scale gas flares in a single-pass flare test facility. Other details of the facility included: an adjustable ceiling; high capacity variable speed fan; sampling ports along working section in stack; windows along working section; and air cooled walls, floor, and ceiling. The fuels used in the flare tip included natural gas, propane, gasoline and inert gases. Details of wind speed, appurtenances and turbulence generating grids were presented, with reference to continuous gas emission measurements. A list of design constraints was provided. Flare performance included wind speed, turbulence and fuel composition. A chart of conversion inefficiencies with a correlation of wind speed and turbulence, fuel flow and pipe size was also presented. Several new tip designs were fabricated for testing, with screening tests for comparison to basic pipe and ranking designs. Significant improvements were found in one of the new designs, including results with 30 per cent propane in fuel. Emissions reduction from 10 to 35 per cent were noted. It was concluded that future work should focus on evaluating improved tip for stability at low wind speeds. Fuel slips are the primary source of emissions, and it was recommended that further research is necessary to improve existing flare tips. tabs, figs.

Some possible improvements in scintillation calorimeters

International Nuclear Information System (INIS)

Lorenz, E.

1985-03-01

Two ideas for improvements of scintillation calorimeters will be presented: a) improved readout of scintillating, totally active electromagnetic calorimeters with combinations of silicon photodiodes and fluorescent panel collectors, b) use of time structure analysis on calorimetry, both for higher rate applications and improved resolution for hadron calorimeters. (orig.)

Do Clinical Practice Guidelines Improve Quality?

Science.gov (United States)

Baldassari, Cristina M

2017-07-01

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

Implementation of a Quality Improvement Initiative: Improved Congenital Muscular Torticollis Outcomes in a Large Hospital Setting.

Science.gov (United States)

Strenk, Mariann L; Kiger, Michelle; Hawke, Jesse L; Mischnick, Amy; Quatman-Yates, Catherine

2017-06-01

The American Physical Therapy Association (APTA) published a guideline for congenital muscular torticollis (CMT) in 2013. Our division adopted the guideline as the institutional practice standard and engaged in a quality improvement (QI) initiative to increase the percentage of patients who achieved resolution of CMT within 6 months of evaluation. The aims of this report are to describe the QI activities conducted to improve patient outcomes and discuss the results and implications for other institutions and patient populations. This was a quality improvement study. In alignment with the Chronic Care Model and Model of Improvement, an aim and operationally defined key outcome and process measures were established. Interventions were tested using Plan-Do-Study-Act cycles. A CMT registry was established to store and manage data extracted from the electronic record over the course of testing. Statistical process control charts were used to monitor progress over time. The QI initiative resulted in an increase in the percentage of patients who achieved full resolution of CMT within a 6-month episode of care from 42% to 61% over an 18-month period. Themes that emerged as key drivers of improvement included: (1) timely, optimal access to care, (2) effective audit and clinician feedback, and (3) accurate, timely documentation. The initiative took place at a single institution with a supportive culture and strong QI resources, which may limit direct translation of interventions and findings to other institutions and patient populations. Improvement science methodologies provided the tools and structure to improve division-wide workflow and increase consistency in the implementation of the APTA CMT guideline. In doing so, significant CMT population outcome improvements were achieved. © 2017 American Physical Therapy Association

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.

Performance improvement: the organization's quest.

Science.gov (United States)

McKinley, C O; Parmer, D E; Saint-Amand, R A; Harbin, C B; Roulston, J C; Ellis, R A; Buchanan, J R; Leonard, R B

1999-01-01

In today's health care marketplace, quality has become an expectation. Stakeholders are demanding quality clinical outcomes, and accrediting bodies are requiring clinical performance data. The Roosevelt Institute's quest was to define and quantify quality outcomes, develop an organizational culture of performance improvement, and ensure customer satisfaction. Several of the organization's leaders volunteered to work as a team to develop a specific performance improvement approach tailored to the organization. To date, over 200 employees have received an orientation to the model and its philosophy and nine problem action and process improvement teams have been formed.

IMPROVING CONCEPTUAL DESIGN QUALITY

DEFF Research Database (Denmark)

Bush, Stuart; Robotham, Antony John

1999-01-01

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

Investigating the improver mechanisms of agricultural water ...

African Journals Online (AJOL)

Investigating the improver mechanisms of agricultural water management in karaj county from the viewpoints of the farmers. ... farmers and people, technical improvement of hydraulic structures, improvement of local people participation, improvement of water management, controlling the disturbance of external factors and ...

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.

23 CFR 1200.25 - Improvement plan.

Science.gov (United States)

2010-04-01

... 23 Highways 1 2010-04-01 2010-04-01 false Improvement plan. 1200.25 Section 1200.25 Highways... Implementation and Management of the Highway Safety Program § 1200.25 Improvement plan. If a review of the Annual... improvement plan. This plan will detail strategies, program activities, and funding targets to meet the...

Assessment of and Improvement Strategies for the Housing of Healthy Elderly: Improving Quality of Life

Directory of Open Access Journals (Sweden)

I-Ming Feng

2018-03-01

Full Text Available Global population is aging, particularly in developed countries and cities. Through the “Friendly Elderly Cities” and “Aging in Place” initiatives, various countries are making great efforts to improve the welfare and quality of life of the elderly, with the aim of catering to the physical and spiritual health as well as social welfare of the elderly. In this regard, the improvement of the housing environment of the elderly is one of the key factors in their quality of life and health. This study aims to effectively assess and improve the housing environment of the elderly in order to enhance their quality of life; it also aims to contribute the knowledge about improving elderly housing by applying an assessment framework using expert interviews and data collected from relevant literature. Using a mixed Multi-Criteria Decision Analysis model, a combination of the DEMATEL (Decision Making Trial and Evaluation Laboratory-based ANP (Analytic Network Process (DANP and the modified VlseKriterijumska Optimizacija I Kompromisno Resenje (VIKOR methods, and the investigations and assessments in the case study, this study proposes strategies and directions for improving elderly housing. The study results indicate that, as distinct from using traditional methodologies where the hypothesis criteria are mutually independent, the proposed hybrid model (examining real-life problems by considering the mutual influences of factors identifies a priority sequence wherein emphasis is placed on improving ventilation and air quality rather than adjustment of temperature. The systemic way of thinking shifts the focus from the most apparent problems to the root cause of the problems. Doing so avoids any mismatch of resource allocation in decision-making and thus maximizes the efficiency and sustainability of the improvement.

Does ownership of improved dairy cow breeds improve child nutrition? A pathway analysis for Uganda.

Directory of Open Access Journals (Sweden)

Nassul S Kabunga

Full Text Available The promotion of livestock production is widely believed to support enhanced diet quality and child nutrition, but the empirical evidence for this causal linkage remains narrow and ambiguous. This study examines whether adoption of improved dairy cow breeds is linked to farm-level outcomes that translate into household-level benefits including improved child nutrition outcomes in Uganda. Using nationwide data from Uganda's National Panel Survey, propensity score matching is used to create an unbiased counterfactual, based on observed characteristics, to assess the net impacts of improved dairy cow adoption. All estimates were tested for robustness and sensitivity to variations in observable and unobservable confounders. Results based on the matched samples showed that households adopting improved dairy cows significantly increased milk yield-by over 200% on average. This resulted in higher milk sales and milk intakes, demonstrating the potential of this agricultural technology to both integrate households into modern value chains and increase households' access to animal source foods. Use of improved dairy cows increased household food expenditures by about 16%. Although undernutrition was widely prevalent in the study sample and in matched households, the adoption of improved dairy cows was associated with lower child stunting in adopter household. In scale terms, results also showed that holding larger farms tends to support adoption, but that this also stimulates the household's ability to achieve gains from adoption, which can translate into enhanced nutrition.

Quality Improvement Initiatives in Inflammatory Bowel Disease.

Science.gov (United States)

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

2017-08-01

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

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

Can an interprofessional tracheostomy team improve weaning to decannulation times? A quality improvement evaluation

Science.gov (United States)

Morrison, Melissa; Catalig, Marifel; Chris, Juliana; Pataki, Janos

2016-01-01

BACKGROUND: Percutaneous tracheostomy is a common procedure in the intensive care unit and, on patient transfer to the wards, there is a gap in ongoing tracheostomy management. There is some evidence that tracheostomy teams can shorten weaning to decannulation times. In response to lengthy weaning to decannulation times at Trillium Health Partners – Credit Valley Hospital site (Mississauga, Ontario), an interprofessional tracheostomy team, led by respiratory therapists and consisting of speech-language pathologists and intensive care physicians, was implemented. OBJECTIVE: To evaluate the interprofessional tracheostomy team and its impact on time from weaning off mechanical ventilation to decannulation; and time from weaning to speech-language pathology referral. METHODS: Performance metrics were collected retrospectively through chart review pre- and post-team implementation. The primary metrics evaluated were the time from weaning off mechanical ventilation to decannulation, and time to referral to speech-language pathology. RESULTS: Following implementation of the interprofessional tracheostomy team, there was no improvement in decannulation times or time from weaning to speech-language pathology referral. A significant improvement was noted in the average time to first tracheostomy tube change (36.2 days to 22.9 days; P=0.01) and average time to speech-language pathology referral following initial tracheostomy insertion (51.8 days to 26.3 days; P=0.01). CONCLUSION: An interprofessional tracheostomy team can improve the quality of tracheostomy care through earlier tracheostomy tube changes and swallowing assessment referrals. The lack of improved weaning to decannulation time was potentially due to poor adherence with established protocols as well as a change in mechanical ventilation practices. To validate the findings from this particular institution, a more rigorous quality improvement methodology should be considered in addition to strategies to improve

24 CFR 901.145 - Improvement Plan.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Improvement Plan. 901.145 Section... PUBLIC HOUSING MANAGEMENT ASSESSMENT PROGRAM § 901.145 Improvement Plan. (a) After receipt of the State... a PHA, or a RMC through the PHA, to prepare and submit to the State/Area Office an Improvement Plan...

45 CFR 1355.35 - Program improvement plans.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Program improvement plans. 1355.35 Section 1355.35... plans. (a) Mandatory program improvement plan. (1) States found not to be operating in substantial conformity shall develop a program improvement plan. The program improvement plan must: (i) Be developed...

Improving performance on core processes of care.

Science.gov (United States)

Austin, John Matthew; Pronovost, Peter J

2016-06-01

This article describes the recent literature on using extrinsic and intrinsic motivators to improve performance on core processes of care, highlighting literature that describes general frameworks for quality improvement work. The literature supporting the effectiveness of extrinsic motivators to improve quality is generally positive for public reporting of performance, with mixed results for pay-for-performance. A four-element quality improvement framework developed by The Armstrong Institute at Johns Hopkins Medicine was developed with intrinsic motivation in mind. The clear definition and communication of goals are important for quality improvement work. Training clinicians in improvement science, such as lean sigma, teamwork, or culture change provides clinicians with the skills they need to drive the improvement work. Peer learning communities offer the opportunity for clinicians to engage with each other and offer support in their work. The transparent reporting of performance helps ensure accountability of performance ranging from individual clinicians to governance. Quality improvement work that is led by and engages clinicians offers the opportunity for the work to be both meaningful and sustainable. The literature supports approaching quality improvement work in a systematic way, including the key elements of communication, infrastructure building, training, transparency, and accountability.

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

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

Directory of Open Access Journals (Sweden)

Cathy Kande

2014-01-01

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

Can proprioception really be improved by exercises?

Science.gov (United States)

Ashton-Miller, J A; Wojtys, E M; Huston, L J; Fry-Welch, D

2001-05-01

There is little question that ankle disc training can improve ankle muscle motor performance in a unipedal balance task, most likely through improved strength and coordination [62] and possibly endurance. How much of the observed improvement in motor performance is due to improved ankle proprioception remains unknown. We have reviewed a number of theoretical ways in which training might improve proprioception for moderately challenging weight-bearing situations such as balancing on one leg. Although the relevant experiments have yet to be performed to test this hypothesis, any improvement would theoretically help to reduce injuries at these moderate levels of challenge. We question, however, whether these exercises can ever improve the reactive response required to prevent injury under the most challenging time-critical situations. If confirmed, this limitation needs to be acknowledged by authors and practitioners alike. Alternative protective strategies for the most challenging time-critical situations should be sought. We conclude that, despite their widespread acceptance, current exercises aimed at "improving proprioception" have not been demonstrated to achieve that goal. We have outlined theoretical scenarios by which proprioception might be improved, but these are speculative. The relevant experiments remain to be conducted. We argue that even if they were proven to improve proprioception, under the best circumstances such exercises could only prevent injury under slow to intermediate rate provocations to the joint musculoligamentous complex in question.

An Example of an Improvable Rao-Blackwell Improvement, Inefficient Maximum Likelihood Estimator, and Unbiased Generalized Bayes Estimator.

Science.gov (United States)

Galili, Tal; Meilijson, Isaac

2016-01-02

The Rao-Blackwell theorem offers a procedure for converting a crude unbiased estimator of a parameter θ into a "better" one, in fact unique and optimal if the improvement is based on a minimal sufficient statistic that is complete. In contrast, behind every minimal sufficient statistic that is not complete, there is an improvable Rao-Blackwell improvement. This is illustrated via a simple example based on the uniform distribution, in which a rather natural Rao-Blackwell improvement is uniformly improvable. Furthermore, in this example the maximum likelihood estimator is inefficient, and an unbiased generalized Bayes estimator performs exceptionally well. Counterexamples of this sort can be useful didactic tools for explaining the true nature of a methodology and possible consequences when some of the assumptions are violated. [Received December 2014. Revised September 2015.].

Towards improving highland ban.anas

African Journals Online (AJOL)

The most fertile land races belonged to 'Nakabululu' and 'Nfuuka' clone sets. Viable seeds were obtained from several land races indicating that genetic improvement ofthese highland bananas through cross breeding is possible. The fertile Iandraces should be cross-pollinated with improved diploids to produce resistant ...

Perspectives: The Continuous Improvement Trap

Science.gov (United States)

Arnold, David L.

2011-01-01

Accrediting agencies, legislators, pundits, and even higher educational professionals have become enamored with applying the language of continuous improvement to learning outcomes. The Southern Association of Colleges and Schools Commission on Colleges specifically uses the term "continuing improvement" in Core Standard 2.5, one of its…

Action research in collaborative improvement

NARCIS (Netherlands)

Middel, H.G.A.; Coghlan, David; Brennan, Louis; McNichols, Tim

2006-01-01

There is an increasing need to apply and transfer continuous improvement (CI) to inter-organisational processes. As such collaborative improvement (CoI) is emerging as a new concept within managerial literature and practice. This paper begins with a discussion on the logic and value of applying

Educational Intervention Improves Compliance With AAN Guidelines for Return Epilepsy Visits: A Quality Improvement Project.

Science.gov (United States)

Nelson, Gary R; Filloux, Francis M; Kerr, Lynne M

2016-10-01

In 2011, the American Academy of Neurology (AAN) released guidelines for return seizure visits detailing 8 points that should be addressed during such visits. These guidelines are designed to improve routine follow-up care for epilepsy patients. The authors performed a quality improvement project aimed at increasing compliance with these guidelines after educating providers about them. The authors performed a chart review before and after an intervention which included: education regarding the guidelines, providing materials to remind providers of the guidelines, and templates to facilitate compliance. The authors reviewed charts at 2 and 6 months after the intervention. Significant improvement in documentation of 4 of the 8 measures was observed after this educational intervention. This suggests that simple educational interventions may help providers change practice and can improve compliance with new guidelines while requiring minimal time and resources to implement. © The Author(s) 2016.

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

Improving Communication in Design

DEFF Research Database (Denmark)

Maier, Anja; Doenmez, Denniz; Hepperle, Clemens

2011-01-01

Communication permeates every aspect of an engineer’s work – from clarifying product specifications to shaping social ties. This paper offers an overview of recommendations from literature to improve communication within and among engineering teams. We assume communication problems are often...... of tasks. To improve these factors in order to enable effective communication, this paper collates more than hundred recommendations from journal articles and textbooks published in the fields of engineering design, management science, sociology, and psychology. Recommendations include, for example...

Identifying continuous quality improvement publications: what makes an improvement intervention ‘CQI’?

Science.gov (United States)

Hempel, Susanne; Lim, Yee-Wei; Danz, Marjorie S; Foy, Robbie; Suttorp, Marika J; Shekelle, Paul G; Rubenstein, Lisa V

2011-01-01

Background The term continuous quality improvement (CQI) is often used to refer to a method for improving care, but no consensus statement exists on the definition of CQI. Evidence reviews are critical for advancing science, and depend on reliable definitions for article selection. Methods As a preliminary step towards improving CQI evidence reviews, this study aimed to use expert panel methods to identify key CQI definitional features and develop and test a screening instrument for reliably identifying articles with the key features. We used a previously published method to identify 106 articles meeting the general definition of a quality improvement intervention (QII) from 9427 electronically identified articles from PubMed. Two raters then applied a six-item CQI screen to the 106 articles. Results Per cent agreement ranged from 55.7% to 75.5% for the six items, and reviewer-adjusted intra-class correlation ranged from 0.43 to 0.62. ‘Feedback of systematically collected data’ was the most common feature (64%), followed by being at least ‘somewhat’ adapted to local conditions (61%), feedback at meetings involving participant leaders (46%), using an iterative development process (40%), being at least ‘somewhat’ data driven (34%), and using a recognised change method (28%). All six features were present in 14.2% of QII articles. Conclusions We conclude that CQI features can be extracted from QII articles with reasonable reliability, but only a small proportion of QII articles include all features. Further consensus development is needed to support meaningful use of the term CQI for scientific communication. PMID:21727199

Practical Approaches to Quality Improvement for Radiologists.

Science.gov (United States)

Kelly, Aine Marie; Cronin, Paul

2015-10-01

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

Who pays for tree improvement?

Science.gov (United States)

Tom D. Byram; E. M. Raley

2011-01-01

Tree improvement has been one of the most successful collaborative research efforts in history, eliciting participation from a wide variety of players. This effort has included state forestry agencies, research universities, integrated forest industries, and the USDA Forest Service. Tree improvement was organized through cooperatives whose objectives were to distribute...

The Architecture of School Improvement

Science.gov (United States)

Murphy, Joseph

2013-01-01

Purpose: The aim of this paper is to present a comprehensive framework for capturing the complex concept the authors call school improvement. Design/methodology/approach: The author begins by anchoring that framework on an historical understanding of school improvement. The framework itself is then presented. Five dimensions are described: the…

Solutions to Improve Educational Management Quality

OpenAIRE

Ramezan Jahanian; Masoomeh Motahari

2013-01-01

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

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.

Evolutionary CANDU 9 plant improvements

International Nuclear Information System (INIS)

Yu, S.K.W.

1999-01-01

The CANDU 9 is a 935 MW(e) nuclear power plant (NPP) based on the multi-unit Darlington and Bruce B designs with additional enhancements from our ongoing engineering and research programs. Added to the advantages of using proven systems and components, CANDU 9 offers improvement features with enhanced safety, improved operability and maintenance including a control centre with advanced man-machine interface, and improved project delivery in both engineering and construction. The CANDU 9 NPP design incorporated safety enhancements through careful attention to emerging licensing and safety issues. The designers assessed, revised and evolved such systems as the moderator, end shield, containment and emergency core cooling (ECC) systems while providing an integrated final design that is more passive and severe-accident-immune. AECL uses a feedback process to incorporate lessons learned from operating plants, from current projects experiences and from the implementation or construction phase of previous projects. Most of the requirements for design improvements are based on a systematic review of current operating CANDU stations in the areas of design and reliability, operability, and maintainability. The CANDU 9 Control Centre provides plant staff with improved operability and maintainability capabilities due to the combination of systematic design with human factors engineering and enhanced operating and diagnostics features. The use of advanced engineering tools and modem construction methods will reduce project implementation risk on project costs and schedules. (author)

A REVIEW OF ORDER PICKING IMPROVEMENT METHODS

Directory of Open Access Journals (Sweden)

Johan Oscar Ong

2014-09-01

Full Text Available As a crucial and one of the most important parts of warehousing, order picking often raises discussion between warehousing professionals, resulting in various studies aiming to analyze how order picking activity can be improved from various perspective. This paper reviews various past researches on order picking improvement, and the various methods those studies analyzed or developed. This literature review is based on twenty research articles on order picking improvement viewed from four different perspectives: Automation (specifically, stock-to-picker system, storage assignment policy, order batching, and order picking sequencing. By reviewing these studies, we try to identify the most prevalent order picking improvement approach to order picking improvement. Keywords: warehousing; stock-to-picker; storage assignment; order batching; order picking sequencing; improvement

Leadership Development and School Improvement

Science.gov (United States)

Rhodes, Christopher; Brundrett, Mark

2009-01-01

The chosen focus of this special issue is timely given the burgeoning international interest and investment in leadership development and school improvement. In many countries leadership and improvement have been closely linked and there is no doubt that this linkage has an international reach. Together, these articles review and extend some of…

Renovated Parks Improve Physical Activity

Centers for Disease Control (CDC) Podcasts

We know that children who are physically active every day are less likely to develop chronic diseases as adults, including obesity. Dr. Sandy Slater, a researcher with the University of Illinois, Chicago Prevention Research Center, discusses how a park improvement project in Chicago helped engage communities to improve areas for play and activity.

Workers' Objectives in Quality Improvement.

Science.gov (United States)

Brossard, Michel

1990-01-01

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

Perceived Factors Associated with Sustained Improvement Following Participation in a Multicenter Quality Improvement Collaborative.

Science.gov (United States)

Stone, Sohini; Lee, Henry C; Sharek, Paul J

2016-07-01

The California Perinatal Quality Care Collaborative led the Breastmilk Nutrition Quality Improvement Collaborative from October 2009 to September 2010 to increase the percentage of very low birth weight infants receiving breast milk at discharge in 11 collaborative neonatal ICUs (NICUs). Observed increases in breast milk feeding and decreases in necrotizing enterocolitis persisted for 6 months after the collaborative ended. Eighteen to 24 months after the end of the collaborative, some sites maintained or further increased their gains, while others trended back toward baseline. A study was conducted to assess the qualitative factors that affect sustained improvement following participation. Collaborative leaders at each of the 11 NICUs that participated in the Breastmilk Nutrition Quality Improvement Collaborative were invited to participate in a site-specific one-hour phone interview. Interviews were recorded and transcribed and then analyzed using qualitative research analysis software to identify themes associated with sustained improvement. Eight of 11 invited centers agreed to participate in the interviews. Thematic saturation was achieved by the sixth interview, so further interviews were not pursued. Factors contributing to sustainability included physician involvement within the multidisciplinary teams, continuous education, incorporation of interventions into the daily work flow, and integration of a data-driven feedback system. Early consideration by site leaders of how to integrate best-practice interventions into the daily work flow, and ensuring physician commitment and ongoing education based in continuous data review, should enhance the likelihood of sustaining improvements. To maximize sustained success, future collaborative design should consider proactively identifying and supporting these factors at participating sites.

Improvements in fitness are not obligatory for exercise training-induced improvements in CV risk factors.

Science.gov (United States)

Hartman, Yvonne A W; Hopman, Maria T E; Schreuder, Tim H; Verheggen, Rebecca J H M; Scholten, Ralph R; Oudegeest-Sander, Madelijn H; Poelkens, Fleur; Maiorana, Andrew J; Naylor, Louise H; Willems, Peter H; Tack, Cees J; Thijssen, Dick H J; Green, Daniel J

2018-02-01

The purpose of this study was to assess whether changes in physical fitness relate to changes in cardiovascular risk factors following standardized, center-based and supervised exercise training programs in subjects with increased cardiovascular risk. We pooled data from exercise training studies of subjects with increased cardiovascular risk (n = 166) who underwent 8-52 weeks endurance training. We determined fitness (i.e., peak oxygen uptake) and traditional cardiovascular risk factors (body mass index, blood pressure, total cholesterol, high-density lipoprotein cholesterol), before and after training. We divided subjects into quartiles based on improvement in fitness, and examined whether these groups differed in terms of risk factors. Associations between changes in fitness and in cardiovascular risk factors were further tested using Pearson correlations. Significant heterogeneity was apparent in the improvement of fitness and individual risk factors, with nonresponder rates of 17% for fitness, 44% for body mass index, 33% for mean arterial pressure, 49% for total cholesterol, and 49% for high-density lipoprotein cholesterol. Neither the number, nor the magnitude, of change in cardiovascular risk factors differed significantly between quartiles of fitness change. Changes in fitness were not correlated with changes in cardiovascular risk factors (all P > 0.05). Our data suggest that significant heterogeneity exists in changes in peak oxygen uptake after training, while improvement in fitness did not relate to improvement in cardiovascular risk factors. In subjects with increased cardiovascular risk, improvements in fitness are not obligatory for training-induced improvements in cardiovascular risk factors. © 2018 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

Design safety improvements of Kozloduy NPP

International Nuclear Information System (INIS)

Hinovski, I.

1999-01-01

Design safety improvements of Kozloduy NPP, discussed in detail, are concerned with: primary circuit integrity; reactor pressure vessel integrity; primary coolant piping integrity; primary coolant overpressure protection; leak before break status; design basis accidents and transients; severe accident analysis; improvements of safety and support systems; containment/confinement leak tightness and strength; seismic safety improvements; WWER-1000 control rod insertion; upgrading and modernization of Units 5 and 6; Year 2000 problem

Mapping social networks in software process improvement

DEFF Research Database (Denmark)

Tjørnehøj, Gitte; Nielsen, Peter Axel

2005-01-01

Software process improvement in small, agile organizations is often problematic. Model-based approaches seem to overlook problems. We have been seeking an alternative approach to overcome this through action research. Here we report on a piece of action research from which we developed an approach...... to map social networks and suggest how it can be used in software process improvement. We applied the mapping approach in a small software company to support the realization of new ways of improving software processes. The mapping approach was found useful in improving social networks, and thus furthers...... software process improvement....

Improving the Service with the Servqual Method

Science.gov (United States)

Midor, Katarzyna; Kučera, Marian

2018-03-01

At the time when economy is growing, there is strong competition in the market, and customers have increasingly higher expectations as regards quality of service and products. Under such conditions, organizations need to improve. One of the areas of improvement for an organization is to research the level of customer satisfaction. The article presents results of customer satisfaction surveys conducted by the Servqual method in a pharmaceutical service company. Use of this method allowed to improve the services provided by that pharmaceutical wholesaler, identify areas that need to be improved as soon as possible in order to improve the level of service provided.

An Adaptive Middleware for Improved Computational Performance

DEFF Research Database (Denmark)

Bonnichsen, Lars Frydendal

, we are improving computational performance by exploiting modern hardware features, such as dynamic voltage-frequency scaling and transactional memory. Adapting software is an iterative process, requiring that we continually revisit it to meet new requirements or realities; a time consuming process......The performance improvements in computer systems over the past 60 years have been fueled by an exponential increase in energy efficiency. In recent years, the phenomenon known as the end of Dennard’s scaling has slowed energy efficiency improvements — but improving computer energy efficiency...... is more important now than ever. Traditionally, most improvements in computer energy efficiency have come from improvements in lithography — the ability to produce smaller transistors — and computer architecture - the ability to apply those transistors efficiently. Since the end of scaling, we have seen...

Using Data to Improve Educational Practice

Directory of Open Access Journals (Sweden)

Matthijs Koopmans

2017-04-01

Full Text Available Review of the book “Action Research in the Classroom: Helping Teachers Assess and Improve their Work” by Sr. Mary Ann Jacobs and Bruce S. Cooper There are many ways in which research can contribute to the improvement of educational practice, and action research is one of them. Action research bridges the gap that typically separates research from practice by having practitioners conduct specific projects to address their own questions and improve their effectiveness based on the answers they obtain. One of the advantages of this type of research is that results are often immediately accessible and have actionable implications. Thus, action research is a good tool for making improvements to the field based on evidence.

Improving Family Communications

Science.gov (United States)

... Spread the Word Shop AAP Find a Pediatrician Family Life Medical Home Family Dynamics Adoption & Foster Care ... Listen Español Text Size Email Print Share Improving Family Communications Page Content Article Body How can I ...

Programs to improve plant performance

International Nuclear Information System (INIS)

Felmus, N.L.

1987-01-01

Looking toward the 1990's, we see a period in which our industry will face the challenge of improving the performance of the nuclear plants which are built and operating. The skills and technology are at hand to make good plant performance a reality and we believe the time has come to use them to achieve that end. As reserve margins decline, utilities and their regulators will increasingly seek to tap the unexploited capacity tied up in plants operating below their optimum availability. This paper describes a number of the programs, plant improvements and operations improvements which can yield a significant increase in nuclear plant availability and capacity factor now and into the 1990's. (author)

Improvements in backscatter measurement devices

International Nuclear Information System (INIS)

Saunders, J.; Hay, W.D.

1978-01-01

Improvements in measuring the thickness of a coating on a substrate by the technique of backscattered particles are described. These improvements enable the measurements to be carried out continuously as an integral part of the coating production line and also permit measurements where the coated elements are separated from one another by a predetermined distance. The former is achieved by situating the backscatter probe and detector on the rim of the measurement wheel and rotating this wheel at a speed such that the coated element and probe are stationary relative to one another. The latter improvement is achieved by an indexing apparatus which automatically positions the probe beside a coated element. (U.K.)

Improvement for BWR operator training

International Nuclear Information System (INIS)

Tsuchiya, Toshio; Masuda, Hisao; Isono, Tomoyuki; Noji, Kunio; Togo, Toshiki

1989-01-01

BWR Operator Training Center Corporation (BTC) was established in April 1971 for the purpose of training the operators from all BWR utilities in Japan. Since April 1974, more than 2600 operators and 1000 shift teams have been trained with the full-scope simulators in BTC up to the end of March 1988. To get the satisfactory results of the training, BTC has been making every effort to improve the facilities, the training materials, the instruction methods and the curricula. In this paper, such a series of recent improvements in the instruction methods and the curricula are presented that are effective to expand the knowledge and to improve the skills of middle or senior class operators. (author)

Baseline budgeting for continuous improvement.

Science.gov (United States)

Kilty, G L

1999-05-01

This article is designed to introduce the techniques used to convert traditionally maintained department budgets to baseline budgets. This entails identifying key activities, evaluating for value-added, and implementing continuous improvement opportunities. Baseline Budgeting for Continuous Improvement was created as a result of a newly named company president's request to implement zero-based budgeting. The president was frustrated with the mind-set of the organization, namely, "Next year's budget should be 10 to 15 percent more than this year's spending." Zero-based budgeting was not the answer, but combining the principles of activity-based costing and the Just-in-Time philosophy of eliminating waste and continuous improvement did provide a solution to the problem.

Design improvements in TRIGA reactors

International Nuclear Information System (INIS)

Batch, John M.

1970-01-01

There have been many design improvements to TRIGA reactor hardware in the past twelve years. One of the more important and most obvious improvements has been in the area of reactor instrumentation. The low profile, completely transistorized Mark III console was a great step forward in a low maintenance, high reliability instrumentation system. Other design improvements include the lazy susan specimen pickup assembly; the specimen container; an empty stainless steel fuel element which can be filled with samples and can be located anywhere in the core; the flexible fuel handling tool; a new fuel measuring tool design; the shock absorber on the adjustable transient rod drive; new testing and evaluation procedures on the thermocouples and other

Improved Biomass Cooking Stoves and Improved Stove Emission Equipment

Energy Technology Data Exchange (ETDEWEB)

HATFIELD, MICHAEL; Still, Dean

2013-04-15

In developing countries, there is an urgent need for access to safe, efficient, and more affordable cooking technologies. Nearly 2.5 billion people currently use an open fire or traditional cookstove to prepare their meals, and recent models predict that use of biomass for cooking will continue to be the dominant energy use in rural, resource-poor households through 2030. For these families, cooking poses serious risks to health, safety, and income. An alarming 4 million people, primarily women and children, die prematurely each year from indoor and outdoor exposure to the harmful emissions released by solid fuel combustion. Use of traditional stoves can also have a significant impact on deforestation and climate change. This dire situation creates a critical need for cookstoves that significantly and verifiably reduce fuel use and emissions in order to reach protective levels for human health and the environment. Additionally, advances in the scientific equipment needed to measure and monitor stove fuel use and emissions have not kept pace with the significant need within the industry. While several testing centers in the developed world may have hundred thousand-dollar emissions testing systems, organizations in the field have had little more than a thermometer, a scale, and subjective observations to quantify the performance of stove designs. There is an urgent need for easy-to-use, inexpensive, accurate, and robust stove testing equipment for use by laboratory and field researchers around the world. ASAT and their research partner, Aprovecho Research Center (ARC), have over thirty years of experience addressing these two needs, improved cookstoves and emissions monitoring equipment, with expertise spanning the full spectrum of development from conceptual design to product manufacturing and dissemination. This includes: 1) research, design, and verification of clean biomass cookstove technology and emissions monitoring equipment; 2) mass production of quality

A High Intensity Interval Training (HIIT)-Based Running Plan Improves Athletic Performance by Improving Muscle Power.

Science.gov (United States)

García-Pinillos, Felipe; Cámara-Pérez, Jose C; Soto-Hermoso, Víctor M; Latorre-Román, Pedro Á

2017-01-01

García-Pinillos, F, Cámara-Pérez, JC, Soto-Hermoso, VM, and Latorre-Román, PÁ. A High Intensity Interval Training (HIIT)-based running plan improves athletic performance by improving muscle power. J Strength Cond Res 31(1): 146-153, 2017-This study aimed to examine the effect of a 5-week high-intensity intermittent training (HIIT)-based running plan on athletic performance and to compare the physiological and neuromuscular responses during a sprint-distance triathlon before and after the HIIT period. Thirteen triathletes were matched into 2 groups: the experimental group (EG) and the control group (CG). The CG was asked to maintain their normal training routines, whereas the EG maintained only their swimming and cycling routines and modified their running routine. Participants completed a sprint-distance triathlon before (pretest) and after (posttest) the intervention period. In both pretest and posttest, the participants performed 4 jumping tests: before the race (baseline), postswim, postcycling, and postrun. Additionally, heart rate was monitored (HRmean), whereas rate of perceived exertion (RPE) and blood lactate accumulation (BLa) were registered after the race. No significant differences (p ≥ 0.05) between groups were found before HIIT intervention (at pretest). Significant group-by-training interactions were found in vertical jumping ability and athletic performance: the EG improved jumping performance (∼6-9%, p ≤ 0.05, effect size (ES) > 0.7), swimming performance (p = 0.013, ES = 0.438), and running time (p = 0.001, ES = 0.667) during the competition, whereas the CG remained unchanged (p ≥ 0.05, ES HIIT-based running plan combined with the high training volumes of these triathletes in swimming and cycling improved athletic performance during a sprint-distance triathlon. This improvement may be due to improved neuromuscular characteristics that were transferred into improved muscle power and work economy.

Substantial Improvements of Fuel Economy

DEFF Research Database (Denmark)

Jørgensen, Kaj; Nielsen, Lars H.

1996-01-01

The paper evaluates the scope for improving the energy and environmental impacts of road transport by means of electrical and hybrid propulsion. These technologies promise considerable improvements of the fuel economy compared to equivalent vehicles mas well as beneficial effects for the energy...... and traffic systems. A case study concerning passenger cars is analysed by means of computer simulation....

Improving the Simplified Acquisition of Base Engineering Requirements (SABER) Delivery Order Award Process: Results of a Process Improvement Plan

Science.gov (United States)

1991-09-01

putting all tasks directed towsrds achieving an outcome in aequence. The tasks can be viewed as steps in the process (39:2.3). Using this...improvement opportunity is investigated. A plan is developed, root causes are identified, and solutions are tested and implemented. The process is... solutions , check for actual improvement, and integrate the successful improvements into the process. ?UP 7. Check Improvement Performance. Finally, the

Process safety improvement-Quality and target zero

Energy Technology Data Exchange (ETDEWEB)

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

2008-11-15

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

Process safety improvement-Quality and target zero

International Nuclear Information System (INIS)

Van Scyoc, Karl

2008-01-01

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

Process safety improvement--quality and target zero.

Science.gov (United States)

Van Scyoc, Karl

2008-11-15

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

Improved fluid-structure coupling

International Nuclear Information System (INIS)

McMaster, W.H.; Gong, E.Y.; Landram, C.S.

1981-01-01

In the computer code PELE-IC, an incompressible Eulerian hydrodynamic algorithm was coupled to a Lagrangian finite element shell algorithm for the analysis of pressure suppression in boiling water reactors. This effort also required the development of a free surface algorithm capable of handling expanding gas bubbles. These algorithms have been improved to strengthen the coupling and to add the capability for following the more complex free surfaces resulting from steam condensation. These improvements have also permitted more economical 2D calculations and have made it feasible to develop a 3D version. A compressible option using the acoustic approximation has also been added, furthering the usefulness of the code. The coupling improvements were made in three areas which are identified as (1) preferential coupling, (2) merged cell coupling, and (3) free surface-structure coupling, and are described. These algorithms have been additionally implemented in a three dimensional version of the code called PELE3D. This version has a free surface capability to follow expanding and contracting bubbles and is coupled to a curved rigid surface

RTEMS CENTRE- RTEMS Improvement

Science.gov (United States)

Silva, Helder; Constantino, Alexandre; Freitas, Daniel; Coutinho, Manuel; Faustino, Sergio; Sousa, Jose; Dias, Luis; Zulianello, Marco

2010-08-01

During the last two years, EDISOFT's RTEMS CENTRE team [1], jointly with the European Space Agency and with the support of the worldwide RTEMS community [2], have been developing an activity to facilitate the qualification of the real-time operating system RTEMS (Real-Time Operating System for Multiprocessor Systems). This paper intends to give a high level visibility of the progress and the results obtained in the RTEMS Improvement [3] activity. The primary objective [4] of the project is to improve the RTEMS product, its documentation and to facilitate the qualification of RTEMS for future space missions, taking into consideration the specific operational requirements. The sections below provide a brief overview of the RTEMS operating system and the activities performed in the RTEMS Improvement project, which includes the selection of API managers to be qualified, the tailoring process, the requirements analysis, the reverse engineering and design of the RTEMS, the quality assurance process, the ISVV activities, the test campaign, the results obtained, the criticality analysis and the facilitation of qualification process.

Improving quality of care in substance abuse treatment using five key process improvement principles

Science.gov (United States)

Hoffman, Kim A.; Green, Carla A.; Ford, James H.; Wisdom, Jennifer P.; Gustafson, David H.; McCarty, Dennis

2012-01-01

Process and quality improvement techniques have been successfully applied in health care arenas, but efforts to institute these strategies in alcohol and drug treatment are underdeveloped. The Network for the Improvement of Addiction Treatment (NIATx) teaches participating substance abuse treatment agencies to use process improvement strategies to increase client access to, and retention in, treatment. NIATx recommends five principles to promote organizational change: 1) Understand and involve the customer; 2) Fix key problems; 3) Pick a powerful change leader; 4) Get ideas from outside the organization; and 5) Use rapid-cycle testing. Using case studies, supplemented with cross-agency analyses of interview data, this paper profiles participating NIATx treatment agencies that illustrate application of each principle. Results suggest that the most successful organizations integrate and apply most, if not all, of the five principles as they develop and test change strategies. PMID:22282129

Clinical performance improvement series. Classic CQI integrated with comprehensive disease management as a model for performance improvement.

Science.gov (United States)

Joshi, M S; Bernard, D B

1999-08-01

In recent years, health and disease management has emerged as an effective means of delivering, integrating, and improving care through a population-based approach. Since 1997 the University of Pennsylvania Health System (UPHS) has utilized the key principles and components of continuous quality improvement (CQI) and disease management to form a model for health care improvement that focuses on designing best practices, using best practices to influence clinical decision making, changing processes and systems to deploy and deliver best practices, and measuring outcomes to improve the process. Experience with 28 programs and more than 14,000 patients indicates significant improvement in outcomes, including high physician satisfaction, increased patient satisfaction, reduced costs, and improved clinical process and outcome measures across multiple diseases. DIABETES DISEASE MANAGEMENT: In three months a UPHS multidisciplinary diabetes disease management team developed a best practice approach for the treatment of all patients with diabetes in the UPHS. After the program was pilot tested in three primary care physician sites, it was then introduced progressively to additional practice sites throughout the health system. The establishment of the role of the diabetes nurse care managers (certified diabetes educators) was central to successful program deployment. Office-based coordinators ensure incorporation of the best practice protocols into routine flow processes. A disease management intranet disseminates programs electronically. Outcomes of the UPHS health and disease management programs so far demonstrate success across multiple dimensions of performance-service, clinical quality, access, and value. The task of health care leadership today is to remove barriers and enable effective implementation of key strategies, such as health and disease management. Substantial effort and resources must be dedicated to gain physician buy-in and achieve compliance. The

Developing a Continuous Improvement System

Science.gov (United States)

2016-09-16

disagree that continuous improvement is critical to an organization’s suc-cess, since conducting business using a status quo philosophy will not work...for implementing one of these processes include: better operational efficiency, increased customer satisfaction, improved employee morale ...when a problem in reliability or maintenance may become the greatest opportunity. As described in the January-February 2011 issue of Defense AT&L

Continuous improvement: A win-win process

International Nuclear Information System (INIS)

Lawrence, T.M.; Wichert, A.

1992-01-01

The strategies used within PanCanadian Petroleum Limited's production division to successfully introduce the continuous improvement (CI) process are discussed. Continuous improvement is an operating philosophy and management style which allows all employees to participate in and improve the way an organization performs its day-to-day business. In the CI work environment the supervisor's traditional role changes from one of monitoring and controlling, to one of inspiring, motivating and leading people by communicating a clear vision. Employees at all levels in the work environment are organized into teams and armed with a good working knowledge of the problem-solving tools which allow them to pursue and implement improvement initiatives. The outcome of the process is an ongoing win-win situation for both PanCanadian and its people. Employees are gaining more trust, eliminating job irritants, and enjoying their work in a team environment. The company is benefiting through increased production, improved safety and reduced operating expenses, thanks to the many innovative ideas introduced by employees. 4 refs

Improved models of dense anharmonic lattices

Energy Technology Data Exchange (ETDEWEB)

Rosenau, P., E-mail: rosenau@post.tau.ac.il; Zilburg, A.

2017-01-15

We present two improved quasi-continuous models of dense, strictly anharmonic chains. The direct expansion which includes the leading effect due to lattice dispersion, results in a Boussinesq-type PDE with a compacton as its basic solitary mode. Without increasing its complexity we improve the model by including additional terms in the expanded interparticle potential with the resulting compacton having a milder singularity at its edges. A particular care is applied to the Hertz potential due to its non-analyticity. Since, however, the PDEs of both the basic and the improved model are ill posed, they are unsuitable for a study of chains dynamics. Using the bond length as a state variable we manipulate its dispersion and derive a well posed fourth order PDE. - Highlights: • An improved PDE model of a Newtonian lattice renders compacton solutions. • Compactons are classical solutions of the improved model and hence amenable to standard analysis. • An alternative well posed model enables to study head on interactions of lattices' solitary waves. • Well posed modeling of Hertz potential.

Improved core protection calculator system algorithm

International Nuclear Information System (INIS)

Yoon, Tae Young; Park, Young Ho; In, Wang Kee; Bae, Jong Sik; Baeg, Seung Yeob

2009-01-01

Core Protection Calculator System (CPCS) is a digitized core protection system which provides core protection functions based on two reactor core operation parameters, Departure from Nucleate Boiling Ratio (DNBR) and Local Power Density (LPD). It generates a reactor trip signal when the core condition exceeds the DNBR or LPD design limit. It consists of four independent channels which adapted a two out of four trip logic. CPCS algorithm improvement for the newly designed core protection calculator system, RCOPS (Reactor COre Protection System), is described in this paper. New features include the improvement of DNBR algorithm for thermal margin, the addition of pre trip alarm generation for auxiliary trip function, VOPT (Variable Over Power Trip) prevention during RPCS (Reactor Power Cutback System) actuation and the improvement of CEA (Control Element Assembly) signal checking algorithm. To verify the improved CPCS algorithm, CPCS algorithm verification tests, 'Module Test' and 'Unit Test', would be performed on RCOPS single channel facility. It is expected that the improved CPCS algorithm will increase DNBR margin and enhance the plant availability by reducing unnecessary reactor trips

Improvement of foundation for inspection

Energy Technology Data Exchange (ETDEWEB)

NONE

2013-08-15

Japan Nuclear Energy Safety Organization has been carrying out improvement of inspection system for nuclear plants in Japan since 2003FY. The new inspection system was introduced into nuclear power plants in{sub -}2008FY. In this project, improvement of comprehensive plant performance assessment and management tool for the new inspection system are developed. In 2012FY, a trend analysis method of the plant performance was developed with reference to the IAEA literature. And the trend analysis was tried based on the results of the comprehensive plant performance assessment of all domestic plants except Fukushima-Daiichi Nuclear Power Station. In addition, the teaching materials for QMS training guideline were made. And improvement of a quality management system evaluation support tool was performed. (author)

Improvement of foundation for inspection

International Nuclear Information System (INIS)

2013-01-01

Japan Nuclear Energy Safety Organization has been carrying out improvement of inspection system for nuclear plants in Japan since 2003FY. The new inspection system was introduced into nuclear power plants in - 2008FY. In this project, improvement of comprehensive plant performance assessment and management tool for the new inspection system are developed. In 2012FY, a trend analysis method of the plant performance was developed with reference to the IAEA literature. And the trend analysis was tried based on the results of the comprehensive plant performance assessment of all domestic plants except Fukushima-Daiichi Nuclear Power Station. In addition, the teaching materials for QMS training guideline were made. And improvement of a quality management system evaluation support tool was performed. (author)

Functional molecular markers for crop improvement.

Science.gov (United States)

Kage, Udaykumar; Kumar, Arun; Dhokane, Dhananjay; Karre, Shailesh; Kushalappa, Ajjamada C

2016-10-01

A tremendous decline in cultivable land and resources and a huge increase in food demand calls for immediate attention to crop improvement. Though molecular plant breeding serves as a viable solution and is considered as "foundation for twenty-first century crop improvement", a major stumbling block for crop improvement is the availability of a limited functional gene pool for cereal crops. Advancement in the next generation sequencing (NGS) technologies integrated with tools like metabolomics, proteomics and association mapping studies have facilitated the identification of candidate genes, their allelic variants and opened new avenues to accelerate crop improvement through development and use of functional molecular markers (FMMs). The FMMs are developed from the sequence polymorphisms present within functional gene(s) which are associated with phenotypic trait variations. Since FMMs obviate the problems associated with random DNA markers, these are considered as "the holy grail" of plant breeders who employ targeted marker assisted selections (MAS) for crop improvement. This review article attempts to consider the current resources and novel methods such as metabolomics, proteomics and association studies for the identification of candidate genes and their validation through virus-induced gene silencing (VIGS) for the development of FMMs. A number of examples where the FMMs have been developed and used for the improvement of cereal crops for agronomic, food quality, disease resistance and abiotic stress tolerance traits have been considered.

Improve your communication skills

CERN Document Server

Barker, Alan

2016-01-01

Excellent communication skills are vital in today's workplace. Whether keeping the interest of a large audience, impressing a potential employer or simply winning the argument at an important meeting, sounding the part is key. This fourth edition of Improve Your Communication Skills is full of practical advice on all aspects of verbal and non-verbal communication. It gives vital tips on improving conversations and building rapport with colleagues, learning the skills of persuasion, and writing effective emails, letters and reports. This editionincludes new information focusing on communicating across borders and virtual teams and a new chapter on managing difficult conversations."

Engineering chloroplasts to improve Rubisco catalysis: prospects for translating improvements into food and fiber crops.

Science.gov (United States)

Sharwood, Robert E

2017-01-01

494 I. 495 II. 496 III. 496 IV. 499 V. 499 VI. 501 VII. 501 VIII. 502 IX. 505 X. 506 507 References 507 SUMMARY: The uncertainty of future climate change is placing pressure on cropping systems to continue to provide stable increases in productive yields. To mitigate future climates and the increasing threats against global food security, new solutions to manipulate photosynthesis are required. This review explores the current efforts available to improve carbon assimilation within plant chloroplasts by engineering Rubisco, which catalyzes the rate-limiting step of CO 2 fixation. Fixation of CO 2 and subsequent cycling of 3-phosphoglycerate through the Calvin cycle provides the necessary carbohydrate building blocks for maintaining plant growth and yield, but has to compete with Rubisco oxygenation, which results in photorespiration that is energetically wasteful for plants. Engineering improvements in Rubisco is a complex challenge and requires an understanding of chloroplast gene regulatory pathways, and the intricate nature of Rubisco catalysis and biogenesis, to transplant more efficient forms of Rubisco into crops. In recent times, major advances in Rubisco engineering have been achieved through improvement of our knowledge of Rubisco synthesis and assembly, and identifying amino acid catalytic switches in the L-subunit responsible for improvements in catalysis. Improving the capacity of CO 2 fixation in crops such as rice will require further advances in chloroplast bioengineering and Rubisco biogenesis. © 2016 The Author. New Phytologist © 2016 New Phytologist Trust.

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.

Evolution and outcomes of a quality improvement program.

Science.gov (United States)

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

2010-01-01

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

Nurses improve migraine management in primary care

NARCIS (Netherlands)

Veenstra, Petra; Kollen, Boudewijn J.; de Jong, Gosse; Baarveld, Frans; van den Berg, J. S. Peter

Introduction Migraine is a common disorder with a high burden. Adequate treatment results in improvement of quality of life. Migraine patients are mainly treated by general practitioners (GPs), but there is still room for improvement. This study investigated whether primary care nurses could improve

Adoption of Improved Potato Varieties in Nepal

Directory of Open Access Journals (Sweden)

Samaya Gairhe

2017-05-01

Full Text Available Nepal is one of the top twenty countries where potato contributes substantially for the human diet. Enhancing adoption of improved potato varieties could impact on farmer’s income, household food and nutritional security. As such, using a multistage sampling procedure, a study was conducted to assess the determinants of improved potato varieties adoption in Nepal covering 180 samples in four districts, two in hills and two in Tarai region. The study revealed that; Kavre and Bardiya districts in the hills and Tarai, respectively, were dominated by improved potato varieties adoption. On the other hand, Dhankuta and Jhapa in the hills and Tarai, respectively, were dominated by local potato varieties adoption. The informal seed sources followed by agro-vet and market were the major sources for improved varietal adoption. Farmers’ accesses to training and formal seed sources were important factor determining improved potato varietal adoption. However, households with larger farm size were less likely to allocate more area for improved potato varieties as many of farmers were reluctant to take potato cultivation as agri-business and still follow subsistence farming. Potato R&D programs, therefore, need to strengthen formal seed system to enhance access to quality potato seeds and build producer’s capacity through regular training and exposer visits in order to improve adoption of improved potato varieties in Nepal.

Continuous improvement methods in the nuclear industry

International Nuclear Information System (INIS)

Heising, Carolyn D.

1995-01-01

The purpose of this paper is to investigate management methods for improved safety in the nuclear power industry. Process improvement management, methods of business process reengineering, total quality management, and continued process improvement (KAIZEN) are explored. The anticipated advantages of extensive use of improved process oriented management methods in the nuclear industry are increased effectiveness and efficiency in virtually all tasks of plant operation and maintenance. Important spin off include increased plant safety and economy. (author). 6 refs., 1 fig

Improving policy implementation through collaborative policymaking

DEFF Research Database (Denmark)

Ansell, Christopher; Sørensen, Eva; Torfing, Jacob

2017-01-01

We offer a fresh perspective on implementation problems by suggesting that collaborative policy design and adaptive policy implementation will help public policy makers to improve policy execution. Classical implementation theories have focused too narrowly on administrative stumbling blocks and ...... collaborative policymaking and adaptive policy implementation might work in theory and practice......We offer a fresh perspective on implementation problems by suggesting that collaborative policy design and adaptive policy implementation will help public policy makers to improve policy execution. Classical implementation theories have focused too narrowly on administrative stumbling blocks...... and New Public Management has reinforced the split between politics and administration. Attempts to improve policy implementation must begin by looking at policy design, which can be improved through collaboration and deliberation between upstream and downstream actors. We provide a broad overview of how...

Improvement in fatigue during Natalizumab treatment is linked to improvement in depression and day-time sleepiness

Directory of Open Access Journals (Sweden)

Iris-Katharina ePenner

2015-02-01

Full Text Available Background: Fatigue is a frequent symptom in multiple sclerosis (MS and often interrelated with depression and sleep disorders making symptomatic treatment decisions difficult. In the single-arm, observational phase IV TYNERGY study, relapsing-remitting MS patients showed a clinically meaningful decrease in fatigue over one year of treatment with natalizumab. Objective: To evaluate whether fatigue improvement might be directly linked to improved depression and daytime sleepiness. Methods: Patients were assessed regarding fatigue, depression, and daytime sleepiness. The relation between changes of the two latter symptoms and changes in fatigue was analysed. Results: After one year of natalizumab treatment, the majority of patients (>92% remained stable or improved in total, motor and cognitive fatigue. Proportion of patients without depression increased by 17% while proportions of mildly depressed patients or patients with potential major depression decreased by 5% and 12%, respectively. Proportion of patients classified as not being sleepy increased by 13% while proportions of sleepy and very sleepy patients decreased by 11% and 2%, respectively. Most importantly, improved depression and sleepiness were significantly related to improved fatigue. Conclusion: Our findings highlight the importance of patient-reported outcomes in identifying potential benefits of drug treatment beyond its well-established effects on disease activity and disability progression.

SEL's Software Process-Improvement Program

Science.gov (United States)

Basili, Victor; Zelkowitz, Marvin; McGarry, Frank; Page, Jerry; Waligora, Sharon; Pajerski, Rose

1995-01-01

The goals and operations of the Software Engineering Laboratory (SEL) is reviewed. For nearly 20 years the SEL has worked to understand, assess, and improve software and the development process within the production environment of the Flight Dynamics Division (FDD) of NASA's Goddard Space Flight Center. The SEL was established in 1976 with the goals of reducing: (1) the defect rate of delivered software, (2) the cost of software to support flight projects, and (3) the average time to produce mission-support software. After studying over 125 projects of FDD, the results have guided the standards, management practices, technologies, and the training within the division. The results of the studies have been a 75 percent reduction in defects, a 50 percent reduction in cost, and a 25 percent reduction in development time. Over time the goals of SEL have been clarified. The goals are now stated as: (1) Understand baseline processes and product characteristics, (2) Assess improvements that have been incorporated into the development projects, (3) Package and infuse improvements into the standard SEL process. The SEL improvement goal is to demonstrate continual improvement of the software process by carrying out analysis, measurement and feedback to projects with in the FDD environment. The SEL supports the understanding of the process by study of several processes including, the effort distribution, and error detection rates. The SEL assesses and refines the processes. Once the assessment and refinement of a process is completed, the SEL packages the process by capturing the process in standards, tools and training.

Genetic improvement of tropical acacias: achievements and ...

African Journals Online (AJOL)

The potential for genetic improvement in form traits and wood properties has also been demonstrated. Genetic improvement objectives must now give heavy weighting to improving disease resistance and tolerance. Ganoderma root rot and Ceratocystis stem wilt have destroyed large areas of acacia plantations in Indonesia ...

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.

Improvement of nuclear ship engineering simulation system. Hardware renewal and interface improvement of the integral type reactor

Energy Technology Data Exchange (ETDEWEB)

Takahashi, Hiroki; Kyoya, Masahiko; Shimazaki, Junya [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment; Kano, Tadashi [KCS, Co., Mito, Ibaraki (Japan); Takahashi, Teruo [Energis, Co., Kobe, Hyogo (Japan)

2001-10-01

JAERI had carried out the design study about a lightweight and compact integral type reactor (an advanced marine reactor) with passive safety equipment as a power source for the future nuclear ships, and completed an engineering design. We have developed the simulator for the integral type reactor to confirm the design and operation performance and to utilize the study of automation of the reactor operation. The simulator can be used also for future research and development of a compact reactor. However, the improvement in a performance of hardware and a human machine interface of software of the simulator were needed for future research and development. Therefore, renewal of hardware and improvement of software have been conducted. The operability of the integral-reactor simulator has been improved. Furthermore, this improvement with the hardware and software on the market brought about better versatility, maintainability, extendibility and transfer of the system. This report mainly focuses on contents of the enhancement in a human machine interface, and describes hardware renewal and the interface improvement of the integral type reactor simulator. (author)

Equipment improvements for performance enhancement

International Nuclear Information System (INIS)

Gaestel, P.; Guesnon, H.; Sauze, G.

1994-01-01

In order to enhance the reactor availability, several improvements on reactor equipment have been developed: design optimization for stator maintenance replacement in the main alternator; adjustment modification of stator coils in the main alternator for an easier maintenance; improvement of the fuel handling line (pole crane, transfer equipment, loading machine); development of a loose part trapping system in the steam generator secondary circuit. 1 tab

Improvement of radioisotope production technology

International Nuclear Information System (INIS)

Li Yongjian

1987-01-01

The widespreading and deepgoing applications of radioisotopes results the increasing demands on both quality and quantity. This in turn stimulating the production technology to be improved unceasingly to meet the different requirements on availability, variety, facility, purity, specific activity and specificity. The major approaches of achieving these improvements including: optimizing mode of production; enhancing irradiation conditions; amelioration target arrangement; adapting nuclear process and inventing chemical processing. (author)

Reduction of mesqa improvement costs

Directory of Open Access Journals (Sweden)

Mohamed Ahmed Saad ElFetyany

2017-10-01

Results show that using the revised approach brings down the cost of mesqa improvement from nearly 10,000LE/fed at present to about 6000LE/fed. These reductions based on the analyses of different mesqa modelling through the adoption of certain parameters such as feasibility of the revised design, effective application of continuous flow for water distribution, and downsizing of the capacity of improved mesqas.

Can verbal working memory training improve reading?

Science.gov (United States)

Banales, Erin; Kohnen, Saskia; McArthur, Genevieve

2015-01-01

The aim of the current study was to determine whether poor verbal working memory is associated with poor word reading accuracy because the former causes the latter, or the latter causes the former. To this end, we tested whether (a) verbal working memory training improves poor verbal working memory or poor word reading accuracy, and whether (b) reading training improves poor reading accuracy or verbal working memory in a case series of four children with poor word reading accuracy and verbal working memory. Each child completed 8 weeks of verbal working memory training and 8 weeks of reading training. Verbal working memory training improved verbal working memory in two of the four children, but did not improve their reading accuracy. Similarly, reading training improved word reading accuracy in all children, but did not improve their verbal working memory. These results suggest that the causal links between verbal working memory and reading accuracy may not be as direct as has been assumed.

Physical Activity Improves Quality of Life

Science.gov (United States)

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

Improving IT Project Portfolio Management: Lessons Learned

DEFF Research Database (Denmark)

Pedersen, Keld

2013-01-01

The IT PPM improvement process is not well understood, and our knowledge about what makes IT PPM improvement succeed or fail is not well developed. This article presents lessons learned from organizations trying to improve their IT PPM practice. Based on this research IT PPM practitioners are adv...

Safety improvements of Temelin NPP

International Nuclear Information System (INIS)

Vita, J.

2000-01-01

A detailed overview is given of the efforts made to enhance the safety level of the plant considering recommendations of a number of assessment missions. A list is presented of 10 international missions of the IAEA at the Temelin plant, covering the period 1990 to 1998. For each mission the date and objective is given, the focus of the assessment is characterized, the international participation of experts is specified, and the main conclusions of the experts is reproduced. A commented list of 60 main design changes and safety improvements is also included, as they were implemented in the wake of various safety assessments. An overview of the Temelin safety improvement programme is attached, comprising brief descriptions of 30 planned improvement items together with the time schedules. (A.K.)

Improved radioanalytical methods

International Nuclear Information System (INIS)

Erickson, M.D.; Aldstadt, J.H.; Alvarado, J.S.; Crain, J.S.; Orlandini, K.A.; Smith, L.L.

1995-01-01

Methods for the chemical characterization of the environment are being developed under a multitask project for the Analytical Services Division (EM-263) within the US Department of Energy (DOE) Office of Environmental Management. This project focuses on improvement of radioanalytical methods with an emphasis on faster and cheaper routine methods. We have developed improved methods, for separation of environmental levels of technetium-99 and strontium-89/90, radium, and actinides from soil and water; and for separation of actinides from soil and water matrix interferences. Among the novel separation techniques being used are element- and class-specific resins and membranes. (The 3M Corporation is commercializing Empore trademark membranes under a cooperative research and development agreement [CRADA] initiated under this project). We have also developed methods for simultaneous detection of multiple isotopes using inductively coupled plasma-mass spectrometry (ICP-MS). The ICP-MS method requires less rigorous chemical separations than traditional radiochemical analyses because of its mass-selective mode of detection. Actinides and their progeny have been isolated and concentrated from a variety of natural water matrices by using automated batch separation incorporating selective resins prior to ICP-MS analyses. In addition, improvements in detection limits, sample volume, and time of analysis were obtained by using other sample introduction techniques, such as ultrasonic nebulization and electrothermal vaporization. Integration and automation of the separation methods with the ICP-MS methodology by using flow injection analysis is underway, with an objective of automating methods to achieve more reproducible results, reduce labor costs, cut analysis time, and minimize secondary waste generation through miniaturization of the process

12 CFR 541.16 - Improved residential real estate.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Improved residential real estate. 541.16... REGULATIONS AFFECTING FEDERAL SAVINGS ASSOCIATIONS § 541.16 Improved residential real estate. The term improved residential real estate means residential real estate containing offsite or other improvements...

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

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

Science.gov (United States)

Cho, Yu Kyung

2016-07-01

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

Are students' impressions of improved learning through active learning methods reflected by improved test scores?

Science.gov (United States)

Everly, Marcee C

2013-02-01

To report the transformation from lecture to more active learning methods in a maternity nursing course and to evaluate whether student perception of improved learning through active-learning methods is supported by improved test scores. The process of transforming a course into an active-learning model of teaching is described. A voluntary mid-semester survey for student acceptance of the new teaching method was conducted. Course examination results, from both a standardized exam and a cumulative final exam, among students who received lecture in the classroom and students who had active learning activities in the classroom were compared. Active learning activities were very acceptable to students. The majority of students reported learning more from having active-learning activities in the classroom rather than lecture-only and this belief was supported by improved test scores. Students who had active learning activities in the classroom scored significantly higher on a standardized assessment test than students who received lecture only. The findings support the use of student reflection to evaluate the effectiveness of active-learning methods and help validate the use of student reflection of improved learning in other research projects. Copyright © 2011 Elsevier Ltd. All rights reserved.

Improved self-exclusion program: preliminary results.

Science.gov (United States)

Tremblay, Nicole; Boutin, Claude; Ladouceur, Robert

2008-12-01

The gambling industry has offered self-exclusion programs for quite a long time. Such measures are designed to limit access to gaming opportunities and provide problem gamblers with the help they need to cease or limit their gambling behaviour. However, few studies have empirically evaluated these programs. This study has three objectives: (1) to observe the participation in an improved self-exclusion program that includes an initial voluntary evaluation, phone support, and a mandatory meeting, (2) to evaluate satisfaction and usefulness of this service as perceived by self-excluders, (3) to measure the preliminary impact of this improved program. One hundred sixteen self-excluders completed a questionnaire about their satisfaction and their perception of the usefulness during the mandatory meeting. Among those participants, 39 attended an initial meeting. Comparisons between data collected at the initial meeting and data taken at the final meeting were made for those 39 participants. Data showed that gamblers chose the improved self-exclusion program 75% of the time; 25% preferred to sign a regular self-exclusion contract. Among those who chose the improved service, 40% wanted an initial voluntary evaluation and 37% of these individuals actually attended that meeting. Seventy percent of gamblers came to the mandatory meeting, which was a required condition to end their self-exclusion. The majority of participants were satisfied with the improved self-exclusion service and perceived it as useful. Major improvements were observed between the final and the initial evaluation on time and money spent, consequences of gambling, DSM-IV score, and psychological distress. The applicability of an improved self-exclusion program is discussed and, as shown in our study, the inclusion of a final mandatory meeting might not be so repulsive for self-excluders. Future research directives are also proposed.

Continuous Improvement in Action: Educators' Evidence Use for School Improvement

Science.gov (United States)

Cannata, Marisa; Redding, Christopher; Rubin, Mollie

2016-01-01

The focus of the article is the process educators use to interpret data to turn it into usable knowledge (Honig & Coburn, 2008) while engaging in a continuous improvement process. The authors examine the types of evidence educators draw upon, its perceived relevance, and the social context in which the evidence is examined. Evidence includes…

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

Science.gov (United States)

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

2015-01-01

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

Using an energy management strategy to drive improved business results and improve manufacturing operations

Energy Technology Data Exchange (ETDEWEB)

Leroux, Marc

2010-09-15

Energy typically represents the single largest controllable cost in manufacturing, and is under constant scrutiny by all levels of management. In this paper we will examine the role and components of an energy management strategy, and focus on the benefits of looking at the strategy from a business perspective. We will then examine the role that an effective program, either existing or new, can play in a collaborative manufacturing environment, and how these improvements can reduce energy requirements while maintaining, or improving productivity.

Measuring a hospital's ability to improve.

Science.gov (United States)

Meurer, Steven J; Counte, Michael A; Rubio, Doris M; Arrington, Barbara

2004-01-01

The aim of this study was to test whether a recently developed measure of Continuous Quality Improvement (CQI) implementation can provide health care researchers and administrators with a tool to assist in understanding and with developing an appropriate structure for improvement efforts in hospitals. Two hundred respondents from 40 Missouri hospitals completed a 28-item survey addressing 8 domains of CQI. Overall, hospital scores showed low implementation of a structure that supports improvement efforts. All survey domains showed acceptable psychometric results. Leadership proved to be the most important domain of CQI because it differentiated well between all levels of the scale. Because of its ease of administration and analysis, and its reliability, validity, and level differentiation results, the researchers recommend the widespread use of this tool to understand and develop a hospital's organizational structure to support improvement activities.

Human Resource Management for Continuous Improvement

DEFF Research Database (Denmark)

Jørgensen, Frances; Laugen, Bjørge Timenes; Boer, Harry

2007-01-01

This paper investigates the relationship between HRM practices and Continuous Improvement (CI) activities in order to gain an understanding of how the HRM function may be utilized to improve CI implementation success, and consequently, company performance. The paper begins with a brief review...... of the HRM and CI literature and then presents statistical analyses of data collected from the Continuous Improvement Network Survey (2003), which demonstrate that HRM has a significant effect on CI behaviour and company performance, with the strongest relationship between HRM, CI and performance occurring...

Continuous Improvement in Schools: Understanding the Practice

Science.gov (United States)

Anderson, Stephen; Kumari, Roshni

2009-01-01

This article investigates conceptually and practically what it means for schools to engage in the practice of continuous improvement. The analysis draws upon prior research and discussion to predict core elements of the practice of continuous improvement in schools. The predictions are then applied to a case study of continuous improvement efforts…

A Systems Approach to Rapid School Improvement

Science.gov (United States)

McCauley, Carlas

2018-01-01

To support systemic thinking about school improvement, the Center on School Turnaround at WestEd developed a framework to assist states, districts, and schools in leading and managing rapid improvement efforts. The framework, which is presented in this article, has four domains that have proved central to rapid, significant improvement: (1)…

Tracing Impact in a Usability Improvement Process

DEFF Research Database (Denmark)

Uldall-Espersen, Tobias; Frøkjær, Erik; Hornbæk, Kasper Anders Søren

2008-01-01

Analyzing usability improvement processes as they take place in real-life organizations is necessary to understand the practice of usability work. This paper describes a case study where the usability of an information system is improved and a relationship between the improvements...... and the evaluation efforts is established. Results show that evaluation techniques complemented each other by suggesting different kinds of usability improvement. Among the techniques applied, a combination of questionnaires and Metaphors of Human Thinking (MOT) showed the largest mean impact and MOT produced...... the largest number of impacts. Logging of real-life use of the system over 6 months indicated six aspects of improved usability, where significant differences among evaluation techniques were found. Concerning five of the six aspects Think Aloud evaluations and the above-mentioned combination of questionnaire...

Improving sample recovery

International Nuclear Information System (INIS)

Blanchard, R.J.

1995-09-01

This Engineering Task Plan (ETP) describes the tasks, i.e., tests, studies, external support and modifications planned to increase the recovery of the recovery of the waste tank contents using combinations of improved techniques, equipment, knowledge, experience and testing to better the recovery rates presently being experienced

Evaluating realized genetic gains from tree improvement.

Science.gov (United States)

J.B. St. Clair

1993-01-01

Tree improvement has become an essential part of the management of forest lands for wood production, and predicting yields and realized gains from forests planted with genetically-improved trees will become increasingly important. This paper discusses concepts of tree improvement and genetic gain important to growth and yield modeling, and reviews previous studies of...

Clinical engagement: improving healthcare together.

Science.gov (United States)

Riches, E; Robson, B

2014-02-01

Clinical engagement can achieve lasting change in the delivery of healthcare. In October 2011, Healthcare Improvement Scotland formulated a clinical engagement strategy to ensure that a progressive and sustainable approach to engaging healthcare professionals is firmly embedded in its health improvement and public assurance activities. The strategy was developed using a 90-day process, combining an evidence base of best practice and feedback from semi-structured interviews and focus groups. The strategy aims to create a culture where clinicians view working with Healthcare Improvement Scotland as a worthwhile venture, which offers a number of positive benefits such as training, career development and research opportunities. The strategy works towards developing a respectful partnership between Healthcare Improvement Scotland, the clinical community and key stakeholders whereby clinicians' contributions are recognised in a non-financial reward system. To do this, the organisation needs a sustainable infrastructure and an efficient, cost-effective approach to clinical engagement. There are a number of obstacles to achieving successful clinical engagement and these must be addressed as key drivers in its implementation. The implementation of the strategy is supported by an action and resource plan, and its impact will be monitored by a measurement plan to ensure the organisation reviews its approaches towards clinical engagement.

Modalities of hemodialysis: Quality improvement

Directory of Open Access Journals (Sweden)

Ayman Karkar

2012-01-01

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

Improving surgical outcomes

Directory of Open Access Journals (Sweden)

Tony Walia

2008-12-01

Full Text Available Outcomes of cataract surgery are worse than we would like them to be. Community-based studies show that up to 40% of eyes have a postoperative presenting vision of < 6/60. Eyes with intraocular lenses (IOLs do better; however, it has been shown that even in prosperous middle-income countries, such as Venezuela, in 20% of pseudophakic eyes presenting vision was < 6/60 and in 15% best corrected vision was worse than 6/60.Poor outcomes matter. Patients deserve improved vision whenever possible and poor outcomes deter prospective patients from coming for surgery and probably reduce their willingness to pay for their treatment – particularly if they have to pay in advance!In this article, we offer some suggestions for improving the quality of cataract surgery. We admit that there is little evidence base for most of these suggestions and that some of them are controversial. However, we hope to stimulate debate.

Continue service improvement at CERN computing centre

International Nuclear Information System (INIS)

Lopez, M Barroso; Everaerts, L; Meinhard, H; Baehler, P; Haimyr, N; Guijarro, J M

2014-01-01

Using the framework of ITIL best practises, the service managers within CERN-IT have engaged into a continuous improvement process, mainly focusing on service operation. This implies an explicit effort to understand and improve all service management aspects in order to increase efficiency and effectiveness. We will present the requirements, how they were addressed and share our experiences. We will describe how we measure, report and use the data to continually improve both the processes and the services being provided. The focus is not the tool or the process, but the results of the continuous improvement effort from a large team of IT experts providing services to thousands of users, supported by the tool and its local team. This is not an initiative to address user concerns in the way the services are managed but rather an on-going working habit of continually reviewing, analysing and improving the service management processes and the services themselves, having in mind the currently agreed service levels and whose results also improve the experience of the users about the current services.

An optimization model for improving highway safety

Directory of Open Access Journals (Sweden)

Promothes Saha

2016-12-01

Full Text Available This paper developed a traffic safety management system (TSMS for improving safety on county paved roads in Wyoming. TSMS is a strategic and systematic process to improve safety of roadway network. When funding is limited, it is important to identify the best combination of safety improvement projects to provide the most benefits to society in terms of crash reduction. The factors included in the proposed optimization model are annual safety budget, roadway inventory, roadway functional classification, historical crashes, safety improvement countermeasures, cost and crash reduction factors (CRFs associated with safety improvement countermeasures, and average daily traffics (ADTs. This paper demonstrated how the proposed model can identify the best combination of safety improvement projects to maximize the safety benefits in terms of reducing overall crash frequency. Although the proposed methodology was implemented on the county paved road network of Wyoming, it could be easily modified for potential implementation on the Wyoming state highway system. Other states can also benefit by implementing a similar program within their jurisdictions.

Improvements in SPECT technology for cerebral imaging

International Nuclear Information System (INIS)

Esser, P.D.

1985-01-01

Advancement in three major areas of SPECT (single photon emission computed tomography) technology have resulted in improved image quality for cerebral studies. In the first area, single-crystal camera electronics, extensive use of microprocessors, custom digital circuitry, an data bus architecture have allowed precise external control of all gantry motions and improved signal processing. The new digital circuitry permits energy, uniformity, and linearity corrections to be an integral part of the processing electronics. Calibration of these correlations is controlled by algorithms stored in the camera's memory. The second area of improved SPECT technology is camera collimation and related imaging techniques. In this area, system resolution has been improved without loss of sensitivity by decreasing the air gap between patient and collimator surface. Since cerebral studies characteristically image high-contrast regions less than 1 cm in size, image quality has been improved by increasing collimator resolution even at the expense of sensitivity. Increased resolution also improved image contrast for studies using 123 I-labeled pharmaceuticals with 3% to 4% 124 I contamination. 65 references

Improved immunocytochemical detection of daunomycin

DEFF Research Database (Denmark)

Ohara, Koji; Shin, Masashi; Larsson, Lars-Inge

2007-01-01

and mitochondria of heart muscle cells may help to improve our understanding of the cardiac toxicity of DM and related anthracyclin antibiotics. A number of ELISA tests were carried out in order to elucidate the mechanisms of H2O2-assisted antigen retrieval. A possible mechanism is that DM is reduced and converted......Improved immunocytochemical (ICC) detection of the anthracycline anticancer antibiotic daunomycin (DM) has been achieved by used of hydrogen peroxide oxidation prior to ICC staining for DM. The new method greatly enhanced the localization of DM accumulation in cardiac, smooth and skeletal muscle...... to its semiquinone and/or hydroquinone derivative in vivo. Oxidation by hydrogen peroxide acts to convert these derivatives back to the native antigen. The improved ICC methodology using oxidation to recreated native antigens from reduced metabolites may be helpful also with respect to the localization...

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

Continuous improvement of pump seals

International Nuclear Information System (INIS)

Wong, W.; Eyvindson, A.; Rhodes, D.B.

2003-01-01

Pump seal reliability continues to be an area needing improvement and ongoing vigilance. Methods have been developed for identifying and assessing factors relating to seal performance, selecting the most relevant ones for a specific station, and then focusing on the most significant aspects and how to improve. Discussion invariably addresses maintenance practices, seal design, monitoring capabilities, operating conditions, transients, and pump and motor design. Success in reliability improvement requires ongoing dialogue among the station operators, pump manufacturers and seal designers. AECL CAN-seals lead the nuclear industry in reliability and seal life. They effectively save operators millions of dollars in outage time and person-rem. This paper describes some of the significant developments in AECL's ongoing program in seal R and D, as well as recent new installations following the most demanding seal qualification programs to date. (author)

Highly porous ceramic oxide aerogels having improved flexibility

Science.gov (United States)

Meador, Mary Ann B. (Inventor); Nguyen, Baochau N. (Inventor); Guo, Haiquan (Inventor)

2012-01-01

Ceramic oxide aerogels having improved flexibility are disclosed. Preferred embodiments exhibit high modulus and other strength properties despite their improved flexibility. The gels may be polymer cross-linked via organic polymer chains to further improve strength properties, without substantially detracting from the improved flexibility. Methods of making such aerogels are also disclosed.

Instrument ampersand controls section (IA) improvements

International Nuclear Information System (INIS)

Kramer, C.; Paul, J.

1993-01-01

This portion of the panel session briefly delineates improvements in the Instrument and Controls (IA) Section over the past few years. These improvements are listed briefly in summary form. The status of publication of the IA Section of AG-1 is reviewed

On the improving of finishing works

International Nuclear Information System (INIS)

Arzamaskov, V.N.; Bondarenko, I.Ya.; Pogozhev, I.M.

1986-01-01

Problems of the improvement of finishing works performed during the construction of power installations are considered. Recommendations on the improvement of the quality of these works, increase of labour productivity and decrease of a manual labour share on their implementation are given

One improved LSB steganography algorithm

Science.gov (United States)

Song, Bing; Zhang, Zhi-hong

2013-03-01

It is easy to be detected by X2 and RS steganalysis with high accuracy that using LSB algorithm to hide information in digital image. We started by selecting information embedded location and modifying the information embedded method, combined with sub-affine transformation and matrix coding method, improved the LSB algorithm and a new LSB algorithm was proposed. Experimental results show that the improved one can resist the X2 and RS steganalysis effectively.

Improved Landau gauge fixing and discretisation errors

International Nuclear Information System (INIS)

Bonnet, F.D.R.; Bowman, P.O.; Leinweber, D.B.; Richards, D.G.; Williams, A.G.

2000-01-01

Lattice discretisation errors in the Landau gauge condition are examined. An improved gauge fixing algorithm in which O(a 2 ) errors are removed is presented. O(a 2 ) improvement of the gauge fixing condition displays the secondary benefit of reducing the size of higher-order errors. These results emphasise the importance of implementing an improved gauge fixing condition

Improving machinery reliability

CERN Document Server

Bloch, Heinz P

1998-01-01

This totally revised, updated and expanded edition provides proven techniques and procedures that extend machinery life, reduce maintenance costs, and achieve optimum machinery reliability. This essential text clearly describes the reliability improvement and failure avoidance steps practiced by best-of-class process plants in the U.S. and Europe.

Improvements for Optics Measurement and Corrections software

CERN Document Server

Bach, T

2013-01-01

This note presents the improvements for the OMC software during a 14 month technical student internship at CERN. The goal of the work was to improve existing software in terms of maintainability, features and performance. Significant improvements in stability, speed and overall development process were reached. The main software, a Java GUI at the LHC CCC, run for months without noteworthy problems. The overall running time of the software chain used for optics corrections was reduced from nearly half an hour to around two minutes. This was the result of analysing and improving several involved programs and algorithms.

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.

Strategic Ambitions as drivers of improvement at DaimlerChrysler

NARCIS (Netherlands)

Bossink, B.A.G.

2002-01-01

Strategic ambitions can function as drivers of improvement in organizations. Continuous improvement is driven by strategic ambitions to: design quality into the structure of the organization; plan and control improvements; assure improvements; set and realize improvement goals; position the

Improving a mother to child HIV transmission programme through health system redesign: quality improvement, protocol adjustment and resource addition.

Directory of Open Access Journals (Sweden)

Michele S Youngleson

2010-11-01

Full Text Available Health systems that deliver prevention of mother to child transmission (PMTCT services in low and middle income countries continue to underperform, resulting in thousands of unnecessary HIV infections of newborns each year. We used a combination of approaches to health systems strengthening to reduce transmission of HIV from mother to infant in a multi-facility public health system in South Africa.All primary care sites and specialized birthing centers in a resource constrained sub-district of Cape Metro District, South Africa, were enrolled in a quality improvement (QI programme. All pregnant women receiving antenatal, intrapartum and postnatal infant care in the sub-district between January 2006 and March 2009 were included in the intervention that had a prototype-innovation phase and a rapid spread phase. System changes were introduced to help frontline healthcare workers to identify and improve performance gaps at each step of the PMTCT pathway. Improvement was facilitated and spread through the use of a Breakthrough Series Collaborative that accelerated learning and the spread of successful changes. Protocol changes and additional resources were introduced by provincial and municipal government. The proportion of HIV-exposed infants testing positive declined from 7.6% to 5%. Key intermediate PMTCT processes improved (antenatal AZT increased from 74% to 86%, PMTCT clients on HAART at the time of labour increased from 10% to 25%, intrapartum AZT increased from 43% to 84%, and postnatal HIV testing from 79% to 95% compared to baseline.System improvement methods, protocol changes and addition/reallocation of resources contributed to improved PMTCT processes and outcomes in a resource constrained setting. The intervention requires a clear design, leadership buy-in, building local capacity to use systems improvement methods, and a reliable data system. A systems improvement approach offers a much needed approach to rapidly improve under

Case Studies in Continuous Process Improvement

Science.gov (United States)

Mehta, A.

1997-01-01

This study focuses on improving the SMT assembly process in a low-volume, high-reliability environment with emphasis on fine pitch and BGA packages. Before a process improvement is carried out, it is important to evaluate where the process stands in terms of process capability.

Improving embryo quality in assisted reproduction

NARCIS (Netherlands)

Mantikou, E.

2013-01-01

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

Human Resource Management for Continuous Improvement

DEFF Research Database (Denmark)

Jørgensen, Frances; Boer, Harry; Laugen, Bjørge

2006-01-01

The objective of this paper is to investigate the relationship between HRM practices and Continuous Improvement (CI) activities in order to gain an understanding of how the HRM function may be utilized to improve CI implementation success, and consequently, organizational performance. The paper i...

Theoretical Frameworks to Guide School Improvement

Science.gov (United States)

Evans, Lisa; Thornton, Bill; Usinger, Janet

2012-01-01

A firm grounding in change theory can provide educational leaders with an opportunity to orchestrate meaningful organizational improvements. This article provides an opportunity for practicing leaders to review four major theories of organizational change--continuous improvement, two approaches to organizational learning, and appreciative inquiry.…

Productivity improvement opportunities at Navy public works activities

OpenAIRE

Dieffenbach, Richard Jacob

1992-01-01

Approved for public release; distribution is unlimited This study identifies six principal opportunities for productivity improvement at Navy Public Works in-house maintenance activities: improving work assignment, increasing shop supervisor effectiveness, reducing long lunches and early quits (through understanding of work impediments as demotivational contributors), improving service order management, improving job quality and miscellaneous opportunities. Activity "productivity opportu...

The Big Improvement in PISA 2009 Reading Achievements in Serbia: Improvement of the Quality of Education or Something Else?

Directory of Open Access Journals (Sweden)

Dragica Pavlović Babić

2011-01-01

Full Text Available The PISA 2009 results in Serbia show a big improvement in reading literacy compared to 2006 – the average score is 41 points higher, which is equal to the effect of a whole year of schooling in OECD countries and represents the second highest improvement ever recorded in a PISA study. In the present paper, we discuss potential reasons for such a big improvement based on analysis of the PISA 2009 reading achievements in different countries, with a special focus on countries from the same region (Croatia, Slovenia, Montenegro, Bulgaria, Romania and Albania. The analysis shows that the largest part of the improvement was realised at lower achieving levels, suggesting that the dominant method of teaching in schools is a traditional method oriented towards the acquisition and reproduction of academic knowledge. Findings of data analysis support the conclusion that the improvement is mainly the result of certain contextual factors, such as higher student motivation and a high level of official support for the PISA study in Serbia, rather than representing a real improvement in the quality of education.

Georgia - Improved Learning Environment

Data.gov (United States)

Millennium Challenge Corporation — The school rehabilitation activity seeks to decrease student and teacher absenteeism, increase students’ time on task, and, ultimately, improve learning and labor...

A measure for provisional-and-urgent sanitary improvement in developing countries: septic-tank performance improvement.

Science.gov (United States)

Harada, H; Dong, N T; Matsui, S

2008-01-01

Although many cities have planed to develop sewerages in developing countries, sewerage establishment still requires huge investment and engineering efforts. Improvement of existing sanitation facilities may contribute the betterment of urban sanitation before sewerage establishment. The purpose of this study is to propose a measure to improve urban sanitation in areas where a sewerage development plan is proposed but has not been yet established, based on a case study in Hanoi, Vietnam. We found that 90.5% of human excreta flowed into septic tanks. However, 89.6% of septic tanks have never been desludged in the past and their performance was observed to be at a low level. The study also showed that if they introduce regular desludging with a frequency of once a year, they can eliminate 72.8% of COD loads from septic tanks. It was indicated that the performance can be dramatically recovered by regular desludging, which could contribute urban sanitation improvement in Hanoi. In conclusion, the performance recovery of septic tanks by regular desludging was proposed as a provisional-and-urgent measure for urban sanitation improvement, together with the septage treatment in sewage sludge treatment facilities, which should be established earlier than other facilities of sewage treatment systems. IWA Publishing 2008.

Partnership for Continuous Improvement

Science.gov (United States)

1990-01-01

The proceedings are presented of the sixth annual conference on quality control between NASA and its contractors. The emphasis is placed on a commitment to quality and excellence that guarantees mission success. A forum is provided for representatives from government, industry, and academia to exchange ideas and experiences, encouraging total quality performance that results in high quality products and services. Key points are highlighted from the presentations and activities are described that have resulted in a broad range of improvements in products and services from government, industry, and academia. Long term commitment to quality is an essential requirement that ensures future success. That commitment reinterates the dedication to excellence in space exploration and to national quality and productivity improvement.

Improving Student Behavior.

Science.gov (United States)

Green, Pamela; Gilbert, Janice T.

This report describes a program for improving the behavior of seventh and eighth grade students with learning disabilities in a self-contained classroom setting. Analysis of probable causes revealed that students demonstrated a lack of problem-solving skills, showed a low frustration tolerance, and exhibited poor self-concepts. Two major…

Multimodal Perioperative Analgesia Regimen to Improve Patient Outcomes After Total Knee Arthroplasty: A Multidisciplinary Quality Improvement Project.

Science.gov (United States)

Donahue, Rebecca E; Bradbury, George R; Zychowicz, Michael E; Muckler, Virginia C

2018-04-01

The primary aim of this quality improvement project was to improve mobilization for patients after total knee arthroscopy by developing and implementing a standardized, evidence-based, multimodal analgesia regimen and patient-educational video. Secondary outcomes included opioid consumption, pain, and length of stay. A pre-post implementation design was used to compare two independent samples. Patients were screened based on inclusion and exclusion criteria 1-2 weeks before surgery. The anesthesia provider made the final determination for inclusion. Data were collected by retrospective chart review. Following implementation, patients displayed significantly improved mobilization, reduced opioid consumption, and reduced length of stay. Patient-reported pain scores were similar or significantly lower in the postimplementation group. Variability of patient outcomes was reduced, and quality of care was improved by standardizing care and incorporating the best available evidence, consistent with organization's resources in the nonacademic-affiliated, community hospital setting. Published by Elsevier Inc.

Improved availability through reduction in rework

International Nuclear Information System (INIS)

Grosswald, M.; Lowman, J.

1985-01-01

The Florida Power and Light Company Quality Improvement Rework Identification Program is discussed. Establishment of the Quality Improvement Rework Identification Task Team, goals, and methods of the program are noted. Resulting from the program are reductions in failure frequency and positive incentives from a teamwork approach

The Legal Context for Teacher Improvement.

Science.gov (United States)

Belsches-Simmons, Grace; Bray, Judith

Teacher improvement programs must comply with federal and state constitutional requirements for due process, equal protection, and freedom of speech, as well as state and federal laws covering collective bargaining, civil rights, and the authority to institute improvement programs. This booklet explores these legal considerations, focusing on…

Improving the Greenlandic Greenhouse Gas Inventory

DEFF Research Database (Denmark)

Nielsen, Ole-Kenneth; Baunbæk, Lene; Gyldenkærne, Steen

The project to improve the Greenlandic greenhouse gas (GHG) inventory was undertaken due to the recommendations made by the UNFCCC review team in connection with the 2008 and 2009 submissions by the Kingdom of Denmark. The improvements made to the Greenlandic GHG emission inventory were substantial...

Reliability-How to Quantify and Improve?

Indian Academy of Sciences (India)

Home; Journals; Resonance – Journal of Science Education; Volume 5; Issue 5. Reliability - How to Quantify and Improve? - Improving the Health of Products. N K Srinivasan. General Article Volume 5 Issue 5 May 2000 pp 55-63. Fulltext. Click here to view fulltext PDF. Permanent link:

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.

Windows with improved energy performances

DEFF Research Database (Denmark)

Laustsen, Jacob Birck; Svendsen, Svend

2003-01-01

Heat loss through windows represents a considerable part of the total heat loss from houses. However, apart from providing daylight access and view, windows offer a unique potential for solar gain to be exploited during the heating season. Until now valuation of the energy performance of windows...... has primary focused on the heat loss coefficient, U-value. However, as the U-value, especially for the glazing part, has improved considerably during the last years, the total solar energy transmittance, g-value, has become equally important to the total energy performance of windows. Improved energy...... resulted in a window with a positive net energy gain (in short the Net Gain Window), which means that it contributes to the space heating of the building. All improvements are based on existing technology and manufacturing methods. The results from this work show that the energy performances of windows can...

Nuclear Station Facilities Improvement Planning

International Nuclear Information System (INIS)

Hooks, R. W.; Lunardini, A. L.; Zaben, O.

1991-01-01

An effective facilities improvement program will include a plan for the temporary relocation of personnel during the construction of an adjoining service building addition. Since the smooth continuation of plant operation is of paramount importance, the phasing plan is established to minimize the disruptions in day-to-day station operation and administration. This plan should consider the final occupancy arrangements and the transition to the new structure; for example, computer hookup and phase-in should be considered. The nuclear industry is placing more emphasis on safety and reliability of nuclear power plants. In order to do this, more emphasis is placed on operations and maintenance. This results in increased size of managerial, technical and maintenance staffs. This in turn requires improved office and service facilities. The facilities that require improvement may include training areas, rad waste processing and storage facilities, and maintenance facilities. This paper discusses an approach for developing an effective program to plan and implement these projects. These improvement projects can range in magnitude from modifying a simple system to building a new structure to allocating space for a future project. This paper addresses the planning required for the new structures with emphasis on site location, space allocation, and internal layout. Since facility planning has recently been completed by Sargent and Leyden at six U. S. nuclear stations, specific examples from some of those plants are presented. Site planning and the establishment of long-range goals are of the utmost importance when undertaking a facilities improvement program for a nuclear station. A plan that considers the total site usage will enhance the value of both the new and existing facilities. Proper planning at the beginning of the program can minimize costs and maximize the benefits of the program

Improvements to Technical Specifications surveillance requirements

International Nuclear Information System (INIS)

Lobel, R.; Tjader, T.R.

1992-12-01

In August 1983 an NRC task group was formed to investigate problems with surveillance testing required by Technical Specifications, and to recommend approaches to effect improvements. NUREG-1024 (''Technical Specifications-Enhancing Safety Impact'') resulted, and it contained recommendations to review the basis for test frequencies; to ensure that the tests promote safety and do not degrade equipment; and to review surveillance tests so that they do not unnecessarily burden personnel. The Technical Specifications Improvement Program (TSIP) was established in December 1984 to provide the framework for rewriting and improving the Technical Specifications. As an element of the TSIP, all Technical Specifications surveillance requirements were comprehensively examined as recommended in NUREG-1024. The results of that effort are presented in this report. The study found that while some testing at power is essential to verify equipment and system operability, safety can be improved, equipment degradation decreased, and unnecessary personnel burden relaxed by reducing the amount of testing at power

Improving functional value of meat products.

Science.gov (United States)

Zhang, Wangang; Xiao, Shan; Samaraweera, Himali; Lee, Eun Joo; Ahn, Dong U

2010-09-01

In recent years, much attention has been paid to develop meat and meat products with physiological functions to promote health conditions and prevent the risk of diseases. This review focuses on strategies to improve the functional value of meat and meat products. Value improvement can be realized by adding functional compounds including conjugated linoneleic acid, vitamin E, n3 fatty acids and selenium in animal diets to improve animal production, carcass composition and fresh meat quality. In addition, functional ingredients such as vegetable proteins, dietary fibers, herbs and spices, and lactic acid bacteria can be directly incorporated into meat products during processing to improve their functional value for consumers. Functional compounds, especially peptides, can also be generated from meat and meat products during processing such as fermentation, curing and aging, and enzymatic hydrolysis. This review further discusses the current status, consumer acceptance, and market for functional foods from the global viewpoints. Future prospects for functional meat and meat products are also discussed.

PROPOSAL OF VOIVODESHIP ROAD SAFETY IMPROVEMENT PROGRAMME

Directory of Open Access Journals (Sweden)

Tomasz SZCZURASZEK

2016-07-01

Full Text Available The article presents a proposal of the ‘GAMBIT KUJAWSKO-POMORSKI’ Road Safety Improvement Programme. The main idea of the Programme is to establish and initiate systems that will be responsible for the most important areas of activity within road safety, including road safety control, supervision, and management systems in the whole Voivodeship. In total, the creation and start of nine such systems has been proposed, namely: the Road Safety Management, the Integrated Road Rescue Service, the Personnel Continuing Education, the Hazardous Road Behaviour Monitoring, the Social Education for Safe Behaviour on Road, the Teaching Personnel Improvement, the Area Development and Planning Process Improvement, the Road Infrastructure Design Quality Improvement, and the Road and Traffic Management Process Efficiency Improvement. The basic aim of each system has been discussed as well as the most important tasks implemented as its part. The Road Safety Improvement Programme for the Kujawsko-Pomorskie Voivodeship presented in this article is a part of the National Road Safety Programme 2013-2020. Moreover, it is not only an original programme in Poland, but also a universal project that may be adapted for other voivodeships as well.

Software Engineering Program: Software Process Improvement Guidebook

Science.gov (United States)

1996-01-01

The purpose of this document is to provide experience-based guidance in implementing a software process improvement program in any NASA software development or maintenance community. This guidebook details how to define, operate, and implement a working software process improvement program. It describes the concept of the software process improvement program and its basic organizational components. It then describes the structure, organization, and operation of the software process improvement program, illustrating all these concepts with specific NASA examples. The information presented in the document is derived from the experiences of several NASA software organizations, including the SEL, the SEAL, and the SORCE. Their experiences reflect many of the elements of software process improvement within NASA. This guidebook presents lessons learned in a form usable by anyone considering establishing a software process improvement program within his or her own environment. This guidebook attempts to balance general and detailed information. It provides material general enough to be usable by NASA organizations whose characteristics do not directly match those of the sources of the information and models presented herein. It also keeps the ideas sufficiently close to the sources of the practical experiences that have generated the models and information.

Diffusion of improved biomass stoves in China

International Nuclear Information System (INIS)

Daxiong Qiu; Shuhua Gu; Catania, P.; Kun Huang

1996-01-01

The large-scale utilization of inefficient biofuel stoves for cooking and heating in the rural areas of China can cause ecological and environmental problems; thus, in 1982, the Chinese government encouraged the diffusion of improved biomass stoves. From 1982 to 1994, these improved biomass stoves have been used by 144 million households or the equivalent of 90% of all improved stoves installed globally; 62% of the Chinese market has been penetrated. This paper presents the fundamental features of China's diffusion programme of improved biomass stoves, analyses of the future domestic market, and defines some of the lessons learned from the diffusion programme which may be applicable in other emerging nations. (Author)

24 Command Fire Improvement Action Program Plan

International Nuclear Information System (INIS)

GRIFFIN, G.B.

2000-01-01

Fluor Hanford (FH) is responsible for providing support to the Department of Energy Richland Operations Office (RL) in the implementation of the Hanford Emergency Preparedness (EP) program. During fiscal year 2000, a number of program improvements were identified from various sources including a major range fire (24 Command Fire). Evaluations of the emergency preparedness program have confirmed that it currently meets all requirements and that performance of personnel involved is good, however the desire to effect continuous improvement resulted in the development of this improvement program plan. This program plan defines the activities that will be performed in order to achieve the desired performance improvements

Improvement of uncertainty relations for mixed states

International Nuclear Information System (INIS)

Park, Yong Moon

2005-01-01

We study a possible improvement of uncertainty relations. The Heisenberg uncertainty relation employs commutator of a pair of conjugate observables to set the limit of quantum measurement of the observables. The Schroedinger uncertainty relation improves the Heisenberg uncertainty relation by adding the correlation in terms of anti-commutator. However both relations are insensitive whether the state used is pure or mixed. We improve the uncertainty relations by introducing additional terms which measure the mixtureness of the state. For the momentum and position operators as conjugate observables and for the thermal state of quantum harmonic oscillator, it turns out that the equalities in the improved uncertainty relations hold

Quality Improvement in Hospitals: Identifying and Understanding Behaviors

Directory of Open Access Journals (Sweden)

Lukasz M. Mazur

2012-01-01

Full Text Available Improving operational performance in hospitals is complicated, particularly if process improvement requires complex behavioral changes. Using single-loop and double-loop learning theory as a foundation, the purpose of this research is to empirically uncover key improvement behaviors and the factors that may be associated with such behaviors in hospitals. A two-phased approach was taken to collect data regarding improvement behaviors and associated factors, and data analysis was conducted using methods proposed by grounded theorists. The contributions of this research are twofold. First, five key behaviors related to process improvement are identified, namely Quick Fixing, Initiating, Conforming, Expediting, and Enhancing. Second, based on these observed behaviors, a set of force field diagrams is developed to structure and organize possible factors that are important to consider when attempting to change improvement behaviors. This begins to fill the gap in the knowledge about what factors drive effective improvement efforts in hospital settings.

The discipline of improvement: something old, something new?

Science.gov (United States)

Clarke, Charlotte L; Reed, Jan; Wainwright, David; McClelland, Siobhan; Swallow, Veronica; Harden, Jane; Walton, Graham; Walsh, Anna

2004-03-01

In response to calls to improve the efficacy of health care services, there is an increasing focus on the processes of achieving a continuous improvement of services and practices. One specific response is that of the NHS Modernization Agency and National Health Service University in relation to the Discipline of Improvement in Health and Social Care. This paper draws on a study that explored the underpinning knowledge base of the Discipline of Improvement and focuses on describing the framework that was developed. The two-dimensional framework is composed of five primary categories, which cross-link to 11 competencies. The study concludes that the Discipline of Improvement draws together a group of ideas that together cohere to form a distinctive model to aid the improvement of health care. While some of these ideas are well-established, the way in which the Discipline of Improvement makes connections between them offers something new to our understanding of change in the complex world of health care provision, and to nursing management.

Improving Employee Satisfaction Priority through Performance Control Matrix

Directory of Open Access Journals (Sweden)

Shun-Hsing Chen

2014-11-01

Full Text Available The study addresses Performance Control Matrix (PCM to determine service quality items of priority for improvement. Most businesses focus on customer satisfaction when undertaking surveys of satisfaction and dissatisfaction, while generally neglecting employee satisfaction. Therefore, this study develops an integrated model to improve service quality in Taiwanese finance industry employees. A questionnaire is designed to determine the priority of improvement objectives derived from certain questionnaire items that fall into the improvement zone of the PCM. Ten items are found to fall into the improvement zone of the PCM. The present results show that the finance industry employees surveyed in Taiwan were dissatisfied with their job security, salaries, annual bonus, and fair distribution of operational profits. The ten improvement items mostly belong to two dimensions - ‘Pay and Benefits’ and ‘Motivation’. The managers of the financial institutions should seek to improve these quality attributes by devoting more resources to these items, thus promoting employee satisfaction.

Piloting improved cookstoves in India.

Science.gov (United States)

Lewis, Jessica J; Bhojvaid, Vasundhara; Brooks, Nina; Das, Ipsita; Jeuland, Marc A; Patange, Omkar; Pattanayak, Subhrendu K

2015-01-01

Despite the potential of improved cookstoves to reduce the adverse environmental and health impacts of solid fuel use, their adoption and use remains low. Social marketing-with its focus on the marketing mix of promotion, product, price, and place-offers a useful way to understand household behaviors and design campaigns to change biomass fuel use. We report on a series of pilots across 3 Indian states that use different combinations of the marketing mix. We find sales varying from 0% to 60%. Behavior change promotion that combined door-to-door personalized demonstrations with information pamphlets was effective. When given a choice amongst products, households strongly preferred an electric stove over improved biomass-burning options. Among different stove attributes, reduced cooking time was considered most valuable by those adopting a new stove. Households clearly identified price as a significant barrier to adoption, while provision of discounts (e.g., rebates given if households used the stove) or payments in installments were related to higher purchase. Place-based factors such as remoteness and nongovernmental organization operations significantly affected the ability to supply and convince households to buy and use improved cookstoves. Collectively, these pilots point to the importance of continued and extensive testing of messages, pricing models, and different stove types before scale-up. Thus, we caution that a one-size-fits-all approach will not boost improved cookstove adoption.

Teaching Strategies to Improve Algebra Learning

Science.gov (United States)

Zbiek, Rose Mary; Larson, Matthew R.

2015-01-01

Improving student learning is the primary goal of every teacher of algebra. Teachers seek strategies to help all students learn important algebra content and develop mathematical practices. The new Institute of Education Sciences[IES] practice guide, "Teaching Strategies for Improving Algebra Knowledge in Middle and High School Students"…

Improved Spectroscopy of Minimal Walking Technicolor

DEFF Research Database (Denmark)

Kerrane, Eoin; Del Debbio, Luigi; Pica, Claudio

2010-01-01

We present an improved study of spectroscopic observables in the $SU(2)$ Yang-Mills theory with two adjoint fermions. We make an improvement on the precision of previous results which clarify the scale of finite volume effects present. This analysis adds to the evidence for near-conformal dynamic...

Play Therapy: Role in Reading Improvement.

Science.gov (United States)

Carmichael, Karla

1991-01-01

Reviews the literature concerning the role of play therapy (particularly sandplay and nondirected play therapy) in the improvement of reading. Suggests that the role of play therapy is to support the child, encourage the child, and build self-esteem thus creating the optimal learning environment for reading improvement. (RS)

Seven propositions of the science of improvement: exploring foundations.

Science.gov (United States)

Perla, Rocco J; Provost, Lloyd P; Parry, Gareth J

2013-01-01

The phrase "Science of Improvement" or "Improvement Science" is commonly used today by a range of people and professions to mean different things, creating confusion to those trying to learn about improvement. In this article, we briefly define the concepts of improvement and science, and review the history of the consideration of "improvement" as a science. We trace key concepts and ideas in improvement to their philosophical and theoretical foundation with a focus on Deming's System of Profound Knowledge. We suggest that Deming's system has a firm association with many contemporary and historic philosophic and scientific debates and concepts. With reference to these debates and concepts, we identify 7 propositions that provide the scientific and philosophical foundation for the science of improvement. A standard view of the science of improvement does not presently exist that is grounded in the philosophical and theoretical basis of the field. The 7 propositions outlined here demonstrate the value of examining the underpinnings of improvement. This is needed to both advance the field and minimize confusion about what the phrase "science of improvement" represents. We argue that advanced scientists of improvement are those who like Deming and Shewhart can integrate ideas, concepts, and models between scientific disciplines for the purpose of developing more robust improvement models, tools, and techniques with a focus on application and problem solving in real world contexts. The epistemological foundations and theoretical basis of the science of improvement and its reasoning methods need to be critically examined to ensure its continued development and relevance. If improvement efforts and projects in health care are to be characterized under the canon of science, then health care professionals engaged in quality improvement work would benefit from a standard set of core principles, a standard lexicon, and an understanding of the evolution of the science of

Methodological approach to organizational performance improvement process

OpenAIRE

Buble, Marin; Dulčić, Želimir; Pavić, Ivan

2017-01-01

Organizational performance improvement is one of the fundamental enterprise tasks. This especially applies to the case when the term “performance improvement” implies efficiency improvement measured by indicators, such as ROI, ROE, ROA, or ROVA/ROI. Such tasks are very complex, requiring implementation by means of project management. In this paper, the authors propose a methodological approach to improving the organizational performance of a large enterprise.

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

Science.gov (United States)

Schwartz, Stephanie P; Rehder, Kyle J

2017-01-01

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

[Sustainable process improvement with application of 'lean philosophy'].

Science.gov (United States)

Rouppe van der Voort, Marc B V; van Merode, G G Frits; Veraart, Henricus G N

2013-01-01

Process improvement is increasingly being implemented, particularly with the aid of 'lean philosophy'. This management philosophy aims to improve quality by reducing 'wastage'. Local improvements can produce negative effects elsewhere due to interdependence of processes. An 'integrated system approach' is required to prevent this. Some hospitals claim that this has been successful. Research into process improvement with the application of lean philosophy has reported many positive effects, defined as improved safety, quality and efficiency. Due to methodological shortcomings and lack of rigorous evaluations it is, however, not yet possible to determine the impact of this approach. It is, however, obvious that the investigated applications are fragmentary, with a dominant focus on the instrumental aspect of the philosophy and a lack of integration in a total system, and with insufficient attention to human aspects. Process improvement is required to achieve better and more goal-oriented healthcare. To achieve this, hospitals must develop integrated system approaches that combine methods for process design with continuous improvement of processes and with personnel management. It is crucial that doctors take the initiative to guide and improve processes in an integral manner.

Improvement attributes in healthcare: implications for integrated care.

Science.gov (United States)

Harnett, Patrick John

2018-04-16

Purpose Healthcare quality improvement is a key concern for policy makers, regulators, carers and service users. Despite a contemporary consensus among policy makers that integrated care represents a means to substantially improve service outcomes, progress has been slow. Difficulties achieving sustained improvement at scale imply that methods employed are not sufficient and that healthcare improvement attributes may be different when compared to prior reference domains. The purpose of this paper is to examine and synthesise key improvement attributes relevant to a complex healthcare change process, specifically integrated care. Design/methodology/approach This study is based on an integrative literature review on systemic improvement in healthcare. Findings A central theme emerging from the literature review indicates that implementing systemic change needs to address the relationship between vision, methods and participant social dynamics. Practical implications Accommodating personal and professional network dynamics is required for systemic improvement, especially among high autonomy individuals. This reinforces the need to recognise the change process as taking place in a complex adaptive system where personal/professional purpose/meaning is central to the process. Originality/value Shared personal/professional narratives are insufficiently recognised as a powerful change force, under-represented in linear and rational empirical improvement approaches.

42 CFR 441.474 - Quality assurance and improvement plan.

Science.gov (United States)

2010-10-01

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

Improved Casting Furnace Conceptual Design

Energy Technology Data Exchange (ETDEWEB)

Fielding, Randall Sidney [Idaho National Lab. (INL), Idaho Falls, ID (United States); Tolman, David Donald [Idaho National Lab. (INL), Idaho Falls, ID (United States)

2017-02-01

In an attempt to ensure more consistent casting results and remove some schedule variance associated with casting, an improved casting furnace concept has been developed. The improved furnace uses the existing arc melter hardware and glovebox utilities. The furnace concept was designed around physical and operational requirements such as; a charge sized of less than 30 grams, high heating rates and minimal additional footprint. The conceptual model is shown in the report as well as a summary of how the requirements were met.

Quality improvement in neurological surgery graduate medical education.

Science.gov (United States)

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

2015-04-01

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

How improving practice relationships among clinicians and nonclinicians can improve quality in primary care.

Science.gov (United States)

Lanham, Holly J; McDaniel, Reuben R; Crabtree, Benjamin F; Miller, William L; Stange, Kurt C; Tallia, Alfred F; Nutting, Paula

2009-09-01

Understanding the role of relationships health care organizations (HCOs) offers opportunities for shaping health care delivery. When quality is treated as a property arising from the relationships within HCOs, then different contributors of quality can be investigated and more effective strategies for improvement can be developed. Data were drawn from four large National Institutes of Health (NIH)-funded studies, and an iterative analytic strategy and a grounded theory approach were used to understand the characteristics of relationships within primary care practices. This multimethod approach amassed rich and comparable data sets in all four studies, which were all aimed at primary care practice improvement. The broad range of data included direct observation of practices during work activities and of patient-clinician interactions, in-depth interviews with physicians and other key staff members, surveys, structured checklists of office environments, and chart reviews. Analyses focused on characteristics of relationships in practices that exhibited a range of success in achieving practice improvement. Complex adaptive systems theory informed these analyses. Trust, mindfulness, heedfulness, respectful interaction, diversity, social/task relatedness, and rich/lean communication were identified as important in practice improvement. A model of practice relationships was developed to describe how these characteristics work together and interact with reflection, sensemaking, and learning to influence practice-level quality outcomes. Although this model of practice relationships was developed from data collected in primary care practices, which differ from other HCOs in some important ways, the ideas that quality is emergent and that relationships influence quality of care are universally important for all HCOs and all medical specialties.

Developing an Interdisciplinary, Team-Based Quality Improvement Leadership Training Program for Clinicians: The Partners Clinical Process Improvement Leadership Program.

Science.gov (United States)

Rao, Sandhya K; Carballo, Victoria; Cummings, Brian M; Millham, Frederick; Jacobson, Joseph O

Although there has been tremendous progress in quality improvement (QI) education for students and trainees in recent years, much less has been published regarding the training of active clinicians in QI. The Partners Clinical Process Improvement Leadership Program (CPIP) is a 6-day experiential program. Interdisciplinary teams complete a QI project framed by didactic sessions, interactive exercises, case-based problem sessions, and a final presentation. A total of 239 teams composed of 516 individuals have graduated CPIP. On completion, participant satisfaction scores average 4.52 (scale 1-5) and self-reported understanding of QI concepts improved. At 6 months after graduation, 66% of survey respondents reported sustained QI activity. Three opportunities to improve the program have been identified: (1) increasing faculty participation through online and tiered course offerings, (2) integrating the faculty-focused program with the trainee curriculum, and (3) developing a postgraduate curriculum to address the challenges of sustained improvement.

Modeling of scroll compressors - Improvements

Energy Technology Data Exchange (ETDEWEB)

Duprez, Marie-Eve; Dumont, Eric; Frere, Marc [Thermodynamics Department, Universite de Mons - Faculte Polytechnique, 31 bd Dolez, 7000 Mons (Belgium)

2010-06-15

This paper presents an improvement of the scroll compressors model previously published by. This improved model allows the calculation of refrigerant mass flow rate, power consumption and heat flow rate that would be released at the condenser of a heat pump equipped with the compressor, from the knowledge of operating conditions and parameters. Both basic and improved models have been tested on scroll compressors using different refrigerants. This study has been limited to compressors with a maximum electrical power of 14 kW and for evaporation temperatures ranging from -40 to 15 C and condensation temperatures from 10 to 75 C. The average discrepancies on mass flow rate, power consumption and heat flow rate are respectively 0.50%, 0.93% and 3.49%. Using a global parameter determination (based on several refrigerants data), this model can predict the behavior of a compressor with another fluid for which no manufacturer data are available. (author)

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 versus maintaining nuclear safety

International Nuclear Information System (INIS)

2002-01-01

The concept of improving nuclear safety versus maintaining it has been discussed at a number of nuclear regulators meetings in recent years. National reports have indicated that there are philosophical differences between NEA member countries about whether their regulatory approaches require licensees to continuously improve nuclear safety or to continuously maintain it. It has been concluded that, while the actual level of safety achieved in all member countries is probably much the same, this is difficult to prove in a quantitative way. In practice, all regulatory approaches require improvements to be made to correct deficiencies and when otherwise warranted. Based on contributions from members of the NEA Committee on Nuclear Regulatory Activities (CNRA), this publication provides an overview of current nuclear regulatory philosophies and approaches, as well as insights into a selection of public perception issues. This publication's intended audience is primarily nuclear safety regulators, but government authorities, nuclear power plant operators and the general public may also be interested. (author)

Improving Indonesian Construction Consulting Services

Directory of Open Access Journals (Sweden)

Rizal Z. Tamin

2015-05-01

Full Text Available Indonesian construction consulting services are facing a complex problem in fulfilling the nation’s expectations regarding high quality infrastructure development and the construction industry’s competitiveness. A study of this problem and a formulation of solutions to improve the situation are presented in this paper. A survey was carried out in Jakarta, West Java, East Java, and North Sumatra provinces to collect data related to this problem. A focus group discussion and a workshop with all stakeholders were conducted to formulate improvement actions that need to be taken. It was revealed that the problems faced include, among others, the limited number of professional engineers compared to the number of national consultancy companies, the uneven distribution of engineers in Indonesian regions, an imperfect procurement system, and low-quality work output in general. Recommended actions include improvement of the government’s role in consulting services nurturing and facilitation, development of partnerships, and amelioration of the professional engineer and consultant certification system.

Local Strategy Improvement for Parity Game Solving

Directory of Open Access Journals (Sweden)

Oliver Friedmann

2010-06-01

Full Text Available The problem of solving a parity game is at the core of many problems in model checking, satisfiability checking and program synthesis. Some of the best algorithms for solving parity game are strategy improvement algorithms. These are global in nature since they require the entire parity game to be present at the beginning. This is a distinct disadvantage because in many applications one only needs to know which winning region a particular node belongs to, and a witnessing winning strategy may cover only a fractional part of the entire game graph. We present a local strategy improvement algorithm which explores the game graph on-the-fly whilst performing the improvement steps. We also compare it empirically with existing global strategy improvement algorithms and the currently only other local algorithm for solving parity games. It turns out that local strategy improvement can outperform these others by several orders of magnitude.

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.

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.

Does competition improve health care quality?

Science.gov (United States)

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

2008-12-01

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

Prioritizing quality improvement in general surgery.

Science.gov (United States)

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

2008-11-01

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

Distance weighting for improved tomographic reconstructions

International Nuclear Information System (INIS)

Koeppe, R.A.; Holden, J.E.

1984-01-01

An improved method for the reconstruction of emission computed axial tomography images has been developed. The method is a modification of filtered back-projection, where the back projected values are weighted to reflect the loss of formation, with distance from the camera, which is inherent in gamma camera imaging. This information loss is a result of: loss of spatial resolution with distance, attenuation, and scatter. The weighting scheme can best be described by considering the contributions of any two opposing views to the reconstruction image pixels. The weight applied to the projections of one view is set to equal the relative amount of the original activity that was initially received in that projection, assuming a uniform attenuating medium. This yields a weighting value which is a function of distance into the image with a value of one for pixels ''near the camera'', a value of .5 at the image center, and a value of zero on the opposite side. Tomographic reconstructions produced with this method show improved spatial resolution when compared to conventional 360 0 reconstructions. The improvement is in the tangential direction, where simulations have indicated a FWHM improvement of 1 to 1.5 millimeters. The resolution in the radial direction is essentially the same for both methods. Visual inspection of the reconstructed images show improved resolution and contrast

Gravity model improvement investigation. [improved gravity model for determination of ocean geoid

Science.gov (United States)

Siry, J. W.; Kahn, W. D.; Bryan, J. W.; Vonbun, F. F.

1973-01-01

This investigation was undertaken to improve the gravity model and hence the ocean geoid. A specific objective is the determination of the gravity field and geoid with a space resolution of approximately 5 deg and a height resolution of the order of five meters. The concept of the investigation is to utilize both GEOS-C altimeter and satellite-to-satellite tracking data to achieve the gravity model improvement. It is also planned to determine the geoid in selected regions with a space resolution of about a degree and a height resolution of the order of a meter or two. The short term objectives include the study of the gravity field in the GEOS-C calibration area outlined by Goddard, Bermuda, Antigua, and Cape Kennedy, and also in the eastern Pacific area which is viewed by ATS-F.

Technological measures to improve automotive product quality

OpenAIRE

Gladkov, V.; Kruglov, S.

2010-01-01

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

Methodological approach to organizational performance improvement process

Directory of Open Access Journals (Sweden)

Marin Buble

2001-01-01

Full Text Available Organizational performance improvement is one of the fundamental enterprise tasks. This especially applies to the case when the term “performance improvement” implies efficiency improvement measured by indicators, such as ROI, ROE, ROA, or ROVA/ROI. Such tasks are very complex, requiring implementation by means of project management. In this paper, the authors propose a methodological approach to improving the organizational performance of a large enterprise.

Improved solar heating systems

Science.gov (United States)

Schreyer, J.M.; Dorsey, G.F.

1980-05-16

An improved solar heating system is described in which the incident radiation of the sun is absorbed on collector panels, transferred to a storage unit and then distributed as heat for a building and the like. The improvement is obtained by utilizing a storage unit comprising separate compartments containing an array of materials having different melting points ranging from 75 to 180/sup 0/F. The materials in the storage system are melted in accordance with the amount of heat absorbed from the sun and then transferred to the storage system. An efficient low volume storage system is provided by utilizing the latent heat of fusion of the materials as they change states in storing ad releasing heat for distribution.

Improved results in paediatric diabetes care using a quality registry in an improvement collaborative: a case study in Sweden.

Directory of Open Access Journals (Sweden)

Anette Peterson

Full Text Available Several studies show that good metabolic control is important for children and adolescents with type 1 diabetes. In Sweden, there are large differences in mean haemoglobin A1c (HbA1c in different hospitals and difficulties implementing national guidelines in everyday practice. This study shows how the participation in an improvement collaborative could facilitate improvements in the quality of care by paediatric diabetes teams. The Swedish paediatric diabetes quality registry, SWEDIABKIDS was used as a tool and resource for feedback and outcome measures.Twelve teams at paediatric diabetes centres, caring for 30% (2302/7660 of patients in Sweden, participated in an 18-month quality improvement program. Each team defined treatment targets, areas needing improvement, and action plans. The main outcome was the centre patients' mean HbA1c levels, but other clinical variables and change concepts were also studied. Data from the previous six months were compared with the first six months after starting the program, and the long-term follow up after another eleven months.All centres reduced mean HbA1c during the second and third periods compared with the first. The mean reduction for all was 3·7 mmol/mol (p<0.001, compared with non-participating centres who improved their mean HbA1c with 1·7 mmol/mol during the same period. Many of the participating centres reduced the frequency of severe hypoglycaemia and/or ketoacidosis, and five centres reached their goal of ensuring that all patients had some sort of physical activity at least once weekly. Change concepts were, for example, improved guidelines, appointment planning, informing the patients, improving teamwork and active use of the registry, and health promotion activities.By involving paediatric diabetes teams in a quality improvement collaborative together with access to a quality register, the quality of paediatric diabetes care can improve, thereby contributing to a reduced risk of late

Principals' Transformational Leadership in School Improvement

Science.gov (United States)

Yang, Yingxiu

2013-01-01

Purpose: This paper aims to contribute experience and ideas of the transformational leadership, not only for the principal want to improve leadership himself (herself), but also for the school at critical period of improvement, through summarizing forming process and the problem during the course and key factors that affect the course.…

Improving Student Teachers' Attitudes to Mathematics

Science.gov (United States)

Amato, Solange Amorim

2004-01-01

The research results presented in this paper were part of an action research performed with the aims of improving primary school student teachers (STs)' understanding of, and attitudes to, mathematics. The teaching strategies used to help STs' improve their understanding and attitudes were similar to the ones suggested for their future use in…

Process Improvement Teams: A TQM Strategy for Improving Community College Systems.

Science.gov (United States)

Needham, Robbie Lee; And Others

The three principle elements of Total Quality Management (TQM) are a focus on customers; an attitude of continuous improvement of a system; and the involvement of everyone within an organization. At Delaware County Community College (DCCC) in Media, Pennsylvania, the first phase of implementing TQM focused on educating top management for the…

Induced mutations for crop improvement

International Nuclear Information System (INIS)

Micke, A.; Donini, B.; Maluszynski, M.

1990-01-01

Mutation induction has become an established tool in plant breeding to supplement existing germ plasma and to improve cultivars in certain specific traits. Hundreds of improved varieties have been released to farmers for many different crop species, demonstrating the economic value of the technology. Limitations arise mainly from the large mutagenized populations to be screened and from the unsatisfactory selection methods. Both limitations may be eased to some extent by advances in techniques of plant in-vitro culture. (author). Refs, 1 fig., 7 tabs

Performance improvement - business excellence processes

International Nuclear Information System (INIS)

Doucett, J.

2010-01-01

This presentation discusses Performance Improvement which is defined as 'the process of identifying and analyzing important organizational and individual performance gaps, planning for future performance improvement, designing and developing cost-effective and ethically justifiable intervention to close performance gaps, implementing the interventions and evaluating the financial and non-financial results', i.e. making things better. Specifically, it discusses the refurbishment outage at the Point Lepreau Power Plant that began at the end of March 2008. The business risks identified in 2008 were leadership, demographics and management system.

Lipoprotein metabolism indicators improve cardiovascular risk prediction.

Directory of Open Access Journals (Sweden)

Daniël B van Schalkwijk

Full Text Available BACKGROUND: Cardiovascular disease risk increases when lipoprotein metabolism is dysfunctional. We have developed a computational model able to derive indicators of lipoprotein production, lipolysis, and uptake processes from a single lipoprotein profile measurement. This is the first study to investigate whether lipoprotein metabolism indicators can improve cardiovascular risk prediction and therapy management. METHODS AND RESULTS: We calculated lipoprotein metabolism indicators for 1981 subjects (145 cases, 1836 controls from the Framingham Heart Study offspring cohort in which NMR lipoprotein profiles were measured. We applied a statistical learning algorithm using a support vector machine to select conventional risk factors and lipoprotein metabolism indicators that contributed to predicting risk for general cardiovascular disease. Risk prediction was quantified by the change in the Area-Under-the-ROC-Curve (ΔAUC and by risk reclassification (Net Reclassification Improvement (NRI and Integrated Discrimination Improvement (IDI. Two VLDL lipoprotein metabolism indicators (VLDLE and VLDLH improved cardiovascular risk prediction. We added these indicators to a multivariate model with the best performing conventional risk markers. Our method significantly improved both CVD prediction and risk reclassification. CONCLUSIONS: Two calculated VLDL metabolism indicators significantly improved cardiovascular risk prediction. These indicators may help to reduce prescription of unnecessary cholesterol-lowering medication, reducing costs and possible side-effects. For clinical application, further validation is required.

The clinical nurse specialist: leadership in quality improvement.

Science.gov (United States)

Finkelman, Anita

2013-01-01

Healthcare delivery is in a crisis, requiring improvement. How to improve and who should assume more leadership are not clear. At the same time, the nursing profession struggles with a weak education system, graduating students who require major support for an extended time. There is also confusion related to nursing roles, particularly with nurses who have a graduate degree. The Institute of Medicine has published a series of reports about the healthcare system and need for improvement and describes a structure for improvement. The clinical nurse specialist is particularly suited to assume a major role in nursing leadership to guide staff and the healthcare system to better ensure improved care. There is great need to communicate that the clinical nurse specialist can and should assume this role. This will require a review and development of more quality improvement content and experiences in clinical nurse specialist educational programs, but much of the content is already in programs. The clinical nurse specialist works in systems, impacts systems, works with staff, and can thus reach more patients with improvement approaches.

Modifying agricultural crops for improved nutrition.

Science.gov (United States)

McGloughlin, Martina Newell

2010-11-30

The first generation of biotechnology products commercialized were crops focusing largely on input agronomic traits whose value was often opaque to consumers. The coming generations of crop plants can be grouped into four broad areas each presenting what, on the surface, may appear as unique challenges and opportunities. The present and future focus is on continuing improvement of agronomic traits such as yield and abiotic stress resistance in addition to the biotic stress tolerance of the present generation; crop plants as biomass feedstocks for biofuels and "bio-synthetics"; value-added output traits such as improved nutrition and food functionality; and plants as production factories for therapeutics and industrial products. From a consumer perspective, the focus on value-added traits, especially improved nutrition, is undoubtedly one of the areas of greatest interest. From a basic nutrition perspective, there is a clear dichotomy in demonstrated need between different regions and socioeconomic groups, the starkest being inappropriate consumption in the developed world and under-nourishment in Less Developed Countries (LDCs). Dramatic increases in the occurrence of obesity and related ailments in affluent regions are in sharp contrast to chronic malnutrition in many LDCs. Both problems require a modified food supply, and the tools of biotechnology have a part to play. Developing plants with improved traits involves overcoming a variety of technical, regulatory and indeed perception hurdles inherent in perceived and real challenges of complex traits modifications. Continuing improvements in molecular and genomic technologies are contributing to the acceleration of product development to produce plants with the appropriate quality traits for the different regions and needs. Crops with improved traits in the pipeline, the evolving technologies and the opportunities and challenges that lie ahead are covered. Copyright © 2010. Published by Elsevier B.V.

Leading Staff Development for School Improvement

Science.gov (United States)

Bubb, Sara; Earley, Peter

2009-01-01

As part of a CfBT Education Trust funded study, we investigated the practical steps school leaders can take to ensure that self-evaluation of school performance led, through the effective staff development, to genuine school improvement. On the journey from self-evaluation to school improvement our research identified what schools did that worked,…

Driving Improvement with a Balanced Scorecard

Science.gov (United States)

Cowart, Scott K.

2010-01-01

This article describes how a school district's use of a transparent tool coalesced support for systemic improvement. The author was looking for a way to push improvement in his 4,000-student school system when he discovered the balanced scorecard, a strategic tool for performance management. The author details how the balanced scorecard helped him…

Improving productivity through more effective time management.

Science.gov (United States)

Arnold, Edwin; Pulich, Marcia

2004-01-01

Effective time management has become increasingly important for managers as they seek to accomplish objectives in today's organizations, which have been restructured for efficiency while employing fewer people. Managers can improve their ability to manage time effectively by examining their attitudes toward time, analyzing time-wasting behaviors, and developing better time management skills. Managers can improve their performance and promotion potential with more effective time utilization. Strategies for improving time management skills are presented.

Improved netting

International Nuclear Information System (INIS)

Bramley, A.; Clabburn, R.J.T.

1976-01-01

A method is described for producing netting composed of longitudinal and transverse threads of irradiation cross linked thermoplastic material, the threads being joined together at their crossings by moulded masses of cross linked thermoplastic material. The thread may be formed of polyethylene filaments, subjected to a radiation dose of 15 to 25 MR. The moulding can be conducted at 245 0 to 260 0 C or higher. The product is claimed to be an improved quality of netting, with bonds of increased strength between crossing threads. (U.K.)

PV Cz silicon manufacturing technology improvements

Science.gov (United States)

Jester, T.

1995-09-01

This describes work done in the final phase of a 3-y, 3-phase contract to demonstrate cost reductions and improvements in manufacturing technology. The work focused on near-term projects in the SSI (Siemens Solar Industries) Czochralski (Cz) manufacturing facility in Camarillo, CA; the final phase was concentrated in areas of crystal growth, wafer technology, and environmental, safety, and health issues. During this period: (1) The crystal-growing operation improved with increased growth capacity; (2) Wafer processing with wire saws continued to progress; the wire saws yielded almost 50 percent more wafers per inch in production. The wire saws needs less etching, too; (3) Cell processing improvements focused on better handling and higher mechanical yield. The cell electrical distribution improved with a smaller standard deviation in the distribution; and (4) Module designs for lower material and labor costs continued, with focus on a new junction box, larger modules with larger cells, and less costly framing techniques. Two modules demonstrating these cost reductions were delivered during this phase.

Design aspects of PHWR for improved performance

International Nuclear Information System (INIS)

Das, M.

1989-01-01

The PHWR fuel bundle is elegantly simple in design consisting of only six components. The unique features of the design include high density natural UO 2 pellets, collapsible zircaloy cladding, no gas plenums and short (50 cm), simple bundle configuration. Over the last 20 years, considerable efforts have been expended and still being continued on development of analytical tools and computer codes generation of technical specifications tests and experimental studies type tests on prototype bundles irradiation of special documented fuel bundles in power reactors and monitoring and analysis of fuel performance. The knowledge thus gained has helped us to modify design requirements, relax technical specifications and to evolve new, improved designs. The PHWR fuel technology in India can now be considered as well proven but there is considerable scope for further improvements both in design and manufacturing. For example, in design, use of thinner wall cladding (to improve burn up) bundle design with graded elements, double dished pellet, improved coatings, use of MOX fuel etc. are being explored. On the manufacturing side emphasis need to be given on maintaining the quality, improvement on production and process control. The use of automation and advances in machine control techniques, for example, using micro processors can effectively contribute to improvements in quality, productivity and lowering of fuel fabrication costs. In this paper, the PHWR fuel design features, different fuel designs evolved, fuel specifications, influence of fabrication variables and future direction in improved fuel performance are discussed. (author) 9 refs., 7 figs

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...

Improved Marine Waters Monitoring

Science.gov (United States)

Palazov, Atanas; Yakushev, Evgeniy; Milkova, Tanya; Slabakova, Violeta; Hristova, Ognyana

2017-04-01

IMAMO - Improved Marine Waters Monitoring is a project under the Programme BG02: Improved monitoring of marine waters, managed by Bulgarian Ministry of environment and waters and co-financed by the Financial Mechanism of the European Economic Area (EEA FM) 2009 - 2014. Project Beneficiary is the Institute of oceanology - Bulgarian Academy of Sciences with two partners: Norwegian Institute for Water Research and Bulgarian Black Sea Basin Directorate. The Project aims to improve the monitoring capacity and expertise of the organizations responsible for marine waters monitoring in Bulgaria to meet the requirements of EU and national legislation. The main outcomes are to fill the gaps in information from the Initial assessment of the marine environment and to collect data to assess the current ecological status of marine waters including information as a base for revision of ecological targets established by the monitoring programme prepared in 2014 under Art. 11 of MSFD. Project activities are targeted to ensure data for Descriptors 5, 8 and 9. IMAMO aims to increase the institutional capacity of the Bulgarian partners related to the monitoring and assessment of the Black Sea environment. The main outputs are: establishment of real time monitoring and set up of accredited laboratory facilities for marine waters and sediments chemical analysis to ensure the ability of Bulgarian partners to monitor progress of subsequent measures undertaken.

IMPROVED PROCESS OF PLUTONIUM CARRIER PRECIPITATION

Science.gov (United States)

Faris, B.F.

1959-06-30

This patent relates to an improvement in the bismuth phosphate process for separating and recovering plutonium from neutron irradiated uranium, resulting in improved decontamination even without the use of scavenging precipitates in the by-product precipitation step and subsequently more complete recovery of the plutonium in the product precipitation step. This improvement is achieved by addition of fluomolybdic acid, or a water soluble fluomolybdate, such as the ammonium, sodium, or potassium salt thereof, to the aqueous nitric acid solution containing tetravalent plutonium ions and contaminating fission products, so as to establish a fluomolybdate ion concentration of about 0.05 M. The solution is then treated to form the bismuth phosphate plutonium carrying precipitate.

Improvement of database on glass dissolution

International Nuclear Information System (INIS)

Hayashi, Maki; Sasamoto, Hiroshi; Yoshikawa, Hideki

2008-03-01

In geological disposal system, high-level radioactive waste (HLW) glass is expected to retain radionuclide for the long term as the first barrier to prevent radionuclide release. The advancement of its performance assessment technology leads to the reliability improvement of the safety assessment of entire geological disposal system. For this purpose, phenomenological studies for improvement of scientific understanding of dissolution/alteration mechanisms, and development of robust dissolution/alteration model based on the study outcomes are indispensable. The database on glass dissolution has been developed for supporting these studies. This report describes improvement of the prototype glass database. Also, this report gives an example of the application of the database for reliability assessment of glass dissolution model. (author)

Altitude training improves glycemic control.

Science.gov (United States)

Chen, Shu-Man; Lin, Hsueh-Yi; Kuo, Chia-Hua

2013-08-31

Under altitude hypoxia condition, energy reliance on anaerobic glycolysis increases to compensate the shortfall caused by reduced fatty acid oxidation. Short-term moderate altitude exposure plus endurance physical activity has been found to improve glucose tolerance (not fasting glucose) in humans, which is associated with the improvement in the whole-body insulin sensitivity. However, most of people cannot accommodate high altitude exposure above 4500 M due to acute mountain sickness and insulin resistance. There is a wide variation among individuals in response to the altitude challenge. In particular, the improvement in glucose tolerance and insulin sensitivity by prolonged altitude hiking activity was not apparent in those individuals with low baseline dehydroepiandrosterone sulfate (DHEA-S) concentration. In rats, exercise training recovery under prolonged hypoxia exposure (14-15% oxygen, 8 h per day for 6 weeks) can also improve insulin sensitivity, secondary to an effective suppression of adiposity. After prolonged hypoxia training, obese abnormality in upregulated baseline levels of AMP-activated protein kinase (AMPK) and AS160 phosphorylation in skeletal muscle can be reversed. In humans, moderate hypoxia increases postprandial blood distribution towards skeletal muscle during a training recovery. This physiological response plays a role in the redistribution of fuel storage among important energy storage sites and may explain its potent effect on the favorable change in body composition. Altitude training can exert strong impact on our metabolic system, and has the potential to be designed as a non-pharmacological or recreational intervention regimen for correcting metabolic syndromes.

Improving photometric redshift estimation using GPZ: size information, post processing, and improved photometry

Science.gov (United States)

Gomes, Zahra; Jarvis, Matt J.; Almosallam, Ibrahim A.; Roberts, Stephen J.

2018-03-01

The next generation of large-scale imaging surveys (such as those conducted with the Large Synoptic Survey Telescope and Euclid) will require accurate photometric redshifts in order to optimally extract cosmological information. Gaussian Process for photometric redshift estimation (GPZ) is a promising new method that has been proven to provide efficient, accurate photometric redshift estimations with reliable variance predictions. In this paper, we investigate a number of methods for improving the photometric redshift estimations obtained using GPZ (but which are also applicable to others). We use spectroscopy from the Galaxy and Mass Assembly Data Release 2 with a limiting magnitude of r Program Data Release 1 and find that it produces significant improvements in accuracy, similar to the effect of including additional features.

Technical issues to improve diuresis renography

International Nuclear Information System (INIS)

Ponnappan, Asha; Mathur, M.; Kumar, S.

2011-01-01

Radionuclide renal scintigraphy is a safe and valuable method provides important functional data to assist in the diagnosis and management of patients with a variety of known or suspected diseases involving the kidney, ureters and bladder. The objective of this article is optimal technique for renography which can improve image quality, which in turn improves diagnostic efficacy

Improving Flood Plain Management through Adaptive Learning ...

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

This project will explore how an adaptive learning approach can improve CBO governance ... for improving resource sustainability and productivity, and facilitate learning and an exchange ... Middlesex University Higher Education Corporation.

Teleophthalmology: improving patient outcomes?

Directory of Open Access Journals (Sweden)

Sreelatha OK

2016-02-01

Full Text Available Omana Kesary Sreelatha,1 Sathyamangalam VenkataSubbu Ramesh2 1Ophthalmology Department, Sultan Qaboos University Hospital, Muscat, Oman; 2Department of Optometry, School of Allied Health Sciences, Manipal University, Manipal, India Abstract: Teleophthalmology is gaining importance as an effective eye care delivery modality worldwide. In many developing countries, teleophthalmology is being utilized to provide quality eye care to the underserved urban population and the unserved remote rural population. Over the years, technological innovations have led to improvement in evidence and teleophthalmology has evolved from a research tool to a clinical tool. The majority of the current teleophthalmology services concentrate on patient screening and appropriate referral to experts. Specialty care using teleophthalmology services for the pediatric group includes screening as well as providing timely care for retinopathy of prematurity (ROP. Among geriatric eye diseases, specialty teleophthalmology care is focused toward screening and referral for diabetic retinopathy (DR, glaucoma, age-related macular degeneration (ARMD, and other sight-threatening conditions. Comprehensive vision screening and refractive error services are generally covered as part of most of the teleophthalmology methods. Over the past decades, outcome assessment of health care system includes patients’ assessments on their health, care, and services they receive. Outcomes, by and large, remain the ultimate validators of the effectiveness and quality of medical care. Teleophthalmology produces the same desired clinical outcome as the traditional system. Remote portals allow specialists to provide care over a larger region, thereby improving health outcomes and increasing accessibility of specialty care to a larger population. A high satisfaction level and acceptance is reported in the majority of the studies because of increased accessibility and reduced traveling cost and time

Intensive care nurses' perceptions of Inter Specialty Trauma Nursing Rounds to improve trauma patient care-A quality improvement project.

Science.gov (United States)

Jennings, Fiona L; Mitchell, Marion

2017-06-01

Trauma patient management is complex and challenging for nurses in the Intensive Care Unit. One strategy to promote quality and evidence based care may be through utilising specialty nursing experts both internal and external to the Intensive Care Unit in the form of a nursing round. Inter Specialty Trauma Nursing Rounds have the potential to improve patient care, collaboration and nurses' knowledge. The purpose of this quality improvement project was to improve trauma patient care and evaluate the nurses perception of improvement. The project included structured, weekly rounds that were conducted at the bedside. Nursing experts and others collaborated to assess and make changes to trauma patients' care. The rounds were evaluated to assess the nurse's perception of improvement. There were 132 trauma patients assessed. A total of 452 changes to patient care occurred. On average, three changes per patient resulted. Changes included nursing management, medical management and wound care. Nursing staff reported an overall improvement of trauma patient care, trauma knowledge, and collaboration with colleagues. Inter Specialty Trauma Nursing Rounds utilizes expert nursing knowledge. They are suggested as an innovative way to address the clinical challenges of caring for trauma patients and are perceived to enhance patient care and nursing knowledge. Copyright © 2017 Elsevier Ltd. All rights reserved.

Performance improvement - business excellence processes

Energy Technology Data Exchange (ETDEWEB)

Doucett, J. [NB Nuclear Power, Point Lepreau, New Brunswick (Canada)

2010-07-01

This presentation discusses Performance Improvement which is defined as 'the process of identifying and analyzing important organizational and individual performance gaps, planning for future performance improvement, designing and developing cost-effective and ethically justifiable intervention to close performance gaps, implementing the interventions and evaluating the financial and non-financial results', i.e. making things better. Specifically, it discusses the refurbishment outage at the Point Lepreau Power Plant that began at the end of March 2008. The business risks identified in 2008 were leadership, demographics and management system.

Research on improving animal nutrition

International Nuclear Information System (INIS)

Ranjhan, S.K.

1977-01-01

With a view to improve animal nutrition, studies have been carried out on the utilization of animal feeds using radioisotopes. Improvement of the nutritive value of straws, digestibility and VFA production by alkali treatment and other treatments has been studied by injecting VFA labelled with C 14 and H 3 . Microbial protein synthesis rates in ruminants were studied using C 14 and S 35 labelled mixed culture of bacterial protozca. Results obtained are helpful in understanding the metabolism in rumens and the microbial proteins available to the host animals on various dietary regimen. (A.K.)

Engaged Research in Process Improvement

DEFF Research Database (Denmark)

Pries-Heje, Jan

2010-01-01

This keynote initiates from an example of engaged research; a Danish software house that made it from maturity level 1 to 5 in eight years. The organizational change implied at each step is discussed and a design theory of process improvement and change derived.......This keynote initiates from an example of engaged research; a Danish software house that made it from maturity level 1 to 5 in eight years. The organizational change implied at each step is discussed and a design theory of process improvement and change derived....

Preliminary definition of improvement in juvenile arthritis.

Science.gov (United States)

Giannini, E H; Ruperto, N; Ravelli, A; Lovell, D J; Felson, D T; Martini, A

1997-07-01

To identify a core set of outcome variables for the assessment of children with juvenile arthritis (JA), to use the core set to develop a definition of improvement to determine whether individual patients demonstrate clinically important improvement, and to promote this definition as a single efficacy measure in JA clinical trials. A core set of outcome variables was established using a combination of statistical and consensus formation techniques. Variables in the core set consisted of 1) physician global assessment of disease activity; 2) parent/patient assessment of overall well-being; 3) functional ability; 4) number of joints with active arthritis; 5) number of joints with limited range of motion; and 6) erythrocyte sedimentation rate. To establish a definition of improvement using this core set, 21 pediatric rheumatologists from 14 countries met, and, using consensus formation techniques, scored each of 72 patient profiles as improved or not improved. Using the physicians' consensus as the gold standard, the chi-square, sensitivity, and specificity were calculated for each of 240 possible definitions of improvement. Definitions with sensitivity or specificity of definitions to discriminate between the effects of active agent and those of placebo, using actual trial data, was then observed. Each definition was also ranked for face validity, and the sum of the ranks was then multiplied by the kappa statistic. The definition of improvement with the highest final score was as follows: at least 30% improvement from baseline in 3 of any 6 variables in the core set, with no more than 1 of the remaining variables worsening by >30%. The second highest scoring definition was closely related to the first; the third highest was similar to the Paulus criteria used in adult rheumatoid arthritis trials, except with different variables. This indicates convergent validity of the process used. We propose a definition of improvement for JA. Use of a uniform definition will help

CONTINUOUS IMPROVEMENT PRACTICE IN LARGE ENTERPRISES: STUDY RESULTS

Directory of Open Access Journals (Sweden)

Dorota Stadnicka

2015-03-01

Full Text Available Continuous improvement is indispensable for ensuring the company's development and its survival on the constantly changing global market. Continuous improvement is particularly important in the quality and production management systems. A company should deliver a product compliant with a client's requirements in a specified time and at an appropriate price. That is why, continuous improvement refers to different areas of an organization's functioning and it is an integral part of Lean Manufacturing. This article presents the results of the study conducted in production enterprises on a limited area. The aim of the study was the assessment of the implementation of continuous improvement in Lean Manufacturing, and, in particular, employees' involvement in the problem identification and in reporting improvements as well as the way of motivating employees to involve themselves. The authors also tried to identify the factors influencing the elements of a continuous improvement system.

Improving Indoor Air Quality

Science.gov (United States)

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

Achieving Improvement Through Nursing Home Quality Measurement

OpenAIRE

Harris, Yael; Clauser, Steven B.

2002-01-01

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

Qinshan NPP in-core fuel management improvement

International Nuclear Information System (INIS)

Kong Deping; Liao Zejun; Wu Xifeng; Wei Wenbin; Wang Yongming; Li Hua

2006-01-01

In the 10-year operation of Qinshan Nuclear Power Plant, the initial designed reloading strategy has been improved step by step based on the operation experiences and the advanced domestic and international fuel management methods. Higher burnup has been achieved and more economic operation gained through the loading pattern improvement and the fuel enrichment increased. The article introduces the in-core fuel management strategy improvement of Qinshan Nuclear Power Plant in its 10-year operation. (authors)

Perceptual learning improves visual performance in juvenile amblyopia.

Science.gov (United States)

Li, Roger W; Young, Karen G; Hoenig, Pia; Levi, Dennis M

2005-09-01

To determine whether practicing a position-discrimination task improves visual performance in children with amblyopia and to determine the mechanism(s) of improvement. Five children (age range, 7-10 years) with amblyopia practiced a positional acuity task in which they had to judge which of three pairs of lines was misaligned. Positional noise was produced by distributing the individual patches of each line segment according to a Gaussian probability function. Observers were trained at three noise levels (including 0), with each observer performing between 3000 and 4000 responses in 7 to 10 sessions. Trial-by-trial feedback was provided. Four of the five observers showed significant improvement in positional acuity. In those four observers, on average, positional acuity with no noise improved by approximately 32% and with high noise by approximately 26%. A position-averaging model was used to parse the improvement into an increase in efficiency or a decrease in equivalent input noise. Two observers showed increased efficiency (51% and 117% improvements) with no significant change in equivalent input noise across sessions. The other two observers showed both a decrease in equivalent input noise (18% and 29%) and an increase in efficiency (17% and 71%). All five observers showed substantial improvement in Snellen acuity (approximately 26%) after practice. Perceptual learning can improve visual performance in amblyopic children. The improvement can be parsed into two important factors: decreased equivalent input noise and increased efficiency. Perceptual learning techniques may add an effective new method to the armamentarium of amblyopia treatments.

Improving the sensitivity of LISA

International Nuclear Information System (INIS)

Nayak, K Rajesh; Pai, A; Dhurandhar, S V; Vinet, J-Y

2003-01-01

It has been shown in several recent papers that the six Doppler data streams obtained from a triangular LISA configuration can be combined by appropriately delaying the data streams for cancelling the laser frequency noise. Raw laser noise is several orders of magnitude above the other noises and thus it is essential to bring it down to the level of other noises such as shot, acceleration, etc. A rigorous and systematic formalism using the powerful techniques of computational commutative algebra was developed, which generates in principle all the data combinations cancelling the laser frequency noise. The relevant data combinations form a first module of syzygies. In this paper, we use this formalism to advantage for optimizing the sensitivity of LISA by analysing the noise and signal covariance matrices. The signal covariance matrix is calculated for binaries whose frequency changes at most adiabatically and the signal is averaged over polarizations and directions. We then present the extremal SNR curves for all the data combinations in the module. They correspond to the eigenvectors of the noise and signal covariance matrices. A LISA 'network' SNR is also computed by combining the outputs of the eigenvectors. We show that substantial gains in sensitivity can be obtained by employing these strategies. The maximum SNR curve can yield an improvement up to 70% over the Michelson, mainly at high frequencies, while the improvement using the network SNR ranges from 40% to over 100%. Finally, we describe a simple toy model, in which LISA rotates in a plane. In this analysis, we estimate the improvement in the LISA sensitivity, if one switches from one data combination to another as it rotates. Here the improvement in sensitivity, if one switches optimally over three cyclic data combinations of the eigenvector, is about 55% on average over the LISA bandwidth. The corresponding SNR improvement increases to 60%, if one maximizes over the module

Sustained participation in annual continuous quality improvement activities improves quality of care for Aboriginal and Torres Strait Islander children.

Science.gov (United States)

McAullay, Daniel; McAuley, Kimberley; Bailie, Ross; Mathews, Veronica; Jacoby, Peter; Gardner, Karen; Sibthorpe, Beverly; Strobel, Natalie; Edmond, Karen

2018-02-01

To determine whether participation in the continuous quality improvement (CQI) Audit and Best Practice for Chronic Disease programme improved care and outcomes for Indigenous children. Data were collected from 59 Australian primary health-care centres providing services to Indigenous people and participating in the programme (February 2008 and December 2013). Indigenous children aged less than 2 years and centres that completed three or more consecutive annual audits within the 6-year study period were included. Crude and adjusted logistic generalised estimating equation models were used to examine the effect of year of audit on the delivery of care. Odds ratio (OR) and 95% confidence interval (CI) were calculated. Outcomes were related to age-relevant health issues, including prevention and early intervention. These included administrative, health check, anticipatory guidance and specific health issues. During the audit period, there were 2360 files from 59 centres. Those that had a recall recorded, improved from 84 to 95% (OR 2.44, 95% CI 1.44-4.11). Hearing assessments improved from 52 to 89% (OR 1.37, 95% CI 1.22-1.54). Improvement in anticipatory guidance, treatment and follow-up of medical conditions was almost universal. We documented significant improvements in quality of care of Indigenous children. Outcomes and their corresponding treatment and follow-ups improved over time. This appears to be related to services participating in annual CQI activities. However, these services may be more committed to CQI than others and therefore possibly better performing. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

Judgment sampling: a health care improvement perspective.

Science.gov (United States)

Perla, Rocco J; Provost, Lloyd P

2012-01-01

Sampling plays a major role in quality improvement work. Random sampling (assumed by most traditional statistical methods) is the exception in improvement situations. In most cases, some type of "judgment sample" is used to collect data from a system. Unfortunately, judgment sampling is not well understood. Judgment sampling relies upon those with process and subject matter knowledge to select useful samples for learning about process performance and the impact of changes over time. It many cases, where the goal is to learn about or improve a specific process or system, judgment samples are not merely the most convenient and economical approach, they are technically and conceptually the most appropriate approach. This is because improvement work is done in the real world in complex situations involving specific areas of concern and focus; in these situations, the assumptions of classical measurement theory neither can be met nor should an attempt be made to meet them. The purpose of this article is to describe judgment sampling and its importance in quality improvement work and studies with a focus on health care settings.

Improvement of Parallel Algorithm for MATRA Code

International Nuclear Information System (INIS)

Kim, Seong-Jin; Seo, Kyong-Won; Kwon, Hyouk; Hwang, Dae-Hyun

2014-01-01

The feasibility study to parallelize the MATRA code was conducted in KAERI early this year. As a result, a parallel algorithm for the MATRA code has been developed to decrease a considerably required computing time to solve a bigsize problem such as a whole core pin-by-pin problem of a general PWR reactor and to improve an overall performance of the multi-physics coupling calculations. It was shown that the performance of the MATRA code was greatly improved by implementing the parallel algorithm using MPI communication. For problems of a 1/8 core and whole core for SMART reactor, a speedup was evaluated as about 10 when the numbers of used processor were 25. However, it was also shown that the performance deteriorated as the axial node number increased. In this paper, the procedure of a communication between processors is optimized to improve the previous parallel algorithm.. To improve the performance deterioration of the parallelized MATRA code, the communication algorithm between processors was newly presented. It was shown that the speedup was improved and stable regardless of the axial node number

Current activities on safety improvement at Ukrainian NPPs

International Nuclear Information System (INIS)

Stovbun, V.V.

2000-01-01

This report describes general development status of the national programs on safety improvement of the Ukrainian NPPs, basic approaches adopted for planning and implementation of safety improvement works, and state of implementation of principal technical activities aimed at safety improvement of Ukrainian NPPs. (author)

12 CFR 541.15 - Improved nonresidential real estate.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Improved nonresidential real estate. 541.15... REGULATIONS AFFECTING FEDERAL SAVINGS ASSOCIATIONS § 541.15 Improved nonresidential real estate. The term improved nonresidential real estate means nonresidential real estate: (a) Containing a permanent structure...

DEVELOPING VENDOR IMPROVEMENT PROGRAM IN MALAYSIA AUTOMOTIVE COMPANY

Directory of Open Access Journals (Sweden)

SHUKRIAH ABDULLAH

2016-04-01

Full Text Available Improvement Program seek to do evaluation well, request to become sufficiently versed in evaluation or to integrate on improvement perspective in all phase of performance, from needs assessment to implementation and evaluation itself. The purpose of this program in the automotive company is to assist vendor as global manufacturer in preparation towards ASEAN Free Trade Agreement (AFTA 2015. This development vendor improvement program emphasize on the downtime reduction to below 200 minutes per month with the ultimate end of improving not only program or solutions but also the organizations and customer. A practical approach either planned or unplanned by the automotive company require policies and procedures that address the same consideration on the downtime identification. 20 top bottom rank vendor were determined based on the downtime performance, followed by classification into different group based on severity. To execute the vendor improvement program three among 20 top bottom rank vendors were selected due to willingness to participate and ease of data access in the program. Selected vendors have high ranking in terms of downtime. The case study method involved an interview and plant observation. The used of secondary data from the automotive company, and previous researcher are also utilised. This improvement program assists the automobile manufacturer to improve its supplier’s performance. The vendor improvement program is implemented through a whole supplier operation assessment.

Lake Naivasha Sustainability : Ecosystem Improvement for Health ...

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

Lake Naivasha Sustainability : Ecosystem Improvement for Health and ... The overall goal is to make recommendations for the sustainable management of natural ... to improve livestock vaccine development and production to benefit farmers ...

Performance Results of CMMI-Based Process Improvement

National Research Council Canada - National Science Library

Gibson, Diane L; Goldenson, Dennis R; Kost, Keith

2006-01-01

.... There now is evidence that process improvement using the CMMI Product Suite can result in improvements in schedule and cost performance, product quality, return on investment and other measures of performance outcome...

Home Improvements Prevent Falls

Science.gov (United States)

... turn JavaScript on. Feature: Falls and Older Adults Home Improvements Prevent Falls Past Issues / Winter 2014 Table ... and ensure your safety. "Safe-ty-fy" Your Home Some Questions for Your Provider Will my medicines ...

Application of Six Sigma towards improving surgical outcomes.

Science.gov (United States)

Shukla, P J; Barreto, S G; Nadkarni, M S

2008-01-01

Six Sigma is a 'process excellence' tool targeting continuous improvement achieved by providing a methodology for improving key steps of a process. It is ripe for application into health care since almost all health care processes require a near-zero tolerance for mistakes. The aim of this study is to apply the Six Sigma methodology into a clinical surgical process and to assess the improvement (if any) in the outcomes and patient care. The guiding principles of Six Sigma, namely DMAIC (Define, Measure, Analyze, Improve, Control), were used to analyze the impact of double stapling technique (DST) towards improving sphincter preservation rates for rectal cancer. The analysis using the Six Sigma methodology revealed a Sigma score of 2.10 in relation to successful sphincter preservation. This score demonstrates an improvement over the previous technique (73% over previous 54%). This study represents one of the first clinical applications of Six Sigma in the surgical field. By understanding, accepting, and applying the principles of Six Sigma, we have an opportunity to transfer a very successful management philosophy to facilitate the identification of key steps that can improve outcomes and ultimately patient safety and the quality of surgical care provided.

[Improving suicide prevention].

Science.gov (United States)

Debout, Michel

2017-04-01

Suicidal thoughts precede a suicide attempt. Knowing the people who are exposed to such thoughts enables prevention to be improved. The results of a study of the general population show that one in five French people claim to have already seriously considered committing suicide. This represents a particularly concerning public health issue. Copyright © 2017. Published by Elsevier Masson SAS.

Improving Formwork Engineering Using the Toyota Way

Directory of Open Access Journals (Sweden)

Jiun-De Kuo

2011-07-01

Full Text Available Construction is a labor-intensive industry with formwork engineering requiring a disproportionate amount of labor and costs. Formwork accounts for approximately one-third of the cost of reinforced concrete construction, partly because traditional formwork processes frequently result in delivery delays and material waste. The purpose of this research is to adapt production concepts pioneered by Toyota (the “Toyota Way” to improve formwork engineering. The Toyota Way of production consists of four tiers of management philosophy, known as the “4Ps” model. This research adopts the 4Ps as steps for formwork improvement. The first step, “establishing long term vision,” emphasizes long term considerations for formwork improvement. Step two, “establishing value streams,” reviews formwork flows and eliminates wastage. The third step, “developing the crew,” forms mold workers as a team. The final step is “developing a culture of continuous improvement” that provides a basis for constant review and provides a basis for continuous progress. The present research used the Toyota Way to improve formwork engineering. The improvements include reductions in resource waste and increases in operational value. In the long run, the proposed model could provide a learning and growth platform for individuals, the business unit, and the company’s extended network of partners. It could also serve to spur innovative thinking in the improvement of formwork engineering.

Connecting Vietnam's isolated communities to improve healthcare ...

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

2018-01-29

Jan 29, 2018 ... Connecting Vietnam's isolated communities to improve healthcare ... of pregnancy and new motherhood improved their interactions with health workers. ... Return to main page: Overcoming eHealth challenges with social and ...

Improvement of infrastructure for risk-informed regulation

International Nuclear Information System (INIS)

2012-01-01

Improvement of the infrastructure of probabilistic safety assessment (PSA) is essential to the risk-informed regulation for nuclear power plants. JNES conducted update of initiating event frequencies and improvement of the method for uncertainty analysis to enhance the technology bases of PSA in 2011. Furthermore, JNES improved the human reliability analysis method and the reliability analysis method for digital reactor protection systems. JNES estimated initiating event frequencies both for power and shutdown operation based on the recent operating experiences in Nuclear Power Plants (NPPs) of Japan using the hierarchical Bayesian method. As for improvement of the uncertainty analysis method, JNES conducted trial analyses using SOKC (State-Of-Knowledge Correlation) for the representative PWR plant and BWR plant of Japan. The study on the advanced HRA method with operator cognitive action model was conducted to improve a quality of HRA. The study on analyses of 'defense in depth' and 'diversity' for introducing digital instrumentation and control (I and C) systems was conducted. In order to ensure the quality of PSA, JNES conducted a peer review of a representative Japanese BWR plant PSA by the professional PSA engineers from the U.S. in order to extract to improve quality of PSA, and made an effort to develop the procedures of internal fire PSA. JNES participated in OECD/NEA PRISME and FIRE project to obtain the latest information and data to validate and improve the fire propagation analysis codes and the parameters for fire PSA as well. Furthermore, JNES studied schemes for the endorsement and application in the risk-informed regulation of PSA standards established by Atomic Energy Society of Japan. (author)

Report: EPA Improved Its National Security Information Program, but Some Improvements Still Needed

Science.gov (United States)

Report #16-P-0196, June 2, 2016. The EPA will continue to improve its national security information program by completing information classification guides that can be used uniformly and consistently throughout the agency.

Improved Power System of the Future

OpenAIRE

Rabinowitz, Mario

2003-01-01

This paper is intended to provide an insight into physics and engineering that can modernize electric power systems. Topics covered are Flexible ac transmission systems (FACTS), Custom Power, Greatly improved Capacitors, Electrical Insulation, Distribution Cables, Improved Polymeric Insulation, Underground Vault Explosions, Fault Location, Smart Cables, Neutral and Ground, Corrosion and Protection, Conventional Transformers, Compact Transformers, Ferroresonance, and Solid State Transformers.

Improving the Engine room of a Yacht

OpenAIRE

Castells, Josep

2016-01-01

The aim of this project is to improve the energy efficiency of a sailing yacht engine room by reducing the inputs and maximizing the outputs and simultaneously striving to reduce the weight. The document is structured in three sections; an introduction about the important concepts and the case, a theoretical part with the technologies that are applicable in the project and that could improve it and finally, an analysis and suggested improvements of the system. This project strives to exp...

Use of Process Improvement Tools in Radiology.

Science.gov (United States)

Rawson, James V; Kannan, Amogha; Furman, Melissa

2016-01-01

Process improvement techniques are common in manufacturing and industry. Over the past few decades these principles have been slowly introduced in select health care settings. This article reviews the Plan, Do, Study, and Act cycle, Six Sigma, the System of Profound Knowledge, Lean, and the theory of constraints. Specific process improvement tools in health care and radiology are presented in the order the radiologist is likely to encounter them in an improvement project. Copyright © 2015 Mosby, Inc. All rights reserved.

The influence of learning in collaborative improvement

DEFF Research Database (Denmark)

Nielsen, Jacob S.; Boer, Harry; Gertsen, Frank

2008-01-01

Collaborative improvement is a purposeful inter-company interactive process that focuses on continuous incremental innovation aimed at enhancing the partnership's overall performance. Considering that in such an environment the capability to learn jointly and individually is crucial, this paper...... takes a learning perspective on collaborative improvement and addresses the question: How do organisational learning and collaboration interplay and affect improvement performance? Based on an analysis of three dyads of the same Extended Manufacturing Enterprise, this paper concludes that a robust...

Interpreting the CMMI a process improvement approach

CERN Document Server

Kulpa, Margaret K

2008-01-01

Written by experienced process improvement professionals who have developed and implemented computer based systems in organizations around the world, Interpreting the CMMI®: A Process Improvement Approach, Second Edition provides you with specific techniques for performing process improvement. Employing everyday language and supported by real world examples, the authors describe the fundamental concepts of the CMMI model, covering goals, practices, architecture, and definitions, and provide a structured approach for implementing the concepts of the CMMI into any organization. They discuss gett

Improvement of Educational Equity & Teacher Training

Directory of Open Access Journals (Sweden)

María J. Rodríguez

2013-10-01

Full Text Available Educational improvement for equity and professional teacher development are crucial issues concerning the essential right all students have of a good education. Firstly the article proposes a contextual reflection on improvement, some considerations related to well known traditions in the field and particularly the social justice and its relationships and implication for educational politics, curriculum, teaching, teacher and community. Secondly, it claims for the coherence of teacher professional development to educational equity. Different analysis and proposals are outlined related to policies and tasks the public administration should undertake and some dimensions of teacher education are considered attending educational equity criteria. Professional learning communities are described and valued as a hypothetical framework in order to improve equity and teacher education relationships.

Improving of enterprise consumer service system

Directory of Open Access Journals (Sweden)

Yа.М. Laguta

2015-12-01

Full Text Available The problems of consumer services at domestic enterprises are showed. The shortcomings in the service of enterprise operation are analyzed. The basic features of the functioning of the service system forming medium are determined. The authors develop the measures to improve the quality of services which can contribute to their development, expansion of the customer base, increase in sales volume (goods and services as well as improving efficiency and profitability. Taking into account the current environment of enterprises the proposed measures are formed. The article proves the expediency of the use of the client-oriented approach to a customer, the use of software programs and the improvement of the CRM-system at enterprises, the introduction of «7P» concept.

Improving Peptide Applications Using Nanotechnology.

Science.gov (United States)

Narayanaswamy, Radhika; Wang, Tao; Torchilin, Vladimir P

2016-01-01

Peptides are being successfully used in various fields including therapy and drug delivery. With advancement in nanotechnology and targeted delivery carrier systems, suitable modification of peptides has enabled achievement of many desirable goals over-riding some of the major disadvantages associated with the delivery of peptides in vivo. Conjugation or physical encapsulation of peptides to various nanocarriers, such as liposomes, micelles and solid-lipid nanoparticles, has improved their in vivo performance multi-fold. The amenability of peptides to modification in chemistry and functionalization with suitable nanocarriers are very relevant aspects in their use and have led to the use of 'smart' nanoparticles with suitable linker chemistries that favor peptide targeting or release at the desired sites, minimizing off-target effects. This review focuses on how nanotechnology has been used to improve the number of peptide applications. The paper also focuses on the chemistry behind peptide conjugation to nanocarriers, the commonly employed linker chemistries and the several improvements that have already been achieved in the areas of peptide use with the help of nanotechnology.

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.

ACED Allegheny Home Improvement Loan Program (AHILP)

Data.gov (United States)

Allegheny County / City of Pittsburgh / Western PA Regional Data Center — The Allegheny Home Improvement Loan Program (AHILP) is the most affordable way for eligible Allegheny County residents to rehabilitate and improve their homes....

Quick and continuous improvement through kaizen blitz.

Science.gov (United States)

McNichols, T; Hassinger, R; Bapst, G W

1999-05-01

It is our objective to provide you with a step-by-step approach to conducting a kaizen blitz within two days and describe how to achieve dramatic performance improvement with employee buy-in through this process. Kaizen blitz has been used dozens of times by the authors, and in some instances the same area has been blitzed as many as four times, with significant improvements each and every time. Employees have even taken it on themselves to conduct informal blitzes as a continuing improvement effort after a formal blitz has been conducted in their area. Blitzes can succeed in a variety of environments. The morning after the employees of one company attended this presentation, they self initiated a mini-blitz and discovered opportunities for improvement that they enthusiastically presented to management.

A modified Continuous Quality Improvement approach to improve culturally and socially inclusive care within rural health services.

Science.gov (United States)

Mitchell, Olivia; Malatzky, Christina; Bourke, Lisa; Farmer, Jane

2018-03-23

The sickest Australians are often those belonging to non-privileged groups, including Indigenous Australians, gay, lesbian, bisexual, transsexual, intersex and queer people, people from culturally and linguistically diverse backgrounds, socioeconomically disadvantaged groups, and people with disabilities and low English literacy. These consumers are not always engaged by, or included within, mainstream health services, particularly in rural Australia where health services are limited in number and tend to be generalist in nature. The aim of this study was to present a new approach for improving the sociocultural inclusivity of mainstream, generalist, rural, health care organisations. This approach combines a modified Continuous Quality Improvement framework with Participatory Action Research principles and Foucault's concepts of power, discourse and resistance to develop a change process that deconstructs the power relations that currently exclude marginalised rural health consumers from mainstream health services. It sets up processes for continuous learning and consumer responsiveness. The approach proposed could provide a Continuous Quality Improvement process for creating more inclusive mainstream health institutions and fostering better engagement with many marginalised groups in rural communities to improve their access to health care. The approach to improving cultural inclusion in mainstream rural health services presented in this article builds on existing initiatives. This approach focuses on engaging on-the-ground staff in the need for change and preparing the service for genuine community consultation and responsive change. It is currently being trialled and evaluated. © 2018 National Rural Health Alliance Ltd.

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.

Leadership Capacity--A Key to Sustaining Lasting Improvement

Science.gov (United States)

Williams, Henry S.

2009-01-01

Studies on school change indicate that schools successful in sustaining school improvement build capacity for leadership within the organization (Harris & Lambert, 2003). Reliance on the leadership of the principal alone is no longer viable if schools are to improve and sustain improvement. Leadership capacity is about creating conditions…

Improving Tanzanian childbirth service quality.

Science.gov (United States)

Jaribu, Jennie; Penfold, Suzanne; Green, Cathy; Manzi, Fatuma; Schellenberg, Joanna

2018-04-16

Purpose The purpose of this paper is to describe a quality improvement (QI) intervention in primary health facilities providing childbirth care in rural Southern Tanzania. Design/methodology/approach A QI collaborative model involving district managers and health facility staff was piloted for 6 months in 4 health facilities in Mtwara Rural district and implemented for 18 months in 23 primary health facilities in Ruangwa district. The model brings together healthcare providers from different health facilities in interactive workshops by: applying QI methods to generate and test change ideas in their own facilities; using local data to monitor improvement and decision making; and health facility supervision visits by project and district mentors. The topics for improving childbirth were deliveries and partographs. Findings Median monthly deliveries increased in 4 months from 38 (IQR 37-40) to 65 (IQR 53-71) in Mtwara Rural district, and in 17 months in Ruangwa district from 110 (IQR 103-125) to 161 (IQR 148-174). In Ruangwa health facilities, the women for whom partographs were used to monitor labour progress increased from 10 to 57 per cent in 17 months. Research limitations/implications The time for QI innovation, testing and implementation phases was limited, and the study only looked at trends. The outcomes were limited to process rather than health outcome measures. Originality/value Healthcare providers became confident in the QI method through engagement, generating and testing their own change ideas, and observing improvements. The findings suggest that implementing a QI initiative is feasible in rural, low-income settings.

IMPROVING STUDENTS‟ PRONUNCIATION USING JAZZ CHANTS

Directory of Open Access Journals (Sweden)

Primanda Dewanti

2017-04-01

Full Text Available As a habit, language needs to be used repeatedly. Jazz chants provides repeated and rhythmical words and sentences which are easily memorized. Due to the fact mentioned, Jazz chants can be considered to be used in conducting the activities enhancing the students‘ pronunciation accuracy. This study aims to analyze (1 whether Jazz chants can improve students‘ pronunciation accuracy, and (2 the advantages of the Jazz chants implementation to improve students‘ pronunciation. This research was conducted in the first semester students of Diploma 3 of Economy and Business Faculty of a university in Surakarta. The action research was conducted in two cycles comprising three meetings in each cycle. The research procedures used in this research are planning, acting, observing, and reflecting. The writer applied observation, interview, questionnaire, and test to collect the data. The quantitative data were analyzed by descriptive statistics, while the qualitative ones by Interactive Model. The research results in the conclusions, including: (1 Jazz chants could improve students‘ pronunciation in terms of stress, intonation, and connected speech and (2 Jazz chants is beneficial that it stimulates the class to be more active, improves motivation, and supports students‘ memory.

ECONOMICS OF IMPROVED AND LOCAL VARIETIES OF ...

African Journals Online (AJOL)

Osondu

2012-04-02

Apr 2, 2012 ... This study was based on the economics of improved and local cassava ... staples because of cassava's low cash input cost ... cultivation and entrepreneurship, several new .... varieties which are more or less not improved.

45 CFR 1304.60 - Deficiencies and quality improvement plans.

Science.gov (United States)

2010-10-01

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

26 CFR 1.611-5 - Depreciation of improvements.

Science.gov (United States)

2010-04-01

... 26 Internal Revenue 7 2010-04-01 2010-04-01 true Depreciation of improvements. 1.611-5 Section 1... (CONTINUED) INCOME TAXES (CONTINUED) Natural Resources § 1.611-5 Depreciation of improvements. (a) In general... there shall be allowed as a deduction a reasonable allowance for depreciation of improvements. Such...

Safety culture improvements in a nuclear laboratory setting

International Nuclear Information System (INIS)

Smith, K.L.; McKenna, J.

2014-01-01

In 2008, AECL performed a comprehensive safety culture assessment using recognized, industry-proven methodologies. Main observations were grouped into several key areas including standards, procedures, error-free work, and leadership fundamentals. Shortly thereafter, in 2009 May, the National Research Universal (NRU) reactor was shut down following discovery of a small leak of heavy water. Extensive repairs were required to return the reactor to service and a root cause investigation was conducted to determine the organizational and programmatic causes that led to the event. Taken together, these presented management with insights into common areas of weaknesses in performance and behaviours. A Corrective Action Plan (CAP) to address both the findings of the root cause analysis and safety culture assessment was captured in a comprehensive improvement plan issued in 2010 March, entitled the Voyageur Program Phase II (Voyageur II). The CAP addresses six key areas: Improve equipment reliability; Drive desired behaviours; Improve problem identification and resolution; Improve use of industry Operating Experience (OPEX) and reduce isolationism; Improve standards of operation; and, Improve management oversight. AECL's safety culture has been monitored regularly using quarterly surveys. A detailed safety culture assessment was executed in 2012 September. Compared with previous results, improvements for AECL were noted in the following areas: Use of Operating Experience, specifically in work planning, pre job briefs and training; Procedure quality; Availability of safety equipment; Control of temporary changes; and, Improved operational standards. (author)

Safety culture improvements in a nuclear laboratory setting

Energy Technology Data Exchange (ETDEWEB)

Smith, K.L.; McKenna, J. [Atomic Energy of Canada Limited, Chalk River, ON (Canada)

2014-07-01

In 2008, AECL performed a comprehensive safety culture assessment using recognized, industry-proven methodologies. Main observations were grouped into several key areas including standards, procedures, error-free work, and leadership fundamentals. Shortly thereafter, in 2009 May, the National Research Universal (NRU) reactor was shut down following discovery of a small leak of heavy water. Extensive repairs were required to return the reactor to service and a root cause investigation was conducted to determine the organizational and programmatic causes that led to the event. Taken together, these presented management with insights into common areas of weaknesses in performance and behaviours. A Corrective Action Plan (CAP) to address both the findings of the root cause analysis and safety culture assessment was captured in a comprehensive improvement plan issued in 2010 March, entitled the Voyageur Program Phase II (Voyageur II). The CAP addresses six key areas: Improve equipment reliability; Drive desired behaviours; Improve problem identification and resolution; Improve use of industry Operating Experience (OPEX) and reduce isolationism; Improve standards of operation; and, Improve management oversight. AECL's safety culture has been monitored regularly using quarterly surveys. A detailed safety culture assessment was executed in 2012 September. Compared with previous results, improvements for AECL were noted in the following areas: Use of Operating Experience, specifically in work planning, pre job briefs and training; Procedure quality; Availability of safety equipment; Control of temporary changes; and, Improved operational standards. (author)

Managerial implications for improving continuous production processes

DEFF Research Database (Denmark)

Capaci, Francesca; Vanhatalo, Erik; Bergquist, Bjarne

2017-01-01

. In this article we highlight SPC and DoE implementation challenges described in the literature for managers, researchers and practitioners interested in continuous production process improvement. The results may help managers support the implementation of these methods and make researchers and practitioners aware......Data analytics remains essential for process improvement and optimization. Statistical process control and design of experiments are among the most powerful process and product improvement methods available. However, continuous process environments challenge the application of these methods...... of methodological challenges in continuous process environments...

Improved communication in post-ICU care by improving writing of ICU discharge letters: a longitudinal before-after study

NARCIS (Netherlands)

Medlock, Stephanie; Eslami, Saeid; Askari, Marjan; van Lieshout, Erik Jan; Dongelmans, Dave A.; Abu-Hanna, Ameen

2011-01-01

The discharge letter is the primary means of communication at patient discharge, yet discharge letters are often not completed on time. A multifaceted intervention was performed to improve communication in patient hand-off from the intensive care unit (ICU) to the wards by improving the timeliness

Improved communication in post-ICU care by improving writing of ICU discharge letters: a longitudinal before-after study

NARCIS (Netherlands)

Medlock, S.; Eslami, S.; Askari, M.; van Lieshout, E.J.; Dongelmans, D.A.; Abu-Hanna, A.

2011-01-01

Background: The discharge letter is the primary means of communication at patient discharge, yet discharge letters are often not completed on time. A multifaceted intervention was performed to improve communication in patient hand-off from the intensive care unit (ICU) to the wards by improving the

Improved safety in ski jumping.

Science.gov (United States)

Wester, K

1988-01-01

Among approximately 2,600 licensed Norwegian ski jumpers, only three injuries that caused a permanent medical disability of at least 10% were incurred during the 5 year period from 1982 through 1986. When compared to the previous 5 year period (1977 to 1981), a dramatic improvement in safety is seen, as both number and severity of such injuries were markedly reduced. There are several probable reasons for this improved safety record: better preparation of the jumps, the return to using only one standard heel block, and the fact that coaches are being more responsible, especially with younger jumpers.

Software Engineering Improvement Activities/Plan

Science.gov (United States)

2003-01-01

bd Systems personnel accomplished the technical responsibilities for this reporting period, as planned. A close working relationship was maintained with personnel of the MSFC Avionics Department Software Group (ED14). Work accomplishments included development, evaluation, and enhancement of a software cost model, performing literature search and evaluation of software tools available for code analysis and requirements analysis, and participating in other relevant software engineering activities. Monthly reports were submitted. This support was provided to the Flight Software Group/ED 1 4 in accomplishing the software engineering improvement engineering activities of the Marshall Space Flight Center (MSFC) Software Engineering Improvement Plan.

Process Improvement: Customer Service.

Science.gov (United States)

Cull, Donald

2015-01-01

Utilizing the comment section of patient satisfaction surveys, Clark Memorial Hospital in Jeffersonville, IN went through a thoughtful process to arrive at an experience that patients said they wanted. Two Lean Six Sigma tools were used--the Voice of the Customer (VoC) and the Affinity Diagram. Even when using these tools, a facility will not be able to accomplish everything the patient may want. Guidelines were set and rules were established for the Process Improvement Team in order to lessen frustration, increase focus, and ultimately be successful. The project's success is driven by the team members carrying its message back to their areas. It's about ensuring that everyone is striving to improve the patients' experience by listening to what they say is being done right and what they say can be done better. And then acting on it.

Containment performance improvement program

International Nuclear Information System (INIS)

Beckner, W.; Mitchell, J.; Soffer, L.; Chow, E.; Lane, J.; Ridgely, J.

1990-01-01

The Containment Performance Improvement (CPI) program has been one of the main elements in the US Nuclear Regulatory Commission's (NRC's) integrated approach to closure of severe accident issues for US nuclear power plants. During the course of the program, results from various probabilistic risk assessment (PRA) studies and from severe accident research programs for the five US containment types have been examined to identify significant containment challenges and to evaluate potential improvements. The five containment types considered are: the boiling water reactor (BMR) Mark I containment, the BWR Mark II containment, the BWR Mark III containment, the pressurized water reactor (PWR) ice condenser containment, and the PWR dry containments (including both subatmospheric and large subtypes). The focus of the CPI program has been containment performance and accident mitigation, however, insights are also being obtained in the areas of accident prevention and accident management

Improving human performance in maintenance personnel

International Nuclear Information System (INIS)

Gonzalez Anez, Francisco; Agueero Agueero, Jorge

2010-01-01

The continuous evolution and improvement of safety-related processes has included the analysis, design and development of training plans for the qualification of maintenance nuclear power plant personnel. In this respect, the international references in this area recommend the establishment of systematic qualification programmes for personnel performing functions or carrying out safety related tasks. Maintenance personnel qualification processes have improved significantly, and training plans have been designed and developed based on Systematic Approach to Training methodology to each job position. These improvements have been clearly reflected in recent training programmes with new training material and training facilities focused not only on developing technical knowledge and skills but also on improving attitudes and safety culture. The objectives of maintenance training facilities such as laboratories, mock-ups real an virtual, hydraulic loops, field simulators and other training material to be used in the maintenance training centre are to cover training necessities for initial and continuous qualification. Evidently, all these improvements made in the qualification of plant personnel should be extended to include supplemental personnel (external or contracted) performing safety-related tasks. The supplemental personnel constitute a very spread group, covering the performance of multiple activities entailing different levels of responsibility. Some of these activities are performed permanently at the plant, while others are occasional or sporadic. In order to establish qualification requirements for these supplemental workers, it is recommended to establish a rigorous analysis of job positions and tasks. The objective will be to identify the qualification requirements to assure competence and safety. (authors)

Halloysite reinforced epoxy composites with improved mechanical properties

Directory of Open Access Journals (Sweden)

Saif Muhammad Jawwad

2016-03-01

Full Text Available Halloysite nanotubes (HNTs reinforced epoxy composites with improved mechanical properties were prepared. The prepared HNTs reinforced epoxy composites demonstrated improved mechanical properties especially the fracture toughness and flexural strength. The flexural modulus of nanocomposite with 6% mHNTs loading was 11.8% higher than that of neat epoxy resin. In addition, the nanocomposites showed improved dimensional stability. The prepared halloysite reinforced epoxy composites were characterized by thermal gravimetric analysis (TGA. The improved properties are attributed to the unique characteristics of HNTs, uniform dispersion of reinforcement and interfacial coupling.

Towards Improved Human Resource Development In Nigeria ...

African Journals Online (AJOL)

Towards Improved Human Resource Development In Nigeria: Challenges And Prospects. ... Journal of Research in National Development ... Consequently, the paper recommended; improved investment in education, implementable policies on human resource development, involvement of private organization in human ...

DESIGN IMPROVEMENTS IN MODERN DISTRIBUTION TRANSFORMERS

OpenAIRE

Ćućić, Branimir; Meško, Nina; Mikulić, Martina; Trstoglavec, Dominik

2017-01-01

In the paper design improvements of distribution transformers related to improved energy efficiency and environmental awareness are discussed. Eco design of transformers, amorphous transformers, voltage regulated transformers and transformers filled with ester liquids are analyzed. As a consequence of growing energy efficiency importance, European Commission has adopted new regulation which defines maximum permissible levels of load and no-load losses of transformers with rated...

Balancing measures or a balanced accounting of improvement impact: a qualitative analysis of individual and focus group interviews with improvement experts in Scotland.

Science.gov (United States)

Toma, Madalina; Dreischulte, Tobias; Gray, Nicola M; Campbell, Diane; Guthrie, Bruce

2018-07-01

As quality improvement (QI) programmes have become progressively larger scale, the risks of implementation having unintended consequences are increasingly recognised. More routine use of balancing measures to monitor unintended consequences has been proposed to evaluate overall effectiveness, but in practice published improvement interventions hardly ever report identification or measurement of consequences other than intended goals of improvement. We conducted 15 semistructured interviews and two focus groups with 24 improvement experts to explore the current understanding of balancing measures in QI and inform a more balanced accounting of the overall impact of improvement interventions. Data were analysed iteratively using the framework approach. Participants described the consequences of improvement in terms of desirability/undesirability and the extent to which they were expected/unexpected when planning improvement. Four types of consequences were defined: expected desirable consequences ( goals ); expected undesirable consequences ( trade-offs ); unexpected undesirable consequences ( unpleasant surprises ); and unexpected desirable consequences ( pleasant surprises ). Unexpected consequences were considered important but rarely measured in existing programmes, and an improvement pause to take stock after implementation would allow these to be more actively identified and managed. A balanced accounting of all consequences of improvement interventions can facilitate staff engagement and reduce resistance to change, but has to be offset against the cost of additional data collection. Improvement measurement is usually focused on measuring intended goals , with minimal use of balancing measures which when used, typically monitor trade-offs expected before implementation. This paper proposes that improvers and leaders should seek a balanced accounting of all consequences of improvement across the life of an improvement programme, including deliberately pausing

ALA Pretreatment Improves Waterlogging Tolerance of Fig Plants.

Directory of Open Access Journals (Sweden)

Yuyan An

Full Text Available 5-aminolevulinic acid (ALA, a natural and environmentally friendly plant growth regulator, can improve plant tolerance to various environmental stresses. However, whether ALA can improve plant waterlogging tolerance is unknown. Here, we investigated the effects of ALA pretreatment on the waterlogging-induced damage of fig (Ficus carica Linn. plants, which often suffer from waterlogging stress. ALA pretreatment significantly alleviated stress-induced morphological damage, increased leaf relative water content (RWC, and reduced leaf superoxide anion ([Formula: see text] production rate and malonaldehyde (MDA content in fig leaves, indicating ALA mitigates waterlogging stress of fig plants. We further demonstrated that ALA pretreatment largely promoted leaf chlorophyll content, photosynthetic electron transfer ability, and photosynthetic performance index, indicating ALA significantly improves plant photosynthetic efficiency under waterlogging stress. Moreover, ALA pretreatment significantly increased activities of leaf superoxide dismutase (SOD and peroxidase (POD, root vigor, and activities of root alcohol dehydrogenase (ADH, and lactate dehydrogenase (LDH, indicating ALA also significantly improves antioxidant ability and root function of fig plants under waterlogging stress. Taken together, ALA pretreatment improves waterlogging tolerance of fig plants significantly, and the promoted root respiration, leaf photosynthesis, and antioxidant ability may contribute greatly to this improvement. Our data firstly shows that ALA can improve plant waterlogging tolerance.

Improving Exclusive Breastfeeding in an Urban Academic Hospital.

Science.gov (United States)

Ward, Laura P; Williamson, Susan; Burke, Stephanie; Crawford-Hemphill, Ruby; Thompson, Amy M

2017-02-01

Breastfeeding has many well-established health benefits for infants and mothers. There is greater risk reduction in health outcomes with exclusive breastfeeding (EBF). Our urban academic facility has had long-standing low EBF rates, serving a population with breastfeeding disparities. We sought to improve EBF rates through a Learning Collaborative model by participating in the Best Fed Beginnings project. Formal improvement science methods were used, including the development of a key driver diagram and plan-do-study-act cycles. Improvement activities followed the Ten Steps to Successful Breastfeeding. We demonstrated significant improvement in the median adherence to 2 process measures, rooming in and skin-to-skin after delivery. Subsequently, the proportion of infants exclusively breastfed at hospital discharge in our facility increased from 37% to 59%. We demonstrated an increase in sustained breastfeeding in a subset of patients at a postpartum follow-up visit. These improvements led to Baby-Friendly designation at our facility. This quality improvement initiative resulted in a higher number of infants exclusively breastfed in our patient population at "high risk not to breastfeed." Other hospitals can use these described methods and techniques to improve their EBF rates. Copyright © 2017 by the American Academy of Pediatrics.

Improved single ion cyclotron resonance mass spectroscopy

International Nuclear Information System (INIS)

Boyce, K.R.

1993-01-01

The author has improved the state of the art for precision mass spectroscopy of a mass doublet to below one part in 10 10 . By alternately loading single ions into a Penning trap, the author has determined the mass ratio M(CO + )/M(N + 2 ) = 0.999 598 887 74(11), an accuracy of 1 x 10 -10 . This is a factor of 4 improvement over previous measurements, and a factor of 10 better than the 1985 atomic mass table adjustment [WAA85a]. Much of the author's apparatus has been rebuilt, increasing the signal-to-noise ratio and improving the reliability of the machine. The typical time needed to make and cool a single ion has been reduced from about half an hour to under 5 minutes. This was done by a combination of faster ion-making and a much faster procedure for driving out ions of the wrong species. The improved S/N, in combination with a much better signal processing algorithm to extract the ion phase and frequency from the author's data, has substantially reduced the time required for the actual measurements. This is important now that the measurement time is a substantial fraction of the cycle time (the time to make a new ion and measure it). The improvements allow over 30 comparisons in one night, compared to 2 per night previously. This not only improves the statistics, but eliminates the possibility of large non-Gaussian errors due to sudden magnetic field shifts

Improving science, technology and mathematics education in ...

African Journals Online (AJOL)

PROF.MIREKU

STM as a result of the different motivation and sensitization workshops (F(4,231) .... improve the teaching and learning of S&T using a more creative, ... Improve teaching and learning methods by using modern approaches like activity based.

Tadpole-improved SU(2) lattice gauge theory

Science.gov (United States)

Shakespeare, Norman H.; Trottier, Howard D.

1999-01-01

A comprehensive analysis of tadpole-improved SU(2) lattice gauge theory is made. Simulations are done on isotropic and anisotropic lattices, with and without improvement. Two tadpole renormalization schemes are employed, one using average plaquettes, the other using mean links in the Landau gauge. Simulations are done with spatial lattice spacings as in the range of about 0.1-0.4 fm. Results are presented for the static quark potential, the renormalized lattice anisotropy at/as (where at is the ``temporal'' lattice spacing), and for the scalar and tensor glueball masses. Tadpole improvement significantly reduces discretization errors in the static quark potential and in the scalar glueball mass, and results in very little renormalization of the bare anisotropy that is input to the action. We also find that tadpole improvement using mean links in the Landau gauge results in smaller discretization errors in the scalar glueball mass (as well as in the static quark potential), compared to when average plaquettes are used. The possibility is also raised that further improvement in the scalar glueball mass may result when the coefficients of the operators which correct for discretization errors in the action are computed beyond the tree level.

Improving ISD Agility in Fast-Moving Software Organizations

DEFF Research Database (Denmark)

Persson, John Stouby; Nørbjerg, Jacob; Nielsen, Peter Axel

2016-01-01

Fast-moving software organizations must respond quickly to changing technological options and market trends while delivering high-quality services at competitive prices. Improving agility of information systems development (ISD) may reconcile these inherent tensions, but previous research...... study on how to improve ISD agility in a fast-moving software organization. The study maps central problems in the ISD management to direct improvements of agility. Our following intervention addressed method improvements in defining types of ISD by customer relations and integrating the method...... with the task management tool used by the organization. The paper discusses how the action research contributes to our understanding of ISD agility in fast-moving software organizations with a framework for mapping and evaluating improvements of agility. The action research specifically points out that project...

South Bank Coke Ovens heating performance improvements

Energy Technology Data Exchange (ETDEWEB)

Fraser, A.J. [South Bank Coke Ovens (United Kingdom)

1995-12-31

The coke oven batteries at South Bank Coke Ovens had a history of refractory failure, overheating, and poor environmental performance despite repeated attempts to solve the problem. The fundamental design was poor, but previous upgrade attempts had a history of short term improvements followed by renewed decline, suggesting that the problem may not merely with the equipment. An audit of the area showed multiple morale, equipment and communications problems, although a significant proportion of the workforce were interested in improving the situation. A group of those interested in performance improvements was called together and objectives agreed upon. Communications were upgraded and problem walls analysed for their particular weaknesses. A team approach was used for maintenance, leading to slowly improving pushing emission factors. Temperature control equipment ensured better environmental performance and lower electricity consumption. 5 refs., 3 figs.

Do Municipal Mergers Improve Fiscal Outcomes?

DEFF Research Database (Denmark)

Hansen, Sune Welling; Houlberg, Kurt; Holm Pedersen, Lene

2014-01-01

Improved fiscal management is a frequent justification for promoting boundary consolidations. However, whether or not this is actually the case is rarely placed under rigorous empirical scrutiny. Hence, this article investigates if fiscal outcomes are improved when municipalities are merged....... The basic argument is that the conceptualisation of fiscal management in political science is often too narrow as it focuses on the budget and pays hardly any attention to balances in the final accounts and debts – elements of management which are central to policy making. On this background, the causal...... relationship between municipal mergers and fiscal outcomes is analysed. Measured on the balance between revenues and expenses, liquid assets and debts, municipal mergers improve the fiscal outcomes of the municipalities in a five-year perspective, although the pre-reform effects tend to be negative...

Improved TOPSIS decision model for NPP emergencies

International Nuclear Information System (INIS)

Zhang Jin; Liu Feng; Huang Lian

2011-01-01

In this paper,an improved decision model is developed for its use as a tool to respond to emergencies at nuclear power plants. Given the complexity of multi-attribute emergency decision-making on nuclear accident, the improved TOPSIS method is used to build a decision-making model that integrates subjective weight and objective weight of each evaluation index. A comparison between the results of this new model and two traditional methods of fuzzy hierarchy analysis method and weighted analysis method demonstrates that the improved TOPSIS model has a better evaluation effect. (authors)

Communication Styles of Interactive Tools for Self-Improvement.

Science.gov (United States)

Niess, Jasmin; Diefenbach, Sarah

Interactive products for self-improvement (e.g., online trainings to reduce stress, fitness gadgets) have become increasingly popular among consumers and healthcare providers. In line with the idea of positive computing, these tools aim to support their users on their way to improved well-being and human flourishing. As an interdisciplinary domain, the design of self-improvement technologies requires psychological, technological, and design expertise. One needs to know how to support people in behavior change, and one needs to find ways to do this through technology design. However, as recent reviews show, the interlocking relationship between these disciplines is still improvable. Many existing technologies for self-improvement neglect psychological theory on behavior change, especially motivational factors are not sufficiently considered. To counteract this, we suggest a focus on the dialog and emerging communication between product and user, considering the self-improvement tool as an interactive coach and advisor. The present qualitative interview study (N = 18) explored the user experience of self-improvement technologies. A special focus was on the perceived dialog between tool and user, which we analyzed in terms of models from communication psychology. Our findings show that users are sensible to the way the product "speaks to them" and consider this as essential for their experience and successful change. Analysis revealed different communication styles of self-improvement tools (e.g., helpful-cooperative, rational-distanced, critical-aggressive), each linked to specific emotional consequences. These findings form one starting point for a more psychologically founded design of self-improvement technology. On a more general level, our approach aims to contribute to a better integration of psychological and technological knowledge, and in consequence, supporting users on their way to enhanced well-being.

Improving Software Developer's Competence

DEFF Research Database (Denmark)

Abrahamsson, Pekka; Kautz, Karlheinz; Sieppi, Heikki

2002-01-01

Emerging agile software development methods are people oriented development approaches to be used by the software industry. The personal software process (PSP) is an accepted method for improving the capabilities of a single software engineer. Five original hypotheses regarding the impact...

Genetic improvement of percids

NARCIS (Netherlands)

Blonk, R.J.W.; Komen, J.

2015-01-01

During the past years, breeding programs for aquaculture have shown fast development. Globally, economically highly relevant species have experienced implementation of large scale breeding programs and it is impossible to imagine life today without them as they significantly improve production

Can Schools Meet the Promise of Continuous Improvement?

Science.gov (United States)

Elgart, Mark A.

2018-01-01

Continuous improvement is "an embedded behavior within the culture of a school that constantly focuses on the conditions, processes, and practices that will improve teaching and learning." The phrase has been part of the lexicon of school improvement for decades, but real progress is rare. Based on its observations of about 5,000…

Improving the identification and management of chronic kidney disease in primary care: lessons from a staged improvement collaborative.

Science.gov (United States)

Harvey, Gill; Oliver, Kathryn; Humphreys, John; Rothwell, Katy; Hegarty, Janet

2015-02-01

Undiagnosed chronic kidney disease (CKD) contributes to a high cost and care burden in secondary care. Uptake of evidence-based guidelines in primary care is inconsistent, resulting in variation in the detection and management of CKD. Routinely collected general practice data in one UK region suggested a CKD prevalence of 4.1%, compared with an estimated national prevalence of 8.5%. Of patients on CKD registers, ∼ 30% were estimated to have suboptimal management according to Public Health Observatory analyses. An evidence-based framework for implementation was developed. This informed the design of an improvement collaborative to work with a sample of 30 general practices. A two-phase collaborative was implemented between September 2009 and March 2012. Key elements of the intervention included learning events, improvement targets, Plan-Do-Study-Act cycles, benchmarking of audit data, facilitator support and staff time reimbursement. Outcomes were evaluated against two indicators: number of patients with CKD on practice registers; percentage of patients achieving evidence-based blood pressure (BP) targets, as a marker for CKD care. In Phase 1, recorded prevalence of CKD in collaborative practices increased ∼ 2-fold more than that in comparator local practices; in Phase 2, this increased to 4-fold, indicating improved case identification. Management of BP according to guideline recommendations also improved. An improvement collaborative with tailored facilitation support appears to promote the uptake of evidence-based guidance on the identification and management of CKD in primary care. A controlled evaluation study is needed to rigorously evaluate the impact of this promising improvement intervention. © The Author 2014. Published by Oxford University Press in association with the International Society for Quality in Health Care.

Quality improvement activity for improving pain management in acute extremity injuries in the emergency department.

Science.gov (United States)

Chang, Hyung Lan; Jung, Jin Hee; Kwak, Young Ho; Kim, Do Kyun; Lee, Jin Hee; Jung, Jae Yun; Kwon, Hyuksool; Paek, So Hyun; Park, Joong Wan; Shin, Jonghwan

2018-03-01

The aim of this study was to investigate the effectiveness of a quality improvement activity for pain management in patients with extremity injury in the emergency department (ED). This was a retrospective interventional study. The patient group consisted of those at least 19 years of age who visited the ED and were diagnosed with International Classification of Diseases codes S40-S99 (extremity injuries). The quality improvement activity consisted of three measures: a survey regarding activities, education, and the triage nurse's pain assessment, including change of pain documentation on electronic medical records. The intervention was conducted from January to April in 2014 and outcome was compared between May and August in 2013 and 2014. The primary outcome was the rate of analgesic prescription, and the secondary outcome was the time to analgesic prescription. A total of 1,739 patients were included, and 20.3% of 867 patients in the pre-intervention period, and 28.8% of 872 patients in the post-intervention period received analgesics (P< 0.001). The prescription rate of analgesics for moderate-to-severe injuries was 36.4% in 2013 and 44.5% in 2014 (P=0.026). The time to analgesics prescription was 116.6 minutes (standard deviation 225.6) in 2013 and 64 minutes (standard deviation 75.5) in 2014 for all extremity injuries. The pain scoring increased from 1.4% to 51.6%. ED-based quality improvement activities including education and change of pain score documentation can improve the rate of analgesic prescription and time to prescription for patients with extremity injury in the ED.

Improved design features of KSNP+ BOP Fluid System

International Nuclear Information System (INIS)

Park, Heung Gyu; Yoon, Kyung Sup

2002-01-01

KOPEC (Korea Power Engineering Co.) in conjunction with the client KHNP (Korea Hydro and Nuclear Power Co.) has been developing the KSNP + (Improved Korean Standard Nuclear Power Plants) design concept since 1998. The main objective of the KSNP + is to enhance safety and economy of KSNP. The design concepts of the KSNP + will be implemented in Shin-Kori Units 1 and 2 Shin-Wolsung Units 1 and 2. This paper provides on an introduction to the improved design features of the KSNP + BOP fluid system consisting of 45 design improvement items. The design improvement concepts of the BOP fluid system have been developed as follows: optimization of system configuration and capacity, simplification of system, and adoption of advanced design features. Improved design features of the BOP fluid system allow additional benefits due to making a contribution to the optimization of plant arrangement and the reduction of operating costs during the plant life time. In conclusion, design improvement to the BOP fluid system have contributed to the KSNP + design concept being more reliable, safe and economically competitive

Process correlation analysis model for process improvement identification.

Science.gov (United States)

Choi, Su-jin; Kim, Dae-Kyoo; Park, Sooyong

2014-01-01

Software process improvement aims at improving the development process of software systems. It is initiated by process assessment identifying strengths and weaknesses and based on the findings, improvement plans are developed. In general, a process reference model (e.g., CMMI) is used throughout the process of software process improvement as the base. CMMI defines a set of process areas involved in software development and what to be carried out in process areas in terms of goals and practices. Process areas and their elements (goals and practices) are often correlated due to the iterative nature of software development process. However, in the current practice, correlations of process elements are often overlooked in the development of an improvement plan, which diminishes the efficiency of the plan. This is mainly attributed to significant efforts and the lack of required expertise. In this paper, we present a process correlation analysis model that helps identify correlations of process elements from the results of process assessment. This model is defined based on CMMI and empirical data of improvement practices. We evaluate the model using industrial data.

Improvements and Revamping of In-Core Instrumentation Systems

International Nuclear Information System (INIS)

Garam, Eric De

1993-01-01

The results of the improvements done by Fumarate Tia in these domains are really satisfying and it is clear that the problems of leakage existing in the old units on the thermocouples sealing systems and on the seal table of the income instrumentation, cannot exist on the French Units or on the units equipped with Fumarate Tia equipment. At the same time, all the equipment which constitute the Income instrumentation have been improved with the aim of reliability and safety. The equipment used to perform maintenance activities has also been improved to both reduce doses and increase efficiency. The purpose of this paper is to describe the principal improvements and revamping of income instrumentation systems, and to summarize the principal lessons learned from our experience on all designs of PWR. Fumarate Tia, is permanently looking for improving the existing systems of instrumentation with the aim of reduction of the dosimetry during the maintenance services, improvement of the liability and lifetime of the equipment, and of course reduction of the duration of the outages in keeping always the same level of quality

Transferring skills in quality collaboratives focused on improving patient logistics

NARCIS (Netherlands)

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

2018-01-01

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

Improving the environmental sustainability of a waste processing plant

International Nuclear Information System (INIS)

Turner, Tom; Watson, Stuart

2013-01-01

This paper describes how the level of environmental sustainability at the Solid Waste Processing plant at Research Sites Restoration Ltd (RSRL) Harwell was measured and improved. It provides reasons to improve environmental performance in an organisation, states best practice on how improvement should be conducted, and gives first-hand experience on how changes were implemented. In this paper sustainability is defined as 'meeting the needs of the present without compromising the ability of future generations to meet their own needs'. A baseline for environmental sustainability was created, by looking at multiple attributes. From this, a matrix was created to show how the baseline environmental performance compared to best practice, and a gap analysis was performed. Results from this analysis showed areas for potential systematic improvement, and actions were created. Nearly all actions were implemented within one year, and environmental sustainability improved significantly. Most improvements cost no money to implement, and the few that did had to pass criteria in a business case. Results from a company-wide survey showed that the vast majority of employees felt that environmental issues were important, and that they were willing to help improve performance. Environmental awareness training was given to everyone in the department, and individuals were given measurable improvement targets. A focus group was set up and met regularly to agree improvements and monitor results. Environmental performance was publicised regularly to highlight successes and seek further engagement and improvement. Improvement ideas were encouraged and managed in a transparent way which showed clear prioritisation and accountability. The culture of environmental improvement changed visibly and results at the end of the first year showed that electricity consumption had reduced by 12.5%, and gas consumption had reduced by 7.3%. In less than two years over UK Pound 60,000 was saved

Improving the environmental sustainability of a waste processing plant

Energy Technology Data Exchange (ETDEWEB)

Turner, Tom [AREVA RMC, Abingdon, Oxfordshire (United Kingdom); Watson, Stuart [RSRL, Harwell, Oxfordshire (United Kingdom)

2013-07-01

This paper describes how the level of environmental sustainability at the Solid Waste Processing plant at Research Sites Restoration Ltd (RSRL) Harwell was measured and improved. It provides reasons to improve environmental performance in an organisation, states best practice on how improvement should be conducted, and gives first-hand experience on how changes were implemented. In this paper sustainability is defined as 'meeting the needs of the present without compromising the ability of future generations to meet their own needs'. A baseline for environmental sustainability was created, by looking at multiple attributes. From this, a matrix was created to show how the baseline environmental performance compared to best practice, and a gap analysis was performed. Results from this analysis showed areas for potential systematic improvement, and actions were created. Nearly all actions were implemented within one year, and environmental sustainability improved significantly. Most improvements cost no money to implement, and the few that did had to pass criteria in a business case. Results from a company-wide survey showed that the vast majority of employees felt that environmental issues were important, and that they were willing to help improve performance. Environmental awareness training was given to everyone in the department, and individuals were given measurable improvement targets. A focus group was set up and met regularly to agree improvements and monitor results. Environmental performance was publicised regularly to highlight successes and seek further engagement and improvement. Improvement ideas were encouraged and managed in a transparent way which showed clear prioritisation and accountability. The culture of environmental improvement changed visibly and results at the end of the first year showed that electricity consumption had reduced by 12.5%, and gas consumption had reduced by 7.3%. In less than two years over UK Pound 60,000 was saved

Induced mutants for cereal grain protein improvement

International Nuclear Information System (INIS)

1982-01-01

Out of 17 papers and one summary presented, six dealing with the genetic improvement of seed protein using ionizing radiations fall within the INIS subject scope. Other topics discussed were non-radiation induced mutants used for cereal grain protein improvement

Automatic systems for assistance in improving pronunciations

CSIR Research Space (South Africa)

Badenhorst, JAC

2006-11-01

Full Text Available Improving the pronunciations of non-native language learners is an important task in a multilingual society. We focus on segmental aspects of pronunciation, and investigate the design of automated assistants that can be used to improve (1...

School effectiveness and school improvement : Sustaining links

NARCIS (Netherlands)

Creemers, B.P.M.; Reezigt, G.J.

1997-01-01

Ideally, school effectiveness research and school improvement might have a relationship with a surplus value for both. In reality, this relationship is often troublesome. Some problems can be attributed to the intrinsic differences between effectiveness and improvement, such as different missions.

Software process improvement, quality assurance and measurement

NARCIS (Netherlands)

Trienekens, J.J.M.; Kusters, R.J.; Balla, K.; Kontogiannis, K.; Zou, Y.; Di Penta, M.

2006-01-01

The aim of this workshop was to present and discuss emergent software quality improvement approaches, with an emphasis on practical applications. Different views on the improvement of software processes, software products, and their interrelations, have been addressed during the workshop.

Improved iodine status is associated with improved mental performance of schoolchildren in Benin.

Science.gov (United States)

van den Briel, T; West, C E; Bleichrodt, N; van de Vijver, F J; Ategbo, E A; Hautvast, J G

2000-11-01

An adequate iodine supply in utero and shortly after birth is known to be crucial to an individual's physical and mental development. The question of whether iodine supplementation later in life can exert a favorable influence on the mental performance of iodine-deficient populations was addressed in various studies, but with contradictory results. The aim of this study was to examine the effect of an improvement in iodine status on mental and psychomotor performance of schoolchildren (7-11 y) who were moderately to severely iodine deficient. The study, which was originally planned as a double-blind, randomized, placebo-controlled intervention, was carried out in an iodine-deficient population of schoolchildren (n = 196) in northern Benin. As the population began to have access to iodized salt during the 1-y intervention period, the study population was split post hoc-on the basis of urinary iodine concentrations-into a group with improved iodine status and a group with unchanged iodine status. Changes in mental and psychomotor performance over the intervention period were compared. Children with increased urinary iodine concentrations had a significantly greater increase in performance on the combination of mental tests than did the group with no change in urinary iodine concentrations. An improvement in iodine status, rather than iodine status itself, determined mental performance in this population, which was initially iodine deficient. These findings suggest a "catch-up" effect in terms of mental performance.

How to Sustain Change and Support Continuous Quality Improvement.

Science.gov (United States)

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

2016-05-06

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

Facial expression recognition based on improved deep belief networks

Science.gov (United States)

Wu, Yao; Qiu, Weigen

2017-08-01

In order to improve the robustness of facial expression recognition, a method of face expression recognition based on Local Binary Pattern (LBP) combined with improved deep belief networks (DBNs) is proposed. This method uses LBP to extract the feature, and then uses the improved deep belief networks as the detector and classifier to extract the LBP feature. The combination of LBP and improved deep belief networks is realized in facial expression recognition. In the JAFFE (Japanese Female Facial Expression) database on the recognition rate has improved significantly.

Quality Improvement Cycles that Reduced Waiting Times at ...

African Journals Online (AJOL)

It was decided to undertake quality improvement (QI) cycles to analyse and improve the situation, using waiting time as a measure of improvement. Methods: A QI team was chosen to conduct two QI cycles. The allocated time for QI cycle 1 was from May to August 2006 and for QI cycle 2 from September to December 2006.

Quick Guide on Making School Climate Improvements. School Climate Improvement Resource Package

Science.gov (United States)

National Center on Safe Supportive Learning Environments, 2016

2016-01-01

Students learn best when they are in environments in which they feel safe, supported, challenged, and accepted. In addition, environments that have strong school climates foster the social, emotional, and academic well-being of all students. Research shows that when schools and districts effectively focus on improving school climate, students are…

Goals and experience of performance improvement

Energy Technology Data Exchange (ETDEWEB)

Tan, H. [CNNO, CNNP, Nuclear Power Operations Management Co., Ltd. (China)

2015-07-01

Performance improvement was achieved by reasonable arrangement of planned window for related work and optimization of time for important maintenance items, outage quality and duration. Unplanned output loss has been reduced through routine unit management and improvements to both personnel skill and equipment reliability. Planned power generation loss is reduced by controlling planned duration and quality of forced shutdowns and outages, to ensure safe and stable plant operation.

Improvements of RGD3 TLD reader

International Nuclear Information System (INIS)

Zhao Jianxing; Wang Jiaqi; Li Yuanfang; Wu Furong; Xiao Wuyun

1999-01-01

The author summarized the main features of the improved RGD3 TLD reader. Through a large number of experiments some persuasive data are obtained, which show that an remarkable improvement has been achieved, especially in its stability to the standard illuminates, data dispersivity, and effectiveness to glow curves analysis. Working with the newly developed data processing software, the comprehensive performance of the whole system will be enhanced greatly

Using Optimization to Improve Test Planning

Science.gov (United States)

2017-09-01

OPTIMIZATION TO IMPROVE TEST PLANNING by Arlene M. Payne September 2017 Thesis Advisor: Jeffrey E. Kline Second Reader: Oleg A. Yakimenko THIS... Project (0704-0188) Washington, DC 20503. 1. AGENCY USE ONLY (Leave blank) 2. REPORT DATE September 2017 3. REPORT TYPE AND DATES COVERED Master’s...thesis 4. TITLE AND SUBTITLE USING OPTIMIZATION TO IMPROVE TEST PLANNING 5. FUNDING NUMBERS 6. AUTHOR(S) Arlene M. Payne 7. PERFORMING ORGANIZATION

Toyota production system quality improvement initiative improves perioperative antibiotic therapy.

Science.gov (United States)

Burkitt, Kelly H; Mor, Maria K; Jain, Rajiv; Kruszewski, Matthew S; McCray, Ellesha E; Moreland, Michael E; Muder, Robert R; Obrosky, David Scott; Sevick, Mary Ann; Wilson, Mark A; Fine, Michael J

2009-09-01

To assess the role of a Toyota production system (TPS) quality improvement (QI) intervention on appropriateness of perioperative antibiotic therapy and in length of hospital stay (LOS) among surgical patients. Pre-post quasi-experimental study using local and national retrospective cohorts. We used TPS methods to implement a multifaceted intervention to reduce nosocomial methicillin-resistant Staphylococcus aureus infections on a Veterans Affairs surgical unit, which led to a QI intervention targeting appropriate perioperative antibiotic prophylaxis. Appropriate perioperative antibiotic therapy was defined as selection of the recommended antibiotic agents for a duration not exceeding 24 hours from the time of the operation. The local computerized medical record system was used to identify patients undergoing the 25 most common surgical procedures and to examine changes in appropriate antibiotic therapy and LOS over time. Overall, 2550 surgical admissions were identified from the local computerized medical records. The proportion of surgical admissions receiving appropriate perioperative antibiotics was significantly higher (P <.01) in 2004 after initiation of the TPS intervention (44.0%) compared with the previous 4 years (range, 23.4%-29.8%) primarily because of improvements in compliance with antibiotic therapy duration rather than appropriate antibiotic selection. There was no statistically significant decrease in LOS over time. The use of TPS methods resulted in a QI intervention that was associated with an increase in appropriate perioperative antibiotic therapy among surgical patients, without affecting LOS.

Improved communication in post-ICU care by improving writing of ICU discharge letters: a longitudinal before-after study.

Science.gov (United States)

Medlock, Stephanie; Eslami, Saeid; Askari, Marjan; van Lieshout, Erik Jan; Dongelmans, Dave A; Abu-Hanna, Ameen

2011-11-01

The discharge letter is the primary means of communication at patient discharge, yet discharge letters are often not completed on time. A multifaceted intervention was performed to improve communication in patient hand-off from the intensive care unit (ICU) to the wards by improving the timeliness of discharge letters. A management directive was operationalised by a working group of ICU staff in a longitudinal before-after study. The intervention consisted of (a) changing policy to require a letter for use as a transfer note at the time of ICU discharge, (b) changing the assignment of responsibility to an automatic process, (c) leveraging positive peer pressure by making the list of patients in need of letters visible to colleagues and (d) provision of decision support, through automatic copying of important content from the patient record to the letter and email reminders if letters were not written on time. Statistical process control charts were used to monitor the longitudinal effect of the intervention. The intervention resulted in a 77.9% absolute improvement in the proportion of patients with a complete transfer note at the time of discharge, and an 85.2% absolute improvement in the number of discharge letters written. Statistical process control shows that the effect was sustained over time. A multifaceted intervention can be highly effective for improving discharge communication from the ICU.

Improvements in the construction of nuclear power plant

International Nuclear Information System (INIS)

1990-01-01

This paper outlines activities to minimize the amount of work at a construction site by employing installation method with large size blocks and shop-assembled units, improvement in facilities such as mechanization of welding and huge roof cover which enables work in all weather conditions, and administration systems using computer for the work activity control as well as quality and progress control for construction work. These improvements are only achieved when supported by related system improvements at the design and fabrication stage, and these improvements contributed a great deal to the quality assurance and the shorter construction period. (author)

New raw materials improve packing sealing efficiency

International Nuclear Information System (INIS)

Igel, B.; McKeague, L.

2012-01-01

End-users and OEM's using or manufacturing on/off and control valves expect a permanent and effective increase in service life together with an increased sealing capability while at the same time minimizing maintenance concerns. Developing materials which provide consistency and repeatability are essential characteristics to optimizing valve performance. “New Generation” materials and yarn allow us to meet this growing demand while complying with the requirements related to chemical purity and an increased level of safety to both plant workers and equipment in the nuclear environment. Through R&D initiatives and developments in new and improved raw materials; a new mechanical packing generation which optimizes friction coefficients and extended life cycle has been introduced to the industry. Lower friction values drastically optimize actuator effort and size improving efficiency for stem operation with significant improvements in flow control of fluids. Combined with new and improved procedures (installation, torque levels and consolidation recommendations), this new packing generation has provided significant improvement in the mechanical behavior of packing materials (independent tests carried out in collaboration with AECL and CETIM) this has provided the opportunity to develop successful Valve Enhancement Programs which offer improved efficiency, valve operation and repeatability. These NEW generation yarns are available with or without wire reinforcement depending on specific operating parameters and conditions. The purpose of this presentation is to demonstrate that new generation material(s). Which are available to the industry for AOV, MOV and Manual valves? - To highlight the steps taken in R&D and manufacturing contributing to the much improved yarns and finished packing products. - Comply and are designed to meet the stringent requirements in the nuclear industry - Simplify valve maintenance without risk to safety or performance - Increase service

Quality Improvement of Liver Ultrasound Images Using Fuzzy Techniques.

Science.gov (United States)

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

2016-12-01

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

Improving adolescent maternal health

African Journals Online (AJOL)

2 Department of Obstetrics and Gynaecology, Faculty of Health Sciences, Nelson R ... of information concerning their bodies and ..... improve quality of healthcare services for adolescents[15] – services that .... equipment, medicines, supplies and technology needed to ensure effective service provision to adolescents.

Improving the workplace environment

CSIR Research Space (South Africa)

Gledhill, Irvy MA

2014-08-01

Full Text Available Research has shown that companies with more diversity and a better workplace perform better. So what makes a good workplace in physics, where women and men can work to their full potential? In the Improving the Workplace Environment workshop...

Driving collaborative improvement processes

NARCIS (Netherlands)

Middel, H.G.A.; Gieskes, J.F.B.; Fisscher, O.A.M.

2002-01-01

Continuous Improvement is a consolidated concept in theory and practice, mainly in the context of stand-alone companies. However, the battlefield of competition is increasingly moving from the level of individual firms to that of organisational settings based on loose company boundaries and

Driving collaborative improvement processes

NARCIS (Netherlands)

Middel, H.G.A.; Gieskes, J.F.B.; Fisscher, O.A.M.

2005-01-01

Continuous improvement is a consolidated concept in theory and practice, mainly in the context of stand-alone companies. However, the battlefield of competition is increasingly moving from the level of individual firms to that of organizational settings based on loose company boundaries and

Methodology of quality improvement projects for the Texas Medicare population.

Science.gov (United States)

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

1998-07-01

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

Social network analysis in software process improvement

DEFF Research Database (Denmark)

Nielsen, Peter Axel; Tjørnehøj, Gitte

2010-01-01

Software process improvement in small organisation is often problematic and communication and knowledge sharing is more informal. To improve software processes we need to understand how they communicate and share knowledge. In this article have studied the company SmallSoft through action research...

Improvement for BWR operator training

International Nuclear Information System (INIS)

Kurisu, Takanori; Takahashi, Yoshitaka; Harada, Mitsuhiro; Takahashi, Iwao.

1988-01-01

BWR Operator Training Center was founded in April, 1971, and in April, 1974, training was begun, since then, 13 years elapsed. During this period, the curriculum and training facilities were strengthened to meet the training needs, and the new training techniques from different viewpoint were developed, thus the improvement of training has been done. In this report, a number of the training techniques which have been developed and adopted recently, and are effective for the improvement of the knowledge and skill of operators are described. Recently Japanese nuclear power stations have been operated at stable high capacity factor, accordingly the chance of experiencing the occurrence of abnormality and the usual start and stop of plants decreased, and the training of operators using simulators becomes more important. The basic concept on training is explained. In the standard training course and the short period fundamental course, the development of the guide for reviewing lessons, the utilization of VTRs and the development of the techniques for diagnosing individual degree of learning were carried out. The problems, the points of improvement and the results of these are reported. (Kako, I.)

Program improvement and applications

International Nuclear Information System (INIS)

Hink, M.; Imke, U.; Pfrang, W.; Porscha, B.; Struwe, D.; Zimmerer, W.; Allan, P.

1995-01-01

An account is given about further improvements of the SAS4A-Ref. 94.R0 version of the HCDA code. They concern in particular the DEFORM fuel rod deformation module. For a validation of the new code version, various CABRI experiments have been calculated, especially tests with high burnup fuel rods. Progress was shown to be achieved, but the precise timing and location of the observed fuel failures is still hard to calculate. The work was performed in close cooperation with partners in France, Britain, and Japan. An important application concerns the CAPRA project of a reactor for actinide burning. Its behavior under ULOF conditions was analyzed using the improved SAS4A Ref. 94 R0 code. The core design turned out to tend toward a long-term coolable configuration even more so than the EFR core design would do in an ULOF. (orig.)

Improving the efficiency of aerodynamic shape optimization

Science.gov (United States)

Burgreen, Greg W.; Baysal, Oktay; Eleshaky, Mohamed E.

1994-01-01

The computational efficiency of an aerodynamic shape optimization procedure that is based on discrete sensitivity analysis is increased through the implementation of two improvements. The first improvement involves replacing a grid-point-based approach for surface representation with a Bezier-Bernstein polynomial parameterization of the surface. Explicit analytical expressions for the grid sensitivity terms are developed for both approaches. The second improvement proposes the use of Newton's method in lieu of an alternating direction implicit methodology to calculate the highly converged flow solutions that are required to compute the sensitivity coefficients. The modified design procedure is demonstrated by optimizing the shape of an internal-external nozzle configuration. Practically identical optimization results are obtained that are independent of the method used to represent the surface. A substantial factor of 8 decrease in computational time for the optimization process is achieved by implementing both of the design procedure improvements.

Improvement of shearing machine in the Tokai Reprocessing Plant

International Nuclear Information System (INIS)

Takae, Akiyoshi; Otani, Yoshikuni

1994-01-01

The shearing machine in the Tokai Reprocessing Plant has been improved and refurbished through its operational experience for about 20 years. Every component except the shear housing and magazine is changed for improved things by PNC, while the shearing machine had been designed and fabricated originally by a French Company. The improvement of the shearing machine was carried out for the purpose of settling the problems which were experienced in the past operation, and improving durability, remote maintainability, and operability. The details of their improvement work are described. (author)

Improved Neutron Scintillators Based on Nanomaterials

International Nuclear Information System (INIS)

Friesel, Dennis

2008-01-01

The development work conducted in this SBIR has so far not supported the premise that using nano-particles in LiFZnS:Ag foils improves their transparency to 420 (or other frequency) light. This conclusion is based solely on the light absorption properties of LiFZnS foils fabricated from nano- and from micro-particles. Furthermore, even for the case of the Gd 2 O 3 foils, the transmission of 420 nm light gained by using nano-particles all but disappears as the foil thickness is increased beyond about 0.2 mm, a practical scintillator thickness. This was not immediately apparent from the preliminary study since no foils thicker than about 0.04 mm were produced. Initially it was believed that the failure to see an improvement by using nano-particles for the LiFZnS foils was caused by the clumping of the particles in Toluene due to the polarity of the ZnS particles. However, we found, much to our surprise, that nano-particle ZnS alone in polystyrene, and in Epoxy, had worse light transmission properties than the micro-particle foils for equivalent thickness and density foils. The neutron detection measurements, while disappointing, are attributable to our inability to procure or fabricate Bulk Doped ZnS nanoparticles. The cause for the failure of nano-particles to improve the scintillation light, and hence improved neutron detection efficiency, is a fundamental one of light scattering within the scintillator. A consequence of PartTec's documentation of this is that several concepts for the fabrication of improved 6 LiFZnS scintillators were formulated that will be the subject of a future SBIR submission.

Improving regulatory oversight of maintenance programs

International Nuclear Information System (INIS)

Cook, S.

2008-01-01

Safe nuclear power plant operation requires that risks due to failure or unavailability of Structures, Systems and Components (SSCs) be minimized. Implementation of an effective maintenance program is a key means for achieving this goal. In its regulatory framework, the important relationship between maintenance and safety is acknowledged by the CNSC. A high level maintenance program requirement is included in the Class I Facilities Regulations. In addition, the operating licence contains a condition based on the principle that the design function and performance of SSCs needs to remain consistent with the plant's design and analysis documents. Nuclear power plant licensees have the primary responsibility for safe operation of their facilities and consequently for implementation of a successful maintenance program. The oversight role of the Canadian Nuclear Safety Commission (CNSC) is to ensure that the licensee carries out that responsibility. The challenge for the CNSC is how to do this consistently and efficiently. Three opportunities for improvement to regulatory maintenance oversight are being pursued. These are related to the regulatory framework, compliance verification inspection activities and monitoring of self-reporting. The regulatory framework has been improved by clarifying expectations through the issuance of S-210 'Maintenance Programs for Nuclear Power Plants'. Inspection activities have been improved by introducing new maintenance inspections into the baseline program. Monitoring is being improved by making better use of self-reported and industry produced maintenance related performance indicators. As with any type of program change, the challenge is to ensure the consistent and optimal application of regulatory activities and resources. This paper is a summary of the CNSC's approach to improving its maintenance oversight strategy. (author)

Getting started with the model for improvement: psychology and leadership in quality improvement.

Science.gov (United States)

Pratap, J Nick; Varughese, Anna M; Adler, Elena; Kurth, C Dean

2013-02-01

Although the case for quality in hospitals is compelling, doctors are often uncertain how to achieve it. This article forms the third and final part of a series providing practical guidance on getting started with a first quality improvement project. Introduction.

Improving designer productivity. [artificial intelligence

Science.gov (United States)

Hill, Gary C.

1992-01-01

Designer and design team productivity improves with skill, experience, and the tools available. The design process involves numerous trials and errors, analyses, refinements, and addition of details. Computerized tools have greatly speeded the analysis, and now new theories and methods, emerging under the label Artificial Intelligence (AI), are being used to automate skill and experience. These tools improve designer productivity by capturing experience, emulating recognized skillful designers, and making the essence of complex programs easier to grasp. This paper outlines the aircraft design process in today's technology and business climate, presenting some of the challenges ahead and some of the promising AI methods for meeting these challenges.

Improved multivariate polynomial factoring algorithm

International Nuclear Information System (INIS)

Wang, P.S.

1978-01-01

A new algorithm for factoring multivariate polynomials over the integers based on an algorithm by Wang and Rothschild is described. The new algorithm has improved strategies for dealing with the known problems of the original algorithm, namely, the leading coefficient problem, the bad-zero problem and the occurrence of extraneous factors. It has an algorithm for correctly predetermining leading coefficients of the factors. A new and efficient p-adic algorithm named EEZ is described. Bascially it is a linearly convergent variable-by-variable parallel construction. The improved algorithm is generally faster and requires less store then the original algorithm. Machine examples with comparative timing are included

Improvements to well scintillation counters

International Nuclear Information System (INIS)

Farukhi, M.R.; Mataraza, G.A.; Wimer, O.D.

1977-01-01

This invention relates to the field of ionising radiation detection. It concerns in particular scintillation detectors of the type that is commonly used in conjunction with a photomultiplier tube and that is used for monitoring radiation, for instance in the clinical measurements of isotopes. This invention enables well scintillation counters to be made, characterised by a high efficiency in measuring the thindown rate of radio-pharmaceutical solutions and to resolve the distribution of energy emanating from the radioactive source. It particularly consists in improving the uniformity of the luminous efficiency, the quality of the resolution and the efficiency whilst improving the reception of light [fr

Acute exercise improves motor memory

DEFF Research Database (Denmark)

Skriver, Kasper Christen; Roig, Marc; Lundbye-Jensen, Jesper

2014-01-01

We have recently shown that a single bout of acute cardiovascular exercise improves motor skill learning through an optimization of long-term motor memory. Here we expand this previous finding, to explore potential exercise-related biomarkers and their association with measures of motor memory...... practice whereas lactate correlated with better retention 1 hour as well as 24 hours and 7 days after practice. Thus, improvements in motor skill acquisition and retention induced by acute cardiovascular exercise are associated with increased concentrations of biomarkers involved in memory and learning...... processes. More mechanistic studies are required to elucidate the specific role of each biomarker in the formation of motor memory....

PSR extraction kicker system improvements

International Nuclear Information System (INIS)

Hardek, T.W.

1991-01-01

A program to improve the reliability of hardware required to operate the Los Alamos Proton Storage Ring has been under way for the past three years. The extraction kicker system for the PSR was identified as one candidate for improvement. Pulse modulators produce 50kV pulses 360 nsec in length at up to 24-Hz pulse repetition rate and drive two 4-meter-long stripline electrodes. Sources of difficulty with this system included short width switch tube lifetime, drive cable electrical breakdown, high-voltage connector failure, and occasional electrode breakdown. This paper discusses modifications completed on this system to correct these difficulties. 2 refs., 3 figs

New technologies and animal improvement

International Nuclear Information System (INIS)

Land, R.B.

1988-01-01

The simplification of genetic selection to the pragmatic choice of an appropriate base population, together with the adoption of such techniques as multiple ovulation and embryo transfer to accelerate the rate of response within the chosen population, would increase the contribution of genetic methods to the improvement of the performance of domestic animals. This is particularly relevant to developing countries where limited funds may constrain the opportunities for husbandry improvement, where it is important to select animals under the local conditions and where the infrastructure might limit the use of extensive programmes such as those based on progeny testing. (author). 5 refs, 1 tab

Improved ATIR concentrator photovoltaic module

Science.gov (United States)

Adriani, Paul M.; Mao, Erwang

2013-09-01

Novel aggregated total internal reflection (ATIR) concentrator photovoltaic module design comprises 2-D shaped primary and secondary optics that effectively combine optical efficiency, low profile, convenient range of acceptance angles, reliability, and manufacturability. This novel optical design builds upon previous investigations by improving the shapes of primary and secondary optics to enable improved long-term reliability and manufacturability. This low profile, low concentration (5x to 10x) design fits well with one-axis trackers that are often used for flat plate crystalline silicon photovoltaic modules in large scale ground mount installations. Standard mounting points, materials, and procedures apply without changes from flat plate modules.

Error review: Can this improve reporting performance?

International Nuclear Information System (INIS)

Tudor, Gareth R.; Finlay, David B.

2001-01-01

AIM: This study aimed to assess whether error review can improve radiologists' reporting performance. MATERIALS AND METHODS: Ten Consultant Radiologists reported 50 plain radiographs, in which the diagnoses were established. Eighteen of the radiographs were normal, 32 showed an abnormality. The radiologists were shown their errors and then re-reported the series of radiographs after an interval of 4-5 months. The accuracy of the reports to the established diagnoses was assessed. Chi-square test was used to calculate the difference between the viewings. RESULTS: On re-reporting the radiographs, seven radiologists improved their accuracy score, two had a lower score and one radiologist showed no score difference. Mean accuracy pre-education was 82.2%, (range 78-92%) and post-education was 88%, (range 76-96%). Individually, two of the radiologists showed a statistically significant improvement post-education (P < 0.01,P < 0.05). Assessing the group as a whole, there was a trend for improvement post-education but this did not reach statistical significance. Assessing only the radiographs where errors were made on the initial viewing, for the group as a whole there was a 63% improvement post-education. CONCLUSION: We suggest that radiologists benefit from error review, although there was not a statistically significant improvement for the series of radiographs in total. This is partly explained by the fact that some radiologists gave incorrect responses post-education that had initially been correct, thus masking the effect of the educational intervention. Tudor, G.R. and Finlay, D.B. (2001

Improving Sound Systems by Electrical Means

DEFF Research Database (Denmark)

Schneider, Henrik

to intelligent control and protection functionality and so on. In this work different strategies towards improvements of sound systems by electrical means was investigated considering the interfaces between each component and the performance of the full system. The strategies can be categorized by improvements...... reduction in the best case. This technology is very promising since it compensates for most distortion mechanisms of the transducer such as non-linearities, production variation, wear-n-tear, temperature changes and so on. Furthermore the accelerometer output can be used for protection purposes. The only...... of the bended copper foils to optimize the DC resistance. The DC resistance was reduced by 30 % compared to the starting point for a 10 turn toroidal inductor using this method. The combined work indicate that large sound system improvements are in reach by use of electrical means. Innovative solutions have...

How benchmarking can improve patient nutrition.

Science.gov (United States)

Ellis, Jane

Benchmarking is a tool that originated in business to enable organisations to compare their services with industry-wide best practice. Early last year the Department of Health published The Essence of Care, a benchmarking toolkit adapted for use in health care. It focuses on eight elements of care that are crucial to patients' experiences. Nurses and other health care professionals at a London NHS trust have begun a trust-wide benchmarking project. The aim is to improve patients' experiences of health care by sharing and comparing information, and by identifying examples of good practice and areas for improvement. The project began with two of the eight elements of The Essence of Care, with the intention of covering the rest later. This article describes the benchmarking process for nutrition and some of the consequent improvements in care.

Football to improve math and reading performance

NARCIS (Netherlands)

Van Klaveren, Chris; De Witte, Kristof

2015-01-01

Schools frequently increase the instructional time to improve primary school children's math and reading skills. There is, however, little evidence that math and reading skills are effectively improved by these instruction-time increases. This study evaluates ‘Playing for Success’ (PfS), an extended

Survival prediction algorithms miss significant opportunities for improvement if used for case selection in trauma quality improvement programs.

Science.gov (United States)

Heim, Catherine; Cole, Elaine; West, Anita; Tai, Nigel; Brohi, Karim

2016-09-01

Quality improvement (QI) programs have shown to reduce preventable mortality in trauma care. Detailed review of all trauma deaths is a time and resource consuming process and calculated probability of survival (Ps) has been proposed as audit filter. Review is limited on deaths that were 'expected to survive'. However no Ps-based algorithm has been validated and no study has examined elements of preventability associated with deaths classified as 'expected'. The objective of this study was to examine whether trauma performance review can be streamlined using existing mortality prediction tools without missing important areas for improvement. We conducted a retrospective study of all trauma deaths reviewed by our trauma QI program. Deaths were classified into non-preventable, possibly preventable, probably preventable or preventable. Opportunities for improvement (OPIs) involve failure in the process of care and were classified into clinical and system deviations from standards of care. TRISS and PS were used for calculation of probability of survival. Peer-review charts were reviewed by a single investigator. Over 8 years, 626 patients were included. One third showed elements of preventability and 4% were preventable. Preventability occurred across the entire range of the calculated Ps band. Limiting review to unexpected deaths would have missed over 50% of all preventability issues and a third of preventable deaths. 37% of patients showed opportunities for improvement (OPIs). Neither TRISS nor PS allowed for reliable identification of OPIs and limiting peer-review to patients with unexpected deaths would have missed close to 60% of all issues in care. TRISS and PS fail to identify a significant proportion of avoidable deaths and miss important opportunities for process and system improvement. Based on this, all trauma deaths should be subjected to expert panel review in order to aim at a maximal output of performance improvement programs. Copyright © 2016 Elsevier

Recent technology on steam turbine performance improvement

International Nuclear Information System (INIS)

Hirada, M.; Watanabe, E.; Tashiro, H.

1991-01-01

Continuous efforts have been made to improve turbine efficiency by applying the latest aerodynamic technologies to meet the energy saving requirement. In recent years, there has been considerable improvement in the field of computational fluid dynamics and these new technologies have been applied to the new blade design for HP, IP and LP turbines. Experimental verification for the new blade in turbine tests has established the overall turbine performance improvement and the excellent correspondence of flow pattern to the predicted value. This paper introduces the latest design technologies for the newly developed high efficiency blade and the verification test results

Improving the Measurement of Earnings Dynamics

DEFF Research Database (Denmark)

Daly, Moira K.; Hryshko, Dmytro; Manovskii, Iourii

The stochastic process for earnings is the key element of incomplete markets models in modern quantitative macroeconomics. We show that a simple modification of the canonical process used in the literature leads to a dramatic improvement in the measurement of earnings dynamics in administrative....... Accounting for these effects enables more accurate analysis using quantitative models with permanent and transitory earnings risk, and improves empirical estimates of consumption insurance against permanent earnings shocks....

Improving Customer Service in Elderly Care

OpenAIRE

Nielsen, Chris

2015-01-01

The elderly care sector is increasingly facing more competition and demanding customers. This leads to a growing pressure on elderly care home providers to find new and improved solutions that will enhance their level of customer service. The will ensure that the elderly service provider is remaining competitive in the elderly care service marketplace. The purpose of this thesis is to identify areas for improvements and propose implementable solutions for enhancing the elderly care custom...

A simple lightning assimilation technique for improving ...

Science.gov (United States)

Convective rainfall is often a large source of error in retrospective modeling applications. In particular, positive rainfall biases commonly exist during summer months due to overactive convective parameterizations. In this study, lightning assimilation was applied in the Kain-Fritsch (KF) convective scheme to improve retrospective simulations using the Weather Research and Forecasting (WRF) model. The assimilation method has a straightforward approach: force KF deep convection where lightning is observed and, optionally, suppress deep convection where lightning is absent. WRF simulations were made with and without lightning assimilation over the continental United States for July 2012, July 2013, and January 2013. The simulations were evaluated against NCEP stage-IV precipitation data and MADIS near-surface meteorological observations. In general, the use of lightning assimilation considerably improves the simulation of summertime rainfall. For example, the July 2012 monthly averaged bias of 6 h accumulated rainfall is reduced from 0.54 to 0.07 mm and the spatial correlation is increased from 0.21 to 0.43 when lightning assimilation is used. Statistical measures of near-surface meteorological variables also are improved. Consistent improvements also are seen for the July 2013 case. These results suggest that this lightning assimilation technique has the potential to substantially improve simulation of warm-season rainfall in retrospective WRF applications. The

Idaho Chemical Processing Plant Process Efficiency improvements

International Nuclear Information System (INIS)

Griebenow, B.

1996-03-01

In response to decreasing funding levels available to support activities at the Idaho Chemical Processing Plant (ICPP) and a desire to be cost competitive, the Department of Energy Idaho Operations Office (DOE-ID) and Lockheed Idaho Technologies Company have increased their emphasis on cost-saving measures. The ICPP Effectiveness Improvement Initiative involves many activities to improve cost effectiveness and competitiveness. This report documents the methodology and results of one of those cost cutting measures, the Process Efficiency Improvement Activity. The Process Efficiency Improvement Activity performed a systematic review of major work processes at the ICPP to increase productivity and to identify nonvalue-added requirements. A two-phase approach was selected for the activity to allow for near-term implementation of relatively easy process modifications in the first phase while obtaining long-term continuous improvement in the second phase and beyond. Phase I of the initiative included a concentrated review of processes that had a high potential for cost savings with the intent of realizing savings in Fiscal Year 1996 (FY-96.) Phase II consists of implementing long-term strategies too complex for Phase I implementation and evaluation of processes not targeted for Phase I review. The Phase II effort is targeted for realizing cost savings in FY-97 and beyond

Proteomics: A Biotechnology Tool for Crop Improvement

Directory of Open Access Journals (Sweden)

Moustafa eEldakak

2013-02-01

Full Text Available A sharp decline in the availability of arable land and sufficient supply of irrigation water along with a continuous steep increase in food demands have exerted a pressure on farmers to produce more with fewer resources. A viable solution to release this pressure is to speed up the plant breeding process by employing biotechnology in breeding programs. The majority of biotechnological applications rely on information generated from various -omic technologies. The latest outstanding improvements in proteomic platforms and many other but related advances in plant biotechnology techniques offer various new ways to encourage the usage of these technologies by plant scientists for crop improvement programs. A combinatorial approach of accelerated gene discovery through genomics, proteomics, and other associated -omic branches of biotechnology, as an applied approach, is proving to be an effective way to speed up the crop improvement programs worldwide. In the near future, swift improvements in -omic databases are becoming critical and demand immediate attention for the effective utilization of these techniques to produce next-generation crops for the progressive farmers. Here, we have reviewed the recent advances in proteomics, as tools of biotechnology, which are offering great promise and leading the path towards crop improvement for sustainable agriculture.

Demystifying theory and its use in improvement

Science.gov (United States)

Davidoff, Frank; Dixon-Woods, Mary; Leviton, Laura; Michie, Susan

2015-01-01

The role and value of theory in improvement work in healthcare has been seriously underrecognised. We join others in proposing that more informed use of theory can strengthen improvement programmes and facilitate the evaluation of their effectiveness. Many professionals, including improvement practitioners, are unfortunately mystified—and alienated—by theory, which discourages them from using it in their work. In an effort to demystify theory we make the point in this paper that, far from being discretionary or superfluous, theory (‘reason-giving’), both informal and formal, is intimately woven into virtually all human endeavour. We explore the special characteristics of grand, mid-range and programme theory; consider the consequences of misusing theory or failing to use it; review the process of developing and applying programme theory; examine some emerging criteria of ‘good’ theory; and emphasise the value, as well as the challenge, of combining informal experience-based theory with formal, publicly developed theory. We conclude that although informal theory is always at work in improvement, practitioners are often not aware of it or do not make it explicit. The germane issue for improvement practitioners, therefore, is not whether they use theory but whether they make explicit the particular theory or theories, informal and formal, they actually use. PMID:25616279

Improved Ion-Channel Biosensors

Science.gov (United States)

Nadeau, Jay; White, Victor; Dougherty, Dennis; Maurer, Joshua

2004-01-01

An effort is underway to develop improved biosensors of a type based on ion channels in biomimetic membranes. These sensors are microfabricated from silicon and other materials compatible with silicon. As described, these sensors offer a number of advantages over prior sensors of this type.

IMPROVING THE SCHOOL ENVIRONMENT.

Science.gov (United States)

PETERS, JON S.; SCHNEIDER, RAYMOND C.

GUIDELINES FOR CREATING IMPROVED EDUCATIONAL ENVIRONMENTS ARE PRESENTED WITH SUPPLEMENTARY DRAWINGS, DIAGRAMS, AND PHOTOGRAPHS. POLICY DECISIONS ARE RELATED TO--(1) THE SCHOOL'S RESPONSIBILITY TO THE FUTURE, (2) INDUSTRY'S RULE IN EDUCATION, AND (3) BUILDING PROGRAM RESPONSIBILITIES. EDUCATIONAL PLANNING IS DISCUSSED IN TERMS OF--(1) ART…

Improved di-electric composition

Energy Technology Data Exchange (ETDEWEB)

Sharp, R C

1915-03-29

An improved di-electric composition is disclosed composed of pitch or bitumen which is melted, and to which is added, while molten, a quantity of finely ground or pulverized spent shale, the whole being mixed or stirred to make a homogeneous composition, substantially as described.

Promoting Continuous Quality Improvement in the Alabama Child Health Improvement Alliance Through Q-Sort Methodology and Learning Collaboratives.