WorldWideScience

Sample records for quality assurance health care

  1. Using management information systems to enhance health care quality assurance.

    Science.gov (United States)

    Rosser, L H; Kleiner, B H

    1995-01-01

    Examines how computers and quality assurance are being used to improve the quality of health care delivery. Traditional quality assurance methods have been limited in their ability to effectively manage the high volume of data generated by the health care process. Computers on the other hand are able to handle large volumes of data as well as monitor patient care activities in both the acute care and ambulatory care settings. Discusses the use of computers to collect and analyse patient data so that changes and problems can be identified. In addition, computer models for reminding physicians to order appropriate preventive health measures for their patients are presented. Concludes that the use of computers to augment quality improvement is essential if the quality of patient care and health promotion are to be improved.

  2. Measuring and Assuring the Quality of Home Health Care

    Science.gov (United States)

    Shaughnessy, Peter W.; Crisler, Kathryn S.; Schlenker, Robert E.; Arnold, Angela G.; Kramer, Andrew M.; Powell, Martha C.; Hittle, David F.

    1994-01-01

    The growth in home health care in the United States since 1970, and the exponential increase in the provision of Medicare-covered home health services over the past 5 years, underscores the critical need to assess the effectiveness of home health care in our society. This article presents conceptual and applied topics and approaches involved in assessing effectiveness through measuring the outcomes of home health care. Definitions are provided for a number of terms that relate to quality of care, outcome measures, risk adjustment, and quality assurance (QA) in home health care. The goal is to provide an overview of a potential systemwide approach to outcome-based QA that has its basis in a partnership between the home health industry and payers or regulators. PMID:10140157

  3. Measuring tangibility and assurance as determinants of service quality for public health care in South Africa

    Directory of Open Access Journals (Sweden)

    J. De Jager

    2007-12-01

    Full Text Available Purpose: The purpose of this research is to measure service quality offered to patients treated in a government controlled hospital in South Africa. Desig/Methodology/Approach: A service satisfaction survey was conducted amongst patients treated at a provincial hospital in Gauteng. The attitudes of the patients were tested regarding pre-identified service quality aspects related to health care. Tangibility and assurance categories are analysed for the purposes of this paper. A total of 583 in- and out-patients were selected at random and were personally interviewed. A five point Likert type scale was used to measure their expectations and perceived performance. Findings: These indicated patient dissatisfaction with both service quality dimensions measured, although significant differences exist between in- and out-patients. Personal safety and cleanliness of facilities were regarded as the most important variables in the assurance and tangibility dimensions. The level of satisfaction was the highest for clear information signage and communication at an understandable level in the tangibility-and assurance categories, respectively. Implications: This paper presents a comprehensive framework for prioritising important issues by provincial hospital management policy makers to satisfy patients' expectations and, because they have more authority over expenditure, the findings are important in the interest of supplying acceptable health care. Originality/Value: This study challenges existing work on health care services. Its significance lies in investigating the diversified health care needs and wants of various cultural groups in South Africa, because it focuses on service quality as experienced by in- and out-patients. It offers a new framework from an original South African perspective, focusing on differences and similarities between in- and outpatients of a Gauteng public hospital.

  4. Telemedicine spirometry training and quality assurance program in primary care centers of a public health system.

    Science.gov (United States)

    Marina Malanda, Nuria; López de Santa María, Elena; Gutiérrez, Asunción; Bayón, Juan Carlos; Garcia, Larraitz; Gáldiz, Juan B

    2014-04-01

    Forced spirometry is essential for diagnosing respiratory diseases and is widely used across levels of care. However, several studies have shown that spirometry quality in primary care is not ideal, with risks of misdiagnosis. Our objective was to assess the feasibility and performance of a telemedicine-based training and quality assurance program for forced spirometry in primary care. The two phases included (1) a 9-month pilot study involving 15 centers, in which spirometry tests were assessed by the Basque Office for Health Technology Assessment, and (2) the introduction of the program to all centers in the Public Basque Health Service. Technicians first received 4 h of training, and, subsequently, they sent all tests to the reference laboratory using the program. Quality assessment was performed in accordance with clinical guidelines (A and B, good; C-F, poor). In the first phase, 1,894 spirometry tests were assessed, showing an improvement in quality: acceptable quality tests increased from 57% at the beginning to 78% after 6 months and 83% after 9 months (passessed after the inclusion of 36 additional centers, maintaining the positive trend (61%, 87%, and 84% at the same time points; pquality of spirometry tests improved in all centers. (2) The program provides a tool for transferring data that allows monitoring of its quality and training of technicians who perform the tests. (3) This approach is useful for improving spirometry quality in the routine practice of a public health system.

  5. Global review of health care surveys using lot quality assurance sampling (LQAS), 1984-2004.

    Science.gov (United States)

    Robertson, Susan E; Valadez, Joseph J

    2006-09-01

    We conducted a global review on the use of lot quality assurance sampling (LQAS) to assess health care services, health behaviors, and disease burden. Publications and reports on LQAS surveys were sought from Medline and five other electronic databases; the World Health Organization; the World Bank; governments, nongovernmental organizations, and individual scientists. We identified a total of 805 LQAS surveys conducted by different management groups during January 1984 through December 2004. There was a striking increase in the annual number of LQAS surveys conducted in 2000-2004 (128/year) compared with 1984-1999 (10/year). Surveys were conducted in 55 countries, and in 12 of these countries there were 10 or more LQAS surveys. Geographically, 317 surveys (39.4%) were conducted in Africa, 197 (28.5%) in the Americas, 115 (14.3%) in the Eastern Mediterranean, 114 (14.2%) in South-East Asia, 48 (6.0%) in Europe, and 14 (1.8%) in the Western Pacific. Health care parameters varied, and some surveys assessed more than one parameter. There were 320 surveys about risk factors for HIV/AIDS/sexually transmitted infections; 266 surveys on immunization coverage, 240 surveys post-disasters, 224 surveys on women's health, 142 surveys on growth and nutrition, 136 surveys on diarrheal disease control, and 88 surveys on quality management. LQAS surveys to assess disease burden included 23 neonatal tetanus mortality surveys and 12 surveys on other diseases. LQAS is a practical field method which increasingly is being applied in assessment of preventive and curative health services, and may offer new research opportunities to social scientists. When LQAS data are collected recurrently at multiple time points, they can be used to measure the spatial variation in behavior change. Such data provide insight into understanding relationships between various investments in social, human, and physical capital, and into the effectiveness of different public health strategies in achieving

  6. [Quality assurance concepts in intensive care medicine].

    Science.gov (United States)

    Brinkmann, A; Braun, J P; Riessen, R; Dubb, R; Kaltwasser, A; Bingold, T M

    2015-11-01

    Intensive care medicine (ICM) is characterized by a high degree of complexity and requires intense communication and collaboration on interdisciplinary and multiprofessional levels. In order to achieve good quality of care in this environment and to prevent errors, a proactive quality and error management as well as a structured quality assurance system are essential. Since the early 1990s, German intensive care societies have developed concepts for quality management and assurance in ICM. In 2006, intensive care networks were founded in different states to support the implementation of evidence-based knowledge into clinical routine and to improve medical outcome, efficacy, and efficiency in ICM. Current instruments and concepts of quality assurance in German ICM include core intensive care data from the data registry DIVI REVERSI, quality indicators, peer review in intensive care, IQM peer review, and various certification processes. The first version of German ICM quality indicators was published in 2010 by an interdisciplinary and interprofessional expert commission. Key figures, indicators, and national benchmarks are intended to describe the quality of structures, processes, and outcomes in intensive care. Many of the quality assurance tools have proved to be useful in clinical practice, but nationwide implementation still can be improved.

  7. Developing cross-sectoral quality assurance for cataract surgery in the statutory quality assurance program of the German health care system: Experiences and lessons learned.

    Science.gov (United States)

    Bramesfeld, Anke; Pauletzki, Jürgen; Behrenz, Lars; Szecsenyi, Joachim; Willms, Gerald; Broge, Björn

    2015-08-01

    Since 2001, statutory external quality assurance (QA) for hospital care has been in place in the German health system. In 2009, the decision was taken to expand it to cross-sectoral procedures. This novel and unprecedented form of national QA aims at (1) making the quality procedures comparable that are provided both in inpatient and outpatient care, (2) following-up outcomes of hospital care after patients' discharge and (3) measuring the quality of complex treatment chains across interfaces. As a pioneer procedure a QA procedure in cataract surgery QA was developed. Using this as an example, challenges of cross-sectoral QA are highlighted. These challenges relate, in particular, to three technical problems: triggering cases for documentation, following-up patients' after hospital discharge, and the burden of documentation in outpatient care. These problems resulted finally in the haltering of the development of the QA procedure. However, the experiences gained with this first development of cross-sectoral QA inspired the reorientation and further development of the field in Germany. Future cross-sectoral QA will rigorously aim at keeping burden of documentation small. It will draw data for QA mainly at three sources: routine data, patient surveys and peer reviews using indicators. Policy implications of this reorientation are discussed. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  8. Health equity monitoring for healthcare quality assurance.

    Science.gov (United States)

    Cookson, R; Asaria, M; Ali, S; Shaw, R; Doran, T; Goldblatt, P

    2018-02-01

    Population-wide health equity monitoring remains isolated from mainstream healthcare quality assurance. As a result, healthcare organizations remain ill-informed about the health equity impacts of their decisions - despite becoming increasingly well-informed about quality of care for the average patient. We present a new and improved analytical approach to integrating health equity into mainstream healthcare quality assurance, illustrate how this approach has been applied in the English National Health Service, and discuss how it could be applied in other countries. We illustrate the approach using a key quality indicator that is widely used to assess how well healthcare is co-ordinated between primary, community and acute settings: emergency inpatient hospital admissions for ambulatory care sensitive chronic conditions ("potentially avoidable emergency admissions", for short). Whole-population data for 2015 on potentially avoidable emergency admissions in England were linked with neighborhood deprivation indices. Inequality within the populations served by 209 clinical commissioning groups (CCGs: care purchasing organizations with mean population 272,000) was compared against two benchmarks - national inequality and inequality within ten similar populations - using neighborhood-level models to simulate the gap in indirectly standardized admissions between most and least deprived neighborhoods. The modelled inequality gap for England was 927 potentially avoidable emergency admissions per 100,000 people, implying 263,894 excess hospitalizations associated with inequality. Against this national benchmark, 17% of CCGs had significantly worse-than-benchmark equity, and 23% significantly better. The corresponding figures were 11% and 12% respectively against the similar populations benchmark. Deprivation-related inequality in potentially avoidable emergency admissions varies substantially between English CCGs serving similar populations, beyond expected statistical

  9. Quality Assurance in Breast Health Care and Requirement for Accreditation in Specialized Units.

    Science.gov (United States)

    Güler, Sertaç Ata; Güllüoğlu, Bahadır M

    2014-07-01

    Breast health is a subject of increasing importance. The statistical increase in the frequency of breast cancer and the consequent increase in death rate increase the importance of quality of services to be provided for breast health. For these reasons, the minimum standards and optimum quality metrics of breast care provided to the community are determined. The quality parameters for breast care service include the results, the structure and the operation of services. Within this group, the results of breast health services are determined according to clinical results, patient satisfaction and financial condition. The structure of quality services should include interdisciplinary meetings, written standards for specific procedures and the existence of standardized reporting systems. Establishing breast centers that adopt integrated multidisciplinary working principles and their cost-effective maintenance are important in terms of operation of breast health services. The importance of using a "reviewing/auditing" procedure that checks if all of these functions existing in the health system are carried out at the desired level and an "accreditation" system indicating that the working breast units/centers provide minimum quality adequacy in all aspects, is undeniable. Currently, the accreditation system for breast centers is being used in the European Union and the United States for the last 5-10 years. This system is thought to provide standardization in breast care services, and is accepted as one of the important factors that resulted in reduction in mortality associated with breast cancer.

  10. Quality assured health care in certified breast centers and improvement of the prognosis of breast cancer patients.

    Science.gov (United States)

    Beckmann, Matthias W; Brucker, Cosima; Hanf, Volker; Rauh, Claudia; Bani, Mayada R; Knob, Stefanie; Petsch, Sabrina; Schick, Stefan; Fasching, Peter A; Hartmann, Arndt; Lux, Michael P; Häberle, Lothar

    2011-01-01

    Increasing effort has been put in the implementation and certification of breast centers in order to establish standardized, quality assured health care for breast cancer patients. The aim of this analysis was to investigate whether patients treated in certified breast centers (CBC) have a favorable prognosis as compared to patients treated outside of certified breast treatment units. The data of 3,940 patients with invasive nonmetastatic breast cancer were analyzed with regard to differences in patient and tumor characteristics and crude overall survival according to diagnosis in or outside CBC in Middle Franconia, Germany. Patient, tumor, and follow-up data were obtained from the clinical cancer registry. Patients in CBC were younger, and had lower disease stages and lower grading. Independent of the effects of these variables on overall survival, being treated at a CBC added to the prediction of overall survival. Patients treated at a CBC had a hazard ratio of 0.70 (95% confidence interval 0.52-0.93) in the adjusted Cox model. Independent from common prognostic factors, diagnosis and treatment of breast cancer at a CBC improves the prognosis of patients. It can be hypothesized that this effect is mediated through quality assured health care provided by the certification process. Copyright © 2011 S. Karger AG, Basel.

  11. Asian Care Certificate (ACC): a care quality assurance framework.

    Science.gov (United States)

    Talaie, Tony

    2018-04-16

    Purpose Quality assuring elderly care through a viable and feasible standard framework is a major challenge for Asian governments. Although several attempts have been made to tackle foreign care worker (FCW) shortage, assuring the quality of the care they provide has been overlooked. The original framework allowed a better control over service quality to assure the elderly about their care according to the agreed standards. The paper aims to discuss these issues. Design/methodology/approach Through several Japanese Governmental meetings, a new Asian Care Certificate (ACC) program is discussed based on the Japanese Care Certificate (JCC). The governments' representatives adopted the JCC to form the ACC, which enables the ACC board to evaluate care workers and to intervene whenever the desired quality level is not achieved. Findings The author describes a new program. The findings of this paper will be confirmed when the ACC is implemented. Practical implications Using the ACC framework, the challenge in providing a high-quality care service using FCWs across Asia would be partly resolved. FCWs' quality of life might also gradually improve especially regarding to their human rights. Originality/value The ACC provides a new framework. Its value is recognized if one considers that many Asian populations are rapidly aging and many governments compromise quality by employing overseas workers to solve care worker shortages.

  12. An operational health physics quality assurance program

    International Nuclear Information System (INIS)

    Costigan, S.A.; McAtee, J.L. III; Somers, W.M.; Huchton, R.L.

    1996-01-01

    DOE Order 5700.6C, Quality Assurance, stipulates QA requirements for all DOE activities. This order is now codified as 10CFR830.120, Nuclear Safety Management, Quality Assurance Requirements, which is applicable to DOE nuclear facilities. A Quality Assurance Management Plan (QAMP) was developed by the Health Physics Operations Group (ESH-1) at Los Alamos National Laboratory (LANL). The goal of the ESH-1 QAMP is to ensure that operational radiation protection activities meet the criteria outlined in DOE Order 5700.6C, DOE-ER-STD-6001-92 and 10CFR830.120. The ten required elements are QA Program, Personal Training and Qualifications, Quality Improvement, Documents and Records, Work Processes, Design, Procurement, Inspection and Acceptance Testing, Management Assessment and Independent Assessment. The QAMP has been useful for the development of QAMPs at nuclear facilities and has helped ensure uniformity of institutional requirements where Health Physics services are deployed to facilities. To implement a subset of QAMP requirements, a Quality Assurance Self-Evaluation Program (QASE) was established. This program provides a novel self-audit mechanism for the formal identification and correction of non-conforming items related to Operational Health Physics. Additionally, the QASE is a useful management tool for Radiological Control Technician Supervisors and staff and provides a tracking mechanism for ongoing problem areas. Data have been Collected for two calendar years on a number of concerns that fall into four general categories: radiological posting and labeling, instrumentation, monitoring requirements, and radiological documents/records

  13. [Quality assurance in occupational health services].

    Science.gov (United States)

    Michalak, J

    1996-01-01

    The general conditions influencing the quality assurance and audit in Polish occupational health services are presented. The factors promoting or hampering the implementation of quality assurance and audits are also discussed. The major influence on the transformation of Polish occupational health services in exorted by employers who are committed to cover the costs of the obligatory prophylactic examination of their employees. This is the factor which also contributes to the improvement of quality if services. The definitions of the most important terms are reviewed to highlight their accordance with the needs of occupational health services in Poland. The examples of audit are presented and the elements of selected methods of auditing are suggested to be adopted in Poland.

  14. [Quality assurance and quality management in intensive care].

    Science.gov (United States)

    Notz, K; Dubb, R; Kaltwasser, A; Hermes, C; Pfeffer, S

    2015-11-01

    Treatment success in hospitals, particularly in intensive care units, is directly tied to quality of structure, process, and outcomes. Technological and medical advancements lead to ever more complex treatment situations with highly specialized tasks in intensive care nursing. Quality criteria that can be used to describe and correctly measure those highly complex multiprofessional situations have only been recently developed and put into practice.In this article, it will be shown how quality in multiprofessional teams can be definded and assessed in daily clinical practice. Core aspects are the choice of a nursing theory, quality assurance measures, and quality management. One possible option of quality assurance is the use of standard operating procedures (SOPs). Quality can ultimately only be achieved if professional groups think beyond their boundaries, minimize errors, and establish and live out instructions and SOPs.

  15. Quality assurance for health and environmental chemistry: 1986

    International Nuclear Information System (INIS)

    Gautier, M.A.; Gladney, E.S.; Moss, W.D.; Phillips, M.B.; O'Malley, B.T.

    1987-11-01

    This report documents the continuing quality assurance efforts of the Health and Environmental Chemistry Group at the Los Alamos National Laboratory. The philosophy, methodology, and computing resources used by the quality assurance program to encompass the diversity of analytical chemistry practiced in the group are described. Included in the report are all quality assurance reference materials used, along with their certified or consensus concentrations, and all analytical chemistry quality assurance measurements made by HSE-9 during 1986. 27 refs., 3 figs

  16. District health care between quality assurance and crisis management. Possibilities within the limits, Mporokoso and Kaputa District, Zambia

    NARCIS (Netherlands)

    van Bergen, J. E.

    1995-01-01

    A tension exists between objectives of health policy makers to achieve high quality standards of care on one hand, and district multi-crisis reality in sub-Saharan Africa on the other hand where sheer survival of the (public) health system is questioned. The collapsing health services as well as the

  17. Tracking the Quality of Care for Sick Children Using Lot Quality Assurance Sampling: Targeting Improvements of Health Services in Jigawa, Nigeria

    OpenAIRE

    Oladele, Edward Adekola; Ormond, Louise; Adeyemi, Olusegun; Patrick, David; Okoh, Festus; Oresanya, Olusola Bukola; Valadez, Joseph J.

    2012-01-01

    BACKGROUND\\ud \\ud In Nigeria, 30% of child deaths are due to malaria. The National Malaria Control Program of Nigeria (NMCP) during 2009 initiated a program to improve the quality of paediatric malaria services delivered in health facilities (HF). This study reports a rapid approach used to assess the existing quality of services in Jigawa state at decentralised levels of the health system.\\ud \\ud METHODS\\ud \\ud NMCP selected Lot Quality Assurance Sampling (LQAS) to identify the variation in ...

  18. EVALUATION OF HEALTH CARE QUALITY

    Directory of Open Access Journals (Sweden)

    Zlatko Fras

    2002-12-01

    Full Text Available Background. It is possible to evaluate quality characteristics of different aspects of health care by many different measures. For these purposes, in various countries all over the world authorised institutions and/or agencies developed number of methodological accessories, criteria and tools for selection of more or less appropriately and optimally defined criteria and indicators of quality clinical performance.Conclusions. Recently we have started with activities for gradual introduction of systematic monitoring, assessment and improvement of quality of health care in Slovenia as well. One of the key prerequisites for selection of valid, practicable, efficient and reliable quality indicators is the establishment of continuous and methodologically appropriate system of development and implementation of evidence-based clinical practice guidelines. We started this process within the framework of national Health Sector Management Project, where all potential key stakeholders from health care sector participated. Also the project on Quality in Health Care in Slovenia, started, leaded and performed by the Medical Chamber of Slovenia, represents one of the important parallel starting steps towards assurance of reliable data on development/establishment of appropriate set of quality indicators and standards of health care in our country.

  19. Using lot quality assurance sampling to assess measurements for growth monitoring in a developing country's primary health care system.

    Science.gov (United States)

    Valadez, J J; Brown, L D; Vargas, W V; Morley, D

    1996-04-01

    Local supervisors used lot quality assurance sampling (LQAS) during routine household visits to assess the technical quality of Costa Rican community-based health workers (CHW): measuring and recording weights of children, interpreting their growth trend and providing nutrition education to mothers. Supervisors sampled 10 households in each of 12 Health Areas (4-8 hours per area). No more than two performance errors were allowed for each CHW. This LQAS decision rule resulted in judgments with a sensitivity and specificity of about 95 percent. Three categories of results are reported: (1) CHW adequately weighed children, calculated ages, identified children requiring nutritional services, and used the growth chart. (2) They needed to improve referral, education, and documentation skills. (3) The lack of system support to regularly provide growth cards, supplementary feeding to identified malnourished children, and other essential materials may have discouraged some CHW resulting in them not applying their skills. Supervisors regularly using LQAS should, by the sixth round of supervision, identify at least 90 percent of inadequately performing CHW. This paper demonstrates the strength of LQAS, namely, to be used easily by low level local health workers to identify poorly functioning components of growth monitoring and promotion.

  20. Quality assurance for health and environmental chemistry: 1989

    International Nuclear Information System (INIS)

    Gautier, M.A.; Gladney, E.S.; Koski, N.L.; Jones, E.A.; Phillips, M.B.; O'Malley, B.T.

    1990-12-01

    This report documents the continuing quality assurance efforts of the Health and Environmental Chemistry Group (HSE-9) at the Los Alamos National Laboratory. The philosophy, methodology, computing resources, and laboratory information management system used by the quality assurance program to encompass the diversity of analytical chemistry practiced in the group are described. Included in the report are all quality assurance reference materials used, along with their certified or consensus concentrations, and all analytical chemistry quality assurance measurements made by HSE-9 during 1989. 38 refs., 8 figs., 3 tabs

  1. Quality assurance

    International Nuclear Information System (INIS)

    Kunich, M.P.; Vieth, D.L.

    1989-01-01

    This paper provides a point/counterpoint view of a quality assurance director and a project manager. It presents numerous aspects of quality assurance requirements along with analyses as to the value of each

  2. Quality assurance

    International Nuclear Information System (INIS)

    Cante; Feger; Genevray; Hennion; Moneyron; Monneyron; Normand; Rastoin; Silberstein; Vaujour.

    1976-01-01

    The general principles of quality assurance and their applications within the French industrial and commercial regulations are presented. The conditions for the practical application of quality assurance to the different stages of the life of a nuclear power station (design, development, operation) are considered and a special mention is made of nuclear fuels and liquid sodium cooled reactors [fr

  3. Tracking the quality of care for sick children using lot quality assurance sampling: targeting improvements of health services in Jigawa, Nigeria.

    Directory of Open Access Journals (Sweden)

    Edward Adekola Oladele

    Full Text Available BACKGROUND: In Nigeria, 30% of child deaths are due to malaria. The National Malaria Control Program of Nigeria (NMCP during 2009 initiated a program to improve the quality of paediatric malaria services delivered in health facilities (HF. This study reports a rapid approach used to assess the existing quality of services in Jigawa state at decentralised levels of the health system. METHODS: NMCP selected Lot Quality Assurance Sampling (LQAS to identify the variation in HF service quality among Senatorial Districts (SD. LQAS was selected because it was affordable and could be used by local health workers (HW in a population-based survey. NMCP applied a 2-stage LQAS using a structured Rapid Health Facility Assessment (R-HFA tool to identify high and low performing SD for specified indicators. FINDINGS: LQAS identified variations in HF performance (n = 21 and enabled resources to be targeted to address priorities. All SD exhibited deficient essential services, supplies and equipment. Only 9.7% of HF had Artemisinin-based Combination Therapies and other first-line treatments for childhood illnesses. No SD and few HF exhibited adequate HW performance for the assessment, treatment or counselling of sick children. Using the IMCI algorithm, 17.5% of HW assessed the child's vaccination status, 46.8% assessed nutritional status, and 65.1% assessed children for dehydration. Only 5.1% of HW treatments were appropriate for the assessment. Exit interviews revealed that 5.1% of caregivers knew their children's illness, and only 19.9% could accurately describe how to administer the prescribed drug. CONCLUSION: This R-HFA, using LQAS principles, is a rapid, simple tool for assessing malaria services and can be used at scale. It identified technical deficiencies that could be corrected by improved continuing medical education, targeted supervision, and recurrent R-HFA assessments of the quality of services.

  4. Tracking the quality of care for sick children using lot quality assurance sampling: targeting improvements of health services in Jigawa, Nigeria.

    Science.gov (United States)

    Oladele, Edward Adekola; Ormond, Louise; Adeyemi, Olusegun; Patrick, David; Okoh, Festus; Oresanya, Olusola Bukola; Valadez, Joseph J

    2012-01-01

    In Nigeria, 30% of child deaths are due to malaria. The National Malaria Control Program of Nigeria (NMCP) during 2009 initiated a program to improve the quality of paediatric malaria services delivered in health facilities (HF). This study reports a rapid approach used to assess the existing quality of services in Jigawa state at decentralised levels of the health system. NMCP selected Lot Quality Assurance Sampling (LQAS) to identify the variation in HF service quality among Senatorial Districts (SD). LQAS was selected because it was affordable and could be used by local health workers (HW) in a population-based survey. NMCP applied a 2-stage LQAS using a structured Rapid Health Facility Assessment (R-HFA) tool to identify high and low performing SD for specified indicators. LQAS identified variations in HF performance (n = 21) and enabled resources to be targeted to address priorities. All SD exhibited deficient essential services, supplies and equipment. Only 9.7% of HF had Artemisinin-based Combination Therapies and other first-line treatments for childhood illnesses. No SD and few HF exhibited adequate HW performance for the assessment, treatment or counselling of sick children. Using the IMCI algorithm, 17.5% of HW assessed the child's vaccination status, 46.8% assessed nutritional status, and 65.1% assessed children for dehydration. Only 5.1% of HW treatments were appropriate for the assessment. Exit interviews revealed that 5.1% of caregivers knew their children's illness, and only 19.9% could accurately describe how to administer the prescribed drug. This R-HFA, using LQAS principles, is a rapid, simple tool for assessing malaria services and can be used at scale. It identified technical deficiencies that could be corrected by improved continuing medical education, targeted supervision, and recurrent R-HFA assessments of the quality of services.

  5. Quality assurance

    International Nuclear Information System (INIS)

    1996-01-01

    The main efforts of Nuclear Regulatory Authority of the Slovak Republic (NRA SR) was focused on support of quality assurance programmes development at responsible organizations Bohunice V-1 and V-v and Mochovce NPPs and their inspection. Development of the level two documentation of a partial quality assurance programme for NPP operation continued at Mochovce NPP. Most of documentation has been submitted to NRA SR for comments and approval. NRA SR invited a mission of French experts to Mochovce NPP to review preparation and performance of internal audits that would be beneficial for improvement in this kind activities at the NPP. Bohunice NPP continued in development of a partial quality assurance programme for operation. The Quality Assurance Programme submitted to NRA SR for approval. Based on a request of Bohunice NPPs, NRA SR consulted the draft quality assurance programme developed by Siemens for stage of the 'Basic Design' of V-1 NPP upgrading. The programme had not been submitted for approval to NRA SR prior to completion of works by Siemens. Based on an internal audit that had been performed, corrective measures were proposed to meet requirements on review and approval of suppliers quality assurance programmes. Requirements related to the quality assurance at nuclear installations were prepared to be incorporated into principles of a act on peaceful use of nuclear power in Slovak Republic

  6. Quality assurance issues and PACS

    NARCIS (Netherlands)

    Banta, H.D.

    1992-01-01

    Quality assessment and assurance is a growing concern in all areas of health care. The concern is fueled by a body of evidence that indicates that quality of care is not optimal, and in many instances, is unacceptably low. Although different standards for quality have been proposed, health outcome

  7. Quality assurance

    OpenAIRE

    Cauchi, Maurice A.M.

    1993-01-01

    The concept of quality assurance refers more specifically to the process of objectifying and clearly enunciating goals, and providing means of assessing the outcomes. In this article the author mentions four fundamental elements of quality assurance which should be applied in the medical profession in Malta. These elements should relate to professional performance, resource utilisation, risk management and patient satisfaction. The aim of the medical professionals in Malta is to provide the b...

  8. Quality assurance

    Energy Technology Data Exchange (ETDEWEB)

    Gillespie, B.M.; Gleckler, B.P.

    1995-06-01

    This section of the 1994 Hanford Site Environmental Report summarizes the quality assurance and quality control practices of Hanford Site environmental monitoring and surveillance programs. Samples are analyzed according to documented standard analytical procedures. This section discusses specific measures taken to ensure quality in project management, sample collection, and analytical results.

  9. Quality assurance

    International Nuclear Information System (INIS)

    Gillespie, B.M.; Gleckler, B.P.

    1995-01-01

    This section of the 1994 Hanford Site Environmental Report summarizes the quality assurance and quality control practices of Hanford Site environmental monitoring and surveillance programs. Samples are analyzed according to documented standard analytical procedures. This section discusses specific measures taken to ensure quality in project management, sample collection, and analytical results

  10. Involving mental health service users in quality assurance

    Science.gov (United States)

    Weinstein, Jenny

    2006-01-01

    Abstract Objective  This study compares the process and outcomes of two approaches to engaging mental health (MH) service users in the quality assurance (QA) process. Background  QA plays a significant role in health and care services, including those delivered in the voluntary sector. The importance of actively, rather than passively, involving service users in evaluation and service development has been increasingly recognized during the last decade. Design  This retrospective small‐scale study uses document analysis to compare two QA reviews of a MH Day Centre, one that took place in 1998 as a traditional inspection‐type event and one that took place in 2000 as a collaborative process with a user‐led QA agenda. Setting and participants  The project was undertaken with staff, volunteers and service users in a voluntary sector MH Day Centre. Intervention  The study compares the management, style, evaluation tools and service user responses for the two reviews; it considers staff perspectives and discusses the implications of a collaborative, user‐led QA process for service development. Results  The first traditional top–down inspection‐type QA event had less ownership from service users and staff and served the main purpose of demonstrating that services met organizational standards. The second review, undertaken collaboratively with a user‐led agenda focused on different priorities, evolving a new approach to seeking users’ views and achieving a higher response rate. Conclusions  Because both users and staff had participated in most aspects of the second review they were more willing to work together and action plan to improve the service. It is suggested that the process contributed to an evolving ethos of more effective quality improvement and user involvement within the organization. PMID:16677189

  11. A new quality assurance package for hospital palliative care teams: the Trent Hospice Audit Group model.

    Science.gov (United States)

    Hunt, J; Keeley, V L; Cobb, M; Ahmedzai, S H

    2004-07-19

    Cancer patients in hospitals are increasingly cared for jointly by palliative care teams, as well as oncologists and surgeons. There has been a considerable growth in the number and range of hospital palliative care teams (HPCTs) in the United Kingdom. HPCTs can include specialist doctors and nurses, social workers, chaplains, allied health professionals and pharmacists. Some teams work closely with existing cancer multidisciplinary teams (MDTs) while others are less well integrated. Quality assurance and clinical governance requirements have an impact on the monitoring of such teams, but so far there is no standardised way of measuring the amount and quality of HPCTs' workload. Trent Hospice Audit Group (THAG) is a multiprofessional research group, which has been developing standards and audit tools for palliative care since the 1990s. These follow a format of structure-process-outcome for standards and measures. We describe a collaborative programme of work with HPCTs that has led to a new set of standards and audit tools. Nine HPCTs participated in three rounds of consultation, piloting and modification of standard statements and tools. The final pack of HPCT quality assurance tools covers: policies and documentation; medical notes review; questionnaires for ward-based staff. The tools measure the HPCT workload and casemix; the views of ward-based staff on the supportive role of the HPCT and the effectiveness of HPCT education programmes, particularly in changing practice. The THAG HPCT quality assurance pack is now available for use in cancer peer review.

  12. Quality assurance

    International Nuclear Information System (INIS)

    Hiller, G.H.

    1979-01-01

    This compendium intends to give fast bibliographic information and to fill the visible gap between documentation and general bibliographic information. The reader is given an outline of quality assurance and some examples of techniques from the relevant literature. The practical engineer, who is always short of time, is thus offered a quick survey and a fast deepening of his understanding by means of literature dealing specifically with his unresolved problems. The mansucript has been kept in tis original form in order to speed up tis publication. The RKW technical department limited itself to checking its contents and the adherence to the established information goals. (orig.) 891 RW/orig. 892 MB [de

  13. Quality assurance when documenting chemical hazards to health and environment

    International Nuclear Information System (INIS)

    Guttormsen, R.; Modahl, S.I.; Tufto, P.A.; Buset, H.

    1991-01-01

    In a joint project between The Norwegian Petroleum Directorate (NPD), the State Pollution Control Agency (SFT) and Conoco Norway Inc. (CNI) we have evaluated the use of quality assurance principles in connection with development and distribution of information about chemicals. Assuring quality of the documentation is first of all depending on: the work in international organizations; the content of national and international guidelines and criteria documents; the use of product registers; activities in manufacturers' organizations; the role of importers and agents. These are aspects which have been evaluated. Recommendations are given in this paper concerning: definition of responsibilities in regulations, standards and guidelines; feedback of experience and coordination through international work; application of quality assurance principles in the use of information technology in international organizations and in manufacturers' organizations; use of quality assurance principles in validation of data

  14. Quality assurance and accreditation.

    Science.gov (United States)

    1997-01-01

    In 1996, the Joint Commission International (JCI), which is a partnership between the Joint Commission on Accreditation of Healthcare Organizations and Quality Healthcare Resources, Inc., became one of the contractors of the Quality Assurance Project (QAP). JCI recognizes the link between accreditation and quality, and uses a collaborative approach to help a country develop national quality standards that will improve patient care, satisfy patient-centered objectives, and serve the interest of all affected parties. The implementation of good standards provides support for the good performance of professionals, introduces new ideas for improvement, enhances the quality of patient care, reduces costs, increases efficiency, strengthens public confidence, improves management, and enhances the involvement of the medical staff. Such good standards are objective and measurable; achievable with current resources; adaptable to different institutions and cultures; and demonstrate autonomy, flexibility, and creativity. The QAP offers the opportunity to approach accreditation through research efforts, training programs, and regulatory processes. QAP work in the area of accreditation has been targeted for Zambia, where the goal is to provide equal access to cost-effective, quality health care; Jordan, where a consensus process for the development of standards, guidelines, and policies has been initiated; and Ecuador, where JCI has been asked to help plan an approach to the evaluation and monitoring of the health care delivery system.

  15. Quality of Big Data in health care.

    Science.gov (United States)

    Sukumar, Sreenivas R; Natarajan, Ramachandran; Ferrell, Regina K

    2015-01-01

    The current trend in Big Data analytics and in particular health information technology is toward building sophisticated models, methods and tools for business, operational and clinical intelligence. However, the critical issue of data quality required for these models is not getting the attention it deserves. The purpose of this paper is to highlight the issues of data quality in the context of Big Data health care analytics. The insights presented in this paper are the results of analytics work that was done in different organizations on a variety of health data sets. The data sets include Medicare and Medicaid claims, provider enrollment data sets from both public and private sources, electronic health records from regional health centers accessed through partnerships with health care claims processing entities under health privacy protected guidelines. Assessment of data quality in health care has to consider: first, the entire lifecycle of health data; second, problems arising from errors and inaccuracies in the data itself; third, the source(s) and the pedigree of the data; and fourth, how the underlying purpose of data collection impact the analytic processing and knowledge expected to be derived. Automation in the form of data handling, storage, entry and processing technologies is to be viewed as a double-edged sword. At one level, automation can be a good solution, while at another level it can create a different set of data quality issues. Implementation of health care analytics with Big Data is enabled by a road map that addresses the organizational and technological aspects of data quality assurance. The value derived from the use of analytics should be the primary determinant of data quality. Based on this premise, health care enterprises embracing Big Data should have a road map for a systematic approach to data quality. Health care data quality problems can be so very specific that organizations might have to build their own custom software or data

  16. [Quality assurance in intensive care: the situation in Switzerland].

    Science.gov (United States)

    Frutiger, A

    1999-10-30

    The movement for quality in medicine is starting to take on the dimensions of a crusade. Quite logically it has also reached the intensive care community. Due to their complex multidisciplinary functioning and because of the high costs involved, ICUs are model services reflecting the overall situation in our hospitals. The situation of Swiss intensive care is particularly interesting, because for over 25 years standards for design and staffing of Swiss ICUs have been in effect and were enforced via onsite visits by the Swiss Society of Intensive Care without government involvement. Swiss intensive care thus defined its structures long before the word "accreditation" had even been used in this context. While intensive care in Switzerland is practised in clearly defined, well equipped and adequately staffed units, much less is known about process quality and outcomes of these services. Statistics on admissions, length of stay and length of mechanical ventilation, as well as severity data based on a simple classification system, are collected nationwide and allow some limited insight into the overall process of care. Results of intensive care are not systematically assessed. In response to the constant threat of cost containment, Swiss ICUs should increasingly focus on process quality and results, while maintaining their existing good structures.

  17. Private sector delivery of health services in developing countries: a mixed-methods study on quality assurance in social franchises

    Science.gov (United States)

    2013-01-01

    Background Across the developing world health care services are most often delivered in the private sector and social franchising has emerged, over the past decade, as an increasingly popular method of private sector health care delivery. Social franchising aims to strengthen business practices through economies of scale: branding clinics and purchasing drugs in bulk at wholesale prices. While quality is one of the established goals of social franchising, there is no published documentation of how quality levels might be set in the context of franchised private providers, nor what quality assurance measures can or should exist within social franchises. The aim of this study was to better understand the quality assurance systems currently utilized in social franchises, and to determine if there are shared standards for practice or quality outcomes that exist across programs. Methods The study included three data sources and levels of investigation: 1) Self-reported program data; 2) Scoping telephone interviews; and 3) In-depth field interviews and clinic visits. Results Social Franchises conceive of quality assurance not as an independent activity, but rather as a goal that is incorporated into all areas of franchise operations, including recruitment, training, monitoring of provider performance, monitoring of client experience and the provision of feedback. Conclusions These findings are the first evidence to support the 2002 conceptual model of social franchising which proposed that the assurance of quality was one of the three core goals of all social franchises. However, while quality is important to franchise programs, quality assurance systems overall are not reflective of the evidence to-date on quality measurement or quality improvement best practices. Future research in this area is needed to better understand the details of quality assurance systems as applied in social franchise programs, the process by which quality assurance becomes a part of the

  18. Private sector delivery of health services in developing countries: a mixed-methods study on quality assurance in social franchises.

    Science.gov (United States)

    Schlein, Karen; De La Cruz, Anna York; Gopalakrishnan, Tisha; Montagu, Dominic

    2013-01-03

    Across the developing world health care services are most often delivered in the private sector and social franchising has emerged, over the past decade, as an increasingly popular method of private sector health care delivery. Social franchising aims to strengthen business practices through economies of scale: branding clinics and purchasing drugs in bulk at wholesale prices. While quality is one of the established goals of social franchising, there is no published documentation of how quality levels might be set in the context of franchised private providers, nor what quality assurance measures can or should exist within social franchises. The aim of this study was to better understand the quality assurance systems currently utilized in social franchises, and to determine if there are shared standards for practice or quality outcomes that exist across programs. The study included three data sources and levels of investigation: 1) Self-reported program data; 2) Scoping telephone interviews; and 3) In-depth field interviews and clinic visits. Social Franchises conceive of quality assurance not as an independent activity, but rather as a goal that is incorporated into all areas of franchise operations, including recruitment, training, monitoring of provider performance, monitoring of client experience and the provision of feedback. These findings are the first evidence to support the 2002 conceptual model of social franchising which proposed that the assurance of quality was one of the three core goals of all social franchises. However, while quality is important to franchise programs, quality assurance systems overall are not reflective of the evidence to-date on quality measurement or quality improvement best practices. Future research in this area is needed to better understand the details of quality assurance systems as applied in social franchise programs, the process by which quality assurance becomes a part of the organizational culture, and the components of

  19. Private sector delivery of health services in developing countries: a mixed-methods study on quality assurance in social franchises

    Directory of Open Access Journals (Sweden)

    Schlein Karen

    2013-01-01

    Full Text Available Abstract Background Across the developing world health care services are most often delivered in the private sector and social franchising has emerged, over the past decade, as an increasingly popular method of private sector health care delivery. Social franchising aims to strengthen business practices through economies of scale: branding clinics and purchasing drugs in bulk at wholesale prices. While quality is one of the established goals of social franchising, there is no published documentation of how quality levels might be set in the context of franchised private providers, nor what quality assurance measures can or should exist within social franchises. The aim of this study was to better understand the quality assurance systems currently utilized in social franchises, and to determine if there are shared standards for practice or quality outcomes that exist across programs. Methods The study included three data sources and levels of investigation: 1 Self-reported program data; 2 Scoping telephone interviews; and 3 In-depth field interviews and clinic visits. Results Social Franchises conceive of quality assurance not as an independent activity, but rather as a goal that is incorporated into all areas of franchise operations, including recruitment, training, monitoring of provider performance, monitoring of client experience and the provision of feedback. Conclusions These findings are the first evidence to support the 2002 conceptual model of social franchising which proposed that the assurance of quality was one of the three core goals of all social franchises. However, while quality is important to franchise programs, quality assurance systems overall are not reflective of the evidence to-date on quality measurement or quality improvement best practices. Future research in this area is needed to better understand the details of quality assurance systems as applied in social franchise programs, the process by which quality assurance

  20. Evaluation of a Standardized Method of Quality Assurance in Mental Health Records: A Pilot Study

    Science.gov (United States)

    Bradshaw, Kelsey M.; Donohue, Bradley; Fayeghi, Jasmine; Lee, Tiffany; Wilks, Chelsey R.; Ross, Brendon

    2016-01-01

    The widespread adoption of research-supported treatments by mental health providers has facilitated empirical development of quality assurance (QA) methods. Research in this area has focused on QA systems aimed at assuring the integrity of research-supported treatment implementation, while examination of QA systems to assure appropriate…

  1. Quality Assurance and Quality Control in Point-of-Care Testing.

    Science.gov (United States)

    Newman, Ashleigh W; Behling-Kelly, Erica

    2016-03-01

    With advancements in the standard of care in veterinary medicine and instrument technology, performing in-house laboratory work on a variety of point-of-care instruments, ranging from glucometers to benchtop chemistry analyzers, has become increasingly commonplace. However, the ability of an instrument to perform a test does not guarantee that those results are accurate. Ensuring that your in-clinic laboratory is providing reliable data requires a comprehensive plan that encompasses both common sense practices aimed at preventing errors at each stage of the testing process, as well as standard operating procedures to validate and monitor analyzer performance. These 2 arms of the plan are known as quality assurance and quality control. Although these concepts are typically out of the comfort zone for veterinarians, just as the thought of business management may deter some veterinarians from practice ownership, it is not beyond the capabilities of veterinarians to learn, understand, and incorporate them into their practice. The objectives of this article are to convey the importance of quality assurance and quality control, walk you through the American Society for Veterinary Clinical Pathology guidelines on this topic, and provide direction to additional resources for further education on this topic, all with the focus on point-of-care testing in the in-clinic laboratory. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Quality assurance of radiotherapy in cancer treatment. Toward improvement of patient safety and quality of care

    International Nuclear Information System (INIS)

    Ishikura, Satoshi

    2008-01-01

    The process of radiotherapy (RT) is complex and involves understanding of the principles of medical physics, radiobiology, radiation safety, dosimetry, radiation treatment planning, simulation and interaction of radiation with other treatment modalities. Each step in the integrated process of RT needs quality control and quality assurance (QA) to prevent errors and to give high confidence that patients will receive the prescribed treatment correctly. Recent advances in RT, including intensity-modulated and image-guided RT, focus on the need for a systematic RTQA program that balances patient safety and quality with available resources. It is necessary to develop more formal error mitigation and process analysis methods, such as failure mode and effect analysis, to focus available QA resources optimally on process components. External audit programs are also effective. The International Atomic Energy Agency has operated both an on-site and off-site postal dosimetry audit to improve practice and to assure the dose from RT equipment. Several countries have adopted a similar approach for national clinical auditing. In addition, clinical trial QA has a significant role in enhancing the quality of care. The Advanced Technology Consortium has pioneered the development of an infrastructure and QA method for advanced technology clinical trials, including credentialing and individual case review. These activities have an impact not only on the treatment received by patients enrolled in clinical trials, but also on the quality of treatment administered to all patients treated in each institution, and have been adopted globally; by the USA, Europe and Japan also. (author)

  3. Quality assurance of radiotherapy in cancer treatment: toward improvement of patient safety and quality of care.

    Science.gov (United States)

    Ishikura, Satoshi

    2008-11-01

    The process of radiotherapy (RT) is complex and involves understanding of the principles of medical physics, radiobiology, radiation safety, dosimetry, radiation treatment planning, simulation and interaction of radiation with other treatment modalities. Each step in the integrated process of RT needs quality control and quality assurance (QA) to prevent errors and to give high confidence that patients will receive the prescribed treatment correctly. Recent advances in RT, including intensity-modulated and image-guided RT, focus on the need for a systematic RTQA program that balances patient safety and quality with available resources. It is necessary to develop more formal error mitigation and process analysis methods, such as failure mode and effect analysis, to focus available QA resources optimally on process components. External audit programs are also effective. The International Atomic Energy Agency has operated both an on-site and off-site postal dosimetry audit to improve practice and to assure the dose from RT equipment. Several countries have adopted a similar approach for national clinical auditing. In addition, clinical trial QA has a significant role in enhancing the quality of care. The Advanced Technology Consortium has pioneered the development of an infrastructure and QA method for advanced technology clinical trials, including credentialing and individual case review. These activities have an impact not only on the treatment received by patients enrolled in clinical trials, but also on the quality of treatment administered to all patients treated in each institution, and have been adopted globally; by the USA, Europe and Japan also.

  4. Quality of health care and the need for assessment | Bosse | East ...

    African Journals Online (AJOL)

    ... of health care workers, a strong determinant of care process quality, might be improved by strengthening internal factors in health facilities. For conclusive validation, further studies using the tool must be conducted with larger numbers of institutions. Keywords: Quality of health care, Quality assessment, Quality assurance, ...

  5. Introduction to quality assurance

    International Nuclear Information System (INIS)

    Kaden, W.

    1980-01-01

    In today's interpretation 'quality assurance' means 'good management'. Quality assurance has to cover all phases of a work, but all quality assurance measures must be adapted to the relevance and complexity of the actual task. Examples are given for the preparation of quality classes, the organization of quality assurance during design and manufacturing and for auditing. Finally, efficiency and limits of quality assurance systems are described. (orig.)

  6. Quality Assurance - Construction

    DEFF Research Database (Denmark)

    Gaarslev, Axel

    1996-01-01

    Gives contains three main chapters:1. Quality Assurance initiated by external demands2. Quality Assurance initiated by internal company goals3. Innovation strategies......Gives contains three main chapters:1. Quality Assurance initiated by external demands2. Quality Assurance initiated by internal company goals3. Innovation strategies...

  7. Contracts and supply assurance in the UK health care market.

    Science.gov (United States)

    Fenn, P; Rickman, N; McGuire, A

    1994-07-01

    We present a formal model of the relationship between a health care purchaser and a provider drawing on the recent experience of explicit contracting in the UK health sector. Specifically we model the contractual relationships emerging between District Health Authorities, who are presently the dominant health care purchasers, and the providers of hospital care. The comparative static analysis implies that the transaction cost of using non-local hospitals, the expected patient demand, the extent of excess capacity in local hospitals, and the proportion of that excess capacity expected to be lost to competitive purchasers, are all important determinants of the choice of contract.

  8. Development and oversight of ethical health promotion quality assurance and evaluation activities involving human participants.

    Science.gov (United States)

    Sainsbury, Peter

    2015-12-01

    This paper considers the role of ethics and ethics review processes in the development of health promotion quality assurance and evaluation activities involving human participants. The Australian National Health and Medical Research Council (NHMRC) National Statement on Ethical Conduct in Human Research and associated documents provide the framework for the ethical conduct and independent review of research (including quality assurance and evaluation) involving humans in Australia. Identifying the level of risk to which participants may be exposed by participation in quality assurance and evaluation activities is essential for health promotion workers undertaking such activities. Organisations can establish processes other than review by a Human Research Ethics Committee for negligible and low risk research activities. Health promotion quality assurance and evaluation activities often involve negligible and low risk to participants. Seven triggers that indicate the need for ethics review of quality assurance and evaluation activities and a procedural checklist for developing ethical quality assurance and evaluation activities are provided. Health promotion workers should be familiar with the NHMRC's National Statement on Ethical Conduct in Human Research. When ethical considerations underpin the planning and conduct of all quality assurance and evaluation from the very beginning, the activity is the better for it, independent 'ethics approval' can mostly be secured without much trouble and workers' frustration levels are reduced. So what? Health promotion quality assurance and evaluation activities must be ethically justified. Health promotion workers should be familiar with the NHMRC's National Statement on Ethical Conduct in Human Research and should use it when developing health promotion quality assurance and evaluation activities.

  9. Data Quality Assurance Governance

    OpenAIRE

    Montserrat Gonzalez; Stephanie Suhr

    2016-01-01

    This deliverable describes the ELIXIR-EXCELERATE Quality Management Strategy, addressing EXCELERATE Ethics requirement no. 5 on Data Quality Assurance Governance. The strategy describes the essential procedures and practices within ELIXIR-EXCELERATE concerning planning of quality management, performing quality assurance and controlling quality. It also depicts the overall organisation of ELIXIR with emphasis on authority and specific responsibilities related to quality assurance.

  10. The Influence of Quality Assurance and Supportive Supervision on the Quality of Medical Care in Children’s Hospitals of the Municipal Level of the Rostov Region

    Directory of Open Access Journals (Sweden)

    Tatiana V. Kulichenko

    2017-01-01

    Full Text Available Background. Improving the quality of medical care is the absolute priority of the World Health Organization and all socially-oriented ministries and departments around the world.Objective. Our aim was to evaluate the effectiveness of quality  assurance and supportive supervision in municipal hospitals to improve the quality of medical care for children (by the example of the Rostov region.Methods. The open observational study included 10 second-level hospitals in the Rostov Region. At the start of the project, the quality of inpatient care for children in the region was audited based on recommendations and tools of the World Health Organization, and training of medical personnel was organized. Monitoring visits to hospitals were carried out by experts every 3 months (supportive supervision. Reaudit of the quality of care was conducted a year later.Results. As a result of regular quality assurance and supportive supervision of hospitals during the first year of operation, such indicators of the quality of medical care as the availability of medical equipment for emergency care for children, the infrastructure of children’s departments, the triage and provision of emergency care in children’s departments, managing patients with various acute conditions (fever, diarrhea, respiratory diseases, supporting care, internal quality assurance, accessibility to standards of care and clinical guidelines for the diagnosis and treatment of various diseases, respect for children’s rights were significantly (p < 0.05 improved.Conclusion. Supportive supervision and regular external quality assurances of hospitals contribute to a rapid increase in the quality of medical care for children.

  11. [Integrated quality assurance].

    Science.gov (United States)

    Bögel, K; Stöhr, K

    1994-07-01

    The definition of terms and connotation of "Quality", "Quality Assurance" and "Integration" lead to an analysis and understanding of inhibiting and fostering factors of the "Health Triad" of people, animals and environment. Although "Quality" is largely or ultimately determined by the consumer, there are considerable differences as this term is applied by (a) the individual consumer, (b) the dynamic producer defending or gaining markets, (c) those engaged in traditional product manufacturing, or (d) governments setting (minimum) requirements for the sake of free trade. "Quality Assurance" offers cooperation of partners all along the food chain from "pasture to table". The managerial process turned into a continuum of responsibility and agreement on processes and product characteristics. This overcomes the disadvantages of strategies stressing distinct defense barriers. In practice this philosophy of a predominant role of defence barriers proved largely partnership destructive, in that it permitted to shift responsibilities for failures and to claim administrative competence according to momentary situations and interests. "Integrated Quality Assurance" means mutual agreement of two or more partners along the food chain (e. g. feed producers, farmers, animal health industry, veterinarians and food processors) on product characteristics and production methods. It involves essential system elements including facilities, materials, manpower, information, transport, management etc. Different principles and procedures of quality assurance have been introduced in practice, including agriculture and food processing. These different approaches are not mutually exclusive but largely of complementary nature.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. Computer software quality assurance

    International Nuclear Information System (INIS)

    Ives, K.A.

    1986-06-01

    The author defines some criteria for the evaluation of software quality assurance elements for applicability to the regulation of the nuclear industry. The author then analyses a number of software quality assurance (SQA) standards. The major extracted SQA elements are then discussed, and finally specific software quality assurance recommendations are made for the nuclear industry

  13. Multinational Quality Assurance

    Science.gov (United States)

    Kinser, Kevin

    2011-01-01

    Multinational colleges and universities pose numerous challenges to the traditional models of quality assurance that are designed to validate domestic higher education. When institutions cross international borders, at least two quality assurance protocols are involved. To guard against fraud and abuse, quality assurance in the host country is…

  14. Quality assurance of nuclear energy

    International Nuclear Information System (INIS)

    1994-12-01

    It consists of 14 chapters, which are outline of quality assurance of nuclear energy, standard of quality assurance, business quality assurance, design quality assurance, purchase quality assurance, production quality assurance, a test warranty operation warranty, maintenance warranty, manufacture of nuclear power fuel warranty, computer software warranty, research and development warranty and quality audit.

  15. Implementing clinical governance in English primary care groups/trusts: reconciling quality improvement and quality assurance.

    Science.gov (United States)

    Campbell, S M; Sheaff, R; Sibbald, B; Marshall, M N; Pickard, S; Gask, L; Halliwell, S; Rogers, A; Roland, M O

    2002-03-01

    To investigate the concept of clinical governance being advocated by primary care groups/trusts (PCG/Ts), approaches being used to implement clinical governance, and potential barriers to its successful implementation in primary care. Qualitative case studies using semi-structured interviews and documentation review. Twelve purposively sampled PCG/Ts in England. Fifty senior staff including chief executives, clinical governance leads, mental health leads, and lay board members. Participants' perceptions of the role of clinical governance in PCG/Ts. PCG/Ts recognise that the successful implementation of clinical governance in general practice will require cultural as well as organisational changes, and the support of practices. They are focusing their energies on supporting practices and getting them involved in quality improvement activities. These activities include, but move beyond, conventional approaches to quality assessment (audit, incentives) to incorporate approaches which emphasise corporate and shared learning. PCG/Ts are also engaged in setting up systems for monitoring quality and for dealing with poor performance. Barriers include structural barriers (weak contractual levers to influence general practices), resource barriers (perceived lack of staff or money), and cultural barriers (suspicion by practice staff or problems overcoming the perceived blame culture associated with quality assessment). PCG/Ts are focusing on setting up systems for implementing clinical governance which seek to emphasise developmental and supportive approaches which will engage health professionals. Progress is intentionally incremental but formidable challenges lie ahead, not least reconciling the dual role of supporting practices while monitoring (and dealing with poor) performance.

  16. The application of quality assurance

    International Nuclear Information System (INIS)

    Lovatt, G.B.

    1988-01-01

    The paper concerns the application of quality assurance to structures, systems and components for the design, construction and operation of nuclear power plant and fuel reprocessing plant. A description is given of:- the requirements for quality assurance, the establishment of quality assurance arrangements, quality assurance documents structure, and quality assurance manuals and programmes. Quality assurance procedures and auditing are also discussed. (U.K.)

  17. RAVEN Quality Assurance Activities

    Energy Technology Data Exchange (ETDEWEB)

    Cogliati, Joshua Joseph [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-09-01

    This report discusses the quality assurance activities needed to raise the Quality Level of Risk Analysis in a Virtual Environment (RAVEN) from Quality Level 3 to Quality Level 2. This report also describes the general RAVEN quality assurance activities. For improving the quality, reviews of code changes have been instituted, more parts of testing have been automated, and improved packaging has been created. For upgrading the quality level, requirements have been created and the workflow has been improved.

  18. Revitalizing quality assurance

    International Nuclear Information System (INIS)

    Hawkins, F.C.

    1998-01-01

    The image of someone inspecting or auditing often comes to mind when people hear the term quality assurance. Although partially correct, this image is not the complete picture. The person doing the inspecting or auditing is probably part of a traditional quality assurance organization, but that organization is only one aspect of a properly conceived and effectively implemented quality assurance system whose goal is improved facility safety and reliability. This paper introduces the underlying philosophies and basic concepts of the International Atomic Energy Agency's new quality assurance initiative that began in 1991 as part of a broad Agency-wide program to enhance nuclear safety. The first product of that initiative was publication in 1996 of a new Quality Assurance Code 50-C/SG-Q and fourteen related Safety Guides. This new suite of documents provide the technical and philosophical foundation upon which Member States can base their quality assurance programs. (author)

  19. Quality systems in Dutch health care institutions.

    NARCIS (Netherlands)

    Casparie, A.F.; Sluijs, E.M.; Wagner, C.; Bakker, D.H. de

    1997-01-01

    The implementation of quality systems in Dutch health care was supervised by a national committee during 1990-1995. To monitor the progress of implementation a large survey was conducted in the beginning of 1995. The survey enclosed all subsectors in health care. A postal questionnaire-derived

  20. Quality assurance in radiotherapy

    International Nuclear Information System (INIS)

    2003-03-01

    Good radiotherapy results and safety of treatment require the radiation to be optimally applied to a specified target area and the correct dose. According to international recommendations, the average uncertainty in therapeutic dose should not exceed 5%. The need for high precision in therapeutic dose requires quality assurance covering the entire radiotherapy process. Besides the physical and technical characteristics of the therapy equipment, quality assurance must include all radiotherapy equipment and procedures that are significant for the correct magnitude and precision of application of the therapeutic dose. The duties and responsibilities pertaining to various stages of treatment must also be precisely defined. These requirements may be best implemented through a quality system. The general requirements for supervision and quality assurance of medical radiation apparatus are prescribed in section 40 of the Radiation Act (592/1991, amendment 1142/1998) and in sections 18 and 32 of the Decree of the Ministry of Social Affairs and Health on the medical use of radiation (423/2000). Guide ST 2.2 imposes requirements on structural radiation shielding of radiotherapy equipment and the premises in which it is used, and on warning and safety arrangements. Guide ST 1.1 sets out the general safety principles for radiation practices and regulatory control procedure for the use of radiation. Guide ST 1.6 provides general requirements for operational measures in the use of radiation. This Guide sets out the duties of responsible parties (the party running a radiation practice) in respect of arranging and maintaining radiotherapy quality assurance. The principles set out in this Guide and Guide ST 6.3 may be applied to radionuclide therapy

  1. Quality assurance in radiodiagnosis

    International Nuclear Information System (INIS)

    Ghilardi Netto, T.; Sao Paulo Univ., Ribeirao Preto

    1983-01-01

    The following topics are dealt with: 1) the importance of the application of a quality assurance program in radiodiagnosis, with its main consequences : improvement of imaging quality, reduction of the patient expossure rate, cost reduction and 2) how to introduce the quality assurance control in the radiodiagnostic area. (M.A.) [pt

  2. Quality Improvement in Athletic Health Care.

    Science.gov (United States)

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

    2017-11-01

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

  3. Quality assurance for HIV point-of-care testing and treatment monitoring assays

    Science.gov (United States)

    Sandstrom, Paul; Denny, Thomas N.; Hurlston, Mackenzie; Ball, Terry B.; Peeling, Rosanna W.; Boeras, Debrah I.

    2016-01-01

    In 2015, UNAIDS launched the 90-90-90 targets aimed at increasing the number of people infected with HIV to become aware of their status, access antiretroviral therapies and ultimately be virally suppressed. To achieve these goals, countries may need to scale up point-of-care (POC) testing in addition to strengthening central laboratory services. While decentralising testing increases patient access to diagnostics, it presents many challenges with regard to training and assuring the quality of tests and testing. To ensure synergies, the London School of Hygiene & Tropical Medicine held a series of consultations with countries with an interest in quality assurance and their implementing partners, and agreed on an external quality assessment (EQA) programme to ensure reliable results so that the results lead to the best possible care for HIV patients. As a result of the consultations, EQA International was established, bringing together EQA providers and implementers to develop a strategic plan for countries to establish national POC EQA programmes and to estimate the cost of setting up and maintaining the programme. With the dramatic increase in the number of proficiency testing panels required for thousands of POC testing sites across Africa, it is important to facilitate technology transfer from global EQA providers to a network of regional EQA centres in Africa for regional proficiency testing panel production. EQA International will continue to identify robust and cost-effective EQA technologies for quality POC testing, integrating novel technologies to support sustainable country-owned EQA programmes in Africa. PMID:28879133

  4. Laboratory quality assurance

    International Nuclear Information System (INIS)

    Delvin, W.L.

    1977-01-01

    The elements (principles) of quality assurance can be applied to the operation of the analytical chemistry laboratory to provide an effective tool for indicating the competence of the laboratory and for helping to upgrade competence if necessary. When used, those elements establish the planned and systematic actions necessary to provide adequate confidence in each analytical result reported by the laboratory (the definition of laboratory quality assurance). The elements, as used at the Hanford Engineering Development Laboratory (HEDL), are discussed and they are qualification of analysts, written methods, sample receiving and storage, quality control, audit, and documentation. To establish a laboratory quality assurance program, a laboratory QA program plan is prepared to specify how the elements are to be implemented into laboratory operation. Benefits that can be obtained from using laboratory quality assurance are given. Experience at HEDL has shown that laboratory quality assurance is not a burden, but it is a useful and valuable tool for the analytical chemistry laboratory

  5. Quality assurance program

    International Nuclear Information System (INIS)

    Brooks, G.L.

    The concept of levels of quality assurance as applied to CANDU-type nuclear power plant components, i.e. maintaining an appropriate cost/benefit ratio, is introduced. The design process itself has quality assurance features by virtue of multi-level review. (E.C.B.)

  6. Quality management in Irish health care.

    Science.gov (United States)

    Ennis, K; Harrington, D

    1999-01-01

    This paper reports on the findings from a quantitative research study of quality management in the Irish health-care sector. The study findings suggest that quality management is what hospitals require to become more cost-effective and efficient. The research also shows that the culture of health-care institutions must change to one where employees experience pride in their work and where all are involved and committed to continuous quality improvement. It is recommended that a shift is required from the traditional management structures to a more participative approach. Furthermore, all managers whether from a clinical or an administration background must understand one another's role in the organisation. Finally, for quality to succeed in the health-care sector, strong committed leadership is required to overcome tensions in quality implementation.

  7. Quality assurance. 6. ed.

    International Nuclear Information System (INIS)

    Masing, W.

    1979-01-01

    Brief introduction to the quality sector. After some explanations of the terms of quality, feature, and defect, the article discusses the planning of quality and testing, industrial metrology, the test risk, quality assurance, quality enhancement, quality cost, and organisational problems. (RW) [de

  8. Quality assurance for HIV point-of-care testing and treatment monitoring assays

    Directory of Open Access Journals (Sweden)

    Adrienne F.A. Meyers

    2016-10-01

    Full Text Available In 2015, UNAIDS launched the 90-90-90 targets aimed at increasing the number of peopleinfected with HIV to become aware of their status, access antiretroviral therapies and ultimatelybe virally suppressed. To achieve these goals, countries may need to scale up point-of-care (POC testing in addition to strengthening central laboratory services. While decentralisingtesting increases patient access to diagnostics, it presents many challenges with regard totraining and assuring the quality of tests and testing. To ensure synergies, the London Schoolof Hygiene & Tropical Medicine held a series of consultations with countries with an interestin quality assurance and their implementing partners, and agreed on an external qualityassessment (EQA programme to ensure reliable results so that the results lead to the bestpossible care for HIV patients. As a result of the consultations, EQA International wasestablished, bringing together EQA providers and implementers to develop a strategic planfor countries to establish national POC EQA programmes and to estimate the cost of setting upand maintaining the programme. With the dramatic increase in the number of proficiencytesting panels required for thousands of POC testing sites across Africa, it is important tofacilitate technology transfer from global EQA providers to a network of regional EQA centresin Africa for regional proficiency testing panel production. EQA International will continue toidentify robust and cost-effective EQA technologies for quality POC testing, integrating noveltechnologies to support sustainable country-owned EQA programmes in Africa.

  9. [Service quality in health care: the application of the results of marketing research].

    Science.gov (United States)

    Verheggen, F W; Harteloh, P P

    1993-01-01

    This paper deals with quality assurance in health care and its relation to quality assurance in trade and industry. We present the service quality model--a model of quality from marketing research--and discuss how it can be applied to health care. Traditional quality assurance appears to have serious flaws. It lacks a general theory of the sources of hazards in the complex process of patient care and tends to stagnate, for no real improvement takes place. Departing from this criticism, modern quality assurance in health care is marked by: defining quality in a preferential sense as "fitness for use"; the use of theories and models of trade and industry (process-control); an emphasis on analyzing the process, instead of merely inspecting it; use of the Deming problem solving technique (plan, do, check, act); improvement of the process of care by altering perceptions of parties involved. We present an experience of application and utilization of this method in the University Hospital Maastricht, The Netherlands. The successful application of this model requires a favorable corporate culture and motivation of the health care workers. This model provides a useful framework to uplift the traditional approach to quality assurance in health care.

  10. Quality assurance and product quality

    International Nuclear Information System (INIS)

    Lacroix, D.; Bastiani, P. de

    2004-01-01

    The basic quality assurance requirements have to be completed by means that are oriented towards the quality of products; in COGEMA LOGISTICS our approach is based on four principles: 1) an integrated management system: Quality, health and safety, environment 2) an organization based on the responsibility of all actors, trust and transparency 3) a methodical approach to continuously improve the methods that are employed to achieve quality: -process management -corrective and preventive actions -self assessments and various surveys 4) but at the same time strong procedures for control and monitoring of all activities: -technical and quality audits (external and internal) -at source inspections -engineering activities inspections This performance-based approach is necessary to guaranty the effectiveness of the traditional formal QA means

  11. Assessing Community Quality of Health Care.

    Science.gov (United States)

    Herrin, Jeph; Kenward, Kevin; Joshi, Maulik S; Audet, Anne-Marie J; Hines, Stephen J

    2016-02-01

    To determine the agreement of measures of care in different settings-hospitals, nursing homes (NHs), and home health agencies (HHAs)-and identify communities with high-quality care in all settings. Publicly available quality measures for hospitals, NHs, and HHAs, linked to hospital service areas (HSAs). We constructed composite quality measures for hospitals, HHAs, and nursing homes. We used these measures to identify HSAs with exceptionally high- or low-quality of care across all settings, or only high hospital quality, and compared these with respect to sociodemographic and health system factors. We identified three dimensions of hospital quality, four HHA dimensions, and two NH dimensions; these were poorly correlated across the three care settings. HSAs that ranked high on all dimensions had more general practitioners per capita, and fewer specialists per capita, than HSAs that ranked highly on only the hospital measures. Higher quality hospital, HHA, and NH care are not correlated at the regional level; regions where all dimensions of care are high differ systematically from regions which score well on only hospital measures and from those which score well on none. © Health Research and Educational Trust.

  12. 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.

  13. Troublesome Knowledge: A New Approach to Quality Assurance in Mental Health Nursing Education.

    Science.gov (United States)

    Leidl, Donald M

    2018-01-01

    Background Quality assurance and quality enhancement processes in nursing education are vital to the establishment of a strong program. Existing quality assurance methods in nursing education such as professional self-regulation and external examination rely on provincial and national nursing associations for evaluation, putting minimal responsibility and accountability on internal program examiners. Threshold concepts and troublesome knowledge provide a framework as outlined by Land that utilizes internal examiners from both student and faculty groups and represents an alternative to traditional quality assurance in nursing education. Purpose To identify troublesome mental health nursing content in a nursing curriculum by exploring students and faculty perspectives. Method A sequential mixed methods design that utilized surveys and focus groups to explore student and faculty perspectives on troublesome mental health nursing content. Results The project data were able to be organized into five main content themes that were identified as being troublesome: the spectrum of mental illness, therapeutic relationships and boundaries, praxis, professionalism in nursing, and brain chemistry and its management. Conclusion The findings from this project are unique to the program of review but show the potential of this new approach to quality assurance and program enhancement initiatives in nursing education.

  14. Quality Assurance Practices in Obstetric Care: A Survey of Hospitals in California.

    Science.gov (United States)

    Lundsberg, Lisbet S; Lee, Henry C; Dueñas, Grace Villarin; Gregory, Kimberly D; Grossetta Nardini, Holly K; Pettker, Christian M; Illuzzi, Jessica L; Xu, Xiao

    2018-02-01

    To assess hospital practices in obstetric quality management activities and identify institutional characteristics associated with utilization of evidence-supported practices. Data for this study came from a statewide survey of obstetric hospitals in California regarding their organization and delivery of perinatal care. We analyzed responses from 185 hospitals that completed quality assurance sections of the survey to assess their practices in a broad spectrum of quality enhancement activities. The association between institutional characteristics and adoption of evidence-supported practices (ie, those supported by prior literature or recommended by professional organizations as beneficial for improving birth outcome or patient safety) was examined using bivariate analysis and appropriate statistical tests. Most hospitals regularly audited adherence to written protocols regarding critical areas of care; however, 77.7% and 16.8% reported not having written guidelines on diagnosis of labor arrest and management of abnormal fetal heart rate, respectively. Private nonprofit hospitals were more likely to have a written protocol for management of abnormal fetal heart rate (P=.002). One in 10 hospitals (9.7%) did not regularly review cases with significant morbidity or mortality, and only 69.0% regularly tracked indications for cesarean delivery. Moreover, 26.3%, 14.3%, and 8.7% of the hospitals reported never performing interprofessional simulations for eclampsia, shoulder dystocia, or postpartum hemorrhage, respectively. Teaching status was associated with more frequent simulations in these three areas (P≤.04 for all), while larger volume was associated with more frequent simulations for eclampsia (P=.04). Hospitals in California engage in a wide range of practices to assure or improve quality of obstetric care, but substantial variation in practice exists among hospitals. There is opportunity for improvement in adoption of evidence-supported practices.

  15. Quality assurance of metabolomics.

    Science.gov (United States)

    Bouhifd, Mounir; Beger, Richard; Flynn, Thomas; Guo, Lining; Harris, Georgina; Hogberg, Helena; Kaddurah-Daouk, Rima; Kamp, Hennicke; Kleensang, Andre; Maertens, Alexandra; Odwin-DaCosta, Shelly; Pamies, David; Robertson, Donald; Smirnova, Lena; Sun, Jinchun; Zhao, Liang; Hartung, Thomas

    2015-01-01

    Metabolomics promises a holistic phenotypic characterization of biological responses to toxicants. This technology is based on advanced chemical analytical tools with reasonable throughput, including mass-spectroscopy and NMR. Quality assurance, however - from experimental design, sample preparation, metabolite identification, to bioinformatics data-mining - is urgently needed to assure both quality of metabolomics data and reproducibility of biological models. In contrast to microarray-based transcriptomics, where consensus on quality assurance and reporting standards has been fostered over the last two decades, quality assurance of metabolomics is only now emerging. Regulatory use in safety sciences, and even proper scientific use of these technologies, demand quality assurance. In an effort to promote this discussion, an expert workshop discussed the quality assurance needs of metabolomics. The goals for this workshop were 1) to consider the challenges associated with metabolomics as an emerging science, with an emphasis on its application in toxicology and 2) to identify the key issues to be addressed in order to establish and implement quality assurance procedures in metabolomics-based toxicology. Consensus has still to be achieved regarding best practices to make sure sound, useful, and relevant information is derived from these new tools.

  16. Software quality assurance handbook

    Energy Technology Data Exchange (ETDEWEB)

    1990-09-01

    There are two important reasons for Software Quality Assurance (SQA) at Allied-Signal Inc., Kansas City Division (KCD): First, the benefits from SQA make good business sense. Second, the Department of Energy has requested SQA. This handbook is one of the first steps in a plant-wide implementation of Software Quality Assurance at KCD. The handbook has two main purposes. The first is to provide information that you will need to perform software quality assurance activities. The second is to provide a common thread to unify the approach to SQA at KCD. 2 figs.

  17. Quality assurance in NDT

    International Nuclear Information System (INIS)

    Krishnamoorthy, K.

    2010-01-01

    The importance of Nondestructive Testing (NDT) as a Quality Control/Quality Assurance tool in the industrial domain cannot be over-emphasized. With the rapid advancement in research and technology, the NDT field is becoming larger and more sophisticated day by day. Innovative research in materials science and digital technology is paving the way for more and more new methods in NDT technology. Although the NDT technology has improved over the years, the basic 'human factor' underlying the success of the NDT field remains the same. There are two major factors that influence the 'Quality Assurance in NDT'. First, knowledgeable and skilled NDT Operators are the most important factor in assuring the reliable test results. Second, the Management oversight of the NDT operations plays a major role in assuring the overall quality of NDT. Management responsibilities include the implementation of a Quality Management System (QMS) that focuses on the NDT operations and apply all the elements of Quality Assurance relevant to NDT. Whether the NDT operations are performed in-house or by a contractor, periodic Management Self-assessments should include the following question: How can the Management assess and improve the 'Quality Assurance in NDT'? This paper attempts to answer the above question. Some practical examples are provided to illustrate the potential quality incidents that could lead to costly failures, and the role of NDT Operator and the Management in preventing such quality incidents. Also, some guidelines are provided on how the Management can apply the elements of Quality Assurance to NDT in order to assess and improve the 'Quality Assurance in NDT'. (author)

  18. The Assessment, Development, Assurance Pharmacist's Tool (ADAPT) for ensuring quality implementation of health promotion programs.

    Science.gov (United States)

    Truong, Hoai-An; Taylor, Catherine R; DiPietro, Natalie A

    2012-02-10

    To develop and validate the Assessment, Development, Assurance Pharmacist's Tool (ADAPT), an instrument for pharmacists and student pharmacists to use in developing and implementing health promotion programs. The 36-item ADAPT instrument was developed using the framework of public health's 3 core functions (assessment, policy development, and assurance) and 10 essential services. The tool's content and usage was assessed and conducted through peer-review and initial validity testing processes. Over 20 faculty members, preceptors, and student pharmacists at 5 institutions involved in planning and implementing health promotion initiatives reviewed the instrument and conducted validity testing. The instrument took approximately 15 minutes to complete and the findings resulted in changes and improvements to elements of the programs evaluated. The ADAPT instrument fills a need to more effectively plan, develop, implement, and evaluate pharmacist-directed public health programs that are evidence-based, high-quality, and compliant with laws and regulations and facilitates documentation of pharmacists' contributions to public health.

  19. Quality assurance and management

    International Nuclear Information System (INIS)

    Newcomb, W.E.

    1989-01-01

    This paper traces the evolution of the quality assurance program of an office of waste management development (OWTD). The program's needs and commitment are examined. The author reports on the role of program and technical managers in such a program

  20. Quality assurance in radiotherapy

    International Nuclear Information System (INIS)

    Groth, S.; Meghzifene, A.; Tatsuzaki, H.; Levin, V.; Izewska, J.

    2001-01-01

    Quality assurance in the management of a patient receiving radiation therapy and the role of the radiation oncologist and medical physicist in this process is described. The constraints on available personnel are recognised and the need for further education resources and IAEA activities in education for both groups described. IAEA activities in the clinical and dosimetric aspects and the resultant publications and education have contributed to a culture of quality assurance. (author)

  1. [Quality of health care, accreditation, and health technology assessment in Croatia: role of agency for quality and accreditation in health].

    Science.gov (United States)

    Mittermayer, Renato; Huić, Mirjana; Mestrović, Josipa

    2010-12-01

    Avedis Donabedian defined the quality of care as the kind of care, which is expected to maximize an inclusive measure of patient welfare, after taking into account the balance of expected gains and losses associated with the process of care in all its segments. According to the World Medical Assembly, physicians and health care institutions have an ethical and professional obligation to strive for continuous quality improvement of services and patient safety with the ultimate goal to improve both individual patient outcomes as well as population health. Health technology assessment (HTA) is a multidisciplinary process that summarizes information about the medical, social, economic and ethical issues related to the use of a health technology in a systematic, transparent, unbiased, robust manner, with the aim to formulate safe and effective health policies that are patient focused and seek to achieve the highest value. The Agency for Quality and Accreditation in Health was established in 2007 as a legal, public, independent, nonprofit institution under the Act on Quality of Health Care. The Agency has three departments: Department of Quality and Education, Department of Accreditation, and Department of Development, Research, and Health Technology Assessment. According to the Act, the Agency should provide the procedure of granting, renewal and cancellation of accreditation of healthcare providers; proposing to the Minister, in cooperation with professional associations, the plan and program for healthcare quality assurance, improvement, promotion and monitoring; proposing the healthcare quality standards as well as the accreditation standards to the Minister; keeping a register of accreditations and providing a database related to accreditation, healthcare quality improvement, and education; providing education in the field of healthcare quality assurance, improvement and promotion; providing the HTA procedure and HTA database, supervising the healthcare insurance

  2. Infection control and quality assurance of health services provided in ICU: development of an ICU website.

    Science.gov (United States)

    Diomidous, Marianna; Ponirou, Paraskevi; Mpizopoulou, Zoi; Tzalera, Vaia; Mechili, Aggelos

    2013-01-01

    The aim of this study is to examine the infections control methods in ICU as well as the issue of quality in health services provided, as they constitute an important quality assurance indicator. Moreover, nowadays the causes of Nosocomial infections are known and so do the measures for their control. There is a need however for an information resource that will promote specialized and general guidelines. The measures include the appropriate use of gloves, cleaning and disinfection of the ICU environment and hand washing which is the most important of all. Therefore an effort was made to develop an easy to navigate webpage with practical and comprehensible clinical guidelines. Additionally, it gives to all visitors the opportunity for further information research with the use of the included links. For the development of the web side existing clinical guide lines were scrutinizes as well as studies that concern the effectiveness of the measures mentioned and for the identification of quality assurance criteria.

  3. eHealth and quality in health care: implementation time

    NARCIS (Netherlands)

    Ossebaard, Hans Cornelis; van Gemert-Pijnen, Julia E.W.C.

    2016-01-01

    The use of information and communication technologies in health and health care could improve healthcare quality in many ways. Today's evidence base demonstrates the (cost-)effectiveness of online education, self-management support and tele-monitoring in several domains of health and care. While new

  4. Quality assurance and the World Health Organization initiative of 'Health for All'

    International Nuclear Information System (INIS)

    Hanson, G.P.

    1989-01-01

    Following a workshop held in Neuherberg, FRG, in 1980 a guide for quality assurance in diagnostic radiology was published by WHO in 1982. Quality assurance programmes were recognized as being necessary for three main objectives: first the improvement of medical diagnostic imaging, secondly cost containment, and thirdly the reduction of radiation exposure. Concurrently, because of the paramount importance for basic diagnostic imaging, WHO prepared Technical Specifications for the X-ray Apparatus to be Used in a Basic Radiological System (BRS), governed by the concepts of ''design-out maintenance'' and ''design-in quality assurance''. The outcome of WHO's efforts, in comparison with the recognized quality assurance objectives, indicates that, although it is too early to measure overall improvements in medical diagnostic imaging, the two main aspects, accessibility and image quality, should be improved. Regarding cost containment, elimination of many logistical and support requirements should result in considerable savings. Regarding the reduction of radiation exposure, and using the entrance skin exposure as an indicator, an important finding is that with the WHO-BRS type X-ray equipment, in most cases the patient exposure was less than the average values in the United States. (author)

  5. [Quality assurance in interventional cardiology].

    Science.gov (United States)

    Gülker, H

    2009-10-01

    Quality assurance in clinical studies aiming at approval of pharmaceutical products is submitted to strict rules, controls and auditing regulations. Comparative instruments to ensure quality in diagnostic and therapeutic procedures are not available in interventional cardiology, likewise in other fields of cardiovascular medicine. Quality assurance simply consists of "quality registers" with basic data not externally controlled. Based on the experiences of clinical studies and their long history of standardization it is assumed that these data may be severely flawed thus being inappropriate to set standards for diagnostic and therapeutic strategies. The precondition for quality assurance are quality data. In invasive coronary angiography and intervention medical indications, the decision making process interventional versus surgical revascularization, technical performance and after - care are essential aspects affecting quality of diagnostics and therapy. Quality data are externally controlled data. To collect quality data an appropriate infrastructure is a necessary precondition which is not existent. For an appropriate infrastructure investments have to be done both to build up as well as to sustain the necessary preconditions. As long as there are no infrastructure and no investments there will be no "quality data". There exist simply registers of data which are not proved to be a basis for significant assurance and enhancement in quality in interventional coronary cardiology. Georg Thieme Verlag KG Stuttgart, New York.

  6. Student evaluation of a primary care clerkship: quality assurance and identification of potential for improvement

    Directory of Open Access Journals (Sweden)

    Himmel Wolfgang

    2009-04-01

    Full Text Available Abstract Background In Germany, like many other countries, general practice clerkships have only recently become mandatory during medical education. The biggest challenges for the organisation of such clerkships are achieving a minimum level of standardisation, and developing and maintaining a system of quality assurance. The aim of this study is to assess the instructional quality in teaching practices using a benchmark system. Methods Before commencing, students anonymously assessed the importance of core aspects of the mandatory primary care clerkship. After the clerkship, they evaluated learning opportunities and teaching performance. Based on this data, a benchmark system was developed to identify areas of strength and weakness for all practices as well as individual teaching practices. Results A total of 695 students evaluated 97 general practices belonging to a teaching network. Prior to the clerkship, most students considered recognition of frequent diseases (85% and communication skills (65% the most important learning goals. After the clerkship, nearly 90% of students confirmed that the general practitioner (GP was good or excellent at teaching these two goals but only two-thirds thought the GP's teaching performance good or excellent in preventive medicine and screening. In an exemplary analysis, we identified the 2 best and the 2 worst practices that consistently received scores far above or below average, respectively. Conclusion We were able to identify areas of weakness in teaching and identified specific GPs who did not meet the students' needs and expectations. This evaluation seems to be a useful quality assurance tool to identify the potential for improvement and faculty development.

  7. Software quality assurance

    CERN Document Server

    Laporte, Claude Y

    2018-01-01

    This book introduces Software Quality Assurance (SQA) and provides an overview of standards used to implement SQA. It defines ways to assess the effectiveness of how one approaches software quality across key industry sectors such as telecommunications, transport, defense, and aerospace. * Includes supplementary website with an instructor's guide and solutions * Applies IEEE software standards as well as the Capability Maturity Model Integration for Development (CMMI) * Illustrates the application of software quality assurance practices through the use of practical examples, quotes from experts, and tips from the authors

  8. SGHWR - quality assurance documentation

    International Nuclear Information System (INIS)

    Garrard, R.S.; Caulfield, J.

    1976-01-01

    The quality assurance program for a modern power station such as an SGHWR type reactor plant must include a record of quality achievement. The case history record which is evidence of the actual quality of the plant and is a data bank of design, manufacture, and results of inspections and tests, is described. Documentation distribution, which keeps all key areas informed of plant item quality status, and the retrieval and storage of information, are briefly discussed. (U.K.)

  9. Quality assurance in nuclear medicine

    International Nuclear Information System (INIS)

    Paras, P.

    1978-01-01

    Quality assurance practices must be followed throughout the entire nuclear medicine process, from the initial decision to perform a particular procedure, through the interpretation and reporting of the results. The various parameters that can be defined and measured in each area must be monitored by quality control tests to assure the excellence of the total nuclear medicine process. The presentation will discuss each of the major areas of nuclear medicine quality control and their interaction as a part of the entire system. Quality control testing results and recommendations for measurements of radioactivity distribution will be described with emphasis on imaging equipment and dose calibrating instrumentation. The role of the health physicist in a quality assurance program will be stressed. (author)

  10. Nuclear fuel quality assurance

    International Nuclear Information System (INIS)

    1976-01-01

    Full text: Quality assurance is used extensively in the design, construction and operation of nuclear power plants. This methodology is applied to all activities affecting the quality of a nuclear power plant in order to obtain confidence that an item or a facility will perform satisfactorily in service. Although the achievement of quality is the responsibility of all parties participating in a nuclear power project, establishment and implementation of the quality assurance programme for the whole plant is a main responsibility of the plant owner. For the plant owner, the main concern is to achieve control over the quality of purchased products or services through contractual arrangements with the vendors. In the case of purchase of nuclear fuel, the application of quality assurance might be faced with several difficulties because of the lack of standardization in nuclear fuel and the proprietary information of the fuel manufacturers on fuel design specifications and fuel manufacturing procedures. The problems of quality assurance for purchase of nuclear fuel were discussed in detail during the seminar. Due to the lack of generally acceptable standards, the successful application of the quality assurance concept to the procurement of fuel depends on how much information can be provided by the fuel manufacturer to the utility which is purchasing fuel, and in what form and how early this information can be provided. The extent of information transfer is basically set out in the individual vendor-utility contracts, with some indirect influence from the requirements of regulatory bodies. Any conflict that exists appears to come from utilities which desire more extensive control over the product they are buying. There is a reluctance on the part of vendors to permit close insight of the purchasers into their design and manufacturing procedures, but there nevertheless seems to be an increasing trend towards release of more information to the purchasers. It appears that

  11. Chapter 8: Quality assurance

    International Nuclear Information System (INIS)

    2001-01-01

    The main efforts of Nuclear Regulatory Authority of the Slovak Republic (UJD) have been focused on inspection of quality assurance programmes of Slovak Power Stations, plc. and its daughter companies at Bohunice and Mochovce. Two quality assurance inspections in the area of periodical in service inspections (V-2 units) and tests of selected equipment (NPP V-2 units) and operation control (V-1 units) has been performed at NPPs Bohunice. One violation of decree on quality assurance of selected equipment has been found in the area of documentation archiving. The inspection concerning the implementation of quality assurance programme for operation of NPP Mochovce in the area of operation control has been performed focused on safety aspects of operation, operational procedures, control of operational events and feedback from operational experience. The results of this inspection were positive. Inspection of implementation of quality assurance programme for operation of radioactive waste repository (RU RAW) at the Mochovce location has been performed focused on receiving of containers, with radioactive wastes, containers handling, radiation monitoring, activities of documentation control and radiation protection at the repository site. No serious deficiencies have been found out. Also one inspection of experimental nuclear installations of VUJE Trnava at Jaslovske Bohunice site has been performed focused on procurement control, quality audits, documentation and quality records control when performing activities at experimental nuclear installations. The activity on development of internal quality assurance system continued. The implementation of this system will assure quality and effective fulfilment enlarged tasks of UJD with limited resources for its activity. The analyses of possible use of existing internal administrative control documentation as a basis for future quality system procedures was performed in co-operation with an external specialised organisation. The

  12. Quality assurance of radiopharmaceuticals

    International Nuclear Information System (INIS)

    Frier, M.; Hesslewood, S.R.

    1980-01-01

    A practical guide has been composed for all persons involved in the preparation and use of radiopharmaceuticals on methods used in quality assurance and their applications. These methods include the calibration of ionization chamber assay calibrators, the determination of radionuclide purity, radiochemical purity and chemical purity, particle size analysis and the measurement of pH. Quality assurance procedures are described for products not described in Compendial Monographs, or where the monograph exists, additional useful information is provided; such radiopharmaceuticals include technetium, indium-labelled and iodine-labelled products. (U.K.)

  13. Quality assurance in microbiology

    OpenAIRE

    Arora D

    2004-01-01

    Quality assurance (QA) is the total process whereby the quality of laboratory reports can be guaranteed. The term quality control covers that part of QA, which primarily concerns the control of errors in the performance of tests and verification of test results. All materials, equipment and procedures must be adequately controlled. Culture media must be tested for sterility and performance. Each laboratory must have standard operating procedures (SOPs). QA of pre-analytical, analytical and po...

  14. Measuring health care process quality with software quality measures.

    Science.gov (United States)

    Yildiz, Ozkan; Demirörs, Onur

    2012-01-01

    Existing quality models focus on some specific diseases, clinics or clinical areas. Although they contain structure, process, or output type measures, there is no model which measures quality of health care processes comprehensively. In addition, due to the not measured overall process quality, hospitals cannot compare quality of processes internally and externally. To bring a solution to above problems, a new model is developed from software quality measures. We have adopted the ISO/IEC 9126 software quality standard for health care processes. Then, JCIAS (Joint Commission International Accreditation Standards for Hospitals) measurable elements were added to model scope for unifying functional requirements. Assessment (diagnosing) process measurement results are provided in this paper. After the application, it was concluded that the model determines weak and strong aspects of the processes, gives a more detailed picture for the process quality, and provides quantifiable information to hospitals to compare their processes with multiple organizations.

  15. Development of a quality assurance system for radiotherapy

    International Nuclear Information System (INIS)

    Vroome, I.H. de; Leer, J.W.H.; Corver, R.

    1997-01-01

    Due to 1996 legislation in the Netherlands, every health care facility should have a quality assurance program. Because it is difficult to measure the quality of the product of care, a choice is made to focus on the process of care. For this purpose PACE was founded. (PACE is a Dutch acronym for Project ACcreditation) with as founding members: Public Health Insurance Council, TNO health research, 4 university hospitals and 4 large general hospitals. For in total 19 services and disciplines quality assurance standards where developed by groups in six of the hospitals. (author)

  16. Survey of point-of-care instrumentation, analysis, and quality assurance in veterinary practice.

    Science.gov (United States)

    Bell, Regan; Harr, Kendal; Rishniw, Mark; Pion, Paul

    2014-06-01

    While there have been ASVCP meeting discussions regarding quality assurance plans and lack thereof for in-clinic analyzers, there are little published data regarding in-clinic quality assurance and control practices. The purpose of this study was the identification of the common equipment used in hematologic, biochemical, urinalysis, and other testing, and assessment of quality control and assurance programs currently being performed in-clinic. All members of the Veterinary Information Network (VIN) were solicited to participate in an online survey between July and September 2007. In total, 452 complete or partial responses were received. Eighty-nine percent of respondents (361/404) said that veterinary technicians (unlicensed, licensed, and registered) performed the majority of analyses. Eighty-eight percent (366/417) of respondents performed some quality assurance on their laboratory equipment, most commonly on chemistry (91%, 324/357), and hematology (84%, 292/347) analyzers, and least commonly on fecal analyses (57%, 148/260) and ELISA assays (25%, 65/256). Ignorance of how to perform quality assurance was the most commonly stated reason (49%, 25/51) for lack of a quality assurance program. The majority of practices (316/374) utilized manufacturer-provided reference intervals without further adjustment or assessment. Roughly one-third of respondents (126/374) used reference intervals from textbooks, which is discouraged by ASVCP guidelines. This study found that the majority of respondents were not in compliance with ASVCP guidelines, illustrating the need for improved education of technical staff, veterinary students, and veterinarians regarding limitations of in-clinic laboratory equipment and the importance of regular quality control, maintenance, training, and reference interval development. © 2014 American Society for Veterinary Clinical Pathology and European Society for Veterinary Clinical Pathology.

  17. Health Literacy and Communication Quality in Health Care Organizations

    Science.gov (United States)

    Wynia, Matthew K.; Osborn, Chandra Y.

    2011-01-01

    The relationship between limited health literacy and poor health may be due to poor communication quality within health care delivery organizations. We explored the relationship between health literacy status and receiving patient-centered communication in clinics and hospitals serving communication-vulnerable patient populations. Thirteen health care organizations nationwide distributed a survey to 5,929 patients. All patients completed seven items assessing patient-centered communication. One third also completed three items assessing health literacy. The majority of patients had self-reported health literacy challenges, reporting problems learning about their medical condition because of difficulty understanding written information (53%), a lack of confidence in completing medical forms by themselves (61%), and needing someone to help them read hospital/clinic materials (57%). Logistic regression models showed that, after adjustment for patient demographic characteristics and health care organization type, patients with limited health literacy were 28–79% less likely than those with adequate health literacy to report their health care organization “always” provides patient-centered communication across seven communication items. Using a scaled composite of these items, limited health literacy remained associated with lower reported communication quality. These results suggest that improving communication quality in health care organizations might help to address the challenges facing patients with limited health literacy. They also highlight that efforts to address the needs of patients with limited health literacy should be sensitive to the range of communication challenges confronting these patients and their caregivers. PMID:20845197

  18. Measurement quality assurance

    International Nuclear Information System (INIS)

    Eisenhower, E.H.

    1988-01-01

    The quality of a radiation protection program can be no better than the quality of the measurements made to support it. In many cases, that quality is unknown and is merely implied on the basis of a calibration of a measuring instrument. If that calibration is inappropriate or is performed improperly, the measurement result will be inaccurate and misleading. Assurance of measurement quality can be achieved if appropriate procedures are followed, including periodic quality control actions that demonstrate adequate performance. Several national measurement quality assurance (MQA) programs are operational or under development in specific areas. They employ secondary standards laboratories that provide a high-quality link between the National Bureau of Standards and measurements made at the field use level. The procedures followed by these secondary laboratories to achieve MQA will be described, as well as plans for similar future programs. A growing general national interest in quality assurance, combined with strong specific motivations for MQA in the area of ionizing radiation, will provide continued demand for appropriate national programs. Such programs must, however, employ procedures that are cost effective and must be developed with participation by all affected parties

  19. Quality Assurance Program Description

    Energy Technology Data Exchange (ETDEWEB)

    Halford, Vaughn Edward [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Ryder, Ann Marie [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2017-07-01

    Effective May 1, 2017, led by a new executive leadership team, Sandia began operating within a new organizational structure. National Technology and Engineering Solutions of Sandia (Sandia’s) Quality Assurance Program (QAP) was established to assign responsibilities and authorities, define workflow policies and requirements, and provide for the performance and assessment of work.

  20. Quality management and quality assurance

    International Nuclear Information System (INIS)

    Pieroni, N.

    1991-01-01

    The main common difficulties are presented found in the implementation of effective Quality Management and Quality Assurance Programmes, based on the recommendations of the IAEA International Nuclear Safety Advisory Group, the information collected by the IAEA experts participating in its meetings, and the results of the IAEA Operational Safety Review Team missions. The difficulties were identified in several areas. The most relevant root causes can be characterized as lack of understanding of quality principles and difficulty in implementation by the responsible management. The IAEA programme is described attempting to provide advice and support in the implementation of an effective quality programme through a number of activities including: preparation of practical guidelines, training programmes for management personnel, assistance in building up qualified manpower, and promoting the quest for excellence through the exchange of experience in the implementation of effective Quality Management and Quality Assurance Programmes in nuclear power plants with good performance records. (Z.S.)

  1. Power transformers quality assurance

    CERN Document Server

    Dasgupta, Indrajit

    2009-01-01

    About the Book: With the view to attain higher reliability in power system operation, the quality assurance in the field of distribution and power transformers has claimed growing attention. Besides new developments in the material technology and manufacturing processes of transformers, regular diagnostic testing and maintenance of any engineering product may be ascertained by ensuring: right selection of materials and components and their quality checks. application of correct manufacturing processes any systems engineering. the user`s awareness towards preventive maintenance. The

  2. Software Quality Assurance Metrics

    Science.gov (United States)

    McRae, Kalindra A.

    2004-01-01

    Software Quality Assurance (SQA) is a planned and systematic set of activities that ensures conformance of software life cycle processes and products conform to requirements, standards and procedures. In software development, software quality means meeting requirements and a degree of excellence and refinement of a project or product. Software Quality is a set of attributes of a software product by which its quality is described and evaluated. The set of attributes includes functionality, reliability, usability, efficiency, maintainability, and portability. Software Metrics help us understand the technical process that is used to develop a product. The process is measured to improve it and the product is measured to increase quality throughout the life cycle of software. Software Metrics are measurements of the quality of software. Software is measured to indicate the quality of the product, to assess the productivity of the people who produce the product, to assess the benefits derived from new software engineering methods and tools, to form a baseline for estimation, and to help justify requests for new tools or additional training. Any part of the software development can be measured. If Software Metrics are implemented in software development, it can save time, money, and allow the organization to identify the caused of defects which have the greatest effect on software development. The summer of 2004, I worked with Cynthia Calhoun and Frank Robinson in the Software Assurance/Risk Management department. My task was to research and collect, compile, and analyze SQA Metrics that have been used in other projects that are not currently being used by the SA team and report them to the Software Assurance team to see if any metrics can be implemented in their software assurance life cycle process.

  3. Radiological Protection and Quality Assurance in Health Sciences: Tele-Education for continued Postgraduate Training

    International Nuclear Information System (INIS)

    Alcaraz, M.; Chico, P.; Armero, D.; Saura Iniesta, A. M.; Vicente, V.

    2003-01-01

    The establishment of an inter departmental project, financed by the Spanish Ministry of Education, has made possible the development to specific didactic materials on Radiological Protection and Quality Assurance in Medical Radiodiagnostic Practices. These have been published as a manual and practical notebook. This material constitutes the grounding work for the first continuous tele-education training course via Internet that Spanish professionals exposed to ionising radiation are following. Interactive multimedia training and tele-education may become one of the alternatives that allow health science professionals to receive continuous training, provided that adequate content and aims had been established during undergraduate training. (Author) 18 refs

  4. Lot quality assurance sampling techniques in health surveys in developing countries: advantages and current constraints.

    Science.gov (United States)

    Lanata, C F; Black, R E

    1991-01-01

    Traditional survey methods, which are generally costly and time-consuming, usually provide information at the regional or national level only. The utilization of lot quality assurance sampling (LQAS) methodology, developed in industry for quality control, makes it possible to use small sample sizes when conducting surveys in small geographical or population-based areas (lots). This article describes the practical use of LQAS for conducting health surveys to monitor health programmes in developing countries. Following a brief description of the method, the article explains how to build a sample frame and conduct the sampling to apply LQAS under field conditions. A detailed description of the procedure for selecting a sampling unit to monitor the health programme and a sample size is given. The sampling schemes utilizing LQAS applicable to health surveys, such as simple- and double-sampling schemes, are discussed. The interpretation of the survey results and the planning of subsequent rounds of LQAS surveys are also discussed. When describing the applicability of LQAS in health surveys in developing countries, the article considers current limitations for its use by health planners in charge of health programmes, and suggests ways to overcome these limitations through future research. It is hoped that with increasing attention being given to industrial sampling plans in general, and LQAS in particular, their utilization to monitor health programmes will provide health planners in developing countries with powerful techniques to help them achieve their health programme targets.

  5. Creating Quality Assurance and International Transparency for Quality Assurance Agencies

    DEFF Research Database (Denmark)

    Kristoffersen, Dorte; Lindeberg, Tobias

    2004-01-01

    The paper presents the experiences gained in the pilot project on mutual recognition conducted by the quality assurance agencies in the Nordic countries and the future perspective for international quality assurance of national quality assurance agencies. The background of the project was the nee...

  6. Hospital heterogeneity: what drives the quality of health care.

    Science.gov (United States)

    Ali, Manhal; Salehnejad, Reza; Mansur, Mohaimen

    2018-04-01

    A major feature of health care systems is substantial variation in health care quality across hospitals. The quality of stroke care widely varies across NHS hospitals. We investigate factors that may explain variations in health care quality using measures of quality of stroke care. We combine NHS trust data from the National Sentinel Stroke Audit with other data sets from the Office for National Statistics, NHS and census data to capture hospitals' human and physical assets and organisational characteristics. We employ a class of non-parametric methods to explore the complex structure of the data and a set of correlated random effects models to identify key determinants of the quality of stroke care. The organisational quality of the process of stroke care appears as a fundamental driver of clinical quality of stroke care. There are rich complementarities amongst drivers of quality of stroke care. The findings strengthen previous research on managerial and organisational determinants of health care quality.

  7. [Web-based electronic patient record as an instrument for quality assurance within an integrated care concept].

    Science.gov (United States)

    Händel, A; Jünemann, A G M; Prokosch, H-U; Beyer, A; Ganslandt, T; Grolik, R; Klein, A; Mrosek, A; Michelson, G; Kruse, F E

    2009-03-01

    A prerequisite for integrated care programmes is the implementation of a communication network meeting quality assurance standards. Against this background the main objective of the integrated care project between the University Eye Hospital Erlangen and the health insurance company AOK Bayern was to evaluate the potential and the acceptance of a web-based electronic patient record in the context of cataract and retinal surgery. Standardised modules for capturing pre-, intra- and post-operative data on the basis of clinical pathway guidelines for cataract- and retinal surgery have been developed. There are 6 data sets recorded per patient (1 pre-operative, 1 operative, 4-6 post-operative). For data collection, a web-based communication system (Soarian Integrated Care) has been chosen which meets the high requirements in data security, as well as being easy to handle. This teleconsultation system and the embedded electronic patient record are independent of the software used by respective offices and hospitals. Data transmission and storage were carried out in real-time. At present, 101 private ophthalmologists are taking part in the IGV contract with the University Eye Hospital Erlangen. This corresponds to 52% of all private ophthalmologists in the region. During the period from January 1st 2006 to December 31st 2006, 1844 patients were entered. Complete documentation was achieved in 1390 (75%) of all surgical procedures. For evaluation of this data, a multidimensional report and analysis tool (Cognos) was used. The deviation from target refraction as one quality indicator was in the mean 0.09 diopter. The web-based patient record used in this project was highly accepted by the private ophthalmologists. However there are still general concerns against the exchange of medical data via the internet. Nevertheless, the web-based patient record is an essential tool for a functional integration between the ambulatory and stationary health-care units. In addition to the

  8. BYU Food Quality Assurance Laboratory

    Data.gov (United States)

    Federal Laboratory Consortium — The Quality Assurance Lab is located in the Eyring Science Center in the department of Nutrition, Dietetics, and Food Science. The Quality Assurance Lab has about 10...

  9. Quality assurance program

    International Nuclear Information System (INIS)

    1977-07-01

    This topical report describes the Gibbs and Hill Quality Assurance Program and sets forth the methods to be followed in controlling quality-related activities performed by Gibbs and Hill and its contractors. The program is based on company experience in nuclear power and related work, and defines a system found effective in providing independent control of quality-related functions and documentation. The scope of the report covers activities involving nuclear safety-related structures, systems, and components covered by Gibbs and Hill' contractual obligation to the Utility Owner for each project

  10. Introduction to quality assurance

    International Nuclear Information System (INIS)

    Raisic, N.

    1980-01-01

    Safety requirements set forth in the regulatory requirement, codes, standards as well as other requirements for various aspects of nuclear power plant design and operation are strictly implemented through QA activities. The overall QA aim is to assure that the plant is soundly and correctly designed and that it is built, tested and operated in accordance with stringent quality standards and conservative engineering practices. In this way a high degree of freedom from faults and errors can be achieved. (orig.)

  11. Creating Quality Assurance and International Transparency for Quality Assurance Agencies

    DEFF Research Database (Denmark)

    Kristoffersen, Dorte; Lindeberg, Tobias

    2004-01-01

    , on the one hand, to advance internationalisation of quality assurance of higher education, and on the other hand, allow for the differences in the national approaches to quality assurance. The paper will focus on two issues: first, the strength and weaknesses of the method employed and of the use of the ENQA......The paper presents the experiences gained in the pilot project on mutual recognition conducted by the quality assurance agencies in the Nordic countries and the future perspective for international quality assurance of national quality assurance agencies. The background of the project was the need...

  12. Helical Tomotherapy Quality Assurance

    International Nuclear Information System (INIS)

    Balog, John; Soisson, Emilie

    2008-01-01

    Helical tomotherapy uses a dynamic delivery in which the gantry, treatment couch, and multileaf collimator leaves are all in motion during treatment. This results in highly conformal radiotherapy, but the complexity of the delivery is partially hidden from the end-user because of the extensive integration and automation of the tomotherapy control systems. This presents a challenge to the medical physicist who is expected to be both a system user and an expert, capable of verifying relevant aspects of treatment delivery. A related issue is that a clinical tomotherapy planning system arrives at a customer's site already commissioned by the manufacturer, not by the clinical physicist. The clinical physicist and the manufacturer's representative verify the commissioning at the customer site before acceptance. Theoretically, treatment could begin immediately after acceptance. However, the clinical physicist is responsible for the safe and proper use of the machine. In addition, the therapists and radiation oncologists need to understand the important machine characteristics before treatment can proceed. Typically, treatment begins about 2 weeks after acceptance. This report presents an overview of the tomotherapy system. Helical tomotherapy has unique dosimetry characteristics, and some of those features are emphasized. The integrated treatment planning, delivery, and patient-plan quality assurance process is described. A quality assurance protocol is proposed, with an emphasis on what a clinical medical physicist could and should check. Additionally, aspects of a tomotherapy quality assurance program that could be checked automatically and remotely because of its inherent imaging system and integrated database are discussed

  13. Metrology's role in quality assurance

    International Nuclear Information System (INIS)

    Zeederberg, L.B.

    1982-01-01

    Metrology, the science of measurement, is playing an increasing role in modern industry as part of an on-going quality assurance programme. At Escom, quality assurance was critical during the construction of the Koeberg nuclear facility, and also a function in controlling services provided by Escom. This article deals with the role metrology plays in quality assurance

  14. Quality assurance and quality control

    International Nuclear Information System (INIS)

    Anon.

    1987-01-01

    The practice of nuclear diagnostic imaging requires an appropriate quality assurance program to attain high standards of efficiency and reliability. The International Atomic Energy Agency defines the term quality assurance as ''the closeness with which the outcome of a given procedure approaches some ideal, free from all errors and artifacts.'' The term quality control is used in reference to the specific measures taken to ensure that one particular aspect of the procedure is satisfactory. Therefore, quality assurance is a hospital-wide concept that should involve all aspects of clinical practice. Quality control is concerned with the submission of requests for procedures; the scheduling of patients; the preparation and dispensing of radiopharmaceuticals; the protection of patients, staff, and the general public against radiation hazards and accidents caused by radioactive materials or by faulty equipment; the setting up, use, and maintenance of electronic instruments; the methodology of the actual procedures; the analysis and interpretation of data; the reporting of results; and, finally, the keeping of records. The chapter discusses each of these areas

  15. Concepts and strategies of quality assurance in care for older people.

    NARCIS (Netherlands)

    Nies, H.L.G.R.; Leichsenring, Kai; Boll, Thomas; Ferring, Dieter; Valsiner, Jaan

    2018-01-01

    In the context of globally rising life expectancy the concepts of quality of care and quality of life need to be redefined for older people who need long-term care at some stage of their lives. To ensure access, sustainability of staffing and funding as well as the quality of facilities and services

  16. Joint CDRH (Center for Devices and Radiological Health) and state quality-assurance surveys in nuclear medicine: Phase 2 - radiopharmaceuticals

    International Nuclear Information System (INIS)

    Hamilton, D.R.; Evans, C.D.

    1986-08-01

    The report discusses survey results on aspects of the quality assurance of radio-pharmaceuticals from 180 nuclear-medicine facilities in the United States. Data were collected from facilities in 8 states. Demographic information about nuclear-medicine operations and quality-assurance programs was gathered by state radiation-control-program personnel. The data collected from the survey show an incomplete acceptance of quality-assurance practices for radiopharmaceuticals. Most of the facilities in the survey indicated that, because an inferior radiopharmaceutical was prepared so infrequently, they did not believe it was cost-effective to perform extensive quality-assurance testing. The Center for Devices and Radiological Health hopes that the information from the survey will stimulate nuclear-medicine professionals and their organizations to encourage appropriate testing of all radiopharmaceuticals

  17. How much quality assurance?

    International Nuclear Information System (INIS)

    Beatty, R.A.; Talboy, J.H.

    1988-01-01

    This paper describes the approach used at Argonne National Laboratory to apply the techniques of quality assurance to research and development activities. The discussion includes the approach, the reasons that it is gaining acceptance, and its wide applicability. This approach is founded on the lessons learned in management of quality at Argonne National Laboratory over a period of more than 15 years. The discussion is confined to the practices at the Illinois site of the Laboratory where more than 3000 researchers and support personnel conduct basic and technology-directed research

  18. Quality assurance services

    International Nuclear Information System (INIS)

    For over 20 years the quality assurance services at the Springfields Laboratories have been concerned with manufacturing both simple and complex engineering products to the highest standard. The scientists working there have considerable expertise in the practical application of quality control and the development and design of inspection and non-destructive testing equipment. The folder contains six sheets or leaflets illustrating the work and equipment. The subjects are the mechanical standards laboratory, non-destructive testing, the digitising table, the peripheral camera, automated measurement, data handling and presentation, and the computer controlled three axis co-ordinate measuring machine. (U.K.)

  19. Quality assurance and reliability

    International Nuclear Information System (INIS)

    Normand, J.; Charon, M.

    1975-01-01

    Concern for obtaining high-quality products which will function properly when required to do so is nothing new - it is one manifestation of a conscientious attitude to work. However, the complexity and cost of equipment and the consequences of even temporary immobilization are such that it has become necessary to make special arrangements for obtaining high-quality products and examining what one has obtained. Each unit within an enterprise must examine its own work or arrange for it to be examined; a unit whose specific task is quality assurance is responsible for overall checking, but does not relieve other units of their responsibility. Quality assurance is a form of mutual assistance within an enterprise, designed to remove the causes of faults as far as possible. It begins very early in a project and continues through the ordering stage, construction, start-up trials and operation. Quality and hence reliability are the direct result of what is done at all stages of a project. They depend on constant attention to detail, for even a minor piece of poor workmanship can, in the case of an essential item of equipment, give rise to serious operational difficulties

  20. Tuberculosis Laboratory Diagnosis Quality Assurance among Public Health Facilities in West Amhara Region, Ethiopia.

    Science.gov (United States)

    Shiferaw, Melashu Balew; Hailu, Hiwot Amare; Fola, Abebe Alemu; Derebe, Mulatu Melese; Kebede, Aimro Tadese; Kebede, Abayneh Admas; Emiru, Manamnot Agegne; Gelaw, Zelalem Dessie

    2015-01-01

    Reliable smear microscopy is an important component of Directly Observed Treatment Scheme (DOTS) strategy for TB control program in countries with limited resources. Despite external quality assessment is established in Ethiopia, there is lower TB detection rate (48%) in Amhara region compared to the World Health Organization (WHO) estimate (70%). This highlights the quality of smear microscopy needs to be evaluated. Therefore, the aim of this study was to assess the quality of sputum smear microscopy performance among health center laboratories in West Amhara region, Ethiopia. A cross sectional study was conducted from July 08, 2013 to July 07, 2014. Data were collected from 201 public health center laboratories using a structured questionnaire. Slides were collected based on Lot Quality Assurance Sampling (LQAS) method and rechecked blindly by trained laboratory technologists. The data were entered into EPI info V.7 and smear quality indicators and AFB results were analyzed by SPSS version 20. Among 201 laboratories enrolled in this study, 47 (23.4%) laboratories had major errors. Forty one (20.4%) laboratories had a total of 67 false negative and 29 (14.4%) laboratories had a total of 68 false positive results. Specimen quality, smear thickness and evenness were found poor in 134 (66.7%), 133 (66.2%) and 126 (62.7%) laboratories, respectively. Unavailability of microscope lens cleaning solution (AOR: 2.90; 95% CI: 1.25-6.75; P: 0.013) and dirty smears (AOR: 2.65; 95% CI: 1.14-6.18; P: 0.024) were correlated with false negative results whereas no previous EQA participation (AOR: 3.43; 95% CI: 1. 39-8.45; P: 0.007) was associated with false positive results. The performance of health facilities for sputum smear microscopy was relatively poor in West Amhara region. Hence, strengthening the EQA program and technical support on sputum smear microscopy are recommended to ensure quality tuberculosis diagnostic service.

  1. Tuberculosis Laboratory Diagnosis Quality Assurance among Public Health Facilities in West Amhara Region, Ethiopia.

    Directory of Open Access Journals (Sweden)

    Melashu Balew Shiferaw

    Full Text Available Reliable smear microscopy is an important component of Directly Observed Treatment Scheme (DOTS strategy for TB control program in countries with limited resources. Despite external quality assessment is established in Ethiopia, there is lower TB detection rate (48% in Amhara region compared to the World Health Organization (WHO estimate (70%. This highlights the quality of smear microscopy needs to be evaluated. Therefore, the aim of this study was to assess the quality of sputum smear microscopy performance among health center laboratories in West Amhara region, Ethiopia.A cross sectional study was conducted from July 08, 2013 to July 07, 2014. Data were collected from 201 public health center laboratories using a structured questionnaire. Slides were collected based on Lot Quality Assurance Sampling (LQAS method and rechecked blindly by trained laboratory technologists. The data were entered into EPI info V.7 and smear quality indicators and AFB results were analyzed by SPSS version 20.Among 201 laboratories enrolled in this study, 47 (23.4% laboratories had major errors. Forty one (20.4% laboratories had a total of 67 false negative and 29 (14.4% laboratories had a total of 68 false positive results. Specimen quality, smear thickness and evenness were found poor in 134 (66.7%, 133 (66.2% and 126 (62.7% laboratories, respectively. Unavailability of microscope lens cleaning solution (AOR: 2.90; 95% CI: 1.25-6.75; P: 0.013 and dirty smears (AOR: 2.65; 95% CI: 1.14-6.18; P: 0.024 were correlated with false negative results whereas no previous EQA participation (AOR: 3.43; 95% CI: 1. 39-8.45; P: 0.007 was associated with false positive results.The performance of health facilities for sputum smear microscopy was relatively poor in West Amhara region. Hence, strengthening the EQA program and technical support on sputum smear microscopy are recommended to ensure quality tuberculosis diagnostic service.

  2. Patients' perceptions of service quality dimensions: an empirical examination of health care in New Zealand.

    Science.gov (United States)

    Clemes, M D; Ozanne, L K; Laurensen, W L

    2001-01-01

    The 1984 liberalization of the New Zealand economy has resulted in a health care sector that has become very competitive (Zwier and Clarke, 1999). The private sector is now able to supply health care services and, as a result, a greater value is being placed on patient satisfaction (Zwier and Clarke, 1999). However, despite the increasing focus on customer satisfaction, research into health care patients' perceptions of the dimensions of service quality is scarce. This can be problematic, as quality of care is an essential issue in the strategic marketing of health care services (Turner and Pol, 1995). This study takes a step towards addressing this deficiency by identifying patients' perceptions of the dimensions of service quality in health care. The findings of this study are based on the empirical analysis of a sample of 389 respondents interviewed by telephone. The findings indicate that the service quality dimensions identified in this health care specific study differ in number and dimensional structure from the widely adopted service quality dimensions first identified by Parasuraman, Berry and Zeithaml (1988): reliability, responsiveness, assurance, empathy and tangibles. The service quality dimensions identified in this study were: reliability, tangibles, assurance, empathy, food, access, outcome, admission, discharge and responsiveness. In addition, health care patients perceive the service quality dimensions relating to the core product in health care delivery (for example, outcome and reliability) as more important than the service quality dimensions relating to the peripheral product in health care delivery (for example, food, access and tangibles). Finally, the results of this study suggest that patients with different geographic, demographic, and behavioristic characteristics have different needs and wants during health care delivery and therefore perceive different service quality dimensions as important.

  3. Quality indicators for international benchmarking of mental health care

    DEFF Research Database (Denmark)

    Hermann, Richard C; Mattke, Soeren; Somekh, David

    2006-01-01

    To identify quality measures for international benchmarking of mental health care that assess important processes and outcomes of care, are scientifically sound, and are feasible to construct from preexisting data.......To identify quality measures for international benchmarking of mental health care that assess important processes and outcomes of care, are scientifically sound, and are feasible to construct from preexisting data....

  4. Quality assurance feedback as a nursing management strategy.

    Science.gov (United States)

    Brannon, D; Bucher, J A

    1989-01-01

    Quality assurance and effective nurse management can be viewed as intersecting goals. Objective feedback derived from quality assurance data is a potentially powerful means of enhancing nurses' performance and job satisfaction. The use of automated information systems to provide such direct feedback offers the additional advantage of recognizing nurses as self-monitoring, self-correcting professionals. The need, opportunity, and challenge involved in meshing quality assurance with human resource management through computer-generated feedback are discussed in the context of the home health care setting.

  5. The Effectiveness of Internet Cognitive Behavioural Therapy (iCBT) for Depression in Primary Care: A Quality Assurance Study

    OpenAIRE

    Williams, Alishia D; Andrews, Gavin

    2013-01-01

    BACKGROUND: Depression is a common, recurrent, and debilitating problem and Internet delivered cognitive behaviour therapy (iCBT) could offer one solution. There are at least 25 controlled trials that demonstrate the efficacy of iCBT. The aim of the current paper was to evaluate the effectiveness of an iCBT Program in primary care that had been demonstrated to be efficacious in two randomized controlled trials (RCTs). METHOD: Quality assurance data from 359 patients prescribed the Sadness Pro...

  6. Quality assurance for geologic investigations

    International Nuclear Information System (INIS)

    Delvin, W.L.; Gustafson, L.D.

    1983-01-01

    A quality assurance handbook was written to provide guidance in the application of quality assurance to geologic work activities associated with the National Waste Terminal Storage (NWTS) Program. It is intended to help geoscientists and NWTS program managers in applying quality assurance to their work activities and projects by showing how technical and quality assurance practices are integrated to provide control within those activities and projects. The use of the guidance found in this handbook should help provide consistency in the interpretation of quality assurance requirements across the various geologic activities wihtin the NWTS Program. This handbook also can assist quality assurance personnel in understanding the relationships between technical and quality assurance practices. This paper describes the handbook

  7. Quality assurance for geologic investigations

    International Nuclear Information System (INIS)

    Delvin, W.L.; Gustafson, L.D.

    1983-01-01

    A quality assurance handbook was written to provide guidance in the application of quality assurance to geologic work activities associated with the National Waste Terminal Storage (NWTS) Program. It is intended to help geoscientists and NWTS program managers in applying quality assurance to their work activitie and projects by showing how technical and quality assurance practices are integrated to provide control within those activities and projects. The use of the guidance found in this handbook should help provide consistency in the interpretation of quality assurance requirements across the various geologic activities within the NWTS Program. This handbook also can assist quality assurance personnel in understanding the relationships between technical and quality assurance practices. This paper describes the handbook

  8. Quality assurance records system

    International Nuclear Information System (INIS)

    1979-01-01

    This Safety Guide was prepared as part of the Agency's programme, referred to as the NUSS programme, for establishing Codes of Practice and Safety Guides relating to nuclear power plants. It supplements the IAEA Code of Practice on Quality Assurance for Safety in Nuclear Power Plants (IAEA Safety Series No.50-C-QA), which requires that for each nuclear power plant a system for the generation, identification, collection, indexing, filing, storing, maintenance and disposition of quality assurance records shall be established and executed in accordance with written procedures and instructions. The purpose of this Safety Guide is to provide assistance in the establishment and operation of such a system. An orderly established and maintained records system is considered to be part of the means of providing a basis for an appropriate level of confidence that the activities which affect the quality of a nuclear power plant have been performed in accordance with the specific requirements and that the required quality has been achieved and is maintained

  9. The quality assurance liaison: Combined technical and quality assurance support

    International Nuclear Information System (INIS)

    Bolivar, S.L.; Day, J.L.

    1993-01-01

    This paper describes the role of the quality assurance liaison, the responsibilities of this position, and the evolutionary changes in duties over the last six years. The role of the quality assurance liaison has had a very positive impact on the Los Alamos Yucca Mountain Site Characterization (YW) quality assurance program. Having both technical and quality assurance expertise, the quality assurance liaisons are able to facilitate communications with scientists on quality assurance issues and requirements, thereby generating greater productivity in scientific investigations. The quality assurance liaisons help ensure that the scientific community knows and implements existing requirements, is aware of new or changing regulations, and is able to conduct scientific work within Project requirements. The influence of the role of the quality assurance liaison can be measured by an overall improvement in attitude of the staff regarding quality assurance requirements and improved job performance, as well as a decrease in deficiencies identified during both internal and external audits and surveillances. This has resulted in a more effective implementation of quality assurance requirements

  10. Designing and implementing a trust-wide quality assurance programme.

    Science.gov (United States)

    Coope, Sally-Ann

    2018-04-02

    Derbyshire Community Health Services (DCHS) NHS Foundation Trust provides a wide range of community-based health services. After the Care Quality Commission (CQC) found gaps in the trust's assurance process, its board decided to develop a method of continuous quality improvements that could be used as a basis for the trust's quality assurance system. The trust adapted and built on an acute model so it was suitable for community services. The final assurance system, Quality Always, has four elements: the clinical assessment and accreditation scheme; leadership development; 'champions' within clinical teams to support and promote the scheme; and dashboards to record and monitor progress. A system to recognise and reward achievement was essential for success. Quality Always has resulted in better care quality, an improved CQC rating, a sense of achievement among staff, the development of support networks, learning (especially among support staff) and good practice being shared.

  11. Hyperthermia quality assurance

    International Nuclear Information System (INIS)

    Shrivastava, P.N.; Paliwal, B.R.

    1984-01-01

    Hyperthermia Physics Center (HPC) operating under contract with the National Cancer Institute is developing a Quality Assurance program for local and regional hyperthermia. The major clinical problem in hyperthermia treatments is that they are extremely difficult to plan, execute, monitor and reproduce. A scientific basis for treatment planning can be established only after ensuring that the performance of heat generating and temperature monitoring systems are reliable. The HPC is presently concentrating on providing uniform NBS traceable calibration of thermometers and evaluation of reproducibility for power generator operation, applicator performance, phanta compositions, system calibrations and personnel shielding. The organizational plan together with recommended evaluation measurements, procedures and criteria are presented

  12. Concrete quality assurance

    Energy Technology Data Exchange (ETDEWEB)

    Holz, N. [Harza Engineering Company, Chicago, IL (United States)

    2000-08-01

    This short article reports on progress at the world's largest civil construction project, namely China's Three Gorges hydro project. Work goes on around the clock to put in place nearly 28 M m{sup 3} of concrete. At every stage of the work there is strong emphasis on quality assurance (QA) and concrete is no exception. The US company Harza Engineering has been providing QA since the mid-1980s and concrete QA has been based on international standards. Harza personnel work in the field with supervisors developing educational tools for supervising concrete construction and quality, as well as providing training courses in concrete technology. Some details on flood control, capacity, water quality and environmental aspects are given..

  13. Quality-based financial incentives in health care: can we improve quality by paying for it?

    Science.gov (United States)

    Conrad, Douglas A; Perry, Lisa

    2009-01-01

    This article asks whether financial incentives can improve the quality of health care. A conceptual framework drawn from microeconomics, agency theory, behavioral economics, and cognitive psychology motivates a set of propositions about incentive effects on clinical quality. These propositions are evaluated through a synthesis of extant peer-reviewed empirical evidence. Comprehensive financial incentives--balancing rewards and penalties; blending structure, process, and outcome measures; emphasizing continuous, absolute performance standards; tailoring the size of incremental rewards to increasing marginal costs of quality improvement; and assuring certainty, frequency, and sustainability of incentive payoffs--offer the prospect of significantly enhancing quality beyond the modest impacts of prevailing pay-for-performance (P4P) programs. Such organizational innovations as the primary care medical home and accountable health care organizations are expected to catalyze more powerful quality incentive models: risk- and quality-adjusted capitation, episode of care payments, and enhanced fee-for-service payments for quality dimensions (e.g., prevention) most amenable to piece-rate delivery.

  14. How does the culture of medical group practices influence the types of programs used to assure quality of care?

    Science.gov (United States)

    Kaissi, Amer; Kralewski, John; Curoe, Ann; Dowd, Bryan; Silversmith, Janet

    2004-01-01

    It is widely acknowledged that the culture of medical group practices greatly influences the quality of care, but little is known about how cultures are translated into specific types of programs focused on quality. This study explores this issue by assessing the influence of the organizational culture on these types of programs in medical group practices in the upper Midwest. Data were obtained from two surveys of medical group practices. The first survey was designed to assess the culture of the practice using a nine-dimension instrument developed previously. The second survey was designed to obtain organizational structure data including the programs identified by the literature as important to the quality of care in medical practices. Completed surveys were obtained from eighty-eight medical groups. The relationship of the group practice culture to structural programs focused on quality of care was analyzed using logistic regression equations. Several interesting patterns emerged. As expected, practices with a strong information culture favor electronic data systems and formal programs that provide comparative or evidence-based data to enhance their clinical practices. However, those with a quality-centered culture appear to prefer patient satisfaction surveys to assess the quality of their care, while practices that are more business-oriented rely on bureaucratic strategies such as benchmarking and physician profiling. Cultures that emphasize the autonomy of physician practice were negatively (but not at a statistically significant level) associated with all the programs studied. Practices with a highly collegial culture appear to rely on informal peer review mechanisms to assure quality rather than any of the structural programs included in this analysis. This study suggests that the types of quality programs that group practices develop differ according to their cultures. Consequently, it is important for practice administrators and medical directors to

  15. 30 CFR 7.7 - Quality assurance.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Quality assurance. 7.7 Section 7.7 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR TESTING, EVALUATION, AND APPROVAL OF MINING PRODUCTS TESTING BY APPLICANT OR THIRD PARTY General § 7.7 Quality assurance. Applicants granted...

  16. 30 CFR 15.8 - Quality assurance.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Quality assurance. 15.8 Section 15.8 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR TESTING, EVALUATION, AND APPROVAL OF... § 15.8 Quality assurance. (a) Applicants granted an approval or an extension of approval under this...

  17. [Quality assurance of pain care in Austria : Classification of management facilities].

    Science.gov (United States)

    Jaksch, Wolfgang; Likar, Rudolf; Folkes, Erika; Machold, Klaus; Herbst, Friedrich; Pils, Katharina; Stippl, Peter; Lettner, Sandra; Alfons, Mildred; Crevenna, Richard; Wiederer, Christian; Dieber, Janina; Glehr, Reinhold

    2017-11-01

    In Austria there is no nationwide coverage of pain management, which meets even approximately international criteria. At present there are about 30 interdisciplinary pain management offices and clinics providing care according to a concept of the Austrian Pain Society (ÖSG), about 10 other outpatient pain clinics are located in district and country hospitals. A few years ago, there still were about 50 pain clinics. Yet closure of outpatient clinics and cost-cutting measures in the health sector jeopardize adequate pain relief for patients with chronic pain conditions.Hence, the supply of care for approx. 1.8 mio. Austrians with chronic pain is not guaranteed due to lack of a comprehensive demand planning of pain care facilities. Furthermore, existing structures such as specialized clinics or emergency services in hospitals are primarily based on the personal commitment of individuals. At present, the various centres for pain management in Austria are run with very different operating times, so that for 74% of the chronic pain patients the desired requirements for outpatient pain management are not met and about 50 full-time pain clinics are missing.Under the patronage of the Austrian Pain Society, various national specialist societies have defined the structure and quality criteria for pain management centres in Austria, include, among others, proof of training, cooperation in interdisciplinary teams or minimum number of new patients per year, depending on the classification of the institution.This stepwise concept of care provision for pain patients is intended as first step to help improve the care of pain patients in Austria!

  18. Quality assurance considerations in nuclear waste management

    International Nuclear Information System (INIS)

    Delvin, W.L.

    1982-01-01

    Proper use of quality assurance will provide the basis for an effective management control system for nuclear waste management programs. Control is essential for achieving successful programs free from costly losses and failures and for assuring the public and regulators that the environment and health and safety are being protected. The essence of quality assurance is the conscientious use of planned and systematic actions, based on selecting and applying appropriate requirements from an established quality assurance standard. Developing a quality assurance program consists of using knowledge of the technical and managerial aspects of a project to identify and evaluate risks of loss and failure and then to select appropriate quality assurance requirements that will minimize the risks. Those requirements are integrated into the project planning documents and are carried out as specific actions during the life of the project

  19. Incorporating health care quality into health antitrust law

    Science.gov (United States)

    2008-01-01

    Background Antitrust authorities treat price as a proxy for hospital quality since health care quality is difficult to observe. As the ability to measure quality improved, more research became necessary to investigate the relationship between hospital market power and patient outcomes. This paper examines the impact of hospital competition on the quality of care as measured by the risk-adjusted mortality rates with the hospital as the unit of analysis. The study separately examines the effect of competition on non-profit hospitals. Methods We use California Office of Statewide Health Planning and Development (OSHPD) data from 1997 through 2002. Empirical model is a cross-sectional study of 373 hospitals. Regression analysis is used to estimate the relationship between Coronary Artery Bypass Graft (CABG) risk-adjusted mortality rates and hospital competition. Results Regression results show lower risk-adjusted mortality rates in the presence of a more competitive environment. This result holds for all alternative hospital market definitions. Non-profit hospitals do not have better patient outcomes than investor-owned hospitals. However, they tend to provide better quality in less competitive environments. CABG volume did not have a significant effect on patient outcomes. Conclusion Quality should be incorporated into the antitrust analysis. When mergers lead to higher prices and lower quality, thus lower social welfare, the antitrust challenge of hospital mergers is warranted. The impact of lower hospital competition on quality of care delivered by non-profit hospitals is ambiguous. PMID:18430219

  20. Incorporating health care quality into health antitrust law

    Directory of Open Access Journals (Sweden)

    Schneider Helen

    2008-04-01

    Full Text Available Abstract Background Antitrust authorities treat price as a proxy for hospital quality since health care quality is difficult to observe. As the ability to measure quality improved, more research became necessary to investigate the relationship between hospital market power and patient outcomes. This paper examines the impact of hospital competition on the quality of care as measured by the risk-adjusted mortality rates with the hospital as the unit of analysis. The study separately examines the effect of competition on non-profit hospitals. Methods We use California Office of Statewide Health Planning and Development (OSHPD data from 1997 through 2002. Empirical model is a cross-sectional study of 373 hospitals. Regression analysis is used to estimate the relationship between Coronary Artery Bypass Graft (CABG risk-adjusted mortality rates and hospital competition. Results Regression results show lower risk-adjusted mortality rates in the presence of a more competitive environment. This result holds for all alternative hospital market definitions. Non-profit hospitals do not have better patient outcomes than investor-owned hospitals. However, they tend to provide better quality in less competitive environments. CABG volume did not have a significant effect on patient outcomes. Conclusion Quality should be incorporated into the antitrust analysis. When mergers lead to higher prices and lower quality, thus lower social welfare, the antitrust challenge of hospital mergers is warranted. The impact of lower hospital competition on quality of care delivered by non-profit hospitals is ambiguous.

  1. Clinical quality assurance in radiation oncology

    International Nuclear Information System (INIS)

    Anon.

    1991-01-01

    A quality assurance program in radiation oncology monitors and evaluates any departmental functions which have an impact on patient outcome. The ultimate purpose of the program is to maximize health benefit to the patient without a corresponding increase in risk. The foundation of the program should be the credo: at least do no harm, usually do some good and ideally realize the greatest good. The steep dose response relationships for tumor control and complications require a high degree of accuracy and precision throughout the entire process of radiation therapy. It has been shown that failure to control local disease with radiation may result in decreased survival and may increase the cost of care by a factor of 3. Therefore, a comprehensive quality assurance program which seeks to optimize dose delivery and which encompasses both clinical and physics components, is needed

  2. Diabetes care may be improved with Steno Quality Assurance Tool--a self-assessment tool in diabetes management

    DEFF Research Database (Denmark)

    Bjerre-Christensen, Ulla; Nielsen, Annemette Anker; Binder, Christian

    2014-01-01

    AIM: To evaluate if improvements in the quality of diabetes care in Indian clinics can be obtained by simple self-surveillance PC-based software. METHOD: Nineteen Indian diabetes clinics were introduced to the principles of quality assurance (QA), and to a software program, the Steno Quality...... patients (baseline) and 4440 (follow-up). The average examination frequency per clinic of the following indicators increased significantly: lipid examination (72-87%) (p=0.007), foot examination (80-94%) (p=0.02), HbA1c investigation (59-77%) (p=0.006), and urine albumin excretion investigation (72-87%) (p.......002). CONCLUSION: Quality of diabetes care can be improved by applying SQAT, a QA self-surveillance software that enables documentation of changes in process and outcome indicators....

  3. Quality assurance for electronic portal imaging devices

    International Nuclear Information System (INIS)

    Shalev, S.; Rajapakshe, R.; Gluhchev, G.; Luchka, K.

    1997-01-01

    Electronic portal imaging devices (EPIDS) are assuming an ever-increasing role in the verification of radiation treatment accuracy. They are used both in a passive capacity, for the determination of field displacement distributions (''setup errors''), and also in an active role whereby the patient setup is corrected on the basis of electronic portal images. In spite of their potential impact on the precision of patient treatment, there are few quality assurance procedures available, and most of the EPIDS in clinical use are subject, at best, to only perfunctory quality assurance. The goals of this work are (a) to develop an objective and reproducible test for EPID image quality on the factory floor and during installation of the EPID on site; (b) to provide the user with a simple and accurate tool for acceptance, commissioning, and routine quality control; and (c) to initiate regional, national and international collaboration in the implementation of standardized, objective, and automated quality assurance procedures. To this end we have developed an automated test in which a simple test object is imaged daily, and the spatial and contrast resolution of the EPID are automatically evaluated in terms of ''acceptable'', ''warning'' and ''stop'' criteria. Our experience over two years shows the test to be highly sensitive, reproducible, and inexpensive in time and effort. Inter-institutional trials are under way in Canada, US and Europe which indicate large variations in EPID image quality from one EPID to another, and from one center to another. We expect the new standardized quality assurance procedure to lead to improved, and consistent image quality, increased operator acceptance of the technology, and agreement on uniform standards by equipment suppliers and health care agencies. (author)

  4. Experiencing health care service quality: through patients' eyes.

    Science.gov (United States)

    Schembri, Sharon

    2015-02-01

    The primary aim of the present study was to consider health care service quality from the patients' perspective, specifically through the patient's eyes. A narrative analysis was performed on 300 patient stories. This rigorous analysis of patient stories is designed to identify and describe health care service quality through patients' eyes in an authentic and accurate, experiential manner. The findings show that there are variant and complex ways that patients experience health care service quality. Patient stories offer an authentic view of the complex ways that patients experience health care service quality. Narrative analysis is a useful tool to identify and describe how patients experience health care service quality. Patients experience health care service quality in complex and varying ways.

  5. [Quality assurance in human genetic testing].

    Science.gov (United States)

    Stuhrmann-Spangenberg, Manfred

    2015-02-01

    Advances in technical developments of genetic diagnostics for more than 50 years, as well as the fact that human genetic testing is usually performed only once in a lifetime, with additional impact for blood relatives, are determining the extraordinary importance of quality assurance in human genetic testing. Abidance of laws, directives, and guidelines plays a major role. This article aims to present the major laws, directives, and guidelines with respect to quality assurance of human genetic testing, paying careful attention to internal and external quality assurance. The information on quality assurance of human genetic testing was obtained through a web-based search of the web pages that are referred to in this article. Further information was retrieved from publications in the German Society of Human Genetics and through a PubMed-search using term quality + assurance + genetic + diagnostics. The most important laws, directives, and guidelines for quality assurance of human genetic testing are the gene diagnostics law (GenDG), the directive of the Federal Medical Council for quality control of clinical laboratory analysis (RiliBÄK), and the S2K guideline for human genetic diagnostics and counselling. In addition, voluntary accreditation under DIN EN ISO 15189:2013 offers a most recommended contribution towards quality assurance of human genetic testing. Legal restraints on quality assurance of human genetic testing as mentioned in § 5 GenDG are fulfilled once RiliBÄK requirements are followed.

  6. A mobile health technology platform for quality assurance and quality improvement of malaria diagnosis by community health workers.

    Directory of Open Access Journals (Sweden)

    Jeremiah Laktabai

    Full Text Available Community health workers (CHWs play an important role in improving access to services in areas with limited health infrastructure or workforce. Supervision of CHWs by qualified health professionals is the main link between this lay workforce and the formal health system. The quality of services provided by lay health workers is dependent on adequate supportive supervision. It is however one of the weakest links in CHW programs due to logistical and resource constraints, especially in large scale programs. Interventions such as point of care testing using malaria rapid diagnostic tests (RDTs require real time monitoring to ensure diagnostic accuracy. In this study, we evaluated the utility of a mobile health technology platform to remotely monitor malaria RDT (mRDT testing by CHWs for quality improvement.As part of a large implementation trial involving mRDT testing by CHWs, we introduced the Fionet system composed of a mobile device (Deki Reader, DR to assist in processing and automated interpretation of mRDTs, which connects to a cloud-based database which captures reports from the field in real time, displaying results in a custom dashboard of key performance indicators. A random sample of 100 CHWs were trained and provided with the Deki Readers and instructed to use it on 10 successive patients. The CHWs interpretation was compared with the Deki Reader's automatic interpretation, with the errors in processing and interpreting the RDTs recorded. After the CHW entered their interpretation on the DR, the DR provided immediate, automated feedback and interpretation based on its reading of the same cassette. The study team monitored the CHW performance remotely and provided additional support.A total of 1251 primary and 113 repeat tests were performed by the 97 CHWs who used the DR. 91.6% of the tests had agreement between the DR and the CHWs. There were 61 (4.9% processing and 52 (4.2% interpretation errors among the primary tests. There was a

  7. A mobile health technology platform for quality assurance and quality improvement of malaria diagnosis by community health workers.

    Science.gov (United States)

    Laktabai, Jeremiah; Platt, Alyssa; Menya, Diana; Turner, Elizabeth L; Aswa, Daniel; Kinoti, Stephen; O'Meara, Wendy Prudhomme

    2018-01-01

    Community health workers (CHWs) play an important role in improving access to services in areas with limited health infrastructure or workforce. Supervision of CHWs by qualified health professionals is the main link between this lay workforce and the formal health system. The quality of services provided by lay health workers is dependent on adequate supportive supervision. It is however one of the weakest links in CHW programs due to logistical and resource constraints, especially in large scale programs. Interventions such as point of care testing using malaria rapid diagnostic tests (RDTs) require real time monitoring to ensure diagnostic accuracy. In this study, we evaluated the utility of a mobile health technology platform to remotely monitor malaria RDT (mRDT) testing by CHWs for quality improvement. As part of a large implementation trial involving mRDT testing by CHWs, we introduced the Fionet system composed of a mobile device (Deki Reader, DR) to assist in processing and automated interpretation of mRDTs, which connects to a cloud-based database which captures reports from the field in real time, displaying results in a custom dashboard of key performance indicators. A random sample of 100 CHWs were trained and provided with the Deki Readers and instructed to use it on 10 successive patients. The CHWs interpretation was compared with the Deki Reader's automatic interpretation, with the errors in processing and interpreting the RDTs recorded. After the CHW entered their interpretation on the DR, the DR provided immediate, automated feedback and interpretation based on its reading of the same cassette. The study team monitored the CHW performance remotely and provided additional support. A total of 1251 primary and 113 repeat tests were performed by the 97 CHWs who used the DR. 91.6% of the tests had agreement between the DR and the CHWs. There were 61 (4.9%) processing and 52 (4.2%) interpretation errors among the primary tests. There was a tendency

  8. Quality-Assurance Program Plan

    International Nuclear Information System (INIS)

    Kettell, R.A.

    1981-05-01

    This Quality Assurance Program Plan (QAPP) is provided to describe the Quality Assurance Program which is applied to the waste management activities conducted by AESD-Nevada Operations at the E-MAD Facility located in Area 25 of the Nevada Test Site. The AESD-Nevada Operations QAPP provides the necessary systematic and administrative controls to assure activities that affect quality, safety, reliability, and maintainability during design, procurement, fabrication, inspection, shipments, tests, and storage are conducted in accordance with established requirements

  9. Towards improvement in quality assurance

    International Nuclear Information System (INIS)

    1987-03-01

    This first document in the series of the International Nuclear Safety Advisory Group (INSAG) Technical Notes is a general guideline for the establishment of effective quality assurance procedures at nuclear facilities. It sets out primary requirements such as quality objectives, methods for measuring the effectiveness of the quality assurance programme, priority of activities in relation to importance of safety of items, motivation of personnel

  10. Monitoring maternal, newborn, and child health interventions using lot quality assurance sampling in Sokoto State of northern Nigeria

    Directory of Open Access Journals (Sweden)

    Dele Abegunde

    2015-10-01

    Full Text Available Background: Maternal mortality ratio and infant mortality rate are as high as 1,576 per 100,000 live births and 78 per 1,000 live births, respectively, in Nigeria's northwestern region, where Sokoto State is located. Using applicable monitoring indicators for tracking progress in the UN/WHO framework on continuum of maternal, newborn, and child health care, this study evaluated the progress of Sokoto toward achieving the Millennium Development Goals (MDGs 4 and 5 by December 2015. The changes in outcomes in 2012–2013 associated with maternal and child health interventions were assessed. Design: We used baseline and follow-up lot quality assurance sampling (LQAS data obtained in 2012 and 2013, respectively. In each of the surveys, data were obtained from 437 households sampled from 19 LQAS locations in each of the 23 local government areas (LGAs. The composite state-level coverage estimates of the respective indicators were aggregated from estimated LGA coverage estimates. Results: None of the nine indicators associated with the continuum of maternal, neonatal, and child care satisfied the recommended 90% coverage target for achieving MDGs 4 and 5. Similarly, the average state coverage estimates were lower than national coverage estimates. Marginal improvements in coverage were obtained in the demand for family planning satisfied, antenatal care visits, postnatal care for mothers, and exclusive breast-feeding. Antibiotic treatment for acute pneumonia increased significantly by 12.8 percentage points. The majority of the LGAs were classifiable as low-performing, high-priority areas for intensified program intervention. Conclusions: Despite the limited time left in the countdown to December 2015, Sokoto State, Nigeria, is not on track to achieving the MDG 90% coverage of indicators tied to the continuum of maternal and child care, to reduce maternal and childhood mortality by a third by 2015. Targeted health system investments at the primary care

  11. Monitoring maternal, newborn, and child health interventions using lot quality assurance sampling in Sokoto State of northern Nigeria.

    Science.gov (United States)

    Abegunde, Dele; Orobaton, Nosa; Shoretire, Kamil; Ibrahim, Mohammed; Mohammed, Zainab; Abdulazeez, Jumare; Gwamzhi, Ringpon; Ganiyu, Akeem

    2015-01-01

    Maternal mortality ratio and infant mortality rate are as high as 1,576 per 100,000 live births and 78 per 1,000 live births, respectively, in Nigeria's northwestern region, where Sokoto State is located. Using applicable monitoring indicators for tracking progress in the UN/WHO framework on continuum of maternal, newborn, and child health care, this study evaluated the progress of Sokoto toward achieving the Millennium Development Goals (MDGs) 4 and 5 by December 2015. The changes in outcomes in 2012-2013 associated with maternal and child health interventions were assessed. We used baseline and follow-up lot quality assurance sampling (LQAS) data obtained in 2012 and 2013, respectively. In each of the surveys, data were obtained from 437 households sampled from 19 LQAS locations in each of the 23 local government areas (LGAs). The composite state-level coverage estimates of the respective indicators were aggregated from estimated LGA coverage estimates. None of the nine indicators associated with the continuum of maternal, neonatal, and child care satisfied the recommended 90% coverage target for achieving MDGs 4 and 5. Similarly, the average state coverage estimates were lower than national coverage estimates. Marginal improvements in coverage were obtained in the demand for family planning satisfied, antenatal care visits, postnatal care for mothers, and exclusive breast-feeding. Antibiotic treatment for acute pneumonia increased significantly by 12.8 percentage points. The majority of the LGAs were classifiable as low-performing, high-priority areas for intensified program intervention. Despite the limited time left in the countdown to December 2015, Sokoto State, Nigeria, is not on track to achieving the MDG 90% coverage of indicators tied to the continuum of maternal and child care, to reduce maternal and childhood mortality by a third by 2015. Targeted health system investments at the primary care level remain a priority, for intensive program scale-up to

  12. Quality assurance of fuel elements

    International Nuclear Information System (INIS)

    Hoerber, J.

    1980-01-01

    The quality assurance activities for reactor fuel elements are based on a quality assurance system which implies the requirements resulting from the specifications, regulations of the authorities, national standards and international rules and regulations. The quality assurance related to production of reactor fuel will be shown for PWR fuel elements in all typical fabrication steps as conversion into UO 2 -powder, pelletizing, rodmanufacture and assembling. A wide range of destructive and nondestructive techniques is applied. Quality assurance is not only verified by testing techniques but also by process monitoring by means of parameter control in production and testing procedures. (RW)

  13. FESA Quality Assurance

    CERN Multimedia

    CERN. Geneva

    2015-01-01

    FESA is a framework used by 100+ developers at CERN to design and implement the real-time software used to control the accelerators. Each new version must be tested and qualified to ensure that no backward compatibility issues have been introduced and that there is no major bug which might prevent accelerator operations. Our quality assurance approach is based on code review and a two-level testing process. The first level is made of unit-test (Python unittest & Google tests for C++). The second level consists of integration tests running on an isolated test environment. We also use a continuous integration service (Bamboo) to ensure the tests are executed periodically and the bugs caught early. In the presentation, we will explain the reasons why we took this approach, the results and some thoughts on the pros and cons.

  14. Subsurface quality assurance practices

    International Nuclear Information System (INIS)

    1987-08-01

    This report addresses only the concept of applying Nuclear Quality Assurance (NQA) practices to repository shaft and subsurface design and construction; how NQA will be applied; and the level of detail required in the documentation for construction of a shaft and subsurface repository in contrast to the level of detail required in the documentation for construction of a traditional mine. This study determined that NQA practices are viable, attainable, as well as required. The study identified the appropriate NQA criteria and the repository's major structures, systems, items, and activities to which the criteria are applicable. A QA plan, for design and construction, and a list of documentation, for construction, are presented. 7 refs., 1 fig., 18 tabs

  15. Construction quality assurance report

    International Nuclear Information System (INIS)

    Roscha, V.

    1994-01-01

    This report provides a summary of the construction quality assurance (CQA) observation and test results, including: The results of the geosynthetic and soil materials conformance testing. The observation and testing results associates with the installation of the soil liners. The observation and testing results associated with the installation of the HDPE geomembrane liner systems. The observation and testing results associated with the installation of the leachate collection and removal systems. The observation and testing results associated with the installation of the working surfaces. The observation and testing results associated with in-plant manufacturing process. Summary of submittal reviews by Golder Construction Services, Inc. The submittal and certification of the piping material specifications. The observation and verification associated of the Acceptance Test Procedure results of the operational equipment functions. Summary of the ECNs which are incorporated into the project

  16. Quality assurance and quality control

    International Nuclear Information System (INIS)

    Kaden, W.

    1986-01-01

    General preconditions and methods for QA work in the nuclear field are analysed. The application of general QA principles to actual situations is illustrated by examples in the fields of engineering and of the manufacturing of mechanical and electrical components. All QA measures must be fitted to the complexity and relevance of the work steps, which are under consideration. The key to good product quality is the control of working processes. The term 'controlled process' is discussed in detail and examples of feed back systems are given. The main QA measures for the operation of nuclear power plants include the establishment of a Quality Assurance Program, training and qualification of personnel, procurement control, inspection and tests, reviews and audits. These activities are discussed. (orig.)

  17. Construction of quality-assured infant feeding process of care data repositories: definition and design (Part 1).

    Science.gov (United States)

    Garcí A-de-León-Chocano, Ricardo; Sáez, Carlos; Muñoz-Soler, Verónica; Garcí A-de-León-González, Ricardo; García-Gómez, Juan M

    2015-12-01

    This is the first paper of a series of two regarding the construction of data quality (DQ) assured repositories for the reuse of information on infant feeding from birth until two years old. This first paper justifies the need for such repositories and describes the design of a process to construct them from Electronic Health Records (EHR). As a result, Part 1 proposes a computational process to obtain quality-assured datasets represented by a canonical structure extracted from raw data from multiple EHR. For this, 13 steps were defined to ensure the harmonization, standardization, completion, de-duplication, and consistency of the dataset content. Moreover, the quality of the input and output data for each of these steps is controlled according to eight DQ dimensions: predictive value, correctness, duplication, consistency, completeness, contextualization, temporal-stability and spatial-stability. The second paper of the series will describe the application of this computational process to construct the first quality-assured repository for the reuse of information on infant feeding in the perinatal period aimed at the monitoring of clinical activities and research. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Implementation of a quality assurance instrument (Preffi 1.0) to improve the effectiveness of health promotion in The Netherlands

    NARCIS (Netherlands)

    Molleman, G.R.M.; Peters, L.W.H.; Hosman, C.M.H.; Kok, G.J.

    2005-01-01

    This paper describes the design and outcomes of implementing Preffi 1.0, a quality assurance instrument for health promotion (HP) interventions, among Dutch HP professionals. The Preffi instrument promotes a systematic way of working that is driven by evidence, which is expected to lead to

  19. The Quality of Health Care Received by Older Adults

    National Research Council Canada - National Science Library

    2004-01-01

    .... Older adults suffer from a multitude of conditions and are especially susceptible to the effects of poor care, yet we know relatively little about the quality of health care older people receive...

  20. Recent Trends in Quality Assurance

    Science.gov (United States)

    Amaral, Alberto; Rosa, Maria Joao

    2010-01-01

    In this paper we present a brief description of the evolution of quality assurance in Europe, paying particular attention to its relationship to the rising loss of trust in higher education institutions. We finalise by analysing the role of the European Commission in the setting up of new quality assurance mechanisms that tend to promote…

  1. Quality assurance of operating instructions

    International Nuclear Information System (INIS)

    Asmuss, G.

    1992-01-01

    It is pointed out that the quality assurance at nuclear power stations must be supported by national and international regulations. Quality assurance is explained using the example of the design of a pressurised water reactor. The operating and emergency manuals are discussed and examples for their structure put forward. The significance of updating is emphasised. 15 figs., 19 refs

  2. Project Specific Quality Assurance Plan

    International Nuclear Information System (INIS)

    Pedersen, K.S.

    1995-01-01

    This Quality Assurance Project Plan (QAPP) identifies the Westinghouse Hanford Co. (WHC) Quality Assurance (QA) program requirements for all contractors involved in the planning and execution of the design, construction, testing and inspection of the 200 Area Effluent BAT/AKART Implementation, Project W-291

  3. Construction of quality-assured infant feeding process of care data repositories: Construction of the perinatal repository (Part 2).

    Science.gov (United States)

    García-de-León-Chocano, Ricardo; Muñoz-Soler, Verónica; Sáez, Carlos; García-de-León-González, Ricardo; García-Gómez, Juan M

    2016-04-01

    This is the second in a series of two papers regarding the construction of data quality (DQ) assured repositories, based on population data from Electronic Health Records (EHR), for the reuse of information on infant feeding from birth until the age of two. This second paper describes the application of the computational process of constructing the first quality-assured repository for the reuse of information on infant feeding in the perinatal period, with the aim of studying relevant questions from the Baby Friendly Hospital Initiative (BFHI) and monitoring its deployment in our hospital. The construction of the repository was carried out using 13 semi-automated procedures to assess, recover or discard clinical data. The initial information consisted of perinatal forms from EHR related to 2048 births (Facts of Study, FoS) between 2009 and 2011, with a total of 433,308 observations of 223 variables. DQ was measured before and after the procedures using metrics related to eight quality dimensions: predictive value, correctness, duplication, consistency, completeness, contextualization, temporal-stability, and spatial-stability. Once the predictive variables were selected and DQ was assured, the final repository consisted of 1925 births, 107,529 observations and 73 quality-assured variables. The amount of discarded observations mainly corresponds to observations of non-predictive variables (52.90%) and the impact of the de-duplication process (20.58%) with respect to the total input data. Seven out of thirteen procedures achieved 100% of valid births, observations and variables. Moreover, 89% of births and ~98% of observations were consistent according to the experts׳ criteria. A multidisciplinary approach along with the quantification of DQ has allowed us to construct the first repository about infant feeding in the perinatal period based on EHR population data. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. An overview of quality assurance

    International Nuclear Information System (INIS)

    Morris, I.T.

    1983-01-01

    A good quality assurance program seeks to minimise radiation exposure and maximise image quality. Factors considered are equipment performance, films and screens, film processing, viewing conditions and film repeats

  5. Quality Assurance Training Tracking (QATTS)

    Data.gov (United States)

    U.S. Environmental Protection Agency — This is metadata documentation for the Quality Assurance Training Tracking System (QATTS) which tracks Quality Assurace training given by R7 QA staff to in-house...

  6. Material quality assurance risk assessment.

    Science.gov (United States)

    2013-01-01

    Over the past two decades the role of SHA has shifted from quality control (QC) of materials and : placement techniques to quality assurance (QA) and acceptance. The role of the Office of Materials : Technology (OMT) has been shifting towards assuran...

  7. [Quality assurance in colorectal cancer in Europe AD 2011].

    Science.gov (United States)

    Mroczkowski, P; Hac, S; Lippert, H; Kube, R

    2013-12-01

    Malignant tumours are the second largest cause of death in Europe. Colorectal cancer takes second place within this group and is responsible for every eighth tumour-related death. Surgical quality assurance requires a prospective observational study, any different type of study is not possible. A complete recording of all treated patients is a prerequisite for quality assurance. Currently, there are quality assurance programmes in Sweden, Norway, Denmark, Great Britain, Spain, Belgium, the Netherlands as well as the multinational study for patients from Germany, Poland and Italy. These projects deliver comprehensive information regarding the treatment of colorectal cancer. However, this information is deeply rooted in the organisation of the health-care system in the given country and is not easily transferable into international settings. Also, an interpretation of the collected data is often possible only within the given health-care system. First, unified initial diagnostics is a prerequisite for quality assurance -  for the local extent and exclusion / confirmation of distant metastases. Until these criteria are unified, any comparison is limited, including a comparison of survival. Second, quality-of-life is not recorded in any of the current projects. Third, the main focus of a quality assurance project must be on therapy-dependent factors. The most sensible method of quality control remains within the connection of preoperative diagnostics (estimate of a best-case scenario), the surgical technique (the actual result) and a standardised pathological examination (evaluation of the actual result). These parameters can be recorded and compared within a quality assurance project regardless of the limitations of the national health-care systems. There is no alternative to a unified diagnostics model and unified histopathological evaluation, a complete picture of treatment quality is also not possible without systematic analysis of the quality of life.

  8. Quality-of-care research in mental health: responding to the challenge.

    Science.gov (United States)

    McGlynn, E A; Norquist, G S; Wells, K B; Sullivan, G; Liberman, R P

    1988-01-01

    Quality-of-care research in mental health is in the developmental stages, which affords an opportunity to take an integrative approach, building on principles from efficacy, effectiveness, quality assessment, and quality assurance research. We propose an analytic strategy for designing research on the quality of mental health services using an adaptation of the structure, process, and outcome classification scheme. As a concrete illustration of our approach, we discuss research on a particular target population-patients with chronic schizophrenia. Future research should focus on developing models of treatment, establishing criteria and standards for outcomes and processes, and gathering data on community practices.

  9. 2014 Child and Adult Health Care Quality Measures

    Data.gov (United States)

    U.S. Department of Health & Human Services — Performance rates on frequently reported health care quality measures in the CMS Medicaid/CHIP Child and Adult Core Sets, for FFY 2014 reporting. Dataset contains...

  10. 2016 Child and Adult Health Care Quality Measures

    Data.gov (United States)

    U.S. Department of Health & Human Services — Performance rates on frequently reported health care quality measures in the CMS Medicaid/CHIP Child and Adult Core Sets, for FFY 2016 reporting. Source: Mathematica...

  11. 2015 Child and Adult Health Care Quality Measures

    Data.gov (United States)

    U.S. Department of Health & Human Services — Performance rates on frequently reported health care quality measures in the CMS Medicaid/CHIP Child and Adult Core Sets, for FFY 2015 reporting. Source: Mathematica...

  12. Cooperation between the occupational health insurance and physicians practicing occupational dermatology: optimization potential in quality assurance.

    Science.gov (United States)

    Elsner, Peter; Aberer, Werner; Bauer, Andrea; Diepgen, Thomas Ludwig; Drexler, Hans; Fartasch, Manigé; John, Swen Malte; Schuhmacher-Stock, Uta; Wehrmann, Wolfgang; Weisshaar, Elke

    2014-05-01

    Quality assurance is a task of the medical profession, but it is also a duty of the occupational health insurance (OHI). Data on the interaction quality between physicians practicing occupational dermatology and the OHI are limited. An online survey was performed in 854 German members of the Working Group on Occupational and Environmental Dermatology in October 2013. Items included demographic data, a judgment on the cooperation between the dermatologists and OHI companies, an economic grading of the current compensation scheme, and prioritization of optimization tasks. 182 members (21.3 % of the invited population) participated in the survey. The cooperation with the OHI companies was judged as "very good" by 10.8 %, as "good" by 56.7  %, as "satisfactory" by 24.2 %, as "sufficient" by 7.0 % and as "inadequate" by 1.3 %. 93.4 % of the interviewed mentioned problems and improvement potentials in the cooperation of their practice or clinic with OHI companies. Main points of criticisms were reimbursement (44.7 %), followed by impairments of the treatment options (36.5 %) and the delay or scope of the treatment in the dermatologist's procedure (29.4 %). While most physicians practicing occupational dermatology give a positive judgment of their cooperation with OHI companies, quality optimization potentials exist regarding the reimbursement of dermatological services, especially regarding time-intensive counselling in the prevention of occupational skin diseases, in the enablement of diagnostic and therapeutic procedures according to current guidelines and in a timely preventive intervention to use the therapeutic window before chronification of skin diseases may occur. © 2014 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  13. Ballistic quality assurance

    International Nuclear Information System (INIS)

    Cassol, E.; Bonnet, J.; Porcheron, D.; Mazeron, J.J.; Peiffert, D.; Alapetite, C.

    2012-01-01

    This review describes the ballistic quality assurance for stereotactic intracranial irradiation treatments delivered with Gamma Knife R either dedicated or adapted medical linear accelerators. Specific and periodic controls should be performed in order to check the mechanical stability for both irradiation and collimation systems. If this step remains under the responsibility of the medical physicist, it should be done in agreement with the manufacturer's technical support. At this time, there are no recent published guidelines. With technological developments, both frequency and accuracy should be assessed in each institution according to the treatment mode: single versus hypo-fractionated dose, circular collimator versus micro-multi-leaf collimators. In addition, 'end-to-end' techniques are mandatory to find the origin of potential discrepancies and to estimate the global ballistic accuracy of the delivered treatment. Indeed, they include frames, non-invasive immobilization devices, localizers, multimodal imaging for delineation and in-room positioning imaging systems. The final precision that could be reasonably achieved is more or less 1 mm. (authors)

  14. Software quality assurance | News

    Science.gov (United States)

    Financial Officer Finance Section Office of the Chief Operating Officer Facilities Engineering Services Accelerator Division Accelerator Physics Center Office of the Chief Safety Officer Environment, Safety, Health and Quality Section Office of the Chief Project Officer Office of Project Support Services Office of

  15. [Quality Indicators of Primary Health Care Facilities in Austria].

    Science.gov (United States)

    Semlitsch, Thomas; Abuzahra, Muna; Stigler, Florian; Jeitler, Klaus; Posch, Nicole; Siebenhofer, Andrea

    2017-07-11

    Background The strengthening of primary health care is one major goal of the current national health reform in Austria. In this context, a new interdisciplinary concept was developed in 2014 that defines structures and requirements for future primary health care facilities. Objective The aim of this project was the development of quality indicators for the evaluation of the scheduled primary health care facilities in Austria, which are in accordance with the new Austrian concept. Methods We used the RAND/NPCRDC method for the development and selection of the quality indicators. We conducted systematic literature searches for existing measures in international databases for quality indicators as well as in bibliographic databases. All retrieved measures were evaluated and rated by an expert panel in a 2-step process regarding relevance and feasibility. Results Overall, the literature searches yielded 281 potentially relevant quality indicators, which were summarized to 65 different quality measures for primary health care. Out of these, the panel rated and accepted 30 measures as relevant and feasible for use in Austria. Five of these indicators were structure measures, 14 were process measures and the remaining 11 were outcome measures. Based on the Austrian primary health care concept, the final set of quality indicators was grouped in the 5 following domains: Access to primary health care (5), quality of care (15), continuity of care (5), coordination of care (4), and safety (1). Conclusion This set of quality measures largely covers the four defined functions of primary health care. It enables standardized evaluation of primary health care facilities in Austria regarding the implementation of the Austrian primary health care concept as well as improvement in healthcare of the population. © Georg Thieme Verlag KG Stuttgart · New York.

  16. Does Medical Malpractice Law Improve Health Care Quality?

    Science.gov (United States)

    Frakes, Michael; Jena, Anupam B.

    2016-01-01

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

  17. Software Quality Assurance Audits Guidebooks

    Science.gov (United States)

    1990-01-01

    The growth in cost and importance of software to NASA has caused NASA to address the improvement of software development across the agency. One of the products of this program is a series of guidebooks that define a NASA concept of the assurance processes that are used in software development. The Software Assurance Guidebook, NASA-GB-A201, issued in September, 1989, provides an overall picture of the NASA concepts and practices in software assurance. Second level guidebooks focus on specific activities that fall within the software assurance discipline, and provide more detailed information for the manager and/or practitioner. This is the second level Software Quality Assurance Audits Guidebook that describes software quality assurance audits in a way that is compatible with practices at NASA Centers.

  18. Modernization of software quality assurance

    Science.gov (United States)

    Bhaumik, Gokul

    1988-01-01

    The customers satisfaction depends not only on functional performance, it also depends on the quality characteristics of the software products. An examination of this quality aspect of software products will provide a clear, well defined framework for quality assurance functions, which improve the life-cycle activities of software development. Software developers must be aware of the following aspects which have been expressed by many quality experts: quality cannot be added on; the level of quality built into a program is a function of the quality attributes employed during the development process; and finally, quality must be managed. These concepts have guided our development of the following definition for a Software Quality Assurance function: Software Quality Assurance is a formal, planned approach of actions designed to evaluate the degree of an identifiable set of quality attributes present in all software systems and their products. This paper is an explanation of how this definition was developed and how it is used.

  19. Statistical methods for quality assurance

    International Nuclear Information System (INIS)

    Rinne, H.; Mittag, H.J.

    1989-01-01

    This is the first German-language textbook on quality assurance and the fundamental statistical methods that is suitable for private study. The material for this book has been developed from a course of Hagen Open University and is characterized by a particularly careful didactical design which is achieved and supported by numerous illustrations and photographs, more than 100 exercises with complete problem solutions, many fully displayed calculation examples, surveys fostering a comprehensive approach, bibliography with comments. The textbook has an eye to practice and applications, and great care has been taken by the authors to avoid abstraction wherever appropriate, to explain the proper conditions of application of the testing methods described, and to give guidance for suitable interpretation of results. The testing methods explained also include latest developments and research results in order to foster their adoption in practice. (orig.) [de

  20. Quality assurance in nuclear medicine

    International Nuclear Information System (INIS)

    Kaul, A.

    1986-01-01

    'Quality Assurance in Nuclear Medicine' is the title of the English language original that has been translated into German. The manual very extensively deals with quality control of nuclear medical equipment. Tests are explained for checking radioactivity measuring devices, manual and automatic in-vitro sample measuring systems, in-vivo measuring systems with single or multiple detectors, rectlinear scanners, and gamma cameras, including the phantoms required for the methods. Other chapters discuss the quality control of radiopharmaceuticals, or the quality assurance in data recording and evaluation of results. Helpful comments on the organisation of quality assurance programms are given. The book is intended as a practical guide for introducing quality assurance principles in nuclear medicine in the Federal Republic of Germany. With 13 figs., 22 tabs [de

  1. Quality assurance during site construction

    International Nuclear Information System (INIS)

    Dommke, J.; Jurgutat, H.

    1980-01-01

    During the time of planing and construction of a nuclear power plant, the following proceeding is approved: - the deliverer of a nuclear power plant provides the reports fixing the quality assurance program, it means that he is responsible to write the safety analysis report, the specifications for the erection of the components, the working manuals and specifications for testing (eg nondestr. testing) - the manufacturing of components or systems will be controlled by an own independent quality assurance group, provided that this group was checked by the quality assurance group of the applicant - the TUeV with its independent assessors will fix the requirements relating to quality assurance in its assessment. On this basis the examination of the applicants specifications, working manuals, testing specifications will be done. The efficiency of quality assurance at the manufacturer and at the applicant will be checked by the TUeV specialists by considering specifications of modifications, repairs or tolerances. A mean point of the quality assurance in Germany is the dynamic adjustment, of an action on the latest state of engineering or science. If there exists a change of rules or guidelines, the quality assurance requirements have to be fit on this state in so far as it is feasible from the technical point of view. (orig./RW)

  2. Radiation shielding quality assurance

    Science.gov (United States)

    Um, Dallsun

    For the radiation shielding quality assurance, the validity and reliability of the neutron transport code MCNP, which is now one of the most widely used radiation shielding analysis codes, were checked with lot of benchmark experiments. And also as a practical example, follows were performed in this thesis. One integral neutron transport experiment to measure the effect of neutron streaming in iron and void was performed with Dog-Legged Void Assembly in Knolls Atomic Power Laboratory in 1991. Neutron flux was measured six different places with the methane detectors and a BF-3 detector. The main purpose of the measurements was to provide benchmark against which various neutron transport calculation tools could be compared. Those data were used in verification of Monte Carlo Neutron & Photon Transport Code, MCNP, with the modeling for that. Experimental results and calculation results were compared in both ways, as the total integrated value of neutron fluxes along neutron energy range from 10 KeV to 2 MeV and as the neutron spectrum along with neutron energy range. Both results are well matched with the statistical error +/-20%. MCNP results were also compared with those of TORT, a three dimensional discrete ordinates code which was developed by Oak Ridge National Laboratory. MCNP results are superior to the TORT results at all detector places except one. This means that MCNP is proved as a very powerful tool for the analysis of neutron transport through iron & air and further it could be used as a powerful tool for the radiation shielding analysis. For one application of the analysis of variance (ANOVA) to neutron and gamma transport problems, uncertainties for the calculated values of critical K were evaluated as in the ANOVA on statistical data.

  3. Factors affecting the adoption of quality assurance technologies in healthcare.

    Science.gov (United States)

    Storey, John

    2013-01-01

    In the light of public concern and of strong policy emphasis on quality and safety in the nursing care of patients in hospital settings, this paper aims to focus on the factors affecting the adoption of innovative quality assurance technologies. Two sets of complementary literature were mined for key themes. Next, new empirical insights were sought. Data gathering was conducted in three phases. The first involved contact with NHS Technology Hubs and other institutions which had insights into leading centres in quality assurance technologies. The second phase was a series of telephone interviews with lead nurses in those hospitals which were identified in the first phase as comprising the leading centres. The third phase comprised a series of face to face interviews with innovators and adopters of healthcare quality assurance technologies in five hospital trusts. There were three main sets of findings. First, despite the strong policy push and the templates established at national level, there were significant variations in the nature and robustness of the quality assurance toolkits that were developed, adapted and adopted. Second, in most of the adopting cases there were important obstacles to the full adoption of the toolkits that were designed. Third, the extent and nature of the ambition of the developers varied dramatically - some wished to see their work impacting widely across the health service; others had a number of different reasons for wanting to restrict the impact of their work. The general concerns about front-line care and the various inquiries into care quality failures emphasise the need for improved and consistent care quality assurance methodologies and practice. The technology adoption literature gives only partial insight into the nature of the challenges; this paper offers specific insights into the factors inhibiting the full adoption of quality assurance technologies in ward-based care.

  4. [Quality management is associated with high quality services in health care].

    Science.gov (United States)

    Nielsen, Tenna Hassert; Riis, Allan; Mainz, Jan; Jensen, Anne-Louise Degn

    2013-12-09

    In these years, quality management has been the focus in order to meet high quality services for the patients in Danish health care. This article provides information on quality management and quality improvement and it evaluates its effectiveness in achieving better organizational structures, processes and results in Danish health-care organizations. Our findings generally support that quality management is associated with high quality services in health care.

  5. R D software quality assurance

    Energy Technology Data Exchange (ETDEWEB)

    Hood, F.C.

    1991-10-01

    Research software quality assurance (QA) requirements must be adequate to strengthen development or modification objectives, but flexible enough not to restrict creativity. Application guidelines are needed for the different kinds of research and development (R D) software activities to assure project objectives are achieved.

  6. Quality assurance in plant engineering

    International Nuclear Information System (INIS)

    Ohsumi, Morimichi

    1977-01-01

    Quality assurance is defined as the intentional and systematic activity carried out to obtain such reliability that the functions of nuclear power generating plants are demonstrated during the plant operation, and the section in charge has the role to organize, adjust and communicate so that the related sections can work smoothly. There are many documents concerning the quality assurance, such as quality assurance basic program, quality assurance manual, quality control plan and its manual and many specifications, etc. The content of the quality assurance is different for every step of plant planning such as at inquiry and order receiving, and prior to manufacturing, for example, inspection specification being decided for the material and the welded parts of classified pipings at the step of order receiving. Document management, engineering schedule and the custody of quality records are also quality assurance activities. Design management is controlled step by step; plant planning including safety analysis, overall layout plan, conceptual design of buildings, aseismatic design guide, heat balance and so on, system design mainly with system description, piping design including piping specification, standard dimensions of edge preparation, piping and valve lists, inspection manual, etc., detailed design, standardization of piping and design review, etc. are explained. The management of the intermediate between soft and hard parts consists of the quality check for material manufacturers and shipment inspection, etc. (Nakai, Y.)

  7. Managerial attitude toward quality assurance

    International Nuclear Information System (INIS)

    Kirschenmann, H.J.

    1983-01-01

    This paper will present what relationships exist between the attitude toward quality assurance and the variables of training and experience on the part of managers within the nuclear power industry. Managerial attitude toward quality assurance was measured via questionnaires submitted to managers within architect-engineering, nuclear steam supplier, and constructor firms throughout the United States. The data from the completed questionnaires were statistically analyzed using the chi-square test and conclusions were drawn. Additional study results related to major factors for positive and negative attitudes toward quality assurance will be presented

  8. Quality assurance of polymer concrete

    International Nuclear Information System (INIS)

    Schulz, H.

    1984-01-01

    With polymer concrete, a whole range of organisational and functional measures have to be met in order to assure the required quality with an economic expenditure. Quality assurance begins in the design and does not end in the production, rather includes all fields of the enterprise. The following deals with a particular range of the total complex, the inspection methods for assuring the quality of machine components of polymer concrete, particularly machine tool bases, this being through the control of the raw material, the production and the finished product. (orig.) [de

  9. Improving patient safety through quality assurance.

    Science.gov (United States)

    Raab, Stephen S

    2006-05-01

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

  10. Methods of Software Quality Assurance under a Nuclear Quality Assurance Program

    International Nuclear Information System (INIS)

    Kim, Jang Yeol; Lee, Young Jun; Cha, Kyung Ho; Cheon, Se Woo; Lee, Jang Soo; Kwon, Kee Choon

    2005-01-01

    This paper addresses a substantial implementation of a software quality assurance under a nuclear quality assurance program. The relationship of the responsibility between a top-level nuclear quality assurance program such as ASME/NQA-1 and its lower level software quality assurance is described. Software quality assurance activities and software quality assurance procedures during the software development life cycle are also described

  11. Improving Quality of Care in Primary Health-Care Facilities in Rural Nigeria

    OpenAIRE

    Ugo, Okoli; Ezinne, Eze-Ajoku; Modupe, Oludipe; Nicole, Spieker; Winifred, Ekezie; Kelechi, Ohiri

    2016-01-01

    Background: Nigeria has a high population density but a weak health-care system. To improve the quality of care, 3 organizations carried out a quality improvement pilot intervention at the primary health-care level in selected rural areas. Objective: To assess the change in quality of care in primary health-care facilities in rural Nigeria following the provision of technical governance support and to document the successes and challenges encountered. Method: A total of 6 states were selected...

  12. Quality of Health Care Activity in Educational Institutions: Conceptual Aspect

    Directory of Open Access Journals (Sweden)

    N. V. Tretyakova

    2013-01-01

    Full Text Available The paper deals with one of the priority tasks of Russian educational system – developing the health responsibility. The recent health deterioration trend among children and adolescents calls for the complex health care measures, equally affecting the learning outcomes. The authors argue that there is a need for proper definition and specification of the key term of health care quality. However, the analysis of the available scientific and documentary recourses demonstrates the absence of such unified definition. The authors describe the existing approaches to defining the health care quality, and examine structural components of the health care activity, their interrelations and interdependence. In authors’ opinion, the synthesis of the available research materials provides the basis for further studies in the theory and practice of quality management activities regarding the health protection of children, adolescents and young adults in educational institutions. 

  13. Diabetes care may be improved with Steno Quality Assurance Tool--a self-assessment tool in diabetes management.

    Science.gov (United States)

    Bjerre-Christensen, Ulla; Nielsen, Annemette Anker; Binder, Christian; Hansen, Jes B; Eldrup, Ebbe

    2014-08-01

    To evaluate if improvements in the quality of diabetes care in Indian clinics can be obtained by simple self-surveillance PC-based software. Nineteen Indian diabetes clinics were introduced to the principles of quality assurance (QA), and to a software program, the Steno Quality Assurance Tool (SQAT). Data was entered for an initial 3 months period. Subsequently data were analyzed by the users, who designed plans to improve indicator status and set goals for the upcoming period. A second data entry period followed after 7-9 months. QA data was analyzed from 4487 T2DM patients (baseline) and 4440 (follow-up). The average examination frequency per clinic of the following indicators increased significantly: lipid examination (72-87%) (p=0.007), foot examination (80-94%) (p=0.02), HbA1c investigation (59-77%) (p=0.006), and urine albumin excretion investigation (72-87%) (p=0.006). Outcome parameters also improved significantly: mean (SD) fasting and post prandial BG reduced from 144(16) to 132(16)mg/dl (p=0.02) and 212(24)-195(29)mg/dl (p=0.03), respectively. Systolic BP reduced from 139(6) to 133(4) (p=0.0008)mmHg and diastolic BP from 83(3) to 81(3)mmHg (p=0.002). Quality of diabetes care can be improved by applying SQAT, a QA self-surveillance software that enables documentation of changes in process and outcome indicators. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  14. Internal marketing: creating quality employee experiences in health care organizations.

    Science.gov (United States)

    Masri, Maysoun Dimachkie; Oetjen, Dawn; Rotarius, Timothy

    2011-01-01

    To cope with the recent challenges within the health care industry, health care managers need to engage in the internal marketing of their various services. Internal marketing has been used as an effective management tool to increase employees' motivation, satisfaction, and productivity (J Mark Commun. 2010;16(5):325-344). Health care managers should understand that an intense focus on internal marketing factors will lead to a quality experience for employees that will ultimately have a positive effect on the patient experiences.

  15. Rollout of quality assurance interventions in labor room in two districts of Bihar, India

    OpenAIRE

    Jyoti Sharma; Sutapa B Neogi; Preeti Negandhi; Monika Chauhan; Siddharth Reddy; Ghanshyam Sethy

    2016-01-01

    Background: Quality of care at the facilities during childbirth remains a major concern. Improved quality could have the greatest dividend in saving maternal and newborn lives. Objective: The objective of this study was to implement quality assurance measures in the labor rooms of select public health facilities in two districts of Bihar. Methods: The labor room quality assurance intervention was implemented in two districts, Gaya and Purnea in Bihar. Health facilities having >200 deliveries/...

  16. BUILDING "BRIDGES" WITH QUALITY ASSURANCE

    Science.gov (United States)

    The papr describes how, rather than building "bridges" across centuries, quality assurance (QA) personnel have the opportunity to build bridges across technical disciplines, between public and private organizations, and between different QA groups. As reviewers and auditors of a...

  17. QANU - Quality Assurance Netherlands Universities

    DEFF Research Database (Denmark)

    Jensen, Henrik Toft; Maria E., Weber; Vyt, André

    The Quality Assurance Netherlands Universities (QANU) underwent an ENQA-coordinated external review in 2016. The review was chaired by Henrik Toft Jensen, Research fellow at Roskilde University (RUC), Denmark....

  18. System management and quality assurance

    International Nuclear Information System (INIS)

    Sastry, A.M.

    1989-01-01

    This paper describes the principles of system management and shows the relationship to quality assurance. It discusses the need for balanced attention to all the project management controls required for project success

  19. Quality assurance within regulatory bodies

    International Nuclear Information System (INIS)

    1999-06-01

    The IAEA directed extensive efforts during the years 1991 to 1995 to the integral revision of all NUSS quality assurance publications, which were approved and issued as Safety Series No.50-C/SG-Q, Quality Assurance for Safety in Nuclear Power Plants and other Nuclear Installations (1996). When these quality assurance publications were developed, their prime focus was on requirements against which work performed by the licensees could be measured and assessed by the regulatory bodies. In this way, they only helped to facilitate the functions of regulators. No requirements or recommendations were provided on how the regulators should ensure the effective implementation of their own activities. The present publication is a first attempt to collect, integrate and offer available experience to directly support performance of regulatory activities. It presents a comprehensive compilation on the application of quality assurance principles and methods by regulatory bodies to their activities. The aim is consistent good performance of regulatory activities through a systematic approach

  20. Redefining and expanding quality assurance.

    Science.gov (United States)

    Robins, J L

    1992-12-01

    To meet the current standards of excellence necessary for blood establishments, we have learned from industry that a movement toward organization-wide quality assurance/total quality management must be made. Everyone in the organization must accept responsibility for participating in providing the highest quality products and services. Quality must be built into processes and design systems to support these quality processes. Quality assurance has been redefined to include a quality planning function described as the most effective way of designing quality into processes. A formalized quality planning process must be part of quality assurance. Continuous quality improvement has been identified as the strategy every blood establishment must support while striving for error-free processing as the long-term objective. The auditing process has been realigned to support and facilitate this same objective. Implementing organization-wide quality assurance/total quality management is one proven plan for guaranteeing the quality of the 20 million products that are transfused into 4 million patients each year and for moving toward the new order.

  1. Usalpharma: A Cloud-Based Architecture to Support Quality Assurance Training Processes in Health Area Using Virtual Worlds

    Directory of Open Access Journals (Sweden)

    Francisco J. García-Peñalvo

    2014-01-01

    Full Text Available This paper discusses how cloud-based architectures can extend and enhance the functionality of the training environments based on virtual worlds and how, from this cloud perspective, we can provide support to analysis of training processes in the area of health, specifically in the field of training processes in quality assurance for pharmaceutical laboratories, presenting a tool for data retrieval and analysis that allows facing the knowledge discovery in the happenings inside the virtual worlds.

  2. Usalpharma: A Cloud-Based Architecture to Support Quality Assurance Training Processes in Health Area Using Virtual Worlds

    Science.gov (United States)

    García-Peñalvo, Francisco J.; Pérez-Blanco, Jonás Samuel; Martín-Suárez, Ana

    2014-01-01

    This paper discusses how cloud-based architectures can extend and enhance the functionality of the training environments based on virtual worlds and how, from this cloud perspective, we can provide support to analysis of training processes in the area of health, specifically in the field of training processes in quality assurance for pharmaceutical laboratories, presenting a tool for data retrieval and analysis that allows facing the knowledge discovery in the happenings inside the virtual worlds. PMID:24778593

  3. Point-of-care urine albumin in general practice offices: effect of participation in an external quality assurance scheme.

    Science.gov (United States)

    Bukve, Tone; Røraas, Thomas; Riksheim, Berit Oddny; Christensen, Nina Gade; Sandberg, Sverre

    2015-01-01

    The Norwegian Quality Improvement of Primary Care Laboratories (Noklus) offers external quality assurance (EQA) schemes (EQASs) for urine albumin (UA) annually. This study analyzed the EQA results to determine how the analytical quality of UA analysis in general practice (GP) offices developed between 1998 (n=473) and 2012 (n=1160). Two EQA urine samples were distributed yearly to the participants by mail. The participants measured the UA of each sample and returned the results together with information about their instrument, the profession and number of employees at the office, frequency of internal quality control (IQC), and number of analyses per month. In the feedback report, they received an assessment of their analytical performance. The number of years that the GP office had participated in Noklus was inversely related to the percentage of "poor" results for quantitative but not semiquantitative instruments. The analytical quality improved for participants using quantitative instruments who received an initial assessment of "poor" and who subsequently changed their instrument. Participants using reagents that had expired or were within 3 months of the expiration date performed worse than those using reagents that were expiring in more than 3 months. Continuous participation in the Noklus program improved the performance of quantitative UA analyses at GP offices. This is probably in part attributable to the complete Noklus quality system, whereby in addition to participating in EQAS, participants are visited by laboratory consultants who examine their procedures and provide practical advice and education regarding the use of different instruments.

  4. Dosimetric quality assurance interpreted for ISO 17025 in public health England's personal dosimetry service

    International Nuclear Information System (INIS)

    Gilvin, P.J.; Gibbens, N.J.; Baker, S.T.

    2016-01-01

    Many individual monitoring services (IMSs) have long experience in delivering high-quality dosimetry, and many follow rigorous quality assurance (QA) procedures. Typically, these procedures have been developed through experience and are highly effective in maintaining high-quality dose measurements. However, it is not always clear how the range of QA procedures normally followed by IMSs maps on to the various requirements of ISO 17025. The Personal Dosimetry Service of Public Health England has interpreted its QA procedures both in operating existing services and in developing a new one. (authors)

  5. Quality management and quality assurance contracts

    International Nuclear Information System (INIS)

    Teichler, M.

    1991-01-01

    Quality assurance contracts belong to the most important instruments of quality management systems. As a result of such contracts, quality control is to be done not only by the buyer, but is made a task to be fulfilled by the manufacturer. The author of the article shows that quality assurance contracts do change the contractual relationship between supplier and buyer, but have no effect on economic and practical conditions. This is so because quality assurance contracts apply only to warranty claims, which play a subordinate role in the legal relationship between producer and buyer, or producer and consumer, as compared to the claims for damages arising out of the contracts. (orig.) [de

  6. 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...

  7. TOTAL QUALITY AND WORK ORGANISATION IN HEALTH CARE FIRMS

    OpenAIRE

    Gianfranco Corio

    1997-01-01

    [The area of organisation is the one to work in so as to improve products/services in health care firms, and to establish the transformation of professional behaviour. The actions and roles of middle management as a strategic entity in the case of the set-up of programs for improvement based on Total Quality. Total Quality as a strategic factor in health care firms with regard to management and as a basic component for "purchasing" decisions made by external customers.

  8. Integration of quality assurance activities into a computerized patient data management system in an intensive care unit.

    Science.gov (United States)

    Weissman, C; Mossel, P; Haimet, S; King, T C

    1990-11-01

    A prototype computer-based patient data management system (PDMS) was developed for a surgery-anesthesiology intensive care unit (ICU) to reduce the time and staff needed to implement quality assurance (QA) functions. Goals of the system were to make QA functions routine and minimally intrusive to the daily operation of the ICU. PDMS collects general data (eg, admissions and discharges, lengths of stay, and bed utilization rates) and specialized data (eg, specific indicators) unique to the ICU and performs prospective monitoring for the occurrence of specific events (occurrence screening) and retrospective examinations of patient records (targeted reviews). Preliminary results suggest that PDMS facilitates the acquisition and analysis of QA data and reduces the time needed to acquire these data. Research to validate these claims and efforts to improve and expand the prototype system with a permanent production system are in progress.

  9. Service quality perceptions in primary health care centres in Greece

    Science.gov (United States)

    Papanikolaou, Vicky; Zygiaris, Sotiris

    2012-01-01

    Abstract Context  The paper refers to the increased competition between health care providers and the need for patient‐centred services in Greece. Using service quality methodology, this paper investigates service quality perceptions of patients in Greek public primary health centres. Objective  To test the internal consistency and applicability of SERVQUAL in primary health care centres in Greece. Strategy  SERVQUAL was used to examine whether patients have different expectations from health care providers and whether different groups of patients may consider some dimensions of care more important than others. Results  The analysis showed that there were gaps in all dimensions measured by SERVQUAL. The largest gap was detected in empathy. Further analysis showed that there were also differences depending on gender, age and education levels. A separate analysis of expectations and perceptions revealed that this gap was because of differences in patients’ perceptions rather than expectations. Discussion and conclusions  This paper raises a number of issues that concern the applicability of SERVQUAL in health care services and could enhance current discussions about SERVQUAL improvement. Quality of health care needs to be redefined by encompassing multiple dimensions. Beyond a simple expectations–perceptions gap, people may hold different understandings of health care that, in turn, influence their perception of the quality of services. PMID:22296402

  10. Service quality perceptions in primary health care centres in Greece.

    Science.gov (United States)

    Papanikolaou, Vicky; Zygiaris, Sotiris

    2014-04-01

    The paper refers to the increased competition between health care providers and the need for patient-centred services in Greece. Using service quality methodology, this paper investigates service quality perceptions of patients in Greek public primary health centres. To test the internal consistency and applicability of SERVQUAL in primary health care centres in Greece. SERVQUAL was used to examine whether patients have different expectations from health care providers and whether different groups of patients may consider some dimensions of care more important than others. The analysis showed that there were gaps in all dimensions measured by SERVQUAL. The largest gap was detected in empathy. Further analysis showed that there were also differences depending on gender, age and education levels. A separate analysis of expectations and perceptions revealed that this gap was because of differences in patients' perceptions rather than expectations. THIS paper raises a number of issues that concern the applicability of SERVQUAL in health care services and could enhance current discussions about SERVQUAL improvement. Quality of health care needs to be redefined by encompassing multiple dimensions. Beyond a simple expectations-perceptions gap, people may hold different understandings of health care that, in turn, influence their perception of the quality of services. © 2012 John Wiley & Sons Ltd.

  11. Countdown to 2015: Tracking Maternal and Child Health Intervention Targets Using Lot Quality Assurance Sampling in Bauchi State Nigeria.

    Science.gov (United States)

    Abegunde, Dele; Orobaton, Nosa; Sadauki, Habib; Bassi, Amos; Kabo, Ibrahim A; Abdulkarim, Masduq

    2015-01-01

    Improving maternal and child health remains a top priority in Nigeria's Bauchi State in the northeastern region where the maternal mortality ratio (MMR) and infant mortality rate (IMR) are as high as 1540 per 100,000 live births and 78 per 1,000 live births respectively. In this study, we used the framework of the continuum of maternal and child care to evaluate the impact of interventions in Bauchi State focused on improved maternal and child health, and to ascertain progress towards the achievement of Millennium Development Goals (MDGs) 4 and 5. At baseline (2012) and then at follow-up (2013), we randomly sampled 340 households from 19 random locations in each of the 20 Local Government Areas (LGA) of Bauchi State in Northern Nigeria, using the Lot Quality Assurance Sampling (LQAS) technique. Women residents in the households were interviewed about their own health and that of their children. Estimated LGA coverage of maternal and child health indicators were aggregated across the State. These values were then compared to the national figures, and the differences from 2012 to 2014 were calculated. For several of the indicators, a modest improvement from baseline was found. However, the indicators in the continuum of care neither reached the national average nor attained the 90% globally recommended coverage level. The majority of the LGA surveyed were classifiable as high priority, thus requiring intensified efforts and programmatic scale up. Intensive scale-up of programs and interventions is needed in Bauchi State, Northern Nigeria, to accelerate, consolidate and sustain the modest but significant achievements in the continuum of care, if MDGs 4 and 5 are to be achieved by the end of 2015. The intentional focus of LGAs as the unit of intervention ought to be considered a condition precedent for future investments. Priority should be given to the re-allocating resources to program areas and regions where coverage has been low. Finally, systematic considerations

  12. Countdown to 2015: Tracking Maternal and Child Health Intervention Targets Using Lot Quality Assurance Sampling in Bauchi State Nigeria.

    Directory of Open Access Journals (Sweden)

    Dele Abegunde

    Full Text Available Improving maternal and child health remains a top priority in Nigeria's Bauchi State in the northeastern region where the maternal mortality ratio (MMR and infant mortality rate (IMR are as high as 1540 per 100,000 live births and 78 per 1,000 live births respectively. In this study, we used the framework of the continuum of maternal and child care to evaluate the impact of interventions in Bauchi State focused on improved maternal and child health, and to ascertain progress towards the achievement of Millennium Development Goals (MDGs 4 and 5.At baseline (2012 and then at follow-up (2013, we randomly sampled 340 households from 19 random locations in each of the 20 Local Government Areas (LGA of Bauchi State in Northern Nigeria, using the Lot Quality Assurance Sampling (LQAS technique. Women residents in the households were interviewed about their own health and that of their children. Estimated LGA coverage of maternal and child health indicators were aggregated across the State. These values were then compared to the national figures, and the differences from 2012 to 2014 were calculated.For several of the indicators, a modest improvement from baseline was found. However, the indicators in the continuum of care neither reached the national average nor attained the 90% globally recommended coverage level. The majority of the LGA surveyed were classifiable as high priority, thus requiring intensified efforts and programmatic scale up.Intensive scale-up of programs and interventions is needed in Bauchi State, Northern Nigeria, to accelerate, consolidate and sustain the modest but significant achievements in the continuum of care, if MDGs 4 and 5 are to be achieved by the end of 2015. The intentional focus of LGAs as the unit of intervention ought to be considered a condition precedent for future investments. Priority should be given to the re-allocating resources to program areas and regions where coverage has been low. Finally, systematic

  13. OECD Health Care Quality Indicator Project. The expert panel on primary care prevention and health promotion

    NARCIS (Netherlands)

    Marshall, Martin; Klazinga, Niek; Leatherman, Sheila; Hardy, Charlie; Bergmann, Eckhard; Pisco, Luis; Mattke, Soeren; Mainz, Jan

    2006-01-01

    PURPOSE: This article describes a project undertaken as part of the Organization for Economic Co-operation and Development (OECD)'s Healthcare Quality Indicator (HCQI) Project, which aimed to develop a set of quality indicators representing the domains of primary care, prevention and health

  14. Quality Assurance Standards for Symptomatic Breast Disease Services

    OpenAIRE

    Department of Health (Ireland)

    2007-01-01

    Quality Assurance Standards for Symptomatic Breast Disease Services People in Ireland have a right to expect that medical care be of good quality. They expect that standards of care are consistently high. They expect that access to care is easy, speedy, effective and efficient. Society expects quality of care to measure up to international norms of good practice. Such assurance can be given by auditing the quality of activity. Click here to download PDF 606kb

  15. Thoughts on Internal and External Quality Assurance

    Science.gov (United States)

    Zhang, Jianxin

    2012-01-01

    Quality assurance of higher education is made up of two parts: internal quality assurance (IQA) and external quality assurance (EQA). Both belong to a union of the coexistence and balance of yin and yang. But in reality there exists a paradox of "confusion of quality assurance (QA) subject consciousness, singularity of social QA and lack of QA…

  16. 10 CFR 71.37 - Quality assurance.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 2 2010-01-01 2010-01-01 false Quality assurance. 71.37 Section 71.37 Energy NUCLEAR... Package Approval § 71.37 Quality assurance. (a) The applicant shall describe the quality assurance program... quality assurance program that are applicable to the particular package design under consideration...

  17. Grading of quality assurance requirements

    International Nuclear Information System (INIS)

    1991-01-01

    The present Manual provides guidance and illustrative examples for applying a method by which graded quality assurance requirements may be determined and adapted to the items and services of a nuclear power plant in conformance with the requirements of the IAEA Nuclear Safety Standards (NUSS) Code and Safety Guides on quality assurance. The Manual replaces the previous publication IAEA-TECDOC-303 on the same subject. Various methods of grading quality assurance are available in a number of Member States. During the development of the present Manual it was not considered practical to attempt to resolve the differences between those methods and it was preferred to identify and benefit from the good practices available in all the methods. The method presented in this Manual deals with the aspects of management, documentation, control, verification and administration which affect quality. 1 fig., 4 tabs

  18. Quality assurance of qualitative analysis

    DEFF Research Database (Denmark)

    Ríos, Ángel; Barceló, Damiá; Buydens, Lutgarde

    2003-01-01

    The European Commission has supported the G6MA-CT-2000-01012 project on "Metrology of Qualitative Chemical Analysis" (MEQUALAN), which was developed during 2000-2002. The final result is a document produced by a group of scientists with expertise in different areas of chemical analysis, metrology...... and quality assurance. One important part of this document deals, therefore, with aspects involved in analytical quality assurance of qualitative analysis. This article shows the main conclusions reported in the document referring to the implementation of quality principles in qualitative analysis...

  19. Next level of board accountability in health care quality.

    Science.gov (United States)

    Pronovost, Peter J; Armstrong, C Michael; Demski, Renee; Peterson, Ronald R; Rothman, Paul B

    2018-03-19

    Purpose The purpose of this paper is to offer six principles that health system leaders can apply to establish a governance and management system for the quality of care and patient safety. Design/methodology/approach Leaders of a large academic health system set a goal of high reliability and formed a quality board committee in 2011 to oversee quality and patient safety everywhere care was delivered. Leaders of the health system and every entity, including inpatient hospitals, home care companies, and ambulatory services staff the committee. The committee works with the management for each entity to set and achieve quality goals. Through this work, the six principles emerged to address management structures and processes. Findings The principles are: ensure there is oversight for quality everywhere care is delivered under the health system; create a framework to organize and report the work; identify care areas where quality is ambiguous or underdeveloped (i.e. islands of quality) and work to ensure there is reporting and accountability for quality measures; create a consolidated quality statement similar to a financial statement; ensure the integrity of the data used to measure and report quality and safety performance; and transparently report performance and create an explicit accountability model. Originality/value This governance and management system for quality and safety functions similar to a finance system, with quality performance documented and reported, data integrity monitored, and accountability for performance from board to bedside. To the authors' knowledge, this is the first description of how a board has taken this type of systematic approach to oversee the quality of care.

  20. Quality Assurance 1992-2012

    Science.gov (United States)

    Brown, Roger

    2012-01-01

    As the author's contribution to a series marking the Golden Jubilee of the Association of University Administrators, he reflects on changes in quality assurance over the past twenty years and speculates on what the future may hold for quality as the association moves into a new and very different competitive regime. He begins by discussing the…

  1. Quality assurance during site construction

    International Nuclear Information System (INIS)

    Eymess, K.J.; Haas, R.; Wellnitz, G.

    1980-01-01

    Quality Assurance for Nuclear Power Plants under consideration of pipe assembling. Flow of Quality Requirements during: - Desing - Construction - Procurement - Prefabrication - Site. Organizational Requirements and Measurements during Erection: - Incoming Control - Material Storage - Surveillance of Tools - Weld Surveillance - Nondestructive Testing - Cleaning - Final Documentation. Qualification and Training of QA Personnel. (orig.)

  2. Quality assurance in mammography

    International Nuclear Information System (INIS)

    Fosmark, H.; Olerud, H.M.

    1992-01-01

    Guidelines in mammography are given, including competence of staff, performance of equipment and quality control procedures. The purpose of the guidelines is to ensure optimum diagnostic quality. 5 refs

  3. The effectiveness of Internet cognitive behavioural therapy (iCBT for depression in primary care: a quality assurance study.

    Directory of Open Access Journals (Sweden)

    Alishia D Williams

    Full Text Available BACKGROUND: Depression is a common, recurrent, and debilitating problem and Internet delivered cognitive behaviour therapy (iCBT could offer one solution. There are at least 25 controlled trials that demonstrate the efficacy of iCBT. The aim of the current paper was to evaluate the effectiveness of an iCBT Program in primary care that had been demonstrated to be efficacious in two randomized controlled trials (RCTs. METHOD: Quality assurance data from 359 patients prescribed the Sadness Program in Australia from October 2010 to November 2011 were included. RESULTS: Intent-to-treat marginal model analyses demonstrated significant reductions in depressive symptoms (PHQ9, distress (K10, and impairment (WHODAS-II with medium-large effect sizes (Cohen's d = .51-1.13., even in severe and/or suicidal patients (Cohen's d = .50-1.49. Secondary analyses on patients who completed all 6 lessons showed levels of clinically significant change as indexed by established criteria for remission, recovery, and reliable change. CONCLUSIONS: The Sadness Program is effective when prescribed by primary care practitioners and is consistent with a cost-effective stepped-care framework.

  4. Nursing Quality Assurance: The Wisconsin System

    Science.gov (United States)

    Hover, Julie; Zimmer, Marie J.

    1978-01-01

    Evaluation model guidelines for hospital departments of nursing to use in their nursing quality assurance programs are presented as developed in Wisconsin. Four essential components of the Wisconsin outcome evaluation system are criteria, assessment, standards, and improvement of care. Sample tests and charts are included in the article. (MF)

  5. University Administrators' Conceptions of Quality and Approaches to Quality Assurance

    Science.gov (United States)

    Goff, Lori

    2017-01-01

    As the quality of university education garners increasingly more interest in both the public and in the literature, and as quality assurance (QA) processes are developed and implemented within universities around the world, it is important to carefully consider what is meant by the term quality. This study attempts to add to the literature…

  6. Quality assurance handbook for measurement laboratories

    International Nuclear Information System (INIS)

    Delvin, W.L.

    1984-10-01

    This handbook provides guidance in the application of quality assurance to measurement activities. It is intended to help those persons making measurements in applying quality assurance to their work activities by showing how laboratory practices and quality assurance requirements are integrated to provide control within those activities. The use of the guidance found in this handbook should help provide consistency in the interpretation of quality assurance requirements across all types of measurement laboratories. This handbook also can assist quality assurance personnel in understanding the relationships between laboratory practices and quality assurance requirements. The handbook is composed of three chapters and several appendices. Basic guidance is provided by the three chapters. In Chapter 1, the role of quality assurance in obtaining quality data and the importance of such data are discussed. Chapter 2 presents the elements of laboratory quality assurance in terms of practices that can be used in controlling work activities to assure the acquisition of quality data. Chapter 3 discusses the implementation of laboratory quality assurance. The appendices provide supplemental information to give the users a better understanding of the following: what is quality assurance; why quality assurance is required; where quality assurance requirements come from; how those requirements are interpreted for application to laboratory operations; how the elements of laboratory quality assurance relate to various laboratory activities; and how a quality assurance program can be developed

  7. Concepts of nuclear quality assurance

    International Nuclear Information System (INIS)

    Randers, G.; Morris, P.A.; Pomeroy, D.

    1976-01-01

    While the safety record of the nuclear industry continues to be excellent, the forced outage rates for recent years continue to be 15% or more. Quality assurance, therefore, needs to be applied not only to nuclear safety matters, but to the goals of increased productivity and reduced construction and operating costs. Broadening the application of the general concept of quality assurance in this way leads to the introduction of reliability technology. The total activity might better be called reliability assurance. That effective quality assurance systems do pay off is described by examples from the utility industry, from a manufacturer of instruments and systems and from the experience of Westinghouse Electric Company's manufacturing divisions. The special situation of applying quality assurance to nuclear fuel is discussed. Problems include the lack of a fully developed regulatory policy in this area, incomplete understanding of the mechanism for pellet-clad interaction failures, incomplete access to manufacturers design and process information, inability to make desirable changes on a timely basis and inadequate feedback of irradiation experience. (author)

  8. Waste Management Quality Assurance Plan

    International Nuclear Information System (INIS)

    1993-01-01

    Lawrence Berkeley Laboratory's Environment Department addresses its responsibilities through activities in a variety of areas. The need for a comprehensive management control system for these activities has been identified by the Department of Energy (DOE). The WM QA (Waste Management Quality Assurance) Plan is an integral part of a management system that provides controls necessary to ensure that the department's activities are planned, performed, documented, and verified. This WM QA Plan defines the requirements of the WM QA program. These requirements are derived from DOE Order 5700.6C, Quality Assurance, the LBL Operating and Assurance Program Plan (OAP, LBL PUB-3111), and other environmental compliance documents applicable to WM activities. The requirements presented herein, as well as the procedures and methodologies that direct the implementation of these requirements, will undergo review and revisions as necessary. The provisions of this QA Plan and its implementing documents apply to quality-affecting activities performed by and for WM. It is also applicable to WM contractors, vendors, and other LBL organizations associated with WM activities, except where such contractors, vendors, or organizations are governed by their own WM-approved QA programs. References used in the preparation of this document are (1) ASME NQA-1-1989, (2) ANSI/ASQC E4 (Draft), (3) Waste Management Quality Assurance Implementing Management Plan (LBL PUB-5352, Rev. 1), (4) LBL Operating and Assurance Program Plan (OAP), LBL PUB-3111, 2/3/93. A list of terms and definitions used throughout this document is included as Appendix A

  9. HEALING THE ROMANIAN HEALTH CARE SYSTEM THROUGH THE TOTAL QUALITY MANAGEMENT METHOD

    Directory of Open Access Journals (Sweden)

    Cosmin Dobrin

    2015-07-01

    Nowadays, this method is used with success and covers a large area of industries, including the sanitary industry. European hospitals have used this method in order to rearrange, from the quality’s point of view, their departments and keep their customers and employees satisfied with the sanitary institution.Total Quality Management is a method that has the ability to convert the health care system, and to cover all “gaps” formed for several years. Starting with correcting as much as possible all the issues found in the health care system, will lead to the top and most important objective: focusing on patient and assuring him a significant level of satisfaction. The applicability of this method made is possible also for Romanian hospitals. Since our health care system is confronting daily with issues that affect the patients (some issues being even deadly, a change in the way the quality is perceived, is suitable for our hospitals and clinics.

  10. The quality-value proposition in health care.

    Science.gov (United States)

    Feazell, G Landon; Marren, John P

    2003-01-01

    Powerful forces are converging in US health care to finally cause recognition of the inherently logical relationship between quality and money. The forces, or marketplace "drivers," which are converging to compel recognition of the relationship between cost and quality are: (1) the increasing costs of care; (2) the recurrence of another medical malpractice crisis; and (3) the recognition inside and outside of health care that quality is inconsistent and unacceptable. It is apparent that hospital administrators, financial officers, board members, and medical staff leadership do not routinely do two things: (1) relate quality to finance; and (2) appreciate the intra-hospital structural problems that impede quality attainment. This article discusses these factors and offers a positive method for re-structuring quality efforts and focusing the hospital and its medical staff on quality. The simple but compelling thesis of the authors is that health care must immediately engage in the transformation to making quality of medical care the fundamental business strategy of the organization.

  11. [Endorsement of risk management and patient safety by certification of conformity in health care quality assessment].

    Science.gov (United States)

    Waßmuth, Ralf

    2015-01-01

    Certification of conformity in health care should provide assurance of compliance with quality standards. This also includes risk management and patient safety. Based on a comprehensive definition of quality, beneficial effects on the management of risks and the enhancement of patient safety can be expected from certification of conformity. While these effects have strong face validity, they are currently not sufficiently supported by evidence from health care research. Whether this relates to a lack of evidence or a lack of investigation remains open. Advancing safety culture and "climate", as well as learning from adverse events rely in part on quality management and are at least in part reflected in the certification of healthcare quality. However, again, evidence of the effectiveness of such measures is limited. Moreover, additional factors related to personality, attitude and proactive action of healthcare professionals are crucial factors in advancing risk management and patient safety which are currently not adequately reflected in certification of conformity programs.

  12. Waste Management Quality Assurance Plan

    International Nuclear Information System (INIS)

    2006-01-01

    The WMG QAP is an integral part of a management system designed to ensure that WMG activities are planned, performed, documented, and verified in a manner that assures a quality product. A quality product is one that meets all waste acceptance criteria, conforms to all permit and regulatory requirements, and is accepted at the offsite treatment, storage, and disposal facility. In addition to internal processes, this QA Plan identifies WMG processes providing oversight and assurance to line management that waste is managed according to all federal, state, and local requirements for waste generator areas. A variety of quality assurance activities are integral to managing waste. These QA functions have been identified in the relevant procedures and in subsequent sections of this plan. The WMG QAP defines the requirements of the WMG quality assurance program. These requirements are derived from Department of Energy (DOE) Order 414.1C, Quality Assurance, Contractor Requirements Document, the LBNL Operating and Assurance Program Plan (OAP), and other applicable environmental compliance documents. The QAP and all associated WMG policies and procedures are periodically reviewed and revised, as necessary, to implement corrective actions, and to reflect changes that have occurred in regulations, requirements, or practices as a result of feedback on work performed or lessons learned from other organizations. The provisions of this QAP and its implementing documents apply to quality-affecting activities performed by the WMG; WMG personnel, contractors, and vendors; and personnel from other associated LBNL organizations, except where such contractors, vendors, or organizations are governed by their own WMG-approved QA programs

  13. Do employers know the quality of health care benefits they provide? Use of HEDIS depression scores for health plans.

    Science.gov (United States)

    Robst, John; Rost, Kathryn; Marshall, Donna

    2013-11-01

    OBJECTIVE Dissemination of health quality measures is a necessary ingredient of efforts to harness market-based forces, such as value-based purchasing by employers, to improve health care quality. This study examined reporting of Healthcare Effectiveness Data and Information Set (HEDIS) measures for depression to firms interested in improving depression care. METHODS During surveys conducted between 2009 and 2011, a sample of 325 employers that were interested in improving depression treatment were asked whether their primary health plan reports HEDIS scores for depression to the National Committee for Quality Assurance (NCQA) and if so, whether they knew the scores. Data about HEDIS reporting by the health plans were collected from the NCQA. RESULTS HEDIS depression scores were reported by the primary health plans of 154 (47%) employers, but only 7% of employers knew their plan's HEDIS scores. Because larger employers were more likely to report knowing the scores, 53% of all employees worked for employers who reported knowing the scores. A number of structural, health benefit, and need characteristics predicted knowledge of HEDIS depression scores by employers. CONCLUSIONS The study demonstrated that motivated employers did not know their depression HEDIS scores even when their plan publicly reported them. Measures of health care quality are not reaching the buyers of insurance products; however, larger employers were more likely to know the HEDIS scores for their health plan, suggesting that value-based purchasing may have some ability to affect health care quality.

  14. Quality assurance in medical laboratories

    International Nuclear Information System (INIS)

    Boroviczeny, K.G. von; Merten, R.; Merten, U.P.

    1987-01-01

    The book presents a comprehensive and specified survey of the quality assurance measures and methods applied in medical laboratories in the pre-analytical phase and in the analytical and post-analytical phases. It also gives information on computer-aided procedures, cost-benefit analyses in this field, and on official requirements and standards in the fields of clinical chemistry, hematology, immunology and microbiology, and equipment testing and inspection. One chapter of the book particularly deals with quality assurance for radioimmunological in-vitro analyses. With 112 figs., 337 tabs [de

  15. The challenge of quality assurance

    International Nuclear Information System (INIS)

    Simon, R.; Krischer, W.; Price, M.S.T.

    1986-01-01

    The paper presents the aims of quality assurance in the design and production of radioactive waste packages. It lists the most relevant acceptance criteria and regulatory requirements, investigates the institutional and technical problems of carrying out Quality Assurance and presents suggestions for establishing suitable organisational structures and technical programmes to provide adequate confidence in the safe nature and the performance of waste packages. The Commission of European Communities has laid emphasis on the development of appropriate test methods in its last research and development programme. First results of the work are reviewed in the context of international progress in this field. (author)

  16. Pacific Northwest Laboratory annual report for 1988 to the Assistant Secretary for Environment, Safety, and Health: Part 5, Environment, safety, health, and quality assurance

    Energy Technology Data Exchange (ETDEWEB)

    Faust, L.G.; Pennell, W.T.; Selby, J.M.

    1989-02-01

    This document summarizes the research programs now underway at Battelle's Pacific Northwest Laboratory in the areas of environmental safety, health, and quality assurance. Topics include internal irradiation, emergency plans, dose equivalents, risk assessment, dose equivalents, surveys, neutron dosimetry, and radiation accidents. (TEM)

  17. Pacific Northwest Laboratory annual report for 1988 to the Assistant Secretary for Environment, Safety, and Health: Part 5, Environment, safety, health, and quality assurance

    International Nuclear Information System (INIS)

    Faust, L.G.; Pennell, W.T.; Selby, J.M.

    1989-02-01

    This document summarizes the research programs now underway at Battelle's Pacific Northwest Laboratory in the areas of environmental safety, health, and quality assurance. Topics include internal irradiation, emergency plans, dose equivalents, risk assessment, dose equivalents, surveys, neutron dosimetry, and radiation accidents

  18. Comparing two survey methods of measuring health-related indicators: Lot Quality Assurance Sampling and Demographic Health Surveys.

    Science.gov (United States)

    Anoke, Sarah C; Mwai, Paul; Jeffery, Caroline; Valadez, Joseph J; Pagano, Marcello

    2015-12-01

    Two common methods used to measure indicators for health programme monitoring and evaluation are the demographic and health surveys (DHS) and lot quality assurance sampling (LQAS); each one has different strengths. We report on both methods when utilised in comparable situations. We compared 24 indicators in south-west Uganda, where data for prevalence estimations were collected independently for the two methods in 2011 (LQAS: n = 8876; DHS: n = 1200). Data were stratified (e.g. gender and age) resulting in 37 comparisons. We used a two-sample two-sided Z-test of proportions to compare both methods. The average difference between LQAS and DHS for 37 estimates was 0.062 (SD = 0.093; median = 0.039). The average difference among the 21 failures to reject equality of proportions was 0.010 (SD = 0.041; median = 0.009); among the 16 rejections, it was 0.130 (SD = 0.010, median = 0.118). Seven of the 16 rejections exhibited absolute differences of 0.10 and 0.20 (mean = 0.261, SD = 0.083). There is 75.7% agreement across the two surveys. Both methods yield regional results, but only LQAS provides information at less granular levels (e.g. the district level) where managerial action is taken. The cost advantage and localisation make LQAS feasible to conduct more frequently, and provides the possibility for real-time health outcomes monitoring. © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  19. Generic Quality Assurance Model (GQAM) for successful e-health acquisition in rural hospitals

    CSIR Research Space (South Africa)

    Ruxwana, N

    2011-07-01

    Full Text Available The e-health evolution has the potential to aid management of scarce resources and improve quality if services within healthcare. However, their implementation continues to fail. Amongst other reasons, the lack of project quality management is found...

  20. Strategies to Improve the Quality of Health Care - Learning from ...

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

    Improving access to primary health care and the quality of services in Latin American countries is urgently needed to address high health inequities in the region. ... International Water Resources Association, in close collaboration with IDRC, is holding a webinar titled “Climate change and adaptive water management: ...

  1. Patient satisfaction with quality of primary health care in Benghazi ...

    African Journals Online (AJOL)

    Objectives: To assess patient satisfaction with quality of PHC assessed in terms of (a) customer profile, (b) patient satisfaction, and (c) health care-seeking behavior. Methodology: A sample of nine health centers and seven polyclinics from various locations in Benghazi, Libya were selected for gathering information by ...

  2. Quality assurance in tissue banking

    International Nuclear Information System (INIS)

    Von Versen, R.; Mnig, H. J.; Bettin, D.

    1999-01-01

    Today the different kinds of human allografts have the full acceptance for the clinical application for the treatment of a very wide range of indications in many medical disciplines. An essential aspect of this acceptance of these allografts is the complete biological safety, first of all the exclusion of virus contaminations. The German Institute for Cell and Tissue Replacement (DIZG) is functioning as a national tissue bank cooperating with more than 300 hospitals in Germany and Austria. Its profile is determined by the processing of tissue allografts like cortical and cancellous bone, fascia lata, tendon as well as skin, skin substitutes and cultured autologous and allogenic kerytinocytes. DIZG is licensed by the German Federal Institute for Pharmaceuticals and Medical Products and the country health authorities. To ensure that the allografts fulfill the highest quality requirements a controlled and certified quality management system has been established. In accordance with the Good Manufacturing Practice all procedures are perform-ned on the basis of validated methods. All non-vital allografts are sterilized by a chemical sterilisation method with peracetic acid (PAA) that is validated by the Robert Koch Institute, an independent governmental institution, for the inactivation of bacteria, fungi and viruses. The used test viruses are Pseudorabies V, Polio V, Bovine Virusdiarrhoe V, Parvo V, Hepatitis A V, HIV). The DIZG quality management system (QMS) is based on ISO 9001 which is required for institutions that are involved in processing, research and education and is certified by an international auditing body. With this presentation the validation design shall be introduced and the responsibility of regional and national tissue banks for internal and external quality control and quality assurance shall be discussed

  3. Assuring quality in narrative analysis.

    Science.gov (United States)

    Bailey, P H

    1996-04-01

    Many nurse-researchers using qualitative strategies have been concerned with assuring quality in their work. The early literature reveals that the concepts of validity and reliability, as understood from the positivist perspective, are somehow inappropriate and inadequate when applied to interpretive research. More recent literature suggests that because of the positivist and interpretive paradigms are epistemologically divergent, the transfer of quality criteria from one perspective to the other is not automatic or even reasonable. The purpose of this article, therefore, is to clarify what the terms quality, trustworthiness, credibility, authenticity, and goodness mean in qualitative research findings. The process of assuring quality, validation, in qualitative research will be discussed within the context of the interpretive method, narrative analysis. A brief review of quality in narrative analysis nursing research will also be presented.

  4. Agreement and disagreement on health care quality concepts among academic health professionals: the Saudi case.

    Science.gov (United States)

    Mahrous, Mohamed Saad

    2014-01-01

    A systematic and rigorous implementation of quality improvement processes is likely to improve the well-being of staff members and heighten their job satisfaction. Assessing professionals' perceptions of health care quality should lead to the betterment of health care services. In Saudi Arabia, no previous studies examine how university health professionals view health care quality concepts. A cross-sectional analytical study employing a self-administered questionnaire with 43 statements assessing quality perceptions of academic health care professionals was used. Despite the agreement of health professionals on numerous quality concepts addressed in this study, there was insufficient agreement on 10 core quality concepts, 3 of which were the following: "quality focuses on customers" (50%), "quality is tangible and therefore measurable" (29.3%), and "quality is data-driven" (62%). Hence, providing health professionals with relevant training likely will generate a better understanding of quality concepts and optimize their performance.

  5. What cost quality assurance

    International Nuclear Information System (INIS)

    Tikkanen, M.W.; Starek, R.; Liddel, P.R.; Grey, R.G.; Peile, R.C.

    1991-01-01

    This paper reports that the increased awareness of global environmental pollution has meant that analytical laboratories are faced with an increasing number of samples to analyze and a greater demand for quality control for their applications. In answer to these demands, more laboratory managers are turning to automation for analytical procedures and automated routines to perform quality control on individual samples. Atomic Absorption analysis, particularly by graphite furnace and hydride generation technique has proved to be adaptable to automated analysis to determine low concentrations of elements such as As, Co, Cd, Hg, Ag, Ba, Cr and Pb. Although highly sensitive, both techniques are time consuming and highly matrix dependent. They may also require extensive sample preparation prior to analysis. Additionally, government imposed methodologies e.g. those used for the USA EPA, Contract Laboratory Program, RCRA and SDWA programs, require very specific time consuming quality control measures

  6. Quality assurance plan: Prepared for the state of Florida, Department of Health and rehabilitative Services, Office of Laboratory Services, Water Certification Program

    International Nuclear Information System (INIS)

    1992-02-01

    This quality assurance plan is for use in ongoing operations in the General Electric Neutron Devices Department. General Electric operates the Department of Energy (DOE) facility in Largo, Florida. All work covered by this quality assurance plan is in support of the operations of the wastewater pretreatment facility operated by GENDD at the DOE facility in Largo, Florida. As a Florida State certified laboratory we will follow Health and Rehabilitation Services (HRS) or HRS approved standard methods, successfully participate in HRS or HRS approved performance evaluation studies, and will maintain Quality Assurance Documentation as outlined in this plan or its subsequent revisions

  7. Project officer's perspective: quality assurance as a management tool.

    Science.gov (United States)

    Heiby, J

    1993-06-01

    Advances in the management of health programs in less developed countries (LDC) have not kept pace with the progress of the technology used. The US Agency for International Development mandated the Quality Assurance Project (QAP) to provide quality improvement technical assistance to primary health care systems in LDCs while developing appropriate quality assurance (QA) strategies. The quality of health care in recent years in the US and Europe focused on the introduction of management techniques developed for industry into health systems. The experience of the QAP and its predecessor, the PRICOR Project, shows that quality improvement techniques facilitate measurement of quality of care. A recently developed WHO model for the management of the sick child provides scientifically based standards for actual care. Since 1988, outside investigators measuring how LDC clinicians perform have revealed serious deficiencies in quality compared with the program's own standards. This prompted developed of new QA management initiatives: 1) communicating standards clearly to the program staff; 2) actively monitoring actual performance corresponds to these standards; and 3) taking action to improve performance. QA means that managers are expected to monitor service delivery, undertake problem solving, and set specific targets for quality improvement. Quality improvement methods strengthen supervision as supervisors can objectively assess health worker performance. QA strengthens the management functions that support service delivery, e.g., training, records management, finance, logistics, and supervision. Attention to quality can contribute to improved health worker motivation and effective incentive programs by recognition for a job well done and opportunities for learning new skills. These standards can also address patient satisfaction. QA challenges managers to aim for the optimal level of care attainable.

  8. Material quality assurance risk assessment : [summary].

    Science.gov (United States)

    2013-01-01

    With the shift from quality control (QC) of materials and placement techniques : to quality assurance (QA) and acceptance over the years, the role of the Office : of Materials Technology (OMT) has been shifting towards assurance of : material quality...

  9. An approach to total quality assurance

    International Nuclear Information System (INIS)

    Archer, L.G.

    1976-01-01

    Total Quality Assurance must be based on amalgamating three quality functions: effective quality control, competent inspection, and regularly audited Quality Assurance programmes. In applying these functions the fuel supplier must regard each of his sub-contractors as part of his own works and ensure a common policy of motivated Quality Assurance throughout his own works and those of his suppliers. (author)

  10. Guide to quality assurance

    Energy Technology Data Exchange (ETDEWEB)

    1976-01-01

    This standard provides general guidance on activities and functions covered with the attainment of quality. Basic aspects covered are management objectives, program and planning, principles of control, design, specification, purchasing, manufacturing, production, marketing, servicing, documentation, and review evaluation procedures. Organizational aspects are also referred to in an appendix.

  11. Quality assurance manual: Volume 1

    International Nuclear Information System (INIS)

    Oijala, J.E.

    1988-06-01

    Stanford Linear Accelerator Center (SLAC) is a DOE-supported research facility that carries out experimental and theoretical research in high energy physics and developmental work in new techniques for particle acceleration and experimental instrumentation. The purpose of this manual is to describe SLAC quality assurance policies and practices in various parts of the Laboratory

  12. Agents for change: nonphysician medical providers and health care quality.

    Science.gov (United States)

    Boucher, Nathan A; Mcmillen, Marvin A; Gould, James S

    2015-01-01

    Quality medical care is a clinical and public health imperative, but defining quality and achieving improved, measureable outcomes are extremely complex challenges. Adherence to best practice invariably improves outcomes. Nonphysician medical providers (NPMPs), such as physician assistants and advanced practice nurses (eg, nurse practitioners, advanced practice registered nurses, certified registered nurse anesthetists, and certified nurse midwives), may be the first caregivers to encounter the patient and can act as agents for change for an organization's quality-improvement mandate. NPMPs are well positioned to both initiate and ensure optimal adherence to best practices and care processes from the moment of initial contact because they have robust clinical training and are integral to trainee/staff education and the timely delivery of care. The health care quality aspects that the practicing NPMP can affect are objective, appreciative, and perceptive. As bedside practitioners and participants in the administrative and team process, NPMPs can fine-tune care delivery, avoiding the problem areas defined by the Institute of Medicine: misuse, overuse, and underuse of care. This commentary explores how NPMPs can affect quality by 1) supporting best practices through the promotion of guidelines and protocols, and 2) playing active, if not leadership, roles in patient engagement and organizational quality-improvement efforts.

  13. Technology transfer quality assurance

    International Nuclear Information System (INIS)

    Hood, F.C.

    1991-03-01

    The results of research conducted at Pacific Northwest Laboratory (PNL) for the DOE are regularly transferred from the laboratory to the private sector. The principal focus of PNL is on environmental research and waste management technology; other programs of emphasis include molecular science research. The technology transfer process is predicated on Quality to achieve its objectives effectively. Total quality management (TQM) concepts and principles readily apply to the development and translation of new scientific concepts into commercial products. The concept of technology transfer epitomizes the TQM tenet of continuous improvement: always striving for a better way to do things and always satisfying the customer. A successful technology transfer process adds value to society by providing new or enhanced processes, products, and services to government and commercial customers, with a guarantee of product pedigree and process validity. 2 refs

  14. New techniques in quality assurance

    International Nuclear Information System (INIS)

    Fornicola, J.C.

    1987-01-01

    GPU Nuclear Corp. has a multifaceted quality assurance (QA) program. This program includes a comprehensive QA organization to help ensure its implementation. The QA organization employs various techniques in assuring quality at GPU Nuclear. These techniques not only include the typical QA/quality-control verification activities, i.e., QA engineering, quality control, and audits, but also include some new innovative techniques. Several new techniques have been developed for verifying activities. These techniques include monitoring and functional audits of safety systems. Several new techniques for assessing performance and adequacy and effectiveness of plant and QA programs, such as plant assessments and QA systems engineering evaluations, have also been developed. This paper provides an overview of these and other new techniques being employed by GPU Nuclear's QA organization

  15. Quality assurance in radiation processing

    International Nuclear Information System (INIS)

    Noriah Mod Ali

    2002-01-01

    The growth of the radiation processing industries in Malaysia has presented the SSDL-MINT a new set of parameter for the Quality Assurance (QA) programs. The large massive doses of radiation required for commercial application of sterilization, cross-linking etc needs measurement method outside the scope of familiar radiation detection instruments. This requires establishment of proper calibration procedure and selection of appropriate transfer system/technique to assure adequate traceability to an international radiation standard. The benefit of accurate in-plant dosimetry for the operator, approving authority and purchaser are balanced against the extra dosimetric efforts required for good QA is presented. (Author)

  16. Health-care quality and information failure: Evidence from Nigeria.

    Science.gov (United States)

    Evans, David K; Welander Tärneberg, Anna

    2018-03-01

    Low-quality health services are a problem across low- and middle-income countries. Information failure may contribute, as patients may have insufficient knowledge to discern the quality of health services. That decreases the likelihood that patients will sort into higher quality facilities, increasing demand for better health services. This paper presents results from a health survey in Nigeria to investigate whether patients can evaluate health service quality effectively. Specifically, this paper demonstrates that although more than 90% of patients agree with any positive statement about the quality of their local health services, satisfaction is significantly associated with the diagnostic ability of health workers at the facility. Satisfaction is not associated with more superficial characteristics such as infrastructure quality or prescriptions of medicines. This suggests that patients may have sufficient information to discern some of the most important elements of quality, but that alternative measures are crucial for gauging the overall quality of care. Copyright © The World Bank Health Economics © 2017 John Wiley & Sons, Ltd.

  17. Private sector delivery of health services in developing countries: a mixed-methods study on quality assurance in social franchises

    OpenAIRE

    Schlein, Karen; De La Cruz, Anna York; Gopalakrishnan, Tisha; Montagu, Dominic

    2013-01-01

    Abstract Background Across the developing world health care services are most often delivered in the private sector and social franchising has emerged, over the past decade, as an increasingly popular method of private sector health care delivery. Social franchising aims to strengthen business practices through economies of scale: branding clinics and purchasing drugs in bulk at wholesale prices. While quality is one of the established goals of social...

  18. Health care in small prisons: incorporating high-quality standards.

    Science.gov (United States)

    Rieder, Jean-Pierre; Casillas, Alejandra; Mary, Gérard; Secretan, Anne-Dominique; Gaspoz, Jean-Michel; Wolff, Hans

    2013-01-01

    In the past, health management in Geneva's six post-trial prisons had been variable and inconsistent. In 2008, the unit of penitentiary medicine of the Geneva University Hospitals was mandated to re-organize and provide health care at all six prison facilities. The specific aim of this paper is to outline the example as a practical solution to some of the common challenges in unifying the structure and process of health services across multiple small facilities, while meeting European prison health and local quality standards. Geneva's post-trial prisons are small and close to one another in geographical proximity - ideal conditions for the construction of a health mobile team (HMT). This multidisciplinary mobile team operated like a community ambulatory care model; it was progressively launched in all prison facilities in Geneva. The authors incorporated an implementation strategy where health providers partnered with prison and community stakeholders in the health delivery model's development and adaption process. The model's strategic initiatives are described along the following areas, in light of other international prison health activity and prior care models: access to a health care professional, equivalence of care, patient consent, confidentiality, humanitarian interventions, and professional competence and independence. From the perspective of the HMT members, the authors provide the "lessons learned" through this experience, especially to providers who are working on prison health services reform and coordination improvement. The paper particularly stresses the importance of partnering with community health stakeholders and prison staff, a key component to the approach.

  19. Quality assurance programme for screen film mammography

    International Nuclear Information System (INIS)

    2009-01-01

    The application of radiation in human health, for both the diagnosis and treatment of disease, is an important component of the work of the IAEA. In the area of diagnostic radiology, this work is focused on quality assurance methods to both the promotion of the effective use of radiation for diagnostic outcome, through achieving and maintaining appropriate image quality, and also on dose determination to allow the monitoring and reduction of dose to the patient. In response to heightened awareness of the importance of patient dose contributed by radiology procedures, the IAEA published Dosimetry in Diagnostic Radiology: An International Code of Practice (Technical Reports Series No. 457) in 2007, to form a basis for patient dose determination for the Member States. Further to this, it is recognized that for complex diagnostic procedures, such as mammography, a detailed guidance document is required to give the professionals in the clinical centre the knowledge necessary to assess the patient dose, as well as to ensure that the procedure gives the maximal patient benefit possible. It is well documented that without the implementation of a quality culture and a systematic quality assurance programme with appropriate education, the detection of breast cancer cannot be made at an early enough stage to allow effective curative treatment to be undertaken. Currently there are a number of established quality assurance protocols in mammography from national and regional institutions, however, many of these protocols are distinctive and so a harmonized approach is required. This will allow the Member States to facilitate quality assurance in mammography in a standardized way which will also facilitate the introduction of national quality assurance programmes that are needed to underpin effective population screening programmes for breast cancer. Development of a quality assurance document for screen film mammography was started in 2005 with the appointment of a drafting

  20. Quality Management, Quality Assurance and Quality Control in Blood Establishments

    OpenAIRE

    Bolbate, N

    2008-01-01

    Quality terms and the roots of the matter are analyzed according to European Committee’s recommendations. Essence of process and product quality control as well as essence of quality assurance is described. Quality system’s structure including quality control, quality assurance and management is justified in the article.

  1. The management of health care service quality. A physician perspective.

    Science.gov (United States)

    Bobocea, L; Gheorghe, I R; Spiridon, St; Gheorghe, C M; Purcarea, V L

    2016-01-01

    Applying marketing in health care services is presently an essential element for every manager or policy maker. In order to be successful, a health care organization has to identify an accurate measurement scale for defining service quality due to competitive pressure and cost values. The most widely employed scale in the services sector is SERVQUAL scale. In spite of being successfully adopted in fields such as brokerage and banking, experts concluded that the SERVQUAL scale should be modified depending on the specific context. Moreover, the SERVQUAL scale focused on the consumer's perspective regarding service quality. While service quality was measured with the help of SERVQUAL scale, other experts identified a structure-process-outcome design, which, they thought, would be more suitable for health care services. This approach highlights a different perspective on investigating the service quality, namely, the physician's perspective. Further, we believe that the Seven Prong Model for Improving Service Quality has been adopted in order to effectively measure the health care service in a Romanian context from a physician's perspective.

  2. 2. Product quality control and assurance system

    International Nuclear Information System (INIS)

    1990-01-01

    Product quality control and assurance are dealt with in relation to reliability in nuclear power engineering. The topics treated include product quality control in nuclear power engineering, product quality assurance of nuclear power plant equipment, quality assurance programs, classification of selected nuclear power equipment, and standards relating to quality control and assurance and to nuclear power engineering. Particular attention is paid to Czechoslovak and CMEA standards. (P.A.). 2 figs., 1 tab., 12 refs

  3. Sick of Health Care Politics? Comparing Views of Quality of Care Between Democrats and Republicans.

    Science.gov (United States)

    Scott, Kirstin W; Blendon, Robert J; Benson, John M

    Improving the quality of care delivered by the U.S. health care system is a topic of important policy and political debate. Although public opinion surveys have shown concerns regarding the state of quality of care nationally, the majority of Americans are satisfied with the quality of care they personally receive. Studies have shown that Republicans and Democrats may differ in these views. We used a 2012 national survey of 1,508 American adults that captured perceptions of quality, political party, medical experiences, and self-reported interactions with the health care system due to an illness to examine these differences. Regardless of having a recent illness or hospitalization, Democrats generally expressed greater concerns about the country's state of health care quality relative to Republicans. Partisan differences also emerged when identifying the most important problems contributing to quality-of-care deficiencies in the nation. However, partisan differences were nonexistent on measures related to self-reported experiences with quality of care. Although their individual experiences with quality of care do not differ, Republicans and Democrats differ in their views on national quality-of-care issues. This may have implications for efforts to improve quality of care in the current polarized healthcare environment.

  4. Quality assurance for hammer forgings

    International Nuclear Information System (INIS)

    Potthast, E.

    1984-01-01

    The quality assurance program introduced by Arbed Saarstahl and laid down in a quality assurance manual is described. A particular attention is attached thereby both to quality practice proper and to a reliable flow of information amongst all the persons involved. The production and test sequence schedules of the hammer forging plant are illustrated by the example of a forged valve housing for nuclear power plants. These schedules specify not only the forging process in the individual production stages but also the workpiece contour after each working operation, the heat treatment, the furnace charging, and the inspection of finished parts. The formalization of the tests is designed both to promote the customer's trust towards the supplier and to prevent the formal operations involved from hindering further technical development. (orig.) [de

  5. Quality assurance in the design

    International Nuclear Information System (INIS)

    Edelmann, J.

    1980-01-01

    System- and product-related quality assurance measures are completing one another. Certainly it is possible to detect a lot of defects in the single technical document by well controlled product related quality inspections and to avoid the consequences of these defects; but also a not unimportant part of defects and deviations has its origin in system linked deficiencies. The latter can be detected more easily and more securely by means of system related reviews (System audit, Product audit). But also the sole implementation of system related quality assurance measures keeps the danger to get stuck only in formality and to loose all references to the specific characteristics of the product. (orig./RW)

  6. Assuring the Quality of Next-Generation Sequencing in Clinical Microbiology and Public Health Laboratories.

    Science.gov (United States)

    Gargis, Amy S; Kalman, Lisa; Lubin, Ira M

    2016-12-01

    Clinical microbiology and public health laboratories are beginning to utilize next-generation sequencing (NGS) for a range of applications. This technology has the potential to transform the field by providing approaches that will complement, or even replace, many conventional laboratory tests. While the benefits of NGS are significant, the complexities of these assays require an evolving set of standards to ensure testing quality. Regulatory and accreditation requirements, professional guidelines, and best practices that help ensure the quality of NGS-based tests are emerging. This review highlights currently available standards and guidelines for the implementation of NGS in the clinical and public health laboratory setting, and it includes considerations for NGS test validation, quality control procedures, proficiency testing, and reference materials. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  7. Grid Technology and Quality Assurance

    International Nuclear Information System (INIS)

    Rippa, A.; Manieri, A.; Begin, M.E.; Di Meglio, A.

    2007-01-01

    Grid is one of the potential architectures of the coming years to support both the research and the commercial environment. Quality assurance techniques need both to adapt to these new architectures and exploit them to improve its effectiveness. Software quality is a key issue in the Digital Era: Industries as well as Public Administrations devote time to check and verify the quality of ICT products and services supplied. The definition of automatic measurement of quality metrics is a key point for implementing effective QA methods. In this paper we propose a quality certification model, named Grid-based Quality Certification Model (GQCM), that uses automatically calculable metrics to asses the quality of software applications; this model has been developed within the ETICS SSA4 activities and exploit grid technology for full automation of metrics calculation. It is however designed to be generic enough such that it can be implemented using any automatic build and test tool. (Author)

  8. Quality Assurance In Radioactivity Measurements

    International Nuclear Information System (INIS)

    Riekstina, D.; Veveris, O.; Smilskalne, G.

    2007-01-01

    The credibility of obtained results is ensured by the quality assurance and control. The main requisitions involved in the quality assurance of the laboratory according to the requirements of LVS EN ISO/IEC 17025:2005 are: 1) the use of calibrated equipment only; 2) the regular and long-time use of reference materials in the control of equipment; 3) the estimation of uncertainty sources and determination of uncertainties within the given interval of credibility; 4) the validation and verification. The very important requirement is regular participation in the interlaboratory intercomparison exercises that makes it possible to estimate and find possible error sources and carry out the corrective actions. The measurements of the radioactivity of Cs-137, Co-60, H-3, the natural radioactive nuclides as well as other radionuclides in different environmental (soil, precipitation, different types of water, needles, et al.) samples, and in various radioactive polluted objects are carried out in the Laboratory of Radiation physics. The quality assurance system was implemented in our laboratory in 2000. Since 1999 laboratory is regular participant in the interlaboratory intercomparison exercises, organized by the RISO National Laboratory (Denmark) and IAEA (Vienna). The paper shows the laboratory's system of quality assurance and its implementation. We have the internal quality audit program that takes into account the requirements of LVS EN ISO/IEC 17025: 2005, but the main attention is paid to the intercomparison of the results of analyses of laboratories, their evaluation and interpretation. Only credible and justified results can be the basis for further use in any field, thus making it possible to make legitimate decisions. (Authors)

  9. Quality assurance in tube manufacture

    International Nuclear Information System (INIS)

    Depken, H.

    1976-01-01

    Reliability in service essential for many high-technology products fabricated today. This is particularly the case within the nuclear industry. Here defective materials or components may have diastrous consequences to the safety of human beings and the environment. A new concept - Quality Assurance - originates from this industry. The concept implies that all contractors, fabricators and material manufactures involved must prove that the quality control system used, fulfits particular requirements at all manufacturing, inspection and testing stages. These requirement are laid down in two standards issued by the U.S. Atomic Energy Commission and the American Society of Mechanical Engineers. These standards are discussed in the paper. As a manufacturer of steel products for nuclear applications Sandvik has been forced to establish a quality assurance system according to these principles. The Sandvik approach is briefly described with regard to organisation and other major quality assurance activities. Further the education and training of operators and technicians is touched upon. Finally some viewpoints regarding audits performed by customers of steel manufacturers are expressed. (author)

  10. Characteristics quality system assurance of university programs

    Directory of Open Access Journals (Sweden)

    Lucian Ion Medar

    2011-03-01

    Full Text Available Quality assurance program of study requires time, dedication, effort, innovative thinking and creativity. Competitive research programs monitored by quality assurance system to create the desired results on the relationship between learning and teaching methods and assessment.

  11. Has quality assurance outlived its usefulness

    International Nuclear Information System (INIS)

    Goldenberg, N.

    1989-01-01

    This paper explores the impact that better management and increased productivity will have on the need for, and role of, quality assurance in the future. The author discusses criticisms of existing quality assurance programs

  12. Quality assurance manual: Volume 2, Appendices

    International Nuclear Information System (INIS)

    Oijala, J.E.

    1988-06-01

    This paper contains quality assurance information on departments of the Stanford Linear Accelerator Center. Particular quality assurance policies and standards discussed are on: Mechanical Systems; Klystron and Microwave Department; Electronics Department; Plant Engineering; Accelerator Department; Purchasing; and Experimental Facilities Department

  13. Quality assurance - how to involve the employees

    DEFF Research Database (Denmark)

    Jørgensen, Michael Søgaard

    1996-01-01

    An overview of strategies for involvement of employees in quality assurance developement and implementation.......An overview of strategies for involvement of employees in quality assurance developement and implementation....

  14. Introducing quality improvement management methods into primary health care services in Uganda.

    Science.gov (United States)

    Omaswa, F; Burnham, G; Baingana, G; Mwebesa, H; Morrow, R

    1996-01-01

    Uganda's National Quality Assurance Program was established in 1994 to monitor the process of decentralization of primary health care services. Guidelines were developed to address problems (e.g., in obtaining health funds channeled through local government) identified at district meetings. Bringing together District Health Teams with local administrators and political leaders to share responsibility for strengthening health services has been a significant program achievement. A smoother functioning referral system from health units to district hospitals has resulted. The response to a measles outbreak in the Arua district in 1993-94 confirmed the utility of the quality management approach. Weaknesses in the district cold chain, problems with diagnostic accuracy, and a poorly functioning information system were identified as key causative factors, and corrective action in these areas led to a subsequent decline in measles cases. Patient dissatisfaction with long waiting times at Masaka Hospital was another concern addressed through the quality assurance approach. Five salient areas were identified for action: low health worker morale, supply shortages, inadequate supervision by hospital management, poor patient flow, and inefficient drug dispensing. As a result, long delays were eliminated and utilization of hospital outpatient services increased by 28%.

  15. Competition in Health Care Markets : Treatment Volume and Quality

    NARCIS (Netherlands)

    Boone, Jan

    2018-01-01

    This paper introduces a workhorse model to analyze the effects of provider and insurer competition in health care markets. The two contracting imperfections we focus on are the following: (i) whether or not a patient should be treated and (ii) treatment quality are both not contractible. We derive

  16. Integrating quality assurance and research and development

    International Nuclear Information System (INIS)

    Dronkers, J.J.

    1985-01-01

    Quality assurance programs cannot be transferred from one organization to another without attention to existing cultures and traditions. Introduction of quality assurance programs constitutes a significant change and represents a significant impact on the organizational structure and operational mode. Quality assurance professionals are change agents, but do not know how to be effective ones. Quality assurance as a body of knowledge and experience can only become accepted when its practitioners become familiar with their role as change agents. 8 references

  17. Changes in Quality of Health Care Delivery after Vertical Integration.

    Science.gov (United States)

    Carlin, Caroline S; Dowd, Bryan; Feldman, Roger

    2015-08-01

    To fill an empirical gap in the literature by examining changes in quality of care measures occurring when multispecialty clinic systems were acquired by hospital-owned, vertically integrated health care delivery systems in the Twin Cities area. Administrative data for health plan enrollees attributed to treatment and control clinic systems, merged with U.S. Census data. We compared changes in quality measures for health plan enrollees in the acquired clinics to enrollees in nine control groups using a differences-in-differences model. Our dataset spans 2 years prior to and 4 years after the acquisitions. We estimated probit models with errors clustered within enrollees. Data were assembled by the health plan's informatics team. Vertical integration is associated with increased rates of colorectal and cervical cancer screening and more appropriate emergency department use. The probability of ambulatory care-sensitive admissions increased when the acquisition caused disruption in admitting patterns. Moving a clinic system into a vertically integrated delivery system resulted in limited increases in quality of care indicators. Caution is warranted when the acquisition causes disruption in referral patterns. © Health Research and Educational Trust.

  18. Improving Quality of Care in Primary Health-Care Facilities in Rural Nigeria: Successes and Challenges.

    Science.gov (United States)

    Ugo, Okoli; Ezinne, Eze-Ajoku; Modupe, Oludipe; Nicole, Spieker; Winifred, Ekezie; Kelechi, Ohiri

    2016-01-01

    Nigeria has a high population density but a weak health-care system. To improve the quality of care, 3 organizations carried out a quality improvement pilot intervention at the primary health-care level in selected rural areas. To assess the change in quality of care in primary health-care facilities in rural Nigeria following the provision of technical governance support and to document the successes and challenges encountered. A total of 6 states were selected across the 6 geopolitical zones of the country. However, assessments were carried out in 40 facilities in only 5 states. Selection was based on location, coverage, and minimum services offered. The facilities were divided randomly into 2 groups. The treatment group received quality-of-care assessment, continuous feedback, and improvement support, whereas the control group received quality assessment and no other support. Data were collected using the SafeCare Healthcare Standards and managed on the SafeCare Data Management System-AfriDB. Eight core areas were assessed at baseline and end line, and compliance to quality health-care standards was compared. Outcomes from 40 facilities were accepted and analyzed. Overall scores increased in the treatment facilities compared to the control facilities, with strong evidence of improvement ( t = 5.28, P = .0004) and 11% average improvement, but no clear pattern of improvement emerged in the control group. The study demonstrated governance support and active community involvement offered potential for quality improvement in primary health-care facilities.

  19. Managing Quality in Health Care: Involving Patient Care Information Systems and Healthcare Professionals in Quality Monitoring and Improvement

    NARCIS (Netherlands)

    M. de Mul (Marleen)

    2009-01-01

    textabstractIt is no longer possible to ignore the issue of quality in health care. Care institutions strive to provide all patients with effective, efficient, safe, timely, patient-centered care. Increased attention for quality is also found in discussions regarding use of information

  20. Paediatric medulloblastoma: patterns of care and radiotherapy quality assurance in Australia

    International Nuclear Information System (INIS)

    Ahern, V.; Koh, E-S.; Gebski, V.; Sathiyaseelan, Y.

    2007-01-01

    Full text: The purpose of this study was to document how children in Australia with medulloblastoma are being treated and to evaluate the quality of radiotherapy (RT) delivered. The Radiotherapy Database of the Australian and New Zealand Children's Haematology and Oncology Group was used to identify 46 children with medulloblastoma younger than the age of 15 years treated with radical intent by craniospinal irradiation between 1997 and 1999 inclusively. Twenty-six patients had completely resected disease without evidence of disease spread. Of these, 16 patients received a craniospinal RT dose of <25 Gy in addition to chemotherapy. RT treatment immobilization methods varied, as did planning methods. RT dose to critical structures was recorded on treatment plans for only 15% of patients. The average systematic error in shield placement at the posterior orbit was 5.2 mm, and two-thirds of patients were 'overshielded' at this site. Adequate coverage of the distal end of the thecal sac was achieved in fewer than 50% of on-treatment verification films for 21 of 45 patients. With a reduction in RT dose to the craniospinal axis for paediatric medulloblastoma, greater attention is needed for patient immobilization, documentation of RT dose to critical structures and the placement and reproducibility of shielding

  1. Quality assurance in diagnostic radiology

    International Nuclear Information System (INIS)

    1982-01-01

    The present guide endeavours to provide an outline of the type of quality assurance programme to be recommended for (1) routine implementation by those performing radiodiagnostic procedures (medical radiology technicians, medical physicists, and radiologists), (2) for application by the responsible national authorities, and (3) for use by international bodies such as the International Society of Radiology (ISR), the International Commission on Radiological Protection (ICRP), and the International Commission on Radiation Units and Measurements (ICRU)

  2. Quality assurance of ageing components

    International Nuclear Information System (INIS)

    Novak, W.

    1992-01-01

    Comprehensive and permanent quality assurance on existing plants places very high requirements on measurement and evaluation technology. The necessary preconditions are often not met, however. By means of stocktaking using an external data registration and evaluation system may provide the basis for the assessment of the object and the existing power station instrumentation. After defining the desired scope and standards for the evaluation process, a specific solution may be produced. 5 figs

  3. Quality Assurance Requirements and Description

    International Nuclear Information System (INIS)

    Ram Murthy

    2002-01-01

    The Quality Assurance Requirements and Description (QARD) is the principal Quality Assurance (QA) document for the Civilian Radioactive Waste Management Program (Program). It establishes the minimum requirements for the QA program [INTRODUCTION :1p2s (NOT A REQUIREMENT)]. The QARD contains regulatory requirements and program commitments necessary for the development of an effective QA program [INTRODUCTION :1p3s (NOT A REQUIREMENT)]. Implementing documents must be based on, and be consistent with the QARD. The QARD applies to the following: (1) Acceptance of spent nuclear fuel and high-level waste. (2) Transport of spent nuclear fuel and high-level waste. (3) Storage of spent nuclear fuel through receipt of storage cask certification or a facility operating license. (4) Monitored Geologic Repository, including the site characterization activities [Exploratory Studies Facility (ESF) and surface based testing], through receipt of an operating license. (5) High-level waste form development through qualification, production, and acceptance. (6) Characterization of DOE spent nuclear fuel, and conditioning through acceptance of DOE spent nuclear fuel. Section 2.0, Quality Assurance Program, defines in greater detail criteria for determining work subject to the QARD

  4. Quality assurance in the nuclear industry

    International Nuclear Information System (INIS)

    Knoedler, D.

    1978-01-01

    Quality assurance is the sum of all activities systematically planned, practiced, and controlled with the aim to assure the quality of deliveries and performances. This assurance today covers all phases of activities, from the planning (including a determination of the required and necessary quality characteristics) to the start-up of a plant. (orig./RW) [de

  5. Quality assurance management policies and requirements

    International Nuclear Information System (INIS)

    1985-10-01

    The purpose of this document is to: set forth overall, integrated quality assurance management policies and requirements for the entire Civilian Radioactive Waste Management Program; define management responsibilities for assuring quality; and provide a general framework for the development of more detailed quality assurance management policies and requirements by program, project, and contractor organizations

  6. 40 CFR 31.45 - Quality assurance.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Quality assurance. 31.45 Section 31.45... Requirements Reports, Records, Retention, and Enforcement § 31.45 Quality assurance. If the grantee's project... quality assurance practices consisting of policies, procedures, specifications, standards, and...

  7. 7 CFR 652.7 - Quality assurance.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Quality assurance. 652.7 Section 652.7 Agriculture... assurance. (a) NRCS will review, in consultation with the Farm Service Agency, as appropriate, the quality... information obtained through its quality assurance process, documentation submitted by the technical service...

  8. 30 CFR 74.9 - Quality assurance.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Quality assurance. 74.9 Section 74.9 Mineral... DUST SAMPLING DEVICES Requirements for Continuous Personal Dust Monitors § 74.9 Quality assurance. (a) General requirements. The applicant shall establish and maintain a quality control system that assures...

  9. 40 CFR 30.54 - Quality assurance.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Quality assurance. 30.54 Section 30.54... NON-PROFIT ORGANIZATIONS Post-Award Requirements Reports and Records § 30.54 Quality assurance. If the... data generation, the grantee shall develop and implement quality assurance practices consisting of...

  10. 10 CFR 76.93 - Quality assurance.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 2 2010-01-01 2010-01-01 false Quality assurance. 76.93 Section 76.93 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) CERTIFICATION OF GASEOUS DIFFUSION PLANTS Safety § 76.93 Quality assurance. The Corporation shall establish, maintain, and execute a quality assurance program satisfying each of...

  11. Competition and quality in home health care markets.

    Science.gov (United States)

    Jung, Kyoungrae; Polsky, Daniel

    2014-03-01

    Market-based solutions are often proposed to improve health care quality; yet evidence on the role of competition in quality in non-hospital settings is sparse. We examine the relationship between competition and quality in home health care. This market is different from other markets in that service delivery takes place in patients' homes, which implies low costs of market entry and exit for agencies. We use 6 years of panel data for Medicare beneficiaries during the early 2000s. We identify the competition effect from within-market variation in competition over time. We analyze three quality measures: functional improvements, the number of home health visits, and discharges without hospitalization. We find that the relationship between competition and home health quality is nonlinear and its pattern differs by quality measure. Competition has positive effects on functional improvements and the number of visits in most ranges, but in the most competitive markets, functional outcomes and the number of visits slightly drop. Competition has a negative effect on discharges without hospitalization that is strongest in the most competitive markets. This finding is different from prior research on hospital markets and suggests that market-specific environments should be considered in developing polices to promote competition. Copyright © 2013 John Wiley & Sons, Ltd.

  12. COMPETITION AND QUALITY IN HOME HEALTH CARE MARKETS†

    Science.gov (United States)

    JUNG, KYOUNGRAE; POLSKY, DANIEL

    2013-01-01

    SUMMARY Market-based solutions are often proposed to improve health care quality; yet evidence on the role of competition in quality in non-hospital settings is sparse. We examine the relationship between competition and quality in home health care. This market is different from other markets in that service delivery takes place in patients’ homes, which implies low costs of market entry and exit for agencies. We use 6 years of panel data for Medicare beneficiaries during the early 2000s. We identify the competition effect from within-market variation in competition over time. We analyze three quality measures: functional improvements, the number of home health visits, and discharges without hospitalization. We find that the relationship between competition and home health quality is nonlinear and its pattern differs by quality measure. Competition has positive effects on functional improvements and the number of visits in most ranges, but in the most competitive markets, functional outcomes and the number of visits slightly drop. Competition has a negative effect on discharges without hospitalization that is strongest in the most competitive markets. This finding is different from prior research on hospital markets and suggests that market-specific environments should be considered in developing polices to promote competition. PMID:23670849

  13. Quality assurance of nuclear fuel

    International Nuclear Information System (INIS)

    1994-01-01

    The guide presents the quality assurance requirements to be completed with in the procurement, design, manufacture, transport, handling and operation of the nuclear fuel. The guide also applies to the procurement of the control rods and the shield elements to be placed in the reactor. The guide is mainly aimed for the licensee responsible for the procurement and operation of fuel, for the fuel designer and manufacturer and for other organizations whose activities affect fuel quality, the safety of fuel transport, storage and operation. (2 refs.)

  14. Quality assurance in digital radiography

    International Nuclear Information System (INIS)

    Busch, H.P.; Lehmann, K.J.

    1989-01-01

    At present, there is no standard way of evaluating performance characteristics of digital radiography systems. Continuous measurements of performance parameters are necessary in order to obtain images of high quality. Parameters of quality assurance in digital radiography, which can be evaluated with simple, quick methods, are spatial resolution, low-contrast detectability, dynamic range and exposure dose. Spatial resolution was determined by a lead bar pattern, whereas the other parameters were measured by commercially available phantoms. Performance measurements of 10 digital subtraction angiography (DSA) units and one digital radiography system for unsubtracted digital radiography were assessed. From these results, recommendations for performance parameter levels will be discussed. (author)

  15. Measuring the quality of health care: state of the art.

    Science.gov (United States)

    Donaldson, M S; Nolan, K

    1997-05-01

    September 12-13, 1996, in Washington, DC, the Institute of Medicine, as part of its Special Initiative on Health Care Quality, held an invitational conference to illustrate exemplary quality measurement and to discuss the results. Patient reports, innovative uses of outcome measures for quality improvement, risk adjustment, assessment in integrated health plans and health care settings, clinical guidelines, and projects on disseminating information on quality measurement techniques and tools were among the topics represented. Brent James described studies undertaken to reduce adverse drug events (ADEs). When implementing any measurement system where error is a possible factor, it is important to emphasize identifying problems for the purpose of learning, not judgment. Lucian Leape agreed that staff involved must feel that the purpose of the study is to examine system problems, not individuals' mistakes. David Classen described a nonproprietary computerized disease-management program designed to reduce ADEs in infectious diseases. "A QUALITY VISION": Robert Brook said that the relationship between cost or resources devoted to care and quality is not well understood and is certainly not simple. He also said that although investments in measurement strategies are needed to make them better, that doesn't mean we shouldn't attempt to use the measurements we have now. Mark Chassin said that the presentations at the conference provided evidence that should allow us to conclude beyond a reasonable doubt that quality can be measured-with a degree of scientific precision equal to that of most of the measures used to take care of patients every day.

  16. Quality assurance techniques for activation analysis

    International Nuclear Information System (INIS)

    Becker, D.A.

    1984-01-01

    The principles and techniques of quality assurance are applied to the measurement method of activation analysis. Quality assurance is defined to include quality control and quality assessment. Plans for quality assurance include consideration of: personnel; facilities; analytical design; sampling and sample preparation; the measurement process; standards; and documentation. Activation analysis concerns include: irradiation; chemical separation; counting/detection; data collection, and analysis; and calibration. Types of standards discussed include calibration materials and quality assessment materials

  17. Monitoring Compliance to Promote Quality Assurance: Development of a Mental Health Clinical Chart Audit Tool in Belize, 2013.

    Science.gov (United States)

    Winer, Rachel A; Bennett, Eleanor; Murillo, Illouise; Schuetz-Mueller, Jan; Katz, Craig L

    2015-09-01

    Belize trained psychiatric nurse practitioners (PNPs) in the early 1990s to provide mental health services throughout the country. Despite overwhelming success, the program is limited by lack of monitoring, evaluation, and surveillance. To promote quality assurance, we developed a chart audit tool to monitor mental healthcare delivery compliance for initial psychiatric assessment notes completed by PNPs. After reviewing the Belize Health Information System electronic medical record system, we developed a clinical audit tool to capture 20 essential components for initial assessment clinical notes. The audit tool was then piloted for initial assessment notes completed during July through September of 2013. One hundred and thirty-four initial psychiatric interviews were audited. The average chart score among all PNPs was 9.57, ranging from 3 to 15. Twenty-three charts-or 17.2%-had a score of 14 or higher and met a 70% compliance benchmark goal. Among indicators most frequently omitted included labs ordered and named (15.7%) and psychiatric diagnosis (21.6%). Explicit statement of medications initiated with dose and frequency occurred in 47.0% of charts. Our findings provide direction for training and improvement, such as emphasizing the importance of naming labs ordered, medications and doses prescribed, and psychiatric diagnoses in initial assessment clinical notes. We hope this initial assessment helps enhance mental health delivery compliance by prompting creation of BHIS templates, development of audits tools for revisit follow-up visits, and establishment of corrective actions for low-scoring practitioners. These efforts may serve as a model for implementing quality assurance programming in other low resource settings.

  18. Health care quality measures for children and adolescents in Foster Care: feasibility testing in electronic records.

    Science.gov (United States)

    Deans, Katherine J; Minneci, Peter C; Nacion, Kristine M; Leonhart, Karen; Cooper, Jennifer N; Scholle, Sarah Hudson; Kelleher, Kelly J

    2018-02-22

    Preventive quality measures for the foster care population are largely untested. The objective of the study is to identify healthcare quality measures for young children and adolescents in foster care and to test whether the data required to calculate these measures can be feasibly extracted and interpreted within an electronic health records or within the Statewide Automated Child Welfare Information System. The AAP Recommendations for Preventive Pediatric Health Care served as the guideline for determining quality measures. Quality measures related to well child visits, developmental screenings, immunizations, trauma-related care, BMI measurements, sexually transmitted infections and depression were defined. Retrospective chart reviews were performed on a cohort of children in foster care from a single large pediatric institution and related county. Data available in the Ohio Statewide Automated Child Welfare Information System was compared to the same population studied in the electronic health record review. Quality measures were calculated as observed (received) to expected (recommended) ratios (O/E ratios) to describe the actual quantity of recommended health care that was received by individual children. Electronic health records and the Statewide Automated Child Welfare Information System data frequently lacked important information on foster care youth essential for calculating the measures. Although electronic health records were rich in encounter specific clinical data, they often lacked custodial information such as the dates of entry into and exit from foster care. In contrast, Statewide Automated Child Welfare Information System included robust data on custodial arrangements, but lacked detailed medical information. Despite these limitations, several quality measures were devised that attempted to accommodate these limitations. In this feasibility testing, neither the electronic health records at a single institution nor the county level Statewide

  19. Quality assurance in radionuclide laboratories

    International Nuclear Information System (INIS)

    Otto, R.; Voelkle, H.; Wershofen, H.; Wilhelm, C.

    2003-01-01

    The authors are members of an ad-hoc working group preparing a contribution to the procedures manual (''Loseblattsammlung'') dealing with quality assurance and quality control in radionuclide laboratories. The Loseblattsammlung is edited by the working group ''Environmental Monitoring'' of the German-Swiss Radiological Protection Association. The intention of the manual under preparation is not to give a procedure on how to establish a quality management system allowing for an accreditation in accordance with the international standard DIN EN ISO/IEC 17025:2000 04 (''ISO 17025'') [1] but to compile routine quality control procedures necessary for reliable measurements and to give tips to the practitioner on how to keep both the extent and the frequency of procedures on a reasonable level. A short version of the Loseblatt is presented here. (orig.)

  20. Is quality assurance really necessary

    International Nuclear Information System (INIS)

    Elwen, L.

    1983-01-01

    The modern concept of quality assurance began to take root in the 50's in Japan. In the rest of the world the demand for quality of products and services might well have arisen through the demise of the craftsman, concurrent with a change in emphasis from quality and workmanship towards economy and output. In the beginning this metamorphosis had its virtues, when rationalisation of production methods benefited both producer and consumer. However, the increasing pressure on production in virtually all sectors of commerce and industry inevitably lead to a trend towards cutting corners, a philosophy not conducive to increasing the standards of quality. The shortage of skilled manpower began to make itself felt at about the same time. The civil construction industry did not remain unscathed

  1. Is quality assurance really necessary

    Energy Technology Data Exchange (ETDEWEB)

    Elwen, L

    1983-03-01

    The modern concept of quality assurance began to take root in the 50's in Japan. In the rest of the world the demand for quality of products and services might well have arisen through the demise of the craftsman, concurrent with a change in emphasis from quality and workmanship towards economy and output. In the beginning this metamorphosis had its virtues, when rationalisation of production methods benefited both producer and consumer. However, the increasing pressure on production in virtually all sectors of commerce and industry inevitably lead to a trend towards cutting corners, a philosophy not conducive to increasing the standards of quality. The shortage of skilled manpower began to make itself felt at about the same time. The civil construction industry did not remain unscathed.

  2. Quality assurance or total quality management

    International Nuclear Information System (INIS)

    Eisl, W.

    1992-01-01

    The globalisation of world trade and the reduction of East West polarisation means that protected markets are disappearing. This is leading to an increase in the ferocity of competition, mainly in large industrialised regions, whereby quality, delivery time, innovation and after-sales service are gaining more and more in significance. This paper is intended to show the deep rooted changes which global competition will bring with it in terms of quality assurance. 7 figs

  3. Economic constraints and quality assurance in mental health services: sensitive indicators.

    Science.gov (United States)

    el-Guebaly, N; Papineau, D

    1984-03-01

    Clinicians in the field of mental health are met with the dual challenge of increased accountability and shrinking resources. Funds are often allocated through the use of crude administrative monitors. This is of little solace to the clinician faced with unmet patients' wants and needs. A set of clinical monitors is outlined requiring the practitioner's cooperation. The presentation of an accurate composite picture is a must in the process of resource allocation. Such clinical monitors include the analysis of characteristics of patients such as the repeaters at emergency, "the revolving door" pool of patients and those falling in between networks. Reviews of waiting lists and lengths of stay, an evaluation of nursing care variables, the auditing of the choice of therapeutic modalities and the use of restraints are other suggested contributors to the assessment of service needs.

  4. Quality Assurance for Clinical Trials

    Science.gov (United States)

    Ibbott, Geoffrey S.; Haworth, Annette; Followill, David S.

    2013-01-01

    Cooperative groups, of which the Radiation Therapy Oncology Group is one example, conduct national clinical trials that often involve the use of radiation therapy. In preparation for such a trial, the cooperative group prepares a protocol to define the goals of the trial, the rationale for its design, and the details of the treatment procedure to be followed. The Radiological Physics Center (RPC) is one of several quality assurance (QA) offices that is charged with assuring that participating institutions deliver doses that are clinically consistent and comparable. The RPC does this by conducting a variety of independent audits and credentialing processes. The RPC has compiled data showing that credentialing can help institutions comply with the requirements of a cooperative group clinical protocol. Phantom irradiations have been demonstrated to exercise an institution’s procedures for planning and delivering advanced external beam techniques (1–3). Similarly, RPC data indicate that a rapid review of patient treatment records or planning procedures can improve compliance with clinical trials (4). The experiences of the RPC are presented as examples of the contributions that a national clinical trials QA center can make to cooperative group trials. These experiences illustrate the critical need for comprehensive QA to assure that clinical trials are successful and cost-effective. The RPC is supported by grants CA 10953 and CA 81647 from the National Cancer Institute, NIH, DHHS. PMID:24392352

  5. Assessing the quality of care in a new nation: South Sudan's first national health facility assessment.

    Science.gov (United States)

    Berendes, Sima; Lako, Richard L; Whitson, Donald; Gould, Simon; Valadez, Joseph J

    2014-10-01

    We adapted a rapid quality of care monitoring method to a fragile state with two aims: to assess the delivery of child health services in South Sudan at the time of independence and to strengthen local capacity to perform regular rapid health facility assessments. Using a two-stage lot quality assurance sampling (LQAS) design, we conducted a national cross-sectional survey among 156 randomly selected health facilities in 10 states. In each of these facilities, we obtained information on a range of access, input, process and performance indicators during structured interviews and observations. Quality of care was poor with all states failing to achieve the 80% target for 14 of 19 indicators. For example, only 12% of facilities were classified as acceptable for their adequate utilisation by the population for sick-child consultations, 16% for staffing, 3% for having infection control supplies available and 0% for having all child care guidelines. Health worker performance was categorised as acceptable in only 6% of cases related to sick-child assessments, 38% related to medical treatment for the given diagnosis and 33% related to patient counselling on how to administer the prescribed drugs. Best performance was recorded for availability of in-service training and supervision, for seven and ten states, respectively. Despite ongoing instability, the Ministry of Health developed capacity to use LQAS for measuring quality of care nationally and state-by-state, which will support efficient and equitable resource allocation. Overall, our data revealed a desperate need for improving the quality of care in all states. © 2014 John Wiley & Sons Ltd.

  6. Quality assurance for gamma knives

    International Nuclear Information System (INIS)

    Jones, E.D.; Banks, W.W.; Fischer, L.E.

    1995-09-01

    This report describes and summarizes the results of a quality assurance (QA) study of the Gamma Knife, a nuclear medical device used for the gamma irradiation of intracranial lesions. Focus was on the physical aspects of QA and did not address issues that are essentially medical, such as patient selection or prescription of dose. A risk-based QA assessment approach was used. Sample programs for quality control and assurance are included. The use of the Gamma Knife was found to conform to existing standards and guidelines concerning radiation safety and quality control of external beam therapies (shielding, safety reviews, radiation surveys, interlock systems, exposure monitoring, good medical physics practices, etc.) and to be compliant with NRC teletherapy regulations. There are, however, current practices for the Gamma Knife not covered by existing, formalized regulations, standards, or guidelines. These practices have been adopted by Gamma Knife users and continue to be developed with further experience. Some of these have appeared in publications or presentations and are slowly finding their way into recommendations of professional organizations

  7. Quality assurance for gamma knives

    Energy Technology Data Exchange (ETDEWEB)

    Jones, E.D.; Banks, W.W.; Fischer, L.E. [Lawrence Livermore National Lab., CA (United States)

    1995-09-01

    This report describes and summarizes the results of a quality assurance (QA) study of the Gamma Knife, a nuclear medical device used for the gamma irradiation of intracranial lesions. Focus was on the physical aspects of QA and did not address issues that are essentially medical, such as patient selection or prescription of dose. A risk-based QA assessment approach was used. Sample programs for quality control and assurance are included. The use of the Gamma Knife was found to conform to existing standards and guidelines concerning radiation safety and quality control of external beam therapies (shielding, safety reviews, radiation surveys, interlock systems, exposure monitoring, good medical physics practices, etc.) and to be compliant with NRC teletherapy regulations. There are, however, current practices for the Gamma Knife not covered by existing, formalized regulations, standards, or guidelines. These practices have been adopted by Gamma Knife users and continue to be developed with further experience. Some of these have appeared in publications or presentations and are slowly finding their way into recommendations of professional organizations.

  8. Digital radiography for quality assurance

    International Nuclear Information System (INIS)

    Thiele, H.; Friemel, H.J.

    2001-01-01

    The digital radiographic system AMICA-401 is described. It is a mobile system originally developed for wall thickness and diameter measurements of insulated and non-insulated pipes which is also suited for quality assurance in fabrication and maintenance. Its advantages are immediate evaluation of images, very short exposure times with reduced radiation loads, and an efficient integrated image processing software. Further, no chemical substances are required for film processing. The system can be used both in mobile and in stationary applications. Practical examples are presented and discussed. (orig.) [de

  9. Mammography quality assurance in Morocco

    International Nuclear Information System (INIS)

    Zaoui, F.; Talsmat, K.; Lalaoui, K.

    2001-01-01

    The 'Centre National de l'Energie, des Sciences et des Techniques Nucleaires' (CNESTEN) realised, from February 1999 to March 2000, a quality control of 41 mammography facilities in Morocco. The protocol and standards adopted for achieving the control of elements constituting the mammography chain are those elaborated by GIM and Qualix association. Statistics and conformities results are presented. The program was performed in order to demonstrate to the practitioners in mammography field, the utility and necessity to have a national quality assurance policy. The main objective of CNESTEN is to be accredited by the Moroccan government as a reference laboratory in quality control and dose evaluation in medical imaging and radiotherapy. To achieve this goal the CNESTEN has set up Medical Physic Unit well trained and equipped with the necessary instruments. (author)

  10. The role of quality assurance in future midwifery practice.

    Science.gov (United States)

    Dawson, J

    1993-08-01

    Recent recommendations have been made which would give midwives a more central role in maternity care and a greater degree of independence than they currently enjoy. This paper argues that midwives' current attitudes to quality assurance are incompatible with this enhanced role. Research conducted in three health districts is described, which explored the perceptions of nurses, midwives and managers towards quality assurance. The findings indicate that quality assurance (in whatever form that concept is operationalized) is a demonstration of accountability. For managers this accountability is primarily for the service as a whole, whilst nurses and midwives view their accountability as being owed to patients/clients. The main methodology which the study identified as being used for monitoring nursing care was the development and auditing of explicit standards. This approach has been actively promoted by the Royal College of Nursing, enabling nurses to regain control of the purely professional aspects of the nursing profession. Midwives in the study districts showed a marked reluctance to adopt such a strategy, taking the view that as independent practitioners consensus standards would be unacceptable. It is argued that this attitude is inconsistent with the basic principle that professionals are accountable for both demonstrating and developing the quality of professional practice. It is further suggested that midwives currently have an opportunity to regain professional control of midwifery practice, which will be lost unless they are prepared to take responsibility for evaluating the standards for which they are accountable.

  11. Quality assurance in dosimetry and treatment planning

    International Nuclear Information System (INIS)

    Cunningham, J.R.

    1984-01-01

    The considerations of tissue response to radiation absorbed dose suggest a need for an accuracy of +/-5% in its delivery. This is very demanding and its regular achievement requires careful quality control. There are three distinct phases to the delivery of the planned treatment: calibration of the radiation beam in a reference situation, calculation of the dose distribution for a patient relative to the reference dose and the delivery of the radiation to the patient as planned. Each has distinctly different quality assurance requirements and must be diligently observed if the desired accuracy is to be achieved

  12. 21 CFR 892.1940 - Radiologic quality assurance instrument.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radiologic quality assurance instrument. 892.1940 Section 892.1940 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1940 Radiologic quality assurance...

  13. The economics of health care quality and medical errors.

    Science.gov (United States)

    Andel, Charles; Davidow, Stephen L; Hollander, Mark; Moreno, David A

    2012-01-01

    Hospitals have been looking for ways to improve quality and operational efficiency and cut costs for nearly three decades, using a variety of quality improvement strategies. However, based on recent reports, approximately 200,000 Americans die from preventable medical errors including facility-acquired conditions and millions may experience errors. In 2008, medical errors cost the United States $19.5 billion. About 87 percent or $17 billion were directly associated with additional medical cost, including: ancillary services, prescription drug services, and inpatient and outpatient care, according to a study sponsored by the Society for Actuaries and conducted by Milliman in 2010. Additional costs of $1.4 billion were attributed to increased mortality rates with $1.1 billion or 10 million days of lost productivity from missed work based on short-term disability claims. The authors estimate that the economic impact is much higher, perhaps nearly $1 trillion annually when quality-adjusted life years (QALYs) are applied to those that die. Using the Institute of Medicine's (IOM) estimate of 98,000 deaths due to preventable medical errors annually in its 1998 report, To Err Is Human, and an average of ten lost years of life at $75,000 to $100,000 per year, there is a loss of $73.5 billion to $98 billion in QALYs for those deaths--conservatively. These numbers are much greater than those we cite from studies that explore the direct costs of medical errors. And if the estimate of a recent Health Affairs article is correct-preventable death being ten times the IOM estimate-the cost is $735 billion to $980 billion. Quality care is less expensive care. It is better, more efficient, and by definition, less wasteful. It is the right care, at the right time, every time. It should mean that far fewer patients are harmed or injured. Obviously, quality care is not being delivered consistently throughout U.S. hospitals. Whatever the measure, poor quality is costing payers and

  14. Quality assurance - not only for engineers

    International Nuclear Information System (INIS)

    Treffner, F.W.

    1984-01-01

    The actual purpose of quality assurance is the definition of effective processes, ways and means of planning, fabricating and obtaining the required characteristics determining the quality of components, subsystems and their fabrication techniques at any place and any time. Service companies can contribute quality assurance, quality control and documentation work do cost-benefit analyses and act as expert consultants. (orig.) [de

  15. The challenge of Quality Assurance

    International Nuclear Information System (INIS)

    Simon, R.; Price, M.S.T.; Krischer, W.

    1985-01-01

    The safe terminal containment of hazardous wastes cannot only rely upon the geographic remoteness and the arid climates of the repository sites. Radioactive and permanently toxic chemical wastes must by prevented from returning to the human environment by natural and engineered barriers. The long-term integrity of these barriers and the safety of waste emplacement operation will be controlled by systematic actions under the common objective of Quality Assurance (QA). The following paper presents the aims of QA in the design and production of waste packages. It lists the most relevant acceptance criteria and regulatory requirements, investigates the institutional and technical problems of carrying out Quality Assurance and presents suggestions for establishing suitable organizational structures and technical programmes to provide adequate confidence in the safe nature and the performance of waste packages. In view of the technical difficulties of verifying the compliance of industrially produced waste forms with the acceptance criteria, the CEC has laid emphasis on the development of appropriate test methods in its last R and D programme. First results of the work are reviewed in the context of international progress in this field

  16. Problems of quality assurance and quality control in diagnostic radiology

    International Nuclear Information System (INIS)

    Angerstein, W.

    1986-01-01

    Topical problems of quality assurance and quality control in diagnostic radiology are discussed and possible solutions are shown. Complex units are differentiated with reference to physicians, technicians, organization of labour, methods of examination and indication. Quality control of radiologic imaging systems should involve three stages: (1) simple tests carried out by radiologic technicians, (2) measurements by service technicians, (3) testing of products by the manufacturer and independent governmental or health service test agencies. (author)

  17. Nuclear power plants - Quality assurance

    International Nuclear Information System (INIS)

    1980-01-01

    This International Standard defines principles for the establishment and implementation of quality assurance programmes during all phases of design, procurement, fabrication, construction, commissioning, operation, maintenance and decommissioning of structures, systems and components of nuclear power plants. These principles apply to activities affecting the quality of items, such as designing, purchasing, fabricating, handling, shipping, storing, cleaning, erecting, installing, testing, commissioning, operating, inspecting, maintaining, repairing, refuelling and modifying and eventually decommissioning. The manner in which the principles described in this document will be implemented in different organizations involved in a specific nuclear power project will depend on regulatory and contractual requirements, the form of management applied to a nuclear power project, and the nature and scope of the work to be performed by different organizations

  18. Quality assurance and statistical control

    DEFF Research Database (Denmark)

    Heydorn, K.

    1991-01-01

    In scientific research laboratories it is rarely possible to use quality assurance schemes, developed for large-scale analysis. Instead methods have been developed to control the quality of modest numbers of analytical results by relying on statistical control: Analysis of precision serves...... to detect analytical errors by comparing the a priori precision of the analytical results with the actual variability observed among replicates or duplicates. The method relies on the chi-square distribution to detect excess variability and is quite sensitive even for 5-10 results. Interference control...... serves to detect analytical bias by comparing results obtained by two different analytical methods, each relying on a different detection principle and therefore exhibiting different influence from matrix elements; only 5-10 sets of results are required to establish whether a regression line passes...

  19. Basic principles of quality assurance

    International Nuclear Information System (INIS)

    Stauffer, M.

    1977-01-01

    After a brief review of the origin of the 'quality concept' and the historical development of quality assurance, questions such as 'what is QA' and 'why is QA so important in nuclear technology' as well as definitions and main requirements of relevant QA codes and standards are presented and discussed. By means of a project realization schematic, tasks, duties, responsibilities, and possible QA organigrammes as well as QA programme and manual requirements are explained and compared. From a QA point of view, it is shown that no basic difference exists between design and production or construction control activities. Special emphasis is layed upon active owner's participation in the implementation of QA programmes for NPP and the advantages offered are described and illustrated by typical examples. (RW) [de

  20. Customer Quality during Prenatal Care in Health Care Centers in Tabriz City

    Directory of Open Access Journals (Sweden)

    Jafar Sadegh Tabrizi

    2015-07-01

    Full Text Available Background and Objectives :  Customer Quality (CQ refers to customer’s characteristics and is concerned with the knowledge, skills and confidence of health services customers who actively participate with health team in proper decision-making, appropriate activities and changing environment and health related behaviors. The purpose of this study was measuring customer quality of pregnant women during prenatal care. Materials and Methods :  This is a cross- sectional study which was conducted with the participation of 185 pregnant women who received prenatal care from urban health centers in Tabriz city. All participants were selected randomly from 40 health centers. Customer quality was measured based on CQMH-CQ questionnaire.  Questionnaire content validity was reviewed and confirmed by 10 experts and its reliability was confirmed based on Cronbach's alpha index (α = 0.714. Spss v.17 was used for data analysis. Results : According to the results, the mean score of customer quality among pregnant women was (11.29± 67.79   and only %14 of the participants reported the highest customer quality score and ability of continuity of care under stressful situations. There was a positive relationship between customer quality score and visiting midwife and a better evaluation of overall quality of care, but there was inverse relationship with early registration at health centers. Conclusion :  The participation of pregnant women in service delivery process and decision-making can promote costumer quality. Furthermore, training health care providers in empowering patients and using their abilities to improve quality of care and paying attention to patient-centered care will be helpful. ​

  1. Opinion of gastroenterologists towards quality assurance in endoscopy.

    Science.gov (United States)

    de Jonge, Vincent; Kuipers, Ernst J; van Leerdam, Monique E

    2011-03-01

    Quality assurance has become an important issue. Many societies are adopting quality assurance programs in order to monitor and improve quality of care. To assess the opinion of gastroenterologists towards quality assurance on the endoscopy department. A survey was sent to all gastroenterologists (n=319) in the Netherlands. It assessed their opinion on a quality assurance program for endoscopy units, including its design, logistics, and content. 200 gastroenterologists (63%) completed the questionnaire. 95% had a positive opinion towards quality assurance and 67% supposed an increase in quality. 28% assumed a negative impact on the time available for patient contact by introducing a quality assurance program and 35% that the capacity would decrease. A negative attitude towards disclosure of results to insurance companies (23%) and media (53%) was reported. Female gastroenterologists were less positive to share the results with other stakeholders (pquality measurements were assessment of complications (97%), standardised reporting (96%), and adequate patient information (95%). Gastroenterologists have a positive attitude towards quality assurance. However, concerns do exist about time investment and disclosure of results to others. Information provision and procedure characteristics were considered the most important aspects of quality assurance. Copyright © 2010 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  2. Public health dental hygiene: an option for improved quality of care and quality of life.

    Science.gov (United States)

    Olmsted, Jodi L; Rublee, Nancy; Zurkawski, Emily; Kleber, Laura

    2013-10-01

    The purpose of this research was to document quality of life (QoL) and quality of care (QoC) measures for families receiving care from dental hygienists within public health departments, and to consider if oral health for families with economic disparities and cultural differences was improved. A descriptive research study using a retrospective record review was conducted considering QoC. A review of state epid "Do preventive oral health programs based in local health departments provide quality care services, thus impacting QoL for underserved populations?" A dental hygienist working in public health made significant contributions to improving access to care and QoL in a rural, socioeconomically disadvantaged community. A total of 2,364 children received education, 1,745 received oral screenings and 1,511 received dental sealants. Of these, 804 children with caries were referred, with 463 receiving restorations and follow-up care. QoL metrics basis assessed Health Outcomes & Health Determinants. Initial QoL data was ranked in the bottom half of the state, while 70% of original determinant data was also ranked in the bottom half of reported metrics. Dental hygienists in public health settings can positively affect patients offering preventive care outreach services. Education and sealant placement were considered effective as measured by access, delivery and, when required, referral for restorative care. Improvement in QoL for individuals was noted through improved health outcomes and determinant metrics.

  3. Quality assurance programme and quality control

    International Nuclear Information System (INIS)

    Alvarez de Buergo, L.

    1979-01-01

    The paper analyses the requirements for the quality assurance and control in nuclear power plant projects which are needed to achieve safe, reliable and economic plants. The author describes the structure for the establishment of a nuclear programme at the national level and the participation of the different bodies involved in a nuclear power plant project. The paper ends with the study of a specific case in Spain. (NEA) [fr

  4. Software quality assurance - seven years experience

    International Nuclear Information System (INIS)

    Malsbury, J.A.

    1987-01-01

    This paper describes seven years experience with software quality assurance at PPPL. It covers the early attempts of 1980 and 1981 to establish software quality assurance; the first attempt of 1982 to develop a complete software quality assurance plan; the significant modifications of this plan in 1985; and the future. In addition, the paper describes the role of the Quality Assurance organization within each plan. The scope of this paper is limited to discussions of the software development procedures used in the seven year period. Other software quality topics, such as configuration control or problem identification and resolution, are not discussed

  5. The First National Report Card on Quality of Health Care in America

    National Research Council Canada - National Science Library

    2004-01-01

    How good is the quality of health care in America? To answer this question Elizabeth McGlynn led a team of experts in the largest and most comprehensive examination ever conducted of health care quality in the United States...

  6. Improving Quality of Care in Primary Health-Care Facilities in Rural Nigeria

    Science.gov (United States)

    Ugo, Okoli; Ezinne, Eze-Ajoku; Modupe, Oludipe; Nicole, Spieker; Kelechi, Ohiri

    2016-01-01

    Background: Nigeria has a high population density but a weak health-care system. To improve the quality of care, 3 organizations carried out a quality improvement pilot intervention at the primary health-care level in selected rural areas. Objective: To assess the change in quality of care in primary health-care facilities in rural Nigeria following the provision of technical governance support and to document the successes and challenges encountered. Method: A total of 6 states were selected across the 6 geopolitical zones of the country. However, assessments were carried out in 40 facilities in only 5 states. Selection was based on location, coverage, and minimum services offered. The facilities were divided randomly into 2 groups. The treatment group received quality-of-care assessment, continuous feedback, and improvement support, whereas the control group received quality assessment and no other support. Data were collected using the SafeCare Healthcare Standards and managed on the SafeCare Data Management System—AfriDB. Eight core areas were assessed at baseline and end line, and compliance to quality health-care standards was compared. Result: Outcomes from 40 facilities were accepted and analyzed. Overall scores increased in the treatment facilities compared to the control facilities, with strong evidence of improvement (t = 5.28, P = .0004) and 11% average improvement, but no clear pattern of improvement emerged in the control group. Conclusion: The study demonstrated governance support and active community involvement offered potential for quality improvement in primary health-care facilities. PMID:28462280

  7. The association between culture, climate and quality of care in primary health care teams.

    Science.gov (United States)

    Hann, Mark; Bower, Peter; Campbell, Stephen; Marshall, Martin; Reeves, David

    2007-09-01

    Culture and climate represent shared beliefs and values that may influence quality of care in health care teams, and which could be manipulated for quality improvement. However, there is a lack of agreement on the theoretical and empirical relationships between climate and culture, and their relative power as predictors of quality of care. This study sought to examine the association between self-report measures of climate and culture in primary care teams and comprehensive measures of quality of care. The data were derived from a cross-sectional survey of 492 professionals in 42 general practices in England. Self-report measures of culture (the Competing Values Framework) and climate (the Team Climate Inventory) were used, together with validated measures of quality of care from medical records and self-report. The majority of practices could be characterized as 'clan' culture type. Practices with a dominant clan culture scored higher on climate for participation and teamwork. There were no associations between culture and quality of care, and only limited evidence of associations between climate and quality. The current analysis would not support the hypothesis that culture and climate are important predictors of quality of care in primary care. Although larger studies are required to provide a definitive test, the results may suggest the need for a more complex model of the associations between culture, climate and outcomes, and further research may be required into the interaction between culture and climate with other determinants of behaviour such as internal and external incentives.

  8. Quality of care offered to children attending primary health care ...

    African Journals Online (AJOL)

    Caregivers experienced long waiting times (mean 135 (standard deviation 72) minutes). Many routine examination ... health needs meaningfully. A deliberate and radical restructuring of PHC for children, with clearly defined and monitored standard clinical practice routines and norms, is required to change the status quo.

  9. Private animal health and welfare standards in quality assurance programmes: a review and proposed framework for critical evaluation.

    Science.gov (United States)

    More, S J; Hanlon, A; Marchewka, J; Boyle, L

    2017-06-24

    In recent years, 'private standards' in animal health and welfare have become increasingly common, and are often incorporated into quality assurance (QA) programmes. Here, we present an overview of the use of private animal health and welfare standards in QA programmes, and propose a generic framework to facilitate critical programme review. Private standards are being developed in direct response to consumer demand for QA, and offer an opportunity for product differentiation and a means to drive consumer choice. Nonetheless, a range of concerns have been raised, relating to the credibility of these standards, their potential as a discriminatory barrier to trade, the multiplicity of private standards that have been developed, the lack of consumer input and compliance costs. There is a need for greater scrutiny of private standards and of associated QA programmes. We propose a framework to clarify the primary programme goal(s) and measureable outputs relevant to animal health and welfare, the primary programme beneficiaries and to determine whether the programme is effective, efficient and transparent. This paper provides a theoretical overview, noting that this framework could be used as a tool directly for programme evaluation, or as a tool to assist with programme development and review. British Veterinary Association.

  10. Quality assurance and nuclear power plant safety

    International Nuclear Information System (INIS)

    Mullan, J.V.

    1983-01-01

    Quality assurance in the nuclear industry was born in the late 1960s. Atomic Energy Control Board staff began its regulatory practice on quality assurance during that period. In this presentation the author traces the circumstances that first led to the establishment of Canadian nuclear power plant quality assurance programmes, summarizes progress over the last decade and a half, and outlines the current regulatory approach and what has been learned so far

  11. [Professional communication in long term health care quality].

    Science.gov (United States)

    Martín Padilla, E; Sarmiento Medina, P; Ramírez Jaramillo, A

    2014-01-01

    To Identify aspects of professional communication that affect the quality of long-term care for patients with chronic illness or disabilities and their families, in the experience of health professionals, as input for the development of an assessment tool. Descriptive qualitative.The data was processed by performing an interpretative analysis from grounded theory. The participants included 12 health professionals (three doctors, three nurses, three therapists and three psychologists), who work at the Hospital of the Universidad de La Sabana, Chia, and other institutions in Bogota, Colombia,with more than five years experience in programs treating chronic disease or disability in hospital therapeutic contexts. Semi-structured interviews and a Delphi survey were used. Validation strategies included, theoretical sampling, script evaluation by judges, triangulation of data collection techniques, and interviewers. We defined specific aspects of professional communication that could optimize the quality of health care, in information management as well as in the relationships with patients and families. From these aspects, an explanatory matrix was designed with axes, categories, and codes as a support for the construction of tools. Health communication, in order to become a therapeutic support element, requires professional training in communication skills to give information in an understandable way, with emotional support and coping possibilities. It should include and involve the family in decision making. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.

  12. Quality assurance in biomarker measurement.

    Science.gov (United States)

    Aitio, A; Apostoli, P

    1995-05-01

    Quality assurance (QA) concerns the validity of all the analytical processes (from collection of the samples to interpretation of the results). It is not an abstract concept but must be adapted to the different situations such as the different exposure levels, the different analytical methods, and the context of use (risk assessment procedures, research, routine determinations). The main requirements in QA programmes regard the control of all the known sources of preanalytical and analytical variations, while the instruments with which adequate QA can be implemented are the certified materials and the quality control programmes (quality manual, internal and external quality controls). Another important concept in QA is that measurements must be placed a different metrological levels: at the highest there are the methods (definitive, reference) to be used for assessing accuracy of routine methods. QA programmes should enable a grading of biomarkers (from experimental only to full evaluated) and of the laboratories in order to identify the significance of the test and to assess the level at which a laboratory could operate.

  13. Hungary Higher Education Quality Assurance System

    Directory of Open Access Journals (Sweden)

    Che Ru-shan

    2013-07-01

    Full Text Available Higher education quality assurance system has drawn much attention since 1980s. Most countries are committed to build the higher education quality assurance system to meet international standards. Under such an international trend, Hungary also actively promotes higher education reform, and established Hungarian Accreditation Committee and in order to ensure the quality of higher education.

  14. Elements of quality assurance in environmental surveillance

    International Nuclear Information System (INIS)

    Johnson, L.J.

    1975-01-01

    Qualities of an environmental surveillance program requiring control or assurance are reviewed. Requirements of accuracy, reproducibility, sensitivity, acceptability, and time and cost effectiveness are qualities discussed. The controls applicable to sample collection, handling, chemical analysis, measurement and data presentation are identified and discussed as they pertain to environmental monitoring. Quality assurance program recommendations for developing and reporting environmental surveillance data are provided

  15. Quality assurance for image-guided radiotherapy

    International Nuclear Information System (INIS)

    Marinello, Ginette

    2008-01-01

    The topics discussed include, among others, the following: Quality assurance program; Image guided radiotherapy; Commissioning and quality assurance; Check of agreement between visual and displayed scales; quality controls: electronic portal imaging device (EPID), MV-kV and kV-kV, cone-beam CT (CBCT), patient doses. (P.A.)

  16. Quality Assurance in Chinese Higher Education

    Science.gov (United States)

    Li, Yuan

    2010-01-01

    Quality assurance has been integrated into the fabric of higher education in China, with the issue of quality in higher education--how to evaluate it and how to enhance it--now taking centre stage in Chinese higher education. In the past decade, the development of quality assurance in Chinese higher education has covered a broad spectrum of…

  17. Quality assurance program for nuclear power plants

    International Nuclear Information System (INIS)

    Gamon, T.H.

    1976-02-01

    The Topical Report presented establishes and provides the basis for the Brown and Root Quality Assurance Program for Nuclear Power Plants from which the Brown and Root Quality Assurance Manual is prepared and implemented. The Quality Assurance Program is implemented by the Brown and Root Power Division during the design, procurement, and construction phases of nuclear power plants. The Brown and Root Quality Assurance Program conforms to the requirements of Nuclear Regulatory Commission Regulation 10 CFR 50, Appendix B; to approved industry standards such as ANSI N45.2 and ''Daughter Standards''; or to equivalent alternatives as indicated in the appropriate sections of the report

  18. Quality assurance program for nuclear power plants

    International Nuclear Information System (INIS)

    Gamon, T.H.

    1976-06-01

    This topical report establishes and provides the basis for the Brown and Root Quality Assurance Program for Nuclear Power Plants from which the Brown and Root Quality Assurance Manual is prepared and implemented. The Quality Assurance Program is implemented by the Brown and Root Power Division during the design, procurement, and construction phases of nuclear power plants. The Brown and Root Quality Assurance Program conforms to the requirements of Nuclear Regulatory Commission Regulation 10 CFR 50, Appendix B; to approved industry standards such as ANSI N45.2 and ''Daughter Standards''; or to equivalent alternatives as indicated in the appropriate sections of this report

  19. References on EPA Quality Assurance Project Plans

    Science.gov (United States)

    Provides requirements for the conduct of quality management practices, including quality assurance (QA) and quality control (QC) activities, for all environmental data collection and environmental technology programs performed by or for this Agency.

  20. Regional variations in health care intensity and physician perceptions of quality of care.

    Science.gov (United States)

    Sirovich, Brenda E; Gottlieb, Daniel J; Welch, H Gilbert; Fisher, Elliott S

    2006-05-02

    Research has documented dramatic differences in health care utilization and spending across U.S. regions with similar levels of patient illness. Although patient outcomes and quality of care have been found to be no better in regions of high health care intensity, it is unknown whether physicians in these regions feel more capable of providing good patient care than those in low-intensity regions. To determine whether physicians in high-intensity regions feel better able to care for patients than physicians in low-intensity regions. Physician telephone survey. 51 metropolitan and 9 nonmetropolitan areas of the United States and a supplemental national sample. 10,577 physicians who provided care to adults in 1998 or 1999 were surveyed for the Community Tracking Study (response rate, 61%). The End-of-Life Expenditure Index, a measure of spending that reflects differences in the overall quantity of medical services provided rather than differences in illness or price, was used to determine health care intensity in the physicians' community. Outcomes included physicians' perceived availability of clinical services, ability to provide high-quality care to patients, and career satisfaction. Although the highest-intensity regions have substantially more hospital beds and specialists per capita, physicians in these regions reported more difficulty obtaining needed services for their patients. The proportion of physicians who felt able to obtain elective hospital admissions ranged from 50% in high-intensity regions to 64% in the lowest-intensity region (P market factors (for example, managed care penetration); the difference in perceived ability to provide high-quality care was no longer statistically significant (P = 0.099). The cross-sectional design prevented demonstration of a causal relationship between intensity and physician perceptions of quality. Despite more resources, physicians in regions of high health care intensity did not report greater ease in obtaining

  1. Evaluating the Effect of Software Quality Characteristics on Health Care Quality Indicators

    Directory of Open Access Journals (Sweden)

    Sakineh Aghazadeh

    2015-07-01

    Full Text Available Introduction: Various types of software are used in health care organizations to manage information and care processes. The quality of software has been an important concern for both health authorities and designers of Health Information Technology. Thus, assessing the effect of software quality on the performance quality of healthcare institutions is essential. Method: The most important health care quality indicators in relation to software quality characteristics are provided via an already performed literature review. ISO 9126 standard model is used for definition and integration of various characteristics of software quality. The effects of software quality characteristics and sub-characteristics on the healthcare indicators are evaluated through expert opinion analyses. A questionnaire comprising of 126 questions of 10-point Likert scale was used to gather opinions of experts in the field of Medical/Health Informatics. The data was analyzed using Structural Equation Modeling. Results: Our findings showed that software Maintainability was rated as the most effective factor on user satisfaction (R2 =0.89 and Functionality as the most important and independent variable affecting patient care quality (R2 =0.98. Efficiency was considered as the most effective factor on workflow (R2 =0.97, and Maintainability as the most important factor that affects healthcare communication (R2 =0.95. Usability and Efficiency were rated as the most effectual factor affecting patient satisfaction (R2 =0.80, 0.81. Reliability, Maintainability, and Efficiency were considered as the main factors affecting care costs (R2 =0.87, 0.74, 0.87. Conclusion: We presented a new model based on ISO standards. The model demonstrates and weighs the relations between software quality characteristics and healthcare quality indicators. The clear relationships between variables and the type of the metrics and measurement methods used in the model make it a reliable method to assess

  2. Quality of Prenatal Care Services in Karabuk Community Health Center

    Directory of Open Access Journals (Sweden)

    Binali Catak

    2012-04-01

    Full Text Available The aim of the study was to evaluate the quality and quantity of prenatal care services according to gestastional week in Karabuk Community Health Center (CHC. Methods: In this descriptive study 365 pregnant women was selected as sample among 753 pregnant women registered at Karabuk CHC in 18/01/2011. 93.0% of women in the selected sample has been visited in their homes and the face to face interviews were done. The questionnaire was prepared according to Prenatal Care Management Guidelines (PCMG of Ministry of Health. Findings The number of follow-ups was not complete in 23.7% of 15-24 month, 34.4% of 25-32 month, 52,1% of 33-42 month pregnant women. At least four follow-up visits were completed only in 66,7% of postpartum women. Timing of first visit was after 15th week in 15,6% of women. In follow up visits 62.5% of of women’s height were never measured, in 13,0% the women hearth sound of infants didn’t monitored at least once. Laboratory test numbers were under the level required by PCMG. The delivery conditions weren’t planned in 41,8% of last trimester and postpartum women and training about breastfeeding wasn’t given to 15,5 of the same group. Result In family medicine model in Karabuk CHC developments in number of prenatal follow-up visits were observed, but no substantial improvements were found in quality of prenatal visits. Regular in service trainings shoud be given to family doctors and midwives. The use of prenatal care guideline published by MoH should be increased. Keywords: Prenatal care, pregnancy, timing of first visit, qality of prenatal care [TAF Prev Med Bull 2012; 11(2.000: 153-162

  3. Quality assurance in military medical research and medical radiation accident management.

    Science.gov (United States)

    Hotz, Mark E; Meineke, Viktor

    2012-08-01

    The provision of quality radiation-related medical diagnostic and therapeutic treatments cannot occur without the presence of robust quality assurance and standardization programs. Medical laboratory services are essential in patient treatment and must be able to meet the needs of all patients and the clinical personnel responsible for the medical care of these patients. Clinical personnel involved in patient care must embody the quality assurance process in daily work to ensure program sustainability. In conformance with the German Federal Government's concept for modern departmental research, the international standard ISO 9001, one of the relevant standards of the International Organization for Standardization (ISO), is applied in quality assurance in military medical research. By its holistic approach, this internationally accepted standard provides an excellent basis for establishing a modern quality management system in line with international standards. Furthermore, this standard can serve as a sound basis for the further development of an already established quality management system when additional standards shall apply, as for instance in reference laboratories or medical laboratories. Besides quality assurance, a military medical facility must manage additional risk events in the context of early recognition/detection of health risks of military personnel on deployment in order to be able to take appropriate preventive and protective measures; for instance, with medical radiation accident management. The international standard ISO 31000:2009 can serve as a guideline for establishing risk management. Clear organizational structures and defined work processes are required when individual laboratory units seek accreditation according to specific laboratory standards. Furthermore, international efforts to develop health laboratory standards must be reinforced that support sustainable quality assurance, as in the exchange and comparison of test results within

  4. Where does good quality qualitative health care research get published?

    Science.gov (United States)

    Richardson, Jane C; Liddle, Jennifer

    2017-09-01

    This short report aims to give some insight into current publication patterns for high-quality qualitative health research, using the Research Excellence Framework (REF) 2014 database. We explored patterns of publication by range and type of journal, by date and by methodological focus. We also looked at variations between the publications submitted to different Units of Assessment, focussing particularly on the one most closely aligned with our own research area of primary care. Our brief analysis demonstrates that general medical/health journals with high impact factors are the dominant routes of publication, but there is variation according to the methodological approach adopted by articles. The number of qualitative health articles submitted to REF 2014 overall was small, and even more so for articles based on mixed methods research, qualitative methodology or reviews/syntheses that included qualitative articles.

  5. A conceptual competitive intelligence quality assurance model

    Directory of Open Access Journals (Sweden)

    Tshilidzi Eric Nenzhelele

    2015-12-01

    Full Text Available Competitive Intelligence (CI improves the quality of product and service, decision-making and it improves quality of life. However, it has been established that decision makers are not happy about the quality of CI. This is because enterprises fail in quality assurance of CI. It has been concluded that most enterprises are clueless concerning CI quality assurance. Studies that previously attempted to resolve CI quality problem were limited in scope and focused too much on the quality of information than the overall CI quality. The purpose of this study is to propose a conceptual CI quality assurance model which will help in quality assurance of CI. The research was qualitative in nature and used content analysis.

  6. eHealth, care and quality of life

    CERN Document Server

    Capello, Fabio; Manca, Marco

    2014-01-01

    The debate over eHealth is alive as never before. Supporters suggest that it will result in dramatic innovations in healthcare, including a giant leap towards patient-centered care, new opportunities to improve effectiveness, and enhanced wellness and quality of life. In addition, the growing market value of investments in health IT suggests that eHealth can offer at least a partial cure for the current economic stagnation. Detractors counter these arguments by claiming that eHealth has already failed: the UK Department of Health has shut down the NHS National Program for IT, Google has discontinued its Health flagship, and doubts have arisen over privacy safeguards for both patients and medical professionals. This book briefly explains why caregivers, professionals, technicians, patients, politicians, and others should all consider themselves stakeholders in eHealth. It offers myth-busting responses to some ill-considered arguments from both sides of the trench, in the process allowing a fresh look at eHeal...

  7. Regulatory viewpoint on nuclear fuel quality assurance

    International Nuclear Information System (INIS)

    Tripp, L.E.

    1976-01-01

    Considerations of the importance of fuel quality and performance to nuclear safety, ''as low reasonably achievable'' release of radioactive materials in reactor effluents, and past fuel performance problems demonstrate the need for strong regulatory input, review and inspection of nuclear fuel quality assurance programs at all levels. Such a regulatory program is being applied in the United States of America by the US Nuclear Regulatory Commission. Quality assurance requirements are contained within government regulations. Guidance on acceptable methods of implementing portions of the quality assurance program is contained within Regulatory Guides and other NRC documents. Fuel supplier quality assurance program descriptions are reviewed as a part of the reactor licensing process. Inspections of reactor licensee control of their fuel vendors as well as direct inspections of fuel vendor quality assurance programs are conducted on a regularly scheduled basis. (author)

  8. Quality assurance program plan for Building 324

    International Nuclear Information System (INIS)

    Tanke, J.M.

    1997-01-01

    This Quality Assurance Program Plan (QAPP) provides an overview of the quality assurance program for Building 324. This plan supersedes the PNNL Nuclear Facilities Quality Management System Description, PNL-NF-QMSD, Revision 2, dated March 1996. The program applies to the facility safety structures, systems, and components and to activities that could affect safety structures, systems, and components. Adherence to the quality assurance program ensures the following: US Department of Energy missions and objectives are effectively accomplished; Products and services are safe, reliable, and meet or exceed the requirements and expectations of the user; Hazards to the public, to Hanford Site and facility workers, and to the environment are minimized. The format of this Quality Assurance Program Plan is structured to parallel that of 10 CFR 83 0.120, Quality Assurance Requirements

  9. Quality Assurance Programme for Computed Tomography: Diagnostic and Therapy Applications

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-08-15

    This publication presents a harmonized approach to quality assurance in the field of computed tomography applied to both diagnostics and therapy. It gives a careful analysis of the principles and specific instructions that can be used for a quality assurance programme for optimal performance and reduced patient dose in diagnostic radiology. In some cases, radiotherapy programmes are making a transition from 2-D to 3-D radiotherapy, a complex process which critically depends on accurate treatment planning. In this respect, the authors also provide detailed information about the elements needed for quality assurance testing, including those relating to accurate patient characterization as needed for radiotherapy treatment planning.

  10. [Access to prenatal care and quality of care in the Family Health Strategy: infrastructure, care, and management].

    Science.gov (United States)

    Guimarães, Wilderi Sidney Gonçalves; Parente, Rosana Cristina Pereira; Guimarães, Thayanne Louzada Ferreira; Garnelo, Luiza

    2018-05-10

    This study focuses on access to prenatal care and quality of care in the Family Health Strategy in Brazil as a whole and in the North region, through evaluation of infrastructure characteristics in the health units, management, and supply of care provided by the teams, from the perspective of regional and state inequalities. A cross-sectional evaluative and normative study was performed, drawing on the external evaluation component of the second round of the Program for Improvement of Access and Quality of Primary Care, in 2013-2014. The results revealed the inadequacy of the primary healthcare network's infrastructure for prenatal care, low adequacy of clinical actions for quality of care, and the teams' low management capacity to guarantee access and quality of care. In the distribution according to geopolitical regions, the findings pertaining to the units' infrastructure indicate a direct relationship between the infrastructure's adequacy and social contexts with higher municipal human development indices and income. For the clinical actions in patient care, the teams in all the regions scored low on adequacy, with slightly better results in the North and South regions of the country. There were important differences between the states of the North, and the states with higher mean income and human development scored higher on adequacy. The results indicate important organizational difficulties in both access and quality of care provided by the health teams, in addition to visible insufficiency in management activities aimed to improve access and quality of prenatal care.

  11. Quality assurance program plan for radionuclide airborne emissions monitoring

    International Nuclear Information System (INIS)

    Boom, R.J.

    1995-03-01

    This Quality Assurance Program Plan identifies quality assurance program requirements and addresses the various Westinghouse Hanford Company organizations and their particular responsibilities in regards to sample and data handling of airborne emissions. The Hanford Site radioactive airborne emissions requirements are defined in National Emissions Standards for Hazardous Air Pollutants (NESHAP), Code of Federal Regulations, Title 40, Part 61, Subpart H (EPA 1991a). Reporting of the emissions to the US Department of Energy is performed in compliance with requirements of US Department of Energy, Richland Operations Office Order 5400.1, General Environmental Protection Program (DOE-RL 1988). This Quality Assurance Program Plan is prepared in accordance with and to the requirements of QAMS-004/80, Guidelines and Specifications for Preparing Quality Assurance Program Plans (EPA 1983). Title 40 CFR Part 61, Appendix B, Method 114, Quality Assurance Methods (EPA 1991b) specifies the quality assurance requirements and that a program plan should be prepared to meet the requirements of this regulation. This Quality Assurance Program Plan identifies NESHAP responsibilities and how the Westinghouse Hanford Company Environmental, Safety, Health, and Quality Assurance Division will verify that the methods are properly implemented

  12. [Local groups as a tool for quality assurance of community health services].

    Science.gov (United States)

    Mjell, J; Hjortdahl, P

    2001-05-30

    The aim of this study was to assess the use of local interprofessional or audit groups as a tool of quality enhancement. Fifty-six doctors, physiotherapists and nurses attended nine local interprofessional groups. The aim was to improve the quality of each professional's practice and to improve communication between the professions. The groups had a total of 62 meetings with each professional attending on average 5.7 meetings. All groups initiated quality enhancement projects. Initially the groups were very active and showed great initiative, but there were few final results. However, many groups reported improved communication and cooperation between the participating professionals. The experience from this project may be summarised as follows: The professionals within one and the same group should have more or less the same background and specialty. We recommend caution with organising interprofessional groups unless their participants work in the same practice. Interprofessional groups should spend adequate time for the members to get to know each other, and they should be guided by an experienced leader.

  13. Implementing and using quality measures for children's health care: perspectives on the state of the practice.

    Science.gov (United States)

    Shaller, Dale

    2004-01-01

    care quality measurement and improvement based on rigorous cost-bigorous cost-benefit analysis and documentation of quantifiable successes; 2) develop new measures to fill the gaps in critical areas (including adolescent health care, behavioral health, and chronic conditions) that can be applied at the hospital and ambulatory care provider levels; 3) invest in building needed research capacity, a trained pool of users of quality measures, and the capacity among providers to understand and use quality-improvement methods and tools; 4) invest in developing an information infrastructure that will support the efficient collection and use of measures for multiple purposes, including clinical practice, quality measurement, and quality improvement; and 5) develop increased public awareness and support for quality measurement based on improved strategies for communicating with consumers, purchasers, providers, and policy makers. Several implications are suggested by these perspectives for the future direction of quality measurement in children's health care. First, to meet the funding needs identified, many funders must improve coordination to reduce the noise and fragmentation generated by numerous competing or redundant activities. Improved coordination among funders will help assure maximum impact and the efficient use of scarce resources. Second, the importance attached to standardization of measures by both users and developers may conflict at times with the need for innovation and flexibility. Child health quality leaders will need to manage this tension between standardization and innovation to maintain an appropriate balance between the benefits of both. Finally, many of the obstacles identified are not unique to children's health care. Child health quality leaders will need to determine to what extent their efforts to overcome these obstacles can be successfully undertaken independently as opposed to in concert with groups concerned about other populations and sectors

  14. 40 CFR 194.22 - Quality assurance.

    Science.gov (United States)

    2010-07-01

    ... General Requirements § 194.22 Quality assurance. (a)(1) As soon as practicable after April 9, 1996, the Department shall adhere to a quality assurance program that implements the requirements of ASME NQA-1-1989... elicitation used to support applications for certification or re-certification of compliance; (vi) Design of...

  15. Quality assurance manual: Volume 2, Appendices

    Energy Technology Data Exchange (ETDEWEB)

    Oijala, J.E.

    1988-06-01

    This paper contains quality assurance information on departments of the Stanford Linear Accelerator Center. Particular quality assurance policies and standards discussed are on: Mechanical Systems; Klystron and Microwave Department; Electronics Department; Plant Engineering; Accelerator Department; Purchasing; and Experimental Facilities Department. (LSP)

  16. Commissioning quality assurance at Pickering NGS

    International Nuclear Information System (INIS)

    Wieckowski, J.T.

    1983-05-01

    Ontario Hydro decided in 1978 to implement a formal quality assurance program applicable to commissioning and operation of nuclear generating stations. Pickering NGS is the first station to have the commissioning quality assurance (CQA) program applied to it. This paper outlines the scope, implementation, and evaluation of the CQA program as applied to Pickering Unit 5

  17. Ontario's Quality Assurance Framework: A Critical Response

    Science.gov (United States)

    Heap, James

    2013-01-01

    Ontario's Quality Assurance Framework (QAF) is reviewed and found not to meet all five criteria proposed for a strong quality assurance system focused on student learning. The QAF requires a statement of student learning outcomes and a method and means of assessing those outcomes, but it does not require that data on achievement of intended…

  18. 48 CFR 2453.246 - Quality Assurance.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Quality Assurance. 2453.246 Section 2453.246 Federal Acquisition Regulations System DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT CLAUSES AND FORMS FORMS Prescription of Forms 2453.246 Quality Assurance. ...

  19. Quality Assurance in Sub-Saharan Africa

    Science.gov (United States)

    Materu, Peter; Righetti, Petra

    2010-01-01

    This article assesses the status and practice of higher education quality assurance in sub-Saharan Africa, focusing on degree-granting tertiary institutions. A main finding is that structured national-level quality assurance processes in African higher education are a very recent phenomenon and that most countries face major capacity constraints.…

  20. Evaluation of immunization coverage by lot quality assurance sampling compared with 30-cluster sampling in a primary health centre in India.

    OpenAIRE

    Singh, J.; Jain, D. C.; Sharma, R. S.; Verghese, T.

    1996-01-01

    The immunization coverage of infants, children and women residing in a primary health centre (PHC) area in Rajasthan was evaluated both by lot quality assurance sampling (LQAS) and by the 30-cluster sampling method recommended by WHO's Expanded Programme on Immunization (EPI). The LQAS survey was used to classify 27 mutually exclusive subunits of the population, defined as residents in health subcentre areas, on the basis of acceptable or unacceptable levels of immunization coverage among inf...

  1. The Concepts of Quality, Quality Assurance and Quality Enhancement

    Science.gov (United States)

    Elassy, Noha

    2015-01-01

    Purpose: This paper aims to critically review and discuss different definitions of the concepts of quality, quality assurance (QA) and quality enhancement (QE) in higher education (HE) with presenting critical perspectives of the literature. Design/methodology/approach: The paper looks at literature concerns with the meaning of quality, QA and QE,…

  2. Reinforcing Quality Assurance in Romanian Higher Education

    Directory of Open Access Journals (Sweden)

    Ana-Maria Dima

    2010-07-01

    Full Text Available Since 1993, the quality assurance system in Romania has gained considerable experience. This experience was recently recognized in 2008 by the ENQA: European Association for Quality Assurance in Higher Education through the admission of ARACIS as a full member of EQAR: the European Quality Assurance Register. The Board of ENQA agreed to grant ARACIS’s full membership of ENQA for five years from 2 June 2009. This article explores the benefits of membership for the Romanian Agency for Quality Assurance in Higher Education – ARACIS, comparing to other regional and global quality assurance agencies networks. The common features and differences between ARACIS and other European agencies are questioned through the frameworks of ENQA and INQAAHE as a case study.

  3. Measuring mechanisms for quality assurance in primary care systems in transition: test of a new instrument in Slovenia and Uzbekistan.

    NARCIS (Netherlands)

    Kringos, D.S.; Boerma, W.G.W.; Pellny, M.

    2009-01-01

    Aim: This WHO study, carried out by the authors, aimed to develop and field test an instrument to assess the availability of structures and mechanisms for managing quality in primary care in countries in transition. Methods: The instrument is based on a literature study, consensus meetings with

  4. Quality Assurance Planning for Region 9

    Science.gov (United States)

    The ultimate success of an environmental program or project depends on the quality of the environmental data collected and used in decision-making. EPA has developed guidances to help state and tribal governments develop Quality Assurance Program Plans.

  5. National Program of Quality Assurance in Radiotherapy in Cuba

    International Nuclear Information System (INIS)

    Alonso Samper, J. L.; Dominguez Hung, L.; Morales Lopez, J. L.; Alfonso Laguardia, R.; Garcia Yip, F.

    2001-01-01

    It tries on the establishment of a Quality Assurance Nacional System, a Quality Assurance Committee implemented in Cuba, and a Quality Auditory National Program implemented in Cuba to control and assure radiotherapy quality

  6. Experience and perspectives of quality of health care in Nigerian ...

    African Journals Online (AJOL)

    Significant percentage of health care services for rural Nigerians is being provided in rural health facilities by rurally based doctors, nurses, midwifes and other categories of health professionals. These services include general medical and obstetric care as well elective and urgent surgeries. As a result of these, there is ...

  7. Printed Circuit Board Quality Assurance

    Science.gov (United States)

    Sood, Bhanu

    2016-01-01

    PCB Assurance Summary: PCB assurance actives are informed by risk in context of the Project. Lessons are being applied across Projects for continuous improvements. Newer component technologies, smaller/high pitch devices: tighter and more demanding PCB designs: Identifying new research areas. New materials, designs, structures and test methods.

  8. Training, Quality Assurance Factors, and Tools Investigation: a Work Report and Suggestions on Software Quality Assurance

    Science.gov (United States)

    Lee, Pen-Nan

    1991-01-01

    Previously, several research tasks have been conducted, some observations were obtained, and several possible suggestions have been contemplated involving software quality assurance engineering at NASA Johnson. These research tasks are briefly described. Also, a brief discussion is given on the role of software quality assurance in software engineering along with some observations and suggestions. A brief discussion on a training program for software quality assurance engineers is provided. A list of assurance factors as well as quality factors are also included. Finally, a process model which can be used for searching and collecting software quality assurance tools is presented.

  9. Association Between Health Plan Exit From Medicaid Managed Care and Quality of Care, 2006-2014.

    Science.gov (United States)

    Ndumele, Chima D; Schpero, William L; Schlesinger, Mark J; Trivedi, Amal N

    2017-06-27

    State Medicaid programs have increasingly contracted with insurers to provide medical care services for enrollees (Medicaid managed care plans). Insurers that provide these plans can exit Medicaid programs each year, with unclear effects on quality of care and health care experiences. To determine the frequency and interstate variation of health plan exit from Medicaid managed care and evaluate the relationship between health plan exit and market-level quality. Retrospective cohort of all comprehensive Medicaid managed care plans (N = 390) during the interval 2006-2014. Plan exit, defined as the withdrawal of a managed care plan from a state's Medicaid program. Eight measures from the Healthcare Effectiveness Data and Information Set were used to construct 3 composite indicators of quality (preventive care, chronic disease care management, and maternity care). Four measures from the Consumer Assessment of Healthcare Providers and Systems were combined into a composite indicator of patient experience, reflecting the proportion of beneficiaries rating experiences as 8 or above on a 0-to-10-point scale. Outcome data were available for 248 plans (68% of plans operating prior to 2014, representing 78% of beneficiaries). Of the 366 comprehensive Medicaid managed care plans operating prior to 2014, 106 exited Medicaid. These exiting plans enrolled 4 848 310 Medicaid beneficiaries, with a mean of 606 039 beneficiaries affected by plan exits annually. Six states had a mean of greater than 10% of Medicaid managed care recipients enrolled in plans that exited, whereas 10 states experienced no plan exits. Plans that exited from a state's Medicaid market performed significantly worse prior to exiting than those that remained in terms of preventive care (57.5% vs 60.4%; difference, 2.9% [95% CI, 0.3% to 5.5%]), maternity care (69.7% vs 73.6%; difference, 3.8% [95% CI, 1.7% to 6.0%]), and patient experience (73.5% vs 74.8%; difference, 1.3% [95% CI, 0.6% to 1

  10. Patients' level of satisfaction on quality of health care at Mwananyamala hospital in Dar es Salaam, Tanzania.

    Science.gov (United States)

    Khamis, Kudra; Njau, Bernard

    2014-09-18

    Enhancing quality of health care delivered in public health facilities in developing countries is a key prerequisite to increase utilization and sustainability of health care services in the population. The aim of the study was to determine patients' level of satisfaction on the quality of health care delivered at the out-patient department (OPD) in Mwananyamala hospital in Dar es Salaam, Tanzania. A cross-sectional study design was conducted from April to May, 2012. A systematic sampling method was employed to select 422 study subjects. A pre-tested SERVQUAL questionnaire was used to collect data and one-sample t-test was employed to identify patients' level of satisfaction and principal component analysis to identify key items that measure quality of care. Patients' level of satisfaction mean gap score was (-2.88 ± 3.1) indicating overall dissatisfaction with the quality of care. The level of dissatisfaction in the five service dimensions were as follows: assurance (-0.47), reliability (-0.49), tangible (-0.52), empathy (-0.55), and responsiveness (-0.72). Patients attending OPD at Mwananyamala hospital demonstrates an overall dissatisfaction on quality of care. Hospital management should focus on: improvement on communication skills among OPD staff in showing compassion, politeness and active listening, ensure availability of essential drugs, and improvement on clinicians' prescription skills.

  11. Competition and quality in health care: the UK experience.

    Science.gov (United States)

    Glennerster, H

    1998-10-01

    The aims of this paper are threefold: first to review briefly the theoretical literature on competition and its predicted effects on health care quality; secondly to describe the attempts to introduce competition into the UK National Health Service (NHS); and third to review the outcomes of this experiment and ask how far the research findings are consistent with the next phase of reform that the new Labour Government proposed in late 1997. A search was conducted using electronic data bases Unicorn, Medline and Health Planning and official monitoring statistics within the NHS. All references relating to district-based purchasing, general practitioner (GP) fundholding in its various forms and GP commissioning were reviewed. Preference was given to prospective before and after studies with and without control groups, retrospective studies with and without controls, and case studies which were reinforced by similar supporting case studies. The evidence suggests that there was little overall change for good or bad as a result of the reforms. The changes that did occur had an impact on speed of treatment, patient convenience and choice, but medical quality was largely unaffected. These benefits were reaped, in particular, by the more competitive agents - the family doctors or GPs. Although not dramatic in outcome, these changes were significant because speed and convenience were the main deficiencies of the NHS in the eyes of UK consumers.

  12. Assuring Adequate Health Insurance for Children With Special Health Care Needs: Progress From 2001 to 2009-2010.

    Science.gov (United States)

    Ghandour, Reem M; Comeau, Meg; Tobias, Carol; Dworetzky, Beth; Hamershock, Rose; Honberg, Lynda; Mann, Marie Y; Bachman, Sara S

    2015-01-01

    To report on coverage and adequacy of health insurance for children with special health care needs (CSHCN) in 2009-2010 and assess changes since 2001. Data were from the National Survey of Children with Special Health Care Needs (NS-CSHCN), a random-digit telephone survey with 40,243 (2009-2010) and 38,866 (2001) completed interviews. Consistency and adequacy of insurance was measured by: 1) coverage status, 2) gaps in coverage, 3) coverage of needed services, 4) reasonableness of uncovered costs, and 5) ability to see needed providers, as reported by parents. Bivariate and multivariable analyses were conducted to assess factors associated with adequate insurance coverage in 2009-2010. Unadjusted and adjusted prevalence estimates were examined to identify changes in the type of insurance coverage and the proportion of CSHCN with adequate coverage by insurance type. The proportion of CSHCN with private coverage decreased from 64.7% to 50.7% between 2001 and 2009-2010, while public coverage increased from 21.7% to 34.7%; the proportion of CSHCN without any insurance declined from 5.2% to 3.5%. The proportion of CSHCN with adequate coverage varied over time and by insurance type: among privately covered CSHCN, the proportion with adequate coverage declined (62.6% to 59.6%), while among publicly covered CSHCN, the proportion with adequate insurance increased (63.0% to 70.7%). Publicly insured CSHCN experienced improvements in each of the 3 adequacy components. There has been a continued shift from private to public coverage, which is more affordable, offers benefits that are more likely to meet CSHCN needs, and allowed CSHCN to see necessary providers. Published by Elsevier Inc.

  13. Finding the gap: revealing local disparities in coverage of maternal, newborn and child health services in South Sudan using lot quality assurance sampling.

    Science.gov (United States)

    Valadez, Joseph J; Berendes, Sima; Lako, Richard; Gould, Simon; Vargas, William; Milner, Susan

    2015-12-01

    We adapted a rapid monitoring method to South Sudan, a new nation with one of the world's highest maternal and child mortality rates, aiming to assess coverage of maternal, neonatal and child health (MNCH) services at the time of independence, and introducing a monitoring and evaluation system (M&E) for equity-sensitive tracking of progress related to Millennium Development Goals (MDG) 4 and 5 at national, state and county levels to detect local variability. We conducted a national cross-sectional household survey among women from six client populations in all, but six of South Sudan's 79 counties. We used lot quality assurance sampling (LQAS) to measure coverage with diverse MNCH indicators to obtain information for national-, state- and county-level health system management decision-making. National coverage of MNCH services was low for all maternal and neonatal care, child immunisation, and child care indicators. However, results varied across states and counties. Central Equatoria State (CES), where the capital is located, showed the highest coverage for most indicators (e.g. ≥4 antenatal care visits range: 4.5% in Jonglei to 40.1% in CES). Urban counties often outperformed rural ones. This adaptation of LQAS to South Sudan demonstrates how it can be used in the future as an M&E system to track progress of MDGs at national, state and county levels to detect local disparities. Overall, our data reveal a desperate need for improving MNCH service coverage in all states. © 2015 The Authors.Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  14. Evaluation of the World Health Organization global measles and rubella quality assurance program, 2001-2008.

    Science.gov (United States)

    Stambos, Vicki; Leydon, Jennie; Riddell, Michaela; Clothier, Hazel; Catton, Mike; Featherstone, David; Kelly, Heath

    2011-07-01

    During 2001-2008, the Victorian Infectious Diseases Reference Laboratory (VIDRL) prepared and provided a measles and rubella proficiency test panel for distribution to the World Health Organization (WHO) measles and rubella network laboratories as part of their annual laboratory accreditation assessment. Panel test results were forwarded to VIDRL, and results from 8 consecutive years were analyzed. We assessed the type of assays used and results achieved on the basis of the positive and negative interpretation of submitted results, by year and WHO region, for measles and rubella. Over time, there has been a noticeable increase in laboratory and WHO regional participation. For all panels, the proportion of laboratories in all WHO regions using the WHO-validated Dade Behring assay for measles and rubella-specific IgM antibodies ranged from 35% to 100% and 59% to 100%, respectively. For all regions and years, the proportion of laboratories obtaining a pass score ranged from 87% to 100% for measles and 93% to 100% for rubella. During 2001-2008, a large proportion of laboratories worldwide achieved and maintained a pass score for both measles and rubella. Measles and rubella proficiency testing is regarded as a major achievement for the WHO measles and rubella laboratory program. © The Author 2011. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved.

  15. Tritium systems test assembly quality assurance program

    International Nuclear Information System (INIS)

    Kerstiens, F.L.; Wilhelm, R.C.

    1986-07-01

    A quality assurance program should establish the planned and systematic actions necessary to provide adequate confidence that fusion facilities and their subsystems will perform satisfactorily in service. The Tritium Systems Test Assembly (TSTA) Quality Assurance Program has been designed to assure that the designs, tests, data, and interpretive reports developed at TSTA are valid, accurate, and consistent with formally specified procedures and reviews. The quality consideration in all TSTA activities is directed toward the early detection of quality problems, coupled with timely and positive disposition and corrective action

  16. SWiFT Software Quality Assurance Plan.

    Energy Technology Data Exchange (ETDEWEB)

    Berg, Jonathan Charles [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2016-01-01

    This document describes the software development practice areas and processes which contribute to the ability of SWiFT software developers to provide quality software. These processes are designed to satisfy the requirements set forth by the Sandia Software Quality Assurance Program (SSQAP). APPROVALS SWiFT Software Quality Assurance Plan (SAND2016-0765) approved by: Department Manager SWiFT Site Lead Dave Minster (6121) Date Jonathan White (6121) Date SWiFT Controls Engineer Jonathan Berg (6121) Date CHANGE HISTORY Issue Date Originator(s) Description A 2016/01/27 Jon Berg (06121) Initial release of the SWiFT Software Quality Assurance Plan

  17. Barriers to quality health care for the transgender population.

    Science.gov (United States)

    Roberts, Tiffany K; Fantz, Corinne R

    2014-07-01

    The transgender community is arguably the most marginalized and underserved population in medicine. A special issue focusing on men's health would be incomplete without mention of this vulnerable population, which includes those transitioning to and from the male gender. Transgender patients face many barriers in their access to healthcare including historical stigmatization, both structural and financial barriers, and even a lack of healthcare provider experience in treating this unique population. Historical stigmatization fosters a reluctance to disclose gender identity, which can have dire consequences for long-term outcomes due to a lack of appropriate medical history including transition-related care. Even if a patient is willing to disclose their gender identity and transition history, structural barriers in current healthcare settings lack the mechanisms necessary to collect and track this information. Moreover, healthcare providers acknowledge that information is lacking regarding the unique needs and long-term outcomes for transgender patients, which contributes to the inability to provide appropriate care. All of these barriers must be recognized and addressed in order to elevate the quality of healthcare delivered to the transgender community to a level commensurate with the general population. Overcoming these barriers will require redefinition of our current system such that the care a patient receives is not exclusively linked to their sex but also considers gender identity. Copyright © 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  18. Quality assurance for fittings considering nuclear technology

    International Nuclear Information System (INIS)

    Kilian, H.J.

    1987-01-01

    Negative experience made during World War II led to the idea of quality assurance being born in the United States. Thoroughly misunderstood, it came to be incorporated in European mechanical engineering. Quality assurance there was initially considered to be a new term for the oganizational combination of all parts of an enterprise dealing with testing. German manufacturers of heavy-duty and safety fittings represented in the international market were compelled at a relatively early date to properly understand and realize a quality assurance programme. But the multi-fariousness of specifications to be applied and great number of the most different parts made eminent demands on the suitability and variability of the products developed. On the basis of 18 quality criteria the article describes the structure of 'quality' and what its consequences are for an effective quality assurance system - suited for all kinds of specifications. (orig.) [de

  19. 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.

  20. 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.

  1. 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

  2. Quality assurance programme for isotope diagnostic laboratories

    International Nuclear Information System (INIS)

    Krasznai, Istvan

    1987-01-01

    Quality assurance systems are suggested to be introduced in laboratories, in accordance with the recommendations of IAEA and WHO, taking local circumstances into consideration. It is emphasized that a quantitative enhancement of work must not endanger its quality; diagnostic information must be undistorted, reproducible, and gathered with the minimum of radiation burden. National authorities are requested to strengthen their supervision. Recommendations for quality assurance methods are given for medical isotope diagnostic laboratories. (author)

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

    Science.gov (United States)

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

    2018-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Janya McCalman

    2018-03-01

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

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

    Science.gov (United States)

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

    2018-01-01

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

  6. Can health workers reliably assess their own work? A test-retest study of bias among data collectors conducting a Lot Quality Assurance Sampling survey in Uganda.

    Science.gov (United States)

    Beckworth, Colin A; Davis, Rosemary H; Faragher, Brian; Valadez, Joseph J

    2015-03-01

    Lot Quality Assurance Sampling (LQAS) is a classification method that enables local health staff to assess health programmes for which they are responsible. While LQAS has been favourably reviewed by the World Bank and World Health Organization (WHO), questions remain about whether using local health staff as data collectors can lead to biased data. In this test-retest research, Pallisa Health District in Uganda is subdivided into four administrative units called supervision areas (SA). Data collectors from each SA conducted an LQAS survey. A week later, the data collectors were swapped to a different SA, outside their area of responsibility, to repeat the LQAS survey with the same respondents. The two data sets were analysed for agreement using Cohens' kappa coefficient and disagreements were analysed. Kappa values ranged from 0.19 to 0.97. On average, there was a moderate degree of agreement for knowledge indicators and a substantial level for practice indicators. Respondents were found to be systematically more knowledgeable on retest indicating bias favouring the retest, although no evidence of bias was found for practices indicators. In this initial study, using local health care providers to collect data did not bias data collection. The bias observed in the knowledge indicators is most likely due to the 'practice effect', whereby respondents increased their knowledge as a result of completing the first survey, as no corresponding effect was seen in the practices indicators. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

  7. The Role of Ethics in Reducing and Improving the Quality of Coercion in Mental Health Care.

    Science.gov (United States)

    Norvoll, Reidun; Hem, Marit Helene; Pedersen, Reidar

    2017-03-01

    Coercion in mental health care gives rise to many ethical challenges. Many countries have recently implemented state policy programs or development projects aiming to reduce coercive practices and improve their quality. Few studies have explored the possible role of ethics (i.e., ethical theory, moral deliberation and clinical ethics support) in such initiatives. This study adds to this subject by exploring health professionals' descriptions of their ethical challenges and strategies in everyday life to ensure morally justified coercion and best practices. Seven semi-structured telephone interviews were carried out in 2012 with key informants in charge of central development projects and quality-assurance work in mental health services in Norway. No facilities used formal clinical ethics support. However, the informants described five areas in which ethics was of importance: moral concerns as implicit parts of local quality improvement initiatives; moral uneasiness and idealism as a motivational source of change; creating a normative basis for development work; value-based leadership; and increased staff reflexivity on coercive practices. The study shows that coercion entails both individual and institutional ethical aspects. Thus, various kinds of moral deliberation and ethics support could contribute to addressing coercion challenges by offering more systematic ways of dealing with moral concerns. However, more strategic use of implicit and institutional ethics is also needed.

  8. Quality assurance plan, Westinghouse Water Reactor Divisions

    Energy Technology Data Exchange (ETDEWEB)

    1976-03-01

    The Quality Assurance Program used by Westinghouse Nuclear Energy Systems Water Reactor Divisions is described. The purpose of the program is to assure that the design, materials, and workmanship on Nuclear Steam Supply System (NSSS) equipment meet applicable safety requirements, fulfill the requirements of the contracts with the applicants, and satisfy the applicable codes, standards, and regulatory requirements.

  9. Quality assurance in nuclear power plant

    International Nuclear Information System (INIS)

    Magalhaes, M.T. de

    1981-01-01

    The factors related to the licensing procedures of a nuclear power plant (quality assurance and safety analysis) are presented and discussed. The consequences of inadequate attitudes towards these factors are shown and suggestions to assure the safety of nuclear power plants in Brazil are presented. (E.G.) [pt

  10. Quality assurance systems at SKODA JS

    International Nuclear Information System (INIS)

    Janecek, P.

    2000-01-01

    In addition to technical requirements put upon the design, manufacture, installation and commissioning of equipment for nuclear power plants, emphasis is laid upon quality assurance of such activities so as to secure nuclear safety of installations over the world. As the technical level of nuclear safety assurance is being enhanced continuously, the requirements are becoming more and more stringent, which is mirrored by the relevant standards and legislation. SKODA JS has always been pursuing the quality goal and has been contributing to this aspect markedly. The quality assurance system at SKODA JS helps the company to satisfy all the appropriate requirements of its customers as well as the applicable standards and regulations. (author)

  11. Quality assurance - the key to the future

    Energy Technology Data Exchange (ETDEWEB)

    Rix, C [British Coal Corporation, London (UK)

    1992-05-01

    Quality assurance seeks to achieve diligence and attention to detail, which can have substantial effects including reduced costs and improved performance, as well as greater customer satisfaction. British Coal has a policy of quality assurance to BS5750 at all collieries and despatch points, to help maintain its competitive position, to respond to customer requirements, and to continue the drive for reduced costs. A pilot exercise was undertaken at Maltby and Kellingley collieries, and at Oxcroft and Gwaun-cae-Gurwen opencast despatch points, in order to gain sufficient experience to allow rapid implementation of quality assurance at all sites.

  12. Guidelines for comprehensive quality assurance in brachytherapy

    International Nuclear Information System (INIS)

    Goldson, A.L.; Nibhanupudy, J.R.

    1984-01-01

    Brachytherapy treatment techniques can provide significant improvement in local control and overall survival, but only when quality assurance can be guaranteed. To establish brachytherapy quality assurance, basic requirements for three predetermined subdivisions of clinical institutions will be forwarded. These are: (1) centers having minimum requirements to provide brachytherapy, (2) intermediate centers such as regional or community hospitals, and (3) optimal centers such as university hospital and cancer centers. This presentation will highlight personnel needs, equipment requirements, academic activities, clinical experience with these systems and proposed quality assurance guidelines

  13. Commissioning quality assurance for nuclear power plants

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1986-09-01

    This standard contains the requirements for the quality assurance program applicable to the commissioning phase of a nuclear power plant. This standard embodies the relevant quality assurance requirements of CSA Standard CAN3-N286.0, and is the governing Standard for commissioning quality assurance activities in the event of any conflicting requirements. This Standard applies to the commissioning of safety-related equipment, systems, and structures as identified by the owner. It may be applied to other equipment, systems, and structures at the discretion of the owner. 1 fig.

  14. A Quality Assurance Program for decommissioning

    International Nuclear Information System (INIS)

    Briggs, P.M.

    1986-01-01

    Defining the Quality Assurance Program for the US Department of Energy Shippingport Station Decommissioning Project (SSDP) was a unique opportunity because this is the first full-sized commercial nuclear power plant to be decommissioned. General Electric Company defined a Quality Assurance Program that provided adequate control, yet was stripped down to the essentials. The Program is designed to provide a flexible degree of monitoring of subcontractor work, built around a core of radiation safety monitoring, detailed planning, inspection and auditing, and operated with a minimum of dedicated personnel. This paper will concentrate on the traditional quality assurance activities, leaving radiation and environmental monitoring for other presentations

  15. Quality assurance organization of the plant owner

    International Nuclear Information System (INIS)

    Staebler, K.

    1980-01-01

    It is not the primary task of the plant owner to assure the quality during erection. It is, however, his responsibility to check the quality assurance system established by the plant, the supplier and the subcontractor. In the lecture, it is shown that the plant owners do this control in the best efficient way. The special consideration of the plant owner in deciding questions of quality assurance is demonstrated by special examples. The meaning of basic safety for the plant owner is presented. (orig./RW)

  16. Commissioning quality assurance for nuclear power plants

    International Nuclear Information System (INIS)

    1986-09-01

    This standard contains the requirements for the quality assurance program applicable to the commissioning phase of a nuclear power plant. This standard embodies the relevant quality assurance requirements of CSA Standard CAN3-N286.0, and is the governing Standard for commissioning quality assurance activities in the event of any conflicting requirements. This Standard applies to the commissioning of safety-related equipment, systems, and structures as identified by the owner. It may be applied to other equipment, systems, and structures at the discretion of the owner. 1 fig

  17. Quality assurance and demolition: 2006 symposium

    International Nuclear Information System (INIS)

    Thierfeldt, S.

    2006-01-01

    The '2006 Symposium: Quality Assurance and Demolition' jointly organized by compra GmbH and Brenk Systemplanung GmbH this year again focused on quality assurance and the demolition of nuclear facilities as its main topics. The papers presented ranged from issues of clearance and disposal to demolition technologies and status reports about specific demolition projects. The sixteen presentations at the '2006 Symposium: Quality Assurance and Demolition' offered an interesting and very topical cross section of decommissioning and demolition of nuclear facilities in Germany. In 2007, the conference about similar main topics will again be held at the Schloss Bensberg Grand Hotel. (orig.)

  18. Informal payments and the quality of health care: Mechanisms revealed by Tanzanian health workers.

    Science.gov (United States)

    Mæstad, Ottar; Mwisongo, Aziza

    2011-02-01

    Informal payments for health services are common in many transitional and developing countries. The aim of this paper is to investigate the nature of informal payments in the health sector of Tanzania and to identify mechanisms through which informal payments may affect the quality of health care. Our focus is on the effect of informal payments on health worker behaviours, in particular the interpersonal dynamics among health workers at their workplaces. We organised eight focus groups with 58 health workers representing different cadres and levels of care in one rural and one urban district in Tanzania. We found that health workers at all levels receive informal payments in a number of different contexts. Health workers sometimes share the payments received, but only partially, and more rarely within the cadre than across cadres. Our findings indicate that health workers are involved in 'rent-seeking' activities, such as creating artificial shortages and deliberately lowering the quality of service, in order to extract extra payments from patients or to bargain for a higher share of the payments received by their colleagues. The discussions revealed that many health workers think that the distribution of informal payments is grossly unfair. The findings suggest that informal payments can impact negatively on the quality of health care through rent-seeking behaviours and through frustrations created by the unfair allocation of payments. Interestingly, the presence of corruption may also induce non-corrupt workers to reduce the quality of care. Positive impacts can occur because informal payments may induce health workers to increase their efforts, and maybe more so if there is competition among health workers about receiving the payments. Moreover, informal payments add to health workers' incomes and might thus contribute to retention of health workers within the health sector. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  19. Quality Control and Quality Assurance of Radiation Oncology

    International Nuclear Information System (INIS)

    Abaza, A.

    2016-01-01

    Radiotherapy (RT) has played important roles in cancer treatment for more than one century. The development of RT techniques allows high-dose irradiation to tumors while reducing the radiation doses delivered to surrounding normal tissues. However, RT is a complex process and involves understanding of the principles of medical physics, radiobiology, radiation safety, dosimetry, radiation treatment planning, simulation and interaction of radiation with other treatment modalities. Each step in the integrated process of RT needs quality control and quality assurance (QA) to prevent errors and to ensure that patients will receive the prescribed treatment correctly. The aim of this study is to help the radio therapists in identifying a system for QA that balances patient safety and quality with available resources. Recent advances in RT focus on the need for a systematic RT QA program that balances patient safety and quality with available resources. It is necessary to develop more formal error mitigation and process analysis methods, such as failure mode and effect analysis (FMEA), to focus available QA resources optimally on the process components. External audit programs are also effective. Additionally, Clinical trial QA has a significant role in enhancing the quality of care. The International Atomic Energy Agency (IAEA) has operated both an on-site and off-site postal dosimetry audit to improve practice and to assure the dose from RT equipment. Both postal dosimetry audit and clinical trial RTQA, especially for advanced technologies, in collaboration with global networks, will serve to enhance patient safety and quality of care

  20. Public reporting in health care: how do consumers use quality-of-care information? A systematic review.

    NARCIS (Netherlands)

    Faber, M.J.; Bosch, M.C.; Wollersheim, H.C.H.; Leatherman, S.; Grol, R.P.T.M.

    2009-01-01

    BACKGROUND: One of the underlying goals of public reporting is to encourage the consumer to select health care providers or health plans that offer comparatively better quality-of-care. OBJECTIVE: To review the weight consumers give to quality-of-care information in the process of choice, to

  1. Two-year impact of the alternative quality contract on pediatric health care quality and spending.

    Science.gov (United States)

    Chien, Alyna T; Song, Zirui; Chernew, Michael E; Landon, Bruce E; McNeil, Barbara J; Safran, Dana G; Schuster, Mark A

    2014-01-01

    To examine the 2-year effect of Blue Cross Blue Shield of Massachusetts' global budget arrangement, the Alternative Quality Contract (AQC), on pediatric quality and spending for children with special health care needs (CSHCN) and non-CSHCN. Using a difference-in-differences approach, we compared quality and spending trends for 126,975 unique 0- to 21-year-olds receiving care from AQC groups with 415,331 propensity-matched patients receiving care from non-AQC groups; 23% of enrollees were CSHCN. We compared quality and spending pre (2006-2008) and post (2009-2010) AQC implementation, adjusting analyses for age, gender, health risk score, and secular trends. Pediatric outcome measures included 4 preventive and 2 acute care measures tied to pay-for-performance (P4P), 3 asthma and 2 attention-deficit/hyperactivity disorder quality measures not tied to P4P, and average total annual medical spending. During the first 2 years of the AQC, pediatric care quality tied to P4P increased by +1.8% for CSHCN (P < .001) and +1.2% for non-CSHCN (P < .001) for AQC versus non-AQC groups; quality measures not tied to P4P showed no significant changes. Average total annual medical spending was ~5 times greater for CSHCN than non-CSHCN; there was no significant impact of the AQC on spending trends for children. During the first 2 years of the contract, the AQC had a small but significant positive effect on pediatric preventive care quality tied to P4P; this effect was greater for CSHCN than non-CSHCN. However, it did not significantly influence (positively or negatively) CSHCN measures not tied to P4P or affect per capita spending for either group.

  2. Principles and Practices for Quality Assurance and Quality Control

    Science.gov (United States)

    Jones, Berwyn E.

    1999-01-01

    Quality assurance and quality control are vital parts of highway runoff water-quality monitoring projects. To be effective, project quality assurance must address all aspects of the project, including project management responsibilities and resources, data quality objectives, sampling and analysis plans, data-collection protocols, data quality-control plans, data-assessment procedures and requirements, and project outputs. Quality control ensures that the data quality objectives are achieved as planned. The historical development and current state of the art of quality assurance and quality control concepts described in this report can be applied to evaluation of data from prior projects.

  3. Primary health care quality and hospitalizations for ambulatory care sensitive conditions in the public health system in Porto Alegre, Brazil.

    Science.gov (United States)

    Gonçalves, Marcelo Rodrigues; Hauser, Lisiane; Prestes, Isaías Valente; Schmidt, Maria Inês; Duncan, Bruce Bartholow; Harzheim, Erno

    2016-06-01

    To investigate the relation of hospitalization for ambulatory care sensitive conditions (ACSC) with the quality of public primary care health services in Porto Alegre, Brazil. Cohort study constructed by probabilistic record linkage performed from August 2006 to December 2011 in a population ≥18 years of age that attended public primary care health services. The Primary Care Assessment Tool (PCATool-Brazil) was used for evaluation of primary care services. Of 1200 subjects followed, 84 were hospitalized for primary care sensitive conditions. The main causes of ACSC hospital admissions were cardiovascular (40.5%) and respiratory (16.2%) diseases. The PCATool average score was 5.3, a level considerably below that considered to represent quality care. After adjustment through Cox proportional hazard modelling for covariates, >60 years of age [hazard ratio (HR): 1.13; P = 0.001), lesser education (HR: 0.66; P = 0.02), ethnicity other than white (HR: 1.77; P = 0.01) and physical inactivity (HR: 1.65; P = 0.04) predicted hospitalization, but higher quality of primary health care did not. Better quality of health care services, in a setting of overwhelmingly low quality services not adapted to the care of chronic conditions, did not influence the rate of avoidable hospitalizations, while social and demographic characteristics, especially non-white ethnicity and lesser schooling, indicate that social inequities play a predominant role in health outcomes. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  4. Software Quality Assurance activities of ITER CODAC

    Energy Technology Data Exchange (ETDEWEB)

    Pande, Sopan, E-mail: sopan.pande@iter.org [ITER Organization, Route de Vinon sur Verdon, 13115 St Paul Lez Durance (France); DiMaio, Franck; Kim, Changseung; Kim, Joohan; Klotz, Wolf-Dieter; Makijarvi, Petri; Stepanov, Denis; Wallander, Anders [ITER Organization, Route de Vinon sur Verdon, 13115 St Paul Lez Durance (France)

    2013-10-15

    Highlights: ► Comprehensive and consistent software engineering and quality assurance of CODAC. ► Applicable to all CODAC software projects executed by ITER DAs and contractors. ► Configurable plans for cost effective application of SQA processes. ► CODAC software plans SQAP, SVVP, SDP, and SCMP. ► CODAC software processes based on IEEE 12207-2008. -- Abstract: Software as an integral part of the plant system I and C is crucial in the manufacturing and integrated operation of ITER plant systems. Software Quality Assurance is necessary to ensure the development and maintenance of consistently high quality I and C software throughout the lifetime of ITER. CODAC decided to follow IEEE 12207-2008 software lifecycle processes for Software Engineering and Software Quality Assurance. Software Development Plan, Software Configuration Management Plan and Software Verification and Validation Plan are the mainstay of Software Quality Assurance which is documented in the Software Quality Assurance Plan. This paper describes the Software Quality Assurance (SQA) activities performed by CODAC. The SQA includes development and maintenance of above plans, processes and resources. With the help of Verification and Validation Teams they gather evidence of process conformance and product conformance, and record process data for quality audits and perform process improvements.

  5. Software Quality Assurance activities of ITER CODAC

    International Nuclear Information System (INIS)

    Pande, Sopan; DiMaio, Franck; Kim, Changseung; Kim, Joohan; Klotz, Wolf-Dieter; Makijarvi, Petri; Stepanov, Denis; Wallander, Anders

    2013-01-01

    Highlights: ► Comprehensive and consistent software engineering and quality assurance of CODAC. ► Applicable to all CODAC software projects executed by ITER DAs and contractors. ► Configurable plans for cost effective application of SQA processes. ► CODAC software plans SQAP, SVVP, SDP, and SCMP. ► CODAC software processes based on IEEE 12207-2008. -- Abstract: Software as an integral part of the plant system I and C is crucial in the manufacturing and integrated operation of ITER plant systems. Software Quality Assurance is necessary to ensure the development and maintenance of consistently high quality I and C software throughout the lifetime of ITER. CODAC decided to follow IEEE 12207-2008 software lifecycle processes for Software Engineering and Software Quality Assurance. Software Development Plan, Software Configuration Management Plan and Software Verification and Validation Plan are the mainstay of Software Quality Assurance which is documented in the Software Quality Assurance Plan. This paper describes the Software Quality Assurance (SQA) activities performed by CODAC. The SQA includes development and maintenance of above plans, processes and resources. With the help of Verification and Validation Teams they gather evidence of process conformance and product conformance, and record process data for quality audits and perform process improvements

  6. Does quality influence utilization of primary health care? Evidence from Haiti.

    Science.gov (United States)

    Gage, Anna D; Leslie, Hannah H; Bitton, Asaf; Jerome, J Gregory; Joseph, Jean Paul; Thermidor, Roody; Kruk, Margaret E

    2018-06-20

    Expanding coverage of primary healthcare services such as antenatal care and vaccinations is a global health priority; however, many Haitians do not utilize these services. One reason may be that the population avoids low quality health facilities. We examined how facility infrastructure and the quality of primary health care service delivery were associated with community utilization of primary health care services in Haiti. We constructed two composite measures of quality for all Haitian facilities using the 2013 Service Provision Assessment survey. We geographically linked population clusters from the Demographic and Health Surveys to nearby facilities offering primary health care services. We assessed the cross-sectional association between quality and utilization of four primary care services: antenatal care, postnatal care, vaccinations and sick child care, as well as one more complex service: facility delivery. Facilities performed poorly on both measures of quality, scoring 0.55 and 0.58 out of 1 on infrastructure and service delivery quality respectively. In rural areas, utilization of several primary cares services (antenatal care, postnatal care, and vaccination) was associated with both infrastructure and quality of service delivery, with stronger associations for service delivery. Facility delivery was associated with infrastructure quality, and there was no association for sick child care. In urban areas, care utilization was not associated with either quality measure. Poor quality of care may deter utilization of beneficial primary health care services in rural areas of Haiti. Improving health service quality may offer an opportunity not only to improve health outcomes for patients, but also to expand coverage of key primary health care services.

  7. The better model to predict and improve pediatric health care quality: performance or importance-performance?

    Science.gov (United States)

    Olsen, Rebecca M; Bryant, Carol A; McDermott, Robert J; Ortinau, David

    2013-01-01

    The perpetual search for ways to improve pediatric health care quality has resulted in a multitude of assessments and strategies; however, there is little research evidence as to their conditions for maximum effectiveness. A major reason for the lack of evaluation research and successful quality improvement initiatives is the methodological challenge of measuring quality from the parent perspective. Comparison of performance-only and importance-performance models was done to determine the better predictor of pediatric health care quality and more successful method for improving the quality of care provided to children. Fourteen pediatric health care centers serving approximately 250,000 patients in 70,000 households in three West Central Florida counties were studied. A cross-sectional design was used to determine the importance and performance of 50 pediatric health care attributes and four global assessments of pediatric health care quality. Exploratory factor analysis revealed five dimensions of care (physician care, access, customer service, timeliness of services, and health care facility). Hierarchical multiple regression compared the performance-only and the importance-performance models. In-depth interviews, participant observations, and a direct cognitive structural analysis identified 50 health care attributes included in a mailed survey to parents(n = 1,030). The tailored design method guided survey development and data collection. The importance-performance multiplicative additive model was a better predictor of pediatric health care quality. Attribute importance moderates performance and quality, making the importance-performance model superior for measuring and providing a deeper understanding of pediatric health care quality and a better method for improving the quality of care provided to children. Regardless of attribute performance, if the level of attribute importance is not taken into consideration, health care organizations may spend valuable

  8. The roles of government in improving health care quality and safety.

    Science.gov (United States)

    Tang, Ning; Eisenberg, John M; Meyer, Gregg S

    2004-01-01

    Discussions surrounding the role of government have been and continue to be a favorite American pastime. A framework is provided for understanding the 10 roles that government plays in improving health care quality and safety in the United States. Examples of proposed federal actions to reduce medical errors and enhance patient safety are provided to illustrate the 10 roles: (1) purchase health care, (2) provide health care, (3) ensure access to quality care for vulnerable populations, (4) regulate health care markets, (5) support acquisition of new knowledge, (6) develop and evaluate health technologies and practices, (7) monitor health care quality, (8) inform health care decision makers, (9) develop the health care workforce, and (10) convene stakeholders from across the health care system. Government's responsibility to protect and advance the interests of society includes the delivery of high-quality health care. Because the market alone cannot ensure all Americans access to quality health care, the government must preserve the interests of its citizens by supplementing the market where there are gaps and regulating the market where there is inefficiency or unfairness. The ultimate goal of achieving high quality of care will require strong partnerships among federal, state, and local governments and the private sector. Translating general principles regarding the appropriate role of government into specific actions within a rapidly changing, decentralized delivery system will require the combined efforts of the public and private sectors.

  9. Manpower requirements for quality assurance during operation

    International Nuclear Information System (INIS)

    Pratt, J.M.; Sollenberger, L.G.

    1982-01-01

    As a result of the Three Mile Island accident and the findings presented in various investigatory reports, some fundamental changes are taking place in the role and scope of quality assurance. Recent changes to United States national codes, guides and standards are analysed in order to identify the principles involved. This analysis shows that the scope of the programme is being extended beyond the equipment designated 'nuclear safety related' and greater emphasis is being placed upon the independent verification of the satisfactory performance of activities affecting safety. Such fundamental changes could lead to a significant increase in the number of quality assurance personnel required to support an operating nuclear power plant. The evolving quality assurance organization at Three Mile Island is used to illustrate how these fundamental changes could affect the quality assurance organization and manpower requirements. (author)

  10. Quality assurance terms and definitions - approved 1973

    International Nuclear Information System (INIS)

    Anon.

    1975-01-01

    Standards for certain terms and their definitions that are important to the uniform understanding of the intent of required quality assurance practices for the construction of nuclear power plants are presented

  11. Maintenance quality assurance peer exchange 2.

    Science.gov (United States)

    2009-04-01

    This report documents a comprehensive study of twenty three maintenance quality assurance : (MQA) programs throughout the United States and Canada. The policies and standards of : each program were synthesized to create a general assessment on the co...

  12. Design quality assurance for nuclear power plants

    International Nuclear Information System (INIS)

    1986-07-01

    This Standard contains the requirements for the quality assurance program applicable to the design phase of a nuclear plant, and is applicable to the design of safety-related equipment, systems, and structures, as identified by the owner. 1 fig

  13. Quality Assurance Project Plan Development Tool

    Science.gov (United States)

    This tool contains information designed to assist in developing a Quality Assurance (QA) Project Plan that meets EPA requirements for projects that involve surface or groundwater monitoring and/or the collection and analysis of water samples.

  14. Achieving quality assurance in the Indian programme

    International Nuclear Information System (INIS)

    Challappa, S.; Alekal, R.S.; Murthy, G.S.K.; Palaniappan, M.

    1984-01-01

    Much of the equipment for India's diverse nuclear programme has come from the central workshops of the Bhabha Atomic Research Centre near Bombay. Engineers from the central workshops describe how quality assurance has been put into practice. (author)

  15. Design quality assurance for nuclear power plants

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1986-07-01

    This Standard contains the requirements for the quality assurance program applicable to the design phase of a nuclear plant, and is applicable to the design of safety-related equipment, systems, and structures, as identified by the owner. 1 fig.

  16. Internal quality assurance reviews: challenges and processes ...

    African Journals Online (AJOL)

    Internal quality assurance reviews: challenges and processes – Walter Sisulu University\\'s Business, Management Sciences and Law Faculty. ... This article examines some of the challenges and processes followed by six of the departments ...

  17. Physicians' perceptions about the quality of primary health care services in transitional Albania

    NARCIS (Netherlands)

    Kellici, Neritan; Dibra, Arvin; Mihani, Joana; Kellici, Suela; Burazeri, Genc

    AIM: To date, the available information regarding the quality of primary health care services in Albania is scarce. The aim of our study was to assess the quality of primary health care services in Albania based on physicians' perceptions towards the quality of the services provided to the general

  18. Quality assurance in performance assessments

    International Nuclear Information System (INIS)

    Maul, P.R.; Watkins, B.M.; Salter, P.; Mcleod, R

    1999-01-01

    Following publication of the Site-94 report, SKI wishes to review how Quality Assurance (QA) issues could be treated in future work both in undertaking their own Performance Assessment (PA) calculations and in scrutinising documents supplied by SKB (on planning a repository for spent fuels in Sweden). The aim of this report is to identify the key QA issues and to outline the nature and content of a QA plan which would be suitable for SKI, bearing in mind the requirements and recommendations of relevant standards. Emphasis is on issues which are specific to Performance Assessments for deep repositories for radioactive wastes, but consideration is also given to issues which need to be addressed in all large projects. Given the long time over which the performance of a deep repository system must be evaluated, the demonstration that a repository is likely to perform satisfactorily relies on the use of computer-generated model predictions of system performance. This raises particular QA issues which are generally not encountered in other technical areas (for instance, power station operations). The traceability of the arguments used is a key QA issue, as are conceptual model uncertainty, and code verification and validation; these were all included in the consideration of overall uncertainties in the Site-94 project. Additionally, issues which are particularly relevant to SKI include: How QA in a PA fits in with the general QA procedures of the organisation undertaking the work. The relationship between QA as applied by the regulator and the implementor of a repository development programme. Section 2 introduces the discussion of these issues by reviewing the standards and guidance which are available from national and international organisations. This is followed in Section 3 by a review of specific issues which arise from the Site-94 exercise. An outline procedure for managing QA issues in SKI is put forward as a basis for discussion in Section 4. It is hoped that

  19. Quality assurance in performance assessments

    Energy Technology Data Exchange (ETDEWEB)

    Maul, P.R.; Watkins, B.M.; Salter, P.; Mcleod, R [QuantiSci Ltd, Henley-on-Thames (United Kingdom)

    1999-01-01

    Following publication of the Site-94 report, SKI wishes to review how Quality Assurance (QA) issues could be treated in future work both in undertaking their own Performance Assessment (PA) calculations and in scrutinising documents supplied by SKB (on planning a repository for spent fuels in Sweden). The aim of this report is to identify the key QA issues and to outline the nature and content of a QA plan which would be suitable for SKI, bearing in mind the requirements and recommendations of relevant standards. Emphasis is on issues which are specific to Performance Assessments for deep repositories for radioactive wastes, but consideration is also given to issues which need to be addressed in all large projects. Given the long time over which the performance of a deep repository system must be evaluated, the demonstration that a repository is likely to perform satisfactorily relies on the use of computer-generated model predictions of system performance. This raises particular QA issues which are generally not encountered in other technical areas (for instance, power station operations). The traceability of the arguments used is a key QA issue, as are conceptual model uncertainty, and code verification and validation; these were all included in the consideration of overall uncertainties in the Site-94 project. Additionally, issues which are particularly relevant to SKI include: How QA in a PA fits in with the general QA procedures of the organisation undertaking the work. The relationship between QA as applied by the regulator and the implementor of a repository development programme. Section 2 introduces the discussion of these issues by reviewing the standards and guidance which are available from national and international organisations. This is followed in Section 3 by a review of specific issues which arise from the Site-94 exercise. An outline procedure for managing QA issues in SKI is put forward as a basis for discussion in Section 4. It is hoped that

  20. Automating linear accelerator quality assurance.

    Science.gov (United States)

    Eckhause, Tobias; Al-Hallaq, Hania; Ritter, Timothy; DeMarco, John; Farrey, Karl; Pawlicki, Todd; Kim, Gwe-Ya; Popple, Richard; Sharma, Vijeshwar; Perez, Mario; Park, SungYong; Booth, Jeremy T; Thorwarth, Ryan; Moran, Jean M

    2015-10-01

    The purpose of this study was 2-fold. One purpose was to develop an automated, streamlined quality assurance (QA) program for use by multiple centers. The second purpose was to evaluate machine performance over time for multiple centers using linear accelerator (Linac) log files and electronic portal images. The authors sought to evaluate variations in Linac performance to establish as a reference for other centers. The authors developed analytical software tools for a QA program using both log files and electronic portal imaging device (EPID) measurements. The first tool is a general analysis tool which can read and visually represent data in the log file. This tool, which can be used to automatically analyze patient treatment or QA log files, examines the files for Linac deviations which exceed thresholds. The second set of tools consists of a test suite of QA fields, a standard phantom, and software to collect information from the log files on deviations from the expected values. The test suite was designed to focus on the mechanical tests of the Linac to include jaw, MLC, and collimator positions during static, IMRT, and volumetric modulated arc therapy delivery. A consortium of eight institutions delivered the test suite at monthly or weekly intervals on each Linac using a standard phantom. The behavior of various components was analyzed for eight TrueBeam Linacs. For the EPID and trajectory log file analysis, all observed deviations which exceeded established thresholds for Linac behavior resulted in a beam hold off. In the absence of an interlock-triggering event, the maximum observed log file deviations between the expected and actual component positions (such as MLC leaves) varied from less than 1% to 26% of published tolerance thresholds. The maximum and standard deviations of the variations due to gantry sag, collimator angle, jaw position, and MLC positions are presented. Gantry sag among Linacs was 0.336 ± 0.072 mm. The standard deviation in MLC

  1. Acute mental health care and South African mental health legislation

    African Journals Online (AJOL)

    information on mental health care outcome, to do a cost analysis and to establish a quality assurance cycle that may facilitate a cost ... clinical record reviews of mental health service delivery, training ... (d) describe the demographic and clinical profile of HIV positive ..... accommodate the differentiated but integrated care of.

  2. End-user perspectives on e-commerce and health care web site quality.

    Science.gov (United States)

    Le Rouge, Cynthia; De Leo, Gianluca

    2008-11-06

    We explore and compare the importance of various quality dimensions for health care and e-commerce web sites. The results show that the importance of various quality attributes for all except four of ten quality dimensions studied differ between health care and e-commerce web sites. These results can help health care managers to improve and/or to guide the design of their web sites.

  3. Linear accelerator quality assurance using EPIQA software

    International Nuclear Information System (INIS)

    Bozhikov, S.; Sokerov, H.; Tonev, A.; Ivanova, K.

    2012-01-01

    Unlike treatment with static fields, using a dynamic multileaf collimator (dMLC), there are significant dosimetric issues which must be assessed before dynamic therapy can be implemented. The advanced techniques require some additional commissioning and quality assurance tests. The results of standard quality assurance (QA) machine tests and commissioning tests for volume modulated arc therapy (VMAT) using electronic portal image device (EPID) and 'EPIQA' software are presented. (authors)

  4. Quality assurance in the nuclear test program

    International Nuclear Information System (INIS)

    Shearer, J.N.

    1979-01-01

    In February 1979 Test Program laid the ground work for a new quality assurance structure. The new approach was based on the findings and recommendations of the Ad Hoc QA Program Review panel, which are summarized in this report. The new structure places the responsibility for quality assurance in the hands of the line organizations, both in the programmatic and functional elements of the LLL matrix

  5. Good manufacturing practice - quality assurance programs

    International Nuclear Information System (INIS)

    Masefield, John; Thompson, Steven

    1986-01-01

    The concept of good manufacturing practice (GMP) in the medical device industry requires the use of controlled methods and equipment in performing each step in the device manufacturing process. Quality assurance programs are used to maintain compliance with GMP requirements by prescribing the operating and control procedures to be used. The specific elements of a quality assurance program for the radiation sterilization of medical devices are described. (author)

  6. Quality assurance and organizational effectiveness in hospitals.

    OpenAIRE

    Hetherington, R W

    1982-01-01

    The purpose of this paper is to explore some aspects of a general theoretical model within which research on the organizational impacts of quality assurance programs in hospitals may be examined. Quality assurance is conceptualized as an organizational control mechanism, operating primarily through increased formalization of structures and specification of procedures. Organizational effectiveness is discussed from the perspective of the problem-solving theory of organizations, wherein effecti...

  7. Quality assurance program for isotopic power systems

    Energy Technology Data Exchange (ETDEWEB)

    Hannigan, R.L.; Harnar, R.R.

    1982-12-01

    This report summarizes the Sandia National Laboratories Quality Assurance Program that applies to non-weapon (reimbursable) Radioisotopic Thermoelectric Generators. The program has been implemented over the past 16 years on power supplies used in various space and terrestrial systems. The quality assurance (QA) activity of the program is in support of the Department of Energy, Office of Space Nuclear Projects. Basic elements of the program are described in the report and examples of program decumentation are presented.

  8. Quality assurance program for isotopic power systems

    International Nuclear Information System (INIS)

    Hannigan, R.L.; Harnar, R.R.

    1982-12-01

    This report summarizes the Sandia National Laboratories Quality Assurance Program that applies to non-weapon (reimbursable) Radioisotopic Thermoelectric Generators. The program has been implemented over the past 16 years on power supplies used in various space and terrestrial systems. The quality assurance (QA) activity of the program is in support of the Department of Energy, Office of Space Nuclear Projects. Basic elements of the program are described in the report and examples of program decumentation are presented

  9. [Quality assurance of take-over from in-patient to out-patient care: experiences in Lower Austria].

    Science.gov (United States)

    Frühwald, Stefan; Karner, Angelika; Seyringer, Michaela-Elena; Skribe, Teresa; Frottier, Patrick; Entenfellner, Anna

    2010-01-01

    Community mental health teams (CMHT) provide support for severely disabled, chronic mentally ill patients. In this study, referrals to CMHT by a psychiatric hospital in Lower Austria were analysed, as were the first few weeks of care for referred patients. Referrals to CMHT of a catchment area (pop 250.000) were analysed for 2002- 2006. In the first 6 months of each year, 124 to 189 patients were referred to CMHT. Between 2002 and 2006, the percentage of affective disorders (ICD-10: F3: 40.0 %), and substance use disorders (F1: 38.9 %) within the referrals diminished, as compared to patients suffering from schizophrenia (F2 initially 25.4 % of referrals vs. 49.7 %) and personality disorders (F6 initially 6.4 % of referrals vs. 22.4 %). In 30.7 % vs. 56.6 % of patients, CMHT workers managed to establish contact to patients after discharge from hospital. They actively sought contact with 39.9 to 74.6 % of referred patients (by means of telephone calls, letters, home visits, etc.). In 26.5 to 46.9 % of the referrals, continuous care was planned. This study emphasizes the advantage of specific referrals to CMHT, if care for severely disabled individuals is needed and should be provided. Furthermore, a description of outreach activities, which are intended to maintain contact with patients characterized by poor compliance, is presented. These activities are not yet part of routine care in German speaking countries.

  10. Quality assurance in surgical practice through auditing.

    Science.gov (United States)

    Wong, W T

    1980-05-01

    An efficient auditing method is presented which involves objective criteria-based numerical screening of medical process and treatment outcome by paramedical staff and detailed analysis of deviated cases by surgeons. If properly performed it requires the study of no more than 50 cases in a diagnostic category to provide sufficient information about the quality of care. Encouraging points as well as problems are communicated to the surgeons to induce the maintenance or improvement of the standard of care. Graphic documentation of case performance is possible, allowing surgeons to compare results with their colleagues. The general performance level of several consecutive studies can be compared at a glance. In addition, logical education programs to improve the medical process can be designed on the basis of the problems identified. As all the cases with an unacceptable outcome are traceable to inadequate medical process, improvement in this area will decrease outcome defects. With the use of auditing and the follow-up technique described, the quality of care in surgery may be assured.

  11. Westinghouse Water Reactor Divisions quality assurance plan

    International Nuclear Information System (INIS)

    1977-09-01

    The Quality Assurance Program used by Westinghouse Water Reactor Divisions is described. The purpose of the program is to assure that the design, materials, and workmanship on Nuclear Steam Supply System (NSSS) equipment meet applicable safety requirements, fulfill the requirements of the contracts with the applicants, and satisfy the applicable codes, standards, and regulatory requirements. This program satisfies the NRC Quality Assurance Criteria, 10CFR50 Appendix B, to the extent that these criteria apply to safety related NSSS equipment. Also, it follows the regulatory position provided in NRC regulatory guides and the requirements of ANSI Standard N45.2.12 as identified in this Topical Report

  12. [Quality assurance in oncology: experiences of an ISO certification].

    Science.gov (United States)

    Szentirmay, Zoltán; Cseh, Lujza; Ottó, Szabolcs; Kásler, Miklós

    2002-01-01

    The ISO 9001 quality assurance of the National Institute of Oncology has been achieved successfully. We give an account of the brief history and the structure of the assurance system of the Institute, the process of setting our goals, and also the experience gained from drafting ISO 9001 handbook and flowcharts. Apart from the bureaucratic nature of quality assurance, it is a good opportunity for us to investigate our everyday work, put it into orderly manner and work more reliably. Experience has shown that the introduction of a quality assurance system increases the level of patient care, the documentation helps the Institute or some of its departments, or even individuals prevent law suits, and serves as a sound basis for proposing promotion, salary increases and bonuses, or even honors.

  13. Quality Assurance for Operation of Nuclear Facilities

    International Nuclear Information System (INIS)

    Park, C. G.; Kwon, H. I.; Kim, K. H.; Oh, Y. W.; Lee, Y. G.; Ha, J. H.; Lim, N. J.

    2008-12-01

    This report describes QA activities performed within 'Quality Assurance for Nuclear facility project' and results thereof. Efforts were made to maintain and improve quality system of nuclear facilities. Varification activities whether quality system was implemented in compliance with requirements. QA department assisted KOLAS accredited testing and calibration laboratories, ISO 9001 quality system, establishment of QA programs for R and D, and carried out reviews and surveys for development of quality assurance technologies. Major items of this report are as follows : - Development and Improvement of QA Programs - QA Activities - Assessment of Effectiveness and Adequacy for QA Programs

  14. Quality in primary health care services in sub-Sahara Africa: right or ...

    African Journals Online (AJOL)

    The Primary Health Care (PHC) system has been the foundation for the operation of the health system in most of Sub-Sahara Africa following the Alma Ata Declaration in 1978. Quality of care is an important determinant of health services utilization, and is a health outcome of public health importance. It is known that the ...

  15. Quality evaluation in health care services based on customer-provider relationships.

    Science.gov (United States)

    Eiriz, Vasco; Figueiredo, José António

    2005-01-01

    To develop a framework for evaluating the quality of Portuguese health care organisations based on the relationship between customers and providers, to define key variables related to the quality of health care services based on a review of the available literature, and to establish a conceptual framework in order to test the framework and variables empirically. Systematic review of the literature. Health care services quality should not be evaluated exclusively by customers. Given the complexity, ambiguity and heterogeneity of health care services, the authors develop a framework for health care evaluation based on the relationship between customers (patients, their relatives and citizens) and providers (managers, doctors, other technical staff and non-technical staff), and considering four quality items (customer service orientation, financial performance, logistical functionality and level of staff competence). This article identifies important changes in the Portuguese health care industry, such as the ownership of health care providers. At the same time, customers are changing their attitudes towards health care, becoming much more concerned and demanding of health services. These changes are forcing Portuguese private and public health care organisations to develop more marketing-oriented services. This article recognises the importance of quality evaluation of health care services as a means of increasing customer satisfaction and organisational efficiency, and develops a framework for health care evaluation based on the relationship between customers and providers.

  16. Quality Assurance for Iraqi Bottled Water Specifications

    Directory of Open Access Journals (Sweden)

    May George Kassir

    2015-10-01

    Full Text Available In this research the specifications of Iraqi drinking bottled water brands are investigated throughout the comparison between local brands, Saudi Arabia and the World Health Organization (WHO for bottled water standard specifications. These specifications were also compared to that of Iraqi Tap Water standards. To reveal variations in the specifications for Iraqi bottled water, and above mentioned standards some quality control tools are conducted for more than 33% of different bottled water brands (of different origins such as spring, purified,..etc in Iraq by investigating the selected quality parameters registered on their marketing labels. Results employing Minitab software (ver. 16 to generate X bar, and Pareto chart. It was found from X bar charts that the quality parameters of some drinking bottled water brands are not within Iraqi standards set by the “Central Agency for Standardization and Quality Control” such as pH values, Fe, Na, and Mg concentrations. While the comparison of previously mentioned standard specifications through radar chart many important issues are detected such as the absence of lower limits the whole bottled water quality parameters such as for Na and Mg also the radar chart shows that Iraqi bottled and tap water specifications are almost equal in their quality values. Also the same chart pictured the limited range of Iraqi specifications compared to that of Saudi Arabia, and WHO and the need to introduce other water specifications such as K, Na, etc. This confirms the need to improve Iraqi bottled water specifications since it was introduced on 2000. These results also highlighted the weakness of quality assurance activities since only 33 % of the investigated companies registered the whole water quality specifications as shown in Pareto chart. Other companies do not register any quality characteristics. Also certain companies should be stopped due to non-conforming specifications, yet these companies are

  17. Quality assurance of malaria case management in an urban and in sub-rural health centres in Goma, Congo

    Directory of Open Access Journals (Sweden)

    Prosper M. Lutala

    2011-10-01

    Objectives: Our aim was to assess the quality of malaria case management in two primary health care centres in the Goma health district. Specific objectives were the assessment of quality accuracy in the dosage, the duration of treatment, the intervals between administrations, and the routes of administration of anti-malarial medication in two health centres, as well as the subsequent comparison of those two sites. Method: A descriptive retrospective study was conducted using the malaria register’s review to assess two health centres in the Goma health district. Socio-demographical and clinical data were recorded and the quality was assessed against the national guidelines. Descriptive statistics with percentages and Chi-square values were computed. Results: Under-dosage was more common in CCLK (Centre Chrétien du Lac Kivu [Lake Kivu Christian Centre] with 55 patients (62.5%; 95% CI, 52% – 71.8% patients, whilst the over-dosage was present in 64 patients (80%; 95% CI, 69.9% – 87.2% in CASOP (Caisse de Solidarité Ouvrière et Paysanne [Fund of Solidarity Workers and Peasants]. The duration of treatment was shorter in CCLK in 15 patients (93.7%; 95% CI, 71.6% – 98.8%; CASOP had a high rate of inappropriate intervals between the administration of drugs in 14 patients (82.3%; 95% CI, 58.9% – 93.8%. Intravenous administration rates were high in both sites with respectively 102 patients in CASOP (62.5%; 95% CI, 54.9% – 69.6% and 61 patients in CCLK (37.4%; 95% CI, 30.3% – 45.0%. Significant differences were found between the two sites with regard to intervals of administration (χ2 = 7.11, p = 0.007, duration of treatment (χ2 = 8.51, p = 0.003, dosage (χ2 = 3.91, p = 0.05. The routes of administration were used in a similar manner, however, in the two sites (χ2 = 0.78, p = 0.37. Conclusion: Abnormalities in dosage, in the duration of treatment, in the intervals between administration and in the routes of administration were found in both sites

  18. Quality assurance of malaria case management in an urban and in sub-rural health centres in Goma, Congo

    Science.gov (United States)

    Kasereka, Claude M.; Kasagila, Eric K.; Inipavudu, John B.; Toranke, Suleiman I.

    2011-01-01

    Abstract Background Every year, up to three million deaths throughout the world occur as a result of malaria, 90% of which occur in Africa. Despite training providers in malaria case management and the availability of appropriate medical suppliers, there are still weaknesses in the management chain of malaria. Objectives Our aim was to assess the quality of malaria case management in two primary health care centres in the Goma health district. Specific objectives were the assessment of quality accuracy in the dosage, the duration of treatment, the intervals between administrations, and the routes of administration of anti-malarial medication in two health centres, as well as the subsequent comparison of those two sites. Method A descriptive retrospective study was conducted using the malaria register's review to assess two health centres in the Goma health district. Socio-demographical and clinical data were recorded and the quality was assessed against the national guidelines. Descriptive statistics with percentages and Chi-square values were computed. Results Under-dosage was more common in CCLK (Centre Chrétien du Lac Kivu [Lake Kivu Christian Centre]) with 55 patients (62.5%; 95% CI, 52% – 71.8%) patients, whilst the over-dosage was present in 64 patients (80%; 95% CI, 69.9% – 87.2%) in CASOP (Caisse de Solidarité Ouvrière et Paysanne [Fund of Solidarity Workers and Peasants]). The duration of treatment was shorter in CCLK in 15 patients (93.7%; 95% CI, 71.6% – 98.8%); CASOP had a high rate of inappropriate intervals between the administration of drugs in 14 patients (82.3%; 95% CI, 58.9% – 93.8%). Intravenous administration rates were high in both sites with respectively 102 patients in CASOP (62.5%; 95% CI, 54.9% – 69.6%) and 61 patients in CCLK (37.4%; 95% CI, 30.3% – 45.0%). Significant differences were found between the two sites with regard to intervals of administration (χ2 = 7.11, p = 0.007), duration of treatment (χ2 = 8.51, p = 0

  19. Caregivers in older peoples' care: perception of quality of care, working conditions, competence and personal health.

    Science.gov (United States)

    From, Ingrid; Nordström, Gun; Wilde-Larsson, Bodil; Johansson, Inger

    2013-09-01

    The aim was to describe and compare nursing assistants', enrolled nurses' and registered nurses' perceptions of quality of care, working conditions, competence and personal health in older peoples' care. Altogether 70 nursing assistants, 163 enrolled nurses and 198 registered nurses completed a questionnaire comprising Quality from the Patient's Perspective modified for caregivers, Creative Climate Questionnaire, Stress of Conscience Questionnaire, items on education and competence and Health Index. The caregivers reported higher perceived reality of quality of care in medical-technical competence and physical-technical conditions than in identity-oriented approach and socio-cultural atmosphere. In subjective importance, the highest rating was assessed in one of the physical-technical items. The organisational climate was for three of the dimensions rather close/reached the value for a creative climate, for seven dimensions close to a stagnant climate. In perceived stress of conscience, there were low values. Nursing assistants had lower values than enrolled nurses and registered nurses. The caregivers reported highest values regarding previous education making them feel safe at work and lowest value on the item about education increasing the ability for a scientific attitude. Registered nurses could use knowledge in practice and to a higher degree than nursing assistants/enrolled nurses reported a need to gain knowledge, but the latter more often received education during working hours. The health index among caregivers was high, but registered nurses scored lower on emotional well-being than nursing assistants/enrolled nurses. The caregivers' different perceptions of quality of care and work climate need further attention. Although stress of conscience was low, it is important to acknowledge what affected the caregivers work in a negative way. Attention should be paid to the greater need for competence development among registered nurses during working hours.

  20. Quality assessment of child care services in primary health care settings of Central Karnataka (Davangere District

    Directory of Open Access Journals (Sweden)

    Rashmi

    2010-01-01

    Full Text Available Background: Infectious disease and malnutrition are common in children. Primary health care came into being to decrease the morbidity. Quality assessment is neither clinical research nor technology assessment. It is primarily an administrative device used to monitor performance to determine whether it continues to remain within acceptable bounds. Aims and Objectives: To assess the quality of service in the delivery of child health care in a primary health care setting. To evaluate client satisfaction. To assess utilization of facilities by the community. Materials and Methods: Study Type: Cross-sectional community-based study. Quality assessment was done by taking 30-50%, of the service provider. Client satisfaction was determined with 1 Immunization and child examination-90 clients each. Utilization of services was assessed among 478 households. Statistical Analysis: Proportions, Likert′s scale to grade the services and Chi-square. Results: Immunization service: Identification of needed vaccine, preparation and care was average. Vaccination technique, documentation, EPI education, maintenance of cold chain and supplies were excellent. Client satisfaction was good. Growth monitoring: It was excellent except for mother′s education andoutreach educational session . Acute respiratory tract infection care: History, physical examination, ARI education were poor. Classification, treatment and referral were excellent. Client satisfaction was good. Diarrheal disease care: History taking was excellent. But examination, classification, treatment, ORT education were poor. Conclusion: Mothers education was not stressed by service providers. Service providers′ knowledge do not go with the quality of service rendered. Physical examination of the child was not good. Except for immunization other services were average.

  1. Current conceptions of industrial quality assurance

    International Nuclear Information System (INIS)

    Zeller, H.

    1978-01-01

    In the electrical engineering industry quality assurance is mainly oriented in accordance with the customers', users', and consumers' requirements concerning the quality of products (including reliability). These requirements are as manifold as the range of products itself. They do not only comprise functional criteria, but also safety against malfunctions, bodily injury or property damage. Quality assurance is embedded in the overall activities of a company; the peripheral conditions, such as organization, profitability, qualification, and responsibility of staff have to be considered. Thus, quality assurance in the electrical engineering industry proceeds in efficient systems which are adapted to the individual forms of production. These systems may include planning, testing, feedback of quality data, statistical procedures, costs and profitability. Their obvious interaction is based on the system of coordinates of integrated quality control. The paper will illustrate the basic features of this interaction by reference to various examples. (orig.) [de

  2. Quality assurance in ionizing radiation application

    International Nuclear Information System (INIS)

    Rastkhah; Nasser.

    1995-01-01

    Quality assurance is a mean for controlling all the activities within an organization which affect the quality of the product or service. A series of international standards have been prepared which incorporate the accumulated knowledge and provide guidance on what activities within an organization should be controlled. A proposal on a quality assurance system to be implemented in ionizing radiation application centers is the primary concern of Atomic Energy Organization of Iran is represented. The Objectives were identification of quality related problems ;Comply with national and international requirements ;Controlling all activities within an organization which affects the quality and assurance of maintaining the quality within organization. In performing protection measures, risk, cost, benefit consideration, cause of problems and the classic solution are summarized in four chapters

  3. Health care access and quality for persons with disability: Patient and provider recommendations.

    Science.gov (United States)

    McClintock, Heather F; Kurichi, Jibby E; Barg, Frances K; Krueger, Alice; Colletti, Patrice M; Wearing, Krizia A; Bogner, Hillary R

    2018-07-01

    Significant disparities in health care access and quality persist between persons with disabilities (PWD) and persons without disabilities (PWOD). Little research has examined recommendations of patients and providers to improve health care for PWD. We sought to explore patient and health care provider recommendations to improve health care access and quality for PWD through focus groups in the physical world in a community center and in the virtual world in an online community. In all, 17 PWD, 4 PWOD, and 6 health care providers participated in 1 of 5 focus groups. Focus groups were conducted in the virtual world in Second Life ® with Virtual Ability, an online community, and in the physical world at Agape Community Center in Milwaukee, WI. Focus group data were analyzed using a grounded theory methodology. Themes that emerged in focus groups among PWD and PWOD as well as health care providers to improve health care access and quality for PWD were: promoting advocacy, increasing awareness and knowledge, improving communication, addressing assumptions, as well as modifying and creating policy. Many participants discussed political empowerment and engagement as central to health care reform. Both PWD and PWOD as well as health care providers identified common themes potentially important for improving health care for PWD. Patient and health care provider recommendations highlight a need for modification of current paradigms, practices, and approaches to improve the quality of health care provision for PWD. Participants emphasized the need for greater advocacy and political engagement. Copyright © 2018 Elsevier Inc. All rights reserved.

  4. APPROACH TO QUALITY ASSURANCE IN HIGHER EDUCATION

    Directory of Open Access Journals (Sweden)

    Zora Arsovski

    2007-03-01

    Full Text Available Quality assurance in higher education is streamed in two interconnected concepts: (1 quality management according to ISO 9000 and (2 Bologna process. In this paper both concepts are presented, with point on internal state and term plan activities for quality improvement in higher education in Serbia.

  5. Transuranic Waste Characterization Quality Assurance Program Plan

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-04-30

    This quality assurance plan identifies the data necessary, and techniques designed to attain the required quality, to meet the specific data quality objectives associated with the DOE Waste Isolation Pilot Plant (WIPP). This report specifies sampling, waste testing, and analytical methods for transuranic wastes.

  6. Transuranic Waste Characterization Quality Assurance Program Plan

    International Nuclear Information System (INIS)

    1995-01-01

    This quality assurance plan identifies the data necessary, and techniques designed to attain the required quality, to meet the specific data quality objectives associated with the DOE Waste Isolation Pilot Plant (WIPP). This report specifies sampling, waste testing, and analytical methods for transuranic wastes

  7. Developing and Implementing a Quality Assurance Strategy for Electroconvulsive Therapy.

    Science.gov (United States)

    Hollingsworth, Jessa; Baliko, Beverly; McKinney, Selina; Rosenquist, Peter

    2018-04-17

    The literature provides scant guidance in effective quality assurance strategies concerning the use of electroconvulsive therapy (ECT) for the treatment of psychiatric conditions. Numerous guidelines are published that provide guidance in the delivery of care; however, little has been done to determine how a program or facility might ensure compliance to best practice for safety, tolerability, and efficacy in performing ECT. The objective of this project was to create a quality assurance strategy specific to ECT. Determining standards for quality care and clarifying facility policy were key outcomes in establishing an effective quality assurance strategy. An audit tool was developed utilizing quality criteria derived from a systematic review of ECT practice guidelines, peer review, and facility policy. All ECT procedures occurring over a 2-month period of May to June 2017 were retrospectively audited and compared against target compliance rates set for the facility's ECT program. Facility policy was adapted to reflect quality standards, and audit findings were used to inform possible practice change initiatives, were used to create benchmarks for continuous quality monitoring, and were integrated into regular hospital quality meetings. Clarification on standards of care and the use of clinical auditing in ECT was an effective starting point in the development of a quality assurance strategy. Audit findings were successfully integrated into the hospital's overall quality program, and recognition of practice compliance informed areas for future quality development and policy revision in this small community-based hospital in the southeastern United States. This project sets the foundation for a quality assurance strategy that can be used to help monitor procedural safety and guide future improvement efforts in delivering ECT. Although it is just the first step in creating meaningful quality improvement, setting clear standards and identifying areas of greatest

  8. [10 years of external quality assurance in dialysis in Germany: Results and future prospects].

    Science.gov (United States)

    Büchtemann, Dorothea; Meinhold, Stefan; Follert, Peter

    2017-10-01

    In 2006, the Federal Joint Committee introduced a quality assurance programme for ambulatory dialysis treatment in Germany. Regarding the impact of chronic dialysis treatment on the quality of life of patients and on health care costs, quality assurance in dialysis is considered highly relevant. The directive on Quality Assurance in Dialysis (QSD-RL) established an external quality assurance programme on the basis of the assessment of certain quality parameters combined with an internal quality management system based on benchmarking parameters in all dialysis practices and centres. Data on quality parameters are collected and analysed quarterly. Regional associations of statutory health insurance physicians take responsibility for quality improvement measures and sanctions. This article aims to provide an overview of the development of quality parameters from 2008 to 2015. We analysed the summarised annual quality reports published on the website of the Federal Joint Committee between 2009 and 2016. We present results on the so-called core quality parameters duration and frequency of dialysis sessions (both for haemodialysis patients), wKt/V for peritoneal dialysis patients, and percentage of haemodialysis patients with central venous catheters which has only been measured since 2014. In 2015, 92,000 patients received outpatient dialysis. Between 2008 and 2015, the results for the core quality parameters duration and frequency of haemodialysis improved while the results for wKt/V seemingly show an unfavourable trend. The percentage of patients with central venous catheters appears to be quite high, and thus indicates that there is potential for quality improvement. For the future, the Federal Joint Committee has resolved to merge the quality assurance programmes in dialysis and in kidney transplantation into a newly designed programme that has the potential to follow patients through all stages and kinds of renal replacement therapy and to focus on further aspects

  9. Quality assurance, quality control and quality audit in diagnostic radiology

    International Nuclear Information System (INIS)

    Vassileva, J.

    2009-01-01

    Full text:The lecture aims to present contemporary view of quality assurance in X-Ray diagnosis and its practical realization in Bulgaria. In the lecture the concepts of quality assurance, quality control and clinical audit will be defined and their scope will be considered. An answer of the following questions will be given: why is it necessary to determine the dose of patient in X-ray studies, what is the reference dose level and how it is used for dosimetric quantity which characterized the patient's exposure in X-ray, mammography and CT scans and how they are measured, who conducted the measurement and how to keep the records, what are the variations of doses in identical tests and what defines them? The findings from a national survey of doses in diagnostic radiology, conducted in 2008-2009 and the developed new national reference levels will be presented. The main findings of the first tests of radiological equipment and the future role of quality control as well as the concept of conducting clinical audit and its role in quality assurance are also presented. Quality assurance of the diagnostic process with minimal exposure of patients is a strategic goal whose realization requires understanding, organization and practical action, both nationally and in every hospital. To achieve this the important role of education and training of physicians, radiological technicians and medical physicists is enhanced

  10. Quality Assurance in Higher Education

    OpenAIRE

    Nurdin, Nurdin

    2009-01-01

    Kualitas telah menjadi isu kritis dalam persaingan modern dewasa ini, dan hal itu telah menjadi beban tugas bagi para manager menengah. Dalam tataran abstrak kualitas telah didefinisikan oleh dua pakar penting bidang kualitas yaitu Joseph Juran dan Edward Deming. Mereka berdua telah berhasil menjadikan kualitas sebagai mindset yang berkembang terus dalam kajian managemen, khususnya managemen kualitas. Ouality assurance dalam dunia pendidikan adalah suatu keniscayaan seiring dengan terjadinya ...

  11. Nevada Nuclear Waste Storage Investigations: Quality Assurance Plan

    International Nuclear Information System (INIS)

    1980-08-01

    The Nevada Nuclear Waste Storage Investigations (NNWSI) were established by DOE/NV to evaluate the geohydrologic setting and underground rock masses of the Nevada Test Site (NTS) and contiguous areas to determine whether a suitable site exists for constructing a repository for isolating highly radioactive solid wastes. Since the results of these evaluations will impact possible risks to public health and safety, a quality assurance program which conforms to the criteria given in the Code of Federal Regulations is needed to control the quality aspects of the work. This Quality Assurance Plan (QAP) describes the general quality assurance program for the overall NNWSI project under which the quality assurance programs of the individual participating organizations and support contractors are to operate. The details of how each of these groups will meet the criteria will differ among participating organizations and support contractors, and those details are given in the QAPP's listed in Appendix A. It is the purpose of this plan to show the commonality of quality assurance programs in effect within the project and to define how each element fits into the entire picture to give total quality assurance coverage for the NNWSI Project

  12. Automating linear accelerator quality assurance

    International Nuclear Information System (INIS)

    Eckhause, Tobias; Thorwarth, Ryan; Moran, Jean M.; Al-Hallaq, Hania; Farrey, Karl; Ritter, Timothy; DeMarco, John; Pawlicki, Todd; Kim, Gwe-Ya; Popple, Richard; Sharma, Vijeshwar; Park, SungYong; Perez, Mario; Booth, Jeremy T.

    2015-01-01

    Purpose: The purpose of this study was 2-fold. One purpose was to develop an automated, streamlined quality assurance (QA) program for use by multiple centers. The second purpose was to evaluate machine performance over time for multiple centers using linear accelerator (Linac) log files and electronic portal images. The authors sought to evaluate variations in Linac performance to establish as a reference for other centers. Methods: The authors developed analytical software tools for a QA program using both log files and electronic portal imaging device (EPID) measurements. The first tool is a general analysis tool which can read and visually represent data in the log file. This tool, which can be used to automatically analyze patient treatment or QA log files, examines the files for Linac deviations which exceed thresholds. The second set of tools consists of a test suite of QA fields, a standard phantom, and software to collect information from the log files on deviations from the expected values. The test suite was designed to focus on the mechanical tests of the Linac to include jaw, MLC, and collimator positions during static, IMRT, and volumetric modulated arc therapy delivery. A consortium of eight institutions delivered the test suite at monthly or weekly intervals on each Linac using a standard phantom. The behavior of various components was analyzed for eight TrueBeam Linacs. Results: For the EPID and trajectory log file analysis, all observed deviations which exceeded established thresholds for Linac behavior resulted in a beam hold off. In the absence of an interlock-triggering event, the maximum observed log file deviations between the expected and actual component positions (such as MLC leaves) varied from less than 1% to 26% of published tolerance thresholds. The maximum and standard deviations of the variations due to gantry sag, collimator angle, jaw position, and MLC positions are presented. Gantry sag among Linacs was 0.336 ± 0.072 mm. The

  13. Automating linear accelerator quality assurance

    Energy Technology Data Exchange (ETDEWEB)

    Eckhause, Tobias; Thorwarth, Ryan; Moran, Jean M., E-mail: jmmoran@med.umich.edu [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan 48109-5010 (United States); Al-Hallaq, Hania; Farrey, Karl [Department of Radiation Oncology and Cellular Oncology, The University of Chicago, Chicago, Illinois 60637 (United States); Ritter, Timothy [Ann Arbor VA Medical Center, Ann Arbor, Michigan 48109 (United States); DeMarco, John [Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, California, 90048 (United States); Pawlicki, Todd; Kim, Gwe-Ya [UCSD Medical Center, La Jolla, California 92093 (United States); Popple, Richard [Department of Radiation Oncology, University of Alabama Birmingham, Birmingham, Alabama 35249 (United States); Sharma, Vijeshwar; Park, SungYong [Karmanos Cancer Institute, McLaren-Flint, Flint, Michigan 48532 (United States); Perez, Mario; Booth, Jeremy T. [Royal North Shore Hospital, Sydney, NSW 2065 (Australia)

    2015-10-15

    Purpose: The purpose of this study was 2-fold. One purpose was to develop an automated, streamlined quality assurance (QA) program for use by multiple centers. The second purpose was to evaluate machine performance over time for multiple centers using linear accelerator (Linac) log files and electronic portal images. The authors sought to evaluate variations in Linac performance to establish as a reference for other centers. Methods: The authors developed analytical software tools for a QA program using both log files and electronic portal imaging device (EPID) measurements. The first tool is a general analysis tool which can read and visually represent data in the log file. This tool, which can be used to automatically analyze patient treatment or QA log files, examines the files for Linac deviations which exceed thresholds. The second set of tools consists of a test suite of QA fields, a standard phantom, and software to collect information from the log files on deviations from the expected values. The test suite was designed to focus on the mechanical tests of the Linac to include jaw, MLC, and collimator positions during static, IMRT, and volumetric modulated arc therapy delivery. A consortium of eight institutions delivered the test suite at monthly or weekly intervals on each Linac using a standard phantom. The behavior of various components was analyzed for eight TrueBeam Linacs. Results: For the EPID and trajectory log file analysis, all observed deviations which exceeded established thresholds for Linac behavior resulted in a beam hold off. In the absence of an interlock-triggering event, the maximum observed log file deviations between the expected and actual component positions (such as MLC leaves) varied from less than 1% to 26% of published tolerance thresholds. The maximum and standard deviations of the variations due to gantry sag, collimator angle, jaw position, and MLC positions are presented. Gantry sag among Linacs was 0.336 ± 0.072 mm. The

  14. Prototype international quality assurance program

    International Nuclear Information System (INIS)

    Broadway, J.A.; Chambless, D.A.; Sapozhnikov, Yu.A.; Kalmykov, S.N.

    1998-01-01

    The international community presently lacks the ability to determine the quality and credibility of environmental measurements that is required to make sound decisions in matters related to international security, public health, and investment-related considerations. The ultimate goal of the work described in this article is to develop a credible information base including measurement capability for determination of environmental contamination and the potential for proliferation of material components of chemical or nuclear weapons. This study compared the accuracy obtained by six Russian and six U.S. laboratories for samples representative of classes of trace metals, dioxing-furans, and radioactive substances. The results obtained in this work indicate that current estimates for laboratory accuracy are likely overly optimistic. The weaknesses discovered by this prototype U.S. - Russia study also exist within the broader international community of laboratories. Further work is proposed to address the urgent need for the international community to improve performance evaluations for analytical measurements. (author)

  15. Quality of drug prescription in primary health care facilities in ...

    African Journals Online (AJOL)

    DR Marwa

    north-western Tanzania. GIVENESS ... Background: Drug therapy can improve a patient's quality of life and health outcomes if only used properly. .... Irrational use of drugs occurs in all countries and causes harm to people (El Mahalli 2012).

  16. Quality assurance in dental radiology

    International Nuclear Information System (INIS)

    Lorber, C.G.

    1992-01-01

    The quality criteria that have determined and the quality optimization measures defined have to regularly checked in order to guarantee the quality standards. The quality control programme is laid down in the publiction of the WHO (ISO 3534-1977), referring to the quality control of equipment, film processing techniques, and to the qualification of the medical and technical personnel. (DG) [de

  17. Improving the Quality of Home Health Care for Children With Medical Complexity.

    Science.gov (United States)

    Nageswaran, Savithri; Golden, Shannon L

    2017-08-01

    The objectives of this study are to describe the quality of home health care services for children with medical complexity, identify barriers to delivering optimal home health care, and discuss potential solutions to improve home health care delivery. In this qualitative study, we conducted 20 semistructured in-depth interviews with primary caregivers of children with medical complexity, and 4 focus groups with 18 home health nurses. During an iterative analysis process, we identified themes related to quality of home health care. There is substantial variability between home health nurses in the delivery of home health care to children. Lack of skills in nurses is common and has serious negative health consequences for children with medical complexity, including hospitalizations, emergency room visits, and need for medical procedures. Inadequate home health care also contributes to caregiver burden. A major barrier to delivering optimal home health care is the lack of training of home health nurses in pediatric care and technology use. Potential solutions for improving care include home health agencies training nurses in the care of children with medical complexity, support for nurses in clinical problem solving, and reimbursement for training nurses in pediatric home care. Caregiver-level interventions includes preparation of caregivers about: providing medical care for their children at home and addressing problems with home health care services. There are problems in the quality of home health care delivered to children with medical complexity. Training nurses in the care of children with medical complexity and preparing caregivers about home care could improve home health care quality. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  18. Quality assurance in the fuel fabrication

    International Nuclear Information System (INIS)

    Darmayan, P.

    1995-01-01

    The paper concentrates on the evolutions that FBFC Franco Belge de Fabrication de Combustible has initiated in order to make a further step in improving quality: 1. Improving each personnel's involment and responsability towards quality. 2. Incorporating quality assurance in a total quality management policy, involving both the fabrication teams of FBFC and the design teams of Framatome in order to improve quality. (orig./HP)

  19. [Topic identification for cross-sectoral quality assurance in stroke and TIA treatment].

    Science.gov (United States)

    Meyer, Sven; Willms, Gerald; Broge, Björn; Szecsenyi, Joachim

    2016-10-01

    The development of cross-sectoral quality assurance programs usually requires extensive topic identification. Illustrated by the complex processes of care for stroke and transient ischemic attacks (TIAs), a method for comprehensive topic identification is presented. The first step involves a thorough literature search in terms of systematic reviews, health technology assessments, guidelines, studies into healthcare delivery and the use of specific instruments. Routine data as well as epidemiologic studies are used to analyze the reality of service provision. In addition, experts are consulted to gain expertise concerning deficits of care, approaches to quality assurance and experience with existing quality assurance programs. Furthermore individual patient experiences are collected to add the patients' perceptions of care. Because of the limitation on the regulatory scope of Book V of the German Social Code, which, in this case, was necessary, another source of information was the legal framework and its impact on rescue chain, acute treatment and rehabilitation. Existent quality management systems, accreditations and quality assurance programs in prevention, acute treatment and rehabilitation have been searched in order to avoid any overlap with existing measures. After identifying a total of 71 quality targets according to deficits of care, recommendations for care and expert opinions in primary and secondary prevention, rescue chain, acute treatment, rehabilitation and supply of assistive equipment and therapies, respectively, the usability of instruments was tested. These instruments included case documentation, patient surveys and routine data. 14 quality targets proved to be reproducible by these instruments and were included in the recommendations for a cross-sectoral quality assurance program for stroke and TIA. Copyright © 2016. Published by Elsevier GmbH.

  20. Nuclear quality assurance operating philosophy: A quality-oriented approach

    International Nuclear Information System (INIS)

    Corcoran, W.R.; Geiger, J.E.; Heibel, R.E.; Cotton, J.B.; Sabol, A.R.

    1992-01-01

    Quality assurance programs have been part of the nuclear utility management process since the publication of the draft of 10CFR50 Appendix B in the late 1960s. The unwritten operational philosophy of nuclear quality assurance organizations focused on compliance with federal regulations. Adverse experiences, including operational events and extended shutdowns, prompted the gradual adoption of isolated practices extending beyond compliance orientation. These practices have an orientation that accommodates a definition of quality, a perspective of the role of nuclear quality assurance organizations in the overall concept of defense-in-depth, a definition of the segments of the nuclear quality assurance mission, and recent advances in the understanding of self-assessment. Observation of these practices at various nuclear utilities resulted in a syntheses of practices and approaches into a coherent quality-oriented nuclear quality assurance operating philosophy that is not totally adopted at any one utility

  1. Chronic care model in primary care: can it improve health-related quality of life?

    Directory of Open Access Journals (Sweden)

    Aryani FMY

    2016-01-01

    Full Text Available Faridah Md Yusof Aryani,1 Shaun Wen Huey Lee,2 Siew Siang Chua,3 Li Ching Kok,4 Benny Efendie,2 Thomas Paraidathathu5 1Pharmaceutical Services Division, Ministry of Health Malaysia, Petaling Jaya, 2School of Pharmacy, Monash University Malaysia, Bandar Sunway, 3Department of Pharmacy, Faculty of Medicine, University of Malaya, 4Clinical Research Centre, Kuala Lumpur Hospital, Kuala Lumpur, 5School of Pharmacy, Taylor’s University, Subang Jaya, Selangor, Malaysia Purpose: Chronic diseases such as hypertension, diabetes mellitus, and hyperlipidemia are public health concerns. However, little is known about how these affect patient-level health measures. The aim of the study was to examine the impact of a chronic care model (CCM on the participant’s health-related quality of life (QoL. Patients and methods: Participants received either usual care or CCM by a team of health care professionals including pharmacists, nurses, dietitians, and general practitioners. The participants in the intervention group received medication counseling, adherence, and dietary advice from the health care team. The QoL was measured using the EQ-5D (EuroQoL-five dimension, health-related quality of life questionnaire and comparison was made between usual care and intervention groups at the beginning and end of the study at 6 months. Results: Mean (standard deviation EQ-5D index scores improved significantly in the intervention group (0.92±0.10 vs 0.95±0.08; P≤0.01, but not in the usual care group (0.94±0.09 vs 0.95±0.09; P=0.084. Similarly, more participants in the intervention group reported improvements in their QoL compared with the usual care group, especially in the pain/discomfort and anxiety/depression dimensions. Conclusion: The implementation of the CCM resulted in significant improvement in QoL. An interdisciplinary team CCM approach should be encouraged, to ultimately result in behavior changes and improve the QoL of the patients. Keywords: diabetes

  2. Technical Limitations of Electronic Health Records in Community Health Centers: Implications on Ambulatory Care Quality

    Science.gov (United States)

    West, Christopher E.

    2010-01-01

    Research objectives: This dissertation examines the state of development of each of the eight core electronic health record (EHR) functionalities as described by the IOM and describes how the current state of these functionalities limit quality improvement efforts in ambulatory care settings. There is a great deal of literature describing both the…

  3. Quality and Safety in Health Care, Part I: Five Pioneers in Quality.

    Science.gov (United States)

    Harolds, Jay

    2015-08-01

    Five pioneers had a huge impact on the quality movement in health care in the United States. Ernest Codman contributed in many ways, including his focus on outcome analysis. Avidis Donabedian is known for his focus on the 3 domains of structure, process, and outcome in health care. Walter Shewhart is known especially for the control chart and early work on what W. Edwards Deming made into the PDSA cycle. Deming is also known for other contributions, including his 14 points of management, correcting system problems rather than blaming the workers, and his System of Profound Knowledge. Juran is known for the Pareto principle and his emphasis on customer satisfaction and addressing the human, not just statistical side, of quality improvement.

  4. The effect of financial incentives on the quality of health care provided by primary care physicians.

    Science.gov (United States)

    Scott, Anthony; Sivey, Peter; Ait Ouakrim, Driss; Willenberg, Lisa; Naccarella, Lucio; Furler, John; Young, Doris

    2011-09-07

    The use of blended payment schemes in primary care, including the use of financial incentives to directly reward 'performance' and 'quality' is increasing in a number of countries. There are many examples in the US, and the Quality and Outcomes Framework (QoF) for general practitioners (GPs) in the UK is an example of a major system-wide reform. Despite the popularity of these schemes, there is currently little rigorous evidence of their success in improving the quality of primary health care, or of whether such an approach is cost-effective relative to other ways to improve the quality of care. The aim of this review is to examine the effect of changes in the method and level of payment on the quality of care provided by primary care physicians (PCPs) and to identify:i) the different types of financial incentives that have improved quality;ii) the characteristics of patient populations for whom quality of care has been improved by financial incentives; andiii) the characteristics of PCPs who have responded to financial incentives. We searched the Cochrane Effective Practice and Organisation of Care (EPOC) Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL) and Cochrane Database of Systematic Reviews (CDSR) (The Cochrane Library), MEDLINE, HealthSTAR, EMBASE, CINAHL, PsychLIT, and ECONLIT. Searches of Internet-based economics and health economics working paper collections were also conducted. Finally, studies were identified through the reference lists of retrieved articles, websites of key organisations, and from direct contact with key authors in the field. Articles were included if they were published from 2000 to August 2009. Randomised controlled trials (RCT), controlled before and after studies (CBA), and interrupted time series analyses (ITS) evaluating the impact of different financial interventions on the quality of care delivered by primary healthcare physicians (PCPs). Quality of care was defined as patient reported outcome

  5. Guidelines for the introduction of a quality assurance programme in a diagnostic imaging department

    International Nuclear Information System (INIS)

    1992-01-01

    Radiographers, whether they practice in the National Health Service (NHS) or other health care systems, always strive to deliver a high quality service for their patients. The profession and its members work hard to maintain and improve standards of patient care and technical accuracy. Why then does the College of Radiographers feel it necessary to publish Quality Assurance Guidelines? The answer lies in the greater awareness that the best possible service provision requires every part of the whole service to be performing as well as it possibly can. To be sure these individual parts are achieving this goal requires that we set standards for them and monitor and reassess them regularly. The quality of an individual's or a system's performance cannot be defined in absolute terms, although this is how many people would see it. There are too many variables, some of which cannot be controlled. Instead, we must define quality as the ability to perform the required task to set standards, given the prevailing conditions and existing resources. In radiography we can assure quality by being sure that those factors over which we have control are optimised. The College of Radiographers Working Party on Quality Assurance was formed in response to members' concerns about the requirements of professionalism and legislation with regard to quality assurance. Members were confused by the approach to quality management issues, standard setting, monitoring, evaluation and the required record keeping. Work began on a comprehensive publication centred on the quality assurance of radiographic processes. However, the College felt there was danger in following a well trodden path, particularly as the passing months saw the release of a series of related publications from various sources pre-emptying the efforts of the Working Party. Ultimately, the original remit was considered to hold greater promise - a set of guidelines for the quality management of the whole of our service delivery

  6. A Comparison of the Audit and Accreditation Tools Used By The Health Care Financing Administration, The Texas Department of Insurance, and The National Committee on Quality Assurance: The Cost of Multi-Agency Oversight on Medicare+Choice Plans in Texas

    Science.gov (United States)

    2001-04-12

    Comparison of Oversight Models in Managed Care 1 Running Head: Comparison of Oversight Models in Managed Care A Comparison of the Audit and...TITLE AND SUBTITLE A Comparison of the Audit and Accreditation Tools Used By The Health Care Financing Administration, The Texas Department of...Comparison of Oversight Models in Managed Care 5 A Comparison of the Audit and Accreditation Tools Used By The Health Care Financing

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

    Science.gov (United States)

    Roche, B G; Sommer, C

    1995-01-01

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

  8. 10 CFR 63.142 - Quality assurance criteria.

    Science.gov (United States)

    2010-01-01

    ... planned and periodic audits to verify compliance with all aspects of the quality assurance program and to... 10 Energy 2 2010-01-01 2010-01-01 false Quality assurance criteria. 63.142 Section 63.142 Energy... REPOSITORY AT YUCCA MOUNTAIN, NEVADA Quality Assurance § 63.142 Quality assurance criteria. (a) Introduction...

  9. Quality assurance of qualitative research: a review of the discourse.

    Science.gov (United States)

    Reynolds, Joanna; Kizito, James; Ezumah, Nkoli; Mangesho, Peter; Allen, Elizabeth; Chandler, Clare

    2011-12-19

    Increasing demand for qualitative research within global health has emerged alongside increasing demand for demonstration of quality of research, in line with the evidence-based model of medicine. In quantitative health sciences research, in particular clinical trials, there exist clear and widely-recognised guidelines for conducting quality assurance of research. However, no comparable guidelines exist for qualitative research and although there are long-standing debates on what constitutes 'quality' in qualitative research, the concept of 'quality assurance' has not been explored widely. In acknowledgement of this gap, we sought to review discourses around quality assurance of qualitative research, as a first step towards developing guidance. A range of databases, journals and grey literature sources were searched, and papers were included if they explicitly addressed quality assurance within a qualitative paradigm. A meta-narrative approach was used to review and synthesise the literature. Among the 37 papers included in the review, two dominant narratives were interpreted from the literature, reflecting contrasting approaches to quality assurance. The first focuses on demonstrating quality within research outputs; the second focuses on principles for quality practice throughout the research process. The second narrative appears to offer an approach to quality assurance that befits the values of qualitative research, emphasising the need to consider quality throughout the research process. The paper identifies the strengths of the approaches represented in each narrative and recommend these are brought together in the development of a flexible framework to help qualitative researchers to define, apply and demonstrate principles of quality in their research. © 2011 Reynolds et al; licensee BioMed Central Ltd.

  10. Quality assurance of qualitative research: a review of the discourse

    Science.gov (United States)

    2011-01-01

    Background Increasing demand for qualitative research within global health has emerged alongside increasing demand for demonstration of quality of research, in line with the evidence-based model of medicine. In quantitative health sciences research, in particular clinical trials, there exist clear and widely-recognised guidelines for conducting quality assurance of research. However, no comparable guidelines exist for qualitative research and although there are long-standing debates on what constitutes 'quality' in qualitative research, the concept of 'quality assurance' has not been explored widely. In acknowledgement of this gap, we sought to review discourses around quality assurance of qualitative research, as a first step towards developing guidance. Methods A range of databases, journals and grey literature sources were searched, and papers were included if they explicitly addressed quality assurance within a qualitative paradigm. A meta-narrative approach was used to review and synthesise the literature. Results Among the 37 papers included in the review, two dominant narratives were interpreted from the literature, reflecting contrasting approaches to quality assurance. The first focuses on demonstrating quality within research outputs; the second focuses on principles for quality practice throughout the research process. The second narrative appears to offer an approach to quality assurance that befits the values of qualitative research, emphasising the need to consider quality throughout the research process. Conclusions The paper identifies the strengths of the approaches represented in each narrative and recommend these are brought together in the development of a flexible framework to help qualitative researchers to define, apply and demonstrate principles of quality in their research. PMID:22182674

  11. Quality assurance of qualitative research: a review of the discourse

    Directory of Open Access Journals (Sweden)

    Reynolds Joanna

    2011-12-01

    Full Text Available Abstract Background Increasing demand for qualitative research within global health has emerged alongside increasing demand for demonstration of quality of research, in line with the evidence-based model of medicine. In quantitative health sciences research, in particular clinical trials, there exist clear and widely-recognised guidelines for conducting quality assurance of research. However, no comparable guidelines exist for qualitative research and although there are long-standing debates on what constitutes 'quality' in qualitative research, the concept of 'quality assurance' has not been explored widely. In acknowledgement of this gap, we sought to review discourses around quality assurance of qualitative research, as a first step towards developing guidance. Methods A range of databases, journals and grey literature sources were searched, and papers were included if they explicitly addressed quality assurance within a qualitative paradigm. A meta-narrative approach was used to review and synthesise the literature. Results Among the 37 papers included in the review, two dominant narratives were interpreted from the literature, reflecting contrasting approaches to quality assurance. The first focuses on demonstrating quality within research outputs; the second focuses on principles for quality practice throughout the research process. The second narrative appears to offer an approach to quality assurance that befits the values of qualitative research, emphasising the need to consider quality throughout the research process. Conclusions The paper identifies the strengths of the approaches represented in each narrative and recommend these are brought together in the development of a flexible framework to help qualitative researchers to define, apply and demonstrate principles of quality in their research.

  12. Quality assurance system in nuclear engineering

    International Nuclear Information System (INIS)

    Adams, H.W.; Hoensch, V.

    1985-01-01

    Due to the close connection between the German Atomic Energy Law and the nuclear control regulations, quality systems in nuclear engineering have taken on a special form. Quality assurance systems as a stipulated organisation of structure and procedure to assure quality have implications for the organisation of the electric supply company at the planning, erection and commissioning stage and for the organisation of the nuclear power station facility. To supervise the application and effectiveness of the stipulated organisation of structure and procedure internally and externally among contractors, special organisation units have been set up at the plant suppliers, manufactures, electric supply companies and nuclear power station facilities, which in the electric supply field go by the name of Quality Assurance Supervision. (orig.) [de

  13. Hanford Tanks Initiative quality assurance implementation plan

    International Nuclear Information System (INIS)

    Huston, J.J.

    1998-01-01

    Hanford Tanks Initiative (HTI) Quality Assurance Implementation Plan for Nuclear Facilities defines the controls for the products and activities developed by HTI. Project Hanford Management Contract (PHMC) Quality Assurance Program Description (QAPD)(HNF-PRO599) is the document that defines the quality requirements for Nuclear Facilities. The QAPD provides direction for compliance to 10 CFR 830.120 Nuclear Safety Management, Quality Assurance Requirements. Hanford Tanks Initiative (HTI) is a five-year activity resulting from the technical and financial partnership of the US Department of Energy's Office of Waste Management (EM-30), and Office of Science and Technology Development (EM-50). HTI will develop and demonstrate technologies and processes for characterization and retrieval of single shell tank waste. Activities and products associated with HTI consist of engineering, construction, procurement, closure, retrieval, characterization, and safety and licensing

  14. Repository construction management and quality assurance

    International Nuclear Information System (INIS)

    Hood, F.C.

    1984-01-01

    An emphasis on preventive rather than reactive management is key to an efficient construction management operation. Development of contingency plans to deal with unexpected adverse conditions, e.g., brine pockets during mining operations, are an integral part of the management program to ensure project safety, quality, cost, schedule and environmental objectives are met. A viable quality assurance program with active management support will optimize management effectiveness in reaching project goals. With adequate planning and perceptive application of the proper management controls, Quality Assurance becomes an essential ingredient for efficiently managing a job because it has been built into the management system rather than being an uninvolved peripheral entity. 6 references, 3 figures

  15. Nuclear powerplant functions: quality assurance, construction

    International Nuclear Information System (INIS)

    Karpa, P.

    1984-01-01

    The author proposes that multilayer Quality Control is burdensome and ineffective. He proposes that the earlier approaches of having responsible field engineers back on the job site instead of at a home office be reinitiated to speed up necessary design changes and hold down costs. It is then the job of the quality control personnel to assure that the field engineer is doing his job. The idea of using the reactor start-up process as part of the quality assurance program is also proposed. Also discussed is the idea of Operating License Contracts or One Step Licensing Approach

  16. Psychosocial work conditions and quality of life among primary health care employees: a cross sectional study

    OpenAIRE

    Teles, Mariza Alves Barbosa; Barbosa, Mirna Rossi; Vargas, Andréa Maria Duarte; Gomes, Viviane Elizângela; e Ferreira, Efigênia Ferreira; Martins, Andréa Maria Eleutério de Barros Lima; Ferreira, Raquel Conceição

    2014-01-01

    Background Workers in Primary Health Care are often exposed to stressful conditions at work. This study investigated the association between adverse psychosocial work conditions and poor quality of life among Primary Health Care workers. Methods This cross-sectional study included all 797 Primary Health Care workers of a medium-sized city, Brazil: doctors, nurses, nursing technicians and nursing assistants, dentists, oral health technicians, and auxiliary oral hygienists, and community health...

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

    Science.gov (United States)

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

    2014-08-01

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

  18. External quality assessment in gynaecological cytology: The Trent Region experience. The Trent Regional Gynaecological Pathology Quality Assurance Group for the National Health Service Cervical Screening Programme.

    Science.gov (United States)

    Slater, D N; Hewer, E M; Melling, S E; Rice, S

    2002-08-01

    A Department of Health Executive Letter stated in 1998 that the principal function of external quality assessment (EQA) is educational. Subsequently, in England, it has no longer been acceptable to assess performance in gynaecological cytology by proficiency testing. This paper describes the EQA scheme in gynaecological cytology that has been run by the Trent Regional Gynaecological Pathology Quality Assurance Group for the NHS Cervical Screening Programme (NHSCSP) since 1998. It conforms as closely as possible to the recommendations published by the Department of Health Working Group on Histopathology EQA Accreditation, and replaced the national proficiency testing protocol. The educational value of the scheme is derived predominantly from a numerical score which provides confidential and quantitative feedback to all participants. Personal performance monitoring occurs as a secondary function. For primary screeners and checkers, this is based purely on the distinction between negative, inadequate and abnormal smears. For pathologists, personal performance monitoring also includes grading of abnormalities. The EQA has been designed so that all professional groups participate in a manner that closely mimics normal practice. Only slides that have achieved an 80% consensus amongst participants are used in the EQA. Substandard performance has been defined as those participants with scores falling below the 2.5%ile. The paper describes the EQA in detail and illustrates its use by means of the second round results. The EQA protocol developed within Trent and described in this paper has contributed to proposals contained in the current national EQA in gynaecological cytology for the NHSCSP. In particular this paper highlights the effectiveness of the scoring system contained within the Trent and National EQA protocols.

  19. [The importance of an early accompanying evaluation of new care forms for the development of indicators for quality assurance in outpatient psychiatric integrated care].

    Science.gov (United States)

    Hausen, A; Glaeske, G

    2015-05-01

    Aim of this contribution is to illustrate the imp-ortance of an early accompanying evaluation of new care forms for the development of indicators. The illustration uses the experience of the accompanying evaluation of the integrated care model for optimisation of outpatient psychiatric care. For the integrated care model we could develop potential indicators by using medical-psychiatric and insured-related routine data, but all potential indicators need further development to enable reliable statements about achieved quality targets. It is shown that the development of indicators in the outpatient psychiatric integrated care is affected by many different factors such as vague target agreements in the contract and missing contractual agreements for the data. As a result it is illustrated that in this project the evaluation was introduced after implementation of this new form of care and the already established contract and the data management impeded the development of indicators. © Georg Thieme Verlag KG Stuttgart · New York.

  20. APPLICATION OF LOT QUALITY ASSURANCE SAMPLING FOR ASSESSING DISEASE CONTROL PROGRAMMES - EXAMINATION OF SOME METHODOLOGICAL ISSUES

    OpenAIRE

    T. R. RAMESH RAO

    2011-01-01

    Lot Quality Assurance Sampling (LQAS), a statistical tool in industrial setup, has been in use since 1980 for monitoring and evaluation of programs on disease control / immunization status among children / health workers performance in health system. While conducting LQAS in the field, there are occasions, even after due care of design, there are practical and methodological issues to be addressed before it is recommended for implementation and intervention. LQAS is applied under the assumpti...

  1. Application of WHOQOL-BREF in measuring quality of life in health-care staff

    Directory of Open Access Journals (Sweden)

    Ali Gholami

    2013-01-01

    Conclusions: The findings from this study confirm that the WHOQOL-BREF questionnaire is a reliable instrument to measure quality of life in health-care staff. From the data, it appears that Neyshabur health-care staff has WHOQOL-BREF scores that might be considered to indicate a relatively moderate quality of life.

  2. A Nursing Interaction Approach to Consumer Internet Training on Quality Health Care

    Science.gov (United States)

    Lesley, Marsha L.; Oermann, Marilyn H.; Vander Wal, Jillon S.

    2004-01-01

    This study examined the effectiveness of using the Internet to teach consumers about quality health care, compared consumer definitions of quality health care prior to and following completion of the Internet experience, and compared ratings of learning, satisfaction and value of the Internet instruction between consumers who completed the…

  3. Automation support for mobile app quality assurance - a tool landscape

    OpenAIRE

    Braun, Susanne; Elberzhager, Frank; Holl, Konstantin

    2017-01-01

    Competitive pressure in app stores, as well as direct and transparent feedback of app store reviews have resulted in an increased demand for outstanding app quality and user experience. At the same time, reduced time-to-market, decreased budgets and time available for quality assurance, and careful user experience design have to be considered. In response, an enormous market for mobile app quality and user experience measurement tools has grown around the mobile app store ecosystems. Develope...

  4. Quality Assurance in University Guidance Services

    Science.gov (United States)

    Simon, Alexandra

    2014-01-01

    In Europe there is no common quality assurance framework for the delivery of guidance in higher education. Using a case study approach in four university career guidance services in England, France and Spain, this article aims to study how quality is implemented in university career guidance services in terms of strategy, standards and models,…

  5. Quality assurance of nuclear medicine instruments

    International Nuclear Information System (INIS)

    Soni, P.S.

    1998-01-01

    Quality assurance in nuclear medicine refers collectively to all aspects of a nuclear medicine programme that may contribute directly or indirectly to the quality of the results obtained. For examples, patients scheduling; preparation and dispensing of radiopharmaceutical; the protection of patients, staff and the general public against radiation hazards and accidents caused by faulty instruments; methodology, data interpretation and record keeping

  6. Ensuring Quality Assurance in Vocational Education

    Science.gov (United States)

    Idialu, Ethel E.

    2013-01-01

    Vocational education emphasises skill acquisition. Quality assurance in vocational education is a concept that is concerned with high performance involving activities with vocational education such as teaching, learning, infrastructures, students' behaviour and the entire academic process. Quality vocational education refers to input and output of…

  7. Supervision and Quality Assurance Strategies in Education ...

    African Journals Online (AJOL)

    This paper examines the need for quality assurance and quality control strategies in improving the effectiveness of educational provision and teacher performance in schools. Governments all over the word in an attempt to educate and develop their citizens spend huge amount of money on teachers and schools but in most ...

  8. Quality assurance for diabetic retinopathy telescreening.

    Science.gov (United States)

    Schneider, S; Aldington, S J; Kohner, E M; Luzio, S; Owens, D R; Schmidt, V; Schuell, H; Zahlmann, G

    2005-06-01

    TOSCA was an EU-Commission supported international research project designed to develop telescreening services in diabetic retinopathy and glaucoma. This paper describes the quality assurance methods developed for the diabetic retinopathy telescreening service within the TOSCA project. The study was performed in 1895 patients with diabetes between 2000 and 2002 at diabetic retinopathy screening sites in five European countries. Data were analysed centrally. Patients attending each clinic's diabetic retinopathy screening service received standardized retinal photography. The images and associated data were transferred electronically to a remote location for grading. Each photographer uploading images and each grader downloading images for assessment was controlled by a systematic quality management approach. The quality assurance measures defined were image quality, intragrader reliability. A cockpit chart was developed for the management and presentation of relevant results and quality measures. For the intragrader reliability tests, 10% of the images were processed for a second grading. An algorithm for calculating differences between repeated gradings was developed. The assessment of image quality for the different sites showed that only 0-0.7% were unassessable. One hundred per cent agreement for both gradings was achieved in 50-85% of graded cases, depending on site and grader, and an agreement better than 95% in 71-100% of cases. A telemedicine-supported quality assurance process is practical and advantageous. The cockpit charts have proven to be useful tools when monitoring the performance of a telescreening service. Grader feedback showed high satisfaction with the quality assurance process.

  9. Quality assurance when refitting - SUSAN example

    International Nuclear Information System (INIS)

    Gautier, R.

    1992-01-01

    The most important points of quality assurance for the realisation of the SUSAN project (special independent system for the dissipation of post-decay heat) at the Muehleberg nuclear power station are discussed in this article. The periodic controls and function tests which have been performed since August 1989, confirm the quality of the products used

  10. Terms and definitions of quality assurance/quality control

    International Nuclear Information System (INIS)

    Kaden, W.

    1980-01-01

    Terms of quality assurance are defined and interpreted. Reference is made to the IAEA Code of Practice and to other important Codes and Standards like ANSI, ASME and KTA. The relevance of these terms to everyday's work and problems of a quality assurance engineer is explained. (orig.)

  11. Health Care Quality: Measuring Obesity in Performance Frameworks.

    Science.gov (United States)

    Zvenyach, Tracy; Pickering, Matthew K

    2017-08-01

    Obesity affects over one-third of Americans and leads to several chronic and costly comorbid conditions. The national movement toward value-based care calls for a refocusing of efforts to address the US obesity epidemic. To help set the stage, the current landscape of obesity-specific quality measures was evaluated. Seven quality measure databases and nine professional societies were searched. Inclusion and exclusion criteria were applied. Measures were then classified by domain and by implementation in national public programs. Eleven obesity-specific quality measures in adults were identified (nine process and two outcome). Three measures received National Quality Forum (NQF) endorsement. Two measures were actively used within Centers for Medicare and Medicaid Services (CMS) programs. Only one measure was both NQF-endorsed and used by CMS. Limitations exist with respect to obesity-specific quality metrics. Such gaps provide opportunities for obesity care specialists to engage and offer valuable insights and pragmatic approaches toward quality measurement. © 2017 The Obesity Society.

  12. Statistical methods in quality assurance

    International Nuclear Information System (INIS)

    Eckhard, W.

    1980-01-01

    During the different phases of a production process - planning, development and design, manufacturing, assembling, etc. - most of the decision rests on a base of statistics, the collection, analysis and interpretation of data. Statistical methods can be thought of as a kit of tools to help to solve problems in the quality functions of the quality loop with respect to produce quality products and to reduce quality costs. Various statistical methods are represented, typical examples for their practical application are demonstrated. (RW)

  13. Implementation and quality monitoring of e-communication across Health care sectors

    DEFF Research Database (Denmark)

    Nicolaisen, Anne; Qvist, Peter

    will identify challenges in e-communication across health care sectors and provide knowledge of the implementation and quality of the Sam:Bo e-communication. Points for discussion: How to improve quality of care using e-communication in general practice in the handover of patients and how to measure it? What......Background: There has been an increased focus on how to improve the quality of care for patients that receives services from more than one sector in the health care system. Continuity in and coordination of patient pathways in the health care system are included in accreditation standards both...... for general practice and hospitals. An important factor for patient-perceived quality of care is the cooperation between the health care sectors that provides services for the patient. In 2009 the Region of Southern Denmark launched a collaboration agreement called Sam:Bo between general practice, hospitals...

  14. Quality Assurance of Chemical Measurements.

    Science.gov (United States)

    Taylor, John K.

    1981-01-01

    Reviews aspects of quality control (methods to control errors) and quality assessment (verification that systems are operating within acceptable limits) including an analytical measurement system, quality control by inspection, control charts, systematic errors, and use of SRMs, materials for which properties are certified by the National Bureau…

  15. Effluent monitoring Quality Assurance Project Plan for radioactive airborne emissions data. Revision 2

    International Nuclear Information System (INIS)

    Frazier, T.P.

    1995-12-01

    This Quality Assurance Project Plan addresses the quality assurance requirements for compiling Hanford Site radioactive airborne emissions data. These data will be reported to the U.S. Environmental Protection Agency, the US Department of Energy, and the Washington State Department of Health. Effluent Monitoring performs compliance assessments on radioactive airborne sampling and monitoring systems. This Quality Assurance Project Plan is prepared in compliance with interim guidelines and specifications. Topics include: project description; project organization and management; quality assurance objectives; sampling procedures; sample custody; calibration procedures; analytical procedures; monitoring and reporting criteria; data reduction, verification, and reporting; internal quality control; performance and system audits; corrective actions; and quality assurance reports

  16. Peer pressure and public reporting within healthcare setting: improving accountability and health care quality in hospitals.

    Science.gov (United States)

    Specchia, Maria Lucia; Veneziano, Maria Assunta; Cadeddu, Chiara; Ferriero, Anna Maria; Capizzi, Silvio; Ricciardi, Walter

    2012-01-01

    In the last few years, the need of public reporting of health outcomes has acquired a great importance. The public release of performance results could be a tool for improving health care quality and many attempts have been made in order to introduce public reporting programs within the health care context at different levels. It would be necessary to promote the introduction of a standardized set of outcome and performance measures in order to improve quality of health care services and to make health care providers aware of the importance of transparency and accountability.

  17. Gastric cancer : staging, treatment, and surgical quality assurance

    NARCIS (Netherlands)

    Dikken, Johannes Leen

    2012-01-01

    Research described in this thesis focuses on several aspects of gastric cancer care: staging and prognostication, multimodality treatment, and surgical quality assurance. PART I - STAGING AND PROGNOSTICATION Cancer staging is one of the fundamental activities in oncology.6,7 For over 50 years, the

  18. The Rockford School of Medicine Undergraduate Quality Assurance Program

    Science.gov (United States)

    Barr, Daniel; And Others

    1976-01-01

    An undergraduate program of ambulatory care quality assurance is described which has been operational at the Rockford School of Medicine for three years. Focus is on involving students in peer review and related audit activities. Results of preliminary evaluation are reported and generalizations offered. (JT)

  19. Health-related quality of life of patients of Brazilian primary health care

    Directory of Open Access Journals (Sweden)

    Bruna de Oliveira Ascef

    2017-11-01

    Full Text Available ABSTRACT OBJECTIVE To analyze the Health-Related Quality of Life (HRQoL of patients of the primary health care of the Brazilian Unified Health System (SUS and its associated factors. METHODS This is a cross-sectional study with data from the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services, 2015. Data were collected with a questionnaire that included the EuroQol 5 Dimensions (EQ-5D instrument. Patients from the five regions of Brazil were interviewed. Multiple linear regression was used to analyze their Health-Related Quality of Life and its associated factors. RESULTS Of the total of 8,590 patients, the most frequent dimensions were pain/discomfort (50.7% and anxiety/depression (38.8%. About 10% of the patients reported extreme problems in these dimensions. The following factors were significantly associated with a worse quality of life: being female; having arthritis, osteoarthritis, or rheumatism; cerebrovascular accident; heart disease; depression; health self-assessment as poor or very poor; drinking alcoholic beverages once or more per month; dieting to lose weight, avoiding salt consumption, and reducing fat intake. Significant association was observed between a better quality of life and: living in the North and Southeast regions of Brazil; practicing physical activities; and having a higher educational level. No association was observed with factors related to the health services. CONCLUSIONS The Health-Related Quality of Life of patients was influenced by demographic and socioeconomic factors that were related to health conditions and lifestyle, being useful to guide specific actions for promoting health and the integral care to patients of the Brazilian Unified Health System.

  20. Quality Improvement in Health Care: The Role of Psychologists and Psychology.

    Science.gov (United States)

    Bonin, Liza

    2018-02-21

    Quality Improvement (QI) is a health care interprofessional team activity wherein psychology as a field and individual psychologists in health care settings can and should adopt a more robust presence. The current article makes the argument for why psychology's participation in QI is good for health care, is good for our profession, and is the right thing to do for the patients and families we serve. It reviews the varied ways individual psychologists and our profession can integrate quality processes and improve health care through: (1) our approach to our daily work; (2) our roles on health care teams and involvement in organizational initiatives; (3) opportunities for teaching and scholarship; and (4) system redesign and advocacy within our health care organizations and health care environment.