WorldWideScience

Sample records for quality improvement activities

  1. IMPROVING QUALITY OF LIFE AT EDERLY PEOPLE, THROUGH GIMN ACTIVITIES

    Directory of Open Access Journals (Sweden)

    Ganciu Mihaela

    2015-10-01

    Full Text Available In light of permanent education, physical education and sports activities should be integrated throughout life. The objective of the research is to improve the quality of life of older people to the initiation of maintenance programs by simple methods, reliable and inexpensive. Therapeutic strategies will be adapted practitioners age, associated diseases, profession. The sample under investigation comprised 30 elderly people who participated in two gymnastics lessons a week and a society dance lesson. Inspection methods that I used: bibliographic study, experimental method, survey method and statistical method - mathematical and graphical representation. Quality of life assessment was done by assessing exercise capacity, the survey method and the call routed. Through a sustained program and rhythmic exercise improves cardiovascular activity, as evidenced by increased exercise capacity by lowering resting heart rate, a major component of cardiovascular disease prevention. Decrease abdominal fat and increased muscle tone abdominal favorable effects on biomechanics of the lumbar spine dynamics can thus be considered to be the prevention of back pain. In summary the study conducted, in order to highlight the benefits of the sport for optimal physical condition and fight aging, it can be concluded that physical activity has a beneficial role for the body, both physically and mentally. Survey conducted among people aged III revealed the following: Practicing the sport of gymnastics in a systematic, consistent results in improving health and fitness as well as comfort, good mood, optimism, improving intellectual activity. In short, we can say that these people the sport of gymnastics has improved quality of life.

  2. Quality improvement.

    Science.gov (United States)

    2014-10-30

    Ready to Lead at tinyurl.com/pd9mmuy is a collection of a short series of articles by senior improvement manager at Healthcare Improvement Scotland Steven Wilson. The collection is aimed at drawing out some of the key behaviours, skills and attributes necessary for successful quality improvement leadership. It is not intended as a comprehensive examination, but offers some alternative and creative ideas about what makes effective quality improvement leaders.

  3. Interacting Patients: The construction of active patientship in quality improvement initiatives

    NARCIS (Netherlands)

    F.D. Vennik (Femke)

    2016-01-01

    markdownabstractThe promotion of active patient participation in healthcare quality improvement projects is an important policy goal in the Netherlands and other Western countries. Healthcare quality improvement is no longer perceived to be an exclusive professional activity; patients, who may be ab

  4. Improvement of nutritional quality and antioxidant activities of yeast ...

    African Journals Online (AJOL)

    Jane

    2011-06-27

    Jun 27, 2011 ... in human diseases. Cancer ... including improving the functional properties of okara protein by acid ... Chemical composition and bioactivity of stale rice were improved by ..... digestion of soybean milk residue (okara). J. Agric.

  5. An Internet-Based Physical Activity Intervention to Improve Quality of Life of Inactive Older Adults

    DEFF Research Database (Denmark)

    Broekhuizen, Karen; de Gelder, Jelle; Wijsman, Carolien A

    2016-01-01

    BACKGROUND: Increasing physical activity is a viable strategy for improving both the health and quality of life of older adults. OBJECTIVE: The aim of this study was to assess if an Internet-based intervention aimed to increase physical activity was effective in improving quality of life...... of inactive older adults. In addition, we analyzed the effect of the intervention on quality of life among those participants who successfully reached their individually targeted increase in daily physical activity as indicated by the intervention program, as well as the dose-response effect of increasing......-worn triaxial accelerometer, respectively. RESULTS: After 3 months, a significant improvement in quality of life was seen in the intervention group compared to the control group for RAND-36 subscales on emotional and mental health (2.52 vs -0.72, respectively; P=.03) and health change (8.99 vs 2...

  6. Active power line conditioners design, simulation and implementation for improving power quality

    CERN Document Server

    Revuelta, Patricio Salmeron; Litrán, Salvador Pérez

    2015-01-01

    Active Power Line Conditioners: Design, Simulation and Implementation for Improving Power Quality presents a rigorous theoretical and practical approach to active power line conditioners, one of the subjects of most interest in the field of power quality. Its broad approach offers a journey that will allow power engineering professionals, researchers, and graduate students to learn more about the latest landmarks on the different APLC configurations for load active compensation. By introducing the issues and equipment needs that arise when correcting the lack of power quality in power grids

  7. 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.

  8. IMPROVING CONCEPTUAL DESIGN QUALITY

    DEFF Research Database (Denmark)

    Bush, Stuart; Robotham, Antony John

    1999-01-01

    This paper will consider how Quality Function Deployment (QFD) and Design for Manufacture and Assembly (DFMA) processes can be used to improve the design quality of products at the concept stage. We appreciate that both QFD and DFMA are techniques that have been used for some time by mature product...... quality is maintained in design project work. The projects described have been carried out with products manufactured by small to medium sized enterprises (SME's), where we have found significant opportunities for product improvement. The quantitative nature of DFMA analysis results allows the novice...... for continuous improvement of their products. However, we consider that if novice designers are able to successfully utilise design tools like QFD and DFMA and achieve improvements in design quality, then SME’s have no excuses for ignoring the benefits they could bring to their own product development activity....

  9. 45 CFR 98.51 - Activities to improve the quality of child care.

    Science.gov (United States)

    2010-10-01

    ...) Activities to improve the quality of child care services may include, but are not limited to: (i) Operating... technical assistance in areas appropriate to the provision of child care services, such as training in... (such as fringe benefits) for full-and part-time staff who provide child care services for which...

  10. Is Physical Activity a Good Way to Improve Quality of Life in the Elder Population?

    Directory of Open Access Journals (Sweden)

    Teresa Bento

    2014-06-01

    Full Text Available Background: Although evidence demonstrates that physical activity beneficially influences major chronic illnesses, older adults remain sedentary. Many interventions to increase physical activity intend to reduce disease complications as well as improve quality of life by enhancing physical function in our even more aging society. Objectives: The purpose of this study was to summarize knowledge on randomized controlled trials studying the effects of physical activity interventions on quality of life in the elder population. Methods: Randomized controlled trials, systematic reviews or meta-analysis were searched in the Pubmed data base. Search terms: “quality of life”, “intervention” and “physical activity” were used to identify English written articles, with humans older than 65 years. Results: From the initial screening of 234 titles, only 5 articles met the inclusion criteria and were included in the final analysis. Conclusions: Physical activity interventions seem to have a slight effect on physical function and in improving quality of life of people aged 65 and over. More intervention studies involving physical activity in older people should include measures of quality of life as primary outcome, as well as a standardization of measures would help to compare results and enlarge the evidence base in this area.

  11. Does physical activity improve quality of life in cancer patients undergoing chemotherapy?

    Science.gov (United States)

    Kripp, Melanie; Heußer, Anna-Lena; Belle, Sebastian; Gerhardt, Axel; Merx, Kirsten; Hofmann, Wolf-Karsten; Hofheinz, Ralf-Dieter

    2015-01-01

    Improved cancer treatments have resulted in prolonged survival. Nevertheless, tumor symptoms and side effects still compromise physical activity and quality of life (QoL). We conducted an anonymous survey among cancer patients undergoing chemotherapy using standardized questionnaires: the 'Freiburger Fragebogen zur körperlichen Aktivität' (Freiburg Questionnaire on Physical Activity) and European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30. Two main questions were addressed: were there differences (1) in physical activity and QoL between patients who do not believe that sport could improve their QoL and those who believe it could (group A vs. B); and (2) in QoL between patients with a total activity (TA) cancer patients undergoing chemotherapy. © 2015 S. Karger GmbH, Freiburg.

  12. Activity cost analysis: a tool to cost medical services and improve quality of care.

    Science.gov (United States)

    Udpa, S

    2001-01-01

    This paper suggests an activity-based cost (ABC) system as the appropriate cost accounting system to measure and control costs under the microstatistical episode of care (EOC) paradigm suggested by D. W. Emery (1999). ABC systems work well in such an environment because they focus on activities performed to provide services in the delivery of care. Thus, under an ABC system it is not only possible to accurately cost episodes of care but also to more effectively monitor and improve the quality of care. Under the ABC system, costs are first traced to activities and then traced from the activities to units of episodic care using cost drivers based on the consumption of activity resources.

  13. Employment of Active Learning at HEIs in Bangladesh to Improve Education Quality

    Science.gov (United States)

    Chowdhury, Faieza

    2016-01-01

    In recent years, education quality and quality assessment have received a great deal of attention at Higher Education Institutions (HEIs) in Bangladesh. Most of the HEIs in Bangladesh face severe resource constraints and find it difficult to improve education quality by improving inputs, such as better infrastructure and modernized classroom…

  14. Driving technology for improving motion quality of active-matrix organic light-emitting diode display

    Science.gov (United States)

    Kim, Jongbin; Kim, Minkoo; Kim, Jong-Man; Kim, Seung-Ryeol; Lee, Seung-Woo

    2014-09-01

    This paper reports transient response characteristics of active-matrix organic light emitting diode (AMOLED) displays for mobile applications. This work reports that the rising responses look like saw-tooth waveform and are not always faster than those of liquid crystal displays. Thus, a driving technology is proposed to improve the rising transient responses of AMOLED based on the overdrive (OD) technology. We modified the OD technology by combining it with a dithering method because the conventional OD method cannot successfully enhance all the rising responses. Our method can improve all the transitions of AMOLED without modifying the conventional gamma architecture of drivers. A new artifact is found when OD is applied to certain transitions. We propose an optimum OD selection method to mitigate the artifact. The implementation results show the proposed technology can successfully improve motion quality of scrolling texts as well as moving pictures in AMOLED displays.

  15. Meeting Resident Scholarly Activity Requirements Through a Longitudinal Quality Improvement Curriculum.

    Science.gov (United States)

    Simasek, Madeline; Ballard, Stephanie L; Phelps, Phillip; Pingul-Ravano, Rowena; Kolb, N Randall; Finkelstein, Alan; Weaver-Agostoni, Jacqueline; Takedai, Teiichi

    2015-03-01

    Quality improvement (QI) skills are learned during residency, yet there are few reports of the scholarly activity outcomes of a QI curriculum in a primary care program. We examined whether scholarly activity can result from a longitudinal, experiential QI curriculum that involves residents, clinic staff, and faculty. The University of Pittsburgh Medical Center Shadyside Family Medicine Residency implemented a required longitudinal outpatient practice improvement rotation (LOPIR) curriculum in 2005. The rotation format includes weekly multidisciplinary work group meetings alternating with resident presentations delivered to the entire program. Residents present the results of a literature review and provide 2 interim project updates to the residency. A completed individual project is required for residency graduation, with project results presented at Residency Research Day. Scholarly activity outcomes of the curriculum were analyzed using descriptive statistics. As of 2014, 60 residents completed 3 years of the LOPIR curriculum. All residents satisfied the 2014 Accreditation Council for Graduate Medical Education (ACGME) scholarly activity and QI requirements with a literature review presentation in postgraduate year 2, and the presentation of a completed QI project at Residency Research Day. Residents have delivered 83 local presentations, 13 state/regional presentations, and 2 national presentations. Residents received 7 awards for QI posters, as well as 3 grants totaling $21,639. The educational program required no additional curriculum time, few resources, and was acceptable to residents, faculty, and staff. LOPIR is an effective way to meet and exceed the 2014 ACGME scholarly activity requirements for family medicine residents.

  16. Teaching quality improvement.

    Science.gov (United States)

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

    2010-08-01

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

  17. Modelling and Simulation of Single-Phase Series Active Compensator for Power Quality Improvement

    Science.gov (United States)

    Verma, Arun Kumar; Mathuria, Kirti; Singh, Bhim; Bhuvaneshwari, G.

    2016-10-01

    A single-phase active series compensator is proposed in this work to reduce harmonic currents at the ac mains and to regulate the dc link voltage of a diode bridge rectifier (DBR) that acts as the front end converter for a voltage source inverter feeding an ac motor. This ac motor drive is used in any of the domestic, commercial or industrial appliances. Under fluctuating ac mains voltages, the dc link voltage of the DBR depicts wide variations and hence the ac motor is used at reduced rating as compared to its name-plate rating. The active series compensator proposed here provides dual functions of improving the power quality at the ac mains and regulating the dc link voltage thus averting the need for derating of the ac motor.

  18. The Influence of Corporate Social Responsibility Activity toward Customer Loyalty through Improvement of Quality of Life in Urban Area

    OpenAIRE

    Tengku Ezni Balqiah; Hapsari Setyowardhani; Khairani Khairani

    2011-01-01

    The success of Corporate Social Responsibility (CSR) activities can create competitive advantage by influencing customer responses to firms’ offering. Customer’s awareness of CSR activity will influence their loyalty through their perception that activity can improve society’s quality of life where the CSR activities were implemented. The objective of this study is to evaluate the relationship between CSR awareness and loyalty that mediated by CSR Belief, Company Ability Belief, Quality of Li...

  19. Amendments and mulches improve the biological quality of soils degraded by mining activities in SE Spain

    Science.gov (United States)

    Luna Ramos, Lourdes; Miralles Mellado, Isabel; Hernández Fernández, María Teresa; García Izquierdo, Carlos; Solé Benet, Albert

    2014-05-01

    Mining and quarrying activities generate negative visual impacts in the landscape and a loss of environmental quality. Substrate properties at the end of mining are in general not suitable for plant growth, even native ones. In an experimental soil restoration in limestone quarries from Sierra de Gádor (Almería), SE Spain, the effect of organic amendment (sewage sludge, compost from the organic fraction of domestic waste or non-amendment) combined or not with two different kind of mulches (fine gravel, chopped forest residue) was tested by triplicate in 5 x 5 m plots with the aim to improve soil/substrate properties and to reduce evaporation and erosion. In each experimental plot 75 native plants (Stipa tenacissima, Anthyllis terniflora and Anthyllis cytisoides) were planted. Effects of adding organic amendments and mulches on some soil microbiological and biochemical parameters (microbial biomass carbon, basal respiration and different enzymatic activities, such as dehydrogenase, phosphatase, β-glucosidase and urease) were analyzed 5 years after the start of the experiment. Vegetation growth was also monitored. The two-way ANOVA, using as factors amendment and mulch, showed a significant positive influence of organic amendments on microbial biomass (Cmic), basal respiration and some enzymatic activities related to the cycles of C and N. The highest values of these parameters were obtained with compost. The influence of the mulch factor and its interactions with the amendment factor on the measured variables did not follow a clear trend with respect the measured parameters. Mulching did not improved significantly (pcontrol, but it is remarkable that the mulch type "forest chopped residue" had a negative effect on vegetation growth. The addition of organic amendments, especially compost from the organic fraction of domestic wastes, is beneficial to restore degraded or man-made soils from quarrying areas because they stimulate microbial growth and activity

  20. Collaborative activities for improving the quality of science teaching and learning and learning to teach science

    Science.gov (United States)

    Tobin, Kenneth

    2012-03-01

    I have been involved in research on collaborative activities for improving the quality of teaching and learning high school science. Initially the collaborative activities we researched involved the uses of coteaching and cogenerative dialogue in urban middle and high schools in Philadelphia and New York (currently I have active research sites in New York and Brisbane, Australia). The research not only transformed practices but also produced theories that informed the development of additional collaborative activities and served as interventions for research and creation of heuristics for professional development programs and teacher certification courses. The presentation describes a collage of collaborative approaches to teaching and learning science, including coteaching, cogenerative dialogue, radical listening, critical reflection, and mindful action. For each activity in the collage I provide theoretical frameworks and empirical support, ongoing research, and priorities for the road ahead. I also address methodologies used in the research, illustrating how teachers and students collaborated as researchers in multilevel investigations of teaching and learning and learning to teach that included ethnography, video analysis, and sophisticated analyses of the voice, facial expression of emotion, eye gaze, and movement of the body during classroom interactions. I trace the evolution of studies of face-to-face interactions in science classes to the current focus on emotions and physiological aspects of teaching and learning (e.g., pulse rate, pulse strength, breathing patterns) that relate to science participation and achievement.

  1. Improvement of IVF results and optimisation of quality control by using intermittent activity.

    Science.gov (United States)

    Frydman, Nelly; Fanchin, Rénato; Le Dû, Anne; Bourrier, Marie Catherine; Tachdjian, Gérard; Frydman, René

    2004-11-01

    For several years the present authors' team had not been satisfied with the pregnancy rate achieved by their unit, especially in comparison with the results achieved by other teams with a similar population. A quality programme was established, and it was decided to switch from non-stop to intermittent activity. It was envisaged that this programme would provide a more realistic view of the team's activity and could also, as a secondary effect, improve its results. The team's experience of an in-series organization was presented for the management of 408 consecutive infertile couples, during 2002. The results obtained during 2002 were compared with those for two previous years. There was a significant increase (P < 0.01) in the clinical pregnancy rate per oocyte retrieval from 28.9% (2000) and 25.2% (2001) to 41% (2002) in IVF and from 23% (2000) and 26% (2001) to 38.5% (2002) in intracytoplasmic sperm injection (ICSI). A significant increase (P < 0.01) was also observed in the implantation rate, from 14.8% and 13.4% to 20% in IVF and from 12.1% and 12.9% to 23.5% in ICSI. The higher pregnancy rate was achieved without an increase in the multiple pregnancy rate. In conclusion, recent data support the hypothesis that the use of a quality management system, can, as in this case, have positive repercussions on pregnancy rates.

  2. Exercise improves quality of life in bariatric surgery candidates: Results from the Bari-Active trial

    Science.gov (United States)

    Bond, Dale S.; Thomas, J. Graham; King, Wendy C.; Vithiananthan, Sivamainthan; Trautvetter, Jennifer; Unick, Jessica L.; Ryder, Beth A.; Pohl, Dieter; Roye, G. Dean; Sax, Harry C.; Wing, Rena R.

    2014-01-01

    OBJECTIVE To examine the impact of a pre-bariatric surgery physical activity intervention (PAI), designed to increase bout-related (≥10-minute) moderate-to-vigorous PA (MVPA), on health-related quality of life (HRQoL). METHODS Analyses included 75 adult participants (86.7% female; BMI=45.0±6.5 kg/m2) who were randomly assigned to 6 weeks of PAI (n=40) or standard pre-surgical care (SC; n=35). PAI received six individual weekly counseling sessions to increase walking exercise. Participants wore an objective PA monitor for 7 days and completed the SF-36 Health Survey at baseline and post-intervention to evaluate bout-related MVPA and HRQoL changes, respectively. RESULTS PAI increased bout-related MVPA from baseline to post-intervention (4.4±5.5 to 21.0±21.4 minutes/day) versus no change (7.9±16.6 to 7.6±11.5 minutes/day) for SC (p=0.001). PAI reported greater improvements than SC on all SF-36 physical and mental scales (p<0.05), except role-emotional. In PAI, better baseline scores on the physical function and general health scales predicted greater bout-related MVPA increases (p<0.05), and greater bout-related MVPA increases were associated with greater post-intervention improvements on the physical function, bodily pain, and general health scales (p<0.05). CONCLUSIONS Increasing PA preoperatively improves physical and mental HRQoL in bariatric surgery candidates. Future studies should examine whether this effect improves surgical safety, weight loss outcomes, and postoperative HRQoL. Trial Registration clinicaltrials.gov Identifier: NCT00962325 PMID:25611582

  3. Strategies to encourage physical activity in patients with Parkinson's disease: improving quality of life

    Directory of Open Access Journals (Sweden)

    Barksdale H

    2016-04-01

    Full Text Available Heather Barksdale,1 Odinachi Oguh,21Department of Rehabilitation, University of Florida College of Medicine, Jacksonville, FL, USA; 2Department of Neurology, University of Florida, Jacksonville, FL, USA Abstract: The purpose of this article is to discuss strategies to encourage physical activity in patients with Parkinson's disease (PD, to consider the effect that physical activity and exercise has on the quality of life in individuals with PD, identify types of physical activity and exercise most recently and best supported by research, and to explore ways to customize physical exercise to PD patients based on stage and severity. Through research, recommendations are made to encourage physical activity and overcome barriers that may hinder participation in physical activity and exercise across different stages of PD. Keywords: Parkinson's disease, physical activity, barriers, exercise, quality of life

  4. An Internet-Based Physical Activity Intervention to Improve Quality of Life of Inactive Older Adults: A Randomized Controlled Trial

    Science.gov (United States)

    Broekhuizen, Karen; de Gelder, Jelle; Wijsman, Carolien A; Wijsman, Liselotte W; Westendorp, Rudi GJ; Verhagen, Evert; Slagboom, Pieternella E; van Mechelen, Willem; van Heemst, Diana; van der Ouderaa, Frans

    2016-01-01

    Background Increasing physical activity is a viable strategy for improving both the health and quality of life of older adults. Objective The aim of this study was to assess if an Internet-based intervention aimed to increase physical activity was effective in improving quality of life of inactive older adults. In addition, we analyzed the effect of the intervention on quality of life among those participants who successfully reached their individually targeted increase in daily physical activity as indicated by the intervention program, as well as the dose-response effect of increasing physical activity on quality of life. Methods The intervention was tested in a randomized controlled trial and was comprised of an Internet program—DirectLife (Philips)—aimed at increasing physical activity using monitoring and feedback by accelerometry and feedback by digital coaching (n=119). The control group received no intervention (n=116). Participants were inactive 60-70-year-olds and were recruited from the general population. Quality of life and physical activity were measured at baseline and after 3 months using the Research ANd Development 36-item health survey (RAND-36) and wrist-worn triaxial accelerometer, respectively. Results After 3 months, a significant improvement in quality of life was seen in the intervention group compared to the control group for RAND-36 subscales on emotional and mental health (2.52 vs -0.72, respectively; P=.03) and health change (8.99 vs 2.03, respectively; P=.01). A total of 50 of the 119 participants (42.0%) in the intervention group successfully reached their physical activity target and showed a significant improvement in quality of life compared to the control group for subscales on emotional and mental health (4.31 vs -0.72, respectively; P=.009) and health change (11.06 vs 2.03, respectively; P=.004). The dose-response analysis showed that there was a significant association between increase in minutes spent in moderate

  5. Quality improvement activity in radiology reading and reporting in a rural setting hospital in Indonesia.

    Science.gov (United States)

    Frelita, Grace; Wongso, Christlyn; Pasaribu, Marganda Dapot Asi

    2012-01-01

    The Republic of Indonesia is an archipelago country, which is located between Asia and Australia. With a population of more than 200 million people, Indonesia only has about 600 Radiologists, whose majority resides in urban areas. In such a challenging situation, the Siloam Hospitals Group (SHG) established a strategy to improve its remote hospitals' Radiologists' quality care standard of patient safety. Although the strategy has produced a positive result, resistance towards cultural change was unavoidable throughout the strategy implementation. By learning from several resources and experiences, SHG's leaders tried to develop a strategy improvement towards better processes, particularly in recognizing and solving interpersonal conflicts.

  6. The Influence of Corporate Social Responsibility Activity toward Customer Loyalty through Improvement of Quality of Life in Urban Area

    Directory of Open Access Journals (Sweden)

    Tengku Ezni Balqiah

    2011-04-01

    Full Text Available The success of Corporate Social Responsibility (CSR activities can create competitive advantage by influencing customer responses to firms’ offering. Customer’s awareness of CSR activity will influence their loyalty through their perception that activity can improve society’s quality of life where the CSR activities were implemented. The objective of this study is to evaluate the relationship between CSR awareness and loyalty that mediated by CSR Belief, Company Ability Belief, Quality of Life, and Company Reputation using Structural Equation Modelling (SEM. The result shows little differrences among five firms/brands as the object of the research, that are beverage, soap, car, lubricant, and cigarette. This result has an implication for the firm that CSR activities are not just cost center activities, but also can create reputation, and in the long run can create customer loyalty that contributes to firm’s financial benefit.

  7. Enzymatic activities in a semiarid soil amended with different soil treatment: Soil quality improvement

    Science.gov (United States)

    Hueso González, Paloma; Elbl, Jakub; Dvořáčková, Helena; Francisco Martinez Murillo, Juan; Damian Ruiz Sinoga, Jose

    2017-04-01

    The use of soil quality indicators may be an effective approach to assess the positive effect of the organic amendment as good restoration methods. Relying on the natural fertility of the soil, the most commonly chemical and physical parameters used to evaluate soil quality are depend to the soil biological parameters. The measurement of soil basal respiration and the mineralization of organic matter are commonly accepted as a key indicator for measuring changes to soil quality. Thus, the simultaneous measurement of various enzymes seems to be useful to evaluate soil biochemical activity and related processes. In this line, Dehydrogenase activity is widely used in evaluating the metabolic activity of soil microorganisms and to evaluate the effects caused by the addition of organic amendments. Variations in phosphatase activity, apart from indicating changes in the quantity and quality of soil phosphorated substrates, are also good indicators of soil biological status. This study assesses the effect of five soil amendments as restoration techniques for semiarid Mediterrenean ecosystems. The goal is to interpret the status of biological and chemical parameters in each treatment as soil quality indicators in degraded forests. The main objectives were to: i) analyze the effect of various organic amendments on the enzimatic activity of soil; ii) analyze the effect of the amendments on soil respiration; iii) assess the effect of these parameters on the soil chemical properties which are indicative of soil healthy; and iv) evaluated form the land management point of view which amendment could result a effective method to restore Mediterranean degraded areas. An experimental paired-plot layout was established in southern of Spain (homogeneous slope gradient: 7.5%; aspect: N170). Five amendments were applied in an experimental set of plots: straw mulching; mulch with chipped branches of Aleppo Pine (Pinus halepensis Mill.); TerraCotten hydroabsobent polymers; sewage

  8. Marketing and satisfaction of employees in the process of improving the quality of business service activities

    Directory of Open Access Journals (Sweden)

    Perić Ružica

    2009-01-01

    Full Text Available Modern society is characterized with the development of public service activities, which are the main generator in creating value of one national economy. Special attention of the service activities development should be paid by the countries in transition, such as our country, because apart from influencing establishing of value, service activities have also taken a considerable role in employment of people. Service enterprises should base their growth and development, and in the first place, the survival itself, on providing the best quality services, that is, to strive to the satisfaction and loyalty of its customers. The customer's satisfaction has been determined to the great extent by the employees' satisfaction, especially in the first line of servicing, who are directly in contact with them.

  9. Improving physical quality of life with group physical activity in the adjunctive treatment of major depressive disorder

    Directory of Open Access Journals (Sweden)

    Mannu Francesca

    2008-01-01

    Full Text Available Abstract Background The aim of the study was to compare the change in quality of life over 32 weeks in depressed women assuming antidepressant drug with (experimental group or without (control group physical exercise from a study which results on objective dimension of outcome were already published. Methods Trial with randomized naturalistic control. Patients selected from the clinical activity registries of a Psychiatric University Unit. Inclusion criteria: female, between 40 and 60 years, diagnosis of Major Depressive Disorders (MMD, DSM-IV TR resistant to ongoing treatment. Exclusion criteria: diagnosis of psychotic disorders; any contraindications to physical activity. 30 patients (71.4% of the eligible participated to the study. Cases: 10 randomized patients undergoing pharmacological treatment plus physical activity. Controls: 20 patients undergoing only pharmacological therapy. Quality of life was measured by means of WHOQOL-Bref. Results The patients that made physical activity had their WHOQOL-Bref physical score improved from T0 to T8, the differences was statistically significant. In the control group WHOQOL-Bref physical remains the same and, consequentially, the difference between T0 and T8 do not reach any statistical significance. The perceived quality of life in the other domains did not change during the treatment in both groups. Thus no other differences were found between and within groups. Discussion and Conclusion The data presented in the previous paper found that physical activity seems a good adjunctive treatment in the long term management of patients with MDD. These new data indicated that physical activity may also improve the perceived physical quality of life. The dimensions related with social functioning, environment and psychical well being seem do not improved, unexpectedly, during the trial. Two objective dimension not strictly related to the depressive symptoms improved: social functioning and Clinical Global

  10. Quality Improvement Practices and Trends

    DEFF Research Database (Denmark)

    Dahlgaard, Jens J.; Hartz, Ove; Edgeman, Rick L.

    1998-01-01

    professor, as well as key individuals from various industries. In addition to the above activities, Rick will be working with the European Foundation for Quality Management on their "European Master's Programme in Total Quality Management." That program involves a consortium of European universities. Rick......The following article, "Quality Improvement Practices and Trends in Denmark," is the first in a series of papers arranged for and co-authored by Dr. Rick L. Edgeman. Rick is a member of QE's Editorial Board and is on sabbatical from Colorado State University. During the year, Rick and his family...... has begun the process of developing a comparable consortium of American universities for the same purpose-- an activity which is cosponsored by the Education Division of the American Society for Quality (ASQ)....

  11. Continuous improvement of software quality

    Energy Technology Data Exchange (ETDEWEB)

    Sivertsen, Terje

    1999-04-15

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

  12. Carbon Monoxide Fumigation Improved the Quality, Nutrients, and Antioxidant Activities of Postharvest Peach

    Directory of Open Access Journals (Sweden)

    Shaoying Zhang

    2014-01-01

    Full Text Available Peaches (Prunus persica cv. Yanhong were fumigated with carbon monoxide (CO at 0, 0.5, 5, 10, and 20 μmol/L for 2 hours. The result showed that low concentration CO (0.5–10 μmol/L might delay the decrease of firmness and titrable acid content, restrain the increase of decay incidence, and postpone the variation of soluble solids content, but treating peaches with high concentration CO (20 μmol/L demonstrated adverse effects. Further research exhibited that exogenous CO could induce the phenylalnine ammonialyase activity, maintain nutrient contents such as Vitamin C, total flavonoid, and polyphenol, and enhance antioxidant activity according to reducing power and 2,2-diphenyl-1-(2,4,6-trinitrophenyl hydrazyl radical scavenging activity. Treating peaches with appropriate concentration CO was beneficial to the quality, nutrients, and antioxidant activity of postharvest peaches during storage time. Therefore, CO fumigation might probably become a novel method to preserve postharvest peach and other fruits in the future.

  13. Improving Internet Quality of Service through Active Queue Management in Routers

    Directory of Open Access Journals (Sweden)

    Gamal Attiya

    2012-01-01

    Full Text Available The traffic characteristics of real-time and non real-time applications require a certain Quality of Service (QoS from the Internet in terms of bandwidth, delay, packet loss, fairness and jitter. However, most of the current Active Queue Management (AQM algorithms at the internet routers do not guarantee QoS for real time traffics such as video and audio. This is because; most of the algorithms handle different packets of different traffics by the same strategy. In this paper, we propose a new AQM strategy to guarantee QoS for real time traffics. The proposed strategy uses three queues at the internet routers, each of which handles a single class of traffic. Where, the arriving packets are queued according to their class type. Additionally, the queued packets are scheduled according to a predefined weight. The proposed algorithm is evaluated and compared with the most recent algorithms by using the Network simulator NS-2.

  14. Effects of Improving Physical Activity Level on Quality of Life and Functional Status of Patients Receiving Peritoneal Dialysis

    Directory of Open Access Journals (Sweden)

    Deran OSKA

    2014-01-01

    Full Text Available OBJECTIVE: The aim of this study was to determine whether patients receiving peritoneal dialysis (PD experience an improvement in physical activity, quality of life and functional status as a result of exercise training at home by motivation about benefi ts of exercising. MATERIAL and METHODS: Twenty-one PD patients of 46.7±14.1 years participated in the study. Participants were encouraged by a physiotherapist to walk for 30 minutes, 3 days a week and motivated by explaining benefi ts of exercising. We assessed quality of life by Kidney Disease Quality of Life Questionnaire-Turkish Version (KDQOL-SF, functional status by Six Minute Walk Test (SMW, physical activity level by International Physical Activity Questionnaire – Long Form (IPAQ-LF. The antropometric measurements were performed with the bioelectrical impedance. Assessments were done at the beginning and 3 months later. RESULTS: Total physical activity score of IPAQ-LF increased signifi cantly 3 months later (p0.05. Improvements in pain and emotional score of KDQOL-SF were statistically signifi cant (p<0.05. CONCLUSION: Regular exercise should be allocated in the PD standard care. Participation of the patient into such a program could be possible by explaining the benefi ts of exercising at the beginning of the treatment.

  15. Console Log Keeping Made Easier - Tools and Techniques for Improving Quality of Flight Controller Activity Logs

    Science.gov (United States)

    Scott, David W.; Underwood, Debrah (Technical Monitor)

    2002-01-01

    At the Marshall Space Flight Center's (MSFC) Payload Operations Integration Center (POIC) for International Space Station (ISS), each flight controller maintains detailed logs of activities and communications at their console position. These logs are critical for accurately controlling flight in real-time as well as providing a historical record and troubleshooting tool. This paper describes logging methods and electronic formats used at the POIC and provides food for thought on their strengths and limitations, plus proposes some innovative extensions. It also describes an inexpensive PC-based scheme for capturing and/or transcribing audio clips from communications consoles. Flight control activity (e.g. interpreting computer displays, entering data/issuing electronic commands, and communicating with others) can become extremely intense. It's essential to document it well, but the effort to do so may conflict with actual activity. This can be more than just annoying, as what's in the logs (or just as importantly not in them) often feeds back directly into the quality of future operations, whether short-term or long-term. In earlier programs, such as Spacelab, log keeping was done on paper, often using position-specific shorthand, and the other reader was at the mercy of the writer's penmanship. Today, user-friendly software solves the legibility problem and can automate date/time entry, but some content may take longer to finish due to individual typing speed and less use of symbols. File layout can be used to great advantage in making types of information easy to find, and creating searchable master logs for a given position is very easy and a real lifesaver in reconstructing events or researching a given topic. We'll examine log formats from several console position, and the types of information that are included and (just as importantly) excluded. We'll also look at when a summary or synopsis is effective, and when extensive detail is needed.

  16. MDSplus quality improvement project

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-11-15

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

  17. Strategies to encourage physical activity in patients with hemophilia to improve quality of life

    Directory of Open Access Journals (Sweden)

    Goto M

    2016-05-01

    Full Text Available Miwa Goto,1 Hideyuki Takedani,2 Kazuhiko Yokota,1 Nobuhiko Haga3 1Rehabilitation Center, The University of Tokyo Hospital, 2Department of Joint Surgery, Research Hospital of the Institute of Medical Science, The University of Tokyo, 3Department of Rehabilitation Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan Abstract: Hemophilia is a bleeding disorder caused by a congenital abnormality of blood coagulation. Until the mid-1970s, patients with hemophilia (PWH were advised to refrain from physical activity (PA because of a perceived increased risk of bleeding. Since then, PA, which is recognized as being essential for health maintenance, is now recommended by the World Federation of Hemophilia. Moreover, a number of studies reported that PA can improve treatment efficacy and prevent bleeding in PWH. Physical assessment and intervention in PA are currently used in clinical practice. However, the necessity of PA is not emphasized, and many PWH generally have low- to- no PA. Therefore, a behavior change approach to encourage patient motivation is becoming ever more important. In this article, we review articles addressing PA in PWH and discuss strategies to encourage PA through a behavior change approach by focusing on factors relevant to hemophilia, such as benefits and bleeding risk of PA, risk management of bleeding, PA characteristics, and difficulty with exercise adherence. The trust relationship between clinicians and patients, a transtheoretical model of behavior change, and motivation theory as approaches to promote PA are introduced. Finally, we review a case report of the clinical success of a behavior change approach to promote PA. Many PWH find it difficult to continue PA because of aging, fear of bleeding, insufficient recognition of PA benefits, and psychological problems. Therefore, it is essential and important to perform prophylaxis with PWH and to heighten their understanding of the benefits and risks of

  18. Active Power Quality Improvement Strategy for Grid-connected Microgrid Based on Hierarchical Control

    DEFF Research Database (Denmark)

    Wei, Feng; Sun, Kai; Guan, Yajuan

    2017-01-01

    When connected to a distorted grid utility, droop-controlled grid-connected microgrids (DCGC-MG) exhibit low equivalent impedance. The harmonic and unbalanced voltage at the point of common coupling (PCC) deteriorates the power quality of the grid-connected current (GCC) of DCGC-MG. This work...

  19. Quality Improvement of Concrete Articles

    Directory of Open Access Journals (Sweden)

    Svatovskaya Larisa

    2016-01-01

    Full Text Available In the paper it is shown that quality of concrete articles and structures may be significantly improved by silica sol solution absorption. Improvements include increase of compressive strength, resistance to low temperatures, coefficient of constructive quality, decrease of water sorption, contraction. The reason of improvement is discussed.

  20. DPC controlled three-phase active filter for power quality improvement

    Energy Technology Data Exchange (ETDEWEB)

    Chaoui, Abdelmadjid; Krim, Fateh [Laboratoire d' Electronique de Puissance et Commande Industrielle (LEPCI), Universite de Setif (Algeria); Gaubert, Jean-Paul; Rambault, Laurent [Laboratoire d' Automatique et d' Informatique Industrielle (LAII-ESIP), Universite de Poitiers (France)

    2008-10-15

    This paper presents a new control method entitled direct power control (DPC) for shunt active power filtering (5th, 7th, 11th,..) (SAPF), which is applied to eliminate line current harmonics and compensate reactive power. Its main goal is to rebuild active and reactive powers to be compared to references values using hysteresis control. The outputs of hysteresis controllers associated with a switching table, control the instantaneous active and reactive power by selecting the optimum switching state of the voltage source inverter (VSI). A theoretical analysis with a complete simulation of the system and experimental results are presented to prove the excellent performance of the proposed control technique. (author)

  1. Power quality improvement using DPC controlled three-phase shunt active filter

    Energy Technology Data Exchange (ETDEWEB)

    Chaoui, Abdelmadjid [Laboratoire d' Automatique et d' Informatique Industrielle (LAII-ESIP), Universite de Poitiers (France); Gaubert, Jean-Paul; Krim, Fateh [Laboratoire d' Electronique de Puissance et Commande Industrielle (LEPCI), Universite de Setif (Algeria)

    2010-06-15

    This paper presents a new control method entitled direct power control (DPC) for shunt active power filter (APF), which is applied to eliminate line current harmonics and compensate reactive power. Its main goal is to rebuild active and reactive source powers to be compared to references values using hysteresis control. The active power reference is issue of DC-side of inverter and reactive power reference is set to zero for unity power factor. The outputs of hysteresis controllers associated with a switching table, control the instantaneous active and reactive power by selecting the optimum switching state of the voltage source inverter (VSI). A theoretical analysis with a complete simulation of the system and experimental results are presented to prove the excellent performance of the proposed technique. (author)

  2. Dairy processing, Improving quality

    NARCIS (Netherlands)

    Smit, G.

    2003-01-01

    This book discusses raw milk composition, production and quality, and reviews developments in processing from hygiene and HACCP systems to automation, high-pressure processing and modified atmosphere packaging.

  3. Power Quality Improvement Using UPQC

    Directory of Open Access Journals (Sweden)

    K. Kalaipriya

    2014-05-01

    Full Text Available This paper presents the power quality improvement using UPQC. UPQC consists of series inverter, shunt inverter and capacitance. Every inverter connected with pulse generator for switching on. UPQC is especially obtained to resolve different kind of power quality drawback like reactive power compensation, voltage interruption and harmonics. DVR is connected in series to deliver the active and reactive power to distribution network. DC-link capacitors stay high as a result of the DVR needs a minimum amount of DC-link voltage to compensate sag. So, DC –link voltage is connected with PV module to reduce the cost. Design of UPQC device with multi-bus system obtained using MATLAB/SIMULINK and simulation results are mentioned to support the developed conception.

  4. Helium-neon laser irradiation of cryopreserved ram sperm enhances cytochrome c oxidase activity and ATP levels improving semen quality.

    Science.gov (United States)

    Iaffaldano, N; Paventi, G; Pizzuto, R; Di Iorio, M; Bailey, J L; Manchisi, A; Passarella, S

    2016-08-01

    This study examines whether and how helium-neon laser irradiation (at fluences of 3.96-9 J/cm(2)) of cryopreserved ram sperm helps improve semen quality. Pools (n = 7) of cryopreserved ram sperm were divided into four aliquots and subjected to the treatments: no irradiation (control) or irradiation with three different energy doses. After treatment, the thawed sperm samples were compared in terms of viability, mass and progressive sperm motility, osmotic resistance, as well as DNA and acrosome integrity. In response to irradiation at 6.12 J/cm(2), mass sperm motility, progressive motility and viability increased (P < 0.05), with no significant changes observed in the other investigated properties. In parallel, an increase (P < 0.05) in ATP content was detected in the 6.12 J/cm(2)-irradiated semen samples. Because mitochondria are the main cell photoreceptors with a major role played by cytochrome c oxidase (COX), the COX reaction was monitored using cytochrome c as a substrate in both control and irradiated samples. Laser treatment resulted in a general increase in COX affinity for its substrate as well as an increase in COX activity (Vmax values), the highest activity obtained for sperm samples irradiated at 6.12 J/cm(2) (P < 0.05). Interestingly, in these irradiated sperm samples, COX activity and ATP contents were positively correlated, and, more importantly, they also showed positive correlation with motility, suggesting that the improved sperm quality observed was related to mitochondria-laser light interactions.

  5. ELECTRICITY-FREE PRODUCTION OF ACTIVATED CARBON FROM BIOMASS IN BORNEO TO IMPROVE WATER QUALITY

    Directory of Open Access Journals (Sweden)

    Yasutaka Sasaki,

    2011-11-01

    Full Text Available Activated carbons (ACs were prepared from biomass of Borneo island (wood charcoal, peat, and coconut husk by using an electricity–free furnace, of which the energy source was exclusively wood charcoal. This furnace was comprised of two parts, an inner vessel equipped with water inlet for steam activation and an outer shell as a heating part for the inner vessel. The inside temperature of the inner vessel was able to reach over 1000 oC. Peat and wood charcoal were converted to AC by carbonization followed by steam activation, and the specific BET surface areas of resultant ACs were 889 m2/g and 749 m2/g, respectively. A mobile apparatus for water purification was newly designed and fabricated with the resultant AC, together with a white quartz sand, which is called keranggas in Kalimantan. The CODOH of both polluted creek water by the University of Palangka Raya and Kahayan River water were remarkably decreased by the purification with the designed apparatus from 20.0 mgO/L to 0.93 mgO/L, and 18.2 mgO/L to 0.74 mgO/L, respectively. Thus, the newly designed furnace and purification apparatus were shown to be highly effective tools to produce a promising agent for water purification and to produce clarified water without use of electricity, respectively.

  6. Concomitant treatment of brain metastasis with Whole Brain Radiotherapy [WBRT] and Temozolomide [TMZ] is active and improves Quality of Life

    Directory of Open Access Journals (Sweden)

    Montella Liliana

    2007-01-01

    Full Text Available Abstract Background Brain metastases (BM represent one of the most frequent complications related to cancer, and their treatment continues to evolve. We have evaluated the activity, toxicity and the impact on Quality of Life (QoL of a concomitant treatment with whole brain radiotherapy (WBRT and Temozolomide (TMZ in patients with brain metastases from solid tumors in a prospective Simon two stage study. Methods Fifty-nine patients were enrolled and received 30 Gy WBRT with concomitant TMZ (75 mg/m2/day for ten days, and subsequently TMZ (150 mg/m2/day for up to six cycles. The primary end points were clinical symptoms and radiologic response. Results Five patients had a complete response, 21 patients had a partial response, while 18 patients had stable disease. The overall response rate (45% exceeded the target activity per study design. The median time to progression was 9 months. Median overall survival was 13 months. The most frequent toxicities included grade 3 neutropenia (15% and anemia (13%, and only one patient developed a grade 4 thrombocytopenia. Age, Karnofsky performance status, presence of extracranial metastases and the recursive partitioning analysis (RPA were found to be predictive factors for response in patients. Overall survival (OS and progression-free survival (PFS were dependent on age and on the RPA class. Conclusion We conclude that this treatment is well tolerated, with an encouraging objective response rate, and a significant improvement in quality of life (p

  7. STANDPOINT OF THE TOP MANAGEMENT ABOUT THE EFFECTS OF INTRODUCED QUALITY SYSTEM AND CONTINUATION AF ACTIVITIES OF ITS IMPROVEMENT

    Directory of Open Access Journals (Sweden)

    Sabahudin Jasarevic

    2015-06-01

    Full Text Available There are number of obstacles on a challenging road to the effectiveness and business and organizational excellence. One of the most difficult ones is human (not understanding of the constant flux of change. Such is the case when it comes to development of quality management system. Will the quality be either a problem or resource of some organization depends above all on the basic standpoint towards quality that exists in the organization. Many authors underline that implementation of quality management system and obtaining ISO 9000 certificate is not an easy task, but also emphasize that its maintenance and improvement is much more difficult task. The greatest number of problems that occur during the realization of project of quality management system as well as its improvement are the result of misunderstanding of the essence of standard, that is its principles. On of these principles is Leadership too, that is the role of Top Management. Managers at the highest levels are certainly the most responsible for establishing the vision and guiding organization in all business aspects, including Quality Management and Quality Management System. This work presents results of research conducted on the top management in 204 organizations with introduced quality system. Results show views of top management about the effects of introduced quality system as well as about future steps in terms of improving the same.

  8. PHOTOVOLTAIC BASED SHUNT ACTIVE FILTER FOR POWER QUALITY IMPROVEMENT USING ICOSΦ THEORY

    Directory of Open Access Journals (Sweden)

    VIJAYAKUMAR G.

    2015-11-01

    Full Text Available This paper presents an optimal operation of Photovoltaic based Shunt Active Filter as (PV-SAF for significant energy conservation, harmonic mitigation and reactive power compensation. When the PV system generates excessive or equal power required to the load demand, then the coordinating logic disconnects the service grid from the load and with a consequent reduction of panel tariff and global warming gasses. The PV module is connected to the DC side of SAF through the DC-DC converter. Converter switch is controlled by fuzzy based Perturb & Observe (P&O Maximum Power Point Tracking (MPPT algorithm and it eliminates the drawback in the conventional PV system. The reference currents are extracted by the Fuzzy logic controller based ICosΦ control strategy. This proposed PV-SAF, if connected at the terminals of a small industry or a home or a small enlightening institution can avoid the use of interruptible power supply and individual stabilizer. An emulation using MATLAB Simulink is presented to validate the advantage of the proposed system.

  9. The efficiency of active cycle of breathing techniques regarding the improvement the quality of life in cystic fibrosis patients

    Directory of Open Access Journals (Sweden)

    Bogdan Almăjan-Guţă

    2008-12-01

    Full Text Available Background: Physiotherapy is well known as one of the most important part of CF patient’s management. The right choice ofappropriate therapy schema will improve the life’s quality of the patients. The purpose of the study was to prove the efficiencyof Active cycle of breathing techniques at children with cystic fibrosis. The study was performed between September 2006-september 2007 and the lot of study consisted of 20 children (11 girls and 9 boys with an age range between 6 and 18 years(average 14,8 years from the records of the Cystic Fibrosis National Centre Timisoara. The results showed an improvement inall measured values: general well-being, coughing, physical signs, X-ray signs and CT, bacteriological exam, nutritional status,functional respiratory tests. The statistical briefing of data shows the fact that there are significant statistical difference (p<0,05, before and after treatment in all ventilator index. The conclusion of this study was that the chosen technique (ACTBproved to be very efficient, in improving of respiratory symptoms and ventilator parameters

  10. Improving Science Pedagogic Quality in Elementary School Using Process Skill Approach Can Motivate Student to Be Active in Learning

    Science.gov (United States)

    Sukiniarti

    2016-01-01

    On global era todays, as the professional teacher should be improving their pedagogic competency, including to improve their science pedagogy quality. This study is aimed to identify: (1) Process skill approach which has been used by Elementary School Teacher in science learning; (2) Teacher's opinion that process skill can motivate the student to…

  11. NETWORKS AND QUALITY IMPROVEMENT

    Directory of Open Access Journals (Sweden)

    Miodrag Hadžistević

    2009-12-01

    Full Text Available Tools used in the past to analyze business value creation, such as value chain and process models, are simply too slow, inadequate, or inappropriate to address this new level of business complexity. In stead of that, company has to find way to create quality management system in a multi-layered supply chain. The problem can be solved by networking in the cluster. Cluster can be known as a competitive cooperation in the purpose to gain higher level of competitiveness and success. Bat there is another problem: Organization of the production process in a company is extremely complex process itself, and when we transfer it to the cluster level, we get a complex task which is difficult to solve. For that purpose, this paper analyses the conditions and possibilities that would enable those structures to adapt to changes in the surroundings - flexibility and management adequacy of production and organizational structures - by creating network value system.

  12. Preanalytical quality improvement : in quality we trust

    NARCIS (Netherlands)

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

    2013-01-01

    Total quality in laboratory medicine should be defined as the guarantee that each activity throughout the total testing process is correctly performed, providing valuable medical decision-making and effective patient care. In the past decades, a 10-fold reduction in the analytical error rate has bee

  13. Preanalytical quality improvement : in quality we trust

    NARCIS (Netherlands)

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

    2013-01-01

    Total quality in laboratory medicine should be defined as the guarantee that each activity throughout the total testing process is correctly performed, providing valuable medical decision-making and effective patient care. In the past decades, a 10-fold reduction in the analytical error rate has bee

  14. Power theories for improved power quality

    CERN Document Server

    Pasko, Marian

    2012-01-01

    Power quality describes a set of parameters of electric power and the load’s ability to function properly under specific conditions. It is estimated that problems relating to power quality costs the European industry hundreds of billions of Euros annually. In contrast, financing for the prevention of these problems amount to fragments of these costs. Power Theories for Improved Power Quality addresses this imbalance by presenting and assessing a range of methods and problems related to improving the quality of electric power supply. Focusing particularly on active compensators and the DSP based control algorithms, Power Theories for Improved Power Quality introduces the fundamental problems of electrical power. This introduction is followed by chapters which discuss: •‘Power theories’ including their historical development and application to practical problems, •operational principles of active compensator’s DSP control based algorithms using examples and results from laboratory research, and •t...

  15. Rice Quality Improvement in China

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    @@ 1. Demand for high quality rice in China Rice is the leading cereal crop that contributes about 40% of the national grain production in China. The total output and areas rank the first and the second position in the world, respectively. In recent years, rice production grows steadily, but the quality improvement has been lagged and the quality becomes a limiting factor. As the grain supply exceeding the demand and the grain price plummeted, the State Council put forward expanding China′ s ongoing reform of the grain distribution system in 1998. Along with the foodstuff circulating system reform and market driving, the structure of rice production is adjusted,the planting acreage of early indica rice with poor quality decreased, and that of japonica rice in north China with good quality increased. With the challenge of China joining the WTO, Chinese government starts to pay premium on good quality rice.

  16. Quality Of Construction Activity

    OpenAIRE

    LOREDANA VALENTINA HEDRE

    2010-01-01

    The problem of the quality works of building has a different importance because, as opposed to another activities of material productions here are not admitted bear of the quality in respect resistances, stability, durability, safeties in exploitation. The responsibility concerning assurance quality is not summed up just to the level of builders or beneficiaries, they became a national problem and last recently, European and even global issues. Implications are considered factors contributing...

  17. CDBG Public Improvements Activity

    Data.gov (United States)

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

  18. IMPROVING QUALITY MANAGEMENT IN PANIFICATION

    Directory of Open Access Journals (Sweden)

    Cornelia Petroman

    2010-12-01

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

  19. Improving Morphological Quality and Uniformity of Hydrothermally Grown ZnO Nanowires by Surface Activation of Catalyst Layer

    Science.gov (United States)

    Murillo, Gonzalo; Lozano, Helena; Cases-Utrera, Joana; Lee, Minbaek; Esteve, Jaume

    2017-01-01

    This paper presents a study about the dependence of the hydrothermal growth of ZnO nanowires (NWs) with the passivation level of the active surface of the Au catalyst layer. The hydrothermal method has many potential applications because of its low processing temperature, feasibility, and low cost. However, when a gold thin film is utilized as the seed material, the grown NWs often lack morphological homogeneity; their distribution is not uniform and the reproducibility of the growth is low. We hypothesize that the state or condition of the active surface of the Au catalyst layer has a critical effect on the uniformity of the NWs. Inspired by traditional electrochemistry experiments, in which Au electrodes are typically activated before the measurements, we demonstrate that such activation is a simple way to effectively assist and enhance NW growth. In addition, several cleaning processes are examined to find one that yields NWs with optimal quality, density, and vertical alignment. We find cyclic voltammetry measurements to be a reliable indicator of the seed-layer quality for subsequent NW growth. Therefore, we propose the use of this technique as a standard procedure prior to the hydrothermal synthesis of ZnO NWs to control the growth reproducibility and to allow high-yield wafer-level processing.

  20. The Improvement of Services Quality

    Directory of Open Access Journals (Sweden)

    Cristian-Ştefan Craciun

    2013-01-01

    Full Text Available In the last decades, there was a strong national and international tendency to increase the services role in the economic social life. The technical progress, the enhancing social division of labor and the increase of demand both from the population and entrepreneurs led to the services development and diversification. Due to the recent radical changes in all economic, political and social fields, the economic agents’ goal to gain a rapid and substantial profit was gradually replaced by the fierce struggle for quality domination among competitors. Therefore, there is an increasing need to find more effective ways to improve the services quality, such as training and motivating the staff and implementing a quality management system.

  1. Apps to improve diet, physical activity and sedentary behaviour in children and adolescents: a review of quality, features and behaviour change techniques.

    Science.gov (United States)

    Schoeppe, Stephanie; Alley, Stephanie; Rebar, Amanda L; Hayman, Melanie; Bray, Nicola A; Van Lippevelde, Wendy; Gnam, Jens-Peter; Bachert, Philip; Direito, Artur; Vandelanotte, Corneel

    2017-06-24

    The number of commercial apps to improve health behaviours in children is growing rapidly. While this provides opportunities for promoting health, the content and quality of apps targeting children and adolescents is largely unexplored. This review systematically evaluated the content and quality of apps to improve diet, physical activity and sedentary behaviour in children and adolescents, and examined relationships of app quality ratings with number of app features and behaviour change techniques (BCTs) used. Systematic literature searches were conducted in iTunes and Google Play stores between May-November 2016. Apps were included if they targeted children or adolescents, focused on improving diet, physical activity and/or sedentary behaviour, had a user rating of at least 4+ based on at least 20 ratings, and were available in English. App inclusion, downloading and user-testing for quality assessment and content analysis were conducted independently by two reviewers. Spearman correlations were used to examine relationships between app quality, and number of technical app features and BCTs included. Twenty-five apps were included targeting diet (n = 12), physical activity (n = 18) and sedentary behaviour (n = 7). On a 5-point Mobile App Rating Scale (MARS), overall app quality was moderate (total MARS score: 3.6). Functionality was the highest scoring domain (mean: 4.1, SD: 0.6), followed by aesthetics (mean: 3.8, SD: 0.8), and lower scoring for engagement (mean: 3.6, SD: 0.7) and information quality (mean: 2.8, SD: 0.8). On average, 6 BCTs were identified per app (range: 1-14); the most frequently used BCTs were providing 'instructions' (n = 19), 'general encouragement' (n = 18), 'contingent rewards' (n = 17), and 'feedback on performance' (n = 13). App quality ratings correlated positively with numbers of technical app features (rho = 0.42, p apps to improve diet, physical activity and sedentary behaviour in children and adolescents had

  2. Shipbuilding pipeline production quality improvement

    Directory of Open Access Journals (Sweden)

    T. Buksa

    2010-06-01

    Full Text Available Purpose: The pipeline production is one of major processes in shipbuilding industry. Quality improvement and risk assessment in this process can yield significant savings, both in terms of internal quality costs as well as in terms of customer satisfactions.Design/methodology/approach: Shipbuilding pipeline production quality improvement has been carried out by application of FMEA (Failure Mode and Effect Analysis method. For the successful implementation of FMEA method it is necessary to identify process failure modes or possibility of the appearance of non-compliance, as well as their possible causes. For qualitative analysis of key input variables of the process, in the paper is used Ishikawa diagram and p-chart.Findings: It is shown that proposed approach to risk assessment in shipbuilding pipeline production is applicable to real casa scenario. The analysis has identified the points in the process with the highest probability of occurrence of nonconformities, or the highest risk for error.Research limitations/implications: As the experimenting has been conducted in shipyard, within production process, research schedule must have been set in accordance with production pace. Also, due to character of production process the data collecting was adopted to the production plan in that particular moment.Practical implications: Dealing with causes of potential nonconformities in the process can significantly contribute to the reliability and robustness of the process. Corrective actions that have been taken based on results of analysis significantly contributed to the level of quality in the pipeline production process.Originality/value: The pepper is dealing with a well known method applied in different production environment that are mostly conservative in production approach. It was shown that successful application of proposed approach can yield benefits especially in improved quality of produced pipelines within shipbuilding industry.

  3. Trehalose improves semen antioxidant enzymes activity, post-thaw quality, and fertility in Nili Ravi buffaloes (Bubalus bubalis).

    Science.gov (United States)

    Iqbal, Sajid; Andrabi, Syed Murtaza Hassan; Riaz, Amjad; Durrani, Aneela Zameer; Ahmad, Nasim

    2016-03-15

    Our objectives were to study the effect of trehalose in extender on (1) antioxidant enzymes profile during cryopreservation (after dilution, before freezing, and after thawing), (2) in vitro quality (after thawing), and (3) in vivo fertility of Nili Ravi buffalo (Bubalus bubalis) bull spermatozoa. Semen samples (n = 20) from four buffalo bulls were diluted in Tris-citric acid-based extender having different concentrations of trehalose (0.0, 15, 30, 45, and 60 mM) and frozen in French straws. At post dilution, profile of sperm catalase (U/mL) was higher (P antioxidant enzymes activity, post thaw quality, and fertility in Nili Ravi buffaloes. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Improving soil enzyme activities and related quality properties of reclaimed soil by applying weathered coal in opencast-mining areas of the Chinese loess plateau

    Energy Technology Data Exchange (ETDEWEB)

    Li, Hua [College of Environment and Resources, Shanxi University, Taiyuan (China); CAS/Shandong Provincial Key Laboratory of Coastal Environmental Process, Yantai Institute of Coastal Zone Research, Chinese Academy of Sciences (CAS), Yantai (China); Shao, Hongbo [CAS/Shandong Provincial Key Laboratory of Coastal Environmental Process, Yantai Institute of Coastal Zone Research, Chinese Academy of Sciences (CAS), Yantai (China); Institute for Life Sciences, Qingdao University of Science and Technology (QUST), Qingdao (China); Li, Weixiang; Bi, Rutian [Shanxi Agricultural University, Taigu (China); Bai, Zhongke [Department of Land Science Technology, University of Geosciences, Beijing (China)

    2012-03-15

    There are many problems for the reclaimed soil in opencast-mining areas of the Loess Plateau of China such as poor soil structure and extreme poverty in soil nutrients and so on. For the sake of finding a better way to improve soil quality, the current study was to apply the weathered coal for repairing soil media and investigate the physicochemical properties of the reclaimed soil and the changes in enzyme activities after planting Robinia pseucdoacacia. The results showed that the application of the weathered coal significantly improved the quality of soil aggregates, increased the content of water stable aggregates, and the organic matter, humus, and the cation exchange capacity of topsoil were significantly improved, but it did not have a significant effect on soil pH. Planting R. pseucdoacacia significantly enhanced the activities of soil catalase, urease, and invertase, but the application of the weathered coal inhibited the activity of catalase. Although the application of appropriate weathered coal was able to significantly increase urease activity, the activities of catalase, urease, or invertase had a close link with the soil profile levels and time. This study suggests that applying weathered coals could improve the physicochemical properties and soil enzyme activities of the reclaimed soil in opencast-mining areas of the Loess Plateau of China and the optimum applied amount of the weathered coal for reclaimed soil remediation is about 27 000 kg hm{sup -2}. (Copyright copyright 2012 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

  5. Using Quality Function Deployment to Improve Reference Services Quality

    Directory of Open Access Journals (Sweden)

    Pao-Long Chang

    1996-12-01

    Full Text Available Much research has been conducted regarding how reference librarians can evaluate and improve the quality of the answers they provide to users' inquiries. There has been considerably less discussion, however, concerning how to improve the quality of the delivery of those answers, and to upgrade the overall quality of reference services as a whole. Suggestions for improving the quality of service contained within the business literature may be applied to improve library services as well. In this paper the use of Quality Function Deployment (QFD as a tool for improving reference services quality is explored and an adapted framework referred to as service quality function deployment is proposed.

  6. Comparisons of activity measurements with radionuclide calibrators-A tool for quality assessment and improvement in nuclear medicine

    Energy Technology Data Exchange (ETDEWEB)

    Oropesa, P. [Centro de Isotopos (CENTIS), P.O. Box 3415, San Jose de las Lajas, Havana (Cuba)]. E-mail: poropesa@centis.edu.cu; Hernandez, A.T. [Centro de Isotopos (CENTIS), P.O. Box 3415, San Jose de las Lajas, Havana (Cuba); Serra, R. [Centro de Isotopos (CENTIS), P.O. Box 3415, San Jose de las Lajas, Havana (Cuba); Varela, C. [Centro de Control Estatal de Equipos Medicos (CCEEM), Calle 4, No 455 (altos), Vedado CP 10400, Havana (Cuba)

    2005-10-01

    A national program of ongoing comparisons for assaying gamma-emitting radiopharmaceuticals for amount of radioactivity using radionuclide calibrators was begun in 2000. Nuclides of the most wide-spread use in Cuban nuclear medicine, {sup 131}I, {sup 201}Tl and {sup 99m}Tc, as well as two measurement geometries, glass vials and plastic syringes, were employed. In this paper, the participants' performance is assessed by mean of a statistical analysis of the reported data. Performance tables have been obtained and a {chi}{sup 2} statistic is calculated from observed and expected frequencies, with the aim of testing the hypothesis about the independence of some characteristics of the comparison results, at a significance level {alpha}=0.05. The proportion of satisfactory results in the years 2002-2004 were found to be at the same level, but higher than in 2000. It reveals an improvement of the measurement quality since 2002. The causes of improvement were investigated using the statistical treatment of several data available as supplementary information.

  7. 活跃英语课堂 提升教学质量%Activating English Classroom and Improving Teachin Quality

    Institute of Scientific and Technical Information of China (English)

    谷咏

    2011-01-01

    课堂教学是对学生实施素质教育的基本途径和主要形式.而素质教育的核心内涵则是“以学生的发展为本”。因而,活跃英语课堂并提升教学质量是当务之急。本文从四个方面论述了笔者的一些看法。%Classroom teaching is the basic way and the main form to implement quality edcuation and the core of quality education is "students' development-orientation". Hence, activating Enhlish classroom and improving teaching quality is top priority. This paper e

  8. Use of pedometer-driven walking to promote physical activity and improve health-related quality of life among meat processing workers: a feasibility trial.

    Science.gov (United States)

    Mansi, Suliman; Milosavljevic, Stephan; Tumilty, Steve; Hendrick, Paul; Baxter, G David

    2013-11-01

    Current evidence supports the use of pedometers as effective motivational tools to promote physical activity and improve health-related quality of life in the general population. The aims of this study are to examine whether a pedometer-driven walking programme can improve health-related quality of life, and increase ambulatory activity in a population of meat processing workers when compared to a control group receiving educational material alone. A feasibility study employing a randomized controlled trial (RCT) design will collect data at three time points. A sample of up to 60 meat workers will be recruited and randomly assigned to either an intervention group N = 30 (12-week pedometer-driven walking program, brief intervention, and educational material), or control group N = 30 (educational material only). The primary outcomes of ambulatory activity, health-related quality of life, and functional capacity, will be evaluated at baseline, immediately following the 12-week intervention and then at three month post-intervention. This paper describes the design of a feasibility randomized controlled trial, which aims to assess the effectiveness of the introduction of a workplace pedometer-driven walking program compared to normal lifestyle advice in meat processing workers. 12613000087752.

  9. Improving Health and Quality of Life

    Science.gov (United States)

    ... Fatigue Syndrome (CFS) Share Compartir Improving Health and Quality of Life On this Page Cognitive Behavioral Therapy (CBT) Support ... and improve their ability to function and their quality of life. Doctors may refer some of their CFS patients ...

  10. Surface quality improvement of B{sub 4}C particles for electroless copper coating by Cu activation and oxidation roughening methods

    Energy Technology Data Exchange (ETDEWEB)

    Zheng, Jiyun [Joint Laboratory of Nuclear Materials and Service Safety, Graduate School at Shenzhen, Tsinghua University, Shenzhen 518055 (China); Shu, Guogang [China Nuclear Power Engineering Co., Ltd., Shenzhen (China); Wang, Wei [Joint Laboratory of Nuclear Materials and Service Safety, Graduate School at Shenzhen, Tsinghua University, Shenzhen 518055 (China); Li, Qiulin, E-mail: liql@sz.tsinghua.edu.cn [Joint Laboratory of Nuclear Materials and Service Safety, Graduate School at Shenzhen, Tsinghua University, Shenzhen 518055 (China); Liu, Wei [School of Materials Science and Engineering, Tsinghua University, Beijing 100084 (China)

    2015-09-15

    Highlights: • Cu activation increases surface activity by depositing Cu nano-crystals on B{sub 4}C. • The best result of Cu activation comes out at pH 12. • Oxidation roughening improves wettability of B{sub 4}C by aqueous solution. • Oxidation roughening promotes Cu nucleation on B{sub 4}C surface. - Abstract: Surface quality improvement by Cu activation and oxidation roughening process was studied during electroless coating Cu on boron carbide (B{sub 4}C) particles. The surface morphology was characterized by scanning electron microscope (SEM) and the phase identification was determined by X-ray diffraction (XRD) analysis. Two aspects concluding surface activation and surface roughening were investigated to understand the effect of each on Cu coating. Cu activation process increased surface activity of B{sub 4}C by pre-deposition Cu nano-crystals, which was effective and cost-saving when compared with conventional Pd activation method. The influence of activation pH on electroless Cu coating was discussed and a moderate pH 12 is suitable for Cu deposition. Surface roughening process availably promoted wettability of B{sub 4}C particles with aqueous solution. Etched pits were formed on B{sub 4}C surface and resulted in fresh surface exposed after oxidization roughening process, which was beneficial for Cu bonding and coating on B{sub 4}C surface.

  11. Teaching Quality Improvement Through a Book Club

    Directory of Open Access Journals (Sweden)

    Benjamin Doolittle

    2015-12-01

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

  12. A culturally adapted telecommunication system to improve physical activity, diet quality, and medication adherence among hypertensive African-Americans: a randomized controlled trial.

    Science.gov (United States)

    Migneault, Jeffrey P; Dedier, Julien J; Wright, Julie A; Heeren, Timothy; Campbell, Marci Kramish; Morisky, Donald E; Rudd, Peter; Friedman, Robert H

    2012-02-01

    Hypertension is more prevalent and clinically severe among African-Americans than whites. Several health behaviors influence blood pressure (BP) control, but effective, accessible, culturally sensitive interventions that target multiple behaviors are lacking. We evaluated a culturally adapted, automated telephone system to help hypertensive, urban African-American adults improve their adherence to their antihypertensive medication regimen and to evidence-based guidelines for dietary behavior and physical activity. We randomized 337 hypertensive primary care patients to an 8-month automated, multi-behavior intervention or to an education-only control. Medication adherence, diet, physical activity, and BP were assessed at baseline and every 4 months for 1 year. Data were analyzed using longitudinal modeling. The intervention was associated with improvements in a measure of overall diet quality (+3.5 points, p telecommunications systems can promote self-management of diet and energy balance in urban African-Americans.

  13. Quality assurance monitoring of a citywide transportation protocol improves clinical indicators of intravenous tissue plasminogen activator therapy: a community-based, longitudinal study.

    Science.gov (United States)

    Atsumi, Chihiro; Hasegawa, Yasuhiro; Tsumura, Kohtaro; Ueda, Toshihiro; Suzuki, Kazunari; Sugiyama, Makoto; Nozaki, Hiroyuki; Suzuki, Shinichi; Nakane, Makoto; Nagashima, Goro; Kitamura, Takayuki; Nikaido, Hirofumi; Sasanuma, Jinichi

    2015-01-01

    Stroke-bypass transportation to the stroke center by paramedics is important to maximize the efficiency of intravenous tissue plasminogen activator (iv-tPA) therapy. To improve access to stroke thrombolysis, a citywide protocol was launched on January 2007 in Kawasaki City (population 1.4 million) using the Maria Prehospital Stroke Scale (MPSS), and quality assurance monitoring has been performed every 6 months. The aim was to identify whether the citywide quality assurance monitoring improves the process and outcome of iv-tPA therapy. All of the MPSS-based transportation data prospectively recorded by the Kawasaki City Fire Department and the associated clinical data in the 11 hospitals that accept stroke-bypass transfers were merged every 6 months for the quality assurance monitoring. Clinical indicators such as ambulance call-to-door time, onset-to-needle time, door-to-needle time, frequency of thrombolytic use, and outcome of thrombolytic therapy were analyzed. These clinical indicators were also compared between patients transferred on weekdays and on weekends. A total of 2049 patients was registered from April 2009 to March 2013. Their mean age was 70.4 ± 13.2 (range, 24-98) years, and 64.3% were male. Ambulance call-to-door time decreased gradually from 37.5 ± 12.5 minutes to 33.9 ± 11.7 minutes over 4 years (P = .000, analysis of variance with the post hoc Dunnett test). Onset-to-needle time and door-to-needle time were similar over the 4 years. Good outcome (modified Rankin Scale score protocol significantly decreased the delay in the ambulance call-to-door time. The implementation of standardized cross-institutional quality assurance programs for acute stroke therapy may improve the process and outcome of iv-tPA therapy in the community. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  14. Quality improvement teaching at medical school: a student perspective

    Directory of Open Access Journals (Sweden)

    Nair P

    2016-03-01

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

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

    Science.gov (United States)

    Greene, Laurence; Moreo, Kathleen

    2015-01-01

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

  16. SF Bay Water Quality Improvement Fund

    Science.gov (United States)

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

  17. Improvement of catheter quality inspection process

    Directory of Open Access Journals (Sweden)

    Bożek Mariusz

    2017-01-01

    Full Text Available Quality inspection is very often one of the most important stages of the production process, although it does not create any added value. Therefore, optimization of the related number of activities is of crucial importance. However, reduction should not be made arbitrarily, but preceded and documented by appropriate research. The article describes a study aimed at reducing the high cost of quality inspection as part of the manufacturing process of a diagnostic catheter at a medical company. The product is used for blood pressure monitoring and blood sampling by the Seldinger technique. A critical quality feature for the catheter is air/water tightness. Following a thorough analysis, some control points were eliminated, and others were improved. The resulting conclusion is that detection of defective components is the most beneficial for this specific production process if carried out during the 100 percent final quality inspection. The finding is based on the fact that the cost of producing the final device with a defective component is lower than a quality inspection run directly after each operation. The authors also managed to decrease the sample size for control charts used to supervise the adhesive connection strength.

  18. Improving Operational Readiness through Total Quality Management

    Science.gov (United States)

    1991-06-21

    DTIC AD-A236 611 EL CT F NAVAL WAR COLL GE C Newport, R. I. IMPROVING OPERATIONAL READINESS THROUGH TOTAL QUALITY MANAGEMENT by Herb Westphal Defense...IMPROVING OPERATIONAL READINESS THROUGH TOTAL QUALITY MANAGEMENT (TQM) A Case Study: The Defense Mapping Agency Combat Support Center (DMACSC) initiated a...of the Defense Mapping Agency Combat Support Center’s (DMACSC) Total Quality Management (TQM) improvement methodology. This allows the reader to

  19. African primary care research: Quality improvement cycles

    Directory of Open Access Journals (Sweden)

    Claire Van Deventer

    2014-01-01

    Full Text Available Improving the quality of clinical care and translating evidence into clinical practice is commonly a focus of primary care research. This article is part of a series on primary care research and outlines an approach to performing a quality improvement cycle as part of a research assignment at a Masters level. The article aims to help researchers design their quality improvement cycle and write their research project proposal.

  20. African primary care research: quality improvement cycles.

    Science.gov (United States)

    van Deventer, Claire; Mash, Bob

    2014-04-24

    Improving the quality of clinical care and translating evidence into clinical practice is commonly a focus of primary care research. This article is part of a series on primary care research and outlines an approach to performing a quality improvement cycle as part of a research assignment at a Masters level. The article aims to help researchers design their quality improvement cycle and write their research project proposal.

  1. How to Begin a Quality Improvement Project.

    Science.gov (United States)

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

    2016-05-01

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

  2. Training health professionals to implement quality improvement activities. Results of a randomized controlled trial after one year of follow-up.

    Science.gov (United States)

    Saturno, P J

    1995-06-01

    To test the advantages of training and of a trainee-centered educational strategy for the implementation of quality evaluation and improvement (QI) activities in Health Centres (HCs). Experimental, with random assignment of HCs to three different groups, two for two different training methods and one as control group. Each group had 10 HCs. HCs network of the region of Murcia (Spain). Selected PHC personnel, grouped by study groups. One of the groups (GI) received trainee-centered training on QI methods with problem-solving oriented methodology. A second group (GII) received more traditional training. The third group (GIII) received no training. 1. Knowledge test before and after the seminars. 2. Post-seminar survey to assess trainees' appraisal of the seminar experience and attitudes towards implementation of QI activities. 3. One year follow-up survey to assess actual implementation of QI activities and attitude towards more training. GI showed significantly higher scores than GII regarding both their subjective appraisal of the training experience, and actual implementation of activities. No QI activity was found in any GIII Center. We conclude that the importance of training in the implementation of QI activities has been confirmed, and also that training method does matter.

  3. CONTINUOUS IMPROVEMENT THROUGH INTEGRATION OF QUALITY TOOLS

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    The relationship between major quality tools such as quality function development (QFD),failure mode and effects analysis (FMEA), design of experiments (DOE) and statistical process control (SPC) is analyzed through an extensive review of the literature and the concurrent quality engineering philosophy, and a basic structure for the integration of quality tools is presented. An integrated quality management system (IQMS) is developed using C++ Builder, nmning in the Windows 2000 Server environment with the basic internet connections, and SQL Server 2000 as the platform for developing the database. An illustrative example applying IQMS to the continuous quality improvement for a crane equipment manufacturing is reported. The result shows that the application of IQMS can optimize the process of design and manufacturing, shorten the cycle time of product, reduce the cost, and realize quality improvement continuously. The proposed integrated framework with IQMS is believed to be applicable to continuous quality improvement in many manufacturing companies.

  4. [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

  5. Study designs for PDSA quality improvement research.

    Science.gov (United States)

    Speroff, Theodore; O'Connor, Gerald T

    2004-01-01

    The purpose of this article is to discuss strengths and weaknesses of quasi-experimental designs used in health care quality improvement research. The target groups for this article are investigators in plan-do-study-act (PDSA) quality improvement initiatives who wish to improve the rigor of their methodology and publish their work and reviewers who evaluate the quality of research proposals or published work. A primary purpose of PDSA quality improvement research is to establish a functional relationship between process changes in systems of health care and variation in outcomes. The time series design is the fundamental paradigm for demonstrating such functional relationships. The rigor of a PDSA quality improvement study design is strengthened using replication schemes and research methodology to address extraneous factors that weaken validity of observational studies. The design of PDSA quality improvement research should follow from the purpose and context of the project. Improving the rigor of the quality improvement literature will build a stronger foundation and more convincing justification for the study and practice of quality improvement in health care.

  6. Techniques to improve technological and sanitary quality

    OpenAIRE

    David, C.; Celette, F.; Abecassis, J; Carcea, M.; Dubois, D.; Friedel, J. K.; Hellou, G.; Jeuffroy, M.-H.; Mäder, P.; Thomsen, I.K.

    2012-01-01

    Agronomical ways for better quality and safety Choice of cultivar is an efficient way to obtain higher grain quality. Intercropping legumes (grain or forage) improves weed competition and N availability for wheat crop or succeeding crop. Green manure can be an effective alternative to farmyard manure. Fertilization with readily available nitrogen improves yield and quality when water is available. Reduced tillage affects soil fertility and wheat yield but has little effects on grain qualit...

  7. Nationwide quality improvement in lung cancer care

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  8. Quality improvement practices and trends in Denmark

    DEFF Research Database (Denmark)

    Dahlgaard, Jens Jørn; Hartz, Ove; Edgeman, Rick L.

    1998-01-01

    It is now well known that the history of quality improvement is neither uniquely American, nor uniquely Japanese, although the contributions from these two nations have received more attention perhaps than those originating elsewhere. This is the first in a series of articles intended to increase...... awareness of quality improvement practices and trends in various European nations, with particular emphasis on western Europe and Scandinavia. Herein the recent history of quality improvement in Denmark is explored and the quality improvement efforts in two Danish companies are chronicled. It is hoped...... that taken in its entirety, this series of articles will contribute to understanding both the rich fabric of European quality improvement that is independent of national boundaries and the colorful national fibers of which the fabric is made....

  9. Power Quality Improvement Using DVR

    Directory of Open Access Journals (Sweden)

    C. Benachaiba

    2009-01-01

    Full Text Available Voltage sags and swells in the medium and low voltage distribution grid are considered to be the most frequent type of power quality problems based on recent power quality studies. Their impact on sensitive loads is severe. The impact ranges from load disruptions to substantial economic losses up to millions of dollars. Different solutions have been developed to protect sensitive loads against such disturbances but the DVR is considered to be the most efficient and effective solution. Its appeal includes lower cost, smaller size and its dynamic response to the disturbance. This research described DVR principles and voltage restoration methods for balanced and/or unbalanced voltage sags and swells in a distribution system. Simulation results were presented to illustrate and understand the performances of DVR under voltage sags/swells conditions.

  10. Foliage Plants for Improving Indoor Air Quality

    Science.gov (United States)

    Wolverton, B. C.

    1988-01-01

    NASA's research with foliage houseplants during the past 10 years has produced a new concept in indoor air quality improvement. This new and exciting technology is quite simple. Both plant leaves and roots are utilized in removing trace levels of toxic vapors from inside tightly sealed buildings. Low levels of chemicals such as carbon monoxide and formaldehyde can be removed from indoor environments by plant leaves alone, while higher concentrations of numerous toxic chemicals can be removed by filtering indoor air through the plant roots surrounded by activated carbon. The activated carbon absorbs large quantities of the toxic chemicals and retains them until the plant roots and associated microorganisms degrade and assimilate these chemicals.

  11. Modeling regional air quality and climate: improving organic aerosol and aerosol activation processes in WRF/Chem version 3.7.1

    Science.gov (United States)

    Yahya, Khairunnisa; Glotfelty, Timothy; Wang, Kai; Zhang, Yang; Nenes, Athanasios

    2017-06-01

    Air quality and climate influence each other through the uncertain processes of aerosol formation and cloud droplet activation. In this study, both processes are improved in the Weather, Research and Forecasting model with Chemistry (WRF/Chem) version 3.7.1. The existing Volatility Basis Set (VBS) treatments for organic aerosol (OA) formation in WRF/Chem are improved by considering the following: the secondary OA (SOA) formation from semi-volatile primary organic aerosol (POA), a semi-empirical formulation for the enthalpy of vaporization of SOA, and functionalization and fragmentation reactions for multiple generations of products from the oxidation of VOCs. Over the continental US, 2-month-long simulations (May to June 2010) are conducted and results are evaluated against surface and aircraft observations during the Nexus of Air Quality and Climate Change (CalNex) campaign. Among all the configurations considered, the best performance is found for the simulation with the 2005 Carbon Bond mechanism (CB05) and the VBS SOA module with semivolatile POA treatment, 25 % fragmentation, and the emissions of semi-volatile and intermediate volatile organic compounds being 3 times the original POA emissions. Among the three gas-phase mechanisms (CB05, CB6, and SAPRC07) used, CB05 gives the best performance for surface ozone and PM2. 5 concentrations. Differences in SOA predictions are larger for the simulations with different VBS treatments (e.g., nonvolatile POA versus semivolatile POA) compared to the simulations with different gas-phase mechanisms. Compared to the simulation with CB05 and the default SOA module, the simulations with the VBS treatment improve cloud droplet number concentration (CDNC) predictions (normalized mean biases from -40.8 % to a range of -34.6 to -27.7 %), with large differences between CB05-CB6 and SAPRC07 due to large differences in their OH and HO2 predictions. An advanced aerosol activation parameterization based on the Fountoukis and Nenes

  12. Discovery of novel Bmy1 alleles increasing β-amylase activity in Chinese landraces and Tibetan wild barley for improvement of malting quality via MAS.

    Directory of Open Access Journals (Sweden)

    Xue Gong

    Full Text Available China has a large barley germplasm collection which has not been well characterized and is therefore underutilized. The Bmy1 locus encoding the β-amylase enzyme on chromosome 4H has been well characterized in the worldwide barley germplasm collections due to its importance in the malting and brewing industry. The Bmy1 locus was chosen as an indicator to understand genetic potential for improvement of malting quality in Chinese landraces and Tibetan wild barley. The genetic diversity of 91 barley accessions was assessed using allele specific Multiplex-ready molecular markers. Eight accessions were further sequenced, based on the Multiplex-ready marker diversity for Bmy1 in the germplasm. Six of the eight accessions clustered together in a unique group, and showed similarities to 'Haruna Nijo', wild barley accession PI296896 and 'Ashqelon'. Sequence comparisons with the known Bmy1 alleles identified not only the existing 13 amino acid substitutions, but also a new substitution positioned at A387T from a Chinese landrace W127, which has the highest β-amylase activity. Two new alleles/haplotypes namely Bmy1-Sd1c and Bmy1-Sd5 were designated based on different amino acid combinations. We identified new amino acid combination of C115, D165, V233, S347 and V430 in the germplasm. The broad variation in both β-amylase activity and amino acid composition provides novel alleles for the improvement of malting quality for different brewing styles, which indicates the high potential value of the Chinese landraces and Tibetan wild barley.

  13. Can Technology Improve the Quality of Colonoscopy?

    Science.gov (United States)

    Thirumurthi, Selvi; Ross, William A; Raju, Gottumukkala S

    2016-07-01

    In order for screening colonoscopy to be an effective tool in reducing colon cancer incidence, exams must be performed in a high-quality manner. Quality metrics have been presented by gastroenterology societies and now include higher adenoma detection rate targets than in the past. In many cases, the quality of colonoscopy can often be improved with simple low-cost interventions such as improved procedure technique, implementing split-dose bowel prep, and monitoring individuals' performances. Emerging technology has expanded our field of view and image quality during colonoscopy. We will critically review several technological advances in the context of quality metrics and discuss if technology can really improve the quality of colonoscopy.

  14. The impact of leadership qualities on quality management improvement

    Directory of Open Access Journals (Sweden)

    Ph. D. Radoslaw Wolniak

    2011-05-01

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

  15. The impact of leadership qualities on quality management improvement

    Directory of Open Access Journals (Sweden)

    Radoslaw Wolniak

    2011-12-01

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

  16. [Quality improvement potential in the pharmaceutical industry].

    Science.gov (United States)

    Nusser, Michael

    2007-01-01

    The performance of the German pharmaceutical industry, future challenges and obstacles to quality improvement are assessed from a systems-of-innovation perspective, using appropriate innovation indicators. The current close-to-market performance indicators paint an unfavourable picture. Early R&D indicators (e.g., publications, patents), however, reveal a positive trend. A lot of obstacles to quality improvements are identified with respect to knowledge base, knowledge/technology transfer, industrial R&D processes, capital markets, market attractiveness and both regulatory and political framework conditions. On this basis, recommendations will finally be derived to improve quality in the pharmaceutical industry.

  17. The ReACH Collaborative--improving quality home care.

    Science.gov (United States)

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

    2007-08-01

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

  18. [Quality improvement of medical diagnostic laboratories].

    Science.gov (United States)

    Horváth, Andrea Rita; Endröczi, Elemér; Mikó, Tivadar

    2003-07-13

    Service quality in medical laboratories is influenced by a number of variables. Medical laboratories have long recognized the need for total quality management that incorporates the continuous improvement of all stages, such as the pre-analytical, analytical and post-analytical phases, of the diagnostic process, in addition to the traditional internal and external quality control of analytical procedures. Based on national and international experience, continuous improvement of quality and its external assessment are of high priority in order to guarantee a reliable, effective and cost-effective diagnostic service. Certification of health care services, according to ISO 9001 standards in Hungarian hospitals, is not sufficient to prove professional competence of medical laboratories, which called for a system of laboratory accreditation. Accreditation is an external professional audit by which an independent accreditation body gives formal recognition that the medical laboratory is competent to provide high quality services that are compliant with rigorous professional standards of best practice. The primary aim of accreditation is the improvement of the quality of diagnostic services by voluntary participation, professional peer review, continuous training and education and compliance with professional standards. In vitro medical laboratories have pioneered quality control and quality assurance in health care. Based on these strengths and traditions, the introduction of the accreditation program of medical laboratories in Hungary is one of the key professional and ethical responsibilities of diagnostic professions, in order to improve the quality, efficiency and effectiveness of laboratory services during the course of Hungary's accession to the European Union.

  19. Healthcare quality improvement programme improves monitoring of people with diabetes

    NARCIS (Netherlands)

    Denig, Petra

    2004-01-01

    Question. Does a healthcare quality improvement programme, incorporating education and claims-based feedback about practice-specific models of monitoring diabetes care, increase the regularity with which primary care physicians assess people with diabetes mellitus receiving Medicare benefits? Study

  20. Supporting colleagues to improve care: educating for quality improvement.

    Science.gov (United States)

    Runnacles, Jane; Roueché, Alice

    2015-08-01

    Clinicians at the front line of healthcare delivery are very well positioned to identify and improve the system in which they work. Training curricula, however, have not always equipped them with the skills or knowledge to implement change. This article looks at educational approaches to support clinicians to be actively involved with quality improvement (QI). It looks at the role of doctors in postgraduate training (DrPGT) and their educational supervisors and builds on the topics discussed throughout the 'EQUIPPED' article series. Factors for success of a QI education programme and practical ideas for overcoming barriers to supporting clinicians in QI are discussed. We present examples of educational initiatives and a framework for evaluating such programmes, and we examine the role of faculty development to help inspire and support colleagues to improve care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  1. Use of Electronic Documentation for Quality Improvement in Hospice

    Science.gov (United States)

    Cagle, John G.; Rokoske, Franziska S.; Durham, Danielle; Schenck, Anna P.; Spence, Carol; Hanson, Laura C.

    2015-01-01

    Little evidence exists on the use of electronic documentation in hospice and its relationship to quality improvement practices. The purposes of this study were to: (1) estimate the prevalence of electronic documentation use in hospice; (2) identify organizational characteristics associated with use of electronic documentation; and (3) determine whether quality measurement practices differed based on documentation format (electronic vs. nonelectronic). Surveys concerning the use of electronic documentation for quality improvement practices and the monitoring of quality-related care and outcomes were collected from 653 hospices. Users of electronic documentation were able to monitor a wider range of quality-related data than users of nonelectronic documentation. Quality components such as advanced care planning, cultural needs, experience during care of the actively dying, and the number/types of care being delivered were more likely to be documented by users of electronic documentation. Use of electronic documentation may help hospices to monitor quality and compliance. PMID:22267819

  2. Modeling regional air quality and climate: improving organic aerosol and aerosol activation processes in WRF/Chem version 3.7.1

    Directory of Open Access Journals (Sweden)

    K. Yahya

    2017-06-01

    Full Text Available Air quality and climate influence each other through the uncertain processes of aerosol formation and cloud droplet activation. In this study, both processes are improved in the Weather, Research and Forecasting model with Chemistry (WRF/Chem version 3.7.1. The existing Volatility Basis Set (VBS treatments for organic aerosol (OA formation in WRF/Chem are improved by considering the following: the secondary OA (SOA formation from semi-volatile primary organic aerosol (POA, a semi-empirical formulation for the enthalpy of vaporization of SOA, and functionalization and fragmentation reactions for multiple generations of products from the oxidation of VOCs. Over the continental US, 2-month-long simulations (May to June 2010 are conducted and results are evaluated against surface and aircraft observations during the Nexus of Air Quality and Climate Change (CalNex campaign. Among all the configurations considered, the best performance is found for the simulation with the 2005 Carbon Bond mechanism (CB05 and the VBS SOA module with semivolatile POA treatment, 25 % fragmentation, and the emissions of semi-volatile and intermediate volatile organic compounds being 3 times the original POA emissions. Among the three gas-phase mechanisms (CB05, CB6, and SAPRC07 used, CB05 gives the best performance for surface ozone and PM2. 5 concentrations. Differences in SOA predictions are larger for the simulations with different VBS treatments (e.g., nonvolatile POA versus semivolatile POA compared to the simulations with different gas-phase mechanisms. Compared to the simulation with CB05 and the default SOA module, the simulations with the VBS treatment improve cloud droplet number concentration (CDNC predictions (normalized mean biases from −40.8 % to a range of −34.6 to −27.7 %, with large differences between CB05–CB6 and SAPRC07 due to large differences in their OH and HO2 predictions. An advanced aerosol activation

  3. Improving embryo quality in assisted reproduction

    NARCIS (Netherlands)

    Mantikou, E.

    2013-01-01

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

  4. Georgia - Improving General Education Quality, Improved Learning Environment Infrastructure

    Data.gov (United States)

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

  5. Continuous quality improvement in nursing service.

    Science.gov (United States)

    Sorrentino, E A

    1992-03-01

    The 1991 Joint Commission standards specify continuous quality improvement in nursing services as a required characteristic. Chief nursing executives are in key positions to spearhead the quality movement in health care services. The 14 points of Deming's philosophy are highly relevant to health care organizations, specifically to nursing services. Each concept within the philosophy has broad applicability, and an organization with a firm commitment to neverending improvement will find it useful. Of primary importance is the recognition that short-run profits that sacrifice quality in patient care do not last. If a health care organization is to survive in a competitive environment, it is essential that a quality philosophy not just be espoused but practiced as well.

  6. Coordination mechanisms for quality improvement and market access in Ethiopian potato value chains

    NARCIS (Netherlands)

    Abebe, G.K.

    2013-01-01

      Market access for smallholders in developing countries often requires the improvement of product quality. As products are traded in value chains, quality improvement entails the coordination of activities and decisions by all actors in the chain. Thus, enhancing smallholders’

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

    Science.gov (United States)

    Godény, Sándor

    2012-02-01

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

  8. Fostering Quality Improvement in EHDI Programs

    Science.gov (United States)

    Bradham, Tamala S.; Hoffman, Jeff; Houston, K. Todd; Guignard, Gayla Hutsell

    2011-01-01

    State coordinators of early hearing detection and intervention (EHDI) programs completed a strengths, weaknesses, opportunities, and threats, or SWOT, analysis that consisted of 12 evaluative areas of EHDI programs. For the quality improvement area, a total of 218 items were listed by 47 EHDI coordinators, and themes were identified in each…

  9. Quality Improvement in University Counseling Centers

    Science.gov (United States)

    Maffini, Cara S.; Toth, Paul L.

    2017-01-01

    University Counseling Centers (UCCs) experience high clinical demands and severe client presentations leaving counselors with limited time and resources to evaluate delivery of services. In this article, we present clinician-friendly quality improvement (QI) strategies used at a large Midwestern university and provide recommendations for…

  10. Fostering Quality Improvement in EHDI Programs

    Science.gov (United States)

    Bradham, Tamala S.; Hoffman, Jeff; Houston, K. Todd; Guignard, Gayla Hutsell

    2011-01-01

    State coordinators of early hearing detection and intervention (EHDI) programs completed a strengths, weaknesses, opportunities, and threats, or SWOT, analysis that consisted of 12 evaluative areas of EHDI programs. For the quality improvement area, a total of 218 items were listed by 47 EHDI coordinators, and themes were identified in each…

  11. ADVANCES IN TRANSGENIC MAIZE FOR QUALITY IMPROVEMENT

    Directory of Open Access Journals (Sweden)

    M.Rajendar Reddy

    2015-12-01

    Full Text Available Maize (Zea mays is a major food and animal feed worldwide and occupies a relevant place in the world economy and trade as an industrial grain crop. Currently more than 70% of maize production is used for food and feed; therefore, knowledge of genes involved in grain structure and chemical is important for improving the nutritional and food-making properties of maize. It is a good source of carbohydrates, fats, proteins, vitamins and minerals but deficient in two essential amino acids, Viz., lysine and tryptophan. To overcome this problem and to improve the above quality characters the maize breeders have followed different strategies like opaque 2, QPM and development of transgenic maize with improved quality characters. Finally we can conclude that the conventional breeding techniques and now plant biotechnology are helping meet the growing demand for food production, nutrition security while preserving our environment for future generations

  12. Creating quality improvement culture in public health agencies.

    Science.gov (United States)

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

    2014-01-01

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

  13. Pediatric CT quality management and improvement program

    Energy Technology Data Exchange (ETDEWEB)

    Larson, David B.; Chan, Frandics P.; Newman, Beverley; Fleischmann, Dominik [Stanford University School of Medicine, Department of Radiology, Stanford, CA (United States); Molvin, Lior Z. [Stanford Hospital and Clinics, Stanford, CA (United States); Wang, Jia [Stanford University, Environmental Health and Safety, Stanford, CA (United States)

    2014-10-15

    Modern CT is a powerful yet increasingly complex technology that continues to rapidly evolve; optimal clinical implementation as well as appropriate quality management and improvement in CT are challenging but attainable. This article outlines the organizational structure on which a CT quality management and improvement program can be built, followed by a discussion of common as well as pediatric-specific challenges. Organizational elements of a CT quality management and improvement program include the formulation of clear objectives; definition of the roles and responsibilities of key personnel; implementation of a technologist training, coaching and feedback program; and use of an efficient and accurate monitoring system. Key personnel and roles include a radiologist as the CT director, a qualified CT medical physicist, as well as technologists with specific responsibilities and adequate time dedicated to operation management, CT protocol management and CT technologist education. Common challenges in managing a clinical CT operation are related to the complexity of newly introduced technology, of training and communication and of performance monitoring. Challenges specific to pediatric patients include the importance of including patient size in protocol and dose considerations, a lower tolerance for error in these patients, and a smaller sample size from which to learn and improve. (orig.)

  14. Internal Resources to Improve the Quality of Higher Education

    Directory of Open Access Journals (Sweden)

    Tatyana V. Zak

    2016-03-01

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

  15. Oil Products Quality Improvement by Adsorption Method

    Directory of Open Access Journals (Sweden)

    Kulash K. Syrmanova

    2017-02-01

    Full Text Available Petroleum takes the leading place in fuel and energy sector. It is a basis of fuel and energy balance of advanced countries economics. Light oil proven reserves reducing is a general trend of modern oil industry development. Almost the entire increase in reserves is due to viscous heavy sour oil [1-2]. Nowadays quality of the most important oil products is a crucial problem in refinery industry. The problem of oil products quality is connected with their using and operation in engines and machines. Requirements increasing to stability and effective technics maintenance leads to oil products running abilities significant hardening. In order to protect the environment, the task to obtain oil products with improved environmental properties was assigned. Properties of the oil determine the direction and condition of its processing and directly affect the quality of the oil products [3-4].

  16. 2.2 Continuous quality improvement.

    Science.gov (United States)

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

    2002-01-01

    Continuous quality improvement (CQI) can be envisaged as a circular process of goal-setting, followed by external and internal evaluations resulting in improvements that can serve as goals for a next cycle. The need for CQI is apparent, because of public accountability, maintaining European standards and the improvement of dental education. Many examples are known where recommendations from both external and internal evaluation are used for the improvement of dental education. Unfortunately, the implementation of the recommendations is inconsistent, rarely systematic and usually not transparent. This section agreed that it is essential to apply CQI in a structured, systematic and transparent way if we are to improve and maintain the quality of dental education. A model is proposed which includes three aspects: a) the process of CQI; b) the subjects to which CQI should be applied; and c) the management tools to govern CQI. It is stressed, that CQI is a process that can be applied in any dental school irrespective of curriculum or educational approach within the relevant context of the country or the region. The approach needs to recognize the complexity and the need to balance a quality improvement with accountability. A CQI system is also constrained in any organization by the attitudes and values of the staff. Inevitably there has to be a wide range in the application of CQI. Nevertheless, an agreed model on CQI might enhance convergence towards higher standards of dental education. The process of CQI can be supported by developments in information and communication technology (ICT): collection of data, identifying the steps in CQI, formats of reports, etc. The section was set, as one of its tasks, to advise on the development of a network based on a number of case studies on the application of CQI in dental education.

  17. A Model to Improve the Quality Products

    Directory of Open Access Journals (Sweden)

    Hasan GOKKAYA

    2010-08-01

    Full Text Available The topic of this paper is to present a solution who can improve product qualityfollowing the idea: “Unlike people who have verbal skills, machines use "sign language"to communicate what hurts or what has invaded their system’. Recognizing the "signs"or symptoms that the machine conveys is a required skill for those who work withmachines and are responsible for their care and feeding. The acoustic behavior of technical products is predominantly defined in the design stage, although the acoustic characteristics of machine structures can be analyze and give a solution for the actual products and create a new generation of products. The paper describes the steps intechnological process for a product and the solution who will reduce the costs with the non-quality of product and improve the management quality.

  18. Improvements in geomagnetic observatory data quality

    DEFF Research Database (Denmark)

    Reda, Jan; Fouassier, Danielle; Isac, Anca

    2011-01-01

    between observatories and the establishment of observatory networks has harmonized standards and practices across the world; improving the quality of the data product available to the user. Nonetheless, operating a highquality geomagnetic observatory is non-trivial. This article gives a record...... of the current state of observatory instrumentation and methods, citing some of the general problems in the complex operation of geomagnetic observatories. It further gives an overview of recent improvements of observatory data quality based on presentation during 11th IAGA Assembly at Sopron and INTERMAGNET......Geomagnetic observatory practice and instrumentation has evolved significantly over the past 150 years. Evolution continues to be driven by advances in technology and by the need of the data user community for higher-resolution, lower noise data in near-real time. Additionally, collaboration...

  19. Improving the ignition quality of fuels

    KAUST Repository

    Sarathy, Mani

    2017-06-08

    Provided herein are compounds and methods of producing compounds for improving ignition quality and combustion efficiency of fuels, for example fossil fuels. In various aspects we generate highly oxygenated compounds from hydrocarbon feedstocks. The feedstock can be a branched alkane or n-alkane having a chain length greater than or equal to 6, a cycloalkane with a 5 or 6 membered ring structure, or a alkylated cycloalkane with 5 or more carbon atoms. The reactant can be fed in the gas- phase to a partial oxidation reactor (with or without a catalyst), and at a fixed temperature, mixture composition, and residence time. The reactant can be converted to a mixture of products including keto hydroperoxides, diketo hydroperoxides, keto dihydroperoxides, hydroperoxyl cyclic ethers, and alkenyl hydroperoxides. The compounds are inherently unstable and can quickly decompose to highly reactive radical species that can be used to improve the ignition quality of a fuel and advance ignition in an engine.

  20. A Model to Improve the Quality Products

    OpenAIRE

    2010-01-01

    The topic of this paper is to present a solution who can improve product quality following the idea: “Unlike people who have verbal skills, machines use "sign language" to communicate what hurts or what has invaded their system’. Recognizing the "signs" or symptoms that the machine conveys is a required skill for those who work with machines and are responsible for their care and feeding. The acoustic behavior of technical products is predominantly defined in the design stage, although the ac...

  1. Quality improvement in neurology: AAN Parkinson disease quality measures

    Science.gov (United States)

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

    2010-01-01

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

  2. Bioethanol Quality Improvement of Coffee Fruit Leather

    Directory of Open Access Journals (Sweden)

    Edahwati Luluk

    2016-01-01

    Full Text Available Recently, Indonesia’s dependence on petroleum is to be reduced and even eliminated. To overcome the problem of finding the needed alternative materials that can produce ethanol, in this case as a substitute material or a transport fuel mix, boosting the octane number, and gasoline ethanol (gasohol can be conducted. In the red coffee processing (cooking that will produce 65% and 35% of coffee beans, coffee leather waste is a source of organic material with fairly high cellulose content of 46.82%, 3.01% of pectin and 7.68% of lignin. In this case, its existence is abundant in Indonesia and optimally utilized. During the coffee fruit peeling, the peel waste is only used as a mixture of animal feed or simply left to rot. The purpose of this study was to produce and improve the quality of the fruit skin of bioethanol from coffee cellulose. However, to improve the quality of bioethanol, the production of the lignin content in the skin of the coffee fruit should be eliminated or reduced. Hydrolysis process using organosolve method is expected to improve the quality of bioethanol produced. In particular, the use of enzyme Saccharomyces and Zymmomonas will change the resulting sugar into bioethanol. On one hand, by using batch distillation process for 8 hours with Saccharomyces, bioethanol obtains high purity which is 39.79%; on the other hand, by using the same batch distillation process with Zymmomonas, the bioethanol obtains 38.78%.

  3. Development of Real Time Implementation of 5/5 Rule based Fuzzy Logic Controller Shunt Active Power Filter for Power Quality Improvement

    Science.gov (United States)

    Puhan, Pratap Sekhar; Ray, Pravat Kumar; Panda, Gayadhar

    2016-12-01

    This paper presents the effectiveness of 5/5 Fuzzy rule implementation in Fuzzy Logic Controller conjunction with indirect control technique to enhance the power quality in single phase system, An indirect current controller in conjunction with Fuzzy Logic Controller is applied to the proposed shunt active power filter to estimate the peak reference current and capacitor voltage. Current Controller based pulse width modulation (CCPWM) is used to generate the switching signals of voltage source inverter. Various simulation results are presented to verify the good behaviour of the Shunt active Power Filter (SAPF) with proposed two levels Hysteresis Current Controller (HCC). For verification of Shunt Active Power Filter in real time, the proposed control algorithm has been implemented in laboratory developed setup in dSPACE platform.

  4. Alemtuzumab improves quality-of-life outcomes compared with subcutaneous interferon beta-1a in patients with active relapsing-remitting multiple sclerosis.

    Science.gov (United States)

    Arroyo González, Rafael; Kita, Mariko; Crayton, Heidi; Havrdova, Eva; Margolin, David H; Lake, Stephen L; Giovannoni, Gavin

    2017-09-01

    Alemtuzumab was superior on clinical and magnetic resonance imaging (MRI) outcomes versus subcutaneous interferon beta-1a in phase 3 trials in patients with relapsing-remitting multiple sclerosis. To examine quality-of-life (QoL) outcomes in the alemtuzumab phase 3 trials. Patients who were treatment naive (Comparison of Alemtuzumab and Rebif(®) Efficacy in Multiple Sclerosis I [CARE-MS I]) or had an inadequate response to prior therapy (CARE-MS II) received annual courses of alemtuzumab 12 mg/day at baseline (5 days) and Month 12 (3 days) or subcutaneous interferon beta-1a 44 µg three times/week. QoL was measured every 6 or 12 months using Functional Assessment of Multiple Sclerosis (FAMS), European Quality of Life-5 Dimensions (EQ-5D) and its visual analog scale (EQ-VAS), and 36-Item Short-Form Survey (SF-36). Statistically significant improvements from baseline with alemtuzumab were observed on all three QoL instruments at the earliest post-baseline assessment and sustained through Year 2. Statistically significant greater QoL improvements over subcutaneous interferon beta-1a were seen at all time points in CARE-MS II with FAMS, EQ-VAS and SF-36 physical component summary, and in CARE-MS I with FAMS. Patients treated with alemtuzumab had improvements in physical, mental, and emotional QoL regardless of treatment history. Improvements were significantly greater with alemtuzumab versus subcutaneous interferon beta-1a on both disease-specific and general measures of QoL.

  5. The SQUIRE (Standards for QUality Improvement Reporting Excellence) guidelines for quality improvement reporting: explanation and elaboration.

    Science.gov (United States)

    Ogrinc, G; Mooney, S E; Estrada, C; Foster, T; Goldmann, D; Hall, L W; Huizinga, M M; Liu, S K; Mills, P; Neily, J; Nelson, W; Pronovost, P J; Provost, L; Rubenstein, L V; Speroff, T; Splaine, M; Thomson, R; Tomolo, A M; Watts, B

    2008-10-01

    As the science of quality improvement in health care advances, the importance of sharing its accomplishments through the published literature increases. Current reporting of improvement work in health care varies widely in both content and quality. It is against this backdrop that a group of stakeholders from a variety of disciplines has created the Standards for QUality Improvement Reporting Excellence, which we refer to as the SQUIRE publication guidelines or SQUIRE statement. The SQUIRE statement consists of a checklist of 19 items that authors need to consider when writing articles that describe formal studies of quality improvement. Most of the items in the checklist are common to all scientific reporting, but virtually all of them have been modified to reflect the unique nature of medical improvement work. This "Explanation and Elaboration" document (E & E) is a companion to the SQUIRE statement. For each item in the SQUIRE guidelines the E & E document provides one or two examples from the published improvement literature, followed by an analysis of the ways in which the example expresses the intent of the guideline item. As with the E & E documents created to accompany other biomedical publication guidelines, the purpose of the SQUIRE E & E document is to assist authors along the path from completion of a quality improvement project to its publication. The SQUIRE statement itself, this E & E document, and additional information about reporting improvement work can be found at http://www.squire-statement.org.

  6. The SQUIRE (Standards for QUality Improvement Reporting Excellence) guidelines for quality improvement reporting: explanation and elaboration

    Science.gov (United States)

    Ogrinc, G; Mooney, S E; Estrada, C; Foster, T; Goldmann, D; Hall, L W; Huizinga, M M; Liu, S K; Mills, P; Neily, J; Nelson, W; Pronovost, P J; Provost, L; Rubenstein, L V; Speroff, T; Splaine, M; Thomson, R; Tomolo, A M; Watts, B

    2008-01-01

    As the science of quality improvement in health care advances, the importance of sharing its accomplishments through the published literature increases. Current reporting of improvement work in health care varies widely in both content and quality. It is against this backdrop that a group of stakeholders from a variety of disciplines has created the Standards for QUality Improvement Reporting Excellence, which we refer to as the SQUIRE publication guidelines or SQUIRE statement. The SQUIRE statement consists of a checklist of 19 items that authors need to consider when writing articles that describe formal studies of quality improvement. Most of the items in the checklist are common to all scientific reporting, but virtually all of them have been modified to reflect the unique nature of medical improvement work. This “Explanation and Elaboration” document (E & E) is a companion to the SQUIRE statement. For each item in the SQUIRE guidelines the E & E document provides one or two examples from the published improvement literature, followed by an analysis of the ways in which the example expresses the intent of the guideline item. As with the E & E documents created to accompany other biomedical publication guidelines, the purpose of the SQUIRE E & E document is to assist authors along the path from completion of a quality improvement project to its publication. The SQUIRE statement itself, this E & E document, and additional information about reporting improvement work can be found at http://www.squire-statement.org. PMID:18836062

  7. Improve the teaching quality by two-way education mode

    Directory of Open Access Journals (Sweden)

    Hongyan Shi

    2017-02-01

    Full Text Available Teaching activities contain teaching and learning, and both teachers and students have to work hard to improve the quality of teaching. This essay introduced the basic conception of “two-way and five-ring” mode first, and expatiated on the structure of this mode. The author used her own experiences to combine the teaching mode with the real situation of military school, emphasized teaching itself and talked about some spe-cific plans. This will give a certain extend help in improving the quality of teaching in military school.

  8. 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...

  9. Health care quality improvement publication trends.

    Science.gov (United States)

    Sun, Gordon H; MacEachern, Mark P; Perla, Rocco J; Gaines, Jean M; Davis, Matthew M; Shrank, William H

    2014-01-01

    To analyze the extent of academic interest in quality improvement (QI) initiatives in medical practice, annual publication trends for the most well-known QI methodologies being used in health care settings were analyzed. A total of 10 key medical- and business-oriented library databases were examined: PubMed, Ovid MEDLINE, EMBASE, CINAHL, PsycINFO, ISI Web of Science, Scopus, the Cochrane Central Register of Controlled Trials, ABI/INFORM, and Business Source Complete. A total of 13 057 articles were identified that discuss at least 1 of 10 well-known QI concepts used in health care contexts, 8645 (66.2%) of which were classified as original research. "Total quality management" was the only methodology to demonstrate a significant decline in publication over time. "Continuous quality improvement" was the most common topic of study across all publication years, whereas articles discussing Lean methodology demonstrated the largest growth in publication volume over the past 2 decades. Health care QI publication volume increased substantially beginning in 1991.

  10. Improving Air Quality Forecasts with AURA Observations

    Science.gov (United States)

    Newchurch, M. J.; Biazer, A.; Khan, M.; Koshak, W. J.; Nair, U.; Fuller, K.; Wang, L.; Parker, Y.; Williams, R.; Liu, X.

    2008-01-01

    Past studies have identified model initial and boundary conditions as sources of reducible errors in air-quality simulations. In particular, improving the initial condition improves the accuracy of short-term forecasts as it allows for the impact of local emissions to be realized by the model and improving boundary conditions improves long range transport through the model domain, especially in recirculating anticyclones. During the August 2006 period, we use AURA/OMI ozone measurements along with MODIS and CALIPSO aerosol observations to improve the initial and boundary conditions of ozone and Particulate Matter. Assessment of the model by comparison of the control run and satellite assimilation run to the IONS06 network of ozonesonde observations, which comprise the densest ozone sounding campaign ever conducted in North America, to AURA/TES ozone profile measurements, and to the EPA ground network of ozone and PM measurements will show significant improvement in the CMAQ calculations that use AURA initial and boundary conditions. Further analyses of lightning occurrences from ground and satellite observations and AURA/OMI NO2 column abundances will identify the lightning NOx signal evident in OMI measurements and suggest pathways for incorporating the lightning and NO2 data into the CMAQ simulations.

  11. Improving Air Quality Forecasts with AURA Observations

    Science.gov (United States)

    Newchurch, M. J.; Biazer, A.; Khan, M.; Koshak, W. J.; Nair, U.; Fuller, K.; Wang, L.; Parker, Y.; Williams, R.; Liu, X.

    2008-01-01

    Past studies have identified model initial and boundary conditions as sources of reducible errors in air-quality simulations. In particular, improving the initial condition improves the accuracy of short-term forecasts as it allows for the impact of local emissions to be realized by the model and improving boundary conditions improves long range transport through the model domain, especially in recirculating anticyclones. During the August 2006 period, we use AURA/OMI ozone measurements along with MODIS and CALIPSO aerosol observations to improve the initial and boundary conditions of ozone and Particulate Matter. Assessment of the model by comparison of the control run and satellite assimilation run to the IONS06 network of ozonesonde observations, which comprise the densest ozone sounding campaign ever conducted in North America, to AURA/TES ozone profile measurements, and to the EPA ground network of ozone and PM measurements will show significant improvement in the CMAQ calculations that use AURA initial and boundary conditions. Further analyses of lightning occurrences from ground and satellite observations and AURA/OMI NO2 column abundances will identify the lightning NOx signal evident in OMI measurements and suggest pathways for incorporating the lightning and NO2 data into the CMAQ simulations.

  12. IMPROVEMENTS IN THE QUALITY OF COURIER DELIVERY

    Directory of Open Access Journals (Sweden)

    Jacek Karcz

    2016-06-01

    Full Text Available The functioning of courier companies is a vital component of modern trade. E-commerce services are changing the way of shopping. Along with them, also courier services change and become more advance. Customers of courier companies become more aware of quality, which they should expect from supplier of these services. The article presents the result of the research of the effectiveness and the timelines of deliveries realized by one of the terminals of a leading courier operator in Poland. The survey involved 55 courier routes over the course of 10 business days. The author analyses weak points of the supply chain and presents two solutions, which may improve quality of delivery processes.

  13. Improving wind power quality with energy storage

    DEFF Research Database (Denmark)

    Rasmussen, Claus Nygaard

    2009-01-01

    The results of simulation of the influence of energy storage on wind power quality are presented. Simulations are done using a mathematical model of energy storage. Results show the relation between storage power and energy, and the obtained increase in minimum available power from the combination...... of wind and storage. The introduction of storage enables smoothening of wind power on a timescale proportional to the storage energy. Storage does not provide availability of wind power at all times, but allows for a certain fraction of average power in a given timeframe to be available with high...... probability. The amount of storage capacity necessary for significant wind power quality improvement in a given period is found to be 20 to 40% of the energy produced in that period. The necessary power is found to be 80 to 100% of the average power of the period....

  14. Improving tomato seed quality- challenges and possibilities

    DEFF Research Database (Denmark)

    Shrestha, Santosh

    2017-01-01

    The thesis investigates the possibility of using single seed near-infrared (NIR) spectroscopy, multispectral imaging (MSI) and NIR hyperspectral imaging (NIR-HSI) in combination with chemometrics for rapid determination of the tomato seed quality. The results of the PhD study are compiled in four...... manuscripts (MS). These non-destructive methods show the potential of sorting tomato seeds as per their viability and varietal identity. The results are discussed in the context of possible contribution from these methods in the improvement of the seed quality in Nepal. In MS I, potential application of NIR...... spectroscopy in combination with chemometrics for prediction of tomato seed viability is demonstrated. The work in MS I also emphasises on identifying the important NIR spectral regions for the chemometric model that are relevant to the separation of viable and non-viable seeds. The NIR-HIS method was also...

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

    Directory of Open Access Journals (Sweden)

    Cathy Kande

    2014-01-01

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

  16. Pediatric collaborative networks for quality improvement and research.

    Science.gov (United States)

    Lannon, Carole M; Peterson, Laura E

    2013-01-01

    Despite efforts of individual clinicians, pediatric practices, and institutions to remedy continuing deficiencies in pediatric safety and health care quality, multiple gaps and disparities exist. Most pediatric diseases are rare; thus, few practices or centers care for sufficient numbers of children, particularly in subspecialties, to achieve large and representative sample sizes, and substantial between-site variation in care and outcomes persists. Pediatric collaborative improvement networks are multi-site clinical networks that allow practice-based teams to learn from one another, test changes to improve quality, and use their collective experience and data to understand, implement, and spread what works in practice. The model was initially developed in 2002 by an American Board of Pediatrics Workgroup to accelerate the translation of evidence into practice, improve care and outcomes for children, and to serve as the gold standard for the performance in practice component of Maintenance of Certification requirements. Many features of an improvement network derive from the Institute for Healthcare Improvement's collaborative improvement model Breakthrough Series, including focus on a high-impact condition or topic; providing support from clinical content and quality improvement experts; using the Model for Improvement to set aims, use data for feedback, and test changes iteratively; providing infrastructure support for data collection, analysis and reporting, and quality improvement coaching; activities to enhance collaboration; and participation of multidisciplinary teams from multiple sites. In addition, they typically include a population registry of the children receiving care for the improvement topic of interest. These registries provide large and representative study samples with high-quality data that can be used to generate information and evidence, as well as to inform clinical decision making. In addition to quality improvement, networks serve as large

  17. Quality improvement in basic histotechnology: the lean approach.

    Science.gov (United States)

    Clark, David

    2016-01-01

    Lean is a comprehensive system of management based on the Toyota production system (TPS), encompassing all the activities of an organization. It focuses management activity on creating value for the end-user by continuously improving operational effectiveness and removing waste. Lean management creates a culture of continuous quality improvement with a strong emphasis on developing the problem-solving capability of staff using the scientific method (Deming's Plan, Do, Check, Act cycle). Lean management systems have been adopted by a number of histopathology departments throughout the world to simultaneously improve quality (reducing errors and shortening turnround times) and lower costs (by increasing efficiency). This article describes the key concepts that make up a lean management system, and how these concepts have been adapted from manufacturing industry and applied to histopathology using a case study of lean implementation and evidence from the literature. It discusses the benefits, limitations, and pitfalls encountered when implementing lean management systems.

  18. Using genomics to improve fruit quality.

    Science.gov (United States)

    Meneses, Claudio; Orellana, Ariel

    2013-01-01

    New fruit varieties are needed to satisfy consumers, and the industry is facing new challenges in order to respond to these demands. The emergence of genomic tools is releasing information on polymorphisms that can be utilized to expedite breeding processes in species that are difficult to breed, given the long periods of time required to get new varieties. The present review describes the current stages of the ongoing efforts that are being taken to apply these technologies to obtain varieties with improved fruit quality in species of the family Rosaceae.

  19. Using Q Methodology in Quality Improvement Projects.

    Science.gov (United States)

    Tiernon, Paige; Hensel, Desiree; Roy-Ehri, Leah

    Q methodology consists of a philosophical framework and procedures to identify subjective viewpoints that may not be well understood, but its use in nursing is still quite limited. We describe how Q methodology can be used in quality improvement projects to better understand local viewpoints that act as facilitators or barriers to the implementation of evidence-based practice. We describe the use of Q methodology to identify nurses' attitudes about the provision of skin-to-skin care after cesarean birth. Copyright © 2017 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

  20. Quality Measures for Improving Technology Trees

    Directory of Open Access Journals (Sweden)

    Teemu J. Heinimäki

    2015-01-01

    Full Text Available The quality of technology trees in digital games can be improved by adjusting their structural and quantitative properties. Therefore, there is a demand for recognizing and measuring such properties. Part of the process can be automated; there are properties measurable by computers, and analyses based on the results (and visualizations of them may help to produce significantly better technology trees, even practically without extra workload for humans. In this paper, we introduce useful technology tree properties and novel measuring features implemented into our software tool for manipulating technology trees.

  1. Improving the Quality of Radiation Treatment for Patients in Ontario: Increasing Peer Review Activities on a Jurisdictional Level Using a Change Management Approach.

    Science.gov (United States)

    Reddeman, Lindsay; Foxcroft, Sophie; Gutierrez, Eric; Hart, Margaret; Lockhart, Elizabeth; Mendelsohn, Marissa; Ang, Michelle; Sharpe, Michael; Warde, Padraig; Brundage, Michael; Reddeman, Lindsay; Foxcroft, Sophie; Gutierrez, Eric; Hart, Margaret; Lockhart, Elizabeth; Mendelsohn, Marissa; Ang, Michelle; Sharpe, Michael; Warde, Padraig; Brundage, Michael

    2016-01-01

    Peer review of radiation treatment (RT) plans is a key component of quality assurance programs in radiation medicine. A 2011 current state assessment identified considerable variation in the percentage of RT plans peer reviewed across Ontario's 14 cancer centers.In response, Cancer Care Ontario launched an initiative to increase peer review of plans for patients receiving radical intent RT. The initiative was designed consistent with the Kotter eight-step process for organizational transformation. A multidisciplinary team conducted site visits to promote and guide peer review and to develop education and implementation processes in collaboration with the centers. A centralized reporting infrastructure enabled the monitoring of the percentage of RT courses peer reviewed and the timing of peer review (before completion of 25%of treatment visits, after completion of >25%treatment visits). The initiative is ongoing, but early results indicate that the proportion of radical intent RT courses peer reviewed province wide increased from 43.5% (April 2013) to 68.0%(March 2015). This proportion is now a quality metric in Ontario and is publicly reported through the Cancer System Quality Index. The performance target for this metric was initially set at 50%(cases treated with radical intent) and revised to 60% in 2014. Provincial performance exceeded targets in both years (58.2% and 68.2%, respectively). Considerable variation was observed, however, in rates and timing of peer review among Cancer Care Ontario centers. This initiative demonstrates that a change management framework can be useful for planning and achieving substantial increases in jurisdictional peer review activities.

  2. 45 CFR 1304.60 - Deficiencies and quality improvement plans.

    Science.gov (United States)

    2010-10-01

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

  3. Motor activity improves temporal expectancy.

    Directory of Open Access Journals (Sweden)

    Lilian Fautrelle

    Full Text Available Certain brain areas involved in interval timing are also important in motor activity. This raises the possibility that motor activity might influence interval timing. To test this hypothesis, we assessed interval timing in healthy adults following different types of training. The pre- and post-training tasks consisted of a button press in response to the presentation of a rhythmic visual stimulus. Alterations in temporal expectancy were evaluated by measuring response times. Training consisted of responding to the visual presentation of regularly appearing stimuli by either: (1 pointing with a whole-body movement, (2 pointing only with the arm, (3 imagining pointing with a whole-body movement, (4 simply watching the stimulus presentation, (5 pointing with a whole-body movement in response to a target that appeared at irregular intervals (6 reading a newspaper. Participants performing a motor activity in response to the regular target showed significant improvements in judgment times compared to individuals with no associated motor activity. Individuals who only imagined pointing with a whole-body movement also showed significant improvements. No improvements were observed in the group that trained with a motor response to an irregular stimulus, hence eliminating the explanation that the improved temporal expectations of the other motor training groups was purely due to an improved motor capacity to press the response button. All groups performed a secondary task equally well, hence indicating that our results could not simply be attributed to differences in attention between the groups. Our results show that motor activity, even when it does not play a causal or corrective role, can lead to improved interval timing judgments.

  4. Biospecimen Reporting for Improved Study Quality (BRISQ)

    Energy Technology Data Exchange (ETDEWEB)

    National Cancer Institute; Jewell, Ph.D., Scott D.; Seijo, M.S., Edward; Kelly, Ph.D., Andrea; Somiari, Ph.D., Stella; B.Chir., M.B.; McShane, Ph.D., Lisa M.; Clark, M.D., Douglas; Greenspan, M.D., Renata; Hayes, M.D., Daniel F.; Hainaut, Ph.D., M.S., Pierre; Kim, Paula; Mansfield, Ph.D., Elizabeth; Potapova, Ph.D., Olga; Riegman, Ph.D., Peter; Rubinstein, Ph.D., Yaffa; Weier, Ph.D., Heinz-Ulrich; Zhu, Ph.D., Claire; Moore, Ph.D., Helen M.; Vaught, Ph.D., Jim; Watson, Peter

    2010-09-02

    Human biospecimens are subjected to collection, processing, and storage that can significantly alter their molecular composition and consistency. These biospecimen preanalytical factors, in turn, influence experimental outcomes and the ability to reproduce scientific results. Currently, the extent and type of information specific to the biospecimen preanalytical conditions reported in scientific publications and regulatory submissions varies widely. To improve the quality of research that uses human tissues, it is crucial that information on the handling of biospecimens be reported in a thorough, accurate, and standardized manner. The Biospecimen Reporting for Improved Study Quality (BRISQ) recommendations outlined herein are intended to apply to any study in which human biospecimens are used. The purpose of reporting these details is to supply others, from researchers to regulators, with more consistent and standardized information to better evaluate, interpret, compare, and reproduce the experimental results. The BRISQ guidelines are proposed as an important and timely resource tool to strengthen communication and publications on biospecimen-related research and to help reassure patient contributors and the advocacy community that their contributions are valued and respected.

  5. Biospecimen Reporting for Improved Study Quality

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Ph.D., Helen M.; Kelly, Ph.D., Andrea B.; Jewell, Ph.D., Scott D.; McShane, Ph.D., Lisa M.; Clark, M.D., Douglas P.; Greenspan, M.D., Renata; Hayes, M.D., Daniel F.; Hainaut, Ph.D., Pierre; Kim, Paula; Mansfield, Ph.D., Elizabeth A.; Potapova, Ph.D., Olga; Riegman, Ph.D., Peter; Rubinstein, Ph.D., Yaffa; Seijo, M.S., Edward; Somiari, Ph.D., Stella; Chir., B; Weier, Ph.D., Heinz-Ulrich; Zhu, Ph.D., Claire; Vaught, Ph.D., Jim; Watson,M.B., Peter

    2010-12-27

    Human biospecimens are subjected to collection, processing, and storage that can significantly alter their molecular composition and consistency. These biospecimen preanalytical factors, in turn, influence experimental outcomes and the ability to reproduce scientific results. Currently, the extent and type of information specific to the biospecimen preanalytical conditions reported in scientific publications and regulatory submissions varies widely. To improve the quality of research that uses human tissues, it is crucial that information on the handling of biospecimens be reported in a thorough, accurate, and standardized manner. The Biospecimen Reporting for Improved Study Quality (BRISQ) recommendations outlined herein are intended to apply to any study in which human biospecimens are used. The purpose of reporting these details is to supply others, from researchers to regulators, with more consistent and standardized information to better evaluate, interpret, compare, and reproduce the experimental results. The BRISQ guidelines are proposed as an important and timely resource tool to strengthen communication and publications on biospecimen-related research and to help reassure patient contributors and the advocacy community that their contributions are valued and respected.

  6. Biospecimen Reporting for Improved Study Quality (BRISQ)

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Ph.D., Helen M.; Kelly Ph.D., Andrea; Jewell Ph.D., Scott D.; McShane Ph.D., Lisa M.; Clark M.D., Douglas P.; Greenspan M.D., Renata; Hayes M.D., Daniel F.; Hainaut Ph.D.,, Pierre; Kim, Paula; Mansfield Ph.D., Elizabeth; Potapova Ph.D., Olga; Riegman Ph.D., Peter; Rubinstein Ph.D., Yaffa; Seijo M.S., Edward; Somiari Ph.D., Stella; Watson M.B., Peter; Weier Ph.D., Heinz-Ulrich; Zhu Ph.D., Claire; Vaught Ph.D., Jim

    2011-04-26

    Human biospecimens are subject to a number of different collection, processing, and storage factors that can significantly alter their molecular composition and consistency. These biospecimen preanalytical factors, in turn, influence experimental outcomes and the ability to reproduce scientific results. Currently, the extent and type of information specific to the biospecimen preanalytical conditions reported in scientific publications and regulatory submissions varies widely. To improve the quality of research utilizing human tissues it is critical that information regarding the handling of biospecimens be reported in a thorough, accurate, and standardized manner. The Biospecimen Reporting for Improved Study Quality (BRISQ) recommendations outlined herein are intended to apply to any study in which human biospecimens are used. The purpose of reporting these details is to supply others, from researchers to regulators, with more consistent and standardized information to better evaluate, interpret, compare, and reproduce the experimental results. The BRISQ guidelines are proposed as an important and timely resource tool to strengthen communication and publications around biospecimen-related research and help reassure patient contributors and the advocacy community that the contributions are valued and respected.

  7. Strategy to Support Improvement of Healthcare Quality.

    Directory of Open Access Journals (Sweden)

    Ing. Andrea Zejdlova

    2013-01-01

    Full Text Available One of the latest market-based solutions to the rising costs and quality gaps in health care is pay for performance. Pay for performance is the use of financial incentives to promote the delivery of designated standards of care. It is an emerging movement in health insurance (initially in Britain and United States. Providers under this arrangement are rewarded for meeting pre-established targets for delivery of healthcare services. This is a fundamental change from fee for service payment.Also known as "P4P" or “value-based purchasing,” this payment model rewards physicians, hospitals, medical groups, and other healthcare providers for meeting certain performance measures for quality and efficiency. Disincentives, such as eliminating payments for negative consequences of care (medical errors or increased costs, have also been proposed. In the developed nations, the rapidly aging population and rising health care costs have recently brought P4P to the forefront of health policy discussions. Pilot studies underway in several large healthcare systems have shown modest improvements in specific outcomes and increased efficiency, but no cost savings due to added administrative requirements. Statements by professional medical societies generally support incentive programs to increase the quality of health care, but express concern with the validity of quality indicators, patient and physician autonomy and privacy, and increased administrative burdens. This article serves as an introduction to pay for performance. We discuss the goals and structure of pay for performance plans and their limitations and potential consequences in the health care area.

  8. Improved Active Vibration Isolation Systems

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    The control force, feedback gain, and actuator stroke of several active vibration isolation systems were analyzed based on a single-layer active vibration isolation system. The analysis shows that the feedback gain and actuator stroke cannot be selected independently and the active isolation system design must make a compromise between the feedback gain and actuator stroke. The performance of active isolation systems can be improved by the joint vibration reduction using an active vibration isolation system with an adaptive dynamic vibration absorber. The results show that the joint vibration reduction method can successfully avoid the compromise between the feedback gain and actuator stroke. The control force and the object vibration amplitude are also greatly reduced.

  9. Quality improvement in neurology: dementia management quality measures.

    Science.gov (United States)

    Odenheimer, Germaine; Borson, Soo; Sanders, Amy E; Swain-Eng, Rebecca J; Kyomen, Helen H; Tierney, Samantha; Gitlin, Laura; Forciea, Mary Ann; Absher, John; Shega, Joseph; Johnson, Jerry

    2014-03-01

    Professional and advocacy organizations have long urged that dementia should be recognized and properly diagnosed. With the passage of the National Alzheimer's Project Act in 2011, an Advisory Council for Alzheimer's Research, Care, and Services was convened to advise the Department of Health and Human Services. In May 2012, the Council produced the first National Plan to address Alzheimer's disease, and prominent in its recommendations is a call for quality measures suitable for evaluating and tracking dementia care in clinical settings. Although other efforts have been made to set dementia care quality standards, such as those pioneered by RAND in its series Assessing Care of Vulnerable Elders (ACOVE), practitioners, healthcare systems, and insurers have not widely embraced implementation. This executive summary (full manuscript available at www.neurology.org) reports on a new measurement set for dementia management developed by an interdisciplinary Dementia Measures Work Group (DWG) representing the major national organizations and advocacy organizations concerned with the care of individuals with dementia. The American Academy of Neurology (AAN), the American Geriatrics Society, the American Medical Directors Association, the American Psychiatric Association, and the American Medical Association-convened Physician Consortium for Performance Improvement led this effort. The ACOVE measures and the measurement set described here apply to individuals whose dementia has already been identified and properly diagnosed. Although similar in concept to ACOVE, the DWG measurement set differs in several important ways; it includes all stages of dementia in a single measure set, calls for the use of functional staging in planning care, prompts the use of validated instruments in patient and caregiver assessment and intervention, highlights the relevance of using palliative care concepts to guide care before the advanced stages of illness, and provides evidence-based support

  10. SF Bay Water Quality Improvement Fund: Projects and Accomplishments

    Science.gov (United States)

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

  11. Early Palliative Care Improves Patients' Quality of Life

    Science.gov (United States)

    ... fullstory_160885.html Early Palliative Care Improves Patients' Quality of Life Also increases chances of having end-of-life ... incurable cancer helps patients cope and improves their quality of life, a new study shows. It also leads to ...

  12. Quality Improvement in Nursing Homes: Identifying Depressed Residents is Critical to Improving Quality of Life.

    Science.gov (United States)

    Crogan, Neval L; Evans, Bronwynne C

    2008-05-01

    The prevalence of depression in nursing home residents is three to five times higher than in older adults from the community.1 Depression is thought to be related to the gloomy institutionalized environment and an assortment of losses, including those associated with function, independence, social roles, friends and relatives, and past leisure activities.2 Despite the public's increased awareness of depression, it remains underrecognized and undertreated by professionals who care for older residents in nursing homes.3 It seems intuitive that depression must be recognized before it can be treated, yet our national long-term care system continues to utilize an unreliable scale from the Minimum Data Set as its foundation for assessment. Warnings of the scale's inadequacy have been sounded repeatedly almost since its conception4,5 and its potential role in lack of recognition and treatment of depression by nursing home staff, nurse practitioners, and physicians is a troubling one.The purpose of this article is to (1) report the prevalence of depression in a sub-sample of residents from a National Institutes of Health study whose depression was not detected by the MDS and, consequently, was previously untreated, (2) compare their nutritional and functional status with residents whose depressive states were previously detected by the MDS and treated, and (3) recommend quality improvement strategies for identification and treatment of depression in nursing home residents.

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

    Science.gov (United States)

    Tout, Kathryn; Isner, Tabitha; Zaslow, Martha

    2011-01-01

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

  14. The outcomes of a 12-week Internet intervention aimed at improving fitness and health-related quality of life in overweight adolescents: the Young & Active controlled trial.

    Directory of Open Access Journals (Sweden)

    Kirsti Riiser

    Full Text Available Overweight and obesity among adolescents may have consequences, with potentially lasting effects on health and health-related quality of life (HRQoL. Excess weight is also associated with decreases in physical activity and cardiorespiratory fitness. The aim of the current study was to investigate the short-term effects of a 12-week Internet intervention in a primary care setting intended to increase cardiorespiratory fitness and HRQoL among overweight and obese adolescents.In this controlled trial, participants (13-15 years were non-randomly allocated to an intervention- or a control group. The intervention group received 12-weeks access to an online program providing tailored physical activity counseling based on principles from Self-determination Theory and Motivational Interviewing. The control group received standard follow-up by the school nurses. The primary outcome measure of cardiorespiratory fitness was determined using a shuttle run test. The secondary outcomes: HRQoL, leisure time exercise, body image and self-determined motivation for physical activity and exercise, were assessed by self-report measures. Age- and gender-adjusted body mass index (BMI was calculated based on measurements of height and weight. To compare pre-to post intervention differences within groups, a paired samples t-test was used while crude differences between groups were analyzed with an independent samples t-test.Of the 120 participants, 108 completed the study, 75 in the intervention group and 33 in the control group. Exposure to the intervention had a small effect on cardiorespiratory fitness (0.14; 95% CI [0.01;0.28]; P = 0.04, and a moderate effect on HRQoL (5.22; 95% CI [0.90; 9.53]; P = 0.02. Moreover, the control group increased significantly in BMI, yielding a moderate preventive effect on BMI (-0.39; 95% CI [-0.74;-0.03]; P = 0.03 for the intervention group.The results suggest that the Internet intervention with tailored physical activity counseling

  15. Improving mental health outcomes: achieving equity through quality improvement

    Science.gov (United States)

    Poots, Alan J.; Green, Stuart A.; Honeybourne, Emmi; Green, John; Woodcock, Thomas; Barnes, Ruth; Bell, Derek

    2014-01-01

    Objective To investigate equity of patient outcomes in a psychological therapy service, following increased access achieved by a quality improvement (QI) initiative. Design Retrospective service evaluation of health outcomes; data analysed by ANOVA, chi-squared and Statistical Process Control. Setting A psychological therapy service in Westminster, London, UK. Participants People living in the Borough of Westminster, London, attending the service (from either healthcare professional or self-referral) between February 2009 and May 2012. Intervention(s) Social marketing interventions were used to increase referrals, including the promotion of the service through local media and through existing social networks. Main Outcome Measure(s) (i) Severity of depression on entry using Patient Health Questionnaire-9 (PHQ9). (ii) Changes to severity of depression following treatment (ΔPHQ9). (iii) Changes in attainment of a meaningful improvement in condition assessed by a key performance indicator. Results Patients from areas of high deprivation entered the service with more severe depression (M = 15.47, SD = 6.75), compared with patients from areas of low (M = 13.20, SD = 6.75) and medium (M = 14.44, SD = 6.64) deprivation. Patients in low, medium and high deprivation areas attained similar changes in depression score (ΔPHQ9: M = −6.60, SD = 6.41). Similar proportions of patients achieved the key performance indicator across initiative phase and deprivation categories. Conclusions QI methods improved access to mental health services; this paper finds no evidence for differences in clinical outcomes in patients, regardless of level of deprivation, interpreted as no evidence of inequity in the service with respect to this outcome. PMID:24521701

  16. Improving Culture, One Quality Improvement Project at a Time.

    Science.gov (United States)

    Vander Schaaf, Emily B; Cornett, Amanda C; Randolph, Greg D

    2017-04-04

    A culture of quality improvement (QI) values collaboration, transparency, and staff empowerment. Organizations exhibiting a culture of QI are more likely to engage in QI. We examined whether local health departments' (LHDs') participation in a longitudinal, experiential QI training program changes QI culture. Prior to and following participation in a QI training program, all employees of participating LHDs were asked to complete an 8-item survey assessing components of QI culture on a 5-point scale. From 2010 to 2015, multidisciplinary teams from North Carolina LHDs participated in sequential cohorts of a 6-month QI training program, during which the teams completed a QI project. We dichotomized culture survey responses, with 4 or 5 being "Supportive." We compared adjusted proportions, using linear regression, clustering at LHD, and controlling for cohort. Data from 42 LHDs were included. At baseline, 7.8% responded that their LHD had a supportive culture for all 8 components, compared with 12% at follow-up (P cultures increased for all components of culture including communication by 4.1% (95% CI: 2.0%-6.2%), problem solving by 2.9% (95% CI: 1.6%-5.5%), team work by 5.2% (95% CI: 2.5%-7.8%), vision by 4.3% (95% CI: 1.1%-7.5%), performance measures by 5.6% (95% CI: 1.6%-9.6%), recognition by 4.7% (95% CI: 1.4%-8.0%), for conflict by 5.5% (95% CI: 1.7%-9.4%), and alignment by 5.8% (95% CI: 2.3%-9.2%). Engagement with structured QI training programs-and perhaps simply completing QI projects-can cause small, but important changes in organizations' cultures, thus increasing engagement in future QI and improving overall care and services. The article demonstrates that when LHDs participate in a longitudinal, experiential QI training program, their cultures of QI improve. Local health departments participating in similar training programs might experience similar improvements in culture, increasing subsequent participation in QI projects and improving related health

  17. Strategy, Structure and Quality Service: Developing School Wide Quality Improvement.

    Science.gov (United States)

    Murgatroyd, Stephen

    1991-01-01

    Builds on earlier contributions to the literature on educational leadership and total quality management in education. Introduces two new tools--the service guarantee and the House of Quality, placing them in the context of strategic marketing, structural change, and other total quality management methods. (19 references) (MLH)

  18. Ensuring and Improving Information Quality for Earth Science Data and Products Role of the ESIP Information Quality Cluster

    Science.gov (United States)

    Ramapriyan, H. K. (Rama); Peng, Ge; Moroni, David; Shie, Chung-Lin

    2016-01-01

    Quality of products is always of concern to users regardless of the type of products. The focus of this paper is on the quality of Earth science data products. There are four different aspects of quality scientific, product, stewardship and service. All these aspects taken together constitute Information Quality. With increasing requirement on ensuring and improving information quality, there has been considerable work related to information quality during the last several years. Given this rich background of prior work, the Information Quality Cluster (IQC), established within the Federation of Earth Science Information Partners (ESIP) has been active with membership from multiple organizations. Its objectives and activities, aimed at ensuring and improving information quality for Earth science data and products, are discussed briefly.

  19. Ensuring and Improving Information Quality for Earth Science Data and Products: Role of the ESIP Information Quality Cluster

    Science.gov (United States)

    Ramapriyan, Hampapuram; Peng, Ge; Moroni, David; Shie, Chung-Lin

    2016-01-01

    Quality of products is always of concern to users regardless of the type of products. The focus of this paper is on the quality of Earth science data products. There are four different aspects of quality - scientific, product, stewardship and service. All these aspects taken together constitute Information Quality. With increasing requirement on ensuring and improving information quality, there has been considerable work related to information quality during the last several years. Given this rich background of prior work, the Information Quality Cluster (IQC), established within the Federation of Earth Science Information Partners (ESIP) has been active with membership from multiple organizations. Its objectives and activities, aimed at ensuring and improving information quality for Earth science data and products, are discussed briefly.

  20. Continuous quality improvement of colorectal cancer screening

    Institute of Scientific and Technical Information of China (English)

    Mariusz; Madalinski

    2013-01-01

    Quality assurance is a key issue in colorectal cancer screening, because effective screening is able to improve primary prevention of the cancer. The quality measure may be described in terms:how well the screening test tells who truly has a disease (sensitivity) and who truly does not have a disease (specificity). This paper raises concerns about identification of the optimal screening test for colorectal cancer. Colonoscopy vs flexible sigmoidoscopy in colorectal cancer screening has been a source of ongoing debate. A multicentre randomised controlled trial comparing flexible sigmoidoscopy with usual care showed that flexible sigmoidoscopy screening is able to diminish the incidence of distal and proximal colorectal cancer, and also mortality related to the distal colorectal cancer. However, colonoscopy provides a more complete examination and remains the more sensitive exam than flexible sigmoidoscopy. Moreover, colonoscopy with polypectomy significantly reduces colorectal cancer incidence and colorectal cancer-related mortality in the general population. The article considers the relative merits of both methods and stresses an ethical aspect of patient’s involvement in decision-making. Patients should be informed not only about tests tolerability and risk of endoscopy complications, but also that different screening tests for bowel cancer have different strength to exclude colonic cancer and polyps. The authorities calculate effectiveness and costs of the screening tests, but patients may not be interested in statistics regarding flexible sigmoidoscopy screening and from an ethical point of view, they have the right to chose colonoscopy, which is able to exclude a cancer and precancerous lesions in the whole large bowel.

  1. Application of quality control circle activities in improving the qualified rate of outpatient prescriptions%品管圈活动在提高门诊处方合格率中的应用

    Institute of Scientific and Technical Information of China (English)

    黄秋红; 聂增尧; 白翠莲

    2016-01-01

    目的:运用品管圈管理工具,提高昌平教学医院门诊处方合格率。方法:成立品管圈,分析门诊处方合格率低的原因,制定相应整改措施并组织实施,评价有形成果和无形成果,制定标准化工作流程。结果:通过品管圈活动,有形成果即门诊处方合格率由活动前72.83%提高到活动后84.20%;无形成果即药师的沟通能力、解决问题能力、自信心等有较大提高。结论:品管圈活动在提高门诊处方合格率中的应用,取得较好效果,建议推广使用。%Objective:To use quality control management tools in order to improve qualified rate of outpatient prescriptions. Methods:Quality management circle was set up and the reasons accounting for low qualiifed rate of outpatient prescriptions were analyzed. Corresponding corrective measures were made and results were evaluated to implement standardized work processes.Results:Through quality management circle activity, qualiifed rate of outpatient prescription increased from72.83% to 84.2%. Communication skills, problem solving skills, self-conifdence of pharmacists have improved greatly.Conclusion: Quality control circle activities in improving the qualiifed rate of outpatient prescription application achieved good effect and it’s recommended to promote application.

  2. PROCESS VARIABILITY REDUCTION THROUGH STATISTICAL PROCESS CONTROL FOR QUALITY IMPROVEMENT

    Directory of Open Access Journals (Sweden)

    B.P. Mahesh

    2010-09-01

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

  3. Applying Triz for Production Quality Improvement

    Directory of Open Access Journals (Sweden)

    Swee Nikalus Shu Luing

    2017-01-01

    Full Text Available This paper aims to provide a thorough analysis on the application of TRIZ in improving the quality of canned food production. TRIZ tools such as engineering systems analysis, function analysis, cause and effect chain analysis, By-separation model and 40 Inventive Principles are applied in order to discover some feasible and elegant solutions to alleviate the problem. Findings revealed that the rejected canned products on the conveyor belt will be isolated or picked up with other good condition canned products which are lined up very closely to the rejected cans; though the visioning system is able detect the fault printing on the canned product. The main root cause is that the rejected canned product is picked up with other canned products in good condition because all cans are lined up on the belt and are very close to each other or having no gaps between the cans. Conversely, all cans on the conveyor belts are required to be very close to each other to avoid collisions that may damage the cans. The root cause is solved by applying function analysis, By-separation tool and Inventive Principles. Therefore, it can be concluded that TRIZ is a powerful tool in inventive problem solving.

  4. Improved quality of life over one year is associated with improved adherence in patients with schizophrenia.

    Science.gov (United States)

    Hayhurst, K P; Drake, R J; Massie, J A; Dunn, G; Barnes, T R E; Jones, P B; Lewis, S W

    2014-03-01

    Quality of life (QoL) is increasingly considered an important outcome in health research. We wished to explore the determinants of change in QoL in patients with schizophrenia over the course of a one-year RCT. Predictors of change in observer-rated QoL (Quality of Life Scale: QLS) were assessed in 363 patients with schizophrenia during the CUtLASS clinical trial. Change in QLS score over the course of a year correlated with change in psychotic and depressive symptoms and treatment adherence. Linear regression showed that improvement in QoL was predicted by reduction in negative and depressive symptoms and improvement in adherence rating. These three change scores together explained 38% of the variance in QLS change. Exploration of the direction of any possible causal effect, using TETRAD, indicated that improved adherence leads to improved QoL, and that change in depression also leads to QoL change. The relationship between QoL and negative symptoms suggests that greater social activity (reflected as better QoL scores) improves negative symptoms. Such a direct relationship between treatment adherence and QoL has not been reported before. Improving adherence to medication would appear to be a key approach to improving measured quality of life in people with schizophrenia. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  5. 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.

  6. Improving the safety and quality of cancer care.

    Science.gov (United States)

    Burke, Harry B

    2017-02-15

    The cancer community is increasingly interested in improving its safety and quality. Improvement will be driven by the expansion of safety and quality research and by a commitment to publish studies that advance high-quality, safe cancer care. Cancer 2017;123:549-550. © 2016 American Cancer Society. © 2016 American Cancer Society.

  7. Improving Data Quality for Pavement Management System

    OpenAIRE

    2015-01-01

    The Metropolitan Transportation Commission (MTC) has developed a pavement management StreetSaver program with more than 400 users in the United States. MTC uses the program to evaluate street and road condition and perform maintenance needs assessments for the 109 cities and counties in the San Francisco Bay Area. Quality pavement condition survey data is a critical component of a pavement management system. MTC has augmented a new quality acceptance (QA) program as part of its Quality Data M...

  8. Improving Quality of Seal Leak Test Product using Six Sigma

    Science.gov (United States)

    Luthfi Malik, Abdullah; Akbar, Muhammad; Irianto, Dradjad

    2016-02-01

    Seal leak test part is a polyurethane material-based product. Based on past data, defect level of this product was 8%, higher than the target of 5%. Quality improvement effort was done using six sigma method that included phases of define, measure, analyse, improve, and control. In the design phase, a Delphi method was used to identify factors that were critical to quality. In the measure phase, stability and process capability was measured. Fault tree analysis (FTA) and failure mode and effect analysis (FMEA) were used in the next phase to analize the root cause and to determine the priority issues. Improve phase was done by compiling, selecting, and designing alternative repair. Some improvement efforts were identified, i.e. (i) making a checklist for maintenance schedules, (ii) making written reminder form, (iii) modifying the SOP more detail, and (iv) performing a major service to the vacuum machine. To ensure the continuity of improvement efforts, some control activities were executed, i.e. (i) controlling, monitoring, documenting, and setting target frequently, (ii) implementing reward and punishment system, (iii) adding cleaning tool, and (iv) building six sigma organizational structure.

  9. Good air quality in offices improves productivity

    DEFF Research Database (Denmark)

    Fanger, Povl Ole

    2000-01-01

    Three recent independent studies have documented that the quality of indoor air has a significant and positive influence or? the productivity of office workers. A combined analysis of the results of the three studies shows a significant relationship between productivity and perceived indoor air...... quality. The impact on productivity justifies a much higher indoor air quality than the minimum levels prescribed in present standards and guidelines. One way of providing air of high quality for people to breathe, without involving excessive ventilation rates and energy use, is to provide "personalized...... air" to each individual. The application of this concept is discussed in this paper: (C) 2000 Journal of Mechanical Engineering. All rights reserved....

  10. Good air quality in offices improves productivity

    DEFF Research Database (Denmark)

    Fanger, Povl Ole

    2000-01-01

    Three recent independent studies have documented that the quality of indoor air has a significant and positive influence on the productivity of office workers. A combined analysis of the results of the three studies shows a significant relationship between productivity and perceived indoor air...... quality. The impact on productivity justifies a much higher indoor air quality than the minimum levels prescribed in present standards and guidelines. One way of providing air of high quality for people to breathe, without involving excessive ventilation rates and energy use, is to provide "personalized...... air" to each individual. The application of this concept is discussed....

  11. Good air quality in offices improves productivity

    DEFF Research Database (Denmark)

    Fanger, Povl Ole

    2000-01-01

    Three recent independent studies have documented that the quality of indoor air has a significant and positive influence or? the productivity of office workers. A combined analysis of the results of the three studies shows a significant relationship between productivity and perceived indoor air...... quality. The impact on productivity justifies a much higher indoor air quality than the minimum levels prescribed in present standards and guidelines. One way of providing air of high quality for people to breathe, without involving excessive ventilation rates and energy use, is to provide "personalized...... air" to each individual. The application of this concept is discussed in this paper: (C) 2000 Journal of Mechanical Engineering. All rights reserved....

  12. Good air quality in offices improves productivity

    DEFF Research Database (Denmark)

    Fanger, Povl Ole

    2000-01-01

    Three recent independent studies have documented that the quality of indoor air has a significant and positive influence on the productivity of office workers. A combined analysis of the results of the three studies shows a significant relationship between productivity and perceived indoor air...... quality. The impact on productivity justifies a much higher indoor air quality than the minimum levels prescribed in present standards and guidelines. One way of providing air of high quality for people to breathe, without involving excessive ventilation rates and energy use, is to provide "personalized...... air" to each individual. The application of this concept is discussed....

  13. Improvement of quality service based on common benchmarks and indicators

    Directory of Open Access Journals (Sweden)

    Pohaydak, Olha Bohdanivna

    2011-11-01

    Full Text Available Consider ways to improve the quality management system based on common criteria and indicators for evaluating the quality of products, works and services in housing and domestic service.

  14. QUALITY IMPROVEMENT METHODS AND THEIR USAGE IN ALBANIAN PUBLIC UNIVERSITIES

    Directory of Open Access Journals (Sweden)

    Arjan QEFALIA

    2012-06-01

    Full Text Available Education and higher education in particular is one of strategic priorities for development, which guarantees progress. Its role is related to all characteristics of a society, and it undoubtedly constitutes one of the most important areas of life of a nation. It has stable and long-term impact on all aspects of activities related to people and their welfare. The challenge to be faced in the transition period requires that higher education in Albania to be developed, consolidated and follow the trend of higher education in developed countries. Quality itself and by using the continuous quality improvement methods by universities, it constitutes the basis for ensuring the success of the Albanian higher education institutions in the future.In this paper, through the use of literature, the questionnaires and interviews directed mainly to the professors / pedagogues working in Albanian public higher education institutions, the focus is to show the continuous quality improvement methods used by universities / faculties / departments, and to test the hypothesis: The use or not of the continuous improvement methods is dependent on the studies type (those higher education institutions that offer first cycle studies, first and second cycle studies, or first, second and third cycle studies that the higher education institution offers.

  15. Improving Quality Higher Education in Nigeria: The Roles of Stakeholders

    Science.gov (United States)

    Asiyai, Romina Ifeoma

    2015-01-01

    This paper discusses the roles of stakeholders in improving quality of university education in Nigeria. Internal and external stakeholders are identified and the various roles they could play in improving the quality of university education are discussed. The paper contends that continuous and holistic improvement in university education system…

  16. Do farm audits improve milk quality?

    NARCIS (Netherlands)

    Flores-Miyamoto, A.; Reij, M.W.; Velthuis, A.G.J.

    2014-01-01

    Milk quality is assessed using bulk milk analysis and by farm audits in the Netherlands. However, the extent of the effect that dairy farm audits have on milk quality is unknown. Data from over 13,000 audits performed on 12,855 dairy farms from February 2006 to April 2008 were merged with laboratory

  17. Guidelines for appraisal and publication of PDSA quality improvement.

    Science.gov (United States)

    Speroff, Theodore; James, Brent C; Nelson, Eugene C; Headrick, Linda A; Brommels, Mats

    2004-01-01

    Plan-do-study-act (PDSA) quality improvement is the application of the scientific method to implement and test the effects of change ideas on the performance of the health care system. Users of quality improvement could benefit with markers to gauge the "best" science. Four core questions can determine the value of a quality improvement study: Is the quality improvement study pertinent and relevant? Are the results valid? Are appropriate criteria used to interpret the results? Will the study help you with your practice or organization of care? A set of guidelines is provided to help answer these questions. Similar guidelines exist for randomized clinical trials and clinical-epidemiologic observational studies. Analogous to these existing research guidelines, the PDSA quality improvement guidelines will provide researchers and reviewers with succinct standards of methodological rigor to assist in critical appraisal of quality improvement protocols and publications.

  18. 品管圈活动对提高产妇母乳喂养率的效果观察%Effect observation of quality control circle activities in the improvement of maternal breastfeeding rate

    Institute of Scientific and Technical Information of China (English)

    喻芳; 于建萍

    2014-01-01

    目的:关爱宝宝健康,促进母乳喂养。方法:建立品管圈,并根据进度表开展活动。结果:引用品管圈后,母乳喂养率由86.7%上升到98.3%。产妇及家属的满意度由86.7%上升到91.7%。结论:品管圈改进了母乳喂养率的护理流程,有助于促进护理工作标准化建设。%Objective:Taking care of the baby health,to promote breast feeding.Methods:Quality control circle was seted up and the activity was carried out according to the schedule.Results:The breastfeeding rate was improved from 86.7% to 98.3% . Maternal satisfaction was improved from 86.7% to 91.7%.Conclusion:The quality control circle improved the nursing process of mother's milk feeding rate, and help to promote nursing standardization construction.

  19. How To Improve Software Quality Assurance In Developing Countries

    Directory of Open Access Journals (Sweden)

    Ali Javed

    2012-04-01

    Full Text Available Quality is an important factor in software industry. Software quality depends upon the customer satisfaction which can be achieved through applying standards. In this era achieving quality software is very important because of the high customer demands. Developed countries are excelling in software industry and improving day by day. Meanwhile developing countries like Pakistan are struggling with software quality and cannot maintain reputation in International Market. Software Quality lacks due tomany reasons. This paper will address the problems for lacking interest in improving the software quality by higher authorities and software assurance team. We have provided solution to the addressed problems also.

  20. Integrating health promotion with quality improvement in a Swedish hospital.

    Science.gov (United States)

    Astnell, Sandra; von Thiele Schwarz, Ulrica; Hasson, Henna; Augustsson, Hanna; Stenfors-Hayes, Terese

    2016-09-01

    Integration of workplace employee health promotion (HP) and occupational health and safety (OHS) work into organizational quality improvement systems is suggested as a way to strengthen HP and OHS activities in an organization. The aim of this article was to study what consequences integration of HP, OHS and a quality improvement system called kaizen has on the frequency and type of HP and OHS activities. A quasi-experimental study design was used where an integration of the three systems for HP, OHS respectively kaizen, was performed at six intervention units at a Swedish hospital. The remaining six units served as controls. Document analysis of all employees' written improvement suggestions (kaizen notes) during 2013 was conducted. The findings show that the intervention group had more suggestions concerning HP and OHS (n = 114) when compared with the control group (n = 78) and a greater variety of HP and OHS suggestions. In addition, only the intervention group had included HP aspects. In both groups, most kaizen notes with health consideration had a preventive focus rather than rehabilitative. The intervention, i.e. the integration of HP, OHS and kaizen work, had a favourable effect on HP and OHS work when compared with the controls. The results of the study support that this system can work in practice at hospitals. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  1. l-Cysteine improves antioxidant enzyme activity, post-thaw quality and fertility of Nili-Ravi buffalo (Bubalus bubalis) bull spermatozoa.

    Science.gov (United States)

    Iqbal, S; Riaz, A; Andrabi, S M H; Shahzad, Q; Durrani, A Z; Ahmad, N

    2016-11-01

    The effects of l-cysteine in extender on antioxidant enzymes profile during cryopreservation, post-thaw quality parameters and in vivo fertility of Nili-Ravi buffalo bull spermatozoa were studied. Semen samples from 4 buffalo bulls were diluted in Tris-citric acid-based extender having different concentrations of l-cysteine (0.0, 0.5, 1.0, 2.0 and 3.0 mm) and frozen in 0.5-ml French straws. The antioxidative enzymes [catalase, super oxide dismutase and total glutathione (peroxidase and reductase)] were significantly higher (P antioxidant enzymes profile, post-thaw quality and in vivo fertility of Nili-Ravi buffalo bull spermatozoa. © 2016 Blackwell Verlag GmbH.

  2. Needs and Opportunities to Improve the Operational Quality of Forwarding Companies

    Directory of Open Access Journals (Sweden)

    Dovilė Kontautaitė

    2013-04-01

    Full Text Available It is essential for forwarding companies to improve their activity by improving their internal and external processes in order to provide for a client an estimated basic and added value and effectively manage the flow of information in the general logistic supply chain. The article analyses the concepts of quality management and activity process, emphasising the main process of a forwarding enterprise and the demand to optimise the activity establishing quality management systems. The scientific literature analysis assists in the provision of quality assessment indicators of forwarding companies and ascertaining quality management systems that are suitable for transport companies.Article in Lithuanian

  3. Coordination mechanisms for quality improvement and market access in Ethiopian potato value chains

    NARCIS (Netherlands)

    Abebe, G.K.

    2013-01-01

      Market access for smallholders in developing countries often requires the improvement of product quality. As products are traded in value chains, quality improvement entails the coordination of activities and decisions by all actors in the chain. Thus, enhancing smallholders’ commercia

  4. Context in Quality of Care: Improving Teamwork and Resilience.

    Science.gov (United States)

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

    2017-09-01

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

  5. Nationwide quality improvement of cholecystectomy: results from a national database

    DEFF Research Database (Denmark)

    Harboe, Kirstine M; Bardram, Linda

    2011-01-01

    To evaluate whether quality improvements in the performance of cholecystectomy have been achieved in Denmark since 2006, after revision of the Danish National Guidelines for treatment of gallstones....

  6. Developing and executing quality improvement projects (concept, methods, and evaluation).

    Science.gov (United States)

    Likosky, Donald S

    2014-03-01

    Continuous quality improvement, quality assurance, cycles of change--these words of often used to express the process of using data to inform and improve clinical care. Although many of us have been exposed to theories and practice of experimental work (e.g., randomized trial), few of us have been similarly exposed to the science underlying quality improvement. Through the lens of a single-center quality improvement study, this article exposes the reader to methodology for conducting such studies. The reader will gain an understanding of these methods required to embark on such a study.

  7. Evaluation of a continuous quality improvement program in anticoagulant therapy

    Science.gov (United States)

    Cantin, Ariane; Lahaie, Alexandre; Odobasic, Bojan; Tremblay, Marie-Philip; Wazzan, Dana; Caron, Stéphanie; Leblanc, Caroline; Martineau, Josée; Lalonde, Lyne

    2016-01-01

    Background: The ACO Program (Programme ACO), a continuous quality improvement program (CQIP) in anticoagulation therapy, was offered in community pharmacies as a pilot project. Objective: To evaluate the participants’ appreciation for the various activities of the program. Methods: Participants had access to training activities, including an audit with feedback, online training activities (OTA), clinical tools and support from facilitators. Cognitive behavioural learning determinants were evaluated before and 5 months after the beginning of the program. Participants’ satisfaction and perception were documented via online questionnaires and a semistructured interview. Results: Of the 52 pharmacists in the ACO Program, 47 participated in this evaluation. Seventy-seven percent of the participants completed at least 1 OTA and 6% published on the forum. The feeling of personal effectiveness rose from 8.01 (7.67-8.35) to 8.62 (8.24-8.99). The audit and feedback, as well as the high-quality OTA and their lecturers, were the most appreciated elements. Discussion: There was a high OTA participation rate. The facilitators seemed to play a key role in the CQIP. The low level of participation in the forum reflects the known phenomenon of social loafing. Technical difficulties affecting the platform and data collection for the audit with feedback constituted limitations. Conclusion: The CQIP in anticoagulation therapy is appreciated by community pharmacists and is associated with an improved feeling of personal effectiveness. PMID:27829859

  8. Needs and Opportunities to Improve the Operational Quality of Forwarding Companies

    OpenAIRE

    Dovilė Kontautaitė; Virgilija Zinkevičiūtė

    2013-01-01

    It is essential for forwarding companies to improve their activity by improving their internal and external processes in order to provide for a client an estimated basic and added value and effectively manage the flow of information in the general logistic supply chain. The article analyses the concepts of quality management and activity process, emphasising the main process of a forwarding enterprise and the demand to optimise the activity establishing quality management systems. The scienti...

  9. Improvement in clinical TNM staging documentation within a prostate cancer quality improvement collaborative.

    Science.gov (United States)

    Filson, Christopher P; Boer, Brooke; Curry, Jon; Linsell, Susan; Ye, Zaojun; Montie, James E; Miller, David C

    2014-04-01

    To assess the effectiveness of a feedback and educational intervention to increase documentation of clinical tumor-node-metastasis (TNM) stage among urologists in a statewide quality improvement collaborative. The Michigan Urological Surgery Improvement Collaborative (MUSIC) is a consortium of urology practices that aims to improve the quality and cost-efficiency of prostate cancer care. In pilot data collection activities, trained abstractors recorded medical record documentation of clinical TNM stage by participating urologists. We compared levels of TNM stage documentation in 12 MUSIC practices at baseline and after performance feedback and a collaborative-wide educational intervention. We examined patient and practice characteristics associated with documentation of TNM stage. We accrued 491 and 581 men with newly diagnosed prostate cancer during the baseline and postfeedback phases of data collection, respectively. At baseline, 58% of patients had clinical TNM staging in the medical record, ranging from 19% to 96% across 12 practices (P TNM stage. This finding underscores the behavioral change possible with the collaborative quality improvement model and ensures the necessary risk stratification data for our ongoing efforts to improve care. Copyright © 2014 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    Dunagan, Pamela B

    2017-08-22

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

  11. Activating Teaching for Quality Learning

    DEFF Research Database (Denmark)

    Zhurbenko, Vitaliy

    2013-01-01

    Activating teaching is an educational concept which is based on active participation of students in the study process. It is becoming an alternative to more typical approach where the teacher will just lecture and the students will take notes. The study described in this paper considers student...... activating teaching methods focusing on those based on knowledge dissemination. The practical aspects of the implemented teaching method are considered, and employed assessment methods and tools are discussed....

  12. Total quality management in hospitals: the contributions of commitment, quality councils, teams, budgets, and training to perceived improvement at Veterans Health Administration hospitals.

    Science.gov (United States)

    Lammers, J C; Cretin, S; Gilman, S; Calingo, E

    1996-05-01

    Studies of total quality management as a means of improving health care quality to date have relied on case studies of individual teams or hospitals. The Total Quality Improvement Registry Project surveyed quality coordinators (n = 36) and quality improvement team leaders (n = 228) to collect both site-level and team-level data on quality improvement in Veterans Health Administration hospitals. Usable responses were received from 100% of quality coordinators and 73.7% (168) of team leaders. Site-level data include hospital structural characteristics and measures of training and commitment, as well as features and activities of the hospital quality councils. Team-level data include size, membership, task, age, activities, and a proxy measure of quality improvement. The authors report on the relations between levels of commitment to total quality management principles, training levels, activities of quality councils, and team formation and success. These data provide support for a model of commitment to quality improvement that involves four realms of influence within the medical centers: (1) management, (2) physician leadership, (3) physician staff and middle management, and (4) nurses and employees. The authors also report on the activities of quality councils and the relation of their activities to commitment and perceived improvement. Using bivariate correlation and multiple regression, the authors found that the age of the quality council, overall facility commitment to total quality management philosophy, and physician commitment are the most critical variables in explaining numbers of teams, training intensity, and total perceived improvement at this sample of medical centers. Specifically, we find that commitment to total quality management philosophy and the number of active teams explains 41% of the observed variation in quality improvement. In future articles, the authors will report details of team activities and the development of teams over time.

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

    Science.gov (United States)

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

    2017-07-31

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

  14. Quality improvement primer part 2: executing a quality improvement project in the emergency department.

    Science.gov (United States)

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

    2017-09-22

    The topics of quality improvement (QI) and patient safety have become important themes in health care in recent years, particularly in the emergency department setting, which is a frequent point of contact with the health care system for patients. In the first of three articles in this series meant as a QI primer for emergency medicine clinicians, we introduced the strategic planning required to develop an effective QI project using a fictional case study as an example. In this second article we continue with our example of improving time to antibiotics for patients with sepsis, and introduce the Model for Improvement. We will review what makes a good aim statement, the various categories of measures that can be tracked during a QI project, and the relative merits and challenges of potential change concepts and ideas. We will also present the Model for Improvement's rapid-cycle change methodology, the Plan-Do-Study-Act (PDSA) cycle. The final article in this series will focus on the evaluation and sustainability of QI projects.

  15. Improving safety and quality: how can education help?

    Science.gov (United States)

    Walton, Merrilyn M; Elliott, Susan L

    2006-05-15

    National efforts to improve the quality and safety of health care present challenges for medical education and training. Today's doctors need to be skilled communicators who know how to identify, prevent and manage adverse events and near misses, how to use evidence and information, how to work safely in a team, how to practise ethically, and how to be workplace teachers and learners. These competencies (knowledge, skills and attitudes) are set out in the National Patient Safety Education Framework (NPSF) of the Australian Council for Safety and Quality in Health Care. The NPSF is designed to help medical schools, vocational colleges, health organisations and private practitioners develop curricula to enable health professionals to work safely. The NPSF describes what doctors (depending on their level of knowledge and experience) can do to demonstrate competencies in a range of quality and safety activities. Medical schools, vocational colleges, health organisations and private practitioners need to work collaboratively with one another and with other health professionals to ensure that patient safety and quality curricula are implemented and evaluated, and that valid and reliable assessments of learning outcomes are developed. Interdisciplinary and vertically integrated education and training are needed, incorporating innovative methods, to create a safer health care system.

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

    Science.gov (United States)

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

    2017-01-01

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

  17. The Efficacy of Quality Improvement Programs in Education.

    Science.gov (United States)

    Curley, John R.

    Total Quality Management (TQM) is being adopted by many governmental entities, including public school districts. A basic tenet of quality improvement is that the customer, not the organization, defines quality. Other tenets are that the organization must satisfy the customer in order to best the competition; and that the organization must change…

  18. Quality Improvement in Virtual Higher Education: A Grounded Theory Approach

    Science.gov (United States)

    Mahdiuon, Rouhollah; Masoumi, Davoud; Farasatkhah, Maghsoud

    2017-01-01

    The article aims to explore the attributes of quality and quality improvement including the process and specific actions associated with these attributes--that contribute enhancing quality in Iranian Virtual Higher Education (VHE) institutions. A total of 16 interviews were conducted with experts and key actors in Iranian virtual higher education.…

  19. Nurse managers' experiences in continuous quality improvement in resource-poor healthcare settings.

    Science.gov (United States)

    Kakyo, Tracy Alexis; Xiao, Lily Dongxia

    2017-06-01

    Ensuring safe and quality care for patients in hospitals is an important part of a nurse manager's role. Continuous quality improvement has been identified as one approach that leads to the delivery of quality care services to patients and is widely used by nurse managers to improve patient care. Nurse managers' experiences in initiating continuous quality improvement activities in resource-poor healthcare settings remain largely unknown. Research evidence is highly demanded in these settings to address disease burden and evidence-based practice. This interpretive qualitative study was conducted to gain an understanding of nurse managers' Continuous Quality Improvement experiences in rural hospitals in Uganda. Nurse managers in rural healthcare settings used their role to prioritize quality improvement activities, monitor the Continuous Quality Improvement process, and utilize in-service education to support continuous quality improvement. The nurse managers in our sample encountered a number of barriers during the implementation of Continuous Quality Improvement, including: limited patient participation, lack of materials, and limited human resources. Efforts to address the challenges faced through good governance and leadership development require more attention. © 2017 John Wiley & Sons Australia, Ltd.

  20. Semen quality improves marginally during young adulthood

    DEFF Research Database (Denmark)

    Perheentupa, Antti; Sadov, Sergey; Rönkä, Riitta

    2016-01-01

    in several studies. The longitudinal development of semen quality in early adulthood is insufficiently understood. STUDY DESIGN, SIZE, DURATION: A longitudinal follow-up of two cohorts of volunteer young adult Finnish men representing the general population was carried out. Cohorts A (discovery cohort, born...

  1. Compost improves urban soil and water quality

    Science.gov (United States)

    Construction in urban zones compacts the soil, which hinders root growth and infiltration and may increase erosion, which may degrade water quality. The purpose of our study was to determine the whether planting prairie grasses and adding compost to urban soils can mitigate these concerns. We simula...

  2. From sensor output to improved product quality

    NARCIS (Netherlands)

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

    2015-01-01

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

  3. Monitoring and improving quality of colonoscopy

    NARCIS (Netherlands)

    S.C. van Doorn

    2015-01-01

    Colorectal cancer (CRC) is one of the most commonly diagnosed cancers in the western world. High quality colonoscopy has the potential to reduce CRC mortality by detecting carcinomas in early stages and reduce its incidence by detecting and removing its main precursor lesions, adenomas. Variability

  4. How to Improve Hotel Service Quality

    Institute of Scientific and Technical Information of China (English)

    高婧

    2014-01-01

    This paper states the importance of provide quality service in hotel industry. The key lessons to be gleaned from the present review are:the advanced training design;the development of service culture&service value throughout the organization; and positive attitudes to complaints. It is also important to have a key person in the organization to stimulate and facilitate the whole process.

  5. From sensor output to improved product quality

    NARCIS (Netherlands)

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

    2015-01-01

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

  6. Does Automated Feedback Improve Writing Quality?

    Science.gov (United States)

    Wilson, Joshua; Olinghouse, Natalie G.; Andrada, Gilbert N.

    2014-01-01

    The current study examines data from students in grades 4-8 who participated in a statewide computer-based benchmark writing assessment that featured automated essay scoring and automated feedback. We examined whether the use of automated feedback was associated with gains in writing quality across revisions to an essay, and with transfer effects…

  7. INTEGRATING SIX-SIGMA AND HEALTHCARE QUALITY IMPROVEMENT CIRCLES IN REDUCING THE NEEDLE STICKING

    OpenAIRE

    Sen-Ji Chen; Frank F. C. Pan; Hsuen C. H. Chen

    2008-01-01

    Six-Sigma (SS) is a managerial philosophy used in detecting the error rate of a particular (set) of activities. This research applies six sigma concepts in dealing with troublesome needle-stick events that occurred in a Taiwan hospital. This research integrates several advanced managerial instruments into one framework, grounded in Continuous Quality Improvement and Total Quality Management. This framework combines Six-Sigma and Health Quality Improvement circle practices. The project suggest...

  8. Implementing quality/productivity improvement initiatives in an engineering environment

    Science.gov (United States)

    Ruda, R. R.

    1985-01-01

    Quality/Productivity Improvement (QPI) initiatives in the engineering environment at McDonnell Douglas-Houston include several different, distinct activities, each having its own application, yet all targeted toward one common goal - making continuous improvement a way of life. The chief executive and the next two levels of management demonstrate their commitment to QPI with hands-on involvement in several activities. Each is a member of a QPI Council which consists of six panels - Participative Management, Communications, Training, Performance/Productivity, Human Resources Management and Strategic Management. In addition, each manager conducts Workplace Visits and Bosstalks, to enhance communications with employees and to provide a forum for the identification of problems - both real and perceived. Quality Circles and Project Teams are well established within McConnel Douglas as useful and desirable employee involvement teams. The continued growth of voluntary membership in the circles program is strong evidence of the employee interest and management support that have developed within the organization.

  9. Sleep Quality Improvement During Cognitive Behavioral Therapy for Anxiety Disorders.

    Science.gov (United States)

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

    2016-01-01

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

  10. 40 CFR 64.8 - Quality improvement plan (QIP) requirements.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Quality improvement plan (QIP) requirements. 64.8 Section 64.8 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) COMPLIANCE ASSURANCE MONITORING § 64.8 Quality improvement plan (QIP) requirements. (a...

  11. Economic implications of neonatal intensive care unit collaborative quality improvement

    NARCIS (Netherlands)

    Rogowski, JA; Horbar, JD; Plsek, PE; Baker, LS; Deterding, J; Edwards, WH; Hocker, J; Kantak, AD; Lewallen, P; Lewis, W; Lewit, E; McCarroll, CJ; Mujsce, D; Payne, NR; Shiono, P; Soll, RF; Leahy, K

    2001-01-01

    Objective. To make measurable improvements in the quality and cost of neonatal intensive care using a multidisciplinary collaborative quality improvement model. Design. Interventional study. Data on treatment costs were collected for infants with birth weight 501 to 1500 g for the period of January

  12. International Accreditations as Drivers of Business School Quality Improvement

    Science.gov (United States)

    Bryant, Michael

    2013-01-01

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

  13. The Role of Staff in Quality Improvement in Early Childhood

    Science.gov (United States)

    Sims, Margaret; Waniganayake, Manjula

    2015-01-01

    There is international recognition of the importance of high quality services for young children with a consensus that three pillars contribute to quality improvement: adult: child ratios, staff qualifications and group size. In Australia over the past 5 years, early childhood policy has attempted to drive improvements in early childhood service…

  14. Nationwide quality improvement of cholecystectomy: results from a national database

    DEFF Research Database (Denmark)

    Harboe, Kirstine M; Bardram, Linda

    2011-01-01

    To evaluate whether quality improvements in the performance of cholecystectomy have been achieved in Denmark since 2006, after revision of the Danish National Guidelines for treatment of gallstones.......To evaluate whether quality improvements in the performance of cholecystectomy have been achieved in Denmark since 2006, after revision of the Danish National Guidelines for treatment of gallstones....

  15. Design and implementation of PV-based three-phase four-wire series hybrid active power filter for power quality improvement

    Indian Academy of Sciences (India)

    M Vijayakumar; S Vijayan

    2014-08-01

    This paper proposes a Photovoltaic (PV)-based three-phase four-wire Series Hybrid Active Power Filter (SHAPF), it comprises of a Series Active Power Filter (SAPF) and an LC shunt passive filter. The proposed system eliminates both the current and voltage harmonics and compensates reactive power, neutral current and voltage interruption. A SAPF demands a source of energy for compensating the voltage sag/swell. This system found a new topology for SHAPF which utilizes the PV with DC–DC boost converter as a source of DC power for the series active filter. The compensation current reference evaluation is based on the twin formulation of the vectorial theory of electrical power theorem with Fuzzy Logic Controller (FLC). The PV array/battery managed DC–DC boost converter is employed to step up the voltage to meet the DC bus voltage requirement of the three-leg Voltage Source Inverter (VSI). The foremost benefit of the proposed system is that, it will provide uninterrupted compensation for the whole day. This system utilizes the renewable energy; accordingly saves the energy and provides the uninterruptable power supply to critical/sensitive load, through the PV array/battery bank during both day time and night time. An experimental model was established and results were obtained, which indicated the capability of the proposed control scheme.

  16. Valuation of improved air quality in Utah County, USA

    Science.gov (United States)

    Pope, C. Arden; Miner, F. Dean

    1988-05-01

    A contingent valuation approach was used to estimate maximum willingness-to-pay for improved air quality in Utah County. Respondents demonstrated a high rate of concern over poor air quality and averaged a willingness-to-pay of 37 per month per household. Noniterative openended questions were used successfully. No information bias was observed but benchmark values did influence bids. Willingness-to-pay for improved air quality was large for both sexes and across all income groups, ages, and occupations.

  17. Laboratory system strengthening and quality improvement in Ethiopia

    Directory of Open Access Journals (Sweden)

    Tilahun M. Hiwotu

    2014-09-01

    Full Text Available Background: In 2010, a National Laboratory Strategic Plan was set forth in Ethiopia to strengthen laboratory quality systems and set the stage for laboratory accreditation. As a result, the Strengthening Laboratory Management Toward Accreditation (SLMTA programme was initiated in 45 Ethiopian laboratories.Objectives: This article discusses the implementation of the programme, the findings from the evaluation process and key challenges.Methods: The 45 laboratories were divided into two consecutive cohorts and staff from each laboratory participated in SLMTA training and improvement projects. The average amount of supportive supervision conducted in the laboratories was 68 hours for cohort I and two hoursfor cohort II. Baseline and exit audits were conducted in 44 of the laboratories and percent compliance was determined using a checklist with scores divided into zero- to five-star ratinglevels.Results: Improvements, ranging from < 1 to 51 percentage points, were noted in 42 laboratories, whilst decreases were recorded in two. The average scores at the baseline and exit audits were 40% and 58% for cohort I (p < 0.01; and 42% and 53% for cohort II (p < 0.01,respectively. The p-value for difference between cohorts was 0.07. At the exit audit, 61% ofthe first and 48% of the second cohort laboratories achieved an increase in star rating. Poor awareness, lack of harmonisation with other facility activities and the absence of a quality manual were challenges identified.Conclusion: Improvements resulting from SLMTA implementation are encouraging. Continuous advocacy at all levels of the health system is needed to ensure involvement of stakeholders and integration with other improvement initiatives and routine activities.

  18. QUALITY IMPROVEMENT MODEL AT THE MANUFACTURING PROCESS PREPARATION LEVEL

    Directory of Open Access Journals (Sweden)

    Dusko Pavletic

    2009-12-01

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

  19. Refractories Quality Improvement for Glass Industry Upgrading

    Institute of Scientific and Technical Information of China (English)

    ZENG Dafan

    2009-01-01

    @@ 1 Glass Industry and Refractories Industry Closely Connect 1.1 Glass Development Drives Refractories Progress Refractories are indispensable to glass industry; the rapid development of glass industry drives the growth of refractories industry. China's glass industry developed slowly before the mid 1980s. The kilns and furnaces were backward and small-scale with furnace life of only 2-3 years; glass was produced with extremely low efficiency and poor quality. During that period, refractories for glass melting furnaces had very limited varieties and inferior quality. The fused cast refractories for advanced glass melting furnaces were imported, for the materials made in China could not meet the requirements, which seriously restrained the technical progress of China's glass industry.

  20. Casting Process Developments for Improving Quality

    Science.gov (United States)

    El-Mahallawy, Nahed A.; Taha, Mohamed A.

    1985-09-01

    This paper presents a short synopsis of the important developments in casting/solidification processes, as well as the important advances in the conventional methods. These developments are discussed related to quality aspects. The position of each process with respect to practice, as well as expected gains in cost, are examined. The paper briefly features the author's work on innovative processes (directional solidification, rheocasting, squeeze-casting and rapid solidification) as well as work of other investigators on developments in conventional methods.

  1. A Value Management Approach to Improving Quality (ICP/JOU-05-00825)

    Energy Technology Data Exchange (ETDEWEB)

    James R. Wixson; Howard Stromberg (Because he has an NT Account)

    2005-07-01

    In October 2001, the Department of Energy’s, Office of Price-Anderson Enforcement determined that the continuous improvement aspect of the INEEL Quality Assurance Program was inadequate. At the request of the INEEL Senior Management, a Quality Assurance Operations (QAO) Task Team was identified and requested to review the INEEL practices to determine whether the INEEL was performing the activities that are required for Quality Implementation. The team consisted of INEEL managers from Operations, Quality Assurance, Document and Records Management, Construction Services, Radiological Control, and Engineering. FAST modeling combined with other analytical techniques were used to identify areas for improvement and resolve the issues related to inadequate continuous improvement efforts.

  2. 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.

  3. Challenges of Using Quality Improvement Methods in Nursing Homes that “Need Improvement”

    Science.gov (United States)

    Rantz, Marilyn J.; Zwygart-Stauffacher, Mary; Flesner, Marcia; Hicks, Lanis; Mehr, David; Russell, Teresa; Minner, Donna

    2012-01-01

    A randomized, two-group, repeated-measures design was used to test a two year intervention for improving quality of care and resident outcomes in facilities in “need of improvement”. Intervention group (n=29) received an experimental multilevel intervention designed to help them (1) use quality-improvement methods, (2) use team and group process for direct-care decision-making, (3) focus on accomplishing the basics of care, and (4) maintain more consistent nursing and administrative leadership committed to communication and active participation of staff in decision-making. A qualitative analysis revealed a subgroup of homes likely to continue quality improvement activities and readiness indicators of homes likely to improve 1) leadership team (NHA, DON) who are interested in learning to use their federal Quality Indicator/Quality Measure (QI/QM) reports to improve resident care and outcomes; 2) one leader who will be the “change champion” and others make sure that current QI/QM reports are consistently shared on each nursing unit; 3) willingness to involve all staff in educational activities to learn about the QI/QM process and federal reports that compare the home with others in the state and nation; 4) plan and continuously educate new staff about the QI/QM process and how to do quality improvement; 5) continuously involve all staff in quality improvement committee and team activities so they “own” the process and are responsible for change. PMID:22926322

  4. Related Measures on Improving the Teaching Quality of DGED Course

    Institute of Scientific and Technical Information of China (English)

    JIN Yi; SHAN Hong-bo; WANG Xiao-hong; YU Hai-yan; GE Bin

    2013-01-01

    Engineering Drawing course is one of the main contents of teaching at most of science and engineering colleges or univer-sities. In this paper, some feasible measures is discussed on improving the teaching quality of Engineering Drawing course from four aspects, including diversified teacher participation and coordinating the teaching process, optimizing the content of teaching and im-proving teaching quality, improving teaching effect and reforming teaching methods, and integrating practice and cultivating practi-cal ability.

  5. The Impact of Elderly Care Competence and Quality Improvement Programme in Four Swedish Municipalities

    Science.gov (United States)

    Westerberg, Kristina; Hjelte, Jan

    2013-01-01

    During a number of years Swedish municipalities have work with improvement of competence and long-term quality in elderly care. The overall aim of the present study was to compare different learning activities (workplace improvement and/or courses), and to relate these activities to learning climate, learning strategies, and perception of care…

  6. The Impact of Elderly Care Competence and Quality Improvement Programme in Four Swedish Municipalities

    Science.gov (United States)

    Westerberg, Kristina; Hjelte, Jan

    2013-01-01

    During a number of years Swedish municipalities have work with improvement of competence and long-term quality in elderly care. The overall aim of the present study was to compare different learning activities (workplace improvement and/or courses), and to relate these activities to learning climate, learning strategies, and perception of care…

  7. Postgraduate Education in Quality Improvement Methods: Initial Results of the Fellows' Applied Quality Training (FAQT) Curriculum.

    Science.gov (United States)

    Winchester, David E; Burkart, Thomas A; Choi, Calvin Y; McKillop, Matthew S; Beyth, Rebecca J; Dahm, Phillipp

    2016-06-01

    Training in quality improvement (QI) is a pillar of the next accreditation system of the Accreditation Committee on Graduate Medical Education and a growing expectation of physicians for maintenance of certification. Despite this, many postgraduate medical trainees are not receiving training in QI methods. We created the Fellows Applied Quality Training (FAQT) curriculum for cardiology fellows using both didactic and applied components with the goal of increasing confidence to participate in future QI projects. Fellows completed didactic training from the Institute for Healthcare Improvement's Open School and then designed and completed a project to improve quality of care or patient safety. Self-assessments were completed by the fellows before, during, and after the first year of the curriculum. The primary outcome for our curriculum was the median score reported by the fellows regarding their self-confidence to complete QI activities. Self-assessments were completed by 23 fellows. The majority of fellows (15 of 23, 65.2%) reported no prior formal QI training. Median score on baseline self-assessment was 3.0 (range, 1.85-4), which was significantly increased to 3.27 (range, 2.23-4; P = 0.004) on the final assessment. The distribution of scores reported by the fellows indicates that 30% were slightly confident at conducting QI activities on their own, which was reduced to 5% after completing the FAQT curriculum. An interim assessment was conducted after the fellows completed didactic training only; median scores were not different from the baseline (mean, 3.0; P = 0.51). After completion of the FAQT, cardiology fellows reported higher self-confidence to complete QI activities. The increase in self-confidence seemed to be limited to the applied component of the curriculum, with no significant change after the didactic component.

  8. It Pays to Improve School Quality

    Science.gov (United States)

    Hanushek, Eric A.; Ruhose, Jens; Woessmann, Ludger

    2016-01-01

    Congress passed the Every Student Succeeds Act, supplanting No Child Left Behind and placing responsibility for public school improvement squarely upon each of the 50 states. With the federal government's role in school accountability sharply diminished, it now falls to state and local governments to take decisive action. Even though most…

  9. How to Sustain Change and Support Continuous Quality Improvement.

    Science.gov (United States)

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

    2016-05-06

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

  10. Empowering heliotherapy improves clinical outcome and quality of life of psoriasis and atopic dermatitis patients.

    Science.gov (United States)

    Karppinen, Toni T; Ylianttila, Lasse; Kautiainen, Hannu; Reunala, Timo; Snellman, Erna

    2015-05-01

    Empowering heliotherapy aims at clinical healing and improved coping with psoriasis and atopic dermatitis, but evidence of long-term effects is scarce. We studied the effect of 2-week empowering heliotherapy in the Canary Islands on clinical outcome and quality of life in 22 psoriasis and 13 atopic dermatitis patients. Empowerment consisted of meeting peers, sharing experiences and performing physical and mental practices. Using the self-administered PASI (SAPASI) psoriasis was alleviated statistically significantly during heliotherapy (p improved (p life quality index (DLQI) improved in both groups (p improvement in psoriasis and atopic dermatitis disease activity, and also in the quality of life of atopic patients.

  11. CONTRIBUTION TO THE IMPROVEMENT OF PRODUCTS QUALITY IN BAKING INDUSTRY

    Directory of Open Access Journals (Sweden)

    Aleksandar Marić

    2009-09-01

    Full Text Available Food industry occupies special place in the processing industry, especially when we talk on the manufacturing of bakery products. Variable products quality on the market initiated the authors of this study to make an attempt, using comparative analysis of methods for quality control that are at most applied in bakery plants and other "convenient" methods to indicate the shortcomings and to argue convenience of using of methods that would improve testing of the quality. That approach could create a base for designing of model of quality improvement the baking industry.

  12. Quality improvement – rival or ally of practice development?

    Directory of Open Access Journals (Sweden)

    Gavin Lavery

    2016-05-01

    Full Text Available The majority of nurses, doctors, allied health professionals and other healthcare staff possess a strong desire to provide the best possible care and experience for their patients. Unfortunately, this sometimes falls short of what was planned or intended (Institute of Medicine, 2001, p 23. The gap between care intended and care delivered can be explained by problems with systems and processes and/or people and culture. The narrowing of this gap is the focus of many strategies, methodologies and approaches. Practice development is described as ‘an activity focused on developing people and practice for the ultimate purpose of achieving high-quality person-centred care’ and a ‘methodology that aims to achieve effective workplace cultures that are person-centred’ (Shaw, 2012; Manley et al., 2014. Practice development undoubtedly has a strong focus on people and culture and the potential to change processes and systems. Another approach, widely referred to as quality improvement, aims to improve safety, effectiveness and person-centredness in healthcare using principles proven effective in other industries such as manufacturing – notably car manufacturing (Toyota, oil production, nuclear power and aviation. The fundamental principles of quality improvement for healthcare include making care reliable (every patient receiving care as intended every time, using well-designed processes and reducing variation (agreeing a consistent way to provide care. At first glance this may appear to be an approach suited only to systems and processes. However, better processes, designed by those who use them, resulting in fewer errors and less re-working or working around problems, can reduce stress on staff, offer greater job satisfaction with improved morale and free up time to provide person-centred care. In his report, A Promise to Learn – a Commitment to Act (2013, p 24, Professor Don Berwick says: ‘Mastery of quality and patient safety sciences and

  13. Improving collected rainwater quality in rural communities.

    Science.gov (United States)

    Garrido, S; Aviles, M; Ramirez, A; Gonzalez, A; Montellano, L; Gonzalez, B; de la Paz, J; Ramirez, R M

    2011-01-01

    The country of Mexico is facing serious problems with water quality and supply for human use and consumption in rural communities, mainly due to topographic and isolation. In Mexico the average annual precipitation is 1,500 cubic kilometers of water, if 3% of that amount were used, 13 million Mexicans could be supplied with drinking water that they currently do not have access. Considering the limited infrastructure and management in rural communities, which do not receive services from the centralized systems of large cities, a modified pilot multi-stage filtration (MMSF) system was designed, developed, and evaluated for treating collected rainwater in three rural communities, Ajuchitlan and Villa Nicolas Zapata (Morelos State) and Xacxamayo (Puebla State). The efficiencies obtained in the treatment system were: colour and turbidity >93%. It is worth mentioning that the water obtained for human use and consumption complies with the Mexican Standard NOM-127-SSA1-1994.

  14. Improvement of power quality using distributed generation

    Energy Technology Data Exchange (ETDEWEB)

    Moreno-Munoz, A.; Lopez-Rodriguez, M.A.; Flores-Arias, J.M.; Bellido-Outerino, F.J. [Universidad de Cordoba, Departamento A.C., Electronica y T.E., Escuela Politecnica Superior, Campus de Rabanales, E-14071 Cordoba (Spain); de-la-Rosa, J.J.G. [Universidad de Cadiz, Area de Electronica, Dpto. ISA, TE y Electronica, Escuela Politecnica Superior Avda, Ramon Puyol, S/N, E-11202-Algeciras-Cadiz (Spain); Ruiz-de-Adana, M. [Universidad de Cordoba, Departamento de Quimica Fisica y Termodinamica Aplicada, Campus de Rabanales, E-14071 Cordoba (Spain)

    2010-12-15

    This paper addresses how Distributed Generation (DG), particularly when configured in Combined Heat and Power (CHP) mode, can become a powerful reliability solution in highlight automated factories, especially when integrated with complimentary Power Quality (PQ) measures. The paper presents results from the PQ audit conducted at a highly automated plant over last year. It was found that the main problems for the equipment installed were voltage sags. Among all categories of electrical disturbances, the voltage sag (dip) and momentary interruption are the nemeses of the automated industrial process. The paper analyzes the capabilities of modern electronic power supplies and the convenience of embedded solution. Finally it is addressed the role of the DG/CHP on the reliability of digital factories. (author)

  15. Quality Improvement of Liver Ultrasound Images Using Fuzzy Techniques

    Science.gov (United States)

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

    2016-01-01

    Background: Liver ultrasound images are so common and are applied so often to diagnose diffuse liver diseases like fatty liver. However, the low quality of such images makes it difficult to analyze them and diagnose diseases. The purpose of this study, therefore, is to improve the contrast and quality of liver ultrasound images. Methods: In this study, a number of image contrast enhancement algorithms which are based on fuzzy logic were applied to liver ultrasound images - in which the view of kidney is observable - using Matlab2013b to improve the image contrast and quality which has a fuzzy definition; just like image contrast improvement algorithms using a fuzzy intensification operator, contrast improvement algorithms applying fuzzy image histogram hyperbolization, and contrast improvement algorithms by fuzzy IF-THEN rules. Results: With the measurement of Mean Squared Error and Peak Signal to Noise Ratio obtained from different images, fuzzy methods provided better results, and their implementation - compared with histogram equalization method - led both to the improvement of contrast and visual quality of images and to the improvement of liver segmentation algorithms results in images. Conclusion: Comparison of the four algorithms revealed the power of fuzzy logic in improving image contrast compared with traditional image processing algorithms. Moreover, contrast improvement algorithm based on a fuzzy intensification operator was selected as the strongest algorithm considering the measured indicators. This method can also be used in future studies on other ultrasound images for quality improvement and other image processing and analysis applications. PMID:28077898

  16. Quality Improvement of Liver Ultrasound Images Using Fuzzy Techniques.

    Science.gov (United States)

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

    2016-12-01

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

  17. Finding Ways to Lift Barriers to Care for Chronic Pain Patients: Outcomes of Using Internet-Based Self-Management Activities to Reduce Pain and Improve Quality of Life.

    Science.gov (United States)

    Rod, Kevin

    2016-01-01

    Background. Chronic pain is prevalent, disabling, costly, and undertreated. There is clearly a need to improve patient understanding of ways to manage their pain. Internet-based programs are continually being developed to facilitate mental health improvement, providing tailored content for patients to manage their pain, anxiety, and depression. Objective. To evaluate the impact of Internet-based patient self-management education and activities on patients' pain, anxiety, and quality of life in patients who could not access multidisciplinary pain management. Design. Observational study. Subjects. Two hundred (200) patients (61% females, 39% males, between 18 and 75 years old) from one community pain clinic in Toronto, Canada (Toronto Poly Clinic), participated. Patients had moderate to severe pain, depression, and anxiety. These patients committed to study from a group of 515 patients with chronic noncancer pain of different origins who were stable on their levels of pain, anxiety, and depression for 12 consecutive months before start of study and could not afford noninsured treatment modalities like physiotherapy, psychology, nutrition, or exercise therapy consultation. Methods. Patients were encouraged to visit two Internet sites (a blog and Twitter postings) for educational postings written by the author about exercise, nutrition, mindfulness meditation, disease management methods, evidence-based supplements, daily relaxation exercises, and overall self-management methods 15 minutes per day for six months. Patients were also encouraged to share their ideas and comments on a blog. Activity logs were kept by patients and reviewed by physician at follow-up visits. Compliance was encouraged via weekly email reminders and phone calls during the observation period. Results. Modest improvements were noted in pain, anxiety, depression, and quality of life. Of the patients with moderate or severe pain before treatment, 45% reported mild levels of pain after treatment

  18. Finding Ways to Lift Barriers to Care for Chronic Pain Patients: Outcomes of Using Internet-Based Self-Management Activities to Reduce Pain and Improve Quality of Life

    Directory of Open Access Journals (Sweden)

    Kevin Rod

    2016-01-01

    Full Text Available Background. Chronic pain is prevalent, disabling, costly, and undertreated. There is clearly a need to improve patient understanding of ways to manage their pain. Internet-based programs are continually being developed to facilitate mental health improvement, providing tailored content for patients to manage their pain, anxiety, and depression. Objective. To evaluate the impact of Internet-based patient self-management education and activities on patients’ pain, anxiety, and quality of life in patients who could not access multidisciplinary pain management. Design. Observational study. Subjects. Two hundred (200 patients (61% females, 39% males, between 18 and 75 years old from one community pain clinic in Toronto, Canada (Toronto Poly Clinic, participated. Patients had moderate to severe pain, depression, and anxiety. These patients committed to study from a group of 515 patients with chronic noncancer pain of different origins who were stable on their levels of pain, anxiety, and depression for 12 consecutive months before start of study and could not afford noninsured treatment modalities like physiotherapy, psychology, nutrition, or exercise therapy consultation. Methods. Patients were encouraged to visit two Internet sites (a blog and Twitter postings for educational postings written by the author about exercise, nutrition, mindfulness meditation, disease management methods, evidence-based supplements, daily relaxation exercises, and overall self-management methods 15 minutes per day for six months. Patients were also encouraged to share their ideas and comments on a blog. Activity logs were kept by patients and reviewed by physician at follow-up visits. Compliance was encouraged via weekly email reminders and phone calls during the observation period. Results. Modest improvements were noted in pain, anxiety, depression, and quality of life. Of the patients with moderate or severe pain before treatment, 45% reported mild levels of pain

  19. Effect of quality control circle activity for improving self-care ability of colostomy patients%品管圈活动在提高肠造口病人自我护理能力中的作用

    Institute of Scientific and Technical Information of China (English)

    陈幸幸; 吴佳丽; 廖庆萍; 谭静; 刘艾; 何金艳

    2014-01-01

    [目的]探讨品管圈活动在提高肠造口病人自我护理能力中的作用。[方法]成立品管圈,以提高造口病人自我护理能力为目标。通过调查、原因分析、对策制定及实施、效果确认等方法,观察自我护理能力情况。[结果]开展品管圈活动后肠造口病人自我护理能力评分高于对照组,能够独立更换造口袋的人数多于对照组,造口相关知识的掌握情况优于对照组,差异有统计学意义(P<0.05)。[结论]品管圈活动的开展,可以提高肠造口病人的自我护理能力,改善病人的生活质量。%Objective:To probe into the effect of quality control circle activity for improving self care ability of colostomy patients.Methods: QCC was founded to improve the self care ability of colostomy patients. The investigation,causative analysis,development and implementation of countermeasures,and effect confirmation were used to observe the self care ability.Results:After QCC activity,self care ability score of colostomy patients in observation group was higher than that of control group.the number of people who can replace ostomy bag independently was more than that of control group,grasping ostomy related knowledge was better than that in control group,the difference was statistically significant(P <0.05).Conclusion:QCC activity can improve the self care ability and quality of life of colostomy patients.

  20. Systematic Quality Improvement in Medicine: Everyone Can Do It

    Directory of Open Access Journals (Sweden)

    Mark L. Zeidel

    2011-07-01

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

  1. Quality Improvement Policies in a Supply Chain with Stackelberg Games

    Directory of Open Access Journals (Sweden)

    Gang Xie

    2014-01-01

    Full Text Available We first analyze quality and price decisions in a supply chain with two Stackelberg games: Manufacturer’s Stackelberg (MS and Supplier’s Stackelberg (SS. Then, we investigate how equilibrium solutions are influenced by proposed quality improvement policies: coordination and manufacturer’s involvement. Also, we derive the conditions under which the policies can be implemented in both MS and SS strategies. Numerical experiments illustrate the problems and several related issues are discussed. The results suggest that proposed quality improvement policies can realize Pareto improvement for the supply chain performance.

  2. Continuous quality improvement in acute health care: creating a holistic and integrated approach.

    Science.gov (United States)

    Sewell, N

    1997-01-01

    Reviews the range of quality activity in a National Health Service hospital trust, using a staff questionnaire survey, self-assessment against the Baldrige Quality Award criteria, and the application of the SERVQUAL approach to service quality assessment. Reviews the acute health care quality programme literature. Finds that there are needs for greater integration of quality effort, to engage with patients in a more meaningful manner, and to achieve greater commitment and involvement from clinicians and managers. Identifies lack of time and resources as a major barrier to greater application of quality programmes. Explores ways of developing a more holistic and integrated programme of quality improvement. Describes the creation and implementation of a model for continuous improvement in health care quality.

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

    Science.gov (United States)

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

    2012-11-01

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

  4. Improving patient satisfaction with ambulatory surgical care through quality control circle activities%开展品管圈活动提升门诊手术患者满意度

    Institute of Scientific and Technical Information of China (English)

    张健; 白晓霞

    2013-01-01

    Objective To explore the effect of quality control circle (QCC) activities on patient satisfaction with ambulatory surgical care.Methods The operating room nursing staff formed a QCC,delved into problems affecting patient satisfaction with ambulatory surgical care,and formulated solutions to the problems through brainstorming.They put forward improvement schemes and put them into practice.Results Patient overall satisfaction with ambulatory surgical care increased from (6.80 ± 0.57) points before QCC activities to (7.41±0.44) points after the activities,with significant difference found in the scores (P<0.01).Nurses' consciousness in participating nursing management,and job satisfaction were enhanced,and staff's enthusiasm,creativity,and initiative were fully exercised.Conclusion QCC activities help improve quality of ambulatory surgical care and patient satisfaction.%目的 探讨品管圈活动用于提升门诊手术患者满意度的效果.方法 由手术室一线护理人员组成品管圈小组,通过脑力激荡,讨论分析门诊手术患者满意度不高的原因,制订相应的整改措施并组织实施.结果 门诊手术患者总体满意度由活动前(6.80±0.57)分提高到活动后的(7.41±0.44)分,效果显著(P<0.01);护理人员参与护理管理的意识和工作满足感增强,护理人员的积极性、创造性、主动性得到充分发挥.结论 品管圈活动的开展,有利于提高门诊手术服务质量、提升门诊手术患者满意度.

  5. IMPROVEMENT OF ENVIRONMENT QUALITY BY GREENERY RECOVERING

    Directory of Open Access Journals (Sweden)

    Мargarita Radomska

    2014-06-01

    Full Text Available Principal reasons of chemical pollution caused by the activity of filling stations, namely losses of hydrocarbon material, which takes place at transport operations and exploitation of imperfect equipment, have been analyzed. The primary sources of filling stations negative environmental impacts are shown to be storm waters, which wash off poured out petrochemicals from their territory, while direct environment pollution as a result of emergency overflows of petrochemicals is a rare phenomenon. It is indicated that the negative consequences of filling stations activity spread on atmospheric air, adjoining soils and water objects, including ground and underground water, and it is expressed in contamination of these environment components with petrochemicals and creation of threats for human health.

  6. Software Quality Improvement in the OMC Team

    CERN Document Server

    Maier, Viktor

    Physicists use self-written software as a tool to fulfill their tasks and often the developed software is used for several years or even decades. If a software product lives for a long time, it has to be changed and adapted to external influences. This implies that the source code has to be read, understood and modified. The same applies to the software of the Optics Measurements and Corrections (OMC) team at CERN. Their task is to track, analyze and correct the beams in the LHC and other accelerators. To solve this task, they revert to a self-written software base with more than 150,000 physical lines of code. The base is subject to continuous changes as well. Their software does its job and is effective, but runs regrettably not efficient because some parts of the source code are in a bad shape and has a low quality. The implementation could be faster and more memory efficient. In addition it is difficult to read and understand the code. Source code files and functions are too big and identifiers do not rev...

  7. Process safety improvement--quality and target zero.

    Science.gov (United States)

    Van Scyoc, Karl

    2008-11-15

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

  8. Process safety improvement-Quality and target zero

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-11-15

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

  9. Examining Pre-School Classroom Quality in a Statewide Quality Rating and Improvement System

    Science.gov (United States)

    Jeon, Lieny; Buettner, Cynthia K.; Hur, Eunhye

    2014-01-01

    Background: Research has documented the importance of high-quality early childhood experiences in preparing children for school. Quality rating and improvement systems (QRIS) have recently emerged in many states as a way to build quality of child care and to promote better child outcomes. Objective: The goal of this study was to determine if…

  10. Physical Activity Improves Quality of Life

    Science.gov (United States)

    ... Check Meal Certification Program Nutrition Requirements Heart-Check Professional Resources Contact the Heart-Check Certification Program Simple Cooking and Recipes Dining Out Choosing a Restaurant Deciphering the Menu Ordering Your Meal Eating Fast ...

  11. Improving Quality of Voice Conversion Systems

    Science.gov (United States)

    Farhid, M.; Tinati, M. A.

    New improvement scheme for voice conversion are proposed in this paper. We take Human factor cepstral coefficients (HFCC), a modification of MFCC that uses the known relationship between center frequency and critical bandwidth from human psychoacoustics to decouple filter bandwidth from filter spacing, as the basic feature. We propose U/V (Unvoiced/Voiced) decision rule such that two sets of codebooks are used to capture the difference between unvoiced and voiced segments of the source speaker. Moreover, we apply three schemes to refine the synthesized voice, including pitch refinement, energy equalization, and frame concatenation. The acceptable performance of the voice conversion system can be verified through ABX listening test and MOS grad.

  12. CONTRIBUTION TO THE IMPROVEMENT OF PRODUCTS QUALITY IN BAKING INDUSTRY

    OpenAIRE

    Aleksandar Marić; Slavko Arsovski; Jasna Mastilović

    2009-01-01

    Food industry occupies special place in the processing industry, especially when we talk on the manufacturing of bakery products. Variable products quality on the market initiated the authors of this study to make an attempt, using comparative analysis of methods for quality control that are at most applied in bakery plants and other "convenient" methods to indicate the shortcomings and to argue convenience of using of methods that would improve testing of the quality. That approach could cre...

  13. Leadership – The Key Element in Improving Quality Management

    Directory of Open Access Journals (Sweden)

    Iveta Paulová

    2011-10-01

    Full Text Available The present contribution is processed partial results of the survey application of leadership as one of the fundamental principles of quality management in organizations in the Slovak Republic. This survey was conducted in the research project VEGA No. 1/0229/08 Perspectives of quality management development in coherence with requirements of Slovak republic market. Results from the survey were the basis for proposals to improve the quality management in Slovak industrial organizations

  14. On-Site Construction Productivity Improvement Through Total Quality Management

    Science.gov (United States)

    1991-12-01

    Total Quality Management (TQM) used by many manufacturing companies to improve the state of their industry. TQM management techniques have been successful in manufacturing, service, and most recently in construction industries. Three Japanese contractors have earned the coveted Deming

  15. Improvement of Flow Quality in NAL Chofu Mach 10 Nozzle

    Science.gov (United States)

    Lacey, John; Inoue, Yasutoshi; Higashida, Akio; Inoue, Manabu; Ishizaka, Kouichi; Korte, John J.

    2002-01-01

    As a result of CFD analysis and remachining of the nozzle, the flow quality of the Mach 10 Hypersonic Wind Tunnel at NAL Chofu, Japan was improved. The subsequent test results validated the CFD analytical predictions by NASA and MHL.

  16. Easing Opioid Dose May Improve Pain and Quality of Life

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_167269.html Easing Opioid Dose May Improve Pain and Quality of Life ... when it comes to long-term use of opioid painkillers, cutting back on the dose of the ...

  17. Performance indicators: A tool for continuous quality improvement

    National Research Council Canada - National Science Library

    Bhatnagar, Nidhi M; Soni, Shital; Gajjar, Maitrey; Shah, Mamta; Shah, Sangita; Patel, Vaidehi

    2016-01-01

    ... (both critical and routine) to number of donors reactive for TTI. We conducted a study to measure the impact of monitoring Performance Indicators and how it could be used as a tool for Continuous Quality Improvement (CQI...

  18. Quality Improvement: Appropriate episiotomies in a district hospital

    African Journals Online (AJOL)

    Abstract. Work satisfaction, enthusiasm and better patient care at times come from the simplest things. ... A multidisciplinary team did a quality improvement project to reduce the number of episiotomies. .... successful in the hospital and in the.

  19. The quality infrastructure measuring, analyzing, and improving library services

    CERN Document Server

    Murphy, Sarah Anne

    2013-01-01

    Summarizing specific tools for measuring service quality alongside tips for using these tools most effectively, this book helps libraries of all kinds take a programmatic approach to measuring, analyzing, and improving library services.

  20. Open Schools for improving Equity and Quality Education

    NARCIS (Netherlands)

    Stracke, Christian M.

    2016-01-01

    Invited Speech at International Lensky Education Forum 2016, Yakutsk, Republic of Sakha, Russian Federation, by Stracke, C. M. (2016, 16 August): "Open Schools for improving Equity and Quality Education"

  1. Aerobic exercise improves quality of life, psychological well-being ...

    African Journals Online (AJOL)

    Aerobic exercise improves quality of life, psychological well-being and systemic ... Methods: Forty Alzheimer elderly subjects were enrolled in two groups; the first ... interleukin-6 (IL-6), Rosenberg Self-Esteem Scale (RSES),Beck Depression ...

  2. Improvement of Flow Quality in NAL Chofu Mach 10 Nozzle

    Science.gov (United States)

    Lacey, John; Inoue, Yasutoshi; Higashida, Akio; Inoue, Manabu; Ishizaka, Kouichi; Korte, John J.

    2002-01-01

    As a result of CFD analysis and remachining of the nozzle, the flow quality of the Mach 10 Hypersonic Wind Tunnel at NAL Chofu, Japan was improved. The subsequent test results validated the CFD analytical predictions by NASA and MHL.

  3. Factors Influencing Team Performance in a Continuous Quality Improvement Process in the Wisconsin Technical College System

    Science.gov (United States)

    Pietz, Victoria Lynn

    2014-01-01

    Continuous Quality Improvement (CQI) programs are growing in popularity in higher education settings and a key component is the use of work groups, which require active employee involvement. The problem addressed in this research was the lack of employee engagement in the Quality Review Process (QRP), which is a statewide CQI model developed by…

  4. Factors Influencing Team Performance in a Continuous Quality Improvement Process in the Wisconsin Technical College System

    Science.gov (United States)

    Pietz, Victoria Lynn

    2014-01-01

    Continuous Quality Improvement (CQI) programs are growing in popularity in higher education settings and a key component is the use of work groups, which require active employee involvement. The problem addressed in this research was the lack of employee engagement in the Quality Review Process (QRP), which is a statewide CQI model developed by…

  5. The cost-effectiveness of using financial incentives to improve provider quality: a framework and application

    DEFF Research Database (Denmark)

    Meacock, R.; Kristensen, Søren Rud; Sutton, M.

    2014-01-01

    , and whether performance improvement is a transitory or investment activity. Our application to the Advancing Quality initiative demonstrates that the incentive payments represented less than half of the 13m pound total programme costs. By generating approximately 5200 quality-adjusted life years and 4.4m...

  6. Quality Emphasis on Career Development and Continuous Self-Improvement.

    Science.gov (United States)

    Green, Joe A.; Foley, Phyllis A.

    1997-01-01

    Describes quality models that community colleges have adopted to improve program effectiveness and customer service, focusing on the use of these models in career development. Discusses exemplary college programs that focus on quality, teamwork and participatory management, and service to students as their prime customers. (AJL)

  7. IMPROVEMENT OF QUALITY IN PRODUCTION PROCESS BY APPLYING KAIKAKU METHOD

    Directory of Open Access Journals (Sweden)

    Milan Radenkovic

    2013-12-01

    Full Text Available In this paper, Kaikaku method is presented. The essence of this method is introduction, principles and ways of implementation in the real systems. The main point how Kaikaku method influences on quality. It is presented on the practical example (furniture industry, one way how to implement Kaikaku method and how influence on quality improvement of production process.

  8. Improving the quality of written feedback using written feedback.

    Science.gov (United States)

    Bartlett, Maggie; Crossley, James; McKinley, Robert

    2017-01-01

    Educational feedback is amongst the most powerful of all learning interventions. (1) Can we measure the quality of written educational feedback with acceptable metrics? (2) Based on such a measure, does a quality improvement (QI) intervention improve the quality of feedback? We developed a QI instrument to measure the quality of written feedback and applied it to written feedback provided to medical students following workplace assessments. We evaluated the measurement characteristics of the QI score using generalisability theory. In an uncontrolled intervention, QI profiles were fed back to GP tutors and pre and post intervention scores compared. A single assessor scoring 6 feedback summaries can discriminate between practices with a reliability of 0.82.The quality of feedback rose for two years after the introduction of the QI instrument and stabilised in the third year. The estimated annual cost to provide this feedback is £12 per practice. Interpretation and recommendations: It is relatively straightforward and inexpensive to measure the quality of written feedback with good reliability. The QI process appears to improve the quality of written feedback. We recommend routine use of a QI process to improve the quality of educational feedback.

  9. Effects of Quality Improvement System for Child Care Centers

    Science.gov (United States)

    Ma, Xin; Shen, Jianping; Kavanaugh, Amy; Lu, Xuejin; Brandi, Karen; Goodman, Jeff; Till, Lance; Watson, Grace

    2011-01-01

    Using multiple years of data collected from about 100 child care centers in Palm Beach County, Florida, the authors studied whether the Quality Improvement System (QIS) made a significant impact on quality of child care centers. Based on a pre- and postresearch design spanning a period of 13 months, QIS appeared to be effective in improving…

  10. Quality Rating and Improvement Systems and Children's Cognitive Development

    Science.gov (United States)

    Jeon, Lieny; Buettner, Cynthia K.

    2015-01-01

    Background: Providing enriched learning environments is important to stimulating children's development in early childhood. Early child-care policymakers in many states in the US have adopted Quality Rating and Improvement Systems (QRIS) as a way to verify quality of child care and to support children's school readiness. Objective: The purpose of…

  11. Effective Interventions on Service Quality Improvement in a Physiotherapy Clinic

    Directory of Open Access Journals (Sweden)

    Farid Gharibi

    2014-07-01

    Full Text Available Background: Service quality is considered as a main domain of quality associated with non-clinical aspect of healthcare. This study aimed to survey and improves service quality of delivered care in the Physiotherapy Clinic affiliated with the Tabriz University of Medical Sciences, Tabriz, Iran. Methods: A quasi experimental interventional study was conducted in the Physiotherapy Clinic, 2010-2011. Data were collected using a validated and reliable researcher made questionnaire with participation of 324 patients and their coadjutors. The study questionnaire consisted of 7 questions about demographic factors and 38 questions for eleven aspects of service quality. Data were then analyzed using paired samples t-test by SPSS16. Results: In the pre intervention phase, six aspects of service quality including choice of provider, safety, prevention and early detection, dignity, autonomy and availability achieved non-acceptable scores. Following interventions, all aspects of the service quality improved and also total service quality score improved from 8.58 to 9.83 (P<0.001. Conclusion: Service quality can be improved by problem implementation of appropriate interventions. The acquired results can be used in health system fields to create respectful environments for healthcare customers.

  12. Combining traditional breeding and genomics to improve pork quality

    NARCIS (Netherlands)

    Heuven, H.C.M.; Wijk, van H.J.; Arendonk, van J.A.M.

    2003-01-01

    Breeding or improved pork quality has been the focus of much research in recent years and some of the results have already been put into practice. The realized genetic response in pork quality to selection within lines has generally been limited, however, compared with the responses obtained for oth

  13. Effective interventions on service quality improvement in a physiotherapy clinic.

    Science.gov (United States)

    Gharibi, Farid; Tabrizi, JafarSadegh; Eteraf Oskouei, MirAli; AsghariJafarabadi, Mohammad

    2014-01-01

    Service quality is considered as a main domain of quality associ-ated with non-clinical aspect of healthcare. This study aimed to survey and im-proves service quality of delivered care in the Physiotherapy Clinic affiliated with the Tabriz University of Medical Sciences, Tabriz, Iran. A quasi experimental interventional study was conducted in the Physiotherapy Clinic, 2010-2011. Data were collected using a validated and reli-able researcher made questionnaire with participation of 324 patients and their coadjutors. The study questionnaire consisted of 7 questions about demographic factors and 38 questions for eleven aspects of service quality. Data were then analyzed using paired samples t-test by SPSS16. In the pre intervention phase, six aspects of service quality including choice of provider, safety, prevention and early detection, dignity, autonomy and availability achieved non-acceptable scores. Following interventions, all aspects of the service quality improved and also total service quality score improved from 8.58 to 9.83 (PService quality can be improved by problem implementation of appropriate interventions. The acquired results can be used in health system fields to create respectful environments for healthcare customers.

  14. A history of industrial statistics and quality and efficiency improvement

    NARCIS (Netherlands)

    de Mast, J.; Coleman, S.; Greenfield, T.; Stewardson, D.; Montgomery, D.C.

    2008-01-01

    The twentieth century witnessed incredible increases in product quality, while in the same period product priced dropped dramatically. These important improvements in quality and efficiency in industry were the result of innovations in management and engineering. But these developments were supporte

  15. The business case for health-care quality improvement.

    Science.gov (United States)

    Swensen, Stephen J; Dilling, James A; Mc Carty, Patrick M; Bolton, Jeffrey W; Harper, Charles M

    2013-03-01

    The business case for health-care quality improvement is presented. We contend that investment in process improvement is aligned with patients' interests, the organization's reputation, and the engagement of their workforce. Four groups benefit directly from quality improvement: patients, providers, insurers, and employers. There is ample opportunity, even in today's predominantly pay-for-volume (that is, evolving toward value-based purchasing) insurance system, for providers to deliver care that is in the best interest of the patient while improving their financial performance.

  16. Better quality of life with neuropsychological improvement on HAART

    Directory of Open Access Journals (Sweden)

    Hall Colin D

    2006-02-01

    Full Text Available Abstract Background Successful highly active antiretroviral therapy (HAART regimens have resulted in substantial improvements in the systemic health of HIV infected persons and increased survival times. Despite increased systemic health, the prevalence of minor HIV-associated cognitive impairment appears to be rising with increased longevity, and it remains to be seen what functional outcomes will result from these improvements. Cognitive impairment can dramatically impact functional ability and day-to-day productivity. We assessed the relationship of quality of life (QOL and neuropsychological functioning with successful HAART treatment. Methods In a prospective longitudinal study, subjects were evaluated before instituting HAART (naïve or before changing HAART regimens because current therapy failed to maintain suppression of plasma viral load (treatment failure. Subjects underwent detailed neuropsychological and neurological examinations, as well as psychological evaluation sensitive to possible confounds. Re-evaluation was performed six months after institution of the new HAART regimen and/or if plasma viral load indicated treatment failure. At each evaluation, subjects underwent ultrasensitive HIV RNA quantitative evaluation in both plasma and cerebrospinal fluid. Results HAART successes performed better than failures on measures exploring speed of mental processing (p Conclusion Our study investigated the relationship between HIV-associated neurocognitive impairment and quality of life. HAART failures experienced slower psychomotor processing, and had increased self-reports of physical health complaints and substance abuse. Contrariwise, HAART successes experienced improved mental processing, demonstrating the impact of successful treatment on functioning. With increasing life expectancy for those who are HIV seropositive, it is important to measure cognitive functioning in relation to the actual QOL these individuals report. The study

  17. Efficiency Improvement and Quality Initiatives Application in Financial Institutions

    OpenAIRE

    MSc. Ajtene Avdullahi; MSc. Vjosa Fejza

    2015-01-01

    Financial institutions in today’s economy have no longer the luxury to improve profit simply by increasing revenue. These firms, due to the significant measuring reductions in the financial services industry needed to improve operational efficiencies and merely support existing processes with fewer resources. This paper explains the benefits of Lean, Six Sigma, Total Quality Management and Lean Six Sigma that have improved organization's performance, by cutting costs and waste, improving thei...

  18. 品管圈活动在提高手术器械包装合格率中的应用%Application of Quality Control Circle activity to improve the qualiifed rate in surgical instruments packaging

    Institute of Scientific and Technical Information of China (English)

    向艺; 郑宣冬

    2014-01-01

    目的:探索通过品管圈活动提高手术器械包装合格率的方法。方法:成立品管圈小组,针对消毒供应中心出现的手术器械包装合格率低的情况,运用品管圈手法进行现状把握、目标设定、要因分析、对策拟定并实施。结果:通过开展品管圈活动,手术器械包装合格率由活动前97.2%提高到99.8%,差异有统计学意义(P<0.01)。结论:开展品管圈活动对提高手术器械包装质量、加强科室间的协作、提升团队精神、快速适应消毒供应中心管理模式变化起到了积极的推动作用。%Objective:To explore the method of improving the rate of qualiifed surgical instruments packaging with the application of Quality Control Circle (QCC) activity. Methods:QCC group was established to grasp the current status, set goals, analyze major factors, form and implement countermeasures with QCC method for the low rate of qualiifed surgical instruments packaging in the disinfection supply center. Result:The rates of qualiifed surgical instruments packaging increased from 97.2%to 99.8%after conducting QCC activities. The difference was statistically significant (P<0.01). Conclusion:QCC activities played a positive role in improving packaging quality of surgical instruments, strengthening collaboration between departments, promoting team spirit, and timely adapting to changes in the management mode of disinfection supply center.

  19. Crossing the quality chasm: lessons from health care quality improvement efforts in England

    OpenAIRE

    Madhok, Rajan

    2002-01-01

    The second report from the US Institute of Medicine Crossing the Quality Chasm, highlighted the deficiencies in health care quality in the USA, analyzed the contributory factors, and proposed 13 recommendations for improvements. Clearly, the challenges are enormous. Can anything be learned from the experiences of other countries? This article describes the author's experiences of health care quality improvement efforts in the National Health Service in England and their implications for the U...

  20. Rating methodological quality: toward improved assessment and investigation.

    Science.gov (United States)

    Moyer, Anne; Finney, John W

    2005-01-01

    Assessing methodological quality is considered essential in deciding what investigations to include in research syntheses and in detecting potential sources of bias in meta-analytic results. Quality assessment is also useful in characterizing the strengths and limitations of the research in an area of study. Although numerous instruments to measure research quality have been developed, they have lacked empirically-supported components. In addition, different summary quality scales have yielded different findings when they were used to weight treatment effect estimates for the same body of research. Suggestions for developing improved quality instruments include: distinguishing distinct domains of quality, such as internal validity, external validity, the completeness of the study report, and adherence to ethical practices; focusing on individual aspects, rather than domains of quality; and focusing on empirically-verified criteria. Other ways to facilitate the constructive use of quality assessment are to improve and standardize the reporting of research investigations, so that the quality of studies can be more equitably and thoroughly compared, and to identify optimal methods for incorporating study quality ratings into meta-analyses.

  1. IMPROVING CAUSE DETECTION SYSTEMS WITH ACTIVE LEARNING

    Data.gov (United States)

    National Aeronautics and Space Administration — IMPROVING CAUSE DETECTION SYSTEMS WITH ACTIVE LEARNING ISAAC PERSING AND VINCENT NG Abstract. Active learning has been successfully applied to many natural language...

  2. Quality control circle activity in improving intestinal tract cleanliness of patients undergoing colonoscopy%品管圈活动在提高结肠镜患者肠道清洁度中的作用

    Institute of Scientific and Technical Information of China (English)

    麦丽梅; 黎晓渝; 何丽芳

    2014-01-01

    Objective:To investigate the role of quality control circle activity in improving intestinal tract cleanliness of patients undergoing colonoscopy. Methods:100 patients who underwent colonoscopy in July 2013 and received oral laxatives were selected as the pre-activity group. Another 100 who underwent colonoscopy in November 2013 and received oral laxatives were selected as the post-activity group. Quality control circle was established to focus on activities towards improving intestinal tract cleanliness of patients who underwent colonoscopy after oral laxatives. The current situation, goal setting, reason analysis, strategy formulation, implementation and effects verification of the strategy, and other measures were adopted. The control rates of intestinal tract cleanliness of the two groups were statistically analyzed. The scores of problem-solving ability, professional knowledge,information retrieval,active service,team spirit and communication skills were assessed. Results:The control rate of intestinal tract cleanliness in patients of the post-activity group was 98% ( 98/100) , significantly higher than the 61% (61/100) of the pre-activity group (P<0.05).After the quality control circle activity,the scores of problem-solving ability, professional knowledge, information retrieval, active service, team spirit and communication skills of the members were significantly higher than those before the treatment ( P<0. 01).Conclusion:Using quality control circle to regulate intestinal tract cleanliness of hospitalized patients who underwent colonoscopy and received oral laxative can not only improve the control rate of intestinal tract cleanliness,but also promote the problem-solving ability,professional knowledge,information retrieval,initiative of active service,team cooperation spirit and communication skills of the nurses.%目的::探讨品管圈( QCC)活动在提高住院结肠镜患者肠道清洁度中的作用。方法:选择本院本科2013年7月行口

  3. Improving the Quality of Electric Energy to Electric Arc Furnace

    Directory of Open Access Journals (Sweden)

    Adrian-Ioan Toma

    2011-10-01

    Full Text Available This paper presents a study of power quality problems created by an electric arc furnace (EAF with eccentric bottom tap (EBT at power system. The analysis have been done to EAF of 100 t capacity used for steel melting. Experimental results show this EAF is substantial source of electric disturbances, such as voltage fluctuations, flicker, harmonics, and unbalance between phases. Improvement of the quality of electric energy at EAF imposes a careful technical and economical analysis. Of all possible solutions for improvement of the power quality for an EAF (passive filter, STATCOM or SVC, SVC is the ideal solution.

  4. Quality assurance and performance improvement in intraoperative neurophysiologic monitoring programs.

    Science.gov (United States)

    Tamkus, Arvydas A; Rice, Kent S; McCaffrey, Michael T

    2013-03-01

    Quality assurance (QA) as it relates to intraoperative neurophysiological monitoring (IONM) can be defined as the systematic monitoring, evaluation, and modification of the IONM service to insure that desired standards of quality are being met. In practice, that definition is usually extended to include the concept that the quality of the IONM service will be improved wherever possible and, although there are some differences in the two terms, in this article the term QA will be understood to include quality improvement (QI) processes as well. The measurement and documentation of quality is becoming increasingly important to healthcare providers. This trend is being driven by pressures from accrediting agencies, payers, and patients. The essential elements of a QA program are described. A real-life example of QA techniques and management relevant to IONM providers is presented and discussed.

  5. The Software Improvement Process - Tools And Rules To Encourage Quality

    CERN Document Server

    Sigerud, K

    2011-01-01

    The Applications section of the CERN accelerator Controls group has decided to apply a systematic approach to quality assurance (QA), the “Software Improvement Process”, SIP. This process focuses on three areas: the development process itself, suitable QA tools, and how to practically encourage developers to do QA. For each stage of the development process we have agreed on the recommended activities and deliverables, and identified tools to automate and support the task. For example we do more code reviews. As peer reviews are resource-intensive, we only do them for complex parts of a product. As a complement, we are using static code checking tools, like FindBugs and Checkstyle. We also encourage unit testing and have agreed on a minimum level of test coverage recommended for all products, measured using Clover. Each of these tools is well integrated with our IDE (Eclipse) and give instant feedback to the developer about the quality of their code. The major challenges of SIP have been to 1) agree on com...

  6. Internal quality audit and quality standards as a method of quality improvement at the Department of Ophthalmology, University Hospital.

    Science.gov (United States)

    Nasić, Mirjana; Pokupec, Rajko; Katusić, Damir; Miklić, Pavle; Suić, Ivan; Galić, Slobodan

    2005-01-01

    Quality assessment of clinical health care with the programme of quality standard is a method of health management, through which better efficiency and safety of health outcomes can be achieved. In the period from 2002 to 2004, a pilot program of quality has been carried out on the Department of Ophthalmology, University Hospital Center in Zagreb. Seven internal audit teams of hospital commission and teams of hospital departments were evaluating introducing practice for quality standards every three months. In the period of two years improvement in all standards of quality has been noticed (expressed in percent of progress towards the ideal result of 100%): personnel 20%, patient rights 15%, medical equipment 40%, quality of emergency service 60%, implementation of clinical guidelines and criteria for elective admission 55%, quality of risk prevention 70%, quality of medical records 60%. The two-years-improvement dynamics of about 46%, first year 24%.

  7. Improving Milk Quality for Dairy Goat Farm Development

    Directory of Open Access Journals (Sweden)

    L. Cyrilla

    2015-12-01

    Full Text Available The present study was designed to evaluate factors affecting goat’s milk quality, consumer’s satisfaction to goat’s milk, and technical responses associated with goat’s milk quality. Three farms having more than 100 dairy goats were purposively selected for the study. Thirty consumers were determined by using judgement sampling techniques to assess the satisfaction of consumer to goat’s milk quality. Data were analyzed by using fishbone diagram and House of Quality matrix. The study revealed that milk quality produced by dairy goat farms met the standard quality of milk composition namely; specific gravity, total solid, fat, protein, and total solid non-fat. The main factors affecting goat milk quantity and quality were the quality of does, pregnancy status, number of kids per birth, shape and size of the udder, lactation length, and the health status of the goat. The attributes of goat’s milk that were able to achieve customer’s satisfaction targets were nutritional content, packaging size, and goat milk color. Technical responses that were major concern in ensuring goat’s milk quality included goat breed quality and health conditions, skills and performances of farmers and employees, feed quality, farm equipment hygiene and completeness, cleanliness, and hygiene of livestock housing and environment. Technical response on livestock health condition was the first priority to be improved.

  8. Current concept review: quality and process improvement in orthopedics

    Directory of Open Access Journals (Sweden)

    Pinney SJ

    2015-12-01

    Full Text Available Stephen J Pinney,1 Alexandra E Page,2 David S Jevsevar,3 Kevin J Bozic4 1Department of Orthopaedic Surgery, St Mary's Medical Center, San Francisco, CA, USA; 2Orthopaedic Surgery, AAOS Health Care Systems Committee, San Diego, CA, USA; 3Department of Orthopaedics, Geisel School of Medicine, Dartmouth University, Hanover, NH, USA; 4Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas, Austin, TX, USAAbstract: Multiple health care stakeholders are increasingly scrutinizing musculoskeletal care to optimize quality and cost efficiency. This has led to greater emphasis on quality and process improvement. There is a robust set of business strategies that are increasingly being applied to health care delivery. These quality and process improvement tools (QPITs have specific applications to segments of, or the entire episode of, patient care. In the rapidly changing health care world, it will behoove all orthopedic surgeons to have an understanding of the manner in which care delivery processes can be evaluated and improved. Many of the commonly used QPITs, including checklist initiatives, standardized clinical care pathways, lean methodology, six sigma strategies, and total quality management, embrace basic principles of quality improvement. These principles include focusing on outcomes, optimizing communication among health care team members, increasing process standardization, and decreasing process variation. This review summarizes the common QPITs, including how and when they might be employed to improve care delivery. Keywords: clinical care pathway, musculoskeletal care, outcomes, quality management, six sigma, lean thinking

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

    Science.gov (United States)

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

    2002-01-01

    Objectives: 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. Design: Qualitative case studies using semi-structured interviews and documentation review. Setting: Twelve purposively sampled PCG/Ts in England. Participants: Fifty senior staff including chief executives, clinical governance leads, mental health leads, and lay board members. Main outcome measures: Participants' perceptions of the role of clinical governance in PCG/Ts. Results: 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). Conclusion: 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. PMID:12078380

  10. Hospital value-based purchasing (VBP) program: measurement of quality and enforcement of quality improvement.

    Science.gov (United States)

    Szablowski, Katarzyna M

    2014-01-01

    VBP program is a novel medicare payment estimatin tool used to encourage clinical care quality improvement as well as improvement of patient experience as a customer of a health care system. The program utilizes well established tools of measuring clinical care quality and patient satisfaction such as the hospital IQR program and HCAHPS survey to estimate Medicare payments and encourage hospitals to continuosly improve the level of care they provide.

  11. 40 CFR 63.176 - Quality improvement program for pumps.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 9 2010-07-01 2010-07-01 false Quality improvement program for pumps... improvement program for pumps. (a) In Phase III, if, on a 6-month rolling average, the greater of either 10 percent of the pumps in a process unit (or plant site) or three pumps in a process unit (or plant...

  12. 40 CFR 63.1035 - Quality improvement program for pumps.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 10 2010-07-01 2010-07-01 false Quality improvement program for pumps... improvement program for pumps. (a) Criteria. If, on a 6-month rolling average, at least the greater of either 10 percent of the pumps in a process unit or affected facility (or plant site) or three pumps in...

  13. Lean management systems: creating a culture of continuous quality improvement.

    Science.gov (United States)

    Clark, David M; Silvester, Kate; Knowles, Simon

    2013-08-01

    This is the first in a series of articles describing the application of Lean management systems to Laboratory Medicine. Lean is the term used to describe a principle-based continuous quality improvement (CQI) management system based on the Toyota production system (TPS) that has been evolving for over 70 years. Its origins go back much further and are heavily influenced by the work of W Edwards Deming and the scientific method that forms the basis of most quality management systems. Lean has two fundamental elements--a systematic approach to process improvement by removing waste in order to maximise value for the end-user of the service and a commitment to respect, challenge and develop the people who work within the service to create a culture of continuous improvement. Lean principles have been applied to a growing number of Healthcare systems throughout the world to improve the quality and cost-effectiveness of services for patients and a number of laboratories from all the pathology disciplines have used Lean to shorten turnaround times, improve quality (reduce errors) and improve productivity. Increasingly, models used to plan and implement large scale change in healthcare systems, including the National Health Service (NHS) change model, have evidence-based improvement methodologies (such as Lean CQI) as a core component. Consequently, a working knowledge of improvement methodology will be a core skill for Pathologists involved in leadership and management.

  14. Quality improvement cycles that reduced waiting times at Tshwane ...

    African Journals Online (AJOL)

    TDH is a level-one hospital, delivering services in the centre of Pretoria since February 2006. ... finding better ways to provide better care and service.11 The QI cycle is a recognised tool for analysing and improving the efficiency and quality ..... in reducing waiting times and improving patient satisfaction.14 The need for ...

  15. MODERN HEMOPHILIA TREATMENT - MEDICAL IMPROVEMENTS AND QUALITY-OF-LIFE

    NARCIS (Netherlands)

    ROSENDAAL, FR; SMIT, C; VAREKAMP, [No Value; BROCKERVRIENDS, AHJT; VANDIJCK, H; SUURMEIJER, TPBM; VANDENBROUCKE, JP; BRIET, E

    1990-01-01

    Adequate replacement therapy in haemophilia has been available for two decades. This has led to considerable improvements in the life expectancy and physical status of haemophilia patients. A study was conducted to investigate whether this has also led to improvements in quality of life. With this a

  16. Applying GRA and QFD to Improve Library Service Quality

    Science.gov (United States)

    Chen, Yen-Ting; Chou, Tsung-Yu

    2011-01-01

    This paper applied Grey Relational Analysis (GRA) to Quality Function Deployment (QFD) to identify service improvement techniques for an academic library. First, reader needs and their importance, and satisfaction degrees were examined via questionnaires. Second, the service improvement techniques for satisfying the reader needs were developed by…

  17. Measuring Active Learning to Predict Course Quality

    Science.gov (United States)

    Taylor, John E.; Ku, Heng-Yu

    2011-01-01

    This study investigated whether active learning within computer-based training courses can be measured and whether it serves as a predictor of learner-perceived course quality. A major corporation participated in this research, providing access to internal employee training courses, training representatives, and historical course evaluation data.…

  18. On Improving Higher Vocational College Education Quality Assessment

    Science.gov (United States)

    Wu, Xiang; Chen, Yan; Zhang, Jie; Wang, Yi

    Teaching quality assessment is a judgment process by using the theory and technology of education evaluation system to test whether the process and result of teaching have got to a certain quality level. Many vocational schools have established teaching quality assessment systems of their own characteristics as the basic means to do self-examination and teaching behavior adjustment. Combined with the characteristics and requirements of the vocational education and by analyzing the problems exist in contemporary vocational school, form the perspective of the content, assessment criteria and feedback system of the teaching quality assessment to optimize the system, to complete the teaching quality information net and offer suggestions for feedback channels, to make the institutionalization, standardization of the vocational schools and indeed to make contribution for the overall improvement of the quality of vocational schools.

  19. Quality improvement in clinical documentation: does clinical governance work?

    Directory of Open Access Journals (Sweden)

    Dehghan M

    2013-12-01

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

  20. 品管圈活动在帕金森病合并抑郁患者中的应用%Effect of quality control circle activity on improving Parkinson’ s disease patients with depression

    Institute of Scientific and Technical Information of China (English)

    王培芝; 代桂宁; 杨洁; 王彦永

    2014-01-01

    Objective To explore the effect of quality control circle activity on depression and activities of daily living of Parkinson ’ s disease with depression .Methods Totals of 80 patients of Parkinson ’ s disease with depression were divided into treatment group and control group with 40 cases in each group according to the time of admission.Treatment group took part in quality control circle activity for 3 months, two groups were obliged to attend a constant activity with all patients per month , received collective health education .Hamilton depression scale ( HAMD) and Activities of Daily Living ( ADL) were used to measure depression degree and activities of daily living of patients before and after the intervention .Results Three months after the intervention, HAMD score of patients in treatment group was reduced to (8.80 ±2.36), that in control group was (19.47 ±1.85),and the difference was statistically significant (t=22.50,P<0.01).ADL score of patients in treatment group was increased to (89.14 ±2.25), while that score of patients in control group was (58.32 ±2.21), and significantly difference was found between two groups (t =61.81,P <0.01). Conclusions Quality control circle activity can improve the effect of health education through continuously giving the patients and caregivers health education , and establishing an effective social support system . Meanwhile , it can improve the patients ’ depression condition and self management ability , so as to improve the quality of their life .%目的:探讨品管圈活动对帕金森病合并抑郁患者抑郁和日常生活能力的影响。方法将80例帕金森合并抑郁的患者按入院顺序分为干预组和对照组,每组40例,干预组参加3个月的品管圈活动,两组患者及主要家庭照料者均参加每月1次的帕金森病友会,接受集体健康教育。采用汉密尔顿抑郁量表(HAMD)和日常生活能力(ADL)量表比较干预前后两组患者的抑郁

  1. Efficiency Improvement and Quality Initiatives Application in Financial Institutions

    Directory of Open Access Journals (Sweden)

    MSc. Ajtene Avdullahi

    2015-06-01

    Full Text Available Financial institutions in today’s economy have no longer the luxury to improve profit simply by increasing revenue. These firms, due to the significant measuring reductions in the financial services industry needed to improve operational efficiencies and merely support existing processes with fewer resources. This paper explains the benefits of Lean, Six Sigma, Total Quality Management and Lean Six Sigma that have improved organization's performance, by cutting costs and waste, improving their products or services, increasing profitability as well as enhancing customer satisfaction. The applicability of quality management practices in financial institutions in Kosovo is presented and also their efficiency and effectiveness. By analyzing data from Raiffeisen Bank Kosovo, this paper highlights the benefits of Individual and Micro companies customer segment as the result of organizational change and successful application of quality initiatives from financial institutions in Kosovo.

  2. [The role and place of pathology services in ensuring and improving the quality of medical care: Organizational and legal aspects].

    Science.gov (United States)

    Timofeev, I V

    2015-01-01

    The paper considers the legal and organizational issues of the activity of pathology services in improving medical care. It shows the main (diagnostic and medico-organizational) areas of pathology work to improve the quality of medical care.

  3. Building Perinatal Case Manager Capacity Using Quality Improvement

    OpenAIRE

    Fitzgerald, Elaine

    2015-01-01

    Improving breastfeeding rates among Black women is a potential strategy to address disparities in health outcomes that disproportionately impact Black women and children. This quality improvement (QI) initiative aimed to improve perinatal case manager knowledge and self-efficacy to promote breastfeeding among Black, low-income women who use services through Boston Healthy Start Initiative. QI methodology was used to develop and test a two-part strategy for perinatal case managers to promote a...

  4. Improving maternal health quality: reviewing the context and consequences

    Directory of Open Access Journals (Sweden)

    Anshul Chauhan

    2017-06-01

    Full Text Available Background: Approximately 99% of pregnancy-related deaths in developing countries are due to preventable causes related to pregnancy and childbirth which signifies that around 800 women die every day due to such causes. Major causes that lead to maternal deaths are post-partum hemorrhage, infections, high blood pressure and unsafe abortion. There are several facilities being provided for pregnant mothers yet the quality of care needs to be analyzed. Objectives: To understand the quality perspective of maternal health services and to review available evidence for strengthening maternal health services. Material & Methods: Research studies published between 2006 and 2016 were selected by specific inclusion criteria. Pub Med and Google Scholar were used to search studies on the topic, and few articles were identified through references and citations. Results: The result of the review highlighted the evidence of pitfalls, gaps in quality care, and need for interventions and approaches to improve the quality of maternal health care. Conclusion: Quality care encompasses various elements which stride towards improving the health of women and the interventions are to be scaled up to improve the quality of care. Generation of public health evidence and uniformity in quality assessments can help interventions to achieve desirable standards.

  5. Rapid core measure improvement through a "business case for quality".

    Science.gov (United States)

    Perlin, Jonathan B; Horner, Stephen J; Englebright, Jane D; Bracken, Richard M

    2014-01-01

    Incentives to improve performance are emerging as revenue or financial penalties are linked to the measured quality of service provided. The HCA "Getting to Green" program was designed to rapidly increase core measure performance scores. Program components included (1) the "business case for quality"-increased awareness of how quality drives financial performance; (2) continuous communication of clinical and financial performance data; and (3) evidence-based clinical protocols, incentives, and tools for process improvement. Improvement was measured by comparing systemwide rates of adherence to national quality measures for heart failure (HF), acute myocardial infarction (AMI), pneumonia (PN), and surgical care (SCIP) to rates from all facilities reporting to the Centers for Medicare and Medicaid Services (CMS). As of the second quarter of 2011, 70% of HCA total measure set composite scores were at or above the 90th percentile of CMS scores. A test of differences in regression coefficients between the CMS national average and the HCA average revealed significant differences for AMI (p = .001), HF (p = .012), PN (p < .001), and SCIP (p = .015). This program demonstrated that presentation of the financial implications of quality, transparency in performance data, and clearly defined goals could cultivate the desire to use improvement tools and resources to raise performance. © 2012 National Association for Healthcare Quality.

  6. Quality improvement and accountability in the Danish health care system.

    Science.gov (United States)

    Mainz, Jan; Kristensen, Solvejg; Bartels, Paul

    2015-12-01

    Denmark has unique opportunities for quality measurement and benchmarking since Denmark has well-developed health registries and unique patient identifier that allow all registries to include patient-level data and combine data into sophisticated quality performance monitoring. Over decades, Denmark has developed and implemented national quality and patient safety initiatives in the healthcare system in terms of national clinical guidelines, performance and outcome measurement integrated in clinical databases for important diseases and clinical conditions, measurement of patient experiences, reporting of adverse events, national handling of patient complaints, national accreditation and public disclosure of all data on the quality of care. Over the years, Denmark has worked up a progressive and transparent just culture in quality management; the different actors at the different levels of the healthcare system are mutually attentive and responsive in a coordinated effort for quality of the healthcare services. At national, regional, local and hospital level, it is mandatory to participate in the quality initiatives and to use data and results for quality management, quality improvement, transparency in health care and accountability. To further develop the Danish governance model, it is important to expand the model to the primary care sector. Furthermore, a national quality health programme 2015-18 recently launched by the government supports a new development in health care focusing upon delivering high-quality health care-high quality is defined by results of value to the patients. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  7. Interventions to improve water quality for preventing diarrhoea

    Science.gov (United States)

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

    2015-01-01

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

  8. Innovative Problems of Improving the Quality of Life of the Welfare State

    Science.gov (United States)

    Panachev, Valery D.

    2016-01-01

    Improvement of the population quality of life should be based on promoting healthy lifestyle, active physical exercises and sports activities as one of its main priorities. In order to facilitate the achievement of this priority, the author proposes management technique of complicated coordination movements in space in the development of…

  9. Using internal marketing to improve organizational commitment and service quality.

    Science.gov (United States)

    Tsai, Yafang; Wu, Shih-Wang

    2011-12-01

    The purpose of this article was to explore the structural relationships among internal marketing, organizational commitment and service quality and to practically apply the findings. Internal marketing is a way to assist hospitals in improving the quality of the services that they provide while executing highly labour-intensive tasks. Through internal marketing, a hospital can enhance the organizational commitment of its employees to attain higher service quality. This research uses a cross-sectional study to survey nursing staff perceptions about internal marketing, organizational commitment and service quality. The results of the survey are evaluated using equation models. The sample includes three regional hospitals in Taiwan. Three hundred and fifty questionnaires were distributed and 288 valid questionnaires were returned, yielding a response rate of 82.3%. The survey process lasted from 1 February to 9 March 2007. The data were analysed with SPSS 12.0, including descriptive statistics based on demographics. In addition, the influence of demographics on internal marketing, organizational commitment and service quality is examined using one-way anova. The findings reveal that internal marketing plays a critical role in explaining employee perceptions of organizational commitment and service quality. Organizational commitment is the mediator between internal marketing and service quality. The results indicate that internal marketing has an impact on both organizational commitment and service quality. Internal marketing should be emphasized to influence frontline nursing staff, thereby helping to create better organizational commitment and service quality. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

  10. An integrated model for continuous quality improvement and productivity improvement in health services organizations.

    Science.gov (United States)

    Rakich, J S; Darr, K; Longest, B B

    1993-01-01

    The health services paradigm with respect to quality has shifted to that of conformance to requirements (the absence of defects) and fitness for use (meeting customer expectations and needs). This article presents an integrated model of continuous quality improvement (CQI) (often referred to as total quality management) and productivity improvement for health services organizations. It incorporates input-output theory and focuses on the CQI challenge--"How can we be certain that we do the right things right the first time, every time?" The twin pillars of CQI are presented. Achievement of both will result in productivity improvement and enhancement of the health services organization's competitive position.

  11. Improving Quality of Emergency Care Through Integration of Mental Health.

    Science.gov (United States)

    Okafor, Martha; Wrenn, Glenda; Ede, Victor; Wilson, Nana; Custer, William; Risby, Emile; Claeys, Michael; Shelp, Frank E; Atallah, Hany; Mattox, Gail; Satcher, David

    2016-04-01

    The goal of this study was to better integrate emergency medical and psychiatric care at a large urban public hospital, identify impact on quality improvement metrics, and reduce healthcare cost. A psychiatric fast track service was implemented as a quality improvement initiative. Data on disposition from the emergency department from January 2011 to May 2012 for patients impacted by the pilot were analyzed. 4329 patients from January 2011 to August 2011 (pre-intervention) were compared with 4867 patients from September 2011 to May 2012 (intervention). There was a trend of decline on overall quality metrics of time to triage and time from disposition to discharge. The trend analysis of the psychiatric length of stay and use of restraints showed significant reductions. Integrated emergency care models are evidence-based approach to ensuring that patients with mental health needs receive proper and efficient treatment. Results suggest that this may also improve overall emergency department's throughput.

  12. Measures to improve the quality of hotel services

    Directory of Open Access Journals (Sweden)

    Anca MADAR

    2017-07-01

    Full Text Available This article aims to exemplify how, starting from the evaluation of customer satisfaction on service quality, the hotel units’ management, can apply different measures and strategies to improve it. To achieve the target, a marketing research survey is conducted based on a sample of 120 customers of Hotel „Kronwell” at the end of 2013. After analysing customer’ responses a series of measures have been taken to improve the quality of services offered by this hotel, then at the end of 2015 a new research was achieved, based on the same questionnaire. The results of this research highlight the increasing of customer satisfaction as a result of improving the quality of hotel services, supported by growth in net profit, turnover and decrease of employees’ number.

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

    Science.gov (United States)

    Godény, Sándor

    2012-01-22

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

  14. Advances in genomics for the improvement of quality in coffee.

    Science.gov (United States)

    Tran, Hue Tm; Lee, L Slade; Furtado, Agnelo; Smyth, Heather; Henry, Robert J

    2016-08-01

    Coffee is an important crop that provides a livelihood to millions of people living in developing countries. Production of genotypes with improved coffee quality attributes is a primary target of coffee genetic improvement programmes. Advances in genomics are providing new tools for analysis of coffee quality at the molecular level. The recent report of a genomic sequence for robusta coffee, Coffea canephora, is a major development. However, a reference genome sequence for the genetically more complex arabica coffee (C. arabica) will also be required to fully define the molecular determinants controlling quality in coffee produced from this high quality coffee species. Genes responsible for control of the levels of the major biochemical components in the coffee bean that are known to be important in determining coffee quality can now be identified by association analysis. However, the narrow genetic base of arabica coffee suggests that genomics analysis of the wild relatives of coffee (Coffea spp.) may be required to find the phenotypic diversity required for effective association genetic analysis. The genomic resources available for the study of coffee quality are described and the potential for the application of next generation sequencing and association genetic analysis to advance coffee quality research are explored. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

  15. Measuring data quality for ongoing improvement a data quality assessment framework

    CERN Document Server

    Sebastian-Coleman, Laura

    2013-01-01

    The Data Quality Assessment Framework shows you how to measure and monitor data quality, ensuring quality over time. You'll start with general concepts of measurement and work your way through a detailed framework of more than three dozen measurement types related to five objective dimensions of quality: completeness, timeliness, consistency, validity, and integrity. Ongoing measurement, rather than one time activities will help your organization reach a new level of data quality. This plain-language approach to measuring data can be understood by both business and IT and provides pra

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

    Science.gov (United States)

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

    2017-01-01

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

  17. A program to improve the quality of emergency endotracheal intubation.

    Science.gov (United States)

    Mayo, Paul H; Hegde, Abhijith; Eisen, Lewis A; Kory, Pierre; Doelken, Peter

    2011-01-01

    To assess the results of a quality improvement (QI) project designed to improve safety of emergency endotracheal intubation (EEI). Single center prospective observational. 16-bed intensive care unit. Nine pulmonary/critical care fellows. For 3 years, EEI performed by the medical intensive care unit team were analyzed to identify interventions that would improve quality of the procedure. By segmental process analysis, the procedure of EEI was subjected to iterative change. Major components of process improvement were development of a combined team approach, a mandatory checklist, use of crew resource management (CRM) tactics, and postevent debriefing. Quality analysis and improvement included training of fellows using scenario-based training (SBT) with computerized patient simulator (CPS) to improve mechanical skills of intubation and team leadership. Fellows received 15 sessions of SBT with CPS using a combined checklist and team approach before assuming team leadership position during real-life EEI. For a 10-month period, fellows carried digital voice recorders to EEI; which, when combined with recording of continuous oximetry and BP monitoring were used to assess the quality of EEI. 128 EEI were performed of which 101 had full data recorded. Complications were 14% severe hypoxemia (3 attempts. EEI may be performed by pulmonary/critical medicine (PCCM) fellows with safety comparable to that described in other studies on EEI. Important parts of the program included the use of formal iterative QI approach, the use of intensive SBT with CPS, basic CRM, a comprehensive checklist, and a combined team approach. A key benefit of the program was to make the process of EEI fully transparent for ongoing quality and safety improvement.

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

    Science.gov (United States)

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

    2015-01-01

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

  19. Product Quality Improvement Using FMEA for Electric Parking Brake (EPB)

    Science.gov (United States)

    Dumitrescu, C. D.; Gruber, G. C.; Tişcă, I. A.

    2016-08-01

    One of the most frequently used methods to improve product quality is complex FMEA. (Failure Modes and Effects Analyses). In the literature various FMEA is known, depending on the mode and depending on the targets; we mention here some of these names: Failure Modes and Effects Analysis Process, or analysis Failure Mode and Effects Reported (FMECA). Whatever option is supported by the work team, the goal of the method is the same: optimize product design activities in research, design processes, implementation of manufacturing processes, optimization of mining product to beneficiaries. According to a market survey conducted on parts suppliers to vehicle manufacturers FMEA method is used in 75%. One purpose of the application is that after the research and product development is considered resolved, any errors which may be detected; another purpose of applying the method is initiating appropriate measures to avoid mistakes. Achieving these two goals leads to a high level distribution in applying, to avoid errors already in the design phase of the product, thereby avoiding the emergence and development of additional costs in later stages of product manufacturing. During application of FMEA method using standardized forms; with their help will establish the initial assemblies of product structure, in which all components will be viewed without error. The work is an application of the method FMEA quality components to optimize the structure of the electrical parking brake (Electric Parching Brake - E.P.B). This is a component attached to the roller system which ensures automotive replacement of conventional mechanical parking brake while ensuring its comfort, functionality, durability and saves space in the passenger compartment. The paper describes the levels at which they appealed in applying FMEA, working arrangements in the 4 distinct levels of analysis, and how to determine the number of risk (Risk Priority Number); the analysis of risk factors and established

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

    Science.gov (United States)

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

    2011-04-01

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

  1. Quality Improvement Of Fan Manufacturing Industry By Using Basic Seven Tools Of Quality: A Case Study

    Directory of Open Access Journals (Sweden)

    Sulaman Muhammad

    2015-04-01

    Full Text Available Research was carried out in a Fan manufacturing industry to address the quality related problems and improve their quality level by implementing basic seven tools of quality. These are important tools used worldwide in manufacturing industries for continual improvement. Flow chart, Check sheet, Histogram, Cause & Effect diagram, Pareto chart, Scatter diagram & Control charts were implemented in different steps of manufacturing process to define the problem, measure its impact, finding out its root cause and its removal to ensure the production of non defective items. The case study was carried out in “FECTO FAN” Gujranwala, Pakistan.

  2. Using mobile technology to improve healthcare service quality.

    Science.gov (United States)

    Chao, Chia Chen; Jen, Wen Yuan; Li, Yu-Chuan; Chi, Y P; Chen, Chang-I; Feng, Chen Chjeh

    2005-01-01

    Improving healthcare service quality for illness of treatment, illness prevention and patient service is difficult for most hospitals because the hospitals are lack adequate resources and labor. In order to provide better healthcare service quality for patients, mobile technology can be used to manage healthcare in a way that provides the optimal healthcare service for patients. Pursuing utilization of mobile technology for better patient service, Taipei Medical University Municipal W. F. Teaching Hospital has implemented a mobile healthcare service (m-HS) system to increase healthcare service quality. The m-HS system improves the quality of medical care as well as healthcare service. The m-HS is a multi-functional healthcare management agent, meets the mobile tendency of the present society. This study seeks to discuss the m-HS architecture and workflow processes. We believe the m-HS does have the potential to improve healthcare service quality. Finally, the conclusions and suggestions for the m-HS are given.

  3. Faculty development on item writing substantially improves item quality.

    Science.gov (United States)

    Naeem, Naghma; van der Vleuten, Cees; Alfaris, Eiad Abdelmohsen

    2012-08-01

    The quality of items written for in-house examinations in medical schools remains a cause of concern. Several faculty development programs are aimed at improving faculty's item writing skills. The purpose of this study was to evaluate the effectiveness of a faculty development program in item development. An objective method was developed and used to assess improvement in faculty's competence to develop high quality test items. This was a quasi experimental study with a pretest-midtest-posttest design. A convenience sample of 51 faculty members participated. Structured checklists were used to assess the quality of test items at each phase of the study. Group scores were analyzed using repeated measures analysis of variance. The results showed a significant increase in participants' mean scores on Multiple Choice Questions, Short Answer Questions and Objective Structured Clinical Examination checklists from pretest to posttest (p development are generally lacking in quality. It also provides evidence of the value of faculty development in improving the quality of items generated by faculty.

  4. Improvement in quality of hospital care during accreditation

    DEFF Research Database (Denmark)

    Bie Bogh, Søren; Falstie-Jensen, Anne Mette; Hollnagel, Erik;

    2016-01-01

    OBJECTIVE: To assess changes over time in quality of hospital care in relation to the first accreditation cycle in Denmark. DESIGN, SETTING AND PARTICIPANTS: We performed a multi-level, longitudinal, stepped-wedge, nationwide study of process performance measures to evaluate the impact of a manda......OBJECTIVE: To assess changes over time in quality of hospital care in relation to the first accreditation cycle in Denmark. DESIGN, SETTING AND PARTICIPANTS: We performed a multi-level, longitudinal, stepped-wedge, nationwide study of process performance measures to evaluate the impact...... of a mandatory accreditation programme in all Danish public hospitals. Patient-level data (n = 1 624 518 processes of care) on stroke, heart failure, ulcer, diabetes, breast cancer and lung cancer care were obtained from national clinical quality registries. INTERVENTION: The Danish Healthcare Quality Programme...... was introduced in 2009, aiming to create a framework for continuous quality improvement. MAIN OUTCOME: Changes in week-by-week trends of hospital care during the study period of 269 weeks prior to, during and post-accreditation. RESULTS: The quality of hospital care improved over time throughout the study period...

  5. Benchmarking: a method for continuous quality improvement in health.

    Science.gov (United States)

    Ettorchi-Tardy, Amina; Levif, Marie; Michel, Philippe

    2012-05-01

    Benchmarking, a management approach for implementing best practices at best cost, is a recent concept in the healthcare system. The objectives of this paper are to better understand the concept and its evolution in the healthcare sector, to propose an operational definition, and to describe some French and international experiences of benchmarking in the healthcare sector. To this end, we reviewed the literature on this approach's emergence in the industrial sector, its evolution, its fields of application and examples of how it has been used in the healthcare sector. Benchmarking is often thought to consist simply of comparing indicators and is not perceived in its entirety, that is, as a tool based on voluntary and active collaboration among several organizations to create a spirit of competition and to apply best practices. The key feature of benchmarking is its integration within a comprehensive and participatory policy of continuous quality improvement (CQI). Conditions for successful benchmarking focus essentially on careful preparation of the process, monitoring of the relevant indicators, staff involvement and inter-organizational visits. Compared to methods previously implemented in France (CQI and collaborative projects), benchmarking has specific features that set it apart as a healthcare innovation. This is especially true for healthcare or medical-social organizations, as the principle of inter-organizational visiting is not part of their culture. Thus, this approach will need to be assessed for feasibility and acceptability before it is more widely promoted.

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

    Directory of Open Access Journals (Sweden)

    Pedro Gabriel Melo de Barros e Silva

    2015-12-01

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

  7. Software quality and process improvement in scientific simulation codes

    Energy Technology Data Exchange (ETDEWEB)

    Ambrosiano, J.; Webster, R. [Los Alamos National Lab., NM (United States)

    1997-11-01

    This report contains viewgraphs on the quest to develope better simulation code quality through process modeling and improvement. This study is based on the experience of the authors and interviews with ten subjects chosen from simulation code development teams at LANL. This study is descriptive rather than scientific.

  8. 40 CFR 65.116 - Quality improvement program for pumps.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Quality improvement program for pumps... pumps. (a) Criteria. If, on a 6-month rolling average, at least the greater of either 10 percent of the pumps in a process unit (or plant site) or three pumps in a process unit (or plant site) leak, the...

  9. Improving NAVFAC's total quality management of construction drawings with CLIPS

    Science.gov (United States)

    Antelman, Albert

    1991-01-01

    A diagnostic expert system to improve the quality of Naval Facilities Engineering Command (NAVFAC) construction drawings and specification is described. C Language Integrated Production System (CLIPS) and computer aided design layering standards are used in an expert system to check and coordinate construction drawings and specifications to eliminate errors and omissions.

  10. Guiding and Modelling Quality Improvement in Higher Education Institutions

    Science.gov (United States)

    Little, Daniel

    2015-01-01

    The article considers the process of creating quality improvement in higher education institutions from the point of view of current organisational theory and social-science modelling techniques. The author considers the higher education institution as a functioning complex of rules, norms and other organisational features and reviews the social…

  11. Faculty development on item writing substantially improves item quality.

    NARCIS (Netherlands)

    Naeem, N.; Vleuten, C.P.M. van der; Alfaris, E.A.

    2012-01-01

    The quality of items written for in-house examinations in medical schools remains a cause of concern. Several faculty development programs are aimed at improving faculty's item writing skills. The purpose of this study was to evaluate the effectiveness of a faculty development program in item develo

  12. Reusable Rationale Blocks: Improving quality and efficiency of design choices

    NARCIS (Netherlands)

    Hordijk, W.T.B.; Wieringa, Roelf J.; Dutoit, A.H.; McCall, R.; Mistrik, I; Paech, B.

    2006-01-01

    In the current practice of designing software for user organizations, as experienced by the authors, designers often produce design knowledge again and again for every decision: They re-invent the wheel. We want to improve the quality, predictability and efficiency of the software design process by

  13. Image quality improvement for underground radar by block migration method

    Science.gov (United States)

    Ho, Gwangsu; Kawanaka, Akira; Takagi, Mikio

    1993-11-01

    Techniques have been developed which have been imaging optically opaque regions using an electromagnetic wave radar in order to estimate the location of the objects in those regions. One important application of these techniques is the detection of buried pipes and cables. In the case of underground radar, its image quality often becomes low because the nature of the soil is not uniform and an electromagnetic wave is attenuated in soil. Hence, the method which improves the quality of the radar images is required. In this paper, we point out that the quality of underground images can be improved significantly by means of the block migration method. In this method LOT (Lapped Orthogonal Transform) was applied. LOT is a new block transform method in which basis functions overlap in adjacent blocks, and it has a fast computation algorithm. In addition to above, we propose a method of estimating dielectric constant in soil using the processed images. The result of applying the block migration method to the underground radar images are presented. It points out the good capability for the image quality improvement and the application of LOT can improve the influence by blocking and the processing time. Also the dielectric constant in each block can be estimated accurately.

  14. Hypothesis Generation in Quality Improvement Projects: Approaches for Exploratory Studies

    NARCIS (Netherlands)

    de Mast, J.; Bergman, M.

    2006-01-01

    In quality improvement projects - such as Six Sigma projects - an exploratory phase can be discerned, during which possible causes, influence factors or variation sources are identified. In a subsequent confirmatory phase the effects of these possible causes are experimentally verified. Whereas the

  15. The Application of Fishbone Diagram Analisis to Improve School Quality

    Directory of Open Access Journals (Sweden)

    Slameto Slameto

    2016-06-01

    Full Text Available The research problems are: 1 What steps are to take in a program development aimed at improving the quality of school using a fishbone analysis? 2 Is the program model using fishbone analysis  effective and efficient in meeting the school’s needs to improve its quality? This is research and developmental which comprises 3 phases, namely Preliminary Study, Model Development, and Evaluation/Model Testing. The qualitative data come from the input of management experts and the result of interviews/FGD with stakeholders. The quantitative data are obtained from the assessment of management experts on the product draft, the observation sheets for the field study on the standards of education, and the try out. Data analisis on the validation result uses a descriptive analysis technique. Data from the questionnaire are analyzed by descriptive statistical technique. The results are: 1 the developmental steps in the school quality improvement program by way of fish bone analysis have gone through 6 phases, 2 the research product using fish bone diagram has proved to be simple, applicable, important, controllable, as well as adaptable. Furthermore, it is communicable, so that it has been effective and efficient in meeting the school’s needs for making its educational quality improved.

  16. Fonio (Digitaria exilis) in West Africa: towards improving nutrient quality

    NARCIS (Netherlands)

    Koreissi, Y.

    2015-01-01

    Fonio (Digitaria exilis) in West Africa: Towards improving nutrient quality Abstract Hidden hunger affects a far greater percentage of the world’s population with iron and zinc deficiencies being the most common, particularly affecting women of reproductive ag

  17. Identifying targets for quality improvement in hospital antibiotic prescribing

    NARCIS (Netherlands)

    Spreuwel, P.C. van; Blok, H.; Langelaar, M.F.; Kullberg, B.J.; Mouton, J.W.; Natsch, S.S.

    2015-01-01

    OBJECTIVES: To audit antibiotic use in a university hospital and to identify targets for quality improvement in a setting with low antibiotic use and resistance rates. METHODOLOGY: A point-prevalence survey (PPS), using a patient-based audit tool for antibiotic use, was executed in the Radboud Unive

  18. Quality improvement in primary care: ethical issues explored.

    NARCIS (Netherlands)

    Tapp, L.; Elwyn, G.; Edwards, A.; Holm, S.; Eriksson, T.

    2009-01-01

    PURPOSE: Quality improvement (QI) processes in family medicine are becoming increasingly complex. Their influence on the organisation of the sector and on the daily work processes is profound and increasing. The literature indicates that many ethical issues are arising from QI work. Therefore this

  19. Use of different additives to improve low quality surimi gelation.

    Directory of Open Access Journals (Sweden)

    Deysi Cando

    2014-06-01

    In conclusion, in general, the physicochemical and viscoelastic properties of gels were improved by the addition of both ingredients, giving stronger gels even at very low level of salt. These results indicate that both ingredients, which do not add calories to the final gels, can be used as a good alternative for the better gelation of the low quality surimis.

  20. Improving Quality of Care in Peptic Ulcer Bleeding

    DEFF Research Database (Denmark)

    Rosenstock, Steffen Jais; Møller, Morten H; Larsson, Heidi

    2013-01-01

    OBJECTIVES:The treatment of peptic ulcer bleeding (PUB) is complex, and mortality remains high. We present results from a nationwide initiative to monitor and improve the quality of care (QOC) in PUB.METHODS:All Danish hospitals treating PUB patients between 2004 and 2011 prospectively registered...

  1. Guiding and Modelling Quality Improvement in Higher Education Institutions

    Science.gov (United States)

    Little, Daniel

    2015-01-01

    The article considers the process of creating quality improvement in higher education institutions from the point of view of current organisational theory and social-science modelling techniques. The author considers the higher education institution as a functioning complex of rules, norms and other organisational features and reviews the social…

  2. Student Evaluations of Teaching: Improving Teaching Quality in Higher Education

    Science.gov (United States)

    Hammonds, Frank; Mariano, Gina J.; Ammons, Gracie; Chambers, Sheridan

    2017-01-01

    Student evaluations of teaching (SET) are widely used in both North America and the UK as a means of documenting and improving teaching quality. This article discusses current research on SET administration and interpretation in both regions. Sections of the article are dedicated to various problems associated with SETs and how these may be…

  3. Controlled release fertilizer improves quality of container longleaf pine seedlings

    Science.gov (United States)

    R. Kasten Dumroese; Jeff Parkhurst; James P. Barnett

    2005-01-01

    In an operational trial, increasing the amount of nitrogen (N) applied to container longleaf pine seedlings by incorporating controlled release fertilizer (CRF) into the media improved seedling growth and quality. Compared with control seedlings that received 40 mg N, seedlings receiving 66 mg N through CRF supplemented with liquid fertilizer had needles that were 4 in...

  4. Training in data definitions improves quality of intensive care data

    NARCIS (Netherlands)

    Arts, DGT; Bosman, RJ; de Jonge, E; Joore, JCA; de Keizer, NF

    2003-01-01

    Background Our aim was to assess the contribution of training in data definitions and data extraction guidelines to improving quality of data for use in intensive care scoring systems such as the Acute Physiology and Chronic Health Evaluation (APACHE) II and Simplified Acute Physiology Score (SAPS)

  5. Improving Lecture Quality through Training in Public Speaking

    Science.gov (United States)

    Mowbray, Robert; Perry, Laura B.

    2015-01-01

    Lecturing is a common instructional format but poor lecturing skills can detract from students' learning experiences and outcomes. As lecturing is essentially a form of public communication, training in public speaking may improve lecture quality. Twelve university lecturers in Malaysia participated in a six-week public speaking skills training…

  6. Improvement of sheep skin quality after treatment with diazinon ...

    African Journals Online (AJOL)

    that sheep treated against lice and keds with diazinon improved the skin quality ... from an average minimum of 6.3°C to an average maximum of 18.8°C) and ..... diff. Carcass wt. (kg). Dressing. %. 1st Round Menz adult(N=10). Total. 150.45.

  7. Improvement of Educational Quality in VET: Who Is Next?

    NARCIS (Netherlands)

    Venne, L. van de; Honingh, M.E.; Genugten, M.L. van

    2017-01-01

    Educational quality is a recurrent theme in the Dutch Vocational and Educational Training (VET) sector. Given the major transformations in school governance and the increased autonomy of schools and school boards, it is important to address whether schools and school boards are able to improve educa

  8. Fonio (Digitaria exilis) in West Africa: towards improving nutrient quality

    NARCIS (Netherlands)

    Koreissi, Y.

    2015-01-01

    Fonio (Digitaria exilis) in West Africa: Towards improving nutrient quality Abstract Hidden hunger affects a far greater percentage of the world’s population with iron and zinc deficiencies being the most common, particularly affecting women of reproductive ag

  9. Improving Lecture Quality through Training in Public Speaking

    Science.gov (United States)

    Mowbray, Robert; Perry, Laura B.

    2015-01-01

    Lecturing is a common instructional format but poor lecturing skills can detract from students' learning experiences and outcomes. As lecturing is essentially a form of public communication, training in public speaking may improve lecture quality. Twelve university lecturers in Malaysia participated in a six-week public speaking skills training…

  10. Quality management science in clinical chemistry: a dynamic framework for continuous improvement of quality.

    Science.gov (United States)

    Westgard, J O; Burnett, R W; Bowers, G N

    1990-10-01

    Current quality assurance approaches will not be adequate to satisfy the needs for quality in the next decade. Quality management science (QMS), as evolving in industry today, provides the dynamic framework necessary to provide continuous improvement of quality. QMS emphasizes the importance of defining quality goals based on the needs and expectations (implied needs) of customers. The laboratory can develop customer-friendly goals and measures of quality by recognizing that customers' experiences are represented by a totality of results. Quality goals and measures are best communicated as "total performance" by specifying a limit and percentile of the distribution, rather than a mean and standard deviation. Application of quality goals within the laboratory will usually require partitioning the total performance goal into components and translating those components into specifications to guide the operation and management of production processes. QMS also extends beyond technical processes to people processes and provides guidance for improving the quality of worklife and caring for the laboratory's most essential resource--our people.

  11. Improving quality at many levels. Profamilia's experience in Colombia.

    Science.gov (United States)

    Trias, M; Plata, M I

    1994-01-01

    Profamilia, the Colombian family planning association and the country's largest family planning provider, began diversifying its services in 1982 to offer prenatal care services as well as general medical consultations. The organization has since attempted to integrate quality assurance at all levels of operation. Specifically, Profamilia is aiming to provide care which is of sustainably high quality to satisfy present clients and attract new ones without overtaxing available organization resources, thereby prompting the eventual financial collapse of the programs and the failure to increase coverage especially among the middle and lower classes of the country. Drawing from the credo of modern corporate enterprise, "the client is always right," Profamilia listens and responds to clients' needs with the goal of making their satisfaction the ultimate objective. Moreover, organization staff receive regular training to motivate their receptiveness to client needs, while the pursuit of quality exists as a major goal at the managerial level. Profamilia regards quality maintenance and improvement as indispensable in program sustainability.

  12. Suggestions of Policy Direction to Improve the Housing Quality in South Korea

    Directory of Open Access Journals (Sweden)

    Miyeon Park

    2016-05-01

    Full Text Available Following the recent global climate changes, many countries, including developed nations, are announcing greenhouse gas (GHG reduction targets and are actively participating in reducing GHG. Therefore, the role of the building sector on reducing GHG is being emphasized, and the establishment of policy structures for both making environmentally friendly capacity compulsory and improving the housing quality is being demanded. South Korea is also developing a policy for improving housing quality, but in order to achieve more competitive growth, this must be preceded by an analysis of current policy status within various countries on improving housing quality. This study aims to suggest direction about policies that will improve the housing quality in South Korea. For this, the policies of major countries were able to categorize and compare according to three major categories (performance, function, and aesthetics, and seven factors (safety, durability, cost and maintenance, response to residents’ needs, habitability, energy saving, and building design regarding housing quality. As a result, from the performance aspect, policy directions were suggested for safe housing, the urban environment, regeneration of quality stock, and the usage of existing stock; from the functional aspect, policies for improving housing quality that responds to the aging population and energy saving housing were suggested; from the aesthetic aspect, housing designs that consider the urban environment were suggested.

  13. Improving the Context Supporting Quality Improvement in a Neonatal Intensive Care Unit Quality Collaborative: An Exploratory Field Study.

    Science.gov (United States)

    Grooms, Heather R; Froehle, Craig M; Provost, Lloyd P; Handyside, James; Kaplan, Heather C

    Successful quality improvement (QI) requires a supportive context. The goal was to determine whether a structured curriculum could help QI teams improve the context supporting their QI work. An exploratory field study was conducted of 43 teams participating in a neonatal intensive care unit QI collaborative. Using a curriculum based on the Model for Understanding Success in Quality, teams identified gaps in their context and tested interventions to modify context. Surveys and self-reflective journals were analyzed to understand how teams developed changes to modify context. More than half (55%) targeted contextual improvements within the microsystem, focusing on motivation and culture. "Information sharing" interventions to communicate information about the project as a strategy to engage more staff were the most common interventions tested. Further study is needed to determine if efforts to modify context consistently lead to greater outcome improvements.

  14. Continuous Improvement in Nursing Education through Total Quality Management (TQM

    Directory of Open Access Journals (Sweden)

    Tang Wai Mun

    2013-11-01

    Full Text Available Total Quality Management (TQM has generally been validated as a crucial revolution in the management field. Many academicians believe that the concept of TQM is applicable to academics and provides guiding principles towards improving education. Therefore, an increasing number of educational institutions such as schools, colleges and universities have started to embrace TQM philosophies to their curricula.Within the context of TQM, this paper would explore the concept of continuous improvement by using the Deming philosophy. Subsequently, this paper would elaborate on the application of TQM to bring about continuous improvement in the current education system.

  15. Increased office productivity through improved indoor air quality

    DEFF Research Database (Denmark)

    Fanger, Povl Ole

    2002-01-01

    Building Syndrome (SBS) symptoms and improve the productivity of office workers. In these experiments, the performance of simulated office work (text typing, addition and proof-reading, all typical office tasks requiring concentration) improved monotonically as the proportion of persons dissatisfied......, future developments in HVCAC technology may include "personalized air ", new ways of improving the quality of supply air (e.g., by filtration), more extensive use of heat recovery from exhaust air and systematic selection of low-polluting building and furnishing materials....

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

    Science.gov (United States)

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

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

  17. Improving the quality of care in Chinese family planning programme.

    Science.gov (United States)

    Jiang, Y; Geng, Q; Haffey, J; Douglas, E

    1994-10-01

    The Chinese State Family Planning Commission (SFPC) is the government department responsible for coordinating and implementing the national population and family planning programs. The commission includes about 300,000 family planning workers and 50 million volunteers. Community workers provide IEC and technical services to couples of reproductive age. In July 1991, SFPC began a five year project to train rural family planning workers in contraceptive technology and interpersonal communication and counseling. These workers were important because of their service to a population of 800 million or 75% of total population. The training program was part of an effort to standardize training and institutionalize it throughout the country. The project involved 20 pilot training stations in 19 provinces. The primary task was to train family planning workers at the grassroots level. 80,000 persons were expected to be trained during the five years. Activities included a training needs assessment, development of training curricula and programs, training of workers, and monitoring and evaluation. Training techniques and topics will include participatory training methods, interpersonal communication and counseling, development of audience based training methods, issues of contraceptive choice and quality of care, and counseling issues such as sexually transmitted disease and HIV infection prevention. About 40,000 family planning workers and volunteers were trained by 1992 in counties, townships, and villages. Trainees learned about "informed choice" and the importance of counseling. Feedback from training activities focused on the appreciation for the participatory training methods such as brainstorming, case study, and role play. Workers appreciated the process involved in training as well as the information received. Evaluation showed that clients improved their knowledge and had positive interactions with workers.

  18. Research on Improving Manufacturing Practice Quality in Mechanical Industrial Design

    Directory of Open Access Journals (Sweden)

    Xiaowei Jiang

    2013-07-01

    Full Text Available In order to solve the problems existing in the manufacturing practice of mechanical industrial design, a series of methods and concrete measures are proposed, so as to improve the quality of manufacturing practice of mechanical industrial design. In this study, the problems existing in the manufacturing practice of mechanical industrial design are analyzed detailedly. And the methods and concrete measures including establishing the new mode of manufacturing practice of mechanical industrial design, improving the understanding to manufacturing practice and knowing the major role, establishing a professional characteristic base of manufacturing practice and strengthening the construction of instructor troops of manufacturing practice are proposed, which will certainly have a profound theoretical and practical guiding significance. On this foundation, the research conclusion on improving manufacturing practice quality in mechanical industrial design is done.

  19. Defect Investigation as a Tool for Quality Improvement

    Directory of Open Access Journals (Sweden)

    B. Gurumurthy

    2002-10-01

    Full Text Available Defect investigation is an important tool for quality improvement as it identifies the root cause of errors and steps to be taken to eliminate these. In this paper, four cases of defect investigation are presented. The case studies cover link elevator, wing-fuselage attachment bolt, and stiff nut for Lakshya unmanned aerial vehicle. It was observed that the link elevator was discolourised even though the material used was the stainless steel. Investigations revealed that the stainless steel was heat-treated. In the case of leading edge, it was found that there was no provision for the location of a component in the tool, resulting in mismatch. Thread damage was noticed in wing-fuselage attachment bolts because of over tightening. All these studies resulted in improvement in the raw material bonding, inspection procedures, and fabrication methods, thus resulting in quality improvement.

  20. Improvement works of water quality in the enclosed area. Heisasei kaiiki ni okeru suishitsu kaizen jigyo

    Energy Technology Data Exchange (ETDEWEB)

    Sega, Y. (Ministry of Transport, Tokyo (Japan))

    1993-08-10

    This paper introduces specific examples of measures to preserve and improve water quality as adopted in the harbor environment administration to prevent pollution and create comfortable environments. In the investigation of ocean bottom purification, a test construction has been carried out using a sand covering method at Mikawa Bay. The sand covering method uses good quality sand to cover sludge on the ocean bottom to suppress dissolution of nutrients that have been revolving from the ocean bottom sludge into sea water. The method also reduces dissolved oxygen consumption in sea water by the ocean bottom sludge and improves the water quality in the area and the ecosystems. In the change of ocean bottom sludge quality in vertical distribution in the sand covered area, the COD content decreased more largely than in the current ocean bottom, but it increased more largely with lapse of time during which floating mud has precipitated. The 'sea blue' technology development project intends to implement the following activities compositely: advancement of environment improving technologies that utilize natural purification ability; environmental improvement including sludge dredging, and improving water quality and ocean bottom quality; improvement of green areas that are highly friendly with water; and application of measures to form amenity spaces. 8 figs., 3 tabs.

  1. A longitudinal examination of sleep quality and physical activity in older adults.

    Science.gov (United States)

    Holfeld, Brett; Ruthig, Joelle C

    2014-10-01

    The relationship between sleep quality and physical activity is bidirectional, yet prior research on older adults has mainly focused on investigating whether increasing levels of physical activity leads to improvements in sleep quality. The current longitudinal study examined both directional relationships by assessing sleep quality and physical activity twice over a two-year period among 426 community-dwelling older adults (ages 61-100). A cross-lagged panel analysis that included age, gender, perceived stress, functional ability, and severity of chronic health conditions as covariates, revealed that better initial sleep quality predicted higher levels of later physical activity beyond the effects of prior physical activity; whereas initial physical activity did not predict later sleep quality after accounting for prior sleep quality. These findings highlight sleep quality as an important contributor to a physically active lifestyle among older adults.

  2. Does Internal Quality Management Contribute to More Control or to Improvement of Higher Education?: A Survey on Faculty's Perceptions

    Science.gov (United States)

    Kleijnen, Jan; Dolmans, Diana; Willems, Jos; van Hout, Hans

    2011-01-01

    Purpose: The purpose of this paper is to explore faculty's perceptions of quality management activities (QMA) within their departments, attention being paid to relevant quality aspects and whether quality management contributes to control or improvement of higher education. Furthermore, it examines differences between departments and relationships…

  3. Does Internal Quality Management Contribute to More Control or to Improvement of Higher Education?: A Survey on Faculty's Perceptions

    Science.gov (United States)

    Kleijnen, Jan; Dolmans, Diana; Willems, Jos; van Hout, Hans

    2011-01-01

    Purpose: The purpose of this paper is to explore faculty's perceptions of quality management activities (QMA) within their departments, attention being paid to relevant quality aspects and whether quality management contributes to control or improvement of higher education. Furthermore, it examines differences between departments and relationships…

  4. Improving the quality of nursing documentation: An action research project

    Directory of Open Access Journals (Sweden)

    Elisha M. Okaisu

    2014-10-01

    Full Text Available Background: Documentation is an important function of professional nursing practise. In spite of numerous improvement efforts globally, inadequate documentation continues to be reported as nurse authors investigate barriers and challenges. Objectives: The project aimed to improve nurses’ documentation of their patient assessments at the CURE Children’s Hospital of Uganda in order to enhance the quality of nursing practise. Method: An action research methodology, using repeated cycles of planning, intervention, reflection and modification, was used to establish best practise approaches in this context for improving nurses’ efficacy in documenting assessments in the patient record. The researchers gathered data from chart audits, literature reviews and key informant interviews. Through analysis and critical reflection, these data informed three cycles of systems and practise modifications to improve the quality of documentation. Results: The initial cycle revealed that staff training alone was insufficient to achievethe project goal. To achieve improved documentation, broader changes were necessary, including building a critical mass of competent staff, redesigned orientation and continuing education, documentation form redesign, changes in nurse skill mix, and continuous leadership support. Conclusion: Improving nursing documentation involved complex challenges in this setting and demanded multiple approaches. Evidence-based practise was the foundation of changes in systems required to produce visible improvement in practise. The involved role of leadership in these efforts was very important.

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

    Science.gov (United States)

    Leff, Ellen W

    2004-05-01

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

  6. A study on regular physical activity's improving the quality of life for the old people%规律体育行为提升老年人生命质量的研究

    Institute of Scientific and Technical Information of China (English)

    费加明; 刘志民

    2014-01-01

    Under the background of rapid development of China's aging population, the research has analyzed the ef-fects factors on the quality of life (QOL) of city elderly by using text analysis, interviews and other methods. As a re-sult, chronic disease, social economic status, living status of marriage, leisure lifestyle, education level are important factors affecting the QOL for the elderly. Research shows that long time regular, moderate intensity physical activity can delay the aging speed, prevent and cure diseases, rich cultural life, improve the ability to adapt to society, it has important significance to improve the overall QOL indispensable city elderly. Based on this, the research puts forward some feasible advice and suggestions for the sake of exercise's enhancing the QOL for the elderly from the three as-pects of policy, social and personal.%在我国人口老龄化快速发展的背景下,运用文本分析、深度访谈等方法对城市老年人生命质量的影响因素进行系统分析。结果认为,有无慢性疾病、社会经济地位高低、婚姻居住状况、闲暇生活方式、受教育水平等是影响老年人生命质量的重要因素。研究表明,较长时间有规律中等强度的健身活动能延缓老年人衰老速度、防病治病、丰富文化生活、提高社会适应能力,对提升城市老年人总体生命质量有不可或缺的重要意义。基于此,本文从政策、社会和个人三个层面就加强体育锻炼提升老年人生命质量的路径提出可操作性的意见和建议。

  7. Influence of activity on quality of life scores after RYGBP.

    Science.gov (United States)

    Forbush, Steven W; Nof, Leah; Echternach, John; Hill, Cheryl

    2011-08-01

    Gastric bypass is one of the medically acceptable interventions for weight loss for the obese. Quality of life greatly improves after surgery. Most improvements in quality of life (QOL) after these surgeries are attributed to the weight loss. Few studies have demonstrated any contribution of other variables to positive outcomes in QOL. The purpose of this study was to suggest variables that improve QOL in this post-surgical population. The Arizona Activity Frequency Questionnaire, the Arizona Food Frequency Questionnaire, and the SF-36 survey were sent to all of the Roux-en-Y gastric bypass procedure (RYGBP) patients who had surgery 1-5 years prior to the study and performed through the same bariatric surgery center (n = 805; respondents = 265; 33%). Analysis was performed through ANOVA testing to determine relationships between selected behaviors and the SF-36 of the respondents. Comparisons of differences in SF-36 scores were analyzed using the variables of hours of activity/day (HOAD) and energy in activity/day (EEAD). Patients with more EEAD and HOAD demonstrated significantly better SF-36 scores in both mental component and physical component scores (p = 0.05) when compared to those with less EEAD or HOAD. Outcomes measured by the SF-36 tool were improved after RYGBP, if the patient expended more energy/day or was active more hours/day. The post-bariatric surgery populations will have improved QOL if the patients expend more energy and are active more hours as demonstrated in activity/day after their surgery.

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

    Directory of Open Access Journals (Sweden)

    Asgar Aghaei Hashjin

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

  9. Statistical process management: An essential element of quality improvement

    Science.gov (United States)

    Buckner, M. R.

    Successful quality improvement requires a balanced program involving the three elements that control quality: organization, people and technology. The focus of the SPC/SPM User's Group is to advance the technology component of Total Quality by networking within the Group and by providing an outreach within Westinghouse to foster the appropriate use of statistic techniques to achieve Total Quality. SPM encompasses the disciplines by which a process is measured against its intrinsic design capability, in the face of measurement noise and other obscuring variability. SPM tools facilitate decisions about the process that generated the data. SPM deals typically with manufacturing processes, but with some flexibility of definition and technique it accommodates many administrative processes as well. The techniques of SPM are those of Statistical Process Control, Statistical Quality Control, Measurement Control, and Experimental Design. In addition, techniques such as job and task analysis, and concurrent engineering are important elements of systematic planning and analysis that are needed early in the design process to ensure success. The SPC/SPM User's Group is endeavoring to achieve its objectives by sharing successes that have occurred within the member's own Westinghouse department as well as within other US and foreign industry. In addition, failures are reviewed to establish lessons learned in order to improve future applications. In broader terms, the Group is interested in making SPM the accepted way of doing business within Westinghouse.

  10. IMPROVING THE QUALITY OF MAINTENANCE PROCESSES USING INFORMATION TECHNOLOGY

    Directory of Open Access Journals (Sweden)

    Zora Arsovski

    2008-06-01

    Full Text Available In essence, process of maintaining equipment is a support process, because it indirectly contributes to operational ability of the production process necessary for the supply chain of the new value. Taking into account increased levels of automatization and quality, this proces s becomes more and more significant and for some branches of industry, even crucial. Due to the fact that the quality of the entire process is more and more dependent on the maintenance process, these processes must be carefully designed and effectively im plemented. There are various techniques and approaches at our disposal, such as technical, logistical and intensive application of the information - communication technologies. This last approach is presented in this work. It begins with organizational goa ls, especially quality objectives. Then, maintenance processes and integrated information system structures are defined. Maintenance process quality and improvement processes are defined using a set of performances, with a special emphasis placed on effectiveness and quality economics. At the end of the work, information system for improving maintenance economics is structured. Besides theoretical analysis, work also presents results authors obtained analyzing food industry, metal processing industry an d building materials industry.

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

    Directory of Open Access Journals (Sweden)

    Anette Peterson

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

  12. Breast cancer practice guidelines: evaluation and quality improvement.

    Science.gov (United States)

    Edge, S B

    1997-11-01

    The utility of practice guidelines in breast cancer management remains unproved. This paper examines the scope and goals of published guidelines and their utility in the process of breast cancer treatment quality improvement. Although existing breast cancer guidelines vary widely in scope and intent, they provide a framework for meaningful quality-of-care evaluation. Among the few comprehensive breast cancer guideline programs are those developed by the Ontario Cancer Treatment Practice Guidelines Initiative, the Revlon/UCLA Breast Center, the Association of Community Cancer Centers (ACCC), the Society of Surgical Oncology (SSO), and the National Comprehensive Cancer Network (NCCN). Ultimately, guidelines will prove useful only if they are utilized as part of a comprehensive program to improve quality, cost-effectiveness, and outcomes. To accomplish this, they must include mechanisms for revision and evaluation. The evaluation of guideline utility in quality improvement, particularly in breast cancer care, is a complex long-term process, which should include input from practitioners, institutions, payors, and government.

  13. Bee pollination improves crop quality, shelf life and commercial value.

    Science.gov (United States)

    Klatt, Björn K; Holzschuh, Andrea; Westphal, Catrin; Clough, Yann; Smit, Inga; Pawelzik, Elke; Tscharntke, Teja

    2014-01-22

    Pollination improves the yield of most crop species and contributes to one-third of global crop production, but comprehensive benefits including crop quality are still unknown. Hence, pollination is underestimated by international policies, which is particularly alarming in times of agricultural intensification and diminishing pollination services. In this study, exclusion experiments with strawberries showed bee pollination to improve fruit quality, quantity and market value compared with wind and self-pollination. Bee-pollinated fruits were heavier, had less malformations and reached higher commercial grades. They had increased redness and reduced sugar-acid-ratios and were firmer, thus improving the commercially important shelf life. Longer shelf life reduced fruit loss by at least 11%. This is accounting for 0.32 billion US$ of the 1.44 billion US$ provided by bee pollination to the total value of 2.90 billion US$ made with strawberry selling in the European Union 2009. The fruit quality and yield effects are driven by the pollination-mediated production of hormonal growth regulators, which occur in several pollination-dependent crops. Thus, our comprehensive findings should be transferable to a wide range of crops and demonstrate bee pollination to be a hitherto underestimated but vital and economically important determinant of fruit quality.

  14. Implementing a user-driven online quality improvement toolkit for cancer care.

    Science.gov (United States)

    Luck, Jeff; York, Laura S; Bowman, Candice; Gale, Randall C; Smith, Nina; Asch, Steven M

    2015-05-01

    Peer-to-peer collaboration within integrated health systems requires a mechanism for sharing quality improvement lessons. The Veterans Health Administration (VA) developed online compendia of tools linked to specific cancer quality indicators. We evaluated awareness and use of the toolkits, variation across facilities, impact of social marketing, and factors influencing toolkit use. A diffusion of innovations conceptual framework guided the collection of user activity data from the Toolkit Series SharePoint site and an online survey of potential Lung Cancer Care Toolkit users. The VA Toolkit Series site had 5,088 unique visitors in its first 22 months; 5% of users accounted for 40% of page views. Social marketing communications were correlated with site usage. Of survey respondents (n = 355), 54% had visited the site, of whom 24% downloaded at least one tool. Respondents' awareness of the lung cancer quality performance of their facility, and facility participation in quality improvement collaboratives, were positively associated with Toolkit Series site use. Facility-level lung cancer tool implementation varied widely across tool types. The VA Toolkit Series achieved widespread use and a high degree of user engagement, although use varied widely across facilities. The most active users were aware of and active in cancer care quality improvement. Toolkit use seemed to be reinforced by other quality improvement activities. A combination of user-driven tool creation and centralized toolkit development seemed to be effective for leveraging health information technology to spread disease-specific quality improvement tools within an integrated health care system. Copyright © 2015 by American Society of Clinical Oncology.

  15. Quality and productivity improvement program (PPKP) from alumni perspective

    Science.gov (United States)

    Ruza, Nadiah; Mustafa, Zainol

    2013-04-01

    Defining the quality of the university education system is not easy. Institutions of higher education, through curriculum are hoped to provide the knowledge, wisdom and personality of students. It is questionable of how far Quality and Productivity Improvement Program (PPKP) are capable to ensure the courses offered relevant and effective in preparing the students for job market. The effectiveness of a university to undertake responsibilities and the impact given to students even after they graduate can be a measure of education quality at university. So, the quality of education can be enhanced and improved from time to time. In general, this study is aims to determine the effectiveness of PPKP's education system from the perspective of their alumni as well as their satisfaction and the importance level based on how PPKP be able to meet their needs. In overall, summary of open-ended questions from the questionnaire, Importance-Performance analysis and correlation analysis were conducted for this study. Based on result, it appears that there are still some deficiencies that can be improve, particularly in terms of teaching skills and PPKP's relationships with external organizations to enable knowledge be channel effectively. Importance-Performance analysis highlights some topics or courses that should be offered by PPKP based on their importance in industrial practice. Summary of the results of correlation analysis was found that women are more positive and not too demanding compared to men. In addition, it is found that the responsibilities and workload of the older generations, higher income and a high level of experience demands them to use and practice what they have learned during their studies at PPKP. Results of this study are hoped could be used to improve the quality of education system at PPKP.

  16. IMPROVEMENT OF ROAD TRAFFIC QUALITY IN ACCIDENT CLUSTERS

    Directory of Open Access Journals (Sweden)

    D. V. Kapsky

    2015-01-01

    Full Text Available Road traffic with its share from 2/3 to 3/4 of the total volume of transport service represents rather large and complicated social and production system with several subsystems that include roads, transport facilities, road traffic organization, law enforcement, personnel training, road traffic service and others. Road traffic quality can be quantitatively evaluated in accordance with values of losses pertaining to social and economic cost of discretionary (unenforced expenses for road traffic process. Road traffic contains accident, ecological, economic and social risks. Accidence is considered as the most important risk for participants involved in road traffic because it directly concerns their life, health and welfare. So accident response has rather high social significance and it is considered as a matter of national importance. In this connection role of road traffic organization has become very important and it is directed on improvement of its quality including security in the accident clusters.Methodological principles for improvement of road traffic quality have been developed in the paper. These principles presuppose the following: maximization of danger while selecting investigation object; minimization of total losses while evaluating quality and selecting solutions on improvement in road traffic safety; balanced accountability of accidental and ecological losses while selecting solutions on higher road traffic safety in ambiguous situations; minimization of total cost pertaining to object operation while selecting measures on improvement of road traffic safety; obligatory operative control evaluation of accidence on the basis of method for conflict situations while introducing measures of road traffic safety. Such approaches will contribute to higher quality of the decisions taken in the field of road traffic organization.

  17. A decade of improvement: New York State fluid milk quality.

    Science.gov (United States)

    Martin, N H; Carey, N R; Murphy, S C; Wiedmann, M; Boor, K J

    2012-12-01

    The microbiological and sensory qualities of New York State (NYS) fluid milk products were assessed as part of an ongoing fluid milk quality program. Commercially packaged pasteurized fluid milk samples were collected twice a year over the 10-yr period from 2001 to 2010 from 14 NYS dairy processing facilities and analyzed at the Milk Quality Improvement Program (MQIP) laboratory. Each sample was tested throughout refrigerated storage (6°C) on day initial, 7, 10, and 14 for standard plate count (SPC), coliform count (CC), and sensory quality. Over the 10-yr period, the percentage of samples with bacterial numbers below the Pasteurized Milk Ordinance (PMO) limit of 20,000 cfu/mL at d 14 postprocessing ranged from a low of 21.1% in 2002 to a high of 48.6% in 2010. Percent samples positive for coliforms during that same period ranged from a high of 26.6% in 2002 to a low of 7.5% in 2007. Mean d 14 sensory scores ranged from a low of 6.0 in 2002 to a high of 7.3 in 2007. Samples contaminated with coliforms after pasteurization have significantly higher SPC counts and significantly lower sensory scores on d 14 of shelf-life than those not contaminated with coliforms. Product factors such as fat level were not significantly associated with SPC, CC, or sensory quality of the product, whereas the factor processing plant significantly affected overall product quality. This study demonstrates that overall fluid milk quality in NYS, as determined by microbiological and sensory analyses, has improved over the last decade, and identifies some challenges that remain.

  18. Prioritising Investments in Marketing Activities to Improve Business Performance

    DEFF Research Database (Denmark)

    Martensen, Anne; Mouritsen, Jan

    2014-01-01

    dimensions: (1) Small m: marketing strategy and marketing implementation and (2) big M: cross-functional coordination and innovation. Big M and small m interact and influence BP similarly. When considering investing in marketing activities to improve financial performance, the first priority is to recruit......The purpose of this study is to prioritise investments in marketing activities based on their effect on business performance (BP). On the basis of the European Foundation for Quality Management (EFQM) model adapted to a marketing context, four generic marketing activities are structured in two...

  19. Software Defect Prediction Models for Quality Improvement: A Literature Study

    Directory of Open Access Journals (Sweden)

    Mrinal Singh Rawat

    2012-09-01

    Full Text Available In spite of meticulous planning, well documentation and proper process control during software development, occurrences of certain defects are inevitable. These software defects may lead to degradation of the quality which might be the underlying cause of failure. In todays cutting edge competition its necessary to make conscious efforts to control and minimize defects in software engineering. However, these efforts cost money, time and resources. This paper identifies causative factors which in turn suggest the remedies to improve software quality and productivity. The paper also showcases on how the various defect prediction models are implemented resulting in reduced magnitude of defects.

  20. Activity-based quality management : Een synthese van kwaliteitsmanagement en Activity-Based Costing

    NARCIS (Netherlands)

    Tillema, K.H.

    2002-01-01

    The NEN-EN-ISO 9000 (the Dutch version of ISO 9000), which describes the basic principles of quality management systems and specifies the relevant terminology, breaks down quality management into quality planning, quality control, quality assurance and quality improvement. Quality planning focusses

  1. Activity-based quality management : Een synthese van kwaliteitsmanagement en Activity-Based Costing

    NARCIS (Netherlands)

    Tillema, K.H.

    2002-01-01

    The NEN-EN-ISO 9000 (the Dutch version of ISO 9000), which describes the basic principles of quality management systems and specifies the relevant terminology, breaks down quality management into quality planning, quality control, quality assurance and quality improvement. Quality planning focusses

  2. Improving sleep quality interventions among menopausal women with sleep disturbances in Taiwan: a preliminary study.

    Science.gov (United States)

    Hsu, Hsiu-Chin; Tsao, Lee-Ing; Lin, Mei-Hsiang

    2015-11-01

    The aim of this study was to evaluate the effectiveness of improving sleep quality interventions in menopausal women with sleep disturbance. Sleep disturbances are an extensive and common problem among menopausal women. There is an increased trend in the use of non-pharmacological methods to alleviate sleep disturbances. Studies that have implemented two or more non-pharmacological strategies for menopausal women are scant. A repeat measurement with a randomized assignment was conducted. A total of 59 menopausal women with sleep disturbance were recruited and randomly assigned to experimental (n = 29) and control (n = 30) groups. Participants in the experimental group received four 2-hour improving sleep quality activities, whereas the control group received regular greeting calls. Sleep quality was measured prior to intervention, and on the 5th and 8th weeks by using the Pittsburg's Sleep Quality Index, and Actiwatch was worn before and during the 8 weeks of intervention. Generalized estimating equation was used to analyze data. The results revealed that subjective sleep quality had significant main effect in group and time. The findings of the objective measurement showed that participants in the experimental group had significantly shorter frequency of awakening time and increased sleep efficiency. The improving sleep quality intervention is a healthy and cost-effective method to improve sleep quality in community-dwelling menopausal women with sleep disturbance. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Improvements of soil quality for increased food production in Norway

    Science.gov (United States)

    Øygarden, Lillian; Klakegg, Ove; Børresen, Trond; Krogstad, Tore; Kjersti Uhlen, Anne

    2016-04-01

    Since the 1990ties, agricultural land in use in Norway has diminished and yields per hectare for cereals and forages have stagnated. An expert panel appointed to advice on how to increase Norwegian grain production emphasizes low profitability and poor soil quality as limiting factors. A White Paper from the Norwegian Government, Report No.9 (2011-2012), stated that the main goal for the agricultural sector is to increase food production proportional to the expected increase in population (20 % by 2030) in order to maintain self-sufficiency at the present level. This is the background for the interdisciplinary project AGROPRO "Agronomy for increased food production - Challenges and solutions" (2013 - 2017)" financed by the Norwegian research council. A mail goal is seeking possibilities for improvements in agronomic practices for increased and sustainable food production and to identify drivers and challenges for their implementation. Are the key to higher yields hidden in the soil? The paper present an overview of the research activities in the project and some results of the improvements of soil quality to minimize yield gap in cereal and forage production. Detailed new soil maps provide soil information on field scale of soil quality and the suitability for growing different crops like cereal production or vegetables. The detailed soil information is also beeing used for development and adaptation of the planning tool «Terranimo» to reduce risk of soil compaction.The farmer get available soil information for each field, provide information about the maschinery in use- tractors and equipment, tyres, pressure. The decision tool evaluate when the soil is suitable for tillage, calculate the risk of compaction for dry, moist and wet soil. New research data for compaction on Norwegian clay and silt soil are included. Climate change with wetter conditions gives challenges for growing cereals. The project is testing genetic variation in cereals for tolerance to water

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

    Science.gov (United States)

    Pflueger, Dane

    2015-04-23

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

  5. Software Engineering Improvement Activities/Plan

    Science.gov (United States)

    2003-01-01

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

  6. Software Engineering Improvement Activities/Plan

    Science.gov (United States)

    2003-01-01

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

  7. 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.

  8. Quality, cost efficiency, the new quality-cost imperative: systemwide improvements can yield financial gains.

    Science.gov (United States)

    Birk, Susan

    2010-01-01

    The need to focus internally on cost management has largely replaced the revenue growth model of the past two decades and the external pursuit of opportunities for market and service expansion, according to Stephen R Mayfield, DHA, senior vice president of quality and performance improvement for the American Hospital Association. Outside financial pressure from primarily uncontrollable forces--the potential bundling of Medicare reimbursements to hospitals and nonpayments for readmissions and adverse events, to name a few--have compelled healthcare organizations to spend more time looking inward to finetune existing capabilities. As a result, quality improvement is evolving into a strategy for fiscal stability as well as a critical priority in itself.

  9. Thalassemia Major: how do we improve quality of life?

    Science.gov (United States)

    Dhirar, Nonita; Khandekar, Jyoti; Bachani, Damodar; Mahto, Deonath

    2016-01-01

    Thalassemia Major is a preventable genetic disorder characterized by abnormal hemoglobin synthesis and lifelong blood transfusions. The children suffering from Thalassemia Major have poor quality of life. This study was conducted to assess the factors influencing quality of life of these children and how it can be improved. A descriptive cross sectional study was conducted in 2014 at Thalassemia Day Care Centre of a tertiary level children's hospital in Delhi, to assess quality of life of children suffering from Thalassemia Major. A total of 241 eligible children (age 2-18 years) were enrolled in the study. Socio demographic and clinical characteristics were collected from interview and existing medical records. The PedsQL 4.0 generic core scale was used for assessing the quality of life of the children. The mean age of children was 8.69 ± 4.98 years. Two-thirds (63.5%) were boys. The total mean QoL score of the children was 82.0 ± 14.4. The quality of life scores were better for boys as compared to girls. The most affected domain was the emotional domain which showed statistically significant (p = 0.025) difference between boys and girls. The total QoL scores were significantly affected by the current age of the child (p = 0.000) and presence of co-morbidity (p = 0.026). Children not on any form of iron chelation therapy (p = 0.003) and fewer hospital visits (p = 0.044) had better QoL scores. Factors improving the quality of life were control of iron overload and adverse effects of ICTs, management of co morbidities and fewer hospital visits.

  10. Crystal quality analysis and improvement using x-ray topography

    Science.gov (United States)

    Maj, J. A.; Goetze, K.; Macrander, A. T.; Zhong, Y. C.; Huang, X. R.; Maj, L.

    2008-08-01

    The Topography X-ray Laboratory of the Advanced Photon Source (APS) at Argonne National Laboratory operates as a collaborative effort with APS users to produce high performance crystals for APS X-ray beamline experiments. For many years the topography laboratory has worked closely with an on-site optics shop to help ensure the production of crystals with the highest quality, most stress-free surface finish possible. It has been instrumental in evaluating and refining methods used to produce high quality crystals. Topographical analysis has shown to be an effective method to quantify and determine the distribution of stresses, to help identify methods that would mitigate the stresses and improve the Rocking curve, and to create CCD images of the crystal. This paper describes the topography process and offers methods for reducing crystal stresses in order to substantially improve the crystal optics.

  11. The epistemology of quality improvement: it's all Greek.

    Science.gov (United States)

    Perla, Rocco J; Parry, Gareth J

    2011-04-01

    In Plato's Theaetetus, knowledge is defined as the intersection of truth and belief, where knowledge cannot be claimed if something is true but not believed or believed but not true. Using an example from neonatal intensive care, this paper adapts Plato's definition of the concept 'knowledge' and applies it to the field of quality improvement in order to explore and understand where current tensions may lie for both practitioners and decision makers. To increase the uptake of effective interventions, not only does there need to be scientific evidence, there also needs to be an understanding of how people's beliefs are changed in order to increase adoption more rapidly. Understanding how best to maximise the overlap between actual and best practice is where quality improvement needs to employ educational and social sciences' methodologies and techniques.

  12. Improving Weld Quality by Arc-Excited Ultrasonic Treatment

    Institute of Scientific and Technical Information of China (English)

    张春雷; 吴敏生; 杜敬磊

    2001-01-01

    Ultrasonic treatment of the solidifying metal is a promising method for improving the quality of fusion welding. A method to combine the ultrasonic waves to the welding process using arc-excited ultrasonic emission, called arc-ultrasonic, was high frequency modulation of the arc-plasma. The effects of arc-ultrasonic on the weld including the fusion zone, the partially melted zone and the heat-affected zone are described. The arc-ultrasonic energy changes the weld microstructure. In the fusion zone, the primary dendrite arm spacing decreases significantly and more acicular ferrite appears. In the partially melted zone, a large amount of fine grains appear. In the heat-affected zone, the width of the tempered zone increases with increasing modulation frequency and the microstructure is refined. The results show that arc-ultrasonic is a new and effective way for improving weld quality.

  13. IMPROVING (SOFTWARE) PATENT QUALITY THROUGH THE ADMINISTRATIVE PROCESS.

    Science.gov (United States)

    Rai, Arti K

    2013-11-24

    The available evidence indicates that patent quality, particularly in the area of software, needs improvement. This Article argues that even an agency as institutionally constrained as the U.S. Patent and Trademark Office ("PTO") could implement a portfolio of pragmatic, cost-effective quality improvement strategies. The argument in favor of these strategies draws upon not only legal theory and doctrine but also new data from a PTO software examination unit with relatively strict practices. Strategies that resolve around Section 112 of the patent statute could usefully be deployed at the initial examination stage. Other strategies could be deployed within the new post-issuance procedures available to the agency under the America Invents Act. Notably, although the strategies the Article discusses have the virtue of being neutral as to technology, they are likely to have a very significant practical impact in the area of software.

  14. Crystal quality analysis and improvement using x-ray topography.

    Energy Technology Data Exchange (ETDEWEB)

    Maj, J.; Goetze, K.; Macrander, A.; Zhong, Y.; Huang, X.; Maj, L.; Univ. of Chicago

    2008-01-01

    The Topography X-ray Laboratory of the Advanced Photon Source (APS) at Argonne National Laboratory operates as a collaborative effort with APS users to produce high performance crystals for APS X-ray beamline experiments. For many years the topography laboratory has worked closely with an on-site optics shop to help ensure the production of crystals with the highest quality, most stress-free surface finish possible. It has been instrumental in evaluating and refining methods used to produce high quality crystals. Topographical analysis has shown to be an effective method to quantify and determine the distribution of stresses, to help identify methods that would mitigate the stresses and improve the Rocking curve, and to create CCD images of the crystal. This paper describes the topography process and offers methods for reducing crystal stresses in order to substantially improve the crystal optics.

  15. Burnishing of rotatory parts to improve surface quality

    Science.gov (United States)

    Celaya, A.; López de Lacalle, L. N.; Albizuri, J.; Alberdi, R.

    2009-11-01

    In this paper, the use of rolling burnishing process to improve the final quality of railway and automotive workpieces is studied. The results are focused on the improvement of the manufacturing processes of rotary workpieces used in railway and automotion industry, attending to generic target of achieving `maximum surface quality with minimal process time'. Burnishing is a finishing operation in which plastic deformation of surface irregularities occurs by applying pressure through a very hard element, a roller or a ceramic ball. This process gives additional advantages to the workpiece such as good surface roughness, increased hardness and high compressive residual stresses. The effect of the initial turning conditions on the final burnishing operation has also been studied. The results show that feeds used in the initial rough turning have little influence in the surface finish of the burnished workpieces. So, the process times of the combined turning and burnishing processes can be reduced, optimizing the shaft's machining process.

  16. Skill Gap Analysis for Improved Skills and Quality Deliverables

    Directory of Open Access Journals (Sweden)

    Mallikarjun Koripadu

    2014-10-01

    Full Text Available With a growing pressure in identifying the skilled resources in Clinical Data Management (CDM world of clinical research organizations, to provide the quality deliverables most of the CDM organizations are planning to improve the skills within the organization. In changing CDM landscape the ability to build, manage and leverage the skills of clinical data managers is very critical and important. Within CDM to proactively identify, analyze and address skill gaps for all the roles involved. In addition to domain skills, the evolving role of a clinical data manager demands diverse skill sets such as project management, six sigma, analytical, decision making, communication etc. This article proposes a methodology of skill gap analysis (SGA management as one of the potential solutions to the big skill challenge that CDM is gearing up for bridging the gap of skills. This would in turn strength the CDM capability, scalability, consistency across geographies along with improved productivity and quality of deliverables

  17. Improving diabetic foot screening at a primary care clinic: A quality improvement project

    Science.gov (United States)

    Allen, Michelle L.; Gunst, Colette

    2016-01-01

    Background Foot screening is an important part of diabetic care as it prevents significant morbidity, loss of function and mortality from diabetic foot complications. However, foot screening is often neglected. Aim This project was aimed at educating health care workers (HCWs) in a primary health care clinic to increase diabetic foot screening practices. Setting A primary health care clinic in the Western Cape province of South Africa Methods A quality improvement project was conducted. HCWs’ needs were assessed using a questionnaire. This was followed by focus group discussions with the HCWs, which were recorded, transcribed and assessed using a general inductive approach. An intervention was designed based on common themes. Staff members were trained on foot screening and patient information pamphlets and screening tools were made available to all clinic staff. Thirty-two consecutive diabetic patient folders were audited to compare screening in 2013 with that in 2014 after initiation of the quality improvement cycle. Results HCWs’ confidence in conducting foot screening using the diabetic foot assessment questionnaire improved markedly after training. Diabetic foot screening practices increased from 9% in 2013 to 69% in 2014 after the first quality improvement cycle. A strengths, opportunities, aspirations and results (SOAR) analysis showed promise for continuing quality improvement cycles. Conclusion The findings showed a significant improvement in the number of diabetic patients screened. Using strategic planning with appreciative intent based on SOAR, proved to be motivational and can be used in the planning of the next cycle. PMID:27608673

  18. Constructive pedagogics as a basis for improvement of education quality in the institutions of higher education

    Directory of Open Access Journals (Sweden)

    Sretenkaya D.A.

    2011-12-01

    Full Text Available Education quality improvement of the future specialists assumes the intensification of training, usage of optimization techniques as well as constructive approach in accordance with the Bologna Declaration. Introduction of constructive approach and inductive and deductive strategies in the teaching process will enable to enhance cognitive activity of students

  19. Power Quality Improvement of a Distributed Generation Power System

    Directory of Open Access Journals (Sweden)

    Panga Harish

    2016-06-01

    Full Text Available The aim of this work is to improve the power quality for Distributed Generation (DG with power storage system. Power quality is the combination of voltage quality and current quality. Power quality is the set of limits of electrical properties that allows electrical systems to function in their intended manner without significant loss of performance or life. The electrical power quality is more concerned issue. The main problems are stationery and transient distortions in the line voltage such as harmonics, flicker, swells, sags and voltage asymmetries. Distributed Generation (DG also called as site generation, dispersed generation, embedded generation, decentralized generation, decentralized energy or distributed energy, generates electricity from the many small energy sources. In recent years, micro electric power systems such as photovoltaic generation systems, wind generators and micro gas turbines, etc., have increased with the deregulation and liberalization of the power market. Under such circumstances the environment surrounding the electric power industry has become ever more complicated and provides high-quality power in a stable manner which becomes an important topic. Here DG is assumed to include Wind power Generation (WG and Fuel Cells (FC, etc. Advantages of this system are constant power supply, constant voltage magnitude, absence of harmonics insupply voltage, un-interrupted power supply. In this project the electric power qualities in two cases will be compared. Case I: With the storage battery when it is introduced. Case II: Without the storage battery. The storage battery executes the control that maintains the voltage in the power system. It will be found that the Electric power quality will be improved, when storage battery is introduced. The model system used in this Project work is composed of a Wind Turbine, an Induction Generator, Fuel Cells, An Inverter and a Storage Battery. A miniature Wind Power Generator is

  20. INNOVATIVE USE OF QUALITY MANAGEMENT METHODS FOR PRODUCT IMPROVEMENT

    Directory of Open Access Journals (Sweden)

    Katarzyna MIDOR

    2016-10-01

    Full Text Available Organisations constantly look for new, innovative solutions and methods which could be used to improve their efficiency and increase the quality of their products. Identifying the causes for returns is an important issue for modern compa-nies, as returns are the cause for the increase in production costs and, most importantly, the loss of credibility in the eyes of the client. Therefore, for the company to be able to sustain or strengthen its position on the market, it has to follow the rules of quality management. Especially important is the rule of constant improvement. This rule is primarily connected with preventing errors and defects from occurring at all the stages of the production process. To achieve that, one must, among other things, use quality management tools. The article presents an analysis of causes for returns of a vibrating screen produced by a company which manufactures machinery and equipment for the extractive industry, using quality management tools such as the Ishikawa diagram and Pareto analysis. The analysis allowed for the identifi-cation of the causes of client returns which could not be previously identified, and proposing solutions for them.

  1. Evaluating investment in quality improvement capacity building: a systematic review.

    Science.gov (United States)

    Mery, Gustavo; Dobrow, Mark J; Baker, G Ross; Im, Jennifer; Brown, Adalsteinn

    2017-02-20

    Leading health systems have invested in substantial quality improvement (QI) capacity building, but little is known about the aggregate effect of these investments at the health system level. We conducted a systematic review to identify key steps and elements that should be considered for system-level evaluations of investment in QI capacity building. We searched for evaluations of QI capacity building and evaluations of QI training programmes. We included the most relevant indexed databases in the field and a strategic search of the grey literature. The latter included direct electronic scanning of 85 relevant government and institutional websites internationally. Data were extracted regarding evaluation design and common assessment themes and components. 48 articles met the inclusion criteria. 46 articles described initiative-level non-economic evaluations of QI capacity building/training, while 2 studies included economic evaluations of QI capacity building/training, also at the initiative level. No system-level QI capacity building/training evaluations were found. We identified 17 evaluation components that fit within 5 overarching dimensions (characteristics of QI training; characteristics of QI activity; individual capacity; organisational capacity and impact) that should be considered in evaluations of QI capacity building. 8 key steps in return-on-investment (ROI) assessments in QI capacity building were identified: (1) planning-stakeholder perspective; (2) planning-temporal perspective; (3) identifying costs; (4) identifying benefits; (5) identifying intangible benefits that will not be included in the ROI estimation; (6) discerning attribution; (7) ROI calculations; (8) sensitivity analysis. The literature on QI capacity building evaluation is limited in the number and scope of studies. Our findings, summarised in a Framework to Guide Evaluations of QI Capacity Building, can be used to start closing this knowledge gap. Published by the BMJ Publishing

  2. Quality Improvement Project to Reduce Delayed Vaccinations in Preterm Infants.

    Science.gov (United States)

    Cuna, Alain; Winter, Lindy

    2017-08-01

    Preterm infants are especially vulnerable to infectious diseases. Although vaccinations are a safe and effective measure to protect preterm infants from vaccine-preventable diseases, delays in vaccinations are not uncommon. The goal of this quality improvement project was to improve on time vaccinations of preterm infants hospitalized in the neonatal intensive care unit. The Plan-Do-Study-Act model of quality improvement was adopted to develop, test, and implement interventions aimed at improving timely vaccination of preterm infants. The primary outcome measure of interest was the rate of on time vaccination, which was defined as the proportion of medically eligible preterm infants who received vaccinations within 2 weeks of the recommended schedule. Baseline on time vaccination rate was only 36%. Following several Plan-Do-Study-Act cycles, a steady increase in on time vaccinations of eligible infants was observed, and a new baseline on time vaccination rate of 82% was achieved. Simple interventions implemented within the context of Plan-Do-Study-Act cycles are effective in improving timely vaccinations among preterm infants. Future research that focuses on vaccinations in preterm infants is needed to further reinforce the safety and efficacy of vaccines. Effective methods on how to disseminate and apply this knowledge to practice should also be studied.Video Abstract available at http://links.lww.com/ANC/A27.

  3. Improving Quality Using Architecture Fault Analysis with Confidence Arguments

    Science.gov (United States)

    2015-03-01

    Improving Quality Using Architecture Fault Analysis with Confidence Arguments Peter H. Feiler Charles B. Weinstock John B. Goodenough...Design 8 2.3 Architecture Fault Modeling and Analysis with EMV2 8 2.4 Confidence Map Concepts and Notation 11 Overview of the Stepper-Motor System...Comparison of the SMS Designs 43 Establishing Confidence in the SMS 45 6.1 Confidence Maps for SMS 45 CMU/SEI-2015-TR-006 | SOFTWARE ENGINEERING

  4. Studying and simulating transformer configuration to improve power quality

    Directory of Open Access Journals (Sweden)

    Oscar J. Peña Huaringa

    2011-07-01

    Full Text Available This paper presents a study and simulation of transformer configurations to improve power quality; it provides theoretical support based on the expansion of the Fourier series and analysis of symmetrical components. A test system was set up in the laboratory, taking measurements and checking configuration effectiveness in reducing the system’s harmonic content. The configurations were modelled with PSCAD / EMTDC software, using two 6 pulse rectifiers as test loads and two variable speed drives.

  5. [Financial incentives in improving healthcare quality. SESPAS Report 2012].

    Science.gov (United States)

    Eirea Eiras, Carlos; Ortún Rubio, Vicente

    2012-03-01

    We address the contribution of financial incentives linked to pay for performance (P4P) to improving the quality of care. The situation of P4P is analyzed internationally and in the distinct health services in Spain. The participation of P4P in wage compensation and the effects of the current economic crisis on these incentives is discussed. We review the results of recent studies to clarify the role of these incentive models and assess possible orientations and new proposals.

  6. Active and Intelligent Packaging: The Indication of Quality and Safety.

    Science.gov (United States)

    Janjarasskul, Theeranun; Suppakul, Panuwat

    2016-09-19

    The food industry has been under growing pressure to feed an exponentially increasing world population and challenged to meet rigorous food safety law and regulation. The plethora of media consumption has provoked consumer demand for safe, sustainable, organic, and wholesome products with "clean" labels. The application of active and intelligent packaging has been commercially adopted by food and pharmaceutical industries as a solution for the future for extending shelf life and simplifying production processes; facilitating complex distribution logistics; reducing, if not eliminating the need for preservatives in food formulations; enabling restricted food packaging applications; providing convenience, improving quality, variety and marketing features; as well as providing essential information to ensure consumer safety. This chapter reviews innovations of active and intelligent packaging which advance packaging technology through both scavenging and releasing systems for shelf life extension, and through diagnostic and identification systems for communicating quality, tracking and brand protection.

  7. German Bowel Cancer Center: An Attempt to Improve Treatment Quality

    Directory of Open Access Journals (Sweden)

    Olof Jannasch

    2015-01-01

    Full Text Available Background. Colorectal cancer remains the second most common cause of death from malignancies, but treatment results show high diversity. Certified bowel cancer centres (BCC are the basis of a German project for improvement of treatment. The aim of this study was to analyze if certification would enhance short-term outcome in rectal cancer surgery. Material and Methods. This quality assurance study included 8197 patients with rectal cancer treated between 1 January 2008 and 31 December 2010. We compared cohorts treated in certified and noncertified hospitals regarding preoperative variables and perioperative outcomes. Outcomes were verified by matched-pair analysis. Results. Patients of noncertified hospitals had higher ASA-scores, higher prevalence of risk factors, more distant metastases, lower tumour localization, lower frequency of pelvic MRI, and higher frequencies of missing values and undetermined TNM classifications (significant differences only. Outcome analysis revealed more general complications in certified hospitals (20.3% versus 17.4%, p=0.03. Both cohorts did not differ significantly in percentage of R0-resections, intraoperative complications, anastomotic leakage, in-hospital death, and abdominal wall dehiscence. Conclusions. The concept of BCC is a step towards improving the structural and procedural quality. This is a good basis for improving outcome quality but cannot replace it. For a primary surgical disease like rectal cancer a specific, surgery-targeted program is still needed.

  8. Assessing local resources and culture before instituting quality improvement projects.

    Science.gov (United States)

    Hawkins, C Matthew

    2014-12-01

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

  9. Quality assessment and performance improvement in transplantation: hype or hope?

    Science.gov (United States)

    Reich, David J

    2013-04-01

    Healthcare reform and the national quality strategy is increasingly impacting transplant practice, as exemplified by quality assessment and performance improvement (QAPI) regulations for pretransplant and posttransplant care. Transplant providers consider not just patient comorbidities, donor quality, and business constraints, but also regulatory mandates when deciding how to care for transplant candidates and recipients. This review describes transplant quality oversight agencies and regulations, and explores recent literature on the pros and cons of transplant QAPI. Transplant's heavily regulated system of care and remuneration involves extensive QAPI process and outcome requirements, and assessment of lifelong, risk-adjusted data from the national, audited, publicly reported, electronic registry. Transplant is a model-integrated delivery system, with payment bundling and accountability for equitable access to high quality, efficient, cost-sensitive, and multidisciplinary care. However, transplant QAPI requires expensive resources and, to bolster wise risk-taking, novel treatments, and access to care, more nuanced risk adjustment, public reporting, and attention to geographic competitive variability. However, transplant QAPI requires expensive resources. In order to bolster wise risk-taking, novel treatments, and access to care, QAPI also requires more nuance in the areas of risk adjustment, public reporting, and attention to geographic competitive variability. With its focus on innovation and on clinical outcomes, transplantation is poised to continue providing outstanding clinical care and to pioneering systems that advance patient safety, satisfaction, and resource utilization, leading in the field of QAPI and healthcare reform.

  10. Helping primary care teams emerge through a quality improvement program.

    Science.gov (United States)

    Hilts, Linda; Howard, Michelle; Price, David; Risdon, Cathy; Agarwal, Gina; Childs, Anne

    2013-04-01

    Approaches to improving the quality of health care recognize the need for systems and cultures that facilitate optimal care. Interpersonal relationships and dynamics are a key factor in transforming a system to one that can achieve quality. The Quality in Family Practice (QIFP) program encompasses clinical and practice management using a comprehensive tool of family practice indicators. The objective of this study was to explore and describe the views of staff regarding changes in the clinical practice environment at two affiliated academic primary care clinics (comprising one Family Health Team, FHT) who participated in QIFP. An FHT in Hamilton, Canada, worked through the quality tool in 2008/2009. A qualitative exploratory case study approach was employed to examine staff perceptions of the process of participating. Semi-structured interviews were conducted in early 2010 with 43 FHT staff with representation from physicians, nurses, allied health professionals, support staff and managers. Interviews were audio-taped and transcribed verbatim. A modified template approach was used for coding, with a complexity theory perspective of analysis. Themes included importance of leadership, changes to practice environment, changes to communication, an increased understanding of team roles and relationships, strengthened teamwork, flattening of hierarchy through empowerment, changes in clinical care and clinical impacts, challenges and rewards and sustainability. The program resulted in perceived changes to relationships, teamwork and morale. Addressing issues of leadership, role clarity, empowerment, flattening of hierarchy and teamwork may go a long way in establishing and maintaining a quality culture.

  11. In patients with schizophrenia, symptoms improvement can be uncorrelated with quality of life improvement.

    Science.gov (United States)

    Wilson-d'Almeida, K; Karrow, A; Bralet, M-C; Bazin, N; Hardy-Baylé, M-C; Falissard, B

    2013-03-01

    Quality of life has been found to be associated with symptoms in patients with schizophrenia. Nevertheless, the mechanism that underlies this association is still unclear. The objective of this paper is to prospectively evaluate the quality of life of patients with schizophrenia in relation to the concurrent evolution of their symptoms, their expectations and their perceived position in life. Participants included 306 outpatients with schizophrenia who were interviewed at baseline, 6 and 12 months, about their quality of life (Outcome revealed by Preference in Schizophrenia, OPS) and symptoms (Positive and Negative Syndrome Scale, PANSS). Quality of life relative to subject expectations remained stable over time. A decrease in symptoms was correlated to an increase in both expectations and perceived position in life but did not correlate to quality of life. The level of expectations seems to play a major role in the subjective assessment of quality of life in patients with schizophrenia. Symptom improvement is not necessarily associated with quality of life improvement relative to subject expectations. Caregivers should be aware of this result so as to deal with possible disappointments in patients receiving a new efficient treatment. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  12. Chimeric enzymes with improved cellulase activities

    Science.gov (United States)

    Xu, Qi; Baker, John O; Himmel, Michael E

    2015-03-31

    Nucleic acid molecules encoding chimeric cellulase polypeptides that exhibit improved cellulase activities are disclosed herein. The chimeric cellulase polypeptides encoded by these nucleic acids and methods to produce the cellulases are also described, along with methods of using chimeric cellulases for the conversion of cellulose to sugars such as glucose.

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

    Directory of Open Access Journals (Sweden)

    Okoli Ugo

    2016-08-01

    Full Text Available 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.

  14. Improved Performance and Quality of Configurators by Receiving Real-Time Information from Suppliers

    DEFF Research Database (Denmark)

    Kristjansdottir, Katrin; Shafiee, Sara; Bonev, Martin

    Companies providing customized products are increasingly applying configurators in order to support the sales and design activities. Yet, especially for engineer-to-order (ETO) companies such activities are often divided across different organizations, where throughout the configuration process p...... and maintaining the systems. Furthermore, with the ability of receiving accurate and up-to-date information from suppliers, the quality of the specifications can be improved, which leads to reduced cost of the overall design....

  15. Family physicians improve patient health care quality and outcomes.

    Science.gov (United States)

    Bowman, Marjorie A; Neale, Anne Victoria

    2013-01-01

    This issue exemplifies family physicians' ability to provide great care and to continuously improve. For example, beyond other specialty care, the care provided by family physicians is associated with improved melanoma diagnosis and outcomes and improved preventive services for those with a history of breast cancer. Electronic health records are providing new avenues to both assess outcomes and influence care. However, to truly reward quality care, simplistic and readily measurable items such as laboratory results or assessment of the provision of preventive services must be adjusted for risk. Health insurance influences classic preventive care services more than personal health behaviors. The care provided at federally qualified health centers throughout the nation is highly appreciated by the people they serve and is not plagued by the types of disparities in other settings.

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

    Science.gov (United States)

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

    2016-01-01

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

  17. Compensation for Power Quality Improvement in Electric Arc Furnace with Considering Economic Index

    Directory of Open Access Journals (Sweden)

    Ghazanfar Shahgholian

    2012-03-01

    Full Text Available In recent years, on the one hand with increasing application of nonlinear loads in power systems and no sinusoidal currents that extracted from system, and on the other hand increasing loads sensitive to power quality and destructive effects of nonlinear loads on power quality of power systems, compensation these loads has been converted to one of the main issues in power systems. The use of flexible AC transmission system (FACTS devices is one of the most progressive methods which are used for improving power quality. In this paper, series and parallel compensators of static synchronous compensator (STATCOM and dynamic voltage restorer (DVR are introduced and the comparison of these two in compensating of power quality phenomena from electric arc furnace is provided. STATCOM is a shunt active filter and DVR is a series active filter. Method which has been selected for control of every one of these devices is an optimal control way that it minimizes power losses.

  18. Effectiveness of a quality improvement curriculum for medical students

    Directory of Open Access Journals (Sweden)

    Kimberly M. Tartaglia

    2015-05-01

    Full Text Available Introduction: As health systems find ways to improve quality of care, medical training programs are finding opportunities to prepare learners on principles of quality improvement (QI. The impact of QI curricula for medical students as measured by student learning is not well delineated. The aim of this study is to evaluate the effectiveness of a QI curriculum for senior medical students as measured by student knowledge and skills. Methods: This study was an observational study that involved a self-assessment and post-test Quality Improvement Knowledge Application Tool (QIKAT for intervention and control students. A QI curriculum consisting of online modules, live discussions, independent readings and reflective writing, and participation in a mentored QI project was offered to fourth-year medical students completing an honor's elective (intervention group. Senior medical students who received the standard QI curriculum only were recruited as controls. Results: A total of 22 intervention students and 12 control students completed the self-assessment and QIKAT. At baseline, there was no difference between groups in self-reported prior exposure to QI principles. Students in the intervention group reported more comfort with their skills in QI overall and in 9 of the 12 domains (p<0.05. Additionally, intervention students performed better in each of the three case scenarios (p<0.01. Discussion: A brief QI curriculum for senior medical students results in improved comfort and knowledge with QI principles. The strengths of our curriculum include effective use of classroom time and faculty mentorship with reliance on pre-existing online modules and written resources. Additionally, the curriculum is easily expandable to larger groups of students and transferable to other institutions.

  19. Improving laboratory data entry quality using Six Sigma.

    Science.gov (United States)

    Elbireer, Ali; Le Chasseur, Julie; Jackson, Brooks

    2013-01-01

    The Uganda Makerere University provides clinical laboratory support to over 70 clients in Uganda. With increased volume, manual data entry errors have steadily increased, prompting laboratory managers to employ the Six Sigma method to evaluate and reduce their problems. The purpose of this paper is to describe how laboratory data entry quality was improved by using Six Sigma. The Six Sigma Quality Improvement (QI) project team followed a sequence of steps, starting with defining project goals, measuring data entry errors to assess current performance, analyzing data and determining data-entry error root causes. Finally the team implemented changes and control measures to address the root causes and to maintain improvements. Establishing the Six Sigma project required considerable resources and maintaining the gains requires additional personnel time and dedicated resources. After initiating the Six Sigma project, there was a 60.5 percent reduction in data entry errors from 423 errors a month (i.e. 4.34 Six Sigma) in the first month, down to an average 166 errors/month (i.e. 4.65 Six Sigma) over 12 months. The team estimated the average cost of identifying and fixing a data entry error to be $16.25 per error. Thus, reducing errors by an average of 257 errors per month over one year has saved the laboratory an estimated $50,115 a year. The Six Sigma QI project provides a replicable framework for Ugandan laboratory staff and other resource-limited organizations to promote quality environment. Laboratory staff can deliver excellent care at a lower cost, by applying QI principles. This innovative QI method of reducing data entry errors in medical laboratories may improve the clinical workflow processes and make cost savings across the health care continuum.

  20. Do quality improvement collaboratives’ educational components match the dominant learning style preferences of the participants?

    NARCIS (Netherlands)

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

    2015-01-01

    markdownabstractBackground: Quality improvement collaboratives are used to improve healthcare by various organizations. Despite their popularity literature shows mixed results on their effectiveness. A quality improvement collaborative can be seen as a temporary learning organization in which

  1. Quality improvement in radiography in a neonatal intensive care unit

    Energy Technology Data Exchange (ETDEWEB)

    Loovere, L.; Boyle, E.M. [Dept. of Pediatrics, McMaster Univ., Hamilton, Ontario (Canada); Blatz, S. [Dept. of Pediactrics, McMaster Children' s Hospital, Hamilton Health Sciences, Hamilton, Ontario (Canada); Bowslaugh, M.; Kereliuk, M. [Dept. of Radiology, Diagnostic Imaging, Hamilton Health Sciences, Hamilton, Ontario (Canada); Paes, B. [Dept. of Pediatrics, McMaster Univ., Hamilton, Ontario (Canada)], E-mail: paes@mcmaster.ca

    2008-10-15

    The primary objective of this study was to ensure that X-rays performed consistently adhere to established technological quality standards and are achieved without compromising patient care while minimizing exposure risks. The secondary objective was to evaluate whether educational sessions targeting areas deemed suboptimal would facilitate improvement. A retrospective, 1-week review of all neonatal X-rays and documentation of clinical information on X-ray requisitions (n = 132) was completed in a tertiary care neonatal intensive care unit (NICU), by a single observer. Standards for X-ray evaluation were defined a priori based on radiographic principles and essential documented medical information for correct interpretation. Targeted areas for improvement were identified and addressed through brief educational sessions and printed pamphlets. The review was repeated after recommendations were implemented. 1 month (n = 93) and 1 year (n = 76) later. Improvements were evident in both the completion of X-ray requisitions and image quality. In particular, there was a statistically significant improvement in requisition legibility (P = 0.019), completeness of the medical history (P < 0.001), reduction in X-ray rotation (P < 0.001), collimation to the specific area of interest (P <0.001), gonadal shielding (P < 0.001), and decrease in monitor leads or artifacts obscuring views (P < 0.001). These improvements were sustained both 1 month and 1 year following the educational sessions. A neonatal X-ray audit is a simple, effective way to evaluate radiographic technique and encourage provision of basic clinical information for diagnostic interpretation by radiologists and neonatologists. As well, structured, collaborative educational sessions between radiology and neonatology staff appear to be a successful and sustainable method to effect overall improvement. (author)

  2. Improving urban air quality in China: Beijing case study.

    Science.gov (United States)

    Hao, Jiming; Wang, Litao

    2005-09-01

    China is undergoing rapid urbanization because of unprecedented economic growth. As a result, many cities suffer from air pollution. Two-thirds of China's cities have not attained the ambient air quality standards applicable to urban residential areas (Grade II). Particulate matter (PM), rather than sulfur dioxide (SO2), is the major pollutant reflecting the shift from coal burning to mixed source pollution. In 2002, 63.2 and 22.4% of the monitored cities have PM and SO2 concentrations exceeding the Grade II standard, respectively. Nitrogen oxides (NOx) concentration kept a relatively stable level near the Grade II standard in the last decade and had an increasing potential in recent years because of the rapid motorization. In general, the air pollutants emission did not increase as quickly as the economic growth and energy consumption, and air quality in Chinese cities has improved to some extent. Beijing, a typical representative of rapidly developing cities, is an example to illustrate the possible options for urban air pollution control. Beijing's case provides hope that the challenges associated with improving air quality can be met during a period of explosive development and motorization.

  3. Improving urban air quality in China: Beijing case study

    Energy Technology Data Exchange (ETDEWEB)

    Jiming Hao; Litao Wang [Tsinghua University, Beijing (China). Department of Environmental Science and Engineering

    2005-09-01

    China is undergoing rapid urbanization because of unprecedented economic growth. As a result, many cities suffer from air pollution. Two-thirds of China's cities have not attained the ambient air quality standards applicable to urban residential areas (Grade II). Particulate matter (PM), rather than sulfur dioxide (SO{sub 2}), is the major pollutant reflecting the shift from coal burning to mixed source pollution. In 2002, 63.2 and 22.4% of the monitored cities have PM and SO{sub 2} concentrations exceeding the Grade II standard, respectively. Nitrogen oxides (NOx) concentration kept a relatively stable level near the Grade II standard in the last decade and had an increasing potential in recent years because of the rapid motorization. In general, the air pollutants emission did not increase as quickly as the economic growth and energy consumption, and air quality in Chinese cities has improved to some extent. Beijing, a typical representative of rapidly developing cities, is an example to illustrate the possible options for urban air pollution control. Beijing's case provides hope that the challenges associated with improving air quality can be met during a period of explosive development and motorization. 21 refs., 19 figs., 6 tabs.

  4. Geocoding coronial data: tools and techniques to improve data quality.

    Science.gov (United States)

    Freestone, Darren; Williamson, Dianne; Wollersheim, Dennis

    2012-01-01

    Clinical, administrative and demographic health information is fundamental to understanding the nature of health and evaluating the effectiveness of efforts to reduce morbidity and mortality of the population. The demographic data item 'location' is an integral part of any injury surveillance tool or injury prevention strategy. The true value of location data can only be realised once these data have been appropriately classified and quality assured. Geocoding as a means of classifying location is increasingly used in various health fields to enable spatial analysis of data. This article reports on research carried out in Australia at the National Coroners Information System (NCIS). Trends in the use of NCIS location-based data by researchers were identified. The research also aimed to establish the factors that impacted on the quality of geocoded data and the extent of this impact. A systematic analysis of the geocoding process identified source documentation, data cleaning, and software settings as key factors impacting on data quality. Understanding and application of these processes can improve data quality and therefore inform the analysis and interpretation of these data by researchers.

  5. Improving Service Quality by Using Organizational Citizenship Behavior: Iranian Evidence

    Directory of Open Access Journals (Sweden)

    Nour-Mohammad Yaghoubi

    2011-09-01

    Full Text Available Nowadays, with increasing service industries, service marketing and service quality have become an important challenge to organizations. The attempts of organizations in this situation are witnesses to this matter. In the past years, the organizations tried to reach service quality appropriation and satisfaction of self-external customers by concepts and approaches of external marketing. One of the important features of service is the direct interaction with customers and having customer-oriented behaviors. Furthermore, with introducing the internal marketing and the important roles of it, an internal customer of organizations, on achievement of organizational plans, was noted to internal marketing more and more than before. So, the study researchers are going to argue about internal marketing and the effect of it on organizational citizenship behaviors and service quality and the important role of it on development and improvement of service quality by using organizational citizenship behaviors. For this purpose, first the researchers have studied internal marketing and its important components and then have done the same to the other items and finally have applied a quantitative study on all of them. It should be mentioned that the researchers have employed SPSS 17.0 and Lisrel 8.54 for data analysis. The findings of the present study illustrated that there is an appropriate interaction among all the items, which has been studied here and the structural equations for the conceptual framework of this study are goodness of fit.

  6. Overarching goals: a strategy for improving healthcare quality and safety?

    Science.gov (United States)

    Nanji, Karen C; Ferris, Timothy G; Torchiana, David F; Meyer, Gregg S

    2013-03-01

    The management literature reveals that many successful organisations have strategic plans that include a bold 'stretch-goal' to stimulate progress over a ten-to-thirty-year period. A stretch goal is clear, compelling and easily understood. It serves as a unifying focal point for organisational efforts. The ambitiousness of such goals has been emphasised with the phrase Big Hairy Audacious Goal ('BHAG'). President Kennedy's proclamation in 1961 that 'this Nation should commit itself to achieving the goal, before this decade is out, of landing a man on the moon and returning him safely to earth' provides a famous example. This goal energised the US National Aeronautics and Space Administration, and it captured the attention of the American public and resulted in one of the largest accomplishments of any organisation. The goal set by Sony, a small, cash-strapped electronics company in the 1950s, to change the poor image of Japanese products around the world represents a classic BHAG. Few examples of quality goals that conform to the BHAG definition exist in the healthcare literature. However, the concept may provide a useful framework for organisations seeking to transform the quality of care they deliver. This review examines the merits and cautions of setting overarching quality goals to catalyse quality improvement efforts, and assists healthcare organisations with determining whether to adopt these goals.

  7. Applying total quality management techniques to improve software development.

    Science.gov (United States)

    Mezher, T; Assem Abdul Malak, M; el-Medawar, H

    1998-01-01

    Total Quality Management (TQM) is a new management philosophy and a set of guiding principles that represent the basis of a continuously improving organization. This paper sheds light on the application of TQM concepts for software development. A fieldwork study was conducted on a Lebanese software development firm and its customers to determine the major problems affecting the organization's operation and to assess the level of adoption of TQM concepts. Detailed questionnaires were prepared and handed out to the firm's managers, programmers, and customers. The results of the study indicate many deficiencies in applying TQM concepts, especially in the areas of planning, defining customer requirements, teamwork, relationship with suppliers, and adopting standards and performance measures. One of the major consequences of these deficiencies is considerably increased programming errors and delays in delivery. Recommendations on achieving quality are discussed.

  8. QUALITY IMPROVEMENT IN MULTIRESPONSE EXPERIMENTS THROUGH ROBUST DESIGN METHODOLOGY

    Directory of Open Access Journals (Sweden)

    M. Shilpa

    2012-06-01

    Full Text Available Robust design methodology aims at reducing the variability in the product performance in the presence of noise factors. Experiments involving simultaneous optimization of more than one quality characteristic are known as multiresponse experiments which are used in the development and improvement of industrial processes and products. In this paper, robust design methodology is applied to optimize the process parameters during a particular operation of rotary driving shaft manufacturing process. The three important quality characteristics of the shaft considered here are of type Nominal-the-best, Smaller-the-better and Fraction defective. Simultaneous optimization of these responses is carried out by identifying the control parameters and conducting the experimentation using L9 orthogonal array.

  9. Organizational culture, continuous quality improvement, and medication administration error reporting.

    Science.gov (United States)

    Wakefield, B J; Blegen, M A; Uden-Holman, T; Vaughn, T; Chrischilles, E; Wakefield, D S

    2001-01-01

    This study explores the relationships among measures of nurses' perceptions of organizational culture, continuous quality improvement (CQI) implementation, and medication administration error (MAE) reporting. Hospital-based nurses were surveyed using measures of organizational culture and CQI implementation. These data were combined with previously collected data on perceptions of MAE reporting. A group-oriented culture had a significant positive correlation with CQI implementation, whereas hierarchical and rational culture types were negatively correlated with CQI implementation. Higher barriers to reporting MAE were associated with lower perceived reporting rates. A group-oriented culture and a greater extent of CQI implementation were positively (but not significantly) associated with the estimated overall percentage of MAEs reported. We conclude that health care organizations have implemented CQI programs, yet barriers remain relative to MAE reporting. There is a need to assess the reliability, validity, and completeness of key quality assessment and risk management data.

  10. Capability studies, helpful tools in process quality improvement

    Directory of Open Access Journals (Sweden)

    Simion Carmen

    2017-01-01

    Full Text Available Ability of processes to meet customer’quality requirements has become essential for providing competitive advantages such as cost savings, reducing the number of nonconfoming products or increasing customer satisfaction. This paper aims to conduct a capability study for a swaging process (that ensures an assembly dimension of a key product characteristic (the outer diameter of a new part, related to the concept of capability and performance indices and how these metrics can be used and interpreted to become powerful tools for decision making. To achieve the goal of the paper, the following key aspects were analyzed: capability of the measurement system capability (gage R&R, production equipment (machine capability and process capability/performance during the first serial production. The analysis was performed with Minitab® 17, the most commonly used software for quality improvement.

  11. Improving the Quality of Published Chemical Names with Nomenclature Software

    Directory of Open Access Journals (Sweden)

    Gernot A. Eller

    2006-11-01

    Full Text Available This work deals with the use of organic systematic nomenclature in scientific literature, its quality, and computerized methods for its improvement. Criteria for classification of systematic names in terms of quality/correctness are discussed and applied to a sample set of several hundred names extracted from the literature. The same structures are named with three popular state-of-the-art nomenclature programs – AutoNom 2000, ChemDraw 10.0, and ACD/Name 9.0. When comparing the results, all nomenclature tools show a significantly better performance than 'average chemists'. One program allows the generation not only of IUPAC names but also of CAS-like index names that are compared with the officially registered names. The scope and limitations of nomenclature software are discussed and a comparison of the programs' actual capabilities is given.

  12. Improving Quality of Life and Depression After Stroke Through Telerehabilitation

    Science.gov (United States)

    Linder, Susan M.; Rosenfeldt, Anson B.; Bay, R. Curtis; Sahu, Komal; Wolf, Steven L.

    2015-01-01

    OBJECTIVE. The aim of this study was to determine the effects of home-based robot-assisted rehabilitation coupled with a home exercise program compared with a home exercise program alone on depression and quality of life in people after stroke. METHOD. A multisite randomized controlled clinical trial was completed with 99 people stroke who had limited access to formal therapy. Participants were randomized into one of two groups, (1) a home exercise program or (2) a robot-assisted therapy + home exercise program, and participated in an 8-wk home intervention. RESULTS. We observed statistically significant changes in all but one domain on the Stroke Impact Scale and the Center for Epidemiologic Studies Depression Scale for both groups. CONCLUSION. A robot-assisted intervention coupled with a home exercise program and a home exercise program alone administered using a telerehabilitation model may be valuable approaches to improving quality of life and depression in people after stroke. PMID:26122686

  13. Quality improvement in nursing: administrative mandate or professional responsibility?

    Science.gov (United States)

    Izumi, Shigeko

    2012-01-01

    For professionals, providing quality service and striving for excellence are ethical responsibilities. In many hospitals in the United States, however, there is evidence indicating that current quality improvement (QI) involving nurses is not always driven by their professional accountability and professional values. QI has become more an administrative mandate than an ethical standard for nurses. In this paper, the tension between QI as nurses' professional ethics and an administrative mandate will be described, and the implicit ideal-reality gap of QI will be examined. The threat to professional nursing posed by the current approach to QI will be examined, and ways to incorporate nursing professional values in a practical QI effort will be explored. © 2012 Wiley Periodicals, Inc.

  14. BIOCHAR TO IMPROVE THE QUALITY AND PRODUCTIVITY OF SOILS

    Directory of Open Access Journals (Sweden)

    Mariola Ścisłowska

    2015-06-01

    Full Text Available The paper presents the results of research focused on the investigations of the possibilities to use biochar to improve the quality and productivity of soils. Biochar is a material similar to the commonly known charcoal obtained from the thermolysis process (a process similar to dry distillation of wood. The structure and technical properties of biochar depend on the type of biomass which is produced and the thermal decomposition process conditions: process time, temperature and atmosphere. It was found that a positive effect of biochar on the soil properties is manifested through the improvement of soil fertility, better water retention, improvement of the cation exchange, and the regulation of the pH. The biochar used in the present study was obtained by autothermal thermolysis of biomass at 300 °C. Three types of biochars of different origin were used. The biochar samples were subjected to ultimate and proximate analysis, as well as structural and porosimetric investigations. The experimental research were also conducted on the experimental test field and gave a positive effect of the presence of biochar on soil quality and plant yield. Biochar introduced into soil allows for long-term storage of carbon. The introduction of biochar to soil has a positive effect on plant growth, higher dose resulted in an increase in biochar and plant mass.

  15. Issues of therapeutic communication relevant for improving quality of care.

    Science.gov (United States)

    Popa-Velea, O; Purcărea, V L

    2014-01-01

    Communication issues are extensively considered a topic of high interest for improving the efficacy of the therapeutic act. This article aimed to overview several issues of therapeutic communication relevant for improving quality of care. A number of 15 bibliographic resources on these topics published in peer-reviewed journals between 1975 and 2010, and indexed in PubMed, ProQuest and EBSCO databases were examined, to seek for evidence regarding these data. Results highlight a number of communication problems commonly reported in the literature, such as the lack of physician communicational skills or their deterioration, the persistence of an asymmetric therapeutic communicational model, communication obstacles brought by the disease itself or by several variables pertaining to the patient, including specific demographic and psychological contexts. Equally, literature reports ways of improving therapeutic communication, such as optimizing the clinical interview, better time management techniques or assertiveness. Integration of communication training in the bio-psycho-social model of care and monitoring parameters like adherence and quality of life as tools reflecting also a good therapeutic communication can be valuable future approaches of obtaining better results in this area.

  16. The Importance of Employment Contract for Umsida Quality Employees Improvement

    Directory of Open Access Journals (Sweden)

    Noor Fatimah Mediawati

    2015-12-01

    Full Text Available The absence of employment contracts in UMSIDA recognized cause some problems. Especially in improving the performance of employees. Issues a little more disturbing harmonious labor relations between employees and UMSIDA. In the terminology of the Labour Act, employment contract terms it is known as the Employment Agreement. Where the existence of labor agreement / contract employment is expected to harmonize the working relationship with the employer in accordance with the applicable rules. The existence of employment contracts is also a legal instrument which according to researchers ought to be put forward in efforts to increase the qualifications and competence of employees. By contract it will also avoid things that are not desirable in an employment relationship, because each party will always carry out their rights and responsibilities are aligned and balanced. Tranquility in the work and the guarantee of legal protection are expected to improve employee performance especially towards quality UMSIDA 2020. So this study explored further the urgency employment contract once its design. How To Cite: Mediawati, N., & Phahlevy, R. (2015. The Importance of Employment Contract for Umsida Quality Employees Improvement. Rechtsidee, 2(2, 141-156. doi:http://dx.doi.org/10.21070/jihr.v2i2.106

  17. Nursing Leader Collaboration to Drive Quality Improvement and Implementation Science.

    Science.gov (United States)

    Ryan, Rosemary W; Harris, Karen K; Mattox, Lisa; Singh, Olivine; Camp, Melanie; Shirey, Maria R

    2015-01-01

    Nursing leadership opportunities to improve quality and align resources in health care exist. An estimated 18% of United States gross domestic product is spent on health care delivery systems that produce poor outcomes. The purpose of this article was to describe how quality improvement and implementation science initiatives enhance outcomes using nursing leadership strategies that play an integral role in aligning key colleagues to drive the collaborative process. A critical appraisal of the literature was conducted, which supports the importance of evidenced-based practice improvement, collaborative change process, and professional role of nursing leadership. Limited evidence exists related to practice strategies for nursing leaders to implement sustainable change at the unit level for successful alignment of resources. Strategies based on Rogers' Diffusion of Innovation Theory are recommended to address the gap in the literature. The strategies aim to increase meaningful knowledge or the "why," create a tipping point, and implement sustainable change starting with the end in mind. Nurse leaders are a central component for driving alignment and implementing change at the unit level. Uses of the described evidenced-based strategies have implications for nursing practice, education, and scholarship.

  18. Clinical performance feedback and quality improvement opportunities for perioperative physicians

    Directory of Open Access Journals (Sweden)

    Kaye AD

    2014-05-01

    Full Text Available Alan David Kaye,1 Olutoyin J Okanlawon,2 Richard D Urman21Department of Anesthesiology, Louisiana State University School of Medicine, New Orleans, LA, 2Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston MA, USAAbstract: Clinical performance feedback is an important component of the ongoing development and education of health care practitioners. For physicians, feedback about their clinical practice and outcomes is central to developing both confidence and competence at all stages of their medical careers. Cultural and financial infrastructures need to be in place, and the concept of feedback needs to be readily embraced and encouraged by clinical leadership and other stakeholders. The "buy-in" includes the expectation and view that feedback occurs on a routine basis, and those engaged in the process are both encouraged to participate and held accountable. Feedback must be part of an overarching quality improvement and physician education agenda; it is not meant to be an isolated, fragmented initiative that is typically undermined by lack of resources or systemic barriers to gaining improvement within programs. Effective feedback should be an integral part of clinical practice. Anesthesiologists and other perioperative physicians are identifying specialty-specific indicators that can be used when creating a broader quality improvement agenda. Placing a more immediate formal feedback strategy that focuses on goal-oriented behavior is rapidly becoming a mainstay. Physicians may use their individual feedback reports for reflection and designing personal development plans as lifelong learners and leaders in improving patient care.Keywords: physician education, outcomes measurement, performance improvement, anesthesiology

  19. A Count for Quality: Child Care Center Directors on Rating and Improvement Systems

    Science.gov (United States)

    Schulman, Karen; Matthews, Hannah; Blank, Helen; Ewen, Danielle

    2012-01-01

    Quality Rating and Improvement Systems (QRIS)--a strategy to improve families' access to high-quality child care--assess the quality of child care programs, offer incentives and assistance to programs to improve their ratings, and give information to parents about the quality of child care. These systems are operating in a growing number of…

  20. 42 CFR 460.132 - Quality assessment and performance improvement plan.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Quality assessment and performance improvement plan...-INCLUSIVE CARE FOR THE ELDERLY (PACE) Quality Assessment and Performance Improvement § 460.132 Quality assessment and performance improvement plan. (a) Basic rule. A PACE organization must have a written quality...

  1. Partnering health disparities research with quality improvement science in pediatrics.

    Science.gov (United States)

    Lion, K Casey; Raphael, Jean L

    2015-02-01

    Disparities in pediatric health care quality are well described in the literature, yet practical approaches to decreasing them remain elusive. Quality improvement (QI) approaches are appealing for addressing disparities because they offer a set of strategies by which to target modifiable aspects of care delivery and a method for tailoring or changing an intervention over time based on data monitoring. However, few examples in the literature exist of QI interventions successfully decreasing disparities, particularly in pediatrics, due to well-described challenges in developing, implementing, and studying QI with vulnerable populations or in underresourced settings. In addition, QI interventions aimed at improving quality overall may not improve disparities, and in some cases, may worsen them if there is greater uptake or effectiveness of the intervention among the population with better outcomes at baseline. In this article, the authors review some of the challenges faced by researchers and frontline clinicians seeking to use QI to address health disparities and propose an agenda for moving the field forward. Specifically, they propose that those designing and implementing disparities-focused QI interventions reconsider comparator groups, use more rigorous evaluation methods, carefully consider the evidence for particular interventions and the context in which they were developed, directly engage the social determinants of health, and leverage community resources to build collaborative networks and engage community members. Ultimately, new partnerships between communities, providers serving vulnerable populations, and QI researchers will be required for QI interventions to achieve their potential related to health care disparity reduction. Copyright © 2015 by the American Academy of Pediatrics.

  2. Cross-cutting activities: Soil quality and soil metagenomics

    OpenAIRE

    Peter P. Motavalli; Garrett, Karen A.

    2008-01-01

    This presentation reports on the work of the SANREM CRSP cross-cutting activities "Assessing and Managing Soil Quality for Sustainable Agricultural Systems" and "Soil Metagenomics to Construct Indicators of Soil Degradation." The introduction gives an overview of the extensiveness of soil degradation globally and defines soil quality. The objectives of the soil quality cross cutting activity are: CCRA-4 (Soil Metagenomics)

  3. Lead/acid batteries in systems to improve power quality

    Science.gov (United States)

    Taylor, P.; Butler, P.; Nerbun, W.

    Increasing dependence on computer technology is driving needs for extremely high-quality power to prevent loss of information, material, and workers' time that represent billions of dollars annually. This cost has motivated commercial and Federal research and development of energy storage systems that detect and respond to power-quality failures in milliseconds. Electrochemical batteries are among the storage media under investigation for these systems. Battery energy storage systems that employ either flooded lead/acid or valve-regulated lead/acid battery technologies are becoming commercially available to capture a share of this emerging market. Cooperative research and development between the US Department of Energy and private industry have led to installations of lead/acid-based battery energy storage systems to improve power quality at utility and industrial sites and commercial development of fully integrated, modular battery energy storage system products for power quality. One such system by AC Battery Corporation, called the PQ2000, is installed at a test site at Pacific Gas and Electric Company (San Ramon, CA, USA) and at a customer site at Oglethorpe Power Corporation (Tucker, GA, USA). The PQ2000 employs off-the-shelf power electronics in an integrated methodology to control the factors that affect the performance and service life of production-model, low-maintenance, flooded lead/acid batteries. This system, and other members of this first generation of lead/acid-based energy storage systems, will need to compete vigorously for a share of an expanding, yet very aggressive, power quality market.

  4. Sleep Quality Improves During Treatment With Bryophyllum pinnatum

    Science.gov (United States)

    Hassani, Taziri Al; Müller-Hübenthal, Boris; Pittl, Sandra; Kuck, Angela; Meden, Harald; Eberhard, Jutta; Decker, Michael; Fürer, Karin; von Mandach, Ursula

    2015-01-01

    Hypothesis. Cancer patients frequently suffer from poor sleep quality. Bryophyllum pinnatum is a herbal medication used in anthroposophic medicine, which has been shown to be associated with improvements in sleep quality during pregnancy with only few and minor or moderate side-effects reported. In this study, the sleep quality of cancer patients during treatment with B pinnatum was investigated. Study Design. In this prospective, observational study, cancer patients suffering from sleep problems were treated with B pinnatum (350 mg tablets, corresponding to 50% of leaf pressed juice [Weleda AG, Arlesheim, Switzerland], dosage at physician’s consideration, but most frequently 2 tablets with evening meal and 2 before going to bed). Methods. Sleep quality (Pittsburgh Sleep Quality Index [PSQI]), daily sleepiness (Epworth Sleeping Scale [ESS]), and fatigue (Fatigue Severity Scale [FSS]) were assessed at the beginning of the treatment and after 3 weeks. Possible adverse drug reactions perceived by the patients during the treatment were recorded. From the 28 recruited patients, 20 completed both questionnaires and were considered in the present analysis. Data are expressed as mean ± standard deviation. Results. Patients were 61 ± 10.4 years old and the majority were female (17 out of 20). During treatment with B pinnatum, the PSQI decreased from 12.2 ± 3.62 to 9.1 ± 3.61 (P < .01), and ESS changed from 8.4 ± 3.18 to 7.1 ± 3.98 (P < .05). There was no change in FSS. The treatment was well tolerated by the majority of patients, with only 6 patients reporting discomfort that might have been caused by B pinnatum (fatigue n = 3, dry throat n = 1, agitation n = 1, difficult digestion n = 1). No serious adverse drug reactions were detected. Conclusion. B pinnatum may be a suitable treatment for sleep problems of cancer patients. Controlled, randomized clinical trials of the use of B pinnatum in sleep disorders are urgently needed. PMID:25873294

  5. Physical activity and quality of life: assessing the influence of activity frequency, intensity, volume, and motives.

    Science.gov (United States)

    Lustyk, M Kathleen B; Widman, Laura; Paschane, Amy A E; Olson, Karen C

    2004-01-01

    In the present study, the authors investigated the impact of exercise frequency, intensity, and volume along with exercise motives on quality of life (QOL) reports. The authors assessed exercise habits with the Godin Leisure Time Activity Scale and measured exercise motives with the Reasons for Exercise Inventory. The Quality of Life Inventory assessed satisfaction in 16 domains including health, work, and recreation. High-frequency exercisers reported significantly higher health, helping, and community-related QOL than those who exercised less frequently. The authors noted significantly higher health-related QOL in the heavy volume group compared with the other volume groups. Multiple regression tests revealed that activity intensity and exercise motives significantly predicted QOL reports. The strongest bivariate correlations with QOL existed for mild activity and exercising for fitness and health reasons. Thus, high-frequency activity of mild intensity that produces high kcal utilization and is performed to improve health and fitness has the strongest influence on QOL reports.

  6. Making quality improvement stick and stay: Two lines of insurance.

    Science.gov (United States)

    Weaver, Lynda; Bossé, Isabelle; Sinclair, Dionne; Blais, Bernard; Pereira, José

    2016-01-01

    This article examines issues related to sustaining Quality Improvement (QI) initiatives in a Canadian subacute care hospital and recommends strategies to address them. The authors define two levels of sustainability, the QI project and the corporate/organizational and how they influence a LEADS (Lead Self, Engage Others, Achieve Results, Develop Coalition and System Transformation) culture. The authors then reflect on the differing factors for QI sustainability and present them under five essential categories of accountability, education, communication, monitoring and reporting, and structure and processes.

  7. Evidence-based quality improvement: the state of the science.

    Science.gov (United States)

    Shojania, Kaveh G; Grimshaw, Jeremy M

    2005-01-01

    Routine practice fails to incorporate research evidence in a timely and reliable fashion. Many quality improvement (QI) efforts aim to close these gaps between clinical research and practice. However, in sharp contrast to the paradigm of evidence-based medicine, these efforts often proceed on the basis of intuition and anecdotal accounts of successful strategies for changing provider behavior or achieving organizational change. We review problems with current approaches to QI research and outline the steps required to make QI efforts based as much on evidence as the practices they seek to implement.

  8. Perinatal information systems for quality improvement: visions for today.

    Science.gov (United States)

    Slagle, T A

    1999-01-01

    Today clinical information is used for a multitude of purposes beyond patient care documentation including quality review and improvement processes, allocation of resources, budgetary and long-term planning, productivity measurement, and justification to payers for services provided. Providers in perinatal medicine are faced with the challenge of finding methods to meet these information needs. Case examples of the different approaches to collecting and using obstetric and neonatal information are described. The role of computer-based patient records is outlined and solutions available to perinatal medicine are reviewed.

  9. The Quality Improvement of Stony Construction and Demolition Waste (CDW)

    Institute of Scientific and Technical Information of China (English)

    XING Wei-hong; Alex Fraaij; Hans Pietersen; Peter Rem; Koen Van Dijk

    2004-01-01

    Worldwide construction and demolition waste (CDW) is currently dumped. To close the building cycle and the building materials cycle by recycling CDW in high technical applications, the technical quality of stony materials must be improved. For this purpose, concrete rubbles and brick rubbles, the two major stony constituents of CDW, should be separated from each other. Based on the differences in density and content of Fe2O3 between the two materials, a wet method of jigging and a dry method of magnetic separation are effective,tested.

  10. Learning leadership skills in practice through quality improvement.

    Science.gov (United States)

    Gamble, James; Vaux, Emma

    2014-02-01

    The development of leadership skills in doctors in training is essential to support both their professional development and the future supply of clinical leaders the NHS so desperately needs. There is, however, limited opportunity in current training programmes for trainees to learn and develop these skills, and what opportunity there is has often focused on management rather than leadership skills. Involvement in trainee-led supported quality improvement projects can teach these skills. We summarise the current limitations in leadership training and discuss how the College's 'Learning To Make a Difference' programme, and others like it, are helping to teach leadership.

  11. Temperature Field for Improving Internal Quality of Stretched Round Billet

    Institute of Scientific and Technical Information of China (English)

    QIU Ping; XIAO Hong

    2009-01-01

    Based on the rigid-plastic theory, using a coupled thermomechanieal model, the stretching process of a cir-cular section billet is simulated by means of FEM software Deform-2D. Through the distribution of internal stress fields of stretched round billet, it is found that the shear stress field is the main factor to induce Mannesmann's effect. The simulation results show that a reasonable distribution of the temperature field may improve the internal quality of the circular section billet in the stretching process.

  12. Reliably Addressing "What Matters" Through a Quality Improvement Process.

    Science.gov (United States)

    Rutherford, Patricia A

    2016-02-01

    Oncology nurses have a critical role in mitigating the intense vulnerability, loss of control, and fear of the unknown that characterizes the experiences of patients with cancer and their family members. Reliably inquiring about the issues that are at the forefront for patients and their loved ones can encourage a deeper dialogue-where nurses can understand and address the issues that are most important to them. A practical quality improvement approach can help to ensure that processes are in place to assist nurses in devoting time to reliably inquire about "what matters" to each patient at every encounter.

  13. Performance improvements in longwall mining using a total quality approach

    Energy Technology Data Exchange (ETDEWEB)

    Singh, R.N.; Porter, I.; Vatovec, W.R. [University of Wollongong, Wollongong, NSW (Australia). Dept. of Civil Mining and Environmental Engineering

    1998-06-01

    The paper briefly describes the production and productivity trends in coal mining in Australia. It is considered that the greatest impediment in achieving full potential from a mechanised longwall face in Australia is the lack of reliability of face equipment and inadequate gate roadways development rates resulting in discontinuity of longwall operations. In the quest for increasing roadway development rates, a new generation of development machinery are being increasingly used. Experience has shown that the application of high-tech equipment alone is unable to achieve desired development rates. Application of Total Quality Management Principles is necessary to improve the organisational behaviour of the mine and therefore, the development rates.

  14. A New Model for Software Engineering Systems Quality Improvement

    Directory of Open Access Journals (Sweden)

    Ahmad A. Al-Rababah

    2014-04-01

    Full Text Available In the continuing effort to improve the system analysis and design process, several different approaches have been developed. This study will propose a new process methodology solves some problems in traditional system development methodologies it will study the strength and limitation of existing system development methodologies from traditional waterfall to iterative model including (Prototyping, Spiral, Rapid Application Development, XP and RUP to Agility. Propose a new methodology focus on produce a high quality product and suitable for all kind of project. Compare the new methodology with others to view some features that is differentiating it from previous methodologies.

  15. Quality improvement in small office settings: an examination of successful practices

    Directory of Open Access Journals (Sweden)

    Sofaer Shoshanna

    2009-02-01

    Full Text Available Abstract Background Physicians in small to moderate primary care practices in the United States (U.S. ( Methods We undertook a qualitative study, based on semi-structured, open-ended interviews conducted with practices (N = 39 that used performance data to drive quality improvement activities. Results Physicians indicated that benefits to performing measurement and QI included greater practice efficiency, patient and staff retention, and higher staff and clinician satisfaction with practice. Internal facilitators included the designation of a practice champion, cooperation of other physicians and staff, and the involvement of practice leaders. Time constraints, cost of activities, problems with information management and or technology, lack of motivated staff, and a lack of financial incentives were commonly reported as barriers. Conclusion These findings shed light on how physicians engage in quality improvement activities, and may help raise awareness of and aid in the implementation of future initiatives in small practices more generally.

  16. Air Quality in Mexico City: Policies Implemented for its Improvement

    Science.gov (United States)

    Paramo, V.

    2007-12-01

    Ozone and suspended particles (PM) are two pollutants in the atmosphere of Mexico City Metropolitan Area (MCMA) that still exceed the recommended Mexican health standards. The other criteria pollutants very seldom exceed their corresponding standards. In 2006, the maximum ozone concentrations were above the health standard (0.11 ppm in 1 hour) during 59 percent of the days for an average of 2.2 hours and 130 points of the Air Quality Index (Índice Metropolitano de la Calidad del Aire - IMECA). In contrast, in 1991, 98 percent of the days exceeded the ozone health standard for an average of 6.6 hours and 200 IMECA points. With regards to PM10, in 2006, 80 percent of the sampled concentrations were below the health standard of 120 µg/m3 in 24 hours. However, the annual health standard of 50 µg/m3 is still exceeded. The air quality management in the MCMA is a difficult task due to several adverse factors. The main one is the large population that increased from nearly 15 million in 1992 to more than 18 million at present. As a result, the urban area grows in the adjoined municipalities of the State of Mexico. The vehicular fleet increases also to almost 4 million and the number of industrial facilities is at present 50,000. Consequently, the fuel consumption is very high. The daily energy consumption is estimated to be 44 million liters of equivalent of gasoline. Despite the fact that the air quality has improved in recent years, the related health standards are still exceeded and therefore it is necessary to continue applying the most cost-effective actions to improve the environment quality. Some actions that have contributed most to the reduction of pollutant emissions are the following: Continuous update of the inspection and maintenance program of the vehicular fleet; substitution of the catalytic converters at the end of their useful life; self-regulation of the diesel fleet; use of alternative fuels; update the No-Driving-Day program; establishment of more

  17. Enhanced imaging of DNA via active quality factor control

    Science.gov (United States)

    Humphris, A. D. L.; Round, A. N.; Miles, M. J.

    2001-10-01

    Adsorption processes at single molecule level are of fundamental importance for the understanding and development of biomaterials. Atomic force microscopy (AFM) has played a critical role in this field due to its high resolution and ability to image in a liquid environment. We present a method that improves the dynamic force sensitivity and the resolution of a conventional AFM. This is achieved via a positive feedback loop that enhances the effective quality factor of the cantilever in a liquid environment to values in excess of 300, compared to a nominal value of ˜1. This active quality factor enhancement has been used to image DNA and an increase in the height of the molecule observed.

  18. Improving health care quality and safety: the role of collective learning

    Directory of Open Access Journals (Sweden)

    Singer SJ

    2015-11-01

    Full Text Available Sara J Singer,1–4 Justin K Benzer,4–6 Sami U Hamdan4,6 1Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA; 2Department of Medicine, Harvard Medical School, Boston, MA, USA; 3Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, MA, USA; 4Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, MA, USA; 5VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX, USA; 6Department of Health Policy and Management, Boston University School of Public Health, Boston, MA, USA Abstract: Despite decades of effort to improve quality and safety in health care, this goal feels increasingly elusive. Successful examples of improvement are infrequently replicated. This scoping review synthesizes 76 empirical or conceptual studies (out of 1208 originally screened addressing learning in quality or safety improvement, that were published in selected health care and management journals between January 2000 and December 2014 to deepen understanding of the role that collective learning plays in quality and safety improvement. We categorize learning activities using a theoretical model that shows how leadership and environmental factors support collective learning processes and practices, and in turn team and organizational improvement outcomes. By focusing on quality and safety improvement, our review elaborates the premise of learning theory that leadership, environment, and processes combine to create conditions that promote learning. Specifically, we found that learning for quality and safety improvement includes experimentation (including deliberate experimentation, improvisation, learning from failures, exploration, and exploitation, internal and external knowledge acquisition, performance monitoring and comparison, and training. Supportive learning environments are characterized by team characteristics like psychological

  19. Nonformal Education in Improving Quality of Life of Underprivileged Children

    Directory of Open Access Journals (Sweden)

    Abdullah Al Mamun

    2013-02-01

    Full Text Available This study explores the role of Non-formal Primary Education (NFPE in improving the quality of the life of underprivileged children in Bangladesh considering their economic, health, environmental issues and life skills. It uses a mixed method approach of research where three NGOs which run NFPE programs were selected purposefully. Data were derived from six NGO officers, nine teachers, ninety students and eighteen guardians by using two sets of questionnaires for NGO officers and teachers, an interview schedule for guardians and 9 focus group discussions with the students. The findings show that there is no income generating program initiated by the organizations for the learners along with education. So, the scope of their income has reduced. But their daily life behavior and skills have improved. Besides, their awareness on health and environmental issues have increased. The findings lead to some recommendations which will give insights to policy makers and professionals engaged in this field.

  20. The practical problem of improving quality in multicenter dialysis facilities.

    Science.gov (United States)

    Balter, Paul

    2003-01-01

    Multifacility dialysis groups are frequently interested in improving overall quality and find that there are major differences between individual units. Upper management must consider what strategy is needed for the whole company and what strategy must be formulated by individual facilities. To make substantive changes, management must decide to adopt a new culture of true teamwork, drive out fear, and emphasize leadership and education both at the management level and in the individual unit. Both at the corporate and unit levels, leaders must be chosen who are able to recognize people who have the ability, the educational background, the enthusiasm, and the time to direct change. Empowering the individual units and individual employees to make changes and be enthusiastic about improvement is the key to success.

  1. TOOLS OF QUALITY IMPROVEMENT – MEASURING CUSTOMER SATISFACTION

    OpenAIRE

    Catalina Soriana Sitnikov

    2009-01-01

    Nowadays, quality is often divided into service quality and product quality. The dimensions of quality of service are quite different from the quality of product due to the main difference between services and products (service intangibility and the customer who can use it only once). Customer satisfaction is one of the topics related with the quality due to the main measurement of quality is customer service. The main question about quality service is what the customer expects to get from th...

  2. Helping COPD patients change health behavior in order to improve their quality of life

    Directory of Open Access Journals (Sweden)

    Almagro P

    2013-07-01

    Full Text Available Pere Almagro, Alejandra CastroAcute Geriatric Care Unity, Internal Medicine Department, University Hospital Mútua de Terrassa, Barcelona, SpainAbstract: Chronic obstructive pulmonary disease (COPD is one of the most prevalent and debilitating diseases in adults worldwide and is associated with a deleterious effect on the quality of life of affected patients. Although it remains one of the leading causes of global mortality, the prognosis seems to have improved in recent years. Even so, the number of patients with COPD and multiple comorbidities has risen, hindering their management and highlighting the need for futures changes in the model of care. Together with standard medical treatment and therapy adherence – essential to optimizing disease control – several nonpharmacological therapies have proven useful in the management of these patients, improving their health-related quality of life (HRQoL regardless of lung function parameters. Among these are improved diagnosis and treatment of comorbidities, prevention of COPD exacerbations, and greater attention to physical disability related to hospitalization. Pulmonary rehabilitation reduces symptoms, optimizes functional status, improves activity and daily function, and restores the highest level of independent physical function in these patients, thereby improving HRQoL even more than pharmacological treatment. Greater physical activity is significantly correlated with improvement of dyspnea, HRQoL, and mobility, along with a decrease in the loss of lung function. Nutritional support in malnourished COPD patients improves exercise capacity, while smoking cessation slows disease progression and increases HRQoL. Other treatments such as psychological and behavioral therapies have proven useful in the treatment of depression and anxiety, both of which are frequent in these patients. More recently, telehealthcare has been associated with improved quality of life and a reduction in exacerbations

  3. Improving imaging utilization through practice quality improvement (maintenance of certification part IV): a review of requirements and approach to implementation.

    Science.gov (United States)

    Griffith, Brent; Brown, Manuel L; Jain, Rajan

    2014-04-01

    The purposes of this article are to review the American Board of Radiology requirements for practice quality improvement and to describe our approach to improving imaging utilization while offering a guide to implementing similar projects at other institutions, emphasizing the plan-do-study-act approach. There is increased emphasis on improving quality in health care. Our institution has undertaken a multiphase practice quality improvement project addressing the appropriate utilization of screening cervical spinal CT in an emergency department.

  4. Interrelationship among physical activity, quality of life, clinical and ...

    African Journals Online (AJOL)

    USER

    using the International Physical Activity Questionnaire, and quality of life was assessed using the Diabetes. Quality of Life .... is a generic scale and has a reliability of 0.80 and criterion ... diabetes care behaviours and satisfaction with diabetes.

  5. Improving Quality of Service from TCP/IP Performance Degradation

    Directory of Open Access Journals (Sweden)

    Prof.N..Penchalaiah

    2011-02-01

    Full Text Available TCP is currently the dominate congestion control protocol for the Internet. However, as the Internet evolves into a high-speed wired-cum-wireless hybrid network, performance degradation problems of TCP have appeared, such as underutilizing high-speed links, regarding wireless loss as congestion signal, and unfairness among flows with different RTTs. In order to improve the quality of service for such highspeed hybrid networks, we propose a router-assisted congestion control protocol called Quick Flow Control Protocol (QFCP. The convergence of many traditional services over IPbased infrastructures drastically increases the amount of IP data traffic to be delivered to user clients, thus raising questions about the management of quality of service in such networks. Quality of service will be of primary importance in order to ensure right operation, and to face the occurrence of congestion conditions, due to bandwidth demandingmultimedia services. in this paper, shows that QFCP can significantly shorten flow completion time, fairly allocate bandwidth resource, and be robust to non-congestion related loss. Also we consider a possible scenarios in which multiple multimedia and control streams are conveyed over the same HAN, and study a possible solution for the implementation of an easily manageable QoS framework, that relies on a QoS router based on open source software.

  6. IMPROVING BANK QUALITY DIMENSIONS TO INCREASE CUSTOMER SATISFACTION

    Directory of Open Access Journals (Sweden)

    Lăcrămioara RADOMIR

    2011-01-01

    Full Text Available The purpose of this study is twofold: 1. examine the relationship betweenservice quality dimensions and customer satisfaction with bank territorialunits; 2. establish which quality measure method out of the four considered inthis study should be applied in order to better determine the areas that needfurther improvement and investment. In this respect, we performed PrincipalComponent Regression (PCR and considered direct importance andperformance measures as well. Our results reveal that human resourceshave the greatest impact on customers’ satisfaction with bank territorial unitsand that both “Convenience and Efficiency” and “Bank personnel” are thedimensions that bank management should consider in their efforts to improveand maintain the service quality level. To the best of our knowledge, this isthe first study which tries to emphasize the relationship between servicequality dimensions and Romanian customers’ satisfaction with bank territorialunits. The main limit of the study lies in the fact that data were collectedamong the customers of a single bank. Nevertheless, it provides valuableinformation about the Romanian market and ought to be considered astarting point for further studies.

  7. Improvement of Power Quality Using a Hybrid Interline UPQC

    Directory of Open Access Journals (Sweden)

    M.K.Elango

    2014-05-01

    Full Text Available This paper proposed the reduced rating star connected transformer based interline unified power quality conditioner. This work comprises of unified power quality conditioner connected between the two feeders, star connected transformer and LC filter. This hybrid approach significantly improves the performance of UPQC under unbalance source voltage condition. The UPQC adopted to compensate current and voltage-quality problems of sensitive loads and suppressing the load current harmonics under distorted supply conditions. The series converter control strategy is based on the fuzzy-logic controller. The extensive simulation results have carried out in MATLAB/Simulink environment power system blockset toolboxes. From the results it has shown that hybrid interline UPQC achieves superior capability of mitigating the effects of voltage sag/swell and suppressing the load current harmonics, phase current harmonics and neutral current under distorted supply conditions. To validate the results produced by the proposed method, it is compared with the conventional UPQC method and better results obtained from the hybrid approach.

  8. Continuous improvement of product and service quality by implementing staff development strategy. Case study S.C. Redplast S.R.L

    National Research Council Canada - National Science Library

    Anca Madar

    2016-01-01

    .... These include the organization staff' development strategy. The staff has an important role in achieving product and services quality, but also in improving the quality of all organization's activities...

  9. Evaluation and measurement for improvement in service-level quality improvement initiatives.

    Science.gov (United States)

    Russell, Nicholas C C; Wallace, Louise M; Ketley, Diane

    2011-11-01

    The National Health Service (NHS) in England, as with other health services worldwide, currently faces the need to reduce costs and to improve the quality of patient care. Evidence gathered through effective and appropriate measurement and evaluation, is essential to achieving this. Through interviews with service improvement managers and analysis of comments in a seminar of NHS staff involved in health service improvement, we found a lack of understanding regarding the definition and methodology of both measurement and evaluation, which decreases the likelihood that NHS staff will be competent to commission or provide these skills. In addition, we highlight the importance of managers assessing their organizations' 'readiness' to undergo change before embarking on a quality improvement (QI) initiative, to ensure that the initiative's impact can be adequately judged. We provide definitions of measurement for improvement and of evaluation, and propose a comparative framework from which to gauge an appropriate approach. Examples of two large-scale QI initiatives are also given, along with descriptions of some of their problems and solutions, to illustrate the use of the framework. We recommend that health service managers use the framework to determine the most appropriate approach to evaluation and measurement for improvement for their context, to ensure that their decisions are evidence based.

  10. Systematic infrared image quality improvement using deep learning based techniques

    Science.gov (United States)

    Zhang, Huaizhong; Casaseca-de-la-Higuera, Pablo; Luo, Chunbo; Wang, Qi; Kitchin, Matthew; Parmley, Andrew; Monge-Alvarez, Jesus

    2016-10-01

    Infrared thermography (IRT, or thermal video) uses thermographic cameras to detect and record radiation in the longwavelength infrared range of the electromagnetic spectrum. It allows sensing environments beyond the visual perception limitations, and thus has been widely used in many civilian and military applications. Even though current thermal cameras are able to provide high resolution and bit-depth images, there are significant challenges to be addressed in specific applications such as poor contrast, low target signature resolution, etc. This paper addresses quality improvement in IRT images for object recognition. A systematic approach based on image bias correction and deep learning is proposed to increase target signature resolution and optimise the baseline quality of inputs for object recognition. Our main objective is to maximise the useful information on the object to be detected even when the number of pixels on target is adversely small. The experimental results show that our approach can significantly improve target resolution and thus helps making object recognition more efficient in automatic target detection/recognition systems (ATD/R).

  11. Combating the 'Sick Building Syndrome' by Improving Indoor Air Quality

    Directory of Open Access Journals (Sweden)

    Pongchai Nimcharoenwon

    2012-11-01

    Full Text Available Research indicates that many of symptoms attributed to the Sick Building Syndrome in air-conditioned office buildings are a result of considerably reduced negative ions in the internal atmosphere and that replacing the depleted negative ions can improve indoor air quality. This paper describes a method used to develop a formula (DOF-NIL formula for calculating the amount of negative ions to be added to air-conditioned buildings, to improve air quality. The formula enables estimates to be made based on how negative ions in the air are reduced by three main factors namely, Video Display Terminals (VDT; heating, ventilation and air conditioning (HVAC and Building Contents (BC. Calculations for a typical air-conditioned office, are compared with an Air Ion Counter instrument. The results show that the formula, when applied to a typical air-conditioned office, provides an accurate estimate for design purposes. The typical rate of additional negative-ions (ion-generating for a negative ion condition is found to be approximately 12.0 billion ions/hr for at least 4 hour ion-generating.

  12. Analysis of Power Quality Based on Real Data and Quality Improvement at Campus Distribution System

    Science.gov (United States)

    Kawasaki, Shoji; Matsuki, Junya; Hayashi, Yasuhiro; Ito, Akitoshi

    In recent years, a lot of equipments have been made using the inverter technology from home electric appliances to office automation apparatuses and industrial equipments with the development of power electronics technology. The voltage distortion of a distribution system has increased due to the harmonic currents generated from these apparatuses, and the increase in harmonics continues to be expected. In addition, the distribution system forms the circuit of harmonic distortion expansion by the prevalence of static capacitor without L for power factor improvement. Moreover, the voltage imbalance occurs by diversification of loads or imbalanced connection of single-phase loads. The deterioration of power quality in the distribution system causes various problems such as the overheating of equipments and malfunction of rotating machines. Since the power quality changes according to air temperature and date, it is desirable to measure the voltages and currents continuously for a long time. In this study, the authors focus attention on the distribution system in the University of Fukui campus, and the authors have measured the voltages and currents in the distribution system for a long period with WAMS (Wide Area Measurement System) using NCT (Network Computing Terminal). Based on the obtained data, the authors analyzed the power quality of the campus distribution system from viewpoints of voltage imbalance, current imbalance, voltage THD (Total Harmonic Distortion), and current THD. Furthermore, the improvement effect of power quality of the campus distribution system by exchange of single-phase load connection is described.

  13. Physical activity, disability, and quality of life in older adults.

    Science.gov (United States)

    Motl, Robert W; McAuley, Edward

    2010-05-01

    This article provides an overview of physical activity and its association with function, disability, and quality of life (QOL) outcomes among older adults. The rationale and the associated onset of chronic disease conditions that influence function, disability, and QOL is embedded in the "Graying of America". The literature reviewed in this article yielded 3 general conclusions: (1) there is an alarming rate of physical inactivity among older adults, particularly those aging with a disability; (2) there is strong evidence for the beneficial effects of physical activity on impairment, function, and health-related aspects of QOL among older adults, but there is less conclusive evidence for positive effects of physical activity on disability and global QOL; and (3) there is emerging support for self-efficacy as a mediator of the association between physical activity and disability, and QOL outcomes in older adults. Researchers should consider designing and testing programs that incorporate strategies for enhancing self-efficacy along with the promotion of physical activity as a means of preventing disablement and improving QOL among older adults. Such work will go a long way in identifying practical approaches that can be applied for improving the later years of life and is critical because many Americans will soon be affected by the aging of adults in the United States.

  14. Ripening for improving the quality of inoculated cheese Rhizopus oryzae

    Directory of Open Access Journals (Sweden)

    ARTINI PANGASTUTI

    2010-01-01

    Full Text Available Estikomah SA, Sutarno, Pangastuti A 2010. Ripening for improving the quality of inoculated cheese Rhizopus oryzae. Nusantara Bioscience 2: 1-6. Cheese is dairy product resulted from fermented milk in which the fermentation process can be done by lactic acid bacteria or fungus. Rhizopus oryzae is able to produce lactic acid, protease and lipase. The ripening process changes the taste and texture. The purpose of this study is ripening to improve the quality of inoculated cheese R. oryzae. In this research the ripening was conducted the concentration variation of temperature (5oC, 10oC, 15oC, and time (7 days, 14 days. The procedure of research consisted of two steps, namely un-ripened cheese preparation followed by ripening cheese preparation. Cheese produced in this study analyzed the value of pH, fat content, protein content, amino acid levels and identification of microbe with ANOVA then followed by DMRT at 5% level of significance. Data results were analyzed with the like’s nonparametric statistical test, followed by Fridman Wilcoxon Signed Rank Test (WSRT at 5% level significance. The results showed that the preferred ripened cheese panelist was at a temperature of 15oC for 14 days. Ripening conditions affect pH, fat content, protein content and do not affect the levels of amino acids that formed ripened cheese. The best quality ripened cheese i.e. at a temperature of 15°C for 14 days, had a pH value of 4.40, the highest protein content of 9.78%, and fat content of 35.02%. The results of identified microbe in un-ripened cheese and ripened cheese include Enterococcus hirae (Enterococcus faecalis, Bacillus subtilis, and Aspergillus sp.

  15. Improved statistical method for temperature and salinity quality control

    Science.gov (United States)

    Gourrion, Jérôme; Szekely, Tanguy

    2017-04-01

    Climate research and Ocean monitoring benefit from the continuous development of global in-situ hydrographic networks in the last decades. Apart from the increasing volume of observations available on a large range of temporal and spatial scales, a critical aspect concerns the ability to constantly improve the quality of the datasets. In the context of the Coriolis Dataset for ReAnalysis (CORA) version 4.2, a new quality control method based on a local comparison to historical extreme values ever observed is developed, implemented and validated. Temperature, salinity and potential density validity intervals are directly estimated from minimum and maximum values from an historical reference dataset, rather than from traditional mean and standard deviation estimates. Such an approach avoids strong statistical assumptions on the data distributions such as unimodality, absence of skewness and spatially homogeneous kurtosis. As a new feature, it also allows addressing simultaneously the two main objectives of an automatic quality control strategy, i.e. maximizing the number of good detections while minimizing the number of false alarms. The reference dataset is presently built from the fusion of 1) all ARGO profiles up to late 2015, 2) 3 historical CTD datasets and 3) the Sea Mammals CTD profiles from the MEOP database. All datasets are extensively and manually quality controlled. In this communication, the latest method validation results are also presented. The method has already been implemented in the latest version of the delayed-time CMEMS in-situ dataset and will be deployed soon in the equivalent near-real time products.

  16. Doctor Who? A Quality Improvement Project to Assess and Improve Patients' Knowledge of Their Inpatient Physicians.

    Science.gov (United States)

    Broderick-Forsgren, Kathleen; Hunter, Wynn G; Schulteis, Ryan D; Liu, Wen-Wei; Boggan, Joel C; Sharma, Poonam; Thomas, Steven; Zaas, Aimee; Bae, Jonathan

    2016-05-01

    Background Patient-physician communication is an integral part of high-quality patient care and an expectation of the Clinical Learning Environment Review program. Objective This quality improvement initiative evaluated the impact of an educational audit and feedback intervention on the frequency of use of 2 tools-business cards and white boards-to improve provider identification. Methods This before-after study utilized patient surveys to determine the ability of those patients to name and recognize their physicians. The before phase began in July 2013. From September 2013 to May 2014, physicians received education on business card and white board use. Results We surveyed 378 patients. Our intervention improved white board utilization (72.2% postintervention versus 54.5% preintervention, P < .01) and slightly improved business card use (44.4% versus 33.7%, P = .07), but did not improve physician recognition. Only 20.3% (14 of 69) of patients could name their physician without use of the business card or white board. Data from all study phases showed the use of both tools improved patients' ability to name physicians (OR = 1.72 and OR = 2.12, respectively; OR = 3.68 for both; P < .05 for all), but had no effect on photograph recognition. Conclusions Our educational intervention improved white board use, but did not result in improved patient ability to recognize physicians. Pooled data of business cards and white boards, alone or combined, improved name recognition, suggesting better use of these tools may increase identification. Future initiatives should target other barriers to usage of these types of tools.

  17. On the Role of Software Quality Management in Software Process Improvement

    DEFF Research Database (Denmark)

    Wiedemann Jacobsen, Jan; Kuhrmann, Marco; Münch, Jürgen

    2016-01-01

    Software Process Improvement (SPI) programs have been implemented, inter alia, to improve quality and speed of software development. SPI addresses many aspects ranging from individual developer skills to entire organizations. It comprises, for instance, the optimization of specific activities...... in the software lifecycle as well as the creation of organizational awareness and project culture. In the course of conducting a systematic mapping study on the state-of-the-art in SPI from a general perspective, we observed Software Quality Management (SQM) being of certain relevance in SPI programs...... and to develop an initial picture of how these topics are addressed in SPI. Our findings show a fairly pragmatic contribution set in which different solutions are proposed, discussed, and evaluated. Among others, our findings indicate a certain reluctance towards standard quality or (test) maturity models...

  18. On the Role of Software Quality Management in Software Process Improvement

    DEFF Research Database (Denmark)

    Wiedemann Jacobson, Jan; Kuhrmann, Marco; Münch, Jürgen

    Software Process Improvement (SPI) programs have been implemented, inter alia, to improve quality and speed of software development. SPI addresses many aspects ranging from individual developer skills to entire organizations. It comprises, for instance, the optimization of specific activities...... in the software lifecycle as well as the creation of organizational awareness and project culture. In the course of conducting a systematic mapping study on the state-of-the-art in SPI from a general perspective, we observed Software Quality Management (SQM) being of certain relevance in SPI programs...... and to develop an initial picture of how these topics are addressed in SPI. Our findings show a fairly pragmatic contribution set in which different solutions are proposed, discussed, and evaluated. Among others, our findings indicate a certain reluctance towards standard quality or (test) maturity models...

  19. Ecological Factors Improving Efficiency of Business Activities

    Directory of Open Access Journals (Sweden)

    Kononova G. A.

    2015-01-01

    Full Text Available The economic importance of optimizing the environmental situation from the perspective of an entrepreneur are assessed in the article. The classification of administrative decisions taken in the course of the business activities is proposed. The authors identified a group of solutions directly providing optimization of environment external to the enterprise, solutions that have an indirect positive impact on the environment and solutions that improve ecology of industrial premises. The nature of economic effect of resulting solutions of various types is taken into account. Vectors of influence of working conditions on the economic results of business activities are described. The nature and strength of the impact of model management decisions results of business activities are defined. Key performance indicators of entrepreneurial activity are identified: employee productivity, the amount of revenue and profitability, solvency, staff stability, the competitiveness of enterprises. Grouping the costs of ecological parameters optimization of the production environment is proposed. Relationship between level of working conditions and socio-psychological climate in the collective enterprise is disclosed. The methods of motivation of entrepreneurs in solving of environmental, production problems are considered. The role of training entrepreneurs engaged of medium and small businesses are underlined especially. Thus, in the article the relationship between environmental and economic problems of entrepreneurial activity is investigated. Role and opportunities of entrepreneurs in solving these problems are defined and structured.

  20. A model of quality assurance and quality improvement for post-graduate medical education in Europe.

    Science.gov (United States)

    Da Dalt, Liviana; Callegaro, Silvia; Mazzi, Anna; Scipioni, Antonio; Lago, Paola; Chiozza, Maria L; Zacchello, Franco; Perilongo, Giorgio

    2010-01-01

    The issue of quality assurance (QA) and quality improvement (QI), being the quality of medical education intimately related to the quality of the health care, is becoming of paramount importance worldwide. To describe a model of implementing a system for internal QA and QI within a post-graduate paediatric training programme based on the ISO 9001:2000 standard. For the ISO 9001:2000 standard, the curriculum was managed as a series of interrelated processes and their level of function was monitored by ad hoc elaborated objective indicators. The training programme was fragmented in 19 interlinked processes, 15 related procedures and 24 working instructions. All these materials, along with the quality policy, the mission, the strategies and the values were made publicly available. Based on the measurable indicators developed to monitor some of the processes, areas of weakness of the system were objectively identified and consequently QI actions implemented. The appropriateness of all this allowed the programme to finally achieve an official ISO 9000:2001 certification. The application of the ISO 9001:2000 standard served to develop an internal QA and QI system and to meet most of the standards developed for QA in higher and medical education.

  1. 品管圈在提高造口患者自我护理能力中的应用%Application of quality control circle activities in improvement the self care ability of colostomy patients

    Institute of Scientific and Technical Information of China (English)

    卢美玲; 刘艾; 张咏梅; 陈幸幸; 何金艳; 苟晓梅; 梁小香; 邓冬雪; 李纳

    2014-01-01

    目的:探讨品管圈质量管理工具在提高造口患者自我护理能力中的应用效果。方法:选择2011年5月~2012年5月在我院胃肠外科住院的45例造口患者作为对照组,应用传统方法对造口患者进行管理;选择2012年8月~2013年8月在我院胃肠外科住院的55例造口患者作为试验组,应用品管圈质量管理工具进行管理。比较两组患者自我护理缺陷发生情况。结果:试验组造口患者自我护理缺陷发生情况低于对照组(P<0.05)。结论:合理运用品管圈质量改进工具可有效提高造口患者的自我护理能力。%Objective:To explore the QCC quality management tool in improving the function of colostomy patients self care ability. Methods:To review in May 2011 to May 2012 gastrointestinal surgery of 45 colostomy patients with the control group,normal colostomy nursing. 55 patients from August 2012 to August 2013 were experimental group,received QCC management. To compare the occur of self-care abilitydefects. Results:The implementation of QCC management method after colostomy patients self-care defects has increased significantly,the difference was statistically significant (P<0. 05). Conclu-sion:The reasonable use QCC quality improvement tools can effectively improve the self-care ability of colostomy patients.

  2. Groundwater Quality Assessment Based on Improved Water Quality Index in Pengyang County, Ningxia, Northwest China

    Directory of Open Access Journals (Sweden)

    Li Pei-Yue

    2010-01-01

    Full Text Available The aim of this work is to assess the groundwater quality in Pengyang County based on an improved water quality index. An information entropy method was introduced to assign weight to each parameter. For calculating WQI and assess the groundwater quality, total 74 groundwater samples were collected and all these samples subjected to comprehensive physicochemical analysis. Each of the groundwater samples was analyzed for 26 parameters and for computing WQI 14 parameters were chosen including chloride, sulphate, pH, chemical oxygen demand (COD, total dissolved solid (TDS, total hardness (TH, nitrate, ammonia nitrogen, fluoride, total iron (Tfe, arsenic, iodine, aluminum, nitrite, metasilicic acid and free carbon dioxide. At last a zoning map of different water quality was drawn. Information entropy weight makes WQI perfect and makes the assessment results more reasonable. The WQI for 74 samples ranges from 12.40 to 205.24 and over 90% of the samples are below 100. The excellent quality water area covers nearly 90% of the whole region. The high value of WQI has been found to be closely related with the high values of TDS, fluoride, sulphate, nitrite and TH. In the medium quality water area and poor quality water area, groundwater needs some degree of pretreated before consumption. From the groundwater conservation view of point, the groundwater still need protection and long term monitoring in case of future rapid industrial development. At the same time, preventive actions on the agricultural non point pollution sources in the plain area are also need to be in consideration.

  3. National Surgical Quality Improvement Program-Pediatric (NSQIP) and the Quality of Surgical Care in Pediatric Orthopaedics.

    Science.gov (United States)

    Brighton, Brian K

    2015-01-01

    In recent years, the safety, quality, and value of surgical care have become increasingly important to surgeons and hospitals. Quality improvement in surgical care requires the ability to collect, measure, and act upon reliable and clinically relevant data. One example of a large-scale quality effort is the American College of Surgeons National Surgical Quality Improvement Program-Pediatric (ACS NSQIP-Pediatric), the only nationwide, risk-adjusted, outcomes-based program evaluating pediatric surgical care.

  4. [Measurement of customer satisfaction and participation of citizens in improving the quality of healthcare services.].

    Science.gov (United States)

    Degrassi, Flori; Sopranzi, Cristina; Leto, Antonella; Amato, Simona; D'Urso, Antonio

    2009-01-01

    Managing quality in health care whilst ensuring equity is a fundamental aspect of the provision of services by healthcare organizations. Measuring perceived quality of care is an important tool for evaluating the quality of healthcare delivery in that it allows the implementation of corrective actions to meet the healthcare needs of patients. The Rome B (ASL RMB) local health authority adopted the UNI EN 10006:2006 norms as a management tool, therefore introducing the evaluation of customer satisfaction as an opportunity to involve users in the creation of quality healthcare services with and for the citizens. This paper presents the activities implemented and the results achieved with regards to shared and integrated continuous improvement of services.

  5. Improving critical care discharge summaries: a collaborative quality improvement project using PDSA.

    Science.gov (United States)

    Goulding, Lucy; Parke, Hannah; Maharaj, Ritesh; Loveridge, Robert; McLoone, Anne; Hadfield, Sophie; Helme, Eloise; Hopkins, Philip; Sandall, Jane

    2015-01-01

    Around 110,000 people spend time in critical care units in England and Wales each year. The transition of care from the intensive care unit to the general ward exposes patients to potential harms from changes in healthcare providers and environment. Nurses working on general wards report anxiety and uncertainty when receiving patients from critical care. An innovative form of enhanced capability critical care outreach called 'iMobile' is being provided at King's College Hospital (KCH). Part of the remit of iMobile is to review patients who have been transferred from critical care to general wards. The iMobile team wished to improve the quality of critical care discharge summaries. A collaborative evidence-based quality improvement project was therefore undertaken by the iMobile team at KCH in conjunction with researchers from King's Improvement Science (KIS). Plan, Do, Study, Act (PDSA) methodology was used. Three PDSA cycles were undertaken. Methods adopted comprised: a scoping literature review to identify relevant guidelines and research evidence to inform all aspects of the quality improvement project; a process mapping exercise; informal focus groups / interviews with staff; patient story-telling work with people who had experienced critical care and subsequent discharge to a general ward; and regular audits of the quality of both medical and nursing critical care discharge summaries. The following behaviour change interventions were adopted, taking into account evidence of effectiveness from published systematic reviews and considering the local context: regular audit and feedback of the quality of discharge summaries, feedback of patient experience, and championing and education delivered by local opinion leaders. The audit results were mixed across the trajectory of the project, demonstrating the difficulty of sustaining positive change. This was particularly important as critical care bed occupancy and through-put fluctuates which then impacts on work

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

    Science.gov (United States)

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

    2012-07-01

    Process and quality improvement techniques have been successfully applied in health care arenas, but efforts to institute these strategies in alcohol and drug treatment are underdeveloped. The Network for the Improvement of Addiction Treatment (NIATx) teaches participating substance abuse treatment agencies to use process improvement strategies to increase client access to, and retention in, treatment. NIATx recommends five principles to promote organizational change: (1) understand and involve the customer, (2) fix key problems, (3) pick a powerful change leader, (4) get ideas from outside the organization, and (5) use rapid cycle testing. Using case studies, supplemented with cross-agency analyses of interview data, this paper profiles participating NIATx treatment agencies that illustrate successful applications of each principle. Results suggest that organizations can successfully integrate and apply the five principles as they develop and test change strategies, improving access and retention in treatment, and agencies' financial status. Upcoming changes requiring increased provision of behavioral health care will result in greater demand for services. Treatment organizations, already struggling to meet demand and client needs, will need strategies that improve the quality of care they provide without significantly increasing costs. The five NIATx principles have potential for helping agencies achieve these goals.

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

    Science.gov (United States)

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

    2014-01-01

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

  8. Relief of BPO or improvement in quality of life?

    Science.gov (United States)

    Teillac, P

    1998-01-01

    Benign prostatic hyperplasia (BPH) can cause benign prostatic enlargement with subsequent benign prostatic obstruction (BPO) and lower urinary tract symptoms (LUTS). A reduction in the size of the prostate has long been considered one of the most important treatment goals. However, there is a poor correlation between prostate size and both LUTS and BPO, and between BPO and symptoms. Today, the urologist's primary objectives are to minimize symptoms, relieve BPO and decrease the morbidity associated with BPO. From the patient's point of view, rapid relief of LUTS and immediate improvement in associated quality of life (QOL) are the most important factors. Although there is a good correlation between relief of symptoms (as measured by the International Prostate Symptom Score [I-PSS], for example) and associated improvement in bothersomeness and QOL, particularly that associated with filling ('irritative') symptoms, it is still important to quantify LUTS-related bothersomeness and QOL. Various questionnaires have been developed to measure bothersomeness (e.g. Symptom Problem Index [SPI], Danish PSS [DAN-PSS], International Continence Society BPH Study Group [ICSmale] questionnaire) and QOL (e.g. I-PSS-QOL, BPH Impact Index [BII] and QOL9 BPH-specific questionnaire). In addition, the impact of treatment on sexual function should also be taken into account when judging the overall well being or QOL of the patient. A grading system to evaluate the global improvement in patients following treatment has been established. Patients are either graded as showing 'slight', 'moderate' or 'marked' improvement, with the reduction in I-PSS or BII scores required for each classification dependent on baseline symptom severity. Medical treatment strategies designed to alleviate the symptoms of BPH and consequently improve the patient's QOL are now becoming increasingly important.

  9. Physical activity and quality of life.

    Science.gov (United States)

    Gill, Diane L; Hammond, Cara C; Reifsteck, Erin J; Jehu, Christine M; Williams, Rennae A; Adams, Melanie M; Lange, Elizabeth H; Becofsky, Katie; Rodriguez, Enid; Shang, Ya-Ting

    2013-01-01

    Physical activity (PA) professionals and participants recognize enhanced quality of life (QoL) as a benefit of and motivator for PA. However, QoL measures are often problematic and rarely consider the participants'perspective. This paper focuses on recent findings from a larger project on the role of QoL in PA and health promotion. More specifically, we focus on the views of participants and potential participants to better understand the relationship of PA and QoL. In earlier stages of the project we began with a conceptual model of QoL and developed a survey. We now focus on participants' views and ask two questions: 1) what is QoL? and 2) how does PA relate to QoL? We first asked those questions of a large sample of university students and community participants as open-ended survey items, and then asked focus groups of community participants. Overall, participants' responses reflected the multidimensional, integrative QoL model, but the responses and patterns provided information that may not be picked up with typical survey measures. Findings suggest that PA contributes to multiple aspects of QoL, that social and emotional benefits are primary motivators and outcomes for participants, and that the meaning of QoL and PA benefits is subjective and contextualized, varying across individuals and settings. Programs that directly target and highlight the multiple dimensions and integrative QoL, while considering the individual participants and contexts, may enhance both PA motivation and participants' health and QoL.

  10. Engaging primary care physicians in quality improvement: lessons from a payer-provider partnership.

    Science.gov (United States)

    Lemak, Christy Harris; Cohen, Genna R; Erb, Natalie

    2013-01-01

    A health insurer in Michigan, through its Physician Group Incentive Program, engaged providers across the state in a collection of financially incentivized initiatives to transform primary care and improve quality. We investigated physicians' and other program stakeholders' perceptions of the program through semistructured interviews with more than 80 individuals. We found that activities across five areas contributed to successful provider engagement: (1) developing a vision of improving primary care, (2) deliberately fostering practice-practice partnerships, (3) using existing infrastructure, (4) leveraging resources and market share, and (5) managing program trade-offs. Our research highlights effective strategies for engaging primary care physicians in program design and implementation processes and creating learning communities to support quality improvement and practice change.

  11. Improving Service Quality: Achieving High Performance in the Public and Private Sectors.

    Science.gov (United States)

    Milakovich, Michael E.

    Quality-improvement principles are a sound means to respond to customer needs. However, when various quality and productivity theories and methods are applied, it is very difficult to consistently deliver quality results, especially in quasi-monopolistic, non-competitive, and regulated environments. This book focuses on quality-improvement methods…

  12. Quality Improvement ? The Key to Reducing Costs in Pancreatoduodenectomy

    Directory of Open Access Journals (Sweden)

    Savio George Barreto

    2016-03-01

    Full Text Available Background With the looming fear of costs for cancer care escalating over the next decade, the general aim of policy makers the world over is directing efforts towards “bending the cost curve”. Pancreatic cancer is on the rise and pancreatoduodenectomy is the only curative option available. The aim of the current report is to analyze the published literature on data addressing the issue of costs in pancreatic cancer surgery (with a focus on pancreatoduodenectomy in an effort to determine how disparate are the lines of investigation of health economics and quality indicators of surgery. Methods A systematic and comprehensive search of major reference databases (MEDLINE, EMBASE, PubMed, and the Cochrane Library was undertaken using a combination of text words “cost”, “pancreatoduodenectomy”, “pancreaticoduodenectomy”, “health care”, “surgery”. The search was restricted to human studies published in literature but was not language restricted. Results The initial search yielded 116 studies of which 25 manuscripts were retrieved for further evaluation. Of the 25 studies retrieved, 7 manuscripts were excluded from the final analysis as the variables analyzed did not significantly influence the costs of pancreatoduodenectomy. The factors most frequently noted (≥2 studies to influence costs of pancreatoduodenectomy were hospital and surgeon volume the occurrence of complications and the implementation of clinical pathways. Conclusions Using pancreatoduodenectomy, as an example, it is evident that the key to ‘bending the cancer cost curve’ is designing strategies to improve quality of the not only the procedure, but the process. Costs and quality cannot be separated. Reduction in costs can, and must only, be achieved by targeting excellence.

  13. Checklists to improve the quality of the orthopaedic literature

    Directory of Open Access Journals (Sweden)

    Mundi Raman

    2008-01-01

    Full Text Available Several checklists have been developed in an effort to help journals and researchers improve the quality of reporting in research. The CONSORT statement and the CLEAR NPT evaluate randomized trials. The MOOSE and QUOROM checklists evaluate meta-analyses. The STROBE checklists assists readers in evaluating observational studies and the STARD checklist was developed for diagnostic test evaluation. The checklists presented here provide an invaluable source of guidance to authors, journal editors and readers who are seeking to prepare and evaluate reports. As evidence-based medicine continues to establish itself as the new paradigm by which medicine is practiced, the need for good reporting for all research designs must also become commonplace as opposed to the exception.

  14. Improving quality of care among patients hospitalised with schizophrenia

    DEFF Research Database (Denmark)

    Jørgensen, Mette; Mainz, Jan; Svendsen, Marie Louise

    2015-01-01

    -based cohort study, we identified 14 228 patients admitted to psychiatric departments between 2004 and 2011 from The Danish Schizophrenia Registry. The registry systematically monitors the adherence to guideline recommended processes of care. RESULTS: The overall proportion of all relevant recommended...... processes of care increased from 64 to 76% between 2004 and 2011. The adherence to individual processes of care increased over time, including assessment of psychopathology using a diagnostic interview (relative risk (RR): 2.01, 95% CI: 1.51-2.68), contact with relatives (RR: 1.44, 95% CI: 1.......27-1.62), psychoeducation (RR: 1.33, 95% CI: 1.19-1.48), psychiatric aftercare (RR: 1.06, 95% CI: 1.01-1.11) and suicide risk assessment (RR: 1.31, 95% CI: 1.21-1.42). CONCLUSIONS: Quality of care improved from 2004 to 2011 among patients hospitalised with schizophrenia in Denmark. DECLARATION OF INTEREST: None. COPYRIGHT...

  15. M-EPAR to Improve the Quality of the MANETs

    Directory of Open Access Journals (Sweden)

    Er.Harjinder singh

    2017-06-01

    Full Text Available In MANET, power aware is important challenge issue to improve the communication energy efficiency at individual nodes. We propose modified efficient power aware routing (M-EPAR, a new power aware routing protocol that increases the network lifetime of MANET. Designing a power aware routing algorithm or technique is one of the most important point considered in Mobile Ad Hoc Networks. These nodes are driven by reactive protocols where broadcasting is mandatory to form a path between two nodes. So in case of death of the node resulting out of less battery calls for re-routing. Since many existing techniques focuses on energy aware routing this paper presents combination of energy aware routing merged with link quality determined by packet drop rate. The proposed scheme has outperformed the existing technique in terms of packet delivery ratio, throughput and energy consumption.

  16. Improvement of Tagliatelle Quality by Addition of Red Quinoa Flour

    Directory of Open Access Journals (Sweden)

    Anamaria Pop

    2014-11-01

    Full Text Available In order to diversification of tagliatelle pasta and increasing segment of consumers it was intended to improvement of tagliatelle pasta quality by addition of red quinoa flour. The products obtained at Bakery Pilot Station of University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca was the result of original recipe. To optimize the recipe were made four experimental variants, white flour and red quinoa flour is used in different proportions: Variant 1 – plain tagliatelle pasta (control sample who used white flour WF in 100%, Variant 2 consisting of 15% red quinoa flour (15 QF, Variant 3 consisting of 30 % red quinoa flour (30 QF and Variant 4 consisting of 50 % red quinoa flour (50 RQF. The experimental variants was analyzed for physico-chemical: moisture content, protein content and acidity. The sensory attributes, were evaluated by using a 9-point Hedonic scale. Present study indicated that the variant 3 were most accepted by consumers.

  17. Implementation of biochemical screening to improve baking quality of barley

    DEFF Research Database (Denmark)

    Vincze, Éva; Dionisio, Giuseppe; Aaslo, Per;

    2011-01-01

    Barley (Hordeum vulgare) has the potential to offer considerable human nutritional benefits, especially as supplement to wheat-based breads. Under current commercial baking conditions it is not possible to introduce more that 20% barley flour to the wheat bread without negative impact...... proteins. Changing the storage protein composition can lessen this problem. Our working hypothesis was that exploiting the substantial genetic variation within the gene pool for storage proteins could enable improving the baking qualities of barley flour. We characterised forty-nine barley cultivars...... for variations in storage protein and AA composition. These cultivars were selected based on their higher protein contents (11.8–17.6%). The results obtained indicated that substantial variation not only in the distribution of the hordein polypeptides but also in the relative proportions of the storage proteins...

  18. Forensic mental health assessment in France: recommendations for quality improvement.

    Science.gov (United States)

    Combalbert, Nicolas; Andronikof, Anne; Armand, Marine; Robin, Cécile; Bazex, Hélène

    2014-01-01

    The quality of forensic mental health assessment has been a growing concern in various countries on both sides of the Atlantic, but the legal systems are not always comparable and some aspects of forensic assessment are specific to a given country. This paper describes the legal context of forensic psychological assessment in France (i.e. pre-trial investigation phase entrusted to a judge, with mental health assessment performed by preselected professionals called "experts" in French), its advantages and its pitfalls. Forensic psychiatric or psychological assessment is often an essential and decisive element in criminal cases, but since a judiciary scandal which was made public in 2005 (the Outreau case) there has been increasing criticism from the public and the legal profession regarding the reliability of clinical conclusions. Several academic studies and a parliamentary report have highlighted various faulty aspects in both the judiciary process and the mental health assessments. The heterogeneity of expert practices in France appears to be mainly related to a lack of consensus on several core notions such as mental health diagnosis or assessment methods, poor working conditions, lack of specialized training, and insufficient familiarity with the Code of Ethics. In this article we describe and analyze the French practice of forensic psychologists and psychiatrists in criminal cases and propose steps that could be taken to improve its quality, such as setting up specialized training courses, enforcing the Code of Ethics for psychologists, and calling for consensus on diagnostic and assessment methods.

  19. Improving regional variation using quality of care measures

    Directory of Open Access Journals (Sweden)

    Scott A Berkowitz

    2009-11-01

    Full Text Available Scott A Berkowitz1, Gary Gerstenblith1, Robert Herbert2, Gerard Anderson1,21Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; 2Center for Hospital Finance and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USAAbstract: There is significant regional variability in the quality of care provided in the United States. This article compares regional performance for three measures that focus on transitions in care, and the care of patients with multiple conditions. Admissions for people with ambulatory care-sensitive conditions, hospital readmissions within 30 days of discharge, and compliance with practice guidelines for people with three chronic conditions (congestive heart failure, chronic obstructive pulmonary disease, and diabetes were analyzed using data drawn from the Centers for Medicare & Medicaid Services’ Standard Analytic Files for 5% of a 2004 national sample of Medicare beneficiaries which was divided by hospital referral regions and regional performance. There were significant regional differences in performance which we hypothesize could be improved through better care coordination and system management.Keywords: performance, quality, chronic condition, ambulatory care, sensitive conditions, readmissions

  20. Improving Software Quality Prediction by Noise Filtering Techniques

    Institute of Scientific and Technical Information of China (English)

    Taghi M. Khoshgoftaar; Pierre Rebours

    2007-01-01

    Accuracy of machine learners is affected by quality of the data the learners are induced on. In this paper,quality of the training dataset is improved by removing instances detected as noisy by the Partitioning Filter. The fit datasetis first split into subsets, and different base learners are induced on each of these splits. The predictions are combined insuch a way that an instance is identified as noisy if it is misclassified by a certain number of base learners. Two versionsof the Partitioning Filter are used: Multiple-Partitioning Filter and Iterative-Partitioning Filter. The number of instancesremoved by the filters is tuned by the voting scheme of the filter and the number of iterations. The primary aim of thisstudy is to compare the predictive performances of the final models built on the filtered and the un-filtered training datasets.A case study of software measurement data of a high assurance software project is performed. It is shown that predictiveperformances of models built on the filtered fit datasets and evaluated on a noisy test dataset are generally better than thosebuilt on the noisy (un-filtered) fit dataset. However, predictive performance based on certain aggressive filters is affected bypresence of noise in the evaluation dataset.