WorldWideScience

Sample records for quality improvement collaborative

  1. 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

  2. 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

  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. 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.

  5. Piloting a Statewide Home Visiting Quality Improvement Learning Collaborative.

    Science.gov (United States)

    Goyal, Neera K; Rome, Martha G; Massie, Julie A; Mangeot, Colleen; Ammerman, Robert T; Breckenridge, Jye; Lannon, Carole M

    2017-02-01

    Objective To pilot test a statewide quality improvement (QI) collaborative learning network of home visiting agencies. Methods Project timeline was June 2014-May 2015. Overall objectives of this 8-month initiative were to assess the use of collaborative QI to engage local home visiting agencies and to test the use of statewide home visiting data for QI. Outcome measures were mean time from referral to first home visit, percentage of families with at least three home visits per month, mean duration of participation, and exit rate among infants learning. A statewide data system was used to generate monthly run charts. Results Mean time from referral to first home visit was 16.7 days, and 9.4% of families received ≥3 visits per month. Mean participation was 11.7 months, and the exit rate among infants learning network, agencies tested and measured changes using statewide and internal data. Potential next steps are to develop and test new metrics with current pilot sites and a larger collaborative.

  6. Determinants of success of quality improvement collaboratives: what does the literature show?

    NARCIS (Netherlands)

    Hulscher, M.E.J.L.; Schouten, L.M.T.; Grol, R.P.T.M.; Buchan, H.

    2013-01-01

    CONTEXT: The apparent inconsistency between the widespread use of quality improvement collaboratives and the available evidence heightens the importance of thoroughly understanding the relative strength of the approach. More insight into factors influencing outcome would mean future collaboratives c

  7. Explaining variation in perceived team effectiveness: Results from eleven quality improvement collaboratives

    NARCIS (Netherlands)

    M.M.H. Strating (Mathilde); A.P. Nieboer (Anna)

    2013-01-01

    textabstractAims and objectives. Explore effectiveness of 11 collaboratives focusing on 11 different topics, as perceived by local improvement teams and to explore associations with collaborative-, organisational- and team-level factors. Background. Evidence underlying the effectiveness of quality

  8. Determinants of success of quality improvement collaboratives: what does the literature show?

    NARCIS (Netherlands)

    Hulscher, M.E.J.L.; Schouten, L.M.T.; Grol, R.P.T.M.; Buchan, H.

    2013-01-01

    CONTEXT: The apparent inconsistency between the widespread use of quality improvement collaboratives and the available evidence heightens the importance of thoroughly understanding the relative strength of the approach. More insight into factors influencing outcome would mean future collaboratives

  9. Creating effective quality-improvement collaboratives: A multiple case study

    NARCIS (Netherlands)

    M.M.H. Strating (Mathilde); A.P. Nieboer (Anna); T. Zuiderent-Jerak (Teun); R.A. Bal (Roland)

    2011-01-01

    textabstractObjective: To explore whether differences between collaboratives with respect to type of topic, type of targets, measures (systems) are also reflected in the degree of effectiveness. Study setting: 182 teams from long-term healthcare organisation developed improvement initiatives in

  10. 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.

  11. 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.

  12. Collaborative Improvement

    DEFF Research Database (Denmark)

    Kaltoft, Rasmus

    The thesis data have been collected in the EU-sponsored project: Collaborative Improvement Tool for the Extended Manufacturing Enterprise, CO-IMPROVE. In this project four universities (Denmark, Ireland, Italy, and The Netherlands), two software vendors (Greece and Sweden) and three companies (De...... learn how to improve operations in (hopefully) a win-win like manner through collaboration.......The thesis data have been collected in the EU-sponsored project: Collaborative Improvement Tool for the Extended Manufacturing Enterprise, CO-IMPROVE. In this project four universities (Denmark, Ireland, Italy, and The Netherlands), two software vendors (Greece and Sweden) and three companies...... (Denmark, Italy and The Netherlands) each with three to five suppliers were involved. The CO-IMPROVE project and the thesis is based on “action research” and “action learning”. The main aim of the whole project is through actual involvement and actions make the researchers, companies and selected suppliers...

  13. Exploring the black box of quality improvement collaboratives: modelling relations between conditions, applied changes and outcomes.

    NARCIS (Netherlands)

    Dückers, M.L.A.; Spreeuwenberg, P.; Wagner, C.; Groenewegen, P.P.

    2009-01-01

    Introduction: Despite the popularity of quality improvement collaboratives (QICs) in different healthcare settings, relatively little is known about the implementation process. The objective of the current study is to learn more about relations between relevant conditions for successful implementati

  14. Exploring the black box of quality improvement collaboratives : modelling relations between conditions, applied changes and outcomes

    NARCIS (Netherlands)

    Dückers, M.L.A.; Spreeuwenberg, P.; Wagner, C.; Groenewegen, P.P.

    2009-01-01

    Introduction: Despite the popularity of quality improvement collaboratives (QICs) in different healthcare settings, relatively little is known about the implementation process. The objective of the current study is to learn more about relations between relevant conditions for successful implementati

  15. Quality improvement collaboratives and the wisdom of crowds : Spread explained by perceived success at group level

    NARCIS (Netherlands)

    Dückers, Michel L A; Groenewegen, Peter P.; Wagner, Cordula

    2014-01-01

    Background: Many studies have been conducted to evaluate the impact of quality improvement collaboratives (QICs) on the quality of healthcare. This article addresses an underexplored topic, namely the use of QICs as 'intentional spread strategy.' Its objective is to predict the dissemination of proj

  16. 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.

  17. Pioneering a Nursing Home Quality Improvement Learning Collaborative: A Case Study of Method and Lessons Learned.

    Science.gov (United States)

    Gillespie, Suzanne M; Olsan, Tobie; Liebel, Dianne; Cai, Xueya; Stewart, Reginald; Katz, Paul R; Karuza, Jurgis

    2016-02-01

    To describe the development of a nursing home (NH) quality improvement learning collaborative (QILC) that provides Lean Six Sigma (LSS) training and infrastructure support for quality assurance performance improvement change efforts. Case report. Twenty-seven NHs located in the Greater Rochester, NY area. The learning collaborative approach in which interprofessional teams from different NHs work together to improve common clinical and organizational processes by sharing experiences and evidence-based practices to achieve measurable changes in resident outcomes and system efficiencies. NH participation, curriculum design, LSS projects. Over 6 years, 27 NHs from urban and rural settings joined the QILC as organizational members and sponsored 47 interprofessional teams to learn LSS techniques and tools, and to implement quality improvement projects. NHs, in both urban and rural settings, can benefit from participation in QILCs and are able to learn and apply LSS tools in their team-based quality improvement efforts. Published by Elsevier Inc.

  18. Improving interprofessional collaboration in a community setting: relationships with burnout, engagement and service quality.

    Science.gov (United States)

    Martinussen, Monica; Adolfsen, Frode; Lauritzen, Camilla; Richardsen, Astrid Marie

    2012-05-01

    The main purpose of this study was, firstly, to evaluate the effect of an intervention aimed at improving interprofessional collaboration and service quality, and secondly, to examine if collaboration could predict burnout, engagement and service quality among human service professionals working with children and adolescents. The intervention included the establishment of local interprofessional teams and offering courses. The sample was recruited from six different small municipalities in Northern Norway (N = 93) and a comparison group from four similar municipalities (N = 58). Participation in the project increased the level of collaboration in the intervention group significantly (Hedges' g = 0.36), but not the perceived level of service quality. Hierarchical regression analyses were used to test a model for predicting burnout, engagement and perceived service quality using work-related factors, including collaboration as predictors. Both burnout and engagement were predicted by job demands and resources after controlling for demographic variables and participation in the project. Service quality was mostly predicted by collaboration. Increasing collaboration seems possible by introducing practice-based changes; however, this intervention did not have the desired effect on perceived service quality.

  19. 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

  20. Interdisciplinary teamwork and the power of a quality improvement collaborative in tertiary neonatal intensive care units.

    Science.gov (United States)

    Grover, Theresa R; Pallotto, Eugenia K; Brozanski, Beverly; Piazza, Anthony J; Chuo, John; Moran, Susan; McClead, Richard; Mingrone, Teresa; Morelli, Lorna; Smith, Joan R

    2015-01-01

    Significant gaps in healthcare quality and outcomes can be reduced via quality improvement collaboratives (QICs), which improve care by leveraging data and experience from multiple organizations.The Children's Hospital Neonatal Consortium Collaborative Initiatives for Quality Improvement team developed an infrastructure for neonatal QICs. We describe the structure and components of an effective multi-institutional neonatal QIC that implemented the "SLUG Bug" project designed to reduce central line-associated bloodstream infections (CLABSIs).The operational infrastructure of SLUG Bug involved 17 tertiary care neonatal intensive care units with a goal to reduce CLABSI in high-risk neonates. Clinical Practice Recommendations were produced, and the Institute of Healthcare Improvement Breakthrough Series provided the framework for the collaborative. Process measures studied the effectiveness of the collaborative structure.CLABSI rates decreased by 20% during a 12-month study period. Compliance bundle reporting exceeded 80%. A QIC score of 2.5 or more ("improvement") was achieved by 94% of centers and a score 4 or more ("significant improvement") was achieved by 35%.Frequent interactive project meetings, well-defined project metrics, continual shared learning opportunities, and individual team coaching were key QIC success components. Through a coordinated approach and committed leadership, QICs can effectively implement change and improve the care of neonates with complex diagnoses and rare diseases.

  1. Nine states' use of collaboratives to improve children's health care quality in medicaid and CHIP.

    Science.gov (United States)

    Devers, Kelly J; Foster, Leslie; Brach, Cindy

    2013-01-01

    We examine quality improvement (QI) collaboratives underway in 9 states participating in the Children's Health Insurance Program Reauthorization Act (CHIPRA) Quality Demonstration Grant Program. A total of 147 diverse, child-serving practices were participating in the collaboratives. We conducted 256 semistructured interviews with key stakeholders from March to August 2012-2 years into the 5-year demonstration projects-and analyzed states' grant applications, operating plans, and progress reports. The collaboratives have multiple complex aims. In addition to developing patient-centered medical home (PCMH) capability, some states use collaboratives to familiarize practices with CMS's Initial Core Set of Children's Health Care Quality Measures, practice-level quality measurement, and improving QI knowledge and skills. The duration of the collaboratives is longer than other well-known collaborative models. Collaboratives also vary in their methods for targeting areas for improvement and strategies for motivating practice recruitment and engagement. States also vary with respect to the other strategies they use to support QI and PCMH development. All states supplement the collaboratives with practice facilitation; the majority utilized practice-level parent engagement, but only 4 used workforce augmentation (ie, providing care coordinators and QI specialists). Practice staff highly valued aspects of the collaboratives and supplemental strategies, including the opportunity to work with experts and other child-serving practices; states' efforts to provide stipends and align demonstration efforts with other professional requirements or programs; receipt of relevant, customized QI materials; opportunities to learn how care coordinators or QI specialists might work in their practice without the risk of hiring them; and satisfaction from learning more about quality measures, QI concepts and techniques, critical medical home components, and how to identify PCMH capacity and

  2. Quality improvement projects targeting health care-associated infections: comparing Virtual Collaborative and Toolkit approaches.

    Science.gov (United States)

    Speroff, Theodore; Ely, E Wes; Greevy, Robert; Weinger, Matthew B; Talbot, Thomas R; Wall, Richard J; Deshpande, Jayant K; France, Daniel J; Nwosu, Sam; Burgess, Hayley; Englebright, Jane; Williams, Mark V; Dittus, Robert S

    2011-05-01

    Collaborative and toolkit approaches have gained traction for improving quality in health care. To determine if a quality improvement virtual collaborative intervention would perform better than a toolkit-only approach at preventing central line-associated bloodstream infections (CLABSIs) and ventilator-associated pneumonias (VAPs). Cluster randomized trial with the Intensive Care Units (ICUs) of 60 hospitals assigned to the Toolkit (n=29) or Virtual Collaborative (n=31) group from January 2006 through September 2007. CLABSI and VAP rates. Follow-up survey on improvement interventions, toolkit utilization, and strategies for implementing improvement. A total of 83% of the Collaborative ICUs implemented all CLABSI interventions compared to 64% of those in the Toolkit group (P = 0.13), implemented daily catheter reviews more often (P = 0.04), and began this intervention sooner (P < 0.01). Eighty-six percent of the Collaborative group implemented the VAP bundle compared to 64% of the Toolkit group (P = 0.06). The CLABSI rate was 2.42 infections per 1000 catheter days at baseline and 2.73 at 18 months (P = 0.59). The VAP rate was 3.97 per 1000 ventilator days at baseline and 4.61 at 18 months (P = 0.50). Neither group improved outcomes over time; there was no differential performance between the 2 groups for either CLABSI rates (P = 0.71) or VAP rates (P = 0.80). The intensive collaborative approach outpaced the simpler toolkit approach in changing processes of care, but neither approach improved outcomes. Incorporating quality improvement methods, such as ICU checklists, into routine care processes is complex, highly context-dependent, and may take longer than 18 months to achieve. Copyright © 2011 Society of Hospital Medicine.

  3. Collaborative Improvement

    DEFF Research Database (Denmark)

    Kaltoft, Rasmus

    -called Extended Manufacturing Enterprises (EMEs). In effect, the battlefield of competition is increasingly moving from the level of individual firms to that of EMEs. Consequently, new approaches must be developed not only to enhance the business performance of EMEs, but also, in particular, the inter-organisational......Many companies have gradually moved from vertically aligned operations to horizontally aligned operations, a change implying that co-ordination is shifting from the hierarchy to the market place with emphasis on collaboration with other companies. One form of collaboration with companies is so...

  4. Quality improvement implementation and disparities: the case of the health disparities collaboratives.

    Science.gov (United States)

    Chin, Marshall H

    2011-12-01

    The Health Disparities Collaboratives (HDCs), a quality improvement (QI) collaborative incorporating rapid QI, a chronic care model, and learning sessions, have been implemented in over 900 community health centers across the country. To determine the HDC's effect on clinical processes and outcomes, their financial impact, and factors important for successful implementation. Systematic review of the literature. The HDCs improve clinical processes of care over short-term period of 1 to 2 years, and clinical processes and outcomes over longer period of 2 to 4 years. Most participants perceive that the HDCs are successful and worth the effort. Analysis of the Diabetes Collaborative reveals that it is societally cost-effective, with an incremental cost-effectiveness ratio of $33,386 per quality-adjusted life year, but that consistent revenue streams for the initiative do not exist. Common barriers to improvement include lack of resources, time, and staff burnout. Highest ranked priorities for more funding are money for direct patient services, data entry, and staff time for QI. Other common requests for more assistance are help with patient self-management, information systems, and getting providers to follow guidelines. Relatively low-cost ways to increase staff morale and prevent burnout include personal recognition, skills development opportunities, and fair distribution of work. The HDCs have successfully improved quality of care, and the Diabetes Collaborative is societally cost-effective, but policy reforms are necessary to create a sustainable business case for these health centers that serve many uninsured and underinsured populations.

  5. Development of the breastfeeding quality improvement in hospitals learning collaborative in New York state.

    Science.gov (United States)

    Fitzpatrick, Eileen; Dennison, Barbara A; Welge, Sara Bonam; Hisgen, Stephanie; Boyce, Patricia Simino; Waniewski, Patricia A

    2013-06-01

    Exclusive breastfeeding is a public health priority. A strong body of evidence links maternity care practices, based on the Ten Steps to Successful Breastfeeding, to increased breastfeeding initiation, duration and exclusivity. Despite having written breastfeeding policies, New York (NY) hospitals vary widely in reported maternity care practices and in prevalence rates of breastfeeding, especially exclusive breastfeeding, during the birth hospitalization. To improve hospital maternity care practices, breastfeeding support, and the percentage of infants exclusively breastfeeding, the NY State Department of Health developed the Breastfeeding Quality Improvement in Hospitals (BQIH) Learning Collaborative. The BQIH Learning Collaborative was the first to use the Institute for Health Care Improvement's Breakthrough Series methodology to specifically focus on increasing hospital breastfeeding support. The evidence-based maternity care practices from the Ten Steps to Successful Breastfeeding provided the basis for the Change Package and Data Measurement Plan. The present article describes the development of the BQIH Learning Collaborative. The engagement of breastfeeding experts, partners, and stakeholders in refining the Learning Collaborative design and content, in defining the strategies and interventions (Change Package) that drive hospital systems change, and in developing the Data Measurement Plan to assess progress in meeting the Learning Collaborative goals and hospital aims is illustrated. The BQIH Learning Collaborative is a model program that was implemented in a group of NY hospitals with plans to spread to additional hospitals in NY and across the country.

  6. Factors influencing success in quality-improvement collaboratives: development and psychometric testing of an instrument

    Directory of Open Access Journals (Sweden)

    Grol Richard PTM

    2010-10-01

    Full Text Available Abstract Background To increase the effectiveness of quality-improvement collaboratives (QICs, it is important to explore factors that potentially influence their outcomes. For this purpose, we have developed and tested the psychometric properties of an instrument that aims to identify the features that may enhance the quality and impact of collaborative quality-improvement approaches. The instrument can be used as a measurement instrument to retrospectively collect information about perceived determinants of success. In addition, it can be prospectively applied as a checklist to guide initiators, facilitators, and participants of QICs, with information about how to perform or participate in a collaborative with theoretically optimal chances of success. Such information can be used to improve collaboratives. Methods We developed an instrument with content validity based on literature and the opinions of QIC experts. We collected data from 144 healthcare professionals in 44 multidisciplinary improvement teams participating in two QICs and used exploratory factor analysis to assess the construct validity. We used Cronbach's alpha to ascertain the internal consistency. Results The 50-item instrument we developed reflected expert-opinion-based determinants of success in a QIC. We deleted nine items after item reduction. On the basis of the factor analysis results, one item was dropped, which resulted in a 40-item questionnaire. Exploratory factor analysis showed that a three-factor model provided the best fit. The components were labeled 'sufficient expert team support', 'effective multidisciplinary teamwork', and 'helpful collaborative processes'. Internal consistency reliability was excellent (alphas between .85 and .89. Conclusions This newly developed instrument seems a promising tool for providing healthcare workers and policy makers with useful information about determinants of success in QICs. The psychometric properties of the instrument are

  7. Influence of a quality improvement learning collaborative program on team functioning in primary healthcare.

    Science.gov (United States)

    Kotecha, Jyoti; Brown, Judith Belle; Han, Han; Harris, Stewart B; Green, Michael; Russell, Grant; Roberts, Sharon; Webster-Bogaert, Susan; Fournie, Meghan; Thind, Amardeep; Reichert, Sonja M; Birtwhistle, Richard

    2015-09-01

    Quality improvement (QI) programs are frequently implemented to support primary healthcare (PHC) team development and to improve care outcomes. In Ontario, Canada, the Quality Improvement and Innovation Partnership (QIIP) offered a learning collaborative (LC) program to support the development of interdisciplinary team function and improve chronic disease management, disease prevention, and access to care. A qualitative study using a phenomenological approach was conducted as part of a mixed-method evaluation to explore the influence of the program on team functioning in participating PHC teams. A purposive sampling strategy was used to identify PHC teams (n = 10), from which participants of different professional roles were selected through a purposeful recruitment process to reflect maximum variation of team roles. Additionally, QI coaches working with the interview participants and the LC administrators were also interviewed. Data were collected through semistructured telephone interviews that were audiotaped and transcribed verbatim. Thematic analysis was conducted through an iterative and interpretive approach. The shared experience of participating in the program appeared to improve team functioning. Participants described increased trust and respect for each other's clinical and administrative roles and were inspired by learning about different approaches to interdisciplinary care. This appeared to enhance collegial relationships, collapse professional silos, improve communication, and increase interdisciplinary collaboration. Teamwork involves more than just physically grouping healthcare providers from multiple disciplines and mandating them to work together. The LC program provided opportunities for participants to learn how to work collaboratively, and participation in the LC program appeared to enhance team functioning.

  8. 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.

  9. More black box to explore: how quality improvement collaboratives shape practice change.

    Science.gov (United States)

    Shaw, Eric K; Chase, Sabrina M; Howard, Jenna; Nutting, Paul A; Crabtree, Benjamin F

    2012-01-01

    Quality improvement collaboratives (QICs) are used extensively to promote quality improvement in health care. Evidence of their effectiveness is limited, prompting calls to "open up the black box" to better understand how and why such collaboratives work. We selected a cohort of 5 primary care practices that participated in a 6-month intervention study aimed at improving colorectal cancer screening rates. Using an immersion/crystallization technique, we analyzed qualitative data that included audio recordings and field notes of QICs and practice-based team meetings. Three themes emerged from our analysis: (1) practice staff became empowered through and drew on the QICs to advance change efforts in the face of leader/physician resistance; (2) a mix of content and media in the QIC program was important for reaching all participants; (3) resources offered at the QIC did little to spur practice change efforts. QICs offer a potentially powerful way of disseminating health care innovations through enhanced strategies for learning and change. Creating collaborative environments in which diverse participants learn, listen, reflect, and share together can enable them to take back to their own organizations key messages and change strategies that benefit them the most.

  10. Improving Population Health Through an Innovative Collaborative: The Be There San Diego Data for Quality Group.

    Science.gov (United States)

    Fremont, Allen; Kranz, Ashley M; Phillips, Jessica; Garber, Chandra

    2017-06-01

    In 2012, leaders from disparate health care organizations established a data group aligned around a regional goal of preventing heart attacks and strokes in San Diego. The group---now named the Be There San Diego Data for Quality (DFQ) Group---is a safe venue for medical directors and other quality-improvement leaders to share performance data on quality-of-care measures for diabetes, hypertension, and cardiovascular disease, as well as insights, lessons learned, and challenges faced by each organization in treating these conditions. The DFQ Group has focused its efforts on improving the quality of services provided by each participating health care organization, and has placed a strong emphasis on analyzing trends in combined quality data to better understand the health of the entire San Diego population. By fostering collaboration among organizations that collectively serve a large portion of the local population and other key community stakeholders, the DFQ Group has helped form the foundation of a unique, multifaceted, multi-stakeholder, regional effort that is gaining national attention and funding for its community-driven approach.

  11. Developing and testing an instrument to measure the presence of conditions for succesful implementation in quality improvement collaboratives.

    NARCIS (Netherlands)

    Dückers, M.L.A.; Wagner, C.; Groenewegen, P.P.

    2008-01-01

    BACKGROUND: In quality improvement collaboratives (QICs) teams of practitioners from different health care organizations are brought together to systematically improve an aspect of patient care. Teams take part in a series of meetings to learn about relevant best practices, quality methods and chang

  12. Applying Collaborative Learning and Quality Improvement to Public Health: Lessons from the Collaborative Improvement and Innovation Network (CoIIN) to Reduce Infant Mortality.

    Science.gov (United States)

    Ghandour, Reem M; Flaherty, Katherine; Hirai, Ashley; Lee, Vanessa; Walker, Deborah Klein; Lu, Michael C

    2017-06-01

    Infant mortality remains a significant public health problem in the U.S. The Collaborative Improvement & Innovation Network (CoIIN) model is an innovative approach, using the science of quality improvement and collaborative learning, which was applied across 13 Southern states in Public Health Regions IV and VI to reduce infant mortality and improve birth outcomes. We provide an in-depth discussion of the history, development, implementation, and adaptation of the model based on the experience of the original CoIIN organizers and participants. In addition to the political genesis and functional components of the initiative, 8 key lessons related to staffing, planning, and implementing future CoIINs are described in detail. This paper reports the findings from a process evaluation of the model. Data on the states' progress toward reducing infant mortality and improving birth outcomes were collected through a survey in the final months of a 24-month implementation period, as well as through ongoing team communications. The peer-to-peer exchange and platform for collaborative learning, as well as the sharing of data across the states, were major strengths and form the foundation for future CoIIN efforts. A lasting legacy of the initiative is the unique application and sharing of provisional "real time" data to inform "real time" decision-making. The CoIIN model of collaborative learning, QI, and innovation offers a promising approach to strengthening partnerships within and across states, bolstering data systems to inform and track progress more rapidly, and ultimately accelerating improvement toward healthier communities, States, and the Nation as a whole.

  13. Factors associated with the impact of quality improvement collaboratives in mental healthcare: An exploratory study

    Science.gov (United States)

    2012-01-01

    Background Quality improvement collaboratives (QICs) bring together groups of healthcare professionals to work in a structured manner to improve the quality of healthcare delivery within particular domains. We explored which characteristics of the composition, participation, functioning, and organization of these collaboratives related to changes in the healthcare for patients with anxiety disorders, dual diagnosis, or schizophrenia. Methods We studied three QICs involving 29 quality improvement (QI) teams representing a number of mental healthcare organizations in the Netherlands. The aims of the three QICs were the implementation of multidisciplinary practice guidelines in the domains of anxiety disorders, dual diagnosis, and schizophrenia, respectively. We used eight performance indicators to assess the impact of the QI teams on self-reported patient outcomes and process of care outcomes for 1,346 patients. The QI team members completed a questionnaire on the characteristics of the composition, participation in a national program, functioning, and organizational context for their teams. It was expected that an association would be found between these team characteristics and the quality of care for patients with anxiety disorders, dual diagnosis, and schizophrenia. Results No consistent patterns of association emerged. Theory-based factors did not perform better than practice-based factors. However, QI teams that received support from their management and both active and inspirational team leadership showed better results. Rather surprisingly, a lower average level of education among the team members was associated with better results, although less consistently than the management and leadership characteristics. Team views with regard to the QI goals of the team and attitudes towards multidisciplinary practice guidelines did not correlate with team success. Conclusions No general conclusions about the impact of the characteristics of QI teams on the quality of

  14. Factors associated with the impact of quality improvement collaboratives in mental healthcare: An exploratory study

    Directory of Open Access Journals (Sweden)

    Versteeg Marleen H

    2012-01-01

    Full Text Available Abstract Background Quality improvement collaboratives (QICs bring together groups of healthcare professionals to work in a structured manner to improve the quality of healthcare delivery within particular domains. We explored which characteristics of the composition, participation, functioning, and organization of these collaboratives related to changes in the healthcare for patients with anxiety disorders, dual diagnosis, or schizophrenia. Methods We studied three QICs involving 29 quality improvement (QI teams representing a number of mental healthcare organizations in the Netherlands. The aims of the three QICs were the implementation of multidisciplinary practice guidelines in the domains of anxiety disorders, dual diagnosis, and schizophrenia, respectively. We used eight performance indicators to assess the impact of the QI teams on self-reported patient outcomes and process of care outcomes for 1,346 patients. The QI team members completed a questionnaire on the characteristics of the composition, participation in a national program, functioning, and organizational context for their teams. It was expected that an association would be found between these team characteristics and the quality of care for patients with anxiety disorders, dual diagnosis, and schizophrenia. Results No consistent patterns of association emerged. Theory-based factors did not perform better than practice-based factors. However, QI teams that received support from their management and both active and inspirational team leadership showed better results. Rather surprisingly, a lower average level of education among the team members was associated with better results, although less consistently than the management and leadership characteristics. Team views with regard to the QI goals of the team and attitudes towards multidisciplinary practice guidelines did not correlate with team success. Conclusions No general conclusions about the impact of the characteristics of

  15. Factors associated with the impact of quality improvement collaboratives in mental healthcare: an exploratory study.

    Science.gov (United States)

    Versteeg, Marleen H; Laurant, Miranda G H; Franx, Gerdien C; Jacobs, Annelies J; Wensing, Michel J P

    2012-01-09

    Quality improvement collaboratives (QICs) bring together groups of healthcare professionals to work in a structured manner to improve the quality of healthcare delivery within particular domains. We explored which characteristics of the composition, participation, functioning, and organization of these collaboratives related to changes in the healthcare for patients with anxiety disorders, dual diagnosis, or schizophrenia. We studied three QICs involving 29 quality improvement (QI) teams representing a number of mental healthcare organizations in the Netherlands. The aims of the three QICs were the implementation of multidisciplinary practice guidelines in the domains of anxiety disorders, dual diagnosis, and schizophrenia, respectively. We used eight performance indicators to assess the impact of the QI teams on self-reported patient outcomes and process of care outcomes for 1,346 patients. The QI team members completed a questionnaire on the characteristics of the composition, participation in a national program, functioning, and organizational context for their teams. It was expected that an association would be found between these team characteristics and the quality of care for patients with anxiety disorders, dual diagnosis, and schizophrenia. No consistent patterns of association emerged. Theory-based factors did not perform better than practice-based factors. However, QI teams that received support from their management and both active and inspirational team leadership showed better results. Rather surprisingly, a lower average level of education among the team members was associated with better results, although less consistently than the management and leadership characteristics. Team views with regard to the QI goals of the team and attitudes towards multidisciplinary practice guidelines did not correlate with team success. No general conclusions about the impact of the characteristics of QI teams on the quality of healthcare can be drawn, but support of

  16. 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

  17. Formal quality improvement curriculum and DMAIC method results in interdisciplinary collaboration and process improvement in renal transplant patients.

    Science.gov (United States)

    Leaphart, Cynthia L; Gonwa, Thomas A; Mai, Martin L; Prendergast, Mary B; Wadei, Hani M; Tepas, Joseph J; Taner, C Burcin

    2012-09-01

    Broad-based formal quality improvement curriculum emphasizing Six Sigma and the DMAIC approach developed by our institution is required for physicians in training. DMAIC methods evaluated the common outcome of postoperative hyponatremia, thus resulting in collaboration to prevent hyponatremia in the renal transplant population. To define postoperative hyponatremia in renal transplant recipients, a project charter outlined project aims. To measure postoperative hyponatremia, serum sodium at admission and immediately postoperative were recorded by retrospective review of renal transplant recipient charts from June 29, 2010 to December 31, 2011. An Ishikawa diagram was generated to analyze potential causative factors. Interdisciplinary collaboration and hospital policy assessment determined necessary improvements to prevent hyponatremia. Continuous monitoring in control phase was performed by establishing the goal of <10% of transplant recipients with abnormal serum sodium annually through quarterly reduction of hyponatremia by 30% to reach this goal. Of 54 transplant recipients, postoperative hyponatremia occurred in 92.6% of patients. These potential causes were evaluated: 1) Hemodialysis was more common than peritoneal dialysis. 2) Alemtuzumab induction was more common than antithymocyte globulin. 3) A primary diagnosis of diabetes existed in 16 patients (30%). 4) Strikingly, 51 patients received 0.45% sodium chloride intraoperatively, suggesting this as the most likely cause of postoperative hyponatremia. A hospital policy change to administer 0.9% sodium chloride during renal transplantation resulted in normal serum sodium levels postoperatively in 59 of 64 patients (92.2%). The DMAIC approach and formal quality curriculum for trainees addresses core competencies by providing a framework for problem solving, interdisciplinary collaboration, and process improvement. Copyright © 2012 Elsevier Inc. All rights reserved.

  18. Managing the Learning Quality in Physics by E-Learning Improvement with Collaborative Education

    Science.gov (United States)

    Kanenaga, Masahiko; Suzuki, Masaru; Abe, Kohji; Nakamura, Jin; Takada, Tohru; Kokubo, Nobuhito; Fuseya, Yuki

    In 2010, the University of Electro-Communications (UEC) reconstructed the freshmen's curriculum in which all students learn the same contents of introductory physics and take the examination at same time. We had constructed Collaborative Education in order to support the students who had a various learning history in high school and the teachers who had not been experts in physics education. In this article, we show the result of Collaborative Education in UEC and its improvement strategy.

  19. Nine States’ Use of Collaboratives to Improve Children’s Health Care Quality in Medicaid and CHIP

    Science.gov (United States)

    Devers, Kelly J.; Foster, Leslie; Brach, Cindy

    2016-01-01

    We examine quality improvement (QI) collaboratives underway in 9 states participating in the Children’s Health Insurance Program Reauthorization Act (CHIPRA) Quality Demonstration Grant Program. A total of 147 diverse, child-serving practices were participating in the collaboratives. We conducted 256 semistructured interviews with key stakeholders from March to August 2012—2 years into the 5-year demonstration projects—and analyzed states’ grant applications, operating plans, and progress reports. The collaboratives have multiple complex aims. In addition to developing patient-centered medical home (PCMH) capability, some states use collaboratives to familiarize practices with CMS’s Initial Core Set of Children’s Health Care Quality Measures, practice-level quality measurement, and improving QI knowledge and skills. The duration of the collaboratives is longer than other well-known collaborative models. Collaboratives also vary in their methods for targeting areas for improvement and strategies for motivating practice recruitment and engagement. States also vary with respect to the other strategies they use to support QI and PCMH development. All states supplement the collaboratives with practice facilitation; the majority utilized practice-level parent engagement, but only 4 used work-force augmentation (ie, providing care coordinators and QI specialists). Practice staff highly valued aspects of the collaboratives and supplemental strategies, including the opportunity to work with experts and other child-serving practices; states’ efforts to provide stipends and align demonstration efforts with other professional requirements or programs; receipt of relevant, customized QI materials; opportunities to learn how care coordinators or QI specialists might work in their practice without the risk of hiring them; and satisfaction from learning more about quality measures, QI concepts and techniques, critical medical home components, and how to identify PCMH

  20. Impact of International Quality Improvement Collaborative on Congenital Heart Surgery in Pakistan.

    Science.gov (United States)

    Khan, Amina; Abdullah, Ahmed; Ahmad, Huzaifa; Rizvi, Arjumand; Batool, Sehrish; Jenkins, Kathy J; Gauvreau, Kimberlee; Amanullah, Muneer; Haq, Anwar; Aslam, Nadeem; Minai, Fauzia; Hasan, Babar

    2017-04-13

    The International Quality Improvement Collaborative (IQIC) was formed to reduce mortality and morbidity from congenital heart disease (CHD) surgeries in low/middle-income countries. We conducted this study to compare the postoperative outcomes of CHD surgeries at a centre in Pakistan before and after joining IQIC. The IQIC provides guidelines targeting key drivers responsible for morbidity and mortality in postoperativepatients with CHD. We focused primarily on nurse empowerment and improving the infection control strategies at our centre. Patients with CHD who underwent surgery at this site during the period 2011-2012 (pre-IQIC) were comparedwith those getting surgery in 2013-2014 (post-IQIC). Morbidity (major infections), mortality and factors associated with them were assessed. There was a significant decrease in surgical site infections and bacterial sepsis in the post-IQIC versus pre-IQIC period (1% vs 30%, p=0.0001, respectively). A statistically insignificant decrease in the mortality rate was also noted in post-IQIC versus pre-IQIC period (6% vs 9%, p=0.17, respectively). Durations of ventilation and intensive care unit (ICU) and hospital stay were significantly reduced in the post-IQIC period. Age Surgery score >3, major chromosomal anomalies, perfusion-related event, longer ventilation and ICU/hospital stay durations were associated with greater odds of morbidity and mortality. Enrolling in the IQIC programme was associated with an improvement in the postsurgical outcomes of the CHD surgeries at our centre. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  1. Up Close and Personal: A Statewide Collaborative's Effort to Get Individual Surgeon Quality Improvement Data to the Practitioner.

    Science.gov (United States)

    Daley, Brian J; Cecil, William; Cofer, Joseph B; Clarke, P Chris; Guillamondegui, Oscar

    2016-03-01

    Ranking of surgeons and hospitals focuses on procedure volume and hospitality. The National Surgical Quality Improvement Program provides vetted outcomes of surgical quality and therefore can direct improvement. Our statewide collaborative's analysis creates personalized surgeon data to drive quality improvement. Statewide National Surgical Quality Improvement Program data generated specific measures from 103,656 general/vascular cases and identified individual surgeon's outcome of occurrences and length of procedure. We assumed a normal distribution and called the top 2.5 per cent as exemplars and the bottom 2.5 per cent as outliers. For length of operation, a standard duration was calculated, and identified outliers as longer than the 95th percentile of the upper confidence interval/procedure. Since 2009, sharing best practice reduced statewide mortality rate by 31.5 per cent and postoperative morbidity by 33.3 per cent. For length of surgery, long outliers have more complications (urinary tract infection, organ space/surgical site infection, sepsis, septic shock, prolonged intubation, pneumonia, deep venous thrombosis, deep incisional infection, and wound disruption). No significant trends in surgeon performance were seen over 24 months. A statewide collaborative has resulted in substantial risk-adjusted reductions in surgical morbidity and mortality. These results of the individual surgeon demonstrate best practices are shared, a proven tool for improvement in our collaborative.

  2. Exploring the black box of quality improvement collaboratives: modelling relations between conditions, applied changes and outcomes.

    Science.gov (United States)

    Dückers, Michel L A; Spreeuwenberg, Peter; Wagner, Cordula; Groenewegen, Peter P

    2009-11-17

    Despite the popularity of quality improvement collaboratives (QICs) in different healthcare settings, relatively little is known about the implementation process. The objective of the current study is to learn more about relations between relevant conditions for successful implementation of QICs, applied changes, perceived successes, and actual outcomes. Twenty-four Dutch hospitals participated in a dissemination programme based on QICs. A questionnaire was sent to 237 leaders of teams who joined 18 different QICs to measure changes in working methods and activities, overall perceived success, team organisation, and supportive conditions. Actual outcomes were extracted from a database with team performance indicator data. Multi-level analyses were conducted to test a number of hypothesised relations within the cross-classified hierarchical structure in which teams are nested within QICs and hospitals. Organisational and external change agent support is related positively to the number of changed working methods and activities that, if increased, lead to higher perceived success and indicator outcomes scores. Direct and indirect positive relations between conditions and perceived success could be confirmed. Relations between conditions and actual outcomes are weak. Multi-level analyses reveal significant differences in organisational support between hospitals. The relation between perceived successes and actual outcomes is present at QIC level but not at team level. Several of the expected relations between conditions, applied changes and outcomes, and perceived successes could be verified. However, because QICs vary in topic, approach, complexity, and promised advantages, further research is required: first, to understand why some QIC innovations fit better within the context of the units where they are implemented; second, to assess the influence of perceived success and actual outcomes on the further dissemination of projects over new patient groups.

  3. Exploring the black box of quality improvement collaboratives: modelling relations between conditions, applied changes and outcomes

    Directory of Open Access Journals (Sweden)

    Wagner Cordula

    2009-11-01

    Full Text Available Abstract Introduction Despite the popularity of quality improvement collaboratives (QICs in different healthcare settings, relatively little is known about the implementation process. The objective of the current study is to learn more about relations between relevant conditions for successful implementation of QICs, applied changes, perceived successes, and actual outcomes. Methods Twenty-four Dutch hospitals participated in a dissemination programme based on QICs. A questionnaire was sent to 237 leaders of teams who joined 18 different QICs to measure changes in working methods and activities, overall perceived success, team organisation, and supportive conditions. Actual outcomes were extracted from a database with team performance indicator data. Multi-level analyses were conducted to test a number of hypothesised relations within the cross-classified hierarchical structure in which teams are nested within QICs and hospitals. Results Organisational and external change agent support is related positively to the number of changed working methods and activities that, if increased, lead to higher perceived success and indicator outcomes scores. Direct and indirect positive relations between conditions and perceived success could be confirmed. Relations between conditions and actual outcomes are weak. Multi-level analyses reveal significant differences in organisational support between hospitals. The relation between perceived successes and actual outcomes is present at QIC level but not at team level. Discussion Several of the expected relations between conditions, applied changes and outcomes, and perceived successes could be verified. However, because QICs vary in topic, approach, complexity, and promised advantages, further research is required: first, to understand why some QIC innovations fit better within the context of the units where they are implemented; second, to assess the influence of perceived success and actual outcomes on the

  4. Reorganisation of healthcare services for children and families: Improving collaboration, service quality, and worker well-being.

    Science.gov (United States)

    Martinussen, Monica; Kaiser, Sabine; Adolfsen, Frode; Patras, Joshua; Richardsen, Astrid M

    2017-07-01

    This study is an evaluation of a reorganisation of different services for children and their families in a Norwegian municipality. The main aim of the reorganisation was to improve interprofessional collaboration through integrating different social services for children and their parents. The evaluation was guided by the Job Demands-Resources Model with a focus on social and healthcare workers' experiences of their work, including job demands and resources, service quality, and well-being at work. The survey of the employees was conducted at three measurement points: before (T1) and after (T2, T3) the reorganisation took place, and included between 87 and 122 employees. A secondary aim was to examine the impact of different job resources and job demands on well-being (burnout, engagement, job satisfaction), and service quality. A one-way ANOVA indicated a positive development on many scales, such as collaboration, work conflict, leadership, and perceived service quality, especially from T1 to T2. No changes were detected in burnout, engagement, or job satisfaction over time. Moderated regression analyses (at T3) indicated that job demands were particularly associated with burnout, and job resources with engagement and job satisfaction. Perceived service quality was predicted by both job demands and resources, in addition to the interaction between workload and collaboration. The reorganisation seems to have contributed to a positive development in how collaboration, work conflict, leadership, and service quality were evaluated, but that other changes are needed to increase worker well-being. The value of the study rests on the findings that support co-locating and merging services for children and their families, and that collaboration is an important resource for healthcare professionals.

  5. Driving collaborative improvement processes

    NARCIS (Netherlands)

    Middel, Rick; Gieskes, José; Fisscher, Olaf

    2002-01-01

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

  6. Driving collaborative improvement processes

    NARCIS (Netherlands)

    Middel, R.; Gieskes, J.; Fisscher, O.

    2005-01-01

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

  7. A business case for quality improvement in addiction treatment: evidence from the NIATx collaborative.

    Science.gov (United States)

    Quanbeck, Andrew R; Madden, Lynn; Edmundson, Eldon; Ford, James H; McConnell, K John; McCarty, Dennis; Gustafson, David H

    2012-01-01

    The Network for the Improvement of Addiction Treatment (NIATx) promotes treatment access and retention through a customer-focused quality improvement model. This paper explores the issue of the "business case" for quality improvement in addiction treatment from the provider's perspective. The business case model developed in this paper is based on case examples of early NIATx participants coupled with a review of the literature. Process inefficiencies indicated by long waiting times, high no-show rates, and low continuation rates cause underutilization of capacity and prevent optimal financial performance. By adopting customer-focused practices aimed at removing barriers to treatment access and retention, providers may be able to improve financial performance, increase staff retention, and gain long-term strategic advantage.

  8. Identifying resident care areas for a quality improvement intervention in long-term care: a collaborative approach

    Directory of Open Access Journals (Sweden)

    Cranley Lisa A

    2012-09-01

    Full Text Available Abstract Background In Canada, healthcare aides (also referred to as nurse aides, personal support workers, nursing assistants are unregulated personnel who provide 70-80% of direct care to residents living in nursing homes. Although they are an integral part of the care team their contributions to the resident care planning process are not always acknowledged in the organization. The purpose of the Safer Care for Older Persons [in residential] Environments (SCOPE project was to evaluate the feasibility of engaging front line staff (primarily healthcare aides to use quality improvement methods to integrate best practices into resident care. This paper describes the process used by teams participating in the SCOPE project to select clinical improvement areas. Methods The study employed a collaborative approach to identify clinical areas and through consensus, teams selected one of three areas. To select the clinical areas we recruited two nursing homes not involved in the SCOPE project and sampled healthcare providers and decision-makers within them. A vote counting method was used to determine the top five ranked clinical areas for improvement. Results Responses received from stakeholder groups included gerontology experts, decision-makers, registered nurses, managers, and healthcare aides. The top ranked areas from highest to lowest were pain/discomfort management, behaviour management, depression, skin integrity, and assistance with eating. Conclusions Involving staff in selecting areas that they perceive as needing improvement may facilitate staff engagement in the quality improvement process.

  9. SU-F-P-06: Moving From Computed Radiography to Digital Radiography: A Collaborative Approach to Improve Image Quality

    Energy Technology Data Exchange (ETDEWEB)

    Sandoval, D; Mlady, G; Selwyn, R [University of New Mexico School of Medicine, Albuquerque, NM (United States); Valenti, D; Bateman, T; Norris, V [University of New Mexico Hospital, Albuquerque, New Mexico (United States)

    2016-06-15

    Purpose: To bring together radiologists, technologists, and physicists to utilize post-processing techniques in digital radiography (DR) in order to optimize image acquisition and improve image quality. Methods: Sub-optimal images acquired on a new General Electric (GE) DR system were flagged for follow-up by radiologists and reviewed by technologists and medical physicists. Various exam types from adult musculoskeletal (n=35), adult chest (n=4), and pediatric (n=7) were chosen for review. 673 total images were reviewed. These images were processed using five customized algorithms provided by GE. An image score sheet was created allowing the radiologist to assign a numeric score to each of the processed images, this allowed for objective comparison to the original images. Each image was scored based on seven properties: 1) overall image look, 2) soft tissue contrast, 3) high contrast, 4) latitude, 5) tissue equalization, 6) edge enhancement, 7) visualization of structures. Additional space allowed for additional comments not captured in scoring categories. Radiologists scored the images from 1 – 10 with 1 being non-diagnostic quality and 10 being superior diagnostic quality. Scores for each custom algorithm for each image set were summed. The algorithm with the highest score for each image set was then set as the default processing. Results: Images placed into the PACS “QC folder” for image processing reasons decreased. Feedback from radiologists was, overall, that image quality for these studies had improved. All default processing for these image types was changed to the new algorithm. Conclusion: This work is an example of the collaboration between radiologists, technologists, and physicists at the University of New Mexico to add value to the radiology department. The significant amount of work required to prepare the processing algorithms, reprocessing and scoring of the images was eagerly taken on by all team members in order to produce better quality

  10. 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.

  11. Collaborative study to improve the quality control of rare earth element determinations in environmental matrices

    NARCIS (Netherlands)

    Kramer, K.J.M.; Dorten, W.S.; Groenewoud, H. van het; Haan, E. de; Kramer, G.N.; Monteiro, L.; Muntau, H.; Quevauviller, P.

    1999-01-01

    In order to control the quality of rare earth determinations in environmental matrices, the Standards, Measurements and Testing Programme (formerly Community Bureau of Reference, BCR) of the European Commission has started a project, the final aim of which is to certify four types of matrices (tuna

  12. Developing and testing an instrument to measure the presence of conditions for successful implementation of quality improvement collaboratives

    Directory of Open Access Journals (Sweden)

    Wagner Cordula

    2008-08-01

    Full Text Available Abstract Background In quality improvement collaboratives (QICs teams of practitioners from different health care organizations are brought together to systematically improve an aspect of patient care. Teams take part in a series of meetings to learn about relevant best practices, quality methods and change ideas, and share experiences in making changes in their own local setting. The purpose of this study was to develop an instrument for measuring team organization, external change agent support and support from the team's home institution in a Dutch national improvement and dissemination programme for hospitals based on several QICs. Methods The exploratory methodological design included two phases: a content development and assessment, resulting in an instrument with 15 items, and b field testing (N = 165. Internal consistency reliability was tested via Cronbach's alpha coefficient. Principal component analyses were used to identify underlying constructs. Tests of scaling assumptions according to the multi trait/multi-item matrix, were used to confirm the component structure. Results Three components were revealed, explaining 65% of the variability. The components were labelled 'organizational support', 'team organization' and 'external change agent support'. One item not meeting item-scale criteria was removed. This resulted in a 14 item instrument. Scale reliability ranged from 0.77 to 0.91. Internal item consistency and divergent validity were satisfactory. Conclusion On the whole, the instrument appears to be a promising tool for assessing team organization and internal and external support during QIC implementation. The psychometric properties were good and warrant application of the instrument for the evaluation of the national programme and similar improvement programmes.

  13. Using a Learning Collaborative Strategy With Office-based Practices to Increase Access and Improve Quality of Care for Patients With Opioid Use Disorders.

    Science.gov (United States)

    Nordstrom, Benjamin R; Saunders, Elizabeth C; McLeman, Bethany; Meier, Andrea; Xie, Haiyi; Lambert-Harris, Chantal; Tanzman, Beth; Brooklyn, John; King, Gregory; Kloster, Nels; Lord, Clifton Frederick; Roberts, William; McGovern, Mark P

    2016-01-01

    Rapidly escalating rates of heroin and prescription opioid use have been widely observed in rural areas across the United States. Although US Food and Drug Administration-approved medications for opioid use disorders exist, they are not routinely accessible to patients. One medication, buprenorphine, can be prescribed by waivered physicians in office-based practice settings, but practice patterns vary widely. This study explored the use of a learning collaborative method to improve the provision of buprenorphine in the state of Vermont. We initiated a learning collaborative with 4 cohorts of physician practices (28 total practices). The learning collaborative consisted of a series of 4 face-to-face and 5 teleconference sessions over 9 months. Practices collected and reported on 8 quality-improvement data measures, which included the number of patients prescribed buprenorphine, and the percent of unstable patients seen weekly. Changes from baseline to 8 months were examined using a p-chart and logistic regression methodology. Physician engagement in the learning collaborative was favorable across all 4 cohorts (85.7%). On 6 of the 7 quality-improvement measures, there were improvements from baseline to 8 months. On 4 measures, these improvements were statistically significant (P learning collaborative approach to engage physicians, modestly improve patient access, and significantly reduce practice variation. The strategy is potentially generalizable to other systems and regions struggling with this important public health problem.

  14. Implementing collaborative care for depression treatment in primary care: A cluster randomized evaluation of a quality improvement practice redesign

    Directory of Open Access Journals (Sweden)

    Lee Martin

    2011-10-01

    Full Text Available Abstract Background Meta-analyses show collaborative care models (CCMs with nurse care management are effective for improving primary care for depression. This study aimed to develop CCM approaches that could be sustained and spread within Veterans Affairs (VA. Evidence-based quality improvement (EBQI uses QI approaches within a research/clinical partnership to redesign care. The study used EBQI methods for CCM redesign, tested the effectiveness of the locally adapted model as implemented, and assessed the contextual factors shaping intervention effectiveness. Methods The study intervention is EBQI as applied to CCM implementation. The study uses a cluster randomized design as a formative evaluation tool to test and improve the effectiveness of the redesign process, with seven intervention and three non-intervention VA primary care practices in five different states. The primary study outcome is patient antidepressant use. The context evaluation is descriptive and uses subgroup analysis. The primary context evaluation measure is naturalistic primary care clinician (PCC predilection to adopt CCM. For the randomized evaluation, trained telephone research interviewers enrolled consecutive primary care patients with major depression in the evaluation, referred enrolled patients in intervention practices to the implemented CCM, and re-surveyed at seven months. Results Interviewers enrolled 288 CCM site and 258 non-CCM site patients. Enrolled intervention site patients were more likely to receive appropriate antidepressant care (66% versus 43%, p = 0.01, but showed no significant difference in symptom improvement compared to usual care. In terms of context, only 40% of enrolled patients received complete care management per protocol. PCC predilection to adopt CCM had substantial effects on patient participation, with patients belonging to early adopter clinicians completing adequate care manager follow-up significantly more often than patients of

  15. Adaptation of the Grasha Riechman Student Learning Style Survey and Teaching Style Inventory to assess individual teaching and learning styles in a quality improvement collaborative.

    Science.gov (United States)

    Ford, James H; Robinson, James M; Wise, Meg E

    2016-09-29

    NIATx200, a quality improvement collaborative, involved 201 substance abuse clinics. Each clinic was randomized to one of four implementation strategies: (a) interest circle calls, (b) learning sessions, (c) coach only or (d) a combination of all three. Each strategy was led by NIATx200 coaches who provided direct coaching or facilitated the interest circle and learning session interventions. Eligibility was limited to NIATx200 coaches (N = 18), and the executive sponsor/change leader of participating clinics (N = 389). Participants were invited to complete a modified Grasha Riechmann Student Learning Style Survey and Teaching Style Inventory. Principal components analysis determined participants' preferred learning and teaching styles. Responses were received from 17 (94.4 %) of the coaches. Seventy-two individuals were excluded from the initial sample of change leaders and executive sponsors (N = 389). Responses were received from 80 persons (25.2 %) of the contactable individuals. Six learning profiles for the executive sponsors and change leaders were identified: Collaborative/Competitive (N = 28, 36.4 %); Collaborative/Participatory (N = 19, 24.7 %); Collaborative only (N = 17, 22.1 %); Collaborative/Dependent (N = 6, 7.8 %); Independent (N = 3, 5.2 %); and Avoidant/Dependent (N = 3, 3.9 %). NIATx200 coaches relied primarily on one of four coaching profiles: Facilitator (N = 7, 41.2 %), Facilitator/Delegator (N = 6, 35.3 %), Facilitator/Personal Model (N = 3, 17.6 %) and Delegator (N = 1, 5.9 %). Coaches also supported their primary coaching profiles with one of eight different secondary coaching profiles. The study is one of the first to assess teaching and learning styles within a QIC. Results indicate that individual learners (change leaders and executive sponsors) and coaches utilize multiple approaches in the teaching and practice-based learning of quality improvement (QI) processes

  16. Exemplar pediatric collaborative improvement networks: achieving results.

    Science.gov (United States)

    Billett, Amy L; Colletti, Richard B; Mandel, Keith E; Miller, Marlene; Muething, Stephen E; Sharek, Paul J; Lannon, Carole M

    2013-06-01

    A number of pediatric collaborative improvement networks have demonstrated improved care and outcomes for children. Regionally, Cincinnati Children's Hospital Medical Center Physician Hospital Organization has sustained key asthma processes, substantially increased the percentage of their asthma population receiving "perfect care," and implemented an innovative pay-for-performance program with a large commercial payor based on asthma performance measures. The California Perinatal Quality Care Collaborative uses its outcomes database to improve care for infants in California NICUs. It has achieved reductions in central line-associated blood stream infections (CLABSI), increased breast-milk feeding rates at hospital discharge, and is now working to improve delivery room management. Solutions for Patient Safety (SPS) has achieved significant improvements in adverse drug events and surgical site infections across all 8 Ohio children's hospitals, with 7700 fewer children harmed and >$11.8 million in avoided costs. SPS is now expanding nationally, aiming to eliminate all events of serious harm at children's hospitals. National collaborative networks include ImproveCareNow, which aims to improve care and outcomes for children with inflammatory bowel disease. Reliable adherence to Model Care Guidelines has produced improved remission rates without using new medications and a significant increase in the proportion of Crohn disease patients not taking prednisone. Data-driven collaboratives of the Children's Hospital Association Quality Transformation Network initially focused on CLABSI in PICUs. By September 2011, they had prevented an estimated 2964 CLABSI, saving 355 lives and $103,722,423. Subsequent improvement efforts include CLABSI reductions in additional settings and populations.

  17. Improving Creativity in Collaborative Process

    DEFF Research Database (Denmark)

    Zhou, Chunfang; Purushothaman, Aparna

    2015-01-01

    This paper aims to build a theoretical framework by a literature review that is focusing on how a learning model based on Communities of Practice (CoP) can be useful in collaborative processes in organizational learning contexts. In the light of social approach to learning theories and knowledge...... management, this paper firstly will discuss: (1) learning as a process involving knowledge conversations between different types of knowledge such as tacit knowledge, explicit knowledge, individual knowledge and collective knowledge, and (2) creativity as a driver to the conversations between the different...... types of knowledge. (3) These points drive this paper to develop a knowledge creation model by discussing how CoP can be used to improve creativity in collaborative processes in organizational learning contexts. The point of departure for the learning model is the learning framework proposed...

  18. Improved obstetric safety through programmatic collaboration.

    Science.gov (United States)

    Goffman, Dena; Brodman, Michael; Friedman, Arnold J; Minkoff, Howard; Merkatz, Irwin R

    2014-01-01

    Healthcare safety and quality are critically important issues in obstetrics, and society, healthcare providers, patients and insurers share a common goal of working toward safer practice, and are continuously seeking strategies to facilitate improvements. To this end, 4 New York City voluntary hospitals with large maternity services initiated a unique collaborative quality improvement program. It was facilitated by their common risk management advisors, FOJP Service Corporation, and their professional liability insurer, Hospitals Insurance Company. Under the guidance of 4 obstetrics and gynecology departmental chairmen, consensus best practices for obstetrics were developed which included: implementation of evidence based protocols with audit and feedback; standardized educational interventions; mandatory electronic fetal monitoring training; and enhanced in-house physician coverage. Each institution developed unique safety related expertise (development of electronic documentation, team training, and simulation education), and experiences were shared across the collaborative. The collaborative group developed robust systems for audit of outcomes and documentation quality, as well as enforcement mechanisms. Ongoing feedback to providers served as a key component of the intervention. The liability carrier provided financial support for these patient safety innovations. As a result of the interventions, the overall AOI for our institutions decreased 42% from baseline (January-June 2008) to the most recently reviewed time period (July-December 2011) (10.7% vs 6.2%, p < 0.001). The Weighted Adverse Outcome Score (WAOS) also decreased during the same time period (3.9 vs 2.3, p = 0.001.) Given the improved outcomes noted, our unique program and the process by which it was developed are described in the hopes that others will recognize collaborative partnering with or without insurers as an opportunity to improve obstetric patient safety.

  19. Key components of external facilitation in an acute stroke quality improvement collaborative in the Veterans Health Administration.

    Science.gov (United States)

    Bidassie, Balmatee; Williams, Linda S; Woodward-Hagg, Heather; Matthias, Marianne S; Damush, Teresa M

    2015-05-14

    Facilitation is a key component for successful implementation in several implementation frameworks; however, there is a paucity of research specifying this component. As part of a stroke quality improvement intervention in the Veterans Health Administration (VHA), facilitation plus data feedback was compared to data feedback alone in 11 VA medical facilities. The objective of this study was to elucidate upon the facilitation components of the stroke quality improvement. We conducted a secondary evaluation of external facilitation using semi-structured interviews. Five facilitators and two program directors were interviewed. Qualitative analysis was performed on transcribed interviews to gain an understanding of the role and activities of external facilitators during the on-site and telephone facilitation. Quantitative frequencies were calculated from the self-reported time spent in facilitation tasks by facilitators. The external facilitators saw their role as empowering the clinical teams to take ownership of the process changes at the clinical sites to improve their performance quality. To fulfill this role, they reported engaging in a number of core tasks during telephone and on-site visits including: assessing the context in which the teams were currently operating, guiding the clinical teams through their planned changes and use of process improvement tools, identifying resources and making referrals, holding teams accountable for plan implementation with on-site visits, and providing support and encouragement to the teams. Time spent in facilitation activities changed across time from guiding change (early) to supporting efforts made by the clinical teams (later). Facilitation activity transitioned to more monitoring, problem solving, and intentional work to hand over the clinical improvement process to the site teams with the coach's role being increasingly that of a more distant consultant. Overall, this study demonstrated that external facilitation is not

  20. Collaborative problem solving with a total quality model.

    Science.gov (United States)

    Volden, C M; Monnig, R

    1993-01-01

    A collaborative problem-solving system committed to the interests of those involved complies with the teachings of the total quality management movement in health care. Deming espoused that any quality system must become an integral part of routine activities. A process that is used consistently in dealing with problems, issues, or conflicts provides a mechanism for accomplishing total quality improvement. The collaborative problem-solving process described here results in quality decision-making. This model incorporates Ishikawa's cause-and-effect (fishbone) diagram, Moore's key causes of conflict, and the steps of the University of North Dakota Conflict Resolution Center's collaborative problem solving model.

  1. Opportunities to improve the measurement of audit quality: a call for collaboration between the profession and academics

    NARCIS (Netherlands)

    van Raak, Jeroen; Thürheimer, Ulrike

    2016-01-01

    Audit research relies on a wide range of publicly available measures to examine which factors influence the quality of financial statement audits. While research to date has to rely largely on remote proxies due to a lack of access to proprietary data, there is considerable doubt about the validity

  2. Opportunities to improve the measurement of audit quality : A call for collaboration between the profession and academics

    NARCIS (Netherlands)

    van Raak, J.J.F.; Thürheimer, Ulrike

    2016-01-01

    Audit research relies on a wide range of publicly available measures to examine which factors influence the quality of financial statement audits. While research to date has to rely largely on remote proxies due to a lack of access to proprietary data, there is considerable doubt about the validity

  3. Impact of the International Quality Improvement Collaborative on outcomes after congenital heart surgery: a single center experience in a developing economy.

    Science.gov (United States)

    Balachandran, Rakhi; Kappanayil, Mahesh; Sen, Amitabh Chanchal; Sudhakar, Abhish; Nair, Suresh G; Sunil, G S; Raj, R Benedict; Kumar, Raman Krishna

    2015-01-01

    The International Quality Improvement Collaborative (IQIC) for Congenital Heart Surgery in Developing Countries was initiated to decrease mortality and major complications after congenital heart surgery in the developing world. We sought to assess the impact of IQIC on postoperative outcomes after congenital heart surgery at our institution. The key components of the IQIC program included creation of a robust worldwide database on key outcome measures and nurse education on quality driven best practices using telemedicine platforms. We evaluated 1702 consecutive patients ≤18 years undergoing congenital heart surgery in our institute from January 2010-December 2012 using the IQIC database. Preoperative variables included age, gender, weight at surgery and surgical complexity as per the RACHS-1 model. The outcome variables included, in- hospital mortality, duration of ventilation, intensive care unit (ICU) stay, bacterial sepsis and surgical site infection. The 1702 patients included 771(45.3%) females. The median age was 8 months (0.03-216) and the median weight was 6.1Kg (1-100). The overall in-hospital mortality was 3.1%, Over the three years there was a significant decline in bacterial sepsis (from 15.1%, to 9.6%, P < 0.001), surgical site infection (11.1% to 2.4%, P < 0.001) and duration of ICU stay from 114(8-999) hours to 72 (18-999) hours (P < 0.001) The decline in mortality from (4.3% to 2.2%) did not reach statistical significance. The inclusion of our institution in the IQIC program was associated with improvement in key outcome measures following congenital heart surgery over a three year period.

  4. Impact of the International Quality Improvement Collaborative on outcomes after congenital heart surgery: A single center experience in a developing economy

    Directory of Open Access Journals (Sweden)

    Rakhi Balachandran

    2015-01-01

    Full Text Available Background: The International Quality Improvement Collaborative (IQIC for Congenital Heart Surgery in Developing Countries was initiated to decrease mortality and major complications after congenital heart surgery in the developing world. Objective: We sought to assess the impact of IQIC on postoperative outcomes after congenital heart surgery at our institution. Methods: The key components of the IQIC program included creation of a robust worldwide database on key outcome measures and nurse education on quality driven best practices using telemedicine platforms. We evaluated 1702 consecutive patients ≤18 years undergoing congenital heart surgery in our institute from January 2010-December 2012 using the IQIC database. Preoperative variables included age, gender, weight at surgery and surgical complexity as per the RACHS-1 model. The outcome variables included, in- hospital mortality, duration of ventilation, intensive care unit (ICU stay, bacterial sepsis and surgical site infection. Results: The 1702 patients included 771(45.3% females. The median age was 8 months (0.03-216 and the median weight was 6.1Kg (1-100. The overall in-hospital mortality was 3.1%, Over the three years there was a significant decline in bacterial sepsis (from 15.1%, to 9.6%, P < 0.001, surgical site infection (11.1% to 2.4%, P < 0.001 and duration of ICU stay from 114(8-999 hours to 72 (18-999 hours (P < 0.001 The decline in mortality from (4.3% to 2.2% did not reach statistical significance. Conclusions: The inclusion of our institution in the IQIC program was associated with improvement in key outcome measures following congenital heart surgery over a three year period.

  5. Cultivating collaborative improvement: an action learning approach

    NARCIS (Netherlands)

    Middel, H.G.A.; McNichols, Timothy

    2006-01-01

    The process of implementing collaborative initiatives across disparate members of supply networks is fraught with difficulties. One approach designed to tackle the difficulties of organisational change and interorganisational improvement in practice is 'action learning'. This paper examines the

  6. A cluster randomized controlled trial aimed at implementation of local quality improvement collaboratives to improve prescribing and test ordering performance of general practitioners: Study Protocol

    Directory of Open Access Journals (Sweden)

    Winkens Ron

    2009-02-01

    Full Text Available Abstract Background The use of guidelines in general practice is not optimal. Although evidence-based methods to improve guideline adherence are available, variation in physician adherence to general practice guidelines remains relatively high. The objective for this study is to transfer a quality improvement strategy based on audit, feedback, educational materials, and peer group discussion moderated by local opinion leaders to the field. The research questions are: is the multifaceted strategy implemented on a large scale as planned?; what is the effect on general practitioners' (GPs test ordering and prescribing behaviour?; and what are the costs of implementing the strategy? Methods In order to evaluate the effects, costs and feasibility of this new strategy we plan a multi-centre cluster randomized controlled trial (RCT with a balanced incomplete block design. Local GP groups in the south of the Netherlands already taking part in pharmacotherapeutic audit meeting groups, will be recruited by regional health officers. Approximately 50 groups of GPs will be randomly allocated to two arms. These GPs will be offered two different balanced sets of clinical topics. Each GP within a group will receive comparative feedback on test ordering and prescribing performance. The feedback will be discussed in the group and working agreements will be created after discussion of the guidelines and barriers to change. The data for the feedback will be collected from existing and newly formed databases, both at baseline and after one year. Discussion We are not aware of published studies on successes and failures of attempts to transfer to the stakeholders in the field a multifaceted strategy aimed at GPs' test ordering and prescribing behaviour. This pragmatic study will focus on compatibility with existing infrastructure, while permitting a certain degree of adaptation to local needs and routines. Trial registration Nederlands Trial Register ISRCTN40008171

  7. The influence of learning in collaborative improvement

    DEFF Research Database (Denmark)

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

    2008-01-01

    takes a learning perspective on collaborative improvement and addresses the question: How do organisational learning and collaboration interplay and affect improvement performance? Based on an analysis of three dyads of the same Extended Manufacturing Enterprise, this paper concludes that a robust......Collaborative improvement is a purposeful inter-company interactive process that focuses on continuous incremental innovation aimed at enhancing the partnership's overall performance. Considering that in such an environment the capability to learn jointly and individually is crucial, this paper...... learning environment (willing and able to learn) creates operational, relational and learning outcomes - a self-reinforcing process. A weak learning environment (some willingness but limited ability to learn) creates operational outcomes but is sensitive to 'accidents' and thus at risk of actually...

  8. 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.

  9. Information technology implementing globalization on strategies for quality care provided to children submitted to cardiac surgery: International Quality Improvement Collaborative Program - IQIC

    Directory of Open Access Journals (Sweden)

    Adilia Maria Pires Sciarra

    2014-03-01

    Full Text Available Introduction: Congenital heart diseases are the world's most common major birth defect, affecting one in every 120 children. Ninety percent of these children are born in areas where appropriate medical care is inadequate or unavailable. Objective: To share knowledge and experience between an international center of excellence in pediatric cardiac surgery and a related program in Brazil. Methods: The strategy used by the program was based on long-term technological and educational support models used in that center, contributing to the creation and implementation of new programs. The Telemedicine platform was used for real-time monthly broadcast of themes. A chat software was used for interaction between participating members and the group from the center of excellence. Results: Professionals specialized in care provided to the mentioned population had the opportunity to share to the knowledge conveyed. Conclusion: It was possible to observe that the technological resources that implement the globalization of human knowledge were effective in the dissemination and improvement of the team regarding the care provided to children with congenital heart diseases.

  10. Information technology implementing globalization on strategies for quality care provided to children submitted to cardiac surgery: International Quality Improvement Collaborative Program--IQIC.

    Science.gov (United States)

    Sciarra, Adilia Maria Pires; Croti, Ulisses Alexandre; Batigalia, Fernando

    2014-01-01

    Congenital heart diseases are the world's most common major birth defect, affecting one in every 120 children. Ninety percent of these children are born in areas where appropriate medical care is inadequate or unavailable. To share knowledge and experience between an international center of excellence in pediatric cardiac surgery and a related program in Brazil. The strategy used by the program was based on long-term technological and educational support models used in that center, contributing to the creation and implementation of new programs. The Telemedicine platform was used for real-time monthly broadcast of themes. A chat software was used for interaction between participating members and the group from the center of excellence. Professionals specialized in care provided to the mentioned population had the opportunity to share to the knowledge conveyed. It was possible to observe that the technological resources that implement the globalization of human knowledge were effective in the dissemination and improvement of the team regarding the care provided to children with congenital heart diseases.

  11. Information technology implementing globalization on strategies for quality care provided to children submitted to cardiac surgery: International Quality Improvement Collaborative Program - IQIC

    Science.gov (United States)

    Sciarra, Adilia Maria Pires; Croti, Ulisses Alexandre; Batigalia, Fernando

    2014-01-01

    Introduction Congenital heart diseases are the world's most common major birth defect, affecting one in every 120 children. Ninety percent of these children are born in areas where appropriate medical care is inadequate or unavailable. Objective To share knowledge and experience between an international center of excellence in pediatric cardiac surgery and a related program in Brazil. Methods The strategy used by the program was based on long-term technological and educational support models used in that center, contributing to the creation and implementation of new programs. The Telemedicine platform was used for real-time monthly broadcast of themes. A chat software was used for interaction between participating members and the group from the center of excellence. Results Professionals specialized in care provided to the mentioned population had the opportunity to share to the knowledge conveyed. Conclusion It was possible to observe that the technological resources that implement the globalization of human knowledge were effective in the dissemination and improvement of the team regarding the care provided to children with congenital heart diseases. PMID:24896168

  12. Interprofessional Collaborative Practice to Improve Patient Outcomes: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Jennifer Styron

    2014-06-01

    Full Text Available This project focused on a pilot project implemented during the 2013-2014 academic year. The overall purpose was to facilitate interprofessional collaborative practice innovations through the development of leadership, core competencies, and the use of technology, especially among nurses. Nursing, medicine, and physician assistant students were educated on the IOM competencies for interprofessional teams and the core competencies identified by the Interprofessional Education Collaborative Expert Panel [1] to develop knowledge, skills, and attitudes needed to practice in the collaborative practice environments. The project addressed four goals: Develop faculty expertise and leadership in interprofessional collaborative practice to provide a current, high quality education to nursing, physician assistant, and medical students; Implement a culturally responsive and respectful collaborative interprofessional practice curriculum to prepare nurses, physician assistants, and medical students to deliver high quality, efficient, team-based care in a dynamically evolving environment; Focus interprofessional collaborative practice education on models and practices that lead to improvement in patient outcomes; and Evaluate the program and disseminate best practices. Findings from this pilot include strategies to engage different health professions' students and faculty, partnering with community agencies, building an effective interprofessional team to guide the project, and seeking funding for extension and expansion of the offerings.

  13. Interprofessional Collaborative Practice to Improve Patient Outcomes: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Jennifer Styron

    2014-10-01

    Full Text Available This project focused on a pilot project implemented during the 2013-2014 academic year. The overall purpose was to facilitate interprofessional collaborative practice innovations through the development of leadership, core competencies, and the use of technology, especially among nurses. Nursing, medicine, and physician assistant students were educated on the IOM competencies for interprofessional teams and the core competencies identified by the Interprofessional Education Collaborative Expert Panel [1] to develop knowledge, skills, and attitudes needed to practice in the collaborative practice environments. The project addressed four goals: Develop faculty expertise and leadership in interprofessional collaborative practice to provide a current, high quality education to nursing, physician assistant, and medical students; Implement a culturally responsive and respectful collaborative interprofessional practice curriculum to prepare nurses, physician assistants, and medical students to deliver high quality, efficient, team-based care in a dynamically evolving environment; Focus interprofessional collaborative practice education on models and practices that lead to improvement in patient outcomes; and Evaluate the program and disseminate best practices. Findings from this pilot include strategies to engage different health professions' students and faculty, partnering with community agencies, building an effective interprofessional team to guide the project, and seeking funding for extension and expansion of the offerings.

  14. Continuous Improvement and Collaborative Improvement: Similarities and Differences

    NARCIS (Netherlands)

    Middel, Rick; Boer, Harry; Fisscher, Olaf

    2006-01-01

    A substantial body of theoretical and practical knowledge has been developed on continuous improvement. However, there is still a considerable lack of empirically grounded contributions and theories on collaborative improvement, that is, continuous improvement in an inter-organizational setting. The

  15. 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

  16. 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....

  17. Understanding organisational development, sustainability, and diffusion of innovations within hospitals participating in a multilevel quality collaborative.

    NARCIS (Netherlands)

    Dückers, M.L.A.; Wagner, C.; Vos, L.; Groenewegen, P.P.

    2011-01-01

    BACKGROUND: Between 2004 and 2008, 24 Dutch hospitals participated in a two-year multilevel quality collaborative (MQC) comprised of (a) a leadership programme for hospital executives, (b) six quality-improvement collaboratives (QICs) for healthcare professionals and other staff, and (c) an internal

  18. Understanding organisational development, sustainability, and diffusion of innovations within hospitals participating in a multilevel quality collaborative.

    NARCIS (Netherlands)

    Dückers, M.L.A.; Wagner, C.; Vos, L.; Groenewegen, P.P.

    2011-01-01

    BACKGROUND: Between 2004 and 2008, 24 Dutch hospitals participated in a two-year multilevel quality collaborative (MQC) comprised of (a) a leadership programme for hospital executives, (b) six quality-improvement collaboratives (QICs) for healthcare professionals and other staff, and (c) an internal

  19. Strategic Collaborative Quality Management and Employee Job Satisfaction

    Directory of Open Access Journals (Sweden)

    Ali Mohammad Mosadeghrad

    2014-05-01

    Full Text Available Background This study aimed to examine Strategic Collaborative Quality Management (SCQM impact on employee job satisfaction. Methods The study presents a case study over six years following the implementation of the SCQM programme in a public hospital. A validated questionnaire was used to measure employees’ job satisfaction. The impact of the intervention was measured by comparing the pre-intervention and post-intervention measures in the hospital. Results The hospital reported a significant improvement in some dimensions of job satisfaction like management and supervision, organisational policies, task requirement, and working conditions. Conclusion This paper provides detailed information on how a quality management model implementation affects employees. A well developed, well introduced and institutionalised quality management model can improve employees’ job satisfaction. However, the success of quality management needs top management commitment and stability.

  20. Strategic collaborative quality management and employee job satisfaction

    Science.gov (United States)

    Mosadeghrad, Ali Mohammad

    2014-01-01

    Background: This study aimed to examine Strategic Collaborative Quality Management (SCQM) impact on employee job satisfaction. Methods: The study presents a case study over six years following the implementation of the SCQM programme in a public hospital. A validated questionnaire was used to measure employees’ job satisfaction. The impact of the intervention was measured by comparing the pre-intervention and post-intervention measures in the hospital. Results: The hospital reported a significant improvement in some dimensions of job satisfaction like management and supervision, organisational policies, task requirement, and working conditions. Conclusion: This paper provides detailed information on how a quality management model implementation affects employees. A well developed, well introduced and institutionalised quality management model can improve employees’ job satisfaction. However, the success of quality management needs top management commitment and stability. PMID:24847482

  1. 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....

  2. Collaborative Business Models for Exploration: - The Expansion of Public-Private Partnerships to Enable Exploration and Improve the Quality of Life on Earth

    Science.gov (United States)

    Davis, Jeffrey R.

    2012-01-01

    In May of 2007, The Space Life Sciences Strategy was published, launching a series of efforts aimed at driving human health and performance innovations that both meet space flight needs and benefit life on Earth. These efforts, led by the Space Life Science Directorate (SLSD) at the NASA Johnson Space Center, led to the development and implementation of the NASA Human Health and Performance Center (NHHPC) in October 2010. The NHHPC now has over 100 members including seven NASA centers; other federal agencies; some of the International Space Station partners; industry; academia and non-profits. The NHHPC seeks to share best practices, develop collaborative projects and experiment with open collaboration techniques such as crowdsourcing. Using this approach, the NHHPC collaborative projects are anticipated to be at the earliest possible stage of development utilizing the many possible public-private partnerships in this center. Two workshops have been successfully conducted in 2011 (January and October) with a third workshop planned for the spring of 2012. The challenges of space flight are similar in many respects to providing health care and environmental monitoring in challenging settings on the earth. These challenges to technology development include the need for low power consumption, low weight, in-situ analysis, operator independence (i.e., minimal training), robustness, and limited resupply or maintenance. When similar technology challenges are identified (such as the need to provide and monitor a safe water supply or develop a portable medical diagnostic device for remote use), opportunities arise for public-private partnerships to engage in co-creation of novel approaches for space exploration and health and environmental applications on earth. This approach can enable the use of shared resources to reduce costs, engage other organizations and the public in participatory exploration (solving real-world problems), and provide technologies with multiple uses

  3. Improving medical education in Kenya: an international collaboration.

    Science.gov (United States)

    Mayo, Alexa

    2014-04-01

    This paper describes a partnership between the University of Nairobi College of Health Sciences (CHS) Library and the University of Maryland Health Sciences and Human Services Library (HS/HSL). The libraries are collaborating to develop best practices for the CHS Library as it meets the challenge of changing medical education information needs in a digital environment. The collaboration is part of a Medical Education Partnership Initiative. The library project has several components: an assessment of the CHS Library, learning visits in the United States and Kenya, development of recommendations to enhance the CHS Library, and ongoing evaluation of the program's progress. Development of new services and expertise at the CHS Library is critical to the project's success. A productive collaboration between the HS/HSL and CHS Library is ongoing. A successful program to improve the quality of medical education will have a beneficial impact on health outcomes in Kenya.

  4. Continuous Improvement and Collaborative Improvement: Similarities and Differences

    DEFF Research Database (Denmark)

    Middel, Rick; Boer, Harry; Fisscher, Olaf

    2006-01-01

    A substantial body of theoretical and practical knowledge has been developed on continuous improvement. However, there is still a considerable lack of impirically grounded contributions and theories on collaborative improvement, that is, continuous improvement in an interorganizational setting....... The CO-IMPROVE project investigated whether and how the concept of continuous improvement can be extended and transferred to such settings. The objective of this article is ti evaluate the CO-IMPROVE research findings in view of existing theories on continuous innovation. The article investigates...

  5. Establishment of a Web-based System for Collection of Patient-reported Outcomes After Radical Prostatectomy in a Statewide Quality Improvement Collaborative.

    Science.gov (United States)

    Lucas, Steven M; Kim, Tae-Kyung; Ghani, Khurshid R; Miller, David C; Linsell, Susan; Starr, Jay; Peabody, James O; Hurley, Patrick; Montie, James; Cher, Michael L

    2017-09-01

    To report on the establishment of a unified, electronic patient-reported outcome (PRO) infrastructure and pilot results from the first 5 practices enrolled in the web-based collection system developed by the Michigan Urological Surgery Improvement Collaborative. Eligible patients were those undergoing radical prostatectomy of 5 academic and community practices. PRO was obtained using a validated 21-item web-based questionnaire, regarding urinary function, erection function, and sexual interest and satisfaction. Data were collected preoperatively, at 3 months, and 6 months postoperatively. Patients were provided a link via email to complete the surveys. Perioperative and PRO data were analyzed as reports for individual patients and summary performance reports for individual surgeons. Among 773 eligible patients, 688 (89%) were enrolled preoperatively. Survey completion rate was 88%, 84%, and 90% preoperatively, at 3 months, and 6 months. Electronic completion rates preoperatively, at 3 months, and 6 months were 70%, 70%, and 68%, respectively. Mean urinary function scores were 18.3, 14.3, and 16.6 (good function ≥ 17), whereas mean erection scores were 18.7, 7.3, and 9.1 (good erection score ≥ 22) before surgery, at 3 months, and 6 months. Variation was noted for erectile function among the practices. Collection of electronic PRO via this unified, web-based format was successful and provided results that reflect expected recovery and identify opportunities for improvement. This will be extended to more practices statewide to improve outcomes after radical prostatectomy. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Plan to Have No Unplanned: A Collaborative, Hospital-Based Quality-Improvement Project to Reduce the Rate of Unplanned Extubations in the Pediatric ICU.

    Science.gov (United States)

    Tripathi, Sandeep; Nunez, Denise J; Katyal, Chaavi; Ushay, H Michael

    2015-08-01

    Although under-reported and understudied, unplanned extubations carry a significant risk of patient harm and even death. They are an important yardstick of quality control of care of intubated patients in the ICU. A unit-based risk assessment and multidisciplinary approach is required to decrease the incidence of unplanned extubations. As part of a quality-improvement initiative of Children's Hospital at Montefiore, all planned and unplanned extubations in a multidisciplinary 20-bed pediatric ICU were evaluated over a 12-month period (January to December 2010). At the end of 6 months, an interim analysis was performed, and high-risk patient groups and patient care factors were identified. These factors were targeted in the second phase of the project. Over this period, there were a total of 267 extubations, of which 231 (87%) were planned extubations and 36 (13%) were unplanned. A patient care policy targeting the risk factors was instituted, along with extensive nursing and other personnel education in the second phase. As a result of this intervention, the unplanned extubation rate in the pediatric ICU decreased from 3.55 to 2.59/100 intubation days. All subjects who had an unplanned extubation during nursing procedures or transport required re-intubation, whereas none of the unplanned extubations during ventilator weaning required re-intubation. A targeted approach based on unit-specific risk factors is most effective in quality-improvement projects. A specific policy for sedation and weaning can be very helpful in managing intubated patients and preventing unintended harm. Copyright © 2015 by Daedalus Enterprises.

  7. Using Collaborative Course Development to Achieve Online Course Quality Standards

    Science.gov (United States)

    Chao, Ining Tracy; Saj, Tami; Hamilton, Doug

    2010-01-01

    The issue of quality is becoming front and centre as online distance education moves into the mainstream of higher education. Many believe collaborative course development is the best way to design quality online courses. This research uses a case study approach to probe into the collaborative course development process and the implementation of…

  8. Improving together: collaborative learning in science communication

    Science.gov (United States)

    Stiller-Reeve, Mathew

    2015-04-01

    Most scientists today recognise that science communication is an important part of the scientific process. Despite this recognition, science writing and communication are generally taught outside the normal academic schedule. If universities offer such courses, they are generally short-term and intensive. On the positive side, such courses rarely fail to motivate. At no fault of their own, the problem with such courses lies in their ephemeral nature. The participants rarely complete a science communication course with an immediate and pressing need to apply these skills. And so the skills fade. We believe that this stalls real progress in the improvement of science communication across the board. Continuity is one of the keys to success! Whilst we wait for the academic system to truly integrate science communication, we can test and develop other approaches. We suggest a new approach that aims to motivate scientists to continue nurturing their communication skills. This approach adopts a collaborative learning framework where scientists form writing groups that meet regularly at different institutes around the world. The members of the groups learn, discuss and improve together. The participants produce short posts, which are published online. In this way, the participants learn and cement basic writing skills. These skills are transferrable, and can be applied to scientific articles as well as other science communication media. In this presentation we reflect on an ongoing project, which applies a collaborative learning framework to help young and early career scientists improve their writing skills. We see that this type of project could be extended to other media such as podcasts, or video shorts.

  9. Cultivating Collaborative Improvement: An Action Learning Approach

    NARCIS (Netherlands)

    Middel, H.G.A.; McNichols, Timothy

    2004-01-01

    As competitive pressure mounts to innovate in the global knowledge economy, many organizations are exploring new ways of collaborating with their supply chain partners. However, the process of implementing collaborative initiatives across disparate members of supply networks is fraught with

  10. Spreading improvements for advanced COPD care through a Canadian Collaborative

    Directory of Open Access Journals (Sweden)

    Rocker GM

    2017-07-01

    Full Text Available Graeme M Rocker,1 Claudia Amar,2 Wendy L Laframboise,3 Jane Burns,4 Jennifer Y Verma2 1Division of Respirology, Nova Scotia Health Authority/Dalhousie University, Halifax, NS, 2Canadian Foundation for Healthcare Improvement, 3The Ottawa Hospital COPD Outreach Program, Ottawa, ON, 4Providence COPD Outreach Program, Vancouver, BC, Canada Background: A year-long pan-Canadian quality improvement collaborative (QIC led by the Canadian Foundation for Healthcare Improvement (CFHI supported the spread of the successful Halifax, Nova Scotia-based INSPIRED COPD Outreach Program™ to 19 teams in the 10 Canadian provinces. We describe QIC results, addressing two main questions: 1 Can the results of the Nova Scotia INSPIRED model be replicated elsewhere in Canada? 2 How did the teams implement and evaluate their versions of the INSPIRED program?Methods: Collaborative faculty selected measures that were evidence-based, relatively simple to collect, and relevant to local context. Chosen process and outcome measures are related to four quality domains: 1 patient- and family-centeredness, 2 coordination, 3 efficiency, and 4 appropriateness. Evaluation of a complex intervention followed a mixed-methods approach.Results: Most participants were nurse managers and/or COPD educators. Only 8% were physicians. Fifteen teams incorporated all core INSPIRED interventions. All teams carried out evaluation. Thirteen teams actively involved patients and families in customized, direct care planning, eg, asking them to complete evaluative surveys and/or conducting interviews. Patients consistently reported greater self-confidence in symptom management, a return to daily activities, and improvements to quality of life. Twelve teams collected data on care transitions using the validated three-item Care Transitions Measure (CTM-3. Twelve teams used the Lung Information Needs Questionnaire (LINQ. Admissions, emergency room visits, and patient-related costs fell substantially for

  11. A Collaborative Learning Network Approach to Improvement: The CUSP Learning Network.

    Science.gov (United States)

    Weaver, Sallie J; Lofthus, Jennifer; Sawyer, Melinda; Greer, Lee; Opett, Kristin; Reynolds, Catherine; Wyskiel, Rhonda; Peditto, Stephanie; Pronovost, Peter J

    2015-04-01

    Collaborative improvement networks draw on the science of collaborative organizational learning and communities of practice to facilitate peer-to-peer learning, coaching, and local adaption. Although significant improvements in patient safety and quality have been achieved through collaborative methods, insight regarding how collaborative networks are used by members is needed. Improvement Strategy: The Comprehensive Unit-based Safety Program (CUSP) Learning Network is a multi-institutional collaborative network that is designed to facilitate peer-to-peer learning and coaching specifically related to CUSP. Member organizations implement all or part of the CUSP methodology to improve organizational safety culture, patient safety, and care quality. Qualitative case studies developed by participating members examine the impact of network participation across three levels of analysis (unit, hospital, health system). In addition, results of a satisfaction survey designed to evaluate member experiences were collected to inform network development. Common themes across case studies suggest that members found value in collaborative learning and sharing strategies across organizational boundaries related to a specific improvement strategy. The CUSP Learning Network is an example of network-based collaborative learning in action. Although this learning network focuses on a particular improvement methodology-CUSP-there is clear potential for member-driven learning networks to grow around other methods or topic areas. Such collaborative learning networks may offer a way to develop an infrastructure for longer-term support of improvement efforts and to more quickly diffuse creative sustainment strategies.

  12. Cultivating Collaborative Improvement: An Action Learning Approach

    NARCIS (Netherlands)

    Middel, Rick; McNichols, Timothy

    2004-01-01

    As competitive pressure mounts to innovate in the global knowledge economy, many organizations are exploring new ways of collaborating with their supply chain partners. However, the process of implementing collaborative initiatives across disparate members of supply networks is fraught with difficul

  13. Quality of collaborative interactions in different CSCL-environments

    NARCIS (Netherlands)

    Kanselaar, G.; Munneke, E.L.; Andriessen, J.E.B.

    2003-01-01

    In the Twins project we study the quality of interactions during collaborative learning in different CSCL-environments. The aim of the research is investigating the effects of synchronous and asynchronous systems and different collaborative tasks on interactions between students. Two experiments

  14. Collaborative Network Management for Enhancing Quality Education of Primary Schools

    Science.gov (United States)

    Chaikoed, Wisithsak; Sirisuthi, Chaiyuth; Numnaphol, Kochaporn

    2017-01-01

    This research aims to study the network and collaborative factors that enhance quality education of primary schools. Different methods were used in this research work: (1) Related approaches, theories, and research literatures and (2) Scholars were interviewed on 871 issues in the form of questionnaire, and the collaborative network factors were…

  15. Improving Quality and Child Outcomes in Early Childhood Education by Redefining the Role Afforded to Teachers in Professional Development: A Continuous Quality Improvement Learning Collaborative among Public Preschools in Chile

    Science.gov (United States)

    Arbour, MaryCatherine; Yoshikawa, Hirokazu; Atwood, Sid; Duran Mellado, Francis Romina; Godoy Ossa, Felipe; Trevino Villareal, Ernesto; Snow, Catherine E.

    2016-01-01

    Based on evidence derived from studies conducted mostly in the United States, many low- and middle-income countries are investing in early childhood education (ECE), with high expectations that it will improve academic outcomes, increase human capital, promote economic growth and reduce economic inequality. In Chile, there has been a great…

  16. Contextualizing learning to improve care using collaborative communities of practices.

    Science.gov (United States)

    Jeffs, Lianne; McShane, Julie; Flintoft, Virginia; White, Peggy; Indar, Alyssa; Maione, Maria; Lopez, A J; Bookey-Bassett, Sue; Scavuzzo, Lauren

    2016-09-02

    The use of interorganizational, collaborative approaches to build capacity in quality improvement (QI) in health care is showing promise as a useful model for scaling up and accelerating the implementation of interventions that bridge the "know-do" gap to improve clinical care and provider outcomes. Fundamental to a collaborative approach is interorganizational learning whereby organizations acquire, share, and combine knowledge with other organizations and have the opportunity to learn from their respective successes and challenges in improvement areas. This learning approach aims to create the conditions for collaborative, reflective, and innovative experiential systems that enable collective discussions regarding daily practice issues and finding solutions for improvement. The concepts associated with interorganizational learning and deliberate learning activities within a collaborative 'Communities-of-practice'(CoP) approach formed the foundation of the of an interactive QI knowledge translation initiative entitled PERFORM KT. Nine teams participated including seven teams from two acute care hospitals, one from a long term care center, and one from a mental health sciences center. Six monthly CoP learning sessions were held and teams, with the support of an assigned mentor, implemented a QI project and monitored their results which were presented at an end of project symposium. 47 individuals participated in either a focus group or a personal interview. Interviews were transcribed and analyzed using an iterative content analysis. Four key themes emerged from the narrative dataset around experiences and perceptions associated with the PERFORM KT initiative: 1) being successful and taking it to other levels by being systematic, structured, and mentored; 2) taking it outside the comfort zone by being exposed to new concepts and learning together; 3) hearing feedback, exchanging stories, and getting new ideas; and 4) having a pragmatic and accommodating approach to

  17. Organizations Collaborating to Improve Educational Practice.

    Science.gov (United States)

    Yin, Robert K.; Gwaltney, Margaret K.

    Three case studies of interorganizational collaboration between regional education agencies (REAs) and school districts illustrate how successful knowledge utilization occurs. Researchers studied how knowledge utilization services in four areas--staff development, linking agent assistance, information retrieval, and broad organizational…

  18. Organizations Collaborating to Improve Educational Practice.

    Science.gov (United States)

    Yin, Robert K.; Gwaltney, Margaret K.

    Three case studies of interorganizational collaboration between regional education agencies (REAs) and school districts illustrate how successful knowledge utilization occurs. Researchers studied how knowledge utilization services in four areas--staff development, linking agent assistance, information retrieval, and broad organizational…

  19. 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

  20. Physician professionalism and accountability: the role of collaborative improvement networks.

    Science.gov (United States)

    Miles, Paul V; Conway, Patrick H; Pawlson, L Gregory

    2013-06-01

    The medical profession is facing an imperative to deliver more patient-centered care, improve quality, and reduce unnecessary costs and waste. With significant unexplained variation in resource use and outcomes, even physicians and health care organizations with "the best" reputations cannot assume they always deliver the best care possible. Going forward, physicians will need to demonstrate professionalism and accountability in a different way: to their peers, to society in general, and to individual patients. The new accountability includes quality and clinical outcomes but also resource utilization, appropriateness and patient-centeredness of recommended care, and the responsibility to help improve systems of care. The pediatric collaborative improvement network model represents an important framework for helping transform health care. For individual physicians, participation in a multisite network offers the opportunity to demonstrate accountability by measuring and improving care as part of an approach that addresses the problems of small sample size, attribution, and unnecessary variation in care by pooling patients from individual practices and requiring standardization of care to participate. For patients and families, the model helps ensure that they are likely to receive the current best evidence-based recommendation. Finally, this model aligns with payers' goals of purchasing value-based care, rewarding quality and improvement, and reducing unnecessary variation around current best evidenced-based, effective, and efficient care. In addition, within the profession, the American Board of Pediatrics recognizes participation in a multisite quality improvement network as one of the most rigorous and meaningful approaches for a diplomate to meet practice performance maintenance of certification requirements.

  1. Improving Student Teamwork in a Collaborative Project-Based Course

    Science.gov (United States)

    Kapp, Edward

    2009-01-01

    While collaborative student projects can be effective in improving student learning, the failure of students to work together effectively remains a widely reported problem in collaborative learning. This article describes a team-building intervention designed to improve the students' abilities to work together in teams successfully. The…

  2. E-Services quality assessment framework for collaborative networks

    Science.gov (United States)

    Stegaru, Georgiana; Danila, Cristian; Sacala, Ioan Stefan; Moisescu, Mihnea; Mihai Stanescu, Aurelian

    2015-08-01

    In a globalised networked economy, collaborative networks (CNs) are formed to take advantage of new business opportunities. Collaboration involves shared resources and capabilities, such as e-Services that can be dynamically composed to automate CN participants' business processes. Quality is essential for the success of business process automation. Current approaches mostly focus on quality of service (QoS)-based service selection and ranking algorithms, overlooking the process of service composition which requires interoperable, adaptable and secure e-Services to ensure seamless collaboration, data confidentiality and integrity. Lack of assessment of these quality attributes can result in e-Service composition failure. The quality of e-Service composition relies on the quality of each e-Service and on the quality of the composition process. Therefore, there is the need for a framework that addresses quality from both views: product and process. We propose a quality of e-Service composition (QoESC) framework for quality assessment of e-Service composition for CNs which comprises of a quality model for e-Service evaluation and guidelines for quality of e-Service composition process. We implemented a prototype considering a simplified telemedicine use case which involves a CN in e-Healthcare domain. To validate the proposed quality-driven framework, we analysed service composition reliability with and without using the proposed framework.

  3. Understanding organisational development, sustainability, and diffusion of innovations within the hospitals participating in a multilevel quality collaborative.

    NARCIS (Netherlands)

    Duckers, M.L.A.; Wagner, C.; Groenewegen, P.P.

    2011-01-01

    Background: Between 2004 and 2008, 24 Dutch hospitals participated in a two-year multilevel quality collaborative (MQC) comprised of (a) a leadership programme for hospital executives, (b) six quality-improvement collaboratives (QICs) for healthcare professionals and other staff, and (c) an

  4. Understanding organisational development, sustainability, and diffusion of innovations within the hospitals participating in a multilevel quality collaborative.

    NARCIS (Netherlands)

    Duckers, M.L.A.; Wagner, C.; Groenewegen, P.P.

    2011-01-01

    Background: Between 2004 and 2008, 24 Dutch hospitals participated in a two-year multilevel quality collaborative (MQC) comprised of (a) a leadership programme for hospital executives, (b) six quality-improvement collaboratives (QICs) for healthcare professionals and other staff, and (c) an internal

  5. Collaborative Improvement – Interplay but not a Game

    DEFF Research Database (Denmark)

    Kaltoft, Rasmus; Boer, Harry; Chapman, Ross

    2006-01-01

    . Developing collaborative improvement is a protracted and difficult process. Previous research has identified a number of factors affecting that process and suggested that it is not so much the individual factors, but rather their interplay that determines the successful development of collaborative...

  6. Collaborating toward improving food security in Nunavut.

    Science.gov (United States)

    Wakegijig, Jennifer; Osborne, Geraldine; Statham, Sara; Issaluk, Michelle Doucette

    2013-01-01

    Community members, Aboriginal organizations, public servants and academics have long been describing a desperate situation of food insecurity in the Eastern Canadian Arctic. The Nunavut Food Security Coalition, a partnership of Inuit Organizations and the Government of Nunavut, is collaborating to develop a territorial food security strategy to address pervasive food insecurity in the context of poverty reduction. The Nunavut Food Security Coalition has carried out this work using a community consultation model. The research was collected through community visits, stakeholder consultation and member checking at the Nunavut Food Security Symposium. In this paper, we describe a continuous course of action, based on community engagement and collective action, that has led to sustained political interest in and public mobilization around the issue of food insecurity in Nunavut. The process described in this article is a unique collaboration between multiple organizations that has led to the development of a sustainable partnership that will inform policy development while representing the voice of Nunavummiut.

  7. A Simulated Student Can Improve Collaborative Learning

    OpenAIRE

    Vizcaíno, Aurora

    2005-01-01

    Copyright 2005, the International AIED Society. Permission is hereby granted to copy this article provided that copies are not sold or distributed and that IJAIED is credited. The final, printed version is obtainable on-line from IOS Press; This paper describes a Simulated Student architecture designed to detect and avoid three situations that decrease the benefits of learning in collaboration. These are off-topic conversations, students with passive behaviour and problems related to students...

  8. From continuous improvement to collaborative improvement: scope, scale, skill and social networking in collaborative improvement

    NARCIS (Netherlands)

    Middel, H.G.A.; Groen, Arend J.; Fisscher, O.A.M.

    2004-01-01

    More than ever, companies are challenged to improve their performance and respond quickly and accurately to changes within the market. As competitive battlefield is moving towards the level of networks of organisations, the individual firm is an inadequate entity for identifying improvements.

  9. Spreading improvements for advanced COPD care through a Canadian Collaborative

    Science.gov (United States)

    Rocker, Graeme M; Amar, Claudia; Laframboise, Wendy L; Burns, Jane; Verma, Jennifer Y

    2017-01-01

    Background A year-long pan-Canadian quality improvement collaborative (QIC) led by the Canadian Foundation for Healthcare Improvement (CFHI) supported the spread of the successful Halifax, Nova Scotia-based INSPIRED COPD Outreach Program™ to 19 teams in the 10 Canadian provinces. We describe QIC results, addressing two main questions: 1) Can the results of the Nova Scotia INSPIRED model be replicated elsewhere in Canada? 2) How did the teams implement and evaluate their versions of the INSPIRED program? Methods Collaborative faculty selected measures that were evidence-based, relatively simple to collect, and relevant to local context. Chosen process and outcome measures are related to four quality domains: 1) patient- and family-centeredness, 2) coordination, 3) efficiency, and 4) appropriateness. Evaluation of a complex intervention followed a mixed-methods approach. Results Most participants were nurse managers and/or COPD educators. Only 8% were physicians. Fifteen teams incorporated all core INSPIRED interventions. All teams carried out evaluation. Thirteen teams actively involved patients and families in customized, direct care planning, eg, asking them to complete evaluative surveys and/or conducting interviews. Patients consistently reported greater self-confidence in symptom management, a return to daily activities, and improvements to quality of life. Twelve teams collected data on care transitions using the validated three-item Care Transitions Measure (CTM-3). Twelve teams used the Lung Information Needs Questionnaire (LINQ). Admissions, emergency room visits, and patient-related costs fell substantially for two teams described in detail (combined enrollment 208 patients). Most teams reported gaining deeper knowledge around complexities of COPD care, optimizing patient care through action plans, self-management support, psychosocial support, advance care planning, and coordinating community partnerships. Conclusion Quality-of-care gains are achievable

  10. 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.

  11. 2011 John M. Eisenberg Patient Safety and Quality Awards. Mentored implementation: building leaders and achieving results through a collaborative improvement model. Innovation in patient safety and quality at the national level.

    Science.gov (United States)

    Maynard, Gregory A; Budnitz, Tina L; Nickel, Wendy K; Greenwald, Jeffrey L; Kerr, Kathleen M; Miller, Joseph A; Resnic, JoAnne N; Rogers, Kendall M; Schnipper, Jeffrey L; Stein, Jason M; Whitcomb, Winthrop F; Williams, Mark V

    2012-07-01

    The Society of Hospital Medicine (SHM) created "Mentored Implementation" (MI) programs with the dual aims of educating and mentoring hospitalists and their quality improvement (QI) teams and accelerating improvement in the inpatient setting in three signature programs: Venous Thromboembolism (VTE) Prevention, Glycemic Control, and Project BOOST (Better Outcomes for Older adults through Safe Transitions). More than 300 hospital improvement teams were enrolled in SHM MI programs in a series of cohorts. Hospitalist mentors worked with individual hospitals/health systems to guide local teams through the life cycle of a QI project. Implementation Guides and comprehensive Web-based "Resource Rooms," as well as the mentor's own experience, provided best-practice definitions, practical implementation tips, measurement strategies, and other tools. E-mail interactions and mentoring were augmented by regularly scheduled teleconferences; group webinars; and, in some instances, a site visit. Performance was tracked in a centralized data tracking center. Preliminary data on all three MI programs show significant improvement in patient outcomes, as well as enhancements of communication and leadership skills of the hospitalists and their QI teams. Although objective data on outcomes and process measures for the MI program's efficacy remain preliminary at this time, the maturing data tracking system, multiple awards, and early results indicate that the MI programs are successful in providing QI training and accelerating improvement efforts.

  12. Improving Nurse-Physician Teamwork: A Multidisciplinary Collaboration.

    Science.gov (United States)

    Streeton, Abigail; Bisbey, Cindy; O'Neill, Carrie; Allen, Danielle; O'Hara, Sara; Weinhold, Megan; Miller, Jenna; Bursiek, April; Grubbs, Pamela

    2016-01-01

    Nurses surveyed on an inpatient gynecology surgical unit suggested communication and teamwork between nurses and physicians could be improved. To enhance teamwork, a multidisciplinary collaboration committee of nurses and physicians was created.

  13. Collaborative Engineering Environments. Two Examples of Process Improvement

    NARCIS (Netherlands)

    Spee, J.B.R.M.; Bijwaard, D.; Laan, D.J.

    1998-01-01

    Companies are recognising that innovative processes are determining factors in competitiveness. Two examples from projects in aircraft development describe the introduction of collaborative engineering environments as a way to improve engineering processes. A multi-disciplinary simulation environmen

  14. Distributed collaborative team effectiveness: measurement and process improvement

    Science.gov (United States)

    Wheeler, R.; Hihn, J.; Wilkinson, B.

    2002-01-01

    This paper describes a measurement methodology developed for assessing the readiness, and identifying opportunities for improving the effectiveness, of distributed collaborative design teams preparing to conduct a coccurent design session.

  15. Fostering Interdisciplinary Collaboration to Improve Student Learning

    Directory of Open Access Journals (Sweden)

    Ronald A. Styron Jr.

    2014-08-01

    Full Text Available The purpose of this study was to compare the impact on student learning of those enrolled in courses where instructors participated in collegial coaching and peer mentoring. A nonequivalent group design methodology was employed along with an analysis of variance to analyze data. Findings indicated higher mastery levels of student learning outcomes, higher levels of perceived critical thinking and collaboration by students, statistical significance in critical thinking constructs, higher levels of persistence, and more A's and B's and fewer D's and F's in courses where faculty members were mentored as compared to courses where faculty members were not.

  16. 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.

  17. Professional learning communities: Teachers working collaboratively for continuous improvement

    Science.gov (United States)

    Griffith, Louise Ann

    Current research indicates that a professional learning community (PLC) is an effective means for helping teachers to bridge the gap between research and practice. A PLC is a team of educators systematically working together to improve teaching practice and student learning. This study evaluated the PLC formed by teachers at a public elementary school. A 2-part formative assessment was conducted: an implementation evaluation to determine if PLC practices were in place and an evaluation to determine the PLC's progress towards meeting its goals. The PLC consisted of 6 4th grade and 5th grade teachers working to increase their science content and pedagogical knowledge. The foundation of this PLC was based in 4 areas of educational research and theory: constructivism, social learning, multiple intelligences, and differentiated instruction. Data were collected by means of interviews, participant observation, and analysis of artifacts. Data were then analyzed using an iterative set of phases: data reduction, data display, conclusion drawing and verification. The implementation evaluation showed that the PLC was in the developing stage. The progress evaluation showed that the PLC was making significant progress towards its goals of increased collaboration and pedagogical knowledge, but there was insufficient evidence to determine if participants' science content knowledge improved. An executive summary of the results and recommendations was presented to the stakeholders. The positive social change implications include knowledge useful for educators who are searching for direction in improving the quality of professional development offered to elementary teachers.

  18. An exploratory analysis of network characteristics and quality of interactions among public health collaboratives

    Directory of Open Access Journals (Sweden)

    Danielle M. Varda

    2012-06-01

    Full Text Available While the benefits of collaboration have become widely accepted and the practice of collaboration is growing within the public health system, a paucity of research exists that examines factors and mechanisms related to effective collaboration between public health and their partner organizations. The purpose of this paper is to address this gap by exploring the structural and organizational characteristics of public health collaboratives. Design and Methods. Using both social network analysis and traditional statistical methods, we conduct an exploratory secondary data analysis of 11 public health collaboratives chosen from across the United States. All collaboratives are part of the PARTNER (www.partnertool.net database. We analyze data to identify relational patterns by exploring the structure (the way that organizations connect and exchange relationships, in relation to perceptions of value and trust, explanations for varying reports of success, and factors related to outcomes. We describe the characteristics of the collaboratives, types of resource contributions, outcomes of the collaboratives, perceptions of success, and reasons for success. We found high variation and significant differences within and between these collaboratives including perceptions of success. There were significant relationships among various factors such as resource contributions, reasons cited for success, and trust and value perceived by organizations. We find that although the unique structure of each collaborative makes it challenging to identify a specific set of factors to determine when a collaborative will be successful, the organizational characteristics and interorganizational dynamics do appear to impact outcomes. We recommend a quality improvement process that suggests matching assessment to goals and developing action steps for performance improvement.

  19. An Exploratory Analysis of Network Characteristics and Quality of Interactions among Public Health Collaboratives.

    Science.gov (United States)

    Varda, Danielle M; Retrum, Jessica H

    2012-06-15

    While the benefits of collaboration have become widely accepted and the practice of collaboration is growing within the public health system, a paucity of research exists that examines factors and mechanisms related to effective collaboration between public health and their partner organizations. The purpose of this paper is to address this gap by exploring the structural and organizational characteristics of public health collaboratives. Design and Methods. Using both social network analysis and traditional statistical methods, we conduct an exploratory secondary data analysis of 11 public health collaboratives chosen from across the United States. All collaboratives are part of the PARTNER (www.partnertool.net) database. We analyze data to identify relational patterns by exploring the structure (the way that organizations connect and exchange relationships), in relation to perceptions of value and trust, explanations for varying reports of success, and factors related to outcomes. We describe the characteristics of the collaboratives, types of resource contributions, outcomes of the collaboratives, perceptions of success, and reasons for success. We found high variation and significant differences within and between these collaboratives including perceptions of success. There were significant relationships among various factors such as resource contributions, reasons cited for success, and trust and value perceived by organizations. We find that although the unique structure of each collaborative makes it challenging to identify a specific set of factors to determine when a collaborative will be successful, the organizational characteristics and interorganizational dynamics do appear to impact outcomes. We recommend a quality improvement process that suggests matching assessment to goals and developing action steps for performance improvement. the authors would like to thank the Robert Wood Johnson Foundation's Public Health Program for funding for this research.

  20. Job satisfaction and perceptions of quality of patient care, collaboration and teamwork in acute care hospitals.

    Science.gov (United States)

    Chang, Wen-Yin; Ma, Jui-Chu; Chiu, Hsiao-Ting; Lin, Kuan-Chia; Lee, Pi-Hsia

    2009-09-01

    This paper is a report of a study conducted to compare levels of job satisfaction and perceptions of the quality of patient care, collaboration and teamwork among healthcare professionals in four acute care hospitals and to determine the factors associated with job satisfaction for physicians, nurses and other healthcare professionals. Positive inter-professional relationships improve quality of patient care and staff job satisfaction. Understanding how healthcare professionals perceive their relationships with each other, and identifying factors that affect their job satisfaction and perceptions of the quality patient care, inform quality improvements. This cross-sectional survey study was conducted in four hospitals in Taiwan. Data were collected in 2007 and analysed using descriptive statistics, one-way anova with the Games-Howell post hoc test and stepwise regression analysis. The survey was completed by 1475 respondent, giving a response rate of 52.2% (180 physicians, 1019 nurses and 276 other healthcare professionals). Physicians were more satisfied with their jobs (F = 26.75, P collaborative relationships than did physicians or other healthcare professionals (F = 279.51, P collaborative relationships were the most important predictors of job satisfaction for healthcare providers. These findings provide important clues for improving interdisciplinary collaboration and ensuring quality patient care through good job satisfaction and teamwork among healthcare professionals in acute care hospitals.

  1. Question Answering for Collaborative Learning with Answer Quality Predictor

    Directory of Open Access Journals (Sweden)

    Kohei Arai

    2013-06-01

    Full Text Available The increasing advances of Internet Technologies in all application domains have changed life styles and interactions. With the rapid development of E-Learning, collaborative learning is an important for teaching, learning methods and strategies. Studies over the years shown that students had actively and more interactively involved in a classroom discussion to gain their knowledge. Students can ask their questions to the classroom discussion when they want to collaborate with others, asking one another for information, evaluating one another’s ideas. Therein, the activity allowing one question has many answer or information that should be selected. Every answer has a weighting and its very subjective to select it. In this paper, we introduce question answering for collaborative learning with answer quality predictor. By using answer quality predictor the quality of the information could be determined. Through the process of collaborative learning, the knowledge base will be enriched for future question answering. Further, not only the student could get answers form others but also provided by the system.

  2. Using a NIATx based local learning collaborative for performance improvement.

    Science.gov (United States)

    Roosa, Mathew; Scripa, Joseph S; Zastowny, Thomas R; Ford, James H

    2011-11-01

    Local governments play an important role in improving substance abuse and mental health services. The structure of the local learning collaborative requires careful attention to old relationships and challenges local governmental leaders to help move participants from a competitive to collaborative environment. This study describes one county's experience applying the NIATx process improvement model via a local learning collaborative. Local substance abuse and mental health agencies participated in two local learning collaboratives designed to improve client retention in substance abuse treatment and client access to mental health services. Results of changes implemented at the provider level on access and retention are outlined. The process of implementing evidence-based practices by using the Plan-Do-Study-Act rapid-cycle change is a powerful combination for change at the local level. Key lessons include: creating a clear plan and shared vision, recognizing that one size does not fit all, using data can help fuel participant engagement, a long collaborative may benefit from breaking it into smaller segments, and paying providers to offset costs of participation enhances their engagement. The experience gained in Onondaga County, New York, offers insights that serve as a foundation for using the local learning collaborative in other community-based organizations. Copyright © 2011 Elsevier Ltd. All rights reserved.

  3. 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.

  4. [Suggestions to improve dentist-endodontist collaboration].

    Science.gov (United States)

    Zabalegui, B; Zabalegui, I; Flores, L

    1989-01-01

    Referrals from the general dentist to the endodontist are in some occasions complicated with lack of proper communication among dentist-patient-specialist, resulting in the loss of confidence or even the patient. Suggestions to improve this communication are discussed, which will provide the patient a higher confidence in the indicated endodontic treatment and a better dental service. It will also enhance the prestige of the general dentists' and specialists' practice.

  5. 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...

  6. Needs and barriers to improve the collaboration in oral anticoagulant therapy: a qualitative study

    Directory of Open Access Journals (Sweden)

    Drewes Hanneke W

    2011-12-01

    Full Text Available Abstract Background Oral anticoagulant therapy (OAT involves many health care disciplines. Even though collaboration between care professionals is assumed to improve the quality of OAT, very little research has been done into the practice of OAT management to arrange and manage the collaboration. This study aims to identify the problems in collaboration experienced by the care professionals involved, the solutions they proposed to improve collaboration, and the barriers they encountered to the implementation of these solutions. Methods In the Netherlands, intensive follow-up of OAT is provided by specialized anticoagulant clinics (ACs. Sixty-eight semi-structured face-to-face interviews were conducted with 103 professionals working at an AC. These semi-structured interviews were transcribed verbatim and analysed inductively. Wagner's chronic care model (CCM and Cabana's framework for improvement were used to categorize the results. Results AC professionals experienced three main bottlenecks in collaboration: lack of knowledge (mostly of other professionals, lack of consensus on OAT, and limited information exchange between professionals. They mentioned several solutions to improve collaboration, especially solutions of CCM's decision support component (i.e. education, regular meetings, and agreements and protocols. Education is considered a prerequisite for the successful implementation of other proposed solutions such as developing a multidisciplinary protocol and changing the allocation of tasks. The potential of the health care organization to improve collaboration seemed to be underestimated by professionals. They experienced several barriers to the successful implementation of the proposed solutions. Most important barriers were the lack motivation of non-AC professionals and lack of time to establish collaboration. Conclusions This study revealed that the collaboration in OAT is limited by a lack of knowledge, a lack of consensus, and a

  7. Strategic collaborative quality management and employee job satisfaction

    OpenAIRE

    Ali Mohammad Mosadeghrad

    2014-01-01

    Background This study aimed to examine Strategic Collaborative Quality Management (SCQM) impact on employee job satisfaction. Methods The study presents a case study over six years following the implementation of the SCQM programme in a public hospital. A validated questionnaire was used to measure employees’ job satisfaction. The impact of the intervention was measured by comparing the pre-intervention and post-intervention measures in the hospital. Results Th...

  8. Involving Users to Improve the Collaborative Logical Framework

    Directory of Open Access Journals (Sweden)

    Olga C. Santos

    2014-01-01

    Full Text Available In order to support collaboration in web-based learning, there is a need for an intelligent support that facilitates its management during the design, development, and analysis of the collaborative learning experience and supports both students and instructors. At aDeNu research group we have proposed the Collaborative Logical Framework (CLF to create effective scenarios that support learning through interaction, exploration, discussion, and collaborative knowledge construction. This approach draws on artificial intelligence techniques to support and foster an effective involvement of students to collaborate. At the same time, the instructors’ workload is reduced as some of their tasks—especially those related to the monitoring of the students behavior—are automated. After introducing the CLF approach, in this paper, we present two formative evaluations with users carried out to improve the design of this collaborative tool and thus enrich the personalized support provided. In the first one, we analyze, following the layered evaluation approach, the results of an observational study with 56 participants. In the second one, we tested the infrastructure to gather emotional data when carrying out another observational study with 17 participants.

  9. 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.

  10. Using e-collaboration to improve management education: three scenarios.

    Directory of Open Access Journals (Sweden)

    Lee Schlenker

    2005-01-01

    Full Text Available This paper explores the potential impact of collaborative technologies in improving managementeducation. The first goal is to expose students to tools and practices that not only assist themwith their current studies, but also serve to reinforce individual and team competencies that canfacilitate their entry into the workforce. In their positions as future managers they will beexpected to not only be familiar with common business practices but also to understand theimplications of information technology for business; in this case with emphasis on tools andtechniques that can help businesses flourish in the networked economy. With an ever-increasingrecognition that e-learning tools are important for (re-training employees, these three scenariosoffer examples of how business schools might expand the boundaries of e-collaboration to helptheir students. These experiments have been conducted in management programs. In the first twoscenarios, students use collaborative platforms in some of their daily work. The third experimentis based on a student-centred design of a learning portal. Our experience reinforces a certainnumber of hypotheses influencing the impact of collaborative technologies in managementeducation. To begin with, information systems are often flawed mirrors of the managerial systemthat they are designed to represent. Secondly, the potential value of collaborative technologies isstrongly influenced by organizational contexts, both in and between the university and thebusiness community. Thirdly, the effectiveness of collaborative technologies depends to a largedegree upon the depth and coherence of learning objectives fixed for learning and work places.Finally, improving the effectiveness of collaborative technologies requires aligning the design oflearning environments with the corporate cultures and visions we are trying to reproduce.

  11. USING E-COLLABORATION TO IMPROVE MANAGEMENT EDUCATION: THREE SCENARIOS

    Directory of Open Access Journals (Sweden)

    Marie-Noëlle Bessagnet

    2006-11-01

    Full Text Available This paper explores the potential impact of collaborative technologies in improving management education. The first goal is to expose students to tools and practices that not only assist them with their current studies, but also serve to reinforce individual and team competencies that can facilitate their entry into the workforce. In their positions as future managers they will be expected to not only be familiar with common business practices but also to understand the implications of information technology for business; in this case with emphasis on tools and techniques that can help businesses flourish in the networked economy. With an ever-increasing recognition that e-learning tools are important for (re-training employees, these three scenarios offer examples of how business schools might expand the boundaries of e-collaboration to help their students. These experiments have been conducted in management programs. In the first two scenarios, students use collaborative platforms in some of their daily work. The third experiment is based on a student-centred design of a learning portal. Our experience reinforces a certain number of hypotheses influencing the impact of collaborative technologies in management education. To begin with, information systems are often flawed mirrors of the managerial system that they are designed to represent. Secondly, the potential value of collaborative technologies is strongly influenced by organizational contexts, both in and between the university and the business community. Thirdly, the effectiveness of collaborative technologies depends to a large degree upon the depth and coherence of learning objectives fixed for learning and work places. Finally, improving the effectiveness of collaborative technologies requires aligning the design of learning environments with the corporate cultures and visions we are trying to reproduce.

  12. Action Research to Improve Collaboration among Student Support Services Teams

    Science.gov (United States)

    Salm, Twyla

    2014-01-01

    This study explores action research as a professional development strategy to improve interprofessional collaboration in a school division team focused on supporting students with a variety of learning and behavioural needs. Occupational therapists, speech and language pathologists, a psychologist, and a social worker worked together to learn more…

  13. Improving Collaborative Teacher Education Research: Creating Tighter Linkages

    Science.gov (United States)

    Brownell, Mary T.; Griffin, Cynthia; Leko, Melinda Marie; Stephens, Jenna

    2011-01-01

    Although collaborative teacher education programs have grown in number over the past two decades, we still do not understand the ways in which these programs, or the practices in those programs, improve the preparation of inclusive teachers. At a time when teacher education's viability is being questioned, it is problematic that little information…

  14. 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.

  15. 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)....

  16. 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)

  17. Understanding organisational development, sustainability, and diffusion of innovations within hospitals participating in a multilevel quality collaborative

    Science.gov (United States)

    2011-01-01

    Background Between 2004 and 2008, 24 Dutch hospitals participated in a two-year multilevel quality collaborative (MQC) comprised of (a) a leadership programme for hospital executives, (b) six quality-improvement collaboratives (QICs) for healthcare professionals and other staff, and (c) an internal programme organisation to help senior management monitor and coordinate team progress. The MQC aimed to stimulate the development of quality-management systems and the spread of methods to improve patient safety and logistics. The objective of this study is to describe how the first group of eight MQC hospitals sustained and disseminated improvements made and the quality methods used. Methods The approach followed by the hospitals was described using interview and questionnaire data gathered from eight programme coordinators. Results MQC hospitals followed a systematic strategy of diffusion and sustainability. Hospital quality-management systems are further developed according to a model linking plan-do-study-act cycles at the unit and hospital level. The model involves quality norms based on realised successes, performance agreements with unit heads, organisational support, monitoring, and quarterly accountability reports. Conclusions It is concluded from this study that the MQC contributed to organisational development and dissemination within participating hospitals. Organisational learning effects were demonstrated. System changes affect the context factors in the theory of organisational readiness: organisational culture, policies and procedures, past experience, organisational resources, and organisational structure. Programme coordinator responses indicate that these factors are utilised to manage spread and sustainability. Further research is needed to assess long-term effects. PMID:21385467

  18. Understanding organisational development, sustainability, and diffusion of innovations within hospitals participating in a multilevel quality collaborative

    Directory of Open Access Journals (Sweden)

    Wagner Cordula

    2011-03-01

    Full Text Available Abstract Background Between 2004 and 2008, 24 Dutch hospitals participated in a two-year multilevel quality collaborative (MQC comprised of (a a leadership programme for hospital executives, (b six quality-improvement collaboratives (QICs for healthcare professionals and other staff, and (c an internal programme organisation to help senior management monitor and coordinate team progress. The MQC aimed to stimulate the development of quality-management systems and the spread of methods to improve patient safety and logistics. The objective of this study is to describe how the first group of eight MQC hospitals sustained and disseminated improvements made and the quality methods used. Methods The approach followed by the hospitals was described using interview and questionnaire data gathered from eight programme coordinators. Results MQC hospitals followed a systematic strategy of diffusion and sustainability. Hospital quality-management systems are further developed according to a model linking plan-do-study-act cycles at the unit and hospital level. The model involves quality norms based on realised successes, performance agreements with unit heads, organisational support, monitoring, and quarterly accountability reports. Conclusions It is concluded from this study that the MQC contributed to organisational development and dissemination within participating hospitals. Organisational learning effects were demonstrated. System changes affect the context factors in the theory of organisational readiness: organisational culture, policies and procedures, past experience, organisational resources, and organisational structure. Programme coordinator responses indicate that these factors are utilised to manage spread and sustainability. Further research is needed to assess long-term effects.

  19. Understanding organisational development, sustainability, and diffusion of innovations within hospitals participating in a multilevel quality collaborative.

    Science.gov (United States)

    Dückers, Michel La; Wagner, Cordula; Vos, Leti; Groenewegen, Peter P

    2011-03-09

    Between 2004 and 2008, 24 Dutch hospitals participated in a two-year multilevel quality collaborative (MQC) comprised of (a) a leadership programme for hospital executives, (b) six quality-improvement collaboratives (QICs) for healthcare professionals and other staff, and (c) an internal programme organisation to help senior management monitor and coordinate team progress. The MQC aimed to stimulate the development of quality-management systems and the spread of methods to improve patient safety and logistics. The objective of this study is to describe how the first group of eight MQC hospitals sustained and disseminated improvements made and the quality methods used. The approach followed by the hospitals was described using interview and questionnaire data gathered from eight programme coordinators. MQC hospitals followed a systematic strategy of diffusion and sustainability. Hospital quality-management systems are further developed according to a model linking plan-do-study-act cycles at the unit and hospital level. The model involves quality norms based on realised successes, performance agreements with unit heads, organisational support, monitoring, and quarterly accountability reports. It is concluded from this study that the MQC contributed to organisational development and dissemination within participating hospitals. Organisational learning effects were demonstrated. System changes affect the context factors in the theory of organisational readiness: organisational culture, policies and procedures, past experience, organisational resources, and organisational structure. Programme coordinator responses indicate that these factors are utilised to manage spread and sustainability. Further research is needed to assess long-term effects.

  20. Improved Collaborative Filtering Recommendation Based on Classification and User Trust

    Institute of Scientific and Technical Information of China (English)

    Xiao-Lin Xu; Guang-Lin Xu

    2016-01-01

    When dealing with the ratings from users, traditional collaborative filtering algorithms do not consider the credibility of rating data, which affects the accuracy of similarity. To address this issue, the paper proposes an improved algorithm based on classification and user trust. It firstly classifies all the ratings by the categories of items. And then, for each category, it evaluates the trustworthy degree of each user on the category and imposes the degree on the ratings of the user. Finally, the algorithm explores the similarities between users, finds the nearest neighbors, and makes recommendations within each category. Simulations show that the improved algorithm outperforms the traditional collaborative filtering algorithms and enhances the accuracy of recommendation.

  1. Intelligent Collaborative Quality Assurance System for Wind Turbine Supply Chain Management

    Directory of Open Access Journals (Sweden)

    B.L. SONG

    2013-03-01

    Full Text Available To determine the root causes or sources of variance of bad quality in supply chains is usually more difficult because multiple parties are involved in the current global manufacturing environment. Each component within a supply chain tends to focus on its own responsibilities and ignores possibilities for interconnectivity and therefore the potential for systematic quality assurance and quality tracing. Rather than concentrating on assigning responsibility for “recall” incidents, it would be better to expend that energy on constructing a collaborative system to assure product quality by employing a systematic view for the entire supply chain. This paper presents a systematic framework for intelligent collaborative quality assurance throughout an entire supply chain based on an expert system for implementing two levels of quality assurance: system level and component level. This proposed system provides intelligent functions for quality prediction, pattern recognition and data mining. A case study for wind turbines is given to demonstrate this approach. The results show that such a system can assure product quality improved in a continuous process.

  2. 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.

  3. 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.

  4. User Collaboration for Improving Access to Historical Texts

    Directory of Open Access Journals (Sweden)

    Clemens Neudecker

    2010-08-01

    Full Text Available The paper will describe how web-based collaboration tools can engage users in the building of historical printed text resources created by mass digitisation projects. The drivers for developing such tools will be presented, identifying the benefits that can be derived for both the user community and cultural heritage institutions. The perceived risks, such as new errors introduced by the users, and the limitations of engaging with users in this way will be set out with the lessons that can be learned from existing activities, such as the National Library of Australia's newspaper website which supports collaborative correction of Optical Character Recognition (OCR output. The paper will present the work of the IMPACT (Improving Access to Text project, a large-scale integrating project funded by the European Commission as part of the Seventh Framework Programme (FP7. One of the aims of the project is to develop tools that help improve OCR results for historical printed texts, specifically those works published before the industrial production of books from the middle of the 19th century. Technological improvements to image processing and OCR engine technology are vital to improving access to historic text, but engaging the user community also has an important role to play. Utilising the intended user can help achieve the levels of accuracy currently found in born-digital materials. Improving OCR results will allow for better resource discovery and enhance performance by text mining and accessibility tools. The IMPACT project will specifically develop a tool that supports collaborative correction and validation of OCR results and a tool to allow user involvement in building historical dictionaries which can be used to validate word recognition. The technologies use the characteristics of human perception as a basis for error detection.

  5. Collaborating With Music Therapists to Improve Patient Care.

    Science.gov (United States)

    Palmer, Jaclyn Bradley; Lane, Deforia; Mayo, Diane

    2016-09-01

    Collaboration between perioperative nurses and music therapists can be beneficial in providing a safe, cost-effective means of managing patients' anxiety and pain and reducing the need for pharmacologic intervention in the perioperative setting. The use of a board-certified music therapist may help to improve patient outcomes, ease nurse workload, and serve as an adjunct therapeutic modality that is enjoyable for both patients and staff members. We conducted a two-year, randomized controlled trial to determine how to best implement a music therapy program, navigate its challenges, and collaborate with nurse colleagues to bring its benefits to surgical patients. This article offers suggestions for alliances between perioperative nursing and music therapy staff members and describes the potential of music therapists to help provide optimal patient care.

  6. COLLABORATIVE STRATEGIC READING IMPLEMENTATION TO IMPROVE STUDENTS’ READING COMPREHENSION

    Directory of Open Access Journals (Sweden)

    Desy Olivia Riani

    2013-01-01

    Full Text Available This collaborative action research is aimed to find out whether or not the implementation of Collaborative Strategic Reading (CSR improves students' reading comprehension and also to identify students' attitude towards the implementation of CSR. CSR is reading strategy that employs four strategies namely Preview, Click and Clunk, Get the Gist and Wrap Up during students’ cooperative learning. A class of eleventh grade students of a public senior high school in Majalengka, West Java, Indonesia is participated as the participant of the study. The required data were collected through the use of questionnaire, observation checklist, and reading test. The data from the questionnaire indicated that 82% students had positive attitude toward the implementation of CSR. They feel that CSR improves their motivation in learning English and CSR brings more fun to the process of learning. Moreover, it was found from observation data that the students were actively participated during CSR implementation and they were motivated when comprehending a text by means CSR strategy. Finally, the study proved that CSR improved students’ reading comprehension. Students’ mean score of reading test in the beginning of the study was 67, meanwhile, after applying CSR as reading strategy, their mean scores improved to 88.

  7. 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.

  8. 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.

  9. Integrated care for patients with a stroke in the Netherlands: results and experiences from a national Breakthrough Collaborative Improvement project

    Directory of Open Access Journals (Sweden)

    M.M.N. Minkman

    2005-03-01

    Full Text Available Purpose: This article considers the question if measurable improvements are achieved in the quality of care in stroke services by using a Breakthrough collaborative quality improvement model. Context of case: Despite the availability of explicit criteria, evidence based guidelines, national protocols and examples of best practices; stroke care in the Netherlands did not improve substantially yet. For that reason a national collaborative started in 2002 to improve integrated stroke care in 23 self selected stroke services. Data sources: Characteristics of sites, teams, aims and changes were assessed by using a questionnaire and monthly self-reports of teams. Progress in achieving significant quality improvement has been assessed on a five point Likert scale (IHI score. Case description: The stroke services (n=23 formed multidisciplinary teams, which worked together in a collaborative based on the IHI Breakthrough Series Model. Teams received instruction in quality improvement, reviewed self reported performance data, identified bottlenecks and improvement goals, and implemented “potentially better practices” based on criteria from the Edisse study, evidence based guidelines, own ideas and expert opinion. Conclusion and discussion: Quality of care has been improved in most participating stroke services. Eighty-seven percent of the teams have improved their care significantly on at least one topic. About 34% of the teams have achieved significant improvement on all aims within the time frame of the project. The project has contributed to the further development and spread of integrated stroke care in the Netherlands.

  10. Collaborative Learning: A Program for Improving the Retention of Minority Students.

    Science.gov (United States)

    Berry, Lemuel, Jr.

    Collaborative learning may be an approach to for a liberal arts college program to help improve the retention of minority students. The importance of collaborative learning can be seen in the power of collaborative action in the Civil Rights Movement and the Women's Rights Movement. In a collaborative experience the teacher acts as a facilitator…

  11. Improving surgical care for children through multicenter registries and QI collaboratives.

    Science.gov (United States)

    Hsiung, Grace E; Abdullah, Fizan

    2015-12-01

    The role of the healthcare organization is shifting and must overcome the challenges of fragmented, costly care, and lack of evidence in practice, to reduce cost, ensure quality, and deliver high-value care. Notable gaps exist within the expected quality and delivery of pediatric healthcare, necessitating a change in the role of the healthcare organization. To realize these goals, the use of collaborative networks that leverage massive datasets to provide information for the development of learning healthcare systems will become increasingly necessary as efforts are made to narrow the gap in healthcare quality for children. By building upon the lessons learned from early collaborative efforts and other industries, operationalizing new technologies, encouraging clinical-community partnerships, and improving performance through transparent pursuit of meaningful goals, pediatric surgery can increase the adoption of best practices by developing collaborative networks that provide evidence-based clinical decision support and accelerate progress toward a new culture of delivering high-quality, high-value, and evidenced-based pediatric surgical care.

  12. Taking Teacher Quality Seriously: A Collaborative Approach to Teacher Evaluation

    Science.gov (United States)

    Karp, Stan

    2012-01-01

    If narrow, test-based evaluation of teachers is unfair, unreliable, and has negative effects on kids, classrooms, and curricula, what's a better approach? By demonizing teachers and unions, and sharply polarizing the education debate, the corporate reform movement has actually undermined serious efforts to improve teacher quality and evaluation.…

  13. Taking Teacher Quality Seriously: A Collaborative Approach to Teacher Evaluation

    Science.gov (United States)

    Karp, Stan

    2012-01-01

    If narrow, test-based evaluation of teachers is unfair, unreliable, and has negative effects on kids, classrooms, and curricula, what's a better approach? By demonizing teachers and unions, and sharply polarizing the education debate, the corporate reform movement has actually undermined serious efforts to improve teacher quality and evaluation.…

  14. NDT education improvements through the North Central Collaboration for NDT

    Science.gov (United States)

    Larson, B. F.; Wormley, S. J.

    2001-04-01

    The North Central Collaboration for Education in NDE/NDT is an effort aimed at enhancing NDE education and improving articulation between community college technician programs and university technical degree programs. NDT instructors at four community colleges are working with the staff at the Center for NDE at Iowa State University. Through this arrangement, advanced teaching methods and new materials that allow students to learn concepts better and in less time are being developed. For example, materials have been developed that will facilitate the use of an X-ray inspection simulation program in teaching basic radiography. Course materials have been developed and posted on the Internet that allow instructors to use interactive Java applets to better illustrate and explain difficult to grasp concepts. Some of the materials introduce subjects that are not currently extensively taught such as real-time radiography and distance-amplitude-correction (DAC) through curved surfaces. This paper will review NDT technician education, discuss the need for improvement in the methods used to educate technicians and highlight some of the efforts of the collaboration.

  15. 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 ...

  16. Collaboration

    Science.gov (United States)

    King, Michelle L.

    2010-01-01

    This article explores collaboration between library media educators and regular classroom teachers. The article focuses on the context of the issue, positions on the issue, the impact of collaboration, and how to implement effective collaboration into the school system. Various books and professional journals are used to support conclusions…

  17. 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

  18. 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

  19. Improving Virtual Collaborative Learning through Canonical Action Research

    Science.gov (United States)

    Weber, Peter; Lehr, Christian; Gersch, Martin

    2014-01-01

    Virtual collaboration continues to gain in significance and is attracting attention also as virtual collaborative learning (VCL) in education. This paper addresses aspects of VCL that we identified as critical in a series of courses named "Net Economy": (1) technical infrastructure, (2) motivation and collaboration, and (3) assessment…

  20. Real-Time Mutual Gaze Perception Enhances Collaborative Learning and Collaboration Quality

    Science.gov (United States)

    Schneider, Bertrand; Pea, Roy

    2013-01-01

    In this paper we present the results of an eye-tracking study on collaborative problem-solving dyads. Dyads remotely collaborated to learn from contrasting cases involving basic concepts about how the human brain processes visual information. In one condition, dyads saw the eye gazes of their partner on the screen; in a control group, they did not…

  1. 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.,

  2. InterDiciplinary Education Agenda project: Improving innovation through academy-industry collaboration

    OpenAIRE

    B. Andres; Poler, R.

    2014-01-01

    Research in collaboration has increased over the last years due to the benefits associated when two or more entities collaborate. Although this research has been more focused on enterprises, collaboration between Academy-Industry is also a current research key factor, especially to carry on and improve innovation activities. Academy-Industry collaboration allows that the pioneering creativity emerged in the Academy is complemented by its implementation in industries. In the light of this, thi...

  3. 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

  4. 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.

  5. 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.

  6. 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.

  7. 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

  8. Evaluating University-Industry Collaboration: The European Foundation of Quality Management Excellence Model-Based Evaluation of University-Industry Collaboration

    Science.gov (United States)

    Kauppila, Osmo; Mursula, Anu; Harkonen, Janne; Kujala, Jaakko

    2015-01-01

    The growth in university-industry collaboration has resulted in an increasing demand for methods to evaluate it. This paper presents one way to evaluate an organization's collaborative activities based on the European Foundation of Quality Management excellence model. Success factors of collaboration are derived from literature and compared…

  9. 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.

  10. Improving the Quality of Host Country Ethical Oversight of International Research: The Use of a Collaborative 'Pre-Review' Mechanism for a Study of Fexinidazole for Human African Trypanosomiasis.

    Science.gov (United States)

    Coleman, Carl H; Ardiot, Chantal; Blesson, Séverine; Bonnin, Yves; Bompart, Francois; Colonna, Pierre; Dhai, Ames; Ecuru, Julius; Edielu, Andrew; Hervé, Christian; Hirsch, François; Kouyaté, Bocar; Mamzer-Bruneel, Marie-France; Maoundé, Dionko; Martinent, Eric; Ntsiba, Honoré; Pelé, Gérard; Quéva, Gilles; Reinmund, Marie-Christine; Sarr, Samba Cor; Sepou, Abdoulaye; Tarral, Antoine; Tetimian, Djetodjide; Valverde, Olaf; Van Nieuwenhove, Simon; Strub-Wourgaft, Nathalie

    2015-12-01

    Developing countries face numerous barriers to conducting effective and efficient ethics reviews of international collaborative research. In addition to potentially overlooking important scientific and ethical considerations, inadequate or insufficiently trained ethics committees may insist on unwarranted changes to protocols that can impair a study's scientific or ethical validity. Moreover, poorly functioning review systems can impose substantial delays on the commencement of research, which needlessly undermine the development of new interventions for urgent medical needs. In response to these concerns, the Drugs for Neglected Diseases Initiative (DNDi), an independent nonprofit organization founded by a coalition of public sector and international organizations, developed a mechanism to facilitate more effective and efficient host country ethics review for a study of the use of fexinidazole for the treatment of late stage African Trypanosomiasis (HAT). The project involved the implementation of a novel 'pre-review' process of ethical oversight, conducted by an ad hoc committee of ethics committee representatives from African and European countries, in collaboration with internationally recognized scientific experts. This article examines the process and outcomes of this collaborative process.

  11. Improved spring model-based collaborative indoor visible light positioning

    Science.gov (United States)

    Luo, Zhijie; Zhang, WeiNan; Zhou, GuoFu

    2016-06-01

    Gaining accuracy with indoor positioning of individuals is important as many location-based services rely on the user's current position to provide them with useful services. Many researchers have studied indoor positioning techniques based on WiFi and Bluetooth. However, they have disadvantages such as low accuracy or high cost. In this paper, we propose an indoor positioning system in which visible light radiated from light-emitting diodes is used to locate the position of receivers. Compared with existing methods using light-emitting diode light, we present a high-precision and simple implementation collaborative indoor visible light positioning system based on an improved spring model. We first estimate coordinate position information using the visible light positioning system, and then use the spring model to correct positioning errors. The system can be employed easily because it does not require additional sensors and the occlusion problem of visible light would be alleviated. We also describe simulation experiments, which confirm the feasibility of our proposed method.

  12. Collaboration.

    Science.gov (United States)

    McDonald, Meme; Pryor, Boori Monty

    2000-01-01

    Describes, in the words of two Australian authors (one Aboriginal and one European-Australian), how they work together when they write books together, and how their collaboration goes beyond the two of them. (SR)

  13. Improving Rural Geriatric Care Through Education: A Scalable, Collaborative Project.

    Science.gov (United States)

    Buck, Harleah G; Kolanowski, Ann; Fick, Donna; Baronner, Lawrence

    2016-07-01

    HOW TO OBTAIN CONTACT HOURS BY READING THIS ISSUE Instructions: 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded after you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. In order to obtain contact hours you must: 1. Read the article, "Improving Rural Geriatric Care Through Education: A Scalable, Collaborative Project," found on pages 306-313, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website to register for contact hour credit. You will be asked to provide your name, contact information, and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until June 30, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. OBJECTIVES Describe the unique nursing challenges that occur in caring for older adults in rural areas. Discuss the

  14. [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

  15. 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.

  16. Collaborative care to improve the management of depressive disorders: a community guide systematic review and meta-analysis.

    Science.gov (United States)

    Thota, Anilkrishna B; Sipe, Theresa Ann; Byard, Guthrie J; Zometa, Carlos S; Hahn, Robert A; McKnight-Eily, Lela R; Chapman, Daniel P; Abraido-Lanza, Ana F; Pearson, Jane L; Anderson, Clinton W; Gelenberg, Alan J; Hennessy, Kevin D; Duffy, Farifteh F; Vernon-Smiley, Mary E; Nease, Donald E; Williams, Samantha P

    2012-05-01

    To improve the quality of depression management, collaborative care models have been developed from the Chronic Care Model over the past 20 years. Collaborative care is a multicomponent, healthcare system-level intervention that uses case managers to link primary care providers, patients, and mental health specialists. In addition to case management support, primary care providers receive consultation and decision support from mental health specialists (i.e., psychiatrists and psychologists). This collaboration is designed to (1) improve routine screening and diagnosis of depressive disorders; (2) increase provider use of evidence-based protocols for the proactive management of diagnosed depressive disorders; and (3) improve clinical and community support for active client/patient engagement in treatment goal-setting and self-management. A team of subject matter experts in mental health, representing various agencies and institutions, conceptualized and conducted a systematic review and meta-analysis on collaborative care for improving the management of depressive disorders. This team worked under the guidance of the Community Preventive Services Task Force, a nonfederal, independent, volunteer body of public health and prevention experts. Community Guide systematic review methods were used to identify, evaluate, and analyze available evidence. An earlier systematic review with 37 RCTs of collaborative care studies published through 2004 found evidence of effectiveness of these models in improving depression outcomes. An additional 32 studies of collaborative care models conducted between 2004 and 2009 were found for this current review and analyzed. The results from the meta-analyses suggest robust evidence of effectiveness of collaborative care in improving depression symptoms (standardized mean difference [SMD]=0.34); adherence to treatment (OR=2.22); response to treatment (OR=1.78); remission of symptoms (OR=1.74); recovery from symptoms (OR=1.75); quality of

  17. Online teaching strategies to improve collaboration among nursing students.

    Science.gov (United States)

    Posey, Laurie; Pintz, Christine

    2006-12-01

    Collaborative problem-solving is an essential competency for nurses and all health professionals. This paper compares the design characteristics and educational benefits of three online-teaching strategies that nurse educators can use to build the critical thinking and social skills needed for effective collaboration: computer supported collaborative learning, case-based facilitated discussion, and cognitive flexibility hypermedia. These strategies support a critical instructional outcome required for effective collaboration: the ability to examine, assess, and synthesize multiple perspectives to resolve illstructured problems (i.e., problems for which there is no clear-cut solution). Descriptions, examples, and guidelines for implementing each strategy are provided. By integrating these strategies into their online courses, nurse educators can prepare nurses to work effectively with others to solve complex problems in clinical practice and the broader health-care system.

  18. 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...

  19. 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....

  20. 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.

  1. A program to improve communication and collaboration between nurses and medical residents.

    Science.gov (United States)

    McCaffrey, Ruth G; Hayes, Rosemarie; Stuart, Wendy; Cassell, Asenath; Farrell, Cheryl; Miller-Reyes, Charmin; Donaldson, Audeanne

    2010-04-01

    A program was implemented for nurses and medical residents to improve communication and collaboration. It has been noted that communication and collaboration between members of the health care team improve patient outcomes and job satisfaction among nurses. Nurses on the unit where medical residents trained attended a 2-hour educational program that reviewed effective communication styles and positive aspects of collaboration, including role-playing examples. Medical residents received a self-learning packet with a posttest that was returned to researchers when completed. Focus groups, including both nurses and medical residents, were held twice a month for 6 months after the educational program. Overall improvements in communication, collaboration, patient outcomes, and job satisfaction were noted from the focus group data. The educational program proved to be successful in improving collaboration and communication between nurses and medical residents, which in turn improved patient care.

  2. 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.

  3. 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.

  4. 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.

  5. [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.

  6. [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.

  7. Improving Healthcare Team Collaboration in Hospital Transfers through Cloud-Based Mobile Systems

    Directory of Open Access Journals (Sweden)

    Andres Neyem

    2016-01-01

    Full Text Available It is a clinical fact that better patient flow management in and between hospitals improves quality of care, resource utilization, and cost efficiency. As the number of patients in hospitals constantly grows, the need for hospital transfers is directly affected. Interhospital transfers can be required for several reasons but they are most commonly made when the diagnostic and therapeutic facilities required for a patient are not available locally. Transferring a critical patient between hospitals is commonly associated with risk of death and complications. This raises the question: How can we improve healthcare team collaboration in hospital transfers through the use of emerging information technology and communication services? This paper presents a cloud-based mobile system for supporting team collaboration and decision-making in the transportation of patients in critical condition. The Rapid Emergency Medicine Score (REMS scale was used as an outcome variable, being a useful scale to assess the risk profile of critical patients requiring transfers between hospitals. This helps medical staff to adopt proper risk-prevention measures when handling a transfer and to react on time if any complications arise in transit.

  8. Improved Collaborative Transport Planning at Dutch Logistics Service Provider Fritom

    NARCIS (Netherlands)

    Buijs, Paul; Lopez Alvarez, Jose Alejandro; Veenstra, Marjolein; Roodbergen, Kees Jan

    2016-01-01

    We study the collaborative transport planning for two autonomous business units of Fritom, a Dutch logistics service provider. This difficult planning problem does not fit any existing type of vehicle routing problem proposed in the academic literature; therefore, we define a new problem class, the

  9. Using Personality Traits and Effective Communication to Improve Collaboration

    Science.gov (United States)

    Buddy, Juanita Warren

    2007-01-01

    Various research studies have shed evidence on the importance of collaboration between teachers and library media specialists. Nearly every aspect of business, management in particular, requires an ability to interact effectively with others. As such, it is advantageous for the library media specialist to view the library media program as a…

  10. 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...

  11. 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

  12. Improving patient and project outcomes using interorganisational innovation, collaboration and co-design.

    Science.gov (United States)

    Evans, Liz; Green, Stuart; Howe, Cathy; Sharma, Kiran; Marinho, Fatima; Bell, Derek; Thomas, Paul

    2014-01-01

    Background Common mental disorders (CMDs) are a leading cause of disability. The Department of Health has launched a large-scale initiative to improve access to evidence-based psychological treatments, such as cognitive behavioural therapy (CBT), through the Improving Access to Psychological Therapy (IAPT) programme. Access to IAPT services by black and minority ethnic (BME) communities is lower than for other groups. Setting The London Borough of Ealing in west London; a diverse borough with areas of high BME population and relatively high deprivation. Aim To compare the outcomes of two linked quality improvement (QI) projects undertaken by Ealing Mental Health and Wellbeing Service (MHWBS), both with the same aim of increasing access to talking therapies for BME communities. Methods Application of QI methodologies supported by the NIHR CLAHRC for northwest London in two different settings in Ealing. One, the 'Southall project', was set within a wider initiative for collaborative improvements and shared learning (the Southall Initiative for Integrated Care) in an ethnically diverse area of Ealing; it was undertaken between April 2010 and September 2011. The second, 'the Ealing project', operated in the two other Ealing localities that did not have the advantage of a broader initiative for collaborative improvements; it was undertaken between April 2011 and September 2012. Results Comparison of the monthly referral rates of BME patients (standardised per 10 000 general practitioner (GP)-registered patients) show that the Southall project was more effective in increasing referrals from BME communities than the Ealing project. Conclusion Broad local participation and ownership in the project design of the Southall project may explain why it was more effective in achieving its aims than the Ealing project which lacked these ownership-creating mechanisms.

  13. 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.

  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. Hospital boards and medical specialists collaborating for quality of care.

    NARCIS (Netherlands)

    Botje, D.; Plochg, T.; Klazinga, N.; Wagner, C.

    2012-01-01

    Context: In European countries policy briefs are stressing the importance of hospital governance for the quality of care. When governing towards quality it is essential for Hospital Boards to receive the proper information to do so. In the Netherlands, the national association for medical

  16. Hospital boards and medical specialists collaborating for quality of care.

    NARCIS (Netherlands)

    Botje, D.; Plochg, T.; Klazinga, N.; Wagner, C.

    2012-01-01

    Context: In European countries policy briefs are stressing the importance of hospital governance for the quality of care. When governing towards quality it is essential for Hospital Boards to receive the proper information to do so. In the Netherlands, the national association for medical specialist

  17. Using Active Listening to Improve Collaboration with Parents: The LAFF Don't CRY Strategy

    Science.gov (United States)

    McNaughton, David; Vostal, Brooks R.

    2010-01-01

    Effective parent-teacher communication builds working relationships that can support strong home-school collaboration and improved educational outcomes. Even though many teachers value the participation of parents, it can be challenging to communicate this positive intent. Effective communication is central to authentic collaboration and relies on…

  18. Improving Tools and Processes in Mechanical Design Collaboration

    Science.gov (United States)

    Briggs, Clark

    2009-01-01

    Cooperative product development projects in the aerospace and defense industry are held hostage to high cost and risk due to poor alignment of collaborative design tools and processes. This impasse can be broken if companies will jointly develop implementation approaches and practices in support of high value working arrangements. The current tools can be used to better advantage in many situations and there is reason for optimism that tool vendors will provide significant support.

  19. Improving hospital care and collaborative communications for the 21st century: key recommendations for general internal medicine.

    Science.gov (United States)

    Wu, Robert C; Lo, Vivian; Rossos, Peter; Kuziemsky, Craig; O'Leary, Kevin J; Cafazzo, Joseph A; Reeves, Scott; Wong, Brian M; Morra, Dante

    2012-09-24

    Communication and collaboration failures can have negative impacts on the efficiency of both individual clinicians and health care system delivery as well as on the quality of patient care. Recognizing the problems associated with clinical and collaboration communication, health care professionals and organizations alike have begun to look at alternative communication technologies to address some of these inefficiencies and to improve interprofessional collaboration. To develop recommendations that assist health care organizations in improving communication and collaboration in order to develop effective methods for evaluation. An interprofessional meeting was held in a large urban city in Canada with 19 nationally and internationally renowned experts to discuss suitable recommendations for an ideal communication and collaboration system as well as a research framework for general internal medicine (GIM) environments. In designing an ideal GIM communication and collaboration system, attendees believed that the new system should possess attributes that aim to: a) improve workflow through prioritization of information and detection of individuals' contextual situations; b) promote stronger interprofessional relationships with adequate exchange of information; c) enhance patient-centered care by allowing greater patient autonomy over their health care information; d) enable interoperability and scalability between and within institutions; and e) function across different platforms. In terms of evaluating the effects of technology in GIM settings, participants championed the use of rigorous scientific methods that span multiple perspectives and disciplines. Specifically, participants recommended that consistent measures and definitions need to be established so that these impacts can be examined across individual, group, and organizational levels. Discussions from our meeting demonstrated the complexities of technological implementations in GIM settings

  20. Quality Teaching in Large University Classes: Designing Online Collaboration among Learners for Deep Understanding

    OpenAIRE

    2015-01-01

    This study aimed to explore the impact of eLearning on quality teaching in higher education and to implement Computer-Supported Collaborative Learning (CSCL) that targeted the quality challenges in practice. It was a mixed method research composing of three stages. It initially focused on university teachers’ perception of quality teaching, problems, and strategies in practice to understand the actual usage of eLearning by practitioners. Seventeen university teachers participated in the inqui...

  1. 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

  2. Using a collaborative Mobile Augmented Reality learning application (CoMARLA) to improve Improve Student Learning

    Science.gov (United States)

    Hanafi, Hafizul Fahri bin; Soh Said, Che; Hanee Ariffin, Asma; Azlan Zainuddin, Nur; Samsuddin, Khairulanuar

    2016-11-01

    This study was carried out to improve student learning in ICT course using a collaborative mobile augmented reality learning application (CoMARLA). This learning application was developed based on the constructivist framework that would engender collaborative learning environment, in which students could learn collaboratively using their mobile phones. The research design was based on the pretest posttest control group design. The dependent variable was students’ learning performance after learning, and the independent variables were learning method and gender. Students’ learning performance before learning was treated as the covariate. The sample of the study comprised 120 non-IT (non-technical) undergraduates, with the mean age of 19.5. They were randomized into two groups, namely the experimental and control group. The experimental group used CoMARLA to learn one of the topics of the ICT Literacy course, namely Computer System; whereas the control group learned using the conventional approach. The research instrument used was a set of multiple-choice questions pertaining to the above topic. Pretesting was carried out before the learning sessions, and posttesting was performed after 6 hours of learning. Using the SPSS, Analysis of Covariance (ANCOVA) was performed on the data. The analysis showed that there were main effects attributed to the learning method and gender. The experimental group outperformed the control group by almost 9%, and male students outstripped their opposite counterparts by as much as 3%. Furthermore, an interaction effect was also observed showing differential performances of male students based on the learning methods, which did not occur among female students. Hence, the tool can be used to help undergraduates learn with greater efficacy when contextualized in an appropriate setting.

  3. Collaborative learning in engineering: A quest to improve student retention

    Science.gov (United States)

    Marquard, Paul J.

    Colleges of engineering are concerned with retention of their undergraduates. Several studies have determined the reasons students leave engineering to major in other disciplines. The list includes poor teaching, a difficult curriculum, and a lack of belonging. This study alters the traditional lecture format of an engineering dynamics class by using a flipped classroom where scheduled class time emphasizes a collaborative learning pedagogy. Material coverage was facilitated with online lectures. After initiating this change, student attitudes and self-efficacy were measured as well as test performance and study time.

  4. Unifying a fragmented effort: a qualitative framework for improving international surgical teaching collaborations.

    Science.gov (United States)

    Fallah, Parisa Nicole; Bernstein, Mark

    2017-09-07

    Access to adequate surgical care is limited globally, particularly in low- and middle-income countries (LMICs). To address this issue, surgeons are becoming increasingly involved in international surgical teaching collaborations (ISTCs), which include educational partnerships between surgical teams in high-income countries and those in LMICs. The purpose of this study is to determine a framework for unifying, systematizing, and improving the quality of ISTCs so that they can better address the global surgical need. A convenience sample of 68 surgeons, anesthesiologists, physicians, residents, nurses, academics, and administrators from the U.S., Canada, and Norway was used for the study. Participants all had some involvement in ISTCs and came from multiple specialties and institutions. Qualitative methodology was used, and participants were interviewed using a pre-determined set of open-ended questions. Data was gathered over two months either in-person, over the phone, or on Skype. Data was evaluated using thematic content analysis. To organize and systematize ISTCs, participants reported a need for a centralized/systematized process with designated leaders, a universal data bank of current efforts/progress, communication amongst involved parties, full-time administrative staff, dedicated funds, a scholarly approach, increased use of technology, and more research on needs and outcomes. By taking steps towards unifying and systematizing ISTCs, the quality of ISTCs can be improved. This could lead to an advancement in efforts to increase access to surgical care worldwide.

  5. National Security: An Overview of Professional Development Activities Intended to Improve Interagency Collaboration

    Science.gov (United States)

    2010-11-01

    professional development activities could help bridge those gaps. GAO was asked to identify: (1) training and other professional development activities intended to improve the ability of key national security agencies’ personnel to collaborate across organizational lines and (2) how these activities were intended to improve participants’ collaboration abilities. To address these objectives, GAO asked nine key agencies involved in national security issues to submit information on professional development activities that

  6. Simulation Modeling and Statistical Network Tools for Improving Collaboration in Military Logistics

    Science.gov (United States)

    2008-10-01

    AFRL-RH-WP-TR-2009-0110 Simulation Modeling and Statistical Network Tools for Improving Collaboration in Military Logistics...SUBTITLE Simulation Modeling and Statistical Network Tools for Improving Collaboration in Military Logistics 5a. CONTRACT NUMBER FA8650-07-1-6848...8 1 1.0 SUMMARY This final technical report describes the research findings of the project Simulation Modeling and Statistical Network

  7. RESULTS OF COLLABORATIVE STUDY FOR TISSUE TYPING QUALITY CONTROL

    Directory of Open Access Journals (Sweden)

    V. Y. Abramov

    2010-01-01

    Full Text Available HLA molecules appear to be the principal target of immune allorecognition. The efficiency of transplant directly depends on coincidence of the data obtained by different HLA laboratories. This study discusses the results produced by 12 tissue typing labs in the framework of the initiative program for tissue typing quality control in 2009. 

  8. Improving collaboration between primary care research networks using Access Grid technology

    Directory of Open Access Journals (Sweden)

    Zsolt Nagykaldi

    2008-05-01

    Full Text Available Access Grid (AG is an Internet2-driven, high performance audio_visual conferencing technology used worldwide by academic and government organisations to enhance communication, human interaction and group collaboration. AG technology is particularly promising for improving academic multi-centre research collaborations. This manuscript describes how the AG technology was utilised by the electronic Primary Care Research Network (ePCRN that is part of the National Institutes of Health (NIH Roadmap initiative to improve primary care research and collaboration among practice- based research networks (PBRNs in the USA. It discusses the design, installation and use of AG implementations, potential future applications, barriers to adoption, and suggested solutions.

  9. Effect of a nurse-patient collaborative quality control program on improving rehabilitation compliance in patients with faciocervical burns%护患合作型质量控制小组活动在提高头面颈部烧伤患者功能锻炼依从性中的作用

    Institute of Scientific and Technical Information of China (English)

    粱月英; 谢肖霞; 伍淑文; 陈楚芬; 李舒婷

    2013-01-01

    为提高头面颈部烧伤患者功能锻炼的依从性,开展护患合作型质量控制小组活动,收集头面颈部烧伤患者不能按计划进行功能锻炼的原因并进行分析,设定目标,制订及实施对策,包括:①加强新护士的培训考核.②加强功能锻炼健康教育.③完善宣教资料及物品.④建立家庭支持系统.⑤制订个性化康复计划.⑥制订健康教育路径.结果显示,实施1年后,头面颈部烧伤患者对功能锻炼的依从性明显优于活动前:对功能锻炼完全依从的患者由活动前的35.5%提高至活动后的60.3% (P<0.05),对功能锻炼部分依从的患者由活动前的45.0%下降至活动后的32.3%(P<0.05),对功能锻炼不依从的患者由活动前的19.5%下降至活动后的7.4%(P<0.05);活动前患者对功能锻炼的满意度为80%,活动后达到预期目标值90%.采用护患合作型质量控制小组活动对开展头面颈部烧伤患者功能锻炼的方法进行持续质量改进,有利于提高患者功能锻炼依从性及患者对功能锻炼的满意度,体现了优质护理服务的内涵.%To improve the compliance to functional exercise protocol in patients with faciocervical bums,a nurse-patient collaborative quality control program was carried out to analyze the problems,set goals,make and implement improvement measures.The key points were strengthening the training and examination of new nurse,reinforcing patients' education about functional exercises,improving the materials of patient education,establishing family support system,formulating individualized rehabilitation plan,developing clinical pathways for patient education,and evaluation of the outcomes.One year later,the patient compliance was improved significantly(P<0.05).The proportion of patients with complete compliance increased from 35.5% to 60.3%,the proportion of patients with partly compliance decreased from 45.0% to 32.3%,the proportion of patients with

  10. 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.

  11. Enhancing the Quality of E-Learning in Virtual Learning Communities by Finding Quality Learning Content and Trustworthy Collaborators

    Science.gov (United States)

    Yang, Stephen J. H.; Chen, Irene Y. L.; Kinshuk; Chen, Nian-Shing

    2007-01-01

    Virtual learning communities encourage members to learn and contribute knowledge. However, knowledge sharing requires mutual-trust collaboration between learners and the contribution of quality knowledge. This task cannot be accomplished by simply storing learning content in repositories. It requires a mechanism to help learners find relevant…

  12. A Repeatable Collaboration Process for Exploring Business Process Improvement Alternatives

    NARCIS (Netherlands)

    Sol, H G; Amiyo, Mercy; Nabukenya, J.

    2012-01-01

    The dynamic nature of organisations has increased demand for business process agility leading to the adoption of continuous Business Process Improvement (BPI). Success of BPI projects calls for continuous process analysis and exploration of several improvement alternatives. These activities are

  13. A collaboration to document and improve PCK in Astronomy Education

    CERN Document Server

    Li, Sissi L; Chilton, Heather; Loverude, Michael E; Read, Jocelyn S; Smith, Joshua R

    2014-01-01

    Introductory astronomy is one of the most widely-taken university science courses and a common means of satisfying general education requirements. At many universities this course is taught in large sections by a variety of instructors, some with little formal training in astronomy. Instruction tends to be lecture-based with relatively little student engagement or interaction. Students thus often fail to connect with what is typically their last formal science experience. At California State University Fullerton, we have engaged in reform efforts in the teaching of introductory astronomy using research-based curricular materials. Additionally, course faculty have collaborated with student Peer Instructors and science education researchers to document student learning and collect information on common student conceptual difficulties. In this reform and research process, we were also able to study the development of Pedagogical Content Knowledge among the instructors. Our findings suggest that this is a fruitfu...

  14. Towards a Context-Aware Framework for Improving Collaboration of Users in Groupware Systems

    Directory of Open Access Journals (Sweden)

    Luis G. Montané-Jiménez

    2014-09-01

    Full Text Available A Context-Aware Groupware System (CAGS enables the members of a team to communicate, cooperate and coordinate their activities to achieve a common goal, by providing them tools that are aware of their current execution context and adapt accordingly. CAGS can be found in several domains such as entertainment, particularly Collaborative First-Person-Shooter (FPS video games. In CAGS, the means of collaboration traditionally provided to users (e.g. text and audio messaging are not necessarily adequate: for instance, in a FPS, messages can distract the gamer due to the speed of the game. This paper reports a study that, for Collaborative FPS, identifies advantages/disadvantages of current means of collaboration and social behaviors that arise when players interact face-to-face or remotely. Based on this study, a context-aware conceptual model and architecture is proposed for CAGS aimed to improve user collaboration.

  15. Collaborative Catchment-Scale Water Quality Management using Integrated Wireless Sensor Networks

    Science.gov (United States)

    Zia, Huma; Harris, Nick; Merrett, Geoff

    2013-04-01

    Electronics and Computer Science, University of Southampton, United Kingdom Summary The challenge of improving water quality (WQ) is a growing global concern [1]. Poor WQ is mainly attributed to poor water management and outdated agricultural activities. We propose that collaborative sensor networks spread across an entire catchment can allow cooperation among individual activities for integrated WQ monitoring and management. We show that sharing information on critical parameters among networks of water bodies and farms can enable identification and quantification of the contaminant sources, enabling better decision making for agricultural practices and thereby reducing contaminants fluxes. Motivation and results Nutrient losses from land to water have accelerated due to agricultural and urban pursuits [2]. In many cases, the application of fertiliser can be reduced by 30-50% without any loss of yield [3]. Thus information about nutrient levels and trends around the farm can improve agricultural practices and thereby reduce water contamination. The use of sensor networks for monitoring WQ in a catchment is in its infancy, but more applications are being tested [4]. However, these are focussed on local requirements and are mostly limited to water bodies. They have yet to explore the use of this technology for catchment-scale monitoring and management decisions, in an autonomous and dynamic manner. For effective and integrated WQ management, we propose a system that utilises local monitoring networks across a catchment, with provision for collaborative information sharing. This system of networks shares information about critical events, such as rain or flooding. Higher-level applications make use of this information to inform decisions about nutrient management, improving the quality of monitoring through the provision of richer datasets of catchment information to local networks. In the full paper, we present example scenarios and analyse how the benefits of

  16. Towards International and Interdisciplinary Research Collaboration for the Measurements of Quality of Life

    Science.gov (United States)

    Mizohata, Sachie; Jadoul, Raynald

    2013-01-01

    This paper focuses on three main subjects: (1) monitoring quality of life (QoL) in old age; (2) international and interdisciplinary collaboration for QoL research; and (3) computer-based technology and infrastructure assisting (1) and (2). This type of computer-supported cooperative work in the social sciences has been termed eHumanities or…

  17. Collaborative Provision Quality Assurance Isn't Just Red Tape …

    Science.gov (United States)

    Hughes, Claire; Thomas, Helen

    2017-01-01

    This paper discusses some research which was undertaken to explore perceptions around quality assurance within collaborative partnership (CP) working, from a range of internal and external stakeholders. The responses we received are being used to enhance policy and processes and inform the development of guidance materials to support all…

  18. 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…

  19. 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…

  20. 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.

  1. 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…

  2. Investigation of a design performance measurement tool for improving collaborative design during a design process

    OpenAIRE

    Yin, Yuanyuan

    2009-01-01

    This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University. With rapid growth of global competition, the design process is becoming more and more complex due largely to cross-functional team collaboration, dynamic design processes, and unpredictable design outcomes. Thus, it is becoming progressively more difficult to support and improve design activities effectively during a design process, especially from a collaboration perspective. Although a grea...

  3. Quality performance of laboratory testing in pharmacies: a collaborative evaluation.

    Science.gov (United States)

    Zaninotto, Martina; Miolo, Giorgia; Guiotto, Adriano; Marton, Silvia; Plebani, Mario

    2016-11-01

    The quality performance and the comparability between results of pharmacies point-of-care-testing (POCT) and institutional laboratories have been evaluated. Eight pharmacies participated in the project: a capillary specimen collected by the pharmacist and, simultaneously, a lithium-heparin sample drawn by a physician of laboratory medicine for the pharmacy customers (n=106) were analyzed in the pharmacy and in the laboratory, respectively. Glucose, cholesterol, HDL-cholesterol, triglycerides, creatinine, uric acid, aspartate aminotransferase, alanine aminotransferase, were measured using: Reflotron, n=5; Samsung, n=1; Cardiocheck PA, n=1; Cholestech LDX, n=1 and Cobas 8000. The POCT analytical performance only (phase 2) were evaluated testing, in pharmacies and in the laboratory, the lithium heparin samples from a female drawn fasting daily in a week, and a control sample containing high concentrations of glucose, cholesterol and triglycerides. For all parameters, except triglycerides, the slopes showed a satisfactory correlation. For triglycerides, a median value higher in POCT in comparison to the laboratory (1.627 mmol/L vs. 0.950 mmol/L) has been observed. The agreement in the subjects classification, demonstrates that for glucose, 70% of the subjects show concentrations below the POCT recommended level (5.8-6.1 mmol/L), while 56% are according to the laboratory limit (pharmacies and specific criticisms in the pre- and post-analytical phases.

  4. 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

  5. Quality of care and interhospital collaboration: a study of patient transfers in Italy.

    Science.gov (United States)

    Lomi, Alessandro; Mascia, Daniele; Vu, Duy Quang; Pallotti, Francesca; Conaldi, Guido; Iwashyna, Theodore J

    2014-05-01

    We examine the dynamics of patient-sharing relations within an Italian regional community of 35 hospitals serving approximately 1,300,000 people. We test whether interorganizational relations provide individual patients access to higher quality providers of care. We reconstruct the complete temporal sequence of the 3461 consecutive interhospital patient-sharing events observed between each pair of hospitals in the community during 2005-2008. We distinguish between transfers occurring between and within different medical specialties. We estimate newly derived models for relational event sequences that allow us to control for the most common forms of network-like dependencies that are known to characterize collaborative relations between hospitals. We use 45-day risk-adjusted readmission rate as a proxy for hospital quality. After controls (eg, geographical distance, size, and the existence of prior collaborative relations), we find that patients flow from less to more capable hospitals. We show that this result holds for patient being shared both between as well as within medical specialties. Nonetheless there are strong and persistent other organizational and relational effects driving transfers. Decentralized patient-sharing decisions taken by the 35 hospitals give rise to a system of collaborative interorganizational arrangements that allow the patient to access hospitals delivering a higher quality of care. This result is relevant for health care policy because it suggests that collaborative relations between hospitals may produce desirable outcomes both for individual patients, and for regional health care systems.

  6. 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.

  7. (Mis)Perceptions of Continuing Education: Insights from Knowledge Translation, Quality Improvement, and Patient Safety Leaders

    Science.gov (United States)

    Kitto, Simon C.; Bell, Mary; Goldman, Joanne; Peller, Jennifer; Silver, Ivan; Sargeant, Joan; Reeves, Scott

    2013-01-01

    Introduction: Minimal attention has been given to the intersection and potential collaboration among the domains of continuing education (CE), knowledge translation (KT), quality improvement (QI), and patient safety (PS), despite their overlapping objectives. A study was undertaken to examine leaders' perspectives of these 4 domains and their…

  8. Community Collaboration to Improve Schools: Introducing a New Model from Ohio

    Science.gov (United States)

    Anderson-Butcher, Dawn; Lawson, Hal A.; Bean, Jerry; Flaspohler, Paul; Boone, Barbara; Kwiatkowski, Amber

    2008-01-01

    Conventional school improvement models traditionally involve "walled-in" approaches. These models focus primarily on academic learning strategies in response to standards-based accountabilities. Although positive outcomes have been documented, expanded school improvement models such as the Ohio Community Collaboration Model for School…

  9. Capacity-Related Innovations Resulting from the Implementation of a Community Collaboration Model for School Improvement

    Science.gov (United States)

    Anderson-Butcher, Dawn; Lawson, Hal A.; Iachini, Aidyn; Bean, Gerald; Flaspohler, Paul D.; Zullig, Keith

    2010-01-01

    A new genus of district and school improvement models entails partnerships with other organizations and new working relationships with families, community leaders, and youths. The Ohio Community Collaboration Model for School Improvement (OCCMSI) is one such model. It enables partners to leverage family and community resources for learning,…

  10. Collaborative improvement: What do we know? Where do we need to go?

    NARCIS (Netherlands)

    Middel, H.G.A.; Boer, Harm; Fisscher, O.A.M.

    2005-01-01

    Although especially through research performed across the CINet community, a lot of theoretical and practical knowledge has been developed on intra-firm continuous improvement, there is still a substantial lack of empirically grounded contributions and theories on collaborative improvement (CoI),

  11. 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.)

  12. Collaborative Learning Supported by Rubrics Improves Critical Thinking

    Science.gov (United States)

    Saiz, Carlos; Rivas, Silvia F.; Olivares, Sonia

    2015-01-01

    In previous works we developed and assessed a teaching program, ARDESOS v.1, with which we aimed to improve the fundamental skills of critical thinking. The results obtained were positive, but modest. After analyzing the limitations of the program we introduced certain modifications and assessed the new version. The changes involved designing the…

  13. Managing and organising collaborative improvement: A System Integrator perspective

    NARCIS (Netherlands)

    Middel, H.G.A.; Fisscher, O.A.M.; Groen, Arend J.

    2004-01-01

    More than ever, companies are challenged to improve their performance and respond quickly and accurately to changes within the market. Due to external dynamics competition is moving towards the level of networks of organisations, and, therefore, the individual firm is an inadequate entity for

  14. Improving Reading Instruction: A Call for Interdisciplinary Collaboration

    Science.gov (United States)

    Sawyer, Diane J.

    2010-01-01

    The state of reading proficiency in the United States has been under attack for decades. Attempts to improve reading achievement through instructional practices have taken the profession through the "reading wars" to "balanced-reading" to "evidenced-based" methods. Unfortunately, the professional development of…

  15. 48 CFR 970.5203-2 - Performance improvement and collaboration.

    Science.gov (United States)

    2010-10-01

    ..., scientific and technical, security, business and administrative, and any other areas of performance in the... be of benefit in resolving common issues, in confronting common problems, or in reducing costs of... in the communication of the success of improvements to other management and operating contractors...

  16. Improvement of Learning Process and Learning Outcomes in Physics Learning by Using Collaborative Learning Model of Group Investigation at High School (Grade X, SMAN 14 Jakarta)

    Science.gov (United States)

    Astra, I. Made; Wahyuni, Citra; Nasbey, Hadi

    2015-01-01

    The aim of this research is to improve the quality of physics learning through application of collaborative learning of group investigation at grade X MIPA 2 SMAN 14 Jakarta. The method used in this research is classroom action research. This research consisted of three cycles was conducted from April to May in 2014. Each cycle consists of…

  17. 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.

  18. 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].

  19. 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.

  20. Improving the Prediction Accuracy of Multicriteria Collaborative Filtering by Combination Algorithms

    Directory of Open Access Journals (Sweden)

    Wiranto

    2014-05-01

    Full Text Available This study focuses on developing the multicriteria collaborative filtering algorithmfor improving the prediction accuracy. The approaches applied were user-item multirating matrix decomposition, the measurement of user similarity using cosine formula and multidimensional distance, individual criteria weight calculation, and rating prediction for the overall criteria by a combination approach. Results of the study show variation in multicriteria collaborative filtering algorithm, which was used for improving the document recommender system with the two following characteristics. First, the rating prediction for four individual criteria using collaborative filtering algorithm by a cosine-based user similarity and a multidimensional distance-based user similarity. Second, the rating prediction for the overall criteria using a combination algorithms. Based on the results of testing, it can be concluded that a variety of models developed for the multicriteria collaborative filtering systems had much better prediction accuracy than for the classic collaborative filtering, which was characterized by the increasingly smaller values of Mean Absolute Error. The best accuracy was achieved by the multicriteria collaborative filtering system with multidimensional distance-based similarity.

  1. A 2-1-1 research collaboration: participant accrual and service quality indicators.

    Science.gov (United States)

    Eddens, Katherine S; Alcaraz, Kassandra I; Kreuter, Matthew W; Rath, Suchitra; Greer, Regina

    2012-12-01

    In times of crises, 2-1-1 serves as a lifeline in many ways. These crises often cause a spike in call volume that can challenge 2-1-1's ability to meet its service quality standards. For researchers gathering data through 2-1-1s, a sudden increase in call volume might reduce accrual as 2-1-1 has less time to administer study protocols. Research activities imbedded in 2-1-1 systems may affect directly 2-1-1 service quality indicators. Using data from a 2-1-1 research collaboration, this paper examines the impact of crises on call volume to 2-1-1, how call volume affects research participant accrual through 2-1-1, and how research recruitment efforts affect 2-1-1 service quality indicators. t-tests were used to examine the effect of call volume on research participant accrual. Linear and logistic regressions were used to examine the effect of research participant accrual on 2-1-1 service quality indicators. Data were collected June 2010-December 2011; data were analyzed in 2012. Findings from this collaboration suggest that crises causing spikes in call volume adversely affect 2-1-1 service quality indicators as well as accrual of research participants. Administering a brief (2-3 minute) health risk assessment did not affect service quality negatively, but administering a longer (15-18 minute) survey had a modest adverse effect on these indicators. In 2-1-1 research collaborations, both partners need to understand the dynamic relationship among call volume, research accrual, and service quality and adjust expectations accordingly. If research goals include administering a longer survey, increased staffing of 2-1-1 call centers may be needed to avoid compromising service quality. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  2. 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.

  3. 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.

  4. Utilizing Collaborative Analysis of Student Learning in Educator Preparation Programs for Continuous Improvement

    Directory of Open Access Journals (Sweden)

    Susan Colby

    2016-12-01

    Full Text Available In this results-oriented era of accountability, educator preparation programs are called upon to provide comprehensive data related to student and program outcomes while also providing evidence of continuous improvement. Collaborative Analysis of Student Learning (CASL is one approach for fostering critical inquiry about student learning. Graduate educator preparation programs in our university used collaborative analysis as the basis for continuous improvement during an accreditation cycle. As authors of this study, we sought to better understand how graduate program directors and faculty used collaborative analysis to inform practice and improve programs. Our findings suggested that CASL has the potential to foster collective responsibility for student learning, but only with a strong commitment from administrators and faculty, purposefully designed protocols and processes, fidelity to the CASL method, and a focus on professional development. Through CASL, programs have the ability to produce meaningful data related to student and program outcomes and meet the requirements for accreditation.

  5. 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...

  6. 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

  7. Improved Conjunction Analysis via Collaborative Space Situational Awareness

    Science.gov (United States)

    Kelso, T.; Vallado, D.; Chan, J.; Buckwalter, B.

    With recent events such as the Chinese ASAT test in 2007 and the USA 193 intercept in 2008, many satellite operators are becoming increasingly aware of the potential threat to their satellites as the result of orbital debris or even other satellites. However, to be successful at conjunction monitoring and collision avoidance requires accurate orbital information for as many space objects (payloads, dead satellites, rocket bodies, and debris) as possible. Given the current capabilities of the US Space Surveillance Network (SSN), approximately 18,500 objects are now being tracked and orbital data (in the form of two-line element sets) is available to satellite operators for 11,750 of them (as of 2008 September 1). The capability to automatically process this orbital data to look for close conjunctions and provide that information to satellite operators via the Internet has been continuously available on CelesTrak, in the form of Satellite Orbital Conjunction Reports Assessing Threatening Encounters in Space (SOCRATES), since May 2004. Those reports are used by many operators as one way to keep apprised of these potential threats. However, the two-line element sets (TLEs) are generated using non-cooperative tracking via the SSN's network of radar and optical sensors. As a result, the relatively low accuracy of the data results in a large number of false alarms that satellite operators must routinely deal with. Yet, satellite operators typically perform orbit maintenance for their own satellites, using active ranging and GPS systems. These data are often an order of magnitude more accurate than those available using TLEs. When combined (in the form of ephemerides) with maneuver planning information, the ability to maintain predictive awareness increases significantly. And when satellite operators share this data, the improved space situational awareness, particularly in the crowded geosynchronous belt, can be dramatic and the number of false alarms can be reduced

  8. 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%.

  9. 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.

  10. Improving healthcare value through clinical community and supply chain collaboration.

    Science.gov (United States)

    Ishii, Lisa; Demski, Renee; Ken Lee, K H; Mustafa, Zishan; Frank, Steve; Wolisnky, Jean Paul; Cohen, David; Khanna, Jay; Ammerman, Joshua; Khanuja, Harpal S; Unger, Anthony S; Gould, Lois; Wachter, Patricia Ann; Stearns, Lauren; Werthman, Ronald; Pronovost, Peter

    2017-03-01

    We hypothesized that integrating supply chain with clinical communities would allow for clinician-led supply cost reduction and improved value in an academic health system. Three clinical communities (spine, joint, blood management) and one clinical community-like physician led team of surgeon stakeholders partnered with the supply chain team on specific supply cost initiatives. The teams reviewed their specific utilization and cost data, and the physicians led consensus-building conversations over a series of team meetings to agree to standard supply utilization. The spine and joint clinical communities each agreed upon a vendor capping model that led to cost savings of $3 million dollars and $1.5 million dollars respectively. The blood management decreased blood product utilization and achieved $1.2 million dollars savings. $5.6 million dollars in savings was achieved by a clinical community-like group of surgeon stakeholders through standardization of sutures and endomechanicals. Physician led clinical teams empowered to lead change achieved substantial supply chain cost savings in an academic health system. The model of combining clinical communities with supply chain offers hope for an effective, practical, and scalable approach to improving value and engaging physicians in other academic health systems. This clinician led model could benefit both private and academic health systems engaging in value optimization efforts. N/A. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. 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.

  12. 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

  13. Improving Social Odometry Robot Networks with Distributed Reputation Systems for Collaborative Purposes

    Directory of Open Access Journals (Sweden)

    Zorana Bankovic

    2011-11-01

    Full Text Available The improvement of odometry systems in collaborative robotics remains an important challenge for several applications. Social odometry is a social technique which confers the robots the possibility to learn from the others. This paper analyzes social odometry and proposes and follows a methodology to improve its behavior based on cooperative reputation systems. We also provide a reference implementation that allows us to compare the performance of the proposed solution in highly dynamic environments with the performance of standard social odometry techniques. Simulation results quantitatively show the benefits of this collaborative approach that allows us to achieve better performances than social odometry.

  14. Improvements to the National Transport Code Collaboration Data Server

    Science.gov (United States)

    Alexander, David A.

    2001-10-01

    The data server of the National Transport Code Colaboration Project provides a universal network interface to interpolated or raw transport data accessible by a universal set of names. Data can be acquired from a local copy of the Iternational Multi-Tokamak (ITER) profile database as well as from TRANSP trees of MDS Plus data systems on the net. Data is provided to the user's network client via a CORBA interface, thus providing stateful data server instances, which have the advantage of remembering the desired interpolation, data set, etc. This paper will review the status and discuss the recent improvements made to the data server, such as the modularization of the data server and the addition of hdf5 and MDS Plus data file writing capability.

  15. Developing enterprise collaboration: a methodology to implement and improve interoperability

    Science.gov (United States)

    Daclin, Nicolas; Chen, David; Vallespir, Bruno

    2016-06-01

    The aim of this article is to present a methodology for guiding enterprises to implement and improve interoperability. This methodology is based on three components: a framework of interoperability which structures specific solutions of interoperability and is composed of abstraction levels, views and approaches dimensions; a method to measure interoperability including interoperability before (maturity) and during (operational performances) a partnership; and a structured approach defining the steps of the methodology, from the expression of an enterprise's needs to implementation of solutions. The relationship which consistently relates these components forms the methodology and enables developing interoperability in a step-by-step manner. Each component of the methodology and the way it operates is presented. The overall approach is illustrated in a case study example on the basis of a process between a given company and its dealers. Conclusions and future perspectives are given at the end of the article.

  16. 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)

  17. 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.

  18. 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...

  19. Improving Access to Pediatric Cardiology in Cape Verde via a Collaborative International Telemedicine Service.

    Science.gov (United States)

    Lapão, Luís Velez; Correia, Artur

    2015-01-01

    This paper addresses the role of international telemedicine services in supporting the evacuation procedures from Cape Verde to Portugal, enabling better quality and cost reductions in the management of the global health system. The Cape Verde, as other African countries, health system lacks many medical specialists, like pediatric cardiologists, neurosurgery, etc. In this study, tele-cardiology shows good results as diagnostic support to the evacuation decision. Telemedicine services show benefits while monitoring patients in post-evacuation, helping to address the lack of responsive care in some specialties whose actual use will help save resources both in provision and in management of the evacuation procedures. Additionally, with tele-cardiology collaborative service many evacuations can be avoided whereas many cases will be treated and followed locally in Cape Verde with remote technical support from Portugal. This international telemedicine service enabled more efficient evacuations, by reducing expenses in travel and housing, and therefore contributed to the health system's improvement. This study provides some evidence of how important telemedicine really is to cope with both the geography and the shortage of physicians.

  20. Designing and Implementing Collaborative Improvement in the Extended Manufacturing Enterprise: Action Learning and Action Research (ALAR) in CO-IMPROVE

    Science.gov (United States)

    Coghlan, David; Coughlan, Paul

    2006-01-01

    Purpose: The purpose of this article is to provide a design and implementation framework for ALAR (action learning action research) programme which aims to address collaborative improvement in the extended manufacturing enterprise. Design/methodology/approach: This article demonstrates the design of a programme in which action learning and action…

  1. Methodology for the collaboration in supply chains with a focus on continuous improvement

    Directory of Open Access Journals (Sweden)

    José Anselmo Mayer

    2016-08-01

    Full Text Available A collaborative relationship between companies in a supply chain makes it possible to improve both the performance and the results of the companies and of the supply chain. Several studies have analyzed supply chains, but few studies have proposed the application of tools for continuous improvement in a collaborative manner within the supply chain. The objective of this work is to present a methodology for the collaboration in a supply chain with a focus on continuous improvement. Three case studies were conducted with Brazilian multinational focal companies that manufacture technology-based products. It was seen that relationships, trust, the exchange of information, and the sharing of gains and risks sustains collaborative practices focused on continuous improvement. The proposed methodology considers the need for supplier development, for the monitoring of the supplies, and for the development of a partnership for problem solving through the application of tools for continuous improvement.

  2. 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.

  3. Improving Video Game Development: Facilitating Heterogeneous Team Collaboration through Flexible Software Processes

    Science.gov (United States)

    Musil, Juergen; Schweda, Angelika; Winkler, Dietmar; Biffl, Stefan

    Based on our observations of Austrian video game software development (VGSD) practices we identified a lack of systematic processes/method support and inefficient collaboration between various involved disciplines, i.e. engineers and artists. VGSD includes heterogeneous disciplines, e.g. creative arts, game/content design, and software. Nevertheless, improving team collaboration and process support is an ongoing challenge to enable a comprehensive view on game development projects. Lessons learned from software engineering practices can help game developers to increase game development processes within a heterogeneous environment. Based on a state of the practice survey in the Austrian games industry, this paper presents (a) first results with focus on process/method support and (b) suggests a candidate flexible process approach based on Scrum to improve VGSD and team collaboration. Results showed (a) a trend to highly flexible software processes involving various disciplines and (b) identified the suggested flexible process approach as feasible and useful for project application.

  4. 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.

  5. 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.

  6. 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.

  7. 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....

  8. 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...

  9. 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.

  10. Use of collaboration software to improve nuclear power plant outage management

    Energy Technology Data Exchange (ETDEWEB)

    Germain, Shawn

    2015-02-01

    Nuclear Power Plant (NPP) refueling outages create some of the most challenging activities the utilities face in both tracking and coordinating thousands of activities in a short period of time. Other challenges, including nuclear safety concerns arising from atypical system configurations and resource allocation issues, can create delays and schedule overruns, driving up outage costs. Today the majority of the outage communication is done using processes that do not take advantage of advances in modern technologies that enable enhanced communication, collaboration and information sharing. Some of the common practices include: runners that deliver paper-based requests for approval, radios, telephones, desktop computers, daily schedule printouts, and static whiteboards that are used to display information. Many gains have been made to reduce the challenges facing outage coordinators; however; new opportunities can be realized by utilizing modern technological advancements in communication and information tools that can enhance the collective situational awareness of plant personnel leading to improved decision-making. Ongoing research as part of the Light Water Reactor Sustainability Program (LWRS) has been targeting NPP outage improvement. As part of this research, various applications of collaborative software have been demonstrated through pilot project utility partnerships. Collaboration software can be utilized as part of the larger concept of Computer-Supported Cooperative Work (CSCW). Collaborative software can be used for emergent issue resolution, Outage Control Center (OCC) displays, and schedule monitoring. Use of collaboration software enables outage staff and subject matter experts (SMEs) to view and update critical outage information from any location on site or off.

  11. Exploring the Notion of Quality in Quality Higher Education Assessment in a Collaborative Future

    Science.gov (United States)

    Maguire, Kate; Gibbs, Paul

    2013-01-01

    The purpose of this article is to contribute to the debate on the notion of quality in higher education with particular focus on "objectifying through articulation" the assessment of quality by professional experts. The article gives an overview of the differentiations of quality as used in higher education. It explores a substantial…

  12. Exploring the Notion of Quality in Quality Higher Education Assessment in a Collaborative Future

    Science.gov (United States)

    Maguire, Kate; Gibbs, Paul

    2013-01-01

    The purpose of this article is to contribute to the debate on the notion of quality in higher education with particular focus on "objectifying through articulation" the assessment of quality by professional experts. The article gives an overview of the differentiations of quality as used in higher education. It explores a substantial piece of…

  13. Implementing collaborative improvement, top-down, bottom-up, or both?

    NARCIS (Netherlands)

    Kaltoft, Rasmus; Boer, H.; Boer, Harm; Caniato, Federico; Gertsen, Frank; Middel, H.G.A.; Steendahl Nielsen, Jacob

    2004-01-01

    The research presented in this paper was aimed at increasing the current understanding of the process of developing collaborative improvement in Extended Manufacturing Enterprises (EME). Based on action research and action learning of three EMEs involving a total of thirteen companies from five

  14. The Collaboration Model and Reading Improvement of High School Students with Learning Disabilities

    Science.gov (United States)

    Sacchetto, Jorge A.

    2014-01-01

    In the field of reading research, studies focusing on improvement of a high school student's reading achievements are lacking. Collaborative interventions for reading instruction are useful and more prevalent for elementary age students but not high school students. Therefore, there remains an important gap in the current literature regarding…

  15. Implementing a Collaborative Consultation Model To Improve Success in Mainstream Courses for Secondary Learning Disabled Students.

    Science.gov (United States)

    Jellie, Carol Rees

    This practicum developed a program to improve the mainstreaming of secondary level students with learning disabilities through provision of: (1) inservice training workshops on the topic of collaborative consultation for regular and exceptional (special) educators, and (2) study skills seminars for the students. In addition to the inservice…

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. Using employer purchasing power to improve the quality of perinatal care.

    Science.gov (United States)

    Castles, A G; Milstein, A; Damberg, C L

    1999-01-01

    Large employers have become increasingly involved in helping to set the agenda for quality measurement and improvement. Moreover, they are beginning to hold health care organizations accountable for their performance through marketplace incentives, including the public reporting of comparative quality data and the linkage of reimbursement to performance on quality measures. The Pacific Business Group on Health (PBGH) is an employer coalition that has been prominent in establishing models for collaborative quality measurement and improvement in the California marketplace. PBGH's involvement in quality stems from an environment in which purchasers were faced with high health care costs, yet virtually no information with which to assess the value their employees received from that care. Research indicating widespread variation in performance across health care organizations and seemingly limited oversight for quality of care within the industry has further motivated purchasers' efforts to better understand the quality of care being delivered to their em-ployees. Using the purchasing power of employers representing 2.5-million covered lives, PBGH endeavors to encourage the transition of the health care marketplace from one that competes solely on price to one that competes on price and quality. This entails collaborating with the health care industry to develop and publicly report valid performance data for use by both large employers and consumers of health care services. It also includes communicating to the marketplace purchasers' commitment to making purchasing decisions based on quality as well as cost. PBGH efforts to measure, report, and improve quality have been demonstrated by several undertakings in the perinatal care arena, including research to assess cesarean section rates and newborn readmission rates across California hospitals.employer coalition, purchaser, quality measurement, quality improvement, report cards, perinatal quality of care.

  1. ``Science Talks'' in Kindergarten Classrooms: Improving Classroom Practice Through Collaborative Action Research

    Science.gov (United States)

    Zhang, Meilan; Passalacqua, Susan; Lundeberg, Mary; Koehler, Matthew J.; Eberhardt, Jan; Parker, Joyce; Urban-Lurain, Mark; Zhang, Tianyi; Paik, Sunhee

    2010-03-01

    In this study we described an action research project enacted by a veteran Kindergarten teacher (Sarah) in the context of a professional development program. Over the course of a year, Sarah collaborated with other teachers in a small group to investigate how to use “Science Talks” to promote student learning in Kindergarten classrooms. A Problem-Based Learning approach was adopted to guide the collaborative action research. Based on a rich set of data sources, we concluded that Sarah’s action research improved student learning and led to her own professional growth. We also identified important conditions in support of action research.

  2. The national improvement partnership network: state-based partnerships that improve primary care quality.

    Science.gov (United States)

    Shaw, Judith S; Norlin, Chuck; Gillespie, R J; Weissman, Mark; McGrath, Jane

    2013-01-01

    Improvement partnerships (IPs) are a model for collaboration among public and private organizations that share interests in improving child health and the quality of health care delivered to children. Their partners typically include state public health and Medicaid agencies, the local chapter of the American Academy of Pediatrics, and an academic health care organization or children's hospital. Most IPs also engage other partners, including a variety of public, private, and professional organizations and individuals. IPs lead and support measurement-based, systems-focused quality improvement (QI) efforts that primarily target primary care practices that care for children. Their projects are most often conducted as learning collaboratives that involve a team from each of 8 to 15 participating practices over 9 to 12 months. The improvement teams typically include a clinician, office manager, clinical staff (nurses or medical assistants), and, for some projects, a parent; the IPs provide the staff and local infrastructure. The projects target clinical topics, chosen because of their importance to public health, local clinicians, and funding agencies, including asthma, attention-deficit/hyperactivity disorder, autism, developmental screening, obesity, mental health, medical home implementation, and several others. Over the past 13 years, 19 states have developed (and 5 are exploring developing) IPs. These organizations share similar aims and methods but differ substantially in leadership, structure, funding, and longevity. Their projects generally engage pediatric and family medicine practices ranging from solo private practices to community health centers to large corporate practices. The practices learn about the project topic and about QI, develop specific improvement strategies and aims that align with the project aims, perform iterative measures to evaluate and guide their improvements, and implement systems and processes to support and sustain those improvements

  3. NOEMI, a collaborative management for ICT process improvement in SME: experience report

    OpenAIRE

    2004-01-01

    This paper relates to an R&D project – called NOEMI – aiming to propose to SME’s a collaborative management of their respective information systems in terms of quality, reliability and cost. The targeted SME are those without IT dedicated internal staff. The model developed in the project focuses on the usual IT activities of the SME’s, which are classified in five domains: infrastructure, support, management, security, and documentation. The NOEMI model has been successfully experimented...

  4. 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...

  5. Collaborative Project: Improving the Representation of Coastal and Estuarine Processes in Earth System Models

    Energy Technology Data Exchange (ETDEWEB)

    Bryan, Frank [Univ. of Washington, Seattle, WA (United States); Dennis, John [Univ. of Washington, Seattle, WA (United States); MacCready, Parker [Univ. of Washington, Seattle, WA (United States); Whitney, Michael [Univ. of Washington, Seattle, WA (United States)

    2016-10-20

    This project aimed to improve long term global climate simulations by resolving and enhancing the representation of the processes involved in the cycling of freshwater through estuaries and coastal regions. This was a collaborative multi-institution project consisting of physical oceanographers, climate model developers, and computational scientists. It specifically targeted the DOE objectives of advancing simulation and predictive capability of climate models through improvements in resolution and physical process representation.

  6. Final Report Collaborative Project: Improving the Representation of Coastal and Estuarine Processes in Earth System Models

    Energy Technology Data Exchange (ETDEWEB)

    Bryan, Frank [Univ. of Connecticut, Storrs, CT (United States); Dennis, John [Univ. of Connecticut, Storrs, CT (United States); MacCready, Parker [Univ. of Connecticut, Storrs, CT (United States); Whitney, Michael M. [Univ. of Connecticut, Storrs, CT (United States)

    2016-09-30

    This project aimed to improve long term global climate simulations by resolving and enhancing the representation of the processes involved in the cycling of freshwater through estuaries and coastal regions. This was a collaborative multi-institution project consisting of physical oceanographers, climate model developers, and computational scientists. It specifically targeted the DOE objectives of advancing simulation and predictive capability of climate models through improvements in resolution and physical process representation.

  7. 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.

  8. 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.

  9. 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.

  10. Self-reported changes in quality of life among people with multiple sclerosis who have participated in treatments based on collaboration between conventional healthcare providers and CAM practitioners

    DEFF Research Database (Denmark)

    Bjerre, Liv; Henningsen, Inge Biehl; Skovgaard, Lasse;

    2011-01-01

    Aim of the study: This study assesses the changes in self-reported quality of life (QoL) from hospitalisation to 18 months later among people with multiple sclerosis (MS) who have participated in treatments based on collaboration between conventional healthcare providers and CAM practitioners......Lwas found within the areas of emotional well-being and thinking/fatigue. Conclusion: The results indicate that collaboration between healthcare providers andCAMpractitioners can improve treatment outcomes regarding some of the psychological aspects of QoL over a period of 18 months for people with MS....

  11. Science Partnerships Enabling Rapid Response: Designing a Strategy for Improving Scientific Collaboration during Crisis Response

    Science.gov (United States)

    Mease, L.; Gibbs, T.; Adiseshan, T.

    2014-12-01

    agencies, academic research institutions, and industry scientists face during oil spill crises. We will also present a synthesis of leverage points in the system that may amplify the impact of an improved collaboration strategy among scientific stakeholders.

  12. 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.

  13. An Interprofessional Diabetes Experience to Improve Pharmacy and Nursing Students’ Competency in Collaborative Practice

    Science.gov (United States)

    Westberg, Sarah; Rowan, Mary; Schweiss, Sarah

    2013-01-01

    Objective. To improve pharmacy and nursing students’ competency in collaborative practice by having them participate in an interprofessional diabetes experience involving social networking. Design. An existing elective course on diabetes management was modified to include interprofessional content based on Interprofessional Education Collaborative (IPEC) competency domains. Web-based collaborative tools (social networking and video chat) were used to allow nursing and pharmacy students located on 2 different campuses to apply diabetes management content as an interprofessional team. Assessment. Mixed-method analyses demonstrated an increase in students’ knowledge of the roles and responsibilities of the other profession and developed an understanding of interprofessional communication strategies and their central role in effective teamwork. Conclusion. Interprofessional content and activities can be effectively integrated into an existing course and offered successfully to students from other professional programs and on remote campuses. PMID:24249859

  14. Research on Improved Collaborative Filtering Recommendation Algorithm on MapReduce

    Directory of Open Access Journals (Sweden)

    Dong Jie

    2016-01-01

    Full Text Available Information overload is one of the most serious problems in big data environment, recommendation systems is a way to effectively mitigate the problem. In order to make use of rich user feedback and social networks information and to further improve the performance of the recommendation system ,This thesis makes a improvement on the user-based collaborative filtering algorithm by normalization method, Meanwhile the algorithm could be run on the MapReduce in the Hadoop platform. The experimental results show that the algorithm on Hadoop platform can effectively improve the accuracy of the data to recommend and computational efficiency, so as to improve the satisfaction of users.

  15. 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.

  16. Evaluation of a VHA collaborative to improve follow-up after a positive colorectal cancer screening test.

    Science.gov (United States)

    Powell, Adam A; Nugent, Sean; Ordin, Diana L; Noorbaloochi, Siamak; Partin, Melissa R

    2011-10-01

    In 2005, the Veterans Health Administration initiated a yearlong Colorectal Cancer Care Collaborative (C4) to improve timely follow-up after positive fecal occult blood tests. Twenty-one facilities formed local quality improvement (QI) teams. Teams received QI training, created process flow maps, implemented process changes, and shared learning through 2 face-to-face meetings, conference calls, and a discussion board. We evaluated pre-post change in the timeliness of follow-up among C4 facilities and 3 control facilities. Outcome measures included the proportion of patients receiving a follow-up colonoscopy within 1 year, the proportion receiving 60-day follow-up (the focus of C4 teams), and average days to colonoscopy. Survey data from C4 team members was analyzed to identify predictors of facility-level improvement. Both C4 and control facilities improved on 1-year follow-up (10% and 9% increases, respectively, both P's<0.001). There was a statistically significant increase in the proportion receiving 60-day follow-up among C4 facilities (27% pre-C4 vs. 39% post-C4, P=0.008) but a nonsignificant decrease among control facilities (45% pre-C4 vs. 29% post-C4, P=0.14). Average days to colonoscopy decreased significantly among C4 facilities (129 pre-C4 vs. 103 post-C4, P=0.004) but increased significantly among control facilities (81 pre-C4 vs. 103 post-C4, P=0.04). Teams with the most improvement established clear roles/goals, had previous QI training, made more use of QI tools, and incorporated primary care education into their improvement work. A Veterans Health Administration improvement collaborative modestly decreased time to colonoscopy after a positive colorectal cancer screening test but significant room for improvement remains and benefits of participation were not realized by all facilities.

  17. 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

  18. 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

  19. Implementing collaborative improvement - top-down, bottom-up or both?

    DEFF Research Database (Denmark)

    Kaltoft, Rasmus; Boer, Harry; Caniato, Federico

    2007-01-01

    , the study identifies three different implementation approaches. The bottom-up learning-by-doing approach starts at a practical level, with simple improvement activities, and aims at gradually developing a wide range of CoI knowledge, skills and initiatives. The top-down directive approach starts......The research presented in this article was aimed at increasing the current understanding of the process of developing Collaborative Improvement (CoI) in Extended Manufacturing Enterprises (EME). Based on action research in three EMEs involving a total of 13 companies from five European countries...... with aligning the partners' CoI objectives and an assessment of their collaboration and CoI maturity in order to provide a common platform before actually starting improvement activities. The laissez-faire approach builds on shared goals/vision, meetings on equal terms and joint work, in a non-directive and non...

  20. 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.

  1. 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 ...

  2. Collaborative Learning and Iranian EFL learners’ Vocabulary Improvement through Snowball and Word-Webbing Techniques

    Directory of Open Access Journals (Sweden)

    Akbar Afghari

    2017-06-01

    Full Text Available The present study was an attempt to look into the effect of collaborative learning on the learners’ improvement in vocabulary learning. Moreover, the learners’ attitudes about vocabulary learning were taken into account as well. The study was conducted with the participation of 30 intermediate Iranian EFL (English as a foreign language learners, who were studying in a private language institute. To collect the data, OPT (Oxford Placement Test was applied to check the learners’ proficiency level and meet the homogeneity requirements. Then, the learners took the vocabulary pre- and post-test to check the effectiveness of treatment sessions on the learners’ vocabulary learning. Semi-structured interview was also done to investigate the learners’ awareness regarding learning vocabularies before and after the treatment sessions. Findings showed that the applied collaborative techniques, i.e. word-webbing and snowball techniques paved the way for the experimental group to outperform the control group since improvement in vocabulary learning was found to be significant. Moreover, Qualitative results revealed the occurrence of positive changes in the learners’ attitudes about vocabulary learning since almost all the learners concurred that the above-mentioned collaborative techniques assisted them in their better speaking and, by having more interaction through group work, enjoyable environment was created for learning target vocabularies. It was suggested that collaborative instruction should be implemented in teaching vocabulary as it can pave the way for both teachers and learners to benefit from a communicative language classroom.

  3. Using interprofessional simulation to improve collaborative competences for nursing, physiotherapy, and respiratory therapy students.

    Science.gov (United States)

    King, Judy; Beanlands, Sarah; Fiset, Valerie; Chartrand, Louise; Clarke, Shelley; Findlay, Tarra; Morley, Michelle; Summers, Ian

    2016-09-01

    Within the care of people living with respiratory conditions, nursing, physiotherapy, and respiratory therapy healthcare professionals routinely work in interprofessional teams. To help students prepare for their future professional roles, there is a need for them to be involved in interprofessional education. The purpose of this project was to compare two different methods of patient simulation in improving interprofessional competencies for students in nursing, physiotherapy, and respiratory therapy programmes. The Canadian Interprofessional Health Collaborative competencies of communication, collaboration, conflict resolution patient/family-centred care, roles and responsibilities, and team functioning were measured. Using a quasi-experimental pre-post intervention approach two different interprofessional workshops were compared: the combination of standardised and simulated patients, and exclusively standardised patients. Students from nursing, physiotherapy, and respiratory therapy programmes worked together in these simulation-based activities to plan and implement care for a patient with a respiratory condition. Key results were that participants in both years improved in their self-reported interprofessional competencies as measured by the Interprofessional Collaborative Competencies Attainment Survey (ICCAS). Participants indicated that they found their interprofessional teams did well with communication and collaboration. But the participants felt they could have better involved the patients and their family members in the patient's care. Regardless of method of patient simulation used, mannequin or standardised patients, students found the experience beneficial and appreciated the opportunity to better understand the roles of other healthcare professionals in working together to help patients living with respiratory conditions.

  4. Goal specificity: a proxy measure for improvements in environmental outcomes in collaborative governance.

    Science.gov (United States)

    Biddle, Jennifer C; Koontz, Tomas M

    2014-12-01

    Collaborative governance critics continually call for evidence to support its prevalent use. As is often the case in environmental policy, environmental outcomes occur at a rate incompatible with political agendas. In addition, a multitude of possibly confounding variables makes it difficult to correlate collaborative governance processes with environmental outcomes. The findings of this study offer empirical evidence that collaborative processes have a measurable, beneficial effect on environmental outcomes. Through the use of a unique paired-waterbody design, our dataset reduced the potential for confounding variables to impact our environmental outcome measurements. The results of a path analysis indicate that the output of setting specific pollutant reduction goals is significantly related to watershed partnerships' level of attainment of their environmental improvement goals. The action of setting specific goals (e.g. percentage of load reductions in pollutant levels) is fostered by sustained participation from partnership members throughout the lifecycle of the collaborative. In addition, this study demonstrates the utility of logic modeling for environmental planning and management, and suggests that the process of setting specific pollutant reduction goals is a useful proxy measure for reporting progress towards improvements in environmental outcomes when long-term environmental data are not available.

  5. 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.

  6. 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…

  7. Flow Experience as a Quality Measure in Evaluating Physically Activating Collaborative Serious Games

    Directory of Open Access Journals (Sweden)

    Kristian J. M. Kiili

    2014-09-01

    Full Text Available The measurement of the subjective playing experience is important part of the game development process. The enjoyment level that a serious game offers is a key factor in determining whether a player will be engaged in the gameplay and achieve the objectives of the game. In this paper we report the results of a game design process in which two prototypes of a collaborative exergame were studied. The main aim of the paper is to explore to what extend the measurement of flow experience can facilitate the game evaluation and design process. Alltogether 102 junior high school students participated in two user experience studies and played collaborative exergames designed to teach soft skills. Playing experience was measured with a flow questionnaire, playing behavior was observed and some of the players were interviewed. The results showed that flow experience can be used to evaluate the overall quality of the gameplay and it provides a structured approach to consider the quality of the game. However, flow does not provide detailed information about the shortages of the game and thus complementary methods is needed to identify the causes. The results also indicated that flow experience was independent of gender that supports its use in quality measurement.

  8. Joining Forces: Collaborating Internationally to Deliver High-Quality, Online Postgraduate Education in Pain Management

    Directory of Open Access Journals (Sweden)

    Elizabeth Devonshire

    2011-01-01

    Full Text Available The effective management of pain is a complex and costly global issue, requiring a range of innovative educational strategies to enable culturally appropriate and high-quality health care provision. In response to this issue, the Pain Management Research Institute at the University of Sydney (Sydney, Australia has established several strategic alliances with other overseas universities to deliver online postgraduate education in pain management. The present article discusses the rationale for joining forces, and the approach adopted in creating and maintaining these alliances. It also provides insights into the benefits, challenges and opportunities associated with collaborative educational initiatives of this nature, from institutional, academic and student perspectives.

  9. 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

  10. Graduate Clinical Nurse Preceptors: Implications for Improved Intra-Professional Collaboration.

    Science.gov (United States)

    Donley, Rosemary; Flaherty, Mary Jean; Sarsfield, Eileen; Burkhard, Agnes; O'Brien, Sandra; Anderson, Kelley M

    2014-07-31

    Advanced practice nurses have increased in number and public acceptance. Students preparing for these roles require quality clinical education so they are prepared to assume collaborative roles in healthcare settings. Although graduate clinical preceptors have a vitally important role in the clinical education and professional socialization of advanced practice students, there is a paucity of evidence about factors that influence their role commitment. In this article, the authors review the literature related to graduate-level, clinical-preceptor experiences; describe their study of 91 graduate clinical preceptors that identified factors influencing graduate clinical preceptors' role commitment; report and discuss their findings; as well as the limitations of this study. They conclude that the graduate clinical preceptor role needs to be more visible and better integrated into schools of nursing and healthcare organizational structures, and identify the need for intra-professional collaboration among nursing faculty, administrators, and clinicians to facilitate the recruitment, cultivation, and retention of graduate clinical preceptors.

  11. An evaluation of an Australian initiative designed to improve interdisciplinary collaboration in primary mental health care.

    Science.gov (United States)

    Fletcher, Justine; King, Kylie; Christo, Jo; Machlin, Anna; Bassilios, Bridget; Blashki, Grant; Gibbs, Chris; Nicholas, Angela; Pirkis, Jane

    2014-08-01

    This paper reports on a multi-component evaluation of Australia's Mental Health Professionals Network (MHPN). MHPN aims to improve consumer outcomes by fostering a collaborative clinical approach to primary mental health care. MHPN has promoted interdisciplinary communication and networking through activity in three inter-related areas: interdisciplinary workshops supported by education and training materials; fostering ongoing, self-sustained interdisciplinary clinical networks; and a website, web portal (MHPN Online) and a toll-free telephone information line. The evaluation showed that MHPN's workshops were highly successful; almost 1200 workshops were attended by 11,930 individuals from a range of mental health professions. Participants from 81% of these workshops have gone on to join ongoing, interdisciplinary networks of local providers, and MHPN is now supporting these networks in a range of innovative ways to encourage them to become self-sustaining and to improve collaborative care practices. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Lifetime Improvement of Wireless Sensor Networks by Collaborative Beamforming and Cooperative Transmission

    CERN Document Server

    Han, Zhu

    2007-01-01

    Extending network lifetime of battery-operated devices is a key design issue that allows uninterrupted information exchange among distributive nodes in wireless sensor networks. Collaborative beamforming (CB) and cooperative transmission (CT) have recently emerged as new communication techniques that enable and leverage effective resource sharing among collaborative/cooperative nodes. In this paper, we seek to maximize the lifetime of sensor networks by using the new idea that closely located nodes can use CB/CT to reduce the load or even avoid packet forwarding requests to nodes that have critical battery life. First, we study the effectiveness of CB/CT to improve the signal strength at a faraway destination using energy in nearby nodes. Then, a 2D disk case is analyzed to assess the resulting performance improvement. For general networks, if information-generation rates are fixed, the new routing problem is formulated as a linear programming problem; otherwise, the cost for routing is dynamically adjusted a...

  13. 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)

  14. Improving Physical Health in Patients With Chronic Mental Disorders: Twelve-Month Results From a Randomized Controlled Collaborative Care Trial.

    Science.gov (United States)

    Kilbourne, Amy M; Barbaresso, Michelle M; Lai, Zongshan; Nord, Kristina M; Bramlet, Margretta; Goodrich, David E; Post, Edward P; Almirall, Daniel; Bauer, Mark S

    2017-01-01

    Persons with chronic mental disorders are disproportionately burdened with physical health conditions. We determined whether Life Goals Collaborative Care compared to usual care improves physical health in patients with mental disorders within 12 months. This single-blind randomized controlled effectiveness study of a collaborative care model was conducted at a midwestern Veterans Affairs urban outpatient mental health clinic. Patients (N = 293 out of 474 eligible approached) with an ICD-9-CM diagnosis of schizophrenia, bipolar disorder, or major depressive disorder and at least 1 cardiovascular disease risk factor provided informed consent and were randomized (February 24, 2010, to April 29, 2015) to Life Goals (n = 146) or usual care (n = 147). A total of 287 completed baseline assessments, and 245 completed 12-month follow-up assessments. Life Goals included 5 weekly sessions that provided semistructured guidance on managing physical and mental health symptoms through healthy behavior changes, augmented by ongoing care coordination. The primary outcome was change in physical health-related quality of life score (Veterans RAND 12-item Short Form Health Survey [VR-12] physical health component score). Secondary outcomes included control of cardiovascular risk factors from baseline to 12 months (blood pressure, lipids, weight), mental health-related quality of life, and mental health symptoms. Among patients completing baseline and 12-month outcomes assessments (N = 245), the mean age was 55.3 years (SD = 10.8; range, 25-78 years), and 15.4% were female. Intent-to-treat analysis revealed that compared to those in usual care, patients randomized to Life Goals had slightly increased VR-12 physical health scores (coefficient = 3.21; P = .01). Patients with chronic mental disorders and cardiovascular disease risk who received Life Goals had improved physical health-related quality of life. ClinicalTrials.gov identifiers: NCT01487668 and NCT01244854.

  15. Improving Physical Health in Patients with Chronic Mental Disorders: 12-Month Results from a Randomized Controlled Collaborative Care Trial

    Science.gov (United States)

    Kilbourne, Amy M.; Barbaresso, Michelle M.; Lai, Zongshan; Nord, Kristina M.; Bramlet, Margretta; Goodrich, David E.; Post, Edward P.; Almirall, Daniel; Bauer, Mark S.

    2015-01-01

    Objective Persons with chronic mental disorders are disproportionately burdened with physical health conditions. We determined whether Life Goals Collaborative Care compared to usual care improves physical health in patients with mental disorders within 12 months. Method This single-blind randomized controlled effectiveness study of a collaborative care model was conducted at a mid-western Veterans Affairs urban outpatient mental health clinic. Patients (N=293 out of 474 eligible approached) with an ICD-9-CM diagnosis of schizophrenia, bipolar disorder, or major depressive disorder and at least one cardiovascular disease risk factor were consented and randomized (02/24/10 to 04/29/15) to Life Goals (N=146) or usual care (N=147). A total of 287 completed baseline assessments and 245 completed 12-month follow-up assessments. Life Goals included five weekly sessions that provided semi-structured guidance on managing physical and mental health symptoms through healthy behavior changes, augmented by ongoing care coordination. The primary outcome was change in physical health-related quality of life score (VR-12 physical health component score). Secondary outcomes included control of cardiovascular risk factors from baseline to 12 months (blood pressure, lipids, weight), mental health-related quality of life, and mental health symptoms. Results Among patients completing baseline and 12-month outcomes assessments (N=245), the mean age was 55.3 (SD=10.8; range 28-75 years) and 15.4% were female. Intent-to-treat analysis revealed that compared to those in usual care, patients randomized to Life Goals had slightly increased VR-12 physical health scores (coefficient=3.21;p=0.01). Conclusion Patients with chronic mental disorders and cardiovascular disease risk who received Life Goals had improved physical health-related quality of life. PMID:27780336

  16. Improvement of Road Safety using Geospatial open data and collaborative users information

    OpenAIRE

    Gómez Castaño, José; Cabrera García, Juan José

    2016-01-01

    This project solve the problem of warning to drivers in advance to take precautions when they are approaching a road risk. This notice cannot be sent too close or too far and it is made by icons, text and audio. The main goal is to use geospatial information in a collaborative way to improve road safety taken relevant information from vehicles, cyclists andpedestrians.

  17. 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.

  18. Lessons Learned From a Collaborative to Improve Care for Patients With Diabetes in 17 Community Health Centers, Massachusetts, 2006

    OpenAIRE

    Lemay, Celeste A.; Beagan, Brianne M.; Ferguson, Warren J.; Lee, J.

    2010-01-01

    Introduction In 2006, the Massachusetts League of Community Health Centers convened a collaborative to systematically improve health care delivery for patients with diabetes in 17 community health centers. Our goal was to identify facilitators of and barriers to success reported by teams that participated in this collaborative. Methods The collaborative's activities lasted 13 months. At their conclusion, we interviewed participating team members. We asked about their teams' successes, challen...

  19. 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.

  20. "Good Practice" School Advisors in Greek Education: The Difficulty in Linking Collaborative Networks, Communities of Practice and Quality Culture

    Science.gov (United States)

    Stamelos, Georgios; Bartzakli, Marianna

    2013-01-01

    Quality in education is considered to be a central aim as far as the formation and the implementation of educational policy worldwide is concerned. The basic prerequisite for it, though, is quality culture. Collaborative networks between school advisors and primary school teachers are examined to reveal how they can affect the formation of…

  1. "Good Practice" School Advisors in Greek Education: The Difficulty in Linking Collaborative Networks, Communities of Practice and Quality Culture

    Science.gov (United States)

    Stamelos, Georgios; Bartzakli, Marianna

    2013-01-01

    Quality in education is considered to be a central aim as far as the formation and the implementation of educational policy worldwide is concerned. The basic prerequisite for it, though, is quality culture. Collaborative networks between school advisors and primary school teachers are examined to reveal how they can affect the formation of…

  2. 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.

  3. H8 Electron beam quality improvement during 2001

    CERN Document Server

    Efthymiopoulos, I; CERN. Geneva. SPS and LHC Division

    2002-01-01

    Since 1999 the ATLAS calorimeter groups who are the main users of the H8 beam line were observing a deterioration of the electron beam quality of the beam. Several studies, within the limited time available due to the tight SPS schedule, were performed before 2001 but without success. Following a systematic study of the problem in 2001, and in collaboration with the ATLAS colleagues, the origin of the problem was found and the beam quality was restored to the level before 1999. Details of the studies performed and the final results on the electron beam quality are summarized here.

  4. 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.

  5. Evaluation of 60 continuous quality improvement projects in French hospitals.

    Science.gov (United States)

    Maguerez, G; Erbault, M; Terra, J L; Maisonneuve, H; Matillon, Y

    2001-04-01

    To evaluate the feasibility of implementing continuous quality improvement (CQI) projects in French health care organizations. The French Ministry of Health issued two calls for CQI projects (in 1995 and 1996). ANAES was commissioned to monitor and evaluate the projects, and to provide advice. ANAES in collaboration with French public hospitals. A jury selected 64 projects from 483 submissions. The first series of projects related to safety issues (e.g. blood transfusions), the second related chiefly to patient management. ANAES instructed project leaders in process analysis (modified four-step FOCUS-PDCA model), convened regular meetings between leaders and performed on-site visits. Objective outcomes: goal achievement, extension of projects to other topics and departments, allocation of resources. Subjective outcomes: changes in attitudes. Statistics were obtained from two questionnaires completed by project leaders. Four projects were discontinued; 82% (49 out of 60) met more than half their objectives. The CQI method was adopted by other departments in 65% and 50% (1st and 2nd series respectively) of cases. Hospital management often chose to provide continued support (81%/88%), offer training (59%/80%), create a CQI unit (62%/73%), and allocate a budget (61%/65%). A positive impact on staff attitudes was noted in over 75% of projects. ANAES' co-ordinated initiative to acquaint a hard core of French public hospitals with CQI proved successful. Identification of the factors for success and of potential hurdles helped pave the way for the national hospital accreditation procedure currently underway.

  6. Adaptive Collaboration Support Systems: Designing Collaboration Support for Dynamic Environments

    NARCIS (Netherlands)

    Janeiro, J.; Knoll, S.W.; Lukosch, S.G.; Kolfschoten, G.L.

    2012-01-01

    Today, engineering systems offer a variety of local and webbased applications to support collaboration by assisting groups in structuring activities, generating and sharing data, and improving group communication. To ensure the quality of collaboration, engineering system design needs to analyze and

  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. Facilitation of computer-supported collaborative learning in mixed- versus same-culture dyads: Does a collaboration script help?

    NARCIS (Netherlands)

    Popov, V.; Biemans, H.J.A.; Brinkman, B.; Kuznetsov, A.N.; Mulder, M.

    2013-01-01

    To foster collaboration and improve the quality of students' discussions in mixed- and same- culture learner groups engaged in computer-supported collaborative learning (CSCL), a collaboration script was introduced. A 2 × 2-factorial design was used to examine the effects of using this collaboration

  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. State "technical assistance programs" for nursing home quality improvement: variations and potential implications.

    Science.gov (United States)

    Li, Yue; Spector, William D; Glance, Laurent G; Mukamel, Dana B

    2012-01-01

    To improve nursing home quality, many states have developed "technical assistance programs" that provide on-site consultation and training for nursing facility staff. We conducted a national survey on these state programs to collect data on program design, operations, financing, and perceived effectiveness. As of 2010, 17 states had developed such programs. Compared to existing state nursing home quality regulations, these programs represent a collaborative, rather than enforcement-oriented, approach to quality. However, existing programs vary substantially in key structural features such as staffing patterns, funding levels, and relationship with state survey and certification agencies. Perceived effectiveness by program officials on quality was high, although few states have performed formal evaluations. Perceived barriers to program effectiveness included lack of appropriate staff and funding, among others. In conclusion, state technical assistance programs for nursing homes vary in program design and perceived effectiveness. Future comparative evaluations are needed to inform evidence-based quality initiatives.

  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. 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.

  18. 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.

  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. 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

  1. 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.

  2. 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....

  3. 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.

  4. Evaluating a Chronic Disease Management Improvement Collaboration: Lessons in Design and Implementation Fundamentals.

    Science.gov (United States)

    Phillips, Kaye; Amar, Claudia; Elicksen-Jensen, Keesa

    2016-01-01

    For the Canadian Foundation for Healthcare Improvement (CFHI), the Atlantic Healthcare Collaboration (AHC) was a pivotal opportunity to build upon its experience and expertise in delivering regional change management training and to apply and refine its evaluation and performance measurement approach. This paper reports on its evaluation principles and approach, as well as the lessons learned as CFHI diligently coordinated and worked with improvement project (IP) teams and a network of stakeholders to design and undertake a suite of evaluative activities. The evaluation generated evidence and learnings about various elements of chronic disease prevention and management (CDPM) improvement processes, individual and team capacity building and the role and value of CFHI in facilitating tailored learning activities and networking among teams, coaches and other AHC stakeholders.

  5. 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

  6. The perceived financial impact of quality improvement efforts in community health centers.

    Science.gov (United States)

    Cheung, Karen; Moiduddin, Adil; Chin, Marshall H; Drum, Melinda L; Brown, Sydney E S; Graber, Jessica E; Heuer, Loretta; Quinn, Michael T; Schaefer, Cynthia T; Schlotthauer, Amy E; Huang, Elbert S

    2008-01-01

    We administered surveys to 100 chief executive officers (CEOs) of community health centers to determine their perceptions of the financial impact of the Health Disparities Collaboratives, a national quality improvement initiative. One third of the CEOs believed that the HDC had a negative financial impact on their health center, and this perception was significantly correlated with centers having a higher proportion of uninsured patients. Performance-based payment incentives may improve care but may also add new financial burdens to facilities that treat the uninsured population. As such, a provider's payer mix may need to be considered in the design of QI programs if they are to be sustainable.

  7. 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...

  8. 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.

  9. 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.

  10. 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.

  11. Improving Collaborative Learning and Global Project Management in Small and Medium Enterprise

    Directory of Open Access Journals (Sweden)

    Stefanie Quade

    2011-11-01

    Full Text Available Globalization needs Collaboration. In a multi-national setting traditional issues of collaboration are exacerbated because of language and culture. This problem is particularly felt by small and medium-sized enterprises (SMEs , which are traditionally not “natural born globals”. For example in Germany, which is dominated by SMEs, experience skill shortages as a result of demographic changes and a declining amount of students in engineering and informatics disciplines are becoming a major challenge. To investigate this situation, develop, and implement solutions, the research project “InterComp SME 2.0” was created. We present models and knowledge management methods to improve the training lifecycle of multi-national SMEs using interactive virtual 3-dimensional worlds such as Second Life. We focus on the case of an already globalized, medium-sized German publishing software firm. Existing training offers are modeled using business process management methods and modularised to improve execution and learning in an intercultural setting. Additional support for our approach is provided by our recent teaching experiences in a practice supervision course at the Berlin School of Economics and Law.

  12. 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…

  13. 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.…

  14. Quality Improvement Intervention for Reduction of Redundant Testing

    Directory of Open Access Journals (Sweden)

    Alan M. Ducatman MD, MS

    2017-05-01

    Full Text Available Laboratory data are critical to analyzing and improving clinical quality. In the setting of residual use of creatine kinase M and B isoenzyme testing for myocardial infarction, we assessed disease outcomes of discordant creatine kinase M and B isoenzyme +/troponin I (− test pairs in order to address anticipated clinician concerns about potential loss of case-finding sensitivity following proposed discontinuation of routine creatine kinase and creatine kinase M and B isoenzyme testing. Time-sequenced interventions were introduced. The main outcome was the percentage of cardiac marker studies performed within guidelines. Nonguideline orders dominated at baseline. Creatine kinase M and B isoenzyme testing in 7496 order sets failed to detect additional myocardial infarctions but was associated with 42 potentially preventable admissions/quarter. Interruptive computerized soft stops improved guideline compliance from 32.3% to 58% ( P 80% ( P < .001 with peer leadership that featured dashboard feedback about test order performance. This successful experience was recapitulated in interrupted time series within 2 additional services within facility 1 and then in 2 external hospitals (including a critical access facility. Improvements have been sustained postintervention. Laboratory cost savings at the academic facility were estimated to be ≥US$635 000 per year. National collaborative data indicated that facility 1 improved its order patterns from fourth to first quartile compared to peer norms and imply that nonguideline orders persist elsewhere. This example illustrates how pathologists can provide leadership in assisting clinicians in changing laboratory ordering practices. We found that clinicians respond to local laboratory data about their own test performance and that evidence suggesting harm is more compelling to clinicians than evidence of cost savings. Our experience indicates that interventions done at an academic facility can be readily

  15. 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...

  16. 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...

  17. 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

  18. 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

  19. 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.

  20. 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

  1. 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…

  2. 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.

  3. 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...

  4. 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…

  5. 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…

  6. 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....

  7. Using technology and collaborative working for a positive patient experience and to improve safety.

    Science.gov (United States)

    Desai, Usha

    2016-09-01

    Clinicians who treat patients with wounds need access to the resources that will enable them to deliver the best and most appropriate treatments. A partnership working initiative between Greenwich CCG Medicines management (commissioner), Oxleas NHS Foundation Trust (provider) and ConvaTec (commercial partner) was set up to provide wound-care dressings and products to patients via the community services. It lead to improved access, greater patient benefits, a reduction in dressings waste, and an increase in clinical confidence to make cost-effective, evidence-based prescribing decisions. This inspired the commissioners to collaborate with BlueBay (technology partner) to 'trailblaze' the development and introduction of an electronic wound care template for practice nurses and doctors in primary care to use in conjunction with VISION and EMIS, clinical software systems used in GP practices. This interoperability of clinical systems to improve wound care is, to date, the only one of its kind in the UK.

  8. 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.

  9. 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.

  10. Exploring the Effect of Geographical Proximity and University Quality on University-Industry Collaboration in the United Kingdom

    DEFF Research Database (Denmark)

    Laursen, Keld; Reichstein, Toke; Salter, Ammon

    2011-01-01

    Exploring the effect of geographical proximity and university quality on university–industry collaboration in the United Kingdom, Regional Studies. This paper concerns the geographical distance between a firm and the universities in its local area. It is argued that firms' decisions to collaborat...

  11. The Role of Collective Efficacy, Cognitive Quality, and Task Cohesion in Computer-Supported Collaborative Learning (CSCL)

    Science.gov (United States)

    Wang, Shu-Ling; Hwang, Gwo-Jen

    2012-01-01

    Research has suggested that CSCL environments contain fewer social context clues, resulting in various group processes, performance or motivation. This study thus attempts to explore the relationship among collective efficacy, group processes (i.e. task cohesion, cognitive quality) and collaborative performance in a CSCL environment. A total of 75…

  12. 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.

  13. 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.

  14. Improving Hypertension Control in Diabetes Mellitus The Effects of Collaborative and Proactive Health Communication

    Science.gov (United States)

    Naik, Aanand D.; Kallen, Michael A.; Walder, Annette; Street, Richard L.

    2013-01-01

    Background Communication between patients and clinicians using collaborative goals and treatment plans may overcome barriers to achieving hypertension control in routine diabetes mellitus care. We assessed the interrelation of patient–clinician communication factors to determine their independent associations with hypertension control in diabetes care. Methods and Results We identified 566 older adults with diabetes mellitus and hypertension at the DeBakey VA Medical Center in Houston, Tex. Clinical and pharmacy data were collected, and a patient questionnaire was sent to all participants. A total of 212 individuals returned surveys. Logistic regression analyses were performed to assess the effect of patient characteristics, self-management behaviors, and communication factors on hypertension control. Three communication factors had significant associations with hypertension control. Two factors, patients' endorsement of a shared decision-making style (odds ratio 1.61, 95% confidence interval 1.01 to 2.57) and proactive communication with one's clinician about abnormal results of blood pressure self-monitoring (odds ratio 1.89, 95% confidence interval 1.10 to 3.26), had direct, independent associations in multivariate regression. Path analysis was used to investigate the direct and indirect effects of communication factors and hypertension control. Decision-making style (β=0.20, P<0.01) and proactive communication (β=0.50, P<0.0001) again demonstrated direct effects on hypertension control. A third factor, clinicians' use of collaborative communication when setting treatment goals, had a total effect on hypertension control of 0.16 (P<0.05) through its direct effects on decision-making style (β=0.28, P<0.001) and proactive communication (β=0.22, P<0.01). Conclusions Three communication factors were found to have significant associations with hypertension control. Patient–clinician communication that facilitates collaborative blood pressure goals and

  15. Improving the Data Quality of Advanced LIGO Based on Early Engineering Run Results

    CERN Document Server

    Nuttall, L K; Areeda, J; Betzwieser, J; Dwyer, S; Effler, A; Fisher, R P; Fritschel, P; Kissel, J S; Lundgren, A P; Macleod, D M; Martynov, D; McIver, J; Mullavey, A; Sigg, D; Smith, J R; Vajente, G; Williamson, A R; Wipf, C C

    2015-01-01

    The Advanced Laser Interferometer Gravitational-wave Observatory (LIGO) detectors have completed their initial upgrade phase and will enter the first observing run in late 2015, with detector sensitivity expected to improve in future runs. Through the combined efforts of on-site commissioners and the Detector Characterization group of the LIGO Scientific Collaboration, interferometer performance, in terms of data quality, at both LIGO observatories has vastly improved from the start of commissioning efforts to present. Advanced LIGO has already surpassed Enhanced LIGO in sensitivity, and the rate of noise transients, which would negatively impact astrophysical searches, has improved. Here we give details of some of the work which has taken place to better the quality of the LIGO data ahead of the first observing run.

  16. 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.

  17. Crop improvement in the CGIAR as a global success story of open access and international collaboration

    Directory of Open Access Journals (Sweden)

    Derek Byerlee

    2009-12-01

    Full Text Available International agricultural research has historically been an example par excellence of open source approach to biological research. Beginning in the 1950s and especially in the 1960s, a looming global food crisis led to the development of a group of international agricultural research centers with a specific mandate to foster international exchange and crop improvement relevant to many countries. This formalization of a global biological commons in genetic resources was implemented through an elaborate system of international nurseries with a breeding hub, free sharing of germplasm, collaboration in information collection, the development of human resources, and an international collaborative network. This paper traces the history of the international wheat program with particular attention to how this truly open source system operated in practice and the impacts that it had on world poverty and hunger. The paper also highlights the challenges of maintaining and evolving such a system over the long term, both in terms of financing, as well the changing ‘rules of the game’ resulting from international agreements on intellectual property rights and biodiversity. Yet the open source approach is just as relevant today, as witnessed by current crises in food prices and looming crop diseases problem of global significance.

  18. 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

  19. 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…

  20. 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

  1. Can we delay the progression of chronic kidney disease (CKD) by improving collaboration between renal units and primary care teams?

    Science.gov (United States)

    Thomas, N

    2005-01-01

    This paper will discuss why nephrology teams should collaborate with primary care teams in delaying the progression of chronic kidney disease (CKD), and explain how they can collaborate to improve the outcomes for patients who eventually need dialysis. The paper will describe the staging of CKD and will discuss evidence-based guidelines for the management of CKD in the community. Practical examples of how a specialist renal nurse can improve communication with primary care and can improve the outcome of patients with early kidney disease will be described.

  2. QASI: A collaboration for implementation of an independent quality assessment programme in India

    Directory of Open Access Journals (Sweden)

    Adrienne F.A. Meyers

    2016-10-01

    Full Text Available Objective: The HIV pandemic remains a significant global health concern. Accurate determination of CD4+ T-cells in patient samples relies on reliable CD4 enumeration. The Quality Assessment and Standardization programme for Immunological measures relevant to HIV/AIDS (QASI programme of the Public Health Agency of Canada provides clinical laboratories from resource-limited countries with a mechanism to evaluate the quality of CD4 testing and develop the implementation of an independent national External Quality Assessment (EQA programme. This study describes how QASI helped develop the capacity for managing a sustainable national CD4 EQA programme in India.Design: Supported by the Public Health Agency of Canada and Clinton Foundation HIV/AIDS Initiative, QASI engaged with the National AIDS Control Organization and the Indian National AIDS Research Institute to assist in technology transfer in preparation for the implementation/ management of an independent CD4 EQA programme. Technology transfer training was provided to support corrective actions and to improve the quality of CD4 testing. Inter- laboratory variation of EQA surveys between pre- and post-skill development was compared.Results: Prior to training, coefficient of variation values were 14.7% (mid-level CD4 count controls and 39.0% (low-level. Following training, variation was reduced to 10.3% for mid- level controls and 20.0% for low-level controls.Conclusion: This training assisted the National AIDS Control Organization and the Indian National AIDS Research Institute in identifying the information necessary for management of an EQA programme, and developed the foundation for India to provide corrective actions for sites with challenges in achieving reliable results for CD4 enumeration. This led to a demonstrable improvement in CD4 testing quality and illustrates how country-specific training significantly improved CD4 enumeration performance for better clinical management of HIV care

  3. Improving computer usage for students with physical disabilities through a collaborative approach: a pilot study.

    Science.gov (United States)

    Borgestig, Maria; Falkmer, Torbjörn; Hemmingsson, Helena

    2013-11-01

    The aim of this study was to evaluate the effect of an assistive technology (AT) intervention to improve the use of available computers as assistive technology in educational tasks for students with physical disabilities during an ongoing school year. Fifteen students (aged 12-18) with physical disabilities, included in mainstream classrooms in Sweden, and their teachers took part in the intervention. Pre-, post-, and follow-up data were collected with Goal Attainment Scaling (GAS), a computer usage diary, and with the Psychosocial Impact of Assistive Devices Scale (PIADS). Teachers' opinions of goal setting were collected at follow-up. The intervention improved the goal-related computer usage in educational tasks and teachers reported they would use goal setting again when appropriate. At baseline, students reported a positive impact from computer usage with no differences over time regarding the PIADS subscales independence, adaptability, or self-esteem. The AT intervention showed a positive effect on computer usage as AT in mainstream schools. Some additional support to teachers is recommended as not all students improved in all goal-related computer usage. A clinical implication is that students' computer usage can be improved and collaboratively established computer-based strategies can be carried out by teachers in mainstream schools.

  4. The integration of psychology in pediatric oncology research and practice: collaboration to improve care and outcomes for children and families.

    Science.gov (United States)

    Kazak, Anne E; Noll, Robert B

    2015-01-01

    Childhood cancers are life-threatening diseases that are universally distressing and potentially traumatic for children and their families at diagnosis, during treatment, and beyond. Dramatic improvements in survival have occurred as a result of increasingly aggressive multimodal therapies delivered in the context of clinical research trials. Nonetheless, cancers remain a leading cause of death in children, and their treatments have short- and long-term impacts on health and well-being. For over 35 years, pediatric psychologists have partnered with pediatric oncology teams to make many contributions to our understanding of the impact of cancer and its treatment on children and families and have played prominent roles in providing an understanding of treatment-related late effects and in improving quality of life. After discussing the incidence of cancer in children, its causes, and the treatment approaches to it in pediatric oncology, we present seven key contributions of psychologists to collaborative and integrated care in pediatric cancer: managing procedural pain, nausea, and other symptoms; understanding and reducing neuropsychological effects; treating children in the context of their families and other systems (social ecology); applying a developmental perspective; identifying competence and vulnerability; integrating psychological knowledge into decision making and other clinical care issues; and facilitating the transition to palliative care and bereavement. We conclude with a discussion of the current status of integrating knowledge from psychological research into practice in pediatric cancer. PsycINFO Database Record (c) 2015 APA, all rights reserved.

  5. 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.

  6. Improving Strategic Planning for Federal Public Health Agencies Through Collaborative Strategic Management

    Science.gov (United States)

    2013-03-01

    preparedness have created an opportunity to rethink the collaborative approach to strategic planning . This thesis considers the role that collaborative...strategic management and collaborative frameworks may play in strengthening strategic planning at the federal level through a policy options analysis

  7. Science and Improv: Saying "YES" to Creative Collaboration and Scintillating Communication

    Science.gov (United States)

    Wong, G. J.

    2015-12-01

    Communicating research results to a non-specialist audience can be challenging. Strategies that work well in lab group meetings, such as using acronyms and jargon, may fall flat with 7th graders or Congressional staffers. Empowering real-world audiences with our stories helps raise awareness and inform decision-making, whether it's related to family food purchases or national policy. Ideally, we scientists, engineers and researchers directly connect with our audiences, responding spontaneously and actively, distilling our messages into conversational morsels that resonate with them. One tool that I have found useful is deeply rooted in the "tao" of improvisational theater. Why improv? Improv is dancing as if no one is watching, baking from scratch, and playing jazz flute. Improv is Iron Chef, MacGyver with a license to thrill, or the game-winning play. Research is inspired improvisation. And improv can teach us a lot about how to play, how to feel comfortable and present even while flailing, and how to truly listen. Effective science communicators listen. In fact, therein lies the power of "yes …", a building block of improvisational theater. "Yes …" is both collaborative ("yes, and …") and innovative ("yes, because …"), and investment in an attitude of saying "yes …" demonstrates an intent to listen. Improv is not any one specific thing so much as a process by which we do things. Skills that strengthen communication, such as spontaneity, authenticity and connectivity, are honed through philosophies inherent in improv. This presentation highlights improv-based activities that enhance science communication with purpose, vividness, and emotion.

  8. 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.

  9. 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)

  10. 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

  11. 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.

  12. Meeting Proceedings: Recommendations for Improved Acute Pain Services: Canadian Collaborative Acute Pain Initiative

    Directory of Open Access Journals (Sweden)

    David H Goldstein

    2004-01-01

    Full Text Available The Canadian Collaborative Acute Pain Initiative, established in 2002, is a voluntary, multidisciplinary consortium of acute pain health professionals from across Canada whose goal is to improve acute pain management through discussion and consensus. The group met in January 2002 to define strategic areas related to the treatment of acute pain. The areas identified were: the definition of pain; the epidemiology of pain; the concept of an 'ideal' acute pain management service; education; therapeutic options; symptom management; and research and safety. In November 2002, a second meeting was held to develop objectives and recommendations for the management of acute pain based on the defined areas. The outcome of these discussions is summarized in this paper.

  13. Workplace safety and health improvements through a labor/management training and collaboration.

    Science.gov (United States)

    Mahan, Bruce; Morawetz, John; Ruttenberg, Ruth; Workman, Rick

    2013-01-01

    Seven hundred thirty-nine workers at Merck's Stonewall plant in Elkton, Virginia, have a safer and healthier workplace because four of them were enthusiastic about health and safety training they received from the union's training center in Cincinnati, Ohio. What emerged was not only that all 739 plant employees received OSHA 10-hour General Industry training, but that it was delivered by "OSHA-authorized" members of the International Chemical Workers Union Council who worked at the plant. Merck created a new full-time position in its Learning and Development Department and filled it with one of the four workers who had received the initial training. Strong plant leadership promoted discussions both during the training, in evaluation, and in newly energized joint labor-management meetings following the training. These discussions identified safety and health issues needing attention. Then, in a new spirit of trust and collaboration, major improvements occurred.

  14. Workplace Safety and Health Improvements Through a Labor/Management Training and Collaboration

    Science.gov (United States)

    Mahan, Bruce; Morawetz, John; Ruttenberg, Ruth; Workman, Rick

    2014-01-01

    Seven hundred thirty-nine workers at Merck's Stonewall plant in Elkton, Virginia, have a safer and healthier workplace because four of them were enthusiastic about health and safety training they received from the union's training center in Cincinnati, Ohio. What emerged was not only that all 739 plant employees received OSHA 10-hour General Industry training, but that it was delivered by “OSHA-authorized” members of the International Chemical Workers Union Council who worked at the plant. Merck created a new fulltime position in its Learning and Development Department and hired one of the four workers who had received the initial training. Strong plant leadership promoted discussions both during the training, in evaluation, and in newly energized joint labor-management meetings following the training. These discussions identified safety and health issues needing attention. Then, in a new spirit of trust and collaboration, major improvements occurred. PMID:24704812

  15. 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

  16. The Role of Social Media for Collaborative Learning to Improve Academic Performance of Students and Researchers in Malaysian Higher Education

    Science.gov (United States)

    Al-Rahmi, Waleed Mugahed; Othman, Mohd Shahizan; Yusuf, Lizawati Mi

    2015-01-01

    Social media is widely considered to improve collaborative learning among students and researchers. However, there is a surprising lack of empirical research in Malaysian higher education to improve performance of students and researchers through the effective use of social media that facilitates desirable outcomes. Thus, this study offers a…

  17. How physician and community pharmacist perceptions of the community pharmacist role in Australian primary care influence the quality of collaborative chronic disease management.

    Science.gov (United States)

    Rieck, Allison; Pettigrew, Simone

    2013-01-01

    Community pharmacists (CPs) have been changing their role to focus on patient-centred services to improve the quality of chronic disease management (CDM) in primary care. However, CPs have not been readily included in collaborative CDM with other primary care professionals such as physicians. There is little understanding of the CP role change and whether it affects the utilisation of CPs in primary care collaborative CDM. To explore physician and CP perceptions of the CP's role in Australian primary care and how these perceptions may influence the quality of physician/CP CDM programmes. Data were collected from physicians and CPs using semi-structured interviews. A qualitative methodology utilising thematic analysis was employed during data analysis. Qualitative methodology trustworthiness techniques, negative case analysis and member checking were utilised to substantiate the resultant themes. A total of 22 physicians and 22 CPs were interviewed. Strong themes emerged regarding the participant perceptions of the CP's CDM role in primary care. The majority of interviewed physicians perceived that CPs did not have the appropriate CDM knowledge to complement physician knowledge to provide improved CDM compared with what they could provide on their own. Most of the interviewed CPs expressed a willingness and capability to undertake CDM; however, they were struggling to provide sustainable CDM in the business setting within which they function in the primary care environment. Role theory was selected as it provided the optimum explanation of the resultant themes. First, physician lack of confidence in the appropriateness of CP CDM knowledge causes physicians to be confused about the role CPs would undertake in a collaborative CDM that would benefit the physicians and their patients. Thus, by increasing physician awareness of CP CDM knowledge, physicians may see CPs as suitable CDM collaborators. Second, CPs are experiencing role conflict and stress in trying to change

  18. 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.

  19. 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...

  20. The GDAHA hospital performance reports project: a successful community-based quality improvement initiative.

    Science.gov (United States)

    Snow, Richard J; Engler, David; Krella, Joseph M

    2003-01-01

    During the past decade there has been increasing distribution of hospital performance information but few examples of how this information is affecting the quality of health care delivery. This article describes the methods of implementation and factors influencing a successful community-based quality improvement initiative in Dayton, Ohio, involving a collaborative of five competing hospitals in partnership with the business community and local and state hospital associations. The initiative contributed to a 36% reduction in acute myocardial infarction mortality over a 3-year period by changing reperfusion patterns in patients with ST segment elevated myocardial infarction. Identification of an opportunity gap, root cause analysis, and development of process measures used to facilitate health care provider change are summarized. The driving and restraining forces that have shaped this initiative from a report card to a quality improvement program are outlined and a list of five contributors to success are presented. These factors can serve as a basis for how other communities can benefit from this collaborative model.

  1. 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.

  2. 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.

  3. Community-based participatory research in Indian country: improving health through water quality research and awareness.

    Science.gov (United States)

    Cummins, Crescentia; Doyle, John; Kindness, Larry; Lefthand, Myra J; Bear Dont Walk, Urban J; Bends, Ada L; Broadaway, Susan C; Camper, Anne K; Fitch, Roberta; Ford, Tim E; Hamner, Steve; Morrison, Athalia R; Richards, Crystal L; Young, Sara L; Eggers, Margaret J

    2010-01-01

    Water has always been held in high respect by the Apsaálooke (Crow) people of Montana. Tribal members questioned the health of the rivers and well water because of visible water quality deterioration and potential connections to illnesses in the community. Community members initiated collaboration among local organizations, the tribe, and academic partners, resulting in genuine community-based participatory research. The article shares what we have learned as tribal members and researchers about working together to examine surface and groundwater contaminants, assess routes of exposure, and use our data to bring about improved health of our people and our waters.

  4. Ocean Observing Public-Private Collaboration to Improve Tropical Storm and Hurricane Predictions in the Gulf of Mexico

    Science.gov (United States)

    Perry, R.; Leung, P.; McCall, W.; Martin, K. M.; Howden, S. D.; Vandermeulen, R. A.; Kim, H. S. S.; Kirkpatrick, B. A.; Watson, S.; Smith, W.

    2016-02-01

    In 2008, Shell partnered with NOAA to explore opportunities for improving storm predictions in the Gulf of Mexico. Since, the collaboration has grown to include partners from Shell, NOAA National Data Buoy Center and National Center for Environmental Information, National Center for Environmental Prediction, University of Southern Mississippi, and the Gulf of Mexico Coastal Ocean Observing System. The partnership leverages complementary strengths of each collaborator to build a comprehensive and sustainable monitoring and data program to expand observing capacity and protect offshore assets and Gulf communities from storms and hurricanes. The program combines in situ and autonomous platforms with remote sensing and numerical modeling. Here we focus on profiling gliders and the benefits of a public-private partnership model for expanding regional ocean observing capacity. Shallow and deep gliders measure ocean temperature to derive ocean heat content (OHC), along with salinity, dissolved oxygen, fluorescence, and CDOM, in the central and eastern Gulf shelf and offshore. Since 2012, gliders have collected 4500+ vertical profiles and surveyed 5000+ nautical miles. Adaptive sampling and mission coordination with NCEP modelers provides specific datasets to assimilate into EMC's coupled HYCOM-HWRF model and 'connect-the-dots' between well-established Eulerian metocean measurements by obtaining (and validating) data between fixed stations (e.g. platform and buoy ADCPs) . Adaptive sampling combined with remote sensing provides satellite-derived OHC validation and the ability to sample productive coastal waters advected offshore by the Loop Current. Tracking coastal waters with remote sensing provides another verification of estimate Loop Current and eddy boundaries, as well as quantifying productivity and analyzing water quality on the Gulf coast, shelf break and offshore. Incorporating gliders demonstrates their value as tools to better protect offshore oil and gas assets

  5. 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…

  6. 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.

  7. Using lean methodology to teach quality improvement to internal medicine residents at a safety net hospital.

    Science.gov (United States)

    Weigel, Charlene; Suen, Winnie; Gupte, Gouri

    2013-01-01

    The overall objective of this initiative was to develop a quality improvement (QI) curriculum using Lean methodology for internal medicine residents at Boston Medical Center, a safety net academic hospital. A total of 90 residents and 8 School of Public Health students participated in a series of four, 60- to 90-minute interactive and hands-on QI sessions. Seventeen QI project plans were created and conducted over a 4-month period. The curriculum facilitated internal medicine residents' learning about QI and development of positive attitudes toward QI (assessed using pre- and post-attitude surveys) and exposed them to an interprofessional team structure that duplicates future working relationships. This QI curriculum can be an educational model of how health care trainees can work collaboratively to improve health care quality.

  8. 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...

  9. 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

  10. 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

  11. 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.

  12. 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 ...

  13. 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...

  14. 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.

  15. 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.

  16. 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"

  17. 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 ...

  18. 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.

  19. 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)

  20. 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.

  1. 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.

  2. 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…

  3. 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…

  4. 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.

  5. 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

  6. 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.

  7. 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

  8. 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.

  9. 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.

  10. 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...

  11. Multidisciplinary centres for safety and quality improvement: learning from climate change science

    Science.gov (United States)

    Batalden, Paul; Davidoff, Frank

    2011-01-01

    Effective improvement and research rely on sustained multidisciplinary collaboration, but few examples are available of centres with the broad range of disciplines and practical experience that are needed to sustain long-term improvement in healthcare quality and safety. In a number of respects, the parlous state of the quality and safety of medical care resembles the problem of climate change. Both constitute a profoundly serious man-made threat to the public good which have until recently been both ignored and denied but are increasingly being recognised, taken seriously and acted on. Among the most interesting and important responses to the challenge of climate change has been the creation of Centres of Climate Change in which experts from multiple diverse disciplines are brought together to tackle the problem. Such centres, while science-based, express their vision in solid pragmatic terms and embrace policy, public engagement and education as essential components of that vision. Cross-discipline collaboration has unfortunately not achieved the same effectiveness or visibility in healthcare quality and safety as it has in the area of climate change. The authors argue that there is a need to create multidisciplinary centres in healthcare to accelerate the improvement of safety and quality, and provide the necessary theoretical and empirical foundations. Such centres would draw on disciplines such as epidemiology, statistics and relevant clinical disciplines but equally from psychology, engineering, ergonomics, sociology, economics, organisational development in addition to engaging with patients and citizens and leaders with practical experience of improvement in the field. In this paper, we address some of the pragmatic challenges of creating such centres and consider how the right groups and networks of researchers and practitioners might be assembled. PMID:21450778

  12. 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...

  13. 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.

  14. Making an IMPAKT; Improving care of Chronic Kidney Disease patients in the community through collaborative working and utilizing Information Technology.

    Science.gov (United States)

    Xu, Gang; Major, Rupert; Shepherd, David; Brunskill, Nigel

    2017-01-01

    Chronic kidney disease (CKD) is a serious long-term condition, which if left untreated causes significant cardiovascular sequele. It is well recognized management of modifiable risk factors, such as blood pressure (BP), can lead to improved long-term outcomes. A novel information technology (IT) solution presents a possible solution to help clinicians in the community identify and manage at risk patients more efficiently. The IMproving Patient care and Awareness of Kidney disease progression Together (IMPAKT) IT tool was used to identify patients with CKD and uncontrolled hypertension in the community. A CKD nurse utilized the tool at primary care practices to identify patients who warranted potential intervention and disseminated this information to clinical staff. Blood pressure management targets and incidence of coded CKD were used to evaluate the project. Altogether 48 practices participated in an 18 month project from April 2014, and data from 20 practices, with a total adult population of 121,362, was available for analysis. Two full consecutive QI (Quality Improvement) audit cycles were completed. There was an increase in the mean recorded prevalence of coded CKD patients over the course of the project. Similarly, there was an increase in the percentage of patients with BP been recorded and importantly there was an accompanying significant increase in CKD patients achieving BP targets. At the end of the project an additional 345 individuals with CKD achieved better blood pressure control. This could potentially prevent 9 cardiovascular events in the CKD group, translating to a cost saving of £320,000 for the 20 practices involved. The most significant change in clinical markers occurred during cycle 1 of the audit, the improvement was maintained throughout cycle 2 of the audit. Our results show the real-life clinical impact of a relatively simple and easy to implement QI project, to help improve outcomes in patients with CKD. This was achieved through more

  15. Making an IMPAKT; Improving care of Chronic Kidney Disease patients in the community through collaborative working and utilizing Information Technology

    Science.gov (United States)

    Xu, Gang; Major, Rupert; Shepherd, David; Brunskill, Nigel

    2017-01-01

    Chronic kidney disease (CKD) is a serious long-term condition, which if left untreated causes significant cardiovascular sequele. It is well recognized management of modifiable risk factors, such as blood pressure (BP), can lead to improved long-term outcomes. A novel information technology (IT) solution presents a possible solution to help clinicians in the community identify and manage at risk patients more efficiently. The IMproving Patient care and Awareness of Kidney disease progression Together (IMPAKT) IT tool was used to identify patients with CKD and uncontrolled hypertension in the community. A CKD nurse utilized the tool at primary care practices to identify patients who warranted potential intervention and disseminated this information to clinical staff. Blood pressure management targets and incidence of coded CKD were used to evaluate the project. Altogether 48 practices participated in an 18 month project from April 2014, and data from 20 practices, with a total adult population of 121,362, was available for analysis. Two full consecutive QI (Quality Improvement) audit cycles were completed. There was an increase in the mean recorded prevalence of coded CKD patients over the course of the project. Similarly, there was an increase in the percentage of patients with BP been recorded and importantly there was an accompanying significant increase in CKD patients achieving BP targets. At the end of the project an additional 345 individuals with CKD achieved better blood pressure control. This could potentially prevent 9 cardiovascular events in the CKD group, translating to a cost saving of £320,000 for the 20 practices involved. The most significant change in clinical markers occurred during cycle 1 of the audit, the improvement was maintained throughout cycle 2 of the audit. Our results show the real-life clinical impact of a relatively simple and easy to implement QI project, to help improve outcomes in patients with CKD. This was achieved through more

  16. Crafting biochars to reduce N2O and CO2 emissions while also improving soil quality

    Science.gov (United States)

    Novak, Jeff; Ippolito, Jim; Spokas, Kurt; Sigua, Gilbert; Kammann, Claudia; Wrage-Monnig, Nicole; Borchard, Nils; Schirrmann, Michael; Estavillo, Jose Maria; Fuertes-Mendizabal, Teresa; Menendez, Sergio; Cayuela, Maria Luz

    2017-04-01

    Biochar used as an amendment has been linked to nitrous oxide (N2O) emission reductions, a decrease in nitrogen (N) leaching, and soil quality improvements (e.g., soil carbon sequestration, pH, etc.). While numerous articles will support these three facts, conversely, there are reports of no to marginal influences. One reason for the mixed biochar performance could be related to applying biochar with incorrect chemical and physical characteristics. As a means to increase biochar efficiency, we introduced the concept of crafting biochars with properties attuned to specific soil deficiencies. Implementing this concept requires a literature review to identify salient biochar characteristics that reduces N2O emissions, impacts N availability, while also improving soil quality. Thus, scientists from the USDA-ARS and through a coalition of European scientists under the FACCE-JPI umbrella have conceived the DesignChar4food (d4f) project. In this project, scientists are working collaboratively to further this concept to match the appropriate biochar for selective soil quality improvement, retain N for crops, and promote greenhouse gas reductions. This presentation will highlight results from the d4f team compromising a meta-analysis of articles on biochar:N2O dynamics, N availability, and how designer biochars can target specific soil quality improvements.

  17. [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.

  18. 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.

  19. Final Report Collaborative Project. Improving the Representation of Coastal and Estuarine Processes in Earth System Models

    Energy Technology Data Exchange (ETDEWEB)

    Bryan, Frank [National Center for Atmospheric Research, Boulder, CO (United States); Dennis, John [National Center for Atmospheric Research, Boulder, CO (United States); MacCready, Parker [Univ. of Washington, Seattle, WA (United States); Whitney, Michael [Univ. of Connecticut

    2015-11-20

    This project aimed to improve long term global climate simulations by resolving and enhancing the representation of the processes involved in the cycling of freshwater through estuaries and coastal regions. This was a collaborative multi-institution project consisting of physical oceanographers, climate model developers, and computational scientists. It specifically targeted the DOE objectives of advancing simulation and predictive capability of climate models through improvements in resolution and physical process representation. The main computational objectives were: 1. To develop computationally efficient, but physically based, parameterizations of estuary and continental shelf mixing processes for use in an Earth System Model (CESM). 2. To develop a two-way nested regional modeling framework in order to dynamically downscale the climate response of particular coastal ocean regions and to upscale the impact of the regional coastal processes to the global climate in an Earth System Model (CESM). 3. To develop computational infrastructure to enhance the efficiency of data transfer between specific sources and destinations, i.e., a point-to-point communication capability, (used in objective 1) within POP, the ocean component of CESM.

  20. 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.

  1. 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%.

  2. 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.

  3. 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

  4. 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.

  5. Improving health care quality and safety: the role of collective learning

    Directory of Open Access Journals (Sweden)

    Singer SJ

    2015-11-01

    safety, appreciation of differences, openness to new ideas social motivation, and team autonomy; team contextual factors including learning resources like time for reflection, access to knowledge, organizational capabilities; incentives; and organizational culture, strategy, and structure; and external environmental factors including institutional pressures, environmental dynamism and competitiveness and learning collaboratives. Lastly learning in the context of quality and safety improvement requires leadership that reinforces learning through actions and behaviors that affect people, such as coaching and trust building, and through influencing contextual factors, including providing resources, developing culture, and taking strategic actions that support improvement. Our review highlights the importance of leadership in both promoting a supportive learning environment and implementing learning processes. Keyword: collective learning, systematic review, scoping review, health care quality, patient safety, quality improvement

  6. Collaborative and individual approach in the flipped learning by assessing students on the basis of spatial data quality control

    Directory of Open Access Journals (Sweden)

    Damijan Bec

    2015-12-01

    Full Text Available A variant of flipped learning based on intensive usage of geomedia in geography and geoinformatics has been developed and presented in the article. Students assessed quality of mapping according to ISO standard. The results show that individuals are considerably better than groups, especially in tasks which required the use of critical judgement, deeper understanding and creative thinking. However, groups are more successful in finding unique differences, where synergy effect of the collaborative learning is an important factor.

  7. 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...

  8. 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...

  9. 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.

  10. 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 ...

  11. 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

  12. 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…

  13. 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.

  14. 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

  15. Using performance tasks employing IOM patient safety competencies to introduce quality improvement processes in medical laboratory science education.

    Science.gov (United States)

    Golemboski, Karen; Otto, Catherine N; Morris, Susan

    2013-01-01

    In order to contribute to improved healthcare quality through patient-centered care, laboratory professionals at all levels of practice must be able to recognize the connection between non-analytical factors and laboratory analysis, in the context of patient outcomes and quality improvement. These practices require qualities such as critical thinking (CT), teamwork skills, and familiarity with the quality improvement process, which will be essential for the development of evidence-based laboratory science practice. Performance tasks (PT) are an educational strategy which can be used to teach and assess CT and teamwork, while introducing Medical Laboratory Science (MLS) students at both baccalaureate and advanced-practice levels to the concepts of quality improvement processes and patient outcomes research. PT presents students with complex, realistic scenarios which require the incorporation of subject-specific knowledge with competencies such as effective team communication, patient-centered care, and successful use of information technology. A PT with assessment rubric was designed for use in a baccalaureate-level MLS program to teach and assess CT and teamwork competency. The results indicated that, even when students were able to integrate subject-specific knowledge in creative ways, their understanding of teamwork and quality improvement was limited. This indicates the need to intentionally teach skills such as collaboration and quality system design. PT represent one of many strategies that may be used in MLS education to develop essential professional competencies, encourage expert practice, and facilitate quality improvement.

  16. 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.

  17. The strategy for improving water-quality monitoring in the United States; final report of the Intergovernmental Task Force on Monitoring Water Quality; technical appendices

    Science.gov (United States)

    ,

    1995-01-01

    The Intergovernmental Task Force on Monitoring Water Quality (ITFM) prepared this report in collaboration with representatives of all levels of government and the private sector. The report recommends a strategy for nationwide water-quality monitoring and technical monitoring improvements to support sound water-quality decisionmaking. The strategy is intended to achieve a better return on public and private investments in monitoring, environmental protection, and natural resources management. It is also designed to expand the base of information useful to a variety of users at multiple geographic scales. Institutional and technical changes are needed to improve water-quality monitoring and to meet the full range of monitoring requirements. Monitoring must be incorporated as a critical element of program planning, implementation, and evaluation. The strategy includes recommendations in many key elements, such as the development of goal-oriented monitoring and indicators, institutional collaboration, and methods comparability. Initial actions have been taken to implement the strategy. Several Federal agencies have jointly purchased and shared remotely sensed land-cover information needed for water assessment. Major agency data systems are using common data-element names and reference tables that will ensure easy sharing of data. A number of States have held meetings with collectors of water information to initiate statewide monitoring strategies. New monitoring guidance has been developed for Federal water-quality grants to States. Many State offices have changed monitoring programs to place emphasis on priority watersheds and to improve assessment of water quality. As the competition increases for adequate supplies of clean water, concerns about public health and the environment escalate, and more demands are placed on the water information infrastructure. To meet these demands, the collaborative approach has already produced benefits, which will continue to grow as

  18. Contributory Role of Collaborative Assessment in Improving Critical Thinking and Writing

    Directory of Open Access Journals (Sweden)

    Mansoor Fahim

    2014-01-01

    Full Text Available Instilling critical thinking skills in language learners’ mind and enhancing second language writing are gaining momentum in the field of English language teaching. Though some approaches to meeting these objectives have been proposed, review of the literature revealed that the contributory role of collaborative assessment in fostering critical thinking and second language writing has been overlooked to date. Thus, this study was conducted to delve into this issue. To this aim, two intact intermediate EFL classes in Iran, each of which contains 18 learners, were included in the study; they were randomly assigned to Student-Student (S-S collaborative assessment and Teacher-Student (T-S collaborative assessment groups.  After receiving six sessions of treatment, both groups wrote an essay on an IELTS topic. Results of the study indicated that collaborative assessment, regardless of its type, has the potential to foster critical thinking and writing proficiency. Further, it came to light that S-S collaborative assessment group significantly outperformed the T-S collaborative assessment group in terms of gains in critical thinking and writing proficiency. In light of the findings, language teachers are suggested to involve learners in collaborative assessment processes; further, some suggestions are offered at the end to show some fruitful avenues for further research. Keywords: collaborative assessment, critical thinking, second language writing

  19. Collaborating to Improve Inquiry-Based Teaching in Elementary Science and Mathematics Methods Courses

    Science.gov (United States)

    Magee, Paula A.; Flessner, Ryan

    2012-01-01

    This study examines the effect of promoting inquiry-based teaching (IBT) through collaboration between a science methods course and mathematics methods course in an elementary teacher education program. During the collaboration, preservice elementary teacher (PST) candidates experienced 3 different types of inquiry as a way to foster increased…

  20. 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...

  1. 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.

  2. Establishing trafficking in human beings for the purpose of organ removal and improving cross-border collaboration in criminal cases

    NARCIS (Netherlands)

    Rijken, Conny

    2016-01-01

    In this short summary report on the legal definition of trafficking in human beings for the purpose of organ removal and improving cross-border collaboration in criminal cases, challenges, and recommendations in the areas of defining the crime, criminal investigation and prosecution, and

  3. Project-based teaching in health informatics: a course on health care quality improvement.

    Science.gov (United States)

    Moehr, J R; Berenji, G R; Green, C J; Kagolovsky, Y

    2001-01-01

    Teaching the skills and knowledge required in health informatics [1] is a challenge because the skill of applying knowledge in real life requires practice. We relate the experience with introducing a practice component to a course in "Health Care Quality Improvement". Working health care professionals were invited to bring an actual quality problem from their place of work and to work alongside students in running the problem through a quality improvement project lifecycle. Multiple technological and process oriented teaching innovations were employed including project sessions in observation rooms, video recording of these sessions, generation of demonstration examples and distance education components. Both students and their collaborators from the work place developed proficiency in applying quality improvement methods as well as in experiencing the realities of group processes, information gaps and organizational constraints. The principles used to achieve high involvement of the whole class, the employed resources and technical support are described. The resulting academic and practical achievements are discussed in relation to the alternative instructional modalities, and with respect to didactic implications for similar endeavors and beyond to other fields such as systems engineering.

  4. 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.

  5. Wiring Role Taking in Collaborative Learning Environments. SNA and Semantic Web can improve CSCL script?

    Directory of Open Access Journals (Sweden)

    Nicola Capuano

    2014-04-01

    Full Text Available Over the past years the concept of role in distance education has become a promising construct for analysing and facilitating collaborative processes and outcomes. Designing effective collaborative learning processes is a complex task that can be supported by existing good practices formulated as pedagogical patterns or scripts. Over the past years, the research on technology enhanced learning has shown that collaborative scripts for learning act as mediating artefacts not only designing educational scenarios but also structuring and prescribing roles and activities. Conversely, existing learning systems are not able to provide dynamic role management in the definition and execution of collaborative scripts. This work proposes the application of Social Network Analysis in order to evaluate the expertise level of a learner when he/she is acting, with an assigned role, within the execution of a collaborative script. Semantic extensions to both IMS Learning Design and Information Packaging specifications are also proposed to support roles management.

  6. The quality and impact of computer supported collaborative learning (CSCL) in radiology case-based learning.

    Science.gov (United States)

    Kourdioukova, Elena V; Verstraete, Koenraad L; Valcke, Martin

    2011-06-01

    The aim of this research was to explore (1) clinical years students' perceptions about radiology case-based learning within a computer supported collaborative learning (CSCL) setting, (2) an analysis of the collaborative learning process, and (3) the learning impact of collaborative work on the radiology cases. The first part of this study focuses on a more detailed analysis of a survey study about CSCL based case-based learning, set up in the context of a broader radiology curriculum innovation. The second part centers on a qualitative and quantitative analysis of 52 online collaborative learning discussions from 5th year and nearly graduating medical students. The collaborative work was based on 26 radiology cases regarding musculoskeletal radiology. The analysis of perceptions about collaborative learning on radiology cases reflects a rather neutral attitude that also does not differ significantly in students of different grade levels. Less advanced students are more positive about CSCL as compared to last year students. Outcome evaluation shows a significantly higher level of accuracy in identification of radiology key structures and in radiology diagnosis as well as in linking the radiological signs with available clinical information in nearly graduated students. No significant differences between different grade levels were found in accuracy of using medical terminology. Students appreciate computer supported collaborative learning settings when tackling radiology case-based learning. Scripted computer supported collaborative learning groups proved to be useful for both 5th and 7th year students in view of developing components of their radiology diagnostic approaches. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  7. 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.

  8. Improvement during baseline: three case studies encouraging collaborative research when evaluating caregiver training.

    Science.gov (United States)

    Sohlberg, M M; Glang, A; Todis, B

    1998-04-01

    The trend in cognitive rehabilitation toward reduced services, which provide more functionally relevant outcomes and the recognition of limited maintenance and generalization with many existing interventions, challenges current research models. There is a need to develop and evaluate interventions that can be implemented by persons other than rehabilitation professionals and that are well suited to naturalistic settings. The researchers responded to these challenges by designing a series of single subject experiments evaluating the effectiveness of training caregivers to provide appropriate cognitive support to persons with brain injury within their own natural living environments. The goal of the original research project included evaluating a collaborative mode of interaction with the subjects and their support persons (as opposed to traditional directive treatment models) where the caregivers and subjects were instrumental in designing the intervention and collective performance data. This paper presents the data from the initial three subject/caregiver groups all of whom demonstrated improvement in the target behaviours during the baseline period. It appeared that the act of measuring client performance changed the behaviours of the support persons and resulted in positive changes in baseline levels. The research and clinical implications of these findings are discussed.

  9. 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.

  10. Improved hydrophobic grid membrane filter method, using EF-18 agar, for detection of Salmonella in foods: collaborative study.

    Science.gov (United States)

    Entis, P

    1990-01-01

    A collaborative study was carried out in 30 laboratories to validate improvements to the official final action hydrophobic grid membrane filter (HGMF) screening method for Salmonella in foods, 985.42, by comparing the performance of the improved HGMF method against that of the AOAC/BAM conventional culture method. Six products were included in the collaborative study: milk chocolate, raw deboned poultry meat, black pepper, soy flour, egg yolk powder, and nonfat dry milk. The raw deboned poultry meat was naturally contaminated with Salmonella, and the remaining 5 products were each inoculated in advance with low levels of individual Salmonella serotypes. The AOAC/BAM method produced 11 false negative results and the improved HGMF method produced 18 false negative results. The improved HGMF Salmonella method has been approved interim official first action for all foods to replace the HGMF official final action method, 985.42.

  11. 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

  12. Continuous quality improvement: a shared governance model that maximizes agent-specific knowledge.

    Science.gov (United States)

    Burkoski, Vanessa; Yoon, Jennifer

    2013-01-01

    Motivate, Innovate, Celebrate: an innovative shared governance model through the establishment of continuous quality improvement (CQI) councils was implemented across the London Health Sciences Centre (LHSC). The model leverages agent-specific knowledge at the point of care and provides a structure aimed at building human resources capacity and sustaining enhancements to quality and safe care delivery. Interprofessional and cross-functional teams work through the CQI councils to identify, formulate, execute and evaluate CQI initiatives. In addition to a structure that facilitates collaboration, accountability and ownership, a corporate CQI Steering Committee provides the forum for scaling up and spreading this model. Point-of-care staff, clinical management and educators were trained in LEAN methodology and patient experience-based design to ensure sufficient knowledge and resources to support the implementation.

  13. Accelerating Best Care in Pennsylvania: adapting a large academic system's quality improvement process to rural community hospitals.

    Science.gov (United States)

    Haydar, Ziad; Gunderson, Julie; Ballard, David J; Skoufalos, Alexis; Berman, Bettina; Nash, David B

    2008-01-01

    Industrial quality improvement (QI) methods such as continuous quality improvement (CQI) may help bridge the gap between evidence-based "best care" and the quality of care provided. In 2006, Baylor Health Care System collaborated with Jefferson Medical College of Thomas Jefferson University to conduct a QI demonstration project in select Pennsylvania hospitals using CQI techniques developed by Baylor. The training was provided over a 6-month period and focused on methods for rapid-cycle improvement; data system design; data management; tools to improve patient outcomes, processes of care, and cost-effectiveness; use of clinical guidelines and protocols; leadership skills; and customer service skills. Participants successfully implemented a variety of QI projects. QI education programs developed and pioneered within large health care systems can be adapted and applied successfully to other settings, providing needed tools to smaller rural and community hospitals that lack the necessary resources to establish such programs independently.

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. Spica cast care: a collaborative staff-led education initiative for improved patient care.

    Science.gov (United States)

    Reed, Cynthia; Carroll, Lee; Baccari, Susan; Shermont, Herminia

    2011-01-01

    One of the most challenging aspects for nurses caring for incontinent children in spica casts is maintaining healthy skin integrity. Noting an increase in the number of phone calls from parents of discharged children in spica casts concerning diaper rash and skin breakdown, inpatient orthopedics staff nurses lead an interdisciplinary quality improvement and educational initiative. They standardized pediatric spica cast care and education by creating an intranet narrated PowerPoint presentation for staff and parents of children with spica casts. A take-home DVD of this education module is now produced and given to parents, reinforcing nursing discharge teaching and giving parents the opportunity to review these new skills at home as needed. The purpose of this article is to share this experience of improving patient outcomes and empowering other orthopedics nurses to develop creative educational solutions.

  19. [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.

  20. Medical education and the quality improvement spiral: A case study from Mpumalanga, South Africa

    Directory of Open Access Journals (Sweden)

    Martin Bac

    2015-02-01

    Full Text Available Background: The short timeframe of medical students’ rotations is not always conducive to successful, in-depth quality-improvement projects requiring a more longitudinal approach.Aim: To describe the process of inducting students into a longitudinal quality-improvement project,using the topic of the Mother- and Baby-Friendly Initiative as a case study; and to explore the possible contribution of a quality-improvement project to the development of student competencies.Setting: Mpumalanga clinical learning centres, where University of Pretoria medical students did their district health rotations.Method: Consecutive student groups had to engage with a hospital’s compliance with specific steps of the Ten Steps to Successful Breastfeeding that form the standards for the Mother- and Baby-Friendly Initiative. Primary data sources included an on-site PowerPoint group presentation (n = 42, a written group report (n = 42 and notes of individual interviews in an end-of-rotation objectively structured clinical examination station (n = 139.Results: Activities in each rotation varied according to the needs identified through the application of the quality-improvement cycle in consultation with the local health team. The development of student competencies is described according to the roles of a medical expert in the CanMEDS framework: collaborator, health advocate, scholar, communicator, manager and professional. The exposure to the real-life situation in South African public hospitals had a great influence on many students, who also acted as catalysts for transforming practice.Conclusion: Service learning and quality-improvement projects can be successfully integrated in one rotation and can contribute to the development of the different roles of a medical expert. More studies could provide insight into the potential of this approach in transforming institutions and student learning.

  1. Collaborative Strategic Reading (CSR): Improving Secondary Students' Reading Comprehension Skills. Research to Practice Brief: Improving Secondary Education and Transition Services through Research.

    Science.gov (United States)

    Bremer, Christine D.; Vaughn, Sharon; Clapper, Ann T.; Kim, Ae-Hwa

    This brief introduces a research-based practice, Collaborative Strategic Reading (CSR). This reading comprehension practice, designed to improve secondary students reading comprehension skills, combines two instructional elements: modified reciprocal teaching and cooperative learning or student pairing. In reciprocal teaching, teachers and…

  2. Revised Ontology Improves United States Water-Quality Data Sharing (Invited)

    Science.gov (United States)

    Scott, J. C.; Gellenbeck, D.; Gunthardt, K.

    2010-12-01

    The United States Environmental Protection Agency (USEPA) and the United States Geological Survey (USGS) have each deployed a web-service based water-quality data-retrieval system that uses mutually consistent nomenclature. Users have access to millions of water-quality results from across the United States through these retrieval systems. The new terminology and domains used in this collaboration evolved from related efforts by partnerships with federal, state, and tribal environmental-monitoring programs. The new nomenclature improves on a decades-old model that employed five-digit parameter codes to identify some combination of measurement attributes such as constituent, medium, fraction, units of measure, and measurement method. That approach created a potpourri of parameter codes that did not lend itself easily to identifying or combining the data. The new web system parses these characteristics into separate data elements such as measured characteristic, units of measurement, and physical fraction. The new format simplifies finding measurements of a single type, such as fecal coliform or sulfate, by characterizing the constituents using a shared vocabulary between the USEPA and USGS retrieval systems. The measured constituent is a foundational domain which is embodied by the USEPA Substance Registry System (SRS). The SRS is a database system for tracking standard terms and synonyms for names of chemicals, physical properties, and biological organisms. All database systems explicitly or implicitly impose an ontology on the subject realm. USGS and USEPA have collaborated for decades on water-quality data storage and retrieval systems. The most recent attempt employs more atomistic and universal concepts than previous efforts and improves retrieval of water-quality data for all interested parties.

  3. 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.

  4. 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.

  5. A pilot program to improve nursing and surgical intern collaboration: Lessons learned from a mixed-methods study.

    Science.gov (United States)

    Raparla, Neha; Davis, Diane; Shumaker, Daria; Kumar, Anagha; Hafiz, Shabnam; Sava, Jack; Adams, Katie; Fitzgibbons, Shimae C

    2017-02-01

    Inter-professional collaboration is an integral component of a successful healthcare team. We sought to evaluate the impact of nursing student participation in a one-day intensive inter-professional education (IPE) training session with surgical interns on participant attitudes toward inter-professional collaboration. Following IRB approval, pre and post IPE session survey responses were compared to determine the impact on participant attitudes toward inter-professional collaboration. Pre and post session semi-structured interviews were transcribed and analyzed to identify relevant themes. Surgical interns (n = 38) more than nursing students (n = 11), demonstrated a measurable improvement in attitude towards 'collaboration and shared education' (interns: median score pre = 26, post = 28, p = 0.0004; nursing student: median score pre = 27, post = 28, p = 0.02). Qualitative analysis of interviews identified major themes that supplemented this finding. An eight hour, one day IPE session has a positive impact on collaborative attitudes and supports the case for increased inter-professional education amongst interns and nursing students. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. 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.

  7. 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.

  8. 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.

  9. Impact of Pharmacist–Psychiatrist Collaborative Patient Education on Medication Adherence and Quality of Life (QOL of Bipolar Affective Disorder (BPAD Patients

    Directory of Open Access Journals (Sweden)

    Ambed Mishra

    2017-10-01

    Full Text Available Background: Bipolar Affective Disorder (BPAD is one of the leading causes of disability globally. Medication non-adherence and low quality of life (QOL are the major challenges associated with the treatment of BPAD patients.Objective: Aim of this study was to assess the impact of pharmacist–psychiatrist collaborative patient education on medication adherence and QOL of BPAD patients.Methodology: A prospective randomized control study was conducted in the psychiatry outpatient department in a tertiary care setting. The eligible patients were enrolled and randomized into test (collaborative care and control (usual care groups. Patient education was provided by pharmacists to the test group patients, along with the usual care provided to all the patients. Patients were followed for three follow-ups of nearly 1 month intervals. Medication adherence and QOL were assessed by Medication Adherence Rating Scale and WHOQOL-BREF questionnaire, respectively. T-test was used and P-values < 0.05 were considered statistically significant.Results: Out of 75 patients enrolled, 73 patients were followed for all the three follow-ups and completed the study. Thirty-eight patients belonged to test and 35 were in control group. The mean age of patients was 34.21 ± 10.91 years. Forty-eight (65.75% patients belonged to age group of 18–39 years. There were 41 males (56.16% and 32 female patients (43.83% in the study. Mean improvement in medication adherence and QOL of the test and control groups were found to be 2.06 ± 0.15 (<0.001 and 13.8 ± 10.5 (<0.05, respectively.Conclusion: This study concluded that pharmacist–psychiatrist collaborative patient education can significantly improve the medication adherence and QOL of the BPAD patients. Statistically significant results indicating improved patient care and outcomes were possible when pharmacists worked as a team with psychiatrists.

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

    Directory of Open Access Journals (Sweden)

    Michele S Youngleson

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

  11. HeapCraft Social Tools: Understanding and Improving Player Collaboration in Minecraft

    OpenAIRE

    Müller, S; Kapadia, M; Frey, S.; Klinger, S; Mann, RP; Solenthaler, B; Sumner, RW; Gross, M.

    2015-01-01

    We introduce a framework to infuence and analyze player collaboration in Minecraft. The framework consists of a telemetry system and several tools to influence player behavior and provide value to server administrators to increase adoption. The data collection includes almost every aspect of gameplay and can be used for analysis beyond player collaboration.1 We started collecting data from several Minecraft servers in March 2015. Most data will be made available to researchers upon request.2 ...

  12. Improving public health through student-led interprofessional extracurricular education and collaboration: a conceptual framework.

    Science.gov (United States)

    Vanderwielen, Lynn M; Vanderbilt, Allison A; Dumke, Erika K; Do, Elizabeth K; Isringhausen, Kim T; Wright, Marcie S; Enurah, Alexander S; Mayer, Sallie D; Bradner, Melissa

    2014-01-01

    In the US, health care professionals are trained predominantly in uniprofessional settings independent of interprofessional education and collaboration. Yet, these professionals are tasked to work collaboratively as part of an interprofessional team in the practice environment to provide comprehensive care to complex patient populations. Although many advantages of interprofessional education have been cited in the literature, interprofessional education and collaboration present unique barriers that have challenged educators and practitioners for years. In spite of these impediments, one student-led organization has successfully implemented interprofessional education and cross-disciplinary collaboration. The purpose of this paper is to provide a conceptual framework for successful implementation of interprofessional education and collaboration for other student organizations, as well as for faculty and administrators. Each member of the interprofessional team brings discipline-specific expertise, allowing for a diverse team to attend to the multidimensional health needs of individual patients. The interprofessional team must organize around a common goal and work collaboratively to optimize patient outcomes. Successful interdisciplinary endeavors must address issues related to role clarity and skills regarding teamwork, communication, and conflict resolution. This conceptual framework can serve as a guide for student and health care organizations, in addition to academic institutions to produce health care professionals equipped with interdisciplinary teamwork skills to meet the changing health care demands of the 21st century.

  13. 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.

  14. 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.

  15. Improving hazard communication through collaborative participatory workshops: challenges and opportunities experienced at Turrialba volcano, Costa Rica

    Science.gov (United States)

    van Manen, S. M.; Avard, G.; Martinez, M.; de Moor, M. J.

    2014-12-01

    Communication is key to disaster risk management before, during and after a hazardous event occurs. In this study we used a participatory design approach to increase disaster preparedness levels around Turrialba volcano (Costa Rica) in collaboration with local communities. We organised five participatory workshops in communities around Turrialba volcano, 2 in February 2014 and a further 3 in May 2014. A total of 101 people attended and participants included the general public, decision makers and relevant government employees. The main finding of the workshops was that people want more information, specifically regarding 1) the activity level at the volcano and 2) how to prepare. In addition, the source of information was identified as an important factor in communication, with credibility and integrity being key. This outcome highlights a communication gap between the communities at risk and the institutions monitoring the volcano, who publish their scientific results monthly. This strong and explicitly expressed desire for more information should be acknowledged and responded to. However, this gives rise to the challenge of how to communicate: how to change the delivery and/or content of the messages already disseminated for greater effectiveness. In our experience, participatory workshops provide a successful mechanism for effective communication. However, critically evaluating the workshops reveals a number of challenges and opportunities, with the former arising from human, cultural and resource factors, specifically the need to develop people's capacity to participate, whereas the latter is predominantly represented by participant empowerment. As disasters are mostly felt at individual, household and community levels, improving communication, not at but with these stakeholders, is an important component of a comprehensive disaster resilience strategy. This work provides an initial insight into the potential value of participatory design approaches for

  16. Virtual strategies to improve transversal competences, using wikis in a collaborative work

    Science.gov (United States)

    Guinau, Marta; Playa, Elisabet

    2016-04-01

    A major educational aim in university degrees since the implementation of the European Credit Transfer System (ECTS) on the European universities is the work based on transversal competences. However, the first course students arrive at the Spanish universities with important deficiencies on some of these competences, especially regarding on oral and written expression, time management and collaborative work. The experience of the teachers involved in this work has revealed the coordination difficulty between the students to work in group, important deficiencies on information management and the stress caused by the oral presentations. The results presented here correspond to a teaching innovation project. It is based on: a) the development of works in groups of 3 or 4 students, proposed as flipped classrooms strategy and b) the implementation of a virtual tool (a wiki). This tool helps the students with scientific information management and facilitates the access of all the students belonging to the work group at the information provided by colleagues. The wiki also improves the monitoring and evaluation of the work and contributions of each student by teachers. Each group must develop a topic related to the subject - General Geology and Geochemistry - that the group chose from a list of earth sciences topics proposed by teachers. The resulting works are presented in poster and oral presentations (10 min. per group and 5 min. for questions). Each work is evaluated by teachers using the evidences provided on the wiki and by means of evaluation guides. Moreover, the students must self and co-evaluate the presented works. The implementation of this project has provided information to analyze the impact of these strategies and to quantify it in terms of 'Learning Analytics'.

  17. 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.

  18. 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.

  19. 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...

  20. The European Society of Gastrointestinal Endoscopy Quality Improvement Initiative: developing performance measures

    Science.gov (United States)

    Senore, Carlo; Bisschops, Raf; Domagk, Dirk; Valori, Roland; Kaminski, Michal F.; Spada, Cristiano; Bretthauer, Michael; Bennett, Cathy; Bellisario, Cristina; Minozzi, Silvia; Hassan, Cesare; Rees, Colin; Dinis-Ribeiro, Mário; Hucl, Tomas; Ponchon, Thierry; Aabakken, Lars; Fockens, Paul

    2015-01-01

    The European Society of Gastrointestinal Endoscopy (ESGE) and United European Gastroenterology (UEG) have a vision to create a thriving community of endoscopy services across Europe, collaborating with each other to provide high quality, safe, accurate, patient-centered and accessible endoscopic care. Whilst the boundaries of what can be achieved by advanced endoscopy are continually expanding, we believe that one of the most fundamental steps to achieving our goal is to raise the quality of everyday endoscopy. The development of robust, consensus- and evidence-based key performance measures is the first step in this vision. ESGE and UEG have identified quality of endoscopy as a major priority. This paper explains the rationale behind the ESGE Quality Improvement Initiative and describes the processes that were followed. We recommend that all units develop mechanisms for audit and feedback of endoscopist and service performance using the ESGE performance measures that will be published in future issues of this journal over the next year. We urge all endoscopists and endoscopy services to prioritize quality and to ensure that these performance measures are implemented and monitored at a local level, so that we can provide the highest possible care for our patients. PMID:26966520