WorldWideScience

Sample records for quality improvement process

  1. Quality improvement tools and processes.

    Science.gov (United States)

    Lau, Catherine Y

    2015-04-01

    The Model for Improvement and the Plan-Do-Study-Act cycle is a popular quality improvement (QI) tool for health care providers to successfully lead QI projects and redesign care processes. This tool has several distinct components that must be addressed in sequence to organize and critically evaluate improvement activities. Unlike other health sciences clinical research, QI projects and research are based on dynamic hypotheses that develop into observable, serial tests of change with continuous collection and feedback of performance data to stakeholders. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Software process improvement, quality assurance and measurement

    NARCIS (Netherlands)

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

    2006-01-01

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

  3. 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.

  4. The process of managerial control in quality improvement initiatives.

    Science.gov (United States)

    Slovensky, D J; Fottler, M D

    1994-11-01

    The fundamental intent of strategic management is to position an organization with in its market to exploit organizational competencies and strengths to gain competitive advantage. Competitive advantage may be achieved through such strategies as low cost, high quality, or unique services or products. For health care organizations accredited by the Joint Commission on Accreditation of Healthcare Organizations, continually improving both processes and outcomes of organizational performance--quality improvement--in all operational areas of the organization is a mandated strategy. Defining and measuring quality and controlling the quality improvement strategy remain problematic. The article discusses the nature and processes of managerial control, some potential measures of quality, and related information needs.

  5. 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.

  6. 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.

  7. Process safety improvement-Quality and target zero

    International Nuclear Information System (INIS)

    Van Scyoc, Karl

    2008-01-01

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

  8. Process safety improvement-Quality and target zero

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-11-15

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

  9. 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

  10. The use of process mapping in healthcare quality improvement projects.

    Science.gov (United States)

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

    2018-05-01

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

  11. Improvement of Selected Logistics Processes Using Quality Engineering Tools

    Science.gov (United States)

    Zasadzień, Michał; Žarnovský, Jozef

    2018-03-01

    Increase in the number of orders, the increasing quality requirements and the speed of order preparation require implementation of new solutions and improvement of logistics processes. Any disruption that occurs during execution of an order often leads to customer dissatisfaction, as well as loss of his/her confidence. The article presents a case study of the use of quality engineering methods and tools to improve the e-commerce logistic process. This made it possible to identify and prioritize key issues, identify their causes, and formulate improvement and prevention measures.

  12. Quality improvement process pilot project at Gallagher station

    International Nuclear Information System (INIS)

    Vondielingen, D.E.

    1992-01-01

    A Quality Improvement Process was piloted at Gallagher station in 1990 to address issues of two Electric System Strategy Group (ESSG) goals. Darrell McElravy headed a group to address quality, productivity and prove and Judy Rushing headed a group to address innovation and recognition. These groups combined when a process was identified that could address both issues. The process was designed for PSI Energy by Business Incentives and is an incentive-based quality improvement process that seeks employee involvement to identify inhibitors t performance and to establish a method to eliminate the problem. Performance goals were also established that help focus efforts to improve performance and reward employees for their efforts

  13. IMPROVING THE QUALITY OF MAINTENANCE PROCESSES USING INFORMATION TECHNOLOGY

    Directory of Open Access Journals (Sweden)

    Zora Arsovski

    2008-06-01

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

  14. Using Quality Function Deployment To Improve Academic Advising Processes.

    Science.gov (United States)

    Barrows, Richard; Murray, Bruce

    1997-01-01

    Quality Function Deployment, a set of concepts and tools used in manufacturing engineering to link consumer needs with product design, can also improve academic advising systems and processes. The technique promotes structured, logical examination of students' advising needs and their relationship to advising system design, processes, methods,…

  15. Developing a Quality Improvement Process to Optimize Faculty Success

    Science.gov (United States)

    Merillat, Linda; Scheibmeir, Monica

    2016-01-01

    As part of a major shift to embed quality improvement processes within a School of Nursing at a medium-sized Midwestern university, a faculty enrichment program using a Plan-Do-Act-Study design was implemented. A central focus for the program was the development and maintenance of an online faculty resource center identified as "My Faculty…

  16. Software quality and process improvement in scientific simulation codes

    Energy Technology Data Exchange (ETDEWEB)

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

    1997-11-01

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

  17. Processes for Quality Improvements in Radiation Oncology Clinical Trials

    International Nuclear Information System (INIS)

    FitzGerald, T.J.; Urie, Marcia; Ulin, Kenneth; Laurie, Fran; Yorty, Jeffrey C.; Hanusik, Richard; Kessel, Sandy; Jodoin, Maryann Bishop; Osagie, Gani; Cicchetti, M. Giulia; Pieters, Richard; McCarten, Kathleen; Rosen, Nancy

    2008-01-01

    Quality assurance in radiotherapy (RT) has been an integral aspect of cooperative group clinical trials since 1970. In early clinical trials, data acquisition was nonuniform and inconsistent and computational models for radiation dose calculation varied significantly. Process improvements developed for data acquisition, credentialing, and data management have provided the necessary infrastructure for uniform data. With continued improvement in the technology and delivery of RT, evaluation processes for target definition, RT planning, and execution undergo constant review. As we move to multimodality image-based definitions of target volumes for protocols, future clinical trials will require near real-time image analysis and feedback to field investigators. The ability of quality assurance centers to meet these real-time challenges with robust electronic interaction platforms for imaging acquisition, review, archiving, and quantitative review of volumetric RT plans will be the primary challenge for future successful clinical trials

  18. Improving the hygienic quality of chicken through radiation processing

    International Nuclear Information System (INIS)

    Torgby-Tetteh, W.

    2010-06-01

    Irradiation is considered one of the most efficient technological processes for the reduction of microorganisms in food, It can be used to improve the safety of food products, and to extend their shelf lives. The aim of this study was to improve the hygienic quality of chicken through radiation processing. As part of the study a microbial assessment of broiler chicken thighs from three retail outlets (supermarket, local markets and farms) was conducted. The total viable count and total coliform counts were determined. Hygienic quality indicator organisms such as Escherichia coli, Salmonella and Staphylococcus aureus were isolated and microbial counts made. Radiation sensitivity test to determine the D 10 (decimal reduction does) of E. coli on chicken at refrigeration and frozen temperature were conducted. D 10 values were 0.22 ± 0.02 and 0.32 ± 0.03 kGy at refrigerated and frozen temperatures respectively. A storage test consisting of an uninoculated pack experiment and a challenge test to explore the effect of irradiation and frozen food storage on the total viable count and survival of E. coli was conducted. Chicken thigh samples were treated with 0 (non irradiated), 2.0, 4.0, 6.0 and 8.0 kGy of gamma irradiation and held frozen for 56 days. The control and irradiated samples were stored at -18 o C and underwent microbial analysis and sensory evaluation at 7 days intervals. It was observed that irradiation and frozen storage reduced microbial loads. There were significant differences in sensory quality characteristics during freezing storage in chicken meat. The combination of irradiation and frozen storage resulted in greater overall reductions on microbial loads thus improving hygienic quality. (au)

  19. Executing Quality: A Grounded Theory of Child Care Quality Improvement Engagement Process in Pennsylvania

    Science.gov (United States)

    Critchosin, Heather

    2014-01-01

    Executing Quality describes the perceived process experienced by participants while engaging in Keystone Standards, Training, Assistance, Resources, and Support (Keystone STARS) quality rating improvement system (QRIS). The purpose of this qualitative inquiry was to understand the process of Keystone STARS engagement in order to generate a…

  20. Performance improvement CME for quality: challenges inherent to the process.

    Science.gov (United States)

    Vakani, Farhan Saeed; O'Beirne, Ronan

    2015-01-01

    The purpose of this paper is to discuss the perspective debates upon the real-time challenges for a three-staged Performance Improvement Continuing Medical Education (PI-CME) model, an innovative and potential approach for future CME, to inform providers to think, prepare and to act proactively. In this discussion, the challenges associated for adopting the American Medical Association's three-staged PI-CME model are reported. Not many institutions in USA are using a three-staged performance improvement model and then customizing it to their own healthcare context for the specific targeted audience. They integrate traditional CME methods with performance and quality initiatives, and linking with CME credits. Overall the US health system is interested in a structured PI-CME model with the potential to improve physicians practicing behaviors. Knowing the dearth of evidence for applying this structured performance improvement methodology into the design of CME activities, and the lack of clarity on challenges inherent to the process that learners and providers encounter. This paper establishes all-important first step to render the set of challenges for a three-staged PI-CME model.

  1. TO IMPROVE QUALITY MANAGEMENT PROCESS : Case: Aiya Restaurant Chain

    OpenAIRE

    Nguyen Thi, Tram Anh

    2012-01-01

    The commissioner of this thesis was Aiya Restaurant Chain, a newly opened yet well known restaurant chain in Vietnam. The core idea of this restaurant is to provide its customers with high quality and hygienic street-side foods. However, the current food quality control process in Aiya is incomplete and leaves space for many defects. Food quality has always been the crucial issue to all restaurants. Yet to Aiya, it is considered even more important, because the quality of food relates directl...

  2. 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

    2014-10-01

    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.

  3. The software improvement process - tools and rules to encourage quality

    International Nuclear Information System (INIS)

    Sigerud, K.; Baggiolini, V.

    2012-01-01

    The Applications section of the CERN accelerator controls group has decided to apply a systematic approach to quality assurance (QA), the 'Software Improvement Process' - SIP. This process focuses on three areas: the development process itself, suitable QA tools, and how to practically encourage developers to do QA. For each stage of the development process we have agreed on the recommended activities and deliverables, and identified tools to automate and support the task. For example we do more code reviews. As peer reviews are resource intensive, we only do them for complex parts of a product. As a complement, we are using static code checking tools, like FindBugs and Checkstyle. We also encourage unit testing and have agreed on a minimum level of test coverage recommended for all products, measured using Clover. Each of these tools is well integrated with our IDE (Eclipse) and give instant feedback to the developer about the quality of their code. The major challenges of SIP have been to 1) agree on common standards and configurations, for example common code formatting and Javadoc documentation guidelines, and 2) how to encourage the developers to do QA. To address the second point, we have successfully implemented 'SIP days', i.e. one day dedicated to QA work to which the whole group of developers participates, and 'Top/Flop' lists, clearly indicating the best and worst products with regards to SIP guidelines and standards, for example test coverage. This paper presents the SIP initiative in more detail, summarizing our experience since two years and our future plans. (authors)

  4. Improvement of quality management in the processes of tobacco production

    OpenAIRE

    Miceski, Trajko

    2004-01-01

    Quality management, now more than ever, occupies an important place in tobacco production. It presents, above all, a continuous process aimed to satisfy the requirements of both the persons employed in tobacco industry and the layers.

  5. USE OF ARTIFICIAL INTELLIGENCE TECHNIQUES IN QUALITY IMPROVING PROCESS

    OpenAIRE

    KALİTE İYİLEŞTİRME SÜRECİNDE YAPAY ZEKÃ KAYA; Orhan ENGİN

    2005-01-01

    Today, changing of competition conditions and customer preferences caused to happen many differences in the viewpoint of firms' quality studies. At the same time, improvements in computer technologies accelerated use of artificial intelligence. Artificial intelligence technologies are being used to solve many industry problems. In this paper, we investigated the use of artificial intelligence techniques to solve quality problems. The artificial intelligence techniques, which are used in quali...

  6. 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

  7. MANAGING THE BUILDING DESIGN PROCESS FOR SUSTAINABILTY AND IMPROVED QUALITY

    Directory of Open Access Journals (Sweden)

    Sunday Bobadoye

    2006-01-01

    Full Text Available The essence of building design process and management for building sustainability in the creation and maintenance of a qualitative architectural product is investigated in this paper. The design process, concept of building sustainability and particularly the quality of the built environment are discussed. Akure, a state capital in Nigeria was used as a case study. The principles and indicators for sustainability of buildings and its implications on the quality of the environment are examined in details. Survey findings include the views of the professionals on the clients, perception on the design process as well as management of projects, and the implications on the quality of the ensuring products and the city’s environment. The data were factor analyzed using varimax rotation criterion (with Kaiser Normalization. The results revealed that five factors were effective, with one of them exhibiting the greatest variability and individual differences. The variables that loaded on this factor were really the aspects of the process and management relating to the clients. The findings also revealed the professionals’ wrong attitude towards design process as shown with a very high degree of variability in the study. The paper concludes by recommending the enactment and enforcement of relevant policies with adequate education of the people and the involvement of all the stakeholders in the management of building projects and environmental programmes for the realization of a qualitative architectural product.

  8. An anticipatory quality improvement process for curricular reform.

    Science.gov (United States)

    Hollander, Harry; Loeser, Helen; Irby, David

    2002-09-01

    standardized set of questions; and examined course schedules, cases, and detailed learning objectives for particular sessions. In July 2001, the committee reported back to the deans with specific recommendations for coordinating the block courses, and about the success in creating integration and the overall balance of topics students would learn. Specific recommendations included increasing the use of pediatric and geriatric cases across courses, creating a case database, developing explicit plans to relocate uncovered material in the four-year curriculum, and bolstering participation of clinical faculty during the first-year blocks. These recommendations were then presented to and endorsed by the Essential Core Steering Committee, which implemented an action plan prior to the September 2001 start date. This proactive approach to quality improvement added an evaluation point before the new curriculum was actually unveiled. The anticipatory planning process substantially aided the interdisciplinary developmental process, increased input into the first-year curriculum by clerkship directors, and identified problems that would have otherwise become apparent after implementation. We believe this model adds value to the curriculum planning process.

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

    Science.gov (United States)

    Rai, Arti K

    2013-11-24

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

  10. Accreditation and improvement in process quality: A nationwide study

    DEFF Research Database (Denmark)

    Falstie-Jensen, Anne Mette; Johnsen, Søren Paaske; Bie Bogh, Søren

    Objectives: To examine the development in process quality related to stroke, heart failure and ulcer (bleeding and perforated) between accredited and non-accredited hospitals. Method: All Danish hospitals which treated patients with stroke or heart failure during 2004-2008 or treated patients......-level processes of care data was obtained from national population-based registries. The accredited and non-accredited hospitals were compared using 20 processes of care indicators reflecting hospital compliance with national clinical guidelines. The 20 indicators included seven indicators for stroke, seven...... indicators for heart failure, three indicators for bleeding ulcer and three indicators for perforated ulcer. The primary outcome was the composite fulfilment of process indicators. The secondary outcome was all-or-none, defined as the proportion of patients receiving 100 % of the recommended processes...

  11. Developing lettuce with improved quality for processed salads.

    Science.gov (United States)

    Lettuce is increasingly consumed as minimally processed salads. Cultivars grown for this market may require breeding for improved shelf-life and resistance to physiological defects such as tipburn (TB). Tipburn is a calcium deficiency related defect causing necrosis on the leaf margins, typically on...

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

    Science.gov (United States)

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

    2012-01-01

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

  13. Improving the Process of Education: Total Quality Management for the College Classroom.

    Science.gov (United States)

    Gilbert, James P.; And Others

    1993-01-01

    A systematic, institutional approach to continuous improvement in college instruction is outlined, based on the four main elements of Total Quality Management: quality defined by customer; top leadership responsibility; systematic analysis of work processes; and continuous quality improvement throughout the organization. Definitions and dimensions…

  14. Quality Improvement Processes in Obesity Surgery Lead to Higher Quality and Value, Lower Costs.

    Science.gov (United States)

    Brousseau, Holli; Pohl, Dieter

    2017-03-01

    In the era of changes in the evaluation of medical services and performance, the Centers for Medicare and Medicaid Services (CMS) has determined that the key components are quality, value, and clinical practice improvement (MACRA). Weight Loss Surgery, also called Bariatric or Obesity Surgery, has been at the forefront of quality improvement and quality reporting through the Center of Excellence Program since 2005. As a result, weight loss surgery is now as safe as gallbladder surgery.1 Even within this culture of quality and safety, improvements are still possible, as described in this article. [Full article available at http://rimed.org/rimedicaljournal-2017-03.asp].

  15. A model of strategic product quality and process improvement incentives

    NARCIS (Netherlands)

    Veldman, Jasper; Gaalman, G.

    2013-01-01

    In many production firms it is common practice to financially reward managers for firm performance improvement. The use of financial incentives for improvement has been widely researched in several analytical and empirical studies. Literature has also addressed the strategic effect of incentives, in

  16. Quality Improvement Process in a Large Intensive Care Unit: Structure and Outcomes.

    Science.gov (United States)

    Reddy, Anita J; Guzman, Jorge A

    2016-11-01

    Quality improvement in the health care setting is a complex process, and even more so in the critical care environment. The development of intensive care unit process measures and quality improvement strategies are associated with improved outcomes, but should be individualized to each medical center as structure and culture can differ from institution to institution. The purpose of this report is to describe the structure of quality improvement processes within a large medical intensive care unit while using examples of the study institution's successes and challenges in the areas of stat antibiotic administration, reduction in blood product waste, central line-associated bloodstream infections, and medication errors. © The Author(s) 2015.

  17. Analysis of an innovative process for landfill gas quality improvement

    International Nuclear Information System (INIS)

    Lombardi, L.; Carnevale, E.A.

    2016-01-01

    Low methane content landfill gas is not suitable for feeding engines and is generally flared. This type of landfill gas may be enriched by removing the inert carbon dioxide. An innovative process, based on the carbon dioxide captured by means of accelerated carbonation of bottom ash was proposed and studied for the above purpose. The process was investigated at a laboratory scale, simulating different landfill gas compositions. The enrichment process is able to decrease the carbon dioxide concentration from 70 to 80% in volume to 60% in volume, requiring about 36 kg of bottom ash per Nm"3 of landfill gas. Using this result it was estimated that an industrial scale plant, processing 100–1000 Nm"3/h of low methane content landfill gas requires about 28,760–2,87,600 t of bottom ash for a one year operation. The specific cost of the studied enrichment process was evaluated as well and ranges from 0.052 to 0.241 Euro per Nm"3 of entering landfill gas. The energy balance showed that about 4–6% of the energy entered with the landfill gas is required for carrying out the enrichment, while the use of the enriched landfill gas in the engine producing electricity allows for negative carbon dioxide emission. - Highlights: • The process uses a waste stream as material to capture CO_2. • The process uses a simple gas/solid fixed bed contact reactor at ambient conditions. • The process captures the CO_2 to enrich low-CH4 landfill gas. • The specific cost ranges from 0.052 to 0.241 Euro per Nm"3 of entering landfill gas. • The process consumes about 4–6% of the entering energy and acts as CO_2 sink.

  18. THE IMPROVEMENT OF ORGANISATIONAL LEARNING PROCESS WITH TOTAL QUALITY MANAGEMENT

    OpenAIRE

    Ana Belén Escrig-Tena

    2003-01-01

    The objective of this paper deals with the influence exerted by TQM on the capability to promote the process of organisational learning, as one of the competencies that the introduction of TQM helps to develop, We discuss the extent to which the critical factors of TQM favour both the exploration of new knowledge that can modify organisational behaviour, and the exploitation of current learning,

  19. Improved binomial charts for monitoring high-quality processes

    NARCIS (Netherlands)

    Albers, Willem/Wim

    2009-01-01

    For processes concerning attribute data with (very) small failure rate p, often negative binomial control charts are used. The decision whether to stop or continue is made each time r failures have occurred, for some r≥1. Finding the optimal r for detecting a given increase of p first requires

  20. Improved binomial charts for high-quality processes

    NARCIS (Netherlands)

    Albers, Willem/Wim

    For processes concerning attribute data with (very) small failure rate p, often negative binomial control charts are used. The decision whether to stop or continue is made each time r failures have occurred, for some r≥1. Finding the optimal r for detecting a given increase of p first requires

  1. New, clean handling process introduced to improve cable quality

    Energy Technology Data Exchange (ETDEWEB)

    Hunt, C G

    1990-05-01

    The clean room system introduced by Canada Wire and Cable Limited in its Toronto plant for its cable manufacturing operation is described. While clean room technology is common in the food processing industry, optical and aerospace manufacturing processes, this is the first time it has been applied to wire and cable extrusion in North America. The purpose of the clean compound handling system is to prevent particle contamination in the shielding and cable insulation materials, as part of an effort to prevent premature underground electric cable failures. Two rooms are dedicated to handling different types of insulation compound, two are dedicated to receiving semi-conducting shielding material, and the fifth room functions as an air lock for the two insulation rooms. The atmosphere is highly regulated with programmable logic control. The air supply filters capture 99.97% of all particles 0.3 microns or larger. The system also maintains air temperature, relative humidity and static pressure. The life variability of cross-linked polyethylene primary distribution cable is dependant on five factors: material purity, extra clean compound handling, cable design, manufacturing process, and installation and operation practices. The clean room system is expected to result in cable that is more resistant to water treeing failures. 2 figs.

  2. Interrupted Time Series Versus Statistical Process Control in Quality Improvement Projects.

    Science.gov (United States)

    Andersson Hagiwara, Magnus; Andersson Gäre, Boel; Elg, Mattias

    2016-01-01

    To measure the effect of quality improvement interventions, it is appropriate to use analysis methods that measure data over time. Examples of such methods include statistical process control analysis and interrupted time series with segmented regression analysis. This article compares the use of statistical process control analysis and interrupted time series with segmented regression analysis for evaluating the longitudinal effects of quality improvement interventions, using an example study on an evaluation of a computerized decision support system.

  3. On the Role of Software Quality Management in Software Process Improvement

    DEFF Research Database (Denmark)

    Wiedemann Jacobsen, Jan; Kuhrmann, Marco; Münch, Jürgen

    2016-01-01

    Software Process Improvement (SPI) programs have been implemented, inter alia, to improve quality and speed of software development. SPI addresses many aspects ranging from individual developer skills to entire organizations. It comprises, for instance, the optimization of specific activities...... and a strong focus on custom review, testing, and documentation techniques, whereas a set of five selected improvement measures is almost equally addressed....

  4. Business Process Quality Computation : Computing Non-Functional Requirements to Improve Business Processes

    NARCIS (Netherlands)

    Heidari, F.

    2015-01-01

    Business process modelling is an important part of system design. When designing or redesigning a business process, stakeholders specify, negotiate, and agree on business requirements to be satisfied, including non-functional requirements that concern the quality of the business process. This thesis

  5. Weaknesses of the Quality Evaluation Process in the Spanish University: Causes, Consequences and Proposals for Improvement

    Directory of Open Access Journals (Sweden)

    Clemente Rodríguez Sabiote

    2003-05-01

    Full Text Available The process of quality assessment going on in the Spanish university since the early nineties has generated undeniable advances. However, there have been detected a series of weaknesses which have affected the process with consequences unpredictable a priori. This article reviews some of the weaknesses, together with their possible causes and consequences. Suggestions are provided for improving the process of evaluating the quality of university institutions.

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

    Science.gov (United States)

    Pietz, Victoria Lynn

    2014-01-01

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

  7. Evaluating the implementation of a quality improvement process in General Practice using a realist evaluation framework.

    Science.gov (United States)

    Moule, Pam; Clompus, Susan; Fieldhouse, Jon; Ellis-Jones, Julie; Barker, Jacqueline

    2018-05-25

    Underuse of anticoagulants in atrial fibrillation is known to increase the risk of stroke and is an international problem. The National Institute for Health Care and Excellence guidance CG180 seeks to reduce atrial fibrillation related strokes through prescriptions of Non-vitamin K antagonist Oral Anticoagulants. A quality improvement programme was established by the West of England Academic Health Science Network (West of England AHSN) to implement this guidance into General Practice. A realist evaluation identified whether the quality improvement programme worked, determining how and in what circumstances. Six General Practices in 1 region, became the case study sites. Quality improvement team, doctor, and pharmacist meetings within each of the General Practices were recorded at 3 stages: initial planning, review, and final. Additionally, 15 interviews conducted with the practice leads explored experiences of the quality improvement process. Observation and interview data were analysed and compared against the initial programme theory. The quality improvement resources available were used variably, with the training being valued by all. The initial programme theories were refined. In particular, local workload pressures and individual General Practitioner experiences and pre-conceived ideas were acknowledged. Where key motivators were in place, such as prior experience, the programme achieved optimal outcomes and secured a lasting quality improvement legacy. The employment of a quality improvement programme can deliver practice change and improvement legacy outcomes when particular mechanisms are employed and in contexts where there is a commitment to improve service. © 2018 John Wiley & Sons, Ltd.

  8. The Poka-Yoke method as an improving quality tool of operations in the process

    OpenAIRE

    M. Dudek-Burlikowska; D. Szewieczek

    2009-01-01

    Purpose: A new approach for the implementation of quality philosophy Zero Quality Defects with usage of the Poka-Yoke method in the polish organization has been presented.Design/methodology/approach: The possibility of usage of mistake proofing device is connected with monitoring and improvement of operations in the process.Findings: At the present time the organizations should implement quality tools, techniques, methods which support the prevention strategy and should pay attention to impro...

  9. A Controlled Agitation Process for Improving Quality of Canned Green Beans during Agitation Thermal Processing.

    Science.gov (United States)

    Singh, Anika; Pratap Singh, Anubhav; Ramaswamy, Hosahalli S

    2016-06-01

    This work introduces the concept of a controlled agitation thermal process to reduce quality damage in liquid-particulate products during agitation thermal processing. Reciprocating agitation thermal processing (RA-TP) was used as the agitation thermal process. In order to reduce the impact of agitation, a new concept of "stopping agitations after sufficient development of cold-spot temperature" was proposed. Green beans were processed in No. 2 (307×409) cans filled with liquids of various consistency (0% to 2% CMC) at various frequencies (1 to 3 Hz) of RA-TP using a full-factorial design and heat penetration results were collected. Corresponding operator's process time to impart a 10-min process lethality (Fo ) and agitation time (AT) were calculated using heat penetration results. Accordingly, products were processed again by stopping agitations as per 3 agitation regimes, namely; full time agitation, equilibration time agitation, and partial time agitation. Processed products were photographed and tested for visual quality, color, texture, breakage of green beans, turbidity, and percentage of insoluble solids in can liquid. Results showed that stopping agitations after sufficient development of cold-spot temperatures is an effective way of reducing product damages caused by agitation (for example, breakage of beans and its leaching into liquid). Agitations till one-log temperature difference gave best color, texture and visual product quality for low-viscosity liquid-particulate mixture and extended agitations till equilibration time was best for high-viscosity products. Thus, it was shown that a controlled agitation thermal process is more effective in obtaining high product quality as compared to a regular agitation thermal process. © 2016 Institute of Food Technologists®

  10. Quality control process improvement of flexible printed circuit board by FMEA

    Science.gov (United States)

    Krasaephol, Siwaporn; Chutima, Parames

    2018-02-01

    This research focuses on the quality control process improvement of Flexible Printed Circuit Board (FPCB), centred around model 7-Flex, by using Failure Mode and Effect Analysis (FMEA) method to decrease proportion of defective finished goods that are found at the final inspection process. Due to a number of defective units that were found at the final inspection process, high scraps may be escaped to customers. The problem comes from poor quality control process which is not efficient enough to filter defective products from in-process because there is no In-Process Quality Control (IPQC) or sampling inspection in the process. Therefore, the quality control process has to be improved by setting inspection gates and IPCQs at critical processes in order to filter the defective products. The critical processes are analysed by the FMEA method. IPQC is used for detecting defective products and reducing chances of defective finished goods escaped to the customers. Reducing proportion of defective finished goods also decreases scrap cost because finished goods incur higher scrap cost than work in-process. Moreover, defective products that are found during process can reflect the abnormal processes; therefore, engineers and operators should timely solve the problems. Improved quality control was implemented for 7-Flex production lines from July 2017 to September 2017. The result shows decreasing of the average proportion of defective finished goods and the average of Customer Manufacturers Lot Reject Rate (%LRR of CMs) equal to 4.5% and 4.1% respectively. Furthermore, cost saving of this quality control process equals to 100K Baht.

  11. Quality improvement - the future begins

    International Nuclear Information System (INIS)

    Boissy, G.J.

    1987-01-01

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

  12. Using Group Projects to Teach Process Improvement in a Quality Class

    Science.gov (United States)

    Neidigh, Robert O.

    2016-01-01

    This paper provides a description of a teaching approach that uses experiential learning to teach process improvement. The teaching approach uses student groups to perform and gather process data in a senior-level quality management class that focuses on Lean Six Sigma. A strategy to link the experiential learning in the group projects to the…

  13. Demystifying process mapping: a key step in neurosurgical quality improvement initiatives.

    Science.gov (United States)

    McLaughlin, Nancy; Rodstein, Jennifer; Burke, Michael A; Martin, Neil A

    2014-08-01

    Reliable delivery of optimal care can be challenging for care providers. Health care leaders have integrated various business tools to assist them and their teams in ensuring consistent delivery of safe and top-quality care. The cornerstone to all quality improvement strategies is the detailed understanding of the current state of a process, captured by process mapping. Process mapping empowers caregivers to audit how they are currently delivering care to subsequently strategically plan improvement initiatives. As a community, neurosurgery has clearly shown dedication to enhancing patient safety and delivering quality care. A care redesign strategy named NERVS (Neurosurgery Enhanced Recovery after surgery, Value, and Safety) is currently being developed and piloted within our department. Through this initiative, a multidisciplinary team led by a clinician neurosurgeon has process mapped the way care is currently being delivered throughout the entire episode of care. Neurosurgeons are becoming leaders in quality programs, and their education on the quality improvement strategies and tools is essential. The authors present a comprehensive review of process mapping, demystifying its planning, its building, and its analysis. The particularities of using process maps, initially a business tool, in the health care arena are discussed, and their specific use in an academic neurosurgical department is presented.

  14. THE QUALITY IMPROVEMENT OF PRIMER PACKAGING PROCESS USING SIX SIGMA METHODOLOGY

    Directory of Open Access Journals (Sweden)

    Prima Ditahardiyani

    2008-01-01

    Full Text Available The implementation of Six Sigma has become a common theme in many organizations. This paper presents the Six Sigma methodology and its implementation in a primer packaging process of Cranberry drink. DMAIC (Define, Measure, Analyze, Improve and Control approach is used to analyze and to improve the primer packaging process, which have high variability and defects output. After the improvement, the results showed that there was an increasing sigma level. However, it is not significantly and has not achieved the world standard quality, yet. Therefore, the implementation of Six Sigma in primer packaging process of Cranberry drink still has a room for doing a further research.

  15. Continuous quality improvement

    International Nuclear Information System (INIS)

    Bourne, P.B.

    1985-01-01

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

  16. Improving lactate metabolism in an intensified CHO culture process: productivity and product quality considerations.

    Science.gov (United States)

    Xu, Sen; Hoshan, Linda; Chen, Hao

    2016-11-01

    In this study, we discussed the development and optimization of an intensified CHO culture process, highlighting medium and control strategies to improve lactate metabolism. A few strategies, including supplementing glucose with other sugars (fructose, maltose, and galactose), controlling glucose level at Productivity and product quality attributes differences between batch, fed-batch, and concentrated fed-batch cultures were discussed. The importance of process and cell metabolism understanding when adapting the existing process to a new operational mode was demonstrated in the study.

  17. THE LEAN SIX SIGMAAPPROACH FOR PROCESS IMPROVEMENT: A CASE STUDY IN A HIGH QUALITY TUSCANY WINERY

    Directory of Open Access Journals (Sweden)

    Riccardo Bettini

    2012-06-01

    Full Text Available This paper describes the application of a Lean Six Sigma (LSS project to a winemaking process in a high-quality, Italian winery. LSS is used to focus on the problem through a quantitative analysis of waste and quality performances. The LSS basic algorithm (called “DMAIC” helps to detect and quantify critical aspects of the process for transferring liquid used in the cellar. The improvement solution is developed and applied through the modification of the cellar system and the process procedure. The results obtained with this solution are shown and discussed in this paper, so too the long term reliability of the improved process analyzed. The results obtained by this case study can help to understand the importance of the LSS method to drive the improvement of agricultural and agrofood productions also in terms of environmental impact which is strongly connected to waste reduction.

  18. [Improvement of medical processes with Six Sigma - practicable zero-defect quality in preparation for surgery].

    Science.gov (United States)

    Sobottka, Stephan B; Töpfer, Armin; Eberlein-Gonska, Maria; Schackert, Gabriele; Albrecht, D Michael

    2010-01-01

    Six Sigma is an innovative management- approach to reach practicable zero- defect quality in medical service processes. The Six Sigma principle utilizes strategies, which are based on quantitative measurements and which seek to optimize processes, limit deviations or dispersion from the target process. Hence, Six Sigma aims to eliminate errors or quality problems of all kinds. A pilot project to optimize the preparation for neurosurgery could now show that the Six Sigma method enhanced patient safety in medical care, while at the same time disturbances in the hospital processes and failure costs could be avoided. All six defined safety relevant quality indicators were significantly improved by changes in the workflow by using a standardized process- and patient- oriented approach. Certain defined quality standards such as a 100% complete surgical preparation at start of surgery and the required initial contact of the surgeon with the patient/ surgical record on the eve of surgery could be fulfilled within the range of practical zero- defect quality. Likewise, the degree of completion of the surgical record by 4 p.m. on the eve of surgery and their quality could be improved by a factor of 170 and 16, respectively, at sigma values of 4.43 and 4.38. The other two safety quality indicators "non-communicated changes in the OR- schedule" and the "completeness of the OR- schedule by 12:30 a.m. on the day before surgery" also show an impressive improvement by a factor of 2.8 and 7.7, respectively, corresponding with sigma values of 3.34 and 3.51. The results of this pilot project demonstrate that the Six Sigma method is eminently suitable for improving quality of medical processes. In our experience this methodology is suitable, even for complex clinical processes with a variety of stakeholders. In particular, in processes in which patient safety plays a key role, the objective of achieving a zero- defect quality is reasonable and should definitely be aspirated. Copyright

  19. 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.

  20. Use of osmotic dehydration to improve fruits and vegetables quality during processing.

    Science.gov (United States)

    Maftoonazad, Neda

    2010-11-01

    Osmotic treatment describes a preparation step to further processing of foods involving simultaneous transient moisture loss and solids gain when immersing in osmotic solutions, resulting in partial drying and improving the overall quality of food products. The different aspects of the osmotic dehydration (OD) technology namely the solutes employed, solutions characteristics used, process variables influence, as well as, the quality characteristics of the osmodehydrated products will be discussed in this review. As the process is carried out at mild temperatures and the moisture is removed by a liquid diffusion process, phase change that would be present in the other drying processes will be avoided, resulting in high quality products and may also lead to substantial energy savings. To optimize this process, modeling of the mass transfer phenomenon can improve high product quality. Several techniques such as microwave heating, vacuum, high pressure, pulsed electric field, etc. may be employed during or after osmotic treatment to enhance performance of the osmotic dehydration. Moreover new technologies used in osmotic dehydration will be discussed. Patents on osmotic dehydration of fruits and vegetables are also discussed in this article.

  1. DEVELOPMENT OF PERFORMANCE MODEL FOR QUALITY AND PROCESS IMPROVEMENT IN BUSINESS PROCESS SERVICE INDUSTRY

    Directory of Open Access Journals (Sweden)

    Samson Oludapo

    2017-06-01

    Full Text Available When it comes to performance improvement process, literature abounds with lean, agile and lean-agile. Over the years, the implementation of the improvement processes of lean and agile had met with resounding success in the manufacturing, production, and construction industry. For this reason, there is an interest to develop a performance process for business process service industry incorporating the key aspect of lean and agile theory extracted from the extant literature. The researcher reviewed a total of 750 scholarly articles, grouped them according to the relationship to central theme - lean or agile, and thereafter uses factor analysis under principal component method to explain the relationship of the items. The result of this study showed that firms focusing on cost will minimize the investment of resources in business operations this, in turn, will lead to difficulties in responding to changing customer's requirements in terms of volume, delivery, and new product. The implication is that on the long run cost focus strategy negatively influence flexibility.

  2. QUALITY IMPROVEMENT USING STATISTICAL PROCESS CONTROL TOOLS IN GLASS BOTTLES MANUFACTURING COMPANY

    Directory of Open Access Journals (Sweden)

    Yonatan Mengesha Awaj

    2013-03-01

    Full Text Available In order to survive in a competitive market, improving quality and productivity of product or process is a must for any company. This study is about to apply the statistical process control (SPC tools in the production processing line and on final product in order to reduce defects by identifying where the highest waste is occur at and to give suggestion for improvement. The approach used in this study is direct observation, thorough examination of production process lines, brain storming session, fishbone diagram, and information has been collected from potential customers and company's workers through interview and questionnaire, Pareto chart/analysis and control chart (p-chart was constructed. It has been found that the company has many problems; specifically there is high rejection or waste in the production processing line. The highest waste occurs in melting process line which causes loss due to trickle and in the forming process line which causes loss due to defective product rejection. The vital few problems were identified, it was found that the blisters, double seam, stone, pressure failure and overweight are the vital few problems. The principal aim of the study is to create awareness to quality team how to use SPC tools in the problem analysis, especially to train quality team on how to held an effective brainstorming session, and exploit these data in cause-and-effect diagram construction, Pareto analysis and control chart construction. The major causes of non-conformities and root causes of the quality problems were specified, and possible remedies were proposed. Although the company has many constraints to implement all suggestion for improvement within short period of time, the company recognized that the suggestion will provide significant productivity improvement in the long run.

  3. A conceptual persistent healthcare quality improvement process for software development management.

    Science.gov (United States)

    Lin, Jen-Chiun; Su, Mei-Ju; Cheng, Po-Hsun; Weng, Yung-Chien; Chen, Sao-Jie; Lai, Jin-Shin; Lai, Feipei

    2007-01-01

    This paper illustrates a sustained conceptual service quality improvement process for the management of software development within a healthcare enterprise. Our proposed process is revised from Niland's healthcare quality information system (HQIS). This process includes functions to survey the satisfaction of system functions, describe the operation bylaws on-line, and provide on-demand training. To achieve these goals, we integrate five information systems in National Taiwan University Hospital, including healthcare information systems, health quality information system, requirement management system, executive information system, and digital learning system, to form a full Deming cycle. A preliminary user satisfaction survey showed that our outpatient information system scored an average of 71.31 in 2006.

  4. IMPROVING QUALITY OF STATISTICAL PROCESS CONTROL BY DEALING WITH NON‐NORMAL DATA IN AUTOMOTIVE INDUSTRY

    Directory of Open Access Journals (Sweden)

    Zuzana ANDRÁSSYOVÁ

    2012-07-01

    Full Text Available Study deals with an analysis of data to the effect that it improves the quality of statistical tools in processes of assembly of automobile seats. Normal distribution of variables is one of inevitable conditions for the analysis, examination, and improvement of the manufacturing processes (f. e.: manufacturing process capability although, there are constantly more approaches to non‐normal data handling. An appropriate probability distribution of measured data is firstly tested by the goodness of fit of empirical distribution with theoretical normal distribution on the basis of hypothesis testing using programme StatGraphics Centurion XV.II. Data are collected from the assembly process of 1st row automobile seats for each characteristic of quality (Safety Regulation ‐S/R individually. Study closely processes the measured data of an airbag´s assembly and it aims to accomplish the normal distributed data and apply it the statistical process control. Results of the contribution conclude in a statement of rejection of the null hypothesis (measured variables do not follow the normal distribution therefore it is necessary to begin to work on data transformation supported by Minitab15. Even this approach does not reach a normal distributed data and so should be proposed a procedure that leads to the quality output of whole statistical control of manufacturing processes.

  5. Application of the suggestion system in the improvement of the production process and product quality control

    Science.gov (United States)

    Gołaś, H.; Mazur, A.; Gruszka, J.; Szafer, P.

    2016-08-01

    The elaboration is a case study and the research was carried out in the company Alco-Mot Ltd., which employs 120 people. The company specializes in the production of lead poles for industrial and traction batteries using gravity casting. The elements embedded in the cast are manufactured on a machining centre, which provides the stability of the process and of the dimensions of the product as well as a very short production time. As a result of observation and analysis the authors have developed a concept for the implementation of a dynamic suggestion system in ALCO-MOT, including, among others, a standard for actions in the implementation of the suggestion system, as well as clear guidelines for the processing and presentation of the activities undertaken in the time between the establishment of the concept (suggestions) and the benefits analysis after the proposed solutions have been implemented. The authors also present how suggestions proposed by ALCO-MOT staff contributed to the improvement of the processes of production and quality control. Employees offered more than 30 suggestions, of which more than a half are being implemented now and further actions are being prepared for implementation. The authors will present the results of improvements in, for example, tool replacement time, scrap reduction. The authors will present how kaizen can improve the production and quality control processes. They will present how the production and quality control processes looked before and after the implementation of employee suggestions.

  6. Process Evaluation of a Quality Improvement Project to Decrease Hospital Readmissions From Skilled Nursing Facilities.

    Science.gov (United States)

    Meehan, Thomas P; Qazi, Daniel J; Van Hoof, Thomas J; Ho, Shih-Yieh; Eckenrode, Sheila; Spenard, Ann; Pandolfi, Michelle; Johnson, Florence; Quetti, Deborah

    2015-08-01

    To describe and evaluate the impact of quality improvement (QI) support provided to skilled nursing facilities (SNFs) by a Quality Improvement Organization (QIO). Retrospective, mixed-method, process evaluation of a QI project intended to decrease preventable hospital readmissions from SNFs. Five SNFs in Connecticut. SNF Administrators, Directors of Nursing, Assistant Directors of Nursing, Admissions Coordinators, Registered Nurses, Certified Nursing Assistants, Receptionists, QIO Quality Improvement Consultant. QIO staff provided training and technical assistance to SNF administrative and clinical staff to establish or enhance QI infrastructure and implement an established set of QI tools [Interventions to Reduce Acute Care Transfers (INTERACT) tools]. Baseline SNF demographic, staffing, and hospital readmission data; baseline and follow-up SNF QI structure (QI Committee), processes (general and use of INTERACT tools), and outcome (30-day all-cause hospital readmission rates); details of QIO-provided training and technical assistance; QIO-perceived barriers to quality improvement; SNF leadership-perceived barriers, accomplishments, and suggestions for improvement of QIO support. Success occurred in establishing QI Committees and targeting preventable hospital readmissions, as well as implementing INTERACT tools in all SNFs; however, hospital readmission rates decreased in only 2 facilities. QIO staff and SNF leaders noted the ongoing challenge of engaging already busy SNF staff and leadership in QI activities. SNF leaders reported that they appreciated the training and technical assistance that their institutions received, although most noted that additional support was needed to bring about improvement in readmission rates. This process evaluation documented mixed clinical results but successfully identified opportunities to improve recruitment of and provision of technical support to participating SNFs. Recommendations are offered for others who wish to conduct

  7. Development and Implementation of a Quality Improvement Process for Echocardiographic Laboratory Accreditation.

    Science.gov (United States)

    Gilliland, Yvonne E; Lavie, Carl J; Ahmad, Homaa; Bernal, Jose A; Cash, Michael E; Dinshaw, Homeyar; Milani, Richard V; Shah, Sangeeta; Bienvenu, Lisa; White, Christopher J

    2016-03-01

    We describe our process for quality improvement (QI) for a 3-year accreditation cycle in echocardiography by the Intersocietal Accreditation Commission (IAC) for a large group practice. Echocardiographic laboratory accreditation by the IAC was introduced in 1996, which is not required but could impact reimbursement. To ensure high-quality patient care and community recognition as a facility committed to providing high-quality echocardiographic services, we applied for IAC accreditation in 2010. Currently, there is little published data regarding the IAC process to meet echocardiography standards. We describe our approach for developing a multicampus QI process for echocardiographic laboratory accreditation during the 3-year cycle of accreditation by the IAC. We developed a quarterly review assessing (1) the variability of the interpretations, (2) the quality of the examinations, (3) a correlation of echocardiographic studies with other imaging modalities, (4) the timely completion of reports, (5) procedure volume, (6) maintenance of Continuing Medical Education credits by faculty, and (7) meeting Appropriate Use Criteria. We developed and implemented a multicampus process for QI during the 3-year accreditation cycle by the IAC for Echocardiography. We documented both the process and the achievement of those metrics by the Echocardiography Laboratories at the Ochsner Medical Institutions. We found the QI process using IAC standards to be a continuous educational experience for our Echocardiography Laboratory physicians and staff. We offer our process as an example and guide for other echocardiography laboratories who wish to apply for such accreditation or reaccreditation. © 2016, Wiley Periodicals, Inc.

  8. [Study of continuous quality improvement for clinical laboratory processes via the platform of Hospital Group].

    Science.gov (United States)

    Song, Wenqi; Shen, Ying; Peng, Xiaoxia; Tian, Jian; Wang, Hui; Xu, Lili; Nie, Xiaolu; Ni, Xin

    2015-05-26

    The program of continuous quality improvement in clinical laboratory processes for complete blood count (CBC) was launched via the platform of Beijing Children's Hospital Group in order to improve the quality of pediatric clinical laboratories. Fifteen children's hospitals of Beijing Children's Hospital group were investigated using the method of Chinese adapted continuous quality improvement with PDCA (Plan-Do-Check-Action). The questionnaire survey and inter-laboratory comparison was conducted to find the existing problems, to analyze reasons, to set forth quality targets and to put them into practice. Then, targeted training was conducted to 15 children's hospitals and the second questionnaire survey, self examinations by the clinical laboratories was performed. At the same time, the Group's online internal quality control platform was established. Overall effects of the program were evaluated so that lay a foundation for the next stage of PDCA. Both quality of control system documents and CBC internal quality control scheme for all of clinical laboratories were improved through this program. In addition, standardization of performance verification was also improved, especially with the comparable verification rate of precision and internal laboratory results up to 100%. In terms of instrument calibration and mandatory diagnostic rates, only three out of the 15 hospitals (20%) failed to pass muster in 2014 from 46.67% (seven out of the 15 hospitals) in 2013. The abnormal data of intraday precision variance coefficients of the five CBC indicator parameters (WBC, RBC, Hb, Plt and Hct) of all the 15 laboratories accounted for 1.2% (2/165) in 2014, a marked decrease from 9.6% (14/145) in 2013. While the number of the hospitals using only one horizontal quality control object for daily quality control has dropped to three from five. The 15 hospitals organized a total of 263 times of training in 2014 from 101 times in 2013, up 160%. The quality improvement program for

  9. Process Reengineering for Quality Improvement in ICU Based on Taylor's Management Theory.

    Science.gov (United States)

    Tao, Ziqi

    2015-06-01

    Using methods including questionnaire-based surveys and control analysis, we analyzed the improvements in the efficiency of ICU rescue, service quality, and patients' satisfaction, in Xuzhou Central Hospital after the implementation of fine management, with an attempt to further introduce the concept of fine management and implement the brand construction. Originating in Taylor's "Theory of Scientific Management" (1982), fine management uses programmed, standardized, digitalized, and informational approaches to ensure each unit of an organization is running with great accuracy, high efficiency, strong coordination, and at sustained duration (Wang et al., Fine Management, 2007). The nature of fine management is a process that breaks up the strategy and goal, and executes it. Strategic planning takes place at every part of the process. Fine management demonstrates that everybody has a role to play in the management process, every area must be examined through the management process, and everything has to be managed (Zhang et al., The Experience of Hospital Nursing Precise Management, 2006). In other words, this kind of management theory demands all people to be involved in the entire process (Liu and Chen, Med Inf, 2007). As public hospital reform is becoming more widespread, it becomes imperative to "build a unified and efficient public hospital management system" and "improve the quality of medical services" (Guidelines on the Pilot Reform of Public Hospitals, 2010). The execution of fine management is of importance in optimizing the medical process, improving medical services and building a prestigious hospital brand.

  10. Implementing a Course Review Process for a Continuous Quality Improvement Model for a Medical School Curriculum.

    Science.gov (United States)

    Ward, Cassandra S; Andrade, Amy; Walker-Winfree, Lena

    2018-01-01

    In 1901, Abraham Flexner, a research scholar at the Carnegie Foundation for the Advancement of Teaching, visited 155 medical schools in the United States and Canada to assess medical education. Flexner's recommendations became the foundation for the Liaison Committee on Medical Education accreditation, a voluntary, peer-reviewed quality assurance process to determine whether a medical education program meets established standards. The Meharry Medical College School of Medicine, a historically Black college/university (HBCU) established the Office of Curriculum Evaluation and Effectiveness in 2013 to ensure the consistent monitoring of the medical education program's compliance with accreditation standards. The motto and logo, LCME 24/7, highlight the school's emphasis on meeting accreditation standards. The school uses the 1994 Plan-Do-Study-Act Cycle for Learning and Improvement for continuous review of course content, outcomes, and evaluations. This process identifies strengths, challenges, and opportunities for innovative steps for continuous quality improvements to the curriculum.

  11. Implementation of quality improvement techniques for management and technical processes in the ACRV project

    Science.gov (United States)

    Raiman, Laura B.

    1992-12-01

    Total Quality Management (TQM) is a cooperative form of doing business that relies on the talents of everyone in an organization to continually improve quality and productivity, using teams and an assortment of statistical and measurement tools. The objective of the activities described in this paper was to implement effective improvement tools and techniques in order to build work processes which support good management and technical decisions and actions which are crucial to the success of the ACRV project. The objectives were met by applications in both the technical and management areas. The management applications involved initiating focused continuous improvement projects with widespread team membership. The technical applications involved applying proven statistical tools and techniques to the technical issues associated with the ACRV Project. Specific activities related to the objective included working with a support contractor team to improve support processes, examining processes involved in international activities, a series of tutorials presented to the New Initiatives Office and support contractors, a briefing to NIO managers, and work with the NIO Q+ Team. On the technical side, work included analyzing data from the large-scale W.A.T.E.R. test, landing mode trade analyses, and targeting probability calculations. The results of these efforts will help to develop a disciplined, ongoing process for producing fundamental decisions and actions that shape and guide the ACRV organization .

  12. Implementation of quality improvement techniques for management and technical processes in the ACRV project

    Science.gov (United States)

    Raiman, Laura B.

    1992-01-01

    Total Quality Management (TQM) is a cooperative form of doing business that relies on the talents of everyone in an organization to continually improve quality and productivity, using teams and an assortment of statistical and measurement tools. The objective of the activities described in this paper was to implement effective improvement tools and techniques in order to build work processes which support good management and technical decisions and actions which are crucial to the success of the ACRV project. The objectives were met by applications in both the technical and management areas. The management applications involved initiating focused continuous improvement projects with widespread team membership. The technical applications involved applying proven statistical tools and techniques to the technical issues associated with the ACRV Project. Specific activities related to the objective included working with a support contractor team to improve support processes, examining processes involved in international activities, a series of tutorials presented to the New Initiatives Office and support contractors, a briefing to NIO managers, and work with the NIO Q+ Team. On the technical side, work included analyzing data from the large-scale W.A.T.E.R. test, landing mode trade analyses, and targeting probability calculations. The results of these efforts will help to develop a disciplined, ongoing process for producing fundamental decisions and actions that shape and guide the ACRV organization .

  13. 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 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.

  14. X-rays taken by radiologists. Influence on a continuous quality improvement process?

    International Nuclear Information System (INIS)

    Kurtz, C.; Freiburg Univ.; Czapp, W.; Trampe, I.; Leppek, R.; Klose, K.J.

    2000-01-01

    Purpose: To evaluate how the training of radiology residents in taking radiographs influences the work of radiographers and the established quality standards. Methods: A first year radiology resident was trained for 4 weeks in focusing and exposure techniques by radiographers. In a second period the resident took 582 radiograms, which were compared with those taken by technicians for error estimation on a daily basis. During a third period the radiographs were produced in a contest between the resident and a skilled radiographer. Errors were analysed by two independent experts according to established guidelines of the German Medical Association. Results: At the beginning of the second period the average error rate of the resident was 11.9% as compared to 8.9% in the technicians team, in the following month 9.2% versus 15.9%. In the third period no relevant difference in errors could be observed. Finally, unexpected quality improvements were implemented like an improved standardization of focusing and exposure techniques as well as dose reduction. Conclusions: Radiology residents easily learn focusing and exposure techniques and achieve comparable results as radiographers within a short period of time. The additionally achieved knowledge improves the technical process of taking radiographs. We recommend to include a two plane radiography training period in the curriculum of radiology residents. It reinforces the radiologist's role in continuous quality improvements of the diagnostic process. (orig.) [de

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

    Science.gov (United States)

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

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

  16. A methodology to improve higher education quality using the quality function deployment and analytic hierarchy process

    NARCIS (Netherlands)

    Raharjo, H.; Xie, M.; Goh, T.N.; Brombacher, A.C.

    2007-01-01

    In order to formulate an effective strategic plan in a customer-driven education context, it is important to recognize who the customers are and what they want. Using Quality Function Deployment (QFD), this information can be translated into strategies to achieve customer satisfaction. Since the

  17. Implementing a Systematic Process for Consistent Nursing Care in a NICU: A Quality Improvement Project.

    Science.gov (United States)

    McCarley, Renay Marie; Dowling, Donna A; Dolansky, Mary A; Bieda, Amy

    2018-03-01

    The global aim of this quality improvement project was to develop and implement a systematic process to assign and maintain consistent bedside nurses for infants and families. A systematic process based on a primary care nursing model was implemented to assign consistent care for a 48-bed, single-family room NICU. Four PDSA cycles were necessary to obtain agreement from the nursing staff as to the best process for assigning primary nurses. Post-intervention data revealed a 9.5 percent decrease of consistent caregivers for infants in the NICU ≤ 28 days and a 2.3 percent increase of consistent caregivers for infants in the NICU ≥ 29 days. Although these findings did not meet the goal of the specific aim, a systematic process was created to assign bedside nurses to infants. Further PDSAs will be needed to refine the process to reach the aim.

  18. Collaborative quality improvement.

    Science.gov (United States)

    Luckenbaugh, Amy N; Miller, David C; Ghani, Khurshid R

    2017-07-01

    Quality improvement collaboratives were developed in many medical and surgical disciplines with the goal of measuring and improving the quality of care provided to patients. The aim of this review is to provide an overview of surgical quality improvement collaboratives, and in particular those aimed at improving urological care. Quality improvement collaboratives collect high-quality data using standardized methodologies, and use the data to provide feedback to physicians and practices, and then implement processes to improve patient outcomes. The largest regional collaborative in urology is the Michigan Urological Surgery Improvement Collaborative (MUSIC). Recent efforts by this group have been focused at understanding variation in care, improving patient selection for treatment, reducing treatment morbidity and measuring and optimizing technical skill. The American Urological Association has also recently launched a national quality registry (AQUA), with an initial focus on prostate cancer care. By understanding factors that result in exemplary performance, quality improvement collaboratives are able to develop best practices around areas of care with high variation that have the potential to improve outcomes and reduce costs. These developments have been made possible by the unique model offered by the collaborative structure with the goal of improving patient care at a population level.

  19. APPLICATION OF FTA AND FMEA METHOD TO IMPROVE SUGAR PRODUCTION PROCESS QUALITY

    Directory of Open Access Journals (Sweden)

    JojoAndriana

    2016-10-01

    Full Text Available Defective product is a product that has poor quality and do not meet the standart. This defective products can give a bad impact to company, such as high production costs and decreased image company. Several methods that can be used to improve the quality is Six Sigma DMAIC methodology, FTA, and FMEA method. This study is conducted for several purpose, they are to determine the value of sigma level on the process of sugar production in PT.PG. Krebet Baru, to determine the factors that cause defective products in the process of sugar production by the FTA method, and to make a suitable solution based on the FMEA defective causes. The process sigma level in PT.PG.Krebet Baru is 3.58. That value sigma level indicates PT. PG. Krebet Baru is a company that are still growing and need improvement. The primary cause of the defects in the production process is a factor of operator and machine. Mode of failure with the highest RPN at 210 is time for steam process is too long, so they need to install the equipment that can detect the water level on sugar. When this equipment is installed, the exact time for drying will be known and the amount of defective product will be decreased.

  20. Instituting organizational learning for quality improvement through strategic planning nominal group processes.

    Science.gov (United States)

    White, D B

    2000-01-01

    Healthcare managers are faced with unprecedented challenges as characterized by managed care constraints, downsizing, increased client needs, and a society demanding more responsive services. Managers must initiate change for quality, efficiency, and survival. This article provides information and strategies for (a) assessing the change readiness of an organization, (b) conducting an organizational diagnosis, (c) instituting a team culture, (d) developing a change strategy, (e) integrating the strategy with a quality improvement process, and (f) identifying the leadership skills to implement organization renewal. Nominal group processes, namely, SWOT and the Search Conference, are described, and case examples are provided. The implementation strategies have been used successfully in a variety of milieus; practical advice for success is described in detail.

  1. Process Improvement to Enhance Quality in a Large Volume Labor and Birth Unit.

    Science.gov (United States)

    Bell, Ashley M; Bohannon, Jessica; Porthouse, Lisa; Thompson, Heather; Vago, Tony

    The goal of the perinatal team at Mercy Hospital St. Louis is to provide a quality patient experience during labor and birth. After the move to a new labor and birth unit in 2013, the team recognized many of the routines and practices needed to be modified based on different demands. The Lean process was used to plan and implement required changes. This technique was chosen because it is based on feedback from clinicians, teamwork, strategizing, and immediate evaluation and implementation of common sense solutions. Through rapid improvement events, presence of leaders in the work environment, and daily huddles, team member engagement and communication were enhanced. The process allowed for team members to offer ideas, test these ideas, and evaluate results, all within a rapid time frame. For 9 months, frontline clinicians met monthly for a weeklong rapid improvement event to create better experiences for childbearing women and those who provide their care, using Lean concepts. At the end of each week, an implementation plan and metrics were developed to help ensure sustainment. The issues that were the focus of these process improvements included on-time initiation of scheduled cases such as induction of labor and cesarean birth, timely and efficient assessment and triage disposition, postanesthesia care and immediate newborn care completed within approximately 2 hours, transfer from the labor unit to the mother baby unit, and emergency transfers to the main operating room and intensive care unit. On-time case initiation for labor induction and cesarean birth improved, length of stay in obstetric triage decreased, postanesthesia recovery care was reorganized to be completed within the expected 2-hour standard time frame, and emergency transfers to the main hospital operating room and intensive care units were standardized and enhanced for efficiency and safety. Participants were pleased with the process improvements and quality outcomes. Working together as a team

  2. Quality Improvement of Ground Works Process with the Use of Chosen Lean Management Tools - Case Study

    Science.gov (United States)

    Nowotarski, Piotr; Paslawski, Jerzy; Wysocki, Bartosz

    2017-12-01

    Ground works are one of the first processes connected with erecting structures. Based on ground conditions like the type of soil or level of underground water different types and solutions for foundations are designed. Foundations are the base for the buildings, and their proper design and execution is the key for the long and faultless use of the whole construction and might influence on the future costs of the eventual repairs (especially when ground water level is high, and there is no proper water insulation made). Article presents the introduction of chosen Lean Management tools for quality improvement of the process of ground works based on the analysis made on the construction site of vehicle control station located in Poznan, Poland. Processes assessment is made from different perspectives taking into account that 3 main groups of workers were directly involved in the process: blue collar-workers, site manager and site engineers. What is more comparison is made on the 3 points of view to the problems that might occur during this type of works, with details analysis on the causes of such situation? Authors presents also the change of approach of workers directly involved in the mentioned processes regarding introduction of Lean Management methodology, which illustrates the problem of scepticism for new ideas of the people used to perform works and actions in traditional way. Using Lean Management philosophy in construction is a good idea to streamline processes in company, get rid of constantly recurring problems, and in this way improve the productivity and quality of executed activities. Performed analysis showed that different groups of people have very different idea and opinion on the problems connected with executing the same process - ground works and only having full picture of the situation (especially in construction processes) management can take proper problems-preventing actions that consequently can influence on the amount of waste generated on

  3. A Case of Engineering Quality for Mobile Healthcare Applications Using Augmented Personal Software Process Improvement

    Directory of Open Access Journals (Sweden)

    Shahbaz Ahmed Khan Ghayyur

    2016-01-01

    Full Text Available Mobile healthcare systems are currently considered as key research areas in the domain of software engineering. The adoption of modern technologies, for mobile healthcare systems, is a quick option for industry professionals. Software architecture is a key feature that contributes towards a software product, solution, or services. Software architecture helps in better communication, documentation of design decisions, risks identification, basis for reusability, scalability, scheduling, and reduced maintenance cost and lastly it helps to avoid software failures. Hence, in order to solve the abovementioned issues in mobile healthcare, the software architecture is integrated with personal software process. Personal software process has been applied successfully but it is unable to address the issues related to architectural design and evaluation capabilities. Hence, a new technique architecture augmented personal process is presented in order to enhance the quality of the mobile healthcare systems through the use of architectural design with integration of personal software process. The proposed process was validated by case studies. It was found that the proposed process helped in reducing the overall costs and effort. Moreover, an improved architectural design helped in development of high quality mobile healthcare system.

  4. Radioscopy applied to the improvement of industrial processes of quality control in the Brazilian footwear production

    Energy Technology Data Exchange (ETDEWEB)

    Fernandes, Marcela Tatiana Fernandes; Mello Filho, Mauro Otto de Cavalcanti, E-mail: mbeserra@cefet-rj.br, E-mail: maurootto@cefet-rj.br [Centro Federal de Educacao Tecnologica Celso Suckow da Fonseca (CEFET-RJ), Rio de Janeiro, RJ (Brazil); Raupp, Fernanda Maria Pereira, E-mail: fraupp@puc-rio.br [Pontificia Universidade Catolica do Rio de Janeiro (PUC-Rio), Rio de Janeiro, RJ (Brazil). Departamento de Engenharia Industrial

    2013-07-01

    According to the Ministry of Development, Industry and Foreign Trade, China has the last five years in the Brazilian footwear market for imports, representing 70% of total imports. Brazil has been recording declines in footwear exports; in 2011 there was an average reduction of 21.5% compared to 2010. Thus, Brazil has moved to the eighth position in the export market. Moreover, Asians have been improving the quality and technological level of their footwear for niche markets. It is well known that the introduction of new technologies into industrial organizations enables adding value to their products, making the organizations more competitive in the global market. In this work, we present a study on the use of radioscopy technique to improve quality control of the Brazilian footwear industry. Being already used by some international footwear manufactures, aiming at the identification of strange bodies, control jumps, among other aspects, this technique brings innovation to the referred industry, since it is a non-destructive test approach that makes use of X-rays. We also propose a tool for the application of radioscopy technique to improve quality control processes of footwear production, employing concepts of Failure Modes and Effects Analysis (FMEA). (author)

  5. Radioscopy applied to the improvement of industrial processes of quality control in the Brazilian footwear production

    International Nuclear Information System (INIS)

    Fernandes, Marcela Tatiana Fernandes; Mello Filho, Mauro Otto de Cavalcanti; Raupp, Fernanda Maria Pereira

    2013-01-01

    According to the Ministry of Development, Industry and Foreign Trade, China has the last five years in the Brazilian footwear market for imports, representing 70% of total imports. Brazil has been recording declines in footwear exports; in 2011 there was an average reduction of 21.5% compared to 2010. Thus, Brazil has moved to the eighth position in the export market. Moreover, Asians have been improving the quality and technological level of their footwear for niche markets. It is well known that the introduction of new technologies into industrial organizations enables adding value to their products, making the organizations more competitive in the global market. In this work, we present a study on the use of radioscopy technique to improve quality control of the Brazilian footwear industry. Being already used by some international footwear manufactures, aiming at the identification of strange bodies, control jumps, among other aspects, this technique brings innovation to the referred industry, since it is a non-destructive test approach that makes use of X-rays. We also propose a tool for the application of radioscopy technique to improve quality control processes of footwear production, employing concepts of Failure Modes and Effects Analysis (FMEA). (author)

  6. Continuous quality improvement process pin-points delays, speeds STEMI patients to life-saving treatment.

    Science.gov (United States)

    2011-11-01

    Using a multidisciplinary team approach, the University of California, San Diego, Health System has been able to significantly reduce average door-to-balloon angioplasty times for patients with the most severe form of heart attacks, beating national recommendations by more than a third. The multidisciplinary team meets monthly to review all cases involving patients with ST-segment-elevation myocardial infarctions (STEMI) to see where process improvements can be made. Using this continuous quality improvement (CQI) process, the health system has reduced average door-to-balloon times from 120 minutes to less than 60 minutes, and administrators are now aiming for further progress. Among the improvements instituted by the multidisciplinary team are the implementation of a "greeter" with enough clinical expertise to quickly pick up on potential STEMI heart attacks as soon as patients walk into the ED, and the purchase of an electrocardiogram (EKG) machine so that evaluations can be done in the triage area. ED staff have prepared "STEMI" packets, including items such as special IV tubing and disposable leads, so that patients headed for the catheterization laboratory are prepared to undergo the procedure soon after arrival. All the clocks and devices used in the ED are synchronized so that analysts can later review how long it took to complete each step of the care process. Points of delay can then be targeted for improvement.

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

    Science.gov (United States)

    Thomas, Elizabeth Anne

    2011-06-01

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

  8. Application of Strategic Management Principles as Tool to Improve Quality of Construction Technological Process

    Science.gov (United States)

    Kluchnikova, O.; Pobegaylov, O.

    2017-11-01

    The article focuses on the basic theory and practical aspects of the strategic management improving in terms of enhancing the quality of a technological process: these aspects have been proven experimentally by their introduction in company operations. The authors have worked out some proposals aimed at the selection of an optimal supplier for building companies as well as the algorithm for the analysis and optimization of a construction company basing on scientific and practical research as well as on the experimental data obtained in the experiment.

  9. THE ROLE OF QUALITY METHODS IN IMPROVING EDUCATION PROCESS: CASE STUDY

    Directory of Open Access Journals (Sweden)

    Dragan Pavlović

    2014-10-01

    Full Text Available This paper presents a methodology for applying the Lean Six Sigma method on the educational process. After defining defects that have negative influence on the final quality evaluation of higher education and how these defects can be remedied, the Pareto analysis is done, and that is used for establishing a vital minority of the exams that are critical for examination of faculty. The next step is the Statistical Process Control (SPC analysis that is performed on the exams that are classified as vital minority in Pareto analysis. Ishikawa diagram shows a relation between considered consequence (small number of passed exams and all factors that influence this consequence. Based on the results of implementation of the Lean Six Sigma method in the educational process and implementation of all suggested improvements, the comparative overview of Pareto analysis is given for 2009/2010 and 2012/2013 academic year at the Faculty of Mechanical Engineering, University of Niš.

  10. Continuous quality improvement

    NARCIS (Netherlands)

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

    2002-01-01

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

  11. Combining metabolic and process engineering strategies to improve recombinant glycoprotein production and quality.

    Science.gov (United States)

    Karengera, Eric; Durocher, Yves; De Crescenzo, Gregory; Henry, Olivier

    2017-11-01

    Increasing recombinant protein production while ensuring a high and consistent protein quality remains a challenge in mammalian cell culture process development. In this work, we combined a nutrient substitution approach with a metabolic engineering strategy that improves glucose utilization efficiency. This combination allowed us to tackle both lactate and ammonia accumulation and investigate on potential synergistic effects on protein production and quality. To this end, HEK293 cells overexpressing the pyruvate yeast carboxylase (PYC2) and their parental cells, both stably producing the therapeutic glycoprotein interferon α2b (IFNα2b), were cultured in media deprived of glutamine but containing chosen substitutes. Among the tested substitutes, pyruvate led to the best improvement in growth (integral of viable cell density) for both cell lines in batch cultures, whereas the culture of PYC2 cells without neither glutamine nor any substitute displayed surprisingly enhanced IFNα2b production. The drastic reduction in both lactate and ammonia in the cultures translated into extended high viability conditions and an increase in recombinant protein titer by up to 47% for the parental cells and the PYC2 cells. Product characterization performed by surface plasmon resonance biosensing using Sambucus nigra (SNA) lectin revealed that the increase in yield was however accompanied by a reduction in the degree of sialylation of the product. Supplementing cultures with glycosylation precursors and a cofactor were effective at counterbalancing the lack of glutamine and allowed improvement in IFNα2b quality as evaluated by lectin affinity. Our study provides a strategy to reconcile protein productivity and quality and highlights the advantages of PYC2-overexpressing cells in glutamine-free conditions.

  12. No improvement without learning: prerequisites for learning the relations between process and product quality in practice

    NARCIS (Netherlands)

    Solingen, van D.M.; Berghout, E.W.; Kusters, R.J.; Trienekens, J.J.M.; Bomarius, F.; Oivo, M.

    2000-01-01

    Generic relationships between process and product quality are rarely available, because such relationships are highly depending on context factors; the impact of a certain process on product quality is often largely influenced by the characteristics of the specific organisation, processes, business

  13. Integrated Assessment and Improvement of the Quality Assurance System for the Cosworth Casting Process

    Science.gov (United States)

    Yousif, Dilon

    The purpose of this study was to improve the Quality Assurance (QA) System at the Nemak Windsor Aluminum Plant (WAP). The project used Six Sigma method based on Define, Measure, Analyze, Improve, and Control (DMAIC). Analysis of in process melt at WAP was based on chemical, thermal, and mechanical testing. The control limits for the W319 Al Alloy were statistically recalculated using the composition measured under stable conditions. The "Chemistry Viewer" software was developed for statistical analysis of alloy composition. This software features the Silicon Equivalency (SiBQ) developed by the IRC. The Melt Sampling Device (MSD) was designed and evaluated at WAP to overcome traditional sampling limitations. The Thermal Analysis "Filters" software was developed for cooling curve analysis of the 3XX Al Alloy(s) using IRC techniques. The impact of low melting point impurities on the start of melting was evaluated using the Universal Metallurgical Simulator and Analyzer (UMSA).

  14. Software Design Improvements. Part 2; Software Quality and the Design and Inspection Process

    Science.gov (United States)

    Lalli, Vincent R.; Packard, Michael H.; Ziemianski, Tom

    1997-01-01

    The application of assurance engineering techniques improves the duration of failure-free performance of software. The totality of features and characteristics of a software product are what determine its ability to satisfy customer needs. Software in safety-critical systems is very important to NASA. We follow the System Safety Working Groups definition for system safety software as: 'The optimization of system safety in the design, development, use and maintenance of software and its integration with safety-critical systems in an operational environment. 'If it is not safe, say so' has become our motto. This paper goes over methods that have been used by NASA to make software design improvements by focusing on software quality and the design and inspection process.

  15. Industrial yogurt manufacture: monitoring of fermentation process and improvement of final product quality.

    Science.gov (United States)

    Soukoulis, C; Panagiotidis, P; Koureli, R; Tzia, C

    2007-06-01

    Lactic acid fermentation during the production of skim milk and whole fat set-style yogurt was continuously monitored by measuring pH. The modified Gompertz model was successfully applied to describe the pH decline and viscosity development during the fermentation process. The viscosity and incubation time data were also fitted to linear models against ln(pH). The investigation of the yogurt quality improvement practices included 2 different heat treatments (80 degrees C for 30 min and 95 degrees C for 10 min), 3 milk protein fortifying agents (skim milk powder, whey powder, and milk protein concentrate) added at 2.0%, and 4 hydrocolloids (kappa-carrageenan, xanthan, guar gum, and pectin) added at 0.01% to whole fat and skim yogurts. Heat treatment significantly affected viscosity and acetaldehyde development without influencing incubation time and acidity. The addition of whey powder shortened the incubation time but had a detrimental effect on consistency, firmness, and overall acceptance of yogurts. On the other hand, addition of skim milk powder improved the textural quality and decreased the vulnerability of yogurts to syneresis. Anionic stabilizers (kappa-carrageenan and pectin) had a poor effect on the texture and palatability of yogurts. However, neutral gums (xanthan and guar gum) improved texture and prevented the wheying-off defect. Skim milk yogurts exhibited longer incubation times and higher viscosities, whereas they were rated higher during sensory evaluation than whole fat yogurts.

  16. Improving the Quality of Services in Residential Treatment Facilities: A Strength-Based Consultative Review Process

    Science.gov (United States)

    Pavkov, Thomas W.; Lourie, Ira S.; Hug, Richard W.; Negash, Sesen

    2010-01-01

    This descriptive case study reports on the positive impact of a consultative review methodology used to conduct quality assurance reviews as part of the Residential Treatment Center Evaluation Project. The study details improvement in the quality of services provided to youth in unmonitored residential treatment facilities. Improvements were…

  17. Application of risk analysis and quality control methods for improvement of lead molding process

    Directory of Open Access Journals (Sweden)

    H. Gołaś

    2016-10-01

    Full Text Available The aim of the paper is to highlight the significance of implication of risk analysis and quality control methods for the improvement of parameters of lead molding process. For this reason, Fault Mode and Effect Analysis (FMEA was developed in the conceptual stage of a new product TC-G100-NR. However, the final product was faulty (a complete lack of adhesion of brass insert to leak regardless of the previously defined potential problem and its preventive action. It contributed to the recognition of root causes, corrective actions and change of production parameters. It showed how these methods, level of their organization, systematic and rigorous study affect molding process parameters.

  18. Initiating statistical process control to improve quality outcomes in colorectal surgery.

    Science.gov (United States)

    Keller, Deborah S; Stulberg, Jonah J; Lawrence, Justin K; Samia, Hoda; Delaney, Conor P

    2015-12-01

    Unexpected variations in postoperative length of stay (LOS) negatively impact resources and patient outcomes. Statistical process control (SPC) measures performance, evaluates productivity, and modifies processes for optimal performance. The goal of this study was to initiate SPC to identify LOS outliers and evaluate its feasibility to improve outcomes in colorectal surgery. Review of a prospective database identified colorectal procedures performed by a single surgeon. Patients were grouped into elective and emergent categories and then stratified by laparoscopic and open approaches. All followed a standardized enhanced recovery protocol. SPC was applied to identify outliers and evaluate causes within each group. A total of 1294 cases were analyzed--83% elective (n = 1074) and 17% emergent (n = 220). Emergent cases were 70.5% open and 29.5% laparoscopic; elective cases were 36.8% open and 63.2% laparoscopic. All groups had a wide range in LOS. LOS outliers ranged from 8.6% (elective laparoscopic) to 10.8% (emergent laparoscopic). Evaluation of outliers demonstrated patient characteristics of higher ASA scores, longer operating times, ICU requirement, and temporary nursing at discharge. Outliers had higher postoperative complication rates in elective open (57.1 vs. 20.0%) and elective lap groups (77.6 vs. 26.1%). Outliers also had higher readmission rates for emergent open (11.4 vs. 5.4%), emergent lap (14.3 vs. 9.2%), and elective lap (32.8 vs. 6.9%). Elective open outliers did not follow trends of longer LOS or higher reoperation rates. SPC is feasible and promising for improving colorectal surgery outcomes. SPC identified patient and process characteristics associated with increased LOS. SPC may allow real-time outlier identification, during quality improvement efforts, and reevaluation of outcomes after introducing process change. SPC has clinical implications for improving patient outcomes and resource utilization.

  19. Process mapping evaluation of medication reconciliation in academic teaching hospitals: a critical step in quality improvement.

    Science.gov (United States)

    Holbrook, Anne; Bowen, James M; Patel, Harsit; O'Brien, Chris; You, John J; Tahavori, Roshan; Doleweerd, Jeff; Berezny, Tim; Perri, Dan; Nieuwstraten, Carmine; Troyan, Sue; Patel, Ameen

    2016-12-30

    Medication reconciliation (MedRec) has been a mandated or recommended activity in Canada, the USA and the UK for nearly 10 years. Accreditation bodies in North America will soon require MedRec for every admission, transfer and discharge of every patient. Studies of MedRec have revealed unintentional discrepancies in prescriptions but no clear evidence that clinically important outcomes are improved, leading to widely variable practices. Our objective was to apply process mapping methodology to MedRec to clarify current processes and resource usage, identify potential efficiencies and gaps in care, and make recommendations for improvement in the light of current literature evidence of effectiveness. Process engineers observed and recorded all MedRec activities at 3 academic teaching hospitals, from initial emergency department triage to patient discharge, for general internal medicine patients. Process maps were validated with frontline staff, then with the study team, managers and patient safety leads to summarise current problems and discuss solutions. Across all of the 3 hospitals, 5 general problem themes were identified: lack of use of all available medication sources, duplication of effort creating inefficiency, lack of timeliness of completion of the Best Possible Medication History, lack of standardisation of the MedRec process, and suboptimal communication of MedRec issues between physicians, pharmacists and nurses. MedRec as practised in this environment requires improvements in quality, timeliness, consistency and dissemination. Further research exploring efficient use of resources, in terms of personnel and costs, is required. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  20. Wound Care Center of Excellence: A Process for Continuous Monitoring and Improvement of Wound Care Quality.

    Science.gov (United States)

    Howell, Raelina S; Kohan, Lauren S; Woods, Jon S; Criscitelli, Theresa; Gillette, Brian M; Donovan, Virginia; Gorenstein, Scott

    2018-05-01

    To provide information about a study using a new process for continuous monitoring to improve chronic wound care quality.This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.After completing this continuing education activity, you should be better able to:1. Recognize problems associated with chronic wound care.2. Identify methods used in this project to improve care.3. Illustrate the findings from this and similar projects and implications for providing improved wound care.Patients with chronic wounds require complex care because of comorbidities that can affect healing. Therefore, the goal of this project was to develop a system of reviewing all hospitalized patients seen by the study authors' wound care service on a weekly basis to decrease readmissions, morbidity, and mortality. Weekly multidisciplinary conferences were conducted to evaluate patient data and systematically assess for adherence to wound care protocols, as well as to create and modify patient care plans. This review of pathology and the performance of root-cause analyses often led to improved patient care.

  1. Improving the quality of the order-writing process for inpatient orders and outpatient prescriptions.

    Science.gov (United States)

    Meyer, T A

    2000-12-15

    Because many preventable medication errors occur at the ordering stage, a program for improving the quality of writing inpatient orders and outpatient prescriptions at one institution was developed. To determine whether potential problems existed in the order-writing process for inpatients, all physician orders for a seven-day period in 1997 were reviewed (n = 3740). More than 10% of all orders had illegible handwriting or were written with a felt-tip pen, which makes NCR copies difficult to read. Other potential errors were also identified. Following educational programs for physicians and residents focusing on the importance of writing orders clearly, physician orders were reviewed for a 24-hour period (n = 654). The use of felt-tip pens decreased to 1.37% of all orders, and no orders had illegible handwriting. A similar quality improvement approach was used to evaluate the outpatient prescription-writing process. A review of all new prescriptions for a consecutive seven-day period at a local hospital-owned community pharmacy (n = 1425) revealed that about 15% of the prescriptions had illegible handwriting and roughly 10% were incomplete. Additional data were gathered through a survey sent to 71 outside provider pharmacies requesting information on problems related to prescriptions written by physicians from the institution; 66% responded. Failure to print prescriber name (96%), illegible signature (94%), failure to include DEA number (89%), and illegible handwriting other than signature (69%) were reported as the main problems. Each physician was given a self-inking name stamp to use when writing prescriptions. In addition, educational programs covering examples of poorly written prescriptions and the legal requirements of a prescription were held for physicians and residents. A follow-up survey showed that 72% of pharmacies saw stamps being used; when stamps were not used, however, illegible signatures continued to be a problem. Follow-up reviews of outpatient

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

    Science.gov (United States)

    Sukiniarti

    2016-01-01

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

  3. Total quality management in a 300-bed community hospital: the quality improvement process translated to health care.

    Science.gov (United States)

    Hughes, J M

    1992-09-01

    Winter Park Memorial Hospital (Winter Park, Florida) began implementation of a well-strategized plan for total quality management (TQM) in 1987. Having no guidelines for applying TQM to health care but using the industrial quality management techniques of Philip Crosby Associates, Inc, the hospital made the transition and saved thousands of dollars in the process. This article describes the transition, especially the integral part played by the Medical Staff Quality Council in changing the hospital's culture.

  4. Trinity of Quality Improvement : Studies on structure, process and outcome related to quality improvement in long-term care in the Netherlands between 2007 and 2011

    NARCIS (Netherlands)

    A.C.M. Winters-van der Meer (Sjenny)

    2014-01-01

    markdownabstract__Abstract__ This thesis discusses quality improvement in long-term care organisations in the Netherlands. It explores the influencing factors on quality improvement and aims at identifying opportunities for long-term care organisations to ‘improve their improvement’. This

  5. Measuring and improving the quality of postoperative epidural analgesia for major abdominal surgery using statistical process control charts.

    Science.gov (United States)

    Duncan, Fiona; Haigh, Carol

    2013-10-01

    To explore and improve the quality of continuous epidural analgesia for pain relief using Statistical Process Control tools. Measuring the quality of pain management interventions is complex. Intermittent audits do not accurately capture the results of quality improvement initiatives. The failure rate for one intervention, epidural analgesia, is approximately 30% in everyday practice, so it is an important area for improvement. Continuous measurement and analysis are required to understand the multiple factors involved in providing effective pain relief. Process control and quality improvement Routine prospectively acquired data collection started in 2006. Patients were asked about their pain and side effects of treatment. Statistical Process Control methods were applied for continuous data analysis. A multidisciplinary group worked together to identify reasons for variation in the data and instigated ideas for improvement. The key measure for improvement was a reduction in the percentage of patients with an epidural in severe pain. The baseline control charts illustrated the recorded variation in the rate of several processes and outcomes for 293 surgical patients. The mean visual analogue pain score (VNRS) was four. There was no special cause variation when data were stratified by surgeons, clinical area or patients who had experienced pain before surgery. Fifty-seven per cent of patients were hypotensive on the first day after surgery. We were able to demonstrate a significant improvement in the failure rate of epidurals as the project continued with quality improvement interventions. Statistical Process Control is a useful tool for measuring and improving the quality of pain management. The applications of Statistical Process Control methods offer the potential to learn more about the process of change and outcomes in an Acute Pain Service both locally and nationally. We have been able to develop measures for improvement and benchmarking in routine care that

  6. IMPROVING CONCEPTUAL DESIGN QUALITY

    DEFF Research Database (Denmark)

    Bush, Stuart; Robotham, Antony John

    1999-01-01

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

  7. 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.

  8. Improving the Quality of Hot Stamping Parts with Innovative Press Technology and Inline Process Control

    Science.gov (United States)

    Vollmer, R.; Palm, C.

    2017-09-01

    The increasing number of hot stamped parts in the automotive industry is challenging different process areas. This paper presents a method how to improve the production rates over the whole life cycle of a hot forming part. In the core element of a hot forming line, the hydraulic press, mainly two processing steps are performed. Forming and quenching of the sheet metal part. In addition to the forming operation, it is inevitable to optimize the quenching condition in the bottom dead centre in order to reach a fully martensitic structure and tight geometrical tolerances of the part. Deviations in the blank thickness, tool wear, polishing of classical tools impair the quenching condition and therefore the part quality over the time. A new press and tool design has been developed to counter this effect by providing homogenous contact pressure over the whole die. Especially with a multi cavity tool, the new method is advantageous. Test series have shown that the new tool and press concept can produce parts with a blank thickness of 1.0 mm within 8.0 s cycle time. The so called PCH flex principle makes it possible to produce such high output rates under reliable conditions.

  9. Improving productivity and quality of biodiesel from Chlorella vulgaris SDEC-3M through customized process designs

    International Nuclear Information System (INIS)

    Qi, Feng; Pei, Haiyan; Ma, Guixia; Zhang, Shuo; Mu, Ruimin

    2016-01-01

    Highlights: • Responses of growth and lipid in SDEC-3M to N concentrations were described. • The high lipid accumulation and biomass production were coexisted in buffer period. • Shorting N-deficient culture stage could improve lipid productivity. • A scheme of optimal designs was suggested to improve lipid productivity. • Biodiesels were meet standards and their performances varied with N-deficient time. - Abstract: In this study, temporal variations of microalgae growth and lipid accumulation in response to different nitrogen concentrations in media were investigated and discussed in detail, using a mutant Chlorella vulgaris SDEC-3M as a model. The results show that a short-term of dramatic lipid accumulation and nonsignificant descent of biomass productivities can be concomitant in SDEC-3M during early N-deficient stage (buffer period). It was found that the maximum lipid productivities of 63.52 mg L"−"1 d"−"1 occurred after 24 h N-shift. It means that, obtained lipid productivity under two-stage strategy with 24 h N-deficient stage was approximately three times as high as the maximum one obtained under N-rich condition and the final one obtained during longer N-deficient culture. Batch culture mode, higher light intensity and light/dark cycle in cooperation with N-rich/N-deficient cycle were also suggested as feasible scheme to improve lipid productivity in large scale culture. Additionally, the fatty acid profiles analysis indirectly showed that the properties of biodiesel from SDEC-3M majorly satisfied biodiesel standards. The fuel performances varied with N-deficient culture time, meaning that better combustion performance, oxidation stability, and exhaust emissions level related to longer N-deficient stage, while the biodiesel produced form N-deficient would perform well under low temperature. The results mean that SDEC-3M-derived biodiesels with customized process designs have commercial potential in the aspects of productivity and quality.

  10. [Feedforward control strategy and its application in quality improvement of ethanol precipitation process of danhong injection].

    Science.gov (United States)

    Yan, Bin-Jun; Guo, Zheng-Tai; Qu, Hai-Bin; Zhao, Bu-Chang; Zhao, Tao

    2013-06-01

    In this work, a feedforward control strategy basing on the concept of quality by design was established for the manufacturing process of traditional Chinese medicine to reduce the impact of the quality variation of raw materials on drug. In the research, the ethanol precipitation process of Danhong injection was taken as an application case of the method established. Box-Behnken design of experiments was conducted. Mathematical models relating the attributes of the concentrate, the process parameters and the quality of the supernatants produced were established. Then an optimization model for calculating the best process parameters basing on the attributes of the concentrate was built. The quality of the supernatants produced by ethanol precipitation with optimized and non-optimized process parameters were compared. The results showed that using the feedforward control strategy for process parameters optimization can control the quality of the supernatants effectively. The feedforward control strategy proposed can enhance the batch-to-batch consistency of the supernatants produced by ethanol precipitation.

  11. What drives quality improvement in chronic kidney disease (CKD) in primary care: process evaluation of the Quality Improvement in Chronic Kidney Disease (QICKD) trial.

    Science.gov (United States)

    Nihat, Akin; de Lusignan, Simon; Thomas, Nicola; Tahir, Mohammad Aumran; Gallagher, Hugh

    2016-04-06

    This study is a process evaluation of the Quality Improvement in Chronic Kidney Disease (QICKD) study, comparing audit-based education (ABE) and sending clinical guidelines and prompts (G&P) with usual practice, in improving systolic blood pressure control in primary care. This evaluation aimed to explore how far clinical staff in participating practices were aware of the intervention, and why change in practice might have taken place. 4 primary care practices in England: 2 received ABE, and 2 G&P. We purposively selected 1 northern/southern/city and rural practice from each study arm (from a larger pool of 132 practices as part of the QICKD trial). The 4 study practices were purposively sampled, and focus groups conducted with staff from each. All staff members were invited to attend. Focus groups in each of 4 practices, at the mid-study point and at the end. 4 additional trial practices not originally selected for in-depth process evaluation took part in end of trial focus groups, to a total of 12 focus groups. These were recorded, transcribed and analysed using the framework approach. 5 themes emerged: (1) involvement in the study made participants more positive about the CKD register; (2) clinicians did not always explain to patients that they had CKD; (3) while practitioners improved their monitoring of CKD, many were sceptical that it improved care and were more motivated by pay-for-performance measures; (4) the impact of study interventions on practice was generally positive, particularly the interaction with specialists, included in ABE; (5) the study stimulated ideas for future clinical practice. Improving quality in CKD is complex. Lack of awareness of clinical guidelines and scepticism about their validity are barriers to change. While pay-for-performance incentives are the main driver for change, quality improvement interventions can have a complementary influence. Published by the BMJ Publishing Group Limited. For permission to use (where not already

  12. Launching a Laboratory Testing Process Quality Improvement Toolkit: From the Shared Networks of Colorado Ambulatory Practices and Partners (SNOCAP).

    Science.gov (United States)

    Fernald, Douglas; Hamer, Mika; James, Kathy; Tutt, Brandon; West, David

    2015-01-01

    Family medicine and internal medicine physicians order diagnostic laboratory tests for nearly one-third of patient encounters in an average week, yet among medical errors in primary care, an estimated 15% to 54% are attributed to laboratory testing processes. From a practice improvement perspective, we (1) describe the need for laboratory testing process quality improvements from the perspective of primary care practices, and (2) describe the approaches and resources needed to implement laboratory testing process quality improvements in practice. We applied practice observations, process mapping, and interviews with primary care practices in the Shared Networks of Colorado Ambulatory Practices and Partners (SNOCAP)-affiliated practice-based research networks that field-tested in 2013 a laboratory testing process improvement toolkit. From the data collected in each of the 22 participating practices, common testing quality issues included, but were not limited to, 3 main testing process steps: laboratory test preparation, test tracking, and patient notification. Three overarching qualitative themes emerged: practices readily acknowledge multiple laboratory testing process problems; practices know that they need help addressing the issues; and practices face challenges with finding patient-centered solutions compatible with practice priorities and available resources. While practices were able to get started with guidance and a toolkit to improve laboratory testing processes, most did not seem able to achieve their quality improvement aims unassisted. Providing specific guidance tools with practice facilitation or other rapid-cycle quality improvement support may be an effective approach to improve common laboratory testing issues in primary care. © Copyright 2015 by the American Board of Family Medicine.

  13. Trauma Quality Improvement: Reducing Triage Errors by Automating the Level Assignment Process.

    Science.gov (United States)

    Stonko, David P; O Neill, Dillon C; Dennis, Bradley M; Smith, Melissa; Gray, Jeffrey; Guillamondegui, Oscar D

    2018-04-12

    Trauma patients are triaged by the severity of their injury or need for intervention while en route to the trauma center according to trauma activation protocols that are institution specific. Significant research has been aimed at improving these protocols in order to optimize patient outcomes while striving for efficiency in care. However, it is known that patients are often undertriaged or overtriaged because protocol adherence remains imperfect. The goal of this quality improvement (QI) project was to improve this adherence, and thereby reduce the triage error. It was conducted as part of the formal undergraduate medical education curriculum at this institution. A QI team was assembled and baseline data were collected, then 2 Plan-Do-Study-Act (PDSA) cycles were implemented sequentially. During the first cycle, a novel web tool was developed and implemented in order to automate the level assignment process (it takes EMS-provided data and automatically determines the level); the tool was based on the existing trauma activation protocol. The second PDSA cycle focused on improving triage accuracy in isolated, less than 10% total body surface area burns, which we identified to be a point of common error. Traumas were reviewed and tabulated at the end of each PDSA cycle, and triage accuracy was followed with a run chart. This study was performed at Vanderbilt University Medical Center and Medical School, which has a large level 1 trauma center covering over 75,000 square miles, and which sees urban, suburban, and rural trauma. The baseline assessment period and each PDSA cycle lasted 2 weeks. During this time, all activated, adult, direct traumas were reviewed. There were 180 patients during the baseline period, 189 after the first test of change, and 150 after the second test of change. All were included in analysis. Of 180 patients, 30 were inappropriately triaged during baseline analysis (3 undertriaged and 27 overtriaged) versus 16 of 189 (3 undertriaged and 13

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

    Science.gov (United States)

    Vogelsang, J

    1999-04-01

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

  15. Improving Safety, Quality and Efficiency through the Management of Emerging Processes: The TenarisDalmine Experience

    Science.gov (United States)

    Bonometti, Patrizia

    2012-01-01

    Purpose: The aim of this contribution is to describe a new complexity-science-based approach for improving safety, quality and efficiency and the way it was implemented by TenarisDalmine. Design/methodology/approach: This methodology is called "a safety-building community". It consists of a safety-behaviour social self-construction…

  16. Psychological Support as a Factor of the Training Process Quality Improvement

    Directory of Open Access Journals (Sweden)

    Jan Kosendiak

    2017-06-01

    Full Text Available Supportive activities may be one of the ways of the training process optimization. Support involves both components of the training process, i.e. training and rest. The training support is aimed at the training load increase or at such orientation of the adaptation processes to meet the training goals as closely as possible. The different aims lay behind the methods that support the rest mechanisms. It is about increasing the peace of the regeneration and recovery processes. This term describes all activities aimed at restoring the full exercise capacity of the athlete after work. The psychological support of the training process can be one of the ways to minimize training disturbances and it should therefore be an essential part of the training process management in case of the top ranked athletes. To improve the psychological support system of the training process and to improve the system quality, it is necessary to analyze the current situation. That’s why, authors of the paper decided to ask the members of the Polish Olympic team competed at the 2016 Olympic Games in Rio de Janeiro on types of relaxation techniques they accepted and used before the competition. The relaxation techniques were deliberately limited to the pre-start relaxation techniques as the study was treated as a pilot study dedicated to the problem identification. Therefore, the authors of the paper formulated its aim, as the identification of the pre-start relaxation preferences of the Olympic team members. The following research questions were formulated to meet the aim of the study:  •     What types of the pre-start relaxation techniques are declared and accepted by the Olympians? •     Could the preferred pre-start relaxation techniques be considered rational, planned, and consciously implemented? A written interview with an online questionnaire was used as a research method. The study was conducted before the 2016 Olympic Games in Rio de

  17. Workers' Objectives in Quality Improvement.

    Science.gov (United States)

    Brossard, Michel

    1990-01-01

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

  18. Quality initiatives: planning, setting up, and carrying out radiology process improvement projects.

    Science.gov (United States)

    Tamm, Eric P; Szklaruk, Janio; Puthooran, Leejo; Stone, Danna; Stevens, Brian L; Modaro, Cathy

    2012-01-01

    In the coming decades, those who provide radiologic imaging services will be increasingly challenged by the economic, demographic, and political forces affecting healthcare to improve their efficiency, enhance the value of their services, and achieve greater customer satisfaction. It is essential that radiologists master and consistently apply basic process improvement skills that have allowed professionals in many other fields to thrive in a competitive environment. The authors provide a step-by-step overview of process improvement from the perspective of a radiologic imaging practice by describing their experience in conducting a process improvement project: to increase the daily volume of body magnetic resonance imaging examinations performed at their institution. The first step in any process improvement project is to identify and prioritize opportunities for improvement in the work process. Next, an effective project team must be formed that includes representatives of all participants in the process. An achievable aim must be formulated, appropriate measures selected, and baseline data collected to determine the effects of subsequent efforts to achieve the aim. Each aspect of the process in question is then analyzed by using appropriate tools (eg, flowcharts, fishbone diagrams, Pareto diagrams) to identify opportunities for beneficial change. Plans for change are then established and implemented with regular measurements and review followed by necessary adjustments in course. These so-called PDSA (planning, doing, studying, and acting) cycles are repeated until the aim is achieved or modified and the project closed.

  19. Using IT to improve quality at NewYork-Presybterian Hospital: a requirements-driven strategic planning process.

    Science.gov (United States)

    Kuperman, Gilad J; Boyer, Aurelia; Cole, Curt; Forman, Bruce; Stetson, Peter D; Cooper, Mary

    2006-01-01

    At NewYork-Presbyterian Hospital, we are committed to the delivery of high quality care. We have implemented a strategic planning process to determine the information technology initiatives that will best help us improve quality. The process began with the creation of a Clinical Quality and IT Committee. The Committee identified 2 high priority goals that would enable demonstrably high quality care: 1) excellence at data warehousing, and 2) optimal use of automated clinical documentation to capture encounter-related quality and safety data. For each high priority goal, a working group was created to develop specific recommendations. The Data Warehousing subgroup has recommended the implementation of an architecture management process and an improved ability for users to get access to aggregate data. The Structured Documentation subgroup is establishing recommendations for a documentation template creation process. The strategic planning process at times is slow, but assures that the organization is focusing on the information technology activities most likely to lead to improved quality.

  20. Accelerate Water Quality Improvement

    Science.gov (United States)

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

  1. Development and implementation of the Caribbean Laboratory Quality Management Systems Stepwise Improvement Process (LQMS-SIP) Towards Accreditation.

    Science.gov (United States)

    Alemnji, George; Edghill, Lisa; Guevara, Giselle; Wallace-Sankarsingh, Sacha; Albalak, Rachel; Cognat, Sebastien; Nkengasong, John; Gabastou, Jean-Marc

    2017-01-01

    Implementing quality management systems and accrediting laboratories in the Caribbean has been a challenge. We report the development of a stepwise process for quality systems improvement in the Caribbean Region. The Caribbean Laboratory Stakeholders met under a joint Pan American Health Organization/US Centers for Disease Control and Prevention initiative and developed a user-friendly framework called 'Laboratory Quality Management System - Stepwise Improvement Process (LQMS-SIP) Towards Accreditation' to support countries in strengthening laboratory services through a stepwise approach toward fulfilling the ISO 15189: 2012 requirements. This approach consists of a three-tiered framework. Tier 1 represents the minimum requirements corresponding to the mandatory criteria for obtaining a licence from the Ministry of Health of the participating country. The next two tiers are quality improvement milestones that are achieved through the implementation of specific quality management system requirements. Laboratories that meet the requirements of the three tiers will be encouraged to apply for accreditation. The Caribbean Regional Organisation for Standards and Quality hosts the LQMS-SIP Secretariat and will work with countries, including the Ministry of Health and stakeholders, including laboratory staff, to coordinate and implement LQMS-SIP activities. The Caribbean Public Health Agency will coordinate and advocate for the LQMS-SIP implementation. This article presents the Caribbean LQMS-SIP framework and describes how it will be implemented among various countries in the region to achieve quality improvement.

  2. Improving quality in Medicaid: the use of care management processes for chronic illness and preventive care.

    Science.gov (United States)

    Rittenhouse, Diane R; Robinson, James C

    2006-01-01

    Care management processes (CMPs), tools to improve the efficiency and quality of primary care delivery, are particularly important for low-income patients facing substantial barriers to care. To measure the adoption of CMPs by medical groups, Independent Practice Associations, community clinics, and hospital-based clinics in California's Medicaid program and the factors associated with CMP adoption. Telephone survey of every provider organization with at least 6 primary care physicians and at least 1 Medi-Cal HMO contract, Spring 2003. One hundred twenty-three organizations participated, accounting for 64% of provider organizations serving Medicaid managed care in California. We surveyed 30 measures of CMP use for asthma and diabetes, and for child and adolescent preventive services. The mean number of CMPs used by each organization was 4.5 for asthma and 4.9 for diabetes (of a possible 8). The mean number of CMPs for preventive services was 4.0 for children and 3.5 for adolescents (of a possible 7). Organizations with more extensive involvement in Medi-Cal managed care used more CMPs for chronic illness and preventive service. Community clinics and hospital-based clinics used more CMPs for asthma and diabetes than did Independent Practice Associations (IPAs), and profitable organizations used more CMPs for child and adolescent preventive services than did entities facing severe financial constraints. The use of CMPs by Medicaid HMOs and the presence of external (financial and nonfinancial) incentives for clinical performance were strongly associated with use of care management by provider organizations. Physician and provider organizations heavily involved in California's Medicaid program are extensively engaged in preventive and chronic care management programs.

  3. Improving the Quality of the Deteriorated Regions of Multicrystalline Silicon Ingots during General Solar Cell Processes

    International Nuclear Information System (INIS)

    Wu Shan-Shan; Wang Lei; Yang De-Ren

    2011-01-01

    The behavior of wafers and solar cells from the border of a multicrystalline silicon (mc-Si) ingot, which contain deteriorated regions, is investigated. It is found that the diffusion length distribution of minority carriers in the cells is uniform, and high efficiency of the solar cells (about 16%) is achieved. It is considered that the quality of the deteriorated regions could be improved to be similar to that of adjacent regions. Moreover, it is indicated that during general solar cell fabrication, phosphorus gettering and hydrogen passivation could significantly improve the quality of deteriorated regions, while aluminum gettering by RTP could not. Therefore, it is suggested that the border of a mc-Si ingot could be used to fabricate high efficiency solar cells, which will increase mc-Si utilization effectively. (condensed matter: structure, mechanical and thermal properties)

  4. Bacon Production: Evaluating Potential Processing and Management Practices to Improve Product Quality of Industrial Sliced Bacon

    Science.gov (United States)

    Scramlin, Stacy Maurine

    2009-01-01

    The objective of this research was to determine areas of improvement to bacon production. The first trial was conducted to determine differences in belly and bacon quality traits in pigs fed ractopamine (RAC) for various durations during finishing. A 2x3x2 factorial arrangement was used with barrows and gilts, fed RAC levels of 0.0, 5.0, or 7.4…

  5. Automation in Siemens fuel manufacturing - the basis for quality improvement by statistical process control (SPC)

    International Nuclear Information System (INIS)

    Drecker, St.; Hoff, A.; Dietrich, M.; Guldner, R.

    1999-01-01

    Statistical Process Control (SPC) is one of the systematic tools to perform a valuable contribution to the control and planning activities for manufacturing processes and product quality. Advanced Nuclear Fuels GmbH (ANF) started a program to introduce SPC in all sections of the manufacturing process of fuel assemblies. The concept phase is based on a realization of SPC in 3 pilot projects. The existing manufacturing devices are reviewed for the utilization of SPC. Subsequent modifications were made to provide the necessary interfaces. The processes 'powder/pellet manufacturing'. 'cladding tube manufacturing' and 'laser-welding of spacers' are located at the different locations of ANF. Due to the completion of the first steps and the experience obtained by the pilot projects, the introduction program for SPC has already been extended to other manufacturing processes. (authors)

  6. Effects of a proposed quality improvement process in the proportion of the reported ultrasound findings unsupported by stored images.

    Science.gov (United States)

    Schenone, Mauro; Ziebarth, Sarah; Duncan, Jose; Stokes, Lea; Hernandez, Angela

    2018-02-05

    To investigate the proportion of documented ultrasound findings that were unsupported by stored ultrasound images in the obstetric ultrasound unit, before and after the implementation of a quality improvement process consisting of a checklist and feedback. A quality improvement process was created involving utilization of a checklist and feedback from physician to sonographer. The feedback was based on findings of the physician's review of the report and images using a check list. To assess the impact of this process, two groups were compared. Group 1 consisted of 58 ultrasound reports created prior to initiation of the process. Group 2 included 65 ultrasound reports created after process implementation. Each chart was reviewed by a physician and a sonographer. Findings considered unsupported by stored images by both reviewers were used for analysis, and the proportion of unsupported findings was compared between the two groups. Results are expressed as mean ± standard error. A p value of improvement process implementation. Thus, we present a simple yet effective quality improvement process to reduce unsupported ultrasound findings.

  7. Inpatient preanalytic process improvements.

    Science.gov (United States)

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

    2013-12-01

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

  8. Application of quality function deployment (QFD and analytic hierarchy process (AHP techniques to improve the quality of postgraduate training

    Directory of Open Access Journals (Sweden)

    Antonio Pastor Sanmillán

    2016-05-01

    Full Text Available The importance of ensuring quality in higher education is evident in the number of local, national and transnational organizations dedicated to this end. The impressive volume of works published on quality in education is further testimony to its importance. All university, traditional or on-line, has a department dedicated to the study of quality, and the academic literature in this area is extremely broad in scope. Yet in this abundant wealth of studies, methodologies, techniques, fantasies and realities in which professors and university administrators, teachers, psychologists, marketing experts and quality professionals focus their attention, there is in our opinion something basic and elemental which is frequently forgotten: to ask the student, the end user (who should be the fundamental object of our interest what aspects of postgraduate study he truly values. The goal of the present study will be to verify the usefulness of multi-criteria analysis, and of the analytic hierarchy process (AHP in particular, attached to quality function deployment (QFD, for performing this task in multicultural environments. The population chosen for our study is comprised of the students enrolled in on-site postgraduate programs at the CEF School of Business.

  9. 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.

  10. Severe postpartum haemorrhage after vaginal delivery: a statistical process control chart to report seven years of continuous quality improvement.

    Science.gov (United States)

    Dupont, Corinne; Occelli, Pauline; Deneux-Tharaux, Catherine; Touzet, Sandrine; Duclos, Antoine; Bouvier-Colle, Marie-Hélène; Rudigoz, René-Charles; Huissoud, Cyril

    2014-07-01

    Severe postpartum haemorrhage after vaginal delivery: a statistical process control chart to report seven years of continuous quality improvement To use statistical process control charts to describe trends in the prevalence of severe postpartum haemorrhage after vaginal delivery. This assessment was performed 7 years after we initiated a continuous quality improvement programme that began with regular criteria-based audits Observational descriptive study, in a French maternity unit in the Rhône-Alpes region. Quarterly clinical audit meetings to analyse all cases of severe postpartum haemorrhage after vaginal delivery and provide feedback on quality of care with statistical process control tools. The primary outcomes were the prevalence of severe PPH after vaginal delivery and its quarterly monitoring with a control chart. The secondary outcomes included the global quality of care for women with severe postpartum haemorrhage, including the performance rate of each recommended procedure. Differences in these variables between 2005 and 2012 were tested. From 2005 to 2012, the prevalence of severe postpartum haemorrhage declined significantly, from 1.2% to 0.6% of vaginal deliveries (pcontrol limits, that is, been out of statistical control. The proportion of cases that were managed consistently with the guidelines increased for all of their main components. Implementation of continuous quality improvement efforts began seven years ago and used, among other tools, statistical process control charts. During this period, the prevalence of severe postpartum haemorrhage after vaginal delivery has been reduced by 50%. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  11. Prevention and management of "do not return" notices: a quality improvement process for supplemental staffing nursing agencies.

    Science.gov (United States)

    Ade-Oshifogun, Jochebed Bosede; Dufelmeier, Thaddeus

    2012-01-01

    This article describes a quality improvement process for "do not return" (DNR) notices for healthcare supplemental staffing agencies and healthcare facilities that use them. It is imperative that supplemental staffing agencies partner with healthcare facilities in assuring the quality of supplemental staff. Although supplemental staffing agencies attempt to ensure quality staffing, supplemental staff are sometimes subjectively evaluated by healthcare facilities as "DNR." The objective of this article is to describe a quality improvement process to prevent and manage "DNR" within healthcare organizations. We developed a curriculum and accompanying evaluation tool by adapting Rampersad's problem-solving discipline approach: (a) definition of area(s) for improvement; (b) identification of all possible causes; (c) development of an action plan; (d) implementation of the action plan; (e) evaluation for program improvement; and (f) standardization of the process. Face and content validity of the evaluation tool was ascertained by input from a panel of experienced supplemental staff and nursing faculty. This curriculum and its evaluation tool will have practical implications for supplemental staffing agencies and healthcare facilities in reducing "DNR" rates and in meeting certification/accreditation requirements. Further work is needed to translate this process into future research. © 2012 Wiley Periodicals, Inc.

  12. Improvements in the malaxation process to enhance the aroma quality of extra virgin olive oils.

    Science.gov (United States)

    Reboredo-Rodríguez, P; González-Barreiro, C; Cancho-Grande, B; Simal-Gándara, J

    2014-09-01

    The influence of olive paste preparation conditions on the standard quality parameters, as well as volatile profiles of extra virgin olive oils (EVOOs) from Morisca and Manzanilla de Sevilla cultivars produced in an emerging olive growing area in north-western Spain and processed in an oil mill plant were investigated. For this purpose, two malaxation temperatures (20/30 °C), and two malaxation times (30/90 min) selected in accordance with the customs of the area producers were tested. The volatile profile of the oils underwent a substantial change in terms of odorant series when different malaxation parameters were applied. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. Improvement in Patient Transfer Process From the Operating Room to the PICU Using a Lean and Six Sigma-Based Quality Improvement Project.

    Science.gov (United States)

    Gleich, Stephen J; Nemergut, Michael E; Stans, Anthony A; Haile, Dawit T; Feigal, Scott A; Heinrich, Angela L; Bosley, Christopher L; Tripathi, Sandeep

    2016-08-01

    Ineffective and inefficient patient transfer processes can increase the chance of medical errors. Improvements in such processes are high-priority local institutional and national patient safety goals. At our institution, nonintubated postoperative pediatric patients are first admitted to the postanesthesia care unit before transfer to the PICU. This quality improvement project was designed to improve the patient transfer process from the operating room (OR) to the PICU. After direct observation of the baseline process, we introduced a structured, direct OR-PICU transfer process for orthopedic spinal fusion patients. We performed value stream mapping of the process to determine error-prone and inefficient areas. We evaluated primary outcome measures of handoff error reduction and the overall efficiency of patient transfer process time. Staff satisfaction was evaluated as a counterbalance measure. With the introduction of the new direct OR-PICU patient transfer process, the handoff communication error rate improved from 1.9 to 0.3 errors per patient handoff (P = .002). Inefficiency (patient wait time and non-value-creating activity) was reduced from 90 to 32 minutes. Handoff content was improved with fewer information omissions (P improved among nearly all PICU providers. By using quality improvement methodology to design and implement a new direct OR-PICU transfer process with a structured multidisciplinary verbal handoff, we achieved sustained improvements in patient safety and efficiency. Handoff communication was enhanced, with fewer errors and content omissions. The new process improved efficiency, with high staff satisfaction. Copyright © 2016 by the American Academy of Pediatrics.

  14. Improving Vintage Seismic Data Quality through Implementation of Advance Processing Techniques

    Science.gov (United States)

    Latiff, A. H. Abdul; Boon Hong, P. G.; Jamaludin, S. N. F.

    2017-10-01

    It is essential in petroleum exploration to have high resolution subsurface images, both vertically and horizontally, in uncovering new geological and geophysical aspects of our subsurface. The lack of success may have been from the poor imaging quality which led to inaccurate analysis and interpretation. In this work, we re-processed the existing seismic dataset with an emphasis on two objectives. Firstly, to produce a better 3D seismic data quality with full retention of relative amplitudes and significantly reduce seismic and structural uncertainty. Secondly, to facilitate further prospect delineation through enhanced data resolution, fault definitions and events continuity, particularly in syn-rift section and basement cover contacts and in turn, better understand the geology of the subsurface especially in regard to the distribution of the fluvial and channel sands. By adding recent, state-of-the-art broadband processing techniques such as source and receiver de-ghosting, high density velocity analysis and shallow water de-multiple, the final results produced a better overall reflection detail and frequency in specific target zones, particularly in the deeper section.

  15. Par-baked Bread Technology: Formulation and Process Studies to Improve Quality.

    Science.gov (United States)

    Almeida, Eveline Lopes; Steel, Caroline Joy; Chang, Yoon Kil

    2016-01-01

    Extending the shelf-life of bakery products has been an important requirement resulting from the mechanization of this industry and the need to increase the distance for the distribution of final products, caused by the increase in production and consumer demand. Technologies based on the interruption of the breadmaking process represent an alternative to overcome product staling and microbiological deterioration. The production of par-baked breads is one of these technologies. It consists of baking the bread in two stages, and due to the possibility of retarding the second stage, it can be said that the bread can always be offered fresh to the consumer. The technology inserts logistics as part of the production process and creates the "hot point" concept, these being the locations where the bread is finalized, such as in the consumers' homes or sales locations. In this work, a review of the papers published on this subject was carried out, and aspects related to both the formulation and the process were considered. This technology still faces a few challenges, such as solving bread quality problems that appear due to process modifications, and these will also be considered. The market for these breads has grown rapidly and the bakery industry searches innovations related to par-baked bread technology.

  16. Quality improvement of fingerprints of decayed corpses by local thanatopractical processing (Thanatoprint

    Directory of Open Access Journals (Sweden)

    Gahr, Britta

    2013-11-01

    Full Text Available Thanatopractical processing allows morphological reconstruction of even advanced decayed bodies. By extracting fluids from the body’s tissue antemortem tenseness and volume can be restored. If bodies are partly subject to thanatopractical processing in the hand region (“Thanatoprint”, fingerprints of high quality can be gathered even in cases of advanced decay. Without this treatment fingerprinting can be extremely difficult, if not impossible. Thanatopractical processing could be applied successfully in cases of partial to subtotal detachment of the epidermis as well. In an interdisciplinary study 400 fingerprints of bodies in various states of decay were examined after application of Thanatoprint. In 76.75% fingerprints were applicable for data entry into AFIS (Automated Fingerprint Identification System; another 11.00% of the fingerprints could be used for the process of non-elimination. Further advantages of the method are low invasivity while maintaining the integrity of the corpse, less time- and material requirement as well as its long-lasting effect.

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

    Science.gov (United States)

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

    2017-08-01

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

  18. Shelf-life extension and quality improvement of minimally processed pear by combination treatments with irradiation

    International Nuclear Information System (INIS)

    Swailam, H.M.; Hammad, A.A.; Serag, M.S.; Mansour, F.A.; Abu El-Nour, S.A.

    2007-01-01

    Fresh-cut pears are not yet commercially available in Egypt. Thus, an attempt has been done to produce this minimally processed fruit manually at the laboratory. Fifteen samples of this manually prepared fresh-produce were evaluated for their microbiological quality. Total aerobic bacterial counts (TAPC) ranged from 7.5 x 10 to 3.5 x 10 cfu g-1, lactic acid bacteria (LAB) ranged from less than 10 to 3.2 x 10 cfu g-1; total mould and yeast counts (TM & Y) ranged from less than 10 to 5.3 x 10 cfu g-1 indicating good quality from the view point of microbiological population. Coliform bacteria and Escherichia coli were found in only 2 samples at levels of 20 to 43 and greater than 3 to 9 most probable numbers per gram (MPN g-1), respectively. On the other hand, Staphylococcus aureus was found in also 2 samples at levels of 102. Aeromonas hydrohila, Listeria monocytogenes and Salmonella spp., were not found in any of the samples. Fresh-cut pear s were dipped in water containing 2% ascorbic acid and 1% calcium lactate. The dipped fresh-cut pears were exposed to 1, 2 and 3 kGy. Dipping fresh-cut pears in 2% ascorbic acid plus 1% calcium lactate prevented browning and enhanced firmness during refrigeration storage. Irradiation dose of 2 kGy was the optimum, since it reduced TAPC by 99.58% and LAB and TM and Y to un-detectable level. These combined treatments extend the shelf life of fresh-cut pears without affecting their chemical, physical and sensorial quality attributes

  19. SQIMSO: Quality Improvement for Small Software Organizations

    OpenAIRE

    Rabih Zeineddine; Nashat Mansour

    2005-01-01

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

  20. The evolution of a doctor of nursing practice capstone process: programmatic revisions to improve the quality of student projects.

    Science.gov (United States)

    Nelson, Joan M; Cook, Paul F; Raterink, Ginger

    2013-01-01

    The past several years have seen explosive growth in the number of doctor of nursing practice (DNP) degree programs offered by colleges of nursing in the United States. Through a process of trial and error since 2005, the faculty at the University of Colorado, College of Nursing, have revised the course structure and procedures related to the DNP capstone project to improve the quality and usefulness of these student projects. Efforts have focused on educating and involving all nursing faculty in the DNP capstone process, distinguishing between competencies for our PhD and DNP projects, clearly aligning the DNP capstone project with quality improvement methods rather than with research, working with our campus institutional review board to clarify regulatory review requirements for quality improvement studies, developing a review committee to oversee DNP students' projects, and structuring our sequential course requirements to encourage students' professional presentations and publications. Our current capstone process reflects 7 years of iterative work, which we summarize in this article in hopes that it will help institutions currently in the process of developing a DNP program. Copyright © 2013 Elsevier Inc. All rights reserved.

  1. Developing Process Maps as a Tool for a Surgical Infection Prevention Quality Improvement Initiative in Resource-Constrained Settings.

    Science.gov (United States)

    Forrester, Jared A; Koritsanszky, Luca A; Amenu, Demisew; Haynes, Alex B; Berry, William R; Alemu, Seifu; Jiru, Fekadu; Weiser, Thomas G

    2018-06-01

    Surgical infections cause substantial morbidity and mortality in low-and middle-income countries (LMICs). To improve adherence to critical perioperative infection prevention standards, we developed Clean Cut, a checklist-based quality improvement program to improve compliance with best practices. We hypothesized that process mapping infection prevention activities can help clinicians identify strategies for improving surgical safety. We introduced Clean Cut at a tertiary hospital in Ethiopia. Infection prevention standards included skin antisepsis, ensuring a sterile field, instrument decontamination/sterilization, prophylactic antibiotic administration, routine swab/gauze counting, and use of a surgical safety checklist. Processes were mapped by a visiting surgical fellow and local operating theater staff to facilitate the development of contextually relevant solutions; processes were reassessed for improvements. Process mapping helped identify barriers to using alcohol-based hand solution due to skin irritation, inconsistent administration of prophylactic antibiotics due to variable delivery outside of the operating theater, inefficiencies in assuring sterility of surgical instruments through lack of confirmatory measures, and occurrences of retained surgical items through inappropriate guidelines, staffing, and training in proper routine gauze counting. Compliance with most processes improved significantly following organizational changes to align tasks with specific process goals. Enumerating the steps involved in surgical infection prevention using a process mapping technique helped identify opportunities for improving adherence and plotting contextually relevant solutions, resulting in superior compliance with antiseptic standards. Simplifying these process maps into an adaptable tool could be a powerful strategy for improving safe surgery delivery in LMICs. Copyright © 2018 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  2. [Quality management in health care - continuous improvement of processes and outcomes].

    Science.gov (United States)

    Vagts, Dierk A; Martin, Jörg; Dahmen, Klaus

    2008-02-01

    What is quality, what is quality management? Who is responsible for quality management in a hospital? Which tools, communication instruments and which instruments for feed back are necessary for institutions to control its tasks in a multi-disciplinary environment? Are there various requirements concerning quality management systems in different hospitals or departments? Which tools of quality management are used in German anaesthesia and intensive care departments? This paper gives an introduction to quality management systems in hospitals and an overview of current models in anaesthesia and intensive care medicine.

  3. Quality improvement: the nurse's role.

    Science.gov (United States)

    Moran, M J; Johnson, J E

    1992-06-01

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

  4. New process modeling[sic], design, and control strategies for energy efficiency, high product quality, and improved productivity in the process industries. Final project report; FINAL

    International Nuclear Information System (INIS)

    Ray, W. Harmon

    2002-01-01

    This project was concerned with the development of process design and control strategies for improving energy efficiency, product quality, and productivity in the process industries. In particular, (i) the resilient design and control of chemical reactors, and (ii) the operation of complex processing systems, was investigated. Specific topics studied included new process modeling procedures, nonlinear controller designs, and control strategies for multiunit integrated processes. Both fundamental and immediately applicable results were obtained. The new design and operation results from this project were incorporated into computer-aided design software and disseminated to industry. The principles and design procedures have found their way into industrial practice

  5. SELECTION OF BUSINESS STRATEGIES FOR QUALITY IMPROVEMENT USING FUZZY ANALYTICAL HIERARCHY PROCESS

    Directory of Open Access Journals (Sweden)

    Prasun Das

    2010-12-01

    Full Text Available Fuzzy linguistic concepts are often used to enhance the traditional analytic hierarchy process (AHP in capturing the fuzziness and subjectiveness of decision makers' judgments. In this paper, fuzzy AHP methodology is adopted for selection of the strategies for business improvement in an Indian industry as a decision making problem. Due to simplicity and effectiveness, triangular fuzzy numbers are adopted as a reference to indicate the influence strength of each element in the hierarchy structure. The confidence level and the optimistic levels of multiple decision makers are captured by using ? -cut based fuzzy number methods. This fuzzy set theory based multi-attribute decision making method is found to be quite useful and effective in industrial environment.

  6. Improving the quality of the order-writing process for inpatient orders in a teaching hospital.

    Science.gov (United States)

    Boehringer, Peter A; Rylander, Jeanette; Dizon, Dominic T; Peterson, Michael W

    2007-01-01

    Physicians' illegible handwriting is a notorious contributing factor to medical errors. Furthermore, an illegible signature or failure to print prescribers' name interferes with the ability of staff to clarify orders. We surveyed support medical staff at a teaching hospital before and 2 months after providing all internal medicine department residents a self-inking stamp with their name and pager number. Responses were received from 51% at the first and 36% at the second survey of 401 eligible staff. Responses to questions regarding illegible or absent signature, illegible or absent pager number, and failure to print prescribers' name showed a significant improvement (P writing process. This kind of signature allows clarification of orders in a timely fashion.

  7. Implementation of the World Health Organization Regional Office for Africa Stepwise Laboratory Quality Improvement Process Towards Accreditation.

    Science.gov (United States)

    Ndihokubwayo, Jean-Bosco; Maruta, Talkmore; Ndlovu, Nqobile; Moyo, Sikhulile; Yahaya, Ali Ahmed; Coulibaly, Sheick Oumar; Kasolo, Francis; Turgeon, David; Abrol, Angelii P

    2016-01-01

    The increase in disease burden has continued to weigh upon health systems in Africa. The role of the laboratory has become increasingly critical in the improvement of health for diagnosis, management and treatment of diseases. In response, the World Health Organization Regional Office for Africa (WHO AFRO) and its partners created the WHO AFRO Stepwise Laboratory (Quality) Improvement Process Towards Accreditation (SLIPTA) program. WHO AFRO defined a governance structure with roles and responsibilities for six main stakeholders. Laboratories were evaluated by auditors trained and certified by the African Society for Laboratory Medicine. Laboratory performance was measured using the WHO AFRO SLIPTA scoring checklist and recognition certificates rated with 1-5 stars were issued. By March 2015, 27 of the 47 (57%) WHO AFRO member states had appointed a SLIPTA focal point and 14 Ministers of Health had endorsed SLIPTA as the desired programme for continuous quality improvement. Ninety-eight auditors from 17 African countries, competent in the Portuguese (3), French (12) and English (83) languages, were trained and certified. The mean score for the 159 laboratories audited between May 2013 and March 2015 was 69% (median 70%; SD 11.5; interquartile range 62-77). Of these audited laboratories, 70% achieved 55% compliance or higher (2 or more stars) and 1% scored at least 95% (5 stars). The lowest scoring sections of the WHO AFRO SLIPTA checklist were sections 6 (Internal Audit) and 10 (Corrective Action), which both had mean scores below 50%. The WHO AFRO SLIPTA is a process that countries with limited resources can adopt for effective implementation of quality management systems. Political commitment, ownership and investment in continuous quality improvement are integral components of the process.

  8. Improving Indoor Air Quality

    Science.gov (United States)

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

  9. Preanalytical quality improvement : in quality we trust

    OpenAIRE

    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 been achieved thanks to improvements in both reliability and standardization of analytical techniques, reagents, and instrumentation. Notable advances in information technology, quality control and qu...

  10. Multileaf collimator performance monitoring and improvement using semiautomated quality control testing and statistical process control

    International Nuclear Information System (INIS)

    Létourneau, Daniel; McNiven, Andrea; Keller, Harald; Wang, An; Amin, Md Nurul; Pearce, Jim; Norrlinger, Bernhard; Jaffray, David A.

    2014-01-01

    Purpose: High-quality radiation therapy using highly conformal dose distributions and image-guided techniques requires optimum machine delivery performance. In this work, a monitoring system for multileaf collimator (MLC) performance, integrating semiautomated MLC quality control (QC) tests and statistical process control tools, was developed. The MLC performance monitoring system was used for almost a year on two commercially available MLC models. Control charts were used to establish MLC performance and assess test frequency required to achieve a given level of performance. MLC-related interlocks and servicing events were recorded during the monitoring period and were investigated as indicators of MLC performance variations. Methods: The QC test developed as part of the MLC performance monitoring system uses 2D megavoltage images (acquired using an electronic portal imaging device) of 23 fields to determine the location of the leaves with respect to the radiation isocenter. The precision of the MLC performance monitoring QC test and the MLC itself was assessed by detecting the MLC leaf positions on 127 megavoltage images of a static field. After initial calibration, the MLC performance monitoring QC test was performed 3–4 times/week over a period of 10–11 months to monitor positional accuracy of individual leaves for two different MLC models. Analysis of test results was performed using individuals control charts per leaf with control limits computed based on the measurements as well as two sets of specifications of ±0.5 and ±1 mm. Out-of-specification and out-of-control leaves were automatically flagged by the monitoring system and reviewed monthly by physicists. MLC-related interlocks reported by the linear accelerator and servicing events were recorded to help identify potential causes of nonrandom MLC leaf positioning variations. Results: The precision of the MLC performance monitoring QC test and the MLC itself was within ±0.22 mm for most MLC leaves

  11. Multileaf collimator performance monitoring and improvement using semiautomated quality control testing and statistical process control.

    Science.gov (United States)

    Létourneau, Daniel; Wang, An; Amin, Md Nurul; Pearce, Jim; McNiven, Andrea; Keller, Harald; Norrlinger, Bernhard; Jaffray, David A

    2014-12-01

    High-quality radiation therapy using highly conformal dose distributions and image-guided techniques requires optimum machine delivery performance. In this work, a monitoring system for multileaf collimator (MLC) performance, integrating semiautomated MLC quality control (QC) tests and statistical process control tools, was developed. The MLC performance monitoring system was used for almost a year on two commercially available MLC models. Control charts were used to establish MLC performance and assess test frequency required to achieve a given level of performance. MLC-related interlocks and servicing events were recorded during the monitoring period and were investigated as indicators of MLC performance variations. The QC test developed as part of the MLC performance monitoring system uses 2D megavoltage images (acquired using an electronic portal imaging device) of 23 fields to determine the location of the leaves with respect to the radiation isocenter. The precision of the MLC performance monitoring QC test and the MLC itself was assessed by detecting the MLC leaf positions on 127 megavoltage images of a static field. After initial calibration, the MLC performance monitoring QC test was performed 3-4 times/week over a period of 10-11 months to monitor positional accuracy of individual leaves for two different MLC models. Analysis of test results was performed using individuals control charts per leaf with control limits computed based on the measurements as well as two sets of specifications of ± 0.5 and ± 1 mm. Out-of-specification and out-of-control leaves were automatically flagged by the monitoring system and reviewed monthly by physicists. MLC-related interlocks reported by the linear accelerator and servicing events were recorded to help identify potential causes of nonrandom MLC leaf positioning variations. The precision of the MLC performance monitoring QC test and the MLC itself was within ± 0.22 mm for most MLC leaves and the majority of the

  12. A novel approach to leveraging electronic health record data to enhance pediatric surgical quality improvement bundle process compliance.

    Science.gov (United States)

    Fisher, Jason C; Godfried, David H; Lighter-Fisher, Jennifer; Pratko, Joseph; Sheldon, Mary Ellen; Diago, Thelma; Kuenzler, Keith A; Tomita, Sandra S; Ginsburg, Howard B

    2016-06-01

    Quality improvement (QI) bundles have been widely adopted to reduce surgical site infections (SSI). Improvement science suggests when organizations achieve high-reliability to QI processes, outcomes dramatically improve. However, measuring QI process compliance is poorly supported by electronic health record (EHR) systems. We developed a custom EHR tool to facilitate capture of process data for SSI prevention with the aim of increasing bundle compliance and reducing adverse events. Ten SSI prevention bundle processes were linked to EHR data elements that were then aggregated into a snapshot display superimposed on weekly case-log reports. The data aggregation and user interface facilitated efficient review of all SSI bundle elements, providing an exact bundle compliance rate without random sampling or chart review. Nine months after implementation of our custom EHR tool, we observed centerline shifts in median SSI bundle compliance (46% to 72%). Additionally, as predicted by high reliability principles, we began to see a trend toward improvement in SSI rates (1.68 to 0.87 per 100 operations), but a discrete centerline shift was not detected. Simple informatics solutions can facilitate extraction of QI process data from the EHR without relying on adjunctive systems. Analyses of these data may drive reductions in adverse events. Pediatric surgical departments should consider leveraging the EHR to enhance bundle compliance as they implement QI strategies. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Implementation of the World Health Organization Regional Office for Africa Stepwise Laboratory Quality Improvement Process Towards Accreditation

    Directory of Open Access Journals (Sweden)

    Jean-Bosco Ndihokubwayo

    2016-05-01

    SLIPTA implementation process: WHO AFRO defined a governance structure with roles and responsibilities for six main stakeholders. Laboratories were evaluated by auditors trained and certified by the African Society for Laboratory Medicine. Laboratory performance was measured using the WHO AFRO SLIPTA scoring checklist and recognition certificates rated with 1–5 stars were issued. Preliminary results: By March 2015, 27 of the 47 (57% WHO AFRO member states had appointed a SLIPTA focal point and 14 Ministers of Health had endorsed SLIPTA as the desired programme for continuous quality improvement. Ninety-eight auditors from 17 African countries, competent in the Portuguese (3, French (12 and English (83 languages, were trained and certified. The mean score for the 159 laboratories audited between May 2013 and March 2015 was 69% (median 70%; SD 11.5; interquartile range 62–77. Of these audited laboratories, 70% achieved 55% compliance or higher (2 or more stars and 1% scored at least 95% (5 stars. The lowest scoring sections of the WHO AFRO SLIPTA checklist were sections 6 (Internal Audit and 10 (Corrective Action, which both had mean scores below 50%. Conclusion: The WHO AFRO SLIPTA is a process that countries with limited resources can adopt for effective implementation of quality management systems. Political commitment, ownership and investment in continuous quality improvement are integral components of the process.

  14. Using Lean to Advance Quality Improvement Research.

    Science.gov (United States)

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

    2016-01-01

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

  15. Business process quality management

    NARCIS (Netherlands)

    Reijers, H.A.; Mendling, J.; Recker, J.; Brocke, vom J.; Rosemann, M.

    2010-01-01

    Abstract Process modeling is a central element in any approach to Business Process Management (BPM). However, what hinders both practitioners and aca demics is the lack of support for assessing the quality of process models — let alone realizing high quality process models. Existing frameworks are

  16. The improvement of the quality of polluted irrigation water through a phytoremediation process in a hydroponic batch culture system

    Science.gov (United States)

    Retnaningdyah, Catur

    2017-11-01

    The objective of this research was to determine the effectiveness of a phytoremediation process using some local hydro macrophytes to reduce fertilizer residue in irrigation water in order to support healthy agriculture and to prevent eutrophication and algae bloom in water. A phytoremediation process was carried out in a hydroponic floating system by using transparent plastic bags of 1 m in diameter and 1 m in height that were placed in collecting ponds before they were used for agricultural activities. Paddy soils were used as substrates in this system. The irrigation water was treated with nutrient enrichment (Urea and SP-36 fertilizers). Then, the system was planted with remediation actors (Azolla sp., Ipomoea aquatica, Limnocharis flava, Marsilea crenata, polyculture of those hydro macrophytes and control). The improvement of the water quality as a result of the phytoremediation process was characterized by a decline in the concentration of some physicochemical parameters, which were measured at 7 days after incubation, as well as an increase in the plankton diversity index value. The results showed that all of the hydro macrophytes used in this research, which was grown in the hydroponic batch culture system for a period of 7 days, were able to significantly improve the irrigation water quality, which was enriched by the synthetic fertilizers Urea and SP36. This was reflected by a significant decrease in the concentration of water TSS, nitrate, BOD, COD and total phosphate and an increase in the value of water DO at 7 days after incubation. Improvement of the water quality is also reflected in the increasing plankton diversity index value as a bioindicator of water pollution indicating a change in the pollution status from moderately polluted to slightly polluted at 7 days after incubation.

  17. Next generation software process improvement

    OpenAIRE

    Turnas, Daniel

    2003-01-01

    Approved for public release; distribution is unlimited Software is often developed under a process that can at best be described as ad hoc. While it is possible to develop quality software under an ad hoc process, formal processes can be developed to help increase the overall quality of the software under development. The application of these processes allows for an organization to mature. The software maturity level, and process improvement, of an organization can be measured with the Cap...

  18. Effects of coconut granular activated carbon pretreatment on membrane filtration in a gravitational driven process to improve drinking water quality.

    Science.gov (United States)

    da Silva, Flávia Vieira; Yamaguchi, Natália Ueda; Lovato, Gilselaine Afonso; da Silva, Fernando Alves; Reis, Miria Hespanhol Miranda; de Amorim, Maria Teresa Pessoa Sousa; Tavares, Célia Regina Granhen; Bergamasco, Rosângela

    2012-01-01

    This study evaluates the performance of a polymeric microfiltration membrane, as well as its combination with a coconut granular activated carbon (GAC) pretreatment, in a gravitational filtration module, to improve the quality of water destined to human consumption. The proposed membrane and adsorbent were thoroughly characterized using instrumental techniques, such as contact angle, Brunauer-Emmett-Teller) and Fourier transform infrared spectroscopy analyses. The applied processes (membrane and GAC + membrane) were evaluated regarding permeate flux, fouling percentage, pH and removal of Escherichia coli, colour, turbidity and free chlorine. The obtained results for filtrations with and without GAC pretreatment were similar in terms of water quality. GAC pretreatment ensured higher chlorine removals, as well as higher initial permeate fluxes. This system, applying GAC as a pretreatment and a gravitational driven membrane filtration, could be considered as an alternative point-of-use treatment for water destined for human consumption.

  19. Impact of Gamma Radiation Processing to Improve the Hygienic Quality of some Chicken Products

    International Nuclear Information System (INIS)

    Mohamed, W.S.; El-Mossalami, I.I.; Nosier, S.M.

    2009-01-01

    For food to be entirely safe from the microbiological viewpoint, it must need to contain the least possible counts of microorganisms of hygienic importance. This investigation aims to study the possible use of gamma radiation for bacterial decontamination of chicken products which are produced in Egypt. One hundred and twenty samples of frozen chicken kofta and burgers (60 each) were purchased from retail markets at Cairo Governorate. They were surveyed for the hygienic quality as well as the effect of gamma radiation (dose levels of 1, 2 and 3 kGy) on the bacterial population, chemical and sensory quality of these products. The results indicated that the total aerobic bacterial counts (APC) ranged from 106 to 107 cfu/g in the examined samples. Moreover, some samples were contaminated with food borne pathogens such as Listeria species and Salmonella species. Gamma irradiation greatly reduced the microbial density of the studied food samples. The microbial reduction increased as the dose level of irradiation increase, whereas irradiation of chicken products at 3 kGy dose reduced aerobic counts and eliminated Salmonella and Listeria species, also it proved to be of great importance in increasing the safety and acceptability of ready to eat frozen chicken products with no adverse effect on their chemical or sensory quality

  20. Making process improvement 'stick'.

    Science.gov (United States)

    Studer, Quint

    2014-06-01

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

  1. Improving productivity and quality in plastic and thin metallic plates manufacturing by using ultrasonic welding processes

    OpenAIRE

    Dehelean,D.; Oanca,O.

    2009-01-01

    The paper presents an overview of the research done at the Romanian National R&D Institute for Welding and Material Testing ISIM Timisoara in the field of ultrasonic process development. It starts with a general presentation of the value added by the welding sector in Europe. There are presented figures representing the size of the welding sector in Romania. The need of development of new high efficiency welding processes is mentioned, ultrasonic welding being one of the special welding proce...

  2. Improving the Quality of Service and Security of Military Networks with a Network Tasking Order Process

    Science.gov (United States)

    2010-09-01

    44 TACFIRE TACtical FIRE direction system 51 TACOPDAT TACtical Operational DATa 20 TBMCS Theater Battle Management...the MAAP process is complete, the ATO data is finally compiled into Theater Battle Management Core System ( TBMCS ), united with any inputs to SPINS...table. 3.1.5 Other NTO Process Considerations The Air Force uses Theater Battle Management Core System ( TBMCS ) to assist in planning and executing

  3. Improving the Quality of Backup Process for Publishing Houses and Printing Houses

    Science.gov (United States)

    Proskuriakov, N. E.; Yakovlev, B. S.; Pries, V. V.

    2018-04-01

    The analysis of main types for data threats, used by print media, and their influence on the vitality and security of information is made. The influence of the programs settings for preparing archive files, the types of file managers on the backup process is analysed. We proposed a simple and economical version of the practical implementation of the backup process consisting of 4 components: the command line interpreter, the 7z archiver, the Robocopy utility, and network storage. We recommend that the best option would be to create backup copies, consisting of three local copies of data and two network copies.

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

    Directory of Open Access Journals (Sweden)

    Perić Ružica

    2009-01-01

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

  5. The influence of drilling process automation on improvement of blasting works quality in open pit mining

    Science.gov (United States)

    Bodlak, Maciej; Dmytryk, Dominik; Mertuszka, Piotr; Szumny, Marcin; Tomkiewicz, Grzegorz

    2018-01-01

    The article describes the monitoring system of blasthole drilling process called HNS (Hole Navigation System), which was used in blasting works performed by Maxam Poland Ltd. Developed by Atlas Copco's, the HNS system - using satellite data - allows for a very accurate mapping of the designed grid of blastholes. The article presents the results of several conducted measurements of ground vibrations triggered by blasting, designed and performed using traditional technology and using the HNS system and shows first observations in this matter.

  6. Quality improvement of CdZnTe single crystal by ultrasound processing

    Science.gov (United States)

    Lisiansky, M.; Berner, A.; Korchnoy, V.

    2017-06-01

    Intrinsic defects and contaminations removal from the undoped p-type Cd0.96Zn0.04Te single crystals has been achieved by the ultrasound vibration processing at the room temperature. Surface analysis based on Auger Electron Spectroscopy, Energy Dispersive Spectroscopy, and Scanning Electron Spectroscopy shows a significant reconstruction of the crystal surface after processing, namely, the appearance of numerous "volcano craters" and triangle-shaped defects with a typical size of 0.2-5.0 μm. Elemental analysis of these defects shows that they are Te inclusions emerged on the surface. The regular crystal surface outside the defects also displays a considerable enrichment by Te. Distinct presence of copper is found in both the thin surface layer and in the defects emerged on the surface. The surface reconstruction is associated with a remarkable change in the bulk material properties, electrical (an increase in the resistivity by a factor of ∼6) and optical (an IR transmittance increase). A post-polishing following the ultrasound processing makes the CdZnTe material more stable and reliable for a wide range of device applications.

  7. Remedial measures for improving the quality of raw stock for leather processing

    International Nuclear Information System (INIS)

    Khan, M.S.; Ahmed, N.; Hasny, S.I.

    2007-01-01

    Leather is an important international commodity of commerce. It plays a vital the country. The raw stock, namely cow, buffalo, goat and sheep skins, are important sources for producing varieties of leather articles, such as shoe uppers, leather garments, bag leather articles, such as, shoe uppers, leather garments, bag leather, sole leather, gloves, belts, upholstery. The quality of raw stock is good in Pakistan but it is damaged due to mishandling during slaughtering and in the later stages, which is actually a heavy economic loss. The main complaint of the tanning industry is that locally available hides are full of butcher cuts. They also leave too much fleshy tissues. The flesh can be removed later, but the cuts, particularly the deep cuts because of holes as a result of improper flaying are irrepairable and permanent. A number of pre and post-mortem defects (during animal life and after slaughter) are visible on hides and skins. These defects, particularly on grain side, reduce the value of the leather. Aniline leather cannot be produced from such raw stock. (author)

  8. The influence of drilling process automation on improvement of blasting works quality in open pit mining

    Directory of Open Access Journals (Sweden)

    Bodlak Maciej

    2018-01-01

    Full Text Available The article describes the monitoring system of blasthole drilling process called HNS (Hole Navigation System, which was used in blasting works performed by Maxam Poland Ltd. Developed by Atlas Copco's, the HNS system – using satellite data – allows for a very accurate mapping of the designed grid of blastholes. The article presents the results of several conducted measurements of ground vibrations triggered by blasting, designed and performed using traditional technology and using the HNS system and shows first observations in this matter.

  9. Post-processing with linear optics for improving the quality of single-photon sources

    International Nuclear Information System (INIS)

    Berry, Dominic W; Scheel, Stefan; Myers, Casey R; Sanders, Barry C; Knight, Peter L; Laflamme, Raymond

    2004-01-01

    Triggered single-photon sources produce the vacuum state with non-negligible probability, but produce a much smaller multiphoton component. It is therefore reasonable to approximate the output of these photon sources as a mixture of the vacuum and single-photon states. We show that it is impossible to increase the probability for a single photon using linear optics and photodetection on fewer than four modes. This impossibility is due to the incoherence of the inputs; if the inputs were pure-state superpositions, it would be possible to obtain a perfect single-photon output. In the more general case, a chain of beam splitters can be used to increase the probability for a single photon, but at the expense of adding an additional multiphoton component. This improvement is robust against detector inefficiencies, but is degraded by distinguishable photons, dark counts or multiphoton components in the input

  10. Identification of Long Bone Fractures in Radiology Reports Using Natural Language Processing to support Healthcare Quality Improvement.

    Science.gov (United States)

    Grundmeier, Robert W; Masino, Aaron J; Casper, T Charles; Dean, Jonathan M; Bell, Jamie; Enriquez, Rene; Deakyne, Sara; Chamberlain, James M; Alpern, Elizabeth R

    2016-11-09

    Important information to support healthcare quality improvement is often recorded in free text documents such as radiology reports. Natural language processing (NLP) methods may help extract this information, but these methods have rarely been applied outside the research laboratories where they were developed. To implement and validate NLP tools to identify long bone fractures for pediatric emergency medicine quality improvement. Using freely available statistical software packages, we implemented NLP methods to identify long bone fractures from radiology reports. A sample of 1,000 radiology reports was used to construct three candidate classification models. A test set of 500 reports was used to validate the model performance. Blinded manual review of radiology reports by two independent physicians provided the reference standard. Each radiology report was segmented and word stem and bigram features were constructed. Common English "stop words" and rare features were excluded. We used 10-fold cross-validation to select optimal configuration parameters for each model. Accuracy, recall, precision and the F1 score were calculated. The final model was compared to the use of diagnosis codes for the identification of patients with long bone fractures. There were 329 unique word stems and 344 bigrams in the training documents. A support vector machine classifier with Gaussian kernel performed best on the test set with accuracy=0.958, recall=0.969, precision=0.940, and F1 score=0.954. Optimal parameters for this model were cost=4 and gamma=0.005. The three classification models that we tested all performed better than diagnosis codes in terms of accuracy, precision, and F1 score (diagnosis code accuracy=0.932, recall=0.960, precision=0.896, and F1 score=0.927). NLP methods using a corpus of 1,000 training documents accurately identified acute long bone fractures from radiology reports. Strategic use of straightforward NLP methods, implemented with freely available

  11. [Impact of quality improvement process upon the state of nutritional support in a critical care unit].

    Science.gov (United States)

    Martinuzzi, A; Ferraresi, E; Orsati, M; Palaoro, A; Chaparro, J; Alcántara, S; Amin, C; Feller, C; Di Leo, M E; Guillot, A; García, V

    2012-01-01

    In a preceding article the state of Nutritional support (NS) in an Intensive Care Unit (ICU) was documented [Martinuzzi A et al. Estado del soporte nutricional en una unidad de Cuidados críticos. RNC 2011; 20: 5-17]. In this follow-up work we set to assess the impact of several organizational, recording and educational interventions upon the current state of NS processes. Interventions comprised presentation of the results of the audit conducted at the ICU before the institution's medical as well as paramedical personnel; their publication in a periodical, peer-reviewed journal; drafting and implementation of a protocol regulating NS schemes to be carried out at the ICU; and conduction of continuous education activities on Nutrition (such as "experts talks", interactive courses, and training in the implementation of the NS protocol). The state of NS processes documented after the interventions was compared with the results annotated in the preceding article. Study observation window ran between March the 1st, 2011 and May 31th, 2011, both included. Study series differed only regarding overall-mortality: Phase 1: 40.0% vs. Phase 2: 20.5%; Difference: 19.5%; Z = 1.927; two-tailed-p = 0.054. Interventions resulted in a higher fulfillment rate of the prescribed NS indication; an increase in the number of patients receiving ≥ 80% of prescribed energy; and a reduction in the number of NS lost days. Mortality was (numerically) lower in patients in which the prescribed NS scheme was fulfilled, NS was early initiated, and whom received ≥ 80% of prescribed energy. Adopted interventions had no effect upon average energy intakes: Phase 1: 574.7 ± 395.3 kcal/24 h⁻¹ vs. Phase 2: 591.1 ± 315.3 kcal/24 h⁻¹; two-tailed-p > 0.05. Educational, recording and organizational interventions might result in a better conduction of NS processes, and thus, in a lower mortality. Hemodynamic instability is still the most formidable obstacle for initiating and completing NS.

  12. NCCDS configuration management process improvement

    Science.gov (United States)

    Shay, Kathy

    1993-01-01

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

  13. Quality Improvement with Trustee Commitment.

    Science.gov (United States)

    Chaffee, Ellen Earle; Seymour, Daniel

    1991-01-01

    Total Quality Management is a comprehensive system for developing organizationwide participation in planning for and implementing continuous improvement in critical processes. In colleges, trustees can be central to the success of the method through their commitment and the development of supportive policy and procedures. (MSE)

  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. Improving Process Quality by Means of Accurate and Traceable Calibration of Flow Devices with Process-oriented Liquids.

    Science.gov (United States)

    Bissig, Hugo; Tschannen, Martin; de Huu, Marc

    2018-03-30

    Calibration of flow devices is important in several areas of pharmaceutical, flow chemistry and health care applications where volumetric dosage or delivery at given flow rates are crucial for the process. Although most of the flow devices are measuring flow rates of process-oriented liquids, their calibrations are often performed with water as calibration liquid. It is recommended to perform the calibrations of the flow devices with process-oriented liquids as the liquid itself might influence the performance of the flow devices. Therefore, METAS has developed facilities with METAS flow generators to address the issue of measuring with process-oriented liquids for flow rates from 400 ml/min down to 50 nl/min with uncertainties from 0.07-0.9 %. Traceability is guaranteed through the calibration of the generated flow rates of the METAS flow generators by means of the dynamic gravimetric method where a liquid of well-known density and a well-controlled evaporation rate is used. The design of the milli-flow facility will be discussed as well as first measurement results of the METAS flow generators in the range of micro-flow and milli-flow using water and other liquids.

  16. THE PROJECT OF ADMINISTRATIVE AND METHODICAL MANAGEMENT AUTOMATIZATION IN EDUCATIONAL INSTITUTION AS A TERM OF EDUCATION PROCESS QUALITY IMPROVEMENT

    Directory of Open Access Journals (Sweden)

    Анна Игоревна Яценко

    2017-12-01

    Full Text Available The article is devoted to the practice of information technologies implementation in the educational process according to the condition of educational informatization. The actuality of main article concept is confirmed by the trend of widespread introduction of information technologies in education both from the state and from business. Taking into account the increased attention to acquiring of high results in the educational process, the information technology tools allows to significantly improve the quality of education. In this regard, the article provides examples of various information systems using in order to administer educational process, their advantages and disadvantages. In consequence, the author formulates the problem of lack of integrated information systems. However, the development of information technologies is oriented towards a worldwide network, which has an access to a vast audience of users. Educational institutions are involved in the electronic process supported by an electronic environment of the educational development. As a result of the issue study above and the modern trends review in the article the author suggests a project description of educational organization management optimization with the help of the integrated information system use on the Internet.

  17. Mobile Phone Apps to Improve Medication Adherence: A Systematic Stepwise Process to Identify High-Quality Apps.

    Science.gov (United States)

    Santo, Karla; Richtering, Sarah S; Chalmers, John; Thiagalingam, Aravinda; Chow, Clara K; Redfern, Julie

    2016-12-02

    There are a growing number of mobile phone apps available to support people in taking their medications and to improve medication adherence. However, little is known about how these apps differ in terms of features, quality, and effectiveness. We aimed to systematically review the medication reminder apps available in the Australian iTunes store and Google Play to assess their features and their quality in order to identify high-quality apps. This review was conducted in a similar manner to a systematic review by using a stepwise approach that included (1) a search strategy; (2) eligibility assessment; (3) app selection process through an initial screening of all retrieved apps and full app review of the included apps; (4) data extraction using a predefined set of features considered important or desirable in medication reminder apps; (5) analysis by classifying the apps as basic and advanced medication reminder apps and scoring and ranking them; and (6) a quality assessment by using the Mobile App Rating Scale (MARS), a reliable tool to assess mobile health apps. We identified 272 medication reminder apps, of which 152 were found only in Google Play, 87 only in iTunes, and 33 in both app stores. Apps found in Google Play had more customer reviews, higher star ratings, and lower cost compared with apps in iTunes. Only 109 apps were available for free and 124 were recently updated in 2015 or 2016. Overall, the median number of features per app was 3.0 (interquartile range 4.0) and only 18 apps had ≥9 of the 17 desirable features. The most common features were flexible scheduling that was present in 56.3% (153/272) of the included apps, medication tracking history in 54.8% (149/272), snooze option in 34.9% (95/272), and visual aids in 32.4% (88/272). We classified 54.8% (149/272) of the included apps as advanced medication reminder apps and 45.2% (123/272) as basic medication reminder apps. The advanced apps had a higher number of features per app compared with the

  18. Improving and monitoring air quality.

    Science.gov (United States)

    DuPont, André

    2018-05-01

    Since the authorization of the Clean Air Act Amendments of 1990, the air quality in the USA has significantly improved because of strong public support. The lessons learned over the last 25 years are being shared with the policy analysts, technical professionals, and scientist who endeavor to improve air quality in their communities. This paper will review how the USA has achieved the "high" standard of air quality that was envisioned in the early 1990s. This document will describe SO 2 gas emission reduction technology and highlight operation of emission monitoring technology. This paper describes the basic process operation of an air pollution control scrubber. A technical review of measures required to operate and maintain a large-scale pollution control system will be described. Also, the author explains how quality assurance procedures in performance of continuous emission monitoring plays a significant role in reducing air pollution.

  19. Narrative review of provider behavior in primary care behavioral health: How process data can inform quality improvement.

    Science.gov (United States)

    Beehler, Gregory P; Lilienthal, Kaitlin R; Possemato, Kyle; Johnson, Emily M; King, Paul R; Shepardson, Robyn L; Vair, Christina L; Reyner, Jacqueline; Funderburk, Jennifer S; Maisto, Stephen A; Wray, Laura O

    2017-09-01

    Primary care behavioral health (PCBH) is a population-based approach to delivering mental and behavioral health care in the primary care setting. Implementation of the PCBH model varies across practice settings, which can impact how PCBH providers deliver services to patients and in turn may predict a variety of important outcomes. This article aims to characterize PCBH provider engagement in key processes of integrated care as demonstrated in results from empirical studies of real-world clinical practice. For this narrative review of published studies on PCBH provider engagement in processes of care, PubMed and PsycINFO databases were searched from January 1990 through May 2016 to identify relevant articles. Provider adherence to the brief, time-limited treatment model appears suboptimal. Common mental health conditions, such as depression, were often the primary focus of provider attention, with less consistent emphasis on behavioral medicine concerns. Whereas providers regularly conducted qualitative functional assessments with patients, routine use of standardized measures was low. Engagement in interprofessional collaboration with the primary care team was also low, but engagement in behaviors that fostered therapeutic relationships was high. This review identified several strengths and weaknesses of typical PCBH provider practices. Results are discussed in relation to their value as areas for future quality improvement initiatives that can improve PCBH service delivery and, ultimately, patient outcomes. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  20. Chemical purification of Gunungpati elephant foot yam flour to improve physical and chemical quality on processed food

    Science.gov (United States)

    Paramita, Octavianti; Wahyuningsih, Ansori, Muhammad

    2017-03-01

    This study was aimed at improving the physicochemical quality of elephant foot yam flour in Gunungpati, Semarang by chemical purification. The utilization of elephant foot yam flour in several processed food was also discussed in this study. The flour purification discussed in this study was expected to become a reference for the manufacturers of elephant foot yam flour and its processed food in Gunungpati. This study modified the elephant foot yam flour using pre - gelatinization method. The physical and chemical quality of each elephant foot yam flour purification sample were assessed using proximate analysis. The likability test was conducted for its processed food. 20 grams of elephant foot yam flour was put into a beaker glass, then 60 ml of water was added. The suspension was then heated at a temperature of 60 ° C and 70 ° C while stirred until it was homogeneous and thickened for 10, 30 and 60 minutes. The flour which had been heated was then cooled at room temperature for 1 hour and then at a temperature of 0 ° C until it was frozen. Furthermore, flour was dried in an oven at a temperature of 60 ° C for 9 hours. The dried flour was sifted with a 80 mesh sieve. Chemical test was conducted after elephant foot yam was pre-gelatinized to determine changes in the quality flour: test levels of protein, fat, crude fiber content, moisture content, ash content and starch content. In addition, color tests and granular test on elephant foot yam flour were also conducted. The pre-gelatinization as chemical treatment on elephant foot yam flour in this study was able to change the functional properties of elephant foot yam flour towards a better processing characterized by a brighter color (L = 70, a = 6 and b = 12), the hydrolysis of polysaccharides flour into shorter chain (flour content decreased to 44%), the expansion of granules in elephant foot yam resulting in a process - ready flour, and better monolayer water content of 9%. The content of protein and fiber

  1. Quality in the fabrication process

    International Nuclear Information System (INIS)

    Romano, A.; Aguirre, F.

    2010-01-01

    Enusa commitment to quality in the manufacture process materializes in the application of the most advanced product quality control technologies such as not-destructive inspection techniques, like artificial vision, X-ray or UT inspection, or process parameter statistical control systems. Quality inspectors are trained and certified by the main National Quality Organizations and receive periodic training under a formal company training program that constantly updates their qualification. Fabrication quality control reliability is based on a strategy that prioritizes redundancy of critical inspection equipment's and inspection personnel knowledge polyvalence. Furthermore, improvement in fabrication quality is obtained by a systematic application of the six sigma methodology where added value is created in projects integrating crosscutting company knowledge, reinforcing the global company vision that the fuel business is based on quality. (Author)

  2. Preanalytical quality improvement: in quality we trust.

    Science.gov (United States)

    Lippi, Giuseppe; Becan-McBride, Kathleen; Behúlová, 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 been achieved thanks to improvements in both reliability and standardization of analytical techniques, reagents, and instrumentation. Notable advances in information technology, quality control and quality assurance methods have also assured a valuable contribution for reducing diagnostic errors. Nevertheless, several lines of evidence still suggest that most errors in laboratory diagnostics fall outside the analytical phase, and the pre- and postanalytical steps have been found to be much more vulnerable. This collective paper, which is the logical continuum of the former already published in this journal 2 years ago, provides additional contribution to risk management in the preanalytical phase and is a synopsis of the lectures of the 2nd European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)-Becton Dickinson (BD) European Conference on Preanalytical Phase meeting entitled "Preanalytical quality improvement: in quality we trust" (Zagreb, Croatia, 1-2 March 2013). The leading topics that will be discussed include quality indicators for preanalytical phase, phlebotomy practices for collection of blood gas analysis and pediatric samples, lipemia and blood collection tube interferences, preanalytical requirements of urinalysis, molecular biology hemostasis and platelet testing, as well as indications on best practices for safe blood collection. Auditing of the preanalytical phase by ISO assessors and external quality assessment for preanalytical phase are also discussed.

  3. Software Process Improvement Defined

    DEFF Research Database (Denmark)

    Aaen, Ivan

    2002-01-01

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

  4. 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.

  5. Improving Healthcare Logistics Processes

    DEFF Research Database (Denmark)

    Feibert, Diana Cordes

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

  6. SU-E-T-191: PITSTOP: Process Improvement Techniques, Software Tools, and Operating Principles for a Quality Initiative Discovery Framework.

    Science.gov (United States)

    Siochi, R

    2012-06-01

    To develop a quality initiative discovery framework using process improvement techniques, software tools and operating principles. Process deviations are entered into a radiotherapy incident reporting database. Supervisors use an in-house Event Analysis System (EASy) to discuss incidents with staff. Major incidents are analyzed with an in-house Fault Tree Analysis (FTA). A meta-Analysis is performed using association, text mining, key word clustering, and differential frequency analysis. A key operating principle encourages the creation of forcing functions via rapid application development. 504 events have been logged this past year. The results for the key word analysis indicate that the root cause for the top ranked key words was miscommunication. This was also the root cause found from association analysis, where 24% of the time that an event involved a physician it also involved a nurse. Differential frequency analysis revealed that sharp peaks at week 27 were followed by 3 major incidents, two of which were dose related. The peak was largely due to the front desk which caused distractions in other areas. The analysis led to many PI projects but there is still a major systematic issue with the use of forms. The solution we identified is to implement Smart Forms to perform error checking and interlocking. Our first initiative replaced our daily QA checklist with a form that uses custom validation routines, preventing therapists from proceeding with treatments until out of tolerance conditions are corrected. PITSTOP has increased the number of quality initiatives in our department, and we have discovered or confirmed common underlying causes of a variety of seemingly unrelated errors. It has motivated the replacement of all forms with smart forms. © 2012 American Association of Physicists in Medicine.

  7. Improving repeatability by improving quality

    Energy Technology Data Exchange (ETDEWEB)

    Ronen, Shuki; Ackers, Mark; Schlumberger, Geco-Prakla; Brink, Mundy

    1998-12-31

    Time lapse (4-D) seismic is a promising tool for reservoir characterization and monitoring. The method is apparently simple: to acquire data repeatedly over the same reservoir, process and interpret the data sets, then changes between the data sets indicate changes in the reservoir. A problem with time lapse seismic data is that reservoirs are a relatively small part of the earth and important reservoir changes may cause very small differences to the time lapse data. The challenge is to acquire and process economical time lapse data such that reservoir changes can be detected above the noise of varying acquisition and environment. 7 refs., 9 figs.

  8. Improvement in the traditional processing method and nutritional quality of traditional extruded cassava-based snack (modified Ajogun).

    Science.gov (United States)

    Obadina, Adewale O; Oyewole, Olusola B; Williams, Oluwasolabomi E

    2013-07-01

    This study was carried out to investigate and improve the traditional processing method and nutritional quality of the traditional cassava snack (Ajogun). Cassava root (Manihot esculenta Crantz L.) of TME 419 variety was processed into mash (40% moisture content). The cassava mash was mixed into different blends to produce fried traditional "Ajogun", fried and baked extrudates (modified Ajogun) as snacks. These products were analyzed to determine the proximate composition including carbohydrate, fat, protein, fiber, ash, and moisture contents and functional properties such as bulk density. The results obtained for the moisture, fat, protein, and ash contents showed significant difference (P extrudates. However, there was no significant difference (P > 0.05) in the carbohydrate and fiber contents between the three samples. There was no significant difference (P > 0.05) in the bulk density of the snacks. Also, sensory evaluation was carried out on the cassava-based snacks using the 9-point hedonic scale to determine the degree of acceptability. Results obtained showed significant difference (P extrudates and control sample in terms of appearance, taste, flavor, color, aroma, texture, and overall acceptability. The highest acceptability level of the product was at 8.04 for the control sample (traditional Ajogun). This study has shown that "Ajogun", which is a lesser known cassava product, is rich in protein and fat.

  9. Process improvement : the creation and evaluation of process alternatives

    NARCIS (Netherlands)

    Netjes, M.

    2010-01-01

    Companies continuously strive to improve their processes to increase productivity and delivered quality against lower costs. With Business Process Redesign (BPR) projects such improvement goals can be achieved. BPR involves the restructuring of business processes, stimulated by the application of

  10. Process Improvement Essentials

    CERN Document Server

    Persse, James R

    2006-01-01

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

  11. 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)....

  12. Continuous improvement of software quality

    International Nuclear Information System (INIS)

    Sivertsen, Terje

    1999-04-01

    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)

  13. 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

  14. MDSplus quality improvement project

    International Nuclear Information System (INIS)

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

    2016-01-01

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

  15. Infrared pre-drying and dry-dehulling of walnuts for improved processing efficiency and product quality

    Science.gov (United States)

    The walnut industry is faced with an urgent need to improve post-harvest processing efficiency, particularly drying and dehulling operations. This research investigated the feasibility of dry-dehulling and infrared (IR) pre-drying of walnuts for improved processing efficiency and dried product quali...

  16. Process air quality data

    Science.gov (United States)

    Butler, C. M.; Hogge, J. E.

    1978-01-01

    Air quality sampling was conducted. Data for air quality parameters, recorded on written forms, punched cards or magnetic tape, are available for 1972 through 1975. Computer software was developed to (1) calculate several daily statistical measures of location, (2) plot time histories of data or the calculated daily statistics, (3) calculate simple correlation coefficients, and (4) plot scatter diagrams. Computer software was developed for processing air quality data to include time series analysis and goodness of fit tests. Computer software was developed to (1) calculate a larger number of daily statistical measures of location, and a number of daily monthly and yearly measures of location, dispersion, skewness and kurtosis, (2) decompose the extended time series model and (3) perform some goodness of fit tests. The computer program is described, documented and illustrated by examples. Recommendations are made for continuation of the development of research on processing air quality data.

  17. Using clinical indicators to facilitate quality improvement via the accreditation process: an adaptive study into the control relationship.

    Science.gov (United States)

    Chuang, Sheuwen; Howley, Peter P; Hancock, Stephen

    2013-07-01

    The aim of the study was to determine accreditation surveyors' and hospitals' use and perceived usefulness of clinical indicator reports and the potential to establish the control relationship between the accreditation and reporting systems. The control relationship refers to instructional directives, arising from appropriately designed methods and efforts towards using clinical indicators, which provide a directed moderating, balancing and best outcome for the connected systems. Web-based questionnaire survey. Australian Council on Healthcare Standards' (ACHS) accreditation and clinical indicator programmes. Seventy-three of 306 surveyors responded. Half used the reports always/most of the time. Five key messages were revealed: (i) report use was related to availability before on-site investigation; (ii) report use was associated with the use of non-ACHS reports; (iii) a clinical indicator set's perceived usefulness was associated with its reporting volume across hospitals; (iv) simpler measures and visual summaries in reports were rated the most useful; (v) reports were deemed to be suitable for the quality and safety objectives of the key groups of interested parties (hospitals' senior executive and management officers, clinicians, quality managers and surveyors). Implementing the control relationship between the reporting and accreditation systems is a promising expectation. Redesigning processes to ensure reports are available in pre-survey packages and refined education of surveyors and hospitals on how to better utilize the reports will support the relationship. Additional studies on the systems' theory-based model of the accreditation and reporting system are warranted to establish the control relationship, building integrated system-wide relationships with sustainable and improved outcomes.

  18. The structure, processes, and outcomes of Banner Health's corporate-wide strategy to improve health care quality.

    Science.gov (United States)

    Kirkman-Liff, Bradford

    2004-01-01

    Banner Health consists of 19 hospitals, 6 long-term care centers and a number of family health clinics, home care programs, and home medical equipment providers in 9 Western and Midwestern states. Banner Health has developed an integrated organization-wide effort called Care Management to simultaneously address quality and safety, reduce patient errors, and measure and report performance, outcomes, and patient satisfaction, while controlling costs through utilization management, care coordination, and performance improvement. Eleven functional areas were identified and more than 36 cross-functional and cross-facility work groups have been created. These work groups use a deliberate process in which knowledge is created, reviewed, synthesized, distributed, taught, and implemented within the system. Key lessons after the first 2 years of this effort are as follows: information sharing and collegial support can be established within newly merged organizations; there must be continued enhancement of both the accuracy and timeliness of data; the ability of health care professionals to understand and use sophisticated statistical tools has increased; a variety of methods should be used to distribute the knowledge products; and the strategy to have functional teams and work groups develop systemwide policies and toolkits but leave implementation to facility employees has worked relatively well.

  19. [Efficacy of the strategy to improve the quality indicators of Diabetes Mellitus 2 Care Process in Advanced Diabetes Centre Macarena].

    Science.gov (United States)

    Vélez, Juan Manuel; García, Rosa; Pina, Enrique; Morales, Cristóbal; Escalera, Carmen; Ortega, Antonio; Poyatos, Blas; Carrasco, Dolores; Prieto, Jesús; Ángeles Eslava, M; Antonio Corrales, J; Barón, María O; Llano, Mercedes; Ruiz, Francisco; Sánchez, Romualdo; Victorino Pino, Manuel; Luisa Redondo, M; Castellanos, Antonio; Mayoral, Eduardo

    2018-02-21

    The assessment of the Diabetes Mellitus 2 Care Process (PAI-DM2) through the assessment tool for the chronic illness' care models (IEMAC-Diabetes) allows the design of health interventions for the improvement of medical care. Analysing the quality of healthcare provided to DM2 patients. Quasiexperimental study before and after intervention with a not randomised control group. Health care district of primary care Sevilla. 12 groups of ascribed patients, 5 Primary Care Healthcenter, chosen in a discretionary way. Physicians and nurses from the 12 intervention groups took part in a training program, including an external rotation in the Diabetes Daycare Hospital. Number of included patients, glycated hemoglobin, feet exploration (FE), and ocular fundus (OF). 1,475 DM-2 patients were analysed. The proportion of included patients per group was 8.5%, 45.5% were women. At the beginning of the study, the rate of patients with HbA1c<7% were 38.9% in 2013 against 47.7% in 2014 and 40.2% in 2016; 33% of the patients had an OF in 2013 against 41.77% in 2014; 51.6% of patients had an EF against 54.7% in 2014. After the intervention, statistically significant differences were reached in HbA1c (p=0.01) and retinography requested (p=0.01). IEMAC-Diabetes allows spotting improvement areas in the PAI-DM2. The absence of statistically significant differences may be the result of contamination in the sample and/or Hawthorne effect. Copyright © 2017 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. The use of data for process and quality improvement in long term care and home care: a systematic review of the literature.

    Science.gov (United States)

    Sales, Anne E; Bostrom, Anne-Marie; Bucknall, Tracey; Draper, Kellie; Fraser, Kimberly; Schalm, Corinne; Warren, Sharon

    2012-02-01

    Standardized resident or client assessments, including the Resident Assessment Instrument (RAI), have been available in long term care and home care settings (continuing care sector) in many jurisdictions for a number of years. Although using these data can make quality improvement activities more efficient and less costly, there has not been a review of the literature reporting quality improvement interventions using standardized data. To address 2 questions: (1) How have RAI and other standardized data been used in process or quality improvement activities in the continuing care sector? and (2) Has the use of RAI and similar data resulted in improvements to resident or other outcomes? Searches using a combination of keyword and controlled vocabulary term searches were conducted in MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, the Cochrane Library, and PsychINFO. ELIGIBILITY CRITERIA, PARTICIPANTS, AND INTERVENTIONS: English language publications from database inception to October 2008 were included. Eligibility criteria included the following: (1) set in continuing care (long-term care facility or home care), (2) involved some form of intervention designed to improve quality or process of care, and (3) used standardized data in the quality or process improvement intervention. After reviewing the articles, we grouped the studies according to the type of intervention used to initiate process improvement. Four different intervention types were identified. We organized the results and discussion by these 4 intervention types. Key word searches identified 713 articles, of which we excluded 639 on abstract review because they did not meet inclusion criteria. A further 50 articles were excluded on full-text review, leaving a total of 24 articles. Of the 24 studies, 10 used a defined process improvement model, 8 used a combination of interventions (multimodal), 5 implemented new guidelines or protocols, and 1 used an education

  1. Discharge documentation of patients discharged to subacute facilities: a three-year quality improvement process across an integrated health care system.

    Science.gov (United States)

    Gandara, Esteban; Ungar, Jonathan; Lee, Jason; Chan-Macrae, Myrna; O'Malley, Terrence; Schnipper, Jeffrey L

    2010-06-01

    Effective communication among physicians during hospital discharge is critical to patient care. Partners Healthcare (Boston) has been engaged in a multi-year process to measure and improve the quality of documentation of all patients discharged from its five acute care hospitals to subacute facilities. Partners first engaged stakeholders to develop a consensus set of 12 required data elements for all discharges to subacute facilities. A measurement process was established and later refined. Quality improvement interventions were then initiated to address measured deficiencies and included education of physicians and nurses, improvements in information technology, creation of or improvements in discharge documentation templates, training of hospitalists to serve as role models, feedback to physicians and their service chiefs regarding reviewed cases, and case manager review of documentation before discharge. To measure improvement in quality as a result of these efforts, rates of simultaneous inclusion of all 12 applicable data elements ("defect-free rate") were analyzed over time. Some 3,101 discharge documentation packets of patients discharged to subacute facilities from January 1, 2006, through September 2008 were retrospectively studied. During the 11 monitored quarters, the defect-free rate increased from 65% to 96% (p improvements were seen in documentation of preadmission medication lists, allergies, follow-up, and warfarin information. Institution of rigorous measurement, feedback, and multidisciplinary, multimodal quality improvement processes improved the inclusion of data elements in discharge documentation required for safe hospital discharge across a large integrated health care system.

  2. Routinely-collected general practice data are complex, but with systematic processing can be used for quality improvement and research

    Directory of Open Access Journals (Sweden)

    Simon de Lusignan

    2006-03-01

    Conclusions Routinely collected primary care data could contribute more to the process of health improvement; however, those working with these data need to understand fully the complexity of the context within which data entry takes place.

  3. Factors affecting implementation of accreditation programmes and the impact of the accreditation process on quality improvement in hospitals: a SWOT analysis.

    Science.gov (United States)

    Ng, G K B; Leung, G K K; Johnston, J M; Cowling, B J

    2013-10-01

    The objectives of this review were to identify factors that influence implementation of hospital accreditation programmes and to assess the impact of the accreditation process on quality improvement in public hospitals. Two electronic databases, Medline (OvidSP) and PubMed, were systematically searched. "Public hospital", "hospital accreditation", and "quality improvement" were used as the search terms. A total of 348 citations were initially identified. After critical appraisal and study selection, 26 articles were included in the review. The data were extracted and analysed using a SWOT (strengths, weaknesses, opportunities, threats) analysis. Increased staff engagement and communication, multidisciplinary team building, positive changes in organisational culture, and enhanced leadership and staff awareness of continuous quality improvement were identified as strengths. Weaknesses included organisational resistance to change, increased staff workload, lack of awareness about continuous quality improvement, insufficient staff training and support for continuous quality improvement, lack of applicable accreditation standards for local use, and lack of performance outcome measures. Opportunities included identification of improvement areas, enhanced patient safety, additional funding, public recognition, and market advantage. Threats included opportunistic behaviours, funding cuts, lack of incentives for participation, and a regulatory approach to mandatory participation. By relating the findings to the operational issues of accreditation, this review discussed the implications for successful implementation and how accreditation may drive quality improvement. These findings have implications for various stakeholders (government, the public, patients and health care providers), when it comes to embarking on accreditation exercises.

  4. Reducing the absorbed dose in analogue radiography of infant chest images by improving the image quality, using image processing techniques

    International Nuclear Information System (INIS)

    Karimian, A.; Yazdani, S.; Askari, M. A.

    2011-01-01

    Radiographic inspection is one of the most widely employed techniques for medical testing methods. Because of poor contrast and high un-sharpness of radiographic image quality in films, converting radiographs to a digital format and using further digital image processing is the best method of enhancing the image quality and assisting the interpreter in their evaluation. In this research work, radiographic films of 70 infant chest images with different sizes of defects were selected. To digitise the chest images and employ image processing the two algorithms (i) spatial domain and (ii) frequency domain techniques were used. The MATLAB environment was selected for processing in the digital format. Our results showed that by using these two techniques, the defects with small dimensions are detectable. Therefore, these suggested techniques may help medical specialists to diagnose the defects in the primary stages and help to prevent more repeat X-ray examination of paediatric patients. (authors)

  5. Statistical methods for quality improvement

    National Research Council Canada - National Science Library

    Ryan, Thomas P

    2011-01-01

    ...."-TechnometricsThis new edition continues to provide the most current, proven statistical methods for quality control and quality improvementThe use of quantitative methods offers numerous benefits...

  6. [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

  7. Optimal changes in the prepress process: a model for evaluation of state and direction of productivity and quality improvements

    Science.gov (United States)

    Kihlberg, Henrik; Lindgren, Mats

    1998-09-01

    The demands changes with the customers marketplace which makes it crucial for prepress companies of today and those of tomorrow to be able to change their services. The production tools are becoming more standardized and similar through out the industry. Intelligent tools are developed at a rapid pace which results in possibilities to automate these processes. Key success factors of today and tomorrow are the ability to change and understand the customers' market. The market demands shorter delivery times and lower costs. The total number of printed editions are decreasing while each edition contains an increased numbers of pages and images. The customers requires higher quality with the ability to control and predict the end result. Case studies, interviews and workshops have been carried out at commercial printing companies, prepress houses, image bureau's, advertising agencies and digital photographers in Sweden. A major part of the research focus on the digital image process at eleven companies in the graphic arts industry, all of which have prepress. The analysis has resulted in the thorough knowledge of both the production process and the parameters to measure productivity and quality. A model for the evaluation of changes is presented, with measurable values for productivity and quality. The model can be used to map and compare the states prepress are in, and/or be used to evaluate if changes are needed.

  8. Does quality improvement work in neonatology improve clinical outcomes?

    Science.gov (United States)

    Ellsbury, Dan L; Clark, Reese H

    2017-04-01

    Quality improvement initiatives in neonatology have been promoted as an important way of improving outcomes of newborns. The purpose of this review is to examine the effectiveness of recent quality improvement work in improving the outcomes of infants requiring neonatal intensive care. Quality improvement collaboratives and single-center projects demonstrate improvement of clinical processes and outcomes in neonatology that impact both preterm and term infants. Declines in morbidities, resource use, and length of stay have been associated with reductions in healthcare costs. Recent quality improvement work has shown evidence of improvement in clinical outcomes in neonatal intensive care patients. These improvements have important implications for the reduction of healthcare costs in this population.

  9. How to Begin a Quality Improvement Project.

    Science.gov (United States)

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

    2016-05-06

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

  10. Quality Control in Production Processes

    Directory of Open Access Journals (Sweden)

    Prístavka Miroslav

    2016-09-01

    Full Text Available The tools for quality management are used for quality improvement throughout the whole Europe and developed countries. Simple statistics are considered one of the most basic methods. The goal was to apply the simple statistical methods to practice and to solve problems by using them. Selected methods are used for processing the list of internal discrepancies within the organization, and for identification of the root cause of the problem and its appropriate solution. Seven basic quality tools are simple graphical tools, but very effective in solving problems related to quality. They are called essential because they are suitable for people with at least basic knowledge in statistics; therefore, they can be used to solve the vast majority of problems.

  11. Software quality: Process or people

    Science.gov (United States)

    Palmer, Regina; Labaugh, Modenna

    1993-01-01

    This paper will present data related to software development processes and personnel involvement from the perspective of software quality assurance. We examine eight years of data collected from six projects. Data collected varied by project but usually included defect and fault density with limited use of code metrics, schedule adherence, and budget growth information. The data are a blend of AFSCP 800-14 and suggested productivity measures in Software Metrics: A Practioner's Guide to Improved Product Development. A software quality assurance database tool, SQUID, was used to store and tabulate the data.

  12. 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....

  13. Implementation of a Quality Improvement Process Aimed to Deliver Higher-Value Physical Therapy for Patients With Low Back Pain: Case Report.

    Science.gov (United States)

    Karlen, Emily; McCathie, Becky

    2015-12-01

    The current state of health care demands higher-value care. Due to many barriers, clinicians routinely do not implement evidence-based care even though it is known to improve quality and reduce cost of care. The purpose of this case report is to describe a theory-based, multitactic implementation of a quality improvement process aimed to deliver higher-value physical therapy for patients with low back pain. Patients were treated from January 2010 through December 2014 in 1 of 32 outpatient physical therapy clinics within an academic health care system. Data were examined from 47,755 patients (mean age=50.3 years) entering outpatient physical therapy for management of nonspecific low back pain, with or without radicular pain. Development and implementation tactics were constructed from adult learning and change management theory to enhance adherence to best practice care among 130 physical therapists. A quality improvement team implemented 4 tactics: establish care delivery expectations, facilitate peer-led clinical and operational teams, foster a learning environment focused on meeting a population's needs, and continuously collect and analyze outcomes data. Physical therapy utilization and change in functional disability were measured to assess relative cost and quality of care. Secondarily, charge data assessed change in physical therapists' application of evidence-based care. Implementation of a quality improvement process was measured by year-over-year improved clinical outcomes, decreased utilization, and increased adherence to evidence-based physical therapy, which was associated with higher-value care. When adult learning and change management theory are combined in quality improvement efforts, common barriers to implementing evidence-based care can be overcome, creating an environment supportive of delivering higher-value physical therapy for patients with low back pain. © 2015 American Physical Therapy Association.

  14. Applying process mapping and analysis as a quality improvement strategy to increase the adoption of fruit, vegetable, and water breaks in Australian primary schools.

    Science.gov (United States)

    Biggs, Janice S; Farrell, Louise; Lawrence, Glenda; Johnson, Julie K

    2014-03-01

    Over the past decade, public health policy in Australia has prioritized the prevention and control of obesity and invested in programs that promote healthy eating-related behaviors, which includes increasing fruit and vegetable consumption in children. This article reports on a study that used process mapping and analysis as a quality improvement strategy to improve the delivery of a nutrition primary prevention program delivered in primary schools in New South Wales, Australia. Crunch&Sip® has been delivered since 2008. To date, adoption is low with only 25% of schools implementing the program. We investigated the cause of low adoption and propose actions to increase school participation. We conducted semistructured interviews with key stakeholders and analyzed the process of delivering Crunch&Sip to schools. Interviews and process mapping and analysis identified a number of barriers to schools adopting the program. The analyses identified the need to simplify and streamline the process of delivering the program to schools and introduce monitoring and feedback loops to track ongoing participation. The combination of stakeholder interviews and process mapping and analysis provided important practical solutions to improving program delivery and also contributed to building an understanding of factors that help and hinder program adoption. The insight provided by this analysis helped identify usable routine measures of adoption, which were an improvement over those used in the existing program plan. This study contributed toward improving the quality and efficiency of delivering a health promoting program to work toward achieving healthy eating behaviors in children.

  15. "Rheum to Improve": Quality Improvement in Outpatient Rheumatology.

    Science.gov (United States)

    Chow, Shirley L; Shojania, Kaveh G

    2017-09-01

    The commitment to improve care processes and patient outcomes is a professional mandate for clinicians and is also seen as an operational priority for institutions. Quality improvement now figures in the accreditation of training programs, specialty examinations, and hospital scorecards. Rheumatologists have traditionally focused primarily on quality problems such as guideline adherence; however, improvement goals should also include other aspects of care that are helpful to patients and are professionally rewarding for practitioners. This review makes use of improvement projects in outlining tangible tools rheumatologists can use to resolve quality concerns in their practices.

  16. CQI project improves discharge process.

    Science.gov (United States)

    1998-08-01

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

  17. Technological measures to improve automotive product quality

    OpenAIRE

    Gladkov, V.; Kruglov, S.

    2010-01-01

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

  18. Improvement of phenolic antioxidants and quality characteristics of virgin olive oil with the addition of enzymes and nitrogen during olive paste processing

    Energy Technology Data Exchange (ETDEWEB)

    Inconomou, D.; Arapoglou, D.; Israilides, C.

    2010-07-01

    The evolution of phenolic compounds and their contribution to the quality characteristics in virgin olive oil during fruit processing was studied with the addition of a combination of various commercial enzymes containing pectinases, polygalacturonases, cellulase and {beta}-glucanase with or without nitrogen flush. Olive fruits (Olea europaea, L.) of the cultivar Megaritiki, at the semi black pigmentation stage of maturity, were used in a 3-phase extraction system in an experiment at industrial scale. The addition of enzymes in the olive paste during processing increased the total phenol and ortho-diphenol contents, as well as some simple phenolic compounds (3,4-DHPEA, p-HPEA) and the secoiridoid derivatives (3,4-DHPEA-EDA and 3,4-DHPEAEA) in olive oil and therefore improved its oxidative stability. Furthermore, enzyme treatment ameliorated the quality parameters of the produced olive oil (acidity and peroxide value) and their sensory attributes. The use of additional N{sub 2} flush with the enzyme treatments did not improve the quality parameters of olive oil any further; however it did not affect the concentration of individual and total sterols or most of the fatty acid composition. Consequently, olive paste treatment with enzymes not only improved the quality characteristics of olive oil and enhanced the overall organoleptic quality, but also increased the olive oil yield. (Author) 33 refs.

  19. Process Improvement: Customer Service.

    Science.gov (United States)

    Cull, Donald

    2015-01-01

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

  20. From fishing to fish processing: Separation of fish from crustaceans in the Norway lobster-directed multispecies trawl fishery improves seafood quality

    DEFF Research Database (Denmark)

    Karlsen, Junita Diana; Krag, Ludvig Ahm; Albertsen, Christoffer Moesgaard

    2015-01-01

    Fishing gears have negative impacts on seafood quality, especially on fish in the mixed trawl fishery targeting Norway lobster (Nephrops norvegicus). In this fishery, which is worth about €80 millions in Denmark alone, the quality of fish can be significantly improved by simple gear changes....... A trawl codend divided into an upper and lower codend was designed to separate fish from Norway lobster during the fishing process by encourage fish to swim into the upper codend by using a frame at the entrance of the lower codend. Separate codends for fish and Norway lobster in the same gear provide...... with hard or spiny surfaces due to successful separation of fish and Norway lobster into the upper and lower codends, respectively, and by lower catch weight in the upper codend of the test codend compared with the standard codend. The decrease in damages may also improve quality indirectly by inflicting...

  1. A Combination of Biochar-Mineral Complexes and Compost Improves Soil Bacterial Processes, Soil Quality, and Plant Properties.

    Science.gov (United States)

    Ye, Jun; Zhang, Rui; Nielsen, Shaun; Joseph, Stephen D; Huang, Danfeng; Thomas, Torsten

    2016-01-01

    Organic farming avoids the use of synthetic fertilizers and promises food production with minimal environmental impact, however this farming practice does not often result in the same productivity as conventional farming. In recent years, biochar has received increasing attention as an agricultural amendment and by coating it with minerals to form biochar-mineral complex (BMC) carbon retention and nutrient availability can be improved. However, little is known about the potential of BMC in improving organic farming. We therefore investigated here how soil, bacterial and plant properties respond to a combined treatment of BMC and an organic fertilizer, i.e., a compost based on poultry manure. In a pakchoi pot trial, BMC and compost showed synergistic effects on soil properties, and specifically by increasing nitrate content. Soil nitrate has been previously observed to increase leaf size and we correspondingly saw an increase in the surface area of pakchoi leaves under the combined treatment of BMC and composted chicken manure. The increase in soil nitrate was also correlated with an enrichment of bacterial nitrifiers due to BMC. Additionally, we observed that the bacteria present in the compost treatment had a high turnover, which likely facilitated organic matter degradation and a reduction of potential pathogens derived from the manure. Overall our results demonstrate that a combination of BMC and compost can stimulate microbial process in organic farming that result in better vegetable production and improved soil properties for sustainable farming.

  2. A combination of biochar-mineral complexes and compost improves soil bacterial processes, soil quality and plant properties

    Directory of Open Access Journals (Sweden)

    JUN eYE

    2016-04-01

    Full Text Available Organic farming avoids the use of synthetic fertilizers and promises food production with minimal environmental impact, however this farming practice does not often result in the same productivity as conventional farming. In recent years, biochar has received increasing attention as an agricultural amendment and by coating it with minerals to form biochar-mineral complex (BMC carbon retention and nutrient availability can be improved. However, little is known about the potential of BMC in improving organic farming. We therefore investigated here how soil, bacterial and plant properties respond to a combined treatment of BMC and an organic fertilizer, i.e. a compost based on poultry manure. In a pakchoi pot trial, BMC and compost showed synergistic effects on soil properties, and specifically by increasing nitrate content. Soil nitrate has been previously observed to increase leaf size and we correspondingly saw an increase in the surface area of pakchoi leaves under the combined treatment of BMC and chicken manure. The increase in soil nitrate was also correlated with an enrichment of bacterial nitrifiers due to BMC. Additionally, we observed that the bacteria present in the compost treatment had a high turnover, which likely facilitated organic matter degradation and a reduction of potential pathogens derived from the manure. Overall our results demonstrate that a combination of BMC and compost can stimulate microbial process in organic farming that result in better vegetable production and improved soil properties for sustainable farming.

  3. Quality improvement through multiple response optimization

    International Nuclear Information System (INIS)

    Noorossana, R.; Alemzad, H.

    2003-01-01

    The performance of a product is often evaluated by several quality characteristics. Optimizing the manufacturing process with respect to only one quality characteristic will not always lead to the optimum values for other characteristics. Hence, it would be desirable to improve the overall quality of a product by improving quality characteristics, which are considered to be important. The problem consists of optimizing several responses using multiple objective decision making approach and design of experiments. A case study will be discussed to show the application of the proposal method

  4. Software Process Improvement

    DEFF Research Database (Denmark)

    Kuhrmann, Marco; Diebold, Philipp; Münch, Jürgen

    2016-01-01

    Software process improvement (SPI) is around for decades: frameworks are proposed, success factors are studied, and experiences have been reported. However, the sheer mass of concepts, approaches, and standards published over the years overwhelms practitioners as well as researchers. What is out...... to new specialized frameworks. New and specialized frameworks account for the majority of the contributions found (approx. 38%). Furthermore, we find a growing interest in success factors (approx. 16%) to aid companies in conducting SPI and in adapting agile principles and practices for SPI (approx. 10...

  5. Practical Approaches to Quality Improvement for Radiologists.

    Science.gov (United States)

    Kelly, Aine Marie; Cronin, Paul

    2015-10-01

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

  6. Patient involvement in the decision-making process improves satisfaction and quality of life in postmastectomy breast reconstruction.

    Science.gov (United States)

    Ashraf, Azra A; Colakoglu, Salih; Nguyen, John T; Anastasopulos, Alexandra J; Ibrahim, Ahmed M S; Yueh, Janet H; Lin, Samuel J; Tobias, Adam M; Lee, Bernard T

    2013-09-01

    The patient-physician relationship has evolved from the paternalistic, physician-dominant model to the shared-decision-making and informed-consumerist model. The level of patient involvement in this decision-making process can potentially influence patient satisfaction and quality of life. In this study, patient-physician decision models are evaluated in patients undergoing postmastectomy breast reconstruction. All women who underwent breast reconstruction at an academic hospital from 1999-2007 were identified. Patients meeting inclusion criteria were mailed questionnaires at a minimum of 1 y postoperatively with questions about decision making, satisfaction, and quality of life. There were 707 women eligible for our study and 465 completed surveys (68% response rate). Patients were divided into one of three groups: paternalistic (n = 18), informed-consumerist (n = 307), shared (n = 140). There were differences in overall general satisfaction (P = 0.034), specifically comparing the informed group to the paternalistic group (66.7% versus 38.9%, P = 0.020) and the shared to the paternalistic group (69.3% versus 38.9%, P = 0.016). There were no differences in aesthetic satisfaction. There were differences found in the SF-12 physical component summary score across all groups (P = 0.033), and a difference was found between the informed and paternalistic groups (P mental component score (P = 0.42). Women undergoing breast reconstruction predominantly used the informed model of decision making. Patients who adopted a more active role, whether using an informed or shared approach, had higher general patient satisfaction and physical component summary scores compared with patients whose decision making was paternalistic. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Improving microbiological safety and quality characteristics of wheat and barley by high voltage atmospheric cold plasma closed processing.

    Science.gov (United States)

    Los, Agata; Ziuzina, Dana; Akkermans, Simen; Boehm, Daniela; Cullen, Patrick J; Van Impe, Jan; Bourke, Paula

    2018-04-01

    Contamination of cereal grains as a key global food resource with insects or microorganisms is a persistent concern for the grain industry due to irreversible damage to quality and safety characteristics and economic losses. Atmospheric cold plasma presents an alternative to conventional grain decontamination methods owing to the high antimicrobial potential of reactive species generated during the treatment, but effects against product specific microflora are required to understand how to optimally develop this approach for grains. This work investigated the influence of ACP processing parameters for both cereal grain decontamination and grain quality as important criteria for grain or seed use. A high voltage (HV) (80 kV) dielectric barrier discharge (DBD) closed system was used to assess the potential for control of native microflora and pathogenic bacterial and fungal challenge microorganisms, in tandem with effects on grain functional properties. Response surface modelling of experimental data probed the key factors in relation to microbial control and seed germination promotion. The maximal reductions of barley background microbiota were 2.4 and 2.1 log 10  CFU/g and of wheat - 1.5 and 2.5 log 10  CFU/g for bacteria and fungi, respectively, which required direct treatment for 20 min followed by a 24 h sealed post-treatment retention time. In the case of challenge organisms inoculated on barley grains, the highest resistance was observed for Bacillus atrophaeus endospores, which, regardless of retention time, were maximally reduced by 2.4 log 10  CFU/g after 20 min of direct treatment. The efficacy of the plasma treatment against selected microorganisms decreased in the following order: E. coli > P. verrucosum (spores) > B. atrophaeus (vegetative cells) > B. atrophaeus (endospores). The challenge microorganisms were more susceptible to ACP treatment than naturally present background microbiota. No major effect of short term

  8. [Effect of a life review process to improve quality of life for the homebound elderly in Japan].

    Science.gov (United States)

    Imuta, Hiromi; Yasumura, Seiji; Ahiko, Tadayuki

    2004-07-01

    This study examined the therapeutic effects of Life Review processes on physical and psychological functions of homebound elderly in Japan. From 1998, a cohort of people aged 65 and over living in two cities in Yamagata Prefecture has been followed. Sixty-three subjects (24 men, 39 women) were classified as rank A (homebound). Fifty-two persons completed the baseline survey in 1999 and 46 eligible persons (18 men and 28 women) were allocated to intervention and control groups whose age and sex distribution were matched. Intervention entailed giving some health information and Life Review processing for four months, twice a month on average. Each session started with provision of health information followed by the Life Review process which took an hour to finish. All subjects of both groups were assessed for dependent variables at the beginning and the end of the intervention period (pretest and post-test). Dependent variables were physical (Activities of Daily Living, Visual deficit, and others), psychological (subjective health, life satisfaction, self-efficacy scale, and others), and social (functional ability and frequency of getting out of the house). The control group received only the pretest and the post-test. Pretest scores for all physical, psychological, and social variables did not significantly differ between the two groups. The rate for improvement/no change were higher with regard to hearing deficit, ADL (eating, dressing), cognition, subjective health, ikigai and frequency of getting out of house in the intervention group than in the control group, but there were no significant differences. The developed intervention program featuring delivery of health information and structured Life Review Process had no negative influence on physical and psycho-social functions. Practicability of the intervention was suggested. But the study highlights problems such as selection of subjects, duration and method of intervention.

  9. A quality control circle process to improve implementation effect of prevention measures for high-risk patients.

    Science.gov (United States)

    Feng, Haixia; Li, Guohong; Xu, Cuirong; Ju, Changping; Suo, Peiheng

    2017-12-01

    The aim of the study was to analyse the influence of prevention measures on pressure injuries for high-risk patients and to establish the most appropriate methods of implementation. Nurses assessed patients using a checklist and factors influencing the prevention of a pressure injury determined by brain storming. A specific series of measures was drawn up and an estimate of risk of pressure injury determined using the Braden Scale, analysis of nursing documents, implementation of prevention measures for pressure sores and awareness of the system both before and after carrying out a quality control circle (QCC) process. The overall scores of implementation of prevention measures ranged from 74.86 ± 14.24 to 87.06 ± 17.04, a result that was statistically significant (P prevention measure scores ranged from 11.48 ± 4.18 to 13.96 ± 3.92. Differences in all of the above results are statistically significant (P prevention measures for patients who are vulnerable to pressure sores and is of practical importance to their prevention and control. © 2017 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  10. Designing quality of care--contributions from parents: Parents' experiences of care processes in paediatric care and their contribution to improvements of the care process in collaboration with healthcare professionals.

    Science.gov (United States)

    Gustavsson, Susanne; Gremyr, Ida; Kenne Sarenmalm, Elisabeth

    2016-03-01

    The aim of this article was to explore whether current quality dimensions for health care services are sufficient to capture how parents perceive and contribute to quality of health care. New quality improvement initiatives that actively involve patients must be examined with a critical view on established quality dimensions to ensure that these measures support patient involvement. This paper used a qualitative and descriptive design. This paper is based on interviews with parents participating in two experience-based co-design projects in a Swedish hospital that included qualitative content analysis of data from 12 parent interviews in paediatric care. Health care professionals often overemphasize their own significance for value creation in care processes and underappreciate parents' ability to influence and contribute to better quality. However, quality is not based solely on how professionals accomplish their task, but is co-created by health care professionals and parents. Consequently, assessment of quality outcomes also must include parents' ability and context. This paper questions current models of quality dimensions in health care, and suggests additional sub-dimensions, such as family quality and involvement quality. This paper underscores the importance of involving parents in health care improvements with health care professionals to capture as many dimensions of quality as possible. © 2015 John Wiley & Sons Ltd.

  11. Improving Tanzanian childbirth service quality.

    Science.gov (United States)

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

    2018-04-16

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

  12. The Value of Quality Improvement Process in the Detection and Correction of Common Errors in Echocardiographic Hemodynamic Parameters in a Busy Echocardiography Laboratory.

    Science.gov (United States)

    Fanari, Zaher; Choudhry, Usman I; Reddy, Vivek K; Eze-Nliam, Chete; Hammami, Sumaya; Kolm, Paul; Weintraub, William S; Marshall, Erik S

    2015-12-01

    Accurate assessment of cardiac structures, ventricular function, and hemodynamics is essential for any echocardiographic laboratory. Quality improvement (QI) processes described by the American Society of Echocardiography (ASE) and the Intersocietal Commission (IAC) should be instrumental in reaching this goal. All patients undergoing transthoracic echocardiogram (TTE) followed by cardiac catheterization within 24 hours at Christiana Care Health System in 2011 and 2012 were identified, with 126 and 133 cases, respectively. Hemodynamic parameters of diastolic function and pulmonary artery systolic pressure (PASP) on TTE correlated poorly with catheterization in 2011. An educational process was developed and implemented at quarterly QI meetings based on ASE and IAC recommendations to target frequently encountered errors and provide methods for improved performance. The hemodynamic parameters were then reexamined in 2012 postintervention. Following the QI process, there was significant improvement in the correlation between invasive and echocardiographic hemodynamic measurements in both systolic and diastolic function, and PASP. This reflected in significant better correlations between echo and cath LVEF [R = 0.88, ICC = 0.87 vs. R = 0.85, ICC = 0.85; P process, as recommended by ASE and IAC, can allow for identification as well as rectification of quality issues in a large regional academic medical center hospital. © 2015, Wiley Periodicals, Inc.

  13. Software Process Improvement

    DEFF Research Database (Denmark)

    Kuhrmann, Marco; Konopka, Claudia; Nellemann, Peter

    2016-01-01

    directions. An analysis of 635 publications draws a big picture of SPI-related research of the past 25 years. Our study shows a high number of solution proposals, experience reports, and secondary studies, but only few theories. In particular, standard SPI models are analyzed and evaluated for applicability......Software process improvement (SPI) is around for decades: frameworks are proposed, success factors are studied, and experiences have been reported. However, the sheer mass of concepts, approaches, and standards published over the years overwhelms practitioners as well as researchers. What is out...... there? Are there new emerging approaches? What are open issues? Still, we struggle to answer the question for what is the current state of SPI and related research? We present initial results from a systematic mapping study to shed light on the field of SPI and to draw conclusions for future research...

  14. Air Quality Management Process Cycle

    Science.gov (United States)

    Air quality management are activities a regulatory authority undertakes to protect human health and the environment from the harmful effects of air pollution. The process of managing air quality can be illustrated as a cycle of inter-related elements.

  15. Improvement of the safety of the red pepper spice with FMEA and post processing EWMA quality control charts.

    Science.gov (United States)

    Ozilgen, Sibel; Bucak, Seyda; Ozilgen, Mustafa

    2013-06-01

    Although there are numerous decades-old studies drawing attention to the presence of aflatoxins in spices, and particularly in red pepper spice, the problem has not been eradicated. In the present study, information presented in the literature, about production method of red pepper spice, its contamination with aflatoxin, and the uncertainty about the data are assessed to find out the points where improvement may be achieved. Failure Mode and Effect Analysis (FMEA) are performed to assess the risk. The highest total risk attributable to chemical plus physical plus biological causes is associated with the washing stage (RPN=363), which is followed by the receiving (RPN=342) and the storage (RPN=342) stages. The highest risk attributable to biological causes (RPN=180) is associated with microbial growth and aflatoxin production due to insufficient control of drying conditions. The highest chemical risk (RPN=144) is found for the presence of unintentional food additives, such as pesticides, herbicides, hormones, and heavy metals in fresh red pepper fruits. EWMA (exponentially weighted average) charts are employed to monitor aflatoxin production during storage. They successfully distinguished between the batches, which turned to be unsafe. Risk associated with unintentional additives may be reduced by using certified additives only. Better drying control will definitely reduce the risk associated with the drying process. Codex Alimentarius plan has worldwide acceptance for assessing safety of the nuts. Risk of accepting the batches contaminated with aflatoxin may be eliminated by applying the Codex Alimentarius sampling plan before putting the dry pulverized red pepper into the storage facility.

  16. Contribuição dos modelos de qualidade e maturidade na melhoria dos processos de software Contribution of quality and maturity models to software process improvement

    Directory of Open Access Journals (Sweden)

    Antonio Carlos Tonini

    2008-01-01

    Full Text Available Grande parte das empresas desenvolvedoras de software criou seu próprio processo de trabalho. Devido à rápida expansão do mercado de software, a concorrência ocorre muito mais em custo do que em diferenciação. Para obter vantagem competitiva, as empresas devem atualizar-se continuamente na tecnologia, buscar a maturidade nos processos e eliminar a ineficiência operacional. Isso requer um envolvimento das pessoas, dos processos e da organização como um todo. O artigo discute a implementação de melhorias nos processos de software segundo os principais modelos de qualidade e de maturidade. Com base em um Estudo de Casos Múltiplos, verifica-se que a melhoria dos processos de software requer que a melhoria ocorra primeiramente entre cada um dos desenvolvedores e, a seguir, envolva os grupos de desenvolvimento e por fim, a organização como um todo. A pesquisa conclui que os modelos de qualidade e maturidade servem como orientadores do processo de melhoria.Many software development companies have developed their own work method. Due to the fast software market growth, the competition focuses more on cost than on differentiation. To achieve competitive advantage, software developer organizations must continually update their technology, reach high level process maturity and eliminate all the operational inefficiency. These procedures involve people, processes and the whole organization. The aim of the paper is to discuss software process improvement implementation according to the most important quality and maturity models. Based on a Multiple Case Study, it is verified that the software process improvement needs firstly individual improvement and, later, it involves the developer teams and the whole organization. The research concludes that the quality and maturity models must be used as improvement process drivers.

  17. 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.

  18. Creating Quality Improvement Culture in Public Health Agencies

    Science.gov (United States)

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

    2014-01-01

    Objectives. We conducted case studies of 10 agencies that participated in early quality improvement efforts. Methods. The agencies participated in a project conducted by the National Association of County and City Health Officials (2007–2008). Case study participants included health directors and quality improvement team leaders and members. We implemented multiple qualitative analysis processes, including cross-case analysis and logic modeling. We categorized agencies according to the extent to which they had developed a quality improvement culture. Results. Agencies were conducting informal quality improvement projects (n = 4), conducting formal quality improvement projects (n = 3), or creating a quality improvement culture (n = 4). Agencies conducting formal quality improvement and creating a quality improvement culture had leadership support for quality improvement, participated in national quality improvement initiatives, had a greater number of staff trained in quality improvement and quality improvement teams that met regularly with decision-making authority. Agencies conducting informal quality improvement were likely to report that accreditation is the major driver for quality improvement work. Agencies creating a quality improvement culture were more likely to have a history of evidence-based decision-making and use quality improvement to address emerging issues. Conclusions. Our findings support previous research and add the roles of national public health accreditation and emerging issues as factors in agencies’ ability to create and sustain a quality improvement culture. PMID:24228680

  19. IMPROVEMENT OF SYSTEM OF QUALITY MANAGEMENT OIL-FAT OF THE ENTERPRISE ON THE BASIS OF PERFECTION OF TECHNOLOGICAL PROCESSES

    Directory of Open Access Journals (Sweden)

    V. N. Vasilenko

    2012-01-01

    Full Text Available The control system of quality in the oil and fat industry which can become the real tool of continuous perfection of activity of the enterprise and a source of economic gains benefits is offered

  20. Application of quality by design principles to the development and technology transfer of a major process improvement for the manufacture of a recombinant protein.

    Science.gov (United States)

    Looby, Mairead; Ibarra, Neysi; Pierce, James J; Buckley, Kevin; O'Donovan, Eimear; Heenan, Mary; Moran, Enda; Farid, Suzanne S; Baganz, Frank

    2011-01-01

    This study describes the application of quality by design (QbD) principles to the development and implementation of a major manufacturing process improvement for a commercially distributed therapeutic protein produced in Chinese hamster ovary cell culture. The intent of this article is to focus on QbD concepts, and provide guidance and understanding on how the various components combine together to deliver a robust process in keeping with the principles of QbD. A fed-batch production culture and a virus inactivation step are described as representative examples of upstream and downstream unit operations that were characterized. A systematic approach incorporating QbD principles was applied to both unit operations, involving risk assessment of potential process failure points, small-scale model qualification, design and execution of experiments, definition of operating parameter ranges and process validation acceptance criteria followed by manufacturing-scale implementation and process validation. Statistical experimental designs were applied to the execution of process characterization studies evaluating the impact of operating parameters on product quality attributes and process performance parameters. Data from process characterization experiments were used to define the proven acceptable range and classification of operating parameters for each unit operation. Analysis of variance and Monte Carlo simulation methods were used to assess the appropriateness of process design spaces. Successful implementation and validation of the process in the manufacturing facility and the subsequent manufacture of hundreds of batches of this therapeutic protein verifies the approaches taken as a suitable model for the development, scale-up and operation of any biopharmaceutical manufacturing process. Copyright © 2011 American Institute of Chemical Engineers (AIChE).

  1. [QUIPS: quality improvement in postoperative pain management].

    Science.gov (United States)

    Meissner, Winfried

    2011-01-01

    Despite the availability of high-quality guidelines and advanced pain management techniques acute postoperative pain management is still far from being satisfactory. The QUIPS (Quality Improvement in Postoperative Pain Management) project aims to improve treatment quality by means of standardised data acquisition, analysis of quality and process indicators, and feedback and benchmarking. During a pilot phase funded by the German Ministry of Health (BMG), a total of 12,389 data sets were collected from six participating hospitals. Outcome improved in four of the six hospitals. Process indicators, such as routine pain documentation, were only poorly correlated with outcomes. To date, more than 130 German hospitals use QUIPS as a routine quality management tool. An EC-funded parallel project disseminates the concept internationally. QUIPS demonstrates that patient-reported outcomes in postoperative pain management can be benchmarked in routine clinical practice. Quality improvement initiatives should use outcome instead of structural and process parameters. The concept is transferable to other fields of medicine. Copyright © 2011. Published by Elsevier GmbH.

  2. Food science meets plant science: A case study on improved nutritional quality by breeding for glucosinolate retention during food processing

    NARCIS (Netherlands)

    Hennig, K.; Verkerk, R.; Boekel, van M.A.J.S.; Dekker, M.; Bonnema, A.B.

    2014-01-01

    Nutritional quality of vegetables is affected by several steps in the food chain. Up to now the effects of these different steps are mostly studied separately. We propose the cooperation between plant breeding and food technology by using food technological parameters as breeding traits to identify

  3. Quality Improvement Initiatives in Inflammatory Bowel Disease.

    Science.gov (United States)

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

    2017-08-01

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

  4. POSSIBILITIES OF APPLICATION OF THE HACCP SYSTEM RULES IN THE PROCESS OF IMPROVING THE QUALITY OF EDUCATION IN AGRICULTURAL SECONDARY SCHOOLS

    Directory of Open Access Journals (Sweden)

    Maria Kaczmarek

    2014-09-01

    Full Text Available The paper presents theoretical issues concerning the possibilities of application of the HACCP system rules in the process of improving the quality of education in secondary schools. The carried out analysis show that it is possible to apply the HACCP system rules in secondary schools. Implementation of the HACCP system rules in schools can be beneficial in four areas: economically-financial, organisational, educational and social. Moreover, the education security would increase, the intellectual loss and failure of students would be diminished and on the educational market an increase of competitiveness and trust to school and its graduates would be observed.

  5. Teacher Research as Continuous Process Improvement

    Science.gov (United States)

    Ellis, Charles; Castle, Kathryn

    2010-01-01

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

  6. Software quality testing process analysis

    OpenAIRE

    Mera Paz, Julián

    2016-01-01

    Introduction: This article is the result of reading, review, analysis of books, magazines and articles well known for their scientific and research quality, which have addressed the software quality testing process. The author, based on his work experience in software development companies, teaching and other areas, has compiled and selected information to argue and substantiate the importance of the software quality testing process. Methodology: the existing literature on the software qualit...

  7. An integrated approach for prioritized process improvement.

    Science.gov (United States)

    Vanteddu, Gangaraju; McAllister, Charles D

    2014-01-01

    The purpose of this paper is to propose an integrated framework to simultaneously identify and improve healthcare processes that are important from the healthcare provider's and patient's perspectives. A modified quality function deployment (QFD) chart is introduced to the field of healthcare quality assurance. A healthcare service example is used to demonstrate the utility of the proposed chart. The proposed framework is versatile and can be used in a wide variety of healthcare quality improvement contexts, wherein, two different perspectives are needed to be considered for identifying and improving critical healthcare processes. The modified QFD chart used in conjunction with the stacked Pareto chart will facilitate the identification of key performance metrics from the patient's and the hospital's perspectives. Subsequently, the chief contributory factors at different levels are identified in a very efficient manner. Healthcare quality improvement professionals will be able to use the proposed modified QFD chart in association with stacked Pareto chart for effective quality assurance.

  8. Structuring the Peer Assessment Process: A Multilevel Approach for the Impact on Product Improvement and Peer Feedback Quality

    Science.gov (United States)

    Gielen, M.; De Wever, B.

    2015-01-01

    In order to optimize students' peer feedback processes, this study investigates how an instructional intervention in the peer assessment process can have a beneficial effect on students' performance in a wiki environment in first-year higher education. The main aim was to study the effect of integrating a peer feedback template with a varying…

  9. Improving care at cystic fibrosis centers through quality improvement.

    Science.gov (United States)

    Kraynack, Nathan C; McBride, John T

    2009-10-01

    Quality improvement (QI) using a clinical microsystems approach provides cystic fibrosis (CF) centers the opportunity to make a significant positive impact on the health of their patients. The availability of center-specific outcomes data and the support of the Cystic Fibrosis Foundation are important advantages for these quality improvement efforts. This article illustrates how the clinical microsystems methodology can improve care delivery and outcomes by describing the gradual application of quality improvement principles over the past 5 years by the CF team at the Lewis Walker Cystic Fibrosis Center at Akron Children's Hospital in Akron, Ohio. Using the example of a project to improve the pulmonary function of the pediatric patients at our center as a framework, we describe the QI process from the initial team-building phase, through the assessment of care processes, standardization of care, and developing a culture of continuous improvement. We outline how enthusiastic commitment from physician leadership, clinical managers and central administration, the availability of coaches, and an appreciation of the importance of measurement, patient involvement, communication, and standardization are critical components for successful process improvement. Copyright Thieme Medical Publishers.

  10. Improving patient safety through quality assurance.

    Science.gov (United States)

    Raab, Stephen S

    2006-05-01

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

  11. Improving PSA quality of KSNP PSA model

    International Nuclear Information System (INIS)

    Yang, Joon Eon; Ha, Jae Joo

    2004-01-01

    In the RIR (Risk-informed Regulation), PSA (Probabilistic Safety Assessment) plays a major role because it provides overall risk insights for the regulatory body and utility. Therefore, the scope, the level of details and the technical adequacy of PSA, i.e. the quality of PSA is to be ensured for the successful RIR. To improve the quality of Korean PSA, we evaluate the quality of the KSNP (Korean Standard Nuclear Power Plant) internal full-power PSA model based on the 'ASME PRA Standard' and the 'NEI PRA Peer Review Process Guidance.' As a working group, PSA experts of the regulatory body and industry also participated in the evaluation process. It is finally judged that the overall quality of the KSNP PSA is between the ASME Standard Capability Category I and II. We also derive some items to be improved for upgrading the quality of the PSA up to the ASME Standard Capability Category II. In this paper, we show the result of quality evaluation, and the activities to improve the quality of the KSNP PSA model

  12. Modalities of hemodialysis: Quality improvement

    Directory of Open Access Journals (Sweden)

    Ayman Karkar

    2012-01-01

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

  13. Benchmarking: A Process for Improvement.

    Science.gov (United States)

    Peischl, Thomas M.

    One problem with the outcome-based measures used in higher education is that they measure quantity but not quality. Benchmarking, or the use of some external standard of quality to measure tasks, processes, and outputs, is partially solving that difficulty. Benchmarking allows for the establishment of a systematic process to indicate if outputs…

  14. Improving coal quality and service

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-06-01

    Russia's new coal export industry has quickly produced a generation of extremely experienced operators. While improvements are happening, can buyers also expect the service, flexibility and quality control that they get from other export sources? In the light of the first-ever Coaltrans Russia conference held in April the article reports on developments in Russia's coal industry, quoting from many of the papers presented. 5 photos.

  15. Quality measurement and improvement in liver transplantation.

    Science.gov (United States)

    Mathur, Amit K; Talwalkar, Jayant

    2018-06-01

    There is growing interest in the quality of health care delivery in liver transplantation. Multiple stakeholders, including patients, transplant providers and their hospitals, payers, and regulatory bodies have an interest in measuring and monitoring quality in the liver transplant process, and understanding differences in quality across centres. This article aims to provide an overview of quality measurement and regulatory issues in liver transplantation performed within the United States. We review how broader definitions of health care quality should be applied to liver transplant care models. We outline the status quo including the current regulatory agencies, public reporting mechanisms, and requirements around quality assurance and performance improvement (QAPI) activities. Additionally, we further discuss unintended consequences and opportunities for growth in quality measurement. Quality measurement and the integration of quality improvement strategies into liver transplant programmes hold significant promise, but multiple challenges to successful implementation must be addressed to optimise value. Copyright © 2018 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

  16. From Fishing to Fish Processing: Separation of Fish from Crustaceans in the Norway Lobster-Directed Multispecies Trawl Fishery Improves Seafood Quality.

    Directory of Open Access Journals (Sweden)

    Junita D Karlsen

    Full Text Available Fishing gears have negative impacts on seafood quality, especially on fish in the mixed trawl fishery targeting Norway lobster (Nephrops norvegicus. In this fishery, which is worth about €80 millions in Denmark alone, the quality of fish can be significantly improved by simple gear changes. A trawl codend divided into an upper and lower codend was designed to separate fish from Norway lobster during the fishing process by encourage fish to swim into the upper codend by using a frame at the entrance of the lower codend. Separate codends for fish and Norway lobster in the same gear provide the opportunity to selectively reduce small low-value fish, which will reduce catch weight and sorting time onboard the vessel. For this horizontally divided test codend and a standard codend, in which the catch was mixed, quality assessments were performed on the same batches of fish during three steps of the value chain: i aboard the fishing vessel; ii at the Fishermen's Collection Central, and iii in the production plant. Four species of fish and fillets from fish caught in the upper codend of the test codend were of significantly better quality for several of the assessed parameters compared with those caught in the standard codend: i newly caught fish showed significantly less scale loss and discolourations and had significantly better texture; ii landed fish had significantly better skin appearance and texture and significantly fewer discolourations; and iii fillets showed significantly fewer blood spots and had significantly better texture. There were no differences in injuries for newly caught fish or gaping and bruises for fillets between the test and standard codends. The decrease in catch-related damages in the test codend is explained by little contact between fish and animals with hard or spiny surfaces due to successful separation of fish and Norway lobster into the upper and lower codends, respectively, and by lower catch weight in the upper

  17. The influence of chemical methods (acid modification) on elephant foot yam flour to improve physical and chemical quality on processed food

    Science.gov (United States)

    Paramita, Octavianti; Wahyuningsih, Ansori, Muhammad

    2018-03-01

    This study was aimed at improving the physicochemical quality of elephant foot yam flour in Gunungpati, Semarang by acid modification. The utilization of elephant foot yam flour in several processed food was also discussed in this study. The flour of the experimental result discussed in this study was expected to become a reference for the manufacturers of elephant foot yam flour and its processed food in Gunungpati. This study modified the elephant foot yam flour using acid modification method. The physical and chemical quality of each elephant foot yam flour of the experimental result sample were assessed using proximate analysis. The resulting tuber flour weighed 50 grams and the soaked in acid solution with various concentrations 5 %, 10 % and 15 % with soaking duration 30, 60 and 90 minutes at temperature 35 °C. The resulting suspension was washed 3 times, filtered and then dried by cabinet dryer using 46 °C for 2 days. The dried flour was sifted with a 80 mesh sieve. Chemical test was conducted after elephant foot yam was acid modification to determine changes in the quality flour: test levels of protein, fat, crude fiber content, moisture content, ash content and starch content. In addition, color tests and granular test on elephant foot yam flour were also conducted. The acid modification as chemical treatment on elephant foot yam flour in this study was able to change the functional properties of elephant foot yam flour towards a better processing characterized by a brighter color (L = 80, a = 8 and b = 12), the hydrolysis of polysaccharides flour into shorter chain (flour content decreased to 72%), the expansion of granules in elephant foot yam resulting in a process - ready flour, and better monolayer water content of 11%. The content of protein and fiber on the elephant foot yam flour also can be maintained at a level of 8% and 1.9% levels.

  18. Driving collaborative improvement processes

    NARCIS (Netherlands)

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

    2002-01-01

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

  19. Driving collaborative improvement processes

    NARCIS (Netherlands)

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

    2005-01-01

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

  20. Yellow sweet potato flour: use in sweet bread processing to increase β-carotene content and improve quality

    Directory of Open Access Journals (Sweden)

    AMANDA C. NOGUEIRA

    2018-02-01

    Full Text Available ABSTRACT Yellow sweet potato is mostly produced by small farmers, and may be a source of energy and carotenoids in the human diet, but it is a highly perishable crop. To increase its industrial application, yellow sweet potato flour has been produced for use in bakery products. This study aimed to evaluate the technological quality and the carotenoids content in sweet breads produced with the replacement of wheat flour by 0, 3, 6, and 9% yellow sweet potato flour. Breads were characterized by technological parameters and β-carotene levels during nine days of storage. Tukey’s test (p<0.05 was used for comparison between means. The increase in yellow sweet potato flour concentrations in bread led to a decrease of specific volume and firmness, and an increase in water activity, moisture, orange coloring, and carotenoids. During storage, the most significant changes were observed after the fifth day, with a decrease in intensity of the orange color. The β-carotene content was 0.1656 to 0.4715 µg/g in breads with yellow sweet potato flour. This work showed a novel use of yellow sweet potato in breads, which brings benefits to consumers’ health and for the agricultural business.

  1. Yellow sweet potato flour: use in sweet bread processing to increase β-carotene content and improve quality.

    Science.gov (United States)

    Nogueira, Amanda C; Sehn, Georgia A R; Rebellato, Ana Paula; Coutinho, Janclei P; Godoy, Helena T; Chang, Yoon K; Steel, Caroline J; Clerici, Maria Teresa P S

    2018-01-01

    Yellow sweet potato is mostly produced by small farmers, and may be a source of energy and carotenoids in the human diet, but it is a highly perishable crop. To increase its industrial application, yellow sweet potato flour has been produced for use in bakery products. This study aimed to evaluate the technological quality and the carotenoids content in sweet breads produced with the replacement of wheat flour by 0, 3, 6, and 9% yellow sweet potato flour. Breads were characterized by technological parameters and β-carotene levels during nine days of storage. Tukey's test (p<0.05) was used for comparison between means. The increase in yellow sweet potato flour concentrations in bread led to a decrease of specific volume and firmness, and an increase in water activity, moisture, orange coloring, and carotenoids. During storage, the most significant changes were observed after the fifth day, with a decrease in intensity of the orange color. The β-carotene content was 0.1656 to 0.4715 µg/g in breads with yellow sweet potato flour. This work showed a novel use of yellow sweet potato in breads, which brings benefits to consumers' health and for the agricultural business.

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

    Science.gov (United States)

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

    2017-06-01

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

  3. Why Process Improvement Training Fails

    Science.gov (United States)

    Lu, Dawei; Betts, Alan

    2011-01-01

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

  4. Entropy based software processes improvement

    NARCIS (Netherlands)

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

    2009-01-01

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

  5. Laboratory quality improvement in Thailand's northernmost provinces.

    Science.gov (United States)

    Kanitvittaya, S; Suksai, U; Suksripanich, O; Pobkeeree, V

    2010-01-01

    In Thailand nearly 1000 public health laboratories serve 65 million people. A qualified indicator of a good quality laboratory is Thailand Medical Technology Council certification. Consequently, Chiang Rai Regional Medical Sciences Center established a development program for laboratory certification for 29 laboratories in the province. This paper seeks to examine this issue. The goal was to improve laboratory service quality by voluntary participation, peer review, training and compliance with standards. The program consisted of specific activities. Training and workshops to update laboratory staffs' quality management knowledge were organized. Staff in each laboratory performed a self-assessment using a standard check-list to evaluate ten laboratory management areas. Chiang Rai Regional Medical Sciences Center staff supported the distribution of quality materials and documents. They provided calibration services for laboratory equipment. Peer groups performed an internal audit and successful laboratories received Thailand Medical Technology Council certification. By December 2007, eight of the 29 laboratories had improved quality sufficiently to be certified. Factors that influenced laboratories' readiness for quality improvement included the number of staff, their knowledge, budget and staff commitment to the process. Moreover, the support of each hospital's laboratory working group or network was essential for success. There was no clear policy for supporting the program. Laboratories voluntarily conducted quality management using existing resources. A bottom-up approach to this kind of project can be difficult to accomplish. Laboratory professionals can work together to illustrate and highlight outcomes for top-level health officials. A top-down, practical approach would be much less difficult to implement. Quality certification is a critical step for laboratory staff, which also encourages them to aspire to international quality standards like ISO. The

  6. X-rays taken by radiologists. Influence on a continuous quality improvement process?; Roentgen durch Radiologen. Einfluss auf einen kontinuierlichen Qualitaetsverbesserungsprozess?

    Energy Technology Data Exchange (ETDEWEB)

    Kurtz, C. [Marburg Univ. (Germany). Abt. fuer Strahlendiagnostik; Freiburg Univ. (Germany). Abt. Roentgendiagnostik; Czapp, W.; Trampe, I.; Leppek, R.; Klose, K.J. [Marburg Univ. (Germany). Abt. fuer Strahlendiagnostik

    2000-04-01

    Purpose: To evaluate how the training of radiology residents in taking radiographs influences the work of radiographers and the established quality standards. Methods: A first year radiology resident was trained for 4 weeks in focusing and exposure techniques by radiographers. In a second period the resident took 582 radiograms, which were compared with those taken by technicians for error estimation on a daily basis. During a third period the radiographs were produced in a contest between the resident and a skilled radiographer. Errors were analysed by two independent experts according to established guidelines of the German Medical Association. Results: At the beginning of the second period the average error rate of the resident was 11.9% as compared to 8.9% in the technicians team, in the following month 9.2% versus 15.9%. In the third period no relevant difference in errors could be observed. Finally, unexpected quality improvements were implemented like an improved standardization of focusing and exposure techniques as well as dose reduction. Conclusions: Radiology residents easily learn focusing and exposure techniques and achieve comparable results as radiographers within a short period of time. The additionally achieved knowledge improves the technical process of taking radiographs. We recommend to include a two plane radiography training period in the curriculum of radiology residents. It reinforces the radiologist's role in continuous quality improvements of the diagnostic process. (orig.) [German] Ziel: Beeinflusst die Ausbildung von radiologischen Weiterbildungsassistenten (WBA) in der Anfertigung von Roentgenaufnahmen die Leistungen der MTRA und den daraus resultierenden Qualitaetsstandard? Material und Methoden: Eine WBA wurde vier Wochen lang von MTRA in Roentgeneinstelltechniken unterrichtet. In der zweiten Periode erstellte sie 582 Roentgenaufnahmen, die in einem taeglichen Vergleich mit denjenigen der MTRA auf Fehler geprueft wurden. In einer

  7. Adopting software quality measures for healthcare processes.

    Science.gov (United States)

    Yildiz, Ozkan; Demirörs, Onur

    2009-01-01

    In this study, we investigated the adoptability of software quality measures for healthcare process measurement. Quality measures of ISO/IEC 9126 are redefined from a process perspective to build a generic healthcare process quality measurement model. Case study research method is used, and the model is applied to a public hospital's Entry to Care process. After the application, weak and strong aspects of the process can be easily observed. Access audibility, fault removal, completeness of documentation, and machine utilization are weak aspects and these aspects are the candidates for process improvement. On the other hand, functional completeness, fault ratio, input validity checking, response time, and throughput time are the strong aspects of the process.

  8. Developing a set of consensus indicators to support maternity service quality improvement: using Core Outcome Set methodology including a Delphi process.

    Science.gov (United States)

    Bunch, K J; Allin, B; Jolly, M; Hardie, T; Knight, M

    2018-05-16

    To develop a core metric set to monitor the quality of maternity care. Delphi process followed by a face-to-face consensus meeting. English maternity units. Three representative expert panels: service designers, providers and users. Maternity care metrics judged important by participants. Participants were asked to complete a two-phase Delphi process, scoring metrics from existing local maternity dashboards. A consensus meeting discussed the results and re-scored the metrics. In all, 125 distinct metrics across six domains were identified from existing dashboards. Following the consensus meeting, 14 metrics met the inclusion criteria for the final core set: smoking rate at booking; rate of birth without intervention; caesarean section delivery rate in Robson group 1 women; caesarean section delivery rate in Robson group 2 women; caesarean section delivery rate in Robson group 5 women; third- and fourth-degree tear rate among women delivering vaginally; rate of postpartum haemorrhage of ≥1500 ml; rate of successful vaginal birth after a single previous caesarean section; smoking rate at delivery; proportion of babies born at term with an Apgar score improvement. Achieving consensus on core metrics for monitoring the quality of maternity care. © 2018 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists.

  9. Improving performance on core processes of care.

    Science.gov (United States)

    Austin, John Matthew; Pronovost, Peter J

    2016-06-01

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

  10. Achieving Improvement Through Nursing Home Quality Measurement

    OpenAIRE

    Harris, Yael; Clauser, Steven B.

    2002-01-01

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

  11. Cross-industry standard process for data mining is applicable to the lung cancer surgery domain, improving decision making as well as knowledge and quality management.

    Science.gov (United States)

    Rivo, Eduardo; de la Fuente, Javier; Rivo, Ángel; García-Fontán, Eva; Cañizares, Miguel-Ángel; Gil, Pedro

    2012-01-01

    The aim of this study was to assess the applicability of knowledge discovery in database methodology, based upon data mining techniques, to the investigation of lung cancer surgery. According to CRISP 1.0 methodology, a data mining (DM) project was developed on a data warehouse containing records for 501 patients operated on for lung cancer with curative intention. The modelling technique was logistic regression. The finally selected model presented the following values: sensitivity 9.68%, specificity 100%, global precision 94.02%, positive predictive value 100% and negative predictive value 93.98% for a cut-off point set at 0.5. A receiver operating characteristic (ROC) curve was constructed. The area under the curve (CI 95%) was 0.817 (0.740- 0.893) (p CRISP-DM process model is very suitable for lung cancer surgery analysis, improving decision making as well as knowledge and quality management.

  12. Chronic lung disease in very low birth weight infants: Persistence and improvement of a quality improvement process in a tertiary level neonatal intensive care unit.

    Science.gov (United States)

    Birenbaum, H J; Pfoh, E R; Helou, S; Pane, M A; Marinkovich, G A; Dentry, A; Yeh, Hsin-Chieh; Updegraff, L; Arnold, C; Liverman, S; Cawman, H

    2016-05-19

    We previously demonstrated a significant reduction in our incidence of chronic lung disease in our NICU using potentially better practices of avoiding delivery room endotracheal intubation and using early nasal CPAP. We sought to demonstrate whether these improvements were sustained and or improved over time. We conducted a retrospective, cross-sectional analysis of infants 501-1500 grams born at our hospital between 2005 and 2013. Infants born during the 2005-2007, 2008-2010 and 2011-2013 epochs were grouped together, respectively. Descriptive analysis was conducted to determine the number and percent of maternal and neonatal characteristics by year grouping. Chi-squared tests were used to determine whether there were any statistically significant changes in characteristics across year groupings.. Two outcome variables were assessed: a diagnosis of chronic lung disease based on the Vermont Oxford Network definition and being discharged home on supplemental oxygen. There was a statistically significant improvement in the incidence of chronic lung disease in infants below 27 weeks' gestation in the three year period in the 2011-2013 cohort compared with those in the 2005-2007 cohort. We also found a statistically significant improvement in the number of infants discharged on home oxygen with birth weights 751-1000 grams and infants with gestational age less than 27 weeks in the 2011-2013 cohort compared to the 2005-2007 cohort. We demonstrated sustained improvement in our incidence of CLD between 2005 and 2013. We speculate that a multifaceted strategy of avoiding intubation and excessive oxygen in the delivery room, the early use of CPAP, as well as the use of volume targeted ventilation, when needed, may help significantly reduce the incidence of CLD.

  13. Quality Improvement and Learning in Productive Systems

    OpenAIRE

    Charles H. Fine

    1986-01-01

    Recent interest in product quality suggests that effort devoted to improving the quality of manufactured products may reduce unit costs. This conjecture---that improving quality can lower costs---challenges the traditional assumption that unit costs increase with increased quality assurance activities and has significant implications for quality management. By introducing the idea of a quality-based learning curve, this paper links the previously disjoint literatures of quality control and le...

  14. Next Generation Software Process Improvement

    National Research Council Canada - National Science Library

    Turnas, Daniel

    2003-01-01

    .... The application of these processes allows for an organization to mature. The software maturity level, and process improvement, of an organization can be measured with the Capability Maturity Model...

  15. Selenium Supplementation Affects Physiological and Biochemical Processes to Improve Fodder Yield and Quality of Maize (Zea mays L.) under Water Deficit Conditions

    Science.gov (United States)

    Nawaz, Fahim; Naeem, Muhammad; Ashraf, Muhammad Y.; Tahir, Muhammad N.; Zulfiqar, Bilal; Salahuddin, Muhammad; Shabbir, Rana N.; Aslam, Muhammad

    2016-01-01

    Climate change is one of the most complex challenges that pose serious threats to livelihoods of poor people who rely heavily on agriculture and livestock particularly in climate-sensitive developing countries of the world. The negative effects of water scarcity, due to climate change, are not limited to productivity food crops but have far-reaching consequences on livestock feed production systems. Selenium (Se) is considered essential for animal health and has also been reported to counteract various abiotic stresses in plants, however, understanding of Se regulated mechanisms for improving nutritional status of fodder crops remains elusive. We report the effects of exogenous selenium supply on physiological and biochemical processes that may influence green fodder yield and quality of maize (Zea mays L.) under drought stress conditions. The plants were grown in lysimeter tanks under natural conditions and were subjected to normal (100% field capacity) and water stress (60% field capacity) conditions. Foliar spray of Se was carried out before the start of tasseling stage (65 days after sowing) and was repeated after 1 week, whereas, water spray was used as a control. Drought stress markedly reduced the water status, pigments and green fodder yield and resulted in low forage quality in water stressed maize plants. Nevertheless, exogenous Se application at 40 mg L-1 resulted in less negative leaf water potential (41%) and enhanced relative water contents (30%), total chlorophyll (53%), carotenoid contents (60%), accumulation of total free amino acids (40%) and activities of superoxide dismutase (53%), catalase (30%), peroxidase (27%), and ascorbate peroxidase (27%) with respect to control under water deficit conditions. Consequently, Se regulated processes improved fodder yield (15%) and increased crude protein (47%), fiber (10%), nitrogen free extract (10%) and Se content (36%) but did not affect crude ash content in water stressed maize plants. We propose that Se

  16. Selenium Supplementation Affects Physiological and Biochemical Processes to Improve Fodder Yield and Quality of Maize (Zea mays L.) under Water Deficit Conditions.

    Science.gov (United States)

    Nawaz, Fahim; Naeem, Muhammad; Ashraf, Muhammad Y; Tahir, Muhammad N; Zulfiqar, Bilal; Salahuddin, Muhammad; Shabbir, Rana N; Aslam, Muhammad

    2016-01-01

    Climate change is one of the most complex challenges that pose serious threats to livelihoods of poor people who rely heavily on agriculture and livestock particularly in climate-sensitive developing countries of the world. The negative effects of water scarcity, due to climate change, are not limited to productivity food crops but have far-reaching consequences on livestock feed production systems. Selenium (Se) is considered essential for animal health and has also been reported to counteract various abiotic stresses in plants, however, understanding of Se regulated mechanisms for improving nutritional status of fodder crops remains elusive. We report the effects of exogenous selenium supply on physiological and biochemical processes that may influence green fodder yield and quality of maize ( Zea mays L.) under drought stress conditions. The plants were grown in lysimeter tanks under natural conditions and were subjected to normal (100% field capacity) and water stress (60% field capacity) conditions. Foliar spray of Se was carried out before the start of tasseling stage (65 days after sowing) and was repeated after 1 week, whereas, water spray was used as a control. Drought stress markedly reduced the water status, pigments and green fodder yield and resulted in low forage quality in water stressed maize plants. Nevertheless, exogenous Se application at 40 mg L -1 resulted in less negative leaf water potential (41%) and enhanced relative water contents (30%), total chlorophyll (53%), carotenoid contents (60%), accumulation of total free amino acids (40%) and activities of superoxide dismutase (53%), catalase (30%), peroxidase (27%), and ascorbate peroxidase (27%) with respect to control under water deficit conditions. Consequently, Se regulated processes improved fodder yield (15%) and increased crude protein (47%), fiber (10%), nitrogen free extract (10%) and Se content (36%) but did not affect crude ash content in water stressed maize plants. We propose that

  17. Selenium Supplementation Affects Physiological and Biochemical Processes to Improve Fodder Yield and Quality of Maize (Zea mays L. under Water Deficit Conditions

    Directory of Open Access Journals (Sweden)

    Fahim Nawaz

    2016-09-01

    Full Text Available Climate change is one of the most complex challenges that pose serious threats to livelihoods of poor people who rely heavily on agriculture and livestock particularly in climate-sensitive developing countries of the world. The negative effects of water scarcity, due to climate change, are not limited to productivity food crops but have far-reaching consequences on livestock feed production systems. Selenium (Se is considered essential for animal health and has also been reported to counteract various abiotic stresses in plants however, understanding of Se regulated mechanisms for improving nutritional status of fodder crops remains elusive. We report the effects of exogenous selenium (Se supply on physiological and biochemical processes that may influence green fodder yield and quality of maize (Zea mays L. under drought stress conditions. The plants were grown in lysimeter tanks under natural conditions and were subjected to normal (100% field capacity and water stress (60% field capacity conditions. Foliar spray of Se was carried out before the start of tasseling stage (65 days after sowing and was repeated after one week, whereas water spray was used as a control. Drought stress markedly reduced the water status, pigments and green fodder yield and resulted in low forage quality in water stressed maize plants. Nevertheless, exogenous Se application at 40 mg L-1 resulted in less negative leaf water potential (41% and enhanced relative water contents (30%, total chlorophyll (53%, carotenoid contents (60%, accumulation of total free amino acids (40% and activities of superoxide dismutase (53%, catalase (30%, peroxidase (27% and ascorbate peroxidase (27% with respect to control under water deficit conditions. Consequently, Se regulated processes improved fodder yield (15% and increased crude protein (47%, fibre (10%, nitrogen free extract (10% and Se content (36% but did not affect crude ash content in water stressed maize plants. We propose

  18. Treatments of tilapia (Oreochromis niloticus) using nitric oxide for quality improvement: Establishing a potential method for large-scale processing of farmed fish.

    Science.gov (United States)

    Wang, Zi-Chao; Yan, Yuzhen; Su, Ping; Zhao, Mou-Ming; Xia, Ning; Chen, De-Wei

    2018-07-01

    To find a succedaneum of present methods for slaughtering tilapia, we have demonstrated the influence of nitric oxide (NO) (saturated NO solution) through euthanasia before slaughter on the animal welfare and muscle color of tilapia. The results suggested that NO euthanasia significantly improved the animal welfare and muscle color. Besides, the investigation of NO postmortem treatment on the muscle color and color stability of tilapia fillets suggested that NO postmortem treatment not only improved the muscle color and color stability but also prolonged the shelf-life of tilapia fillets during the refrigerated storage. To further investigate the effect of NO euthanasia on the quality of tilapia fillets and to estimate the safety of NO treatments (NO euthanasia and NO postmortem treatment) for the application of NO treatments in industrial manufacturing of tilapia and possibly of other fish species. NO euthanasia was adopted in this study following a simulated fish processing line. HbNO and MbNO values were measured to clarify the mechanism and process of NO euthanasia. The blood parameters, muscle pH, rigor index, drip loss and total volatile basic nitrogen (TVB-N) values were measured to evaluate the quality of the fillets obtained from NO euthanized tilapia. Besides, the nitrate (NO 3 - ) levels in the muscles after the refrigerated storage were detected to estimate the food safety of both NO euthanasia and NO postmortem treatment. Fillets obtained from the tilapia euthanized by NO showed a later reduction of muscle pH, a later onset of rigor mortis postmortem and less drip loss during the refrigerated storage than control. NO euthanasia caused less TVB-N than control and prolonged the shelf life of tilapia fillets. Moreover, the NO 3 - levels in the muscles of both NO euthanasia and NO postmortem treatment after the refrigerated storage were below the maximum permitted limit. Both the NO euthanasia and NO postmortem treatment are suitable for improving the

  19. Trading emissions improve air quality

    International Nuclear Information System (INIS)

    Lents, J.M.

    1993-01-01

    While admitting sharply contrasting views exist, James M. Lents of the South Coast Air Quality Management District in southern California sees emissions trading open-quotes as a lifesaver for our troubled planet.close quotes He explains: open-quotes If political support for the environment is to be maintained, we must seek the most economical and flexible means of pursuing cleanup. At present, market incentives and emissions trading represent our best hope.close quotes Lents is putting his money where his pen is. The air quality management district he heads plans to use market incentives, including emissions trading, to reduce air pollution in the notoriously dirty southern California area. When the system goes into operation in 1994, he estimates it will save southern California businesses more than $400 million a year in compliance costs, while also making major improvements in the region's air quality. If the idea works there, why won't it work elsewhere, even on a global scale, Lents asks? He believes it will. But open-quotes the ultimate success of emissions-trading programs, whether regional, national, or international in scope, lies in the proof that they're actually achieving reductions in harmful emissions,close quotes he emphasizes. open-quotes These reductions must be real and verifiable to satisfy the Clean Air Act and a skeptical public.close quotes

  20. Idaho Chemical Processing Plant Process Efficiency improvements

    International Nuclear Information System (INIS)

    Griebenow, B.

    1996-03-01

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

  1. Engaging Clinical Nurses in Quality Improvement Projects.

    Science.gov (United States)

    Moore, Susan; Stichler, Jaynelle F

    2015-10-01

    Clinical nurses have the knowledge and expertise required to provide efficient and proficient patient care. Time and knowledge deficits can prevent nurses from developing and implementing quality improvement or evidence-based practice projects. This article reviews a process for professional development of clinical nurses that helped them to define, implement, and analyze quality improvement or evidence-based practice projects. The purpose of this project was to educate advanced clinical nurses to manage a change project from inception to completion, using the Six Sigma DMAIC (Define, Measure, Analyze, Improve, Control) Change Acceleration Process as a framework. One-to-one mentoring and didactic in-services advanced the knowledge, appreciation, and practice of advanced practice clinicians who completed multiple change projects. The projects facilitated clinical practice changes, with improved patient outcomes; a unit cultural shift, with appreciation of quality improvement and evidence-based projects; and engagement with colleagues. Project outcomes were displayed in poster presentations at a hospital exposition for knowledge dissemination. Copyright 2015, SLACK Incorporated.

  2. Bioethanol Quality Improvement of Coffee Fruit Leather

    Directory of Open Access Journals (Sweden)

    Edahwati Luluk

    2016-01-01

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

  3. Successfully reducing newborn asphyxia in the labour unit in a large academic medical centre: a quality improvement project using statistical process control.

    Science.gov (United States)

    Hollesen, Rikke von Benzon; Johansen, Rie Laurine Rosenthal; Rørbye, Christina; Munk, Louise; Barker, Pierre; Kjaerbye-Thygesen, Anette

    2018-02-03

    A safe delivery is part of a good start in life, and a continuous focus on preventing harm during delivery is crucial, even in settings with a good safety record. In January 2013, the labour unit at Copenhagen University Hospital, Hvidovre, undertook a quality improvement (QI) project to prevent asphyxia and reduced the percentage of newborns with asphyxia by 48%. The change theory consisted of two primary elements: (1) the clinical content, including three clinical bundles of evidence-based care, a 'delivery bundle', an 'oxytocin bundle' and a 'vacuum extraction bundle'; (2) an implementation theory, including improving skills in interpretation of cardiotocography, use of QI methods and participation in a national learning network. The Model for Improvement and Deming's system of profound knowledge were used as a methodological framework. Data on compliance with the care bundles and the number of deliveries between newborns with asphyxia (Apgar statistical process control. Compliance with all three clinical care bundles improved to 95% or more, and the percentages of newborns with pH <7 and Apgar <7 after 5 min were reduced by 48% and 31%, respectively. In general, the QI approach strengthened multidisciplinary teamwork, systematised workflow and structured communication around the deliveries. Changes included making a standard memo in the medical record, the use of a bedside whiteboard, bedside handovers, shared decisions with a peer when using an oxytocin infusion and the use of a checklist before vacuum extractions. This QI project illustrates how aspects of patient safety, such as the prevention of asphyxia, can be improved using QI methods to more reliably implement best practice, even in high-performing systems. © 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.

  4. A quality improvement management model for renal care.

    Science.gov (United States)

    Vlchek, D L; Day, L M

    1991-04-01

    The purpose of this article is to explore the potential for applying the theory and tools of quality improvement (total quality management) in the renal care setting. We believe that the coupling of the statistical techniques used in the Deming method of quality improvement, with modern approaches to outcome and process analysis, will provide the renal care community with powerful tools, not only for improved quality (i.e., reduced morbidity and mortality), but also for technology evaluation and resource allocation.

  5. Improvement of phenolic antioxidants and quality characteristics of virgin olive oil with the addition of enzymes and nitrogen during olive paste processing

    Directory of Open Access Journals (Sweden)

    Iconomou, D.

    2010-09-01

    Full Text Available The evolution of phenolic compounds and their contribution to the quality characteristics in virgin olive oil during fruit processing was studied with the addition of a combination of various commercial enzymes containing pectinases, polygalacturonases, cellulase and β-glucanase with or without nitrogen flush. Olive fruits (Olea europaea, L. of the cultivar Megaritiki, at the semi black pigmentation stage of maturity, were used in a 3-phase extraction system in an experiment at industrial scale. The addition of enzymes in the olive paste during processing increased the total phenol and ortho-diphenol contents, as well as some simple phenolic compounds (3,4-DHPEA, p-HPEA and the secoiridoid derivatives (3,4-DHPEA-EDA and 3,4-DHPEAEA in olive oil and therefore improved its oxidative stability. Furthermore, enzyme treatment ameliorated the quality parameters of the produced olive oil (acidity and peroxide value and their sensory attributes. The use of additional N2 flush with the enzyme treatments did not improve the quality parameters of olive oil any further; however it did not affect the concentration of individual and total sterols or most of the fatty acid composition. Consequently, olive paste treatment with enzymes not only improved the quality characteristics of olive oil and enhanced the overall ogranoleptic quality, but also increased the olive oil yield.

    La evolución de los compuestos fenólicos y su contribución a las caracterísiticas de calidad de aceite de oliva virgen durante el procesado del fruto fue estudiado mediante la adición de una combinación de varias enzimas comerciales conteniendo pectinasas, poligalacturonasa, celulasa y β-glucanasa con y sin flujo de nitrógeno. Las aceitunas (Olea europaea, L. de la variedad Megaritiki, con un estado de madurez correspondiente a una pigmentación semi-negra, fueron usadas en un experimento a escala industrial mediante un sistema de extracción de 3-fase. La

  6. Solutions to Improve Educational Management Quality

    OpenAIRE

    Ramezan Jahanian; Masoomeh Motahari

    2013-01-01

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

  7. Improving the quality of life.

    Science.gov (United States)

    Suyono, H

    1993-12-01

    It is encouraging that most developing countries now have population policies, but it is discouraging that some countries have been unable to implement their policies. Therefore, Indonesia believes technical cooperation should be strengthened among developing countries. International cooperation is working in 108 developing countries, but the desired impact has yet to be reached, and the quality of life in many countries is still unacceptable. For example, life expectancy at birth in developing countries is 14-17 years shorter for females and 10-13 years shorter for males as compared to developed countries which have superior health and welfare systems. The speed of population growth is also hindering efforts to help improve living conditions, and the biggest increase in growth will occur in Asia and Africa. This will increase the numbers of poor, hungry, and illiterate in developing countries and will lead to a lack of arable land, deterioration in education, and increase in unsafe sanitation. In order to slow population growth, quality family planning (FP) services must be provided to those who want them. By the year 2000, developed countries and donors should be ready to provide half of the required US$10.5 billion to FP services in developing countries. In Indonesia, population programs and policies have been governed by the National FP Coordinating Board as well as by the State Ministry for Population and the Environment, which was divided into two ministries in 1993 in order to deal with the enormity and seriousness of the two issues.

  8. Association between product quality control and process quality control of bulk milk

    NARCIS (Netherlands)

    Velthuis, A.; Asseldonk, van M.A.P.M.

    2010-01-01

    Assessment of dairy-milk quality is based on product quality control (testing bulk-milk samples) and process quality control (auditing dairy farms). It is unknown whether process control improves product quality. To quantify possible association between product control and process control a

  9. Improved Manufacturing Process for Pyronaridine Tetraphosphate

    International Nuclear Information System (INIS)

    Lee, Dong Won; Lee, Seung Kyu; Cho, Jun Ho; Yoon, Seung Soo

    2014-01-01

    Pyronaridine tetraphosphate (1) is a well-known antimalarial drug. However, it required a carefully optimized production process for the manufacture of pyronaridine tetraphosphate. Each step of its manufacturing process was reinvestigated. For the cyclization of 4-chloro-2-(6-methoxy-pyridin-3-yl-amino)-benzoic acid 6 to 7,10-dichloro-2-methoxybenzo[b]-1,5-naphthyridine 5, an improved process was developed to eliminated critical process impurity (BIA). By the redesign of the formation of triphosphate salt, the purity as API grade was increased. Thus, a robust manufacturing process with an acceptable process performance has been developed to produce high quality pyronaridine tetraphosphate

  10. System-Level Action Required for Wide-Scale Improvement in Quality of Primary Health Care: Synthesis of Feedback from an Interactive Process to Promote Dissemination and Use of Aggregated Quality of Care Data.

    Science.gov (United States)

    Bailie, Jodie; Laycock, Alison; Matthews, Veronica; Bailie, Ross

    2016-01-01

    There is an enduring gap between recommended practice and care that is actually delivered; and there is wide variation between primary health care (PHC) centers in delivery of care. Where aspects of care are not being done well across a range of PHC centers, this is likely due to inadequacies in the broader system. This paper aims to describe stakeholders' perceptions of the barriers and enablers to addressing gaps in Australian Aboriginal and Torres Strait Islander chronic illness care and child health, and to identify key drivers for improvement. This paper draws on data collected as part of a large-scale continuous quality improvement project in Australian Indigenous PHC settings. We undertook a qualitative assessment of stakeholder feedback on the main barriers and enablers to addressing gaps in care for Aboriginal and Torres Strait Islander children and in chronic illness care. Themes on barriers and enablers were further analyzed to develop a "driver diagram," an improvement tool used to locate barriers and enablers within causal pathways (as primary and secondary drivers), enabling them to be targeted by tailored interventions. We identified 5 primary drivers and 11 secondary drivers of high-quality care, and associated strategies that have potential for wide-scale implementation to address barriers and enablers for improving care. Perceived barriers to addressing gaps in care included both health system and staff attributes. Primary drivers were: staff capability to deliver high-quality care; availability and use of clinical information systems and decision support tools; embedding of quality improvement processes and data-driven decision-making; appropriate and effective recruitment and retention of staff; and community capacity, engagement and mobilization for health. Suggested strategies included mechanisms for increasing clinical supervision and support, staff retention, reorientation of service delivery, use of information systems and community health

  11. System level action required for wide-scale improvement in quality of primary healthcare: synthesis of feedback from an interactive process to promote dissemination and use of aggregated quality of care data

    Directory of Open Access Journals (Sweden)

    Jodie eBailie

    2016-05-01

    Full Text Available IntroductionThere is an enduring gap between recommended practice and care that is actually delivered; and there is wide variation between primary healthcare (PHC centres in delivery of care. Where aspects of care are not being done well across a range of PHC centres, this is likely due to inadequacies in the broader system. This paper aims to describe stakeholders’ perceptions of the barriers and enablers to addressing gaps in Australian Aboriginal and Torres Strait Islander chronic illness care and child health, and to identify key drivers for improvement.MethodsThis paper draws on data collected as part of a large scale continuous quality improvement project in Australian Indigenous PHC settings. We undertook a qualitative assessment of stakeholder feedback on the main barriers and enablers to addressing gaps in care for Aboriginal and Torres Strait Islander children and in chronic illness care. Themes on barriers and enablers were further analysed to develop a ‘driver diagram’, an improvement tool used to locate barriers and enablers within causal pathways, (as primary and secondary drivers, enabling them to be targeted by tailored interventions. ResultsWe identified five primary drivers and eleven secondary drivers of high quality care, and associated strategies that have potential for wide-scale implementation to address barriers and enablers for improving care. Perceived barriers to addressing gaps in care included both health system and staff attributes. Primary drivers were: staff capability to deliver high quality care; availability and use of clinical information systems and decision support tools; embedding of quality improvement processes and data driven decision making; appropriate and effective recruitment and retention of staff; and community capacity, engagement and mobilisation for health. Suggested strategies included mechanisms for increasing clinical supervision and support, staff retention, reorientation of service

  12. 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.

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

    Directory of Open Access Journals (Sweden)

    K. Yahya

    2017-06-01

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

  14. Surface quality in rapid prototype MMD process

    Directory of Open Access Journals (Sweden)

    Lisandro Vargas Henríquez

    2004-09-01

    Full Text Available This article summarises a Manufacturing Materials and Processes MSc thesis written for the Mechanical and Electrical Engineering Department. The paper shows the interaction of process, gap (deposition distance and extursion terminal velocity modelled process parameters for CEIF's (Centro de Equipos Interfacultades rapid prototype molten material deposit (MMD Titan SH-1 machine by analysing prototupes improved surface quality and resistence to tension and characterising material. The project applies experimental design criteria for orientating the selection of experimental process parameters. Acrylonitrile-buttadin-styrene (ABS had alredy been mechanically and physicochemically characterised (i.e the material used in the MMD process.

  15. The improving processes in the human resources management

    OpenAIRE

    Darja Holátová

    2002-01-01

    The quality management of the human resources management, the quality of the products, services and prosperities of the firms is among others dependent on the quality management. Managers convey a leadership and commitment necessary for creating the environment for quality improvement. The managers are responsible for their own actions, development and improvement of their own work processes.

  16. The Power of Process Improvement

    Science.gov (United States)

    Fairfield-Sonn, James W.; Morgan, Sandra; Sumukadas, Narendar

    2004-01-01

    Over the last several decades many systematic management approaches, such as Total Quality Management, aimed at improving organizational performance and employee satisfaction have captured organizations' attention. Given their origins in statistics, operations management, and engineering, many of the concepts and techniques are technical. When…

  17. Quality improvement and emerging global health priorities

    Science.gov (United States)

    Mensah Abrampah, Nana; Syed, Shamsuzzoha Babar; Hirschhorn, Lisa R; Nambiar, Bejoy; Iqbal, Usman; Garcia-Elorrio, Ezequiel; Chattu, Vijay Kumar; Devnani, Mahesh; Kelley, Edward

    2018-01-01

    Abstract Quality improvement approaches can strengthen action on a range of global health priorities. Quality improvement efforts are uniquely placed to reorient care delivery systems towards integrated people-centred health services and strengthen health systems to achieve Universal Health Coverage (UHC). This article makes the case for addressing shortfalls of previous agendas by articulating the critical role of quality improvement in the Sustainable Development Goal era. Quality improvement can stimulate convergence between health security and health systems; address global health security priorities through participatory quality improvement approaches; and improve health outcomes at all levels of the health system. Entry points for action include the linkage with antimicrobial resistance and the contentious issue of the health of migrants. The work required includes focussed attention on the continuum of national quality policy formulation, implementation and learning; alongside strengthening the measurement-improvement linkage. Quality improvement plays a key role in strengthening health systems to achieve UHC. PMID:29873793

  18. Improving engineering performance by utilizing process indicators

    International Nuclear Information System (INIS)

    Roberts, T.E.

    1992-01-01

    The purpose of the work discussed in this paper was to develop engineering performance indicators used to facilitate improvement to the technical quality, cost-effectiveness, and delivery of engineering products and service. This work was specifically tailored for engineering support products and service associated with operating Florida Power and Light Company (FP and L) nuclear plants. The engineering process for the development of plant change packages was reviewed to identify critical in-process activities. Because each engineering project usually deals with a specific component or plant system, the different tasks are usually technically unique and of varying magnitudes. Although each engineering product may employ different analytical techniques or industry code requirements, several activities in documenting the engineering design process are generic. The quality of performance in these activities can be monitored analogously to the steps in a manufacturing process. This concept builds quality concepts into the package in lieu of inspecting package quality at the end of the process. The work has resulted in a valuable self-assessment tool that serves as a basis for engineering process improvements. The indicators are published in a semi-yearly performance report for FP and L contractors as well as FP and L in-house engineering work. Contracts have been set up to base fees on meeting targets established for the performance report. The ability to meet performance targets continues to improve

  19. Results of a 1-year quality-improvement process to reduce door-to-needle time in acute ischemic stroke with MRI screening.

    Science.gov (United States)

    Sablot, D; Gaillard, N; Colas, C; Smadja, P; Gely, C; Dutray, A; Bonnec, J-M; Jurici, S; Farouil, G; Ferraro-Allou, A; Jantac, M; Allou, T; Pujol, C; Olivier, N; Laverdure, A; Fadat, B; Mas, J; Dumitrana, A; Garcia, Y; Touzani, H; Perucho, P; Moulin, T; Richard, C; Heroum, C; Bouly, S; Sagnes-Raffy, C; Heve, D

    To determine the effects of a 1-year quality-improvement (QI) process to reduce door-to-needle (DTN) time in a secondary general hospital in which multimodal MRI screening is used before tissue plasminogen activator (tPA) administration in patients with acute ischemic stroke (AIS). The QI process was initiated in January 2015. Patients who received intravenous (iv) tPAprocess; the "2015 cohort") were identified (n=130), and their demographic and clinical characteristics and timing metrics compared with those of patients treated by iv tPA in 2014 (the "2014 cohort", n=135). Of the 130 patients in the 2015 cohort, 120 (92.3%) of them were screened by MRI. The median DTN time was significantly reduced by 30% (from 84min in 2014 to 59min; Pimprovement in DTN time was associated with better outcomes after discharge (patients with a 0-2 score on the modified rankin scale: 59% in the 2015 cohort vs 42.4% in the 2014 cohort; Pprocess, the median DTN time decreased by 15% (from 65min in the first trimester to 55min in the last trimester; P≤0.04) with a non-significant 1.5-fold increase in the proportion of treated patients with a DTN time≤60min (from 41% to 62%; P=0.09). It is feasible to deliver tPA to patients with AIS within 60min in a general hospital, using MRI as the routine screening modality, making this QI process to reduce DTN time widely applicable to other secondary general hospitals. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  20. 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

  1. 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.

  2. Towards improvement in quality assurance

    International Nuclear Information System (INIS)

    1987-03-01

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

  3. Waste Management Process Improvement Project

    International Nuclear Information System (INIS)

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

    2002-01-01

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

  4. The challenge of transferring an implementation strategy from academia to the field: a process evaluation of local quality improvement collaboratives in Dutch primary care using the normalization process theory.

    Science.gov (United States)

    Trietsch, Jasper; van Steenkiste, Ben; Hobma, Sjoerd; Frericks, Arnoud; Grol, Richard; Metsemakers, Job; van der Weijden, Trudy

    2014-12-01

    A quality improvement strategy consisting of comparative feedback and peer review embedded in available local quality improvement collaboratives proved to be effective in changing the test-ordering behaviour of general practitioners. However, implementing this strategy was problematic. We aimed for large-scale implementation of an adapted strategy covering both test ordering and prescribing performance. Because we failed to achieve large-scale implementation, the aim of this study was to describe and analyse the challenges of the transferring process. In a qualitative study 19 regional health officers, pharmacists, laboratory specialists and general practitioners were interviewed within 6 months after the transfer period. The interviews were audiotaped, transcribed and independently coded by two of the authors. The codes were matched to the dimensions of the normalization process theory. The general idea of the strategy was widely supported, but generating the feedback was more complex than expected and the need for external support after transfer of the strategy remained high because participants did not assume responsibility for the work and the distribution of resources that came with it. Evidence on effectiveness, a national infrastructure for these collaboratives and a general positive attitude were not sufficient for normalization. Thinking about managing large databases, responsibility for tasks and distribution of resources should start as early as possible when planning complex quality improvement strategies. Merely exploring the barriers and facilitators experienced in a preceding trial is not sufficient. Although multifaceted implementation strategies to change professional behaviour are attractive, their inherent complexity is also a pitfall for large-scale implementation. © 2014 John Wiley & Sons, Ltd.

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

    OpenAIRE

    Nair, Pooja; Barai, Ishani; Prasad, Sunila; Gadhvi, Karishma

    2016-01-01

    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

  6. 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

  7. Goal hierarchy: Improving asset data quality by improving motivation

    Energy Technology Data Exchange (ETDEWEB)

    Unsworth, Kerrie, E-mail: Kerrie.unsworth@uwa.edu.au [UWA Business School, University of Western Australia, Crawley, WA 6009 (Australia); Adriasola, Elisa; Johnston-Billings, Amber; Dmitrieva, Alina [UWA Business School, University of Western Australia, Crawley, WA 6009 (Australia); Hodkiewicz, Melinda [School of Mechanical Engineering, University of Western Australia, Crawley, WA 6009 (Australia)

    2011-11-15

    Many have recognized the need for high quality data on assets and the problems in obtaining them, particularly when there is a need for human observation and manual recording. Yet very few have looked at the role of the data collectors themselves in the data quality process. This paper argues that there are benefits to more fully understanding the psychological factors that lay behind data collection and we use goal hierarchy theory to understand these factors. Given the myriad of potential reasons for poor-quality data it has previously proven difficult to identify and successfully deploy employee-driven interventions; however, the goal hierarchy approach looks at all of the goals that an individual has in their life and the connections between them. For instance, does collecting data relate to whether or not they get a promotion? Stay safe? Get a new job? and so on. By eliciting these goals and their connections we can identify commonalities across different groups, sites or organizations that can influence the quality of data collection. Thus, rather than assuming what the data collectors want, a goal hierarchy approach determines that empirically. Practically, this supports the development of customized interventions that will be much more effective and sustainable than previous efforts. - Highlights: > We need to consider psychological aspects of data collectors to improve data quality. > We show how goal hierarchy theory furthers understanding. > Looks at the multiple goals of each individual to determine their behavior.

  8. Goal hierarchy: Improving asset data quality by improving motivation

    International Nuclear Information System (INIS)

    Unsworth, Kerrie; Adriasola, Elisa; Johnston-Billings, Amber; Dmitrieva, Alina; Hodkiewicz, Melinda

    2011-01-01

    Many have recognized the need for high quality data on assets and the problems in obtaining them, particularly when there is a need for human observation and manual recording. Yet very few have looked at the role of the data collectors themselves in the data quality process. This paper argues that there are benefits to more fully understanding the psychological factors that lay behind data collection and we use goal hierarchy theory to understand these factors. Given the myriad of potential reasons for poor-quality data it has previously proven difficult to identify and successfully deploy employee-driven interventions; however, the goal hierarchy approach looks at all of the goals that an individual has in their life and the connections between them. For instance, does collecting data relate to whether or not they get a promotion? Stay safe? Get a new job? and so on. By eliciting these goals and their connections we can identify commonalities across different groups, sites or organizations that can influence the quality of data collection. Thus, rather than assuming what the data collectors want, a goal hierarchy approach determines that empirically. Practically, this supports the development of customized interventions that will be much more effective and sustainable than previous efforts. - Highlights: → We need to consider psychological aspects of data collectors to improve data quality. → We show how goal hierarchy theory furthers understanding. → Looks at the multiple goals of each individual to determine their behavior.

  9. Voltage Quality Improvement Using Solar Photovoltaic Systems

    Directory of Open Access Journals (Sweden)

    Denisa Galzina

    2015-06-01

    This paper briefly shows the methods of power quality improvement, and then the results of on-site power quality measurements in the grid before and after the connection of the solar photovoltaic system.

  10. San Francisco 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.,

  11. Engaged Research in Process Improvement

    DEFF Research Database (Denmark)

    Pries-Heje, Jan

    2010-01-01

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

  12. 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.…

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

    Science.gov (United States)

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

    2016-10-01

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

  14. 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.

  15. Involving vendors in continuous quality improvement efforts.

    Science.gov (United States)

    McDevitt, M C

    1995-03-01

    In the hospital environment, vendors supply a wide range of items, from surgical sutures to the latest in high-cost technological equipment. Also, many clinical and support services, such as respiratory therapy, transcription, and computer databanks are now outsourced to commercial vendors. Interaction with such vendors is often less than satisfactory, with prolonged timelines and disruption of an important process that is being computerized. Although hospitals deal with very few vendors in long-term relationships, such as those seen in manufacturing, this should not preclude the formation of a supplier-customer relationship that goes beyond management's interaction with the sales representative in response to a request for proposal. This is especially true when a process improvement team has studied an internal process and defined a key quality characteristic.

  16. Implications of Continuous Quality Improvement for Program Evaluation and Evaluators.

    Science.gov (United States)

    Mark, Melvin M.; Pines, Edward

    1995-01-01

    Explores the implications that continuous quality improvement (CQI) programs are likely to have for evaluation. CQI, often known as total quality management, offers a structured approach to the analysis of an organization's processes and improvement that should provide advantages to evaluators once they have gained experience with the approach.…

  17. 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…

  18. Towards an Evaluation Framework for Software Process Improvement

    OpenAIRE

    Cheng, Chow Kian; Permadi, Rahadian Bayu

    2009-01-01

    Software has gained an essential role in our daily life in the last decades. This condition demands high quality software. To produce high quality software many practitioners and researchers put more attention on the software development process. Large investments are poured to improve the software development process. Software Process Improvement (SPI) is a research area which is aimed to address the assessment and improvement issues in the software development process. One of the most impor...

  19. Process evaluation of the Data-driven Quality Improvement in Primary Care (DQIP) trial: quantitative examination of variation between practices in recruitment, implementation and effectiveness.

    Science.gov (United States)

    Dreischulte, Tobias; Grant, Aileen; Hapca, Adrian; Guthrie, Bruce

    2018-01-05

    The cluster randomised trial of the Data-driven Quality Improvement in Primary Care (DQIP) intervention showed that education, informatics and financial incentives for general medical practices to review patients with ongoing high-risk prescribing of non-steroidal anti-inflammatory drugs and antiplatelets reduced the primary end point of high-risk prescribing by 37%, where both ongoing and new high-risk prescribing were significantly reduced. This quantitative process evaluation examined practice factors associated with (1) participation in the DQIP trial, (2) review activity (extent and nature of documented reviews) and (3) practice level effectiveness (relative reductions in the primary end point). Invited practices recruited (n=33) and not recruited (n=32) to the DQIP trial in Scotland, UK. (1) Characteristics of recruited versus non-recruited practices. Associations of (2) practice characteristics and 'adoption' (self-reported implementation work done by practices) with documented review activity and (3) of practice characteristics, DQIP adoption and review activity with effectiveness. (1) Recruited practices had lower performance in the quality and outcomes framework than those declining participation. (2) Not being an approved general practitioner training practice and higher self-reported adoption were significantly associated with higher review activity. (3) Effectiveness ranged from a relative increase in high-risk prescribing of 24.1% to a relative reduction of 77.2%. High-risk prescribing and DQIP adoption (but not documented review activity) were significantly associated with greater effectiveness in the final multivariate model, explaining 64.0% of variation in effectiveness. Intervention implementation and effectiveness of the DQIP intervention varied substantially between practices. Although the DQIP intervention primarily targeted review of ongoing high-risk prescribing, the finding that self-reported DQIP adoption was a stronger predictor of

  20. Do Clinical Practice Guidelines Improve Quality?

    Science.gov (United States)

    Baldassari, Cristina M

    2017-07-01

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

  1. 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.

  2. A study of the x-ray image quality improvement in the examination of the respiratory system based on the new image processing technique

    Science.gov (United States)

    Nagai, Yuichi; Kitagawa, Mayumi; Torii, Jun; Iwase, Takumi; Aso, Tomohiko; Ihara, Kanyu; Fujikawa, Mari; Takeuchi, Yumiko; Suzuki, Katsumi; Ishiguro, Takashi; Hara, Akio

    2014-03-01

    Recently, the double contrast technique in a gastrointestinal examination and the transbronchial lung biopsy in an examination for the respiratory system [1-3] have made a remarkable progress. Especially in the transbronchial lung biopsy, better quality of x-ray fluoroscopic images is requested because this examination is performed under a guidance of x-ray fluoroscopic images. On the other hand, various image processing methods [4] for x-ray fluoroscopic images have been developed as an x-ray system with a flat panel detector [5-7] is widely used. A recursive filtering is an effective method to reduce a random noise in x-ray fluoroscopic images. However it has a limitation for its effectiveness of a noise reduction in case of a moving object exists in x-ray fluoroscopic images because the recursive filtering is a noise reduction method by adding last few images. After recursive filtering a residual signal was produced if a moving object existed in x-ray images, and this residual signal disturbed a smooth procedure of the examinations. To improve this situation, new noise reduction method has been developed. The Adaptive Noise Reduction [ANR] is the brand-new noise reduction technique which can be reduced only a noise regardless of the moving object in x-ray fluoroscopic images. Therefore the ANR is a very suitable noise reduction method for the transbronchial lung biopsy under a guidance of x-ray fluoroscopic images because the residual signal caused of the moving object in x-ray fluoroscopic images is never produced after the ANR. In this paper, we will explain an advantage of the ANR by comparing of a performance between the ANR images and the conventional recursive filtering images.

  3. Quality assurance in radiation processing

    International Nuclear Information System (INIS)

    Noriah Mod Ali

    2002-01-01

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

  4. 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.

  5. Actions to improve the quality of the training process in the higher education from the classes of philosophical discipline and socio political theory.

    OpenAIRE

    Anna Lidia Beltrán Marín; Edelso Valero Orellana; Lavinia Pérez García

    2012-01-01

    The employment of didactic materials in the classes of the philosophical discipline and socio political theory has improved the quality of the teaching and in consequence the professional's formation. With the purpose of socializing the results that have been applied and their possible implementation in entities of superior education in the territory, the following dissertation is presented which collect a synthesis of the main materials made by a community of professors and investigators of ...

  6. Using Deming To Improve Quality in Colleges and Universities.

    Science.gov (United States)

    Cornesky, Robert A.; And Others

    Of all the people known for stressing quality in industry, W. Edwards Deming is the pioneer. He stresses statistical process control (SPC) and a 14-point process for managers to improve quality and productivity. His approach is humanistic and treats people as intelligent human beings who want to do a good job. Twelve administrators in a university…

  7. Total quality drives nuclear plant improvements

    International Nuclear Information System (INIS)

    Richey, R.B.

    1991-01-01

    Total quality (TQ) at Carolina Power and Light (CP and L) is fulfilling a 1985 vision of Sherwood H. Smith, Jr., CP and L's chairman, president, and chief executive officer. The TQ concept has provided a way for employees to align their creative energies toward meeting the business needs of the company. Throughout CP and L, TQ has been recognized as the vehicle for reducing operating costs and improving customer satisfaction. Within the nuclear organization, application of the TQ process has helped to improve communications, resolve challenges, and provide more consistent work practices among CP and L's three nuclear plants. Total quality was introduced from the top down, with initial benefits coming from team interactions. Senior management at CP and L defined the corporate expectations and outlined the training requirements for implementing TQ. Management staffs at each organizational level became steering committees for TQ team activities within their departments. Teams of employees most knowledgeable about a given work area were empowered to solve problems or overcome obstacles related to that work area. Employees learned to become better team players and to appreciate the quality of decisions reached through group consensus. Now, formalized methods that started TQ are becoming part of the day-to-day work ethic

  8. Physical Activity Improves Quality of Life

    Science.gov (United States)

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

  9. Improved Si0.5Ge0.5/Si interface quality achieved by the process of low energy hydrogen plasma cleaning and investigation of interface quality with positron annihilation spectroscopy

    Science.gov (United States)

    Liao, M.-H.; Chen, C.-H.

    2013-04-01

    The Positron Annihilation Spectra (PAS), Raman, and Photoluminescence spectroscopy reveal that Si0.5Ge0.5/Si interface quality can be significantly improved by the low energy plasma cleaning process using hydrogen. In the PAS, the particularly small value of lifetime and intensity near the Si0.5Ge0.5/Si interface in the sample with the treatment indicate that the defect concentration is successfully reduced 2.25 times, respectively. Fewer defects existed in the Si0.5Ge0.5/Si interface result in the high compressive strain about 0.36% in the top epi-Si0.5Ge0.5 layer, which can be observed in Raman spectra and stronger radiative recombination rate about 1.39 times for the infrared emission, which can be observed in the photoluminescence spectra. With better Si0.5Ge0.5/Si interface quality, the SiGe-based devices can have better optical and electrical characteristics for more applications in the industry. The PAS is also demonstrated that it is the useful methodology tool to quantify the defect information in the SiGe-based material.

  10. DFI oxyfuel process for saving energy and improving the performance and quality of continuous strip lines; DFI-Oxyfuel-Verfahren zur Energieeinsparung, Leistungs- und Qualitaetssteigerung von Banddurchlaufanlagen

    Energy Technology Data Exchange (ETDEWEB)

    Eichelkraut, H. [ThyssenKrupp Steel AG, Duisburg (Germany). Standort Bruckhausen; Heiler, H.J. [ThyssenKrupp Steel AG, Finnentrop (Germany); Domels, H.P.; Hoegner, W. [ThyssenKrupp Steel AG, Duisburg (Germany). Energie/Anlagenwirtschaft

    2007-07-01

    The development of the 'Direct Flame Impingement (DFI)-Oxyfuel' process - in which an oxyfuel (oxygen-fuel) flame impinges directly on the material to be heated - represents a further development of furnace technology for continuous strip lines. With assistance from the cooperation partner Linde, the process was used on a hot-dip galvanizing line for the first time at ThyssenKrupp Steel's Finnentrop plant. Right from the start it produced outstanding results in terms of increased throughput, product quality, plant quality and energy efficiency and thus also a reduction in direct CO{sub 2} emissions. In the meantime, this technology also is being used at an additional strip galvanizing and aluminizing facility in the Duisburg-Bruckhausen plant. (orig.)

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

    Science.gov (United States)

    Yildiz, Ozkan; Demirörs, Onur

    2012-01-01

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

  12. Performance improvement - business excellence processes

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-07-01

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

  13. Performance improvement - business excellence processes

    International Nuclear Information System (INIS)

    Doucett, J.

    2010-01-01

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

  14. Performance Results of CMMI-Based Process Improvement

    National Research Council Canada - National Science Library

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

    2006-01-01

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

  15. Software Process Improvement for SMEs using OMM

    OpenAIRE

    Rodríguez, Jessica

    2010-01-01

    Software Process Improvement initiatives have been implemented by many companies in order to achieve quality of products and practices. Many models like CMMI and IDEAL have been adopted as a means to gain competitive advantages among competitors and trustworthiness of customers. Although these models have proved successful results, the inherent characteristics of SMEs make it difficult and in many cases unfeasible to implement such models, without meaning that those companies are less capable...

  16. Service Quality and Process Maturity Assessment

    Directory of Open Access Journals (Sweden)

    Serek Radomir

    2013-12-01

    Full Text Available This article deals with service quality and the methods for its measurement and improvements to reach the so called service excellence. Besides older methods such as SERVQUAL and SERPERF, there are also shortly described capability maturity models based on which the own methodology is developed and used for process maturity assessment in organizations providing technical services. This method is equally described and accompanied by examples on pictures. The verification of method functionality is explored on finding a correlation between service employee satisfaction and average process maturity in a service organization. The results seem to be quite promising and open an arena for further studies.

  17. An approach to optimize the batch mixing process for improving the quality consistency of the products made from traditional Chinese medicines*

    Science.gov (United States)

    Yan, Bin-jun; Qu, Hai-bin

    2013-01-01

    The efficacy of traditional Chinese medicine (TCM) is based on the combined effects of its constituents. Variation in chemical composition between batches of TCM has always been the deterring factor in achieving consistency in efficacy. The batch mixing process can significantly reduce the batch-to-batch quality variation in TCM extracts by mixing them in a well-designed proportion. However, reducing the quality variation without sacrificing too much of the production efficiency is one of the challenges. Accordingly, an innovative and practical batch mixing method aimed at providing acceptable efficiency for industrial production of TCM products is proposed in this work, which uses a minimum number of batches of extracts to meet the content limits. The important factors affecting the utilization ratio of the extracts (URE) were studied by simulations. The results have shown that URE was affected by the correlation between the contents of constituents, and URE decreased with the increase in the number of targets and the relative standard deviations of the contents. URE could be increased by increasing the number of storage tanks. The results have provided a reference for designing the batch mixing process. The proposed method has possible application value in reducing the quality variation in TCM and providing acceptable production efficiency simultaneously. PMID:24190450

  18. An approach to optimize the batch mixing process for improving the quality consistency of the products made from traditional Chinese medicines.

    Science.gov (United States)

    Yan, Bin-jun; Qu, Hai-bin

    2013-11-01

    The efficacy of traditional Chinese medicine (TCM) is based on the combined effects of its constituents. Variation in chemical composition between batches of TCM has always been the deterring factor in achieving consistency in efficacy. The batch mixing process can significantly reduce the batch-to-batch quality variation in TCM extracts by mixing them in a well-designed proportion. However, reducing the quality variation without sacrificing too much of the production efficiency is one of the challenges. Accordingly, an innovative and practical batch mixing method aimed at providing acceptable efficiency for industrial production of TCM products is proposed in this work, which uses a minimum number of batches of extracts to meet the content limits. The important factors affecting the utilization ratio of the extracts (URE) were studied by simulations. The results have shown that URE was affected by the correlation between the contents of constituents, and URE decreased with the increase in the number of targets and the relative standard deviations of the contents. URE could be increased by increasing the number of storage tanks. The results have provided a reference for designing the batch mixing process. The proposed method has possible application value in reducing the quality variation in TCM and providing acceptable production efficiency simultaneously.

  19. Structured data quality reports to improve EHR data quality.

    Science.gov (United States)

    Taggart, Jane; Liaw, Siaw-Teng; Yu, Hairong

    2015-12-01

    To examine whether a structured data quality report (SDQR) and feedback sessions with practice principals and managers improve the quality of routinely collected data in EHRs. The intervention was conducted in four general practices participating in the Fairfield neighborhood electronic Practice Based Research Network (ePBRN). Data were extracted from their clinical information systems and summarised as a SDQR to guide feedback to practice principals and managers at 0, 4, 8 and 12 months. Data quality (DQ) metrics included completeness, correctness, consistency and duplication of patient records. Information on data recording practices, data quality improvement, and utility of SDQRs was collected at the feedback sessions at the practices. The main outcome measure was change in the recording of clinical information and level of meeting Royal Australian College of General Practice (RACGP) targets. Birth date was 100% and gender 99% complete at baseline and maintained. DQ of all variables measured improved significantly (pImprovement was greatest with allergies. There was no significant change in duplicate records. SDQRs and feedback sessions support general practitioners and practice managers to focus on improving the recording of patient information. However, improved practice DQ, was not sufficient to meet RACGP targets. Randomised controlled studies are required to evaluate strategies to improve data quality and any associated improved safety and quality of care. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  20. Improving Creativity in Collaborative Process

    DEFF Research Database (Denmark)

    Zhou, Chunfang; Purushothaman, Aparna

    2015-01-01

    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......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...

  1. Improving Quality in Colorectal Surgery

    NARCIS (Netherlands)

    J.C. Slieker (Juliette)

    2014-01-01

    markdownabstract__Abstract__ Colorectal surgery is an important aspect of our current health system, due to the high incidence of colorectal cancer combined with an ageing population, improved long-term outcomes after colorectal surgery, and the perfectioning of the operative and postoperative

  2. Improving the Process of Student Evaluation

    Directory of Open Access Journals (Sweden)

    Gabriela Neacşu

    2013-12-01

    Full Text Available In this paper we analyzed the process of student evaluation from “Spiru Haret” University. The process under consideration occurs according to a specific Procedure – Process of student evaluation from the Manual of Quality Assurance Procedures, “Spiru Haret” University, Edition 1, 2012. The goal of this procedure, mentioned in the Manual, is to present the student evaluation procedure by using the Blackboard educational platform and other evaluation techniques of quality learning, based on materials developed by teachers of “Spiru Haret” University, as well as corresponding responsibilities, in order to increase the learning process quality and the exigency degree in the examination process, as well as students’ satisfaction measured by accumulated competences. We appreciate that the purpose of this procedure is first and foremost to ensure transparency and objectivity in exam passing decision. After identifying the weaknesses with the “cause - effect” chart, we have sought to improve student evaluation process using PDCA (Plan-Do-Check-Act method, resulting in the design of a new assessment flowchart.

  3. How can we recognize continuous quality improvement?

    Science.gov (United States)

    Rubenstein, Lisa; Khodyakov, Dmitry; Hempel, Susanne; Danz, Margie; Salem-Schatz, Susanne; Foy, Robbie; O'Neill, Sean; Dalal, Siddhartha; Shekelle, Paul

    2014-02-01

    Continuous quality improvement (CQI) methods are foundational approaches to improving healthcare delivery. Publications using the term CQI, however, are methodologically heterogeneous, and labels other than CQI are used to signify relevant approaches. Standards for identifying the use of CQI based on its key methodological features could enable more effective learning across quality improvement (QI) efforts. The objective was to identify essential methodological features for recognizing CQI. Previous work with a 12-member international expert panel identified reliably abstracted CQI methodological features. We tested which features met rigorous a priori standards as essential features of CQI using a three-phase online modified-Delphi process. Primarily United States and Canada. 119 QI experts randomly assigned into four on-line panels. Participants rated CQI features and discussed their answers using online, anonymous and asynchronous discussion boards. We analyzed ratings quantitatively and discussion threads qualitatively. Main outcome measure(s) Panel consensus on definitional CQI features. /st> Seventy-nine (66%) panelists completed the process. Thirty-three completers self-identified as QI researchers, 18 as QI practitioners and 28 as both equally. The features 'systematic data guided activities,' 'designing with local conditions in mind' and 'iterative development and testing' met a priori standards as essential CQI features. Qualitative analyses showed cross-cutting themes focused on differences between QI and CQI. We found consensus among a broad group of CQI researchers and practitioners on three features as essential for identifying QI work more specifically as 'CQI.' All three features are needed as a minimum standard for recognizing CQI methods.

  4. Does competition improve health care quality?

    Science.gov (United States)

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

    2008-12-01

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

  5. The process approach to service quality management

    OpenAIRE

    Kamila Kowalik; Dorota Klimecka-Tatar

    2018-01-01

    In this paper a model of service quality management based on the process approach has been presented. The first part of the article contains the theoretical framework of service quality and the process approach in management. Next, quality of service process has been presented in reference to a process-based definition in quoted literature. Finally, the outcomes of a customer questionnaire concerning the validity of particular quality attributes has been presented. The collected data in relat...

  6. 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.

  7. 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.

  8. 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.

  9. Quality control of static irradiation processing products

    International Nuclear Information System (INIS)

    Bao Jianzhong; Chen Xiulan; Cao Hong; Zhai Jianqing

    2002-01-01

    Based on the irradiation processing practice of the nuclear technique application laboratory of Yangzhou Institute of Agricultural Science, the quality control of irradiation processing products is discussed

  10. 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.

  11. 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.

  12. Preoperative teaching and stoma marking in an inpatient population: a quality improvement process using a FOCUS-Plan-Do-Check-Act model.

    Science.gov (United States)

    Zimnicki, Katherine M

    2015-01-01

    Preoperative teaching and stoma marking are supported by research and included in clinical practice guidelines from the WOCN Society and others. Using a FOCUS-Plan-Do-Check-Act model of Total Quality Management, a multidisciplinary team was formed that developed a flow chart outlining the process of care for patients undergoing planned ostomy surgery that included an educational intervention that enabled staff nurses to perform preoperative stoma site marking and education. After 3 months, we found a statistically significant increase in the number of surgical patients who received these evidence-based interventions (14% vs 64%; χ = 9.32; P = .002).

  13. Improving Accuracy of Processing Through Active Control

    Directory of Open Access Journals (Sweden)

    N. N. Barbashov

    2016-01-01

    Full Text Available An important task of modern mathematical statistics with its methods based on the theory of probability is a scientific estimate of measurement results. There are certain costs under control, and under ineffective control when a customer has got defective products these costs are significantly higher because of parts recall.When machining the parts, under the influence of errors a range scatter of part dimensions is offset towards the tolerance limit. To improve a processing accuracy and avoid defective products involves reducing components of error in machining, i.e. to improve the accuracy of machine and tool, tool life, rigidity of the system, accuracy of the adjustment. In a given time it is also necessary to adapt machine.To improve an accuracy and a machining rate there, currently  become extensively popular various the in-process gaging devices and controlled machining that uses adaptive control systems for the process monitoring. Improving the accuracy in this case is compensation of a majority of technological errors. The in-cycle measuring sensors (sensors of active control allow processing accuracy improvement by one or two quality and provide a capability for simultaneous operation of several machines.Efficient use of in-cycle measuring sensors requires development of methods to control the accuracy through providing the appropriate adjustments. Methods based on the moving average, appear to be the most promising for accuracy control since they include data on the change in some last measured values of the parameter under control.

  14. Improving healthcare using Lean processes.

    Science.gov (United States)

    Baker, G Ross

    2014-01-01

    For more than a decade, healthcare organizations across Canada have been using Lean management tools to improve care processes, reduce preventable adverse events, increase patient satisfaction and create better work environments. The largest system-wide effort in Canada, and perhaps anywhere, is currently under way in Saskatchewan. The jury is still out on whether Lean efforts in that province, or elsewhere in Canada, are robust enough to transform current delivery systems and sustain new levels of performance. This issue of Healthcare Quarterly features several articles that provide a perspective on Lean methods in healthcare. Copyright © 2014 Longwoods Publishing.

  15. Coping with transition: improving the management process

    International Nuclear Information System (INIS)

    Griffin, J.; McAlister, J.

    1985-01-01

    It goes without saying that the industry is indeed in transition. Not only do expectations from regulators and the public continue to grow in intensity and complexity, but out ability to make appropriate responses seems to be becoming exceedingly more difficult as well. At AP and L, the energy supply department has some 2,000 employees and operates (in addition to providing general office engineering, technical, and administrative support) all of AP and L's power plants. These include two nuclear units and four coal units as well as hydro, oil and gas plants. In January 1984 the company began an effort with our senior departmental management to try and improve the management process itself. The ultimate goal is to create a climate conductive to improved productivity and quality without the initial (and sometimes risky) across-the-board implementation of techniques such as quality circles

  16. A quality-refinement process for medical imaging applications.

    Science.gov (United States)

    Neuhaus, J; Maleike, D; Nolden, M; Kenngott, H-G; Meinzer, H-P; Wolf, I

    2009-01-01

    To introduce and evaluate a process for refinement of software quality that is suitable to research groups. In order to avoid constraining researchers too much, the quality improvement process has to be designed carefully. The scope of this paper is to present and evaluate a process to advance quality aspects of existing research prototypes in order to make them ready for initial clinical studies. The proposed process is tailored for research environments and therefore more lightweight than traditional quality management processes. Focus on quality criteria that are important at the given stage of the software life cycle. Usage of tools that automate aspects of the process is emphasized. To evaluate the additional effort that comes along with the process, it was exemplarily applied for eight prototypical software modules for medical image processing. The introduced process has been applied to improve the quality of all prototypes so that they could be successfully used in clinical studies. The quality refinement yielded an average of 13 person days of additional effort per project. Overall, 107 bugs were found and resolved by applying the process. Careful selection of quality criteria and the usage of automated process tools lead to a lightweight quality refinement process suitable for scientific research groups that can be applied to ensure a successful transfer of technical software prototypes into clinical research workflows.

  17. Instant noodles: processing, quality, and nutritional aspects.

    Science.gov (United States)

    Gulia, Neelam; Dhaka, Vandana; Khatkar, B S

    2014-01-01

    Noodles are one of the staple foods consumed in many Asian countries. Instant noodles have become internationally recognized food, and worldwide consumption is on the rise. The properties of instant noodles like taste, nutrition, convenience, safety, longer shelf-life, and reasonable price have made them popular. Quality factors important for instant noodles are color, flavor, and texture, cooking quality, rehydration rates during final preparation, and the presence or absence of rancid taste after extended storage. Microstructure of dough and noodles has been studied to understand the influence of ingredients and processing variables on the noodle quality by employing scanning electron microscopy. Applications of newer techniques like confocal laser scanning microscopy and epifluorescence light microscopy employed to understand the microstructure changes in dough and noodles have also been discussed. Sincere efforts of researchers are underway to improve the formulation, extend the shelf life, and promote universal fortification of instant noodles. Accordingly, many researchers are exploring the potential of noodle fortification as an effective public health intervention and improve its nutritional properties. This review focuses on the functionality of ingredients, unit operations involved, quality criteria for evaluation, recent trends in fortification, and current knowledge in relation to instant noodles.

  18. Quality control of CANDU6 fuel element in fabrication process

    International Nuclear Information System (INIS)

    Li Yinxie; Zhang Jie

    2012-01-01

    To enhance the fine control over all aspects of the production process, improve product quality, fuel element fabrication process for CANDU6 quality process control activities carried out by professional technical and management technology combined mode, the quality of the fuel elements formed around CANDU6 weak links - - end plug , and brazing processes and procedures associated with this aspect of strict control, in improving staff quality consciousness, strengthening equipment maintenance, improved tooling, fixtures, optimization process test, strengthen supervision, fine inspection operations, timely delivery carry out aspects of the quality of information and concerns the production environment, etc., to find the problem from the improvement of product quality and factors affecting the source, and resolved to form the active control, comprehensive and systematic analysis of the problem of the quality management concepts, effectively reducing the end plug weld microstructure after the failure times and number of defects zirconium alloys brazed, improved product quality, and created economic benefits expressly provided, while staff quality consciousness and attention to detail, collaboration department, communication has been greatly improved and achieved very good management effectiveness. (authors)

  19. A Report Card on Continuous Quality Improvement

    Science.gov (United States)

    Blumenthal, David; Kilo, Charles M.

    1998-01-01

    Efforts to incorporate the principles of continuous quality improvement (CQI) into health care have been underway for about ten years. In order to understand the lessons of this decade of experience, senior organizational leaders and experts in the field of health care were interviewed. This select group agreed that there have been concrete accomplishments: the tactic of assigning blame for mistakes to individuals is gradually giving way to an emphasis on detecting problems with process; there is a new focus on the health care customer; and many valuable projects have been inaugurated. Nevertheless, the interviews underlined the reality that the movement has not yet made a sizable impact on the U.S. health care system. Until there is a profound, organization-wide recognition of the need for change, universal commitment to CQI principles will not be achieved. PMID:9879305

  20. 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...

  1. Reaching Rural Mammographers for Quality Improvement

    National Research Council Canada - National Science Library

    Urban, Nicole

    1997-01-01

    The Fred Hutchinson Cancer Research Center, the University of Washington, and the Washington State Department of Health are collaborating to develop and implement a mammography quality improvement program (MQIP...

  2. Reaching Rural Mammographers for Quality Improvement

    National Research Council Canada - National Science Library

    Urban, Nicole

    1998-01-01

    The Fred Hutchinson Cancer Research Center, the University of Washington, and the Washington State Department of Health are collaborating to develop and implement a mammography quality improvement. program (MQIP...

  3. Reaching Rural Mammographers for Quality Improvement

    National Research Council Canada - National Science Library

    Urban, Nicole

    1999-01-01

    The Fred Hutchinson Cancer Research Center, the University of Washington, and the Washington State Department of Health are collaborating to develop and implement a mammography quality improvement program (MQIP...

  4. Formalising medical quality indicators to improve guidelines

    NARCIS (Netherlands)

    Van Gendt, Marjolein; Ten Teije, Annette; Serban, Radu; Van Harmelen, Frank

    2005-01-01

    Medical guidelines can significantly improve quality of medical care and reduce costs. But how do we get sound and well-structured guidelines? This paper investigates the use of quality indicators that are formulated by medical institutions to evaluate medical care. The main research questions are

  5. Product focused process improvement in the embedded systems industry

    NARCIS (Netherlands)

    Solingen, van D.M.; Derks, P.; Hirvensalo, J.; Kusters, R.J.; Cowderoy, A.; Heemstra, F.J.; Veenendaal, E.P.W.M.

    1999-01-01

    Software specific problems have been handled in the software community through focusing on the software process, and continuous improvement of that software process. However, the contribution of software process improvement (SPI) to product quality has not been proven yet. The PROFES project

  6. 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.

  7. Nationwide survey to evaluate the decision-making process in euthanasia requests in Belgium: do specifically trained 2nd physicians improve quality of consultation?

    Science.gov (United States)

    Cohen, Joachim; Van Wesemael, Yanna; Smets, Tinne; Bilsen, Johan; Onwuteaka-Philipsen, Bregje; Distelmans, Wim; Deliens, Luc

    2014-07-16

    Following the 2002 enactment of the Belgian law on euthanasia, which requires the consultation of an independent second physician before proceeding with euthanasia, the Life End Information Forum (LEIF) was founded which provides specifically trained physicians who can act as mandatory consultants in euthanasia requests. This study assesses quality of consultations in Flanders and Brussels and compares these between LEIF and non-LEIF consultants. A questionnaire was sent in 2009 to a random sample of 3,006 physicians in Belgium from specialties likely involved in the care of dying patients. Several questions about the last euthanasia request of one of their patients were asked. As LEIF serves the Flemish speaking community (i.e. region of Flanders and the bilingual Brussels Capital Region) and no similar counterpart is present in Wallonia, analyses were limited to Flemish speaking physicians in Flanders and Brussels. Response was 34%. Of the 244 physicians who indicated having received a euthanasia request seventy percent consulted a second physician in their last request; in 30% this was with a LEIF physician. Compared to non-LEIF physicians, LEIF physicians were more often not a colleague (69% vs 42%) and not a co-attending physician (89% vs 66%). They tended to more often discuss the request with the attending physician (100% vs 95%) and with the family (76% vs 69%), and also more frequently helped the attending physician with performing euthanasia (44% vs 24%). No significant differences were found in the extent to which they talked to the patient (96% vs 93%) and examined the patient file (94% vs 97%). In cases of explicit euthanasia requests in Belgium, the consultation procedure of another physician by the attending physician is not optimal and can be improved. Training and putting at disposal consultants through forums such as LEIF seems able to improve this situation. Adding stipulations in the law about the necessary competencies and tasks of consulting

  8. REMOTE SENSING IMAGE QUALITY ASSESSMENT EXPERIMENT WITH POST-PROCESSING

    Directory of Open Access Journals (Sweden)

    W. Jiang

    2018-04-01

    Full Text Available This paper briefly describes the post-processing influence assessment experiment, the experiment includes three steps: the physical simulation, image processing, and image quality assessment. The physical simulation models sampled imaging system in laboratory, the imaging system parameters are tested, the digital image serving as image processing input are produced by this imaging system with the same imaging system parameters. The gathered optical sampled images with the tested imaging parameters are processed by 3 digital image processes, including calibration pre-processing, lossy compression with different compression ratio and image post-processing with different core. Image quality assessment method used is just noticeable difference (JND subject assessment based on ISO20462, through subject assessment of the gathered and processing images, the influence of different imaging parameters and post-processing to image quality can be found. The six JND subject assessment experimental data can be validated each other. Main conclusions include: image post-processing can improve image quality; image post-processing can improve image quality even with lossy compression, image quality with higher compression ratio improves less than lower ratio; with our image post-processing method, image quality is better, when camera MTF being within a small range.

  9. Analysis of fruit and oil quantity and quality distribution in high-density olive trees in order to improve the mechanical harvesting process

    Energy Technology Data Exchange (ETDEWEB)

    Castillo-Ruiz, F. J.; Jiménez-Jiménez, F.; Blanco-Roldán, G.L.; Sola-Guirado, R. R.; Agüera-Vega, J.; Castro-Garcia, S.

    2015-07-01

    Olive fruit production and oil quality distribution with respect to canopy distribution are important criteria for selection and improvement of mechanical harvesting methods. Tests were performed in a high-density olive orchard (Olea europea L., cv. Arbequina) in southern Spain. Fruit distribution, fruit properties and oil parameters were measured by taken separate samples for each canopy location and tree. Results showed a high percentage of fruits and oil located in the middle-outer and upper canopy, representing more than 60% of total production. The position of these fruits along with their higher weight per fruit, maturity index and polyphenol content make them the target for all mechanical harvesting systems. The fruits from the lower canopy represented close to 30% of fruit and oil production, however, the mechanical harvesting of these fruits is inefficient for mechanical harvesting systems. Whether these fruits cannot be properly harvested, enhance tree training to raise their position is recommended. Fruits located inside the canopy are not a target location for mechanical harvesting systems as they were a small percentage of the total fruit (<10%). Significant differences were found for polyphenol content with respect to canopy height, although this was not the case with acidity. In addition, the ripening index did not influence polyphenol content and acidity values within the canopy. Fruit production, properties and oil quality varied depending on fruit canopy position. Thus harvesting systems may be targeted at maximize harvesting efficiency including an adequate tree training system adapted to the harvesting system. (Author)

  10. Analysis of fruit and oil quantity and quality distribution in high-density olive trees in order to improve the mechanical harvesting process

    Directory of Open Access Journals (Sweden)

    Francisco J. Castillo-Ruiz

    2015-06-01

    Full Text Available Olive fruit production and oil quality distribution with respect to canopy distribution are important criteria for selection and improvement of mechanical harvesting methods. Tests were performed in a high-density olive orchard (Olea europea L., cv. Arbequina in southern Spain. Fruit distribution, fruit properties and oil parameters were measured by taken separate samples for each canopy location and tree. Results showed a high percentage of fruits and oil located in the middle-outer and upper canopy, representing more than 60% of total production. The position of these fruits along with their higher weight per fruit, maturity index and polyphenol content make them the target for all mechanical harvesting systems. The fruits from the lower canopy represented close to 30% of fruit and oil production, however, the mechanical harvesting of these fruits is inefficient for mechanical harvesting systems. Whether these fruits cannot be properly harvested, enhance tree training to raise their position is recommended. Fruits located inside the canopy are not a target location for mechanical harvesting systems as they were a small percentage of the total fruit (<10%. Significant differences were found for polyphenol content with respect to canopy height, although this was not the case with acidity. In addition, the ripening index did not influence polyphenol content and acidity values within the canopy. Fruit production, properties and oil quality varied depending on fruit canopy position. Thus harvesting systems may be targeted at maximize harvesting efficiency including an adequate tree training system adapted to the harvesting system.

  11. Continuous quality improvement program for hip and knee replacement.

    Science.gov (United States)

    Marshall, Deborah A; Christiansen, Tanya; Smith, Christopher; Squire Howden, Jane; Werle, Jason; Faris, Peter; Frank, Cy

    2015-01-01

    Improving quality of care and maximizing efficiency are priorities in hip and knee replacement, where surgical demand and costs increase as the population ages. The authors describe the integrated structure and processes from the Continuous Quality Improvement (CQI) Program for Hip and Knee Replacement Surgical Care and summarize lessons learned from implementation. The Triple Aim framework and 6 dimensions of quality care are overarching constructs of the CQI program. A validated, evidence-based clinical pathway that measures quality across the continuum of care was adopted. Working collaboratively, multidisciplinary experts embedded the CQI program into everyday practices in clinics across Alberta. Currently, 83% of surgeons participate in the CQI program, representing 95% of the total volume of hip and knee surgeries. Biannual reports provide feedback to improve care processes, infrastructure planning, and patient outcomes. CQI programs evaluating health care services inform choices to optimize care and improve efficiencies through continuous knowledge translation. © The Author(s) 2014.

  12. Structural and Process Quality of Danish Preschools

    DEFF Research Database (Denmark)

    Slot, Pauline Louise; Bleses, Dorthe; Justice, Laura M.

    2018-01-01

    Structural quality in childcare centers is considered a precondition for process quality, which in turn is related to children’s outcomes. However, the evidence on relations between structural and process quality is mixed. Moreover, despite strong theoretical claims, empirical evidence supporting...

  13. 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.

  14. 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

  15. Business Process Modelling for Measuring Quality

    NARCIS (Netherlands)

    Heidari, F.; Loucopoulos, P.; Brazier, F.M.

    2013-01-01

    Business process modelling languages facilitate presentation, communication and analysis of business processes with different stakeholders. This paper proposes an approach that drives specification and measurement of quality requirements and in doing so relies on business process models as

  16. Harness cavitation to improve processing

    Energy Technology Data Exchange (ETDEWEB)

    Pandit, A.G.; Moholkar, V.S. [Univ. of Bombay (India)

    1996-07-01

    Mention cavitation to most chemical engineers, and they undoubtedly think of it as an operational problem. Indeed, the rapid creation and then collapse of bubbles, which is after all what cavitation involves, can destroy pumps and erode other equipment. Cavitation, however, also can have a positive side--presuming it is designed for and not unplanned. In this article, the authors look at how cavitation can be harnessed to improve processes, and the mechanisms for inducing cavitation--ultrasonics and hydrodynamics--and their likely roles. Sonication, that is, the use of ultrasound, is the conventional approach for creating cavitation, and so they turn to it first. Over the past few years, a number of groups have attempted to solve the problem of scale-up and design of ultrasonic reactors. The authors review the systems that already exist and also explore a simpler and efficient alternative to the ultrasonic reactor, the hydrodynamic cavitation reactor.

  17. Vacuolar invertase gene silencing in potato (Solanum tuberosum L. improves processing quality by decreasing the frequency of sugar-end defects.

    Directory of Open Access Journals (Sweden)

    Xiaobiao Zhu

    Full Text Available Sugar-end defect is a tuber quality disorder and persistent problem for the French fry processing industry that causes unacceptable darkening of one end of French fries. This defect appears when environmental stress during tuber growth increases post-harvest vacuolar acid invertase activity at one end of the tuber. Reducing sugars produced by invertase form dark-colored Maillard reaction products during frying. Acrylamide is another Maillard reaction product formed from reducing sugars and acrylamide consumption has raised health concerns worldwide. Vacuolar invertase gene (VInv expression was suppressed in cultivars Russet Burbank and Ranger Russet using RNA interference to determine if this approach could control sugar-end defect formation. Acid invertase activity and reducing sugar content decreased at both ends of tubers. Sugar-end defects and acrylamide in fried potato strips were strongly reduced in multiple transgenic potato lines. Thus vacuolar invertase silencing can minimize a long-standing French fry quality problem while providing consumers with attractive products that reduce health concerns related to dietary acrylamide.

  18. Ninety to Nothing: a PDSA quality improvement project.

    Science.gov (United States)

    Prybutok, Gayle Linda

    2018-05-14

    Purpose The purpose of this paper is to present a case study of a successful quality improvement project in an acute care hospital focused on reducing the time of the total patient visit in the emergency department. Design/methodology/approach A multidisciplinary quality improvement team, using the PDSA (Plan, Do, Study, Act) Cycle, analyzed the emergency department care delivery process and sequentially made process improvements that contributed to project success. Findings The average turnaround time goal of 90 minutes or less per visit was achieved in four months, and the organization enjoyed significant collateral benefits both internal to the organization and for its customers. Practical implications This successful PDSA process can be duplicated by healthcare organizations of all sizes seeking to improve a process related to timely, high-quality patient care delivery. Originality/value Extended wait time in hospital emergency departments is a universal problem in the USA that reduces the quality of the customer experience and that delays necessary patient care. This case study demonstrates that a structured quality improvement process implemented by a multidisciplinary team with the authority to make necessary process changes can successfully redefine the norm.

  19. 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

  20. Making quality improvement programs more effective.

    Science.gov (United States)

    Shaw-Taylor, Yoku

    2014-01-01

    In the past 25 years, and as recent as 2011, all external evaluations of the Quality Improvement Organization (QIO) Program have found its impact to be small or difficult to discern. The QIO program costs about $200 million on average to administer each year to improve quality of healthcare for people of 65 years or older. The program was created to address questionable quality of care. QIOs review how care is provided based on performance measures. The paper aims to discuss these issues. In 2012, the author supported the production of quarterly reports and reviewed internal monitoring and evaluation protocols of the program. The task also required reviewing all previous program evaluations. The task involved many conversations about the complexities of the program, why impact is difficult to discern and possible ways for eventual improvement. Process flow charts were created to simulate the data life cycle and discrete event models were created based on the sequence of data collection and reporting to identify gaps in data flow. The internal evaluation uncovered data gaps within the program. The need for a system of specification rules for data conceptualization, collection, distribution, discovery, analysis and repurposing is clear. There were data inconsistencies and difficulty of integrating data from one instance of measurement to the next. The lack of good and reliable data makes it difficult to discern true impact. The prescription is for a formal data policy or data governance structure to integrate and document all aspects of the data life cycle. The specification rules for governance are exemplified by the Data Documentation Initiative and the requirements published by the Data Governance Institute. The elements are all in place for a solid foundation of the data governance structure. These recommendations will increase the value of program data. The model specifies which agency units must be included in the governance authority and the data team. The

  1. Re-engineering quality related processes and activities

    International Nuclear Information System (INIS)

    Preisser, T.E.

    1995-01-01

    Given both desire and opportunity, improvements to program quality hinge upon a thorough understanding of what processes are currently performed, which are necessary to support the product or service, and what ideal processes should look like. Thorough understanding derives from process analysis, process mapping, and the use of other quality tools. Despite the level of knowledge any process team claims, there is likely to be at least one area that was hidden before the process was deeply analyzed. Finding that hidden element may mean the difference between evolving an improvement versus a breakthrough

  2. 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.

  3. Process-Based Quality (PBQ) Tools Development

    Energy Technology Data Exchange (ETDEWEB)

    Cummins, J.L.

    2001-12-03

    The objective of this effort is to benchmark the development of process-based quality tools for application in CAD (computer-aided design) model-based applications. The processes of interest are design, manufacturing, and quality process applications. A study was commissioned addressing the impact, current technologies, and known problem areas in application of 3D MCAD (3-dimensional mechanical computer-aided design) models and model integrity on downstream manufacturing and quality processes. The downstream manufacturing and product quality processes are profoundly influenced and dependent on model quality and modeling process integrity. The goal is to illustrate and expedite the modeling and downstream model-based technologies for available or conceptual methods and tools to achieve maximum economic advantage and advance process-based quality concepts.

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

    Science.gov (United States)

    Schwartz, Stephanie P; Rehder, Kyle J

    2017-01-01

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

  5. Improvements of the Swarm Accelerometer Data Processing

    DEFF Research Database (Denmark)

    Siemes, Christian; Grunwaldt, Ludwig; Peresty, Radek

    , the most prominent being slow temperature-induced bias variations and sudden bias changes. These disturbances have caused a significant delay of the accelerometer data release.In this presentation, we describe the new, improved four-stage processing that is required for transforming the disturbed...... acceleration measurements into scientifically valuable thermospheric neutral densities. In the first stage, the sudden bias changes in the acceleration measurements are manually removed using a dedicated software tool. The second stage is the calibration of the accelerometer measurements against the non...... in each stage, highlight the difficulties encountered, and comment on the quality of the thermospheric neutral density data set....

  6. Collaborative process improvement with examples from the software world

    CERN Document Server

    Yeakley, C

    2007-01-01

    Collaborative Process Improvement specifically addresses software companies that are interested in addressing quality in human terms. Using Collaborative Process Improvement techniques builds effective processes to deliver quality products; it helps readers relate to what quality means to the end-user and provides the essential tools and methods to integrate the face of the customer into the organization's day-to-day processes. It comes complete with real-world examples that are practical and unders andable to professionals in every role of a company.

  7. Electronic health records improve clinical note quality.

    Science.gov (United States)

    Burke, Harry B; Sessums, Laura L; Hoang, Albert; Becher, Dorothy A; Fontelo, Paul; Liu, Fang; Stephens, Mark; Pangaro, Louis N; O'Malley, Patrick G; Baxi, Nancy S; Bunt, Christopher W; Capaldi, Vincent F; Chen, Julie M; Cooper, Barbara A; Djuric, David A; Hodge, Joshua A; Kane, Shawn; Magee, Charles; Makary, Zizette R; Mallory, Renee M; Miller, Thomas; Saperstein, Adam; Servey, Jessica; Gimbel, Ronald W

    2015-01-01

    The clinical note documents the clinician's information collection, problem assessment, clinical management, and its used for administrative purposes. Electronic health records (EHRs) are being implemented in clinical practices throughout the USA yet it is not known whether they improve the quality of clinical notes. The goal in this study was to determine if EHRs improve the quality of outpatient clinical notes. A five and a half year longitudinal retrospective multicenter quantitative study comparing the quality of handwritten and electronic outpatient clinical visit notes for 100 patients with type 2 diabetes at three time points: 6 months prior to the introduction of the EHR (before-EHR), 6 months after the introduction of the EHR (after-EHR), and 5 years after the introduction of the EHR (5-year-EHR). QNOTE, a validated quantitative instrument, was used to assess the quality of outpatient clinical notes. Its scores can range from a low of 0 to a high of 100. Sixteen primary care physicians with active practices used QNOTE to determine the quality of the 300 patient notes. The before-EHR, after-EHR, and 5-year-EHR grand mean scores (SD) were 52.0 (18.4), 61.2 (16.3), and 80.4 (8.9), respectively, and the change in scores for before-EHR to after-EHR and before-EHR to 5-year-EHR were 18% (pquality scores significantly improved over the 5-year time interval. The EHR significantly improved the overall quality of the outpatient clinical note and the quality of all its elements, including the core and non-core elements. To our knowledge, this is the first study to demonstrate that the EHR significantly improves the quality of clinical notes. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association.

  8. Using complaints to enhance quality improvement: developing an analytical tool.

    Science.gov (United States)

    Hsieh, Sophie Yahui

    2012-01-01

    This study aims to construct an instrument for identifying certain attributes or capabilities that might enable healthcare staff to use complaints to improve service quality. PubMed and ProQuest were searched, which in turn expanded access to other literature. Three paramount dimensions emerged for healthcare quality management systems: managerial, operational, and technical (MOT). The paper reveals that the managerial dimension relates to quality improvement program infrastructure. It contains strategy, structure, leadership, people and culture. The operational dimension relates to implementation processes: organizational changes and barriers when using complaints to enhance quality. The technical dimension emphasizes the skills, techniques or information systems required to achieve successfully continuous quality improvement. The MOT model was developed by drawing from the relevant literature. However, individuals have different training, interests and experiences and, therefore, there will be variance between researchers when generating the MOT model. The MOT components can be the guidelines for examining whether patient complaints are used to improve service quality. However, the model needs testing and validating by conducting further research before becoming a theory. Empirical studies on patient complaints did not identify any analytical tool that could be used to explore how complaints can drive quality improvement. This study developed an instrument for identifying certain attributes or capabilities that might enable healthcare professionals to use complaints and improve service quality.

  9. 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

  10. Caring, learning, improving quality and doing research: Different ...

    African Journals Online (AJOL)

    The aim of this article is to describe the similarities between the consultation process, the quality improvement (QI) process, action- and problem-based learning and participatory action research (PAR). We feel this understanding adds value to our work in enabling personal development as practitioners, fostering teamwork ...

  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. Quality procedure management for improved nuclear safety

    International Nuclear Information System (INIS)

    Forzano, P.; Castagna, P.

    1995-01-01

    Emergency Operating Procedures and Accident Management Procedures are the next step in the computerization of NPP control rooms. Different improvements are presently conceivable for this operator aid tool, and research activities are in development. Undergoing activities regard especially formal aspects of knowledge representation, Human-Machine interface and procedure life cycle management. These aspects have been investigated deeply by Ansaldo, and partially incorporated in the DIAM prototype. Nuclear Power Plant Procedures can be seen from essentially two viewpoints: the process and the information management. From the first point of view, it is important to supply the knowledge apt to solve problems connected with the control of the process, from the second one the focus of attention is on the knowledge representation, its structure, elicitation and maintenance, and formal quality assurance. These two aspects of procedure representation can be considered and solved separately. In particular, methodological, formal and management issues require long and tedious activities, that in most cases constitute a great barrier for procedures development and upgrade. To solve these problems, Ansaldo is developing DIAM, a wide integrated tool for procedure management to support in procedure writing, updating, usage, and documentation. One of the most challenging features of DIAM is AUTO-LAY, a CASE sub-tool that, in a complete automatical way, structures parts or complete flow diagram. This is the feature that is partial present in some other CASE products, that, anyway, do not allow complex graph handling and isomorphism between video and paper representation. AUTO-LAY has the unique prerogative to draw graphs of any complexity to section them in pages, and to automatically compose a document. This has been recognized in the literature as the most important a second-generation CASE improvement. (Author) 9 Figs., 5 Refs

  13. Quality Indicators for the Total Testing Process.

    Science.gov (United States)

    Plebani, Mario; Sciacovelli, Laura; Aita, Ada

    2017-03-01

    ISO 15189:2012 requires the use of quality indicators (QIs) to monitor and evaluate all steps of the total testing process, but several difficulties dissuade laboratories from effective and continuous use of QIs in routine practice. An International Federation of Clinical Chemistry and Laboratory Medicine working group addressed this problem and implemented a project to develop a model of QIs to be used in clinical laboratories worldwide to monitor and evaluate all steps of the total testing process, and decrease error rates and improve patient services in laboratory testing. All laboratories are invited, at no cost, to enroll in the project and contribute to harmonized management at the international level. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Actions to improve the quality of the training process in the higher education from the classes of philosophical discipline and socio political theory.

    Directory of Open Access Journals (Sweden)

    Anna Lidia Beltrán Marín

    2012-04-01

    Full Text Available The employment of didactic materials in the classes of the philosophical discipline and socio political theory has improved the quality of the teaching and in consequence the professional's formation. With the purpose of socializing the results that have been applied and their possible implementation in entities of superior education in the territory, the following dissertation is presented which collect a synthesis of the main materials made by a community of professors and investigators of Sancti Spiritus University, As well as the way that have been employed in each case and the presentation in events and the publication of some results of the investigations made as a part of Project for the Study of philosophy, history of the education and the educational and social institutions in Sancti Spíritus. Results presented as thesis in option to academic titles of Master in Sciences of the Education and Superior Education and some experiences of professors that have assumed the teaching of the philosophy in the municipalization are exposed also.

  15. Quality in Acute Stroke Care (QASC): process evaluation of an intervention to improve the management of fever, hyperglycemia, and swallowing dysfunction following acute stroke.

    Science.gov (United States)

    Drury, Peta; Levi, Christopher; D'Este, Catherine; McElduff, Patrick; McInnes, Elizabeth; Hardy, Jennifer; Dale, Simeon; Cheung, N Wah; Grimshaw, Jeremy M; Quinn, Clare; Ward, Jeanette; Evans, Malcolm; Cadilhac, Dominique; Griffiths, Rhonda; Middleton, Sandy

    2014-08-01

    Our randomized controlled trial of a multifaceted evidence-based intervention for improving the inpatient management of fever, hyperglycemia, and swallowing dysfunction in the first three-days following stroke improved outcomes at 90 days by 15%. We designed a quantitative process evaluation to further explain and illuminate this finding. Blinded retrospective medical record audits were undertaken for patients from 19 stroke units prior to and following the implementation of three multidisciplinary evidence-based protocols (supported by team-building workshops, and site-based education and support) for the management of fever (temperature ≥37·5°C), hyperglycemia (glucose >11 mmol/l), and swallowing dysfunction in intervention stroke units. Data from 1804 patients (718 preintervention; 1086 postintervention) showed that significantly more patients admitted to hospitals allocated to the intervention group received care according to the fever (n = 186 of 603, 31% vs. n = 74 of 483, 15%, P < 0·001), hyperglycemia (n = 22 of 603, 3·7% vs. n = 3 of 483, 0·6%, P = 0·01), and swallowing dysfunction protocols (n = 241 of 603, 40% vs. n = 19 of 483, 4·0%, P ≤ 0·001). Significantly more patients in these intervention stroke units received four-hourly temperature monitoring (n = 222 of 603, 37% vs. n = 90 of 483, 19%, P < 0·001) and six-hourly glucose monitoring (194 of 603, 32% vs. 46 of 483, 9·5%, P < 0·001) within 72 hours of admission to a stroke unit, and a swallowing screen (242 of 522, 46% vs. 24 of 350, 6·8%, P ≤ 0·0001) within the first 24 hours of admission to hospital. There was no difference between the groups in the treatment of patients with fever with paracetamol (22 of 105, 21% vs. 38 of 131, 29%, P = 0·78) or their hyperglycemia with insulin (40 of 100, 40% vs. 17 of 57, 30%, P = 0·49). Our intervention resulted in better protocol adherence in intervention stroke units

  16. ISO certification pays off in quality improvement

    International Nuclear Information System (INIS)

    Vermeer, F.J.G.

    1992-01-01

    This paper reports that by obtaining and maintaining International Standards Organization (ISO) 9001 certification, a company can improve its quality control system, cut waste, and motivate its employees. In so doing it improves its competitive position in both international and domestic markets. The success of a number of countries (notably Japan) in the world markets has focused the attention of the industrialized countries on improving quality levels and striving for a unified, worldwide quality standard. This has been particularly true in Europe; with several countries competing in a single market, a common quality standard has been a highly desirable goal for decades. One of the first multinational quality standards evolved in the European Community, which is estimated to become a single market with a gross national product of $4.5 trillion by 1992. As a consequence, in 1987 the International Standards Organization created ISO 9000, a single standard to ensure uniform quality in products and services offered with this growing market. U.S. petroleum and natural gas companies must recognize and implement the ISO 9000 standards or possibly lose international markets. If the present worldwide trend towards ISO 9000 continues (and there is no reason to believe that it will not), the standards will be just as important in the domestic market

  17. Applications of process improvement techniques to improve workflow in abdominal imaging.

    Science.gov (United States)

    Tamm, Eric Peter

    2016-03-01

    Major changes in the management and funding of healthcare are underway that will markedly change the way radiology studies will be reimbursed. The result will be the need to deliver radiology services in a highly efficient manner while maintaining quality. The science of process improvement provides a practical approach to improve the processes utilized in radiology. This article will address in a step-by-step manner how to implement process improvement techniques to improve workflow in abdominal imaging.

  18. Fostering evidence-based quality improvement for patient-centered medical homes: Initiating local quality councils to transform primary care.

    Science.gov (United States)

    Stockdale, Susan E; Zuchowski, Jessica; Rubenstein, Lisa V; Sapir, Negar; Yano, Elizabeth M; Altman, Lisa; Fickel, Jacqueline J; McDougall, Skye; Dresselhaus, Timothy; Hamilton, Alison B

    Although the patient-centered medical home endorses quality improvement principles, methods for supporting ongoing, systematic primary care quality improvement have not been evaluated. We introduced primary care quality councils at six Veterans Health Administration sites as an organizational intervention with three key design elements: (a) fostering interdisciplinary quality improvement leadership, (b) establishing a structured quality improvement process, and (c) facilitating organizationally aligned frontline quality improvement innovation. Our evaluation objectives were to (a) assess design element implementation, (b) describe implementation barriers and facilitators, and (c) assess successful quality improvement project completion and spread. We analyzed administrative records and conducted interviews with 85 organizational leaders. We developed and applied criteria for assessing design element implementation using hybrid deductive/inductive analytic techniques. All quality councils implemented interdisciplinary leadership and a structured quality improvement process, and all but one completed at least one quality improvement project and a toolkit for spreading improvements. Quality councils were perceived as most effective when service line leaders had well-functioning interdisciplinary communication. Matching positions within leadership hierarchies with appropriate supportive roles facilitated frontline quality improvement efforts. Two key resources were (a) a dedicated internal facilitator with project management, data collection, and presentation skills and (b) support for preparing customized data reports for identifying and addressing practice level quality issues. Overall, quality councils successfully cultivated interdisciplinary, multilevel primary care quality improvement leadership with accountability mechanisms and generated frontline innovations suitable for spread. Practice level performance data and quality improvement project management support

  19. 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...

  20. Concept Evaluation Using the PDSA Cycle for Continuous Quality Improvement.

    Science.gov (United States)

    Laverentz, Delois Meyer; Kumm, Sharon

    As concept-based nursing education gains popularity, there is little literature on how to sustain quality after initiation of the curriculum. Critical appraisal of concepts in a university program revealed varying definitions, attributes, and exemplars resulting in student confusion. The Plan, Do, Study, Act (PDSA) cycle for continuous quality improvement was used for concept evaluation. The goals of the evaluation project were: 1) to develop common definition and attributes for concepts and 2) to develop horizontal and vertical leveling of exemplars to build on prior student learning. The continuous quality improvement process can be used to prevent "concept creep" and ensure internal consistency of concept definitions, attributes, and exemplars.

  1. 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

  2. Systematic quality improvement in medicine: everyone can do it.

    Science.gov (United States)

    Zeidel, Mark L

    2011-07-01

    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 systematic quality

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

    African Journals Online (AJOL)

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

  4. Strategies to improve quality of childbirth care

    Directory of Open Access Journals (Sweden)

    farahnaz Changaee

    2015-01-01

    Full Text Available Background: Access to affordable and quality health care is one of the most important ways for reducing maternal and child mortality. The purpose of this study was to provide strategies to promote the quality of care during childbirth in Lorestan province in 2011. Materials and Methods: This research was a mixed method (quantitative, qualitative, study in which quality of 200 care during childbirth in hospitals of Lorestan Province were evaluated. Data gathered through self-made tools (Checklists prepared according to the guidelines of the ministry of health. Descriptive statistics and SPSS software were used to data analysis.In the second part of the study which was qualitative, interview with service providers, hospital officials and high-ranking officials of Lorestan university of medical sciences (decision makers was used to discuss strategies to improve the quality of care. Results: The results showed that the care of the first stage delivery in %54.5, second stage %57 and third stage 66% were in accordance with the desired status and care in this three stages was of moderate quality. Based on the interviews, the officials who are in charge of Lorestan university of medical sciences, proposed strategies such as financial incentives and in-service training of midwives as suitable strategies to improve quality of services. Conclusion: According to the results, strategies such as financial incentives, increased use of private sector services to reduce the workload of the public sector and increase of quality and use of more in-service training, to improve the quality of services, are recommended.

  5. Does supplier evaluation impact process improvement?

    Directory of Open Access Journals (Sweden)

    Shiva Prasad h c

    2016-09-01

    Full Text Available Purpose: The research explores and examines factors for supplier evaluation and its impact on process improvement particularly aiming on a steel pipe manufacturing firm in Gujarat, India. Design/Methodology/approach: The conceptual research framework was developed and hypotheses were stated considering the analysis of literature and discussions with the managers and engineers of a steel pipe manufacturing company in Gujarat, India. Data was collected using in-depth interview. The questionnaire primarily involves the perception of evaluation of supplier. Factors influencing supplier evaluation and its influence on process improvement is also examined in this study. The model testing and validation was done using partial least square method. Outcomes signified that the factors that influence evaluation of the supplier are quality, cost, delivery and supplier relationship management. Findings: The study depicted that quality and cost factors for supplier evaluation are insignificant. The delivery and supplier relationship management have significant influence on evaluation of the supplier. The research also depicted that supplier evaluation has significant influence on process improvement. Research limitations/implications: The study has been made specifically for ABC steel pipe manufacturing industry in Gujarat, India and may not be appropriate to the other industries or any parts of the world. There is a possibility of response bias as the conclusions of this research was interpreted on survey responses taken from the employees of case study company, so it is suggested that future research can overcome this problem by employing various methodologies in addition to surveys like carrying out focus group and in-depth interviews, brainstorming sessions with the experts etc. Originality/value: Many researchers have considered quality, cost and delivery as the factors for evaluating the suppliers. But for a company it is quintessential to have good

  6. Avaliação da qualidade demandada e diretrizes de melhoria no processo de interação Universidade-Empresa Assessment of quality demand and guidelines for improving the University-Industry interaction process

    Directory of Open Access Journals (Sweden)

    Ana Paula Matei

    2012-01-01

    Full Text Available O artigo apresenta o processo de interação Universidade-Empresa no âmbito da Universidade Federal do Rio Grande do Sul (UFRGS, sob a responsabilidade da Secretaria de Desenvolvimento Tecnológico (SEDETEC. O objetivo é identificar as demandas de qualidade no processo de interação UFRGS-Empresas parceiras e propor melhorias para este processo. As demandas são identificadas com base em uma pesquisa de mercado, sendo desdobradas em características de qualidade e procedimentos para atendimento, por meio do Quality Function Deployment (QFD. Posteriormente, são propostas sugestões de melhorias para a SEDETEC. Os principais resultados são: a identificação e a priorização da qualidade demandada pelo setor empresarial; a avaliação dos requisitos e dos procedimentos que atendem a estas demandas e a proposição de diretrizes para melhorias no serviço da SEDETEC, destacando-se: ampliação e dinamização das formas de comunicação; criação de um sistema de indicadores de desempenho; e análise de mercado para as tecnologias desenvolvidas.This paper presents the university-industry interaction process through which the Federal University of Rio Grande do Sul (UFRGS is under the responsibility of the Secretary for Technological Development (SEDETEC. The purpose this article was to identify quality demands of the interaction process between UFRGS and partner companies, as well as to propose improvements to this process. Demands were identified through market research and then analyzed by means of the Quality Function Deployment (QFD, which provides insights for quality improvements. We then propose improvement actions to SEDETEC. Main results identify the quality demanded by the corporative segment, evaluate requirements and actions to achieve such quality demands, and propose improvement guidelines to the services provided by SEDETEC. Such improvements include a more dynamic communication system, a new set of indices for performance

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

    Science.gov (United States)

    Godény, Sándor

    2012-02-05

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

  8. Improving Power Quality in AC Supply Grids

    Directory of Open Access Journals (Sweden)

    Piotr Fabijański

    2015-12-01

    Full Text Available This paper describes a digital and actual model of the UPQC (Unified Power Quality Conditioner integrated system for power quality improvement. The UPQC’s design and its connection to an AC supply grid, 1-phase and 3-phase alike, provide effective compensation of unwanted interferences in the waveforms of load supply voltages and non-linear load currents. This article presents an overview of topologies and control strategies. The study of the UPQC confirmed its positive impact on the power quality. The electricity parameters were significantly improved. Total harmonic distortion in supply voltage THDu decreased six-fold to 1.89%, and total harmonic distortion in load current THDi decreased more than ten-fold to 2.38% for a non-linear load (uncontrolled bridge rectifier with load L. Additionally, symmetrisation of supply voltages and reactive power compensation Q of linear load was obtained. The UPQC integrated system for power quality improvement can be used wherever high-quality and PN-EN 50160 standard – compliant electricity is required.

  9. Improving the Quality of Constructive Peer Feedback

    Science.gov (United States)

    Waggoner Denton, Ashley

    2018-01-01

    This article presents some simple strategies that instructors can use to improve the quality of the feedback students provide each other during a peer review activity. Briefly, I recommend that emphasis be placed solely on the provision of constructive comments, and that in order to qualify as constructive, a comment must: (1) identify a specific…

  10. Improving the Quality of Think-Alouds

    Science.gov (United States)

    Ness, Molly; Kenny, MaryBeth

    2016-01-01

    An essential element in teaching children to effectively comprehend text is the use of teacher-led think alouds. This article presents a three-step model to improve the quality and quantity of think alouds in K-6 classrooms. The article follows elementary teachers who planned, implemented, transcribed, and reflected upon think aloud lessons to…

  11. Teaching Quality Improvement Through a Book Club

    Directory of Open Access Journals (Sweden)

    Benjamin Doolittle

    2015-12-01

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

  12. 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…

  13. National Quality Improvement Center on Early Childhood

    Science.gov (United States)

    Browne, Charlyn Harper

    2014-01-01

    The national Quality Improvement Center on early Childhood (QIC-eC) funded four research and demonstration projects that tested child maltreatment prevention approaches. The projects were guided by several key perspectives: the importance of increasing protective factors in addition to decreasing risk factors in child maltreatment prevention…

  14. Semen quality improves marginally during young adulthood

    DEFF Research Database (Denmark)

    Perheentupa, Antti; Sadov, Sergey; Rönkä, Riitta

    2016-01-01

    STUDY QUESTION: Does semen quality improve during early adulthood? SUMMARY ANSWER: Semen variables change little during the third decade of life, however some improvement in sperm morphology and motility may occur. WHAT IS KNOWN ALREADY: A suspicion of deteriorating semen quality has been raised...... 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...... 1979-1981, n = 336) and B (validation cohort, born 1983, n = 197) were followed up from the age of 19 years onward for 10 years. PARTICIPANTS/MATERIALS, SETTING, METHODS: Inclusion criteria included that both the men and their mothers were born in Finland. Semen analysis was performed in cohorts...

  15. Simulation modeling of quality assurance processes in an industrial plant

    Directory of Open Access Journals (Sweden)

    Gumerov Anwar Vazykhovich

    2013-11-01

    Full Text Available Quality management and the need for continuous improvement requires the development of methods of analysis and diagnostic parameters. The use of simulation techniques and statistical quality control methods will provide the basis for process control of industrial enterprises.

  16. Bringing quality improvement into the intensive care unit.

    Science.gov (United States)

    McMillan, Tracy R; Hyzy, Robert C

    2007-02-01

    During the last several years, many governmental and nongovernmental organizations have championed the application of the principles of quality improvement to the practice of medicine, particularly in the area of critical care. To review the breadth of approaches to quality improvement in the intensive care unit, including measures such as mortality and length of stay, and the use of protocols, bundles, and the role of large, multiple-hospital collaboratives. Several agencies have participated in the application of the quality movement to medicine, culminating in the development of standards such as the intensive care unit core measures of the Joint Commission on Accreditation of Healthcare Organizations. Although "zero defects" may not be possible in all measurable variables of quality in the intensive care unit, several measures, such as catheter-related bloodstream infections, can be significantly reduced through the implementation of improved processes of care, such as care bundles. Large, multiple-center, quality improvement collaboratives, such as the Michigan Keystone Intensive Care Unit Project, may be particularly effective in improving the quality of care by creating a "bandwagon effect" within a geographic region. The quality revolution is having a significant effect in the critical care unit and is likely to be facilitated by the transition to the electronic medical record.

  17. Prioritizing quality improvement in general surgery.

    Science.gov (United States)

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

    2008-11-01

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

  18. QUALITY MANAGEMENT TOOLS APPLYING IN THE STRATEGY OF LOGISTICS SERVICES QUALITY IMPROVEMENT

    Directory of Open Access Journals (Sweden)

    Agnieszka Czajkowska

    2015-11-01

    Full Text Available Combination of factors such as: properly organized logistics process, lack of nonconformities, transport damages avoiding and transport in accordance Just In Time idea significantly reduces costs and streamlines the entire production process. This paper proposes the quality management tool for the logistics services assessment based on the results obtained in the selected company operating in Eastern Europe. Customers’ expectations and perceptions were compared using the SERVQUAL method that concerns the service quality assessment in five areas such as: materiality, reliability, promptness, competency and empathy. The research method SERVQUAL allows assessing the service quality level and identifying company areas that requires corrective actions within the improvement process.

  19. Results-driven approach to improving quality and productivity

    Science.gov (United States)

    John Dramm

    2000-01-01

    Quality control (QC) programs do not often realize their full potential. Elaborate and expensive QC programs can easily get side tracked by the process of building a program with promises of “Someday, this will all pay off.” Training employees in QC methods is no guarantee that quality will improve. Several documented cases show that such activity-centered efforts...

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

    Science.gov (United States)

    Leff, Ellen W

    2004-05-01

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

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

    Science.gov (United States)

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

    2018-01-01

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

  2. Case Studies in Continuous Process Improvement

    Science.gov (United States)

    Mehta, A.

    1997-01-01

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

  3. Distributed power quality improvement in residential microgrids

    DEFF Research Database (Denmark)

    Naderi Zarnaghi, Yahya; Hosseini, Seyed Hossein; Ghassem Zadeh, Saeid

    2017-01-01

    The importance of power quality issue on micro grids and also the changing nature of power system distortions will lead the future power systems to use distributed power quality improvement (DPQI) devices. One possible choice of these DPQIs are multifunctional DGs that could compensate some...... harmonics in the location of generation and prevent the harmonics to enter main power grid. In this paper a control method based on virtual harmonic impedance is presented for these multifunctional DGs and the effect of the location of these DGs on compensation procedure is studied with simulating...

  4. Aligning Business Process Quality and Information System Quality

    OpenAIRE

    Heinrich, Robert

    2013-01-01

    Business processes and information systems mutually affect each other in non-trivial ways. Frequently, the business process design and the information system design are not well aligned. This means that business processes are designed without taking the information system impact into account, and vice versa. Missing alignment at design time often results in quality problems at runtime, such as large response times of information systems, large process execution times, overloaded information s...

  5. 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.)

  6. Pediatric CT quality management and improvement program

    International Nuclear Information System (INIS)

    Larson, David B.; Chan, Frandics P.; Newman, Beverley; Fleischmann, Dominik; Molvin, Lior Z.; Wang, Jia

    2014-01-01

    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.)

  7. Targeting Environmental Quality to Improve Population Health ...

    Science.gov (United States)

    Key goals of health care reform are to stimulate innovative approaches to improve healthcare quality and clinical outcomes while holding down costs. To achieve these goals value-based payment places the needs of the patient first and encourages multi-stakeholder cooperation. Yet, the stakeholders are typically all within the healthcare system, e.g. the Accountable Care Organization or Patient-Centered Medical Home, leaving important contributors to the health of the population such as the public health and environmental health systems absent. And rarely is the quality of the environment regarded as a modifiable factor capable of imparting a health benefit. Underscoring this point, a PubMed search of the search terms “environmental quality” with “value-based payment”, “value-based healthcare” or “value-based reimbursement” returned no relevant articles, providing further evidence that the healthcare industry largely disregards the quality of the environment as a significant determinant of wellbeing and an actionable risk factor for clinical disease management and population health intervention. Yet, the quality of the environment is unequivocally related to indicators of population health including all-cause mortality. The EPA’s Environmental Quality Index (EQI) composed of five different domains (air, land use, water, built environment and social) has provided new estimates of the associations between environmental quality and health stat

  8. Significant improvement in the thermal annealing process of optical resonators

    Science.gov (United States)

    Salzenstein, Patrice; Zarubin, Mikhail

    2017-05-01

    Thermal annealing performed during process improves the quality of the roughness of optical resonators reducing stresses at the periphery of their surface thus allowing higher Q-factors. After a preliminary realization, the design of the oven and the electronic method were significantly improved thanks to nichrome resistant alloy wires and chopped basalt fibers for thermal isolation during the annealing process. Q-factors can then be improved.

  9. 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.

  10. Process improvement for alcohol manufacture

    Energy Technology Data Exchange (ETDEWEB)

    Keo, L J

    1965-01-01

    K. claims to have isolated a superior yeast for blackstrap molasses fermentation into alcohol at a concentration of 20% sugar instead of the normal 12% in diluted molasses on a commercial scale. Further improvement of the product was effected by removal of aldehyde by distillation and impurities by oxidation. Flow diagrams are presented with details of each stage.

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

    Science.gov (United States)

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

    2016-04-01

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

  12. 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.

  13. Assessment and improvement of sound quality in cochlear implant users.

    Science.gov (United States)

    Caldwell, Meredith T; Jiam, Nicole T; Limb, Charles J

    2017-06-01

    Cochlear implants (CIs) have successfully provided speech perception to individuals with sensorineural hearing loss. Recent research has focused on more challenging acoustic stimuli such as music and voice emotion. The purpose of this review is to evaluate and describe sound quality in CI users with the purposes of summarizing novel findings and crucial information about how CI users experience complex sounds. Here we review the existing literature on PubMed and Scopus to present what is known about perceptual sound quality in CI users, discuss existing measures of sound quality, explore how sound quality may be effectively studied, and examine potential strategies of improving sound quality in the CI population. Sound quality, defined here as the perceived richness of an auditory stimulus, is an attribute of implant-mediated listening that remains poorly studied. Sound quality is distinct from appraisal, which is generally defined as the subjective likability or pleasantness of a sound. Existing studies suggest that sound quality perception in the CI population is limited by a range of factors, most notably pitch distortion and dynamic range compression. Although there are currently very few objective measures of sound quality, the CI-MUSHRA has been used as a means of evaluating sound quality. There exist a number of promising strategies to improve sound quality perception in the CI population including apical cochlear stimulation, pitch tuning, and noise reduction processing strategies. In the published literature, sound quality perception is severely limited among CI users. Future research should focus on developing systematic, objective, and quantitative sound quality metrics and designing therapies to mitigate poor sound quality perception in CI users. NA.

  14. 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. Project HOPE—The People-to-People Health Foundation, Inc.

  15. Modern trends in increasing the quality of the steels intended for cutting and metal-working tools: I. Improvement of granule metallurgy processes

    Science.gov (United States)

    Belyanchikov, L. N.

    2008-12-01

    The following new technological processes for producing fine gas-atomized powders of tool and high-speed steels with a low content of nonmetallic inclusions are considered: the process designed by Böhler Uddeholm Powder Technology (Austria) and processes involving a heated gas. In the former process, a metal is poured from a ladle with electroslag heating, and the atomizing unit consists of three injectors. A new process of producing tools from fine powders by three-dimensional printing, i.e., so-called 3D-printing, is described.

  16. Research on construction quality and improvement of assembly construction

    Science.gov (United States)

    Cheng, Fei

    2017-11-01

    Based on the acceleration of the urbanization process and the improvement of the quality of life of our residents, the demand for building construction has been increasing. In this context, the construction industry in order to promote the construction efficiency, quality improvement, to meet the needs of the development of the times to strengthen the new technology, the use of new technologies. At present, China’s engineering construction units in the process of carrying out the project to strengthen the use of assembly-type construction technology, which thus achieved for the traditional construction work low-level, high time-consuming issues, and promote the steady improvement of production efficiency. Based on this, this paper focuses on the analysis of the connotation of the assembly structure and analyzes the quality problems in the construction process of the construction projects and puts forward the improvement measures to promote the improvement of the building quality and the construction of the building Construction speed. Based on this, this paper analyzes the structural system and design of prefabricated building.

  17. Guiding and Modelling Quality Improvement in Higher Education Institutions

    Science.gov (United States)

    Little, Daniel

    2015-01-01

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

  18. Improving of the management quality of human resources

    OpenAIRE

    Miceski, Trajko

    2004-01-01

    Improvement of the management quality of human resources is a continuous process, based on multidimensional concept of activities, with special emphasis on increasing the level of competence of the employees both in their working place and in additional activities in the decision making bodies.

  19. Model-based software process improvement

    Science.gov (United States)

    Zettervall, Brenda T.

    1994-01-01

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

  20. 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.

  1. Improving the ignition quality of fuels

    KAUST Repository

    Sarathy, Mani; Wang, Zhandong; Shankar, Vijai Shankar Bhavani

    2017-01-01

    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.

  2. 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.

  3. Quality Improvement in Athletic Health Care.

    Science.gov (United States)

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

    2017-11-01

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

  4. In Brief: Improving Mississippi River water quality

    Science.gov (United States)

    Showstack, Randy

    2007-10-01

    If water quality in the Mississippi River and the northern Gulf of Mexico is to improve, the U.S. Environmental Protection Agency (EPA) needs to take a stronger leadership role in implementing the federal Clean Water Act, according to a 16 October report from the U.S. National Research Council. The report notes that EPA has failed to use its authority to coordinate and oversee activities along the river. In addition, river states need to be more proactive and cooperative in efforts to monitor and improve water quality, and the river should be monitored and evaluated as a single system, the report indicates. Currently, the 10 states along the river conduct separate and widely varying water quality monitoring programs. ``The limited attention being given to monitoring and managing the Mississippi's water quality does not match the river's significant economic, ecological, and cultural importance,'' said committee chair David A. Dzombak, director of the Steinbrenner Institute for Environmental Education and Research at Carnegie Mellon University, Pittsburgh, Pa. The report notes that while measures taken under the Clean Water Act have successfully reduced much point source pollution, nutrient and sediment loads from nonpoint sources continue to be significant problems. For more information, visit the Web site: http://books.nap.edu/catalog.php?record_id=12051.

  5. Measures of Quality in Business Process Modelling

    Directory of Open Access Journals (Sweden)

    Radek Hronza

    2015-06-01

    Full Text Available Business process modelling and analysing is undoubtedly one of the most important parts of Applied (Business Informatics. Quality of business process models (diagrams is crucial for any purpose in this area. The goal of a process analyst’s work is to create generally understandable, explicit and error free models. If a process is properly described, created models can be used as an input into deep analysis and optimization. It can be assumed that properly designed business process models (similarly as in the case of correctly written algorithms contain characteristics that can be mathematically described. Besides it will be possible to create a tool that will help process analysts to design proper models. As part of this review will be conducted systematic literature review in order to find and analyse business process model’s design and business process model’s quality measures. It was found that mentioned area had already been the subject of research investigation in the past. Thirty-three suitable scietific publications and twenty-two quality measures were found. Analysed scientific publications and existing quality measures do not reflect all important attributes of business process model’s clarity, simplicity and completeness. Therefore it would be appropriate to add new measures of quality.

  6. Improving quality of service in the internet

    OpenAIRE

    Flückiger, François

    2000-01-01

    The Internet transport technology was designed to be robust, resilient to link or node outages, and with no single point of failure. The resulting connectionless system supports what is called a "best effort datagram delivery service", the perfo rmance of which is often greatly unpredictable. To improve the predictability of IP-based networks, several Quality of Service technologies have been designed over the past decade. The first one, RSVP, based on reservation of resources, is operational...

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

    Directory of Open Access Journals (Sweden)

    Asgar Aghaei Hashjin

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

  8. Methods and Conditions for Achieving Continuous Improvement of Processes

    OpenAIRE

    Florica BADEA; Catalina RADU; Ana-Maria GRIGORE

    2010-01-01

    In the early twentieth century, the Taylor model improved, in a spectacular maner the efficiency of the production processes. This allowed obtaining high productivity by low-skilled workers, but used in large number in the execution of production. Currently this model is questioned by experts and was replaced by the concept of "continuous improvement". The first signs of change date from the '80s, with the apparition of quality circles and groups of operators on quality issues, principles whi...

  9. Mapping social networks in software process improvement

    DEFF Research Database (Denmark)

    Tjørnehøj, Gitte; Nielsen, Peter Axel

    2005-01-01

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

  10. Process improvement of reconversion facilities

    International Nuclear Information System (INIS)

    Park, J. H.; Chang, I. S.; Kim, E. H.; Kim, T. J.; Jeong, K. C.; Woo, M. S.; Hong, S. B.; Choi, J. H.; Chung, W. M.; Lee, K. I.; Hwang, D. S.; Kim, Y. W.; Kim, Y. K.; Choi, C. S.

    1993-01-01

    The project is for the development of recovery and reusing process of ammonium carbonate(AC) which is generated as a waste liquid from the reconversion facilities to reduce the manufacturing cost and the quantity of the waste liquid, and also for the development of the continuous fludized bed reaction process to promote the economics and safeties of the calcination and reduction process. In this second year report, measured the properties of AC solution and analyzed the AC concentration quantitatively. Examined the properties of AUC to investigate the properties of UO 2 powder which was converted from AUC, prepared with AC solution. Designed and installed the 2 tons-U/year pilot plant. Experimented in powder properties to set up the range of operating conditions. Modeled CFB reactor to estimate the conversion of reactor and to analyze the change of fluorine concentration to carry out the defluorination reaction. Experimented out the optimum conditions of the major operating parameters : solid circulation rate, gas velocity, solid holdup and initial inventory in cold bed to get the referential design data for hot bed. (Author)

  11. Nationwide survey to evaluate the decision-making process in euthanasia requests in Belgium: do specifically trained 2nd physicians improve quality of consultation?

    OpenAIRE

    Cohen, J.; van Wesemael, Y.; Smets, T.; Bilsen, J.; Onwuteaka-Philipsen, B.D.; Distelmans, W.; Deliens, L.

    2014-01-01

    Background: Following the 2002 enactment of the Belgian law on euthanasia, which requires the consultation of an independent second physician before proceeding with euthanasia, the Life End Information Forum (LEIF) was founded which provides specifically trained physicians who can act as mandatory consultants in euthanasia requests. This study assesses quality of consultations in Flanders and Brussels and compares these between LEIF and non-LEIF consultants. Methods. A questionnaire was sent ...

  12. QUALITY LOSS FUNCTION FOR MACHINING PROCESS ACCURACY

    Directory of Open Access Journals (Sweden)

    Adrian Stere PARIS

    2017-05-01

    Full Text Available The main goal of the paper is to propose new quality loss models for machining process accuracy in the classical case “zero the best”, MMF and Harris type. In addition a numerical example illustrates that the choose regression functions are directly linked with the quality loss of manufacturing process. The proposed models can be adapted for the “maximal the best” and “nominal the best” cases.

  13. Process capability improvement through DMAIC for aluminum alloy wheel machining

    Science.gov (United States)

    Sharma, G. V. S. S.; Rao, P. Srinivasa; Babu, B. Surendra

    2017-07-01

    This paper first enlists the generic problems of alloy wheel machining and subsequently details on the process improvement of the identified critical-to-quality machining characteristic of A356 aluminum alloy wheel machining process. The causal factors are traced using the Ishikawa diagram and prioritization of corrective actions is done through process failure modes and effects analysis. Process monitoring charts are employed for improving the process capability index of the process, at the industrial benchmark of four sigma level, which is equal to the value of 1.33. The procedure adopted for improving the process capability levels is the define-measure-analyze-improve-control (DMAIC) approach. By following the DMAIC approach, the C p, C pk and C pm showed signs of improvement from an initial value of 0.66, -0.24 and 0.27, to a final value of 4.19, 3.24 and 1.41, respectively.

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

    Science.gov (United States)

    Cho, Yu Kyung

    2016-07-01

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

  15. The maturing of the quality improvement paradigm in the SEL

    Science.gov (United States)

    Basili, Victor R.

    1993-01-01

    The Software Engineering Laboratory uses a paradigm for improving the software process and product, called the quality improvement paradigm. This paradigm has evolved over the past 18 years, along with our software development processes and product. Since 1976, when we first began the SEL, we have learned a great deal about improving the software process and product, making a great many mistakes along the way. Quality improvement paradigm, as it is currently defined, can be broken up into six steps: characterize the current project and its environment with respect to the appropriate models and metrics; set the quantifiable goals for successful project performance and improvement; choose the appropriate process model and supporting methods and tools for this project; execute the processes, construct the products, and collect, validate, and analyze the data to provide real-time feedback for corrective action; analyze the data to evaluate the current practices, determine problems, record findings, and make recommendations for future project improvements; and package the experience gained in the form of updated and refined models and other forms of structured knowledge gained from this and prior projects and save it in an experience base to be reused on future projects.

  16. Improving processes through evolutionary optimization.

    Science.gov (United States)

    Clancy, Thomas R

    2011-09-01

    As systems evolve over time, their natural tendency is to become increasingly more complex. Studies on complex systems have generated new perspectives on management in social organizations such as hospitals. Much of this research appears as a natural extension of the cross-disciplinary field of systems theory. This is the 18th in a series of articles applying complex systems science to the traditional management concepts of planning, organizing, directing, coordinating, and controlling. In this article, I discuss methods to optimize complex healthcare processes through learning, adaptation, and evolutionary planning.

  17. How Does Software Process Improvement Address Global Software Engineering?

    DEFF Research Database (Denmark)

    Kuhrmann, Marco; Diebold, Philipp; Münch, Jürgen

    2016-01-01

    For decades, Software Process Improvement (SPI) programs have been implemented, inter alia, to improve quality and speed of software development. To set up, guide, and carry out SPI projects, and to measure SPI state, impact, and success, a multitude of different SPI approaches and considerable...

  18. Multifamily Housing Rehabilitation Process Improvements

    Energy Technology Data Exchange (ETDEWEB)

    Sweet, Marshall L. [Partnership for Home Innovation, Upper Marlboro, MD (United States); Francisco, Abby [Partnership for Home Innovation, Upper Marlboro, MD (United States); Roberts, Sydney G. [Partnership for Home Innovation, Upper Marlboro, MD (United States)

    2016-03-01

    Rea Ventures Group, LLC, (Rea Ventures) partnered with Southface Energy Institute (Southface) on the rehabilitation of 418 low-income rental multifamily apartments located at 14 different properties in Georgia (Climate Zones 2-4). These 22-year old, individually-metered units were arranged in rowhouse or townhouse style units. Rehabilitation plans were developed using a process prescribed by the US Department of Agriculture (USDA) Rural Development program, who partially funded the building upgrades. The USDA is responsible for building, upgrading, and subsidizing housing in rural areas nationwide. In 2012, over $100 million was allocated in grants and loans. Due to the unique financing mechanism as well as long-term ownership requirements, property owners are especially motivated to invest in upgrades that will increase durability and tenant retention. These buildings represent a large stock of rural affordable housing that have the potential for significant energy and cost savings for property owners and tenants. Southface analyzed the energy upgrade potential of one stereotypical property in the Rea Ventures portfolio. This study will provide insight into the most cost-effective, implementable energy efficiency and durability upgrades for this age multifamily housing, having an enormous impact not only on the portfolio of Rea Ventures but on the vast USDA and larger Federal portfolio. Additionally, Southface will identify gaps in the current capital needs assessment process, examine available audit and simulation tools and protocols, and evaluate additional auditor training or certification needs.

  19. Engaging clinical nurses in quality and performance improvement activities.

    Science.gov (United States)

    Albanese, Madeline P; Evans, Dietra A; Schantz, Cathy A; Bowen, Margaret; Disbot, Maureen; Moffa, Joseph S; Piesieski, Patricia; Polomano, Rosemary C

    2010-01-01

    Nursing performance measures are an integral part of quality initiatives in acute care; however, organizations face numerous challenges in developing infrastructures to support quality improvement processes and timely dissemination of outcomes data. At the Hospital of the University of Pennsylvania, a Magnet-designated organization, extensive work has been conducted to incorporate nursing-related outcomes in the organization's quality plan and to integrate roles for clinical nurses into the Department of Nursing and organization's core performance-based programs. Content and strategies that promote active involvement of nurses and prepare them to be competent and confident stakeholders in quality initiatives are presented. Engaging clinical nurses in the work of quality and performance improvement is essential to achieving excellence in clinical care. It is important to have structures and processes in place to bring meaningful data to the bedside; however, it is equally important to incorporate outcomes into practice. When nurses are educated about performance and quality measures, are engaged in identifying outcomes and collecting meaningful data, are active participants in disseminating quality reports, and are able to recognize the value of these activities, data become one with practice.

  20. Increased Mercury Bioaccumulation Follows Water Quality Improvement

    Energy Technology Data Exchange (ETDEWEB)

    Bogle, M.A.; Peterson, M.J.; Smith, J.G.; Southworth, G.R.

    1999-09-15

    Changes in physical and chemical characteristics of aquatic habitats made to reduce or eliminate ecological risks can sometimes have unforeseen consequences. Environmental management activities on the U.S. Dept. of Energy reservation in Oak Ridge, Tennessee,have succeeded in improving water quality in streams impacted by discharges fi-om industrial facilities and waste disposal sites. The diversity and abundance of pollution-sensitive components of the benthic macroinvertebrate communities of three streams improved after new waste treatment systems or remedial actions reduced inputs of various toxic chemicals. Two of the streams were known to be mercury-contaminated from historical spills and waste disposal practices. Waterborne mercury concentrations in the third were typical of uncontaminated systems. In each case, concentrations of mercury in fish, or the apparent biological availability of mercury increased over the period during which ecological metrics indicated improved water quality. In the system where waterborne mercury concentrations were at background levels, increased mercury bioaccumulation was probably a result of reduced aqueous selenium concentrations; however, the mechanisms for increased mercury accumulation in the other two streams remain under investigation. In each of the three systems, reduced inputs of metals and inorganic anions was followed by improvements in the health of aquatic invertebrate communities. However, this reduction in risk to aquatic invertebrates was accompanied by increased risk to humans and piscivorous wildlife related to increased mercury concentrations in fish.

  1. Increased Mercury Bioaccumulation Follows Water Quality Improvement

    International Nuclear Information System (INIS)

    Bogle, M.A.; Peterson, M.J.; Smith, J.G.; Southworth, G.R.

    1999-01-01

    Changes in physical and chemical characteristics of aquatic habitats made to reduce or eliminate ecological risks can sometimes have unforeseen consequences. Environmental management activities on the U.S. Dept. of Energy reservation in Oak Ridge, Tennessee,have succeeded in improving water quality in streams impacted by discharges fi-om industrial facilities and waste disposal sites. The diversity and abundance of pollution-sensitive components of the benthic macroinvertebrate communities of three streams improved after new waste treatment systems or remedial actions reduced inputs of various toxic chemicals. Two of the streams were known to be mercury-contaminated from historical spills and waste disposal practices. Waterborne mercury concentrations in the third were typical of uncontaminated systems. In each case, concentrations of mercury in fish, or the apparent biological availability of mercury increased over the period during which ecological metrics indicated improved water quality. In the system where waterborne mercury concentrations were at background levels, increased mercury bioaccumulation was probably a result of reduced aqueous selenium concentrations; however, the mechanisms for increased mercury accumulation in the other two streams remain under investigation. In each of the three systems, reduced inputs of metals and inorganic anions was followed by improvements in the health of aquatic invertebrate communities. However, this reduction in risk to aquatic invertebrates was accompanied by increased risk to humans and piscivorous wildlife related to increased mercury concentrations in fish

  2. Activated charcoal-alum-zeolite improve the water quality

    International Nuclear Information System (INIS)

    Saryati; Sutisna; Sumarjo; ZL, Wildan; Wahyuningsih; Suprapti, Siti

    2002-01-01

    The composite of charcoal-tawas-zeolite has been studied to improve a drinking water quality. This study was doing to find the optimum composition in preparation of a simple technology og bath and small volume drinking treatment this treatment consist of coagulation, floculation, precipitation, ion exchange and adsorption. The improvement of water quality has been observed from a turbidity, a permanganate number and a quality of Cu, Cd, Pb, Al ions and coli bactery containing in the water after processing. It has been concluded that the composite materials has an ability to decrease the turbidity more than its components. The starch addition in the composite can be accelerate water clarity process. By this composite the turbidity, the permanganate number and the coli bacteria in the water can be decreased significantly. The optimum composite composition is 1000 mg activated charcoal, 1000 mg zeolite, 60 mg tawas, 40 mg natrium bicarbonate and 50 mg starch with grains size less than 80 mesh

  3. Managerial implications for improving continuous production processes

    DEFF Research Database (Denmark)

    Capaci, Francesca; Vanhatalo, Erik; Bergquist, Bjarne

    2017-01-01

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

  4. Quality costs in the production process

    OpenAIRE

    J. Michalska

    2006-01-01

    Purpose: The aim of this paper is showing the relationship of the quality costs with a production process. In this paper it was worked out and introduced the way of marking the documents with regard to the quality costs.Design/methodology/approach: In the frames of own research it has been analysed the quality costs in the production process from the documents marked using the worked out way of marking.Findings: On the basis of the own research it can be stated, that the majority of the eleme...

  5. Assessing the impact of continuous quality improvement/total quality management: concept versus implementation.

    Science.gov (United States)

    Shortell, S M; O'Brien, J L; Carman, J M; Foster, R W; Hughes, E F; Boerstler, H; O'Connor, E J

    1995-01-01

    OBJECTIVE: This study examines the relationships among organizational culture, quality improvement processes and selected outcomes for a sample of up to 61 U. S. hospitals. DATA SOURCES AND STUDY SETTING: Primary data were collected from 61 U. S. hospitals (located primarily in the midwest and the west) on measures related to continuous quality improvement/total quality management (CQI/TQM), organizational culture, implementation approaches, and degree of quality improvement implementation based on the Baldrige Award criteria. These data were combined with independently collected data on perceived impact and objective measures of clinical efficiency (i.e., charges and length of stay) for six clinical conditions. STUDY DESIGN: The study involved cross-sectional examination of the named relationships. DATA COLLECTION/EXTRACTION METHODS: Reliable and valid scales for the organizational culture and quality improvement implementation measures were developed based on responses from over 7,000 individuals across the 61 hospitals with an overall completion rate of 72 percent. Independent data on perceived impact were collected from a national survey and independent data on clinical efficiency from a companion study of managed care. PRINCIPAL FINDINGS: A participative, flexible, risk-taking organizational culture was significantly related to quality improvement implementation. Quality improvement implementation, in turn, was positively associated with greater perceived patient outcomes and human resource development. Larger-size hospitals experienced lower clinical efficiency with regard to higher charges and higher length of stay, due in part to having more bureaucratic and hierarchical cultures that serve as a barrier to quality improvement implementation. CONCLUSIONS: What really matters is whether or not a hospital has a culture that supports quality improvement work and an approach that encourages flexible implementation. Larger-size hospitals face more difficult

  6. Process perspective on image quality evaluation

    Science.gov (United States)

    Leisti, Tuomas; Halonen, Raisa; Kokkonen, Anna; Weckman, Hanna; Mettänen, Marja; Lensu, Lasse; Ritala, Risto; Oittinen, Pirkko; Nyman, Göte

    2008-01-01

    The psychological complexity of multivariate image quality evaluation makes it difficult to develop general image quality metrics. Quality evaluation includes several mental processes and ignoring these processes and the use of a few test images can lead to biased results. By using a qualitative/quantitative (Interpretation Based Quality, IBQ) methodology, we examined the process of pair-wise comparison in a setting, where the quality of the images printed by laser printer on different paper grades was evaluated. Test image consisted of a picture of a table covered with several objects. Three other images were also used, photographs of a woman, cityscape and countryside. In addition to the pair-wise comparisons, observers (N=10) were interviewed about the subjective quality attributes they used in making their quality decisions. An examination of the individual pair-wise comparisons revealed serious inconsistencies in observers' evaluations on the test image content, but not on other contexts. The qualitative analysis showed that this inconsistency was due to the observers' focus of attention. The lack of easily recognizable context in the test image may have contributed to this inconsistency. To obtain reliable knowledge of the effect of image context or attention on subjective image quality, a qualitative methodology is needed.

  7. Process for improving metal production in steelmaking processes

    Science.gov (United States)

    Pal, Uday B.; Gazula, Gopala K. M.; Hasham, Ali

    1996-01-01

    A process and apparatus for improving metal production in ironmaking and steelmaking processes is disclosed. The use of an inert metallic conductor in the slag containing crucible and the addition of a transition metal oxide to the slag are the disclosed process improvements.

  8. Multifamily Housing Rehabilitation Process Improvements

    Energy Technology Data Exchange (ETDEWEB)

    Sweet, Marshall L. [Partnership for Home Innovation, Upper Marlboro, MD (United States); Francisco, Abby [Partnership for Home Innovation, Upper Marlboro, MD (United States); Roberts, Sydney G. [Partnership for Home Innovation, Upper Marlboro, MD (United States)

    2016-03-01

    Rea Ventures Group, LLC (Rea Ventures) partnered with Southface Energy Institute (Southface)—a member of the U.S. Department of Energy’s Partnership for Home Innovation Building America research team—to rehabilitate 418 low-income multifamily rental apartments located at 14 properties in Georgia (International Energy Conservation Code Climate Zones 2–4). These 22-year-old units with individual utility meters were arranged in row house or townhouse style. Rehabilitation plans were developed using a process prescribed by the U.S. Department of Agriculture (USDA) Rural Development program, which partially funded the building upgrades. The USDA is responsible for building, upgrading, and subsidizing housing in rural areas nationwide; this housing includes more than 14,000 existing multifamily housing developments. In 2012, more than $100 million in grants and loans were allocated for that purpose.

  9. Process for molding improved polyethylene

    International Nuclear Information System (INIS)

    Kanai, Masanori; Aine, Norio; Nakada, Shinsaku.

    1962-01-01

    Various configurations in size and shape of polyethylene are molded by: (a) irradiating powders of polyethylene with ionizing radiations in the presence of oxygen to the extent of producing substantially no cross-linking among the molecules of polyethylene, and thereafter (b) molding the thus irradiated powders of polyethylene at 100-250 0 C to cross-link the molding. In this process, a uniform and desirable degree of cross-linking and any desirable configuration are provided for the polyethylene molding. Any extruder and any molding machine producing heat can be employed in this process. In embodiments, the radiation dose units may preferably be 1x10 6 to 1.5x10 7 roentgen. The ionizing radiations may be X-rays, gamma-rays or electron beams, but preferably gamma-rays. The preheating prior to molding may be effected in vacuum, in inert gas, or in oxygen at 100-250 0 C, but preferably in oxygen at 100 0 C. In an example, a polyethylene powder of 100 mesh was irradiated with gamma-rays from a Co-60 source with a dose of 3.1x10 6 r at a dose rate of 5.5x10 4 r/hr in air, then preheated in air at 80 0 C for 1 hr, and finally extruded to form a rod of 5 mm phi at 200 0 C. max. The degree of product cross-linking was 0% after irradiation in step (a), and 38% after heating in step (b). (Iwakiri, K.)

  10. MODERN CONCEPTS OF THE SIX SIGMA METHODOLOGY FOR IMPROVING THE QUALITY

    Directory of Open Access Journals (Sweden)

    MARGARITA JANESKA

    2018-02-01

    Full Text Available Product quality is generally accepted as being crucial in today’s industrial business. The traditional aspects of product quality are connected to product design (translating customer demands into attractive features and technical specifications and to the design and specification of high performance production processes with low defect rates. Quality management is the general expression for all actions leading to quality. Quality management is focused on improving customer satisfaction through continuous improvement of processes including the removal of uncertain activities, and continuous improvement of the quality of processes, products and services. The quality management includes four key processes, such as quality planning, quality assurance, quality control and quality costs. The main accent in this paper will be on quality control and the application of one of the quality control tools in order to improve it. Six Sigma is different from other quality improvement concepts in that its framework is comprised of many principles, tools and techniques, which, together with experience, are all integrated and translated into best practices. Bearing in mind that the goal of every company is to work effectively and effectively in the long run, this paper focuses on Six Sigma as a way to continuously improve quality. Namely, this paper emphasizes the key features of the quality of products / services, the Need for the application of Six Sigma for quality assurance, and also a detailed list of tools and techniques that can be used during the implementation of Six Sigma.

  11. Statistical process control for radiotherapy quality assurance

    International Nuclear Information System (INIS)

    Pawlicki, Todd; Whitaker, Matthew; Boyer, Arthur L.

    2005-01-01

    Every quality assurance process uncovers random and systematic errors. These errors typically consist of many small random errors and a very few number of large errors that dominate the result. Quality assurance practices in radiotherapy do not adequately differentiate between these two sources of error. The ability to separate these types of errors would allow the dominant source(s) of error to be efficiently detected and addressed. In this work, statistical process control is applied to quality assurance in radiotherapy for the purpose of setting action thresholds that differentiate between random and systematic errors. The theoretical development and implementation of process behavior charts are described. We report on a pilot project is which these techniques are applied to daily output and flatness/symmetry quality assurance for a 10 MV photon beam in our department. This clinical case was followed over 52 days. As part of our investigation, we found that action thresholds set using process behavior charts were able to identify systematic changes in our daily quality assurance process. This is in contrast to action thresholds set using the standard deviation, which did not identify the same systematic changes in the process. The process behavior thresholds calculated from a subset of the data detected a 2% change in the process whereas with a standard deviation calculation, no change was detected. Medical physicists must make decisions on quality assurance data as it is acquired. Process behavior charts help decide when to take action and when to acquire more data before making a change in the process

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

    International Nuclear Information System (INIS)

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

    2006-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-07-01

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

  14. Evaluation of economic efficiency of process improvement in food packaging

    Directory of Open Access Journals (Sweden)

    Jana Hron

    2012-01-01

    Full Text Available In general, we make gains in process by the three fundamental ways. First, we define or redefine our process in a strategic sense. Second, once defined or redefined, we commence process operations and use process control methods to target and stabilize our process. Third, we use process improvement methods, as described in this paper, along with process control to fully exploit our process management and/or technology. Process improvement is focused primarily in our subprocesses and sub-subprocesses. Process leverage is the key to process improvement initiatives. This means that small improvements of the basic manufacturing operations can have (with the assumption of mass repetition of the operation a big impact on the functioning of the whole production unit. The complexity within even small organizations, in people, products, and processes, creates significant challenges in effectively and efficiently using these initiatives tools. In this paper we are going to place process purposes in the foreground and initiatives and tools in the background as facilitator to help accomplish process purpose. Initiatives and tools are not the ends we are seeking; result/outcomes in physical, economics, timeliness, and customer service performance matter. In the paper process boundaries (in a generic sense are set by our process purpose and our process definition. Process improvement is initiated within our existing process boundaries. For example, in a fast-food restaurant, if we define our cooking process around a frying technology, then we provide process improvements within our frying technology. On the other hand, if we are considering changing to a broiling technology, then we are likely faced with extensive change, impacting our external customers, and a process redefinition may be required. The result / aim of the paper are based on the example of the process improving of a food packaging quality. Specifically, the integration of two approaches

  15. Interpreting the CMMI a process improvement approach

    CERN Document Server

    Kulpa, Margaret K

    2008-01-01

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

  16. How to Measure and Interpret Quality Improvement Data.

    Science.gov (United States)

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

    2016-05-06

    This article will demonstrate how to conduct a quality improvement project using the change idea generated in "How To Use Quality Improvement Tools in Clinical Practice: How To Diagnose Solutions to a Quality of Care Problem" by Dr. Ziv Harel and colleagues in this Moving Points feature. This change idea involves the introduction of a nurse educator into a CKD clinic with a goal of increasing rates of patients performing dialysis independently at home (home hemodialysis or peritoneal dialysis). Using this example, we will illustrate a Plan-Do-Study-Act (PDSA) cycle in action and highlight the principles of rapid cycle change methodology. We will then discuss the selection of outcome, process, and balancing measures, and the practicalities of collecting these data in the clinic environment. We will also introduce the PDSA worksheet as a practical way to oversee the progress of a quality improvement project. Finally, we will demonstrate how run charts are used to visually illustrate improvement in real time, and how this information can be used to validate achievement, respond appropriately to challenges the project may encounter, and prove the significance of results. This article aims to provide readers with a clear and practical framework upon which to trial their own ideas for quality improvement in the clinical setting. Copyright © 2016 by the American Society of Nephrology.

  17. Zerodur polishing process for high surface quality and high efficiency

    International Nuclear Information System (INIS)

    Tesar, A.; Fuchs, B.

    1992-08-01

    Zerodur is a glass-ceramic composite importance in applications where temperature instabilities influence optical and mechanical performance, such as in earthbound and spaceborne telescope mirror substrates. Polished Zerodur surfaces of high quality have been required for laser gyro mirrors. Polished surface quality of substrates affects performance of high reflection coatings. Thus, the interest in improving Zerodur polished surface quality has become more general. Beyond eliminating subsurface damage, high quality surfaces are produced by reducing the amount of hydrated material redeposited on the surface during polishing. With the proper control of polishing parameters, such surfaces exhibit roughnesses of < l Angstrom rms. Zerodur polishing was studied to recommend a high surface quality polishing process which could be easily adapted to standard planetary continuous polishing machines and spindles. This summary contains information on a polishing process developed at LLNL which reproducibly provides high quality polished Zerodur surfaces at very high polishing efficiencies

  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. Improvements in techniques and processes

    International Nuclear Information System (INIS)

    Cairon, B.; Nolin, D.

    2003-01-01

    The paper presents the De-construction And Decontamination Techniques used at COGEMA-La Hague for dismantling and decontamination of plant UP2 400. Intervention under water particularly intervention from the edge of the pool are described while significant radiological constraints due to the presence of fuel are observed. The Under water fuel operations were undertaking to recover pieces of UNGG fuel and miscellaneous technological waste under 5 m of water and with reduced visibility. Here remote works implying reduced dosimetry and increased security were carried out. Specific issues concerning tools and procedures are addressed as fallows: Pendulous telescopic tool holder on runway channel 215.40; HP cutting under water; Cutting machine set up in the facility; Suction of sludge; Gripping and handling system for the slider and lid; Dredging the Sludge; tests in facility; Control console; Shock absorbing units; Moving the shock absorbing mattresses using slings; Decontamination of large areas of stainless steel walls; Cutting bulky parts in air; Cutting a tubular structure under water; Compacting the drums; Concrete skinning using skinning machines; Concrete skinning using the BRH, hydraulic rock breaker; Concrete skinning using shot blasting; Dismantling the process cell using the 'ATENA' remote power carrier; Removing openings through dry core sample drilling; Removing openings through demolition

  20. Process correlation analysis model for process improvement identification.

    Science.gov (United States)

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

    2014-01-01

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

  1. Continuous quality improvement in the ambulatory endoscopy center.

    Science.gov (United States)

    Johanson, John F

    2002-04-01

    What does quality assessment have to do with the practicing gastroenterologist? Why should one spend the time and effort to incorporate CQI activities into an already busy practice? First and foremost, quality improvement should directly benefit the patient by ensuring that they receive the highest quality of care possible. For example, comparing endoscopic use or outcomes, such as procedure success or complications, with national standards or other endoscopists in the same community may identify physicians who could benefit from additional training. Similar analyses may likewise identify outstanding physicians who might serve as resources for other physicians. Surveys of patient satisfaction may reveal deficiencies, which might be unknown to a physician who is otherwise technically excellent; deficiencies that would never have been uncovered by traditional measures of quality. Second, applying the techniques of CQI to study one's own practice can provide a competitive edge when vying for managed care or corporate contracts. In this regard, CQI can be used to document physician or practice performance through tracking of endoscopic use, procedure success and complication rates, and patient satisfaction. Finally, the rising concern among various patient advocacy groups has led to an increased emphasis on quality improvement, and in most cases it is a required activity as part of the accreditation process. Steps to quality improvement There is more to quality improvement than simply selecting and implementing a performance improvement plan. A number of steps have been suggested to achieve fundamental improvement in the quality of medical care [3]. The first is to use outcomes management for improvement rather than for judgment. One of the major criticisms of QA is that it will be used to judge physicians providing care. It is feared that CQI will be used to identify poor performers who will then be punished. This strategy leads to fear and inhibits an honest pursuit

  2. Process quality planning of quality function deployment for carrot syrup

    Science.gov (United States)

    Ekawati, Yurida; Noya, Sunday; Widjaja, Filemon

    2017-06-01

    Carrot products are rarely available in the market. Based on previous research that had been done using QFD to generate product design of carrots products, the research to produce the process quality planning had been carried out. The carrot product studied was carrot syrup. The research resulted in a process planning matrix for carrot syrup. The matrix gives information about critical process plan and the priority of the critical process plan. The critical process plan on the production process of carrot syrup consists of carrots sorting, carrots peeling, carrots washing, blanching process, carrots cutting, the making of pureed carrots, filtering carrot juice, the addition of sugar in carrot juice, the addition of food additives in carrot juice, syrup boiling, syrup filtering, syrup filling into the bottle, the bottle closure and cooling. The information will help the design of the production process of carrot syrup.

  3. A Measurement Approach for Process Improvement | Woherem ...

    African Journals Online (AJOL)

    engineering project. They do so through planned rearchitecting of their processes to engender higher magnitudes of improvements. However, in almost all the organisations undertaking process re-engineering, they do so blindly without any means ...

  4. Improving tomato seed quality- challenges and possibilities

    DEFF Research Database (Denmark)

    Shrestha, Santosh

    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...

  5. 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....

  6. An Improved Publication Process for the UMVF.

    Science.gov (United States)

    Renard, Jean-Marie; Brunetaud, Jean-Marc; Cuggia, Marc; Darmoni, Stephan; Lebeux, Pierre; Beuscart, Régis

    2005-01-01

    The "Université Médicale Virtuelle Francophone" (UMVF) is a federation of French medical schools. Its main goal is to share the production and use of pedagogic medical resources generated by academic medical teachers. We developed an Open-Source application based upon a workflow system which provides an improved publication process for the UMVF. For teachers, the tool permits easy and efficient upload of new educational resources. For web masters it provides a mechanism to easily locate and validate the resources. For both the teachers and the web masters, the utility provides the control and communication functions that define a workflow system.For all users, students in particular, the application improves the value of the UMVF repository by providing an easy way to find a detailed description of a resource and to check any resource from the UMVF to ascertain its quality and integrity, even if the resource is an old deprecated version. The server tier of the application is used to implement the main workflow functionalities and is deployed on certified UMVF servers using the PHP language, an LDAP directory and an SQL database. The client tier of the application provides both the workflow and the search and check functionalities and is implemented using a Java applet through a W3C compliant web browser. A unique signature for each resource, was needed to provide security functionality and is implemented using the MD5 Digest algorithm. The testing performed by Rennes and Lille verified the functionality and conformity with our specifications.

  7. The continuous improvement process and ergonomics in ultrasound department.

    Science.gov (United States)

    Coffin, Carolyn T

    2013-01-01

    Continuous improvement processes, such as Lean, Six Sigma and Quality Control Circles, have been implemented in the manufacturing industries in an effort to increase productivity, eliminate waste, and engage employees in problem solving. These processes can be adapted to the healthcare sector as medical facilities strive to improve the patient experience, increase financial returns, and improve worker safety and morale. In the ultrasound department, productivity can be improved and the quality of patient care can be ensured by standardizing exam protocols and decreasing work related musculoskeletal disorders among sonography professionals. This article summarizes the more commonly used continuous improvement processes and provides a description of how one method might be applied to the ultrasound department.

  8. A variation reduction allocation model for quality improvement to minimize investment and quality costs by considering suppliers’ learning curve

    Science.gov (United States)

    Rosyidi, C. N.; Jauhari, WA; Suhardi, B.; Hamada, K.

    2016-02-01

    Quality improvement must be performed in a company to maintain its product competitiveness in the market. The goal of such improvement is to increase the customer satisfaction and the profitability of the company. In current practice, a company needs several suppliers to provide the components in assembly process of a final product. Hence quality improvement of the final product must involve the suppliers. In this paper, an optimization model to allocate the variance reduction is developed. Variation reduction is an important term in quality improvement for both manufacturer and suppliers. To improve suppliers’ components quality, the manufacturer must invest an amount of their financial resources in learning process of the suppliers. The objective function of the model is to minimize the total cost consists of investment cost, and quality costs for both internal and external quality costs. The Learning curve will determine how the employee of the suppliers will respond to the learning processes in reducing the variance of the component.

  9. Radiation technology of improved quality materials production

    International Nuclear Information System (INIS)

    Zajkin, Yu.A.; Nadirov, N.K.; Zajkina, R.F.

    1997-01-01

    The technology of materials production from metals and alloys with high operational properties is developed. The technology is based on use of radiation methods in powder metallurgy. Use of radiation processing allows to improve technological conditions of sintering. It is established, that in certain regimes the sintering temperature is decreasing from 1200 deg C up to 950 deg C in the result of radiation processing of stainless steel powders . According to the processing regimes it is possible load reduction by powder pressing on 15-20 % and sintering time in to 1,5 - 2 times . The radiation methods give possibility to produce high qualitative goods from cheap powder materials without use energy-intensive processes and prolonged processing of finished products

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

    Science.gov (United States)

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

    2013-01-01

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

  11. Improving technology and setting-up a production line for high quality zinc oxide (99.5%) with a capacity of 150 ton/year by evaporation-oxidation process

    International Nuclear Information System (INIS)

    Phan Dinh Thinh; Pham Minh Tuan; Luong Manh Hung; Tran Ngoc Vuong

    2015-01-01

    This report presents the technology improvement and a production line to produce high quality zinc oxide of purity upper than 99.5% ZnO by evaporation-oxidation method. Secondary zinc metal recovered from galvanizing industrial will undergo a pre-treatment to meet all requirements of standardized feed material for evaporation-oxidation process. Zinc metal is melted at a temperature of about 650"oC, some impurities and metallic oxides are separated preliminary, then zinc metal is converted into liquid in evaporation pot. Here the temperature is maintained around 1050"oC, zinc liquid is evaporated, zinc vapor is oxidized by air in the oxidation chamber naturally by oxygen in the air and then zinc vapor is converted to zinc oxide. Zinc oxide is passed through a product classification systems and then go to a product collection of filtering bag design. The whole process of melting, evaporation, oxidation, particles classification and product collection is a continuous process. The efficiency of the transformation of zinc metal into zinc oxide can reach the value of 1.1 to 1.2. ZnO product quality is higher than 99.5%. (author)

  12. Improving drug manufacturing with process analytical technology.

    Science.gov (United States)

    Rodrigues, Licinia O; Alves, Teresa P; Cardoso, Joaquim P; Menezes, José C

    2006-01-01

    Within the process analytical technology (PAT) framework, as presented in the US Food and Drug Administration guidelines, the aim is to design, develop and operate processes consistently to ensure a pre-defined level of quality at the end of the manufacturing process. Three PAT implementation scenarios can be envisaged. Firstly, PAT could be used in its most modest version (in an almost non-PAT manner) to simply replace an existing quality control protocol (eg, using near-infrared spectroscopy for an in-process quality control, such as moisture content). Secondly, the use of in-process monitoring and process analysis could be integrated to enhance process understanding and operation for an existing industrial process. Thirdly, PAT could be used extensively and exclusively throughout development, scale-up and full-scale production of a new product and process. Although the first type of implementations are well known, reports of the second and third types remain scarce. Herein, results obtained from PAT implementations of the second and third types are described for two industrial processes for preparing bulk active pharmaceutical ingredients, demonstrating the benefits in terms of increased process understanding and process control.

  13. THE CUBAN ENTERPRISE, COMPETITIVENESS, IMPROVEMENT BUSINESS AND QUALITY

    Directory of Open Access Journals (Sweden)

    Andrés Fernández-Companioni

    2016-01-01

    Full Text Available This article offers some reflections on the Cuban enterprise, its business process improvement and competitiveness that firms must have in entering the world market. It analyzes the economic policies of the last two Congresses of the Communist Party of Cuba that give importance to the role of the Cuban socialist state enterprise system. It conceptualizes the category: business. Knowledge of the categories: effectiveness, efficiency, effectiveness, competitiveness, quality and productivity must for Cuban entrepreneurs. To increase export capacity, we must address a number of factors such as quality and product innovation, the price level depends on the productivity of the inflation differential between countries and other factors with indirect effects on competitiveness, and service quality or corporate image. Are some of the mistakes made in business development in the country. Relate some of the quality awards granted in the world and which should aim to achieve the necessary visibility in international business. Relate some of the quality awards that are granted in the world and which should aim for Cuban entrepreneurs to achieve the necessary visibility in international business. It provides a table that lists the entities Award Winning Quality in Cuba until 2008. It shows a country ranking of the indicators of global competitiveness generated annually by The Global Competitiveness Report. Reasoning about the causes that led to the business improvement process (SPE (Legislative Decree 252 and Decree 281. 

  14. Quality Rating and Improvement System State Evaluations and Research

    Science.gov (United States)

    Ferguson, Daniel

    2016-01-01

    A quality rating and improvement system (QRIS) is a method used by states and local jurisdictions to assess the level of quality of child care and early education programs, improve quality, and convey quality ratings to parents and other consumers. A typical QRIS incorporates the following components: quality standards for participating providers;…

  15. A model for ageing-home-care service process improvement

    OpenAIRE

    Yu, Shu-Yan; Shie, An-Jin

    2017-01-01

    The purpose of this study was to develop an integrated model to improve service processes in ageing-home-care. According to the literature, existing service processes have potential service failures that affect service quality and efficacy. However, most previous studies have only focused on conceptual model development using New Service Development (NSD) and fail to provide a systematic model to analyse potential service failures and facilitate managers developing solutions to improve the se...

  16. 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.

  17. Process Improvement: An Application in Special Steel Production Sector

    Directory of Open Access Journals (Sweden)

    Tansu TÜRKAN

    2017-07-01

    Full Text Available Customer requests are increasingly varied with the changing of the living conditions and developing technology. In this point, customers want to be met the demands which are good quality and suitable price quickly. The trend in today’s global competitive environment is to provide high quality, reasonably priced products and respond in the required time to customer demands. In this point, organizations should review their processes continuously and improve them. In this study begin with the general information about concept of process, process management and process improvement techniques. This paper continuous with an application in a steel production company which supplies product to the customers in the automotive industry that working with just in time philosophy. In this study different techniques for process improvement (Kaizen, Cause and Effect Diagram, Poka-Yoke, 8D, Failure Modes and Effects Analysis were used in combination.

  18. Developing a lean measurement system to enhance process improvement

    Directory of Open Access Journals (Sweden)

    Lewis P.

    2013-01-01

    Full Text Available A key ingredient to underpin process improvement is a robust, reliable, repeatable measurement system. Process improvement activity needs to be supported by accurate and precise data because effective decision making, within process improvement activity, demands the use of “hard” data. One of the oldest and most established process improvement methods is Deming’s Plan-Do-Check-Act (PDCA cycle which is reliant on the check phase, a measurement activity where data is being gathered and evaluated. Recent expansions of the PDCA such as the Six-Sigma Define-Measure-Analyse-Improve-Control (DMAIC methodology place significant importance upon measurement. The DMAIC cycle incorporates the regimented requirement for the inclusion of measurement system analysis (MSA into the breakthrough strategy. The call for MSA within the DMAIC cycle is to provide the improvement activity with a robust measurement system that will ensure a pertinent level of data during any validation process. The Lean methodology is heavily centred on the removal of the seven Mudas (wastes from a manufacturing process: defects, overproduction, transportation, waiting, inventory, motion and processing. The application of lean, particularly within the manufacturing industry, has led to a perception that measurement is a waste within a manufacturing process because measurement processes identify defective products. The metrologists’ pursuit for measurement excellence could be construed as a hindrance by the “cost down” demands being perpetrated from the same organisation’s lean policy. So what possible benefits does enforcing the regimes of the lean and quality philosophies upon the measurement process have and how does this ultimately enhance the process improvement activity? The key fundamental to embed with any process improvement is the removal of waste. The process improvement techniques embedded within lean and quality concepts are extremely powerful practices in the

  19. Catalytic quality improvement of waste polyolefin originated fractions

    Directory of Open Access Journals (Sweden)

    Tóth O.

    2018-03-01

    Full Text Available The demand for alternative fuels having low greenhouse gases emission is continuously growing worldwide. Therefore it is preferred to produce new, waste originated components. One option is the recycling of plastic waste with cracking. The produced hydrocarbon fraction is not suitable for fuels thus it is important to improve its quality. The aim of our experimental work was to study the quality improvement of this