WorldWideScience

Sample records for quality improvement programme

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

    NARCIS (Netherlands)

    Denig, Petra

    2004-01-01

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

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

    Science.gov (United States)

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

    1994-10-01

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

  3. Towards Quality Technical Vocational Education and Training (Tvet) Programmes in Nigeria: Challenges and Improvement Strategies

    Science.gov (United States)

    Ayonmike, Chinyere Shirley; Okwelle, P. Chijioke; Okeke, Benjamin Chukwumaijem

    2015-01-01

    Technical Vocational Education and Training (TVET) is widely recognized as a vital driving force for the socio-economic growth and technological development of nations. In achieving the goals and objectives of TVET in Nigeria, the quality of the programme needs to be improved and sustained. The purpose of this study is to ascertain the challenges…

  4. A Systems Thinking Approach To The Sustainability Of Quality Improvement Programmes

    Directory of Open Access Journals (Sweden)

    Van Dyk, Dirk Johannes

    2014-05-01

    Full Text Available The challenge for organisations to continually provide the best return on investment for their shareholders has become increasingly difficult through globalisation of the market place. There are many responses a company could make to these challenges for example, new product development, increased market capitalisation, cost reduction initiatives, and quality management. This last response focuses on, but is not restricted to, customer satisfaction, continuous improvement, and environmental impact. Continuous improvement addresses waste in the business design and manufacturing processes, which could lead to improved profit margins. The sustainability of quality improvement programmes remains a challenge. Causality can be studied, using Six Sigma tools, to relate cause and effect. But these tools do not always allow the user to study and understand feedback from other factors, such as soft human issues, in the improvement process system, typically referred to as feedback causality. System dynamics may improve this understanding. Quality improvement programmes in the heavy engineering manufacturing environment are not researched to the same degree as those in the automotive manufacturing environment. The purpose of this paper is to share results from research into the sustainability of quality improvement programmes, and the development of an appropriate system dynamics model, using qualitative case study data gathered and coded in a heavy engineering manufacturing environment.

  5. Programme Learning Outcomes Assessment and Continuous Quality Improvement in Faculty of Mechanical and Manufacturing, UTHM

    Science.gov (United States)

    Taib, H.; Salleh, S. M.; Zain, B. A. Md; Azlan, M. A.; Mahzan, S.; Hafeez, Z. A.; Ong, P.; Ahmad, S.; N. A Rahman, M.; Nasir, N. F.; Azham Azmi, M.; Rahman, H. A.; Ngali, Z.

    2017-01-01

    This paper describes the assessment and continuous quality improvement of Programme Learning Outcomes (PLOs) in the Faculty of Mechanical Engineering and Manufacturing. PLO is known as an elementary requirement in Outcome Based Education (OBE) system. All PLOs have been mapped with graduate attributes by EAC Manual 2012. Conceptual process for establishing and reviewing PLOs has been explained in the Plan-Check-Do-Act cycle. PLO assessment has been shown in different types which classified as direct and indirect methods. Continuous Quality Improvement has been extracted from a variety of assessment and has been discussed. Seven (7) CQIs are identified using different assessment methods of PLO during years 2013 to 2016 and subsequent improvement actions have been taken by the faculty within three years.

  6. Quality improvement programme for diabetes care in family practice settings in Dubai.

    Science.gov (United States)

    Khattab, M S; Swidan, A M; Farghaly, M N; Swidan, H M; Ashtar, M S; Darwish, E A; Al Mazrooei, A K; Mohammad, A A

    2007-01-01

    A continuous quality improvement programme for the care of registered diabetes patients was introduced in 16 government-affiliated primary health care centres in Dubai. Quality improvement teams were formed, clinical guidelines and information systems were developed, diabetes nurse practitioners were introduced and a team approach was mobilized. Audits before and after the introduction of the scheme showed significant improvements in rates of recording key clinical indicators and in their outcomes. For example, the proportion of patients with glycosylated haemoglobin levels < 7% increased from 20.6% to 31.7% and with LDL cholesterol < 100 mg/dL increased from 20.8% to 33.6%. Mean systolic blood pressure of registered patients fell from 135.3 mmHg to 133.2 mmHg.

  7. Training and nutritional components of PMTCT programmes associated with improved intrapartum quality of care in Mali and Senegal

    National Research Council Canada - National Science Library

    Pirkle, Catherine McLean; Dumont, Alexandre; Traoré, Mamadou; Zunzunegui, Maria-Victoria

    2014-01-01

    .... This study assesses whether PMTCT programmes, or components of these programmes, are associated with better obstetrical quality of care and how PMTCT may reinforce existing maternal health programmes...

  8. Improving the management of non-ST elevation acute coronary syndromes: systematic evaluation of a quality improvement programme European QUality Improvement Programme for Acute Coronary Syndrome: The EQUIP-ACS project protocol and design

    Directory of Open Access Journals (Sweden)

    Bardaji Alfredo

    2010-01-01

    Full Text Available Abstract Background Acute coronary syndromes, including myocardial infarction and unstable angina, are important causes of premature mortality, morbidity and hospital admissions. Acute coronary syndromes consume large amounts of health care resources, and have a major negative economic and social impact through days lost at work, support for disability, and coping with the psychological consequences of illness. Several registries have shown that evidence based treatments are under-utilised in this patient population, particularly in high-risk patients. There is evidence that systematic educational programmes can lead to improvement in the management of these patients. Since application of the results of important clinical trials and expert clinical guidelines into clinical practice leads to improved patient care and outcomes, we propose to test a quality improvement programme in a general group of hospitals in Europe. Methods/Design This will be a multi-centre cluster-randomised study in 5 European countries: France, Spain, Poland, Italy and the UK. Thirty eight hospitals will be randomised to receive a quality improvement programme or no quality improvement programme. Centres will enter data for all eligible non-ST segment elevation acute coronary syndrome patients admitted to their hospital for a period of approximately 10 months onto the study database and the sample size is estimated at 2,000-4,000 patients. The primary outcome is a composite of eight measures to assess aggregate potential for improvement in the management and treatment of this patient population (risk stratification, early coronary angiography, anticoagulation, beta-blockers, statins, ACE-inhibitors, clopidogrel as a loading dose and at discharge. After the quality improvement programme, each of the eight measures will be compared between the two groups, correcting for cluster effect. Discussion If we can demonstrate important improvements in the quality of patient care as

  9. [Improving diet quality in children through a new nutritional education programme: INFADIMED].

    Science.gov (United States)

    Bibiloni, Maria Del Mar; Fernández-Blanco, Jordi; Pujol-Plana, Noemí; Martín-Galindo, Núria; Fernández-Vallejo, Maria Mercè; Roca-Domingo, Mariona; Chamorro-Medina, Juan; Tur, Josep A

    2017-04-11

    To assess the results of a nutritional education programme developed by using available local resources to improve diet quality and decrease overweight and obesity prevalence among children. A longitudinal intervention study by means of nutritional education (INFADIMED) in children (aged 3-7 years) from Vilafranca del Penedès (Barcelona, Spain), recruited from preschool centres and primary schools, with an intervention or INFADIMED group (n=319; 50.2% female) and a control group (n=880; 49.8% female). Weight, height and body mass index were measured in both groups at the beginning and at the end of the programme. Adherence to the Mediterranean diet was also assessed using the KIDMED test. Consumption of fruit or juices, vegetables, yogurt and/or cheese, pasta or rice, and nuts increased, while skipping breakfast, consumption of bakery products for breakfast, and/or consumption of sweets several times per day decreased in the INFADIMED group. INFADIMED also changed, from the beginning to the end of the study, the adherence to a Mediterranean diet: high (39.2% to 70.5%), acceptable (49.2% to 28.2%), and low (11.6% to 1.3%). Approximately 2.6% of the participants in the control group and 11.3% of the participants in the INFADIMED group who were overweight and obese changed to normal weight (odds ratio: 4.08; 95% confidence interval: 2.37-7.04). INFADIMED is a nutritional education programme with benefits on both diet quality and overweight and obesity prevalence among children. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Michele S Youngleson

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

  11. Air Quality Monitoring Programme

    DEFF Research Database (Denmark)

    Kemp, K.; Palmgren, F.

    The Danish Air Quality Monitoring Programme (LMP IV) has been revised in accordance with the Framework Directive and the first three daughter directives of SO2, NOx/NO2, PM10, lead, benzene, CO and ozone. PM10 samplers are under installation and the installation will be completed during 2002...

  12. Air Quality Monitoring Programme

    DEFF Research Database (Denmark)

    Kemp, K.; Palmgren, F.

    The Danish Air Quality Monitoring Programme (LMP IV) has been revised in accordance with the Framework Directive and the first three daughter directives of SO2, NOx/NO2, PM10, lead, benzene, CO and ozone. PM10 samplers are under installation and the installation will be completed during 2002....... The PM10 results from 2000 are spares, only TSP are thus included in this report. The data sets for year 2000 is complete for many stations. The monitoring programme consists of 10 stations plus 2 extra stations under the Municipality of Copenhagen. The SO2 and lead levels are still decreasing and far...

  13. SWOT analysis of a pediatric rehabilitation programme: a participatory evaluation fostering quality improvement.

    Science.gov (United States)

    Camden, Chantal; Swaine, Bonnie; Tétreault, Sylvie; Bergeron, Sophie

    2009-01-01

    To present the results of a strengths, weaknesses, opportunities and threats (SWOT) analysis used as part of a process aimed at reorganising services provided within a pediatric rehabilitation programme (PRP) in Quebec, Canada and to report the perceptions of the planning committee members regarding the usefulness of the SWOT in this process. Thirty-six service providers working in the PRP completed a SWOT questionnaire and reported what they felt worked and what did not work in the existing model of care. Their responses were used by a planning committee over a 12-month period to assist in the development of a new service delivery model. Committee members shared their thoughts about the usefulness of the SWOT. Current programme strengths included favourable organisational climate and interdisciplinary work whereas weaknesses included lack of psychosocial support to families and long waiting times for children. Opportunities included working with community partners, whereas fear of losing professional autonomy with the new service model was a threat. The SWOT results helped the planning committee redefine the programme goals and make decisions to improve service coordination. SWOT analysis was deemed as a very useful tool to help guide service reorganisation. SWOT analysis appears to be an interesting evaluation tool to promote awareness among service providers regarding the current functioning of a rehabilitation programme. It fosters their active participation in the reorganisation of a new service delivery model for pediatric rehabilitation.

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

    Science.gov (United States)

    Westerberg, Kristina; Hjelte, Jan

    2013-01-01

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

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

    Science.gov (United States)

    Westerberg, Kristina; Hjelte, Jan

    2013-01-01

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

  16. Changes in geriatric rehabilitation: a national programme to improve quality of care. The Synergy and Innovation in Geriatric Rehabilitation study

    Directory of Open Access Journals (Sweden)

    Marije S. Holstege

    2015-12-01

    Full Text Available Objective: To describe changes in the health service delivery process experienced by professionals, patients and informal caregivers during implementation of a national programme to improve quality of care of geriatric rehabilitation by improving integration of health service delivery processes. Study setting: Sixteen skilled nursing facilities. Study design: Prospective study, comparing three consecutive cohorts. Data collection: Professionals (elderly care physicians, physiotherapists and nursing staff rated four domains of health service delivery at admission and at discharge of 1075 patients. In addition, these patients [median age 79 (Interquartile range 71–85 years, 63% females] and their informal caregivers rated their experiences on these domains 4 weeks after discharge. Principal findings: During the three consecutive cohorts, professionals reported improvement on the domain team cooperation, including assessment for intensive treatment and information transfer among professionals. Fewer improvements were reported within the domains alignment with patients’ needs, care coordination and care quality. Between the cohorts, according to patients (n = 521 and informal caregivers (n = 319 there were no changes in the four domains of health service delivery. Conclusion: This national programme resulted in small improvements in team cooperation as reported by the professionals. No effects were found on patients’ and informal caregivers’ perceptions of health service delivery.

  17. Changes in geriatric rehabilitation: a national programme to improve quality of care. The Synergy and Innovation in Geriatric Rehabilitation study

    Directory of Open Access Journals (Sweden)

    Marije S. Holstege

    2015-12-01

    Full Text Available Objective: To describe changes in the health service delivery process experienced by professionals, patients and informal caregivers during implementation of a national programme to improve quality of care of geriatric rehabilitation by improving integration of health service delivery processes.Study setting: Sixteen skilled nursing facilities.Study design: Prospective study, comparing three consecutive cohorts.Data collection: Professionals (elderly care physicians, physiotherapists and nursing staff rated four domains of health service delivery at admission and at discharge of 1075 patients. In addition, these patients [median age 79 (Interquartile range 71–85 years, 63% females] and their informal caregivers rated their experiences on these domains 4 weeks after discharge.Principal findings: During the three consecutive cohorts, professionals reported improvement on the domain team cooperation, including assessment for intensive treatment and information transfer among professionals. Fewer improvements were reported within the domains alignment with patients’ needs, care coordination and care quality. Between the cohorts, according to patients (n = 521 and informal caregivers (n = 319 there were no changes in the four domains of health service delivery.Conclusion: This national programme resulted in small improvements in team cooperation as reported by the professionals. No effects were found on patients’ and informal caregivers’ perceptions of health service delivery.

  18. Implementation of a vascular access quality programme improves vascular access care

    NARCIS (Netherlands)

    van Loon, M.; van der Mark, W.; Beukers, N.; de Bruin, C.; Blankestijn, P. J.; Huisman, R. M.; Zijlstra, J. J.; van der Sande, F. M.; Tordoir, J. H. M.

    2007-01-01

    Introduction. In the Netherlands an access quality improvement plan (QIP) was introduced by vascular access coordinators (VAC) with the aim to decrease vascular access-related complications by preemptive intervention of malfunctioning accesses. A vascular access QIP was established in 24 centres (46

  19. Implementation of a vascular access quality programme improves vascular access care

    NARCIS (Netherlands)

    van Loon, M.; van der Mark, W.; Beukers, N.; de Bruin, C.; Blankestijn, P. J.; Huisman, R. M.; Zijlstra, J. J.; van der Sande, F. M.; Tordoir, J. H. M.

    2007-01-01

    Introduction. In the Netherlands an access quality improvement plan (QIP) was introduced by vascular access coordinators (VAC) with the aim to decrease vascular access-related complications by preemptive intervention of malfunctioning accesses. A vascular access QIP was established in 24 centres (46

  20. Implementation of a vascular access quality programme improves vascular access care

    NARCIS (Netherlands)

    van Loon, M.; van der Mark, W.; Beukers, N.; de Bruin, C.; Blankestijn, P. J.; Huisman, R. M.; Zijlstra, J. J.; van der Sande, F. M.; Tordoir, J. H. M.

    Introduction. In the Netherlands an access quality improvement plan (QIP) was introduced by vascular access coordinators (VAC) with the aim to decrease vascular access-related complications by preemptive intervention of malfunctioning accesses. A vascular access QIP was established in 24 centres

  1. The impact of a large-scale quality improvement programme on work engagement: preliminary results from a national cross-sectional-survey of the 'Productive Ward'

    OpenAIRE

    White, Mark; Wells, John S G; Butterworth, Tony

    2014-01-01

    Background: Quality improvement (QI) Programmes, like the Productive Ward: Releasing-time-to-care initiative, aim to 'engage' and 'empower' ward teams to actively participate, innovate and lead quality improvement at the front line. However, little is known about the relationship and impact that QI work has on the 'engagement' of the clinical teams who participate and vice-versa. Objective: This paper explores and examines the impact of a large-scale QI programme, the Productive Ward, on the ...

  2. Plagiarism: a case study of quality improvement in a taught postgraduate programme.

    Science.gov (United States)

    Marshall, Tom; Taylor, Beck; Hothersall, Ellie; Pérez-Martín, Leticia

    2011-01-01

    Plagiarism is a common issue in education. Software can detect plagiarism but little is known about prevention. To identify ways to reduce the incidence of plagiarism in a postgraduate programme. From 2006, all student assignments were monitored using plagiarism detection software (Turn It In) to produce percentage text matches for each assignment. In 2007, students were advised software was being used, and that plagiarism would result in penalties. In 2008, students attending a key module took part in an additional interactive seminar on plagiarism. A separate cohort of students did not attend the seminar, allowing comparison between attendees and non-attendees. Between 2006 and 2007, mean percentage text match values were consistent with a stable process, indicating advice and warnings were ineffective. Control chart analysis revealed that between 2007 and 2008, mean percentage text match changes showed a reduced text match in all nine modules, where students attended the interactive seminar, but none where students did not. This indicated that the interactive seminar had an effect. In 2008, there were no occurrences of plagiarism. Improvements were maintained in 2009. Advice and warnings against plagiarism were ineffective but a subsequent interactive seminar was effective at reducing plagiarism.

  3. The impact of a large-scale quality improvement programme on work engagement: Preliminary results from a national cross-sectional-survey of the 'Productive Ward'

    LENUS (Irish Health Repository)

    White, Mark

    2014-05-14

    Quality improvement (QI) Programmes, like the Productive Ward: Releasing-time-to-care initiative, aim to \\'engage\\' and \\'empower\\' ward teams to actively participate, innovate and lead quality improvement at the front line. However, little is known about the relationship and impact that QI work has on the \\'engagement\\' of the clinical teams who participate and vice-versa.

  4. Evaluation of the theory-based Quality Improvement in Physical Therapy (QUIP) programme: a one-group, pre-test post-test pilot study

    OpenAIRE

    Rutten, Geert M; Harting, Janneke; Bartholomew, L. Kay; Schlief, Angelique; Oostendorp, Rob AB; de Vries, Nanne K

    2013-01-01

    Background Guideline adherence in physical therapy is far from optimal, which has consequences for the effectiveness and efficiency of physical therapy care. Programmes to enhance guideline adherence have, so far, been relatively ineffective. We systematically developed a theory-based Quality Improvement in Physical Therapy (QUIP) programme aimed at the individual performance level (practicing physiotherapists; PTs) and the practice organization level (practice quality manager; PQM). The aim ...

  5. Paediatric ED BiPAP continuous quality improvement programme with patient analysis: 2005–2013

    Science.gov (United States)

    Abramo, Thomas; Williams, Abby; Mushtaq, Samaiya; Meredith, Mark; Sepaule, Rawle; Crossman, Kristen; Burney Jones, Cheryl; Godbold, Suzanne; Hu, Zhuopei; Nick, Todd

    2017-01-01

    Objective In paediatric moderate-to-severe asthmatics, there is significant bronchospasm, airway obstruction, air trapping causing severe hyperinflation with more positive intraplural pressure preventing passive air movement. These effects cause an increased respiratory rate (RR), less airflow and shortened inspiratory breath time. In certain asthmatics, aerosols are ineffective due to their inadequate ventilation. Bilevel positive airway pressure (BiPAP) in acute paediatric asthmatics can be an effective treatment. BiPAP works by unloading fatigued inspiratory muscles, a direct bronchodilation effect, offsetting intrinsic PEEP and recruiting collapsed alveoli that reduces the patient's work of breathing and achieves their total lung capacity quicker. Unfortunately, paediatric emergency department (PED) BiPAP is underused and quality analysis is non-existent. A PED BiPAP Continuous Quality Improvement Program (CQIP) from 2005 to 2013 was evaluated using descriptive analytics for the primary outcomes of usage, safety, BiPAP settings, therapeutics and patient disposition. Interventions PED BiPAP CQIP descriptive analytics. Setting Academic PED. Participants 1157 patients. Interventions A PED BiPAP CQIP from 2005 to 2013 for the usage, safety, BiPAP settings, therapeutic response parameters and patient disposition was evaluated using descriptive analytics. Primary and secondary outcomes Safety, usage, compliance, therapeutic response parameters, BiPAP settings and patient disposition. Results 1157 patients had excellent compliance without complications. Only 6 (0.5%) BiPAP patients were intubated. BiPAP median settings: IPAP 18 (16,20) cm H2O range 12–28; EPAP 8 cmH2O (8,8) range 6–10; inspiratory-to-expiratory time (I:E) ratio 1.75 (1.5,1.75). Pediatric Asthma Severity score and RR decreased (pcare units (PICU), 832 wards, with 52 of these PED ward patients were discharged home with only 2 hours of PED BiPAP with no returning to the PED within 72

  6. Inclusion of emergency department patients in early stages of sepsis in a quality improvement programme has the potential to improve survival: a prospective dual-centre study.

    Science.gov (United States)

    De Groot, Bas; Struyk, Bastiaan; Najafi, Rashed; Halma, Nieke; Pelser, Loekie; Vorst, Denise; Mertens, Bart; Ansems, Annemieke; Rijpsma, Douwe

    2017-09-01

    Sepsis quality improvement programmes typically focus on severe sepsis (ie, with acute organ failure). However, quality of ED care might be improved if these programmes included patients whose progression to severe sepsis could still be prevented (ie, infection without acute organ failure). We compared the impact on mortality of implementing a quality improvement programme among ED patients with a suspected infection with or without acute organ failure. This prospective observational study among ED patients hospitalised with suspected infection was conducted in two hospitals in the Netherlands. After stratification by sepsis category (with or without organ failure), in-hospital mortality was compared between a full compliance (all quality performance measures achieved) and an incomplete compliance group. Multivariable logistic regression analysis was used to quantify the impact of full compliance on in-hospital mortality, adjusting for disease severity, disposition and hospital. There were 1732 ED patients and 130 deaths. Full compliance was independently associated with approximately two-thirds reduction in the odds of hospital mortality (adjusted OR of 0.30 (95% CI 0.19 to 0.47), which was similar in patients with and without organ failure. Among the 1379 patients with suspected infection without acute organ failure, there were 64 deaths, 15 (1.1%) in the full compliance group and 49 (3.6%) in the incomplete compliance group (mortality difference 2.5% (95% CI 1.6% to 3.3%)). Among 353 patients with organ failure, there were 66 deaths, 12 (3.4%) in the full compliance compared with 54 (15.3%) in the incomplete compliance group (mortality difference 11.9% (95% CI 8.5% to 15.3%)). Thus, there was a difference of 76 deaths between full and incomplete compliance groups, and 34 (45%) who benefited were those without acute organ failure. Sepsis quality improvement programmes should incorporate ED patients in earlier stages of sepsis given the potential to reduce in

  7. Air Quality Monitoring Programme

    DEFF Research Database (Denmark)

    Kemp, K.; Palmgren, F.

    The air quality in Danish cities has been monitored continuously since 1982 within the Danish Air Quality (LMP) network. The aim has been to follow the concentration levels of toxic pollutants in the urban atmosphere and to provide the necessary knowledge to assess the trends, to perform source...... apportionment, and to evaluate the chemical reactions and the dispersion of the pollutants in the atmosphere. In 2002 the air quality was measured in four Danish cities and at two background sites. NO2 and PM10 were at several stations found in concentrations above the new EU limit values, which the Member...

  8. Air Quality Monitoring Programme

    DEFF Research Database (Denmark)

    Kemp, K.; Palmgren, F.

    The air quality in Danish cities has been monitored continuously since 1982 within the Danish Air Quality (LMP) network. The aim has been to follow the concentration levels of toxic pollutants in the urban atmosphere and to provide the necessary knowledge to assess the trends, to perform source...... apportionment, and to evaluate the chemical reactions and the dispersion of the pollutants in the atmosphere. In 2002 the air quality was measured in four Danish cities and at two background sites. NO2 and PM10 were at several stations found in concentrations above the new EU limit values, which the Member...

  9. Quality Management in Slovenian Education Programmes

    Directory of Open Access Journals (Sweden)

    Milena Alič

    2015-05-01

    Full Text Available Product and service quality, effective process management, continuous improvement and innovation are some essential conditions for making a successful business. They are often emphasised by managers of successful organizations, by authors of professional and scientific papers and even by politicians and journalists. Quality management standards and models, such as ISO 9001 and EFQM model appeared in assistance to the needs of organisations to assure stable product and service quality, to improve it and to make the production process and its supporting processes effective. It has been 28 years since the standard ISO 9001 appeared. Now it is the most widely spread global standard implemented in more than 1.100.000 organizations worldwide. If quality management was proved to be an important approach to make organizations operate better and thus to contribute to well-being of the society, it would be expected that it is somehow included in our regular school programmes on all the levels. We expect that learning and living quality approaches in childhood and youth would be the least costly way to improve the culture of quality in the society and to implement it in our organizations as well. The paper gives some insight in the situation by searching for quality management related programmes and approaches in our primary, secondary and tertiary school programmes. The purpose of this paper is only to highlight the issue of teaching for quality in our regular education programmes – just to become aware of it and to find some improvement opportunities. There should be still some more detailed research on this topic to give strong suggestions.

  10. Quality improvement.

    Science.gov (United States)

    2014-10-30

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

  11. 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.

  12. The Danish Air Quality Monitoring Programme

    DEFF Research Database (Denmark)

    Kemp, K.; Palmgren, F.

    will be started including i.a. measurements of PM10 and Benzene at several locations. The present report describes the results from 1999 and updates the trends from the start of the programme in 1982. Measurements are performed at twin sites in the cities of Copenhagen, Odense and Aalborg. One of the sites...... continuously in order to improve the knowledge about the NO, NO2 and O3 problem complex. At the rural site outside Copenhagen the same program is conducted as at the street stations with the inclusion of O3. Only NO, NO2 and O3 are reported from the other rural site. Air quality limit values have been...

  13. Healthcare Quality Improvement and 'work engagement'; concluding results from a national, longitudinal, cross-sectional study of the 'Productive Ward-Releasing Time to Care' Programme.

    Science.gov (United States)

    White, Mark; Butterworth, Tony; Wells, John Sg

    2017-08-01

    Concerns about patient safety and reducing harm have led to a particular focus on initiatives that improve healthcare quality. However Quality Improvement (QI) initiatives have in the past typically faltered because they fail to fully engage healthcare professionals, resulting in apathy and resistance amongst this group of key stakeholders. Productive Ward: Releasing Time to Care (PW) is a ward-based QI programme created to help ward-based teams redesign and streamline the way that they work; leaving more time to care for patients. PW is designed to engage and empower ward-based teams to improve the safety, quality and delivery of care. The main objective of this study was to explore whether PW sustains the 'engagement' of ward-based teams by examining the longitudinal effect that the national QI programme had on the 'work-engagement' of ward-based teams in Ireland. Utilising the Utrecht Work Engagement Scale questionnaire (UWES-17), we surveyed nine PW (intervention) sites from typical acute Medical/Surgical, Rehabilitation and Elderly services (representing the entire cohort of a national phase of PW implementation in Ireland) and a cohort of matched control sites. The numbers surveyed from the PW group at T1 (up to 3 months after commencing the programme) totalled 253 ward-team members and 249 from the control group. At T2 (12 months later), the survey was repeated with 233 ward-team members from the PW sites and 236 from the control group. Overall findings demonstrated that those involved in the QI initiative had higher 'engagement' scores at T1 and T2 in comparison to the control group. Total 'engagement' score (TES), and its 3 dimensions, were all significantly higher in the PW group at T1, but only the Vigour dimension remained significantly higher at T2 (p = 0.006). Our results lend some support to the assertions of the PW initiative itself and suggest that when compared to a control group, ward-based teams involved in the QI programme are more likely

  14. A multimodal physiotherapy programme plus deep water running for improving cancer-related fatigue and quality of life in breast cancer survivors.

    Science.gov (United States)

    Cuesta-Vargas, A I; Buchan, J; Arroyo-Morales, M

    2014-01-01

    The aim of the study was to assess the feasibility and effectiveness of aquatic-based exercise in the form of deep water running (DWR) as part of a multimodal physiotherapy programme (MMPP) for breast cancer survivors. A controlled clinical trial was conducted in 42 primary breast cancer survivors recruited from community-based Primary Care Centres. Patients in the experimental group received a MMPP incorporating DWR, 3 times a week, for an 8-week period. The control group received a leaflet containing instructions to continue with normal activities. Statistically significant improvements and intergroup effect size were found for the experimental group for Piper Fatigue Scale-Revised total score (d = 0.7, P = 0.001), as well as behavioural/severity (d = 0.6, P = 0.05), affective/meaning (d = 1.0, P = 0.001) and sensory (d = 0.3, P = 0.03) domains. Statistically significant differences between the experimental and control groups were also found for general health (d = 0.5, P quality of life (d = 1.3, P quality of life in breast cancer survivors. Further, the high level of adherence and lack of adverse events indicate such a programme is safe and feasible. © 2013 John Wiley & Sons Ltd.

  15. The Danish Air Quality Monitoring Programme

    DEFF Research Database (Denmark)

    Kemp, K.; Palmgren, F.; Manscher, O. H.

    The Danish Air Quality Monitoring Programme (LMP) was started in 1982 as the first nation-wide urban air pollution monitoring programme in Denmark. The programme has been adjusted to the pollution pattern by two revisions. The present phase (LMP III) was started in 1992. This report presents...... Copenhagen the same program is con-ducted as at the street stations with the inclusion of O3. Only NO, NO2 and O3 are reported from the other rural site. Air quality limit values have been implemented in Den-mark for NO2, SO2, TSP in order to protect human health. All limit values are based on EU limit...

  16. The Danish Air Quality Monitoring Programme

    DEFF Research Database (Denmark)

    Kemp, K.; Palmgren, F.

    The Danish Air Quality Monitoring Programme (LMP) was started in 1982 as the first nation-wide urban air pollution monitoring programme in Denmark. The programme has been adjusted to the pollution pattern by two revisions. The present phase (LMP III) was started in 1992. From 2000 a new phase...... concentrations an increase was observed in 1999. This is probably mainly due to the meteorological conditions in 1999. The SO2 concentrations have been continuously decreasing since 1982. In 1999 they were only about 1/10 of the limit values. They are also far below the new values proposed by the EU commission...

  17. The impact of a large-scale quality improvement programme on work engagement: preliminary results from a national cross-sectional-survey of the 'Productive Ward'.

    Science.gov (United States)

    White, Mark; Wells, John S G; Butterworth, Tony

    2014-12-01

    Quality improvement (QI) Programmes, like the Productive Ward: Releasing-time-to-care initiative, aim to 'engage' and 'empower' ward teams to actively participate, innovate and lead quality improvement at the front line. However, little is known about the relationship and impact that QI work has on the 'engagement' of the clinical teams who participate and vice-versa. This paper explores and examines the impact of a large-scale QI programme, the Productive Ward, on the 'work engagement' of the nurses and ward teams involved. Using the Utrecht Work Engagement Scale (UWES), we surveyed, measured and analysed work engagement in a representative test group of hospital-based ward teams who had recently commenced the latest phase of the national 'Productive Ward' initiative in Ireland and compared them to a control group of similar size and matched (as far as is possible) on variables such as ward size, employment grade and clinical specialty area. 338 individual datasets were recorded, n=180 (53.6%) from the Productive Ward group, and n=158 (46.4%) from the control group; the overall response rate was 67%, and did not differ significantly between the Productive Ward and control groups. The work engagement mean score (±standard deviation) in the Productive group was 4.33(±0.88), and 4.07(±1.06) in the control group, representing a modest but statistically significant between-group difference (p=0.013, independent samples t-test). Similarly modest differences were observed in all three dimensions of the work engagement construct. Employment grade and the clinical specialty area were also significantly related to the work engagement score (pengagement (the vigour, absorption and dedication) of ward-based teams. The use and suitability of the UWES as an appropriate measure of 'engagement' in QI interventions was confirmed. The engagement of nurses and front-line clinical teams is a major component of creating, developing and sustaining a culture of improvement. Copyright

  18. Can physiotherapy after stroke based on the Bobath concept result in improved quality of movement compared to the motor relearning programme.

    Science.gov (United States)

    Langhammer, Birgitta; Stanghelle, Johan K

    2011-06-01

    The primary aim of the present study was to investigate, based on data from our study in 2000, whether the Bobath approach enhanced quality of movement better than the Motor Relearning Programme (MRP) during rehabilitation of stroke patients. A randomized controlled stratified trial of acute stroke patients. The patients were treated according to Motor Relearning Programme and Bobath approach and assessed with Motor Assessment Scale, Sødring Motor Evaluation Scale, Nottingham Health Profile and the Barthel Index. A triangulation of the test scores was made in reference to the Movement Quality Model and biomechanical, physiological, psycho-socio-cultural, and existential themes. The items arm (p = 0.02-0.04) sitting (p = 0.04) and hand (p = 0.01-0.03) were significantly better in the Motor Relearning Programme group than in the Bobath group, in both Sødring Motor Evaluation Scale and Motor Assessment Scale. Leg function, balance, transfer, walking and stair climbing did not differ between the groups. The Movement Quality Model and the movement qualities biomechanical, physiological and psycho-socio-cultural showed higher scoring in the Motor Relearning Programme group, indicating better quality of movement in all items. Regression models established the relationship with significant models of motor performance and self reported physical mobility (adjusted R(2) 0.30-0.68, p < 0.0001), energy (adjusted R(2) 0.13-0.14, p = 0.03-0.04, emotion (adjusted R(2) 0.30-0.38, p < 0.0001) and social interaction (arm function, adjusted R(2) 0.25, p = 0.0001). These analyses confirm that task oriented exercises of the Motor Relearning Programme type are preferable regarding quality of movement in the acute rehabilitation of patients with stroke. Copyright © 2010 John Wiley & Sons, Ltd.

  19. The WHO AFRO external quality assessment programme (EQAP: Linking laboratory networks through EQA programmes

    Directory of Open Access Journals (Sweden)

    Debrah I. Boeras

    2016-10-01

    Full Text Available External Quality Assessment (EQA surveys performed by the World Health Organization Regional Office for Africa (WHO AFRO revealed the need for the strengthening of publichealth microbiology laboratories, particularly for testing of epidemic-prone diseases in theAfrican Region. These surveys revealed common issues such as supply chain managementskilled personnel, logistical support and overall lack of quality standards. For sustainableimprovements to health systems as well as global health security, deficiencies identified needto be actively corrected through robust quality assurance programmes and implementation oflaboratory quality management systems.Given all the pathogens of public health importance, an external quality assessment programmewith a focus on vaccine-preventable diseases and emerging and re-emerging dangerouspathogens is important, and should not be stand-alone, but integrated within laboratorynetworks as seen in polio, measles, yellow fever and rubella.In 2015, WHO AFRO collaborated with the US Centers for Disease Control and Preventionthe London School of Hygiene & Tropical Medicine and partners in a series of consultationswith countries and national and regional EQA providers for the development of qualityassurance models to support HIV point-of-care testing and monitoring. These consultationsrevealed similar challenges as seen in the WHO AFRO surveys. WHO AFRO brought forthits experience in implementing quality standards for health programmes, and also openeddiscussions on how lessons learned through such established programmes can be utilised tosupporting and strengthening the introduction of early infant diagnosis of HIV and viralload point-of-care testing.An optimised external quality assessment programme will impact the ability of countries tomeet core capacities, providing improved quality management systems, improving theconfidence of diagnostic network services in Africa, and including capacities to detect eventsof

  20. A Water Quality Monitoring Programme for Schools and Communities

    Science.gov (United States)

    Spellerberg, Ian; Ward, Jonet; Smith, Fiona

    2004-01-01

    A water quality monitoring programme for schools is described. The purpose of the programme is to introduce school children to the concept of reporting on the "state of the environment" by raising the awareness of water quality issues and providing skills to monitor water quality. The programme is assessed and its relevance in the…

  1. A Water Quality Monitoring Programme for Schools and Communities

    Science.gov (United States)

    Spellerberg, Ian; Ward, Jonet; Smith, Fiona

    2004-01-01

    A water quality monitoring programme for schools is described. The purpose of the programme is to introduce school children to the concept of reporting on the "state of the environment" by raising the awareness of water quality issues and providing skills to monitor water quality. The programme is assessed and its relevance in the…

  2. Improving regional universal newborn hearing screening programmes in Italy.

    Science.gov (United States)

    Molini, E; Cristi, M C; Lapenna, R; Calzolaro, L; Muzzi, E; Ciciriello, E; Della Volpe, A; Orzan, E; Ricci, G

    2016-02-01

    The Universal Newborn Hearing Screening (UNHS) programme aims at achieving early detection of hearing impairment. Subsequent diagnosis and intervention should follow promptly. Within the framework of the Ministry of Health project CCM 2013 "Preventing Communication Disorders: a Regional Program for early Identification, Intervention and Care of Hearing Impaired Children", the limitations and strengths of current UNHS programs in Italy have been analysed by a group of professionals working in tertiary centres involved in regional UNHS programmes, using SWOT analysis and a subsequent TOWS matrix. Coverage and lost-to-follow up rates are issues related to UNHS programmes. Recommendations to improve the effectiveness of the UNHS programme have been identified. The need for homogeneous policies, high-quality information and dissemination of knowledge for operators and families of hearing-impaired children emerged from the discussion.

  3. A mixed exercise training programme is feasible and safe and may improve quality of life and muscle strength in multiple myeloma survivors

    Directory of Open Access Journals (Sweden)

    Groeneveldt Lara

    2013-01-01

    Full Text Available Abstract Background Exercise programmes are beneficial for cancer patients however evidence is limited in patients with multiple myeloma (MM, a cancer that is characterised by osteolytic bone disease, giving rise to high levels of bone morbidity including fractures and bone pain. Methods We conducted a single arm phase 2 study of an exercise programme (EP as rehabilitation for treated MM patients, to evaluate feasibility, effects on QOL and physiological parameters. Patients were given individualised programmes, comprising stretching, aerobic and resistance exercises, carried out under supervision for 3 months then at home for a further 3 months. Results Study uptake was high, 60 of 75 (80% patients approached consented to the study. Screen failures (11, due to fracture risk and disease relapse and patient withdrawals (12 resulted in a final 37 patients enrolling on the programme. These 37 patients demonstrated high attendance rates in the supervised classes (87%, and high levels of adherence in home exercising (73%. Patients reported better QOL following the EP, with improvement in FACT-G and Fatigue scores over time from baseline (p Conclusions An EP in MM patients is feasible and safe, with high attendance and adherence. Benefits in QOL, fatigue and muscle strength await confirmation in randomized studies, prompting urgent evaluation of the benefits of EP in the rehabilitation of MM patients.

  4. National infection prevention and control programmes: Endorsing quality of care.

    Science.gov (United States)

    Stempliuk, Valeska; Ramon-Pardo, Pilar; Holder, Reynaldo

    2014-01-01

    Core components Health care-associated infections (HAIs) are a major cause of morbidity and mortality. In addition to pain and suffering, HAIs increase the cost of health care and generates indirect costs from loss of productivity for patients and society as a whole. Since 2005, the Pan American Health Organization has provided support to countries for the assessment of their capacities in infection prevention and control (IPC). More than 130 hospitals in 18 countries were found to have poor IPC programmes. However, in the midst of many competing health priorities, IPC programmes are not high on the agenda of ministries of health, and the sustainability of national programmes is not viewed as a key point in making health care systems more consistent and trustworthy. Comprehensive IPC programmes will enable countries to reduce the mobility, mortality and cost of HAIs and improve quality of care. This paper addresses the relevance of national infection prevention and control (NIPC) programmes in promoting, supporting and reinforcing IPC interventions at the level of hospitals. A strong commitment from national health authorities in support of national IPC programmes is crucial to obtaining a steady decrease of HAIs, lowering health costs due to HAIs and ensuring safer care.

  5. The programme benefits of improving project team communication through a contact centre

    Directory of Open Access Journals (Sweden)

    Bond-Barnard, T. J.

    2013-08-01

    Full Text Available A South African national programme to repair government infrastructure uses a contact centre (or call centre to facilitate and manage communication. An important question is: How does the contact centre benefit the programme and its projects? This study discusses the findings of a survey that quantified the benefits of the programme when the communication between team members in the programme was improved by using a contact centre. The results show that, by using a contact centre to improve the communication between project team members, their perception of communication effectiveness, quality of project deliverables, service delivery, and customer satisfaction of the programme dramatically increases.

  6. Nurse-led home visitation programme to improve health-related quality of life and reduce disability among potentially frail community-dwelling older people in general practice: a theory-based process evaluation.

    Science.gov (United States)

    Stijnen, Mandy M N; Jansen, Maria W J; Duimel-Peeters, Inge G P; Vrijhoef, Hubertus J M

    2014-10-25

    Population ageing fosters new models of care delivery for older people that are increasingly integrated into existing care systems. In the Netherlands, a primary-care based preventive home visitation programme has been developed for potentially frail community-dwelling older people (aged ≥75 years), consisting of a comprehensive geriatric assessment during a home visit by a practice nurse followed by targeted interdisciplinary care and follow-up over time. A theory-based process evaluation was designed to examine (1) the extent to which the home visitation programme was implemented as planned and (2) the extent to which general practices successfully redesigned their care delivery. Using a mixed-methods approach, the focus was on fidelity (quality of implementation), dose delivered (completeness), dose received (exposure and satisfaction), reach (participation rate), recruitment, and context. Twenty-four general practices participated, of which 13 implemented the home visitation programme and 11 delivered usual care to older people. Data collection consisted of semi-structured interviews with practice nurses (PNs), general practitioners (GPs), and older people; feedback meetings with PNs; structured registration forms filled-out by PNs; and narrative descriptions of the recruitment procedures and registration of inclusion and drop-outs by members of the research team. Fidelity of implementation was acceptable, but time constraints and inadequate reach (i.e., the relatively healthy older people participated) negatively influenced complete delivery of protocol elements, such as interdisciplinary cooperation and follow-up of older people over time. The home visitation programme was judged positively by PNs, GPs, and older people. Useful tools were offered to general practices for organising proactive geriatric care. The home visitation programme did not have major shortcomings in itself, but the delivery offered room for improvement. General practices received

  7. A regional programme to improve skin cancer management.

    Science.gov (United States)

    McGeoch, Graham R; Sycamore, Mark J; Shand, Brett I; Simcock, Jeremy W

    2015-12-01

    In 2008, public specialist and general practice services in Canterbury were unable to manage demand for skin cancer treatment. Local clinicians decided the solution was to develop a see-and-treat skin excision clinic staffed by plastic surgeons and general practitioners (GPs), and the introduction of subsidised excisions in general practice. This paper describes the collaboration between clinicians, managers and funders and the results and quality management measures of these initiatives. There is an increasing incidence of skin cancer. GPs in Canterbury were unable to meet increasing demand for skin cancer treatment because some lacked confidence and competence in skin cancer management. There was no public funding for primary care management of skin cancer, driving patients to fully funded secondary care services. Secondary care services were at capacity, with no coordinated programme across primary and secondary care. The programme has resulted in a greater number of skin cancers being treated by the public health system, a reduction in waiting times for treatment, and fewer minor skin lesions being referred to secondary care. Quality measures have been achieved and are improving steadily. Development of the programme has improved working relationships between primary and secondary care clinicians. The strategy was to facilitate the working relationship between primary and secondary care and increase the capacity for skin lesion excisions in both sectors. Skin cancer management can be improved by a coordinated approach between primary and secondary care.

  8. The Danish Air Quality Monitoring Programme

    DEFF Research Database (Denmark)

    Kemp, K.; Palmgren, F.; Manscher, O. H.

    the results from 1996 and updates the trends from the start of the programme in 1982. Measurements are performed at twin sites in the cities of Copenhagen, Odense and Aalborg. One of the sites is at kerb side at a street with heavy traffic and the other is at the roof of a building a couple of hundreds meters...... direction, wind speed, tem-perature, relative humidity and global radiation are measured at the roof sites. Additional measurements of CO at street and NO and NO2 at roof sites are performed in campaigns in order to improve the knowledge about the NO, NO2 and O3 problem complex. At the rural site outside...

  9. 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.

  10. Quality Improvement Practices and Trends

    DEFF Research Database (Denmark)

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

    1998-01-01

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

  11. DANIDA; Air Quality Monitoring Programme. Mission 2 Report

    Energy Technology Data Exchange (ETDEWEB)

    Sivertsen, B.

    1996-06-01

    The report deals with the EIMP (Environmental Information and Monitoring Programme for the Arab Republic of Egypt). The programme is funded by Danida which is a cooperation project between Norway and Denmark. The programme covers the monitoring of air pollution, coastal water monitoring, and the monitoring of pollution sources and emissions. This report pays the attention to the Norwegian part of the programme executed by NILU (Norwegian Institute for Air Research) which covers the development air quality monitoring network. 14 refs., 51 figs., 18 tabs.

  12. Improving the urban family planning programme.

    Science.gov (United States)

    1997-10-01

    This report presents the directives on improving urban family planning (FP) programs issued by various Chinese departments in March 1997. The departments included the State Family Planning Commission, State Economic and Trade Commission, Ministry of Public Security, Ministry of Personnel, Ministry of Labor, Ministry of Public Health, and the National Industrial and Commercial Administration. The directives related to time frame, objectives, management, local level operations, IEC, the floating population's needs, the responsibility system, and a well-trained staff. It was stated that urban FP improvements will take some time, due to expansion of urban population, the increase in floating population, and the demand for quality services. The guiding principles support Deng Xiaoping's theory of building socialism with Chinese characteristics and balancing population with socioeconomic and sustainable development. The aim is to improve IEC and services and achieve low fertility as a way of creating favorable demographics for modernization. Leaders must be held responsible for the practice of FP in their unit. Subdistrict offices are a key link for managing FP in all units and neighborhood committees in their territory. Efforts need to be increased to spread IEC on population and FP and to reduce abortion. Every department registry should make an effort to provide comprehensive FP to floating populations. Urban centers should concentrate on improving the quality of FP services. Staff should be carefully chosen.

  13. QUALITY OF AN ACADEMIC STUDY PROGRAMME - EVALUATION MODEL

    Directory of Open Access Journals (Sweden)

    Mirna Macur

    2016-01-01

    Full Text Available Quality of an academic study programme is evaluated by many: employees (internal evaluation and by external evaluators: experts, agencies and organisations. Internal and external evaluation of an academic programme follow written structure that resembles on one of the quality models. We believe the quality models (mostly derived from EFQM excellence model don’t fit very well into non-profit activities, policies and programmes, because they are much more complex than environment, from which quality models derive from (for example assembly line. Quality of an academic study programme is very complex and understood differently by various stakeholders, so we present dimensional evaluation in the article. Dimensional evaluation, as opposed to component and holistic evaluation, is a form of analytical evaluation in which the quality of value of the evaluand is determined by looking at its performance on multiple dimensions of merit or evaluation criteria. First stakeholders of a study programme and their views, expectations and interests are presented, followed by evaluation criteria. They are both joined into the evaluation model revealing which evaluation criteria can and should be evaluated by which stakeholder. Main research questions are posed and research method for each dimension listed.

  14. The potential for integrated care programmes to improve quality of care as assessed by patients with COPD: early results from a real-world implementation study in The Netherlands

    Directory of Open Access Journals (Sweden)

    Jane Murray Cramm

    2012-09-01

    Full Text Available Objective: We investigated whether patients with chronic obstructive pulmonary disease (COPD who were enrolled in disease-management programmes (DMPs felt that they received a better quality of care than non-enrolled COPD patients.  Methods: Our cross-sectional study was performed among patients ('n' = 665 enrolled in four DMPs in The Netherlands. We also evaluated COPD patients ('n' = 227 not enrolled in such programmes. Patients' assessment of chronic-illness care (PACIC was measured with a 20-item questionnaire. The instrument had five pre-defined domains: patient activation (three items, delivery-system/practice design (three items, goal setting/tailoring (five items, problem solving/contextual (four items, and follow-up/coordination (five items.  Results: The mean overall PACIC score (scale: 1-5 of enrolled DMP patients was 2.94, and that of non-enrolled DMP patients was 2.73 ('p' ≤ 0.01. Differences in the same direction were found in the subscales of patient activation ('p' ≤ 0.01, delivery-system/practice design ('p' ≤ 0.001, and problem solving/contextual ('p' ≤ 0.001.  Conclusions: Our results suggest that even in the early stages of implementation, DMPs for COPD may significantly improve care.

  15. Quality Assurance of Joint Programmes. ENQA Workshop Report 19

    Science.gov (United States)

    Frederiks, Mark; Grifoll, Josep; Hiltunen, Kirsi; Hopbach, Achim

    2012-01-01

    In view of the Bologna ministerial conference to be held in April 2012 in Bucharest, ENQA organised a seminar in September 2011 on Quality Assurance of Joint Programmes in collaboration with the Austrian Accreditation Council (OAR). The purpose of this seminar was twofold: first, to analyse the experience already gained in quality assurance of…

  16. IMPROVING CONCEPTUAL DESIGN QUALITY

    DEFF Research Database (Denmark)

    Bush, Stuart; Robotham, Antony John

    1999-01-01

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

  17. Improving the participation in the Erasmus Programme

    OpenAIRE

    Vossensteyn, Johan J.; Beerkens-Soo, M.; Beerkens, Maarja; Cremonini, Leon; Besançon, Barbara; Focken, Noor; Leurs, Bart; McCoshan, Andrew; Huisman, Jeroen; Mozuraityte, Neringa; Souto-Otero, Manuel; de Wit, Hans

    2010-01-01

    This study explores the extent to which European students experience financial and other barriers to participation in the ERASMUS programme. The evidence indicates that the main barriers to participation vary significantly between countries, with the exception of financial issues, which are an important concern for students everywhere. ERASMUS participation is associated with students’ socio-economic background, primarily influenced by individual preferences and cost-benefit considerations ra...

  18. Improving Demand-oriented Quality Care in Family Planning--A Review of Practice and Experience in Family Planning Programme of Qianjiang, Hubei

    Institute of Scientific and Technical Information of China (English)

    Jia-yuan LIAO; Meng-ye PENG; Er-sheng GAO

    2003-01-01

    @@ With the mainstreaming being the demand from the people at reproductive age, we systematically analyzed the ideas and ways to implement quality care (QC) in family planning (FP) in Qianjiang, including advocating the conception of quality care, carrying out health education and counseling, strengthening capacity building of service system and reforming measurement of the evaluation and other aspects. The demand-oriented QC in FP has met personalized and verified demands from people of reproductive age satisfactorily, and kept the fertility rate at a lower level while uplifting satisfaction of the public. The demand-oriented QC in FP in Qianjiang county proved to be a successful and great worth practice.

  19. The potential for integrated care programmes to improve quality of care as assessed by patients with COPD: early results from a real-world implementation study in The Netherlands

    NARCIS (Netherlands)

    J.M. Cramm (Jane); M.P.M.H. Rutten-van Mölken (Maureen); A.P. Nieboer (Anna)

    2012-01-01

    textabstractObjective: We investigated whether patients with chronic obstructive pulmonary disease (COPD) who were enrolled in disease-management programmes (DMPs) felt that they received a better quality of care than non-enrolled COPD patients. Methods: Our cross-sectional study was performed among

  20. DANIDA; Air Quality Monitoring Programme. Mission 3 Report

    Energy Technology Data Exchange (ETDEWEB)

    Sivertsen, B.; Marsteen, L.

    1996-12-31

    In the development of the Environmental Information and Monitoring Programme for the Arab Republic of Egypt (EIMP), NILU is responsible for the establishment of an air pollution monitoring system. This report summarizes the third mission to Egypt and includes meetings and site visit reports. Air quality sites in Alexandria are described and comments are given to earlier selected sites in Cairo

  1. Ensuring successful admission to hospital for young people with learning difficulties, autism and challenging behaviour: a continuous quality improvement and change management programme.

    Science.gov (United States)

    Pratt, K; Baird, G; Gringras, P

    2012-11-01

    Children and young people with autism spectrum conditions frequently have adverse experiences in accessing health care. An audit of experiences of families known to our tertiary service and hospital staff was conducted. A checklist asking about particular aspects of behaviour and communication was developed and incorporated into pre-admission planning. Awareness of the child/young person's communication needs and behaviours, plus good preplanning by all staff involved and a team member allocated to ensure that the care plan is carried through, has resulted in a vastly improved 'patient experience' from the perspective of family and staff. Children and young people with autism spectrum disorder, often with co-existing learning difficulties, vary greatly in their reactions to hospital admission. Preplanning that involves the family with a dedicated informed staff member can dramatically reduce distress and improve the patient and staff experience. © 2011 Blackwell Publishing Ltd.

  2. Balance Right in Multiple Sclerosis (BRiMS): a guided self-management programme to reduce falls and improve quality of life, balance and mobility in people with secondary progressive multiple sclerosis: a protocol for a feasibility randomised controlled trial.

    Science.gov (United States)

    Gunn, H; Andrade, J; Paul, L; Miller, L; Creanor, S; Green, C; Marsden, J; Ewings, P; Berrow, M; Vickery, J; Barton, A; Marshall, B; Zajicek, J; Freeman, J A

    2018-01-01

    Impaired mobility is a cardinal feature of multiple sclerosis (MS) and is rated by people with MS as their highest priority. By the secondary progressive phase, balance, mobility and physical activity levels are significantly compromised; an estimated 70% of people with secondary progressive MS fall regularly. Our ongoing research has systematically developed 'Balance Right in MS' (BRiMS), an innovative, manualised 13-week guided self-management programme tailored to the needs of people with MS, designed to improve safe mobility and minimise falls. Our eventual aim is to assess the clinical and cost effectiveness of BRiMS in people with secondary progressive MS by undertaking an appropriately statistically powered, multi-centre, assessor-blinded definitive, randomised controlled trial. This feasibility study will assess the acceptability of the intervention and test the achievability of running such a definitive trial. This is a pragmatic multi-centre feasibility randomised controlled trial with blinded outcome assessment. Sixty ambulant people with secondary progressive MS who self-report two or more falls in the previous 6 months will be randomly allocated (1:1) to either the BRiMS programme plus usual care or to usual care alone. All participants will be assessed at baseline and followed up at 15 weeks and 27 weeks post-randomisation. The outcomes of this feasibility trial include:Feasibility outcomes, including trial recruitment, retention and completionAssessment of the proposed outcome measures for the anticipated definitive trial (including measures of walking, quality of life, falls, balance and activity level)Measures of adherence to the BRiMS programmeData to inform the economic evaluation in a future trialProcess evaluation (assessment of treatment fidelity and qualitative evaluation of participant and treating therapist experience). The BRiMS intervention aims to address a key concern for MS service users and providers. However, there are several

  3. The Effect of a Multidisciplinary Regional Educational Programme on the Quality of Colon Cancer Resection

    DEFF Research Database (Denmark)

    Sheehan-Dare, Gemma E; Marks, Kate M; Tinkler-Hundal, Emma

    2017-01-01

    Mesocolic plane surgery with central vascular ligation produces an oncologically superior specimen following colon cancer resection and appears to be related to optimal outcomes. Aim We aimed to assess whether a regional educational programme in optimal mesocolic surgery led to an improvement...... in the quality of specimens. METHOD: Following an educational programme in the Capital and Zealand areas of Denmark, 686 cases of primary colon cancer resected across six hospitals were assessed by grading the plane of surgery and undertaking tissue morphometry. These were compared to 263 specimens resected...... educational programme in optimal mesocolic surgery improved the oncological quality of colon cancer specimens as assessed by mesocolic planes, however, there was no significant effect on the amount of tissue resected centrally. Surgeons who attempt central vascular ligation continue to produce more radical...

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

    Directory of Open Access Journals (Sweden)

    Adrienne F.A. Meyers

    2016-10-01

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

  5. DANIDA; Air Quality Monitoring Programme. Mission 4 Report

    Energy Technology Data Exchange (ETDEWEB)

    Sivertsen, B.

    1997-12-31

    In the development of the Environmental Information and Monitoring Programme for the Arab Republic of Egypt (EIMP), NILU is responsible for the establishment of an air pollution monitoring system. This report summarizes the fourth mission to Egypt, including planning of the second phase meetings and site visits. Additional air quality sites in Cairo have been described. A project group meeting and a visit to Egypt Meteorological Service have been reported

  6. Development and perceived effects of an educational programme on quality and safety in medication handling in residential facilities.

    Science.gov (United States)

    Mygind, Anna; El-Souri, Mira; Rossing, Charlotte; Thomsen, Linda Aagaard

    2017-03-27

    To develop and test an educational programme on quality and safety in medication handling for staff in residential facilities for the disabled. The continuing pharmacy education instructional design model was used to develop the programme with 22 learning objectives on disease and medicines, quality and safety, communication and coordination. The programme was a flexible, modular seven + two days' course addressing quality and safety in medication handling, disease and medicines, and medication supervision and reconciliation. The programme was tested in five Danish municipalities. Municipalities were selected based on their application for participation; each independently selected a facility for residents with mental and intellectual disabilities, and a facility for residents with severe mental illnesses. Perceived effects were measured based on a questionnaire completed by participants before and after the programme. Effects on motivation and confidence as well as perceived effects on knowledge, skills and competences related to medication handling, patient empowerment, communication, role clarification and safety culture were analysed conducting bivariate, stratified analyses and test for independence. Of the 114 participants completing the programme, 75 participants returned both questionnaires (response rate = 66%). Motivation and confidence regarding quality and safety in medication handling significantly improved, as did perceived knowledge, skills and competences on 20 learning objectives on role clarification, safety culture, medication handling, patient empowerment and communication. The programme improved staffs' motivation and confidence and their perceived ability to handle residents' medication safely through improved role clarification, safety culture, medication handling and patient empowerment and communication skills. © 2017 Royal Pharmaceutical Society.

  7. Improving access to dental care for vulnerable children; further development of the Back2School programme in 2013.

    Science.gov (United States)

    Simons, D; Pearson, N; Evans, P; Wallace, T; Eke, M; Wright, D

    2015-06-01

    This paper describes a service evaluation of a dental treatment programme providing care to children not normally taken to the dentist. It explains the extension of the Back2School programme from the pilot phase and assesses if a mobile dental unit (MDU) can provide a high quality service. The public health competencies it illustrates include oral health improvement, developing and monitoring quality dental services, and collaborative working.

  8. Review of quality assessment tools for family planning programmes in low- and middle-income countries.

    Science.gov (United States)

    Sprockett, Andrea

    2017-03-01

    Measuring and tracking the quality of healthcare is a critical part of improving service delivery, clinic efficiency and health outcomes. However, no standardized or widely accepted tool exists to assess the quality of clinic-based family planning services in low- and middle-income countries. The objective of this literature review was to identify widely used public domain quality assessment tools with existing or potential application in clinic-based family planning programmes. Using PubMed, PopLine, Google Scholar and Google, key terms such as ‘quality assessment tool’, ‘quality assessment method’, ‘quality measurement’, ‘LMIC’, ‘developing country’, ‘family planning’ and ‘reproductive health’ were searched for articles, identifying 20 relevant tools. Tools were assessed to determine the type of quality components assessed, divided into structure and process components, level of application (national or facility), health service domain that can be assessed by the tool, cost and current use of the tool. Tools were also assessed for shortcomings based on application in a low- and middle-income clinic-based family planning programme, including personnel required, re-assessment frequency, assessment of structure, process and outcome quality, comparability of data over time and across facilities and ability to benchmark clinic results to a national benchmark. No tools met all criteria, indicating a critical gap in quality assessment for low- and middle-income family planning programmes. To achieve Universal Health Coverage, agreed on in the Sustainable Development Goals and to improve system-wide healthcare quality, we must develop and widely adopt a standardized quality assessment tool.

  9. 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

  10. Task 9. Deployment of photovoltaic technologies: co-operation with developing countries. The role of quality management, hardware certification and accredited training in PV programmes in developing countries

    Energy Technology Data Exchange (ETDEWEB)

    Fitzgerald, M. C. [Institute for Sustainable Power, Highlands Ranch, CO (United States); Oldach, R.; Bates, J. [IT Power Ltd, The Manor house, Chineham (United Kingdom)

    2003-09-15

    This report for the International Energy Agency (IEA) made by Task 9 of the Photovoltaic Power Systems (PVPS) programme takes a look at the role of quality management, hardware certification and accredited training in PV programmes in developing countries. The objective of this document is to provide assistance to those project developers that are interested in implementing or improving support programmes for the deployment of PV systems for rural electrification. It is to enable them to address and implement quality assurance measures, with an emphasis on management, technical and training issues and other factors that should be considered for the sustainable implementation of rural electrification programmes. It is considered important that quality also addresses the socio-economic and the socio-technical aspects of a programme concept. The authors summarise that, for a PV programme, there are three important areas of quality control to be implemented: quality management, technical standards and quality of training.

  11. [Applicability and perceived utility of the European Quality Instrument for Health Promotion (EQUIHP) in a health promotion programme].

    Science.gov (United States)

    Cerdá-Gómez, Rebeca; Paredes-Carbonell, Joan J; López-Sánchez, M Pilar

    2017-03-23

    To describe the results of applying the European Quality Instrument for Health Promotion (EQUIHP) tool in the MIHsalud programme and to discuss its perceived utility by the programme's team members. Evaluation study applying EQUIHP to a health promotion programme. A total of ten MIHsalud staff (eight women and two men) completed the EQUIHP and participated in two group interviews to discuss its perceived utility. The programme obtained a total score of 6.5 points out of 10 in quality. The use of EQUIHP enabled the programme's weaknesses to be identified, such as lack of a communication plan, evaluability and sustainability; as well as its strengths, such as the inclusion of health promotion principles. The MIHsalud team believes that the EQUIHP is a useful tool which can facilitate a comprehensive evaluation of the programme in terms of a health promotion initiative. The use of the EQUIHP has made it possible to evaluate the quality of the programme and to make recommendations for its improvement, and it could be applied to other programmes and activities. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. Programme Reporting Standards (PRS) for improving the reporting of sexual, reproductive, maternal, newborn, child and adolescent health programmes.

    Science.gov (United States)

    Kågesten, Anna E; Tunçalp, Özge; Portela, Anayda; Ali, Moazzam; Tran, Nhan; Gülmezoglu, A Metin

    2017-08-03

    Information about design, implementation, monitoring and evaluation is central to understand the impact of programmes within the field of sexual, reproductive, maternal, newborn, child and adolescent health (SRMNCAH). Existing reporting guidelines do not orient on reporting of contextual and implementation issues in sufficient detail. We therefore developed Programme Reporting Standards (PRS) to be used by SRMNCAH programme implementers and researchers. Building on the first step of the PRS development (a systematic review to identify reporting items), we conducted a three-round online Delphi consensus survey with experts. Consensus was defined a-priori as 80% agreement of items as essential. This was followed by a technical consultation with a group of experts to refine the items, definitions and their structuring. The revised PRS was piloted to assess its relevance to current SRMNCAH programme reports and identify key issues regarding the use of the PRS. Of the 81 participants invited to the Delphi survey, 20 responded to all three rounds. In the final round, 27 items received consensus as essential; three items were ranked as "borderline" essential; 20 items as supplementary. The items were subsequently revised, followed by a technical consultation with 29 experts to further review and refine the PRS. The feedback resulted in substantial changes to the structure and content of the PRS into 24 items across five domains: Programme overview; Programme components and implementation; Monitoring of Implementation; Evaluation and Results; and Synthesis. This version was used in a piloting exercise, where questions regarding how much information to report and how to comment on the quality of the information reported were addressed. All items were kept in the PRS following the pilot although minor changes were made to the flow and description of items. The PRS 1.0 is the result of a structured, collaborative process, including methods to incorporate input from SRMNCAH

  13. Can digital tools be used for improving immunization programmes?

    Directory of Open Access Journals (Sweden)

    Alberto Eugenio Tozzi

    2016-03-01

    Full Text Available In order to successfully control and eliminate vaccine-preventable infectious diseases, an appropriate vaccine coverage has to be achieved and maintained. This task requires a high level of effort, as it may be compromised by a number of barriers. Public health agencies have issued specific recommendations to address these barriers and therefore improve immunization programmes. In the present review, we characterize issues and challenges of immunization programmes for which digital tools are a potential solution. In particular, we explore previously published research on the use of digital tools in the following vaccine-related areas: immunization registries, dose tracking, and decision support systems; vaccine preventable diseases surveillance; surveillance of adverse events following immunizations; vaccine confidence monitoring; delivery of information on vaccines to the public. Subsequently, we analyze the limits of the use of digital tools in such contexts and envision future possibilities and challenges.

  14. One-year effect of a supervised exercise programme on functional capacity and quality of life in peripheral arterial disease.

    OpenAIRE

    Guidon, Marie; McGee, Hannah

    2013-01-01

    PURPOSE: Peripheral arterial disease (PAD) is a chronic, progressive disease with a significant cardiovascular and cerebrovascular risk burden and a considerable impact on functional capacity and quality of life (QoL). Exercise programmes result in significant improvements in walking distances but long-term effects are uncertain. The aim of this study was to assess the one-year effects of participation in a 12-week supervised exercise programme on functional capacity and QoL for PAD patients....

  15. Quality Improvement of Concrete Articles

    Directory of Open Access Journals (Sweden)

    Svatovskaya Larisa

    2016-01-01

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

  16. Evaluating the Quality of BEd Programme: Students' Views of Their College Experiences

    Science.gov (United States)

    Khan, Shafqat Hussain; Saeed, Muhammad

    2010-01-01

    Quality assurance of teacher training has become of a great concern nowadays. This paper addresses the quality of BEd programme of the University of Education (UE) Lahore. The main purpose of the study was to evaluate the quality of BEd programme with regard to the internal efficiency of Government Colleges for Elementary Teachers (GCETs), the…

  17. Dairy processing, Improving quality

    NARCIS (Netherlands)

    Smit, G.

    2003-01-01

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

  18. Review of SKB's Quality Assurance Programme

    Energy Technology Data Exchange (ETDEWEB)

    Baldwin, Tamara D.; Hicks, Timothy W. (Galson Sciences LTD, Oakham, Rutland (United Kingdom))

    2009-06-15

    SKB is preparing a license application for the construction of a final repository for spent nuclear fuel in Sweden. This application will be supported by the safety assessment SR-Site for the post-closure phase. The assessment of long-term safety is based on a broad range of experimental results from laboratory scale, intermediate scale and up to full scale experiments. It is essential that there is a satisfactory level of assurance that experiments have been carried of with sufficient quality, so that results can be considered to be reliable within the context of their use in safety assessment. SSM has initiated a series of reviews of SKB's methods of quality assurance and their implementation. This project includes reviews of the quality assurance (QA) procedures and instructions that have been prepared for the SR-Site assessment as well as reviews of QA implementation at the canister and buffer/backfill laboratories in Oskarshamn, Sweden. The purpose of this project is to assess SKB's quality assurance with the view of providing a good basis for subsequent quality reviews in the context of future licensing. This has been achieved by examination of a number of SKB experiments using a check list, visits to the relevant facilities, and meetings with contractors and a few members of the SKB staff. Overall, the reviewed set of QA documents and instructions do provide reasonably comprehensive coverage of quality-affecting issues relating to the SR-Site safety assessment and, if implemented correctly, will generate confidence in the reliability of the safety assessment results. The results show that the efforts involving quality assurance are increasing within the SKB programme and in general appear to be satisfactory for ongoing experiments and measurements. However, progress in development of the QA documents and instructions has been relatively recent and it may be difficult for these to be fully implemented in the short period remaining before the planned

  19. Review of SKB's Quality Assurance Programme

    Energy Technology Data Exchange (ETDEWEB)

    Baldwin, Tamara D.; Hicks, Timothy W. (Galson Sciences LTD, Oakham, Rutland (United Kingdom))

    2009-06-15

    SKB is preparing a license application for the construction of a final repository for spent nuclear fuel in Sweden. This application will be supported by the safety assessment SR-Site for the post-closure phase. The assessment of long-term safety is based on a broad range of experimental results from laboratory scale, intermediate scale and up to full scale experiments. It is essential that there is a satisfactory level of assurance that experiments have been carried of with sufficient quality, so that results can be considered to be reliable within the context of their use in safety assessment. SSM has initiated a series of reviews of SKB's methods of quality assurance and their implementation. This project includes reviews of the quality assurance (QA) procedures and instructions that have been prepared for the SR-Site assessment as well as reviews of QA implementation at the canister and buffer/backfill laboratories in Oskarshamn, Sweden. The purpose of this project is to assess SKB's quality assurance with the view of providing a good basis for subsequent quality reviews in the context of future licensing. This has been achieved by examination of a number of SKB experiments using a check list, visits to the relevant facilities, and meetings with contractors and a few members of the SKB staff. Overall, the reviewed set of QA documents and instructions do provide reasonably comprehensive coverage of quality-affecting issues relating to the SR-Site safety assessment and, if implemented correctly, will generate confidence in the reliability of the safety assessment results. The results show that the efforts involving quality assurance are increasing within the SKB programme and in general appear to be satisfactory for ongoing experiments and measurements. However, progress in development of the QA documents and instructions has been relatively recent and it may be difficult for these to be fully implemented in the short period remaining before the planned

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

    Science.gov (United States)

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

    2012-07-01

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

  1. A review of how the quality of HIV clinical services has been evaluated or improved.

    Science.gov (United States)

    Hung, Anna; Pradel, Françoise

    2015-06-01

    To examine approaches being used to evaluate and improve quality of HIV clinical services we searched the MEDLINE, Cochrane Library collection, EMBASE, Global Health, and Web of Science databases for articles and abstracts focused on evaluating or improving quality of HIV clinical services. We extracted country income level, targeted clinical services, and quality evaluation approaches, data sources, and criteria. Fifty journal articles and 46 meeting abstracts were included. Of the 96 studies reviewed, 65% were programme evaluations, 71% focused on low- and middle-income countries, and 65% focused on antiretroviral therapy services. With regard to quality, 45% used a quality improvement model or programme, 13% set a quality threshold, and 51% examined patient records to evaluate quality. No studies provided a definition for quality HIV care. Quality assurance and improvement of HIV clinical services is increasingly important. This review highlights gaps in knowledge for future research, and may also help countries and programmes develop their HIV care quality improvement frameworks.

  2. 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.

  3. PROGRAMME

    African Journals Online (AJOL)

    MEASUREMENT OF SURVIVAL IN A PRIVATE. SECTOR HIV/AIDS DISEASE ... during the first 4 years of the programme was published in 2003.' The purpose of this ... that their scheme offers a Dl\\/IP, and must be willing to disclose their HlV ...

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

    Science.gov (United States)

    Runnacles, Jane; Roueché, Alice

    2015-08-01

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

  5. Multimethod study of a large-scale programme to improve patient safety using a harm-free care approach

    Science.gov (United States)

    Power, Maxine; Brewster, Liz; Parry, Gareth; Brotherton, Ailsa; Minion, Joel; Ozieranski, Piotr; McNicol, Sarah; Harrison, Abigail; Dixon-Woods, Mary

    2016-01-01

    Objectives We aimed to evaluate whether a large-scale two-phase quality improvement programme achieved its aims and to characterise the influences on achievement. Setting National Health Service (NHS) in England. Participants NHS staff. Interventions The programme sought to (1) develop a shared national, regional and locally aligned safety focus for 4 high-cost, high volume harms; (2) establish a new measurement system based on a composite measure of ‘harm-free’ care and (3) deliver improved outcomes. Phase I involved a quality improvement collaborative intended to involve 100 organisations; phase II used financial incentives for data collection. Measures Multimethod evaluation of the programme. In phase I, analysis of regional plans and of rates of data submission and clinical outcomes reported to the programme. A concurrent process evaluation was conducted of phase I, but only data on submission rates and clinical outcomes were available for phase II. Results A context of extreme policy-related structural turbulence impacted strongly on phase I. Most regions' plans did not demonstrate full alignment with the national programme; most fell short of recruitment targets and attrition in attendance at the collaborative meetings occurred over time. Though collaborative participants saw the principles underlying the programme as attractive, useful and innovative, they often struggled to convert enthusiasm into change. Developing the measurement system was arduous, yet continued to be met by controversy. Data submission rates remained patchy throughout phase I but improved in reach and consistency in phase II in response to financial incentives. Some evidence of improvement in clinical outcomes over time could be detected but was hard to interpret owing to variability in the denominators. Conclusions These findings offer important lessons for large-scale improvement programmes, particularly when they seek to develop novel concepts and measures. External contexts may

  6. Implementation quality of family literacy programmes: a review of literature

    NARCIS (Netherlands)

    Rie, S. de la; Steensel, R. van; Gelderen, A.J.S. van

    2016-01-01

    Raising the literacy levels of young children is a major concern in many countries for which various programmes have been suggested. One of these is family literacy programmes. In previous meta-analyses wide variability in effects has been found and it has been suggested that this is partly caused b

  7. An Investigation of Learning Efficacy, Management Difficulties and Improvements in Tertiary CLIL (Content and Language Integrated Learning) Programmes in Taiwan: A Survey of Stakeholder Perspectives

    Science.gov (United States)

    Yang, Wenhsien

    2016-01-01

    In 2011, Taiwan's Ministry of Education conducted a national-scale appraisal of 92 CLIL programmes. However, we lack an effective model for examining by precisely how much improvement in the quality of the CLIL programmes will rise as a consequence of the increased language proficiency and the acquisition of disciplinary knowledge. To gain greater…

  8. Practice-based collection of quality indicator data for a comprehensive quality assessment programme in Canadian family practices.

    Science.gov (United States)

    Price, David; Howard, Michelle; Dolovich, Lisa; Laryea, Stephanie; Hilts, Linda; Barbara, Angela

    2010-12-01

    Quality improvement in primary care can be facilitated by the ability to measure indicators in practice. This paper reports on the process and impacts of data collection on indicators of a quality assessment tool in seven interprofessional group family practices in Ontario, Canada. The programme addressed indicators and collected data across multiple domains of practice including clinical quality, physical factors, and patient and staff perceptions. A system audit of the practice, a patient survey, a staff satisfaction survey and chart audits (on hypothyroidism and hyperlipidaemia) were designed to measure selected indicators across the domains. Practices were trained and collected their own data. Practices provided feedback on the process and impacts during a postprogramme workshop and on a survey 1 year later. Four-hundred charts audits were completed for each of hyperlipidaemia and hypothyroidism, 319 patient satisfaction surveys were administered in four practices, and the staff satisfaction survey was completed by 77 staff in six practices. Most practices demonstrated indicators of privacy, access and safety. There was more variability in indicators relating to staff professional development and team involvement in meetings. Patient satisfaction with providers was rated highly, whereas some aspects of practice access were rated lower. Practices approached the challenge of participation by engaging multidisciplinary team members and dividing tasks. Most practices reported continued participation in various quality improvement initiatives 1 year later. Using a set of indicators, structured processes and training, family practices find the process of gathering and reviewing their data useful for quality improvement.

  9. Rice Quality Improvement in China

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

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

  10. 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.

  11. Evaluation of a continuous improvement programme of enhanced recovery after caesarean delivery under neuraxial anaesthesia.

    Science.gov (United States)

    Deniau, Benjamin; Bouhadjari, Nacima; Faitot, Valentina; Mortazavi, Antoine; Kayem, Gilles; Mandelbrot, Laurent; Keita, Hawa

    2016-12-01

    To assess the performance of a multidisciplinary programme for enhanced recovery after caesarean delivery under neuraxial anaesthesia. Prospective single-centre study. Programme in 6 steps including 3 professional practice audits based on clinical records and questioning patients: audit T0, first "existing state", creation of a working group, drafting and implementation of a multidisciplinary rehabilitation procedure, second audit (T0+4 months), information about and implementation of corrective measures and a third audit (T0+8 months). Assessment of the performance of the continuous improvement programmes based on six measures comprising the post-caesarean rehabilitation score: duration infusion, early oral analgesia, time to removal of the urinary catheter, time to return to drinking, eating recovery time, use of carbetocin. Two hundred and thirty-one patients were included, with 45, 64 and 122 patients at T0, T0+4 months and T0+8 months, respectively. There was a significant increase in patients who received the recovery measures (P<0.0001 for all items) between T0 and T0+8 months: removal of the infusion before 24h (49% versus 93.5%), drinking before 6h (31% versus 55%), eating before 6h (2% versus 38.5%), early oral analgesia before 24h (38% versus 95%), withdrawal of the urinary catheter before 24h (80% versus 95%), use of carbetocin (0% versus 99%). Improved practices in rehabilitation after caesarean can be obtained by setting up a multidisciplinary programme as part of a quality approach. Copyright © 2016 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

  12. Continuous improvement of software quality

    Energy Technology Data Exchange (ETDEWEB)

    Sivertsen, Terje

    1999-04-15

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

  13. Continuous Improvement in the Industrial and Management Systems Engineering Programme at Kuwait University

    Science.gov (United States)

    Aldowaisan, Tariq; Allahverdi, Ali

    2016-01-01

    This paper describes the process employed by the Industrial and Management Systems Engineering programme at Kuwait University to continuously improve the programme. Using a continuous improvement framework, the paper demonstrates how various qualitative and quantitative analyses methods, such as hypothesis testing and control charts, have been…

  14. Continuous Improvement in the Industrial and Management Systems Engineering Programme at Kuwait University

    Science.gov (United States)

    Aldowaisan, Tariq; Allahverdi, Ali

    2016-01-01

    This paper describes the process employed by the Industrial and Management Systems Engineering programme at Kuwait University to continuously improve the programme. Using a continuous improvement framework, the paper demonstrates how various qualitative and quantitative analyses methods, such as hypothesis testing and control charts, have been…

  15. Mindfulness-based cancer stress management: impact of a mindfulness-based programme on psychological distress and quality of life.

    Science.gov (United States)

    Fish, J A; Ettridge, K; Sharplin, G R; Hancock, B; Knott, V E

    2014-05-01

    Within the area of cancer care, mindfulness-based therapeutic interventions have been found to be efficacious in reducing psychological distress related to a cancer diagnosis; however, the impact of mindfulness-based interventions on quality of life is unclear. This study explores the impact of a Mindfulness-Based Cancer Stress Management programme on psychological distress and quality of life. Research methodology included a single-group quasi-experimental study of 26 participants experiencing distress related to a cancer diagnosis, including carers, who completed an MBCSM programme and all assessments. Participants completed the Functional Assessment of Cancer Therapy - General version 4 (FACT-G) and its associated spirituality index (FACIT-Sp-Ex), Hospital Anxiety and Depression Scale (HADS), Freiburg Mindfulness Inventory (FMI), and the Distress Thermometer at baseline, post-intervention, and three months after programme completion. Significant improvements were observed on all measures (ranges: P ≤ 0.001 to 0.008, r = -0.53 to -0.79) following the intervention, which were maintained at 3-month follow-up. Mindfulness was significantly correlated with all main outcome measures at post-intervention (range: r = -0.41 to 0.67) and 3-month follow-up (range: r = -0.49 to 0.73), providing evidence for the internal validity of the study. Our findings indicate that the MBCSM programme is effective in reducing psychological distress and improving quality of life, including spiritual well-being.

  16. Quality assurance and quality control programme in the Personal Dosimetry Department of the Greek Atomic Energy Commission.

    Science.gov (United States)

    Kamenopoulou, V; Drikos, G; Carinou, E; Papadomarkaki, E; Askounis, P; Kyrgiakou, H; Kefalonitis, N

    2002-01-01

    A quality assurance (QA) and quality control (QC) programme was applied to the personal monitoring department (TLD based) of the Greek Atomic Energy Commission (GAEC). This programme was designed according to the recommendations of international bodies such as the International Organization for Standardization (ISO), the International Electrotechnical Commission (IEC), the International Atomic Energy Agency (IAEA) and the European Commission (CEC). This paper deals with the presentation of the QA/QC programme which includes administrative data and information, technical checking of the equipment, acceptance tests of new equipment and dosemeters, issuing and processing of the dosemeters, dose evaluation, record keeping and reporting, traceability and reproducibility, handling of complaints, internal reviews and external audits.

  17. LANGUAGE AWARENESS IN THE LANGUAGE IMPROVEMENT COMPONENT OF AN ESP PROGRAMME

    Institute of Scientific and Technical Information of China (English)

    1997-01-01

    When talking about the roles of an EFL teacher trainee,Edge identifies three major roles:as alanguage user,a language analyst,and a language teacher.With reference to these three roles,Edgegoes on to suggest three major course components for an EFL teacher training programme:languagecomponents for an EFL teacher training programme:language improvement,language studies,andteaching methodology(1988).The present ESP programme in Zhejiang University,a post-graduatecertificate level teacher training programme,basically comprises these three components.Forlanguage improvement,such courses as"Advanced General English"."Academic Listening & Note-taking"."Academic Writing"are offered.

  18. Understanding and improving access to prompt and effective malaria treatment and care in rural Tanzania: the ACCESS Programme

    Directory of Open Access Journals (Sweden)

    Alba Sandra

    2007-06-01

    Full Text Available Abstract Background Prompt access to effective treatment is central in the fight against malaria. However, a variety of interlinked factors at household and health system level influence access to timely and appropriate treatment and care. Furthermore, access may be influenced by global and national health policies. As a consequence, many malaria episodes in highly endemic countries are not treated appropriately. Project The ACCESS Programme aims at understanding and improving access to prompt and effective malaria treatment and care in a rural Tanzanian setting. The programme's strategy is based on a set of integrated interventions, including social marketing for improved care seeking at community level as well as strengthening of quality of care at health facilities. This is complemented by a project that aims to improve the performance of drug stores. The interventions are accompanied by a comprehensive set of monitoring and evaluation activities measuring the programme's performance and (health impact. Baseline data demonstrated heterogeneity in the availability of malaria treatment, unavailability of medicines and treatment providers in certain areas as well as quality problems with regard to drugs and services. Conclusion The ACCESS Programme is a combination of multiple complementary interventions with a strong evaluation component. With this approach, ACCESS aims to contribute to the development of a more comprehensive access framework and to inform and support public health professionals and policy-makers in the delivery of improved health services.

  19. Inland Water Quality Assessment--A Joint European Masters Programme

    Science.gov (United States)

    Waara, K. -O.; Petersen, A.; Lanaras, T.; Paulauskas, V.; Kleiven, S.; Crosa, G.; Penttinen, O. -P.; Quesada, A.; Kovats, N.; Galinou-Mitsoudi, S.; Lapinska, M.; Newton, A.; Balode, M.; Hindak, F.; Marsalek, B.

    2006-01-01

    At present, there is a European shortage of personnel qualified to adequately address the comprehensive scientific and regulatory requirements of the Water Framework Directive (WFD). The joint Masters programme described in this paper will provide students with the requisite expert knowledge and skills to progress the implementation of the WFD.…

  20. Learning leadership skills in practice through quality improvement.

    Science.gov (United States)

    Gamble, James; Vaux, Emma

    2014-02-01

    The development of leadership skills in doctors in training is essential to support both their professional development and the future supply of clinical leaders the NHS so desperately needs. There is, however, limited opportunity in current training programmes for trainees to learn and develop these skills, and what opportunity there is has often focused on management rather than leadership skills. Involvement in trainee-led supported quality improvement projects can teach these skills. We summarise the current limitations in leadership training and discuss how the College's 'Learning To Make a Difference' programme, and others like it, are helping to teach leadership.

  1. THE INFLUENCE OF ORGANISATIONAL CULTURE ON THE TOTAL QUALITY MANAGEMENT PROGRAMME PERFORMANCE

    Directory of Open Access Journals (Sweden)

    Roldán, José L.

    2012-09-01

    Full Text Available This paper aims to examine the relationships between different types of cultures and effectiveness in Total Quality Management (TQM implementation. Using Cameron’s framework, we have tested the connection between a quality culture taxonomy and TQM programme performance using data from a survey carried out with 113 Spanish companies that have implemented TQM systems. A structural equation modelling is proposed to assess the links between both types of constructs using the Partial Least Squares (PLS technique. The most substantial results confirm, in the sample analysed, the relationship between quality culture types and the TQM programme performance, and there being different influence levels of the quality cultures.

  2. A novel method of assessing quality of postgraduate psychiatry training: experiences from a large training programme.

    Science.gov (United States)

    Bizrah, Mukhtar; Iacoponi, Eduardo; Parker, Elizabeth; Rymer, Janice; Iversen, Amy; Wessely, Simon

    2013-06-14

    Most assessments of the quality of postgraduate training are based on anonymised questionnaires of trainees. We report a comprehensive assessment of the quality of training at a large postgraduate psychiatry training institute using non-anonymised face-to-face interviews with trainees and their trainers. Two consultant psychiatrists interviewed 99 trainees and 109 trainers. Scoring of interview responses was determined by using a pre-defined criteria. Additional comments were recorded as free text. Interviews covered 13 domains, including: Clinical, teaching, research and management opportunities, clinical environment, clinical supervision, adequacy of job description, absence of bullying and job satisfaction. Multiple interview domain scores were combined, generating a 'Combined' score for each post. The interview response rate was 97% for trainers 88% for trainees. There was a significant correlation between trainee and trainer scores for the same interview domains (Pearson's r = 0.968, pJob satisfaction scores of year 1 to year 3 core trainees showed a significant increase with increasing seniority (Linear regression coefficient = 0.273, 95% CI: 0.033 to 0.513, ANOVA p= 0.026). This in-depth examination of the quality of training on a large psychiatry training programme successfully elicited strengths and weakness of our programme. Such an interview scheme could be easily implemented in smaller schemes and may well provide important information to allow for targeted improvement of training. Additionally, trends in quality of training and job satisfaction amongst various psychiatric specialities were identified; specifically speciality posts and liaison posts in psychiatry were revealed to be the most popular with trainees.

  3. The Improvement of Services Quality

    Directory of Open Access Journals (Sweden)

    Cristian-Ştefan Craciun

    2013-01-01

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

  4. Improving communication: a practical programme for teaching trainees about communication issues in the general practice consultation.

    Science.gov (United States)

    Boulton, M; Griffiths, J; Hall, D; McIntyre, M; Oliver, B; Woodward, J

    1984-07-01

    This paper describes a teaching programme, for use in general practice vocational training, which provides a theoretical and practical framework for exploring key aspects of the consultation with trainees. A particular emphasis is on the educational or 'cognitive' outcomes of the consultation and skills for improving them. The five stages of the programme are described and an example of experience of each stage is given. The paper concludes with an evaluation of the programme by the trainers, trainees and social scientist involved.

  5. Shipbuilding pipeline production quality improvement

    Directory of Open Access Journals (Sweden)

    T. Buksa

    2010-06-01

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

  6. Bridging the gap in sexual healthcare in nursing practice: implementing a sexual healthcare training programme to improve outcomes.

    Science.gov (United States)

    Sung, Su-Ching; Jiang, Huey-Hwa; Chen, Ru-Rong; Chao, Jian-Kang

    2016-10-01

    This study aimed to evaluate the effectiveness of a sexual healthcare training programme for clinical nurses, with respect to knowledge, attitudes and self-efficacy concerning sexual healthcare. Inadequate sexual healthcare can result in poor treatment and quality of life for patients. Few studies have examined the development of sexual healthcare and related interventions from nurses' perspectives. The study included two stages involving focus groups and a quasi-experimental design. The first stage consisted of an exploratory, descriptive session to assess nurses' perceptions and educational needs concerning sexual healthcare via two focus groups (N = 16). The second stage involved a quasi-experimental session to evaluate the training programme, based on the results of the first stage. In total, 117 nurses were recruited from a Taiwanese hospital; the experimental group (n = 59) completed a four-week (16 hours) training programme, and the control group (n = 58) did not participate in a training programme. Data were collected at four time points over 17 weeks. Longitudinal changes that occurred over time were examined using hierarchical linear models. The experimental group demonstrated significant improvements in knowledge (β = 0·16, p training programme for sexual healthcare could exert positive and beneficial effects on nurses' development of knowledge regarding sexual healthcare and clarify their values and attitudes. The training programme could reduce challenges related to sexual healthcare issues in nursing care. © 2016 John Wiley & Sons Ltd.

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

    Science.gov (United States)

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

    2005-01-01

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

  8. Improving Tools for JavaScript Programmers (Position Paper)

    DEFF Research Database (Denmark)

    Andreasen, Esben; Feldthaus, Asger; Jensen, Simon Holm;

    We present an overview of three research projects that all aim to provide better tools for JavaScript web application programmers1: TAJS, which infers static type information for JavaScript applications using dataflow analysis; JSRefac- tor, which enables sound code refactorings; and Artemis, which...

  9. Improving Tools for JavaScript Programmers (Position Paper)

    DEFF Research Database (Denmark)

    Andreasen, Esben; Feldthaus, Asger; Jensen, Simon Holm

    We present an overview of three research projects that all aim to provide better tools for JavaScript web application programmers1: TAJS, which infers static type information for JavaScript applications using dataflow analysis; JSRefac- tor, which enables sound code refactorings; and Artemis, which...

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

    Science.gov (United States)

    Sewell, N

    1997-01-01

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

  11. Impact of participation in a theatre programme on quality of life among older adults with chronic conditions: a pilot study.

    Science.gov (United States)

    Yuen, Hon Keung; Mueller, Kris; Mayor, Ellise; Azuero, Andres

    2011-12-01

    The purpose of this mixed methods study was to evaluate the effect of participation in the "Seasoned Arts At the Samford for You" (SAASY) programme, which included a 6-week acting class and four public performances, on the psychological well-being and health-related quality of life of older adults. Twelve older adults with chronic conditions from a low-income senior apartment and a senior living community participated in the programme. The acting class, led by two professional artists, met for a 2-hour class weekly for six weeks. Participants completed the General Well-being Schedule (GWBS) and the 36-Item Short-Form Health Survey (SF-36) both at the beginning of the programme and one month after the programme ended. In addition, participants were individually interviewed to explore the perceived impact of the theatre programme on their well-being. Participants reported a significantly higher score in the GWBS and on the physical but not on the mental component summary of the SF-36 at post-SAASY programme. Content analysis of the interview transcripts revealed that participants attained an improved sense of self-worth and self-advocacy and overcame self-imposed limitations. Results showed improvement in psychological well-being and health-related quality of life, most notably in the physical health component of SF-36 after participating in the programme. Practice implications for occupational therapists using drama as a creative leisure occupation to promote health among older adults with chronic conditions may involve analysis of participants' occupational profile, identification of deficit areas and adaptation of the acting programme content to meet specific needs and goals. The present study used a pretest and post test one group design that has numerous inherent limitations that affect the ability to make valid inferences from study findings. A more rigorous research design with a wait-listed control group and collection of outcome measures immediately after

  12. E-CUSTOMS PROGRAMME - NEW QUALITY OF SERVICES PROVIDED BY CUSTOMS ADMINISTRATIONS TO EUROPEAN BUSINESS

    Directory of Open Access Journals (Sweden)

    Małgorzata Czermińska

    2016-09-01

    Full Text Available E-Customs initiative includes a number of IT projects, organizational and legal measures. They are designed to creation of a simple and paperless environment for trade and customs, to short the duration of customs clearance and to ensure an appropriate level of security of commercial transactions. Modern customs administration must operate on the basis of advanced infrastructure in the field of information and communication technologies. Only then will it be able to provide cheaper and more efficient customs services. Therefore, the greatest challenge and the main goal of the e-Customs programme is to harmonize customs procedures and systems in the 28 Member States. The article describes the assumptions and objectives of the e-Customs, presents its genesis and evolution. Particular attention was paid to the activities that are aimed at improving the quality of customs services provided to European companies.

  13. Quality Assurance in Psychology Programmes across Europe: Survey and Reflections

    Science.gov (United States)

    Marques, J. Frederico

    2013-01-01

    The present article examines how different institutions that offer psychology study cycles across Europe have adopted quality principles and have taken up particular quality assurance initiatives to raise standards and enhance quality. Thirty-eight different institutions from 32 countries who were members of a European psychology network responded…

  14. Using Quality Function Deployment to Improve Reference Services Quality

    Directory of Open Access Journals (Sweden)

    Pao-Long Chang

    1996-12-01

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

  15. THE QUALITY OF THE WEB SITES FROM THE IIRC PILOT PROGRAMME

    Directory of Open Access Journals (Sweden)

    Ionelia-Alexandra FELDIOREANU

    2015-04-01

    Full Text Available This study aims to investigate the quality of the Web sites content of the companies from the IIRC Pilot Programme in 2013 and how corporations use their Web sites to emphasize the environmental responsibility. We try to determine the quality of the web sites of by the organizations included in the IIRC Pilot Programme in 2013 and their ability to support the access to environmental elements. In the first part, the paper tries to review the existing literature regarding the quality of the Web sites especially regarding their attitude towards presentations of the informations through their Web page. And in the second part we present our result.

  16. THE QUALITY OF THE WEB SITES FROM THE IIRC PILOT PROGRAMME

    Directory of Open Access Journals (Sweden)

    Ionelia-Alexandra FELDIOREANU

    2015-04-01

    Full Text Available This study aims to investigate the quality of the Web sites content of the companies from the IIRC Pilot Programme in 2013 and how corporations use their Web sites to emphasize the environmental responsibility. We try to determine the quality of the web sites of by the organizations included in the IIRC Pilot Programme in 2013 and their ability to support the access to environmental elements. In the first part, the paper tries to review the existing literature regarding the quality of the Web sites especially regarding their attitude towards presentations of the informations through their Web page. And in the second part we present our result.

  17. Quality of Individualised Education Programme Goals and Objectives for Preschool Children with Disabilities

    Science.gov (United States)

    Rakap, Salih

    2015-01-01

    Individualised education programmes (IEPs) are the road maps for individualising services for children with disabilities, specifically through the development of high-quality child goals/objectives. High-quality IEP goals/objectives that are developed based on a comprehensive assessment of child functioning and directly connected to intervention…

  18. Quality of Individualised Education Programme Goals and Objectives for Preschool Children with Disabilities

    Science.gov (United States)

    Rakap, Salih

    2015-01-01

    Individualised education programmes (IEPs) are the road maps for individualising services for children with disabilities, specifically through the development of high-quality child goals/objectives. High-quality IEP goals/objectives that are developed based on a comprehensive assessment of child functioning and directly connected to intervention…

  19. Power Quality Improvement Using UPQC

    Directory of Open Access Journals (Sweden)

    K. Kalaipriya

    2014-05-01

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

  20. Quality indicators for implementation of safety promotion: towards valid and reliable global certification of local programmes.

    Science.gov (United States)

    Timpka, Toomas; Nordqvist, Cecilia; Festin, Karin; Lindqvist, Kent

    2012-01-01

    The theoretical underpinnings of safety promotion have not yet been integrated with implementation practice to ascertain between-community programme quality. This study sets out to develop a framework for verifying of the quality of community-based safety-promotion programmes in the global context. We analysed the certification indicators deployed in the international Safe Community movement in light of systems theory. Data were collected from focus group interviews with representatives from 10 certified Swedish communities and then analysed by qualitative methods. The community representatives were found to have used the present indicators mainly for marketing the safety-promotion concept to stakeholders rather than as benchmarks for safety practice. When appraised in regard to systems theory, it was found that the indicators did not cover important aspects of health-services implementation. Attainment of outcomes at the population level was not included. Consequently, that information about programme effects in high-risk groups and in risk environments could be neglected. We conclude that programme processes and outcomes at both organisational and population levels must be assessed when the quality of safety-promotion programmes is being certified. A revised set of indicators for certification of safety-promotion programmes fulfilling these criteria is presented.

  1. From Inspection to School Improvement? Evaluating the Accelerated Inspection Programme in Waltham Forest.

    Science.gov (United States)

    Hopkins, David; Harris, Alma; Watling, Rob; Beresford, John

    1999-01-01

    Outlines the main findings from the evaluation of the Accelerated Inspection Programme (AIP) in Waltham Forest under three main phases (pre-inspection, inspection, and post inspection). Focuses on the relationship between inspection and school improvement. Discusses the recommendations. (CMK)

  2. The Features of Pyhsics Course Programmes in Terms Of Total Quality in General Secondary Schools (Lycees

    Directory of Open Access Journals (Sweden)

    Cenk AKAY

    2009-06-01

    Full Text Available Total Quality Management dates back to 19th century and it is not only a key factor in production sector but also a directing steer in education. Quality approach in education is fictialised on input-process-output trio. Stating a quality apprehension is directly proportional with the output. What effects the quality of output are everything related with education and school. There are different types of data collection instruments to present the tone constructed by existing situtation in education. The features of the pyhsics course programme in terms of total quality are founded by Six Sigma model in eight lycees in Mersin. The research showed that the features of the existing programme are not sufficient to answer the needs of the students, teachers and the director staff in schools. The study unearthed the substantial structure in schools and provided some solution offers for deficiencies in terms of total quality.

  3. Improving Maternal and Child Healthcare Programme Using Community-Participatory Interventions in Ebonyi State Nigeria

    Directory of Open Access Journals (Sweden)

    Chigozie Jesse Uneke

    2014-10-01

    Full Text Available In Nigeria, the government is implementing the Free Maternal and Child Health Care Programme (FMCHCP. The policy is premised on the notion that financial barriers are one of the most important constraints to equitable access and use of skilled maternal and child healthcare. In Ebonyi State, Southeastern Nigeria the FMCHCP is experiencing implementation challenges including: inadequate human resource for health, inadequate funding, out of stock syndrome, inadequate infrastructure, and poor staff remuneration. Furthermore, there is less emphasis on community involvement in the programme implementation. In this policy brief, we recommend policy options that emphasize the implementation of community-based participatory interventions to strengthen the government’s FMCHCP as follows: Option 1: Training community women on prenatal care, life-saving skills in case of emergency, reproductive health, care of the newborn and family planning. Option 2: Sensitizing the community women towards behavioural change, to understand what quality services that respond to their needs are but also to seek and demand for such. Option 3: Implementation packages that provide technical skills to women of childbearing age as well as mothers’ groups, and traditional birth attendants for better home-based maternal and child healthcare. The effectiveness of this approach has been demonstrated in a number of community-based participatory interventions, building on the idea that if community members take part in decision-making and bring local knowledge, experiences and problems to the fore, they are more likely to own and sustain solutions to improve their communities’ health.

  4. Research monitoring by US medical institutions to protect human subjects: compliance or quality improvement?

    Science.gov (United States)

    de Jong, Jean Philippe; van Zwieten, Myra C B; Willems, Dick L

    2013-04-01

    In recent years, to protect the rights and welfare of human subjects, institutions in the USA have begun to set up programmes to monitor ongoing medical research. These programmes provide routine, onsite oversight, and thus go beyond existing oversight such as investigating suspected misconduct or reviewing paperwork provided by investigators. However, because of a lack of guidelines and evidence, institutions have had little guidance in setting up their programmes. To help institutions make the right choices, we used interviews and document analysis to study how and why 11 US institutions have set up their monitoring programmes. Although these programmes varied considerably, we were able to distinguish two general types. 'Compliance' programmes on the one hand were part of the institutional review board office and set up to ensure compliance with regulations. Investigators' participation was mandatory. Monitors focused on documentation. Investigators could be disciplined, and could be obliged to take corrective actions. 'Quality-improvement' programmes on the other hand were part of a separate office. Investigators requested to be monitored. Monitors focused more on actual research conduct. Investigators and other parties received feedback on how to improve the research process. Although both types of programmes have their drawbacks and advantages, we argue that if institutions want to set up monitoring programmes, quality improvement is the better choice: it can help foster an atmosphere of trust between investigators and the institutional review board, and can help raise the standards for the protection of human subjects.

  5. Improving the Participation of Tribal Women in Developmental Programmes

    Directory of Open Access Journals (Sweden)

    R. Nisha

    2017-09-01

    Full Text Available Tribal women are gradually becoming integrated into village organizations. The present study was conducted among 120 tribal women respondents in four selected panchayats of Nilgiris district in Tamil Nadu. The respondents were selected using proportionate random sampling method. The data were collected from each respondent through a pre-tested interview schedule. The results were analysed with the help of statistical tools like mean, frequency and percentage. The results revealed that majority of the women respondents had more social taboos, superstitions and traditions as the major constraints in participating in various developmental programmes

  6. Improving Health and Quality of Life

    Science.gov (United States)

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

  7. Improvement in quality of hospital care during accreditation

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  8. Continuous improvement in the Industrial and Management Systems Engineering programme at Kuwait University

    Science.gov (United States)

    Aldowaisan, Tariq; Allahverdi, Ali

    2016-07-01

    This paper describes the process employed by the Industrial and Management Systems Engineering programme at Kuwait University to continuously improve the programme. Using a continuous improvement framework, the paper demonstrates how various qualitative and quantitative analyses methods, such as hypothesis testing and control charts, have been applied to the results of four assessment tools and other data sources to improve performance. Important improvements include the need to reconsider two student outcomes as they were difficult to implement in courses. In addition, through benchmarking and the engagement of Alumni and Employers, key decisions were made to improve the curriculum and enhance employability.

  9. The Danish air quality monitoring programme. Annual summary for 2008

    Energy Technology Data Exchange (ETDEWEB)

    Kemp, K.; Ellemann, T.; Brandt, J.; Christensen, Jesper; Ketzel, M.; Solvang Jensen, S.

    2010-06-15

    The air quality in Danish cities has been monitored continuously since 1982 within the Danish Air Quality Monitoring (LMP) network. The aim has been to follow the concentration levels of toxic pollutants in the urban atmosphere and to provide the necessary knowledge to assess the trends, to perform source apportionment, and to evaluate the chemical reactions and the dispersion of the pollutants in the atmosphere. In 2007 the air quality was measured in four Danish cities and at two background sites. Model calculations were also carried out to supplement the measurements. At several stations NO{sub 2} and PM{sub 10} were found in concentrations above EU limit values, which the Member States have to comply with in 2005 and 2010. The concentrations for most pollutants have been strongly decreasing since 1982, however, only a slight decrease has been observed for NO{sub 2} and O{sub 3}. (author)

  10. The Danish air quality monitoring programme. Annual Summary for 2007

    Energy Technology Data Exchange (ETDEWEB)

    Kemp, K.; Ellemann, T.; Brandt, J.; Christensen, Jesper; Ketzel, M.; Solvang Jensen, S.

    2008-07-15

    The air quality in Danish cities has been monitored continuously since 1982 within the Danish Air Quality Monitoring (LMP) network. The aim has been to follow the concentration levels of toxic pollutants in the urban atmosphere and to provide the necessary knowledge to assess the trends, to perform source apportionment, and to evaluate the chemical reactions and the dispersion of the pollutants in the atmosphere. In 2007 the air quality was measured in four Danish cities and at two background sites. Model calculations were also carried out to supplement the measurements. At several stations NO{sub 2} and PM{sub 10} were found in concentrations above EU limit values, which the Member States have to comply with in 2005 and 2010. The concentrations for most pollutants have been strongly decreasing since 1982, however, only a slight decrease has been observed for NO{sub 2} and O{sub 3}. (au)

  11. The Danish air quality monitoring programme. Annual Summary for 2006

    Energy Technology Data Exchange (ETDEWEB)

    Kemp, K.; Ellemann, T.; Brandt, J.; Christensen, Jesper; Ketzel, M.

    2007-06-15

    The air quality in Danish cities has been monitored continuously since 1982 within the Danish Air Quality Monitoring (LMP) network. The aim has been to monitor the levels of toxic pollutants in the urban atmosphere and to provide the necessary knowledge to assess the concentration trends, to perform source apportionment, and to evaluate the chemical reactions and the dispersion of the pollutants in the atmosphere. In 2006 the air quality was measured in four Danish cities and at two background sites. Besides this model calculations were carried out to supplement the measurements. NO{sub 2} and PM{sub 10} were at several stations found in concentrations above EU limit values, which the Member States have to comply 2005 and in 2010. While the concentrations for most other pollutants have been strongly decreasing since 1982, only a minor decrease has been observed for NO{sub 2} and O{sub 3}. (au)

  12. Preanalytical quality improvement : in quality we trust

    NARCIS (Netherlands)

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

    2013-01-01

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

  13. Preanalytical quality improvement : in quality we trust

    NARCIS (Netherlands)

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

    2013-01-01

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

  14. Creating a sustainable culture of quality through the SLMTA programme in a district hospital laboratory in Kenya

    Directory of Open Access Journals (Sweden)

    Phidelis M. Maruti

    2014-09-01

    Full Text Available Background: Bungoma District Hospital Laboratory (BDHL, which supports a 200-bed referral facility, began its Strengthening Laboratory Management Toward Accreditation (SLMTA journey in 2011 together with eight other laboratories in the second round of SLMTA rollout in Kenya.Objectives: To describe how the SLMTA programme and enhanced quality interventions changed the culture and management style at BDHL and instilled a quality system designed to sustain progress for years to come.Methods: SLMTA implementation followed the standard three-workshop series, mentorship site visits and audits. In order to build sustainability of progress, BDHL integrated quality improvement processes into its daily operations. The lab undertook a process of changing its internal culture to align all hospital stakeholders – including upper management, clinicians, laboratory staff and maintenance staff – to the mission of sustainable quality practices at BDHL.Results: After 16 months in the SLMTA programme, BDHL improved from zero stars (38% to four stars (89%. Over a period of two to three years, external quality assessment results improved from 47% to 87%; staff punctuality increased from 49% to 82%; clinician complaints decreased from 83% to 16; rejection rates decreased from 12% to 3%; and annual equipment repairs decreased from 40 to 15. Twelve months later the laboratory scored three stars (81% in an external surveillance audit conducted by Kenya Accreditation Service (KENAS.Conclusion: Management buy-in, staff participation, use of progress-monitoring tools and feedback systems, as well as incorporation of improvement processes into routine daily activities, were vital in developing and sustaining a culture of quality improvement.

  15. Effect of a 10-week yoga programme on the quality of life of women after breast cancer surgery

    Directory of Open Access Journals (Sweden)

    Aleksandra Andysz

    2014-06-01

    Full Text Available Aim of the study : The following research is aimed at determining the effect of yoga on the quality of life of women after breast cancer surgery. Material and methods : A 10-week yoga programme included 90-minute yoga lessons once a week. To estimate the quality of life, questionnaires developed by the European Organisation for Research and Treatment of Cancer (QLQ-C30 and QLQ-BR23 were used. An experimental group consisted of 12 women who practised yoga, a control group – of 16 women who did not. Between groups there were no differences in age, time from operation and characteristics associated with disease, treatment and participation in rehabilitation. Results : Our results revealed an improvement of general health and quality of life, physical and social functioning as well as a reduction of difficulties in daily activities among exercising women. Also their future prospects enhanced – they worried less about their health than they used to before participating in the programme. As compared to baseline, among exercising women, fatigue, dyspnoea and discomfort (pain, swelling, sensitivity in the arm and breast on the operated side decreased. Conclusions : Participation in the exercising programme resulted in an improvement of physical functioning, reduction of fatigue, dyspnoea, and discomfort in the area of the breast and arm on the operated side. Based on our results and those obtained in foreign studies, we conclude that rehabilitation with the use of yoga practice improves the quality of life of the patients after breast cancer surgery. However, we recommend further research on this issue in Poland.

  16. The Danish air quality monitoring programme. Annual summary for 2011

    Energy Technology Data Exchange (ETDEWEB)

    Ellemann, T.; Klenoe Noejgaard, J.; Nordstroem, C.; Brandt, J.; Christensen, Jesper; Ketzel, M.; Solvang Jensen, S.

    2012-10-15

    The air quality in Danish cities has been monitored continuously since 1982 within the Danish Air Quality Monitoring network. The aim is to follow the concentration levels of toxic pollutants in the urban atmosphere and to provide the necessary knowledge to assess the trends, to perform source apportionment, and to understand the governing processes that determine the level of air pollution in Denmark. In 2011 the air quality was measured in four Danish cities and at two background sites. In addition model calculations were carried out to supplement the measurements. At one street station (H.C. Andersens Boulevard) in Copenhagen NO{sub 2} was found in concentrations above EU limit values while NO{sub 2} levels in Odense, Aarhus and Aalborg were below the limit value. Model calculations indicate exceedances of NO{sub 2} limit values at several streets in Copenhagen. Annual averages of PM{sub 10} and PM{sub 2.5} were below limit values at all stations. However, concentrations levels in Copenhagen exceeded the daily limit value for PM{sub 10}. Winter salting of roads was one of the main reasons for this exceedance. The concentrations for most pollutants have been strongly decreasing during the last decades, however, only a slight decrease has been observed for NO{sub 2} and O{sub 3}. (Author)

  17. The Danish air quality monitoring programme. Annual summary for 2012

    Energy Technology Data Exchange (ETDEWEB)

    Ellermann, T.; Klenoe Noejgaard, J.; Nordstroem, C.; Brandt, J.; Christensen, Jesper; Ketzel, M.; Jansen, S.; Massling, A.; Solvang Jensen, S.

    2013-10-15

    The air quality in Danish cities has been monitored continuously since 1982 within the Danish Air Quality Monitoring network. The aim is to follow the concentration levels of toxic pollutants in the urban atmosphere and to provide the necessary knowledge to assess the trends, to perform source apportionment, and to understand the governing processes that determine the level of air pollution in Denmark. In 2012 the air quality was measured in four Danish cities and at two background sites. In addition model calculations were carried out to supplement the measurements. At one street station (H.C. Andersens Boulevard) in Copenhagen NO{sub 2} was found in concentrations above EU limit values while NO{sub 2} levels in Odense, Aarhus and Aalborg were below the limit value. Model calculations indicate exceedances of NO{sub 2} limit values at several streets in Copenhagen. Annual averages of PM{sub 10} and PM{sub 2.5} were below limit values at all stations. The concentrations for most pollutants have been decreasing during the last decades. (Author)

  18. A model of quality assurance and quality improvement for post-graduate medical education in Europe.

    Science.gov (United States)

    Da Dalt, Liviana; Callegaro, Silvia; Mazzi, Anna; Scipioni, Antonio; Lago, Paola; Chiozza, Maria L; Zacchello, Franco; Perilongo, Giorgio

    2010-01-01

    The issue of quality assurance (QA) and quality improvement (QI), being the quality of medical education intimately related to the quality of the health care, is becoming of paramount importance worldwide. To describe a model of implementing a system for internal QA and QI within a post-graduate paediatric training programme based on the ISO 9001:2000 standard. For the ISO 9001:2000 standard, the curriculum was managed as a series of interrelated processes and their level of function was monitored by ad hoc elaborated objective indicators. The training programme was fragmented in 19 interlinked processes, 15 related procedures and 24 working instructions. All these materials, along with the quality policy, the mission, the strategies and the values were made publicly available. Based on the measurable indicators developed to monitor some of the processes, areas of weakness of the system were objectively identified and consequently QI actions implemented. The appropriateness of all this allowed the programme to finally achieve an official ISO 9000:2001 certification. The application of the ISO 9001:2000 standard served to develop an internal QA and QI system and to meet most of the standards developed for QA in higher and medical education.

  19. Milk quality assurance programmes for paratuberculosis: stochastic simulation of within-herd infection dynamics and economics

    NARCIS (Netherlands)

    Weber, M.F.; Roermund, van H.J.W.; Velthuis, A.G.J.; Koeijer, de A.A.; Jong, de M.C.M.; Nielen, M.W.F.

    2005-01-01

    A bulk milk quality assurance programme for Mycobacterium avium subsp. paratuberculosis (Map) in dairy herds was simulated. Herds were certified as `low-Map bulk milk¿ if, with a certain probability, the concentration of Map in bulk milk did not exceed a maximum acceptable concentration (MAC). The M

  20. Strategies for Enhancing Quality Assurance in Business Teacher Education Programme in Nigerian Universities

    Science.gov (United States)

    Okoro, James

    2015-01-01

    This study investigated the strategies for enhancing quality assurance in business teacher education programme in Nigerian universities. Two research questions and four hypotheses guided the study. This study adopted a descriptive survey design. The population of the study comprised 129 Business Education lecturers in state and federal…

  1. Stakeholders' Cooperation in the Study Programme Quality Assurance: Theory and Practice in Lithuania

    Science.gov (United States)

    Pileicikiene, Nora

    2011-01-01

    The cooperation of various stakeholders' groups is a prerequisite to develop and realise high-quality study programmes, i.e. during studies to develop skills that are relevant to the labour market and social life. In order to achieve effective stakeholders' cooperation, it is necessary to identify stakeholder's groups relevant to a study programme…

  2. Bioindicators of changes in water quality on coral reefs: review and recommendations for monitoring programmes

    Science.gov (United States)

    Cooper, T. F.; Gilmour, J. P.; Fabricius, K. E.

    2009-09-01

    Effective environmental management requires monitoring programmes that provide specific links between changes in environmental conditions and ecosystem health. This article reviews the suitability of a range of bioindicators for use in monitoring programmes that link changes in water quality to changes in the condition of coral-reef ecosystems. From the literature, 21 candidate bioindicators were identified, whose responses to changes in water quality varied spatially and temporally; responses ranged from rapid (hours) changes within individual corals to long-term (years) changes in community composition. From this list, the most suitable bioindicators were identified by determining whether responses were (i) specific, (ii) monotonic, (iii) variable, (iv) practical and (v) ecologically relevant to management goals. For long-term monitoring programmes that aim to quantify the effects of chronic changes in water quality, 11 bioindicators were selected: symbiont photophysiology, colony brightness, tissue thickness and surface rugosity of massive corals, skeletal elemental and isotopic composition, abundance of macro-bioeroders, micro- and meiobenthic organisms such as foraminifera, coral recruitment, macroalgal cover, taxonomic richness of corals and the maximal depth of coral-reef development. For short-term monitoring programmes, or environmental impact assessments that aim to quantify the effects of acute changes in water quality, a subset of seven of these bioindicators were selected, including partial mortality. Their choice will depend on the specific objectives and the timeframe available for each monitoring programme. An assessment framework is presented to assist in the selection of bioindicators to quantify the effects of changing water quality on coral-reef ecosystems.

  3. IAEA programme on the quality of marine radioactivity data

    Energy Technology Data Exchange (ETDEWEB)

    Sanchez-Cabeza, J.A. [Radiometrics Laboratory, International Atomic Energy Agency, Marine Environment Laboratories, 4 Quai Antoine 1er, 98000 Monaco (Monaco)], E-mail: j.a.sanchez-cabeza@iaea.org; Pham, M.K.; Povinec, P.P. [Radiometrics Laboratory, International Atomic Energy Agency, Marine Environment Laboratories, 4 Quai Antoine 1er, 98000 Monaco (Monaco)

    2008-10-15

    Society's growing interest in environmental issues requires the production of reliable information for policy-makers, stakeholders and society in general. This information must be based on accurate data produced by qualified laboratories and data need to be comparable between numerous laboratories for joint assessments, e.g. in International Conventions. The Marine Environment Laboratories of the International Atomic Energy Agency has been providing Quality Assurance services to laboratories involved in marine radioactivity studies for the past 30 years. This has included training, organization of laboratory intercomparison exercises, production of Reference Materials (RMs) and more recently, production of Certified Reference Materials (CRMs) that comply with relevant ISO standards. Here, the overall process of Certification of Reference Materials is reviewed, past work summarized and future needs of marine radioactivity laboratories briefly discussed.

  4. Training, supervision and quality of care in selected integrated community case management (iCCM) programmes: A scoping review of programmatic evidence

    Science.gov (United States)

    Bosch–Capblanch, Xavier; Marceau, Claudine

    2014-01-01

    Aim To describe the training, supervision and quality of care components of integrated Community Case Management (iCCM) programmes and to draw lessons learned from existing evaluations of those programmes. Methods Scoping review of reports from 29 selected iCCM programmes purposively provided by stakeholders containing any information relevant to understand quality of care issues. Results The number of people reached by iCCM programmes varied from the tens of thousands to more than a million. All programmes aimed at improving access of vulnerable populations to health care, focusing on the main childhood illnesses, managed by Community Health Workers (CHW), often selected bycommunities. Training and supervision were widely implemented, in different ways and intensities, and often complemented with tools (eg, guides, job aids), supplies, equipment and incentives. Quality of care was measured using many outcomes (eg, access or appropriate treatment). Overall, there seemed to be positive effects for those strategies that involved policy change, organisational change, standardisation of clinical practices and alignment with other programmes. Positive effects were mostly achieved in large multi–component programmes. Mild or no effects have been described on mortality reduction amongst the few programmes for which data on this outcome was available to us. Promising strategies included teaming–up of CHW, micro–franchising or social franchising. On–site training and supervision of CHW have been shown to improve clinical practices. Effects on caregivers seemed positive, with increases in knowledge, care seeking behaviour, or caregivers’ basic disease management. Evidence on iCCM is often of low quality, cannot relate specific interventions or the ways they are implemented with outcomes and lacks standardisation; this limits the capacity to identify promising strategies to improve quality of care. Conclusion Large, multi–faceted, iCCM programmes, with strong

  5. The effectiveness of an improved multidisciplinary pain management programme: a 6- and 12-month follow-up study.

    Science.gov (United States)

    Dysvik, Elin; Kvaløy, Jan Terje; Natvig, Gerd Karin

    2012-05-01

      This article is a report of a Norwegian-revised study on the effectiveness of a follow-up multidisciplinary management programme for chronic pain to investigate the change processes associated with treatment.   Substantial evidence supports the use of Cognitive Behavioural Therapy approaches to chronic pain. As relapse is often reported, follow-up sessions should be included.   A follow-up quasi-experimental design was performed, and a previous control group was used. The study initially included 117 participants, and 104 of the sample completed the 6- and 12-month follow-up programme. The 6-month follow-up consisted of therapeutic dialogue and education combined with physical activity. At the 12-month follow-up, a telephonic consultation was conducted. The data collection period was between September 2006 and January 2008. The statistical and clinical significance were considered.   Findings suggest that this follow-up programme can potentially maintain the positive results of the basic programme in terms of reduced pain perception, improved health-related quality of life, and movement towards self-management.   These results are consistent with the ultimate goal of Cognitive Behavioural Therapy approaches, which is to help patients with chronic pain to cope more effectively and to improve their health-related quality of life and functioning. To maintain treatment improvements and advance nursing, there is a clear need for research that tests the efficacy of follow-up interventions that are designed to prevent drop out and relapse. © 2011 Blackwell Publishing Ltd.

  6. SF Bay Water Quality Improvement Fund

    Science.gov (United States)

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

  7. Considerations in breeding for improved yield and quality in Arabica coffee (Coffee arabica L.)

    NARCIS (Netherlands)

    Walyaro, D.J.A.

    1983-01-01

    Variation for growth., yield and quality characters was studied in a diallel cross among 11 varieties of arabica coffee. The objective was to demonstrate the possible application of such information in breeding programmes for improved yield and coffee quality.Growth characters especially girth, heig

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  9. Improving Operational Readiness through Total Quality Management

    Science.gov (United States)

    1991-06-21

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

  10. African primary care research: Quality improvement cycles

    Directory of Open Access Journals (Sweden)

    Claire Van Deventer

    2014-01-01

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

  11. African primary care research: quality improvement cycles.

    Science.gov (United States)

    van Deventer, Claire; Mash, Bob

    2014-04-24

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

  12. How to Begin a Quality Improvement Project.

    Science.gov (United States)

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

    2016-05-01

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

  13. CONTINUOUS IMPROVEMENT THROUGH INTEGRATION OF QUALITY TOOLS

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

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

  14. Diversity in diabetes care programmes and views on high quality diabetes care: are we in need of a standardized framework?

    Directory of Open Access Journals (Sweden)

    Liesbeth A.D. Borgermans

    2008-04-01

    Full Text Available Methods: A review of systematic reviews was performed. Four databases (MEDLINE database of the National Library of Medicine, COCHRANE database of Systematic Reviews, the Cumulative Index to Nursing and Allied Health Database-CINAHL and Pre-Cinahl were searched for English review articles published between November 1989 and December 2006. Methodological quality of the articles was assessed. A standardized extraction form was used to assess features of diabetes care programmes and diabetes quality indicators with special reference to those aspects that hinder the conceptualization of high quality diabetes care. Based on these findings the relationship between diversity in diabetes care programmes and the conceptualization of high quality diabetes care was further explored. Results: Twenty-one systematic reviews met the inclusion criteria representing a total of 185 diabetes care programmes. Six elements were identified to produce a picture of diversity in diabetes care programmes and hinder their standardization: 1 the variety and relative absence of conceptual backgrounds in diabetes care programmes, 2 confusion over what is considered a constituent of a diabetes care program and components of the implementation strategy, 3 large variety in type of diabetes care programmes, settings and related goals, 4 a large number and variety in interventions and quality indicators used, 5 no conclusive evidence on effectiveness, 6 no systematic results on costs. Conclusions: There is large diversity in diabetes care programmes and related quality indicators. From this review and our analysis on the mutual relationship between diversity in diabetes care programmes and the conceptualization of high quality diabetes care, we conclude that no single conceptual framework used to date provides a comprehensive overview of attributes of high quality diabetes care linked to quality indicators at the structure, process and outcome level. There is a need for a

  15. [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

  16. The SHE programme: a European initiative to improve the care of women living with HIV

    Directory of Open Access Journals (Sweden)

    M Johnson

    2012-11-01

    Full Text Available Purpose of the study: In Europe, the number of women living with HIV is increasing, but data are limited and guidelines scarce. HIV care poses unique challenges for women living with HIV and their healthcare providers. The SHE programme is a response to these unmet needs. SHE supports women living with HIV to feel empowered to get the most from their healthcare services and provides education to healthcare providers. The objective of SHE is to improve the quality of life of women living with HIV. Methods: SHE is run by a community faculty and a scientific faculty. Both faculties include women living with HIV and healthcare professionals. SHE scientific faculty reviewed available data pertaining to HIV in women. Data gaps were validated and prioritised at a scientific meeting held in June 2011, attended by 80 invited delegates from 13 European countries. SHE community faculty held advisory workshops to examine the challenges faced by women living with HIV. Following these activities, medical and community toolkits have been developed. To integrate scientific and community activities, ‘SHE units’ are being launched at specific sites. Each SHE unit will be a multidisciplinary team working to improve and promote best clinical practice. Summary of results: The scientific faculty identified five key topics: 1. situation of women with HIV in Europe; 2. challenges of testing; 3. antiretroviral treatment (ART; 4. women with HIV of childbearing age; and 5. long-term treatment. The highest priority gaps were guidance on the management of women living with HIV, coordination of registries of ART in pregnant women, and more gender-specific data. An educational ‘medical toolkit’ has been developed including an overview of current data on these topics and a summary of continuing data gaps. A peer support toolkit has been developed for women living with HIV who wish to facilitate peer support sessions. The toolkit includes topics such as diagnosis

  17. Study designs for PDSA quality improvement research.

    Science.gov (United States)

    Speroff, Theodore; O'Connor, Gerald T

    2004-01-01

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

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

    Science.gov (United States)

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

    2016-08-01

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

  19. Physician education programme improves quality of diabetes care

    African Journals Online (AJOL)

    complications. Guidelines are available ... Globally diabetes mellitus is a significant problem with an estimated 140 .... reduction of macrovascular disease in diabetic patients, micro- albuminuria, and ..... Microvascular complications in South.

  20. Policy issues for improving monitoring and evaluation of agricultural extension programmes in Nigeria

    Directory of Open Access Journals (Sweden)

    Akinnagbe O. Matthew

    2016-06-01

    Full Text Available Monitoring and evaluation are important, yet, frequently neglected functions in most organisations. In Nigeria, many programmes have been established over the years but only little monitoring and evaluation have been carried out because of many implementation problems and lack of realistic and/or stable policy framework. This paper was designed to X-ray policy issues for improving monitoring and evaluation of agricultural programmes in Nigeria. Inductive and deductive reasoning through a review of relevant literature was used in this philosophical paper. To improve the performance of agricultural extension programmes in Nigeria, the following policy issues must be addressed: The questions of what should be monitored or evaluated, when should monitoring and/or evaluation be carried out and who should monitor and/or evaluate; and the methodology to be adopted in any project should be included in any agricultural programmes and/or policies. Manpower and financial resources, effective communication and the issue of accountability must be properly considered. The tools for monitoring and evaluation are also very crucial. The paper concluded that planning a good agricultural programme is not a problem in Nigeria but poor implementation is, as a result of poor monitoring and evaluation. Therefore, attention should be on when, how and who should be involved in monitoring and evaluation.

  1. Use of a programmable desk-top calculator for the statistical quality control of radioimmunoassays.

    Science.gov (United States)

    Cernosek, S F; Gutierrez-Cernosek, R M

    1978-07-01

    We have developed an interactive statistical quality-control system for the small- to medium-sized radioimmunoassay laboratory, which can be used in a programmable desk-top calculator instead of the medium- or large-scale computer systems usually required. The design of this quality-control system is modeled after the suggestions of Rodbard and has three components. The first component evaluates the relationship between the measured response variable of the radioimmunoassay and the precision (or variance) of these measurements. This derived relationship is then used in the second component of the system as the basis for the weighting function used to calculate an interative, weighted, least squares regression of the logit-log transformation of the dose-response curve. The third component uses the quality-control parameters statistically calculated from the linearized dose-response curve to monitor whether the assay is "in-control". The calculator tabulates the means and confidence limits for the various parameters and can plot the statistical quality-control charts. The major benefit of this statistical quality-control system is that it allows the real-time computation and plotting of quality-control data with a programmable desk-top calculator.

  2. Techniques to improve technological and sanitary quality

    OpenAIRE

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

    2012-01-01

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

  3. 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....

  4. Productivity assessments in small ruminants improvement programmes. A case study of the West African Dwarf Goat.

    NARCIS (Netherlands)

    Bosman, H.

    1995-01-01

    Livestock production in the tropics is characterised by a high degree of variability in terms of composition, setting and aims. A good understanding of these characteristics is a prerequisite for the planning of a successful improvement programme. A frequently used criterion to assess the suitabilit

  5. Productivity assessments in small ruminant improvement programmes : a case study of the West African dwarf goat

    NARCIS (Netherlands)

    Bosman, H.G.

    1995-01-01

    Livestock production in the tropics is characterised by a high degree of variability in terms of composition, setting and aims. A good understanding of these characteristics is a prerequisite for the planning of a successful improvement programme. A frequently used criterion to assess the

  6. Quality improvement practices and trends in Denmark

    DEFF Research Database (Denmark)

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

    1998-01-01

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

  7. Power Quality Improvement Using DVR

    Directory of Open Access Journals (Sweden)

    C. Benachaiba

    2009-01-01

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

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

    Science.gov (United States)

    Mainz, Jan; Kristensen, Solvejg; Bartels, Paul

    2015-12-01

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

  9. Quality Regulation in Expansion of Educational Systems: A Case of Privately Sponsored Students' Programme in Kenya's Public Universities

    Science.gov (United States)

    Yego, Helen J. C.

    2016-01-01

    This paper examines the expansion and management of quality of parallel programmes in Kenya's public universities. The study is based on Privately Sponsored Students Programmes (PSSP) at Moi University and its satellite campuses in Kenya. The study was descriptive in nature and adopted an ex-post facto research design. The study sample consisted…

  10. Can Technology Improve the Quality of Colonoscopy?

    Science.gov (United States)

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

    2016-07-01

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

  11. Implementation of a teaching programme to improve doctors' awareness of DVLA guidelines: a multicentre study.

    Science.gov (United States)

    Maruthappu, Mahiben; Sykes, Mark; Green, Ben L; Watson, Robert; Gollop, Nicholas D; Shalhoub, Joseph; Ng, Ka Ying Bonnie

    2017-02-01

    Over half of the UK population holds a driver's licence. Driver and Vehicle Licensing Authority (DVLA) guidelines are available for conditions from most specialties. Despite this, no focused training occurs in the undergraduate or postgraduate setting. We evaluate the impact of a teaching programme to improve guideline awareness. A 25-point questionnaire was designed using the current DVLA guidelines. Five questions were included for the following fields: neurology, cardiology, drug and alcohol abuse, visual disorders and respiratory. This was distributed to doctors in training at five hospitals. Four weeks later, a single-session teaching programme was implemented. The questionnaire was redistributed. Preintervention and postintervention scores were compared using the Wilcoxon rank sum test. 139 preteaching and 144 post-teaching questionnaires were completed. Implementation of a single-session teaching programme significantly improved the knowledge of DVLA guidelines in all five areas explored. Median scores: neurology, preteaching 40%, post-teaching 100%, pvisual disorders, 40%, 100%, pteaching programme can significantly improve guideline knowledge and awareness, serving as a cost-effective intervention. 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. Interplay between air passengers’ service quality, satisfaction, loyalty and loyalty programmes in South African owned airlines

    Directory of Open Access Journals (Sweden)

    Nicholas O. Mantey

    2017-01-01

    Full Text Available Orientation: Delivering service quality is crucial for the continuous operation and sustainability of South African owned airlines. The term ‘South African owned airlines’ refers to six South African owned registered airlines, and is used for purpose of anonymity and confidentiality.Research purpose: The main aim of this study was to examine the interplay between service quality delivery, satisfaction, loyalty programmes and passengers’ loyalty to South African owned airlines.Motivation for the study: Intended to provide insight into quality to society of airline services, the global airline industry in general and the airline industry in South Africa in particular.Research approach, design and method: A quantitative research approach was adopted, using a cross-sectional (sample survey method. Empirical data was directly collected by the researchers from 684 passengers at O.R. Tambo International Airport in Johannesburg and King Shaka International Airport in Durban using a non-probability random sampling technique.Main findings: The study’s main findings were that: (1 generally, passengers of South African owned airlines were satisfied with the airlines’ service quality and rated such satisfaction as moderate to high. (2 Only 22% of passengers were part of a loyalty programme. However, in the South African context, loyalty programme membership is not indicative of passengers’ loyalty to airlines: 86% of the respondents stated that they are consistently loyal to the airlines (3. There was no association between passengers’ loyalty and frequency of travel. (4 South African passengers have limited choice of airlines; therefore, loyalty and patronage does not lean towards a particular airline.Practical implications: By offering superior service quality to passengers, South African owned airlines could gain competitive advantage ongoing patronage and loyalty, thus increasing overall profitability.Contributions: This study provides

  13. 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.

  14. 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.

  15. Improving child health promotion practices in multiple sectors – outcomes of the Swedish Salut Programme

    Directory of Open Access Journals (Sweden)

    Edvardsson Kristina

    2012-10-01

    Full Text Available Abstract Background To improve health in the population, public health interventions must be successfully implemented within organisations, requiring behaviour change in health service providers as well as in the target population group. Such behavioural change is seldom easily achieved. The purpose of this study was to examine the outcomes of a child health promotion programme (The Salut Programme on professionals’ self-reported health promotion practices, and to investigate perceived facilitators and barriers for programme implementation. Methods A before-and-after design was used to measure programme outcomes, and qualitative data on implementation facilitators and barriers were collected on two occasions during the implementation process. The sample included professionals in antenatal care, child health care, dental services and open pre-schools (n=144 pre-implementation in 13 out of 15 municipalities in a Swedish county. Response rates ranged between 81% and 96% at the four measurement points. Results Self-reported health promotion practices and collaboration were improved in all sectors at follow up. Significant changes included: 1 an increase in the extent to which midwives in antenatal care raised issues related to men’s violence against women, 2 an increase in the extent to which several lifestyle topics were raised with parents/clients in child health care and dental services, 3 an increased use of motivational interviewing (MI and separate ‘fathers visits’ in child health care 4 improvements in the supply of healthy snacks and beverages in open pre-schools and 5 increased collaboration between sectors. Main facilitators for programme implementation included cross-sectoral collaboration and sector-specific work manuals/questionnaires for use as support in everyday practice. Main barriers included high workload, and shortage of time and staff. Conclusion This multisectoral programme for health promotion, based on sector

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

    Science.gov (United States)

    Nusser, Michael

    2007-01-01

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

  17. [Quality improvement of medical diagnostic laboratories].

    Science.gov (United States)

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

    2003-07-13

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

  18. Experience with the European quality assurance guidelines for digital mammography systems in a national screening programme.

    Science.gov (United States)

    McCullagh, J; Keavey, E; Egan, G; Phelan, N

    2013-02-01

    The transition to a fully digital breast screening programme, utilising three different full-field digital mammography (FFDM) systems has presented many challenges to the implementation of the European guidelines for physico-technical quality assurance (QA) testing. An analysis of the QA results collected from the FFDM systems in the screening programme over a 2-y period indicates that the three different systems have similar QA performances. Generally, the same tests were failed by all systems and failure rates were low. The findings provide some assurance that the QA guidelines are being correctly implemented. They also suggest that there is more scope for the development of the relevance of the guidelines with respect to modern FFDM systems. This study has also shown that a summary review of the QA data can be achieved by simple organisation of the QA data storage and by automation of data query and retrieval using commonly available software.

  19. Review of Improved Cookstoves Programme in Western Himalayan State of India

    Energy Technology Data Exchange (ETDEWEB)

    Aggarwal, R.K. [Dr. Y.S. Parmar Univ. of Horticulture and Forestry, Nauni, Solan (India); Chandel, S.S. [State Council for Science, Technology and Environment, Kasumpti, Shimla (India)

    2004-08-01

    The status of National Programme on Improved Cookstoves (NPIC) in Himachal Pradesh, the Western Himalayan Indian state, is presented. The lessons learnt from the success and failures in the implementation of the programme are highlighted. The research and development efforts of the Technology Back Up Centre, in developing energy-efficient space-heating metal stoves for high-altitude regions of the state are described. The feedback survey indicates that these improved stoves based on traditional stove designs are more acceptable to people. The study shows that NPIC needs to continue with new vigour in the ecologically fragile Himalayan region for the protection of forests and health of women. A new approach for the implementation of NPIC is outlined which includes massive awareness campaign about harmful impact of smoke emissions, improved ventilated kitchen designs, introduction of alternate cooking and space heating technologies including passive solar house technology for space heating in extreme cold climates. (Author)

  20. Improving vision awareness in autism services: Evaluation of a dedicated education programme for support practitioners.

    Science.gov (United States)

    Long, Joseph J; Butchart, Maggie; Brown, Michael; Bain, Janice; McMillan, Anne; Karatzias, Thanos

    2017-02-20

    The research reported here sought to evaluate whether a dedicated education programme in vision awareness improved the knowledge and skills of autism support practitioners in identifying visual impairment in autistic people with intellectual disabilities and providing better support to those individuals identified as visually impaired. Researchers undertook a mixed methods evaluation. A survey questionnaire was devised and administered before and after training and focus groups were undertaken in order to gain qualitative data relating how practitioners implemented their learning in practice. Knowledge confidence and practice confidence scores of participants were significantly improved by the programme, which maintained its impact one year on. Practitioners reported increased access to optometry, changes to support practice and improvements to service environments as a result of the training. Autism support practitioners' skills in identifying and supporting people with visual impairments were demonstrably enhanced through dedicated vision training. © 2017 John Wiley & Sons Ltd.

  1. Faculty Perceptions of Instrumental and Improvement Reasons behind Quality Assessments in Higher Education: The Roles of Participation and Identification

    Science.gov (United States)

    Trullen, Jordi; Rodriguez, Sebastian

    2013-01-01

    While the stated aim of quality assessments is to improve the quality of the products and services offered by universities, some faculty view them as instrumental in justifying government budget cuts in education. By means of a survey administered to more than 300 faculty from 20 academic programmes undergoing quality assessments, we studied…

  2. 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...

  3. Nutritional counselling and its effects on diet, nutritional knowledge and status, physical activity and quality of life in a Southern Europe population: evaluation of a health promotion programme.

    Directory of Open Access Journals (Sweden)

    Cecilia Quercioli

    2011-06-01

    Full Text Available

    Abstract:
    Background: Health promotion and primary prevention are key points for fighting the increase in non- communicable diseases. Aim: To test the effectiveness of a nutritional counselling programme in improving nutritional behaviours, knowledge and status, physical activity and health-related quality of life in a general population. Methods: In the period between January–December 2007, we studied the application of the nutritional counselling programme (NCP developed by Local Health Agency 10 (Florence-Italy. We compared , diet, nutritional knowledge, physical activity, health related quality of life (measured by SF36 questionnaire, body mass index (BMI and waist circumference before and after a two months intensive nutritional counselling programme using the paired t test and McNemar test. Diet, nutritional knowledge, physical activity, socio-demographic and morbidity information were collected through questionnaires. BMI and waist circumference were assessed by a medical doctor. Results: We enrolled 74 persons, 59 of whom completed the educational programme. Of these, 34 had a nutritional status assessment after the programme. Mean age was 49 years, 80% were females. BMI, waist circumference and diet, except for water intake, did not change. The percentage of people who had “never exercised in a week" decreased from 46% to 17% (p<0.001. Mean percentage of right answers to nutritional knowledge indicators increased from 64% to 78% (p<0.001. Health related quality of life (HRQL improved especially with regard to “Physical" and “Emotional Role". Conclusions: The NCP showed important results in promoting physical activity and improving HRQL and nutritional knowledge, moderate/none results in improving diet and nutritional status.

  4. Applying total quality management techniques to improve software development.

    Science.gov (United States)

    Mezher, T; Assem Abdul Malak, M; el-Medawar, H

    1998-01-01

    Total Quality Management (TQM) is a new management philosophy and a set of guiding principles that represent the basis of a continuously improving organization. This paper sheds light on the application of TQM concepts for software development. A fieldwork study was conducted on a Lebanese software development firm and its customers to determine the major problems affecting the organization's operation and to assess the level of adoption of TQM concepts. Detailed questionnaires were prepared and handed out to the firm's managers, programmers, and customers. The results of the study indicate many deficiencies in applying TQM concepts, especially in the areas of planning, defining customer requirements, teamwork, relationship with suppliers, and adopting standards and performance measures. One of the major consequences of these deficiencies is considerably increased programming errors and delays in delivery. Recommendations on achieving quality are discussed.

  5. Monitoring NSL. Progress of the Dutch National Air Quality Cooperation Programme (NSL). State of affairs 2012; Monitoringsrapportage NSL. Stand van zaken 2012 Nationaal Samenwerkingsprogamma Luchtkwaliteit

    Energy Technology Data Exchange (ETDEWEB)

    Van Zanten, M.C.; Wesseling, J.; Mooibroek, D.; Van Alphen, A.; Nguyen, L. [Rijksinstituut voor Volksgezondheid en Milieu RIVM, Bilthoven (Netherlands); Groot Wassink, H.; Verbeek, C. [InfoMil, Agentschap NL, Den Haag (Netherlands)

    2012-11-15

    The National Air Quality Cooperation Programme (NSL) has been created to facilitate improvements in air quality in the Netherlands and to ensure that the Netherlands meets the respective deadlines set for compliance to EU limit values for particulate matter (PM10) and nitrogen dioxide (NO2). Local, regional and national authorities work together within the framework of this programme to ensure that these goals will be met. A monitoring programme has been put in place to monitor progress and, if necessary, to enable timely modifications to the programme. The annual results of the monitoring programme have been bundled together by the Monitoring Bureau (collaboration between RIVM and the InfoMil Knowledge Centre) into the 2012 progress report [Dutch] Om de luchtkwaliteit te verbeteren is het Nationaal Samenwerkingsprogramma Luchtkwaliteit (NSL) opgezet. Hierin werken de Rijksoverheid en decentrale overheden samen om te zorgen dat Nederland overal tijdig aan de grenswaarden voor fijn stof en stikstofdioxide zal voldoen. Om de voortgang van dit verbeterprogramma te volgen en tijdig eventuele extra maatregelen te kunnen nemen, is aan het NSL een monitoringsprogramma verbonden. De uitvoering van de monitoring is neergelegd bij Bureau Monitoring, een samenwerkingsverband tussen het RIVM en Kenniscentrum InfoMil.

  6. Quality evaluation of clinical records of a group of general dental practitioners entering a quality assurance programme.

    Science.gov (United States)

    Morgan, R G

    2001-10-27

    This paper discusses the importance of maintaining high quality clinical records. Evidence from studies carried out in the USA, Australia and Scandinavia shows that record keeping often falls well below accepted standards. Evidence of current standards in the UK, however, has tended to be anecdotal or circumstantial. An assessment was carried out on 47 general practitioners entering the quality assurance programme of a private capitation scheme. A sample of clinical records from each practitioner was analysed, and the presence or absence of key diagnostic and treatment planning entries were recorded. Overall, the quality of record keeping was poor, and in line with the findings of the other worldwide studies. Fundamental clinical entries that could impact on basic dental care provision were missing from many records. The frequency of recording for patients whose treatment was funded under NHS regulations was significantly worse than for patients whose treatment was privately funded.

  7. Return-to-work coordination programmes for improving return to work in workers on sick leave.

    Science.gov (United States)

    Vogel, Nicole; Schandelmaier, Stefan; Zumbrunn, Thomas; Ebrahim, Shanil; de Boer, Wout El; Busse, Jason W; Kunz, Regina

    2017-03-30

    To limit long-term sick leave and associated consequences, insurers, healthcare providers and employers provide programmes to facilitate disabled people's return to work. These programmes include a variety of coordinated and individualised interventions. Despite the increasing popularity of such programmes, their benefits remain uncertain. We conducted a systematic review to determine the long-term effectiveness of return-to-work coordination programmes compared to usual practice in workers at risk for long-term disability. To assess the effects of return-to-work coordination programmes versus usual practice for workers on sick leave or disability. We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 11), MEDLINE, Embase, CINAHL and PsycINFO up to 1 November 2016. We included randomised controlled trials (RCTs) that enrolled workers absent from work for at least four weeks and randomly assigned them to return-to-work coordination programmes or usual practice. Two review authors independently screened titles, abstracts and full-text articles for study eligibility; extracted data; and assessed risk of bias from eligible trials. We contacted authors for additional data where required. We conducted random-effects meta-analyses and used the GRADE approach to rate the quality of the evidence. We identified 14 studies from nine countries that enrolled 12,568 workers. Eleven studies focused on musculoskeletal problems, two on mental health and one on both. Most studies (11 of 14) followed workers 12 months or longer. Risk of bias was low in 10 and high in 4 studies, but findings were not sensitive to their exclusion.We found no benefits for return-to-work coordination programmes on return-to-work outcomes.For short-term follow-up of six months, we found no effect on time to return to work (hazard ratio (HR) 1.32, 95% confidence interval (CI) 0.93 to 1.88, low-quality evidence), cumulative sickness absence (mean difference (MD) -16.18 work

  8. The role of epidemiological quality parameters in a mammography screening programme; Die Rolle der epidemiologischen Qualitaetsparameter im Mammographie-Screeningprogramm

    Energy Technology Data Exchange (ETDEWEB)

    Becker, N. [Deutsches Krebsforschungszentrum, Heidelberg (Germany). Abt. Klinische Epidemiologie

    2006-11-15

    In the recently established mammography screening programme, for the first time in Germany an extensive data collection for prompt quantification of specified quality parameters will be intrinsic to an early detection programme. Epidemiological parameters taken from the European Guidelines are central. This article outlines how epidemiology is involved in quality assurance of cancer screening and why epidemiological quality indicators will be quantified. The reasons for focussing on those parameters, on which the European Guidelines and now the German programme are based, and their significance in the long-term effectiveness of this programme are explained. (orig.) [German] Bei dem gerade im Aufbau begriffenen Mammographie-Screeningprogramm wird erstmalig in Deutschland eine umfangreiche Datenerhebung zur zeitnahen Quantifizierung bestimmter Qualitaetsparameter zum integralen Bestandteil eines Frueherkennungsprogramms. Ein Herzstueck dieser in europaeischen Richtlinien festgelegten und in das deutsche Programm uebernommenen Parameter sind epidemiologische Groessen. In dem vorliegenden Beitrag wird dargestellt, weshalb im Kontext der Qualitaetssicherung von Krebsfrueherkennung die Epidemiologie eine Rolle spielt, und warum epidemiologische Qualitaetsparameter zu quantifizieren sind. Darauf aufbauend wird erlaeutert, aus welchen Gruenden man gerade diejenigen Groessen gewaehlt hat, die im Zentrum der europaeischen Richtlinien und nun auch der Qualitaetssicherung des deutschen Programms stehen, und was sie hinsichtlich der langfristigen Effektivitaet des Programms aussagen. (orig.)

  9. Improving embryo quality in assisted reproduction

    NARCIS (Netherlands)

    Mantikou, E.

    2013-01-01

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

  10. Training, supervision and quality of care in selected integrated community case management (iCCM programmes: A scoping review of programmatic evidence

    Directory of Open Access Journals (Sweden)

    Xavier Bosch–Capblanch

    2014-11-01

    Full Text Available To describe the training, supervision and quality of care components of integrated Community Case Management (iCCM programmes and to draw lessons learned from existing evaluations of those programmes

  11. Laboratory system strengthening and quality improvement in Ethiopia

    Directory of Open Access Journals (Sweden)

    Tilahun M. Hiwotu

    2014-09-01

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

  12. Coaching to Quality: Increasing Quality in Early Care and Education Programmes through Community-University Partnership

    Science.gov (United States)

    Gilbert, Jaesook Lee; Harte, Helene Arbouet

    2013-01-01

    This paper describes efforts to increase the quality in early care and education through targeted coaching. A collaborative including several community agencies and a university developed a framework of support for early care and education providers, using coaching as its foundational basis, called Coaching to Quality (CTQ). This paper provides a…

  13. Improvement of quality of life following 6 months of methadone maintenance therapy in Malaysia

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    Baharom Nizam

    2012-08-01

    Full Text Available Abstract Background Methadone Maintenance Therapy (MMT is one of the popular choices for drug substitution therapy and is fairly new in Malaysia. Aside from its role in harm reduction against HIV infection, MMT programme may potentially enhances clients’ quality of life. This study aims to identify the impact of MMT programme on clients’ quality of life after 6 months in treatment and to explore factors that may be associated with changes in their quality of life. Methods In this retrospective report review, 122 subjects from 2 government MMT clinics were selected from the district of Tampin, Negeri Sembilan, Malaysia. The raw score from the WHO Quality of Life questionnaire (WHOQOL-BREF, at baseline and 6 months after therapy were collected and converted to 0–100 scale form to give quality of life scores for four domains; physical, psychological, social relationships and environment. Other variables of interest were socio-demography, age when joining MMT programme, age and duration of illicit drug use, HIV and Hepatitis C status, and the Opiate Treatment Index (OTI score on drug use, sexual and social aspect at the baseline. Statistical analysis used the SPSS version 16. Results There was significant improvement in all four domains of quality of life, after 6 months of MMT. The largest improvement was for psychological domain (mean score difference 15.54 ± 20.81. Multivariable linear regression analysis showed that, for the physical domain, there was no significant predictor. For both the psychological and social domains, having tertiary education is a significant predictor for improvement in both aspects of quality of life. Negative HIV status is associated with improvement for the environment domain. Conclusions There was a significant short term improvement in the quality of life of MMT clients who stayed in the programme for at least 6 months in the district of Tampin, Negeri Sembilan, Malaysia.

  14. A Model for Improving the Quality of Student Internship Placements in Engineering Degrees

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    Rafael Garcia

    2011-02-01

    Full Text Available Work Internship Placements (WIP is a new and transversal enterprise internships programme, which is focused on quality improvement, academic control and satisfaction of collaborating enterprises. This programme is addressed to the engineering students of the Polytechnic School at the University of Girona (UdG in Spain. The fundamental WIP infrastructure combines a web-based intranet platform, that provides a complete set of WIP tools, with a protocol of procedures and tasks that are observed and followed at all internship stages by every participating agent, i.e. enterprises, students, coaching professors and administrative staff. Our new programme is centered on a broader, more holistic internship placement procedure than the traditional “career and academic goals” approach. The WIP programme has been found to be a valuable asset in addressing enterprise and student needs in the experiential project.

  15. Continuous quality improvement in nursing service.

    Science.gov (United States)

    Sorrentino, E A

    1992-03-01

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

  16. Improvement of photovoltaic pumping systems based on standard frequency converters by means of programmable logic controllers

    Energy Technology Data Exchange (ETDEWEB)

    Fernandez-Ramos, Jose [Departamento de Electronica, Universidad de Malaga, Complejo Tecnologico de Teatinos (2.2.39), 29071 Malaga (Spain); Narvarte-Fernandez, Luis; Poza-Saura, Fernando [Instituto de Energia Solar, Universidad Politecnica de Madrid (IES-UPM), Avenida Complutense s/n (204), 28040 Madrid (Spain)

    2010-01-15

    Photovoltaic pumping systems (PVPS) based on standard frequency converters (SFCs) are currently experiencing a growing interest in pumping programmes implemented in remote areas because of their high performance in terms of component reliability, low cost, high power range and good availability of components virtually anywhere in the world. However, in practical applications there have appeared a number of problems related to the adaptation of the SFCs to the requirements of the photovoltaic pumping systems (PVPS). Another disadvantage of dedicated PVPS is the difficulty in implementing maximum power point tracking (MPPT). This paper shows that these problems can be solved through the addition of a basic industrial programmable logic controller (PLC) to the system. This PLC does not increase the cost and complexity of the system, but improves the adaptation of the SFC to the photovoltaic pumping system, and increases the overall performance of the system. (author)

  17. Campaigns and Awareness Raising Strategies in Traffic Safety (CAST). Deliverable 0.3: Programme handbook for Quality Assurance QA procedures.

    NARCIS (Netherlands)

    Twisk, D.

    2009-01-01

    The Programme Handbook for Quality Assurance (QA) Procedures contains information about the quality assurance process and dissemination of study results. It includes the format to be used for various progress, effort and cost reports and it provides a list of duties for the steering committee and th

  18. Service Quality and Students' Satisfaction with the Professional Teacher Development Programmes by Distance Mode in a South African University

    Science.gov (United States)

    Oduaran, A. B.

    2011-01-01

    This article reports on the relationship between seven factors that described dimensions of education service quality and overall service quality on one hand, and students' satisfaction with the professional teacher development programmes by distance mode in a South African University on the other. We sought to find out whether students enrolled…

  19. Service Quality and Students' Satisfaction with the Professional Teacher Development Programmes by Distance Mode in a South African University

    Science.gov (United States)

    Oduaran, A. B.

    2011-01-01

    This article reports on the relationship between seven factors that described dimensions of education service quality and overall service quality on one hand, and students' satisfaction with the professional teacher development programmes by distance mode in a South African University on the other. We sought to find out whether students enrolled…

  20. Slant transform applied to electric power quality detection with field programmable gate array design enhanced

    Energy Technology Data Exchange (ETDEWEB)

    Hsieh, Cheng-Tao [Dept. of Electrical Engineering, Kun Shan University, Tainan (China); Lin, Jeu-Min [Dept. of Electrical Engineering, Far East University, Tainan (China); Huang, Shyh-Jier [Dept. of Electrical Engineering, National Cheng Kung University, Tainan (China)

    2010-06-15

    In this paper, a slantlet transform is proposed with the field-programmable gate array (FPGA) hardware realization for electrical power system disturbance detection. By embedding the slantlet functions into wavelet basis, the method is anticipated to increase the capability of signal discrimination, hence improving the grasping the disturbance intrusion. Furthermore, with the hardware realization of FPGA chip, the practicality of the method can be better ensured. In order to validate the effectiveness of the proposed approach, several scenarios have been considered and verified with good agreement. (author)

  1. A proposed adaptation of the European Foundation for Quality Management Excellence Model to physical activity programmes for the elderly - development of a quality self-assessment tool using a modified Delphi process

    Directory of Open Access Journals (Sweden)

    Marques Ana I

    2011-09-01

    Full Text Available Abstract Background There has been a growing concern in designing physical activity (PA programmes for elderly people, since evidence suggests that such health promotion interventions may reduce the deleterious effects of the ageing process. Complete programme evaluations are a necessary prerequisite to continuous quality improvements. Being able to refine, adapt and create tools that are suited to the realities and contexts of PA programmes for the elderly in order to support its continuous improvement is, therefore, crucial. Thus, the aim of this study was to develop a self-assessment tool for PA programmes for the elderly. Methods A 3-round Delphi process was conducted via the Internet with 43 national experts in PA for the elderly, management and delivery of PA programmes for the elderly, sports management, quality management and gerontology, asking experts to identify the propositions that they considered relevant for inclusion in the self-assessment tool. Experts reviewed a list of proposed statements, based on the criteria and sub-criteria from the European Foundation for Quality Management Excellence Model (EFQM and PA guidelines for older adults and rated each proposition from 1 to 8 (disagree to agree and modified and/or added propositions. Propositions receiving either bottom or top scores of greater than 70% were considered to have achieved consensus to drop or retain, respectively. Results In round 1, of the 196 originally-proposed statements (best practice principles, the experts modified 41, added 1 and achieved consensus on 93. In round 2, a total of 104 propositions were presented, of which experts modified 39 and achieved consensus on 53. In the last round, of 51 proposed statements, the experts achieved consensus on 19. After 3 rounds of rating, experts had not achieved consensus on 32 propositions. The resulting tool consisted of 165 statements that assess nine management areas involved in the development of PA programmes for

  2. A 31-day time to surgery compliant exercise training programme improves aerobic health in the elderly.

    Science.gov (United States)

    Boereboom, C L; Phillips, B E; Williams, J P; Lund, J N

    2016-06-01

    Over 41,000 people were diagnosed with colorectal cancer (CRC) in the UK in 2011. The incidence of CRC increases with age. Many elderly patients undergo surgery for CRC, the only curative treatment. Such patients are exposed to risks, which increase with age and reduced physical fitness. Endurance-based exercise training programmes can improve physical fitness, but such programmes do not comply with the UK, National Cancer Action Team 31-day time-to-treatment target. High-intensity interval training (HIT) can improve physical performance within 2-4 weeks, but few studies have shown HIT to be effective in elderly individuals, and those who do employ programmes longer than 31 days. Therefore, we investigated whether HIT could improve cardiorespiratory fitness in elderly volunteers, age-matched to a CRC population, within 31 days. This observational cohort study recruited 21 healthy elderly participants (8 male and 13 female; age 67 years (range 62-73 years)) who undertook cardiopulmonary exercise testing before and after completing 12 sessions of HIT within a 31-day period. Peak oxygen consumption (VO2 peak) (23.9 ± 4.7 vs. 26.2 ± 5.4 ml/kg/min, p = 0.0014) and oxygen consumption at anaerobic threshold (17.86 ± 4.45 vs. 20.21 ± 4.11 ml/kg/min, p = 0.008) increased after HIT. It is possible to improve cardiorespiratory fitness in 31 days in individuals of comparable age to those presenting for CRC surgery.

  3. Effects of a Leisure Programme on Quality of Life and Stress of Individuals with ASD

    Science.gov (United States)

    Garcia-Villamisar, D. A.; Dattilo, J.

    2010-01-01

    Background: Even though there is research demonstrating a positive relationship between leisure participation and the two constructs of quality of life and stress reduction, current conceptualisation of leisure as a contributor to quality of life is limited. In addition, in spite of improvements in accurate diagnosis of autism spectrum disorder…

  4. Programmable intrathecal pumps for the management of chronic pain: recommendations for improved efficiency

    Directory of Open Access Journals (Sweden)

    Wilkes D

    2014-10-01

    Full Text Available Denise Wilkes Department of Anesthesiology and Pain Medicine, University of Texas Medical Branch, Galveston, TX, USA Abstract: The management of chronic pain can be very challenging. Often, physicians employ intrathecal (IT drug delivery systems as a last resort to relieve intractable pain. The system consists of an implantable pump that stores and delivers medication through a catheter to the IT space. Programmability is achieved by positioning an external devise over the implanted pump to change the mode of drug delivery. The innovations in programmable IT drug delivery systems are expanding more rapidly than ever before. Unfortunately, the rapid expansion is accompanied by a lack of prospective randomized trials examining these new options. In an effort to improve results and reduce side effects, publications by experts or expert consensus panels provide guidance for the community. The purpose of this article is to provide a summary of high interest topics in recent publications. Keywords: intrathecal morphine, chronic pain, programmable drug delivery, implantable drug delivery

  5. 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…

  6. Quality Improvement in University Counseling Centers

    Science.gov (United States)

    Maffini, Cara S.; Toth, Paul L.

    2017-01-01

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

  7. 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.

  8. Fostering Quality Improvement in EHDI Programs

    Science.gov (United States)

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

    2011-01-01

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

  9. Stakeholder analysis of the Programme for Improving Mental health carE (PRIME): baseline findings.

    Science.gov (United States)

    Makan, Amit; Fekadu, Abebaw; Murhar, Vaibhav; Luitel, Nagendra; Kathree, Tasneem; Ssebunya, Joshua; Lund, Crick

    2015-01-01

    The knowledge generated from evidence-based interventions in mental health systems research is seldom translated into policy and practice in low and middle-income countries (LMIC). Stakeholder analysis is a potentially useful tool in health policy and systems research to improve understanding of policy stakeholders and increase the likelihood of knowledge translation into policy and practice. The aim of this study was to conduct stakeholder analyses in the five countries participating in the Programme for Improving Mental health carE (PRIME); evaluate a template used for cross-country comparison of stakeholder analyses; and assess the utility of stakeholder analysis for future use in mental health policy and systems research in LMIC. Using an adapted stakeholder analysis instrument, PRIME country teams in Ethiopia, India, Nepal, South Africa and Uganda identified and characterised stakeholders in relation to the proposed action: scaling-up mental health services. Qualitative content analysis was conducted for stakeholder groups across countries, and a force field analysis was applied to the data. Stakeholder analysis of PRIME has identified policy makers (WHO, Ministries of Health, non-health sector Ministries and Parliament), donors (DFID UK, DFID country offices and other donor agencies), mental health specialists, the media (national and district) and universities as the most powerful, and most supportive actors for scaling up mental health care in the respective PRIME countries. Force field analysis provided a means of evaluating cross-country stakeholder power and positions, particularly for prioritising potential stakeholder engagement in the programme. Stakeholder analysis has been helpful as a research uptake management tool to identify targeted and acceptable strategies for stimulating the demand for research amongst knowledge users, including policymakers and practitioners. Implementing these strategies amongst stakeholders at a country level will

  10. A novel educational programme to improve knowledge regarding health care-associated infection and hand hygiene.

    Science.gov (United States)

    Fitzpatrick, Maureen; Everett-Thomas, Ruth; Nevo, Igal; Shekhter, Ilya; Rosen, Lisa F; Scheinman, Stephen R; Arheart, Kristopher L; Birnbach, David J

    2011-06-01

    Lack of hand hygiene by health-care workers is the most significant cause of health care-associated infection. This programme was designed to make health-care workers want to wash their hands, to change their knowledge regarding hand hygiene and health care-associated infection, and influence practice. Improvement between pre- and post-test scores was statistically significant. Compliance is a multifactorial problem that involves knowledge and behaviour. Educational awareness and frequent reminders are critical to maintain high rates of hand hygiene compliance.

  11. Improving hospital food: Evaluating the impact of the Soil Association Food for Life programme

    OpenAIRE

    Gray, S.; Means, R.; Orme, J.; Pitt, H.; Jones, M.; Salmon, D.

    2015-01-01

    Food for Life (FFL) is an initiative which aims to encourage a healthy, sustainable food culture in communities, and is led by the Soil Association (SA), a UK charity. Thanks to a Big Lottery Fund grant, FFL have been able to develop the programme within hospitals. The Soil Association (SA) also runs the Food for Life Catering Mark scheme that provides an independent endorsement that food providers are taking steps to improve the food they serve, using fresh ingredients which are free from un...

  12. Road accident rates: strategies and programmes for improving road traffic safety.

    Science.gov (United States)

    Goniewicz, K; Goniewicz, M; Pawłowski, W; Fiedor, P

    2016-08-01

    Nowadays, the problem of road accident rates is one of the most important health and social policy issues concerning the countries in all continents. Each year, nearly 1.3 million people worldwide lose their life on roads, and 20-50 million sustain severe injuries, the majority of which require long-term treatment. The objective of the study was to identify the most frequent, constantly occurring causes of road accidents, as well as outline actions constituting a basis for the strategies and programmes aiming at improving traffic safety on local and global levels. Comparative analysis of literature concerning road safety was performed, confirming that although road accidents had a varied and frequently complex background, their causes have changed only to a small degree over the years. The causes include: lack of control and enforcement concerning implementation of traffic regulation (primarily driving at excessive speed, driving under the influence of alcohol, and not respecting the rights of other road users (mainly pedestrians and cyclists), lack of appropriate infrastructure and unroadworthy vehicles. The number of fatal accidents and severe injuries, resulting from road accidents, may be reduced through applying an integrated approach to safety on roads. The strategies and programmes for improving road traffic should include the following measures: reducing the risk of exposure to an accident, prevention of accidents, reduction in bodily injuries sustained in accidents, and reduction of the effects of injuries by improvement of post-accident medical care.

  13. ADVANCES IN TRANSGENIC MAIZE FOR QUALITY IMPROVEMENT

    Directory of Open Access Journals (Sweden)

    M.Rajendar Reddy

    2015-12-01

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

  14. Air quality management in the WHO European Region--results of a quality assurance and control programme on air quality monitoring (1994-2004).

    Science.gov (United States)

    Mücke, Hans-Guido

    2008-07-01

    Since the last decade the WHO Collaborating Centre for Air Quality Management and Air Pollution Control, Berlin, Germany, operates a quality assurance and control (QA/QC) programme on air quality monitoring in the WHO European Region. As main activity Intercomparison workshops have been established for air monitoring network laboratories on a regular basis to harmonise air quality measurements, analysis and calibration techniques. 36 air hygiene laboratories of public health and environmental institutions of 24 countries participated in twelve Intercomparisons between 1994 and 2004. The majority was carried out for NO, NO(2), SO(2) and O(3). The results were predominantly satisfactory for automatic methods. The results of manual methods were mainly in a good, and for several concentration levels partly very good accordance with the data obtained by the monitors.

  15. 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.

  16. Empowering communities and strengthening systems to improve transgender health: outcomes from the Pehchan programme in India

    Science.gov (United States)

    Shaikh, Simran; Mburu, Gitau; Arumugam, Viswanathan; Mattipalli, Naveen; Aher, Abhina; Mehta, Sonal; Robertson, James

    2016-01-01

    -based collectivization and gender-affirming approaches significantly improved both demand and access to tailored HIV, health and social services for transgender individuals across India. Furthermore, the Pehchan programme successfully fostered both self-efficacy and collective identity and served as a model for addressing the unique health needs of transgender communities. Continued strengthening of health, social and community systems to better respond to the unique needs of transgender communities is needed in order to sustain these gains. PMID:27431474

  17. Empowering communities and strengthening systems to improve transgender health: outcomes from the Pehchan programme in India

    Directory of Open Access Journals (Sweden)

    Simran Shaikh

    2016-07-01

    involvement, rights-based collectivization and gender-affirming approaches significantly improved both demand and access to tailored HIV, health and social services for transgender individuals across India. Furthermore, the Pehchan programme successfully fostered both self-efficacy and collective identity and served as a model for addressing the unique health needs of transgender communities. Continued strengthening of health, social and community systems to better respond to the unique needs of transgender communities is needed in order to sustain these gains.

  18. Improving quality in national reference laboratories: The role of SLMTA and mentorship

    Directory of Open Access Journals (Sweden)

    Rosemary A. Audu

    2014-09-01

    Full Text Available Background: The Nigerian Institute of Medical Research houses two reference laboratories: the virology and tuberculosis laboratories. Both were enrolled in the Strengthening Laboratory Management Toward Accreditation (SLMTA programme. Objective: To describe the impact of SLMTA and discuss factors affecting the results, with an emphasis on mentorship. Methods: The SLMTA programme was implemented from April 2010 through November 2012. Participants attended three workshops and executed quality improvement projects; laboratory auditors evaluated performance using a standard checklist. The virology laboratory did not receive mentorship; however, the tuberculosis laboratory had an international mentor who visited the laboratory four times during the programme, spending two to four weeks embedded within the laboratory during each visit. Results: There was an overall improvement in the performance of both laboratories, with the virology laboratory increasing 13% (from 80% at baseline to 93% at exit audit and the tuberculosis laboratory increasing 29% (from 66% to 95%. These scores were maintained nine months later at the surveillance audit. Conclusion: The SLMTA programme resulted in improved and sustained quality management performance for both laboratories. Mentoring was a possible factor in the substantial improvement made by the tuberculosis laboratory and should be considered in order to augment the training received from the SLMTA workshops.

  19. Quality assurance and quality control programme in use at the individual monitoring service of ITN-DPRSN

    Energy Technology Data Exchange (ETDEWEB)

    Alves, J.G.; Novais, I.; Rangel, S.; Flores, E. [Instituto Tecnologico e Nuclear, Dept. de Proteccao Radiologica e Seguranca Nuclear Estrada Nacional, Sacavem (Portugal)

    2006-07-01

    The Individual Monitoring Service (I.M.S.) of the Departamento de Proteccao Radiologica e Seguranca Nuclear (D.P.R.S.N.) at the Instituto Tecnologico e Nuclear (I.T.N.) in Portugal operates a thermoluminescence dosimetry system to monitor approximately 3,000 workers for external radiation exposure on a monthly basis. The workers come from nearly 230 facilities in the medical, research and conventional industry fields of activity and almost 85% of the people monitored in 2005 are from medical facilities. The TLD system in use is based on two Harshaw 6600 automatic readers and on the Harshaw 8814 T.L. card and holder containing two detector elements of LiF:Mg,Ti (TLD-100) for the evaluation of Hp(10) and Hp(0.07). All the workers are monitored on a monthly basis using whole body dosemeters. The I.M.S. has implemented a Quality Assurance and Quality Control (Q.A./Q.C.) programme that covers all the aspects of monitoring, from the monitoring request of a customer to the final issue of a dose report. The main aspects of the Q.A./Q.C. programme implemented at the I.M.S. will be presented in this paper using fluxograms and schemes. Several issues will be addressed, e.g., administrative procedures, technical procedures, dealing with complaints, training of staff, etc. The relationship of the I.M.S. with external entities like the customer, the regulatory authority, the central dose registry, the calibration facility, suppliers, maintenance providers, etc. will be mentioned on the administrative procedures described as well as on the technical procedures where applicable. The main technical procedures will be presented in this paper and references will be made to a TLD Quality Control database internally developed and designed for the storage of important Q.C. parameters like the element correction coefficients, reader calibration factors, electronic quality control data generated on a daily basis, and the study of their evolution with time. (author)

  20. 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.)

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

    Science.gov (United States)

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

    2016-01-01

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

  2. Practical guidelines for radiographers to improve computed radiography image quality

    OpenAIRE

    Pongnapang, N

    2005-01-01

    Computed Radiography (CR) has become a major digital imaging modality in a modern radiological department. CR system changes workflow from the conventional way of using film/screen by employing photostimulable phosphor plate technology. This results in the changing perspectives of technical, artefacts and quality control issues in radiology departments. Guidelines for better image quality in digital medical enterprise include professional guidelines for users and the quality control programme...

  3. Oil Products Quality Improvement by Adsorption Method

    Directory of Open Access Journals (Sweden)

    Kulash K. Syrmanova

    2017-02-01

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

  4. 2.2 Continuous quality improvement.

    Science.gov (United States)

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

    2002-01-01

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

  5. 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.

  6. Improvements in geomagnetic observatory data quality

    DEFF Research Database (Denmark)

    Reda, Jan; Fouassier, Danielle; Isac, Anca

    2011-01-01

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

  7. 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.

  8. A Model to Improve the Quality Products

    OpenAIRE

    2010-01-01

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

  9. 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

  10. The development, implementation and evaluation of a transitional care programme to improve outcomes of frail older patients after hospitalisation

    DEFF Research Database (Denmark)

    Heim, Noor; Rolden, Herbert; van Fenema, Esther M;

    2016-01-01

    BACKGROUND: fragmented healthcare systems are poorly suited to treat the increasing number of older patients with multimorbidity. OBJECTIVE: to report on the development, implementation and evaluation of a regional transitional care programme, aimed at improving the recovery rate of frail...... hospitalised older patients. METHODS: the programme was drafted in co-creation with organisations representing older adults, care providers and knowledge institutes. Conducting an action research project, the incidence of adverse outcomes within 3 months after hospital admission, and long-term care expenses...... (LTCE) were compared between samples in 2010-11 (pre-programme) and 2012-13 (post-programme) in frail and non-frail patients. Hospitalised patients aged ≥70 years were included in four hospitals in the targeted region. RESULTS: developed innovations addressed (i) improved risk management; (ii) delivery...

  11. 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%.

  12. Improvement of catheter quality inspection process

    Directory of Open Access Journals (Sweden)

    Bożek Mariusz

    2017-01-01

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

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

    Science.gov (United States)

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

    2008-10-01

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

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

    Science.gov (United States)

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

    2008-01-01

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

  15. [Institute for clinical management of nephro-urological diseases: the benefits of a quality care programme].

    Science.gov (United States)

    Santiñá, M; Arrizabalaga, P; Prat, A; Alcaraz, A; Campistol, J M; Trilla, A

    2009-01-01

    The Clinic Institute of Nefro and Urology (ICNU) was formed in Clinic Hospital of Barcelona in 1999. It grouped together services of Nephrology, Urology and Renal Transplant. At the same time, in order to ensure Quality in this process of change, we designed a specific quality program. In this program, we defined objectives to improve the quality of these services in one year and we defined different quality indicators in order to maintain and monitor health quality. The indicators referred to technical quality and perceived quality and we periodically evaluated their evolution. The results of the last five years indicate that the majority of the indicators have improved, except those concerning infections surgery and the response to complaints. This has helped the consolidation and recognition of the work of this innovatory project in the health management of the nephrologic and urinary systems that locate the patient in the center of the organization and recognize the health professionals as the true managers of this model.

  16. Challenges in data quality: the influence of data quality assessments on data availability and completeness in a voluntary medical male circumcision programme in Zimbabwe

    Science.gov (United States)

    Xiao, Y; Bochner, A F; Makunike, B; Holec, M; Xaba, S; Tshimanga, M; Chitimbire, V; Barnhart, S; Feldacker, C

    2017-01-01

    Objectives To assess availability and completeness of data collected before and after a data quality audit (DQA) in voluntary medical male circumcision (VMMC) sites in Zimbabwe to determine the effect of this process on data quality. Setting 4 of 10 VMMC sites in Zimbabwe that received a DQA in February, 2015 selected by convenience sampling. Participants Retrospective reviews of all client intake forms (CIFs) from November, 2014 and May, 2015. A total of 1400 CIFs were included from those 2 months across four sites. Primary and secondary outcomes Data availability was measured as the percentage of VMMC clients whose CIF was on file at each site. A data evaluation tool measured the completeness of 34 key CIF variables. A comparison of pre-DQA and post-DQA results was conducted using χ2 and t-tests. Results After the DQA, high record availability of over 98% was maintained by sites 3 and 4. For sites 1 and 2, record availability increased by 8.0% (p=0.001) and 9.7% (p=0.02), respectively. After the DQA, sites 1, 2 and 3 improved significantly in data completeness across 34 key indicators, increasing by 8.6% (p<0.001), 2.7% (p=0.003) and 3.8% (p<0.001), respectively. For site 4, CIF data completeness decreased by 1.7% (p<0.01) after the DQA. Conclusions Our findings suggest that CIF data availability and completeness generally improved after the DQA. However, gaps in documentation of vital signs and adverse events signal areas for improvement. Additional emphasis on data completeness would help support high-quality programme implementation and availability of reliable data for decision-making. PMID:28132009

  17. A multidisciplinary intervention programme has positive effects on quality of life in overweight and obese preschool children

    NARCIS (Netherlands)

    Bocca, Gianni; Kuitert, M.W.B.; Sauer, P.J.J.; Stolk, R.P.; Flapper, B.C.; Corpeleijn, E.

    AIM: Up to 18.1% of Dutch children aged three to five are overweight and up to 3.3% are obese, with higher levels in girls. This study assessed the effect of a multidisciplinary intervention programme on health-related quality of life (HRQoL) in this patient group. METHODS: We randomised 75 children

  18. A multidisciplinary intervention programme has positive effects on quality of life in overweight and obese preschool children

    NARCIS (Netherlands)

    Bocca, Gianni; Kuitert, M.W.B.; Sauer, P.J.J.; Stolk, R.P.; Flapper, B.C.; Corpeleijn, E.

    2014-01-01

    AIM: Up to 18.1% of Dutch children aged three to five are overweight and up to 3.3% are obese, with higher levels in girls. This study assessed the effect of a multidisciplinary intervention programme on health-related quality of life (HRQoL) in this patient group. METHODS: We randomised 75 children

  19. Improving Educational Objectives of the Industrial and Management Systems Engineering Programme at Kuwait University

    Science.gov (United States)

    Aldowaisan, Tariq; Allahverdi, Ali

    2016-01-01

    This paper describes the process of developing programme educational objectives (PEOs) for the Industrial and Management Systems Engineering programme at Kuwait University, and the process of deployment of these PEOs. Input of the four constituents of the programme, faculty, students, alumni, and employers, is incorporated in the development and…

  20. Improving Educational Objectives of the Industrial and Management Systems Engineering Programme at Kuwait University

    Science.gov (United States)

    Aldowaisan, Tariq; Allahverdi, Ali

    2016-01-01

    This paper describes the process of developing programme educational objectives (PEOs) for the Industrial and Management Systems Engineering programme at Kuwait University, and the process of deployment of these PEOs. Input of the four constituents of the programme, faculty, students, alumni, and employers, is incorporated in the development and…

  1. Improving Physics Teaching through Action Research: The Impact of a Nationwide Professional Development Programme

    Science.gov (United States)

    Grace, Marcus; Rietdijk, Willeke; Garrett, Caro; Griffiths, Janice

    2015-01-01

    This article presents an independent evaluation of the Action Research for Physics (ARP) programme, a nationwide professional development programme which trains teachers to use action research to increase student interest in physics and encourage them to take post-compulsory physics. The impact of the programme was explored from the perspective of…

  2. Improving Physics Teaching through Action Research: The Impact of a Nationwide Professional Development Programme

    Science.gov (United States)

    Grace, Marcus; Rietdijk, Willeke; Garrett, Caro; Griffiths, Janice

    2015-01-01

    This article presents an independent evaluation of the Action Research for Physics (ARP) programme, a nationwide professional development programme which trains teachers to use action research to increase student interest in physics and encourage them to take post-compulsory physics. The impact of the programme was explored from the perspective of…

  3. 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...

  4. Health care quality improvement publication trends.

    Science.gov (United States)

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

    2014-01-01

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

  5. Improving Air Quality Forecasts with AURA Observations

    Science.gov (United States)

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

    2008-01-01

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

  6. Improving Air Quality Forecasts with AURA Observations

    Science.gov (United States)

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

    2008-01-01

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

  7. Effects of Psychosocial Day Care Programme on Quality of Life in Patients Affected with Schizophrenia - a Prospective Study.

    Science.gov (United States)

    Juretić, Tanja Grahovac; Ružić, Klementina; Letica-Crepulja, Marina; Petrić, Daniela; Dadić-Hero, Elizabeta; Frančišković, Tanja

    2016-06-01

    The basic aim of this prospective research was to establish the effect of psychosocial day care programme on the therapy outcomes in patients with schizophrenia. While 115 patients with schizophrenia were invited to participate, 100 of them completed the study and were subdivided into two groups. In addition to pharmacotherapy, the experimental group only (N=50) was integrated into a day-hospital-based psychosocial day care programme. The instruments were applied in three phases: the first measurement for experimental group subjects took place on the first day of psychosocial day-care programme, while for the control group subjects the same was performed on the last day of inpatient care. The second measurement for the experimental group was performed in the end of psychosocial day-care programme, while for the control group patients it occurred four months after inpatient treatment. The third measurement was carried out six months after the second one. The following instruments were applied: General Demographic Questionnaire at the first measurement, Manchester Short Assessment of Quality of Life-MANSA both at the first and third measurement, and Positive and Negative Symptoms Scale-PANSS at all three measurements. Experimental group patients showed a statistically significant increase in quality of life outcomes as well as statistically significant decrease in positive symptoms and general psychopathology at all three measurements and with regard to the control group. As to the negative symptoms, only the third measurement revealed a statistically significant difference. The results obtained indicate that the adjuvant treatment of psychosocial day care programme has a positive effect on treatment outcomes: on the increase of the patients' quality of life, and, to some extent, on the decrease of symptom intensity in positive symptoms in schizophrenia spectrum. However, the effect of psychosocial day-care programme on the negative symptoms was proved to be

  8. THE PROQUALITY NATIONAL PROGRAMME – THE MAIN APPROACH TO IMPROVEMENTS IN COMPETITIVENESS ON THE GLOBAL MARKET, TO REDUCING THE GAPS AND TO INSURING A LASTING

    Directory of Open Access Journals (Sweden)

    Rosca Remus Dorel

    2008-05-01

    Full Text Available The Japanese miracle is not a miracle. The outstanding evolution of the Japanese economy after the Second World War owes to both the cult for labor present in the Japanese society and to the influx of knowledge on quality passed on by the two American scientists, Deming şi Juran in the 1950s. The postwar economic recovery programme of Japan focussed mainly on the high quality of products. Based on the realities of the Romanian economy, we thought it mandatory for a person preoccupied and dedicated to the field of quality to conceive a project for promoting the cult of quality in the Romanian society, aimed at improving the individual, organizational and national performance in this respect, for the ultimate increase in general welfare

  9. 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.

  10. 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....

  11. Improving tomato seed quality- challenges and possibilities

    DEFF Research Database (Denmark)

    Shrestha, Santosh

    2017-01-01

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

  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. THE EXPERIMENTAL REASON OF THE AUTHOR'S PROGRAMME OF THE DEVELOPMENT AND IMPROVEMENT OF IMAGES OF THE MOTIVE STUDENTS AWF OF FIRST NEAR THE TEACHING OF GYMNASTIC PRACTICES.

    Directory of Open Access Journals (Sweden)

    Zdzieszynski A.

    2010-12-01

    Full Text Available The low level of the quality of the teaching of gymnastic practices was affirmed on practical occupations from gymnastics at students AWF. It was established on the basis of conducted investigations and experts opinion that the insufficient development was one of causes at the students of motive images about made gymnastic practices. The author's programme of the development was created and the improvement of the motive images which was introduced on practical occupations near the teaching of gymnastic practices. Author's programme turns on four programmes of practices. They have aims, tasks, centres, the elements of control and control and adequate names to their aims: „The time of the movement", „The sense of the movement", „Spatial orientation", „The control of the pose of the body". Introduced author's programme differentiated the efficiency of teaching and the realization of gymnastic practices on the advantage of the experimental group on the end of the experiment indeed (p < 0,05.

  14. Empowering women to obtain high quality care: evidence from an evaluation of Mexico's conditional cash transfer programme.

    Science.gov (United States)

    Barber, Sarah L; Gertler, Paul J

    2009-01-01

    To evaluate the impact of Mexico's conditional cash transfer programme on the quality of health care received by poor women. Quality is measured by maternal reports of prenatal care procedures received that correspond with clinical guidelines. The data describe retrospective reports of care received from 892 women in poor rural communities in seven Mexican states. The women were participating in an effectiveness study and randomly assigned to incorporation into the programme in 1998 or 1999. Eligible women accepted cash transfers conditional on obtaining health care and nutritional supplements, and participated in health education sessions. Oportunidades beneficiaries received 12.2% more prenatal procedures compared with non-beneficiaries (adjusted mean 78.9, 95% Confidence Interval (CI): 77.5-80.3; P Oportunidades conditional cash transfer programme is associated with better quality of prenatal care for low-income, rural women in Mexico. This result is probably a manifestation of the programme's empowerment goal, by encouraging beneficiaries to be informed and active health consumers.

  15. Hypnosis-Induced Mental Training Programmes as a Strategy to Improve the Self-Concept of Students

    Science.gov (United States)

    De Vos, H. M.; Louw, D. A.

    2009-01-01

    The creation and implementation of strategies that could improve student development is receiving new research interest. The main objective of the research was to establish whether hypnosis-induced mental training programmes as a strategy could alter the self-concept of students which in turn could improve their overall academic functioning. Two…

  16. Hypnosis-Induced Mental Training Programmes as a Strategy to Improve the Self-Concept of Students

    Science.gov (United States)

    De Vos, H. M.; Louw, D. A.

    2009-01-01

    The creation and implementation of strategies that could improve student development is receiving new research interest. The main objective of the research was to establish whether hypnosis-induced mental training programmes as a strategy could alter the self-concept of students which in turn could improve their overall academic functioning. Two…

  17. 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.

  18. Using Q Methodology in Quality Improvement Projects.

    Science.gov (United States)

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

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

  19. Quality Measures for Improving Technology Trees

    Directory of Open Access Journals (Sweden)

    Teemu J. Heinimäki

    2015-01-01

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

  20. Identification of bacterial strains by laboratories participating in the Deutsches Krebsforschungszentrum quality assurance programme.

    Science.gov (United States)

    Boot, R; Reubsaet, F A G

    2007-10-01

    The quality assurance programme (QAP) of the Deutsches Krebsforschungszentrum (DKFZ) is a proficiency testing system developed to service the laboratory animal discipline. QAP comprises the quarterly distribution of two bacterial strains originating from various species of animals for identification to the species level and antibiotic susceptibility testing. We compared identification results reported by QAP participants over the years 1996-2004 with those obtained by the Dutch Bacterial Diagnostics reference laboratory on 68 samples comprising 71 bacterial strains and a fungus. Significant differences were found in the frequency of reported and correct identifications when bacteria were assigned to different groups based on morphology by Gram stain and on origin (animal versus environmental, rodent and rabbit versus other animal species, pathogen versus non-pathogens). Rodent and rabbit pathogens yielded 73% correct identifications, and with all bacterial strains only 60% of the identifications were correct. We assume that most QAP participants were from laboratory animal diagnostic laboratories. If this is true, the capabilities of laboratories in the laboratory animal discipline to correctly identify bacterial species are well below what are considered acceptable limits for human diagnostic laboratories. The distribution of cultured bacteria circumvents the most difficult step in the microbiological monitoring of animals, namely primary culture from clinical samples. We propose to set up a QAP that comprises the distribution of specimens mimicking clinical samples normally submitted to laboratory animal diagnostic laboratories.

  1. The ELIXIR-EXCELERATE Train-the-Trainer pilot programme: empower researchers to deliver high-quality training.

    Science.gov (United States)

    Morgan, Sarah L; Palagi, Patricia M; Fernandes, Pedro L; Koperlainen, Eija; Dimec, Jure; Marek, Diana; Larcombe, Lee; Rustici, Gabriella; Attwood, Teresa K; Via, Allegra

    2017-01-01

    One of the main goals of the ELIXIR-EXCELERATE project from the European Union's Horizon 2020 programme is to support a pan-European training programme to increase bioinformatics capacity and competency across ELIXIR Nodes. To this end, a Train-the-Trainer (TtT) programme has been developed by the TtT subtask of EXCELERATE's Training Platform, to try to expose bioinformatics instructors to aspects of pedagogy and evidence-based learning principles, to help them better design, develop and deliver high-quality training in future. As a first step towards such a programme, an ELIXIR-EXCELERATE TtT (EE-TtT) pilot was developed, drawing on existing 'instructor training' models, using input both from experienced instructors and from experts in bioinformatics, the cognitive sciences and educational psychology. This manuscript describes the process of defining the pilot programme, illustrates its goals, structure and contents, and discusses its outcomes. From Jan 2016 to Jan 2017, we carried out seven pilot EE-TtT courses (training more than sixty new instructors), collaboratively drafted the training materials, and started establishing a network of trainers and instructors within the ELIXIR community. The EE-TtT pilot represents an essential step towards the development of a sustainable and scalable ELIXIR TtT programme. Indeed, the lessons learned from the pilot, the experience gained, the materials developed, and the analysis of the feedback collected throughout the seven pilot courses have both positioned us to consolidate the programme in the coming years, and contributed to the development of an enthusiastic and expanding ELIXIR community of instructors and trainers.

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

    Science.gov (United States)

    2010-10-01

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

  3. 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.

  4. 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.

  5. 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.

  6. The economic value of an improved malaria treatment programme in Zambia: results from a contingent valuation survey

    Directory of Open Access Journals (Sweden)

    Rehnberg Clas

    2005-12-01

    Full Text Available Abstract Background Zambia is facing a double crisis of increasing malaria burden and dwindling capacity to deal with the endemic malaria burden. The pursuit of sustainable but equity mechanisms for financing malaria programmes is a subject of crucial policy discussion. This requires that comprehensive accounting of the economic impact of the various malaria programmes. Information on the economic value of programmes is essential in soliciting appropriate funding allocations for malaria control. Aims and objectives This paper specifically seeks to elicit a measure of the economic benefits of an improved malaria treatment programme in Zambia. The paper also studies the equity implications in malaria treatment given that demand or malaria treatment is determined by household socio-economic status. Methods A contingent valuation survey of about 300 Zambian households was conducted in four districts. Willingness-to-pay (WTP was elicited for an improved treatment programme for malaria in order to generate a measure of the economic benefits of the programme. The payment card method was used in eliciting WTP bids. Findings The study reports that malaria treatment has significant economic benefits to society. The total economic benefits of an improved treatment programme were estimated at an equivalent of US$ 77 million per annum, representing about 1.8% of Zambia's GDP. The study also reports the theoretically anticipated association between WTP and several socio-economic factors. Our income elasticity of demand is positive and similar in magnitude to estimates reported in similar studies. Finally, from an equity standpoint, the constraints imposed by income and socio-economic status are discussed.

  7. Strategy to Support Improvement of Healthcare Quality.

    Directory of Open Access Journals (Sweden)

    Ing. Andrea Zejdlova

    2013-01-01

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

  8. The effectiveness of a physical activity stimulation programme for children with cerebral palsy on social participation, self-perception and quality of life: a randomized controlled trial.

    Science.gov (United States)

    Van Wely, Leontien; Balemans, Astrid Cj; Becher, Jules G; Dallmeijer, Annet J

    2014-10-01

    To determine the effects of a six-month physical activity stimulation programme on social participation, self-perception and quality of life in children with cerebral palsy. Multicentre randomized controlled trial with concealed allocation, blinded assessments and intention-to-treat analysis. Paediatric physiotherapy practices, special schools for children with a disability, and the child's own home. Forty-nine children with spastic cerebral palsy (28 male), aged 7-13 years, able to walk with and without walking aids. The intervention group followed a six-month physical activity stimulation programme involving counselling through motivational interviewing, home-based physiotherapy and four months of fitness training. The control group continued regular paediatric physiotherapy. Outcomes included social participation in domestic life, social participation in recreation and leisure (Life-Habits for Children questionnaire and Children's Assessment of Participation and Enjoyment questionnaire), self-perception (Harter's Self-Perception Profile for Children) and parent-reported quality of life (Cerebral Palsy Quality of Life Questionnaire). Assessments were performed at baseline, at six months (except quality of life) and at twelve months. Intervention resulted in a positive effect on social participation in domestic life at twelve months (mean between-group difference = 0.9, 95% confidence interval (CI) = 0.1 to 1.7 [1-10 scale], P = 0.03), but not at six months. No significant effects were found for social participation in recreation and leisure, self-perception at six months and twelve months or for quality of life at twelve months. The combination of counselling, home-based physiotherapy and fitness training was not effective in improving social participation in recreation and leisure, self-perception or quality of life, but did show a potential for improving social participation in domestic life over the longer term. © The Author(s) 2013.

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

    Science.gov (United States)

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

    2014-03-01

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

  10. 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

  11. THE INFLUENCE OF CONTINGENCIES ON THE ADOPTION OF ACTION PROGRAMMES

    DEFF Research Database (Denmark)

    Timenes Laugen, Bjørge; Acur, Nuran; Boer, Harry

    2008-01-01

    production process types, company size, and market dynamics and competition intensity affect the adoption of manufacturing improvement programmes. Analysing data from the International Manufacturing Strategy Survey (IMSS) IV, we find that production process type seems to determine the adoption of supply...... chain management and quality programmes, but not programmes aimed at organizational, manufacturing process or NPD improvement. The adoption of all five groups of action programmes increases with company size, which suggests company size to be the most important determining factor for the adoption...... of manufacturing action programmes. Further, companies operating in dynamic markets adopt programmes to improve the manufacturing process, probably due to the need for increased capacity. Finally, companies facing intense competition appear to adopt programmes aimed at improving the quality and new product...

  12. The impact of SLMTA in improving laboratory quality systems in the Caribbean Region

    Directory of Open Access Journals (Sweden)

    Giselle Guevara

    2014-09-01

    Full Text Available Background: Past efforts to improve laboratory quality systems and to achieve accreditation for better patient care in the Caribbean Region have been slow.Objective: To describe the impact of the Strengthening of Laboratory Management Toward Accreditation (SLMTA training programme and mentorship amongst five clinical laboratories in the Caribbean after 18 months.Method: Five national reference laboratories from four countries participated in the SLMTA programme that incorporated classroom teaching and implementation of improvement projects. Mentors were assigned to the laboratories to guide trainees on their improvement projects and to assist in the development of Quality Management Systems (QMS. Audits were conducted at baseline, six months, exit (at 12 months and post-SLMTA (at 18 months using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA checklist to measure changes in implementation of the QMS during the period. At the end of each audit, a comprehensive implementation plan was developed in order to address gaps.Results: Baseline audit scores ranged from 19% to 52%, corresponding to 0 stars on the SLIPTA five-star scale. After 18 months, one laboratory reached four stars, two reached three stars and two reached two stars. There was a corresponding decrease in nonconformities and development of over 100 management and technical standard operating procedures in each of the five laboratories.Conclusion: The tremendous improvement in these five Caribbean laboratories shows that SLMTA coupled with mentorship is an effective, user-friendly, flexible and customisable approach to the implementation of laboratory QMS. It is recommended that other laboratories in the region consider using the SLMTA training programme as they engage in quality systems improvement and preparation for accreditation.

  13. Quality Assurance in Open and Distance Education: a Case Study of Kota Open University

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    After a brief analysis of the concept of quality in open and distance education, information technology for quality assurance and Indian initiative for quality improvement, the paper examines the quality assurance measures at Kota Open University under the following areas: planning academic programmes ;developing academic programmes; producing learning materials; implementing programmes; reviewing courses/programmes ; and developing human resources.

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

    Science.gov (United States)

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

  15. Early Palliative Care Improves Patients' Quality of Life

    Science.gov (United States)

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

  16. Improving reading comprehension in reading and listening settings: the effect of two training programmes focusing on metacognition and working memory.

    Science.gov (United States)

    Carretti, Barbara; Caldarola, Nadia; Tencati, Chiara; Cornoldi, Cesare

    2014-06-01

    Metacognition and working memory (WM) have been found associated with success in reading comprehension, but no studies have examined their combined effect on the training of reading comprehension. Another open question concerns the role of listening comprehension: In particular, it is not clear whether training to improve reading comprehension must necessarily be based on processing written material or whether, as suggested in a recent study by Clarke et al. (2010, Psychol. Sci., 21, 1106), a programme based on verbal language could also be effective. The study examined the feasibility of improving text comprehension in school children by comparing the efficacy of two training programmes, both involving metacognition and WM, but one based on listening comprehension, the other on reading comprehension. The study involved a sample of 159 pupils attending eight classes in the fourth and fifth grades (age range 9-11 years). The listening and reading programmes focused on the same abilities/processes strictly related to text comprehension, and particularly metacognitive knowledge and control, WM (per se and in terms of integrating information in a text). The training programmes were implemented by school teachers as part of the class's normal school activities, under the supervision of experts. Their efficacy was compared with the results obtained in an active control group that completed standard text comprehension activities. Our results showed that both the training programmes focusing on specific text comprehension skills were effective in improving the children's achievement, but training in reading comprehension generated greater gains than the listening comprehension programme. Our study suggests that activities focusing specifically on metacognition and WM could foster text comprehension, but the potential benefit is influenced by the training modality, that is, the Reading group obtained greater and longer-lasting improvements than the Active control or

  17. Analytical performance specifications based on how clinicians use laboratory tests. Experiences from a post-analytical external quality assessment programme.

    Science.gov (United States)

    Thue, Geir; Sandberg, Sverre

    2015-05-01

    Analytical performance specifications can be based on three different models: the effect of analytical performance on clinical outcome, based on components of biological variation of the measurand or based on state-of-the-art. Models 1 and 3 may to some degree be combined by using case histories presented to a large number of clinicians. The Norwegian Quality Improvement of Primary Care Laboratories (Noklus) has integrated vignettes in its external quality assessment programme since 1991, focusing on typical clinical situations in primary care. Haemoglobin, erythrocyte sedimentation rate (ESR), HbA1c, glucose, u-albumin, creatinine/estimated glomerular filtration rate (eGFR), and Internationl Normalised Ratio (INR) have been evaluated focusing on critical differences in test results, i.e., a change from a previous result that will generate an "action" such as a change in treatment or follow-up of the patient. These critical differences, stated by physicians, can translate into reference change values (RCVs) and assumed analytical performance can be calculated. In general, assessments of RCVs and therefore performance specifications vary both within and between groups of doctors, but with no or minor differences regarding specialisation, age or sex of the general practitioner. In some instances state-of-the-art analytical performance could not meet clinical demands using 95% confidence, whereas clinical demands were met using 80% confidence in nearly all instances. RCVs from vignettes should probably not be used on their own as a basis for setting analytical performance specifications, since clinicians seem "uninformed" regarding important principles. They could rather be used as a background for focus groups of "informed" physicians in discussions of performance specifications tailored to "typical" clinical situations.

  18. Foliage Plants for Improving Indoor Air Quality

    Science.gov (United States)

    Wolverton, B. C.

    1988-01-01

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

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

    Science.gov (United States)

    Tout, Kathryn; Isner, Tabitha; Zaslow, Martha

    2011-01-01

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

  20. First thermal building simulation programmes tested by the quality mark test; Eerste thermische gebouwsimulatieprogramma`s ondergingen de keurmerktest

    Energy Technology Data Exchange (ETDEWEB)

    Wijsman, A.J.Th.; Plokker, W. [TNO Bouw, Delft (Netherlands)

    1999-04-01

    Within Annex 21 of the IEA Building and Community Systems (`Calculation of Energy and Environmental Performance of Buildings`) several tools were developed to reduce the differences between presently applied computer programmes for thermal calculations on buildings or installations. In the Netherlands a project was started to tailor those tools to the Dutch conditions. Also a quality mark test procedure has been developed, based on those tools. Project information and test results are presented. 2 refs.

  1. Internet-Based Training to Improve Preschool Playground Safety: Evaluation of the Stamp-in-Safety Programme

    Science.gov (United States)

    Schwebel, David C.; Pennefather, Jordan; Marquez, Brion; Marquez, Jessie

    2015-01-01

    Objective: Playground injuries result in over 200,000 US pediatric emergency department visits annually. One strategy to reduce injuries is improved adult supervision. The Stamp-in-Safety programme, which involves supervisors stamping rewards for children playing safely, has been demonstrated in preliminary classroom-based work to reduce child…

  2. The role of intrinsic motivation in a group of low vision patients participating in a self-management programme to enhance self-efficacy and quality of life.

    Science.gov (United States)

    Tay, Kay Chai Peter; Drury, Vicki Blair; Mackey, Sandra

    2014-02-01

    Self-management programmes have previously been found to decrease health problems, enhance quality of life and increase independence. However, there is no literature that examines the influence of the participants' intrinsic motivation on the outcomes of such programmes. This study examined the role of intrinsic motivation in a pilot low vision self-management programme to enhance self-efficacy and quality of life of the programme participants. A positive association was observed between the female participants' perceived choice and perceived competence, two underlying dimensions of the Intrinsic Motivation Inventory. In addition, a positive correlation was observed between the younger participants' perceived competence and the change in their quality of life. The findings provide some support for consideration of participants' intrinsic motivation in the development of effective self-management programmes.

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

    Science.gov (United States)

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

    2014-01-01

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

  4. Improving problem solving in primary school students: The effect of a training programme focusing on metacognition and working memory.

    Science.gov (United States)

    Cornoldi, Cesare; Carretti, Barbara; Drusi, Silvia; Tencati, Chiara

    2015-09-01

    Despite doubts voiced on their efficacy, a series of studies has been carried out on the capacity of training programmes to improve academic and reasoning skills by focusing on underlying cognitive abilities and working memory in particular. No systematic efforts have been made, however, to test training programmes that involve both general and specific underlying abilities. If effective, these programmes could help to increase students' motivation and competence. This study examined the feasibility of improving problem-solving skills in school children by means of a training programme that addresses general and specific abilities involved in problem solving, focusing on metacognition and working memory. The project involved a sample of 135 primary school children attending eight classes in the third, fourth, and fifth grades (age range 8-10 years). The classes were assigned to two groups, one attending the training programme in the first 3 months of the study (Training Group 1) and the other serving as a waiting-list control group (Training Group 2). In the second phase of the study, the role of the two groups was reversed, with Training Group 2 attending the training instead of Training Group 1. The training programme led to improvements in both metacognitive and working memory tasks, with positive-related effects on the ability to solve problems. The gains seen in Training Group 1 were also maintained at the second post-test (after 3 months). Specific activities focusing on metacognition and working memory may contribute to modifying arithmetical problem-solving performance in primary school children. © 2015 The British Psychological Society.

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

    Science.gov (United States)

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

    2017-04-04

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

  6. Practical guidelines for radiographers to improve computed radiography image quality.

    Science.gov (United States)

    Pongnapang, N

    2005-10-01

    Computed Radiography (CR) has become a major digital imaging modality in a modern radiological department. CR system changes workflow from the conventional way of using film/screen by employing photostimulable phosphor plate technology. This results in the changing perspectives of technical, artefacts and quality control issues in radiology departments. Guidelines for better image quality in digital medical enterprise include professional guidelines for users and the quality control programme specifically designed to serve the best quality of clinical images. Radiographers who understand technological shift of the CR from conventional method can employ optimization of CR images. Proper anatomic collimation and exposure techniques for each radiographic projection are crucial steps in producing quality digital images. Matching image processing with specific anatomy is also important factor that radiographers should realise. Successful shift from conventional to fully digitised radiology department requires skilful radiographers who utilise the technology and a successful quality control program from teamwork in the department.

  7. Realization of National Programme of Municipal Wastewater Treatment and the quality of surface water in Poland

    Directory of Open Access Journals (Sweden)

    Sylwia Myszograj

    2012-09-01

    Full Text Available One of the aims of improving water quality, resulting directly from the Water Framework Directive 2000/60/EC, is to achieve in 2015, at least good status for all waters in the country. Following the adoption by Poland of the Water Framework Directive assessment of the economic and general cleanliness of water was replaced by an assessment of ecological status. In this way, the analysis of water status shall be treated as not only economic resources, but primarily as part of the ecosystem. The most important from the standpoint of human health protection, is the quality of water intended for human consumption.In the document „The purity of rivers based on the results of tests carried out within the national environmental monitoring in 2007–2009” is given that: – only 10.6% of the surface of flowing water meets the requirements of collective waters used for water supply for drinking, – up 28.7% of the length of monitored water is too polluted for them mildest demands posed conditioned needs of the economy. The decrease in water quality was affected by the physico-chemical pollutants such as pH, total suspension, manganese, polycyclic aromatic hydrocarbons (PAHs, CODCr, BOD5 and TOC. Large impact on reducing water quality category also had microbial contamination, the number of fecal coliform bacteria, fecal streptococci and total coliforms.

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

    Science.gov (United States)

    Murgatroyd, Stephen

    1991-01-01

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

  9. Impact on quality of life of a nursing intervention programme for patients with chronic non-cancer pain: an open, randomized controlled parallel study protocol.

    Science.gov (United States)

    Morales-Fernandez, Angeles; Morales-Asencio, Jose Miguel; Canca-Sanchez, Jose Carlos; Moreno-Martin, Gabriel; Vergara-Romero, Manuel

    2016-05-01

    To determine the effect of a nurse-led intervention programme for patients with chronic non-cancer pain. Chronic non-cancer pain is a widespread health problem and one that is insufficiently controlled. Nurses can play a vital role in pain management, using best practices in the assessment and management of pain under a holistic approach where the patient plays a proactive role in addressing the disease process. Improving the quality of life, reducing disability, achieving acceptance of health status, coping and breaking the vicious circle of pain should be the prime objectives of our care management programme. Open randomized parallel controlled study. The experimental group will undertake one single initial session, followed by six group sessions led by nurses, aimed at empowering patients for the self-management of pain. Healthy behaviours will be encouraged, such as sleep and postural hygiene, promotion of physical activity and healthy eating. Educational interventions on self-esteem, pain-awareness, communication and relaxing techniques will be carried out. As primary end points, quality of life, perceived level of pain, anxiety and depression will be evaluated. Secondary end points will be coping and satisfaction. Follow-up will be performed at 12 and 24 weeks. The study was approved by the Ethics and Research Committee Costa del Sol. If significant effects were detected, impact on quality of life through a nurse-led programme would offer a complementary service to existing pain clinics for a group of patients with frequent unmet needs. © 2016 John Wiley & Sons Ltd.

  10. Using field programmable gate array hardware for the performance improvement of ultrasonic wave propagation imaging system

    Energy Technology Data Exchange (ETDEWEB)

    Shan, Jaffry Syed [Hamdard University, Karachi (Pakistan); Abbas, Syed Haider; Lee, Jung Ryul [Dept. of Aerospace Engineering, Korea Advanced Institute of Science and Technology, Daejeon (Korea, Republic of); Kang, Dong Hoon [Advanced Materials Research Team, Korea Railroad Research Institute, Uiwang (Korea, Republic of)

    2015-12-15

    Recently, wave propagation imaging based on laser scanning-generated elastic waves has been intensively used for nondestructive inspection. However, the proficiency of the conventional software based system reduces when the scan area is large since the processing time increases significantly due to unavoidable processor multitasking, where computing resources are shared with multiple processes. Hence, the field programmable gate array (FPGA) was introduced for a wave propagation imaging method in order to obtain extreme processing time reduction. An FPGA board was used for the design, implementing post-processing ultrasonic wave propagation imaging (UWPI). The results were compared with the conventional system and considerable improvement was observed, with at least 78% (scanning of 100x100mm{sup 2} with 0.5 mm interval) to 87.5% (scanning of 200x200mm{sup 2} with 0.5 mm interval) less processing time, strengthening the claim for the research. This new concept to implement FPGA technology into the UPI system will act as a break-through technology for full-scale automatic inspection.

  11. Continuous quality improvement of colorectal cancer screening

    Institute of Scientific and Technical Information of China (English)

    Mariusz; Madalinski

    2013-01-01

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

  12. Improving educational objectives of the Industrial and Management Systems Engineering programme at Kuwait University

    Science.gov (United States)

    Aldowaisan, Tariq; Allahverdi, Ali

    2016-05-01

    This paper describes the process of developing programme educational objectives (PEOs) for the Industrial and Management Systems Engineering programme at Kuwait University, and the process of deployment of these PEOs. Input of the four constituents of the programme, faculty, students, alumni, and employers, is incorporated in the development and update of the PEOs. For each PEO an assessment process is employed where performance measures are defined along with target attainment levels. Results from assessment tools are compared with the target attainment levels to measure performance with regard to the PEOs. The assessment indicates that the results meet or exceed the target attainment levels of the PEOs' performance measures.

  13. Yoga: A tool for improving the quality of life in chronic pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Surinder Sareen; Vinita Kumari; Karaminder Singh Gajebasia; Nimanpreet Kaur Gajebasia

    2007-01-01

    AIM: To determine the effectiveness of yoga on improving the quality of life in patients of chronic pancreatitis.METHODS: The patients were randomized to two groups. The control group continued their usual care as directed by their physicians. Patients in the yoga group, in addition, received biweekly yoga sessions for 12 wk. The patients' demographic and health behaviour variables were assessed before and after the yoga programme using Medical Outcomes Short Form (SF-36) for quality of life, Profile of Mood States for assessing mood and Symptoms of Stress Inventory for measuring stress.RESULTS: A total of 60 patients were enrolled, with 8drop-outs.Thirty patients were randomized to the yoga group and 30 to the control group. Significant improvements were seen in overall quality of life, symptoms of stress, mood changes, alcohol dependence and appetite after the 12 wk period apart from the general feeling of well-being and desire to continue with the programme in future in the yoga group, while there was no difference in the control group.CONCLUSION: Yoga is effective on improving the quality of life in patients of chronic pancreatitis.

  14. 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.

  15. Strategies to improve the implementation of healthy eating, physical activity and obesity prevention policies, practices or programmes within childcare services.

    Science.gov (United States)

    Wolfenden, Luke; Jones, Jannah; Williams, Christopher M; Finch, Meghan; Wyse, Rebecca J; Kingsland, Melanie; Tzelepis, Flora; Wiggers, John; Williams, Amanda J; Seward, Kirsty; Small, Tameka; Welch, Vivian; Booth, Debbie; Yoong, Sze Lin

    2016-10-04

    Despite the existence of effective interventions and best-practice guideline recommendations for childcare services to implement policies, practices and programmes to promote child healthy eating, physical activity and prevent unhealthy weight gain, many services fail to do so. The primary aim of the review was to examine the effectiveness of strategies aimed at improving the implementation of policies, practices or programmes by childcare services that promote child healthy eating, physical activity and/or obesity prevention. The secondary aims of the review were to:1. describe the impact of such strategies on childcare service staff knowledge, skills or attitudes;2. describe the cost or cost-effectiveness of such strategies;3. describe any adverse effects of such strategies on childcare services, service staff or children;4. examine the effect of such strategies on child diet, physical activity or weight status. We searched the following electronic databases on 3 August 2015: the Cochrane Central Register of Controlled trials (CENTRAL), MEDLINE, MEDLINE In Process, EMBASE, PsycINFO, ERIC, CINAHL and SCOPUS. We also searched reference lists of included trials, handsearched two international implementation science journals and searched the World Health Organization International Clinical Trials Registry Platform (www.who.int/ictrp/) and ClinicalTrials.gov (www.clinicaltrials.gov). We included any study (randomised or non-randomised) with a parallel control group that compared any strategy to improve the implementation of a healthy eating, physical activity or obesity prevention policy, practice or programme by staff of centre-based childcare services to no intervention, 'usual' practice or an alternative strategy. The review authors independently screened abstracts and titles, extracted trial data and assessed risk of bias in pairs; we resolved discrepancies via consensus. Heterogeneity across studies precluded pooling of data and undertaking quantitative

  16. Basic life support skill improvement with newly designed renewal programme: cluster randomised study of small-group-discussion method versus practice-while-watching method.

    Science.gov (United States)

    Na, Ji Ung; Lee, Tae Rim; Kang, Mun Ju; Shin, Tae Gun; Sim, Min Seob; Jo, Ik Joon; Song, Keun Jeong; Jeong, Yeon Kwon

    2014-12-01

    For the basic life support (BLS) renewal course, we have devised a new educational programme entitled a small-group-discussion (SGD) programme using personalised video-based debriefing. We compared the efficacy in BLS skill improvement of the SGD programme with the currently used practice-while-watching (PWW) programme, which uses a standardised education video. This was a prospective, cluster randomised study, conducted in a single centre, over 6 months from May 2009 to October 2009. Training was performed in two groups of participants, each group with a different renewal education programme. The efficacy of the programmes was compared using the modified Cardiff test and skill-reporting manikins. Results from 2169 participants were analysed: 1061 in the SGD programme group and 1108 in the PWW programme group. There were no differences between groups on the pretest, either in compression or non-compression skills. However, on the post-test, the SGD programme gave better results for both compression skills and non-compression skills. The new SGD renewal programme is more effective than the PWW programme for improving skills in BLS renewal training. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  17. Applying Triz for Production Quality Improvement

    Directory of Open Access Journals (Sweden)

    Swee Nikalus Shu Luing

    2017-01-01

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

  18. Does addressing gender inequalities and empowering women and girls improve health and development programme outcomes?

    Science.gov (United States)

    Taukobong, Hannah F G; Kincaid, Mary M; Levy, Jessica K; Bloom, Shelah S; Platt, Jennifer L; Henry, Sarah K; Darmstadt, Gary L

    2016-12-01

    This article presents evidence supporting the hypothesis that promoting gender equality and women's and girls' empowerment (GEWE) leads to better health and development outcomes. We reviewed the literature across six sectors-family planning (FP); maternal, newborn and child health (MNCH); nutrition; agriculture; water, sanitation and hygiene; and financial services for the poor-and found 76 studies from low and middle-income countries that met our inclusion criteria. Across these studies, we identified common GEWE variables that emerged repeatedly as significant predictors of sector outcomes. We grouped these variables into 10 thematic categories, which we termed 'gender-related levers'. These levers were then classified by the strength of evidence into Wedges, Foundations and Facilitators. Wedges are gender-related levers that had strong associations with improved outcomes across multiple sectors. They include: 'control over income/assets/resources', 'decision-making power' and 'education'. Elements of these levers overlap, but combined, they encapsulate agency. Increasing female agency promotes equality and broadly improves health and development for women, their families and their communities. The second classification, Foundations, displayed strong, positive associations across FP, MNCH and nutrition. Foundations have a more proximal relationship with sector outcomes and include: 'equitable interpersonal relationships', 'mobility' and 'personal safety'. Finally, the third group of levers, Facilitators, was associated with improved outcomes in two to three sectors and include: 'access to information', 'community groups', 'paid labour' and 'rights'. These levers make it easier for women and girls to achieve their goals and are more traditional elements of development programmes. Overall, gender-related levers were associated with improvements in a variety of health and development outcomes. Furthermore, these associations were cross-sectoral, suggesting that to

  19. A clinically integrated post-graduate training programme in evidence-based medicine versus 'no intervention' for improving disability evaluations: a cluster randomised clinical trial.

    Directory of Open Access Journals (Sweden)

    Rob Kok

    Full Text Available BACKGROUND: Although several studies have shown that teaching EBM is effective in improving knowledge, at present, there is no convincing evidence that teaching EBM also changes professional behaviour in practice. Therefore, the primary aim of this study was to evaluate the effectiveness of a clinically integrated post-graduate training programme in EBM on evidence-based disability evaluation. METHODS AND FINDINGS: In a cluster randomised controlled trial, fifty-four case-based learning groups consisting of 132 physicians and 1680 patients were randomly assigned to the intervention or control groups. A clinically integrated, post-graduate, 5-day training programme in evidence-based medicine, consisting of (home assignments, peer teaching, interactive training in searching databases, lectures and brainstorming sessions was provided to the intervention group. The control group received no training. The primary outcome was evidence-based disability evaluation, as indicated by the frequency in use of evidence of sufficient quality in disability evaluation reports. There are no general EBM behaviour outcome measures available. Therefore, we followed general guidelines for constructing performance indicators and defined an a priori cut-off for determination of sufficient quality as recommended for evaluating EB training. Physicians trained in EBM performed more evidence-based disability evaluations compared to physicians in the control group (difference in absolute proportion 9.7%, 95% CI 3.5 to 15.9. The primary outcome differences between groups remained significant after both cluster-adjusted analysis and additional sensitivity analyses accounting for subjects lost to follow-up. CONCLUSIONS: A EBM programme successfully improved the use of evidence in a non-hospital based medical specialty. Our findings support the general recommendations to use multiple educational methods to change physician behaviour. In addition, it appeared important that the

  20. Improving the safety and quality of cancer care.

    Science.gov (United States)

    Burke, Harry B

    2017-02-15

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

  1. Information systems for administration, clinical documentation and quality assurance in an Austrian disease management programme.

    Science.gov (United States)

    Beck, Peter; Truskaller, Thomas; Rakovac, Ivo; Bruner, Fritz; Zanettin, Dominik; Pieber, Thomas R

    2009-01-01

    5.9% of the Austrian population is affected by diabetes mellitus. Disease Management is a structured treatment approach that is suitable for application to the diabetes mellitus area and often is supported by information technology. This article describes the information systems developed and implemented in the Austrian disease management programme for type 2 diabetes. Several workflows for administration as well as for clinical documentation have been implemented utilizing the Austrian e-Health infrastructure. De-identified clinical data is available for creating feedback reports for providers and programme evaluation.

  2. Effectiveness of a community-based nutrition programme to improve child growth in rural Ethiopia: a cluster randomized trial.

    Science.gov (United States)

    Kang, Yunhee; Kim, Sungtae; Sinamo, Sisay; Christian, Parul

    2017-01-01

    Few trials have shown that promoting complementary feeding among young children is effective in improving child linear growth in resource-challenged settings. We designed a community-based participatory nutrition promotion (CPNP) programme adapting a Positive Deviance/Hearth approach that engaged mothers in 2-week nutrition sessions using the principles of 'learning by doing' around child feeding. We aimed to test the effectiveness of the CPNP for improving child growth in rural Ethiopia. A cluster randomized trial was implemented by adding the CPNP to the existing government nutrition programmes (six clusters) vs. government programmes only (six clusters). A total of 1790 children aged 6 to 12 months (876 in the intervention and 914 in the control areas) were enrolled and assessed on anthropometry every 3 months for a year. Multi-level mixed-effect regression analysis of longitudinal outcome data (n = 1475) examined the programme impact on growth, adjusting for clustering and enrollment characteristics. Compared with children 6 to 24 months of age in the control area, those in the intervention area had a greater increase in z scores for length-for-age [difference (diff): 0.021 z score/month, 95% CI: 0.008, 0.034] and weight-for-length (diff: 0.042 z score/month, 95% CI: 0.024, 0.059). At the end of the 12-month follow-up, children in the intervention area showed an 8.1% (P = 0.02) and 6.3% (P = 0.046) lower prevalence of stunting and underweight, respectively, after controlling for differences in the prevalence at enrollment, compared with the control group. A novel CPNP programme was effective in improving child growth and reducing undernutrition in this setting. © 2016 John Wiley & Sons Ltd.

  3. Improving Data Quality for Pavement Management System

    OpenAIRE

    2015-01-01

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

  4. Good air quality in offices improves productivity

    DEFF Research Database (Denmark)

    Fanger, Povl Ole

    2000-01-01

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

  5. Good air quality in offices improves productivity

    DEFF Research Database (Denmark)

    Fanger, Povl Ole

    2000-01-01

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

  6. Good air quality in offices improves productivity

    DEFF Research Database (Denmark)

    Fanger, Povl Ole

    2000-01-01

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

  7. Good air quality in offices improves productivity

    DEFF Research Database (Denmark)

    Fanger, Povl Ole

    2000-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Pohaydak, Olha Bohdanivna

    2011-11-01

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

  9. Quality of Assessment of Prior Learning (APL) in University Programmes: Perceptions of Candidates, Tutors and Assessors

    Science.gov (United States)

    Brinke, D. Joosten-ten; Sluijsmans, D. M. A.; Jochems, W. M. G.

    2009-01-01

    Formal diplomas and certificates have been accepted as proof that students may receive exemption for parts of their educational programme. Nowadays, though, it is socially desirable that informal and non-formal learning experiences are also recognised. Assessment of prior learning (APL) addresses this issue. In APL, the candidate's knowledge,…

  10. Quality of assessment of prior learning in university programmes : Perceptions of candidates, tutors and assessors

    NARCIS (Netherlands)

    Sluijsmans, Dominique; Joosten-ten Brinke, Desirée; Jochems, W.

    2009-01-01

    Formal diplomas and certificates have been accepted as proof that students may receive exemption for parts of their educational programme. Nowadays, though, it is socially desirable that informal and non-formal learning experiences are also recognised. Assessment of prior learning (APL) addresses th

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

    Science.gov (United States)

    Asiyai, Romina Ifeoma

    2015-01-01

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

  12. Oral hygiene caregivers' educational programme improves oral health conditions in institutionalised independent and functional elderly.

    Science.gov (United States)

    Portella, Fernando F; Rocha, Aline W; Haddad, Daniel C; Fortes, Carmem B B; Hugo, Fernando N; Padilha, Dalva M P; Samuel, Susana M W

    2015-03-01

    The goal of this study was to determine the impact of an oral hygiene education programme for caregivers on the oral health of institutionalised elderly and to examine the effect of disability and low muscle strength on programme outcomes. The subjects of this study were geriatric patients (n = 80) from a nursing home. Katz Index for activities of daily living, handgrip strength and mucosal-plaque score (MPS) was evaluated at baseline and 1 year after intervention. The intervention consisted of an educational programme and specific guidelines for caregivers (to perform oral hygiene for dependent elderly and to supervise the independent elderly during oral hygiene practices). Differences on MPS were evaluated using a paired-sample t-test. A stratified analysis was carried out to identify differences in response to the programme according to the Katz Index and handgrip strength of elderly. The MPS was significantly reduced (p = 0.001) at follow-up; however, a separate analysis showed that only the independent elderly (p = 0.002) and those with normal muscle strength (p = 0.006) showed a reduction in MPS during the follow-up examination. The oral hygiene education programme for caregivers resulted in a positive impact on oral hygiene of the independent and functional elderly. © 2013 The Gerodontology Society and John Wiley & Sons A/S.

  13. A repeated short educational intervention improves asthma control and quality of life.

    Science.gov (United States)

    Plaza, Vicente; Peiró, Meritxell; Torrejón, Montserrat; Fletcher, Monica; López-Viña, Antolín; Ignacio, José María; Quintano, José Antonio; Bardagí, Santiago; Gich, Ignasi

    2015-11-01

    We assessed the effectiveness of an asthma educational programme based on a repeated short intervention (AEP-RSI) to improve asthma control (symptom control and future risk) and quality of life. A total of 230 adults with mild-to-moderate persistent uncontrolled asthma participated in a 1-year cluster randomised controlled multicentre study. The AEP-RSI was given in four face-to-face sessions at 3-month intervals, and included administration of a written personalised action plan and training on inhaler technique. Centres were randomised to the AEP-RSI (intervention) group or usual clinical practice group. Specialised centres using a standard educational programme were the gold standard group. A significant improvement in the Asthma Control Test score was observed in all three groups (pimprovements were higher in the intervention and gold standard groups than in the usual clinical practice group (p=0.042), which also showed fewer exacerbations (mean±sd; 1.20±2.02 and 0.56±1.5 versus 2.04±2.72, respectively) and greater increases in the Mini Asthma Quality of Life Questionnaire scores (0.95±1.04 and 0.89±0.84 versus 0.52±0.97, respectively). The AEP-RSI was effective in improving asthma symptom control, future risk and quality of life.

  14. Do farm audits improve milk quality?

    NARCIS (Netherlands)

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2004-01-01

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

  16. Improvement of the Performance of Scheduled Stepwise Power Programme Changes within the European Power System

    DEFF Research Database (Denmark)

    Welfonder, E.; Weissbach, T.; Schulz, U.

    2008-01-01

    units. These power imbalances may occur within single control areas or between different control areas. Therefore, as a countermeasure, power output ramps with a standardised ramp duration of 2T ≤ 15 min are required so that no power imbalance occurs during scheduled power programme changes. After......Since the deregulation of the electrical energy market, the technical realisation of power transactions based on energy market contracts often effects large stepwise power programme changes – especially at the change of the hour. Due to mainly economic reasons these stepwise power programme changes...... lead to remarkable power imbalances within the European Power System causing large unintended frequency deviations. In case of these – mostly negative – frequency deviations up to Δf = -150 mHz, considerably more than half of the primary control reserve is activated needlessly, which highly stresses...

  17. How To Improve Software Quality Assurance In Developing Countries

    Directory of Open Access Journals (Sweden)

    Ali Javed

    2012-04-01

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

  18. 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

  19. Impact on outcome of a targeted performance improvement programme in haemodynamically unstable patients with a pelvic fracture.

    Science.gov (United States)

    Perkins, Z B; Maytham, G D; Koers, L; Bates, P; Brohi, K; Tai, N R M

    2014-08-01

    We describe the impact of a targeted performance improvement programme and the associated performance improvement interventions, on mortality rates, error rates and process of care for haemodynamically unstable patients with pelvic fractures. Clinical care and performance improvement data for 185 adult patients with exsanguinating pelvic trauma presenting to a United Kingdom Major Trauma Centre between January 2007 and January 2011 were analysed with univariate and multivariate regression and compared with National data. In total 62 patients (34%) died from their injuries and opportunities for improved care were identified in one third of deaths. Three major interventions were introduced during the study period in response to the findings. These were a massive haemorrhage protocol, a decision-making algorithm and employment of specialist pelvic orthopaedic surgeons. Interventions which improved performance were associated with an annual reduction in mortality (odds ratio 0.64 (95% confidence interval (CI) 0.44 to 0.93), p = 0.02), a reduction in error rates (p = 0.024) and significant improvements in the targeted processes of care. Exsanguinating patients with pelvic trauma are complex to manage and are associated with high mortality rates; implementation of a targeted performance improvement programme achieved sustained improvements in mortality, error rates and trauma care in this group of severely injured patients.

  20. Effectiveness of a structured education reminiscence-based programme for staff on the quality of life of residents with dementia in long-stay units: a study protocol for a cluster randomised trial.

    LENUS (Irish Health Repository)

    O'Shea, Eamon

    2011-02-01

    Current projections indicate that there will be a significant increase in the number of people with dementia in Ireland, from approximately 40,000 at present to 100,000 by 2036. Psychosocial interventions, such as reminiscence, have the potential to improve the quality of life of people with dementia. However, while reminiscence is used widely in dementia care, its impact on the quality of life of people with dementia remains largely undocumented and there is a need for a robust and fair assessment of its overall effectiveness. The DementiA education programme incorporating REminiscence for Staff study will evaluate the effectiveness of a structured reminiscence-based education programme for care staff on the quality of life of residents with dementia in long-stay units.

  1. Improvement of the Performance of Scheduled Stepwise Power Programme Changes within the European Power System

    DEFF Research Database (Denmark)

    Welfonder, E.; Weissbach, T.; Schulz, U.

    2008-01-01

    Since the deregulation of the electrical energy market, the technical realisation of power transactions based on energy market contracts often effects large stepwise power programme changes – especially at the change of the hour. Due to mainly economic reasons these stepwise power programme changes...... lead to remarkable power imbalances within the European Power System causing large unintended frequency deviations. In case of these – mostly negative – frequency deviations up to Δf = -150 mHz, considerably more than half of the primary control reserve is activated needlessly, which highly stresses...

  2. Improved Switching Performance Analysis of Space Vector Pulse Width Modulation on Field Programmable Gate Array

    Directory of Open Access Journals (Sweden)

    Nagalingam RAJESWARAN

    2014-02-01

    Full Text Available Nowadays VLSI (Very Large Scale Integration technology is being successfully implemented by using Pulse Width Modulation (PWM in applications like power electronics and drives. The main problems in PWM viz. harmonic distortion and switching speed are overcome by implementing the Space-Vector PWM (SVPWM technique by using the Xilinx tool VHDL (Verilog High Speed Integrated Circuit (VHSIC Hardware Description Language and tested in programmable Integrated Circuits of Field Programmable Gate Array (FPGA. The results are provided along with simulation analysis in terms of hardware utilization and schematic, power report, computing time and usage of memory.

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

    Science.gov (United States)

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

    2017-02-20

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

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

    Science.gov (United States)

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

    2017-09-01

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

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

    DEFF Research Database (Denmark)

    Harboe, Kirstine M; Bardram, Linda

    2011-01-01

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

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

    Science.gov (United States)

    Likosky, Donald S

    2014-03-01

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

  7. The VIDA Programme

    DEFF Research Database (Denmark)

    Jensen, Bente; Iannone, Rosa Lisa

    and Innovation’ within the project ‘Curriculum Quality Analysis and Impact Review of European Education and Care’ (CARE). The programme at the centre of this case builds on theory drawn from research on child development, social disadvantage related to issues of social inequality, and research on organisational...... learning and innovation. The latter field has tended to focus primarily on technological innovation, leaving socially-driven innovation in the shade (Dawson & Daniel, 2010). Here, in the field of early childhood education and care (ECEC), we draw on Dawson and Daniel’s (ibid., p. 10) definition...... programme period (2010-2013) and beyond?; 2) What is the impact of the VIDA approach to professional development on i) educators’ practices regarding high quality ECEC (output), ii) child outcomes (outcome), and iii) improved practice at the municipal level (impact in a broader sense)?; and 3) Which factors...

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

    Science.gov (United States)

    Dunagan, Pamela B

    2017-08-22

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

  9. How the Admission Criteria to a Competitive-Entry Undergraduate Programme Could Be Improved

    Science.gov (United States)

    Shulruf, Boaz; Shaw, John

    2015-01-01

    The introduction of a new standards-based secondary school assessment system, the National Certificate of Educational Achievement (NCEA), necessitated significant changes to the admissions processes for New Zealand universities, particularly for competitive-entry programmes such as medicine, engineering and pharmacy. Selection to such programmes…

  10. The Contribution of Group Work Programmes to Early Intervention and Improving Children's Emotional Well-Being

    Science.gov (United States)

    Parton, Christine; Manby, Martin

    2009-01-01

    Recent government policy has emphasised links between the acquisition of social skills by children and young people and their educational attainment. This study aims to fill a gap in the literature about the contribution of school-based group work programmes to developing children's social skills. National Society for the Prevention of Cruelty to…

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

    Data.gov (United States)

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

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

    Science.gov (United States)

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

    2017-07-31

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

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

    Science.gov (United States)

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

    2017-09-22

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

  14. 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.

  15. Persistent quality of life impairments in differentiated thyroid cancer patients: results from a monitoring programme

    Energy Technology Data Exchange (ETDEWEB)

    Gamper, Eva-Maria [Medical University Innsbruck, Department for Nuclear Medicine, Innsbruck (Austria); Medical University Innsbruck, Department for Psychiatry and Psychotherapy, Innsbruck (Austria); Wintner, Lisa M.; Holzner, Bernhard [Medical University Innsbruck, Department for Psychiatry and Psychotherapy, Innsbruck (Austria); Rodrigues, Margarida; Buxbaum, Sabine; Nilica, Bernhard; Virgolini, Irene [Medical University Innsbruck, Department for Nuclear Medicine, Innsbruck (Austria); Singer, Susanne [University of Mainz, Institute of Medical Biostatistics, Epidemiology, and Informatics, Mainz (Germany); Giesinger, Johannes M. [Netherlands Cancer Institute, Amsterdam (Netherlands)

    2015-07-15

    Health-related quality of life (HRQOL) in differentiated thyroid cancer (DTC) research has so far received little attention and available results are conflicting. We studied the HRQOL of radioiodine-naive DTC patients in comparison with the general population (GP), investigated the course of HRQOL up to 30 months after radioiodine remnant ablation (RAA) and sought to identify patient characteristics associated with HRQOL. We analysed data from routine HRQOL monitoring at a nuclear medicine department. Between 2005 and 2013, a total of 439 thyroid cancer patients (all histologies) completed the EORTC Quality of Life Questionnaire Core-30 (QLQ-C30) at least once during their treatment at the department. We compared patients' baseline HRQOL scores before RAA with scores from age-matched and sex-matched controls from the Austrian GP. We then determined the course of HRQOL over the 30 months after RAA and assessed the impact of the following clinical variables on HRQOL: method of thyroid-stimulating hormone (TSH) stimulation, histology (papillary vs. follicular) and disease stage. A total of 284 patients (mean age 48.3 years, SD 15.0 years; 71.6 % women; 80.7 % papillary type) with a baseline HRQOL assessment before RAA were available. We found clinically meaningful differences in the detriment in patients on almost all domains. These were largest for fatigue (23 points) and role functioning (25 points). Data from 241 patients (mean age 48.6 years, SD 15.9 years; 68.9 % women; 76.3 % papillary type) were included in the longitudinal analysis. Investigating the course of HRQOL, a significant improvement over time was found for role and emotional functioning, fatigue, pain, and dyspnoea. A range of HRQOL scores were improved in patients with exogenous TSH stimulation, but some scores both in patients with exogenous TSH stimulation and in those followed for 30 months, especially fatigue and role functioning, did not reach levels in the GP sample. Our results show that

  16. The Efficacy of Quality Improvement Programs in Education.

    Science.gov (United States)

    Curley, John R.

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

  17. 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.…

  18. Semen quality improves marginally during young adulthood

    DEFF Research Database (Denmark)

    Perheentupa, Antti; Sadov, Sergey; Rönkä, Riitta

    2016-01-01

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

  19. Compost improves urban soil and water quality

    Science.gov (United States)

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

  20. From sensor output to improved product quality

    NARCIS (Netherlands)

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

    2015-01-01

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

  1. Monitoring and improving quality of colonoscopy

    NARCIS (Netherlands)

    S.C. van Doorn

    2015-01-01

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

  2. How to Improve Hotel Service Quality

    Institute of Scientific and Technical Information of China (English)

    高婧

    2014-01-01

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

  3. From sensor output to improved product quality

    NARCIS (Netherlands)

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

    2015-01-01

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

  4. Does Automated Feedback Improve Writing Quality?

    Science.gov (United States)

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  6. 40 CFR 64.8 - Quality improvement plan (QIP) requirements.

    Science.gov (United States)

    2010-07-01

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

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

    NARCIS (Netherlands)

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

    2001-01-01

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

  8. 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…

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

    Science.gov (United States)

    Sims, Margaret; Waniganayake, Manjula

    2015-01-01

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

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

    DEFF Research Database (Denmark)

    Harboe, Kirstine M; Bardram, Linda

    2011-01-01

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

  11. The Effectiveness of Group-based Self-management Programmes to Improve Physical and Psychological Outcomes in Patients with Cancer: a Systematic Review and Meta-analysis of Randomised Controlled Trials.

    Science.gov (United States)

    Smith-Turchyn, J; Morgan, A; Richardson, J

    2016-05-01

    The purpose of this study was to determine if patients with cancer who participate in group-based self-management programmes have better physical and psychological outcomes than patients with cancer who do not participate in group-based self-management programmes. A literature search was conducted in Ovid MEDLINE, Embase, PsycINFO, CINAHL, CENTRAL, Web of Science and ProQUEST using the terms 'self-management' OR 'self-care' AND 'cancer' OR 'neoplasm'. Randomised controlled trials comparing outcomes for people with cancer participating in group-based self-management programmes with those not participating in these programmes were selected after screening by two reviewers. Initial searches yielded 563 articles. Two reviewers independently extracted data using piloted forms and assessed risk of bias using Cochrane's tool. Standard mean differences were calculated for continuous outcomes. The percentage of variability due to heterogeneity was assessed using I(2). A subgroup analysis was carried out where possible. Six trials were included in the review after 141 full-text articles were screened. Group-based self-management programmes were found to improve physical function [standard mean difference (95% confidence interval) = 0.34 (0.02, 0.65), P = 0.04]. No significant results were found between groups for quality of life [0.48 (-0.16, 1.11), P = 0.14] and physical activity level [0.21 (-0.07, 0.5), P = 0.15] outcomes. Group-based self-management programmes for individuals with cancer resulted in improvements in physical outcomes. However, considerable heterogeneity was found between the included studies and the quality of evidence was very low for all main outcomes. Therefore the results should be viewed with caution.

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

    Science.gov (United States)

    Pope, C. Arden; Miner, F. Dean

    1988-05-01

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

  13. An inpatient lifestyle-change programme improves heart rate recovery in overweight and obese children and adolescents (LOGIC Trial).

    Science.gov (United States)

    Wilks, Désirée C; Rank, Melanie; Christle, Jeff; Langhof, Helmut; Siegrist, Monika; Halle, Martin

    2014-07-01

    Impaired heart rate recovery (HRR) is a strong predictor of overall mortality and cardio-metabolic risk. This study aimed at investigating (1) the effect of participation in a lifestyle-change programme for weight loss on HRR in overweight and obese children and (2) potential associations between the changes in one minute HRR (HRR1) and fitness, weight loss and cardio-metabolic risk. The analysis included 429 individuals (169 boys) aged 13.9 ± 2.3 years who participated in an inpatient weight loss programme for four to six weeks. At baseline and the end of the programme clinical investigations were performed, including blood analyses, blood pressure, anthropometry and maximal cycle ergometer exercise testing with continuous heart rate (HR) monitoring. HRR was calculated as the difference between the highest exercising HR and HR at one, three and five minutes post-exercise. Average body weight decreased from 90.7 ± 22.5 kg to 81.9 ± 20.0 kg and peak exercise capacity increased from 1.66 ± 0.38 W/kg to 2.05 ± 0.45 W/kg (p changes in exercise capacity (p changes in body weight and cardio-metabolic risk factors. HRR considerably improved after an inpatient weight loss programme in overweight and obese children. This was not associated with improvements in body weight and cardio-metabolic risk; hence HRR would be a valuable addition to cardiovascular risk assessment in this group. © The European Society of Cardiology 2012.

  14. 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.

  15. The Heart in Haart: Quality of Life of Patients Enrolled in the Public Sector Antiretroviral Treatment Programme in the Free State Province of South Africa

    Science.gov (United States)

    Booysen, F. Le R.; Van Rensburg, H. C. J.; Bachmann, M.; Louwagie, G.; Fairall, L.

    2007-01-01

    This paper reports on the quality of life of patients enrolled in the public sector antiretroviral treatment programme in the Free State province of South Africa. Statistical analysis of cross-sectional data reveals that it is not access to treatment "per se" that enhances the quality of life of those who have come forward for ART.…

  16. Premarital screening for beta-thalassaemia in Southern Iran: options for improving the programme.

    Science.gov (United States)

    Karimi, Mehran; Jamalian, Nima; Yarmohammadi, Hooman; Askarnejad, Abdolrasoul; Afrasiabi, Abdolreza; Hashemi, Alireza

    2007-01-01

    beta-thalassaemia is a preventable disease. Iran has about 20,000 homozygote beta-thalassaemia patients and 3,750,000 carriers. To assess the 10-year results of the screening programme, which has been operating in Southern Iran since 1995. All couples wanting to marry were required to be checked for beta-thalassaemia by their red blood cell indices in order to receive a permit for marriage registration. The results were reported to the nearest counselling team. If the results were conspicuous, haemoglobin A(2)(HbA(2)) and, in some subjects, Hb electrophoresis was performed. Couples in which both partners were carriers received counselling. For those who, in spite of the recommendation, decided to marry, prenatal diagnosis and termination of pregnancy in case of an affected fetus was offered. The latter was offered only in the last three years. In 1995, 1999 and 2004, 296, 94 and 56 beta-thalassaemia homozygotes, respectively, were born (2.53, 1.07 and 0.82 patients per 1000 births). This programme has decreased the birth prevalence of beta-thalassaemia, but has unfortunately not eliminated the disease altogether. The reasons for the birth of new cases, in spite of the screening programmes, are: (i) premarital screening programme started in 1995; therefore, carrier couples who married before this did not receive counselling and gave birth to homozygote beta-thalassaemia children; (ii) unwanted pregnancy among the carrier couples; (iii) the couples knew about their problem, but they married for cultural and religious causes (illegal marriages).

  17. Refractories Quality Improvement for Glass Industry Upgrading

    Institute of Scientific and Technical Information of China (English)

    ZENG Dafan

    2009-01-01

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

  18. Casting Process Developments for Improving Quality

    Science.gov (United States)

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

    1985-09-01

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

  19. The Roadmap from Quality Assurance in Programmes and Teaching towards Quality Development as a Strategic Instrument of University Management

    Directory of Open Access Journals (Sweden)

    Bianka Lichtenberger

    2013-12-01

    Full Text Available An inflation of publicly formulated expectations and requirements with regard to instruments and methods for preparing, securing and monitoring research and teaching quality as well as the quality of the management of higher education give the impression of an overload of quality management and thus a new “quality of bureaucracy”. Behind it appears at a first glance an in transparent and confusing puzzle of highly diverse procedures which are subsumed under the term quality management. The cause of this development can be seen in the context of the Bologna process and the Lisbon strategy, which has defined development and control of a high quality in teaching and research as a central success factor in the implementation of higher education policy reforms and as an organizational obligation for Higher Education Institutions.

  20. Live births achieved via IVF are increased by improvements in air quality and laboratory environment

    Science.gov (United States)

    Heitmann, Ryan J; Hill, Micah J; James, Aidita N; Schimmel, Tim; Segars, James H; Csokmay, John M; Cohen, Jacques; Payson, Mark D

    2016-01-01

    Infertility is a common disease, which causes many couples to seek treatment with assisted reproduction techniques. Many factors contribute to successful assisted reproduction technique outcomes. One important factor is laboratory environment and air quality. Our facility had the unique opportunity to compare consecutively used, but separate assisted reproduction technique laboratories, as a result of a required move. Environmental conditions were improved by strategic engineering designs. All other aspects of the IVF laboratory, including equipment, physicians, embryologists, nursing staff and protocols, were kept constant between facilities. Air quality testing showed improved air quality at the new IVF site. Embryo implantation (32.4% versus 24.3%; P < 0.01) and live birth (39.3% versus 31.8%, P < 0.05) were significantly increased in the new facility compared with the old facility. More patients met clinical criteria and underwent mandatory single embryo transfer on day 5 leading to both a reduction in multiple gestation pregnancies and increased numbers of vitrified embryos per patient with supernumerary embryos available. Improvements in IVF laboratory conditions and air quality had profound positive effects on laboratory measures and patient outcomes. This study further strengthens the importance of the laboratory environment and air quality in the success of an IVF programme. PMID:26194882

  1. Good adherence to HAART and improved survival in a community HIV/AIDS treatment and care programme: the experience of The AIDS Support Organization (TASO, Kampala, Uganda

    Directory of Open Access Journals (Sweden)

    Kalyango Joan N

    2008-11-01

    Full Text Available Abstract Background Poor adherence to highly active antiretroviral therapy (HAART may result in treatment failure and death. Most reports of the effect of adherence to HAART on mortality come from studies where special efforts are made to provide HAART under ideal conditions. However, there are few reports of the impact of non-adherence to HAART on mortality from community HIV/AIDS treatment and care programmes in developing countries. We therefore conducted a study to assess the effect of adherence to HAART on survival in The AIDS Support Organization (TASO community HAART programme in Kampala, Uganda. Methods The study was a retrospective cohort of 897 patients who initiated HAART at TASO clinic, Kampala, between May 2004 and December 2006. A total of 7,856 adherence assessments were performed on the data. Adherence was assessed using a combination of self-report and pill count methods. Patients who took ≤ 95% of their regimens were classified as non-adherent. The data was stratified at a CD4 count of 50 cells/mm3. Kaplan Meier curves and Cox proportional hazards regression models were used in the analysis. Results A total of 701 (78.2% patients had a mean adherence to ART of > 95%. The crude death rate was 12.2 deaths per 100 patient-years, with a rate of 42.5 deaths per 100 patient-years for non-adherent patients and 6.1 deaths per 100 patient-years for adherent patients. Non-adherence to ART was significantly associated with mortality. Patients with a CD4 count of less than 50 cells/mm3 had a higher mortality (HR = 4.3; 95% CI: 2.22–5.56 compared to patients with a CD4 count equal to or greater than 50 cells/mm3 (HR = 2.4; 95% CI: 1.79–2.38. Conclusion Our study showed that good adherence and improved survival are feasible in community HIV/AIDS programmes such as that of TASO, Uganda. However, there is need to support community HAART programmes to overcome the challenges of funding to provide sustainable supplies particularly of

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

    Institute of Scientific and Technical Information of China (English)

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

    2013-01-01

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

  3. Behavioural treatment strategies improve adherence to lifestyle intervention programmes in adults with obesity: a systematic review and meta-analysis.

    Science.gov (United States)

    Burgess, E; Hassmén, P; Welvaert, M; Pumpa, K L

    2017-04-01

    Poor adherence to lifestyle intervention remains a key factor hindering treatment effectiveness and health outcomes for adults with obesity. The aim of this systematic review and meta-analysis is to determine if behavioural treatment strategies (e.g. goal setting, motivational interviewing, relapse prevention, cognitive restructuring etc.) improve adherence to lifestyle intervention programmes in adults with obesity. Randomized controlled trials that investigated the use of behavioural treatment strategies in obesity management were identified by systematically reviewing the literature within Medline, PsycINFO, CINAHL, SPORTDiscus and Web of Science from their inception to August 2016. This meta-analysis shows that behavioural treatment interventions have a significant positive effect on session attendance (percentage) and physical activity (total min/week) in adults with obesity (M = 17.63 (95% confidence interval (CI) = 10.77, 24.50), z =5.0337, P obesity. These strategies should be routinely incorporated into lifestyle intervention, obesity management and weight loss programmes with the aim of improving engagement and adherence. If adherence were improved, treatment effectiveness, health outcomes and the ultimate burden of chronic disease could also be improved.

  4. A home-based training programme improves family caregivers' oral care practices with stroke survivors: a randomized controlled trial.

    Science.gov (United States)

    Kuo, Y-W; Yen, M; Fetzer, S; Chiang, L-C; Shyu, Y-Il; Lee, T-H; Ma, H-I

    2016-05-01

    Stroke survivors experience poor oral health when discharged from the hospital to the community. The aim of this study was to evaluate the effectiveness of a home-based oral care training programme on knowledge, attitude, self-efficacy and practice behaviour of family caregivers. A randomized controlled trial was conducted. The experimental group consisted of 48 family caregivers who received the home-based oral care training programme, and the control group consisted of 46 family caregivers who received routine oral care education. The outcomes were measured by the Knowledge of Oral Care, Attitude towards Oral Care, Self-Efficacy of Oral Care and Behaviour of Oral Care before the training programme, and at one and two months afterwards. The data were analysed using mixed model anova to determine differences in the outcomes between the two groups. The findings demonstrated that the intervention group had more knowledge (t = 8.80, P caregivers' behaviour of oral care at one and two months of the intervention for both groups. Our individualized home-based oral care education can achieve significant improvements in oral care knowledge and self-efficacy among family caregivers of stroke survivors, and it can sufficiently empower them to modify their oral care practices in a home-based healthcare environment. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Use of Electronic Documentation for Quality Improvement in Hospice

    Science.gov (United States)

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

    2015-01-01

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

  6. Improving teamwork between students from two professional programmes in dental education

    Science.gov (United States)

    Leisnert, L; Karlsson, M; Franklin, I; Lindh, L; Wretlind, K

    2012-01-01

    In Sweden, the National Board of Health and Welfare forecasts a decrease in dentists with 26% and an increase in dental hygienists with 47% until the year of 2023. This, together with changes in both epidemiology, especially of dental caries, and political priorities, calls for an effective and well-developed cooperation between dentists and dental hygienists in future dentistry. Hence, the aim of this project was to investigate whether highlighting teamwork during the undergraduate studies of dental students and dental hygiene students could improve the students’ holistic view on patients as well as their knowledge of and insight into each other’s future professions. Thirty-four dental students and 24 dental hygiene students participated in the study. At the beginning of their final year in undergraduate education, a questionnaire testing the level of knowledge of the dental hygienists’ clinical competences was completed by both groups of students. In addition, activities intending to improve teamwork quality included the following: (i) a seminar with a dentist representing the Public Dental Health Services in Sweden, (ii) dental students as supervisors for dental hygiene students, (iii) planning and treatment for shared patients and (iv) students’ presentations of the treatments and their outcomes at a final seminar. The project was ended by the students answering the above-mentioned questionnaire for the second time, followed by an evaluation of the different activities included in the study. The knowledge of dental hygienists’ competences showed higher scores in almost all questions. Both groups of students considered the following aspects important: seminars with external participants, dental students acting as supervisors and planning and treating shared patients. By initiating and encouraging teamwork between dental students and dental hygiene students, it is possible to increase knowledge on dental hygienists’ competence and also to develop and

  7. It Pays to Improve School Quality

    Science.gov (United States)

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

    2016-01-01

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

  8. 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

  9. A Conceptual Framework for the Quality Assurance of Programme Design at the Durban University of Technology

    Science.gov (United States)

    Sattar, K.; Cooke, L. A.

    2012-01-01

    At the end of 2010 the Durban University of Technology initiated a Curriculum Renewal Project, central to which is the aspiration to become a student centred university through the transformation of teaching and learning and the promotion of quality enhancement. However, the current realities for curriculum development and quality assurance at the…

  10. Burnout and quality of life among orthopaedic trainees in a modern educational programme

    NARCIS (Netherlands)

    van Vendeloo, S. N.; Brand, P. L. P.; Verheyen, C. C. P. M.

    2014-01-01

    We aimed to determine quality of life and burnout among Dutch orthopaedic trainees following a modern orthopaedic curriculum, with strict compliance to a 48-hour working week. We also evaluated the effect of the clinical climate of learning on their emotional wellbeing. We assessed burnout, quality

  11. A Capabilities Perspective on Education Quality: Implications for Foundation Phase Teacher Education Programme Design

    Science.gov (United States)

    Baxen, Jean; Nsubuga, Yvonne; Botha, Liz Johanson

    2014-01-01

    While governments and communities across the globe are faced with the challenge of providing their citizens with good-quality education, there is lack of consensus on how education quality should be defined. Whereas a great deal has been written about the human capital and human rights approaches, which currently dominate the debate, the potential…

  12. 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.

  13. 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.

  14. Improving collected rainwater quality in rural communities.

    Science.gov (United States)

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

    2011-01-01

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

  15. Improvement of power quality using distributed generation

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-12-15

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

  16. Quality Improvement of Liver Ultrasound Images Using Fuzzy Techniques

    Science.gov (United States)

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

    2016-01-01

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

  17. 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.

  18. 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

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

    Directory of Open Access Journals (Sweden)

    Gang Xie

    2014-01-01

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

  20. Impact of mentorship on WHO-AFRO Strengthening Laboratory Quality Improvement Process Towards Accreditation (SLIPTA

    Directory of Open Access Journals (Sweden)

    Talkmore Maruta

    2011-12-01

    : The mentorship programme in this study resulted in significant measurable improvements towards preparation for the WHO-AFRO SLIPTA process in less than six months. We recommend that mentorship be incorporated into laboratory quality improvement and management training programmes such as SLMTA, in order to accelerate the progress of laboratories towards achieving accreditation.

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

    Science.gov (United States)

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

    2012-11-01

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

  2. Muscle metabolism and performance improvement after two training programmes of sprint running differing in rest interval duration.

    Science.gov (United States)

    Saraslanidis, Ploutarchos; Petridou, Anatoli; Bogdanis, Gregory C; Galanis, Nikiforos; Tsalis, George; Kellis, Spiros; Mougios, Vassilis

    2011-08-01

    Repeated-sprint training often involves short sprints separated by inadequate recovery intervals. The effects of interval duration on metabolic and performance parameters are unclear. We compared the effects of two training programmes, differing in rest interval duration, on muscle (vastus lateralis) metabolism and sprint performance. Sixteen men trained three times a week for 8 weeks, each training session comprising 2-3 sets of two 80-m sprints. Sprints were separated by 10 s (n = 8) or 1 min (n = 8). Both training programmes improved performance in the 100-, 200-, and 300-m sprints, but the improvement was greater in the 10-s group during the final 100 m of the 200- and 300-m runs. Independent of interval duration, training mitigated the drop of muscle ATP after two 80-m sprints. The drop in phosphocreatine and the increases in glucose-6-phosphate and fructose-6-phosphate after two 80-m sprints were greater in the 10-s group. In conclusion, training with a limited number of repeated short sprints (≤10 s) may be more effective in improving speed maintenance in 200- and 300-m runs when performed with a 1:1 rather than a 1:6 exercise-to-rest ratio. This may be due to a greater activation of glycolysis caused, in part, by the limited resynthesis of phosphocreatine during the very short rest interval.

  3. Improving oral hygiene skills among children undergoing treatment at the haemato-oncology department - an interventional programme.

    Science.gov (United States)

    Levin, Liran; Bilder, Leon; Borisov, Oxana

    2015-08-01

    The aim of this interventional programme was to educate children undergoing treatment at the haemato-oncology department in how to improve their oral hygiene skills. Children (and their parents) treated at the haemato-oncology department for haematological malignancies and disorders were educated and instructed in how to improve their dental oral hygiene skills. Instructions, demonstration and practice of toothbrushing techniques, as well as interproximal cleaning, were carried out in three separate sessions. In each session, toothbrushing skills were evaluated using the Ashkenazi index to assess improvement in oral hygiene skills over time. Four assessments were performed and recorded for each participant: before the initial explanation; immediately following the explanation; and 3 and 6 weeks following the first visit. Overall, 52 children were enrolled in the programme. The first toothbrushing performance skill evaluation revealed a low score of 10.44 out of a total of 40; this was significantly increased, following the instruction session, to 33.02 (P oral health and prevent future disease in this population. © 2015 FDI World Dental Federation.

  4. Software Quality Improvement in the OMC Team

    CERN Document Server

    Maier, Viktor

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

  5. 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.

  6. 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.

  7. Cardiorespiratory fitness and walking endurance improvements after 12 months of an individualised home and community-based exercise programme for people after stroke.

    Science.gov (United States)

    Dunn, Ashlee; Marsden, Dianne L; Barker, Daniel; Van Vliet, Paulette; Spratt, Neil J; Callister, Robin

    2017-09-05

    To evaluate the immediate and longer-term effects of an individually tailored, home- and community-based exercise programme with ongoing remote support in people with stroke on cardiorespiratory fitness (CRF), ambulation and health-related quality of life (HRQoL). Twenty people 5.3 ± 3.5 months post stroke completed the 12-week HowFITSS? exercise programme aimed at increasing CRF and daily physical activity. Support was provided by phone and email, which decreased in frequency over time. Participants were assessed at baseline, then at 3, 6 and 12 months after initiation of the intervention. CRF (VO2peak) was evaluated using a portable metabolic system during the 6-minute walk test (6MWT), the Shuttle Walk Test (SWT) and the cycle graded exercise test (cGXT). Walking speed, balance, body composition, fatigue, depression and HRQoL were also measured. CRF improved significantly from pre-intervention to 12-month follow-up on the 6MWT (Effect Size, ES = 0.87; p = 0.002) and cGXT (ES = 0.60; p < 0.001), with more modest improvements on the SWT (ES = 0.52; p = 0.251). From baseline to 12 months, significant within-participant improvements were found for self-selected walking speed, balance and HRQoL. Performances on the remaining tests were maintained over the post-intervention period. There may be health benefits of providing people with stroke an exercise intervention with long-term support that encourages increased regular physical activity.

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

    Science.gov (United States)

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

    2014-01-01

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

  9. Improving Quality of Voice Conversion Systems

    Science.gov (United States)

    Farhid, M.; Tinati, M. A.

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

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

    OpenAIRE

    Aleksandar Marić; Slavko Arsovski; Jasna Mastilović

    2009-01-01

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

  11. 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

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

    Science.gov (United States)

    1991-12-01

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

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

    Science.gov (United States)

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

    2002-01-01

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

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

    Science.gov (United States)

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

  15. Performance indicators: A tool for continuous quality improvement

    National Research Council Canada - National Science Library

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

    2016-01-01

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

  16. Quality Improvement: Appropriate episiotomies in a district hospital

    African Journals Online (AJOL)

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

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

    CERN Document Server

    Murphy, Sarah Anne

    2013-01-01

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

  18. Open Schools for improving Equity and Quality Education

    NARCIS (Netherlands)

    Stracke, Christian M.

    2016-01-01

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

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

    African Journals Online (AJOL)

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

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

    Science.gov (United States)

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

    2002-01-01

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

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

    Science.gov (United States)

    Green, Joe A.; Foley, Phyllis A.

    1997-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Milan Radenkovic

    2013-12-01

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

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

    Science.gov (United States)

    Bartlett, Maggie; Crossley, James; McKinley, Robert

    2017-01-01

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

  4. Effects of Quality Improvement System for Child Care Centers

    Science.gov (United States)

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

    2011-01-01

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

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

    Science.gov (United States)

    Jeon, Lieny; Buettner, Cynthia K.

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Farid Gharibi

    2014-07-01

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

  7. Combining traditional breeding and genomics to improve pork quality

    NARCIS (Netherlands)

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

    2003-01-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

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

    NARCIS (Netherlands)

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

    2008-01-01

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

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

    Science.gov (United States)

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

    2013-03-01

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

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

    Science.gov (United States)

    Crogan, Neval L; Evans, Bronwynne C

    2008-05-01

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

  12. Efficiency Improvement and Quality Initiatives Application in Financial Institutions

    OpenAIRE

    MSc. Ajtene Avdullahi; MSc. Vjosa Fejza

    2015-01-01

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

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

    OpenAIRE

    Madhok, Rajan

    2002-01-01

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

  14. Sustainable microbial water quality monitoring programme design using phage-lysis and multivariate techniques.

    Science.gov (United States)

    Nnane, Daniel Ekane

    2011-11-15

    Contamination of surface waters is a pervasive threat to human health, hence, the need to better understand the sources and spatio-temporal variations of contaminants within river catchments. River catchment managers are required to sustainably monitor and manage the quality of surface waters. Catchment managers therefore need cost-effective low-cost long-term sustainable water quality monitoring and management designs to proactively protect public health and aquatic ecosystems. Multivariate and phage-lysis techniques were used to investigate spatio-temporal variations of water quality, main polluting chemophysical and microbial parameters, faecal micro-organisms sources, and to establish 'sentry' sampling sites in the Ouse River catchment, southeast England, UK. 350 river water samples were analysed for fourteen chemophysical and microbial water quality parameters in conjunction with the novel human-specific phages of Bacteroides GB-124 (Bacteroides GB-124). Annual, autumn, spring, summer, and winter principal components (PCs) explained approximately 54%, 75%, 62%, 48%, and 60%, respectively, of the total variance present in the datasets. Significant loadings of Escherichia coli, intestinal enterococci, turbidity, and human-specific Bacteroides GB-124 were observed in all datasets. Cluster analysis successfully grouped sampling sites into five clusters. Importantly, multivariate and phage-lysis techniques were useful in determining the sources and spatial extent of water contamination in the catchment. Though human faecal contamination was significant during dry periods, the main source of contamination was non-human. Bacteroides GB-124 could potentially be used for catchment routine microbial water quality monitoring. For a cost-effective low-cost long-term sustainable water quality monitoring design, E. coli or intestinal enterococci, turbidity, and Bacteroides GB-124 should be monitored all-year round in this river catchment. Copyright © 2011 Elsevier B.V. All

  15. What would it take to improve the quality of healthcare: more money, or more data?

    Science.gov (United States)

    Tomson, Charles R V

    2009-04-01

    Despite a sustained and massive increase in spending with the NHS, the evidence that care has improved, other than in areas of performance that have been intensively managed or rewarded by additional cash bonuses, is poor to non-existent. This failure to achieve across-the-board improvement is attributable to the fact that the outcomes of healthcare are 'system properties' and are unlikely to improve as a result of more work being put through the same system, and instead will only improve if healthcare providers at all levels are actively encouraged to redesign the system to improve on current performance. The most important way to achieve the 'will' to make such changes is to use data, preferably collected with minimal additional work, to generate clinically convincing case-mix-adjusted analyses of quality of care. Examples are given from the centre-specific analyses published by the UK Renal Registry, a fully electronic registry that analyses data extracted direct from renal information technology systems used in each primary care trust that provides renal replacement therapy, and from other national and regional quality improvement programmes. The NHS has unrivalled opportunities to learn from high performance and to use this learning to narrow the gap between best and worst.

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

    Science.gov (United States)

    Moyer, Anne; Finney, John W

    2005-01-01

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

  17. Outreach services to improve access to health care in South Africa: lessons from three community health worker programmes

    Directory of Open Access Journals (Sweden)

    Nonhlanhla Nxumalo

    2013-01-01

    Full Text Available Introduction: In South Africa, there are renewed efforts to strengthen primary health care and community health worker (CHW programmes. This article examines three South African CHW programmes, a small local non-governmental organisation (NGO, a local satellite of a national NGO, and a government-initiated service, that provide a range of services from home-based care, childcare, and health promotion to assist clients in overcoming poverty-related barriers to health care. Methods: The comparative case studies, located in Eastern Cape and Gauteng, were investigated using qualitative methods. Thematic analysis was used to identify factors that constrain and enable outreach services to improve access to care. Results: The local satellite (of a national NGO, successful in addressing multi-dimensional barriers to care, provided CHWs with continuous training focused on the social determinants of ill-health, regular context-related supervision, and resources such as travel and cell-phone allowances. These workers engaged with, and linked their clients to, agencies in a wide range of sectors. Relationships with participatory structures at community level stimulated coordinated responses from service providers. In contrast, an absence of these elements curtailed the ability of CHWs in the small NGO and government-initiated service to provide effective outreach services or to improve access to care. Conclusion: Significant investment in resources, training, and support can enable CHWs to address barriers to care by negotiating with poorly functioning government services and community participation structures.

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

    Science.gov (United States)

    Godény, Sándor

    2012-02-01

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

  19. Developing a Quality Management System for a Postgraduate Education Programme: A Case Study.

    Science.gov (United States)

    Houston, Don; Rees, Malcolm

    1999-01-01

    Reports on a student-based action research project in quality management within a postgraduate education program at Massey University (New Zealand). Finds the program to be complex, interconnected to the wider university system, with poorly defined processes, and unclear assignment of responsibilities. Considers the role of students and other…

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

    Directory of Open Access Journals (Sweden)

    Adrian-Ioan Toma

    2011-10-01

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

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

    Science.gov (United States)

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

    2013-03-01

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

  2. The effectiveness of the quality program Pac-IficO to improve pain management in hospitalized cancer patients: a before-after cluster phase II trial

    National Research Council Canada - National Science Library

    Ripamonti, Carla Ida; Prandi, Cesarina; Costantini, Massimo; Perfetti, Elisa; Pellegrini, Fabio; Visentin, Marco; Garrino, Lorenza; De Luca, Anna; Pessi, Maria Adelaide; Peruselli, Carlo

    2014-01-01

    ...) the symptom is still under-diagnosed and its treatment is not appropriate in many patients. The objective of the study is to evaluate the efficacy of the Pac-IFicO programme in improving the quality of pain management in hospitalised cancer patients...

  3. Improving Milk Quality for Dairy Goat Farm Development

    Directory of Open Access Journals (Sweden)

    L. Cyrilla

    2015-12-01

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

  4. 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

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

    Science.gov (United States)

    Szablowski, Katarzyna M

    2014-01-01

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

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

    Science.gov (United States)

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

    2004-11-01

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

  7. Making sense of it: a brief programme to improve reading comprehension in adolescents with language impairments in main stream school.

    Science.gov (United States)

    Wright, Aileen; Mitchell, Siobhán; O'Donoghue, Anne; Cowhey, Suzanne; Kearney, Mairead

    2015-01-01

    Children with language impairment show academic outcomes that are consistently poorer than those of their typically developing peers. A contributor to this is difficulty with reading comprehension. Although these difficulties are reported to continue well into adolescence, this population is generally underserved with regard to therapy. The efficacy of interventions for reading comprehension is well established in the research literature, but whether the same effects are achievable within a reasonable time reflecting available resources in real-life circumstances is less clear. Efficacy trials may significantly overestimate how strong an effect will be when the treatment is used under more natural conditions and within local constraints. The aim was to discover whether a short classroom intervention would be effective in improving reading comprehension in adolescents with the heterogeneous profiles of general or specific learning disabilities, additional diagnoses and behavioural and socio-emotional problems found in mainstream schools today. Twenty-eight adolescents with heterogeneous language and reading profiles were recruited from a mainstream school. The intervention programme comprised eight sessions of instruction in multiple reading comprehension strategies, held over 4 weeks. Experiment 1 had 10 participants. Experiment 2 had 18 participants who underwent the same programme, plus the addition of a session dedicated to decoding skills. Efficacy was evaluated within a pre- and post-study design, with baseline and post-therapy measures taken using the York Assessment of Reading for Comprehension (YARC). Both experiments showed a significant group difference pre/post-intervention, with similar large effect sizes. Experiment 2 also showed a significant group difference in decoding ability pre and post the single intervention session. This short intervention programme proved effective in a population with heterogeneous profiles, and fitted well with delivery in

  8. Enabling technologies to improve area-wide integrated pest management programmes for the control of screwworms.

    Science.gov (United States)

    Robinson, A S; Vreysen, M J B; Hendrichs, J; Feldmann, U

    2009-06-01

    The economic devastation caused in the past by the New World screwworm fly Cochliomyia hominivorax (Coquerel) (Diptera: Calliphoridae) to the livestock industry in the U.S.A., Mexico and the rest of Central America was staggering. The eradication of this major livestock pest from North and Central America using the sterile insect technique (SIT) as part of an area-wide integrated pest management (AW-IPM) programme was a phenomenal technical and managerial accomplishment with enormous economic implications. The area is maintained screwworm-free by the weekly release of 40 million sterile flies in the Darien Gap in Panama, which prevents migration from screwworm-infested areas in Columbia. However, the species is still a major pest in many areas of the Caribbean and South America and there is considerable interest in extending the eradication programme to these countries. Understanding New World screwworm fly populations in the Caribbean and South America, which represent a continuous threat to the screwworm-free areas of Central America and the U.S.A., is a prerequisite to any future eradication campaigns. The Old World screwworm fly Chrysomya bezziana Villeneuve (Diptera: Calliphoridae) has a very wide distribution ranging from Southern Africa to Papua New Guinea and, although its economic importance is assumed to be less than that of its New World counterpart, it is a serious pest in extensive livestock production and a constant threat to pest-free areas such as Australia. In the 1980s repeated introductions and an expansion of Old World screwworm populations were reported in the Middle East; in the 1990s it invaded Iraq and since late 2007 it has been reported in Yemen, where a severe outbreak of myiasis occurred in 2008. Small-scale field trials have shown the potential of integrating the SIT in the control of this pest and various international organizations are considering using the release of sterile insects as part of an AW-IPM approach on a much wider scale

  9. 40 CFR 63.176 - Quality improvement program for pumps.

    Science.gov (United States)

    2010-07-01

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

  10. 40 CFR 63.1035 - Quality improvement program for pumps.

    Science.gov (United States)

    2010-07-01

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

  11. 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.

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

    African Journals Online (AJOL)

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

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

    NARCIS (Netherlands)

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

    1990-01-01

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

  14. Applying GRA and QFD to Improve Library Service Quality

    Science.gov (United States)

    Chen, Yen-Ting; Chou, Tsung-Yu

    2011-01-01

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

  15. Quality of Life Enhancement Programme for Individuals with Mood Disorder: A Randomized Controlled Pilot Study

    Directory of Open Access Journals (Sweden)

    Yun-Ling Chen

    2015-06-01

    Conclusion: The participants who received the 8-week QOLEP demonstrated significant improvement in the level of depression. Studies with a sample size of at least 104 participants are recommended in the future.

  16. The Nedd for Policy Framework in Maintaining Quality in Open and Distance Education Programmes in Southern Africa

    Directory of Open Access Journals (Sweden)

    Rebecca LEKOKO

    2005-10-01

    Full Text Available The Nedd for Policy Framework in Maintaining Quality in Open andDistance Education Programmes in Southern AfricaProf. Dele BRAIMOHNational University of LesothoLesotho-SOUTH AFRICA Dr. Rebecca LEKOKOUniversity of BotswanaBostwana-SOUTH AFRICA ABSTRACT The ideals of education for all as proposed by UNESCO (2000 cannot be achieved without tapping into all the existing educational delivery systems. Open and distance education system has caught the attention of a number of Southern African Universities as a viable and ‘Siamese’ twin of the conventional education in achieving flexibility, open and greater access for the heterogeneous clientele of the region. Despite the glowing virtues of distance education, this mode is still looked down upon by some people as inferior to the conventional teaching and learning processes. Paradoxically, learning through the distance education mode has a greater potential to provide education for more learners than the conventional education system. In a dynamic society such as the Southern African region, development has made education a phenomenon that transcends the four walls of the formal classrooms. Thus, a policy framework is needed to ensure that quality education is provided for learners of diverse cultures, including economic background and geographical regions. Such a framework is not only a basic requirement for positive development of the newly emerging distance education institutions but also an essential instrument for the continued success of the long established institutions, both single and dual mode. The proposed policy framework addresses some of the following (i academic (e.g. course integrity, transferability and accreditation; (ii governance, (e.g. tuition, fiscal regulation; (iii faculty (e.g. training, workload, support and evaluation; (iv legal (e.g. intellectual property, students and institutional liability; (v technical (e.g. physical delivery networks, systems reliability, setup and

  17. On Improving Higher Vocational College Education Quality Assessment

    Science.gov (United States)

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

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

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

    Directory of Open Access Journals (Sweden)

    Dehghan M

    2013-12-01

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

  19. Evidence from 617 laboratories in 47 countries for SLMTA-driven improvement in quality management systems

    Directory of Open Access Journals (Sweden)

    Katy Yao

    2014-09-01

    Full Text Available Background: The Strengthening Laboratory Management Toward Accreditation (SLMTA programme is a large-scale effort to improve the quality of laboratories in resource-limitedcountries.Objectives: This study sought to evaluate the first four years (2010–2013 of SLMTA implementation.Methods: Country-level data were submitted by SLMTA programme leads and compiledglobally. Performance was measured before (baseline and after (exit SLMTA implementation using an audit checklist which results in a percentage score and a rating of zero to five stars. Some laboratories continued to monitor performance in post-exit surveillance audits. We evaluated score improvements using two-tailed t-tests for equal variances and estimated the number of tests performed by SLMTA laboratories based on star level.Results: SLMTA was implemented in 617 laboratories in 47 countries in Africa, the Caribbean, Latin America and Southeast Asia. At the baseline audit, the laboratories scored an average of 39% on the checklist and 84% of them were rated below one star. As of December 2013, 302 laboratories had completed the SLMTA programme; mean checklist scores increased from39% at baseline to 64% at exit (p < 0.001 over an average 16-month programme duration. Ninety-two laboratories conducted a surveillance audit at a median of 11 months after their exit audit; 62% further increased their performance. Six SLMTA laboratories have achieved accreditation status. In total, the 617 SLMTA laboratories conduct an estimated 111 milliontests annually. Only 16% of these tests were conducted by laboratories with at least one star at baseline, which increased to 68% of tests after SLMTA training. Thus, approximately 23 million tests are conducted annually by laboratories previously at zero stars that now have one to five stars; this number is projected to increase to 58 million when currently-enrolled laboratories complete the programme.Conclusion: SLMTA has transformed the laboratory

  20. 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.

  1. In Pursuit of Teacher Quality in Diversity: A Study of the Selection Mechanisms of New Secondary Teacher Education Programmes in Taiwan

    Science.gov (United States)

    Wang, Hsiou-Huai; Fwu, Bih-Jen

    2007-01-01

    As the definition of teacher quality changes with time, the selection mechanism of students into teacher education programmes may also change accordingly. In Taiwan, before the 1994 teacher education reform, selection of pre-service students was based solely on academic achievement. Afterwards, the selection was delegated to individual teacher…

  2. 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.

  3. Expand Your Horizon: A programme that improves body image and reduces self-objectification by training women to focus on body functionality.

    Science.gov (United States)

    Alleva, Jessica M; Martijn, Carolien; Van Breukelen, Gerard J P; Jansen, Anita; Karos, Kai

    2015-09-01

    This study tested Expand Your Horizon, a programme designed to improve body image by training women to focus on the functionality of their body using structured writing assignments. Eighty-one women (Mage=22.77) with a negative body image were randomised to the Expand Your Horizon programme or to an active control programme. Appearance satisfaction, functionality satisfaction, body appreciation, and self-objectification were measured at pretest, posttest, and one-week follow-up. Following the intervention, participants in the Expand Your Horizon programme experienced greater appearance satisfaction, functionality satisfaction, and body appreciation, and lower levels of self-objectification, compared to participants in the control programme. Partial eta-squared effect sizes were of small to medium magnitude. This study is the first to show that focusing on body functionality can improve body image and reduce self-objectification in women with a negative body image. These findings provide support for addressing body functionality in programmes designed to improve body image. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Building Perinatal Case Manager Capacity Using Quality Improvement

    OpenAIRE

    Fitzgerald, Elaine

    2015-01-01

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

  5. Investigating organizational quality improvement systems, patient empowerment, organizational culture, professional involvement and the quality of care in European hospitals: the 'Deepening our Understanding of Quality Improvement in Europe (DUQuE' project

    Directory of Open Access Journals (Sweden)

    Thompson Andrew

    2010-09-01

    at hospital and multilevel. In addition, we will apply sophisticated methodological elements such as the use of causal diagrams, outcome modelling, double robust estimation and detailed sensitivity analysis or multiple bias analyses to assess the impact of the various sources of bias. Discussion Products of the project will include a catalogue of instruments and tools that can be used to build departmental or hospital quality and safety programme and an appraisal scheme to assess the maturity of the quality improvement system for use by hospitals and by purchasers to contract hospitals.

  6. Pediatric collaborative networks for quality improvement and research.

    Science.gov (United States)

    Lannon, Carole M; Peterson, Laura E

    2013-01-01

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

  7. A Pragmatic Randomised, Controlled Trial of Intensive Care follow up programmes in improving Longer-term outcomes from critical illness. The PRACTICAL study

    Directory of Open Access Journals (Sweden)

    Ramsey Craig

    2007-07-01

    Full Text Available Abstract Background A number of intensive care (ICU patients experience significant problems with physical, psychological, and social functioning for some time after discharge from ICU. These problems have implications not just for patients, but impose a continuing financial burden for the National Health Service. To support recovery, a number of hospitals across the UK have developed Intensive Care follow-up clinics. However, there is a lack of evidence base to support these, and this study aims to test the hypothesis that intensive care follow up programmes are effective and cost-effective at improving physical and psychological quality of life in the year after intensive care discharge. Methods/Design This is a multi-centre, pragmatic, randomised controlled trial. Patients (n = 270 will be recruited prior to hospital discharge from three intensive care units in the UK, and randomised to one of two groups. The control group will receive standard in-hospital follow-up and the intervention group will participate in an ICU follow-up programme with clinic appointments 2–3 and 9 months after ICU discharge. The primary outcome measure is Health-related Quality of Life (HRQoL 12 months after ICU discharge as measured by the Short Form-36. Secondary measures include: HRQoL at six months; Quality-adjusted life years using EQ-5D; posttraumatic psychopathology as measured by Davidson Trauma Scale; and anxiety and depression using the Hospital Anxiety and Depression Scale at both six and twelve months after ICU discharge. Contacts with health services in the twelve months after ICU discharge will be measured as part of the economic analysis. Discussion The provision of intensive care follow-up clinics within the UK has developed in an ad hoc manner, is inconsistent in both the number of hospitals offering such a service or in the type of service offered. This study provides the opportunity to evaluate such services both in terms of patient benefit and

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

    Directory of Open Access Journals (Sweden)

    Anshul Chauhan

    2017-06-01

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

  9. Improving Latino Children's Early Language and Literacy Development: Key Features of Early Childhood Education within Family Literacy Programmes

    Science.gov (United States)

    Jung, Youngok; Zuniga, Stephen; Howes, Carollee; Jeon, Hyun-Joo; Parrish, Deborah; Quick, Heather; Manship, Karen; Hauser, Alison

    2016-01-01

    Noting the lack of research on how early childhood education (ECE) programmes within family literacy programmes influence Latino children's early language and literacy development, this study examined key features of ECE programmes, specifically teacher-child interactions and child engagement in language and literacy activities and how these…

  10. Improving Latino Children's Early Language and Literacy Development: Key Features of Early Childhood Education within Family Literacy Programmes

    Science.gov (United States)

    Jung, Youngok; Zuniga, Stephen; Howes, Carollee; Jeon, Hyun-Joo; Parrish, Deborah; Quick, Heather; Manship, Karen; Hauser, Alison

    2016-01-01

    Noting the lack of research on how early childhood education (ECE) programmes within family literacy programmes influence Latino children's early language and literacy development, this study examined key features of ECE programmes, specifically teacher-child interactions and child engagement in language and literacy activities and how these…

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

    Science.gov (United States)

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

    2014-01-01

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

  12. Effects of an exercise programme on self-esteem, self-concept and quality of life in women with fibromyalgia: a randomized controlled trial.

    Science.gov (United States)

    García-Martínez, Aida M; De Paz, José A; Márquez, Sara

    2012-07-01

    This study was aimed to investigate the effects of an exercise trial on self-esteem, self-concept and quality of life in patients with fibromyalgia and to evaluate whether improvements in psychological distress were related to changes in physical functioning. Twenty-eight women with a primary diagnosis of fibromyalgia were randomized to a usual care control group or to a 12-week supervised training programme consisting of 3 weekly sessions of aerobic, strengthening and flexibility exercises. Outcomes were physical functioning (Fibromyalgia Impact Questionnaire (FIQ), lower-body strength and flexibility) and psychological functioning (SF-36, Rosenberg self-esteem scale and Erdmann self-concept scale). Outcomes were measured at study entry and at the end of the intervention. Compared to the control group, statistically significant improvements in self-esteem, self-concept, FIQ, physical functioning, role physical, bodily pain, vitality, role emotional, social functioning, mental health, isometric strength, muscular endurance and flexibility were evident in the exercise group at the end of treatment. Self-esteem and self-concept scores were correlated positively with role emotional, mental health and the mental component summary of SF-36 and were negatively correlated to FIQ scores. No significant correlation existed between self-esteem or self-concept and isometric strength, muscular endurance or flexibility. Our results highlight the need for a broader array of physical and mental outcomes and the importance of examining patient's perceptions in future research therapies.

  13. 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.

  14. Early resort to ovarian stimulation improves the cost-effectiveness of a donor insemination programme.

    Science.gov (United States)

    Lashen, H; Afnan, M; Kennefik, A

    1999-08-01

    Women undergoing donor insemination (DI) are usually regularly ovulating, therefore the role of ovulation induction in this modality of treatment has been controversial. Some recent studies reported higher pregnancy rates in stimulated cycles in comparison with natural cycles. We employed a sequential step-up protocol in which treatment was started in a natural cycle, continued with a clomiphene citrate-stimulated cycle, and finished with an ovulation induction cycle. The patients were allowed three attempts at each step before moving to the next if conception did not occur. The aim of this protocol was to enhance the cost-effectiveness of the DI programme by increasing the cycle fecundability. A total of 101 patients underwent 216 cycles of DI, including 44 patients in 80 natural cycles, 38 patients in 89 CC-stimulated cycles, and 19 patients in 47 ovulation induction cycles. The clinical pregnancy rate per started cycle (CPR/C) and per patient during this period was 14% and 30% respectively. The pregnancy rates per started cycle and per patient in the natural, CC-stimulated and ovulation induction cycles were: 13 and 32%, 10 and 18%, and 21 and 53% respectively. There was no significant difference in the CPR/C in the three groups; however, the CPR per patient in the induced ovulation cycles was significantly higher than in the CC-stimulated cycles (P = 0.005). Only one patient during this period had a multiple pregnancy in the ovulation induction group, giving an overall multiple pregnancy of 3%. By using this treatment strategy, we achieved a high clinical pregnancy rate, a low multiple pregnancy rate and a low cost of treatment per pregnancy.

  15. Children’s perceptions of their right to quality healthcare in Uganda: Critical gaps in programme and policy development

    Directory of Open Access Journals (Sweden)

    Hilda K. Nankunda

    2015-09-01

    Full Text Available In 1989, Article 24 of the Convention on the Rights of the Child (UNCRC stipulated good quality healthcare, the best healthcare possible, as a human right for every child. This qualitative study in Uganda examined children’s awareness of and access to timely, quality healthcare as part of a broader study examining whether institutions established for children in Africa are raising awareness about children’s rights amongst children and engaging with children in decision-making and planning. To establish whether children possessed knowledge of their rights and could inform decisions at a community level. Using action research approaches, the team conducted focus group discussions (FGD, drawing, key informant interviews(KII, dialogue meetings (DM, and observations in one village in a rural and another in aperi-urban district, with 72 participants (21 children aged 10–15 and 51 adult stakeholders at community, district and national levels. Children were aware of their right to quality health services. In FGDs and drawing, children described their dissatisfaction with and difficulties in accessing healthcare services. These were confirmed with the adult stakeholders in the KIIs and DMs, the DMs also including children who presented their FGD results to community stakeholders. The findings suggested a lack of clear guidelines in schools or health facilities to support children needing medical attention. There was limited stakeholder capacity to involve children meaningfully in programme plans and decisions directly affecting them. Recommendations included the development of explicit policies with specific strong linkages between educational, health and other service institutions to promote, protect and respect children’s rights and also training to elicit children’s perspectives in decisions that affect them.

  16. Interventions to improve water quality for preventing diarrhoea

    Science.gov (United States)

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

    2015-01-01

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

  17. Work as treatment? The effectiveness of re-employment programmes for unemployed persons with severe mental health problems on health and quality of life: a systematic review and meta-analysis.

    Science.gov (United States)

    van Rijn, Rogier M; Carlier, Bouwine E; Schuring, Merel; Burdorf, Alex

    2016-04-01

    Given the importance of unemployment in health inequalities, re-employment of unemployed persons into paid employment may be a powerful intervention to increase population health. It is suggested that integrated programmes of vocational reintegration with health promotion may improve the likelihood of entering paid employment of long-term unemployed persons with severe mental health problems. However, the current evidence regarding whether entering paid employment of this population will contribute to a reduction in health problems remains unambiguous. This systematic review and meta-analysis aimed to assess the effects of re-employment programmes with regard to health and quality of life. Three electronic databases were searched (up to March 2015). Two reviewers independently selected articles and assessed the risk of bias on prespecified criteria. Measures of effects were pooled and random effect meta-analysis of randomised controlled trials was conducted, where possible. Sixteen studies were included. Nine studies described functioning as an outcome measure. Five studies with six comparisons provided enough information to calculate a pooled effect size of -0.01 (95% CI -0.13 to 0.11). Fifteen studies presented mental health as an outcome measure of which six with comparable psychiatric symptoms resulted in a pooled effect size of 0.20 (95% CI -0.23 to 0.62). Thirteen studies described quality of life as an outcome measure. Seven of these studies, describing eight comparisons, provided enough information to calculate a pooled effect size of 0.28 (95% CI 0.04 to 0.52). Re-employment programmes have a modest positive effect on the quality of life. No evidence was found for any effect of these re-employment programmes on functioning and mental health. 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/

  18. 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.

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

    Science.gov (United States)

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

    1993-01-01

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

  20. Quality of obstetric referral services in India's JSY cash transfer programme for institutional births: a study from Madhya Pradesh province.

    Directory of Open Access Journals (Sweden)

    Sarika Chaturvedi

    Full Text Available BACKGROUND: India launched JSY cash transfer programme to increase access to emergency obstetric and neonatal care (EmONC by incentivising in-facility births. This increased in-facility births from 30%in 2005 to 73% in 2012 however, decline in maternal mortality follows a secular trend. Dysfunctional referral services can contribute to poor programme impact on outcomes. We hence describe inter- facility referrals and study quality of referral services in JSY. METHODS AND RESULTS: Women accessing intra natal care (n = 1182 at facilities (reporting >10 deliveries/month, n = 96 were interviewed in a 5 day cross sectional survey in 3 districts of Madhya Pradesh province. A nested matched case control study (n = 68 pairs was performed to study association between maternal referral and adverse birth outcomes. There were 111 (9.4% in referrals and 69 (5.8% out referrals. Secondary level facilities sent most referrals and 40% were for conditions expected to be treated at this level. There were 36 adverse birth outcomes (intra partum and in-facility deaths. After matching for type of complication and place of delivery, conditional logistic regression model showed maternal referral at term delivery was associated with higher odds of adverse birth outcomes (OR- 2.6, 95% CI: 1.0-6.6 p = 0.04. Maternal death record review (April 10-March 12 was conducted at the CEmOC facility in one district. Spatial analysis of transfer time from sending to the receiving CEmOC facility among in-facility maternal deaths was conducted in ArcGIS10 applying two hours (equated to 100 Km as desired transfer time. There were 124 maternal deaths, 55 of which were among mothers referred in. Buffer analysis revealed 98% mothers were referred from <2 hours. Median time between arrival and death was 6.75 hours. CONCLUSIONS: High odds of adverse birth outcomes associated with maternal referral and high maternal deaths despite spatial access to referral care indicate poor

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

    Science.gov (United States)

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

    2016-04-01

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

  2. Measures to improve the quality of hotel services

    Directory of Open Access Journals (Sweden)

    Anca MADAR

    2017-07-01

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

  3. Improving quality in healthcare: What makes a satisfied patient?

    Science.gov (United States)

    Más, A; Parra, P; Bermejo, R M; Hidalgo, M D; Calle, J E

    2016-01-01

    To update the metric properties of a perceived quality questionnaire for patients admitted to hospital medical departments, to determine the level of patient satisfaction achieved, and to identify the variables which predict satisfaction. Self-administered questionnaire completed at home following patient discharge, using a questionnaire prepared by the authors on a sample of 7207 users of medical departments in 9 public hospitals during the years 2006-2009. A principal component analysis with varimax rotation was performed. Reliability was assessed using internal consistency coefficient. An analysis was made of the compliance with each indicator reported by respondents. A logistic regression analysis was performed to determine the perceived quality dimensions which predicted overall patient satisfaction. The results of the reliability analysis indicated good coefficients for interpersonal manner (0.94) and professional competence (0.85) dimensions, and moderate values for the other dimensions (comfort 0.55, information 0.38, and organisation 0.37). Factor analyses showed single factors in each of the perceived quality dimensions, with a percentage of explained variance greater than 35% for information, interpersonal manner, professional competence, and comfort, and less than 30% for organisation. The dimensions which predicted satisfaction were interpersonal manner of healthcare staff, professional competence, and information. The metric properties of the questionnaire used have been updated, yielding a valid and reliable questionnaire for assessing patient satisfaction in quality management programmes, both for internal purposes and for conducting external comparisons. A positive relationship was obtained between the level of patient satisfaction and level of professional competence, interpersonal manner of healthcare staff, and information received. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

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

    Science.gov (United States)

    Godény, Sándor

    2012-01-22

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

  5. A Quality Improvement Approach to Reducing the Caesarean section Surgical Site Infection Rate in a Regional Hospital

    LENUS (Irish Health Repository)

    O’ Hanlon, M

    2016-09-01

    Surgical site infection (SSI) rates are used extensively by hospitals as a basis for quality improvement. A 30-day post-discharge SSI programme for Caesarean section operations has been implemented in Our Lady of Lourdes Hospital since 2011. It has been shown that skin antisepsis and antibiotic prophylaxis are key factors in the prevention of SSI. Using quality improvement methodology, an infection prevention bundle was introduced to address these two factors. Skin antisepsis was changed from povidone-iodine to chlorhexidine-alcohol. Compliance with choice of antibiotic prophylaxis increased from 89.6% in 2014 to 98.5% in 2015. Compliance with timing also improved. The SSI rate of 7.5% was the lowest recorded to date, with the majority of SSIs (64%) diagnosed after hospital discharge. The level of variation was also reduced. However, the continued presence of variation and possibility of lower infection rates from the literature imply that further improvements are required.

  6. 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.

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

    Directory of Open Access Journals (Sweden)

    Hongyan Shi

    2017-02-01

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

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

    Science.gov (United States)

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

    2011-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  10. 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.

  11. Utilising theories of change to understand the engagement of general practitioners in service improvement: a formative evaluation of the Lewisham Depression Programme.

    Science.gov (United States)

    Riley, Anthony J; Byng, Richard; White, Corinna; Smith, Steve

    2008-01-01

    Mental health issues such as depression are commonly treated within primary care. In accordance with new UK National Institute for Health and Clinical Excellence (NICE) guidance, primary care practitioners have increased responsibilities to manage mild depression in primary care. This paper reports on an evaluation of a depression programme marketing strategy, and factors contributing towards practitioner engagement or non-engagement. The main aims of the study were to conduct an evaluation that was programme specific, to immediately feed results back iteratively through early development and engagement of general practitioners (GPs) and nurses and their practices in a multifaceted programme, and to investigate decisions to participate or not participate in the depression recognition audit as a first point of engagement, in order to gain a better understanding of what motivates GPs and nurses to be involved and what prohibits involvement, in order to address any future potential barriers to improvement. The methods for this formative evaluation can be categorised in three distinct ways: firstly, the iterative development of 'theories of change' (programme-based assumptions) using ethnographic techniques, which led to the development of a list of predefined theories of change and formed the basis of two questionnaires; secondly, questionnaires were sent to engaged GPs and nurses and a separate questionnaire was sent to a matched sample of GPs and nurses not engaged; finally, results were fed back on an ongoing basis to inform the ongoing programme development and evaluation and to produce final theories of change for engagement. The response rate to the questionnaire was 54%. Those involved in the audit reported individual motivation, team working, wider networks and method of engagement, all as positively influencing their decision to take part. Those not involved focused on practice organisational issues leading to non-participation, such as not having enough time

  12. The HAT TRICK programme for improving physical activity, healthy eating and connectedness among overweight, inactive men: study protocol of a pragmatic feasibility trial.

    Science.gov (United States)

    Caperchione, Cristina M; Bottorff, Joan L; Oliffe, John L; Johnson, Steven T; Hunt, Kate; Sharp, Paul; Fitzpatrick, Kayla M; Price, Ryley; Goldenberg, S Larry

    2017-09-06

    Physical activity, healthy eating and maintaining a healthy weight are associated with reduced risk of cardiovascular disease, type 2 diabetes and cancer and with improved mental health. Despite these benefits, many men do not meet recommended physical activity guidelines and have poor eating behaviours. Many health promotion programmes hold little appeal to men and consequently fail to influence men's health practices. HAT TRICK was designed as a 12-week face-to-face, gender-sensitised intervention for overweight and inactive men focusing on physical activity, healthy eating and social connectedness and was delivered in collaboration with a major junior Canadian ice hockey team (age range 16-20 years). The programme was implemented and evaluated to assess its feasibility. This article describes the intervention design and study protocol of HAT TRICK. HAT TRICK participants (n=60) were men age 35 years, residing in the Okanagan Region of British Columbia, who accumulate 150 min of moderate to vigorous physical activity a week, with a body mass index of >25 kg/m(2) and a pant waist size of >38'. Each 90 min weekly session included targeted health education and theory-guided behavioural change techniques, as well as a progressive (ie, an increase in duration and intensity) group physical activity component. Outcome measures were collected at baseline, 12 weeks and 9 months and included the following: objectively measured anthropometrics, blood pressure, heart rate, physical activity and sedentary behaviour, as well as self-reported physical activity, sedentary behaviour, diet, smoking, alcohol consumption, sleep habits, risk of depression, health-related quality of life and social connectedness. Programme feasibility data (eg, recruitment, satisfaction, adherence, content delivery) were assessed at 12 weeks via interviews and self-report. Ethical approval was obtained from the University of British Columbia Okanagan Behavioural Research Ethics Board (reference no H

  13. A Flowchart-Based Intelligent Tutoring System for Improving Problem-Solving Skills of Novice Programmers

    Science.gov (United States)

    Hooshyar, D.; Ahmad, R. B.; Yousefi, M.; Yusop, F. D.; Horng, S.-J.

    2015-01-01

    Intelligent tutoring and personalization are considered as the two most important factors in the research of learning systems and environments. An effective tool that can be used to improve problem-solving ability is an Intelligent Tutoring System which is capable of mimicking a human tutor's actions in implementing a one-to-one personalized and…

  14. How a One-Year Overseas Teacher Education Programme Improved a Teacher's Motivation Strategies

    Science.gov (United States)

    Wong, Ruth

    2016-01-01

    This longitudinal study investigates how in-service study abroad can improve the professional skills of teachers in regard to the strategies and attitudes they use to better motivate their students to learn English. The subject of this study is an in-service English as a Foreign Language (EFL) teacher from China who undertook a one-year teacher…

  15. A Flowchart-Based Intelligent Tutoring System for Improving Problem-Solving Skills of Novice Programmers

    Science.gov (United States)

    Hooshyar, D.; Ahmad, R. B.; Yousefi, M.; Yusop, F. D.; Horng, S.-J.

    2015-01-01

    Intelligent tutoring and personalization are considered as the two most important factors in the research of learning systems and environments. An effective tool that can be used to improve problem-solving ability is an Intelligent Tutoring System which is capable of mimicking a human tutor's actions in implementing a one-to-one personalized and…

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

    Science.gov (United States)

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

    2011-04-01

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

  17. The ELIXIR-EXCELERATE Train-the-Trainer pilot programme: empower researchers to deliver high-quality training [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Sarah L Morgan

    2017-08-01

    Full Text Available One of the main goals of the ELIXIR-EXCELERATE project from the European Union’s Horizon 2020 programme is to support a pan-European training programme to increase bioinformatics capacity and competency across ELIXIR Nodes. To this end, a Train-the-Trainer (TtT programme has been developed by the TtT subtask of EXCELERATE’s Training Platform, to try to expose bioinformatics instructors to aspects of pedagogy and evidence-based learning principles, to help them better design, develop and deliver high-quality training in future. As a first step towards such a programme, an ELIXIR-EXCELERATE TtT (EE-TtT pilot was developed, drawing on existing ‘instructor training’ models, using input both from experienced instructors and from experts in bioinformatics, the cognitive sciences and educational psychology. This manuscript describes the process of defining the pilot programme, illustrates its goals, structure and contents, and discusses its outcomes. From Jan 2016 to Jan 2017, we carried out seven pilot EE-TtT courses (training more than sixty new instructors, collaboratively drafted the training materials, and started establishing a network of trainers and instructors within the ELIXIR community. The EE-TtT pilot represents an essential step towards the development of a sustainable and scalable ELIXIR TtT programme. Indeed, the lessons learned from the pilot, the experience gained, the materials developed, and the analysis of the feedback collected throughout the seven pilot courses have both positioned us to consolidate the programme in the coming years, and contributed to the development of an enthusiastic and expanding ELIXIR community of instructors and trainers.

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

    Directory of Open Access Journals (Sweden)

    Sulaman Muhammad

    2015-04-01

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

  19. Improved quality and quantity of written feedback is associated with a structured feedback proforma.

    Science.gov (United States)

    Newton, Philip M; Wallace, Melisa J; McKimm, Judy

    2012-01-01

    Facilitating the provision of detailed, deep and useful feedback is an important design feature of any educational programme. Here we evaluate feedback provided to medical students completing short transferable skills projects. Feedback quantity and depth were evaluated before and after a simple intervention to change the structure of the feedback-provision form from a blank free-text feedback form to a structured proforma that asked a pair of short questions for each of the six domains being assessed. Each pair of questions consisted of asking the marker 'what was done well?' and 'what changes would improve the assignment?' Changing the form was associated with a significant increase in the quantity of the feedback and in the amount and quality of feedback provided to students. We also observed that, for these double-marked projects, the marker designated as 'marker 1' consistently wrote more feedback than the marker designated 'marker 2'.

  20. [Can implementation of intensified perinatal survey be effective in improving the quality of perinatal care?].

    Science.gov (United States)

    Troszyński, Michał

    2010-01-01

    obligatory to conduct medical audit which is a form of specialistic supervision. It is probable that higher number of stillbirths and premature births may be caused by late start of perinatal care in pregnancy. In primary health care, insufficient objective parameters are investigated which lead to assessment of the quality of perinatal care. Correct filling up of the pregnancy chart could improve the quality of the management of prophylactic procedures leading to a fall in the number of premature births and stillbirths. This would also lead to a reduction of costs associated with life saving procedures and improving the quality of life in newborns with low and extremly low birth weight. 1. The survey of fetal and newborn perinatal mortality of fetuses and newborn should be the base for elaborating the perinatal care programme as well as the main source of data for medical audit. This is the instrument for evaluation of the three level perinatal care. It also serves to assess the effectivness of diagnostic and therapeutic recommendations and the programme of active prevention. 2. In order to obtain effectivness in functioning of the three step perinatal care within the framework of the National Health Programme the following steps are needed: - urgent elaboration of new or improved medical documentation which will become obligatory, - implementation of educational programmes and training of teachers. 3. Implementation of medical audit, carried out periodically at all three levels of perinatal care.

  1. Health education programmes to improve foot self-care practices and foot problems among older people with diabetes: a systematic review.

    Science.gov (United States)

    Ahmad Sharoni, Siti Khuzaimah; Minhat, Halimatus Sakdiah; Mohd Zulkefli, Nor Afiah; Baharom, Anisah

    2016-09-01

    To assess the effectiveness of health education programmes to improve foot self-care practices and foot problems among older people with diabetes. The complications of diabetes among older people are a major health concern. Foot problems such as neuropathy, ulcer and ultimately amputation are a great burden on older people with diabetes. Diabetes foot education programmes can influence the behaviour of older people in practising foot self-care and controlling the foot problems. However, the educational approaches used by the educators are different. Therefore, it is important to assess the education programmes from various evidence-based practices. Six databases, EBSCOhost medical collections (MEDLINE, CINAHL, Psychology and Behavioral Sciences Collection), SAGE, Wiley Online Library, ScienceDirect, SpringerLink and Web of Science, were used to search for articles published from January 2000 to March 2015. The search was based on the inclusion criteria and keywords including 'foot', 'care' and 'diabetes'. Fourteen studies were assessed and reviewed in the final stage. Health education programmes varied according to their design, setting, approach, outcome measured and results. Foot assessment, verbal and written instructions and discussion were proved to improve the foot self-care and foot problems. Subsequent follow-ups and evaluations had a significant effect. An improvement was observed in foot self-care scores and foot problems (such as neuropathy, foot disability, lesion, ulcer, tinea pedis and callus grade) after implementation of the health education programme. The findings of this study support the claim that a health education programme increases the foot self-care scores and reduces the foot problems. However, there were certain methodological concerns in the reviewed articles, indicating the need for further evaluation. In future, researchers and practitioners must implement a vigorous education programme focusing on diabetes foot self-care among the

  2. Using mobile technology to improve healthcare service quality.

    Science.gov (United States)

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

    2005-01-01

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

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

    Science.gov (United States)

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

    2012-08-01

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

  4. Construction of the image of politics in Spanish TV news programmes. The endo- and exo- balances of the quality of political information

    Directory of Open Access Journals (Sweden)

    M Palencia-Lefler

    2013-02-01

    Full Text Available In our society the image that citizens have of politics is strongly conditioned by the way politics are represented in the media and, in particular, in TV news programmes. This article, a product of an R&D project funded by the Spanish Ministry of Education, Social Policy and Sport, analyses the presence and image of political news in eight Spanish TV channels. This article also proposes a new method to measure the quality of political information in Spanish TV news programmes through the definition of the endo- and exo- balances of the political content of news programmes. The main conclusions of this study are that the news programmes of Televisión Española and Cuatro offer a more balanced image of politics, while the news programmes from Sexta and Canal 9 offer more unbalanced image. The percentage of news devoted to politics does not depend on the channels’ ownership (public or private or broadcast coverage (national or regional. On the other hand, there is a relation between the percentages of political issues and policy issues news presented on television.

  5. Proteomic and genomic analysis to improve the quality and safety of agricultural productions

    Directory of Open Access Journals (Sweden)

    Miriam Odoardi

    2008-04-01

    Full Text Available Food health and quality are the keywords recurring both into the VII Framework Programme of EU, both in the PNR and development plans arranged by several Italian regions. Essentially, the increase and definition of quality of agri-food products represent necessary tools to give new impulse and renovation to this sector. The late developments of European and Italian laws show a clear trend towards the need to give consumer clear indications on different qualitative aspects of agri-food products, besides their microbiological security. The capacity to increase the quantity of secondary metabolites (vitamins and antioxidants in crops is particularly interesting for the development of products with high health value (functional food. Breeding programmes have already obtained lines improved about these characteristics. The need to develop assessment strategies giving scientifically reliable information on traceability and health of food derived from genetically modified plants. Assessment of the risk coming from genetically modified plants is mainly based on the so-called “principle of substantial equivalence” or “of comparative safety”, claiming that a transgenic genotype shouldn’t show any substantial change with respect of the corresponding non-transgenic genotype. These changes are obviously considered healthy in case of the current commercial varieties. The new “-omics” disciplines such as genomics, transcriptomics, proteomics and metabolomics, born together with and subsequent to the complete sequencing of model genomes, can give an overview of first matters and food compositions, thus allowing the making of an overall assessment of their quality and safety. These new and sophisticated tools for molecular investigation can help and strengthen the commonly used methods, meeting the new requirements of traceability and authenticity certification.

  6. Quality of life is reduced in obese dogs but improves after successful weight loss.

    Science.gov (United States)

    German, A J; Holden, S L; Wiseman-Orr, M L; Reid, J; Nolan, A M; Biourge, V; Morris, P J; Scott, E M

    2012-06-01

    Obesity is thought to affect quality of life, but limited objective data exist to support this supposition. The current study aim was to use a questionnaire to determine health-related quality of life (HRQOL) both before and after weight loss, in obese client-owned dogs. Fifty obese dogs were included, and represented a variety of breeds and genders. Prior to weight loss, owners were asked to complete a validated standardised questionnaire to determine HRQOL. Thirty of the dogs successfully completed their weight loss programme and reached target, and owners then completed a follow-up questionnaire. The completed questionnaire responses were transformed to scores corresponding to each of four factors (vitality, emotional disturbance, anxiety and pain), and scored on a scale of 0-6. Changes in the scores were used to explore the sensitivity of the questionnaire, and scores were correlated with responses to direct questions about quality of life and pain, as well as weight loss. Dogs that failed to complete their weight loss programme had lower vitality and higher emotional disturbance scores than those successfully losing weight (P=0.03 for both). In the 30 dogs that completed, weight loss led to an increased vitality score (Panxiety (P=0.09). The change in vitality score was positively associated with percentage weight loss (r(P)=0.43, P=0.02) and percentage body fat loss (r(P)=0.39, P=0.03). These results indicate demonstrable improvement in HRQOL for obese dogs that successfully lose weight.

  7. Social skills programmes for schizophrenia.

    Science.gov (United States)

    Almerie, Muhammad Qutayba; Okba Al Marhi, Muhammad; Jawoosh, Muhammad; Alsabbagh, Mohamad; Matar, Hosam E; Maayan, Nicola; Bergman, Hanna

    2015-06-09

    . Global state was measured in one trial by numbers not experiencing a clinical improvement, results favoured social skills (1 RCT, n = 67, RR 0.29 CI 0.12 to 0.68, very low quality evidence). Quality of life was also improved in the social skills programme compared to standard care (1 RCT, n = 112, MD -7.60 CI -12.18 to -3.02, very low quality evidence). However, when social skills programmes were compared to a discussion group control, we found no significant differences in the participants social functioning, relapse rates, mental state or quality of life, again the quality of evidence for these outcomes was very low. Compared to standard care, social skills training may improve the social skills of people with schizophrenia and reduce relapse rates, but at present, the evidence is very limited with data rated as very low quality. When social skills training was compared to discussion there was no difference on patients outcomes. Cultural differences might limit the applicability of the current results, as most reported studies were conducted in China. Whether social skills training can improve social functioning of people with schizophrenia in different settings remains unclear and should be investigated in a large multi-centre randomised controlled trial.

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

    Directory of Open Access Journals (Sweden)

    Pedro Gabriel Melo de Barros e Silva

    2015-12-01

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

  9. Publication guidelines for quality improvement in health care: evolution of the SQUIRE project.

    Science.gov (United States)

    Davidoff, F; Batalden, P; Stevens, D; Ogrinc, G; Mooney, S

    2008-10-01

    In 2005, draft guidelines were published for reporting studies of quality improvement interventions as the initial step in a consensus process for development of a more definitive version. This article contains the full revised version of the guidelines, which the authors refer to as SQUIRE (Standards for QUality Improvement Reporting Excellence). This paper also describes the consensus process, which included informal feedback from authors, editors and peer reviewers who used the guidelines; formal written commentaries; input from a group of publication guideline developers; ongoing review of the literature on the epistemology of improvement and methods for evaluating complex social programmes; a two-day meeting of stakeholders for critical discussion and debate of the guidelines' content and wording; and commentary on sequential versions of the guidelines from an expert consultant group. Finally, the authors consider the major differences between SQUIRE and the initial draft guidelines; limitations of and unresolved questions about SQUIRE; ancillary supporting documents and alternative versions that are under development; and plans for dissemination, testing and further development of SQUIRE.

  10. 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.

  11. 40 CFR 65.116 - Quality improvement program for pumps.

    Science.gov (United States)

    2010-07-01

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

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

    Science.gov (United States)

    Antelman, Albert

    1991-01-01

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

  13. 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…

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

    NARCIS (Netherlands)

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

    2012-01-01

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

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

    NARCIS (Netherlands)

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

    2006-01-01

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

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

    Science.gov (United States)

    Ho, Gwangsu; Kawanaka, Akira; Takagi, Mikio

    1993-11-01

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

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

    NARCIS (Netherlands)

    de Mast, J.; Bergman, M.

    2006-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Slameto Slameto

    2016-06-01

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

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

    NARCIS (Netherlands)

    Koreissi, Y.

    2015-01-01

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

  20. Identifying targets for quality improvement in hospital antibiotic prescribing

    NARCIS (Netherlands)

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

    2015-01-01

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