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Sample records for quality improvement project

  1. 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

  2. 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.

  3. 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.

  4. 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.

  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. Newland A Watershed Water Quality Improvement Project

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This project was an effort to address the drainage problems associated with Newland. As a result of significant flooding, urban development, and the concern for the...

  7. 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

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

    Science.gov (United States)

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

    2017-07-31

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

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

    Science.gov (United States)

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

    2001-04-01

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

  10. Assessing local resources and culture before instituting quality improvement projects.

    Science.gov (United States)

    Hawkins, C Matthew

    2014-12-01

    The planning phases of quality improvement projects are commonly overlooked. Disorganized planning and implementation can escalate chaos, intensify resistance to change, and increase the likelihood of failure. Two important steps in the planning phase are (1) assessing local resources available to aid in the quality improvement project and (2) evaluating the culture in which the desired change is to be implemented. Assessing local resources includes identifying and engaging key stakeholders and evaluating if appropriate expertise is available for the scope of the project. This process also involves engaging informaticists and gathering available IT tools to plan and automate (to the extent possible) the data-gathering, analysis, and feedback steps. Culture in a department is influenced by the ability and willingness to manage resistance to change, build consensus, span boundaries between stakeholders, and become a learning organization. Allotting appropriate time to perform these preparatory steps will increase the odds of successfully performing a quality improvement project and implementing change. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Elisha M. Okaisu

    2014-10-01

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

  12. 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.

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

    Science.gov (United States)

    Cuna, Alain; Winter, Lindy

    2017-08-01

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

  14. 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.

  15. Optimizing insulin pump therapy: a quality improvement project.

    Science.gov (United States)

    Meade, Lisa T; Rushton, Wanda E

    2013-01-01

    The purpose of the study was to assess insulin pump use and provide ongoing education. A quality improvement project using a pump assessment questionnaire was implemented at an endocrinology office in the southeastern United States. The questionnaire was designed to evaluate all aspects of insulin pump therapy, including pump operations, infusion set failure, management of acute complications, and usage of advanced device features. Eighty-nine patients (80% with type 1 diabetes and 20% with type 2 diabetes) completed the questionnaire at the endocrinology practice. A certified diabetes educator reviewed the questions with each patient, identifying deficiencies and training opportunities. The most common areas of deficiency identified after implementation of the assessment form included the following: expired or no basal insulin prescription in the event of pump failure or removal, no mupirocin (Bactroban®, GlaxoSmithKline, Research Triangle Park, North Carolina) prescription for suspected site infections, lack of insulin syringe if pump stopped working, failure to check urine ketones, no antiemetic prescription for sick day intervention, using manual bolus instead of bolus calculator, and lack of in-date glucagon kit. Use of a pump assessment questionnaire allows for focused discussion concerning patient behaviors related to pump operations, troubleshooting, and self-management. Incorporating use of a pump assessment questionnaire into routine practice may result in improved patient education and avoidance of adverse events specific to insulin pump therapy.

  16. Quality Improvement Project to Improve Patient Satisfaction With Pain Management: Using Human-Centered Design.

    Science.gov (United States)

    Trail-Mahan, Tracy; Heisler, Scott; Katica, Mary

    2016-01-01

    In this quality improvement project, our health system developed a comprehensive, patient-centered approach to improving inpatient pain management and assessed its impact on patient satisfaction across 21 medical centers. Using human-centered design principles, a bundle of 6 individual and team nursing practices was developed. Patient satisfaction with pain management, as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems pain composite score, increased from the 25th to just under the 75th national percentile.

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

    Science.gov (United States)

    Allen, Michelle L.; Gunst, Colette

    2016-01-01

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

  18. Improving patient care through student leadership in team quality improvement projects.

    Science.gov (United States)

    Tschannen, Dana; Aebersold, Michelle; Kocan, Mary Jo; Lundy, Francene; Potempa, Kathleen

    2015-01-01

    In partnership with a major medical center, senior-level nursing students completed a root cause analysis and implementation plan to address a unit-specific quality issue. To evaluate the project, unit leaders were asked their perceptions of the value of the projects and impact on patient care, as well as to provide exemplars depicting how the student root cause analysis work resulted in improved patient outcome and/or unit processes. Liaisons noted benefits of having an RCA team, with positive impact on patient outcomes and care processes.

  19. Improving critical care discharge summaries: a collaborative quality improvement project using PDSA.

    Science.gov (United States)

    Goulding, Lucy; Parke, Hannah; Maharaj, Ritesh; Loveridge, Robert; McLoone, Anne; Hadfield, Sophie; Helme, Eloise; Hopkins, Philip; Sandall, Jane

    2015-01-01

    Around 110,000 people spend time in critical care units in England and Wales each year. The transition of care from the intensive care unit to the general ward exposes patients to potential harms from changes in healthcare providers and environment. Nurses working on general wards report anxiety and uncertainty when receiving patients from critical care. An innovative form of enhanced capability critical care outreach called 'iMobile' is being provided at King's College Hospital (KCH). Part of the remit of iMobile is to review patients who have been transferred from critical care to general wards. The iMobile team wished to improve the quality of critical care discharge summaries. A collaborative evidence-based quality improvement project was therefore undertaken by the iMobile team at KCH in conjunction with researchers from King's Improvement Science (KIS). Plan, Do, Study, Act (PDSA) methodology was used. Three PDSA cycles were undertaken. Methods adopted comprised: a scoping literature review to identify relevant guidelines and research evidence to inform all aspects of the quality improvement project; a process mapping exercise; informal focus groups / interviews with staff; patient story-telling work with people who had experienced critical care and subsequent discharge to a general ward; and regular audits of the quality of both medical and nursing critical care discharge summaries. The following behaviour change interventions were adopted, taking into account evidence of effectiveness from published systematic reviews and considering the local context: regular audit and feedback of the quality of discharge summaries, feedback of patient experience, and championing and education delivered by local opinion leaders. The audit results were mixed across the trajectory of the project, demonstrating the difficulty of sustaining positive change. This was particularly important as critical care bed occupancy and through-put fluctuates which then impacts on work

  20. Selecting clinical quality improvement projects: getting a bigger return for your investment.

    Science.gov (United States)

    Leininger, C J; Seaman, L H

    2000-02-01

    An urban medical center developed and implemented a process for selecting clinical quality-improvement projects. The process was designed to select projects that would deliver greater returns than had previous projects. The four-step process involved: (1) establishing project selection criteria, (2) identifying potential projects, (3) assigning points and ranking projects, and (4) selecting projects based on rank and available resources. This process won physician commitment and secured administrative support. It identified projects that had unprecedented success in improving clinical outcomes, increasing patient satisfaction, and reducing cost.

  1. Establishing a portfolio of quality-improvement projects in pediatric surgery through advanced improvement leadership systems.

    Science.gov (United States)

    Gerrein, Betsy T; Williams, Christina E; Von Allmen, Daniel

    2013-01-01

    Formal quality-improvement (QI) projects require that participants are educated in QI methods to provide them with the capability to carry out successful, meaningful work. However, orchestrating a portfolio of projects that addresses the strategic mission of the institution requires an extension of basic QI training to provide the division or business unit with the capacity to successfully develop and manage the portfolio. Advanced Improvement Leadership Systems is a program to help units create a meaningful portfolio. This program, used by the Division of Pediatric General and Thoracic Surgery at Cincinnati Children's Hospital Medical Center, helped establish a portfolio of targeted QI projects designed to achieve outstanding outcomes at competitive costs in multiple clinical areas aligned with the institution's strategic goals (improve disease-based outcomes, patient safety, flow, and patient and family experience). These objectives are addressed in an institutional strategic plan built around 5 core areas: Safety, Productivity, Care Coordination and Outcomes, Patient and Family Experience, and Value. By combining the portfolio of QI projects with improvements in the divisional infrastructure, effective improvement efforts were realized throughout the division. In the 9 months following the program, divisional capability resulted in a 16.5% increase (5.7% to 22.2%) of formally trained staff working on 10 QI teams. Concurrently, a leadership team, designed to coordinate projects, remove barriers, and provide technical support, provided the capacity to pursue this ongoing effort. The Advanced Improvement Leadership Systems program increased the Division's efficiency and effectiveness in pursing the QI mission that is integral at our hospital.

  2. Improvement in Herpes Zoster Vaccination in Patients with Rheumatoid Arthritis: A Quality Improvement Project.

    Science.gov (United States)

    Sheth, Heena; Moreland, Larry; Peterson, Hilary; Aggarwal, Rohit

    2017-01-01

    To improve herpes zoster (HZ) vaccination rates in high-risk patients with rheumatoid arthritis (RA) being treated with immunosuppressive therapy. This quality improvement project was based on the pre- and post-intervention design. The project targeted all patients with RA over the age of 60 years while being treated with immunosuppressive therapy (not with biologics) seen in 13 rheumatology outpatient clinics. The study period was from July 2012 to June 2013 for the pre-intervention and February 2014 to January 2015 for the post-intervention phase. The electronic best practice alert (BPA) for HZ vaccination was developed; it appeared on electronic medical records during registration and medication reconciliation of the eligible patient by the medical assistant. The BPA was designed to electronically identify patient eligibility and to enable the physician to order the vaccine or to document refusal or deferral reason. Education regarding vaccine guidelines, BPA, vaccination process, and feedback were crucial components of the project interventions. The vaccination rates were compared using the chi-square test. We evaluated 1823 and 1554 eligible patients with RA during the pre-intervention and post-intervention phases, respectively. The HZ vaccination rates, reported as patients vaccinated among all eligible patients, improved significantly from the pre-intervention period of 10.1% (184/1823) to 51.7% (804/1554) during the intervention phase (p Electronic identification of vaccine eligibility and BPA significantly improved HZ vaccination rates. The process required minimal modification of clinic work flow and did not burden the physician's time, and has the potential for self-sustainability and generalizability.

  3. Conducting a Successful Practice Quality Improvement Project for American Board of Radiology Certification.

    Science.gov (United States)

    Lee, Cindy S; Wadhwa, Vibhor; Kruskal, Jonathan B; Larson, David B

    2015-10-01

    Practice quality improvement (PQI) is a required component of the American Board of Radiology (ABR) Maintenance of Certification (MOC) cycle, with the goal to "improve the quality of health care through diplomate-initiated learning and quality improvement." The essential requirements of PQI projects include relevance to one's practice, achievability in one's clinical setting, results suited for repeat measurements during an ABR MOC cycle, and reasonable expectation to result in quality improvement (QI). PQI projects can be performed by a group or an individual or as part of a participating institution. Given the interdisciplinary nature of radiology, teamwork is critical to ensure patient safety and the success of PQI projects. Additionally, successful QI requires considerable investment of time and resources, coordination, organizational support, and individual engagement. Group PQI projects offer many advantages, especially in larger practices and for processes that cross organizational boundaries, whereas individual projects may be preferred in small practices or for focused projects. In addition to the three-phase "plan, do, study, act" model advocated by the ABR, there are several other improvement models, which are based on continuous data collection and rapid simultaneous testing of multiple interventions. When properly planned, supported, and executed, group PQI projects can improve the value and viability of a radiology practice.

  4. AN APPROACH TO THE QUALITY IMPROVEMENT OF A MASSIVE INVESTMENT PROJECT BY INTEGRATING ICT AND QMS

    Directory of Open Access Journals (Sweden)

    Tamara Gvozdenovic

    2007-12-01

    Full Text Available This work has presented an approach to the quality improvement of an investment project by the change in the concept of project management. Building time of the investment project is a complex factor which needs a special attention. It is well known that the PERT method has been applied with long-lasting investment projects, where a big time distance brings about significant uncertainty of future situations. Microsoft Project 2002 and Matlab: Neural Network Toolbox are the software tools used for solving the problem of investment project management.

  5. Institutionalizing pain management: the Post-Operative Pain Management Quality Improvement Project.

    Science.gov (United States)

    Dahl, June L; Gordon, Deb; Ward, Sandra; Skemp, Marty; Wochos, Sarah; Schurr, Michael

    2003-09-01

    Clinical practice and quality improvement (QI) guidelines for acute postoperative pain management have been developed to address the well-documented problem of undertreatment of postoperative pain. The Post-Operative Pain Management Quality Improvement Project (the POP Project) was initiated to determine whether an intervention designed to support hospitals in the development of QI efforts would lead to improvements in structures, processes, and outcomes consistent with recommended guidelines. A nationwide sample of 233 hospitals joined the project. The intervention consisted of written resource materials accompanied by support services that included an e-mail list server, a resource Web page, and assistance from POP Project staff via telephone. Data regarding critical structures, processes (practice patterns), and patient outcomes were collected at baseline before the intervention began and at follow-up 12 to 18 months later. Results showed a statistically significant increase from baseline (45%) to follow-up (72%) in the presence of structural elements that are critical to improving pain management. There were statistically significant improvements in practices including documented use of pain rating scales, decreased use of intramuscular opioids, and increased use of nonpharmacologic strategies. Patient survey data showed no change in pain outcomes. Evaluation data showed that 70% of hospitals were very or extremely satisfied with their participation in the POP Project and 90% of them planned to continue efforts to improve pain management after the POP Project ended. Further research is needed to determine how to translate the excellent results obtained for structure and process into meaningful outcomes for patients.

  6. The Dorset Seedcorn Project: interprofessional learning and continuous quality improvement in primary care.

    Science.gov (United States)

    Wilcock, Peter M; Campion-Smith, Charles; Head, Michael

    2002-10-01

    There is a need to develop models of practice-based learning that are effective in bringing about improvement in the quality of care that patients receive. This paper describes a facilitated practice-based project where five general practices in Dorset formed interprofessional teams that worked over a six-month period using a continuous quality improvement (CQI) approach to make a change in areas of importance to them. All the teams completed the project and planned and implemented demonstrable changes. Qualitative enquiry showed changes in relationships and teamworking that extended beyond the specific topic of the project with teams reporting an enhanced sense of competence and achievement. The project facilitators were able to develop a model of learning that acknowledges and utilises the depth of experience and understanding within interprofessional practice teams. Protected time and an environment and processes that encourage full partcipation of a wide range of team members is essential.

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

    Science.gov (United States)

    Leff, Ellen W

    2004-05-01

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

  8. Quality improvement project to determine outpatient chemotherapy capacity and improve utilization.

    Science.gov (United States)

    Gruber, Marcia; Smith, Debra; O'Neal, Charnese; Hennessy, Kelli; Therrien, Melissa

    2008-01-01

    Nurses in chemotherapy administration settings are constantly challenged to increase utilization while maintaining patient safety. A performance improvement project was carried out to identify barriers to patient throughput and opportunities to improve utilization while not compromising patient safety. We found ways to safely increase the number of patients from 92 to 108 per day; however, patient tardiness and staff vacancies had a negative impact on patient wait times and nursing staff overtime.

  9. Integrating Safe Sleep Practices into a Pediatric Hospital: Outcomes of a Quality Improvement Project.

    Science.gov (United States)

    Rowe, Angela D; Sisterhen, Laura L; Mallard, Ellen; Borecky, Betsy; Schmid, Barbara; Rettiganti, Mallikarjuna; Luo, Chunqiao

    2016-01-01

    A quality improvement project for implementing safe sleep practices (SSP) was conducted at a large, U.S children's hospital. The intervention involved education of staff and standardization of infant sleep practices utilizing a multifaceted approach. Staff surveys and environmental audits were conducted pre- and post-intervention. Safe Sleep Environment (SSE) audits showed an improvement from 23% to 34% (psafe sleep practices have the potential to reduce infant mortality.

  10. Implementing an organization-wide quality improvement initiative: insights from project leads, managers, and frontline nurses.

    Science.gov (United States)

    Jeffs, Lianne P; Lo, Joyce; Beswick, Susan; Campbell, Heather

    2013-01-01

    With the movement to advance quality care and improve health care outcomes, organizations have increasingly implemented quality improvement (QI) initiatives to meet these requirements. Key to implementation success is the multilevel involvement of frontline clinicians and leadership. To explore the perceptions and experiences of frontline nurses, project leads, and managers associated with an organization-wide initiative aimed at engaging nurses in quality improvement work. To address the aims of this study, a qualitative research approach was used. Two focus groups were conducted with a total of 13 nurse participants, and individual interviews were done with 10 managers and 6 project leads. Emergent themes from the interview data included the following: improving care in a networked approach; driving QI and having a sense of pride; and overcoming challenges. Specifically, our findings elucidate the value of communities of practice and ongoing mentorship for nurses as key strategies to acquire and apply QI knowledge to a QI project on their respective units. Key challenges emerged including workload and time constraints, as well as resistance to change from staff. Our study findings suggest that leaders need to provide learning opportunities and protected time for frontline nurses to participate in QI projects.

  11. Doctor Who? A Quality Improvement Project to Assess and Improve Patients' Knowledge of Their Inpatient Physicians.

    Science.gov (United States)

    Broderick-Forsgren, Kathleen; Hunter, Wynn G; Schulteis, Ryan D; Liu, Wen-Wei; Boggan, Joel C; Sharma, Poonam; Thomas, Steven; Zaas, Aimee; Bae, Jonathan

    2016-05-01

    Background Patient-physician communication is an integral part of high-quality patient care and an expectation of the Clinical Learning Environment Review program. Objective This quality improvement initiative evaluated the impact of an educational audit and feedback intervention on the frequency of use of 2 tools-business cards and white boards-to improve provider identification. Methods This before-after study utilized patient surveys to determine the ability of those patients to name and recognize their physicians. The before phase began in July 2013. From September 2013 to May 2014, physicians received education on business card and white board use. Results We surveyed 378 patients. Our intervention improved white board utilization (72.2% postintervention versus 54.5% preintervention, P < .01) and slightly improved business card use (44.4% versus 33.7%, P = .07), but did not improve physician recognition. Only 20.3% (14 of 69) of patients could name their physician without use of the business card or white board. Data from all study phases showed the use of both tools improved patients' ability to name physicians (OR = 1.72 and OR = 2.12, respectively; OR = 3.68 for both; P < .05 for all), but had no effect on photograph recognition. Conclusions Our educational intervention improved white board use, but did not result in improved patient ability to recognize physicians. Pooled data of business cards and white boards, alone or combined, improved name recognition, suggesting better use of these tools may increase identification. Future initiatives should target other barriers to usage of these types of tools.

  12. 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.

  13. Software for improving the quality of project management, a case study: international manufacture of electrical equipment

    Science.gov (United States)

    Preradović, D. M.; Mićić, Lj S.; Barz, C.

    2017-05-01

    Production conditions in today’s world require software support at every stage of production and development of new products, for quality assurance and compliance with ISO standards. In addition to ISO standards such as usual metrics of quality, companies today are focused on other optional standards, such as CMMI (Capability Maturity Model Integrated) or prescribing they own standards. However, while there is intensive progress being made in the PM (project management), there is still a significant number of projects, at the global level, that are failures. These have failed to achieve their goals, within budget or timeframe. This paper focuses on checking the role of software tools through the rate of success in projects implemented in the case of internationally manufactured electrical equipment. The results of this research show the level of contribution of the project management software used to manage and develop new products to improve PM processes and PM functions, and how selection of the software tools affects the quality of PM processes and successfully completed projects.

  14. A Quality Improvement Project to Improve Family Recognition of Medical Team Member Roles.

    Science.gov (United States)

    Hayes, Rebecca M; Wickline, Afton; Hensley, Christina; Cowen, Kelsey; Jessie, Ashley; Akers, Melanie; Dolan, Jenna; Pritt, Audra; Goodrich, Shea; O'Neill, Kelly; Flesher, Susan L

    2015-09-01

    Previous studies have shown that inpatients and families in academic settings have a limited ability to recall either their medical team members or the roles of those members. This is an important issue for patient and family satisfaction as well as patient safety. The objective of this study was to increase families' recognition of medical team members' roles. We established a multidisciplinary quality improvement leadership team, measured family recognition of medical team members and their roles, and conducted 2 PDSA (Plan-Do-Study-Act) cycles. The first intervention was standardization of the content and delivery of our verbal team introductions to ensure inclusion of essential elements and family engagement. The second intervention was addition of an informational white board in each patient room. The prospective study included 105 families in the preintervention phase, 103 post-PDSA cycle 1, and 92 post-PDSA cycle 2. After conduction of 2 PDSA cycles, the recognition of the attending role increased from 49% to 87% (P = .000), the resident role from 39% to 73% (P = .000), and the medical student from 75% to 89% (P = .038). The multidisciplinary quality improvement model was effective in improving family recognition of the roles of attending physicians, resident physicians, and medical students. Consistent attention to engaging the families and explaining our roles as well as providing informational white boards are effective interventions to facilitate this process. Copyright © 2015 by the American Academy of Pediatrics.

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

    Science.gov (United States)

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

    2001-01-01

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

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

    Science.gov (United States)

    Raiman, Laura B.

    1992-12-01

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

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

    Science.gov (United States)

    Raiman, Laura B.

    1992-01-01

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

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

    Science.gov (United States)

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

    2015-08-01

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

  19. Quality Improvement Project to Improve Timeliness Between Bronchodilator Treatments from Emergency Department to Medical Wards.

    Science.gov (United States)

    Cockerham, Jennifer R; Lowe, Gary R; Willis, Randy; Stecks, Ryan M; Berlinski, Ariel

    2016-12-01

    Quality improvement methodology was applied to study sporadic reports that patients with asthma were not given bronchodilator treatments or assessed within an appropriate time frame when they were admitted from the emergency department to the medical ward. The goal was to increase the number of patients who had an interval between emergency department assessment/bronchodilator treatment and medical ward assessment/treatment of flow chart diagram, a fishbone diagram, data collection, intervention implementation, and data monitoring and analysis were used in this study. Data were collected on a pre-test of change cohort of 227 subjects with asthma from January 2013 to March 2014. A test of change adding a Q2H respiratory therapist assessment and as needed bronchodilator treatment order while the subject was in the emergency department was implemented during May of 2014. These data were compared with a post-test of change cohort of 278 subjects with asthma from May 2014 to July 2015. Data collection for both cohorts included the time from the last assessment/bronchodilator treatment in the emergency department to emergency department discharge, the time from emergency department discharge to assessment/treatment in the medical ward, and the sum of these 2 time periods. Mean times (minutes) were noted, and comparisons were made using 2-tailed independent t tests with significance set at P process control charts. There was a 124% increase noted in the percentage of subjects who received bronchodilator treatment within 120 min, a 53% increase within 180 min, and a 19% increase within 240 min. The interval time between treatments decreased 21%. Through quality improvement methodology, the group was able to significantly decrease the time between the last assessment/bronchodilator treatment in the emergency department and the first assessment/treatment in the medical ward for subjects with asthma. Moreover, improvement was seen in all studied parameters despite similar

  20. The effect of a resident-led quality improvement project on improving communication between hospital-based and outpatient physicians.

    Science.gov (United States)

    Kalanithi, Lucy; Coffey, Charles E; Mourad, Michelle; Vidyarthi, Arpana R; Hollander, Harry; Ranji, Sumant R

    2013-01-01

    This article reports on a resident-led quality improvement program to improve communication between inpatient internal medicine residents and their patients' primary care physicians (PCPs). The program included education on care transitions, standardization of documentation, audit and feedback of documented PCP communication rates with public reporting of performance, rapid-cycle data analysis and improvement projects, and a financial incentive. At baseline, PCP communication was documented in 55% of patients; after implementation of the intervention, communication was documented in 89.3% (2477 of 2772) of discharges during the program period. The program was associated with a significant increase in referring PCP satisfaction with communication at hospital admission (baseline, 27.7% "satisfied" or "very satisfied"; postintervention, 58.2%; P importance of PCP communication for patient care and audit and feedback of their performance as the principal drivers of their engagement in the project.

  1. The Pediatrix BabySteps Data Warehouse and the Pediatrix QualitySteps improvement project system--tools for "meaningful use" in continuous quality improvement.

    Science.gov (United States)

    Spitzer, Alan R; Ellsbury, Dan L; Handler, Darren; Clark, Reese H

    2010-03-01

    The Pediatrix BabySteps Clinical Data Warehouse (CDW) is a rich and novel tool allowing unbiased extraction of information from an entire neonatal population care by physicians and advanced practice nurses in Pediatrix Medical Group. Because it represents the practice of newborn medicine ranging from small community intensive care units to some of the largest neonatal intensive care units in the United States, it is highly representative of scope of practice in this country. Its value in defining outcome measures, quality improvement projects, and research continues to grow annually. Now coupled with the BabySteps QualitySteps program for defined clinical quality improvement projects, it represents a robust methodology for meaningful use of an electronic health care record, as designated during this era of health care reform. Continued growth of the CDW should result in continued important observations and improvements in neonatal care.

  2. An asthma and diabetes quality improvement project: enhancing care in clinics and community health centers.

    Science.gov (United States)

    Silver, Alan; Figge, James; Haskin, Donna L; Pryor, Veronica; Fuller, Karen; Lemme, Thomas; Li, Nancy; O'Brien, Mary Jane

    2011-04-01

    Asthma and diabetes are major chronic conditions in the United States, particularly in the Medicaid population. The majority of care for these diseases occurs at ambulatory practice sites. The New York State Department of Health Office of Health Insurance Programs (OHIP) worked with IPRO, the New York State Medicare quality improvement organization, to develop and implement a quality improvement project (QIP) for these conditions. The approach was based upon the Chronic Care Model and used an iterative academic-detailing methodology. Clinics and community health centers volunteered to participate and used IPRO-collected data with audit and feedback to improve their practices. Several metrics significantly improved for asthma (e.g., use of anti-inflammatory long term controller agents, assessment of asthma severity, use of asthma action plans) and for diabetes (e.g., lipid testing and control, A1c testing). Key organizational elements of success included senior medical leadership commitment and practice site quality improvement team meetings. OHIP has used the QIP experience to begin patient-centered medical home implementation in New York State.

  3. Advanced practice quality improvement project: how to influence physician radiologic imaging ordering behavior.

    Science.gov (United States)

    Durand, Daniel J; Kohli, Marc D

    2014-12-01

    With growing pressure on the health care sector to improve quality and reduce costs, the stakes associated with imaging appropriateness have never been higher. Although radiologists historically functioned as imaging gatekeepers, this role has been deprioritized in the recent past. This article discusses several potential practice quality improvement projects that can help radiologists regain their role as valued consultants and integral members of the care team. By applying the PDSA framework, radiologists can incrementally optimize their practice's consultation service. While it can be expected that different strategies will gain traction in different environments, it is our hope that the methodology described here will prove useful to most or all practices as a starting point. In addition, we discuss several other influencing techniques that extend beyond traditional consultation services.

  4. Combining Quality Improvement and Geriatrics Training: The Nursing Home Polypharmacy Outcomes Project

    Science.gov (United States)

    Kojima, Gotaro; Bell, Christina L.; Tamura, Bruce; Davis, James; Inaba, Michiko; Lorenzo, Pia; Blanchette, Patricia Lanoie; Iwasaki, Wendy; Masaki, Kamal

    2014-01-01

    To examine sustained effects of an educational intervention, we repeated a successful quality improvement (QI) project on medication safety and cost-effectiveness. In October 2007 and August 2008, facility leadership and geriatrics faculty identified all patients receiving ≥9 medications (polypharmacy cohort) in a 170-bed teaching nursing home and taught Geriatric Medicine fellows (n=12 in 2007, 11 in 2008) to: 1) systematically collect medication data; 2) generate medication recommendations (stop, taper, or continue) based on expert criteria (Beers Criteria) or drug-drug interaction programs; 3) discuss recommendations with patients’ attending physicians; and 4) implement approved recommendations. Over the two projects, the polypharmacy cohorts demonstrated decreased potentially inappropriate medications (odds ratio (OR) 0.78, 95% confidence interval (95%CI)0.69–0.88, pclinical and educational benefits. PMID:24829040

  5. Decreasing the Use of Damage Control Laparotomy in Trauma: A Quality Improvement Project.

    Science.gov (United States)

    Harvin, John A; Kao, Lillian S; Liang, Mike K; Adams, Sasha D; McNutt, Michelle K; Love, Joseph D; Moore, Laura J; Wade, Charles E; Cotton, Bryan A; Holcomb, John B

    2017-08-01

    Our institution has published damage control laparotomy (DCL) rates of 30% and documented the substantial morbidity associated with the open abdomen. The purpose of this quality improvement (QI) project was to decrease the rate of DCL at a busy, Level I trauma center in the US. A prospective cohort of all emergent trauma laparotomies from November 2013 to October 2015 (QI group) was followed. The QI intervention was multifaceted and included audit and feedback for every DCL case. Morbidity and mortality of the QI patients were compared with those from a published control (control group: emergent laparotomy from January 2011 to October 2013). A significant decrease was observed immediately on beginning the QI project, from a 39% DCL rate in the control period to 23% in the QI group (p control 16% vs QI 12%; p = 0.15), fascial dehiscence (6% vs 8%; p = 0.20), unplanned relaparotomy (11% vs 10%; p = 0.58), or mortality (9% vs 10%; p = 0.69) were observed. The reduction in use resulted in a decrease of 68 DCLs over the 2-year period. There was a further reduction in the rate of DCL to 17% after completion of the QI project. A QI initiative rapidly changed the use of DCL and improved quality of care by decreasing resource use without an increase morbidity or mortality. This decrease was sustained during the QI period and further improved upon after its completion. Copyright © 2017 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  6. 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.

  7. A project to improve the quality of abortion services in Moldova.

    Science.gov (United States)

    Comendant, Rodica

    2005-11-01

    Abortion has been available legally in Moldova since 1955, and since then the abortion rate has gradually declined. The quality of abortion care remains low, however, and there is a high level of maternal mortality related to unsafe abortion. The goals of the 2005-2015 National Reproductive Health Strategy are to reduce unwanted pregnancy, reduce abortion-related morbidity and mortality, improve access to and quality of abortion care, including the methods of vacuum aspiration and medical abortion. This paper presents information on the current abortion law, policy and services in Moldova. It describes a project whose aim is to improve the quality of abortion services, including the introduction of medical abortion through training of service providers and community education. Manual vacuum aspiration has also recently been introduced. The drugs for medical abortion are officially approved, a clinical study evaluating the efficacy and acceptability of medical abortion in a low-resource setting has been completed, and training of providers has been carried out. However, institutionalisation of medical abortion faces many problems in relation to organisation of service delivery, the higher cost of medical than aspiration abortion, and doctors' reluctance to use new methods.

  8. Integrating community outreach into a quality improvement project to promote maternal and child health in Ghana.

    Science.gov (United States)

    Cofie, Leslie E; Barrington, Clare; Akaligaung, Akalpa; Reid, Amy; Fried, Bruce; Singh, Kavita; Sodzi-Tettey, Sodzi; Barker, Pierre M

    2014-01-01

    Quality improvement (QI) is used to promote and strengthen maternal and child health services in middle- and low-income countries. Very little research has examined community-level factors beyond the confines of health facilities that create demand for health services and influence health outcomes. We examined the role of community outreach in the context of Project Fives Alive!, a QI project aimed at improving maternal and under-5 outcomes in Ghana. Qualitative case studies of QI teams across six regions of Ghana were conducted. We analysed the data using narrative and thematic techniques. QI team members used two distinct outreach approaches: community-level outreach, including health promotion and education efforts through group activities and mass media communication; and direct outreach, including one-on-one interpersonal activities between health workers, pregnant women and mothers of children under-5. Specific barriers to community outreach included structural, cultural, and QI team-level factors. QI efforts in both rural and urban settings should consider including context-specific community outreach activities to develop ties with communities and address barriers to health services. Sustaining community outreach as part of QI efforts will require improving infrastructure, strengthening QI teams, and ongoing collaboration with community members.

  9. Innovative model of delivering quality improvement education for trainees – a pilot project

    Directory of Open Access Journals (Sweden)

    Kannan Ramar

    2015-09-01

    Full Text Available Background: After incorporating quality improvement (QI education as a required curriculum for our trainees in 2010, a need arose to readdress our didactic sessions as they were too long, difficult to schedule, and resulting in a drop in attendance. A ‘flipped classroom’ (FC model to deliver QI education was touted to be an effective delivery method as it allows the trainees to view didactic materials on videos, on their own time, and uses the classroom to clarify concepts and employ learned tools on case-based scenarios including workshops. Methods: The Mayo Quality Academy prepared 29 videos that incorporated the previously delivered 17 weekly didactic sessions, for a total duration of 135 min. The half-day session clarified questions related to the videos, followed by case examples and a hands-on workshop on how to perform and utilize a few commonly used QI tools and methods. Results: Seven trainees participated. There was a significant improvement in knowledge as measured by pre- and post-FC model test results [improvement by 40.34% (SD 16.34, p<0.001]. The survey results were overall positive about the FC model with all trainees strongly agreeing that we should continue with this model to deliver QI education. Conclusions: The pilot project of using the FC model to deliver QI education was successful in a small sample of trainees.

  10. Residency Training: Quality improvement projects in neurology residency and fellowship: applying DMAIC methodology.

    Science.gov (United States)

    Kassardjian, Charles D; Williamson, Michelle L; van Buskirk, Dorothy J; Ernste, Floranne C; Hunderfund, Andrea N Leep

    2015-07-14

    Teaching quality improvement (QI) is a priority for residency and fellowship training programs. However, many medical trainees have had little exposure to QI methods. The purpose of this study is to review a rigorous and simple QI methodology (define, measure, analyze, improve, and control [DMAIC]) and demonstrate its use in a fellow-driven QI project aimed at reducing the number of delayed and canceled muscle biopsies at our institution. DMAIC was utilized. The project aim was to reduce the number of delayed muscle biopsies to 10% or less within 24 months. Baseline data were collected for 12 months. These data were analyzed to identify root causes for muscle biopsy delays and cancellations. Interventions were developed to address the most common root causes. Performance was then remeasured for 9 months. Baseline data were collected on 97 of 120 muscle biopsies during 2013. Twenty biopsies (20.6%) were delayed. The most common causes were scheduling too many tests on the same day and lack of fasting. Interventions aimed at patient education and biopsy scheduling were implemented. The effect was to reduce the number of delayed biopsies to 6.6% (6/91) over the next 9 months. Familiarity with QI methodologies such as DMAIC is helpful to ensure valid results and conclusions. Utilizing DMAIC, we were able to implement simple changes and significantly reduce the number of delayed muscle biopsies at our institution. © 2015 American Academy of Neurology.

  11. Improving Quality Assurance with CDIO Self-Evaluation: Experiences From a Nordic Project

    DEFF Research Database (Denmark)

    Kontio, Juha; Roslöf, Janne; Edström, Kristina

    2012-01-01

    The main goal of the Nordic project Quality Assurance in Higher Education was to develop and implement a self-evaluation model in the participating Higher Education Institutes (HEIs) to support their quality assurance work and continuous curriculum development. Furthermore, the project aimed...... at strengthening the cooperation of HEIs in quality assurance (QA) and disseminating good practices of QA. The framework of development is based on the CDIO approach and the CDIO self-evaluation process. The main results are a detailed definition of the self-evaluation process, well-documented self...

  12. 73. Surgical site infection after CABG: Root cause analysis and quality measures recommendation SSI quality improvement project

    Directory of Open Access Journals (Sweden)

    A. Arifi

    2016-07-01

    Full Text Available Surgical site infection (SSI, is a preventable and devastating complication with significant morbidity after cardiac surgery. The reported SSI rate at our center, ranging from 3.4% to 11.2% (2007–2013. This rate is considered to be above the standardized rate recommended by the NHSN. Quality improvement project team to address the issue of SSI, (SCIP, where formed by the medical administration late 2014. The aim of the study was to identify SSI risk factors at our cardiac surgical unit, using evidence based practices while taking a local approach to problem solving. We performed Root Cause Analysis (RCA, and we applied other quality improvement tools to identify the area for potential improvement. Data include a Process Map of the pre-operative, intra-operative and post-operative factors that might contribute to SSI risk. We prospectively used the RCA form to investigate all the stages of the patient process map (pre, intra op, and post operatively. The data included the Patient related factors, the sterilization and the hygiene practice in the operating room, and the operating room traffic, and the compliance to the bundle of care. Figure represent the “Fishbone” diagram of the possible causes of SSI after cardiac surgery in our unit. Demographic features of patients with SSI were as follows: mean age-65 years; female 83%; time to infection (mean 101 days; range 1–36 days;. The root cause analysis identified a significant weakness in the compliance to the bundle of care to prevent SSI. Furthermore, the patient flow, the operating theatre cleaning and traffic was also identified as a contributing factor to SSI. Surgical site infection after cardiac surgery is a preventable complication. The application of the evidence based practice and structured way of thinking in problem solving, will help identify the potential risk factors. Focusing on solving the right patient process and visually represents the problem will help identifying the

  13. Disease management of early childhood caries: results of a pilot quality improvement project.

    Science.gov (United States)

    Ng, Man Wai; Torresyap, Gay; White, Alex; Melvin, Patrice; Graham, Dionne; Kane, Daniel; Scoville, Richard; Ohiomoba, Henry

    2012-08-01

    The purpose is to report findings of a quality improvement (QI) project implemented at two hospital-based dental clinics that care for children with early childhood caries (ECC). We tested a disease management (DM) approach in children younger than age 60 months with ECC. After 30 months, for the 403 and 234 DM patients at Children's Hospital Boston (CHB) and Saint Joseph Hospital (SJH) who returned for at least two visits, rates of new cavitation, pain, and referrals to the OR were 26.1, 13.4 and 10.9% for CHB and 41.0, 7.3 and 14.9% for SJH. Rates of new cavitation, pain, and referrals to the OR for historical controls were 75.2, 21.7, and 20.9% for CHB and 71.3, 31.3, and 25.0% for SJH. A risk-based DM approach utilizing QI strategies to address ECC can be implemented into practice and has the potential to improve care and health outcomes.

  14. 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....

  15. Continuous quality improvement in intensive care medicine. The GiViTI Margherita Project - Report 2005.

    Science.gov (United States)

    Boffelli, S; Rossi, C; Anghileri, A; Giardino, M; Carnevale, L; Messina, M; Neri, M; Langer, M; Bertolini, G

    2006-06-01

    The assessment of the quality of intensive care medicine is mandatory in the modern healthcare system. In Italy, the GiViTI (Gruppo Italiano per la Valutazione degli Interventi in Terapia Intensiva) network is working in this field since 1991 and it now involves 295 out of the about 450 Italian intensive care units (ICU). In 2002 GiViTI launched a project for the continuous quality assessment and improvement that is now joined by 180 ICUs. Data collected in 2005 are analyzed and presented. All admitted patients were entered in a validated software, which performs a multitude of validity checks during the data entry. Data were further reviewed by the co-ordinating center; patients admitted in months with more than 10% of incomplete or inconsistent records in each ICU were excluded from the analysis. Each year, a multivariate logistic regression model is fitted to identify predictors of hospital mortality. Starting from the SAPS 2 and the 2004 GiViTI model predictions of hospital mortality, two calibration tables and curves are presented. In 2005, 180 Italian ICUs collected data on 55 246 patients. After excluding those admitted in months with an unjustified lower recruitment rate or with less than 90% of complete and consistent data, we had 52 816 (95.6%) valid cases. Although the rough hospital mortality in 2005 was 1% higher than in 2004 (22.6% vs 21.5%), the adjusted mortality shows a statistically significant 4% reduction (obser-ved-to-expected ratio: 0.96; 95% CI: 0.94-0.97). Italian ICUs in 2005 performed better than in 2004, at a parity of patient severity.

  16. A quality improvement project: Strategies to reduce intradialytic hypotension in hemodialysis patients.

    Science.gov (United States)

    Ghaffar, Umbar; Easom, Andrea K

    2015-05-01

    Intradialytic hypotension is defined as a decrease in systolic blood pressure by ≥ 20 mm Hg or a decrease in mean arterial pressure by 10 mm Hg, and is associated with symptoms that include abdominal discomfort, yawning, sighing, nausea, vomiting, muscle cramps, restlessness, dizziness or fainting, and anxiety. The incidence of a symptomatic reduction in blood pressure during (or immediately following) dialysis ranges from 15-50% of dialysis sessions. It is a major cause for morbidity in elderly hemodialysis patients and those with cardiovascular compromise. It impairs patient well-being, limits ultrafiltration, and increases the risk for coronary and cerebral ischemic events as well as vascular access thrombosis. Several studies have shown a poorer survival in dialysis patients who experience frequent hypotensive episodes on dialysis as opposed to those who do not. In our outpatient dialysis unit, we identified that 9% of our dialysis patients experienced a decrease in their systolic blood pressure to below 80 during dialysis. The purpose of this quality improvement project was to study the factors associated with intradialytic hypotension in these patients and institute appropriate measures to mitigate this issue. Another aim was to educate the dialysis staff on how to manage these patients. Patients were selected using data from weekly rounding reports and orders were written for interventions including ultrafiltration profiling, cool (36 degrees C) dialysate, weight-based ultrafiltration, etc. Outcomes were studied over a period of 3 months. We found that up to 40% of patients experienced an improvement in their blood pressure profile over the period of the study, suggesting that simple changes to dialysis prescription can result in a significant reduction in the incidence of intradialytic hypotension.

  17. Safe and High Quality Food Production using Low Quality Waters and Improved Irrigation Systems and Management, EU Project

    DEFF Research Database (Denmark)

    Plauborg, Finn; Jensen, Christian Richardt; Dalsgaard, Anders

    2009-01-01

    while at the same time reducing the use of natural resources and the impact on aquatic ecosystems that are frequently already polluted. These problems are linked, since most of our vegetables are produced using irrigation water from the same ecosystems. To ensure food safety and quality, the innovative......: the safety and quality of food products, and the increasing competition for clean freshwater. SAFIR is funded for the period 2005-2009 under the Food Quality and Safety thematic area of the EU 6th Framework Research Programme. The challenge for the next years will be to produce safe and high quality foods...... a multi-disciplinary team, with food safety and quality experts, engineers, agronomists and economists from17 research institutes and private companies in Europe, Israel and China working together. The project assesses potential risks to farmers. Coupled with farm management and economic models, a new...

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

    Science.gov (United States)

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

    2012-01-01

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

  19. Publication guidelines for quality improvement studies in health care: evolution of the SQUIRE project.

    Science.gov (United States)

    Davidoff, Frank; Batalden, Paul; Stevens, David; Ogrinc, Greg; Mooney, Susan E

    2009-01-19

    In 2005 we published draft guidelines for reporting studies of quality improvement, as the initial step in a consensus process for development of a more definitive version. The current article contains the revised version, which we refer to as standards for quality improvement reporting excellence (SQUIRE). This narrative progress report summarises the special features of improvement that are reflected in SQUIRE, and describes major differences between SQUIRE and the initial draft guidelines. It also briefly describes the guideline development process; considers the limitations of and unresolved questions about SQUIRE; describes ancillary supporting documents and alternative versions under development; and discusses plans for dissemination, testing, and further development of SQUIRE.

  20. Implications of the Trauma Quality Improvement Project inclusion of nonsurvivable injuries in performance benchmarking.

    Science.gov (United States)

    Heaney, Jiselle Bock; Schroll, Rebecca; Turney, Jennifer; Stuke, Lance; Marr, Alan B; Greiffenstein, Patrick; Robledo, Rosemarie; Theriot, Amanda; Duchesne, Juan; Hunt, John

    2017-10-01

    The Trauma Quality Improvement Project (TQIP) uses an injury prediction model for performance benchmarking. We hypothesize that at a Level I high-volume penetrating trauma center, performance outcomes will be biased due to inclusion of patients with nonsurvivable injuries. Retrospective chart review was conducted for all patients included in the institutional TQIP analysis from 2013 to 2014 with length of stay (LOS) less than 1 day to determine survivability of the injuries. Observed (O)/expected (E) mortality ratios were calculated before and after exclusion of these patients. Completeness of data reported to TQIP was examined. Eight hundred twenty-six patients were reported to TQIP including 119 deaths. Nonsurvivable injuries accounted 90.9% of the deaths in patients with an LOS of 1 day or less. The O/E mortality ratio for all patients was 1.061, and the O/E ratio after excluding all patients with LOS less than 1 day found to have nonsurvivable injuries was 0.895. Data for key variables were missing in 63.3% of patients who died in the emergency department, 50% of those taken to the operating room and 0% of those admitted to the intensive care unit. Charts for patients who died with LOS less than 1 day were significantly more likely than those who lived to be missing crucial. This study shows TQIP inclusion of patients with nonsurvivable injuries biases outcomes at an urban trauma center. Missing data results in imputation of values, increasing inaccuracy. Further investigation is needed to determine if these findings exist at other institutions, and whether the current TQIP model needs revision to accurately identify and exclude patients with nonsurvivable injuries. Prognostic and epidemiological, level III.

  1. THE ARTHRITIS AND MUSCULOSKELETAL QUALITY IMPROVEMENT PROGRAM (AMQUIP: A BREAKTHROUGH SERIES METHODOLOGY PROJECT

    Directory of Open Access Journals (Sweden)

    MASTURA I

    2008-01-01

    Full Text Available The Australian government had funded the National Primary Care Collaborative (NPCC program with funding of $14.6 million over three years. One of the pilots project was the Arthritis and Musculoskeletal Quality Improvement Program (AMQuIP.The study aims to optimize general practitioners (GPs management of patients with osteoarthritis (OA of the hip and knee by identifying gaps between their current practice and best practice. The Breakthrough Series Collaborative methodology with several Plan-Do-Study-Act (PDSA cycles was employed. Participants comprises of 12 GPs/practices from two Victorian Divisions of general Practice (one rural, one metropolitan with 10 patients per GP/practice. GPs/practices attended an orientation and three learning workshops and a videoconference. GPs/practices completed PDSA cycles between workshop and reported results at workshops. GPs/practices reported use of guidelines, change in patient management and change in practice management/systems. All recruited patients completed the SF-12v2 Health Survey and WOMAC OA Index Questionnaire twice. Follow up activities including focus groups and face-to-face interviews were held six months after the final workshop. All GPs/practices used the guidelines/key messages, introduced “new” management strategies to patients, and made positive changes to their practice management/systems. Patient reported positive changes and outcomes. By using a structured methodology and evidence-based guidelines/key messages; GPs can introduce new patient management strategies, and by identifying gaps in practice management systems, positive changes can be achieved.

  2. Multidisciplinary In Situ Simulation-Based Training as a Postpartum Hemorrhage Quality Improvement Project.

    Science.gov (United States)

    Lutgendorf, Monica A; Spalding, Carmen; Drake, Elizabeth; Spence, Dennis; Heaton, Jason O; Morocco, Kristina V

    2017-03-01

    Postpartum hemorrhage is a common obstetric emergency affecting 3 to 5% of deliveries, with significant maternal morbidity and mortality. Effective management of postpartum hemorrhage requires strong teamwork and collaboration. We completed a multidisciplinary in situ postpartum hemorrhage simulation training exercise with structured team debriefing to evaluate hospital protocols, team performance, operational readiness, and real-time identification of system improvements. Our objective was to assess participant comfort with managing obstetric hemorrhage following our multidisciplinary in situ simulation training exercise. This was a quality improvement project that utilized a comprehensive multidisciplinary in situ postpartum hemorrhage simulation exercise. Participants from the Departments of Obstetrics and Gynecology, Anesthesia, Nursing, Pediatrics, and Transfusion Services completed the training exercise in 16 scenarios run over 2 days. The intervention was a high fidelity, multidisciplinary in situ simulation training to evaluate hospital protocols, team performance, operational readiness, and system improvements. Structured debriefing was conducted with the participants to discuss communication and team functioning. Our main outcome measure was participant self-reported comfort levels for managing postpartum hemorrhage before and after simulation training. A 5-point Likert scale (1 being very uncomfortable and 5 being very comfortable) was used to measure participant comfort. A paired t test was used to assess differences in participant responses before and after the simulation exercise. We also measured the time to prepare simulated blood products and followed the number of postpartum hemorrhage cases before and after the simulation exercise. We trained 113 health care professionals including obstetricians, midwives, residents, anesthesiologists, nurse anesthetists, nurses, and medical assistants. Participants reported a higher comfort level in managing

  3. Improving value-add work and satisfaction in medical residents training: a resident-led quality improvement project employing the lean method to improve hospital supply usage.

    Science.gov (United States)

    Yang, Jesse X; Hunt, Tristan D; Ting, Henry H; Henderson, Dan; Finkelstein, Julia; Davidson, Karina W

    2017-04-01

    Our hospital has a Housestaff Quality Council that fosters education and mentorship of medical residents for quality improvement methodologies. Medical residents on our council identified non-standardised storage rooms as a source of medical resident inefficiency and dissatisfaction. To improve value-add work, medical residents implemented and evaluated a quality improvement project of storage room supplies using the lean method. Using 5S principle and lean methodology, we designed and implemented a standardised supply cart with physician specific supplies. Between April 2014 and April 2015, 40 random observations (20 residents and 20 nurses) both before and after the standardised supply cart implementation were made. The duration time to locate an item was measured in seconds. The paths taken to locate items were drawn as spaghetti diagrams. Nurses served as our control group given that their supplies were not moved in the implementation. Fifty residents were surveyed to assess their satisfaction. Implementation of the standardised supply cart reduced the time for residents to locate an item per visit from 50.8 to 30.2 s in one unit (p5S principles and lean methodology to identify and solve a problem that created inefficiency and dissatisfaction. 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/.

  4. Development of Team Action Projects in Surgery (TAPS): a multilevel team-based approach to teaching quality improvement.

    Science.gov (United States)

    Waits, Seth A; Reames, Bradley N; Krell, Robert W; Bryner, Benjamin; Shih, Terry; Obi, Andrea T; Henke, Peter K; Minter, Rebecca M; Englesbe, Michael J; Wong, Sandra L

    2014-01-01

    To meet the Accreditation Council for Graduate Medical Education core competency in Practice-Based Learning and Improvement, educational curricula need to address training in quality improvement (QI). We sought to establish a program to train residents in the principles of QI and to provide practical experiences in developing and implementing improvement projects. We present a novel approach for engaging students, residents, and faculty in QI efforts-Team Action Projects in Surgery (TAPS). Large academic medical center and health system. Multiple teams consisting of undergraduate students, medical students, surgery residents, and surgery faculty were assembled and QI projects developed. Using "managing to learn" Lean principles, these multilevel groups approached each project with robust data collection, development of an A3, and implementation of QI activities. A total of 5 resident led QI projects were developed during the TAPS pilot phase. These included a living kidney donor enhanced recovery protocol, consult improvement process, venous thromboembolism prophylaxis optimization, Clostridium difficile treatment standardization, and understanding variation in operative duration of laparoscopic cholecystectomy. Qualitative and quantitative assessment showed significant value for both the learner and stakeholders of QI related projects. Through the development of TAPS, we demonstrate a novel approach to addressing the increasing focus on QI within graduate medical education. Efforts to expand this multilevel team based approach would have value for teachers and learners alike. Copyright © 2014. Published by Elsevier Inc.

  5. Improving Project Manufacturing Coordination

    Directory of Open Access Journals (Sweden)

    Korpivaara Ville

    2014-09-01

    Full Text Available The objective of this research is to develop firms’ project manufacturing coordination. The development will be made by centralizing the manufacturing information flows in one system. To be able to centralize information, a deep user need assessment is required. After user needs have been identified, the existing system will be developed to match these needs. The theoretical background is achieved through exploring the literature of project manufacturing, development project success factors and different frameworks and tools for development project execution. The focus of this research is rather in customer need assessment than in system’s technical expertise. To ensure the deep understanding of customer needs this study is executed by action research method. As a result of this research the information system for project manufacturing coordination was developed to respond revealed needs of the stakeholders. The new system improves the quality of the manufacturing information, eliminates waste in manufacturing coordination processes and offers a better visibility to the project manufacturing. Hence it provides a solid base for the further development of project manufacturing.

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

    Science.gov (United States)

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

    2011-05-01

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

  7. Improving image quality in Electrical Impedance Tomography (EIT using Projection Error Propagation-based Regularization (PEPR technique: A simulation study

    Directory of Open Access Journals (Sweden)

    Tushar Kanti Bera

    2011-03-01

    Full Text Available A Projection Error Propagation-based Regularization (PEPR method is proposed and the reconstructed image quality is improved in Electrical Impedance Tomography (EIT. A projection error is produced due to the misfit of the calculated and measured data in the reconstruction process. The variation of the projection error is integrated with response matrix in each iterations and the reconstruction is carried out in EIDORS. The PEPR method is studied with the simulated boundary data for different inhomogeneity geometries. Simulated results demonstrate that the PEPR technique improves image reconstruction precision in EIDORS and hence it can be successfully implemented to increase the reconstruction accuracy in EIT.>doi:10.5617/jeb.158 J Electr Bioimp, vol. 2, pp. 2-12, 2011

  8. Project Quality Plan

    DEFF Research Database (Denmark)

    Sandborg-Petersen, Ulrik; Øhrstrøm, Peter

    This document defines the procedures, standards, and strategies which will be used to ensure high standards of quality of the work produced within the HANDS project. It contains the following sections......This document defines the procedures, standards, and strategies which will be used to ensure high standards of quality of the work produced within the HANDS project. It contains the following sections...

  9. Accuracy of reporting endocervical component adequacy--a continuous quality improvement project.

    Science.gov (United States)

    Roberson, Janie; Connolly, Kathy; St John, Kay; Eltoum, Isam; Chhieng, David C

    2002-09-01

    Inaccurate reporting of the absence of an endocervical (EC) component on Pap smears often results in slide rescreens, amended reports, clinician dissatisfaction, and sometimes unnecessary repeat smears. Therefore, the accuracy of reporting EC component adequacy was selected as a quality indicator for the laboratory continuous quality improvement program (CQI). The process consisted of problem identification, analysis of the situation, collection of data, implementation of solutions, and evaluation of results. The objective of the study was to determine if the accuracy of reporting EC component adequacy on Pap smears improved after application of such a program. During the first phase, 150 Pap smears originally reported with the absence of an adequate EC component and 150 smears reported with the presence of an adequate EC component were rescreened to measure the baseline accuracy of EC component adequacy reporting. The improvement process was then implemented. A cause-and-effect diagram was developed and root cause was determined. A presentation was then made to the cytology staff. Criteria for EC component adequacy were reviewed, examples were shown, and standardized marking of EC component was implemented. Following improvement actions, a second audit of 150 Pap smears reported with the absence of an adequate EC component as well as 150 smears reported with the presence of an adequate EC component was undertaken to measure change in performance in assessing EC component adequacy. For the baseline rescreening, before initiation of the CQI program, 98% accuracy was achieved with smears that were reported as adequate for EC component present. However, the accuracy with smears reported as absence of an adequate EC component was only 71%, i.e., an adequate EC component was identified in almost 1/3 of these cases on rescreen. After the implementation of improvement actions, the accuracy with smears reported with the presence of EC component remained high (98%) and the

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

    Science.gov (United States)

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

    2003-01-01

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

  11. 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.

  12. Analysis of Irrigation Water Quality at Kadawa Irrigation Project for Improved Productivity

    Directory of Open Access Journals (Sweden)

    AR Sanda

    2014-09-01

    Full Text Available In the face of water scarcity and the several negative consequences, such as water wastage, flooding, water logging, soil losses and production losses, conserving the finite amount of fresh water is a must. The quality of irrigation water must therefore be ascertained. The chemical quality of three sources of irrigation water from canal and drainage water, namely drainage water, fresh irrigation water from canal, and drainage/irrigation water mixture, were analyzed from Kadawa irrigation Project for year 2013 and 2014 cropping seasons, with the view to evaluating the potential risks associated with their use in irrigation and hence their suitability or otherwise for irrigation purposes. The analysis revealed that the use of drainage water alone for irrigation may result in problems associated with salinity, while a blend of drainage/irrigation water in the ratio of 1:1 is a viable means of water conservation and a good means of crop production. DOI: http://dx.doi.org/10.3126/ije.v3i3.11082 International Journal of Environment Vol.3(3 2014: 235-240

  13. Release Process on Quality Improvement in Open Source Software Project Management

    Directory of Open Access Journals (Sweden)

    S. Chandra Kumar Mangalam

    2012-01-01

    Full Text Available Problem statement: The Software Industry has changed and developed as a consequence of the impact of Open Source Software (OSS since 1990s. Over a period of time, OSS has evolved in an integrated manner and most of the participants in OSS activity are volunteers. Approach: This coordination form of development has produced a considerable quantity of software; and often, the development method has been viewed as an unorganized and unstructured method of development. Few existing researches deal with the Open Source Software phenomenon from a quality perception point of view and studies where enhancements are possible in the development process. Results: Release Process in OSS plays a key role in most of the OSS projects. As this process is related to the evolution of a quality software from the community of OSS developers, this research attempts to explore the process practices which are employed by OSS developers and examines the problems associated with the development process. The scope of the study is mainly confined to process management in OSS. “Prototype development and iterative development process” approaches were adapted as a methodology. Conclusion/Recommendations: The major finding and conclusion drawn is ‘lack of coordination among developers’ who are geographically isolated. Hence, the study suggests the need for coordination among developers to line up their development process for achieving the goal of the software release process.

  14. How Can Clients Improve the Quality of Transport Infrastructure Projects? The Role of Knowledge Management and Incentives

    Directory of Open Access Journals (Sweden)

    Abukar Warsame

    2013-01-01

    Full Text Available The aim of this paper is to argue for a number of statements about what is important for a client to do in order to improve quality in new infrastructure projects, with a focus on procurement and organizational issues. The paper synthesizes theoretical and empirical results concerning organizational performance, especially the role of the client for the quality of a project. The theoretical framework used is contract theory and transaction cost theory, where assumptions about rationality and self-interest are made and where incentive problems, asymmetric information, and moral hazard are central concepts. It is argued that choice of procurement type will not be a crucial factor. There is no procurement method that guarantees a better quality than another. We argue that given the right conditions all procurement methods can give good results, and given the wrong conditions, all of them can lead to low quality. What is crucial is how the client organization manages knowledge and the incentives for the members of the organization. This can be summarized as “organizational culture.” One way to improve knowledge and create incentives is to use independent second opinions in a systematic way.

  15. How can clients improve the quality of transport infrastructure projects? The role of knowledge management and incentives.

    Science.gov (United States)

    Warsame, Abukar; Borg, Lena; Lind, Hans

    2013-01-01

    The aim of this paper is to argue for a number of statements about what is important for a client to do in order to improve quality in new infrastructure projects, with a focus on procurement and organizational issues. The paper synthesizes theoretical and empirical results concerning organizational performance, especially the role of the client for the quality of a project. The theoretical framework used is contract theory and transaction cost theory, where assumptions about rationality and self-interest are made and where incentive problems, asymmetric information, and moral hazard are central concepts. It is argued that choice of procurement type will not be a crucial factor. There is no procurement method that guarantees a better quality than another. We argue that given the right conditions all procurement methods can give good results, and given the wrong conditions, all of them can lead to low quality. What is crucial is how the client organization manages knowledge and the incentives for the members of the organization. This can be summarized as "organizational culture." One way to improve knowledge and create incentives is to use independent second opinions in a systematic way.

  16. Integration of SERVQUAL and KANO Model Into QFD To Improve Quality of Simulation-Based Training on Project Management

    Directory of Open Access Journals (Sweden)

    Arief Rahmana

    2014-01-01

    Full Text Available This study was performed to measure and to make priority of quality improvement of simulation-based training on project management field by using integration of SERVQUAL and KANO Models into Quality Function Deployment (QFD method. This proposed approach aims to help training provider to evaluate trainee satisfaction, to improve performance, and to improve quality of simulation-based training. Descriptive-survey study was conducted with distribution of 3 training providers, 2 instructors, 3 industry managers, and 130 trainees. The standard questionnaire of SERVQUAL and KANO model has been used as the main research tool. The findings of KANO and SERVQUAL models show that six of the total 31 service quality attributes as trainee needs are chosen to be improved, implying the maximum effect on trainee satisfaction. Through QFD method, seven of the total 9 technical requirements are properly proposed to answer the trainee needs as follows: optimize couching program, increasing number of instructor, develop a instructor competency, transforming learning method, adjusting the time of training, revising training module, delivery training module on punctual.

  17. An e-Chart Review of Chaplains' Interventions and Outcomes: A Quality Improvement and Documentation Practice Enhancement Project.

    Science.gov (United States)

    Stang, Vivian B

    2017-09-01

    In Canada, the spiritual care landscape in health care settings is becoming more regulated and standardized documentation is part of this rigorous environment. Staff chaplains at The Ottawa Hospital participated in a Quality Improvement project that aimed to advance patient-centered care through better charting practices. A sample of 104 spiritual-care assessments that had been posted on the patient electronic health record was examined. This chart review focused on chaplains' activities that were reported as interventions as well as chaplain-reported outcomes for the patient. These interventions and outcomes were coded into discreet categories in order to get a better sense of the activities and the impact of their work. The chaplains' electronic charting content and practices were evaluated. Chaplains found that the Quality Improvement process was beneficial as they updated their electronic templates in order to meet the new reporting requirements of the College of Registered Psychotherapists of Ontario.

  18. 突出质量行为监督努力提高工程质量%Emphasis on Quality Behavior Supervision Effort to Improve Engineering Project Quality

    Institute of Scientific and Technical Information of China (English)

    姜仁荣; 姜安宇

    2014-01-01

    本文通过对质量行为与实体质量特点属性和影响工程质量因素的分析,提出“人”是影响工程质量五因素中最重要的因素、责任主体的不良质量行为是导致实体质量存在和发生问题的根源,进而提出必须突出对责任主体质量行为的监督,并运用“教育培训——覆盖全员,监督管理——贯穿全程,监督内容——务求全面,责任追究——严格有力”的监督管理措施和手段,以求更好地消除人为因素,有效控制质量行为,提高工程实体质量。%After analyzing the characteristics of quality behavior,characteristics and the factors affecting construction project quality,this thesis indicates that the human factor is the most significant one among the five factors which affecting construction project quality and the origin of the construction project quality problem is the unethical behavior of the liability subject. Then it presents the importance of quality behavior supervision and management,the effective supervision and management approaches including training, whole stakeholder management,entire supervision,building accountability systems,using tighter and powerful management and supervision tools.These approaches can reduce human influence,effective control quality behavior and improve construction project quality.

  19. Improved Mass Spectrometer Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The Improved Mass Spectrometer project will develop system requirements and analyze the path to space qualification.   The results of this project...

  20. An interprofessional quality improvement project to implement maternal/infant skin-to-skin contact during cesarean delivery.

    Science.gov (United States)

    Brady, Karen; Bulpitt, Denise; Chiarelli, Caren

    2014-01-01

    Immediate skin-to-skin contact between a mother and her newborn has been associated with successful breastfeeding outcomes. One of the challenges nurses face in promoting skin-to-skin occurs in the operating room during a cesarean delivery. Utilizing an interprofessional approach for this quality improvement project, we successfully implemented skin-to-skin contact for all eligible mother/infant couplets after cesarean birth. Exclusive breastfeeding rates for these women increased as a result. © 2014 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  1. 造船项目质量管理的改进研究%Improved Mechanisms of Shipbuilding Project Quality Management

    Institute of Scientific and Technical Information of China (English)

    吕淳威

    2012-01-01

    在调查研究的基础上,提出了建立造船项目质量管理体系的改进意见,并围绕它提出了改进造船项目管理体系、确立以项目经理为项目质量控制中心、建立项目质量管理组织体系以及实现项目质量管理信息化等实施对策。%In the investigation, based on the proposed establishment of shipbuilding project quality management system improvements responsibilities, and around it an improved shipbuilding project management system, establish the project manager for the project quality control center, the establishment of project quality management organization system and the achievement of project quality management information the implementation of such measures.

  2. 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.

  3. A quality improvement project to improve the rate of early breast milk expression in mothers of preterm infants.

    Science.gov (United States)

    Murphy, Lindsey; Warner, Diane D; Parks, Jessica; Whitt, Jenny; Peter-Wohl, Sigal

    2014-11-01

    Providing breast milk is challenging for non-nursing mothers of premature infants. Early breast milk expression results in successful and longer lactation in mothers of very low birth weight (VLBW) infants. This quality improvement initiative sought to increase the rate of early milk expression in mothers of VLBW infants and increase the proportion of infants receiving maternal breast milk (MBM) at 28 days of age and at discharge. Phase 1 (n = 45) occurred between April 1, 2012, and August 31, 2012. Phase 2 (n = 58) occurred between September 1, 2012, and February 28, 2013. Pre-phase 2 actions included increased lactation consultant workforce, early lactation consultation, tracking of MBM supply, and physician education. Inborn infants MBM at 28 days and at discharge was 64% and 74%, respectively (P = .40), and the proportion of infants receiving exclusive MBM at discharge increased from 37% to 59% (P = .046). In conclusion, a multidisciplinary initiative aimed at improving the rate of early milk expression was associated with more VLBW infants receiving exclusive MBM at discharge.

  4. OVERVIEW ABOUT PROJECT QUALITY MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Catalin Drob

    2014-01-01

    Full Text Available The purpose of this study is to emphasize the main aspects regarding project quality management. This study tries to present in the comparative manner, different approaches of the main guidelines, international standards and methodologies regarding project quality management (the PMBOK ® Guide elaborated by the Project Management Institute, the PRINCE method elaborated by the British Office of Government Commerce etc.. The PMBOK® Guide describes three elements (processes of quality management: quality planning (plan quality management, quality assurance (perform quality assurance and quality control (control quality. The PMBOK approach regarding project quality management is that quality management must lead to achieving and validating project requirements. According the PRINCE method the quality is one of the six variables involved in any project. The PRINCE approach regarding project quality management considers that strategy in this field must lead to achieving just the level of quality needed to achieve in the project and not to ensuring the best quality.

  5. Public Health Nurses in Israel: A Case Study on a Quality Improvement Project of Nurse's Work Life.

    Science.gov (United States)

    Kagan, Ilya; Shachaf, Sara; Rapaport, Zofia; Livne, Tzipi; Madjar, Batya

    2017-01-01

    Public health nurses (PHNs) working in Well Baby Clinic in Israel's Haifa district were voicing great distress to inspectors-the impossibility of meeting their workload, feeling overwhelmed, poor physical, and technological conditions. They were feeling tired and frustrated and burn-out was rising. The district's nursing management took the decision, together with Tel Aviv University's nursing research unit, to conduct a quality improvement project based on issues that arose from meetings with focus groups on the nurses' difficulties. This paper is a case study of a quality improvement project targeting nurses daily working life. One of its chief contributions is as a study of meeting PHNs' frustration by integrating focus groups and round-table brainstorming (involving nurses, clinic managers and nursing inspectors) in order to identify targets for practical intervention. This strategy has been very successful. It has provided the district's nursing management a battery of forcefully argued and realistically grounded proposals for making the work of Well Baby clinics more relevant to their communities and giving nurses (a) the conditions to meet their assignments and (b) greater professional self-respect.

  6. Interstate Electrification Improvement Project

    Energy Technology Data Exchange (ETDEWEB)

    Puckette, Margaret [Shorepower Technologies, Hillsboro, OR (United States); Kim, Jeff [Shorepower Technologies, Hillsboro, OR (United States)

    2015-07-01

    The Interstate Electrification Improvement Project, publicly known as the Shorepower Truck Electrification Project (STEP), started in May 2011 and ended in March 2015. The project grant was awarded by the Department of Energy’s Vehicles Technology Office in the amount of $22.2 million. It had three overarching missions: 1. Reduce the idling of Class 8 tractors when parked at truck stops, to reduce diesel fuel consumption and thus U.S. dependence on foreign petroleum; 2. Stimulate job creation and economic activity as part of the American Reinvestment and Recovery Act of 2009; 3. Reduce greenhouse gas emissions (GHG) from diesel combustion and the carbon footprint of the truck transportation industry. The project design was straightforward. First, build fifty Truck Stop Electrification (TSE) facilities in truck stop parking lots across the country so trucks could plug-in to 110V, 220V, or 480VAC, and shut down the engine instead of idling. These facilities were strategically located at fifty truck stops along major U.S. Interstates with heavy truck traffic. Approximately 1,350 connection points were installed, including 150 high-voltage electric standby Transport Refrigeration Unit (eTRU) plugs--eTRUs are capable of plugging in to shore power1 to cool the refrigerated trailer for loads such as produce, meats and ice cream. Second, the project provided financial incentives on idle reduction equipment to 5,000 trucks in the form of rebates, to install equipment compatible with shore power. This equipment enables drivers to shut down the main engine when parked, to heat or cool their cab, charge batteries, or use other household appliances without idling—a common practice that uses approximately 1 gallon of diesel per hour. The rebate recipients were intended to be the first fleets to plug into Shorepower to save diesel fuel and ensure there is significant population of shore power capable trucks. This two part project was designed to complement each other by

  7. Improving the quality of pork and pork products (EU-project)

    DEFF Research Database (Denmark)

    Christensen, M.; Grunert, Klaus G.; Bonneau, M.

    . The European Unions self-sufficiency and leading position in the global market for pork and pork products is challenged by a number of non-European countries. Therefore, there is a need for developing innovative, integrated, and sustainable food production chains of high quality pork products matching consumer...... impact. Q-PorkChains is composed of six research modules (consumer and citizen demands, pig production, product development, pork chain management, molecular quality control and knowledge synthesis) and two horizontal modules focusing on implementation of obtained knowledge in pilot and demonstration...

  8. Safe and High Quality Food Production using Low Quality Waters and Improved Irrigation Systems and Management, EU Project

    DEFF Research Database (Denmark)

    Plauborg, Finn; Jensen, Christian Richardt; Dalsgaard, Anders

    2009-01-01

    while at the same time reducing the use of natural resources and the impact on aquatic ecosystems that are frequently already polluted. These problems are linked, since most of our vegetables are produced using irrigation water from the same ecosystems. To ensure food safety and quality, the innovative......: the safety and quality of food products, and the increasing competition for clean freshwater. SAFIR is funded for the period 2005-2009 under the Food Quality and Safety thematic area of the EU 6th Framework Research Programme. The challenge for the next years will be to produce safe and high quality foods...... SAFIR irrigation systems combine state-of-the-art water-cleaning technology with high-efficiency irrigation systems. The water treatments consist of both high tech and low tech solutions supplying sub-surface and surface drip irrigation system with roughly treated waste water. SAFIR has assembled...

  9. The capacity of the US food system to accommodate improved diet quality: Projections to 2030

    Science.gov (United States)

    Objective: To estimate the capacity of the US agricultural system to produce enough food, in the right amounts, to accommodate a population shift toward healthier diet patterns. This analysis has immediate and long-term implications for the nutritional quality of the food supply, as well as for envi...

  10. 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

    NARCIS (Netherlands)

    Groene, O.; Klazinga, N.; Wagner, C.; Arah, O.A.; Thompson, A.; Bruneau, C.; Suñol, R.

    2010-01-01

    Hospitals in European countries apply a wide range of quality improvement strategies. Knowledge of the effectiveness of these strategies, implemented as part of an overall hospital quality improvement system, is limited. We propose to study the relationships among organisational quality improvement

  11. Campania Region's Educational Quality Facilities Project

    Science.gov (United States)

    Ponti, Giorgio

    2009-01-01

    This article describes the Educational Quality Facilities project undertaken by Italy's Campania Region to provide quality facilities to all of its communities basing new spaces on the "Flexible Learning Module". The objectives of the five-year project are to: build and equip new educational spaces; improve the quality of existing…

  12. Pressure ulcer prevalence, use of preventive measures, and mortality risk in an acute care population: a quality improvement project.

    Science.gov (United States)

    Leijon, Siv; Bergh, Ingrid; Terstappen, Karin

    2013-01-01

    The primary aim of this quality improvement project was to determine pressure prevalence, risk of mortality, and use of preventive measures in a group of hospitalized patients. Two hundred fifty-eight patients recruited from Skaraborg Hospital in Sweden were assessed. A 1-day point prevalence study was carried out using a protocol advocated by the European PU Advisory Panel. Patients' age, gender, severity of PU (grades I-IV), anatomical location of PU, and use of preventive measures were recorded. The Swedish language version of the Modified Norton Scale was used for PU risk assessment. Data were collected by nurses trained according to the Web-based training: PU classification, "ePuclas2." After 21 months, a retrospective audit of the electronic records for patients identified with pressure ulcers was completed. The point prevalence of pressure ulcers was 23%. The total number of ulcers was 85, most were grade 1 (n = 39). The most common locations were the sacrum (n = 15) and the heel (n = 10). Three percent of patients (n = 9) had been assessed during their current hospital stay using a risk assessment tool. There was a statistically significant relationship between pressure ulcer occurrence and a low total score on the Modified Norton Scale. The patients' ages correlated significantly to the presence of a pressure ulcer. Patients with a pressure ulcer had a 3.6-fold increased risk of dying within 21 months, as compared with those without a pressure ulcer. Based on results from this quality improvement project, we recommend routine pressure ulcer risk assessment for all patients managed in a hospital setting such as ours. We further recommend that particular attention should be given to older and frail patients who are at higher risk for pressure ulcer occurrence and mortality.

  13. Quality improvement project to reduce infiltration and extravasation events in a pediatric hospital.

    Science.gov (United States)

    Tofani, Barbara F; Rineair, Sylvia A; Gosdin, Craig H; Pilcher, Patricia M; McGee, Susan; Varadarajan, Kartik R; Schoettker, Pamela J

    2012-12-01

    A safety event response team at Cincinnati Children's Hospital Medical Center developed and tested improvement strategies to reduce peripheral intravenous (PIV) infiltration and extravasation injuries. Improvement activities included development of the touch-look-compare method for hourly PIV site assessment, staff education and mandatory demonstration of PIV site assessment, and performance monitoring and sharing of compliance results. We observed a significant reduction in the injury rate immediately following implementation of the interventions that corresponded with monitoring compliance in performing hourly assessments on patients with a PIV, but this was not sustained. The team is currently examining other strategies to reduce PIV injuries.

  14. Does Agency Competition Improve the Quality of Policy Analysis? Evidence from OMB and CBO Fiscal Projections

    Science.gov (United States)

    Krause, George A.; Douglas, James W.

    2006-01-01

    Public management scholars often claim that agency competition provides an effective institutional check on monopoly authority, and hence, leads to improvement of administrative performance in public sector agencies. This logic was central for creating the Congressional Budget Office (CBO) in 1975 to challenge the policy information provided by…

  15. What impedes and what facilitates a quality improvement project for older hospitalized patients?

    NARCIS (Netherlands)

    IJkema, R.; Langelaan, M.; Steeg, L. van de; Wagner, C.

    2014-01-01

    Objective: To gain insight into which factors impede, and which facilitate, the implementation of a complex multi-component improvement initiative in hospitalized older patients. Design: A qualitative study based on semi-structured interviews. The three dimensions of Pettigrew and Whipp's theoretica

  16. Electronic Health Record Tools to Care for At-Risk Older Drivers: A Quality Improvement Project.

    Science.gov (United States)

    Casey, Colleen M; Salinas, Katherine; Eckstrom, Elizabeth

    2015-06-01

    Evaluating driving safety of older adults is an important health topic, but primary care providers (PCP) face multiple barriers in addressing this issue. The study's objectives were to develop an electronic health record (EHR)-based Driving Clinical Support Tool, train PCPs to perform driving assessments utilizing the tool, and systematize documentation of assessment and management of driving safety issues via the tool. The intervention included development of an evidence-based Driving Clinical Support Tool within the EHR, followed by training of internal medicine providers in the tool's content and use. Pre- and postintervention provider surveys and chart review of driving-related patient visits were conducted. Surveys included self-report of preparedness and knowledge to evaluate at-risk older drivers and were analyzed using paired t-test. A chart review of driving-related office visits compared documentation pre- and postintervention including: completeness of appropriate focused history and exam, identification of deficits, patient education, and reporting to appropriate authorities when indicated. Data from 86 providers were analyzed. Pre- and postintervention surveys showed significantly increased self-assessed preparedness (p < .001) and increased driving-related knowledge (p < .001). Postintervention charts showed improved documentation of correct cognitive testing, more referrals/consults, increased patient education about community resources, and appropriate regulatory reporting when deficits were identified. Focused training and an EHR-based clinical support tool improved provider self-reported preparedness and knowledge of how to evaluate at-risk older drivers. The tool improved documentation of driving-related issues and led to improved access to interdisciplinary care coordination. Published by Oxford University Press on behalf of the Gerontological Society of America 2015.

  17. Response of acid mobilization of iron-containing mineral dust to improvement of air quality projected in the future

    Directory of Open Access Journals (Sweden)

    A. Ito

    2013-10-01

    Full Text Available Acidification of dust aerosols may increase aerosol iron (Fe solubility, which is linked to mineral properties. Combustion aerosols can also elevate aerosol iron solubility when aerosol loading is low. Here, we use an atmospheric chemical transport model to investigate the deposition of filterable iron and its response to changes in anthropogenic emissions of both combustion aerosols and precursor gases. By introducing three classes of iron-containing minerals into the detailed aerosol chemistry model, we provide a theoretical examination of the effects of different dissolution behaviors on the acid mobilization of iron. Comparisons of modeled Fe dissolution curves with the measured dissolution rates for African (Tibesti and Asian (Beijing dust samples show overall good agreement under acidic conditions. The improved treatment of Fe in mineral dust and its dissolution scheme results in reasonable predictive capability for iron solubility over the oceans in the Northern Hemisphere. Our model results suggest that the improvement of air quality projected in the future will lead to a decrease of the filterable iron deposition from iron-containing mineral dust to the northeastern Pacific due to less acidification in Asian dust, which is mainly associated with the reduction of nitrogen oxides (NOx emissions. These results could have important implications for iron fertilization of phytoplankton growth, and highlight the necessity of improving the process-based quantitative understanding of the response of the chemical modification in iron-containing minerals to environmental changes.

  18. The NCC project: A quality management perspective

    Science.gov (United States)

    Lee, Raymond H.

    1993-01-01

    The Network Control Center (NCC) Project introduced the concept of total quality management (TQM) in mid-1990. The CSC project team established a program which focused on continuous process improvement in software development methodology and consistent deliveries of high quality software products for the NCC. The vision of the TQM program was to produce error free software. Specific goals were established to allow continuing assessment of the progress toward meeting the overall quality objectives. The total quality environment, now a part of the NCC Project culture, has become the foundation for continuous process improvement and has resulted in the consistent delivery of quality software products over the last three years.

  19. Enhancing rehabilitation of mechanically ventilated patients in the intensive care unit: a quality improvement project.

    Science.gov (United States)

    McWilliams, David; Weblin, Jonathan; Atkins, Gemma; Bion, Julian; Williams, Jenny; Elliott, Catherine; Whitehouse, Tony; Snelson, Catherine

    2015-02-01

    Prolonged periods of mechanical ventilation are associated with significant physical and psychosocial adverse effects. Despite increasing evidence supporting early rehabilitation strategies, uptake and delivery of such interventions in Europe have been variable. The objective of this study was to evaluate the impact of an early and enhanced rehabilitation program for mechanically ventilated patients in a large tertiary referral, mixed-population intensive care unit (ICU). A new supportive rehabilitation team was created within the ICU in April 2012, with a focus on promoting early and enhanced rehabilitation for patients at high risk for prolonged ICU and hospital stays. Baseline data on all patients invasively ventilated for at least 5 days in the previous 12 months (n = 290) were compared with all patients ventilated for at least 5 days in the 12 months after the introduction of the rehabilitation team (n = 292). The main outcome measures were mobility level at ICU discharge (assessed via the Manchester Mobility Score), mean ICU, and post-ICU length of stay (LOS), ventilator days, and in-hospital mortality. The introduction of the ICU rehabilitation team was associated with a significant increase in mobility at ICU discharge, and this was associated with a significant reduction in ICU LOS (16.9 vs 14.4 days, P = .007), ventilator days (11.7 vs 9.3 days, P rehabilitation within this European ICU improved levels of mobility at critical care discharge, and this was associated with reduced ICU and hospital LOS and reduced days of mechanical ventilation. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

  20. Shaping the Jail Inreach Project: program evaluation as a quality improvement measure to inform programmatic decision making and improve outcomes.

    Science.gov (United States)

    Brown, Carlie A; Hickey, J Scott; Buck, David S

    2013-05-01

    The Jail Inreach Project was initiated in 2007 as a pilot program by Healthcare for the Homeless-Houston, an FQHC serving homeless individuals in Harris County, Texas, as a collaborative effort with the Harris County Sheriff's Office and the Mental Health Mental Retardation Authority of Harris County. It addresses the disproportionate number of homeless individuals with behavioral health diagnoses cycling through the Harris County Jail without provisions for continuity of care. Throughout the years, several evaluations have been conducted to inform programmatic planning and assess the success of the program on affecting patterns of recidivism of mentally ill homeless clients being served. Findings reinforce the importance of linking releasees to services immediately upon release as a measure for breaking the cycle of repeated incarceration and chronic homelessness. This paper illuminates characteristics of a successful intervention by examining three program evaluations conducted at different times in the program's history. It further illustrates how program evaluation has been utilized to help shape the program design and related policies.

  1. An Observational Study to Explore the Feasibility of Assessing Bereaved Relatives' Experiences Before and After a Quality Improvement Project to Improve Care of Dying Medical Inpatients.

    Science.gov (United States)

    Clark, Katherine; Willis, Abby; Byfieldt, Naomi

    2017-04-01

    Although hospitals are the most likely place of death, the quality of care received by dying inpatients remains variable. This is concerning for both the dying person and their relatives, with poorer bereavement outcomes likely for those who perceived their family member suffered unduly. There is a real need to consider how this situation can be improved. This work was conducted with the aim of exploring the feasibility of including bereaved relatives' experiences as part of a larger project exploring the use of a care bundle to improve care of the dying inpatients. Fifty relatives of inpatients who had died previously in hospital were contacted by letter with a request for interview before the implementation of a care bundle for the dying, with a care bundle being a collection of care processes that are implemented together. After this project had been in place for 6 months, a further 50 families were contacted who had died on the bundle. Ten families responded initially to the first request and 10 the second, with the interviews based on the Quality of Dying and Death (QODD) tool and a final open-ended question. Although all families who agree to be interviewed completed the session, with regard to the QODD, some families indicated that they would rather talk than provide numeric scores. No major differences in the prescores and postscores were noted. When invited to share their experiences, without prompting, families spoke of consistent concerns that included communication, place of death, and symptom control. This work confirms that it is highly feasible to incorporate assessments of bereaved family members' opinions as part of the wider assessment of research into end-of-life care.

  2. A multidisciplinary project to improve the quality of cancer pain management in Italy: background, methods, and preliminary results.

    Science.gov (United States)

    Apolone, Giovanni; Mangano, Simone; Compagnoni, Anna; Negri, Emanuele; Mosconi, Paola; Mannino, Salvatore; Villa, Marco; Zuccaro, Piergiorgio

    2006-01-01

    Pain afflicts most cancer patients, mainly in the advanced and metastatic phases of the disease. Despite the existence of several guidelines for cancer pain management that are based on the recommendations by the World Health Organization and the availability of effective treatments for 70% to 90% of cases, undertreatment is well documented and can involve up to 40% of patients. Undertreatment is usually attributed to an incorrect use of opioids for reasons often conceptualized in terms of barriers related to healthcare provider, patient, family, institution, and society. In Italy, opioid consumption rates are among the lowest in Europe despite some of recent efforts to improve the analgesic prescription and utilization. In the context of a wide project coordinated by the Mario Negri Institute, a non-for-profit private foundation located in Milan, Italy, 4 activities were launched: (1) a critical appraisal of information available on the Web, with the preparation and publication of a meta-site to facilitate the use of selected resources; (2) an evaluation of prescriptions of analgesic drugs in a cohort of cancer patients using a large administrative database; (3) a nationwide outcome research study to assess the epidemiology, quality, and effectiveness of different analgesic strategies; and (4) a multimodal, community-based intervention based on information, education, and training programs to change the knowledge, opinions, and attitude toward cancer pain treatment. Activities started in 2005. Some results and outputs are already available; others will be ready by the end of 2007.

  3. 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.

    NARCIS (Netherlands)

    Groene, O.; Klazinga, N.; Wagner, C.; Arah, O.A.; Thompson, A.; Bruneau, C.; Suñol, R.

    2010-01-01

    Background: Hospitals in European countries apply a wide range of quality improvement strategies. Knowledge of the effectiveness of these strategies, implemented as part of an overall hospital quality improvement system, is limited. Methods/Design: We propose to study the relationships among organis

  4. 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.,

  5. Developing a Deep Brain Stimulation Neuromodulation Network for Parkinson Disease, Essential Tremor, and Dystonia: Report of a Quality Improvement Project

    Science.gov (United States)

    O’Suilleabhain, Padraig E.; Sanghera, Manjit; Patel, Neepa; Khemani, Pravin; Lacritz, Laura H.; Chitnis, Shilpa; Whitworth, Louis A.; Dewey, Richard B.

    2016-01-01

    Objective To develop a process to improve patient outcomes from deep brain stimulation (DBS) surgery for Parkinson disease (PD), essential tremor (ET), and dystonia. Methods We employed standard quality improvement methodology using the Plan-Do-Study-Act process to improve patient selection, surgical DBS lead implantation, postoperative programming, and ongoing assessment of patient outcomes. Results The result of this quality improvement process was the development of a neuromodulation network. The key aspect of this program is rigorous patient assessment of both motor and non-motor outcomes tracked longitudinally using a REDCap database. We describe how this information is used to identify problems and to initiate Plan-Do-Study-Act cycles to address them. Preliminary outcomes data is presented for the cohort of PD and ET patients who have received surgery since the creation of the neuromodulation network. Conclusions Careful outcomes tracking is essential to ensure quality in a complex therapeutic endeavor like DBS surgery for movement disorders. The REDCap database system is well suited to store outcomes data for the purpose of ongoing quality assurance monitoring. PMID:27711133

  6. HOW EGYPTIAN CONTRACTING COMPANIES TRANSLATE PROJECTS' QUALITY TO PROJECTS' PERFORMANCE

    Directory of Open Access Journals (Sweden)

    Said SHAWKY HOZIEN

    2011-07-01

    Full Text Available A model for continuous quality improvement for Egyptian contracting projects’ (CQIM is developed through the extensive reviewing of the Total Quality Management (TQM, Continuous Quality Improvement (CQIliterature, preceding researches, consensus opinions of managers and experts of the construction industry and the quality management system (ISO 9000. This model comprises of 13 main factors divided into 9 CQI constructs and 4 Indices, the Indices are broken down to 46 practical measures, while the CQI constructs are further divided into 58 sub-factors consisting of 231 practical requirements, all targeting the evaluation and improvement of the overall project performance (OPP . This model assists its users to assess their points of weaknesses and strengths, by setting-up a road map for improvement, utilizing a guided framework. This model is used as a benchmarking tool to achieve the goal of this research “Projects' Continuous Quality Improvement”.

  7. A quality improvement project using a problem based post take ward round proforma based on the SOAP acronym to improve documentation in acute surgical receiving

    Directory of Open Access Journals (Sweden)

    R. Dolan

    2016-02-01

    Conclusions: Standardised proformas improve the documentation of post-take ward round notes. This helps to clarify the onward management plan for all aspects of a patient's care and will help avoid adverse events and litigation. This should improve the quality and safety of Patient Care.

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

    Energy Technology Data Exchange (ETDEWEB)

    Ray, W. Harmon

    2002-06-05

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

  9. A quality improvement plan for hypertension control: the INCOTECA Project (INterventions for COntrol of hyperTEnsion in CAtalonia

    Directory of Open Access Journals (Sweden)

    Vallès-Fernandez Roser

    2009-03-01

    Full Text Available Abstract Background Different studies have shown insufficient blood pressure (BP control in hypertensive patients. Multiple factors influence hypertension management, and the quality of primary care is one of them. We decided therefore to evaluate the effectiveness of a quality improvement plan directed at professionals of Primary Health Care Teams (PHCT with the aim to achieve a better control of hypertension. The hypothesis of the study is that the implementation of a quality improvement plan will improve the control of hypertension. The primary aim of this study will be to evaluate the effectiveness of this plan. Methods and design Design: multicentric study quasi-experimental before – after with control group. The non-randomised allocation of the intervention will be done at PHCT level. Setting: 18 PHCT in the Barcelona province (Spain. Sample: all patients with a diagnosis of hypertension (population based study. Exclusion criteria: patients with a diagnosis of hypertension made later than 01/01/2006 and patients younger than 18 years. Intervention: a quality improvement plan, which targets primary health care professionals and includes educational sessions, feedback to health professionals, audit and implementation of recommended clinical practice guidelines for the management of hypertensive patients. Measurements: age, sex, associated co-morbidity (diabetes mellitus type I and II, heart failure and renal failure. The following variables will be recorded: BP measurement, cardiovascular risk and antihypertensive drugs used. Results will be measured before the start of the intervention and twelve months after the start of the study. Dependent variable: prevalence of hypertensive patients with poor BP control. Analysis: Chi-square test and Student's t-test will be used to measure the association between independent qualitative and quantitative variables, respectively. Non-parametric tests will be used for the analysis of non

  10. 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)

  11. 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

  12. The intended and unintended consequences of quality improvement interventions for small practices in a community-based electronic health record implementation project.

    Science.gov (United States)

    Ryan, Andrew M; McCullough, Colleen M; Shih, Sarah C; Wang, Jason J; Ryan, Mandy S; Casalino, Lawrence P

    2014-09-01

    Despite the rapid rise in the implementation of electronic health records (EHR), commensurate improvements in health care quality have not been consistently observed. To evaluate whether the implementation of EHRs and complementary interventions-including clinical decision support, technical assistance, and financial incentives-improved quality of care. The study included 143 practices that implemented EHRs as part of the Primary Care Information Project-a long-standing community-based EHR implementation initiative. A total of 71 practices were randomized to receive financial incentives and quality feedback and 72 were randomized to feedback alone. All practices received technical assistance and had clinical decision support in their EHR. Using data from 2009 to 2011, we estimated measure-level fixed effects models to evaluate the association between exposure to clinical decision support, technical assistance, financial incentives, and quality of care. Associations were estimated separately for 4 cardiovascular measures that were rewarded by the financial incentive program and 4 measures that were not rewarded by incentives. Financial incentives for quality were consistently associated with higher performance for the incentivized measures [+10.1 percentage points at 18 mo of exposure (approximately +22%), P<0.05] and lower performance for the unincentivized measures [-8.3 percentage points at 12 mo of exposure (approximately -20%), P<0.05]. Technical assistance was associated with higher quality for the unincentivized measures, but not for the incentivized measures. Technical assistance and financial incentives-alongside EHR implementation-can improve quality of care. Financial incentives for quality may not result in similar improvements for incentivized and unincentivized measures.

  13. 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.

  14. 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.

  15. The impact of brief quality improvement (QI projects by medical students in primary care in Gauteng or the North West Province, South Africa

    Directory of Open Access Journals (Sweden)

    Claire van Deventer

    2012-08-01

    Full Text Available Background: The Integrated Primary Care (IPC rotation is undertaken over six weeks by final year medical students at the University of Witwatersrand. Students are placed in either rural or urban primary health care centres based in Gauteng or the North West Province. Aspart of the IPC rotation, students undertake short quality improvement (QI projects. The purpose of this study is to evaluate the impact of the QI projects undertaken over the period stretching from 2006 to 2010.Methods: An observational study of QI reports done by students. Project reports assessed and compared to site marks, indicators of learning assessed and individual and group marks compared.Results: Of 274 projects undertaken, 223 (81.4% were available for evaluation. Geographical placements and QI themes were categorised. Management issues were most frequently identified as being problematic followed by chronic illnesses. Understanding and applying the principles of QI was partially achieved and gaps were identified for future projects. The most common intervention was training of personnel and design and distribution of posters or pamphlets.Conclusions: Most QI projects were well thought out and relevant to the chosen setting. In the majority of cases, a great deal of effort and creativity went into the process and skills other than clinical skills were employed such as writing, presentation of data in graphs and tables. Integration of theory and practice was achieved only partially.

  16. The impact of brief quality improvement (QI projects by medical students in primary care in Gauteng or the North West Province, South Africa

    Directory of Open Access Journals (Sweden)

    Claire van Deventer

    2012-02-01

    Full Text Available Background: The Integrated Primary Care (IPC rotation is undertaken over six weeks by final year medical students at the University of Witwatersrand. Students are placed in either rural or urban primary health care centres based in Gauteng or the North West Province. As part of the IPC rotation, students undertake short quality improvement (QI projects. The purpose of this study is to evaluate the impact of the QI projects undertaken over the period stretching from 2006 to 2010. Methods: An observational study of QI reports done by students. Project reports assessed and compared to site marks, indicators of learning assessed and individual and group marks compared.Results: Of 274 projects undertaken, 223 (81.4% were available for evaluation. Geographical placements and QI themes were categorised. Management issues were most frequently identified as being problematic followed by chronic illnesses. Understanding and applying the principles of QI was partially achieved and gaps were identified for future projects. The most common intervention was training of personnel and design and distribution of posters or pamphlets.Conclusions: Most QI projects were well thought out and relevant to the chosen setting. In the majority of cases, a great deal of effort and creativity went into the process and skills other than clinical skills were employed such as writing, presentation of data in graphs and tables. Integration of theory and practice was achieved only partially.

  17. Practical improvement of the radiological quality of milk produced by peasant farmers in the territories of Belarus contaminated by the Chernobyl accident. The ETHOS project.

    Science.gov (United States)

    Lepicard, S; Dubreuil, G H

    2001-01-01

    The Chernobyl post-accident situation has highlighted how the sudden emergence of persistent radioactive contamination in the environment is severely affecting the quality of life of the inhabitants in the concerned territories. The management of this situation is complex, mainly conditioned by the ability of the inhabitants themselves to be directly involved in the process of improving their living conditions. In this process, quality of life cannot be restricted solely to the dimension of radiological risk, but needs to encompass the diverse aspects of daily living, including the social, psychological, economic, political and ethical aspects. This paper presents the experience of the involvement of a group of peasant farmers from a village in the Republic of Belarus, in the process of improving the radiological quality of privately produced milk. This experience took place in the context of the ETHOS project, funded by the radiation protection research programme of the European Commission. The principal objective was to implement a complementary approach to the rehabilitation strategies adopted so far in the contaminated territories of the Republic of Belarus. This paper retraces the process of involvement of the inhabitants in a working group. It describes the characterisation of the situation by local actors, the opening of new possible actions to improve the radiological quality of milk at the individual level and the positive consequences at the scale of the village. The ETHOS project also illustrates how the scientific knowledge accumulated over many years since the Chernobyl accident in the field of radiation protection and radioecology can enter into local practices in the form of practical tools, which can be used by the population to produce significant improvements in the radiological situation.

  18. Reducing the incidence of Obstetric Sphincter Injuries using a hands-on technique: an interventional quality improvement project

    Science.gov (United States)

    Rasmussen, Ole Bredahl; Yding, Annika; Anh Ø, Jacob; Sander Andersen, Charlotte; Boris, Jane

    2016-01-01

    A main concern for women giving birth is the risk of obstetric anal sphincter injuries. In our department the incidence of sphincter injuries was around 8 % among vaginally delivering first time mothers. We aimed to halve the incidence to 4 % or less. A prospective interventional program was instituted. We implemented a hands-on technique with four elements in a bundle of care together with a certification process for all staff on the delivery ward. The incidence of episiotomies served as a balancing indicator. The adherence to three of the four elements of the care bundle rose significantly while the all-or-nothing indicator leveled around 80 %. The median number of deliveries between cases with a sphincter injury increased from 9.5 in the baseline period to 20 during the intervention period. This corresponded with a reduction in the incidence from 7.0 % to 3.4 %. The rate of episiotomy remained low at 8.4 % in this group. By implementing the hands-on technique, we halved the risk of obstetric anal sphincter injuries. Our data suggest that further improvement may be anticipated. The study has demonstrated how implementation of a hands-on technique can be carried out within a quality improvement framework with rapid and sustainable results. PMID:28074131

  19. Reducing time delay in the thrombolysis of myocardial infarction: an internal quality improvement project. ARIAM Project Group. Analisis del Retraso en Infarto Agudo de Miocardio.

    Science.gov (United States)

    Saturno, P J; Felices, F; Segura, J; Vera, A; Rodriguez, J J

    2000-01-01

    The objectives of this study were to improve thrombolytic therapy in acute myocardial infarction by reducing the "door-to-needle" time in a 285-bed university hospital in Spain. A quality management approach was used involving all the relevant staff. Target standard was set at 35 minutes. Baseline data, intervention effect, and continuous monitoring were analyzed using x control charts. Analysis of baseline data showed a wide out-of-control variation and 72 minutes' average delay. Cause analysis revealed organizational and clinical problems that were subjected to intervention. Postintervention data showed a stable process, with an average of 30 minutes. Continuous monitoring showed further improvement in average time and predictable variation. The template of the current control chart has an average of 26 minutes. Quality management methods, particularly staff involvement in problem analysis and intervention design, and the use of control charts were useful to understand, solve, and continuously monitor an important clinical problem whose existence was evident only after it was measured.

  20. The effect of a complementary e-learning course on implementation of a quality improvement project regarding care for elderly patients: a stepped wedge trial

    Directory of Open Access Journals (Sweden)

    Van de Steeg Lotte

    2012-03-01

    Full Text Available Abstract Background Delirium occurs frequently in elderly hospitalised patients and is associated with higher mortality, increased length of hospital stay, functional decline, and admission to long-term care. Healthcare professionals frequently do not recognise delirium, indicating that education can play an important role in improving delirium care for hospitalised elderly. Previous studies have indicated that e-learning can provide an effective way of educating healthcare professionals and improving quality of care, though results are inconsistent. Methods and design This stepped wedge cluster randomised trial will assess the effects of a complementary delirium e-learning course on the implementation of quality improvement initiative, which aims to enhance the recognition and management of delirium in elderly patients. The trial will be conducted in 18 Dutch hospitals and last 11 months. Measurements will be taken in all participating wards using monthly record reviews, in order to monitor delivered care. These measurements will include the percentage of elderly patients who were screened for the risk of developing delirium, use of the Delirium Observation Screening scale, use of nursing or medical interventions, and the percentage of elderly patients who were diagnosed with delirium. Data regarding the e-learning course will be gathered as well. These data will include user characteristics, information regarding use of the course, delirium knowledge before and after using the course, and the attitude and intentions of nurses concerning delirium care. Setting The study will be conducted in internal medicine and surgical wards of eighteen hospitals that are at the beginning stages of implementing the Frail Elderly Project in the Netherlands. Discussion Better recognition of elderly patients at risk for delirium and subsequent care is expected from the introduction of an e-learning course for nurses that is complementary to an existing quality

  1. Preparing Electronic Clinical Data for Quality Improvement and Comparative Effectiveness Research: The SCOAP CERTAIN Automation and Validation Project.

    Science.gov (United States)

    Devine, Emily Beth; Capurro, Daniel; van Eaton, Erik; Alfonso-Cristancho, Rafael; Devlin, Allison; Yanez, N David; Yetisgen-Yildiz, Meliha; Flum, David R; Tarczy-Hornoch, Peter

    2013-01-01

    The field of clinical research informatics includes creation of clinical data repositories (CDRs) used to conduct quality improvement (QI) activities and comparative effectiveness research (CER). Ideally, CDR data are accurately and directly abstracted from disparate electronic health records (EHRs), across diverse health-systems. Investigators from Washington State's Surgical Care Outcomes and Assessment Program (SCOAP) Comparative Effectiveness Research Translation Network (CERTAIN) are creating such a CDR. This manuscript describes the automation and validation methods used to create this digital infrastructure. SCOAP is a QI benchmarking initiative. Data are manually abstracted from EHRs and entered into a data management system. CERTAIN investigators are now deploying Caradigm's Amalga™ tool to facilitate automated abstraction of data from multiple, disparate EHRs. Concordance is calculated to compare data automatically to manually abstracted. Performance measures are calculated between Amalga and each parent EHR. Validation takes place in repeated loops, with improvements made over time. When automated abstraction reaches the current benchmark for abstraction accuracy - 95% - itwill 'go-live' at each site. A technical analysis was completed at 14 sites. Five sites are contributing; the remaining sites prioritized meeting Meaningful Use criteria. Participating sites are contributing 15-18 unique data feeds, totaling 13 surgical registry use cases. Common feeds are registration, laboratory, transcription/dictation, radiology, and medications. Approximately 50% of 1,320 designated data elements are being automatically abstracted-25% from structured data; 25% from text mining. In semi-automating data abstraction and conducting a rigorous validation, CERTAIN investigators will semi-automate data collection to conduct QI and CER, while advancing the Learning Healthcare System.

  2. A quality improvement project to tackle under-reporting of hazards by doctors by using an anonymous telephone hotline.

    Science.gov (United States)

    Johnson, Sarah

    2016-01-01

    An anonymous hazard reporting hotline was established for doctors to use on two general medical wards at Weston General Hospital (WGH) in North Somerset in England during an eight day period in July/August 2014. Doctors were encouraged to report hazards and near misses or just start a conversation about a concern. The existing computer based significant event system remained alongside the hotline and was to be used where actual harm had come to a patient. A team of consultants and quality improvement administrators monitored the hotline on a daily basis, categorized the level of risk being reported and ensured, where possible, that action was taken to address the doctors' concerns. The hotline increased reporting rates from two per month to 25 in eight days. The system identified 13 amber (medium risk) and five red (high risk) hazards which would otherwise not have been known about. This author believes these five high risk reports alone make the case for a new, quicker, easier, and anonymous reporting system for doctors at WGH urgent and irrefutable.

  3. A quality improvement project using a problem based post take ward round proforma based on the SOAP acronym to improve documentation in acute surgical receiving.

    Science.gov (United States)

    Dolan, R; Broadbent, P

    2016-02-01

    Ward round documentation provides one of the most important means of communication between healthcare professionals. We aimed to establish if the use of a problem based standardised proforma can improve documentation in acute surgical receiving. Gold standards were established using the RCSE record keeping guidelines. We audited documentation for seven days using the following headings: patient name/identification number, subjective findings, objective findings, clinical impression/diagnosis, plan, diet status, discharge decision, discharge planning, signature, and grade. After the initial audit cycle, a ward round proforma was introduced using the above headings and re-audited over a seven day period. The pre-intervention arm contained 50 patients and the post intervention arm contained 47. The following headings showed an improvement in documentation compliance to 100%: patient name/identification number vs 96%, subjective findings vs 84%, objective findings vs 48%, plan vs 98%, signature vs 96%, and grade vs 62%. Documentation of the clinical impression/diagnosis improved to 98% vs 30%, diet status rose to 83% vs 16%, discharge decision to 66% vs 16%, and discharge planning to 40% vs 20%. Standardised proformas improve the documentation of post-take ward round notes. This helps to clarify the onward management plan for all aspects of a patient's care and will help avoid adverse events and litigation. This should improve the quality and safety of Patient Care.

  4. A quality improvement project using a problem based post take ward round proforma based on the SOAP acronym to improve documentation in acute surgical receiving

    Science.gov (United States)

    Dolan, R.; Broadbent, P.

    2015-01-01

    Objectives Ward round documentation provides one of the most important means of communication between healthcare professionals. We aimed to establish if the use of a problem based standardised proforma can improve documentation in acute surgical receiving. Methods Gold standards were established using the RCSE record keeping guidelines. We audited documentation for seven days using the following headings: patient name/identification number, subjective findings, objective findings, clinical impression/diagnosis, plan, diet status, discharge decision, discharge planning, signature, and grade. After the initial audit cycle, a ward round proforma was introduced using the above headings and re-audited over a seven day period. Results The pre-intervention arm contained 50 patients and the post intervention arm contained 47. The following headings showed an improvement in documentation compliance to 100%: patient name/identification number vs 96%, subjective findings vs 84%, objective findings vs 48%, plan vs 98%, signature vs 96%, and grade vs 62%. Documentation of the clinical impression/diagnosis improved to 98% vs 30%, diet status rose to 83% vs 16%, discharge decision to 66% vs 16%, and discharge planning to 40% vs 20%. Conclusions Standardised proformas improve the documentation of post-take ward round notes. This helps to clarify the onward management plan for all aspects of a patient's care and will help avoid adverse events and litigation. This should improve the quality and safety of Patient Care. PMID:26858834

  5. Peer-to-peer nursing rounds and hospital-acquired pressure ulcer prevalence in a surgical intensive care unit: a quality improvement project.

    Science.gov (United States)

    Kelleher, Alyson Dare; Moorer, Amanda; Makic, MaryBeth Flynn

    2012-01-01

    We conducted a quality improvement project in order to evaluate the effect of nurse-to-nurse bedside "rounding" as a strategy to decrease hospital-acquired pressure ulcers (HAPU) in a surgical intensive care unit. We instituted weekly peer-to-peer bedside skin rounds in a 17-bed surgical intensive care unit. Two nurses were identified as skin champions and trained by the hospital's certified WOC nurse to conduct skin rounds. The skin champion nurses conducted weekly peer-to-peer rounds that included discussions about key elements of our patients' skin status including current Braden Scale for Pressure Sore Risk score, and implementation of specific interventions related to subscale risk assessment. If a pressure ulcer was present, the current action plan was reevaluated for effectiveness. Quarterly HAPU prevalence studies were conducted from January 2008 to December 2010. Nineteen patients experienced a HAPU: 17 were located on the coccyx and 2 on the heel. Ten ulcers were classified as stage II, 3 PU were stage IV, 5 were deemed unstageable, and 1 was classified as a deep tissue injury. The frequency of preventive interventions rose during our quality improvement project. Specifically, the use of prevention surfaces increased 92%, repositioning increased 30%, nutrition interventions increased 77%, and moisture management increased 100%. Prior to focused nursing rounds, the highest HAPU prevalence rate was 27%. After implementing focused nursing rounds, HAPU rates trended down and were 0% for 3 consecutive quarters.

  6. Creating quality improvement culture in public health agencies.

    Science.gov (United States)

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

    2014-01-01

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

  7. A Continuous Quality Improvement Project to Implement Infant-Driven Feeding as a Standard of Practice in the Newborn/Infant Intensive Care Unit.

    Science.gov (United States)

    Chrupcala, Kimberly A; Edwards, Taryn M; Spatz, Diane L

    2015-01-01

    To increase the number of neonates who were fed according to cues prior to discharge and potentially decrease length of stay. Continuous quality improvement. Eighty-five bed level IV neonatal intensive care unit. Surgical and nonsurgical neonates of all gestational ages. Neonates younger than 32 weeks gestation, who required intubation, continuous positive airway pressure (CPAP), high flow nasal cannula (HFNC), or did not have suck or gag reflexes were excluded as potential candidates for infant-driven feeding. The project was conducted over a 13-month period using the following methods: (a) baseline data collection, (b) designation of Infant Driven Feeding (IDF) Champions, (c) creation of a multidisciplinary team, (d) creation of electronic health record documentation, (e) initial staff education, (f) monthly team meetings, (g) reeducation throughout the duration of the project, and (h) patient-family education. Baseline data were collected on 20 neonates with a mean gestational age of 36 0/7(th) weeks and a mean total length of stay (LOS) of 43 days. Postimplementation data were collected on 150 neonates with a mean gestational age of 36 1/7(th) weeks and a mean total LOS of 36.4 days. A potential decrease in the mean total LOS of stay by 6.63 days was achieved during this continuous quality improvement (CQI) project. Neonates who are fed according to cues can become successful oral feeders and can be safely discharged home regardless of gestational age or diagnosis. © 2015 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

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

    Science.gov (United States)

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

    2015-08-01

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

  9. The continuous quality improvement project for telephone-assisted instruction of cardiopulmonary resuscitation increased the incidence of bystander CPR and improved the outcomes of out-of-hospital cardiac arrests.

    Science.gov (United States)

    Tanaka, Yoshio; Taniguchi, Junro; Wato, Yukihiro; Yoshida, Yutaka; Inaba, Hideo

    2012-10-01

    In 2007, the Ishikawa Medical Control Council initiated the continuous quality improvement (CQI) project for telephone-assisted cardiopulmonary resuscitation (telephone-CPR), which included instruction on chest-compression-only CPR, education on how to recognise out-of-hospital cardiac arrests (OHCAs) with agonal breathing, emesis and convulsion, recommendations for on-line or redialling instructions and feedback from emergency physicians. This study aimed to investigate the effect of this project on the incidence of bystander CPR and the outcomes of OHCAs. The baseline data were prospectively collected on 4995 resuscitation-attempted OHCAs, which were recognised or witnessed by citizens rather than emergency medical technicians during the period of February 2004 to March 2010. The incidence of telephone-CPR and bystander CPR, as well as the outcomes of the OHCAs, was compared before and after the project. The incidence of telephone-CPR and bystander CPR significantly increased after the project (from 42% to 62% and from 41% to 56%, respectively). The incidence of failed telephone-CPR due to human factors significantly decreased from 30% to 16%. The outcomes of OHCAs significantly improved after the projects. A multiple logistic regression analysis revealed that the CQI project is one of the independent factors associated with one-year (1-Y) survival with favourable neurological outcomes (odds ratio=1.81, 95% confidence interval=1.20-2.76). The CQI project for telephone-CPR increased the incidence of bystander CPR and improved the outcome of OHCAs. A CQI project appeared to be essential to augment the effects of telephone-CPR. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  10. MoMa: From Molecules to Man: Space Research Applied to the improvement of the Quality of Life of the Ageing Population on Earth. Evolution of a project

    Science.gov (United States)

    Zambito, Anna Maria; Curcio, Francesco; Meli, Antonella; Saverio Ambesi-Impiombato, Francesco

    The "MoMa" project: "From Molecules to Man: Space Research Applied to the improvement of the Quality of Life of the Ageing Population on Earth started June 16 2006 and finished right on schedule June 25 2009, has been the biggest of the three projects funded by ASI in the sector "Medicine and Biotechnology. In the last years the scientific community had formed a national chain of biomedical spatial research with different research areas. MoMa responds to the necessity of unification in ASI of the two areas "Radiobiology and Protection" and "Cellular and Molecular Biotechnology" in a line of joint research: "Biotechnological Applications" were the interests of all groups would be combined and unified in a goal of social relevance. MoMa is the largest project ever developed in the biomedical area in Italy, the idea was born thinking about the phenomenon of acceleration of the aging process observed in space, and already described in literature, and the aim of studying the effects of the space environment at cellular, molecular and human organism level. "MoMa" was divided into three primary areas of study: Molecules, Cells and Man with an industrial area alongside. This allowed to optimize the work and information flows within the scientific research more similar and more culturally homogeneous and allowed a perfect industrial integration in a project of great scientific importance. Within three scientific areas 10 scientific lines in total are identified, each of them coordinated by a subcontractor. The rapid and efficient exchange of information between different areas of science and the development of industrial applications in various areas of interest have been assured by a strong work of Scientific Coordination of System Engineering and Quality Control. After three years of intense and coordinated activities within the MoMa project, the objectives achieved are very significant not only as regards the scientific results and the important hardware produced but

  11. Maui Smart Grid Demonstration Project Managing Distribution System Resources for Improved Service Quality and Reliability, Transmission Congestion Relief, and Grid Support Functions

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2014-09-30

    The Maui Smart Grid Project (MSGP) is under the leadership of the Hawaii Natural Energy Institute (HNEI) of the University of Hawaii at Manoa. The project team includes Maui Electric Company, Ltd. (MECO), Hawaiian Electric Company, Inc. (HECO), Sentech (a division of SRA International, Inc.), Silver Spring Networks (SSN), Alstom Grid, Maui Economic Development Board (MEDB), University of Hawaii-Maui College (UHMC), and the County of Maui. MSGP was supported by the U.S. Department of Energy (DOE) under Cooperative Agreement Number DE-FC26-08NT02871, with approximately 50% co-funding supplied by MECO. The project was designed to develop and demonstrate an integrated monitoring, communications, database, applications, and decision support solution that aggregates renewable energy (RE), other distributed generation (DG), energy storage, and demand response technologies in a distribution system to achieve both distribution and transmission-level benefits. The application of these new technologies and procedures will increase MECO’s visibility into system conditions, with the expected benefits of enabling more renewable energy resources to be integrated into the grid, improving service quality, increasing overall reliability of the power system, and ultimately reducing costs to both MECO and its customers.

  12. 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.

  13. 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.

  14. Use of 4MAT Learning Theory to Promote Better Skin Care During Radiation Therapy: An Evidence-Based Quality Improvement Project.

    Science.gov (United States)

    Bauer, Carole; Magnan, Morris; Laszewski, Pamela

    Radiation therapy is a key treatment modality for cancer patients, but it is associated with adverse side effects such as radiation dermatitis. To mitigate the adverse effects of radiation on the skin, patients must participate in skin-related self-care. However, even with self-care instruction, adherence can be poor. This quality improvement project used best available evidence for skin care in patients undergoing radiation therapy and a theoretical framework, 4MATing, to provide a structured approach to patient education designed to enhance adherence to skin care recommendations. Implementation of this approach resulted in increased adherence to a topical skin care protocol in our facility. Patients were highly satisfied with their education. While there was a 4-day delay in the onset of radiation dermatitis, this difference was not statistically significant.

  15. 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.

  16. The CHPRC Columbia River Protection Project Quality Assurance Project Plan

    Energy Technology Data Exchange (ETDEWEB)

    Fix, N. J.

    2008-11-30

    Pacific Northwest National Laboratory researchers are working on the CHPRC Columbia River Protection Project (hereafter referred to as the Columbia River Project). This is a follow-on project, funded by CH2M Hill Plateau Remediation Company, LLC (CHPRC), to the Fluor Hanford, Inc. Columbia River Protection Project. The work scope consists of a number of CHPRC funded, related projects that are managed under a master project (project number 55109). All contract releases associated with the Fluor Hanford Columbia River Project (Fluor Hanford, Inc. Contract 27647) and the CHPRC Columbia River Project (Contract 36402) will be collected under this master project. Each project within the master project is authorized by a CHPRC contract release that contains the project-specific statement of work. This Quality Assurance Project Plan provides the quality assurance requirements and processes that will be followed by the Columbia River Project staff.

  17. A quality improvement initiative project to evaluate a newborn hearing screening program in a Baby-Friendly Hospital Initiative setting

    Directory of Open Access Journals (Sweden)

    Stacey R. Lim

    2015-02-01

    Full Text Available Hearing loss present from birth can have a detrimental impact on later language and educational outcomes. Newborn hearing screening has allowed early identification and intervention of hearing loss, giving children the opportunity to develop age-appropriate language skills. The aim of this quality initiative study was to evaluate the quality of the newborn hearing screening program in the context of a newly implemented Baby-Friendly Hospital Initiative Program at Summa Health System Akron City Hospital. The goals were (1 to determine whether screening environment (mother’s room vs. nursery affected screening results, (2 to identify challenges and positive outcomes encountered by the audiologists, and (3 to ensure that Pass/Refer rates met state standards. A Quest Technologies sound level meter (Model 1800; St. Paul, MN, USA was used to measure noise levels in the nursery rooms where newborns were tested. The length of screening time was determined using a calibrated SP® Traceable® (ISO 17025 stopwatch (McGraw Park, IL, USA. Pass/Refer rates and observed challenges and benefits were noted. All well-baby infants born in the month of February 2013 (n = 101 were included, and Pass/Refer results were compared to those in years 2008-2012.Noise levels in the mother’s room did not appear to negatively affect the Pass/Refer rates. Some challenges were present, including interruptions and louder environmental noise. This protocol was considered appropriate for assessing a hearing screening program in a Baby-Friendly Hospital Initiative (BFHI setting.Benefits of performing hearing screening in the mother’s room included test transparency for parents and the ability to immediately discuss the results. Results obtained in the mother’s room were comparable to past results obtained in the nursery. Noise levels in the screening rooms and challenges should be noted, to ensure accuracy of screening results.

  18. Ares Project Overview - Quality in Design

    Science.gov (United States)

    Cianciola, Chris; Crane, Kenneth

    2008-01-01

    This presentation introduces the audience to the overall goals of the Ares Project, which include providing human access to low-Earth orbit, the Moon, and beyond. The presentation also provides an overview of with the vehicles that will execute those goals and progress made on the vehicles to date. The briefing will provide an introduction to Lean, Six Sigma, and Kaizen practices Ares will use to improve the overall effectiveness and quality of its efforts. Finally, the briefing includes a summary of Safety and Mission Assurance practices being implemented within[Ares to ensure safety and quality early in the design process. Integrating Safety and Mission Assurance in Design: This presentation describes how the Ares Projects are learning from the successes and failures of previous launch systems in order to maximize safety and reliability while maintaining fiscal responsibility. The Ares Projects are integrating Safer T and Mission Assurance into design activities and embracing independent assessments by Quality experts in thorough reviews of designs and processes. Incorporating Lean thinking into the design process, Ares is also streamlining existing processes and future manufacturing flows which will yield savings during production. Understanding the value of early involvement of Quality experts, the Ares Projects are leading launch vehicle development into the 21st century.

  19. Ten years of percutaneous coronary intervention in a low-volume military treatment facility: a quality improvement project.

    Science.gov (United States)

    Fentanes, Emilio; Wisenbaugh, Thomas W

    2013-09-01

    The quality assurance of a percutaneous coronary intervention (PCI) program is particularly important when the volume of procedures is low in the center. Determine predictors of the 30-day and long-term incidence of stent thrombosis, myocardial infarction, and death from any cause for all PCIs performed at Tripler Army Medical Center from January 2002 to June 2012. 929 PCIs were performed in 795 patients, resulting in an average PCI volume of 88 per year. Follow-up data were obtained for 99.8% of the patients at 30 days and for 83% at 3 years. 18 deaths occurred during the first 30 days after PCI, with an observed morality rate of 2.26%. Multivariate logistic regression identified independent predictors of death at 30 days: stent thrombosis (OR 96), acute myocardial infarction, hemodynamic instability (OR 47), emergent (OR 17) or salvage (OR 28) PCI, and the need for preprocedural balloon pumping (OR 27). The long-term survival Kaplan-Meier estimates were 94% at 1 year and 90.4% at 3 years. The 30-day mortality was similar to the expected mortality based on the risk factors in the New York State Registry model, and long-term survival was comparable with that reported in large registries. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

  20. Quality in Supply in Project Configured Networks

    DEFF Research Database (Denmark)

    Koch, Christian; Larsen, Casper Schultz

    2006-01-01

    The paper argues that in the AEC-industry the material and knowledge supply chains are increasingly intertwined and moreover characterised by configuration by project. In such a setting creating value for the customers and the enterprises becomes dependent of the ability to organise and coordinate...... network. 160 failures were found in 38 working days. The paper discusses quality improvement strategies on strategic and processual level, proposing initiatives, especially at engineer to order production, to strengthen partnerships in supply chains with focus on quality specifications, integrated...

  1. Rebuilding Habitat and Shoreline Resilience through Improved Flood Control Project

    Science.gov (United States)

    Information about the SFBWQP Rebuilding Habitat and Shoreline Resilience through Improved Flood Control Project, part of an EPA competitive grant program to improve SF Bay water quality focused on restoring impaired waters and enhancing aquatic resources.

  2. BODIES OF KNOWLEDGE IN PROJECT MANAGEMENT AND PROJECT QUALITY MANAGEMENT

    OpenAIRE

    Tamara Gvozdenovic; Mirjana Miljanovic; Aleksandar Jegdic; Zeljko Crnogorcic

    2008-01-01

    One of the main trends is standardization of project management. Some of the most important bodies of knowledge in project management, which were created by professional associations for project management are given in this paper. The main of the project management, apart from minimization of time, resources and costs, is to finish the project in the required quality, i.e. it is very important during the whole process of project management to provide realizing the project without any deviatio...

  3. Distributed Wind Competitiveness Improvement Project

    Energy Technology Data Exchange (ETDEWEB)

    2016-05-01

    The Competitiveness Improvement Project (CIP) is a periodic solicitation through the U.S. Department of Energy and its National Renewable Energy Laboratory. Manufacturers of small and medium wind turbines are awarded cost-shared grants via a competitive process to optimize their designs, develop advanced manufacturing processes, and perform turbine testing. The goals of the CIP are to make wind energy cost competitive with other distributed generation technology and increase the number of wind turbine designs certified to national testing standards. This fact sheet describes the CIP and funding awarded as part of the project.

  4. NETWORKS AND QUALITY IMPROVEMENT

    Directory of Open Access Journals (Sweden)

    Miodrag Hadžistević

    2009-12-01

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

  5. A Procedural Model for Process Improvement Projects

    OpenAIRE

    Kreimeyer, Matthias;Daniilidis, Charampos;Lindemann, Udo

    2017-01-01

    Process improvement projects are of a complex nature. It is therefore necessary to use experience and knowledge gained in previous projects when executing a new project. Yet, there are few pragmatic planning aids, and transferring the institutional knowledge from one project to the next is difficult. This paper proposes a procedural model that extends common models for project planning to enable staff on a process improvement project to adequately plan their projects, enabling them to documen...

  6. 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.

  7. Project quality management: why, what and how

    National Research Council Canada - National Science Library

    Rose, K.H

    2005-01-01

    This book provides a background of quality concepts and their evolution over time, but is focused on the limited information that is necessary for project managers to understand the context of quality...

  8. 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.

  9. Prescribing Data in General Practice Demonstration (PDGPD project - a cluster randomised controlled trial of a quality improvement intervention to achieve better prescribing for chronic heart failure and hypertension

    Directory of Open Access Journals (Sweden)

    Williamson Margaret

    2012-08-01

    Full Text Available Abstract Background Research literature consistently documents that scientifically based therapeutic recommendations are not always followed in the hospital or in the primary care setting. Currently, there is evidence that some general practitioners in Australia are not prescribing appropriately for patients diagnosed with 1 hypertension (HT and 2 chronic heart failure (CHF. The objectives of this study were to improve general practitioner’s drug treatment management of these patients through feedback on their own prescribing and small group discussions with peers and a trained group facilitator. The impact evaluation includes quantitative assessment of prescribing changes at 6, 9, 12 and 18 months after the intervention. Methods A pragmatic multi site cluster RCT began recruiting practices in October 2009 to evaluate the effects of a multi-faceted quality improvement (QI intervention on prescribing practice among Australian general practitioners (GP in relation to patients with CHF and HT. General practices were recruited nationally through General Practice Networks across Australia. Participating practices were randomly allocated to one of three groups: two groups received the QI intervention (the prescribing indicator feedback reports and small group discussion with each group undertaking the clinical topics (CHF and HT in reverse order to the other. The third group was waitlisted to receive the intervention 6 months later and acted as a “control” for the other two groups. De-identified data on practice, doctor and patient characteristics and their treatment for CHF and HT are extracted at six-monthly intervals before and after the intervention. Post-test comparisons will be conducted between the intervention and control arms using intention to treat analysis and models that account for clustering of practices in a Network and clustering of patients within practices and GPs. Discussion This paper describes the study protocol for a

  10. [Potentials of cooperative quality management initiatives: BQS Institute projects, January 2010 - July 2013].

    Science.gov (United States)

    Veit, Christof; Bungard, Sven; Hertle, Dagmar; Grothaus, Franz-Josef; Kötting, Joachim; Arnold, Nicolai

    2013-01-01

    Alongside the projects of internal quality management and mandatory quality assurance there is a variety of quality driven projects across institutions initiated and run by various partners to continuously improve the quality of care. The multiplicity and characteristics of these projects are discussed on the basis of projects run by the BQS Institute between 2010 and 2013. In addition, useful interactions and linking with mandatory quality benchmarking and with internal quality management are discussed. (As supplied by publisher).

  11. The Impact of Delirium Screening on Admission to General Hospital Using Stanford Proxy Test for Delirium SPTD [1]® , A Quality Improvement Project

    Directory of Open Access Journals (Sweden)

    Adel Zaraa

    2016-09-01

    Full Text Available In this Quality Improvement Project QIP, we hypothesized that implementing screening tool for detecting delirium at admission to general hospital will term a higher yield; thus early recognition and diagnosis will eventually lead to an early intervention and prevention. Method: We set to screen every patient admitted to a community general hospital. Exclusion criteria: Any congenital neurological malformation, a history of pervasive developmental disorder, or documented brain injury. For this purpose we used The Stanford Proxy Test for Delirium (S-PTD which is the first diagnostic test for delirium that combines criteria from the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5 and the International Classification of Diseases, 10th revision (ICD-10 2015. This test was generated in Stanford University 2015 by Jose R. Maldonado, MD et al. and discussed in the APM conference in November 2015, in New Orleans then in the APA meeting, 2016 Atlanta, USA. The test assesses the patient’s twelve different parameters. When set the positive cutoff score at 4 or more, the S-PTD had a sensitivity of 79%, specificity of 91%, positive predictive value of 70%, and negative predictive value of 94%. One of the big advantages of this tool is required 2 minutes to complete. Also, the nursing staff can easily administer it to their patient during their shift, which means measuring patients cognitive function in different times through the day [1]. Results: 19.55% of all admission suffered from delirium on admission, while the admitting officer clinically recognized 5.3% of all admission. Conclusion: using the SPTD [1] on admission yield 400% more positive result. It’s highly recommended to use screening tool as part of admission process.

  12. Muskuloskeletal radiography as a specialty. A quality improvement project on positioning of musculoskeletal x-rays with a multimethodology and multidisciplinary approach

    DEFF Research Database (Denmark)

    Jensen, Janni; Torfing, Trine

    of quality and to measure continuous improvement by means of audits subdividing quality from 1-4 (1=perfect and 4=inadequate , should have been repeated). Involved personnel: radiographers, reporting radiographers, radiologists and orthopedics. Various methods are applied continuously involving all...... radiographers specialized in muskuloskeletal radiography. Methods applied: • Audits are performed regularly by three alternating radiographers • Short educational sessions for radiographers on positioning and pathology are given and repeated regularly in the department by reporting radiographers • Morning...... to improve quality substantially. The number of inadequate wrist x-rays were reduced with 50% between the two first audits (one month apart) but subsequent audits (five months apart) showed improvement of wrist x-rays reduced to 20% when compared to baseline audit. Including all audits on all anatomies...

  13. Cost-effectiveness analysis of quality improvement projects of blood culture in ICU%ICU血培养送检质量改善成效分析

    Institute of Scientific and Technical Information of China (English)

    侯铁英; 黄德弘; 张莉滟; 廖亚龙

    2012-01-01

    ; compared with the same period in 2009, the contamination rate of blood culture was significantly lower in the second half of 2010, decreasing from 2. 7% to 1. 6%, the positive rate significantly increased from 6.3% to 10. 9%; the ratio of submission of catheter blood was significantly increased, there were 63 cases confirmed as catheter-related bloodstream infections (CRBSI)in 2010 with an increase of 200. 0% as compared with 2009. CONCLUSION The quality of blood culture in ICU has been effectively improved through quality improvement projects with the contamination rate reduced and the detection rate of the suspected pathogens raised as well as the diagnosis rate of CRBS1 improved, meanwhile, it promotes the standardized construction of laboratory.

  14. 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)....

  15. POOR QUALITY IN BUILDING PROJECTS

    OpenAIRE

    Mahajan Ganesh S*

    2016-01-01

    The cost of quality are cost associated with the prevention, discovery, and resolving of defects. These costs can arise whether the product is in design stages, manufacturing plants, or in customer’s hand. It is important to identify the cost of quality so that one can determine the expenses associated with producing a quality product. The present paper aims at making a review associated with use of quality in construction industry. Data necessary to achieve the objective of the paper i...

  16. Gains in oral health and improved quality of life of 12-13-year-old Nepali schoolchildren: outcomes of an advocacy project to fluoridate toothpaste.

    NARCIS (Netherlands)

    Yee, R.; McDonald, N.; Palenstein Helderman, W.H. van

    2006-01-01

    OBJECTIVES: To report on gains in oral health and improved quality of life of 12-13-year-old Nepali schoolchildren five and six years after the introduction of fluoride toothpaste in 1999. DESIGN: Cross sectional baseline surveys in 1999 and 2001, and follow up surveys in 2004 and 2005 were multi-st

  17. Gains in oral health and improved quality of life of 12-13-year-old Nepali schoolchildren: outcomes of an advocacy project to fluoridate toothpaste.

    NARCIS (Netherlands)

    Yee, R.; McDonald, N.; Palenstein Helderman, W.H. van

    2006-01-01

    OBJECTIVES: To report on gains in oral health and improved quality of life of 12-13-year-old Nepali schoolchildren five and six years after the introduction of fluoride toothpaste in 1999. DESIGN: Cross sectional baseline surveys in 1999 and 2001, and follow up surveys in 2004 and 2005 were

  18. The Optimizing Patient Transfers, Impacting Medical Quality, andImproving Symptoms:Transforming Institutional Care approach: preliminary data from the implementation of a Centers for Medicare and Medicaid Services nursing facility demonstration project.

    Science.gov (United States)

    Unroe, Kathleen T; Nazir, Arif; Holtz, Laura R; Maurer, Helen; Miller, Ellen; Hickman, Susan E; La Mantia, Michael A; Bennett, Merih; Arling, Greg; Sachs, Greg A

    2015-01-01

    The Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care (OPTIMISTIC) project aims to reduce avoidable hospitalizations of long-stay residents enrolled in 19 central Indiana nursing facilities. This clinical demonstration project, funded by the Centers for Medicare and Medicaid Services Innovations Center, places a registered nurse in each nursing facility to implement an evidence-based quality improvement program with clinical support from nurse practitioners. A description of the model is presented, and early implementation experiences during the first year of the project are reported. Important elements include better medical care through implementation of Interventions to Reduce Acute Care Transfers tools and chronic care management, enhanced transitional care, and better palliative care with a focus on systematic advance care planning. There were 4,035 long-stay residents in 19 facilities enrolled in OPTIMISTIC between February 2013 and January 2014. Root-cause analyses were performed for all 910 acute transfers of these long stay residents. Of these transfers, the project RN evaluated 29% as avoidable (57% were not avoidable and 15% were missing), and opportunities for quality improvement were identified in 54% of transfers. Lessons learned in early implementation included defining new clinical roles, integrating into nursing facility culture, managing competing facility priorities, communicating with multiple stakeholders, and developing a system for collecting and managing data. The success of the overall initiative will be measured primarily according to reduction in avoidable hospitalizations of long-stay nursing facility residents.

  19. Quality management in construction project design and management

    CSIR Research Space (South Africa)

    Conradie, Dirk CU

    2008-03-01

    Full Text Available The aim of this paper is to propose the use of simulation to improve design quality and to introduce new opportunities to use quality management throughout the various development stages of construction projects. The paper will attempt to identify...

  20. The Seattle-King County healthy homes project: implementation of a comprehensive approach to improving indoor environmental quality for low-income children with asthma.

    OpenAIRE

    2002-01-01

    Pediatric asthma is a growing public health issue, disproportionately affecting low-income people and people of color. Exposure to indoor asthma triggers plays an important role in the development and exacerbation of asthma. We describe the implementation of the Seattle-King County Healthy Homes Project, a randomized, controlled trial of an outreach/education intervention to improve asthma-related health status by reducing exposure to allergens and irritants in the home. We randomly assigned ...

  1. 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.

  2. A Lean Six Sigma quality improvement project to increase discharge paperwork completeness for admission to a comprehensive integrated inpatient rehabilitation program.

    Science.gov (United States)

    Neufeld, Nathan J; Hoyer, Erik H; Cabahug, Philippines; González-Fernández, Marlís; Mehta, Megha; Walker, N Colbey; Powers, Richard L; Mayer, R Samuel

    2013-01-01

    Lean Six Sigma (LSS) process analysis can be used to increase completeness of discharge summary reports used as a critical communication tool when a patient transitions between levels of care. The authors used the LSS methodology as an intervention to improve systems process. Over the course of the project, 8 required elements were analyzed in the discharge paperwork. The authors analyzed the discharge paperwork of patients (42 patients preintervention and 143 patients postintervention) of a comprehensive integrated inpatient rehabilitation program (CIIRP). Prior to this LSS project, 61.8% of required discharge elements were present. The intervention improved the completeness to 94.2% of the required elements. The percentage of charts that were 100% complete increased from 11.9% to 67.8%. LSS is a well-established process improvement methodology that can be used to make significant improvements in complex health care workflow issues. Specifically, the completeness of discharge documentation required for transition of care to CIIRP can be improved.

  3. HOW EGYPTIAN CONTRACTING COMPANIES TRANSLATE PROJECTS' QUALITY TO PROJECTS' PERFORMANCE

    OpenAIRE

    Said SHAWKY HOZIEN; REFAAT HASSAN ABDEL-RAZEK; ADEL AHMED EL-KORDI; SHAFIK SHAWKY KHOURY

    2011-01-01

    A model for continuous quality improvement for Egyptian contracting projects’ (CQIM) is developed through the extensive reviewing of the Total Quality Management (TQM), Continuous Quality Improvement (CQI)literature, preceding researches, consensus opinions of managers and experts of the construction industry and the quality management system (ISO 9000). This model comprises of 13 main factors divided into 9 CQI constructs and 4 Indices, the Indices are broken down to 46 practical measures, w...

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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

  9. 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.

  10. 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.

  11. The PAMINO-project: evaluating a primary care-based educational program to improve the quality of life of palliative patients

    Directory of Open Access Journals (Sweden)

    Engeser Peter

    2007-05-01

    Full Text Available Abstract Background The care of palliative patients challenges the health care system in both quantity and quality. Especially the role of primary care givers needs to be strengthened to provide them with the knowledge and the confidence of applying an appropriate end-of-life care to palliative patients. To improve health care services for palliative patients in primary care, interested physicians in and around Heidelberg, Germany, are enabled to participate in the community-based program 'Palliative Medical Initiative North Baden (PAMINO' to improve their knowledge in dealing with palliative patients. The impact of this program on patients' health and quality of life remains to be evaluated. Methods/Design The evaluation of PAMINO is a non-randomized, controlled study. Out of the group of primary care physicians who took part in the PAMINO program, a sample of 45 physicians and their palliative patients will be compared to a sample of palliative patients of 45 physicians who did not take part in the program. Every four weeks for 6 months or until death, patients, physicians, and the patients' family caregivers in both groups answer questions to therapy strategies, quality of life (QLQ-C15-PAL, POS, pain (VAS, and burden for family caregivers (BSFC. The inclusion of physicians and patients in the study starts in March 2007. Discussion Although participating physicians value the increase in knowledge they receive from PAMINO, the effects on patients remain unclear. If the evaluation reveals a clear benefit for patients' quality of life, a larger-scale implementation of the program is considered. Trial registration: The study was registered at ‘current controlled trials (CCT’, registration number: ISRCTN78021852.

  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. 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

  14. Power Quality and Reliability Project

    Science.gov (United States)

    Attia, John O.

    2001-01-01

    One area where universities and industry can link is in the area of power systems reliability and quality - key concepts in the commercial, industrial and public sector engineering environments. Prairie View A&M University (PVAMU) has established a collaborative relationship with the University of'Texas at Arlington (UTA), NASA/Johnson Space Center (JSC), and EP&C Engineering and Technology Group (EP&C) a small disadvantage business that specializes in power quality and engineering services. The primary goal of this collaboration is to facilitate the development and implementation of a Strategic Integrated power/Systems Reliability and Curriculum Enhancement Program. The objectives of first phase of this work are: (a) to develop a course in power quality and reliability, (b) to use the campus of Prairie View A&M University as a laboratory for the study of systems reliability and quality issues, (c) to provide students with NASA/EPC shadowing and Internship experience. In this work, a course, titled "Reliability Analysis of Electrical Facilities" was developed and taught for two semesters. About thirty seven has benefited directly from this course. A laboratory accompanying the course was also developed. Four facilities at Prairie View A&M University were surveyed. Some tests that were performed are (i) earth-ground testing, (ii) voltage, amperage and harmonics of various panels in the buildings, (iii) checking the wire sizes to see if they were the right size for the load that they were carrying, (iv) vibration tests to test the status of the engines or chillers and water pumps, (v) infrared testing to the test arcing or misfiring of electrical or mechanical systems.

  15. 浅析如何提高电力基建项目施工档案质量%Brief Analysis on How to Improve the Quality of the Electricity Infrastructure Project's Construction Archives

    Institute of Scientific and Technical Information of China (English)

    叶莞玉

    2014-01-01

    电力基建工程质量的优劣直接关系着电力行业的健康发展,对国民经济和人民生活影响重大。而电力基建项目的施工档案是电力基本建设过程中形成的真实记录,也是全面鉴定电力建设项目质量、工程使用和维护的重要依据。目前,电力基建项目的施工文件材料质量还存在很多问题,影响了技术资料的存档。因此,本文就如何提高电力基建项目的施工档案质量提出了若干建议。%The quality of the electricity infrastructure construction engineering directly matters the healthy de-velopment of electric power industry, and also has significant influences on national economy and people's liveli-hood. The construction archives of the electricity infrastructure project are real records that are formed during con-struction procedures. They are an important basis to completely identify the electricity infrastructure project's qual-ity, the project's application and maintain. Currently, there exist many problems in the quality of the construction file material of electricity infrastructure project, which affects the technical data archiving. As general contractor of the construction, we put forward some views about how to improve the quality of the electricity infrastructure pro-ject's construction archives.

  16. Quality Assurance Program Plan (QAPP) Waste Management Project

    Energy Technology Data Exchange (ETDEWEB)

    HORHOTA, M.J.

    2000-12-21

    The Waste Management Project (WMP) is committed to excellence in our work and to delivering quality products and services to our customers, protecting our employees and the public and to being good stewards of the environment. We will continually strive to understand customer requirements, perform services, and activities that meet or exceed customer expectations, and be cost-effective in our performance. The WMP maintains an environment that fosters continuous improvement in our processes, performance, safety and quality. The achievement of quality will require the total commitment of all WMP employees to our ethic that Quality, Health and Safety, and Regulatory Compliance must come before profits. The successful implementation of this policy and ethic requires a formal, documented management quality system to ensure quality standards are established and achieved in all activities. The following principles are the foundation of our quality system. Senior management will take full ownership of the quality system and will create an environment that ensures quality objectives are met, standards are clearly established, and performance is measured and evaluated. Line management will be responsible for quality system implementation. Each organization will adhere to all quality system requirements that apply to their function. Every employee will be responsible for their work quality, to work safely and for complying with the policies, procedures and instructions applicable to their activities. Quality will be addressed and verified during all phases of our work scope from proposal development through closeout including contracts or projects. Continuous quality improvement will be an ongoing process. Our quality ethic and these quality principles constantly guide our actions. We will meet our own quality expectations and exceed those of our customers with vigilance, commitment, teamwork, and persistence.

  17. Improvement of Construction Project Management Processes

    OpenAIRE

    Nazarko, J.

    2017-01-01

    The common denominator of the five papers published in the current edition of the Journal of Engineering, Project, and Production Management is the improvement of construction project management processes for effective use of resources. Execution of proper project management processes is widely recognized as a key success factor influencing likelihood of project success (Alleman, 2014). It is noticeable that four out of five papers in this issue of the Journal are authored or co-authored by I...

  18. Identifying Contractors’ Planned Quality Costs in Indonesian Construction Projects

    Directory of Open Access Journals (Sweden)

    Puti F. Marzuki

    2014-12-01

    Full Text Available In a very competitive construction industry, quality costs have to be measured to be able to identify potential quality problem areas and to focus attention on work output improvement opportunities. The awareness of contractors on the importance of quality costs could be reflected in the extent of their quality costs planning. This paper presents an identification of planned quality costs in three construction projects executed by two large Indonesian contractors, a state-owned company and a private company in Jakarta. The objective is to enable the contractors to elaborate their quality costs planning and thereby improve their work output based on the findi ngs. Quality costs are first grouped into three categories: prevention, appraisal, and failure costs. Based on the works of previous researchers, a list of quality management activities that should be covered in each quality costs category is then created. The contractors’ planned quality costs data for each category are identified and collected through interviews and questionnaire surveys that refer to the list. Quality costs are expressed as a percentage of contract value. It is revealed that although large contractors already have certain knowledge on quality costs in construction projects, these costs are not planned in a structured way through an analysis of systematic quality costs records. Through cost categorization it is also shown that higher prevention and appraisal costs lead to lower failure costs. It is then concluded that a lot of work is still to be done by the contractors to set up a quality costs recording system which can serve as a basis for their quality improvement planning.

  19. 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 ...

  20. Quality management of microfilming projects

    Directory of Open Access Journals (Sweden)

    Hans van Dormolen

    2003-06-01

    Full Text Available I would like to tell you something about my work as quality manager microfilming and about the high quality standards for substitute microfilming we apply within the Dutch preservation programme Metamorfoze. Let me start with going back in time a bit. To be precise, to the year 1870. In this year, William Henry Jackson went riding into the hills of Wyoming, USA. Jackson was the chief photographer for the Hayden expedition. The aim of the Hayden expedition was to record the area as minutely as possible, in order to convince politicians to turn this area into a national park. There were two Hayden expeditions: in 1870 and in 1871. For both of these expeditions William Henry Jackson was the chief photographer. In 1872, the area was indeed proclaimed a national park as a result of the expeditions. And the pictures William Henry Jackson took played an important role in this US government decision. The reason I'm telling you this is not because I want to chat about the beautiful environment of Yellowstone National Park, nor do I want to emphasize the fact that it was quite an achievement that William Henry Jackson was travelling into the Wild West on horseback and coach without breaking the glass negatives he used. It's because I would like to focus your attention on the fact that today we still have access to these photographs made by Jackson and many others of his colleagues from the early days of photography, due to the excellent conditions under which these materials have been kept all this time. Without any doubt, these photographs have an important cultural and historical value.

  1. Improved hyperspectral imaging technologies Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Improved hyperspectral imaging technologies could enable lower-cost analysis for planetary science including atmospheric studies, mineralogical investigations, and...

  2. DWIP - Durban Water Improvement Project

    NARCIS (Netherlands)

    Van Duffelen, L.; Van Eeden, B.; Hofland, F.; Rietmeijer, A.; Verhey, P.

    2016-01-01

    The water quality at the beachfront of Durban, KwaZulu-Natal, is currently insufficient to meet the Blue Flag standard, leading to health issues for the beach users. Since Durban can be recognised by its busy port and attractive beachfront, it is a major centre for tourism. This means that research

  3. DWIP - Durban Water Improvement Project

    NARCIS (Netherlands)

    Van Duffelen, L.; Van Eeden, B.; Hofland, F.; Rietmeijer, A.; Verhey, P.

    2016-01-01

    The water quality at the beachfront of Durban, KwaZulu-Natal, is currently insufficient to meet the Blue Flag standard, leading to health issues for the beach users. Since Durban can be recognised by its busy port and attractive beachfront, it is a major centre for tourism. This means that research

  4. 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

  5. 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

  6. Project Management and Total Quality Management : Complementary or confused?

    Directory of Open Access Journals (Sweden)

    Selma KATLANE BEN MLOUKA

    2009-01-01

    Full Text Available Quality management and project management appear as themes of strategic management today. The adoption of the project management constitutes a new way in organizing the production. It helps to cope with the complexity of the environment, to reduce the product life cycles and to make working arrangements more flexible. It should also adapt to the ICT revolution and restructuring of enterprises due to the dematerialisation of structures and transactions. Quality management, applied to more operations and strongly influenced by the quantitative approach seems compatible with project management. Indeed, the two paradigms emphasize the importance of customer satisfaction, teamwork, the role of leadership and the continuous improvement of processes and products. This paper aims to revisit the principles of relationship between total quality management and project management. Having shown the importance of incorporating fine patterns and project quality in business organization, we will explain how the ability to generate, select and conduct projects in an oriented accountability of management is able to enroll in a total quality.

  7. Measuring Data Quality in Analytical Projects

    Directory of Open Access Journals (Sweden)

    Anca Ioana ANDREESCU

    2014-05-01

    Full Text Available Measuring and assuring data quality in analytical projects are considered very important issues and overseeing their benefits may cause serious consequences for the efficiency of organizations. Data profiling and data cleaning are two essential activities in a data quality process, along with data integration, enrichment and monitoring. Data warehouses require and provide extensive support for data cleaning. These loads and renew continuously huge amounts of data from a variety of sources, so the probability that some of the sources contain "dirty data" is great. Also, analytics tools offer, to some extent, facilities for assessing and assuring data quality as a built in support or by using their proprietary programming languages. This paper emphasizes the scope and relevance of a data quality measurement in analytical projects by the means of two intensively used tools such as Oracle Warehouse Builder and SAS 9.3.

  8. Research of Supply Chain Quality Improvement Based on Agile Project Management%基于敏捷项目管理的供应链质量改进研究

    Institute of Scientific and Technical Information of China (English)

    叶书铭

    2015-01-01

    In order to improve the quality of the supply chain and solve the he problem of traditional supply chain quality management, through preliminary exploration of the Agile Project Management (APM), apply the thought of the Iterative-increment to a certain case, and design an APM model for this case. Based on the result of data analysis, comparing the result of traditional quality improvement model, we ifgure out the APM has remarkable effect on the quality improvement in supply chin. Finally we evaluate the model and look ahead.%为进一步改进供应链质量,改善传统供应链质量管理问题,通过对敏捷项目管理的探索,应用其迭代增量思想,针对特定案例设计了敏捷项目管理模型。基于模型数据分析,对比传统供应链质量改进结果,得出敏捷项目管理对于供应链的质量改进具有显著的效果。最后对模型进行评价,并提出展望。

  9. Topography improvements in MEMS DMs for high-contrast, high-resolution imaging Project

    Data.gov (United States)

    National Aeronautics and Space Administration — This project will develop and demonstrate an innovative microfabrication process to substantially improve the surface quality achievable in high-resolution...

  10. Reduction of Catheter-Associated Urinary Tract Infections Through the Use of an Evidence-Based Nursing Algorithm and the Implementation of Shift Nursing Rounds: A Quality Improvement Project.

    Science.gov (United States)

    Thomas, Kamishia L

    2016-01-01

    Catheter-associated urinary tract infections (CAUTIs) are the most common hospital-acquired infections. The purpose of this quality improvement (QI) project was to successfully implement a nurse-led evidence-based practice change designed to reduce CAUTIs in a cardiac intensive care and step-down unit. The QI project was implemented using a convenience sample of patients admitted to the cardiac intensive care and step-down unit.Evaluation data were collected 3 months preimplementation and 9 months postimplementation. We used Wick's Check-Plan-Do-Check-Act model of continuous QI to guide the project. A statistically significant change in the number of CAUTIs (P = .009) and CAUTI occurrences (P = .005) was observed following the intervention. The number of indwelling catheter days and indwelling catheter utilization did not significantly differ following implementation of the intervention. Nurse compliance with the intervention was computed for each month; the average compliance rate was 91%. Findings from this project indicate that a nurse-led evidence-based practice project exerted a positive influence on CAUTI occurrences.

  11. Improving imaging utilization through practice quality improvement (maintenance of certification part IV): a review of requirements and approach to implementation.

    Science.gov (United States)

    Griffith, Brent; Brown, Manuel L; Jain, Rajan

    2014-04-01

    The purposes of this article are to review the American Board of Radiology requirements for practice quality improvement and to describe our approach to improving imaging utilization while offering a guide to implementing similar projects at other institutions, emphasizing the plan-do-study-act approach. There is increased emphasis on improving quality in health care. Our institution has undertaken a multiphase practice quality improvement project addressing the appropriate utilization of screening cervical spinal CT in an emergency department.

  12. 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

  13. Development and application of new quality model for software projects.

    Science.gov (United States)

    Karnavel, K; Dillibabu, R

    2014-01-01

    The IT industry tries to employ a number of models to identify the defects in the construction of software projects. In this paper, we present COQUALMO and its limitations and aim to increase the quality without increasing the cost and time. The computation time, cost, and effort to predict the residual defects are very high; this was overcome by developing an appropriate new quality model named the software testing defect corrective model (STDCM). The STDCM was used to estimate the number of remaining residual defects in the software product; a few assumptions and the detailed steps of the STDCM are highlighted. The application of the STDCM is explored in software projects. The implementation of the model is validated using statistical inference, which shows there is a significant improvement in the quality of the software projects.

  14. Improvement of Construction Project Management Processes

    Directory of Open Access Journals (Sweden)

    Nazarko, J.

    2017-07-01

    Full Text Available The common denominator of the five papers published in the current edition of the Journal of Engineering, Project, and Production Management is the improvement of construction project management processes for effective use of resources. Execution of proper project management processes is widely recognized as a key success factor influencing likelihood of project success (Alleman, 2014. It is noticeable that four out of five papers in this issue of the Journal are authored or co-authored by Iranian researchers from the same Institute but their conclusions bear importance that cannot be limited to the authors’ region.

  15. SNF project engineering process improvement plan

    Energy Technology Data Exchange (ETDEWEB)

    KELMENSON, R.L.

    1999-05-24

    This Engineering Process Improvement Plan documents the activities and plans to be taken by the SNF Project (the Project) to support its engineering process and to produce a consolidated set of engineering procedures that are fully compliant with the requirements of HNF-PRO-1819 (1819). These requirements are imposed on all engineering activities performed for the Project and apply to all life-cycle stages of the Project's systems, structures and components (SSCs). This Plan describes the steps that will be taken by the Project during the transition period to ensure that new procedures are effectively integrated into the Project's work process as these procedures are issued. The consolidated procedures will be issued and implemented by September 30, 1999.

  16. Pediatric CT dose reduction for suspected appendicitis: a practice quality improvement project using artificial gaussian noise--part 2, clinical outcomes.

    Science.gov (United States)

    Callahan, Michael J; Anandalwar, Seema P; MacDougall, Robert D; Stamoulis, Catherine; Kleinman, Patricia L; Rangel, Shawn J; Bachur, Richard G; Taylor, George A

    2015-03-01

    OBJECTIVE. The purpose of this study was to determine the effect of a nominal 50% reduction in median absorbed radiation dose on sensitivity, specificity, and negative appendectomy rate of CT for acute appendicitis in children. MATERIALS AND METHODS. On the basis of a departmental practice quality improvement initiative using computer-generated gaussian noise for CT dose reduction, we applied a nominal dose reduction of 50% to abdominal CT techniques used for bowel imaging. This retrospective study consisted of 494 children who underwent a CT for suspected acute appendicitis before (n = 244; mean age, 133 months) and after (n = 250; mean age, 145 months) the nominal 50% dose reduction. Test performance characteristics of CT for acute appendicitis and impact on the negative appendectomy rate were compared for both time periods. Primary analyses were performed with histologic diagnosis as the outcome standard. Volume CT dose index and dose-length product were recorded from dose reports and size-specific dose estimates were calculated. RESULTS. The nominal 50% dose reduction resulted in an actual 39% decrease in median absorbed radiation dose. Sensitivity of CT for diagnosis of acute appendicitis was 98% (95% CI, 91-100%) versus 97% (91-100%), and specificity was 93% (88-96%) versus 94% (90-97%) before and after dose reduction, respectively. The negative appendectomy rate was 4.5% (0.8-10.25%) before dose reduction and 4.0% (0.4-7.6%) after dose reduction. CONCLUSION. The negative appendectomy rate and performance characteristics of the CT-based diagnosis of acute appendicitis were not affected by a 39% reduction in median absorbed radiation dose.

  17. 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

  18. 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.

  19. [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

  20. [The QUALI Project: a quality study of the structure of the primary care teams (PCT) of Catalonia. The Quality Improvement Commission of the Societat Catalana de Medicina Familiar i Comunitària].

    Science.gov (United States)

    Botinas, M; Sant, E; Casajuana, J; Zapater, F; Bueno, J M

    2000-02-28

    To analyse the compliance with the primary health care quality criteria of the Committee for Quality Improvement of the Catalan Society of Family and Community Medicine. Cross-sectional descriptive study. Reformed primary care centres (PCC) in Catalonia (186), of which 73 (39.2%) filled out the disk with the results. A total of 202 criteria, divided into five sections (structure and material resources, human resources, work organisation, systems of recording and access, and continuity, confidentiality and participation), were self-evaluated in each PCC. These criteria were defined as basic or optimal and compliance with them was graded from 1 to 4. 72.8% of the criteria were fully complied with. In 7.4% there was partial compliance, and in 19.7% non-compliance. The basic criteria had 74% total compliance, whereas the optimal criteria had 51.9%. The groups with least compliance (sum of the total plus the partial) were records systems (68.6%) and human resources (73.5%). The organisation group had the best compliance (85.5%). By sub-groups, the greatest compliance was found in privacy (93.7%), direct care (89.2%) and recording actions (89.1%). Sub-groups with least compliance were long-term treatments (61.8%), vaccinations (46.4%) and storage (42%). Eight of the 18 criteria not complied with by 50% or more were considered responsibility of the team. There was 37.8% total compliance and 24% partial in the criteria referring to the specific training of primary care professionals. Up to 80% non-compliance was found in quality of long-term prescription records, vaccinations and storage. The high level of compliance in the sections which depend most on professionals should be noted (accessibility-continuity and organisation). This study is a first approach towards understanding the quality of the structure of PC in Catalonia, and enables proposals for improvement to be set up.

  1. The SCRI Acrylamide Project: Improved breeding and variety evaluation methods to reduce acrylamide content and increase quality in processed potato products

    Science.gov (United States)

    The highest priority of the US potato industry is the need to introduce new varieties that reduce the acrylamide content of processed products and minimize health concerns related to acrylamide consumption. The SCRI acrylamide project is a national, coordinated effort that addresses this need. Thi...

  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. 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....

  5. 关于提高数学类专业本科毕业设计质量的研究%Improving the quality of graduation projects of the undergraduates majored in mathematics

    Institute of Scientific and Technical Information of China (English)

    解惠青

    2015-01-01

    Based on my experiences of guiding many graduation projects of the undergraduates majored in mathematics and the investigation of the graduation theses of the undergraduates of recent years in the department of mathematics of ECUST,we analyzed the main problems in graduation projects of the undergraduates majored in mathematics,especially in science and technology university. Then some measures on course installation,teaching style and school supervision are provided to improve the quality of graduation projects of the undergraduates majored in mathematics,especially in science and technology university.%以作者多年来指导数学类专业本科毕业设计的实践为基础,结合华东理工大学数学系近年来本科毕业设计的现状,分析了(理工科院校)数学类专业本科毕业设计中存在的问题,从课程设置、授课方式、学校监管等方面给出了提高(理工科院校)数学类专业本科毕业设计质量的措施。

  6. 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.

  7. The PAMINO-project: evaluating a primary care-based educational program to improve the quality of life of palliative patients.

    NARCIS (Netherlands)

    Rosemann, T.J.; Hermann, K.; Miksch, A.; Engeser, P.; Szecsenyi, J.

    2007-01-01

    BACKGROUND: The care of palliative patients challenges the health care system in both quantity and quality. Especially the role of primary care givers needs to be strengthened to provide them with the knowledge and the confidence of applying an appropriate end-of-life care to palliative patients. To

  8. The PAMINO-project: evaluating a primary care-based educational program to improve the quality of life of palliative patients.

    NARCIS (Netherlands)

    Rosemann, T.J.; Hermann, K.; Miksch, A.; Engeser, P.; Szecsenyi, J.

    2007-01-01

    BACKGROUND: The care of palliative patients challenges the health care system in both quantity and quality. Especially the role of primary care givers needs to be strengthened to provide them with the knowledge and the confidence of applying an appropriate end-of-life care to palliative patients. To

  9. 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.

  10. 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

  11. 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.

  12. 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.

  13. [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.

  14. [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.

  15. Lessons learnt from a primary care asthma improvement project.

    Science.gov (United States)

    Lenney, Warren; Clayton, Sadie; Gilchrist, Francis J; Price, David; Small, Iain; Smith, Judy; Sutton, Emma J

    2016-01-07

    Asthma is a very common disease that can occur at any age. In the UK and in many other countries it is mainly managed in primary care. The published evidence suggests that the key to improving diagnosis and management lies in better training and education rather than in the discovery of new medications. An asthma improvement project managed through the British Lung Foundation is attempting to do this. The project has three pilot sites: two in England supported by the Department of Health and one in Scotland supported by the Scottish Government. If the project is successful it will be rolled out to other health areas within the UK. The results of this project are not yet available. This article highlights the challenges encountered in setting up the project and may well be applicable to other areas in the UK and to other countries where similar healthcare systems exist. The encountered challenges reflect the complex nature of healthcare systems and electronic data capture in primary care. We discuss the differences between general practices in their ability and willingness to support the project, the training and education of their staff on asthma management, governance issues in relation to information technology systems, and the quality of data capture. Virtually all the challenges have now been overcome, but discussing them should ensure that others become aware of them at an early stage should they wish to undertake similar projects in the future.

  16. Risk Management Improvement of Engineering Projects in Woodworking Industry

    Directory of Open Access Journals (Sweden)

    Simona Bartkutė

    2014-02-01

    Full Text Available Risk is a complex phenomenon that has physical, monetary, cultural and social dimensions. Every company wants tosave money, time, increase quality, optimise manufacturing, but each factor may involve different risks with different influenceto company, its reputation. The aim of the research is to find better risk management improvement decisions, using techniquesthat could help to reduce risk impact in wood-based nonstandard production with shorter project time, smoother design process,lower costs, better project coordination, increased ability to manage problems, technical solutions.

  17. 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...

  18. 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

  19. Providing quality services. JICA Reproductive Health Project. Thanh Chuong district.

    Science.gov (United States)

    Nguyen Huu Son

    1999-01-01

    This article concerns the quality of services provided by the different groups sponsored by the Japan International Cooperation Agency (JICA) Reproductive Health project. Nguyen Huu Son, Chairperson of the People's Committee of Thanh Tien Commune, cites that the JICA project has helped improve their Commune Health Center (CHC). The project has provided basic medical equipment that has been lacking in the CHCs, subsequently making the task of providing quality services easier and more comfortable for midwives and other health personnel. For the Thanh Tien Commune Health Center, Nguyen Hoang An reports that the JICA project has brought about improvement in their CHC fields; namely, 1) providing health knowledge to community people; 2) increase in health staff's skills through training; 3) keeping record of management and the CHC services; and 4) renovating health facilities. As a result, clients have increased and many of the community people now have confidence in their services. For the Women's Union of Thanh Tien Commune, Nguyen Thi Loc reports that the assistance provided by JICA has greatly helped in the acquisition of necessary skills for disseminating adequate information to women.

  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. 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

  2. Teaching internal medicine residents to sustain their improvement through the quality assessment and improvement curriculum.

    Science.gov (United States)

    Oyler, Julie; Vinci, Lisa; Johnson, Julie K; Arora, Vineet M

    2011-02-01

    Although sustainability is a key component in the evaluation of continuous quality improvement (CQI) projects, medicine resident CQI projects are often evaluated by immediate improvements in targeted areas without addressing sustainability. AIM/SETTING: To assess the sustainability of resident CQI projects in an ambulatory university-based clinic. During their ambulatory rotation, all second year internal medicine residents use the American Board of Internal Medicine's Clinical Preventive Services (CPS) Practice Improvement Modules (PIM) to complete chart reviews, patient surveys, and a system survey. The residents then develop a group CQI project and collect early post data. Third year residents return to evaluate their original CQI project during an ambulatory rotation two to six months later and complete four plan-do-study-act (PDSA) cycles on each CQI project. From July 2006 to June 2009, 64 (100%) medicine residents completed the CQI curriculum. Residents completed six group projects and examined their success using early (2 to 6 weeks) and late (2 to 6 months) post-intervention data. Three of the projects demonstrated sustainable improvement in the resident continuity clinic. When residents are taught principles of sustainability and spread and asked to complete multiple PDSA cycles, they are able to identify common themes that may contribute to success of QI projects over time.

  3. Software Quality Assurance in Software Projects: A Study of Pakistan

    Directory of Open Access Journals (Sweden)

    Faisal Shafique Butt

    2013-05-01

    Full Text Available Software quality is specific property which tells what kind of standard software should have. In a software project, quality is the key factor of success and decline of software related organization. Many researches have been done regarding software quality. Software related organization follows standards introduced by Capability Maturity Model Integration (CMMI to achieve good quality software. Quality is divided into three main layers which are Software Quality Assurance (SQA, Software Quality Plan (SQP and Software Quality Control (SQC. So In this study, we are discussing the quality standards and principles of software projects in Pakistan software Industry and how these implemented quality standards are measured and managed. In this study, we will see how many software firms are following the rules of CMMI to create software. How many are reaching international standards and how many firms are measuring the quality of their projects. The results show some of the companies are using software quality assurance techniques in Pakstan.

  4. 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

  5. Modeling air quality over China: Results from the Panda project

    Science.gov (United States)

    Katinka Petersen, Anna; Bouarar, Idir; Brasseur, Guy; Granier, Claire; Xie, Ying; Wang, Lili; Wang, Xuemei

    2015-04-01

    China faces strong air pollution problems related to rapid economic development in the past decade and increasing demand for energy. Air quality monitoring stations often report high levels of particle matter and ozone all over the country. Knowing its long-term health impacts, air pollution became then a pressing problem not only in China but also in other Asian countries. The PANDA project is a result of cooperation between scientists from Europe and China who joined their efforts for a better understanding of the processes controlling air pollution in China, improve methods for monitoring air quality and elaborate indicators in support of European and Chinese policies. A modeling system of air pollution is being setup within the PANDA project and include advanced global (MACC, EMEP) and regional (WRF-Chem, EMEP) meteorological and chemical models to analyze and monitor air quality in China. The poster describes the accomplishments obtained within the first year of the project. Model simulations for January and July 2010 are evaluated with satellite measurements (SCIAMACHY NO2 and MOPITT CO) and in-situ data (O3, CO, NOx, PM10 and PM2.5) observed at several surface stations in China. Using the WRF-Chem model, we investigate the sensitivity of the model performance to emissions (MACCity, HTAPv2), horizontal resolution (60km, 20km) and choice of initial and boundary conditions.

  6. 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.

  7. Los Alamos National Laboratory Yucca Mountain Site Characterization Project 1994 quality program status report

    Energy Technology Data Exchange (ETDEWEB)

    Bolivar, S.L.

    1996-03-01

    This status report is for calendar year 1994. It summarizes the annual activities and accomplishments of the Los Alamos National Laboratory Yucca Mountain Site Characterization Project (YMP or Project) quality assurance program. By identifying the accomplishments of the quality program, a baseline is established that will assist in decision making, improve administrative controls and predictability, and allow us to annually identify adverse trends and to evaluate improvements. This is the fourth annual status report.

  8. The Columbia River Protection Supplemental Technologies Quality Assurance Project Plan

    Energy Technology Data Exchange (ETDEWEB)

    Fix, N. J.

    2008-03-12

    Pacific Northwest National Laboratory researchers are working on the Columbia River Protection Supplemental Technologies Project. This project is a U. S. Department of Energy, Office of Environmental Management-funded initiative designed to develop new methods, strategies, and technologies for characterizing, modeling, remediating, and monitoring soils and groundwater contaminated with metals, radionuclides, and chlorinated organics. This Quality Assurance Project Plan provides the quality assurance requirements and processes that will be followed by the Technologies Project staff.

  9. APPLICATION OF DATA QUALITY OBJECTIVES AND MEASUREMENT QUALITY OBJECTIVES TO RESEARCH PROJECTS

    Science.gov (United States)

    The paper assists systematic planning for research projects. It presents planning concepts in terms that have some utility for researchers. For example, measurement quality objectives are more familiar to researchers than data quality objectives because these quality criteria are...

  10. Improving laboratory data entry quality using Six Sigma.

    Science.gov (United States)

    Elbireer, Ali; Le Chasseur, Julie; Jackson, Brooks

    2013-01-01

    The Uganda Makerere University provides clinical laboratory support to over 70 clients in Uganda. With increased volume, manual data entry errors have steadily increased, prompting laboratory managers to employ the Six Sigma method to evaluate and reduce their problems. The purpose of this paper is to describe how laboratory data entry quality was improved by using Six Sigma. The Six Sigma Quality Improvement (QI) project team followed a sequence of steps, starting with defining project goals, measuring data entry errors to assess current performance, analyzing data and determining data-entry error root causes. Finally the team implemented changes and control measures to address the root causes and to maintain improvements. Establishing the Six Sigma project required considerable resources and maintaining the gains requires additional personnel time and dedicated resources. After initiating the Six Sigma project, there was a 60.5 percent reduction in data entry errors from 423 errors a month (i.e. 4.34 Six Sigma) in the first month, down to an average 166 errors/month (i.e. 4.65 Six Sigma) over 12 months. The team estimated the average cost of identifying and fixing a data entry error to be $16.25 per error. Thus, reducing errors by an average of 257 errors per month over one year has saved the laboratory an estimated $50,115 a year. The Six Sigma QI project provides a replicable framework for Ugandan laboratory staff and other resource-limited organizations to promote quality environment. Laboratory staff can deliver excellent care at a lower cost, by applying QI principles. This innovative QI method of reducing data entry errors in medical laboratories may improve the clinical workflow processes and make cost savings across the health care continuum.

  11. Image quality assessment metrics by using directional projection

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Objective image quality mcasure, which is a fundamental and challenging job in image processing, evaluates the image quality consistently with human perception automatically. On the assumption that any image distortion could be modeled as the difference between the directional projection-based maps of reference and distortion images, wc propose a new objective quality assessment method based on directional projection for full reference model. Experimental results show that the proposed metrics are well consistent with the subjective quality score.

  12. Evaluation of School Improvement through an Educational Effectiveness Model: The Case of Indonesia's PEQIP Project.

    Science.gov (United States)

    van der Werf, Greetje; Creemers, Bert; De Jong, Rob; Klaver, Elizabeth

    2000-01-01

    In 1992, the government of Indonesia initiated the Primary Education Quality Improvement Project (PEQIP) to improve educational quality at the elementary level. A World Bank-sponsored assessment of school effectiveness in two provinces found very large differences in student achievement among schools, with implementation of PEQIP components…

  13. Improving the quality of palliative and terminal care in the hospital by a network of palliative care nurse champions: the study protocol of the PalTeC-H project

    National Research Council Canada - National Science Library

    Witkamp, Frederika E; van Zuylen, Lia; van der Maas, Paul J; van Dijk, Helma; van der Rijt, Carin C D; van der Heide, Agnes

    2013-01-01

    ... university hospital in the Netherlands. We designed a controlled before and after study. The intervention is the establishment of a network for palliative care nurse champions, aiming to improve the quality of hospital end-of-life care...

  14. Understanding uptake of continuous quality improvement in Indigenous primary health care: lessons from a multi-site case study of the Audit and Best Practice for Chronic Disease project

    Directory of Open Access Journals (Sweden)

    Togni Samantha

    2010-03-01

    Full Text Available Abstract Background Experimentation with continuous quality improvement (CQI processes is well underway in Indigenous Australian primary health care. To date, little research into how health organizations take up, support, and embed these complex innovations is available on which services can draw to inform implementation. In this paper, we examine the practices and processes in the policy and organisational contexts, and aim to explore the ways in which they interact to support and/or hinder services' participation in a large scale Indigenous primary health care CQI program. Methods We took a theory-driven approach, drawing on literature on the theory and effectiveness of CQI systems and the Greenhalgh diffusion of innovation framework. Data included routinely collected regional and service profile data; uptake of tools and progress through the first CQI cycle, and data collected quarterly from hub coordinators on their perceptions of barriers and enablers. A total of 48 interviews were also conducted with key people involved in the development, dissemination, and implementation of the Audit and Best Practice for Chronic Disease (ABCD project. We compiled the various data, conducted thematic analyses, and developed an in-depth narrative account of the processes of uptake and diffusion into services. Results Uptake of CQI was a complex and messy process that happened in fits and starts, was often characterised by conflicts and tensions, and was iterative, reactive, and transformational. Despite initial enthusiasm, the mixed successes during the first cycle were associated with the interaction of features of the environment, the service, the quality improvement process, and the stakeholders, which operated to produce a set of circumstances that either inhibited or enabled the process of change. Organisations had different levels of capacity to mobilize resources that could shift the balance toward supporting implementation. Different forms of

  15. References on EPA Quality Assurance Project Plans

    Science.gov (United States)

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

  16. 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…

  17. 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…

  18. Fostering Quality Improvement in EHDI Programs

    Science.gov (United States)

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

    2011-01-01

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

  19. Quality Management System at Construction Project: A Questionnaire Survey

    Directory of Open Access Journals (Sweden)

    P.P.Mane

    2015-03-01

    Full Text Available The best quality, time and cost are the important aspects of successful construction project which fulfills the main goal of construction industry. The quality management has to provide the environment within which related tools, techniques and procedures can be deployed effectively leading to operational success for a construction project. The role of quality management for a construction company is not an isolated activity, but intertwined with all the operational and managerial processes of the construction project. The quality management system (QMS in construction industry refers to quality planning, quality assurance and quality control. The paper includes the outcome of the research methodology decided by authors based on interview of project participants and analysis of scrutinized interview data.

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

    Science.gov (United States)

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

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

  1. Quality framework proposal for Component Material Evaluation (CME) projects.

    Energy Technology Data Exchange (ETDEWEB)

    Christensen, Naomi G.; Arfman, John F.; Limary, Siviengxay

    2008-09-01

    This report proposes the first stage of a Quality Framework approach that can be used to evaluate and document Component Material Evaluation (CME) projects. The first stage of the Quality Framework defines two tools that will be used to evaluate a CME project. The first tool is used to decompose a CME project into its essential elements. These elements can then be evaluated for inherent quality by looking at the subelements that impact their level of quality maturity or rigor. Quality Readiness Levels (QRLs) are used to valuate project elements for inherent quality. The Framework provides guidance for the Principal Investigator (PI) and stakeholders for CME project prerequisites that help to ensure the proper level of confidence in the deliverable given its intended use. The Framework also Provides a roadmap that defined when and how the Framework tools should be applied. Use of these tools allow the Principal Investigator (PI) and stakeholders to understand what elements the project will use to execute the project, the inherent quality of the elements, which of those are critical to the project and why, and the risks associated to the project's elements.

  2. 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

  3. Impact of Requirements Quality on Project Success or Failure

    Science.gov (United States)

    Tamai, Tetsuo; Kamata, Mayumi Itakura

    We are interested in the relationship between the quality of the requirements specifications for software projects and the subsequent outcome of the projects. To examine this relationship, we investigated 32 projects started and completed between 2003 and 2005 by the software development division of a large company in Tokyo. The company has collected reliable data on requirements specification quality, as evaluated by software quality assurance teams, and overall project performance data relating to cost and time overruns. The data for requirements specification quality were first converted into a multiple-dimensional space, with each dimension corresponding to an item of the recommended structure for software requirements specifications (SRS) defined in IEEE Std. 830-1998. We applied various statistical analysis methods to the SRS quality data and project outcomes.

  4. Quality management system for application of the analytical quality assurance cycle in a research project

    Science.gov (United States)

    Camargo, R. S.; Olivares, I. R. B.

    2016-07-01

    The lack of quality assurance and quality control in academic activities have been recognized by the inability to demonstrate reproducibility. This paper aim to apply a quality tool called Analytical Quality Assurance Cycle on a specific research project, supported by a Verification Programme of equipment and an adapted Quality Management System based on international standards, to provide traceability to the data generated.

  5. Pediatric CT quality management and improvement program

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-10-15

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

  6. The Columbia River Protection Supplemental Technologies Quality Assurance Project Plan

    Energy Technology Data Exchange (ETDEWEB)

    Fix, N. J.

    2007-01-10

    The U.S. Department of Energy (DOE) has conducted interim groundwater remedial activities on the Hanford Site since the mid-1990s for several groundwater contamination plumes. DOE established the Columbia River Protection Supplemental Technologies Project (Technologies Project) in 2006 to evaluate alternative treatment technologies. The objectives for the technology project are as follows: develop a 300 Area polyphosphate treatability test to immobilize uranium, design and test infiltration of a phosphate/apatite technology for Sr-90 at 100-N, perform carbon tetrachloride and chloroform attenuation parameter studies, perform vadose zone chromium characterization and geochemistry studies, perform in situ biostimulation of chromium studies for a reducing barrier at 100-D, and perform a treatability test for phytoremediation for Sr-90 at 100-N. This document provides the quality assurance guidelines that will be followed by the Technologies Project. This Quality Assurance Project Plan is based on the quality assurance requirements of DOE Order 414.1C, Quality Assurance, and 10 CFR 830, Subpart A--Quality Assurance Requirements as delineated in Pacific Northwest National Laboratory’s Standards-Based Management System. In addition, the technology project is subject to the Environmental Protection Agency (EPA) Requirements for Quality Assurance Project Plans (EPA/240/B-01/003, QA/R-5). The Hanford Analytical Services Quality Assurance Requirements Documents (HASQARD, DOE/RL-96-68) apply to portions of this project and to the subcontractors. HASQARD requirements are discussed within applicable sections of this plan.

  7. 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].

  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. 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.

  10. 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.

  11. 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...

  12. 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.

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

    Science.gov (United States)

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

    2013-01-01

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

  14. 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...

  15. TARGET ANALYSIS OF SUZHOU CREEK REHABILITATION PROJECT STAGE II:BASED ON WATER QUALITY MODEL

    Institute of Scientific and Technical Information of China (English)

    LIAO Zhen-liang; XU Zu-xin

    2004-01-01

    The Suzhou Creek is a seriously polluted tidal river in Shanghai. The Suzhou Creek Rehabilitation Project was launched in 1998, and the total investment will surpass 10 billion yuan RMB. It is important to assess the effectiveness of the project and ascertain its targets. In this study, by analyzing the achievements of Suzhou Creek Rehabilitation Project (Stage I) and its remaining problems, the main tasks of the Project Stage II are proposed. These works are wastewater interception, sediment dredging, bidirectional water diversion, and reconstruction of municipal pump stations. The water quality model established with USEPA's WASP is employed to analyze the quantitative targets of the Project Stage II. In the Project Stage II, the water quality of mainstream and tributaries will be improved continuously, the valus of CODCr, BOD5, DO in the mainstream will steadily attain Class IV according to the National Surface Water Quality Standard, and the ecological environment of Suzhou Creek with continuously recover.

  16. 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

  17. 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%.

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

    NARCIS (Netherlands)

    F.D. Vennik (Femke)

    2016-01-01

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

  19. Training Psychiatry Residents in Quality Improvement: An Integrated, Year-Long Curriculum

    Science.gov (United States)

    Arbuckle, Melissa R.; Weinberg, Michael; Cabaniss, Deborah L.; Kistler; Susan C.; Isaacs, Abby J.; Sederer, Lloyd I.; Essock, Susan M.

    2013-01-01

    Objective: The authors describe a curriculum for psychiatry residents in Quality Improvement (QI) methodology. Methods: All PGY3 residents (N=12) participated in a QI curriculum that included a year-long group project. Knowledge and attitudes were assessed before and after the curriculum, using a modified Quality Improvement Knowledge Assessment…

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

    Science.gov (United States)

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

    2010-01-01

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

  1. Quality Improvement Initiative in School-Based Health Centers across New Mexico

    Science.gov (United States)

    Booker, John M.; Schluter, Janette A.; Carrillo, Kris; McGrath, Jane

    2011-01-01

    Background: Quality improvement principles have been applied extensively to health care organizations, but implementation of quality improvement methods in school-based health centers (SBHCs) remains in a developmental stage with demonstration projects under way in individual states and nationally. Rural areas, such as New Mexico, benefit from the…

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

    Science.gov (United States)

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

    2010-01-01

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

  3. 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.

  4. SNF Project Engineering Process Improvement Plan

    Energy Technology Data Exchange (ETDEWEB)

    DESAI, S.P.

    2000-02-09

    This plan documents the SNF Project activities and plans to support its engineering process. It describes five SNF Project Engineering initiatives: new engineering procedures, qualification cards process; configuration management, engineering self assessments, and integrated schedule for engineering activities.

  5. [Strategies for improving care of oncologic patients: SHARE Project results].

    Science.gov (United States)

    Reñones Crego, María de la Concepción; Fernández Pérez, Dolores; Vena Fernández, Carmen; Zamudio Sánchez, Antonio

    2016-01-01

    Cancer treatment is a major burden for the patient and its family that requires an individualized management by healthcare professionals. Nurses are in charge of coordinating care and are the closest healthcare professionals to patient and family; however, in Spain, there are not standard protocols yet for the management of oncology patients. The Spanish Oncology Nursing Society developed between 2012 and 2014 the SHARE project, with the aim of establishing strategies to improve quality of life and nursing care in oncology patients. It was developed in 3 phases. First, a literature search and review was performed to identify nursing strategies, interventions and tools to improve cancer patients' care. At the second stage, these interventions were agreed within a group of oncology nursing experts; and at the third phase, a different group of experts in oncology care categorized the interventions to identify the ones with highest priority and most feasible to be implemented. As a result, 3 strategic actions were identified to improve nursing care during cancer treatment: To provide a named nurse to carry out the follow up process by attending to the clinic or telephonic consultation, develop therapeutic education with adapted protocols for each tumor type and treatment and ensure specific training for nurses on the management of the cancer patients. Strategic actions proposed in this paper aim to improve cancer patients' healthcare and quality of life through the development of advanced nursing roles based on a higher level of autonomy, situating nurses as care coordinators to assure an holistic care in oncology patients.

  6. Quality function deployment (QFD in the development of training projects: an exploratory study for service

    Directory of Open Access Journals (Sweden)

    Francisco José Dias Junior

    2012-01-01

    Full Text Available Training is important in preparing employees. The Quality Function Deployment (QFD is an effective method to systematically translate customer requirements into project specifications. This study presents the use of QFD method in development of training project. It is a qualitative research conducted in the industry services company. The results show that the use of QFD is an effective alternative for managers to develop or improve their training projects.

  7. Skill Gap Analysis for Improved Skills and Quality Deliverables

    Directory of Open Access Journals (Sweden)

    Mallikarjun Koripadu

    2014-10-01

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

  8. 42 CFR 441.474 - Quality assurance and improvement plan.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Quality assurance and improvement plan. 441.474... improvement plan. (a) The State must provide a quality assurance and improvement plan that describes the State... pursue opportunities for system improvement. (b) The quality assurance and improvement plan shall also...

  9. Health care quality improvement publication trends.

    Science.gov (United States)

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

    2014-01-01

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

  10. Improving Air Quality Forecasts with AURA Observations

    Science.gov (United States)

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

    2008-01-01

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

  11. Improving Air Quality Forecasts with AURA Observations

    Science.gov (United States)

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

    2008-01-01

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

  12. IMPROVEMENTS IN THE QUALITY OF COURIER DELIVERY

    Directory of Open Access Journals (Sweden)

    Jacek Karcz

    2016-06-01

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

  13. Improving wind power quality with energy storage

    DEFF Research Database (Denmark)

    Rasmussen, Claus Nygaard

    2009-01-01

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

  14. Improving tomato seed quality- challenges and possibilities

    DEFF Research Database (Denmark)

    Shrestha, Santosh

    2017-01-01

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

  15. Improving Environmental Literacy through GO3 Citizen Science Project

    Science.gov (United States)

    Wilkening, B.

    2011-12-01

    In the Global Ozone (GO3) Project students measure ground-level ozone on a continuous basis and upload their results to a global network used by atmospheric scientists and schools. Students learn important concepts such as chemical measurement methods; instrumentation; calibration; data acquisition using computers; data quality; statistics; data analysis and graphing; posting of data to the web; the chemistry of air pollution; stratospheric ozone depletion and global climate change. Students collaborate with researchers and other students globally in the GO3 network. Wilson K-8 School is located in a suburban area in Pima County, Arizona. Throughout the year we receive high ozone alert days. Prior to joining the GO3 project, my students were unaware of air pollution alerts, risks and causes. In the past when Pima County issued alerts to the school, they were posted on signs around the school. No explanation was provided to the students and the signs were often left up for days. This discounted the potential health effects of the situation, resulting in the alerts effectively being ignored. The GO3 project is transforming both my students and our school community. Now my students are: Performing science research Utilizing technology and increasing their skills Collaborating in a responsible manner on the global GO3 social network Communicating their work to the community Issuing their own ozone alerts to their school Advocating for actions that will improve air quality My students participation in this citizen science project is creating a more cognizant and active community in regards to air pollution.

  16. Slope excavation quality assessment and excavated volume calculation in hydraulic projects based on laser scanning technology

    Directory of Open Access Journals (Sweden)

    Chao Hu

    2015-04-01

    Full Text Available Slope excavation is one of the most crucial steps in the construction of a hydraulic project. Excavation project quality assessment and excavated volume calculation are critical in construction management. The positioning of excavation projects using traditional instruments is inefficient and may cause error. To improve the efficiency and precision of calculation and assessment, three-dimensional laser scanning technology was used for slope excavation quality assessment. An efficient data acquisition, processing, and management workflow was presented in this study. Based on the quality control indices, including the average gradient, slope toe elevation, and overbreak and underbreak, cross-sectional quality assessment and holistic quality assessment methods were proposed to assess the slope excavation quality with laser-scanned data. An algorithm was also presented to calculate the excavated volume with laser-scanned data. A field application and a laboratory experiment were carried out to verify the feasibility of these methods for excavation quality assessment and excavated volume calculation. The results show that the quality assessment indices can be obtained rapidly and accurately with design parameters and scanned data, and the results of holistic quality assessment are consistent with those of cross-sectional quality assessment. In addition, the time consumption in excavation project quality assessment with the laser scanning technology can be reduced by 70%−90%, as compared with the traditional method. The excavated volume calculated with the scanned data only slightly differs from measured data, demonstrating the applicability of the excavated volume calculation method presented in this study.

  17. Quality standards for rheumatology outpatient clinic. The EXTRELLA project.

    Science.gov (United States)

    Nolla, Joan M; Martínez, Carmen; García-Vicuña, Rosario; Seoane-Mato, Daniel; Rosario Lozano, M Piedad; Alonso, Alberto; Alperi, Mercedes; Barbazán, Ceferino; Calvo, Jaime; Delgado, Concepción; Fernández-Nebro, Antonio; Mateo, Lourdes; Pérez Sandoval, Trinidad; Pérez Venegas, José; Rodríguez Lozano, Carlos; Rosas, José

    2016-01-01

    In recent years, outpatient clinics have undergone extensive development. At present, patients with rheumatic diseases are mainly assisted in this area. However, the quality standards of care are poorly documented. To develop specific quality criteria and standards for an outpatient rheumatology clinic. The project was based on the two-round Delphi method. The following groups of participants took part: scientific committee (13 rheumatologists), five nominal groups (45 rheumatologists and 12 nurses) and a group of discussion formed by 9 patients. Different drafts were consecutively generated until a final document was obtained that included the standards that received a punctuation equal or over 7 in at least 70% of the participants. 148 standards were developed, grouped into the following 9 dimensions: a) structure (22), b) clinical activity and relationship with the patients (34), c) planning (7), d) levels of priority (5), e) relations with primary care physicians, with Emergency Department and with other clinical departments, f) process (26), g) nursing (13), h) teaching and research (13) and i) activity measures (8). This study established specific quality standards for rheumatology outpatient clinic. It can be a useful tool for organising this area in the Rheumatology Department and as a reference when proposing improvement measures to health administrators. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  18. Assessing the quality of risk factor survey data: lessons from the WHO MONICA Project.

    Science.gov (United States)

    Tolonen, Hanna; Dobson, Annette; Kulathinal, Sangita

    2006-02-01

    Survey data quality is a combination of the representativeness of the sample, the accuracy and precision of measurements, data processing and management with several subcomponents in each. The purpose of this paper is to show how, in the final risk factor surveys of the WHO MONICA Project, information on data quality were obtained, quantified, and used in the analysis. In the WHO MONICA (Multinational MONItoring of trends and determinants in CArdiovascular disease) Project, the information about the data quality components was documented in retrospective quality assessment reports. On the basis of the documented information and the survey data, the quality of each data component was assessed and summarized using quality scores. The quality scores were used in sensitivity testing of the results both by excluding populations with low quality scores and by weighting the data by its quality scores. Detailed documentation of all survey procedures with standardized protocols, training, and quality control are steps towards optimizing data quality. Quantifying data quality is a further step. Methods used in the WHO MONICA Project could be adopted to improve quality in other health surveys.

  19. Generic project definitions for improvement of health care delivery: a case-based approach.

    Science.gov (United States)

    Niemeijer, Gerard C; Does, Ronald J M M; de Mast, Jeroen; Trip, Albert; van den Heuvel, Jaap

    2011-01-01

    The purpose of this article is to create actionable knowledge, making the definition of process improvement projects in health care delivery more effective. This study is a retrospective analysis of process improvement projects in hospitals, facilitating a case-based reasoning approach to project definition. Data sources were project documentation and hospital-performance statistics of 271 Lean Six Sigma health care projects from 2002 to 2009 of general, teaching, and academic hospitals in the Netherlands and Belgium. Objectives and operational definitions of improvement projects in the sample, analyzed and structured in a uniform format and terminology. Extraction of reusable elements of earlier project definitions, presented in the form of 9 templates called generic project definitions. These templates function as exemplars for future process improvement projects, making the selection, definition, and operationalization of similar projects more efficient. Each template includes an explicated rationale, an operationalization in the form of metrics, and a prototypical example. Thus, a process of incremental and sustained learning based on case-based reasoning is facilitated. The quality of project definitions is a crucial success factor in pursuits to improve health care delivery. We offer 9 tried and tested improvement themes related to patient safety, patient satisfaction, and business-economic performance of hospitals.

  20. Quality Matters™: An Educational Input in an Ongoing Design-Based Research Project

    Science.gov (United States)

    Adair, Deborah; Shattuck, Kay

    2015-01-01

    Quality Matters (QM) has been transforming established best practices and online education-based research into an applicable, scalable course level improvement process for the last decade. In this article, the authors describe QM as an ongoing design-based research project and an educational input for improving online education.

  1. Mobile Water Quality Information Tool Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Water quality remote sensing has grown to allow for operational monitoring of trophic status, assessment of cyanobacteria blooms, and historical and trend analysis...

  2. 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.

  3. 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.

  4. Implementation of quality management in early stages of research and development projects at a university.

    Science.gov (United States)

    Fiehe, Sandra; Wagner, Georg; Schlanstein, Peter; Rosefort, Christiane; Kopp, Rüdger; Bensberg, Ralf; Knipp, Peter; Schmitz-Rode, Thomas; Steinseifer, Ulrich; Arens, Jutta

    2014-04-01

    The ultimate objective of university research and development projects is usually to create knowledge, but also to successfully transfer results to industry for subsequent marketing. We hypothesized that the university technology transfer requires efficient measures to improve this important step. Besides good scientific practice, foresighted and industry-specific adapted documentation of research processes in terms of a quality management system might improve the technology transfer. In order to bridge the gap between research institute and cooperating industry, a model project has been accompanied by a project specific amount of quality management. However, such a system had to remain manageable and must not constrain the researchers' creativity. Moreover, topics and research team are strongly interdisciplinary, which entails difficulties regarding communication because of different perspectives and terminology. In parallel to the technical work of the model project, an adaptable quality management system with a quality manual, defined procedures, and forms and documents accompanying the research, development and validation was implemented. After process acquisition and analysis the appropriate amount of management for the model project was identified by a self-developed rating system considering project characteristics like size, innovation, stakeholders, interdisciplinarity, etc. Employees were trained according to their needs. The management was supported and the technical documentation was optimized. Finally, the quality management system has been transferred successfully to further projects.

  5. Making quality improvement stick and stay: Two lines of insurance.

    Science.gov (United States)

    Weaver, Lynda; Bossé, Isabelle; Sinclair, Dionne; Blais, Bernard; Pereira, José

    2016-01-01

    This article examines issues related to sustaining Quality Improvement (QI) initiatives in a Canadian subacute care hospital and recommends strategies to address them. The authors define two levels of sustainability, the QI project and the corporate/organizational and how they influence a LEADS (Lead Self, Engage Others, Achieve Results, Develop Coalition and System Transformation) culture. The authors then reflect on the differing factors for QI sustainability and present them under five essential categories of accountability, education, communication, monitoring and reporting, and structure and processes.

  6. 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.

  7. A New Model for Software Engineering Systems Quality Improvement

    Directory of Open Access Journals (Sweden)

    Ahmad A. Al-Rababah

    2014-04-01

    Full Text Available In the continuing effort to improve the system analysis and design process, several different approaches have been developed. This study will propose a new process methodology solves some problems in traditional system development methodologies it will study the strength and limitation of existing system development methodologies from traditional waterfall to iterative model including (Prototyping, Spiral, Rapid Application Development, XP and RUP to Agility. Propose a new methodology focus on produce a high quality product and suitable for all kind of project. Compare the new methodology with others to view some features that is differentiating it from previous methodologies.

  8. Designing a Clinical Data Warehouse Architecture to Support Quality Improvement Initiatives.

    Science.gov (United States)

    Chelico, John D; Wilcox, Adam B; Vawdrey, David K; Kuperman, Gilad J

    2016-01-01

    Clinical data warehouses, initially directed towards clinical research or financial analyses, are evolving to support quality improvement efforts, and must now address the quality improvement life cycle. In addition, data that are needed for quality improvement often do not reside in a single database, requiring easier methods to query data across multiple disparate sources. We created a virtual data warehouse at NewYork Presbyterian Hospital that allowed us to bring together data from several source systems throughout the organization. We also created a framework to match the maturity of a data request in the quality improvement life cycle to proper tools needed for each request. As projects progress in the Define, Measure, Analyze, Improve, Control stages of quality improvement, there is a proper matching of resources the data needs at each step. We describe the analysis and design creating a robust model for applying clinical data warehousing to quality improvement.

  9. Evaluating Quality in Educational Spaces: OECD/CELE Pilot Project

    Science.gov (United States)

    von Ahlefeld, Hannah

    2009-01-01

    CELE's International Pilot Project on Evaluating Quality in Educational Spaces aims to assist education authorities, schools and others to maximise the use of and investment in learning environments. This article provides an update on the pilot project, which is currently being implemented in Brazil, Mexico, New Zealand, Portugal and the United…

  10. Faculty Development and Quality Assurance in the EU ERAMIS Project

    Directory of Open Access Journals (Sweden)

    Agathe Merceron

    2012-07-01

    Full Text Available The aim of the ERAMIS project is to create a
    network of Masters degrees “Informatics as a Second
    Competence” in nine beneficiary universities of Kazakhstan,
    Kyrgyzstan and Russia. This contribution presents how
    faculty development is organized and quality assurance
    implemented inside this project.

  11. Power Quality Improvement of a Distributed Generation Power System

    Directory of Open Access Journals (Sweden)

    Panga Harish

    2016-06-01

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

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

    OpenAIRE

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

    2008-01-01

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

  13. 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...

  14. One Small Step at a Time: Implementing Continuous Quality Improvement in Child and Youth Mental Health Services

    Science.gov (United States)

    Chovil, Nicole

    2009-01-01

    Continuous quality improvement (CQI) is increasingly being adopted by health care, including child and youth mental health services. As part of the commitment to ongoing quality improvement, child and youth mental health teams in the Fraser region in British Columbia undertook CQI projects over a one year period (2007-2008). The projects covered a…

  15. 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.

  16. 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.

  17. 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.

  18. Software metrics: The key to quality software on the NCC project

    Science.gov (United States)

    Burns, Patricia J.

    1993-01-01

    Network Control Center (NCC) Project metrics are captured during the implementation and testing phases of the NCCDS software development lifecycle. The metrics data collection and reporting function has interfaces with all elements of the NCC project. Close collaboration with all project elements has resulted in the development of a defined and repeatable set of metrics processes. The resulting data are used to plan and monitor release activities on a weekly basis. The use of graphical outputs facilitates the interpretation of progress and status. The successful application of metrics throughout the NCC project has been instrumental in the delivery of quality software. The use of metrics on the NCC Project supports the needs of the technical and managerial staff. This paper describes the project, the functions supported by metrics, the data that are collected and reported, how the data are used, and the improvements in the quality of deliverable software since the metrics processes and products have been in use.

  19. 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.

  20. IT Best Practices Management, Teams, Quality, Performance, and Projects

    CERN Document Server

    Witt, Tom C

    2011-01-01

    Consistent success does not happen by chance. It occurs by having an understanding of what is happening in the environment and then having the skills to execute the necessary changes. Ideal for project, IT, and systems development managers, IT Best Practices: Management, Teams, Quality, Performance, and Projects details the skills, knowledge, and attributes needed to succeed in bringing about large-scale change. It explains how to incorporate quality methods into the change management process and outlines a holistic approach for transformation management. Detailing time-tested project manageme

  1. A SELF PROCESS IMPROVEMENT FOR ACHIEVING HIGH SOFTWARE QUALITY

    Directory of Open Access Journals (Sweden)

    DR. SHASHANK.D.JOSHI

    2011-05-01

    Full Text Available Quality has been one of the most important factors in judging any product. Quality means “a degree or grade of excellence or worth”. Quality is a term that is usually described using adjectives. Quality has several attributes to it, some of which can be quantified using metrics. These attributes such as usability, portability, security, performance, reliability etc have different importance in different projects. Different software quality assurance methods & practices have been used in different software projects to attain the true value. Quality is an attribute which is a distinct feature and it differs with people’s perception. Achieving high software quality involves measurement of software metrics and optimization based on estimated values. As the software systems grow larger, complexity ofdesign and implementation increases, and this in turn is more prone to defects and hence directly affect the quality of the systems. However, in any software project, high quality is always desirable, and many projects have specific quality requirements. Achieving high software quality involves measurement of software metrics and optimization based on estimated values. Developing high quality software is governed by factors such as people, process, technology and cost. This paper attempts to present a novel approach towards achieving high software quality in various kinds of projects under given constraints.

  2. German Bowel Cancer Center: An Attempt to Improve Treatment Quality

    Directory of Open Access Journals (Sweden)

    Olof Jannasch

    2015-01-01

    Full Text Available Background. Colorectal cancer remains the second most common cause of death from malignancies, but treatment results show high diversity. Certified bowel cancer centres (BCC are the basis of a German project for improvement of treatment. The aim of this study was to analyze if certification would enhance short-term outcome in rectal cancer surgery. Material and Methods. This quality assurance study included 8197 patients with rectal cancer treated between 1 January 2008 and 31 December 2010. We compared cohorts treated in certified and noncertified hospitals regarding preoperative variables and perioperative outcomes. Outcomes were verified by matched-pair analysis. Results. Patients of noncertified hospitals had higher ASA-scores, higher prevalence of risk factors, more distant metastases, lower tumour localization, lower frequency of pelvic MRI, and higher frequencies of missing values and undetermined TNM classifications (significant differences only. Outcome analysis revealed more general complications in certified hospitals (20.3% versus 17.4%, p=0.03. Both cohorts did not differ significantly in percentage of R0-resections, intraoperative complications, anastomotic leakage, in-hospital death, and abdominal wall dehiscence. Conclusions. The concept of BCC is a step towards improving the structural and procedural quality. This is a good basis for improving outcome quality but cannot replace it. For a primary surgical disease like rectal cancer a specific, surgery-targeted program is still needed.

  3. Organ Donation European Quality System: ODEQUS project methodology.

    Science.gov (United States)

    Manyalich, M; Guasch, X; Gomez, M P; Páez, G; Teixeira, L

    2013-01-01

    Differences in the number of organ donors among hospitals cannot be explained only by the number of intensive care unit beds used or neurologic patients treated. The figures obtained are influenced by the organizational structure of the donation process and how efficient it is. The Organ Donation European Quality System (ODEQUS) is a 3-year project (from October 2010 to September 2013) co-financed by the European Agency for Health and Consumers (EAHC20091108) which aims to define a methodology to evaluate organ procurement performance at the hospital level. ODEQUS's specific objectives are to identify quality criteria and to develop quality indicators in three types of organ donation (after brain death, after cardiac death, and living donation). Those tools will be useful for hospitals' self-assessment as well as for developing an international auditing model. A consortium has been established involving 14 associated partners from Austria, Croatia, France, Germany, Italy, Poland, Portugal, Romania, Spain, Sweden, and the United Kingdom, as well as five collaborating partners from Greece, Hungary, Malta, Slovenia, and Turkey. The project has been established in three steps: 1) Design of a survey about the use of quality tools in a wide sample of European hospitals; 2) Development of quality criteria and quality indicators by the project experts. The main fields considered have been organizational structures, clinical procedures, and outcomes; and 3) Elaboration of an evaluation system to test the quality indicators in 11 European hospitals. Two types of training have been designed and performed: one concerns the development of quality criteria and quality indicators, whereas another is focused on how to use evaluation tools. Following this methodology, the project has so far identified 131 quality criteria and developed 31 quality indicators. Currently, the quality indicators are being tested in 11 selected hospitals.

  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. 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

  6. How to Improve the Quality of Construction Projects in China Discussed%有关于如何提高我国建筑工程质量的探讨

    Institute of Scientific and Technical Information of China (English)

    聂梅; 史华谦

    2012-01-01

      The construction is closely related to People's Dai-ly life, whose quality problem is not only closely related to the healthy development of the relationship of the national cons-truction industry, but also the people's life and property safety, therefore, completing the construction engineering quality co-ntrol is a very important work. There are a lot of uncontrollable factors Influencing construction project quality, which also puts forward a certain problem for construction engineering quality management work, therefore, in the construction eng-ineering ,there must be reasonable arrangement and planning to do the construction engineering quality management work. This article mainly from three aspects of the importance of construction quality, the problems of construction engineering quality and how to make construction engineering quality is discussed.%  建筑工程与人们的日常生活息息相关,其质量问题不仅与国家建筑行业的健康发展息息相关,而且关系着人们的生命以及财产安全,因此,做好建筑工程质量控制工作至关重要。影响建筑工程项目质量的不可控因素有很多,这也就为建筑工程的质量管理工作提出了一定的难题,因此,在建筑工程施工中,一定要合理安排与规划,切实做好建筑工程的施工质量管理工作。本文主要从建筑工程质量的重要性、建筑工程质量方面存在的问题以及如何做好建筑工程质量三个方面进行探讨。

  7. Advanced Acoustic Blankets for Improved Aircraft Interior Noise Reduction Project

    Data.gov (United States)

    National Aeronautics and Space Administration — In this project advanced acoustic blankets for improved low frequency interior noise control in aircraft will be developed and demonstrated. The improved performance...

  8. Teaching quality essentials: the effectiveness of a team-based quality improvement curriculum in a tertiary health care institution.

    Science.gov (United States)

    Majka, Andrew J; Cook, Katlyn E; Lynch, Stacia L; Garovic, Vesna D; Ghosh, Amit K; West, Colin P; Feyereisn, Wayne L; Paat, John J; Williams, Brandon J; Hale, Curt W; Botz, Catherine T; Phul, Ashley E; Mueller, Paul S

    2013-01-01

    A unique quality improvement (QI) curriculum was implemented within the Division of General Internal Medicine to improve QI knowledge through multidisciplinary, team-based education, which also met the QI requirement for the American Board of Internal Medicine (ABIM) Maintenance of Certification (MOC) and the Mayo Quality Fellows program. Participants completed up to 4 QI learning modules, including pretest and posttest assessments. A participant who successfully completed all 4 modules received certification as a Silver Quality Fellow and credit toward the quality requirement for ABIM MOC. Of 62 individuals invited to participate, 33 (53%) completed all 4 modules and corresponding pretests and posttests. Participants substantially improved knowledge in all 4 quality modules. Study group participants' pretest scores averaged 71.0%, and their posttest scores averaged 92.7%. Posttest scores of reference group participants compared favorably, averaging 89.2%. Initial assessments showed substantial knowledge improvements and successful implementation of staff-developed QI projects.

  9. 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 ...

  10. Air quality performed with satellite measurement within the QUITSAT project

    Science.gov (United States)

    Masieri, Samuele; Petritoli, Andrea; Premuda, Margarita; Kostadinov, Ivan; Bortoli, Daniele; Ravegnani, Fabrizio; Giovanelli, Giorgio

    Ground pollutants monitoring, using satellite observation, represents an interesting and high potential approach to air quality that could be inserted into Global monitoring systems. The QUITSAT Italian pilot project (air QUality with Integration of ground based and SAtellite measurements and chemical Transport and multiphase model), funded by the Italian Space Agency (ASI), proposes a new approach producing some interesting results in this frame. The approach focuses in the integration of the satellite observations (ENVISAT/SCIAMACHY and AURA/OMI) with the outputs of the GAMES (Gas Aerosol Modelling Evaluation System) chemical transport model, to provide the evaluation of the tropospheric profiles of some atmo-spheric compounds such as NO2 , O3 , HCHO and SO2 . This activity appears to be very useful to retrieve the surface concentration of trace gases from tropospheric columns of atmospheric compounds obtained with satellite instrumentation. The comparison with the in situ analyzer network over the Po' Valley shows a good correlation between the two data set. The corre-spondence can be improved taking into account also concentration gradients between different stations, classifying the ground base stations according to their rural or urban characteristics and considering the general orography of the ground. Results and methodology are presented and discussed.

  11. 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.

  12. The Surgical Care Improvement Project Antibiotic Guidelines: Should We Expect More Than Good Intentions?

    Science.gov (United States)

    Schonberger, Robert B; Barash, Paul G; Lagasse, Robert S

    2015-08-01

    Since 2006, the Surgical Care Improvement Project (SCIP) has promoted 3 perioperative antibiotic recommendations designed to reduce the incidence of surgical site infections. Despite good evidence for the efficacy of these recommendations, the efforts of SCIP have not measurably improved the rates of surgical site infections. We offer 3 arguments as to why SCIP has fallen short of expectations. We then suggest a reorientation of quality improvement efforts to focus less on reporting, and incentivizing adherence to imperfect metrics, and more on creating local and regional quality collaboratives to educate clinicians about how to improve practice. Ultimately, successful quality improvement projects are behavioral interventions that will only succeed to the degree that they motivate individual clinicians, practicing within a particular context, to do the difficult work of identifying failures and iteratively working toward excellence.

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

    Science.gov (United States)

    Tout, Kathryn; Isner, Tabitha; Zaslow, Martha

    2011-01-01

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

  14. Software Quality Measurement Demonstration Project II.

    Science.gov (United States)

    1987-10-01

    Report ............................... 1-7 1.4-4 Time Log .................................................. 1-8 2.0-1 ECOAEA Scores for Worksheet 1...34 Conduct independent software quality evaluation and validation to include goal specification, data collection, worksheet scoring, assessment of time logs ...8217n ’~’t"~ i m ’u ~ ~ ej 𔃺 vall-datc. s;Cores )..3SieL dd Spcf ’,t~ii,, it -~ L Th~ 1r 3QM prc:"d’:ae 1c ricvn r )o aL used i n measuring the cpaiity

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

    Science.gov (United States)

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

    2016-02-01

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

  16. Groundwater quality data from the National Water-Quality Assessment Project, May 2012 through December 2013

    Science.gov (United States)

    Arnold, Terri L.; DeSimone, Leslie A.; Bexfield, Laura M.; Lindsey, Bruce D.; Barlow, Jeannie R.; Kulongoski, Justin T.; Musgrove, Marylynn; Kingsbury, James A.; Belitz, Kenneth

    2016-06-20

    Groundwater-quality data were collected from 748 wells as part of the National Water-Quality Assessment Project of the U.S. Geological Survey National Water-Quality Program from May 2012 through December 2013. The data were collected from four types of well networks: principal aquifer study networks, which assess the quality of groundwater used for public water supply; land-use study networks, which assess land-use effects on shallow groundwater quality; major aquifer study networks, which assess the quality of groundwater used for domestic supply; and enhanced trends networks, which evaluate the time scales during which groundwater quality changes. Groundwater samples were analyzed for a large number of water-quality indicators and constituents, including major ions, nutrients, trace elements, volatile organic compounds, pesticides, and radionuclides. These groundwater quality data are tabulated in this report. Quality-control samples also were collected; data from blank and replicate quality-control samples are included in this report.

  17. Improving Software Engineering on NASA Projects

    Science.gov (United States)

    Crumbley, Tim; Kelly, John C.

    2010-01-01

    Software Engineering Initiative: Reduces risk of software failure -Increases mission safety. More predictable software cost estimates and delivery schedules. Smarter buyer of contracted out software. More defects found and removed earlier. Reduces duplication of efforts between projects. Increases ability to meet the challenges of evolving software technology.

  18. Investment Planning of Interdependent Waterway Improvement Projects

    Science.gov (United States)

    1993-03-01

    effects that cut across many, if not all subsets of the project set. Several authors including [Schoeman 68, Aaker 78, Baker 75, Gear 80, Fox 84...solution or at least a good suboptimal solution. 118 RZFIRUNCEB Aaker , D. A. and Tyebjee, T. T., "A Model for the Selection of Interdependent R and D

  19. 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

  20. Development and implementation of a quality improvement curriculum for child neurology residents: lessons learned.

    Science.gov (United States)

    Maski, Kiran P; Loddenkemper, Tobias; An, Sookee; Allred, Elizabeth N; Urion, David K; Leviton, Alan

    2014-05-01

    Quality improvement is a major component of the Accreditation Council for Graduate Medical Education core competencies required of all medical trainees. Currently, neither the Neurology Residency Review Committee nor the Accreditation Council for Graduate Medical Education defines the process by which this competency should be taught and assessed. We developed a quality improvement curriculum that provides mentorship for resident quality improvement projects and is clinically relevant to pediatric neurologists. Before and after implementation of the quality improvement curriculum, a 14-item survey assessed resident comfort with quality improvement project skills and attitudes about implementation of quality improvement in clinical practice using a 5-point Likert scale. We used the Kruskal-Wallis and Fisher exact tests to evaluate pre to post changes. Residents' gained confidence in their abilities to identify measures (P = 0.02) and perform root cause analysis (P = 0.02). Overall, 73% of residents were satisfied or very satisfied with the quality improvement curriculum. Our child neurology quality improvement curriculum was well accepted by trainees. We report the details of this curriculum and its impact on residents and discuss its potential to meet the Accreditation Council for Graduate Medical Education's Next Accreditation System requirements. Published by Elsevier Inc.

  1. 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)

  2. Improved optical planar waveguides for lasers Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Demonstrate efficacy of a novel growth technique for planar waveguides (PWG) Enable PWG laser technology with improved performance, efficiency and manufacturability....

  3. Improving IT Project Portfolio Management: Lessons Learned

    DEFF Research Database (Denmark)

    Pedersen, Keld

    2013-01-01

    The IT PPM improvement process is not well understood, and our knowledge about what makes IT PPM improvement succeed or fail is not well developed. This article presents lessons learned from organizations trying to improve their IT PPM practice. Based on this research IT PPM practitioners are adv...... are advised to respect the limitations for fundamentally changing the way that organizational actors and teams make portfolio decisions, invest in understanding IT PPM decision-making, focus on decision-risks, and balance formalization and professionalization during improvement efforts....

  4. Improving IT Project Portfolio Management: Lessons Learned

    DEFF Research Database (Denmark)

    Pedersen, Keld

    2013-01-01

    The IT PPM improvement process is not well understood, and our knowledge about what makes IT PPM improvement succeed or fail is not well developed. This article presents lessons learned from organizations trying to improve their IT PPM practice. Based on this research IT PPM practitioners are adv...... are advised to respect the limitations for fundamentally changing the way that organizational actors and teams make portfolio decisions, invest in understanding IT PPM decision-making, focus on decision-risks, and balance formalization and professionalization during improvement efforts....

  5. 提高军校本科毕业设计(论文)质量的几点思考%Countermeasures to Improve the Undergraduate Graduation Project(Thesis)Quality of Military Academy

    Institute of Scientific and Technical Information of China (English)

    黄高山

    2016-01-01

    Undergraduate graduation project (thesis) is a complete scientific research training process of students under the guidance of tutor, and is also the last teaching link of undergraduate training task. Combined with the practice of military academies, this paper analyzes the problems in the undergraduate graduation project (thesis), and puts forward targeted improvement measures, in order to realize the standardization of undergraduate graduation project (thesis) of military academy and train students' ability of scientific research and work.%本科毕业设计(论文)是学员在导师的指导下进行的一次完整的科研训练过程,也是学校完成本科生培养任务的最后一个教学环节。本文结合军队院校实际,对本科学院毕业设计(论文)存在的问题进行分析,提出有针对性的改进措施,为实现军队院校本科毕业设计(论文)规范化、培养学员科研和工作能力提供了参考依据。

  6. NIF Projects Controls and Information Systems Software Quality Assurance Plan

    Energy Technology Data Exchange (ETDEWEB)

    Fishler, B

    2011-03-18

    Quality achievement for the National Ignition Facility (NIF) and the National Ignition Campaign (NIC) is the responsibility of the NIF Projects line organization as described in the NIF and Photon Science Directorate Quality Assurance Plan (NIF QA Plan). This Software Quality Assurance Plan (SQAP) is subordinate to the NIF QA Plan and establishes quality assurance (QA) activities for the software subsystems within Controls and Information Systems (CIS). This SQAP implements an activity level software quality assurance plan for NIF Projects as required by the LLNL Institutional Software Quality Assurance Program (ISQAP). Planned QA activities help achieve, assess, and maintain appropriate quality of software developed and/or acquired for control systems, shot data systems, laser performance modeling systems, business applications, industrial control and safety systems, and information technology systems. The objective of this SQAP is to ensure that appropriate controls are developed and implemented for management planning, work execution, and quality assessment of the CIS organization's software activities. The CIS line organization places special QA emphasis on rigorous configuration control, change management, testing, and issue tracking to help achieve its quality goals.

  7. 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.

  8. L2 Quality as a Competitive Edge - Project Presentation

    DEFF Research Database (Denmark)

    Ditlevsen, Marianne Grove; Kastberg, Peter

    2000-01-01

    In our paper we would like to present an interdisciplinary project "L2 as a Competitive Edge". We'll be doing this by first giving you a project overview in section 0. The overview will then in the section 1 and 2 be followed by a presentation of two of the most interesting themes, serving as poi...... of departure for further discussion. The two themes are "The evaluation of language quality" and "Method - an Integrated Approach"....

  9. 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.

  10. 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.

  11. Improving Project Management with Simulation and Completion Distribution Functions

    Science.gov (United States)

    Cates, Grant R.

    2004-01-01

    million per month is being spent on this project, which is scheduled to complete by 2010. NASA project stakeholders participated in determining and managing completion distribution functions produced from PAST. The first result was that project stakeholders improved project completion risk awareness. Secondly, using PAST, mitigation options were analyzed to improve project completion performance and reduce total project cost.

  12. Up-Stream Dissolved Oxygen TMDL Project Quality Assurance ProjectPlan

    Energy Technology Data Exchange (ETDEWEB)

    Stringfellow, William T.

    2005-05-13

    A quality assurance project plan (QAPP) for the execution of an ecosystem level monitoring and research program examining algal ecology in highly impaired rivers. Procedures for executing both field and laboratory surface water quality and flow analysis are described. The procedures described here are compatible with the California Surface Water Ambient Monitoring program (SWAMP).

  13. Changing Traditional Ideas and Perfecting System --Exploration on How to Improve Quality of Graduation Project%转变观念与完善制度——探索提高工科类本科毕业设计质量的途径

    Institute of Scientific and Technical Information of China (English)

    孙凤杰; 杨建国; 匡亚莉; 刘焕胜

    2012-01-01

    Graduation Project is an important part of talents cultivation which directly influences the whole quality of higher education. Some methods on how to determine the topics, guide and manage the whole process, evaluate the performance and effectively improve the graduation project quality are dis- cussed in this paper%毕业设计是高校人才培养的重要实践性教学环节,其质量的高低直接影响整个高等人才培养。本文针对工科类本科人才培养的特点,分别从毕业设计的选题、过程指导与管理及成绩评定等方面系统分析与讨论了有效提高工科类本科毕业设计质量的途径与方法。

  14. Effectiveness of a quality improvement curriculum for medical students

    Directory of Open Access Journals (Sweden)

    Kimberly M. Tartaglia

    2015-05-01

    Full Text Available Introduction: As health systems find ways to improve quality of care, medical training programs are finding opportunities to prepare learners on principles of quality improvement (QI. The impact of QI curricula for medical students as measured by student learning is not well delineated. The aim of this study is to evaluate the effectiveness of a QI curriculum for senior medical students as measured by student knowledge and skills. Methods: This study was an observational study that involved a self-assessment and post-test Quality Improvement Knowledge Application Tool (QIKAT for intervention and control students. A QI curriculum consisting of online modules, live discussions, independent readings and reflective writing, and participation in a mentored QI project was offered to fourth-year medical students completing an honor's elective (intervention group. Senior medical students who received the standard QI curriculum only were recruited as controls. Results: A total of 22 intervention students and 12 control students completed the self-assessment and QIKAT. At baseline, there was no difference between groups in self-reported prior exposure to QI principles. Students in the intervention group reported more comfort with their skills in QI overall and in 9 of the 12 domains (p<0.05. Additionally, intervention students performed better in each of the three case scenarios (p<0.01. Discussion: A brief QI curriculum for senior medical students results in improved comfort and knowledge with QI principles. The strengths of our curriculum include effective use of classroom time and faculty mentorship with reliance on pre-existing online modules and written resources. Additionally, the curriculum is easily expandable to larger groups of students and transferable to other institutions.

  15. Improvement in Space Food Packaging Methods Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The Space Food Systems Laboratory's (SFSL) current Bulk Overwrap Bag (BOB) package, while simple and effective, leaves room for improvement. Currently, BOBs are...

  16. Quality Management in Project Management Consulting. A Case Study in an International Consulting Company

    Directory of Open Access Journals (Sweden)

    Eduard-Gabriel Ceptureanu

    2017-02-01

    Full Text Available The present paper addresses quality management from the specific perspective of project management consulting service providers, in the framework of large infrastructure projects. Because of their supposed superiority in knowledge and experience, project management consultants have an ultimate responsibility for the proper implementing of the project. Therefore, quality management in consulting organizations should focus on critical success factors. As there is no consensus yet regarding the most important aspects of the consulting activity on which depend the achievement of the project aims, there is scope for further investigating this subject. Here, the case of a project management consulting organization involved in large infrastructure projects in Romania, Bulgaria, Moldova, Ukraine and Serbia is analyzed. Data collected through a questionnaire-based survey among international consultants and support personnel suggest that factors related to leadership style and communication skills are more closely tied to the success of the project than more technical aspects. The results constitute an empirical evidence of main success factors for specialized consulting services in project management and can be useful in improving business and project performance and achieving business excellence.

  17. Applying quality management tools to medical photography services: a pilot project.

    Science.gov (United States)

    Murray, Peter

    2003-03-01

    The Medical Photography Department at Peterborough Hospitals NHS Trust set up a pilot project to reduce the turnaround time of fundus fluorescein angiograms to the Ophthalmology Department. Quality management tools were used to analyse current photographic practices and develop more efficient methods of service delivery. The improved service to the Ophthalmology Department demonstrates the value of quality management in developing medical photography services at Peterborough Hospitals.

  18. Quality Assurance Project Plan for Facility Effluent Monitoring Plan activities

    Energy Technology Data Exchange (ETDEWEB)

    Frazier, T.P.

    1994-10-20

    This Quality Assurance Project Plan addresses the quality assurance requirements for the activities associated with the Facility Effluent Monitoring Plans, which are part of the overall Hanford Site Environmental Protection Plan. This plan specifically applies to the sampling and analysis activities and continuous monitoring performed for all Facility Effluent Monitoring Plan activities conducted by Westinghouse Hanford Company. It is generic in approach and will be implemented in conjunction with the specific requirements of the individual Facility Effluent Monitoring Plans.

  19. Near-facility environmental monitoring quality assurance project plan

    Energy Technology Data Exchange (ETDEWEB)

    McKinney, S.M.

    1997-11-24

    This Quality Assurance Project Plan addresses the quality assurance requirements for the activities associated with the preoperational and near facility environmental monitoring performed by Waste Management Federal Services, Inc., Northwest Operations and supersedes WHC-EP-0538-2. This plan applies to all sampling and monitoring activities performed by waste management Federal Services, Inc., Northwest Operations in implementing facility environmental monitoring at the Hanford Site.

  20. Fuzzy system for risk analysis in software projects through the attributes of quality standards iso 25000

    Directory of Open Access Journals (Sweden)

    Chau Sen Shia

    2014-02-01

    Full Text Available With the growth in demand for products and services in the IT area, companies encounter difficulties in establishing a metric or measure of quality of services to address measurably qualitative values in their planning. In this work fuzzy logic, standard SQuaRE (measurement of the quality of software products, Likertscale, GQM method (Goal-Question-Metric -indicator of quality of Software and the project risk analysis model of Boehm were used to assess the quality of services and decision-making, according to your demand and requests for software development. With the aim of improving the quality in the provision of services, the application is used to integrate the team and follow the life cycle of a project from its initial phase, and to assist in the comparison with the proposed schedule during the requirements elicitation.

  1. 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.

  2. The Environmental Management Project Manager`s Handbook for improved project definition

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-02-01

    The United States Department of Energy (DOE) is committed to providing high quality products that satisfy customer needs and are the associated with this goal, DOE personnel must possess the knowledge, skills, and abilities to ensure successful job performance. In addition, there must be recognition that the greatest obstacle to proper project performance is inadequate project definition. Without strong project definition, DOE environmental management efforts are vulnerable to fragmented solutions, duplication of effort, and wastes resources. The primary means of ensuring environmental management projects meet cost and schedule milestones is through a structured and graded approach to project definition, which is the focus of this handbook.

  3. The Environmental Management Project Manager`s Handbook for improved project definition

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-02-01

    The United States Department of Energy (DOE) is committed to providing high quality products that satisfy customer needs and are the associated with this goal, DOE personnel must possess the knowledge, skills, and abilities to ensure successful job performance. In addition, there must be recognition that the greatest obstacle to proper project performance is inadequate project definition. Without strong project definition, DOE environmental management efforts are vulnerable to fragmented solutions, duplication of effort, and wastes resources. The primary means of ensuring environmental management projects meet cost and schedule milestones is through a structured and graded approach to project definition, which is the focus of this handbook.

  4. NIF Project Quality Assurance Program Plan Revision E

    Energy Technology Data Exchange (ETDEWEB)

    Dun, C; Brereton, S; Yatabe, J; Moses, E I

    2001-06-01

    The National Ignition Facility (NIF) is a key constituent of the Department Energy's (DOE's) Stockpile Stewardship Program. The NIF will use inertial confinement fusion (ICF) to produce ignition and energy gain in ICF targets and will perform weapons physics, weapons effects, and high-energy-density experiments in support of national security and civilian objectives. The primary mission of the NIF Project is the design and construction of the facility and equipment, acceptance testing, and activation. To accomplish this mission, the LLNL Director created the NIF Programs Directorate, and within that Directorate, the NIF Project Office to organize and manage the Project. The NIF Project Office establishes this QA Program to ensure its success. This QA Program Plan (QAPP) defines and describes the program--the management system--for specifying, achieving, and assuring the quality of all NIF Project work consistent with the policies of LLNL and the NIF Programs Directorate.

  5. An Assessment of Stream Health in Urban Creeks with Community Led Improvement Projects

    Science.gov (United States)

    Sanchez, L.; Mercado, M.

    2016-12-01

    Small-scale restoration and improvement projects along urban creeks have become increasingly common and the need to assess their impact on stream health is necessary. Courtland and Peralta Creek have been subject to a variety of community, non-profit and city sponsored improvement projects. Assessment of nutrient contamination in the form of ammonia and nitrate indicate that these urban creeks have been impacted by human activity (Water Quality of Peralta and Courtland Creeks Oakland, CA, A. Ahumada). Continued assessment of the stream health through nitrate, ammonia and phosphate concentrations, benthic invertebrate derived biotic index and E. coli concentrations were used to assess site improvements. Youth and community site improvement project at Courtland Creek has resulted in the decline of nitrate contamination and an overall increase in benthic invertebrates species. Peralta Creek has a group of dedicated community volunteers that participate in clean up events but is just now implementing a planned restoration project increasing native plant diversity at the site.

  6. Structural equation model to investigate the factors influencing quality performance in Indian construction projects

    Indian Academy of Sciences (India)

    S Shanmugapriya; K Subramanian

    2015-09-01

    Indian construction industry has seen remarkable growth and it is an integral part of the economy with massive foreign investments which demands quality construction. The pressure to reduce time and cost of construction increases the risk on the part of stakeholders with respect to quality and safety of the construction. The problem is serious and dangerous in developing countries like India which requires focus and attention for sustained growth in construction sector. This research reports on the adoption and development of structural equation model to study the fundamental relationship between five enablers of European Foundation for quality management (EFQM) framework to improve the quality performance in Indian construction projects. Data collected from clients, contractors and consultants of Indian construction industry through questionnaire survey was used to analyze the conceptual framework using smart PLS software. The conceptual model in this research includes eight hypotheses and T-statistics values is used for checking the significance of the hypothesis. The findings of the study revealed that leadership factor has strongest total effect on people factor (Path coefficient = 0.77) and process factor has strongest effect in achieving the goals of quality performance improvement in construction projects (Path coefficient = 0.7). The results indicate that Indian construction organizations must give top priority to leadership and process related problems in various phases of the project to result in continuous improvement in quality performance.

  7. 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.

  8. Improving health promotion using quality improvement techniques in Australian Indigenous primary health care

    Directory of Open Access Journals (Sweden)

    Nikki ePercival

    2016-03-01

    Full Text Available While some areas of clinical health care are becoming adept at implementing continuous quality improvement (CQI projects, there has been limited experimentation of CQI in health promotion. In this study, we examined the impact of a CQI intervention on health promotion in four Australian Indigenous primary health care centres. Our study objectives were to: (a describe the scope and quality of health promotion activities; (b describe the status of health centre system support for health promotion activities; and (c introduce a CQI intervention and examine the impact on health promotion activities and health centres systems over two years. Baseline assessments showed sub-optimal health centre systems support for health promotion and significant evidence-practice gaps. After two annual CQI cycles, there were improvements in staff understanding of health promotion and systems for planning and documenting health promotion activities had been introduced. Actions to improve best practice health promotion, such as community engagement and intersectoral partnerships, were inhibited by the way health centre systems were organized, predominately to support clinical and curative services. These findings suggest that CQI can improve the delivery of evidence based health promotion by engaging front line health practitioners in decision making processes about the design/redesign of health centre systems to support the delivery of best practice health promotion. However, further and sustained improvements in health promotion will require broader engagement of management, senior staff and members of the local community to address organisational and policy level barriers.

  9. Project EDDIE: Improving Big Data skills in the classroom

    Science.gov (United States)

    Soule, D. C.; Bader, N.; Carey, C.; Castendyk, D.; Fuller, R.; Gibson, C.; Gougis, R.; Klug, J.; Meixner, T.; Nave, L. E.; O'Reilly, C.; Richardson, D.; Stomberg, J.

    2015-12-01

    High-frequency sensor-based datasets are driving a paradigm shift in the study of environmental processes. The online availability of high-frequency data creates an opportunity to engage undergraduate students in primary research by using large, long-term, and sensor-based, datasets for science courses. Project EDDIE (Environmental Data-Driven Inquiry & Exploration) is developing flexible classroom activity modules designed to (1) improve quantitative and reasoning skills; (2) develop the ability to engage in scientific discourse and argument; and (3) increase students' engagement in science. A team of interdisciplinary faculty from private and public research universities and undergraduate institutions have developed these modules to meet a series of pedagogical goals that include (1) developing skills required to manipulate large datasets at different scales to conduct inquiry-based investigations; (2) developing students' reasoning about statistical variation; and (3) fostering accurate student conceptions about the nature of environmental science. The modules cover a wide range of topics, including lake physics and metabolism, stream discharge, water quality, soil respiration, seismology, and climate change. Assessment data from questionnaire and recordings collected during the 2014-2015 academic year show that our modules are effective at making students more comfortable analyzing data. Continued development is focused on improving student learning outcomes with statistical concepts like variation, randomness and sampling, and fostering scientific discourse during module engagement. In the coming year, increased sample size will expand our assessment opportunities to comparison groups in upper division courses and allow for evaluation of module-specific conceptual knowledge learned. This project is funded by an NSF TUES grant (NSF DEB 1245707).

  10. Recommendations for improved acceptance of wind farm projects in France with regard to acoustic noise

    Energy Technology Data Exchange (ETDEWEB)

    Dutilleux, P.; Gabriel, J. [Deutsches Windenergie-Institut GmbH (DEWI), Wilhelmshaven (Germany)

    2008-03-15

    From the consideration of the various acoustic issues that are raised by wind farm projects, the similarities and differences of approaches and methods used in France and in Germany are reviewed. Recommendations to the acousticians, to the wind turbine manufacturers, to the developers and to the operators are derived with the objective of improving the acoustic quality of wind farm projects and their acceptance by the population. (orig.)

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

    Science.gov (United States)

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

    2016-06-01

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

  12. 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...

  13. Improving Sustainability Performance for Public-Private-Partnership (PPP Projects

    Directory of Open Access Journals (Sweden)

    Liyin Shen

    2016-03-01

    Full Text Available Improving sustainability performance in developing infrastructure projects is an important strategy for pursuing the mission of sustainable development. In recent years, the business model of public-private-partnership (PPP is promoted as an effective approach in developing infrastructure projects. It is considered that the distribution of the contribution on project investment between private and public sectors is one of the key variables affecting sustainability performance of PPP-type projects. This paper examines the impacts of the contribution distribution between public and private sectors on project sustainability performance. A model named the sustainability performance-based evaluation model (SPbEM is developed for assisting the assessment of the level of sustainability performance of PPP projects. The study examines the possibility of achieving better sustainability through proper arrangement of the investment distribution between the two primary sectors in developing PPP-type infrastructure projects.

  14. 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....

  15. 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....

  16. 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....

  17. 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....

  18. Improving Project Management Using Formal Models and Architectures

    Science.gov (United States)

    Kahn, Theodore; Sturken, Ian

    2011-01-01

    This talk discusses the advantages formal modeling and architecture brings to project management. These emerging technologies have both great potential and challenges for improving information available for decision-making. The presentation covers standards, tools and cultural issues needing consideration, and includes lessons learned from projects the presenters have worked on.

  19. Project quality management critical success factors for buildings

    CERN Document Server

    Low, Sui Pheng

    2014-01-01

    The book presents the development of the Construction Quality Assessment System (CONQUAS), Singapore’s de facto quality performance measurement system, explains the application of the Quality Management System (QMS) to manage CONQUAS and identifies 33 critical success factors (CSFs) for achieving high CONQUAS scores. Through CONQUAS, the reader benefits from understanding how the Singapore government developed and implemented the first objective system for measuring what many building professionals have perceived to be elusive quality standards in the construction industry. The book presents both the theoretical concepts as well as the practical aspects to achieving strategic Project Quality Management that is anchored on the CSFs to building best practices. To realistically reflect the practical aspects and challenging issues faced by stakeholders in the construction industry, questionnaire surveys were conducted with building professionals to distinguish the importance level and extent of adoption of the ...

  20. 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

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

    Science.gov (United States)

    Ruda, R. R.

    1985-01-01

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

  2. 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.

  3. 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…

  4. 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

  5. Projects to improve mathematics performance at a university of technology

    Directory of Open Access Journals (Sweden)

    Ina Louw

    2009-09-01

    Full Text Available Lecturers at tertiary institutions have been expressing concern about the quality of students in mathematics for a long time now. Blame is usually placed at the door of secondary schools, but through put figures are still determining state subsidies and as such necessitate institutions to constantly revisit their efforts in terms of improving performance in mathematics. In this article, the results of two studies to improve the mathematics performance at a technical university are reported. The first study took place at the former Technikon Northern Gauteng and was an action research project with an experimental design. The study entailed the implementation of tutorial sessions and it revealed certain traits of tertiary mathematics education. Data were collected through structured observation, questionnaires and focus group interviews. A standardized questionnaire, Study Orientation Questionnaire in Maths (SOM, was introduced and “study habits” was the field in the test that featured most significantly in both the experimental and the control groups. The results revealed, inter alia, that timely assessment is needed to detect and correct misconceptions as soon as possible. It also pointed out that attendance of lectures (and tutorials impacted strongly on performance. Lastly, it was found that students preferred communicating mathematics through the medium of English and not by using their mother tongue. The second project was conducted at the Tshwane University of Technology (TUT and consisted of an investigation into assessment practices in first year mathematics. The study was executed with action research as strategy and data were collected through interviews, questionnaires and focus group interviews. Qualitative and quantitative data were collected and respondents were exposed to contemporary assessment strategies as suggested by OBE. The aim of the study was to enhance the respondents’ insight into contemporary assessment

  6. A portfolio evaluation framework for air transportation improvement projects

    Science.gov (United States)

    Baik, Hyeoncheol

    This thesis explores the application of portfolio theory to the Air Transportation System (ATS) improvement. The ATS relies on complexly related resources and different stakeholder groups. Moreover, demand for air travel is significantly increasing relative to capacity of air transportation. In this environment, improving the ATS is challenging. Many projects, which are defined as technologies or initiatives, for improvement have been proposed and some have been demonstrated in practice. However, there is no clear understanding of how well these projects work in different conditions nor of how they interact with each other or with existing systems. These limitations make it difficult to develop good project combinations, or portfolios that maximize improvement. To help address this gap, a framework for identifying good portfolios is proposed. The framework can be applied to individual projects or portfolios of projects. Projects or portfolios are evaluated using four different groups of factors (effectiveness, time-to-implement, scope of applicability, and stakeholder impacts). Portfolios are also evaluated in terms of interaction-determining factors (prerequisites, co-requisites, limiting factors, and amplifying factors) because, while a given project might work well in isolation, interdependencies between projects or with existing systems could result in lower overall performance in combination. Ways to communicate a portfolio to decision makers are also introduced. The framework is unique because (1) it allows using a variety of available data, and (2) it covers diverse benefit metrics. For demonstrating the framework, an application to ground delay management projects serves as a case study. The portfolio evaluation approach introduced in this thesis can aid decision makers and researchers at universities and aviation agencies such as Federal Aviation Administration (FAA), National Aeronautics and Space Administration (NASA), and Department of Defense (DoD), in

  7. Power Quality Improvements of Wind Farm

    DEFF Research Database (Denmark)

    Søbrink, Kent H.; Pedersen, Jørgen Kaas; Pedersen, Knud Ole Helgesen

    1998-01-01

    The book was written at the conclusion of an EU-project to install and monitor the performance of an 8 MVar Advanced Static VAr Compensator (ASVC) at the Rejsby Hede wind farm in Jutland, Denmark......The book was written at the conclusion of an EU-project to install and monitor the performance of an 8 MVar Advanced Static VAr Compensator (ASVC) at the Rejsby Hede wind farm in Jutland, Denmark...

  8. Power Quality Improvements of Wind Farms

    DEFF Research Database (Denmark)

    Søbrink, Kent H.; Stöber, Ralf; Schettler, Frank

    1998-01-01

    The book was written at the conclusion of an EU-project to install and monitor the performance of an 8 MVar Advanced Static VAr Compensator (ASVC) at the Rejsby Hede wind farm in Jutland, Denmark......The book was written at the conclusion of an EU-project to install and monitor the performance of an 8 MVar Advanced Static VAr Compensator (ASVC) at the Rejsby Hede wind farm in Jutland, Denmark...

  9. 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.

  10. 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.

  11. Implementation and implication of total quality management on client- contractor relationship in residential projects

    Science.gov (United States)

    Murali, Swetha; Ponmalar, V.

    2017-07-01

    To make innovation and continuous improvement as a norm, some traditional practices must become unlearnt. Change for growth and competitiveness are required for sustainability for any profitable business such as the construction industry. The leading companies are willing to implement Total Quality Management (TQM) principles, to realise potential advantages and improve growth and efficiency. Ironically, researches recollected quality as the most significant provider for competitive advantage in industrial leadership. The two objectives of this paper are 1) Identify TQM effectiveness in residential projects and 2) Identify the client satisfaction/dissatisfaction areas using Analytical Hierarchy Process (AHP) and suggest effective mitigate measures. Using statistical survey techniques like set of questionnaire survey, it is observed that total quality management was applied in some leading successful organization to an extent. The main attributes for quality achievement can be defined as teamwork and better communication with single agreed goal between client and contractor. Onsite safety is a paramount attribute in the identifying quality within the residential projects. It was noticed that the process based quality methods such as onsite safe working condition; safe management system and modern engineering process safety controls etc. as interlinked functions. Training and effective communication with all stakeholders on quality management principles is essential for effective quality work. Late Only through effective TQM principles companies can avoid some contract litigations with an increased client satisfaction Index.

  12. 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.

  13. Management of Highway Projects in Egypt through Identifying Factors Influencing Quality Performance

    Directory of Open Access Journals (Sweden)

    Ahmed Ebrahim Abu El-Maaty

    2016-01-01

    Full Text Available While project management success focuses upon the processes and the successful accomplishments of cost and time objectives, product success deals with the quality of the final product. Recently, quality of the constructed highway has been considered highly important reason for the pavement response and its design life. The main objective of this paper is to improve the management of highway projects in Egypt by determining the most important factors influencing the quality performance of this industry. In total, 39 factors that may influence the quality of highway projects have been defined through a detailed literature review. The factors are tabulated in a questionnaire form, which is sent out to 13 owners of divided highways, 27 owners of regional roads, and 15 consultants. The analysis of the respondents’ perspectives using fuzzy triangle approach shows that the most important factors affecting the quality are availability of experienced staff in the owner’s and contractor’s teams during the project execution; efficiency of the owner’s inspection team; clarity of responsibilities and roles for each owner, consultant, and contractor; pavement which is not designed according to the regional conditions (e.g., soil type, temperature, and traffic volume; and asphalt quality and type used in the construction process.

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

    Directory of Open Access Journals (Sweden)

    Nair P

    2016-03-01

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

  15. Resistance Factors in the Implementation of Software Process Improvement Project in Malaysia

    Directory of Open Access Journals (Sweden)

    Mohd H.N.M. Nasir

    2008-01-01

    Full Text Available For the past two decades, improving the quality of software has become an important agenda in the software industries as they have been assessed according to standards such as the CMM, CMM-I, ISO 9000 SIX-SIGMA and etc. As the result, software process improvement project implementations have been the main targets by most software companies. However, many initiatives are facing variety of problems and difficulties due to lack of guidance and experience. Hence, this research attempted to identify and analyze main resistance factors which influenced the implementation of the software process improvement project specifically companies operated in Malaysia including local and multi-national companies. The findings helped other software companies to manage future projects through the use of preventive actions or proper planning which intended to lessen anticipated problems during software process improvement projects implementation. This research used a survey instrument to gather data from 29 companies operated across Malaysia with the total of 174 business and software professionals responded. Average of 4 to 8 questionnaires were distributed to each company with the objective of getting wider views on each SPI project. The questionnaires were mainly distributed to professionals who are directly involved in SPI projects. The results showed that the most critical resistance factor is lack of adhesion and participation of the entire individual involved in SPI projects. This result is similar with the result gained by Brietzke and Rabello which they have conducted it in Brazil and corroborated the research findings experience in SPI project.

  16. 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.

  17. 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....

  18. 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

  19. Large hadron collider (LHC) project quality assurance plan

    Energy Technology Data Exchange (ETDEWEB)

    Gullo, Lisa; Karpenko, Victor; Robinson, Kem; Turner, William; Wong, Otis

    2002-09-30

    The LHC Quality Assurance Plan is a set of operating principles, requirements, and practices used to support Berkeley Lab's participation in the Large Hadron Collider Project. The LHC/QAP is intended to achieve reliable, safe, and quality performance in the LHC project activities. The LHC/QAP is also designed to fulfill the following objectives: (1) The LHC/QAP is Berkeley Lab's QA program document that describes the elements necessary to integrate quality assurance, safety management, and conduct of operations into the Berkeley Lab's portion of the LHC operations. (2) The LHC/QAP provides the framework for Berkeley Lab LHC Project administrators, managers, supervisors, and staff to plan, manage, perform, and assess their Laboratory work. (3) The LHC/QAP is the compliance document that conforms to the requirements of the Laboratory's Work Smart Standards for quality assurance (DOE O 414.1, 10 CFR 830.120), facility operations (DOE O 5480.19), and safety management (DOE P 450.4).

  20. Linking Six Sigma to simulation: a new roadmap to improve the quality of patient care.

    Science.gov (United States)

    Celano, Giovanni; Costa, Antonio; Fichera, Sergio; Tringali, Giuseppe

    2012-01-01

    Improving the quality of patient care is a challenge that calls for a multidisciplinary approach, embedding a broad spectrum of knowledge and involving healthcare professionals from diverse backgrounds. The purpose of this paper is to present an innovative approach that implements discrete-event simulation (DES) as a decision-supporting tool in the management of Six Sigma quality improvement projects. A roadmap is designed to assist quality practitioners and health care professionals in the design and successful implementation of simulation models within the define-measure-analyse-design-verify (DMADV) or define-measure-analyse-improve-control (DMAIC) Six Sigma procedures. A case regarding the reorganisation of the flow of emergency patients affected by vertigo symptoms was developed in a large town hospital as a preliminary test of the roadmap. The positive feedback from professionals carrying out the project looks promising and encourages further roadmap testing in other clinical settings. The roadmap is a structured procedure that people involved in quality improvement can implement to manage projects based on the analysis and comparison of alternative scenarios. The role of Six Sigma philosophy in improvement of the quality of healthcare services is recognised both by researchers and by quality practitioners; discrete-event simulation models are commonly used to improve the key performance measures of patient care delivery. The two approaches are seldom referenced and implemented together; however, they could be successfully integrated to carry out quality improvement programs. This paper proposes an innovative approach to bridge the gap and enrich the Six Sigma toolbox of quality improvement procedures with DES.

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

    Science.gov (United States)

    Kapp, Edward

    2009-01-01

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

  2. Embedding organisational quality improvement through middle manager ownership.

    Science.gov (United States)

    Balding, Cathy

    2005-01-01

    To strengthen the middle manager role in a hospital quality improvement (QI) program, with a view to increasing and sustaining organisational QI implementation. Case study based action research project, combining pre- and post-action quantitative and qualitative data collection, relating to a QI program intervention in an Australian metropolitan specialist teaching hospital. A model for enhancing the middle manager role in QI was developed and then implemented as the action over a 12-month period. Middle manager understanding and ownership of the QI program and organisational QI implementation significantly increased, although their perceived enjoyment of being involved in QI decreased. This case-study based action research project was limited to one organisation of a specific type - a large specialist metropolitan teaching hospital. The composition of the middle manager group, therefore, is necessarily limited to particular specialties. It is acknowledged that findings from case study and action research methodologies are limited in their generalisability, but assist in the development of knowledge and principles that can be adapted to different settings. This QI implementation model can increase levels of organisational QI implementation by effecting a positive change in middle manager attitude to and involvement in QI. There are many theories regarding the importance of the middle manager role in QI, but little empirical research into exactly what this role may be and how it may be strengthened. This research adds to the knowledge base, and provides clear steps for achieving increased staff involvement and QI implementation.

  3. 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...

  4. Short and long term improvements in quality of chronic care delivery predict program sustainability.

    Science.gov (United States)

    Cramm, Jane Murray; Nieboer, Anna Petra

    2014-01-01

    Empirical evidence on sustainability of programs that improve the quality of care delivery over time is lacking. Therefore, this study aims to identify the predictive role of short and long term improvements in quality of chronic care delivery on program sustainability. In this longitudinal study, professionals [2010 (T0): n=218, 55% response rate; 2011 (T1): n=300, 68% response rate; 2012 (T2): n=265, 63% response rate] from 22 Dutch disease-management programs completed surveys assessing quality of care and program sustainability. Our study findings indicated that quality of chronic care delivery improved significantly in the first 2 years after implementation of the disease-management programs. At T1, overall quality, self-management support, delivery system design, and integration of chronic care components, as well as health care delivery and clinical information systems and decision support, had improved. At T2, overall quality again improved significantly, as did community linkages, delivery system design, clinical information systems, decision support and integration of chronic care components, and self-management support. Multilevel regression analysis revealed that quality of chronic care delivery at T0 (pquality changes in the first (pmanagement programs based on the chronic care model improved the quality of chronic care delivery over time and that short and long term changes in the quality of chronic care delivery predicted the sustainability of the projects.

  5. ELECTRICAL SAFETY IMPROVEMENT PROJECT A COMPLEX WIDE TEAMING INITIATIVE

    Energy Technology Data Exchange (ETDEWEB)

    GRAY BJ

    2007-11-26

    This paper describes the results of a year-long project, sponsored by the Energy Facility Contractors Group (EFCOG) and designed to improve overall electrical safety performance throughout Department of Energy (DOE)-owned sites and laboratories. As evidenced by focused metrics, the Project was successful primarily due to the joint commitment of contractor and DOE electrical safety experts, as well as significant support from DOE and contractor senior management. The effort was managed by an assigned project manager, using classical project-management principles that included execution of key deliverables and regular status reports to the Project sponsor. At the conclusion of the Project, the DOE not only realized measurable improvement in the safety of their workers, but also had access to valuable resources that will enable them to do the following: evaluate and improve electrical safety programs; analyze and trend electrical safety events; increase electrical safety awareness for both electrical and non-electrical workers; and participate in ongoing processes dedicated to continued improvement.

  6. 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.

  7. Total Quality Management: Analysis, Evaluation and Implementation Within ACRV Project Teams

    Science.gov (United States)

    Raiman, Laura B.

    1991-01-01

    Total quality management (TQM) is a cooperative form of doing business that relies on the talents of everyone in an organization to continually improve quality and productivity, using teams and an assortment of statistical and measurement tools. The Assured Crew Return Vehicle (ACRV) Project Office was identified as an excellent project in which to demonstrate the applications and benefits of TQM processes. As the ACRV Program moves through its various stages of development, it is vital that effectiveness and efficiency be maintained in order to provide the Space Station Freedom (SSF) crew an affordable, on-time assured return to Earth. A critical factor for the success of the ACRV is attaining the maximum benefit from the resources applied to the program. Through a series of four tutorials on various quality improvement techniques, and numerous one-on-one sessions during the SSF's 10-week term in the project office, results were obtained which are aiding the ACRV Office in implementing a disciplined, ongoing process for generating fundamental decisions and actions that shape and guide the organization. Significant advances were made in improving the processes for two particular groups - the correspondence distribution team and the WATER Test team. Numerous people from across JSC were a part of the various team activities including engineering, man systems, and safety. The work also included significant interaction with the support contractor to the ACRV Project. The results of the improvement activities can be used as models for other organizations desiring to operate under a system of continuous improvement. In particular, they have advanced the ACRV Project Teams further down the path of continuous improvement, in support of a working philosophy of TQM.

  8. 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…

  9. 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.…

  10. Improving Software Quality Prediction by Noise Filtering Techniques

    Institute of Scientific and Technical Information of China (English)

    Taghi M. Khoshgoftaar; Pierre Rebours

    2007-01-01

    Accuracy of machine learners is affected by quality of the data the learners are induced on. In this paper,quality of the training dataset is improved by removing instances detected as noisy by the Partitioning Filter. The fit datasetis first split into subsets, and different base learners are induced on each of these splits. The predictions are combined insuch a way that an instance is identified as noisy if it is misclassified by a certain number of base learners. Two versionsof the Partitioning Filter are used: Multiple-Partitioning Filter and Iterative-Partitioning Filter. The number of instancesremoved by the filters is tuned by the voting scheme of the filter and the number of iterations. The primary aim of thisstudy is to compare the predictive performances of the final models built on the filtered and the un-filtered training datasets.A case study of software measurement data of a high assurance software project is performed. It is shown that predictiveperformances of models built on the filtered fit datasets and evaluated on a noisy test dataset are generally better than thosebuilt on the noisy (un-filtered) fit dataset. However, predictive performance based on certain aggressive filters is affected bypresence of noise in the evaluation dataset.

  11. 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...

  12. 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...

  13. 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

  14. 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.

  15. 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…

  16. Quality tools in a process of technical project management

    OpenAIRE

    Gwiazda, A.

    2006-01-01

    Purpose: The aim of this paper is to show how it could utilize the tools of quality management for the processof project management. Also it could be presented a modification of the Ishikawa diagram.Design/methodology/approach: In presented work has been applied the research methodology that bases onthe theoretical analysis and on the empirical researches. It is also presented a practical solution that proved thevalidity of proposed method.Findings: The base finding of the presented work is t...

  17. A review of quality surveillance projects on cosmetics in Taiwan

    Directory of Open Access Journals (Sweden)

    Meng-Hsuan Chung

    2014-12-01

    Full Text Available The Food and Drug Administration in Taiwan is responsible for the quality regulation and control of cosmetics. In order to have a clear understanding of the trends in the product quality monitoring outcomes and the regulatory control measures over the past years, this study has put together the reports of nine cosmetic surveillance projects conducted between 1982 and 2012. The findings can be used as a reference in developing a more solid quality monitoring plan and management system for cosmetic products. Results show that permanent wave products, hair dye products, and phthalate esters in cosmetic products have the highest average noncompliance rates at 39.2%, 14.2%, and 11.2%, respectively. These are followed by the average noncompliance rates of mercury in products, sunscreen products, and microorganisms in products, at 8.5%, 7.1%, and 5.5%, respectively, and the remaining three projects averaging below 4.1%. Since 1997, when new standards were announced and assistance to manufacturers was reinforced, the noncompliance rates of permanent wave products decreased annually, until 2007, when it was fully qualified for the standards. Overall, the study showed that the noncompliance rates of permanent wave products and for levels of phthalate esters, mercury, and hydroquinone in cosmetic products have all decreased in the previous years. The results of surveillance projects conducted after 2005 revealed only one noncompliance sample with lead, arsenic, and cadmium, whereas the surveillance projects on permanent wave products and chloroform- and 1,4-dioxane-containing products revealed full compliance with regulation standards. However, the noncompliance rates for microorganisms in cosmetics and the ingredients in hair dye products and sunscreen products were still high. These high-risk products must be monitored. These surveillance projects are conducted to ensure the safety of cosmetics in the market.

  18. Improving Perinatal Mental Health Care for Women Veterans: Description of a Quality Improvement Program.

    Science.gov (United States)

    Katon, Jodie G; Lewis, Lacey; Hercinovic, Selma; McNab, Amanda; Fortney, John; Rose, Susan M

    2017-02-06

    Purpose We describe results from a quality improvement project undertaken to address perinatal mental healthcare for women veterans. Description This quality improvement project was conducted in a single VA healthcare system between 2012 and 2015 and included screening for depressive symptoms with the Edinburgh Postnatal Depression Scale (EPDS) three times during the perinatal period, a dedicated maternity care coordinator (MCC), an on-site clinical social worker, and an on-site obstetrician/gynecologist (Ob/gyn). Information on prior mental health diagnosis was collected by the MCC or Ob/gyn. The prevalence of perinatal depressive symptoms and receipt of mental healthcare among those with such symptoms are reported by presence of a pre-pregnancy mental health diagnosis. Assessment Of the 199 women who used VA maternity benefits between 2012 and 2015, 56% (n = 111) had at least one pre-pregnancy mental health diagnosis. Compared to those without a pre-pregnancy mental health diagnosis, those with such a diagnosis were more likely to be screened for perinatal depressive symptoms at least once (61.5% vs. 46.8%, p = 0.04). Prevalence of depressive symptoms was 46.7% among those with a pre-pregnancy mental health diagnosis and 19.2% among those without. Among those with a pre-pregnancy mental health diagnosis and depressive symptoms (n = 35), 88% received outpatient mental healthcare and 77% met with the clinical social worker. Among those without a pre-pregnancy mental health diagnosis and depressive symptoms (n = 8), none received outpatient mental healthcare, but 77.8% met with the clinical social worker. Conclusion Improving perinatal mental healthcare for women veterans requires a multidisciplinary approach, including on-site integrated mental healthcare.

  19. 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.

  20. 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...

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

    NARCIS (Netherlands)

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

    2001-01-01

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

  2. 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…

  3. 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…

  4. 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....

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. Nourishing a partnership to improve middle school lunch options: a community-based participatory research project.

    Science.gov (United States)

    Reich, Stephanie M; Kay, Joseph S; Lin, Grace C

    2015-01-01

    Community-based participatory research is predicated on building partnerships that tackle important issues to the community and effectively improve these issues. Community-based participatory research can also be an empowering experience, especially for children. This article describes a university-community partnership in which students at a low-income middle school worked to improve the quality of the cafeteria food provided to the 986 students eligible for free and reduced price lunches. The project led to menu changes, improved communication between youth, school administrators, and district staff, and enabled youth to enact school improvements that were beneficial for their health.

  10. Innovations in projecting emissions for air quality modeling ...

    Science.gov (United States)

    Air quality modeling is used in setting air quality standards and in evaluating their costs and benefits. Historically, modeling applications have projected emissions and the resulting air quality only 5 to 10 years into the future. Recognition that the choice of air quality management strategy has climate change implications is encouraging longer modeling time horizons. However, for multi-decadal time horizons, many questions about future conditions arise. For example, will current population, economic, and land use trends continue, or will we see shifts that may alter the spatial and temporal pattern of emissions? Similarly, will technologies such as building-integrated solar photovoltaics, battery storage, electric vehicles, and CO2 capture emerge as disruptive technologies - shifting how we produce and use energy - or will these technologies achieve only niche markets and have little impact? These are some of the questions that are being evaluated by researchers within the U.S. EPA’s Office of Research and Development. In this presentation, Dr. Loughlin will describe a range of analytical approaches that are being explored. These include: (i) the development of alternative scenarios of the future that can be used to evaluate candidate management strategies over wide-ranging conditions, (ii) the application of energy system models to project emissions decades into the future and to assess the environmental implications of new technologies, (iii) and methodo

  11. Documentation of quality improvement exposure by internal medicine residency applicants

    Directory of Open Access Journals (Sweden)

    Victor O. Kolade

    2016-02-01

    Full Text Available Background: Quality improvement (QI has become an essential component of medical care in the United States. In residency programs, QI is a focus area of the Clinical Learning Environment Review visits conducted by the Accreditation Council for Graduate Medical Education. The readiness of applicants to internal medicine residency to engage in QI on day one is unknown. Purpose: To document the reporting of QI training or experience in residency applications. Methods: Electronic Residency Application Service applications to a single internal medicine program were reviewed individually looking for reported QI involvement or actual projects in the curriculum vitae (CVs, personal statements (PSs, and letters of recommendation (LORs. CVs were also reviewed for evidence of education in QI such as completion of Institute for Healthcare Improvement (IHI modules. Results: Of 204 candidates shortlisted for interview, seven had QI items on their CVs, including one basic IHI certificate. Three discussed their QI work in their PSs, and four had recommendation letters describing their involvement in QI. One applicant had both CV and LOR evidence, so that 13 (6% documented QI engagement. Conclusion: Practice of or instruction in QI is rarely mentioned in application documents of prospective internal medicine interns.

  12. Documentation of quality improvement exposure by internal medicine residency applicants.

    Science.gov (United States)

    Kolade, Victor O; Sethi, Anuradha

    2016-01-01

    Quality improvement (QI) has become an essential component of medical care in the United States. In residency programs, QI is a focus area of the Clinical Learning Environment Review visits conducted by the Accreditation Council for Graduate Medical Education. The readiness of applicants to internal medicine residency to engage in QI on day one is unknown. To document the reporting of QI training or experience in residency applications. Electronic Residency Application Service applications to a single internal medicine program were reviewed individually looking for reported QI involvement or actual projects in the curriculum vitae (CVs), personal statements (PSs), and letters of recommendation (LORs). CVs were also reviewed for evidence of education in QI such as completion of Institute for Healthcare Improvement (IHI) modules. Of 204 candidates shortlisted for interview, seven had QI items on their CVs, including one basic IHI certificate. Three discussed their QI work in their PSs, and four had recommendation letters describing their involvement in QI. One applicant had both CV and LOR evidence, so that 13 (6%) documented QI engagement. Practice of or instruction in QI is rarely mentioned in application documents of prospective internal medicine interns.

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

    Science.gov (United States)

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

    2016-04-01

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

  14. Applying the Advancing Excellence in America's Nursing Homes Circle of Success to improving and sustaining quality.

    Science.gov (United States)

    Bakerjian, Debra; Zisberg, Anna

    2013-01-01

    Looking forward to the Quality Assurance Performance Improvement (QAPI) program to be implemented and required in 2014, and as nursing home staff provide care for residents with increasingly complex health issues, knowledge of how to implement quality improvement (QI) is imperative. The nursing home administrator and director of nursing (DON) provide overall leadership, but it is the primary responsibility of the DON and other registered nurse staff to implement and manage the day to day QI process. This article describes potential roles of nursing leaders and key components of a QI project using a pressure ulcer case study exemplar to illustrate a quality improvement process. The authors suggest specific methods that RN leaders can employ using the Advancing Excellence Campaign Circle of Success as an organizing framework along with evidence-based resources. Nursing home leaders could use this article as a guideline for implementing any clinical quality improvement process. Copyright © 2013 Mosby, Inc. All rights reserved.

  15. Guide for prioritizing power plant productivity improvement projects: handbook of availability improvement methodology

    Energy Technology Data Exchange (ETDEWEB)

    1981-09-15

    As part of its program to help improve electrical power plant productivity, the Department of Energy (DOE) has developed a methodology for evaluating productivity improvement projects. This handbook presents a simplified version of this methodology called the Availability Improvement Methodology (AIM), which provides a systematic approach for prioritizing plant improvement projects. Also included in this handbook is a description of data taking requirements necessary to support the AIM methodology, benefit/cost analysis, and root cause analysis for tracing persistent power plant problems. In applying the AIM methodology, utility engineers should be mindful that replacement power costs are frequently greater for forced outages than for planned outages. Equivalent availability includes both. A cost-effective ranking of alternative plant improvement projects must discern between those projects which will reduce forced outages and those which might reduce planned outages. As is the case with any analytical procedure, engineering judgement must be exercised with respect to results of purely mathematical calculations.

  16. Quality of road construction projects in Sweden between 1990 and 2010

    Directory of Open Access Journals (Sweden)

    Abukar Warsame

    2014-03-01

    Full Text Available It has been reported that productivity developments in construction are slow compared to other sectors. Measuring productivity is however not easy and it might have been underestimated due to deficiencies in the index that is used when the value added in current prices is converted into value added at constant prices. A central problem when deflating nominal prices is that the deflation should only take away price changes for identical products and not price changes related to quality changes and improvements necessitated by new environmental conditions and legislation as well as demand for higher safety. The aim of this project is to help fill this gap by looking at the quality changes over time in road construction. A combination of comparative studies and interviews with practitioners from public and private sectors that are involved in road construction projects were conducted. It was found that there had been both direct quality changes in the roads, primarily to improve safety on the roads and for noise protection, and indirect quality changes related to building in more difficult circumstances because of giving higher weight to other social objectives, especially environmental objectives. As these quality increases are not taken into account when productivity is measured, productivity improvements could be underestimated by around 1% per year.

  17. 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.

  18. Study on the Countermeasures of Improving the Level of Project Cost Compilation Based on Quality Assurance System%基于质量保证体系提升工程造价编审水平的对策研究

    Institute of Scientific and Technical Information of China (English)

    陈敏宁

    2016-01-01

    With the continuous development of the market economy, the demand of construction engineering project for cost consulting industry is also growing. The quality of consulting has a great influence on the customers' cognition and trust, and then affects the interests of the enterprise. Increasing the project cost and quality level and establishing a good cost consultation quality assurance system are very important. Based on the analysis of the characteristics and current situation of cost consulting industry, this paper puts forward the existing problems of cost consultation industry, the measures to improve the editing quality level of cost and the necessity of establishing the quality assurance system of cost consulting.%随着市场经济的不断深入发展,建筑工程项目对造价咨询业的需求也越来越大。咨询质量的好坏很大程度的影响着客户对企业的认知和信任度,进而影响着企业的利益。提高工程造价编审质量水平,建立良好的造价咨询质量保证体系十分重要。本文在分析造价咨询业的特点及现状的基础上,提出造价咨询业存在的问题及提升造价编审质量水平的措施,造价咨询的质量保证体系建立的必要性。

  19. The effect of the SQUIRE (Standards of QUality Improvement Reporting Excellence) guidelines on reporting standards in the quality improvement literature: a before-and-after study.

    Science.gov (United States)

    Howell, Victoria; Schwartz, Amanda Eva; O'Leary, James Daniel; Mc Donnell, Conor

    2015-06-01

    The SQUIRE (Standards of QUality Improvement Reporting Excellence) guidelines were developed to improve the reporting of quality improvement (QI) projects. The effect of the guidelines on the completeness of reporting in the QI literature is unknown. Our primary objective was to determine if the completeness of reporting in the QI literature has been improved[OUP_CE13] since the introduction of the SQUIRE guidelines. We performed a before-and-after evaluation of QI articles selected from four prominent journals of healthcare quality. Twenty-five articles published in each of two time periods (2006-2008 and 2010-2011) were confirmed to be QI projects using a standardised definition and were independently evaluated by two investigators as an interim evaluation of a planned larger sample. Articles were assessed using 50 statements of the SQUIRE guidelines, and the overall change in the completeness of reporting between the two groups was determined. The value of pSQUIRE statements completed by authors before and after publication of the SQUIRE guidelines, 20.2 (5.0) versus 20.4 (7.0), p=0.9. The study was stopped early due to the absence of any significant trend in the completeness of reporting. There was no overall improvement observed in the completeness of reporting of QI projects after the publication of the SQUIRE guidelines, and the study was stopped early. There is potential for improvement in reporting standards, particularly for those guideline items or statements specific to QI projects. 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.

  20. 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

  1. 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…

  2. The Satellite based Monitoring Initiative for Regional Air quality (SAMIRA): Project summary and first results

    Science.gov (United States)

    Schneider, Philipp; Stebel, Kerstin; Ajtai, Nicolae; Diamandi, Andrei; Horalek, Jan; Nemuc, Anca; Stachlewska, Iwona; Zehner, Claus

    2017-04-01

    We present a summary and some first results of a new ESA-funded project entitled Satellite based Monitoring Initiative for Regional Air quality (SAMIRA), which aims at improving regional and local air quality monitoring through synergetic use of data from present and upcoming satellite instruments, traditionally used in situ air quality monitoring networks and output from chemical transport models. Through collaborative efforts in four countries, namely Romania, Poland, the Czech Republic and Norway, all with existing air quality problems, SAMIRA intends to support the involved institutions and associated users in their national monitoring and reporting mandates as well as to generate novel research in this area. The primary goal of SAMIRA is to demonstrate the usefulness of existing and future satellite products of air quality for improving monitoring and mapping of air pollution at the regional scale. A total of six core activities are being carried out in order to achieve this goal: Firstly, the project is developing and optimizing algorithms for the retrieval of hourly aerosol optical depth (AOD) maps from the Spinning Enhanced Visible and InfraRed Imager (SEVIRI) onboard of Meteosat Second Generation. As a second activity, SAMIRA aims to derive particulate matter (PM2.5) estimates from AOD data by developing robust algorithms for AOD-to-PM conversion with the support from model- and Lidar data. In a third activity, we evaluate the added value of satellite products of atmospheric composition for operational European-scale air quality mapping using geostatistics and auxiliary datasets. The additional benefit of satellite-based monitoring over existing monitoring techniques (in situ, models) is tested by combining these datasets using geostatistical methods and demonstrated for nitrogen dioxide (NO2), sulphur dioxide (SO2), and aerosol optical depth/particulate matter. As a fourth activity, the project is developing novel algorithms for downscaling coarse

  3. A project management focused framework for assuring quality work processes

    Energy Technology Data Exchange (ETDEWEB)

    Gamsby, S.O.; Mize, J.D. [Allied Signal, Inc., Albuquerque, NM (United States). Federal Mfg. and Technologies; Reid, R.A. [New Mexico Univ., Albuquerque, NM (United States)

    1996-10-01

    Federal Manufacturing & Technologies/New Mexico (FM&T/NM) of AlliedSignal is an organization of approximately 300 associates providing operations support, engineering, and other technical services for DOE, New Mexico`s National Laboratories, etc. Work performed is primarily project-oriented and ranges from executing a major long-term contract for retrofitting and maintaining a large fleet of escort vehicles to creating a single, small, prototype electronic device for measuring radiation in a unique environment. FM&T/NM is functionally organized and operates in a classic matrix format with functional departments providing personnel with technical expertise, necessary physical resources, and administrative support to several project-based groups. Like most matrix-based organizations that provide support to diverse customers, FM&T/NM has encountered problems that occur when a group of project managers is expected to work together in using and scheduling a shared set of limited resources for the good of the organization as a whole. The framework for managing projects that we present focuses on developing, understanding, and managing the relationships between the functional organization structure, the system of work processes, and the management of projects. FM&T/NM retains its functional structure which primarily assigns personnel to work processes. The evolving role of the process leader focuses primarily on designing, managing, and improving the process, and the interactions among the subprocesses. The project manager is responsible for (1) translating customer requirements into product specifications, (2) determining the sequence of activities needed to meet project goals, (3) scheduling the required work processes, (4) monitoring project progress, (5) providing liaison between the customer and process leaders, and (6) having the desired product and/or service delivered to a satisfied customer in a timely manner.

  4. 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.

  5. Improving the quality of palliative and terminal care in the hospital by a network of palliative care nurse champions: The study protocol of the PalTeC-H project

    NARCIS (Netherlands)

    F.E. Witkamp (Frederika); L. van Zuylen (Lia); P.J. van der Maas (Paul); H.V. Dijk (Helma Van); C.C.D. van der Rijt (Carin); A. van der Heide (Agnes)

    2013-01-01

    textabstractBackground: The quality of care of patients dying in the hospital is often judged as insufficient. This article describes the protocol of a study to assess the quality of care of the dying patient and the contribution of an intervention targeted on staff nurses of inpatient wards of a

  6. Improving the quality of palliative and terminal care in the hospital by a network of palliative care nurse champions: The study protocol of the PalTeC-H project

    NARCIS (Netherlands)

    F.E. Witkamp (Frederika); L. van Zuylen (Lia); P.J. van der Maas (Paul); H.V. Dijk (Helma Van); C.C.D. van der Rijt (Carin); A. van der Heide (Agnes)

    2013-01-01

    textabstractBackground: The quality of care of patients dying in the hospital is often judged as insufficient. This article describes the protocol of a study to assess the quality of care of the dying patient and the contribution of an intervention targeted on staff nurses of inpatient wards of a la

  7. Deepening our understanding of quality improvement in Europe (DUQuE): overview of a study of hospital quality management in seven countries.

    NARCIS (Netherlands)

    Secanell, M.; Groene, O.; Arah, O.A.; Lopez, M.A.; Kutryba, B.; Pfaff, H.; Klazinga, N.; Wagner, C.; Kristensen, S.; Bartels, P.D.; Garel, P.; Bruneau, C.; Escoval, A.; França, M.; Mora, N.; Suñol, R.

    2014-01-01

    Introduction and Objective: This paper provides an overview of the DUQuE (Deepening our Understanding of Quality Improvement in Europe) project, the first study across multiple countries of the European Union (EU) to assess relationships between quality management and patient outcomes at EU level. T

  8. 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.

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

    Science.gov (United States)

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

    2015-01-01

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

  10. 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.

  11. Using project performance to measure effectiveness of quality management system maintenance and practices in construction industry.

    Science.gov (United States)

    Leong, Tiong Kung; Zakuan, Norhayati; Mat Saman, Muhamad Zameri; Ariff, Mohd Shoki Md; Tan, Choy Soon

    2014-01-01

    This paper proposed seven existing and new performance indicators to measure the effectiveness of quality management system (QMS) maintenance and practices in construction industry. This research is carried out with a questionnaire based on QMS variables which are extracted from literature review and project performance indicators which are established from project management's theory. Data collected was analyzed using correlation and regression analysis. The findings indicate that client satisfaction and time variance have positive and significant relationship with QMS while other project performance indicators do not show significant results. Further studies can use the same project performance indicators to study the effectiveness of QMS in different sampling area to improve the generalizability of the findings.

  12. Using Project Performance to Measure Effectiveness of Quality Management System Maintenance and Practices in Construction Industry

    Directory of Open Access Journals (Sweden)

    Tiong Kung Leong

    2014-01-01

    Full Text Available This paper proposed seven existing and new performance indicators to measure the effectiveness of quality management system (QMS maintenance and practices in construction industry. This research is carried out with a questionnaire based on QMS variables which are extracted from literature review and project performance indicators which are established from project management's theory. Data collected was analyzed using correlation and regression analysis. The findings indicate that client satisfaction and time variance have positive and significant relationship with QMS while other project performance indicators do not show significant results. Further studies can use the same project performance indicators to study the effectiveness of QMS in different sampling area to improve the generalizability of the findings.

  13. Improving collected rainwater quality in rural communities.

    Science.gov (United States)

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

    2011-01-01

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

  14. Improvement of power quality using distributed generation

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-12-15

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

  15. Quality Improvement of Liver Ultrasound Images Using Fuzzy Techniques

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2016-12-01

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

  17. 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

  18. Quality Assurance Project Plan for Facility Effluent Monitoring Plan activities

    Energy Technology Data Exchange (ETDEWEB)

    Nickels, J.M.

    1991-06-01

    This Quality Assurance Project Plan addresses the quality assurance requirements for the Facility Monitoring Plans of the overall site-wide environmental monitoring plan. This plan specifically applies to the sampling and analysis activities and continuous monitoring performed for all Facility Effluent Monitoring Plan activities conducted by Westinghouse Hanford Company. It is generic in approach and will be implemented in conjunction with the specific requirements of individual Facility Effluent Monitoring Plans. This document is intended to be a basic road map to the Facility Effluent Monitoring Plan documents (i.e., the guidance document for preparing Facility Effluent Monitoring Plans, Facility Effluent Monitoring Plan determinations, management plan, and Facility Effluent Monitoring Plans). The implementing procedures, plans, and instructions are appropriate for the control of effluent monitoring plans requiring compliance with US Department of Energy, US Environmental Protection Agency, state, and local requirements. This Quality Assurance Project Plan contains a matrix of organizational responsibilities, procedural resources from facility or site manuals used in the Facility Effluent Monitoring Plans, and a list of the analytes of interest and analytical methods for each facility preparing a Facility Effluent Monitoring Plan. 44 refs., 1 figs., 2 tabs.

  19. 242-A evaporator quality assurance project plan: Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    Tucker, B.J.

    1994-11-04

    The scope of this quality assurance project plan (Plan) is sampling and analytical services including, but not limited to, sample receipt, handling and storage, analytical measurements, submittal of data deliverables, archiving selected portions of samples, returning unneeded sample material to Westinghouse Hanford Company (WHC), and/or sample disposal associated with candidate feed samples and process condensate compliance samples. Sampling and shipping activities are also included within the scope. The purpose of this project is to provide planning, implementation, and assessment guidance for achieving established data quality objectives measurement parameters. This Plan requires onsite and offsite laboratories to conform to that guidance. Laboratory conformance will help ensure that quality data are being generated and therefore, that the 242-A evaporator is operating in a safe and compliant manner. The 242-A evaporator feed stream originates from double-shell tanks (DSTs) identified as candidate feed tanks. The 242-A evaporator reduces the volume of aqueous waste contained in DSTs by boiling off water and sending it to the Liquid Effluent Retention Facility (LERF) storage basin before further treatment. The slurry product is returned to DSTs. Evaporation results in considerable savings by reducing the volume of mixed waste for disposal.

  20. What drives continuous improvement project success in healthcare?

    Science.gov (United States)

    Stelson, Paul; Hille, Joshua; Eseonu, Chinweike; Doolen, Toni

    2017-02-13

    Purpose The purpose of this paper is to present findings from a study of factors that affect continuous improvement (CI) project success in hospitals. Design/methodology/approach Quantitative regression analysis was performed on Likert scale survey responses. Qualitative thematic analysis was performed on open-ended survey responses and written reports on CI projects. Findings The paper identifies managerial and employee factors that affect project success. These factors include managerial support, communication, and affective commitment. Affective commitment is the extent to which employees perceive the change as being needed or necessary. Practical implications The results highlight how managerial decisions, approaches to communication - including communication before, during and after CI projects affect project success. The results also show that success depends on the way employees perceive proposed changes. This suggests the need for a more individualized approach to CI, lean, and broader change initiatives. Originality/value This research is the first to fuse project success and sustainability theory to CI projects, beyond Kaizen events, in healthcare environments. The research is particularly important at a time when healthcare organizations are required to make rapid changes with limited resources as they work toward outcome-based assessment and reimbursement rules.

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

    Directory of Open Access Journals (Sweden)

    Gang Xie

    2014-01-01

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

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

    Science.gov (United States)

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

    1996-05-01

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

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

    Science.gov (United States)

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

    2012-11-01

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

  4. Columbia River Channel Improvement Project Rock Removal Blasting: Monitoring Plan

    Energy Technology Data Exchange (ETDEWEB)

    Carlson, Thomas J.; Johnson, Gary E.

    2010-01-29

    This document provides a monitoring plan to evaluate take as outlined in the National Marine Fisheries Service 2002 Biological Opinion for underwater blasting to remove rock from the navigation channel for the Columbia River Channel Improvement Project. The plan was prepared by the Pacific Northwest National Laboratory (PNNL) for the U.S. Army Corps of Engineers (USACE), Portland District.

  5. Safe and high quality food production using low quality waters and improved irrigation systems and management

    DEFF Research Database (Denmark)

    Plauborg, Finn; Andersen, Mathias Neumann; Liu, Fulai

    2010-01-01

    uneven irrigation patterns can increase the water use efficiency as well as the quality of vegetable crops. Furthermore, recent innovations in the water treatment and irrigation industry have shown potential for the use of low quality water resources, such as reclaimed water or surface water in peri......The present paper presents the SAFIR project (www.safir4eu.org), which addresses two fundamental problems that over the past decade increasingly have become concerns of the general public: the one problem being the jeopardizing of safety and quality of our food products, while the other being...... the increasing competition for clean freshwater. The SAFIR project has a multi-disciplinary approach, which integrates the European as well as the global dimension of the EU-policy on food quality and safety. The main driving force behind the project idea is new research results that demonstrated that scheduled...

  6. Software Quality Improvement in the OMC Team

    CERN Document Server

    Maier, Viktor

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

  7. 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.

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

    Science.gov (United States)

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

    2014-01-01

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

  9. Antenatal care strengthening for improved quality of care in Jimma, Ethiopia

    DEFF Research Database (Denmark)

    Villadsen, Sarah Fredsted; Negussie, Dereje; GebreMariam, Abebe;

    2015-01-01

    in the evaluation. Improved content of care (physical examinations, laboratory testing, tetanus toxoid (TT)-immunization, health education, conduct of health professionals, and waiting time) were defined as proximal project outcomes and increased quality of care (better identification of health problems....... The effect of the intervention was assessed by comparing the change in quality of care from before to after the intervention period at intervention sites, relative to control sites, using logistic mixed effect regression. RESULTS: The continued attention to the ANC provision during implementation stimulated...... of intervention on various outcomes was significantly modified by maternal education. CONCLUSION: The quality of care can be improved in some important aspects with limited resources. Moreover, the study provides strategic perspectives on how to facilitate improved quality of ANC....

  10. Application of Six-Sigma for Data Quality Improvement in an Insurance Company

    Directory of Open Access Journals (Sweden)

    Mohit Panwar

    2015-08-01

    Full Text Available Abstract Billions of dollars annually is what poor data quality costs Insurance businesses according to the Data Warehousing Institute. Poor data is also the leading cause of many IT project failures. Many companies are designing their data management programs and quality initiatives to deal with this problem of erroneous and inconsistent data. This paper discusses these topics as well as those detailing how companies can improve their data quality using the quality improvement technique of applying Six-Sigma. The method of creating a new initiative for identifying measuring and controlling the data errors is discussed in this paper. Finally the paper ends with a conclusion and expected results and benefits of the technique. The insurance industry is data-dependent. Today carriers and intermediaries are engaged in improving data capture to help them to better manage their business manage their risk and know their customers. Business and regulatory drivers are pushing the industry to manage its data better.

  11. IMPROVING PROJECT SCHEDULE ESTIMATES USING HISTORICAL DATA AND SIMULATION

    Directory of Open Access Journals (Sweden)

    P.H. Meyer

    2012-01-01

    Full Text Available

    ENGLISH ABSTRACT: Many projects are not completed on time or within the original budget. This is caused by uncertainty in project variables as well as the occurrence of risk events. A study was done to determine ways of measuring the risk in development projects executed by a mining company in South Africa. The main objective of the study was to determine whether historical project data would provide a more accurate means of estimating the total project duration. Original estimates and actual completion times for tasks of a number of projects were analysed and compared. The results of the study indicated that a more accurate total duration for a project could be obtained by making use of historical project data. The accuracy of estimates could be improved further by building a comprehensive project schedule database within a specific industry.

    AFRIKAANSE OPSOMMING: Verskeie projekte word nie binne die oorspronklike skedule of begroting voltooi nie. Dit word dikwels veroorsaak deur onsekerheid oor projekveranderlikes en die voorkoms van risiko’s. 'n Studie is gedoen om 'n metode te ontwikkel om risiko te meet vir ontwikkelingsprojekte van 'n mynmaatskappy in Suid Afrika. Die hoofdoel van die studie was om te bepaal of historiese projekdata gebruik kon word om 'n akkurater tydsduur vir 'n projek te beraam. Die geraamde tydsduur van take vir 'n aantal projekte is ontleed en vergelyk met die werklike tydsduur. Die resultate van die studie het getoon dat 'n akkurater totale tydsduur vir die projek verkry kon word deur gebruik te maak van historiese projekdata. Die akkuraatheid kan verder verbeter word deur 'n databasis van projekskedules vir 'n bepaalde industrie te ontwikkel en by datum te hou.

  12. 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.

  13. 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.

  14. Quality Assurance Project Plan for waste tank vapor characterization

    Energy Technology Data Exchange (ETDEWEB)

    Suydam, C.D. Jr.

    1993-12-01

    This Quality Assurance Project Plan, WHC-SD-WM-QAPP-013, applies to four separate vapor sampling tasks associated with Phases 1 and 2 of the Tank Vapor Issue Resolution Program and support of the Rotary Mode Core Drilling Portable Exhauster Permit. These tasks focus on employee safety concerns and tank ventilation emission control design requirements. Previous characterization efforts and studies are of insufficient accuracy to adequately define the problem. It is believed that the technology and maturity of sampling and analytical methods can be sufficiently developed to allow the characterization of the constituents of the tank vapor space.

  15. Desirable qualities of REDD+ projects not considered in decisions of project locations

    Science.gov (United States)

    Pasgaard, M.; Mertz, O.

    2016-11-01

    Reducing emissions from deforestation and forest degradation (REDD+) has become a major conservation and development concept for international climate change mitigation over the past years with hundreds of so-called ‘demonstration’ or ‘pilot’ projects being planned and implemented across the Global South. Since the broad aim of such projects is to demonstrate climate benefits from reduced deforestation, as well as social co-benefits in receiving countries, the decision on REDD+ locations should ideally center on specific geographical and socioeconomic characteristics, such as high deforestation threat, low opportunity costs, large forest area size, and high local willingness to engage. Based on recent literature supplemented with opinions and perspectives from REDD+ specialists, we compare these desirable qualities for REDD+ locations with actual location of REDD+ projects. We illustrate how locating REDD+ projects is often in the hands of external organizations and tightly connected to their previous engagements in the location. We also show how specific characteristics of these externally driven REDD+ project locations vary according to the sub-objectives of the individual projects and do not always correspond with the overall goal of REDD+. These pre-conditioned decisions and diverging objectives at the meso-level may further complicate global REDD+ agreements.

  16. 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…

  17. 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.

  18. 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...

  19. Analyzing Quality Attributes as a Means to Improve Acquisition Strategies

    Science.gov (United States)

    2014-04-30

    prp @sei.cmu.edu] Lisa Brownsword—is a senior member of the technical staff at the Software Engineering Institute. She manages and participates in...was “The prime contractor trains the subcontractor in project management.” Just as occurs in a QAW, different acquisition quality attribute

  20. 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

  1. 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.

  2. 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 ...

  3. 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...

  4. 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.

  5. 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"

  6. 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 ...

  7. 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.

  8. Optimizing care in osteoporosis: The Canadian quality circle project

    Directory of Open Access Journals (Sweden)

    Kvern Brent

    2008-10-01

    Full Text Available Abstract Background While the Osteoporosis Canada 2002 Canadian guidelines provided evidence based strategies in preventing, diagnosing, and managing this condition, publication and distribution of guidelines have not, in and of themselves, been shown to alter physicians clinical approaches. We hypothesize that primary care physicians enrolled in the Quality Circle project would change their patient management of osteoporosis in terms of awareness of osteoporosis risk factors and bone mineral density testing in accordance with the guidelines. Methods The project consisted of five Quality Circle phases that included: 1 Training & Baseline Data Collection, 2 First Educational Intervention & First Follow-Up Data Collection 3 First Strategy Implementation Session, 4 Final Educational Intervention & Final Follow-up Data Collection, and 5 Final Strategy Implementation Session. A total of 340 circle members formed 34 quality circles and participated in the study. The generalized estimating equations approach was used to model physician awareness of risk factors for osteoporosis and appropriate utilization of bone mineral density testing pre and post educational intervention (first year of the study. Odds ratios (OR and 95% confidence intervals (95% CI were calculated. Results After the 1st year of the study, physicians' certainty of their patients' risk factor status increased. Certainty varied from an OR of 1.4 (95% CI: 1.1, 1.8 for prior vertebral fracture status to 6.3 (95% CI: 2.3, 17.9 for prior hip fracture status. Furthermore, bone mineral density testing increased in high risk as compared with low risk patients (OR: 1.4; 95% CI: 1.2, 1.7. Conclusion Quality Circle methodology was successful in increasing both physicians' awareness of osteoporosis risk factors and appropriate bone mineral density testing in accordance with the 2002 Canadian guidelines.

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

    Science.gov (United States)

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

    2017-02-01

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

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

    Science.gov (United States)

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

    2012-05-01

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

  11. Change management for effective quality improvement: a primer.

    Science.gov (United States)

    Varkey, Prathibha; Antonio, Kayla

    2010-01-01

    Technological and medical advancements have dramatically accelerated the speed of change in the realm of health care. New technology, the changing needs of patients, and economic pressures all contribute to the need for health organizations to modify practices continually. Quality improvement (QI) of current processes is central to these efforts. To best manage the introduction of change through QI in a health organization, a focus on the people side of change is necessary. Change management is any action or process taken to smoothly transition an individual or group from the current state to a future desired state of being. The authors provide an overview of the steps to design and execute QI projects that require change management. Key steps for successful change management include assessing readiness for change, establishing a sense of urgency, assembling the steering team, developing an implementation plan, executing a pilot, disseminating change, and anchoring the change within the organization. Adoption of change management practices increases the odds of success because focus is placed on the people in the organization who make things happen.

  12. 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)

  13. 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.

  14. 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.

  15. 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…

  16. 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…

  17. 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.

  18. 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

  19. 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.

  20. 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

  1. 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.

  2. 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.

  3. 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...

  4. 提高审计项目质量刍议--谈审计项目负责人的“六员”角色%On Improving the Quality of Audit Project---the Audit Leader’s “Six Roles”

    Institute of Scientific and Technical Information of China (English)

    何必

    2016-01-01

    审计工作质量的高低,决定着审计工作目标能否成功实现。作为审计人员,尤其是审计项目负责人,要切实履行审计监督职责,在实施审计过程中,当好联络员、调查员、质检员、辅导员、书记员、协调员等角色,努力提高审计项目质量,确保审计工作目标顺利实现。%The quality of audit work determines whether the target of the audit work can be realized successfully or not. As an audit staff, especially the person in charge of the audit project, must fulfill the duty of audit supervision in the process of audit with “six roles” of liaison officers, investigators, inspectors, counselors, clerks, coordinator and other roles, and strive to improve the quality of audit projects, ensure that the audit target will be achieved successfully.

  5. Environmental Assessment of the Prather Water Line Improvement Project Otero County, New Mexico

    Science.gov (United States)

    2009-04-01

    remaining two sites has not been determined (LA II244I, LA I55866). From June II to June 13, 2008, archeologists from Ecological Communications...the pipeline on wildlife, vegetation, sensitive ecological features, and sensitive species. 4.4.2 Potential Impacts 4.4.2.1 Alternative A: U.S...Assessment - Prather Water Line Improvement Project April 2009 5-1 6.0 LIST OF PREP ARERS Victor Palma , EComm Quality Assurance Officer B.S. in Biology

  6. Influence of volunteer and project characteristics on data quality of biological surveys.

    Science.gov (United States)

    Lewandowski, Eva; Specht, Hannah

    2015-06-01

    Volunteer involvement in biological surveys is becoming common in conservation and ecology, prompting questions on the quality of data collected in such surveys. In a systematic review of the peer-reviewed literature on the quality of data collected by volunteers, we examined the characteristics of volunteers (e.g., age, prior knowledge) and projects (e.g., systematic vs. opportunistic monitoring schemes) that affect data quality with regards to standardization of sampling, accuracy and precision of data collection, spatial and temporal representation of data, and sample size. Most studies (70%, n = 71) focused on the act of data collection. The majority of assessments of volunteer characteristics (58%, n = 93) examined the effect of prior knowledge and experience on quality of the data collected, often by comparing volunteers with experts or professionals, who were usually assumed to collect higher quality data. However, when both groups' data were compared with the same accuracy standard, professional data were more accurate in only 4 of 7 cases. The few studies that measured precision of volunteer and professional data did not conclusively show that professional data were less variable than volunteer data. To improve data quality, studies recommended changes to survey protocols, volunteer training, statistical analyses, and project structure (e.g., volunteer recruitment and retention). © 2015, Society for Conservation Biology.

  7. 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...

  8. 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.

  9. Legacy Management CERCLA Sites. Quality Assurance Project Plan

    Energy Technology Data Exchange (ETDEWEB)

    Riddle, Donna L.

    2007-05-03

    S.M. Stoller Corporation is the contractor for the Technical Assistance Contract (TAC) for the U.S. Department of Energy (DOE) Office of Legacy Management (LM) operations. Stoller employs a management system that applies to all programs, projects, and business management systems funded through DOE-LM task orders. The management system incorporates the philosophy, policies, and requirements of health and safety, environmental compliance, and quality assurance (QA) in all aspects of project planning and implementation. Health and safety requirements are documented in the Health and Safety Manual (STO 2), the Radiological Control Manual (STO 3), the Integrated Safety Management System Description (STO 10), and the Drilling Health and Safety Requirements (STO 14). Environmental compliance policy and requirements are documented in the Environmental Management Program Implementation Manual (STO 11). The QA Program is documented in the Quality Assurance Manual (STO 1). The QA Manual (STO 1) implements the specific requirements and philosophy of DOE Order 414.1C, Quality Assurance. This manual also includes the requirements of other standards that are regularly imposed by customers, regulators, or other DOE orders. Title 10 Code of Federal Regulations Part 830, “Quality Assurance Requirements,” ANSI/ASQC E4-2004, “Quality Systems for Environmental Data and Technology Programs – Requirements with Guidance for Use,” and ISO 14001-2004, “Environmental Management Systems,” have been included. These standards are similar in content. The intent of the QA Manual (STO 1) is to provide a QA management system that incorporates the requirements and philosophy of DOE and other customers within the QA Manual. Criterion 1, “Quality Assurance Program,” identifies the fundamental requirements for establishing and implementing the QA management system; QA Instruction (QAI) 1.1, “QA Program Implementation,” identifies the TAC organizations that have responsibility for

  10. Improving image quality in laboratory x-ray phase-contrast imaging

    Science.gov (United States)

    De Marco, F.; Marschner, M.; Birnbacher, L.; Viermetz, M.; Noël, P.; Herzen, J.; Pfeiffer, F.

    2017-03-01

    Grating-based X-ray phase-contrast (gbPC) is known to provide significant benefits for biomedical imaging. To investigate these benefits, a high-sensitivity gbPC micro-CT setup for small (≍ 5 cm) biological samples has been constructed. Unfortunately, high differential-phase sensitivity leads to an increased magnitude of data processing artifacts, limiting the quality of tomographic reconstructions. Most importantly, processing of phase-stepping data with incorrect stepping positions can introduce artifacts resembling Moiré fringes to the projections. Additionally, the focal spot size of the X-ray source limits resolution of tomograms. Here we present a set of algorithms to minimize artifacts, increase resolution and improve visual impression of projections and tomograms from the examined setup. We assessed two algorithms for artifact reduction: Firstly, a correction algorithm exploiting correlations of the artifacts and differential-phase data was developed and tested. Artifacts were reliably removed without compromising image data. Secondly, we implemented a new algorithm for flatfield selection, which was shown to exclude flat-fields with strong artifacts. Both procedures successfully improved image quality of projections and tomograms. Deconvolution of all projections of a CT scan can minimize blurring introduced by the finite size of the X-ray source focal spot. Application of the Richardson-Lucy deconvolution algorithm to gbPC-CT projections resulted in an improved resolution of phase-contrast tomograms. Additionally, we found that nearest-neighbor interpolation of projections can improve the visual impression of very small features in phase-contrast tomograms. In conclusion, we achieved an increase in image resolution and quality for the investigated setup, which may lead to an improved detection of very small sample features, thereby maximizing the setup's utility.

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

    Directory of Open Access Journals (Sweden)

    Martin Bac

    2015-02-01

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

  12. [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.

  13. Quality Assurance Program Plan (QAPP) Waste Management Project

    Energy Technology Data Exchange (ETDEWEB)

    VOLKMAN, D.D.

    1999-10-27

    This document is the Quality Assurance Program Plan (QAPP) for Waste Management Federal Services of Hanford, Inc. (WMH), that implements the requirements of the Project Hanford Management Contract (PHMC), HNF-MP-599, Project Hanford Quality Assurance Program Description (QAPD) document, and the Hanford Federal Facility Agreement with Consent Order (Tri-Party Agreement), Sections 6.5 and 7.8. WHM is responsible for the treatment, storage, and disposal of liquid and solid wastes generated at the Hanford Site as well as those wastes received from other US Department of Energy (DOE) and non-DOE sites. WMH operations include the Low-Level Burial Grounds, Central Waste Complex (a mixed-waste storage complex), a nonradioactive dangerous waste storage facility, the Transuranic Storage Facility, T Plant, Waste Receiving and Processing Facility, 200 Area Liquid Effluent Facility, 200 Area Treated Effluent Disposal Facility, the Liquid Effluent Retention Facility, the 242-A Evaporator, 300 Area Treatment Effluent Disposal Facility, the 340 Facility (a radioactive liquid waste handling facility), 222-S Laboratory, the Waste Sampling and Characterization Facility, and the Hanford TRU Waste Program.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1993-08-10

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

  15. Teaching internal medicine residents quality improvement and patient safety: a lean thinking approach.

    Science.gov (United States)

    Kim, Christopher S; Lukela, Michael P; Parekh, Vikas I; Mangrulkar, Rajesh S; Del Valle, John; Spahlinger, David A; Billi, John E

    2010-01-01

    Patient safety (PS) and quality improvement (QI) are among the highest priorities for all health systems. Resident physicians are often at the front lines of providing care for patients. In many instances, however, QI and PS initiatives exclude trainees. By aligning the goals of the health system with those of the residency program to engage residents in QI and PS projects, there is a unique opportunity to fulfill both a corporate and educational mission to improve patient care. Here, the authors briefly describe one residency program's educational curriculum to provide foundational knowledge in QI and PS to all its trainees and highlight a resident team-based project that applied principles of lean thinking to evaluate the process of responding to an in-hospital cardiopulmonary arrest. This approach provided residents with a practical experience but also presented an opportunity for trainees to align with the health system's approach to improving quality and safety.

  16. 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.

  17. Guiding inpatient quality improvement: a systematic review of Lean and Six Sigma.

    Science.gov (United States)

    Glasgow, Justin M; Scott-Caziewell, Jill R; Kaboli, Peter J

    2010-12-01

    Two popular quality improvement (QI) approaches in health care are Lean and Six Sigma. Hospitals continue to adopt these QI approaches-or the hybrid Lean Sigma approach-with little knowledge on how well they produce sustainable improvements. A systematic literature review was conducted to determine whether Lean, Six Sigma, or Lean Sigma have been effectively used to create and sustain improvements in the acute care setting. Databases were searched for articles published in the health care, business, and engineering literatures. Study inclusion criteria required identification of a Six Sigma, Lean, or Lean Sigma project; QI efforts focused on hospitalized patients; descriptions of project improvements; and reported results. Depending on the quality of data reported, articles were classified as summary reports, pre-post observational studies, or time-series reports. Database searches identified 539 potential articles. After review of titles, abstracts, and full text, 47 articles met inclusion criteria--10 articles summarized multiple projects, 12 reported Lean projects, 20 reported Six Sigma projects, and 5 reported Lean Sigma projects. Generally, the studies provided limited data, with only 15 articles providing any sort of follow-up data; of the 15, only 3 report a follow-up period greater than two years. Lean, Six Sigma, and Lean Sigma as QI approaches can aid institutions in tackling a wide variety of problems encountered in acute care. However, the true impact of these approaches is difficult to judge, given that the lack of rigorous evaluation or clearly sustained improvements provides little evidence supporting broad adoption. There is still a need for future work that will improve the evidence base for understanding more about QI approaches and how to achieve sustainable improvement.

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

    Science.gov (United States)

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

    2010-01-01

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

  19. 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.

  20. 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%.