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Sample records for satisfaction continuous improvement

  1. How to improve patient satisfaction when patients are already satisfied: a continuous process-improvement approach.

    Science.gov (United States)

    Friesner, Dan; Neufelder, Donna; Raisor, Janet; Bozman, Carl S

    2009-01-01

    The authors present a methodology that measures improvement in customer satisfaction scores when those scores are already high and the production process is slow and thus does not generate a large amount of useful data in any given time period. The authors used these techniques with data from a midsized rehabilitation institute affiliated with a regional, nonprofit medical center. Thus, this article functions as a case study, the findings of which may be applicable to a large number of other healthcare providers that share both the mission and challenges faced by this facility. The methodology focused on 2 factors: use of the unique characteristics of panel data to overcome the paucity of observations and a dynamic benchmarking approach to track process variability over time. By focusing on these factors, the authors identify some additional areas for process improvement despite the institute's past operational success.

  2. Evaluation of a continuous quality improvement program in anticoagulant therapy: Feasibility, satisfaction and perception.

    Science.gov (United States)

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

    2016-11-01

    The ACO Program (Programme ACO), a continuous quality improvement program (CQIP) in anticoagulation therapy, was offered in community pharmacies as a pilot project. To evaluate the participants' appreciation for the various activities of the program. 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. 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. 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. The CQIP in anticoagulation therapy is appreciated by community pharmacists and is associated with an improved feeling of personal effectiveness.

  3. Increasing the satisfaction of general practitioners with continuing medical education programs: A method for quality improvement through increasing teacher-learner interaction

    Directory of Open Access Journals (Sweden)

    Fogelman Yacov

    2002-08-01

    Full Text Available Abstract Background Continuing medical education (CME for general practitioners relies on specialist-based teaching methods in many settings. Formal lectures by specialists may not meet the learning needs of practitioners and may cause dissatisfaction with traditional CME. Increasing learner involvement in teaching programs may improve learner satisfaction. Methods A quality improvement program for CME for 18 general practitioners in the Tel Aviv region was designed as a result of dissatisfaction with traditional CME activities. A two-step strategy for change was developed. The CME participants first selected the study topics relevant to them from a needs assessment and prepared background material on the topics. In the second step, specialist teachers were invited to answer questions arising from the preparation of selected topics. Satisfaction with the traditional lecture program and the new participatory program were assessed by a questionnaire. The quality criteria included the relevance, importance and applicability of the CME topic chosen to the participant's practice, the clarity of the presentation and the effective use of teaching aids by the lecturer and the potential of the lecturer to serve as a consultant to the participant. Results The participatory model of CME significantly increased satisfaction with relevance, applicability and interest in CME topics compared to the traditional lecture format. Conclusions Increased learner participation in the selection and preparation of CME topics, and increased interaction between CME teachers and learners results in increased satisfaction with teaching programs. Future study of the effect of this model on physician performance is required.

  4. 护理质量持续改进对患者满意度的影响%The influence of continuous improvement of the quality of nursing on patient satisfaction

    Institute of Scientific and Technical Information of China (English)

    刘燕; 曾桂红; 杨铃

    2015-01-01

    目的:探讨护理质量持续改进对患者满意度的影响。方法:回顾性分析2012年1月-12月间住院患者的满意度调查结果,在此基础上针对存在的问题采取相应的护理质量持续改进措施,对比措施实施前后的患者满意度。结果:实施护理质量改进措施后,每月患者满意度高于实施前(P<0.05),差异有统计学意义。结论:针对患者满意度调查中存在的问题进行分析,并实施相应的护理措施,有利于提高患者满意度。%Objective: The influence of continuous improvement of the quality of nursing on patient satisfaction were explored. Methods: From January 2012 to December 2012, satisfaction survey of hospitalized patients was retrospective analyzed. On the basis, the appropriate continuous improvement of the quality of nursing were adopted, while comparing patient satisfaction before and after the implementation of measures. Results: After the implementation of continuous improvement of the quality of nursing, patient satisfaction months was higher (P<0.05), with statistically significant difference. Conclusion: According to problems in patient satisfaction survey, appropriate care measures were adopted, to improve patient satisfaction.

  5. The Effect of 5S-Continuous Quality Improvement-Total Quality Management Approach on Staff Motivation, Patients' Waiting Time and Patient Satisfaction with Services at Hospitals in Uganda.

    Science.gov (United States)

    Take, Naoki; Byakika, Sarah; Tasei, Hiroshi; Yoshikawa, Toru

    2015-03-31

    This study aimed at analyzing the effect of 5S practice on staff motivation, patients' waiting time and patient satisfaction with health services at hospitals in Uganda. Double-difference estimates were measured for 13 Regional Referral Hospitals and eight General Hospitals implementing 5S practice separately. The study for Regional Referral Hospitals revealed 5S practice had the effect on staff motivation in terms of commitment to work in the current hospital and waiting time in the dispensary in 10 hospitals implementing 5S, but significant difference was not identified on patient satisfaction. The study for General Hospitals indicated the effect of 5S practice on patient satisfaction as well as waiting time, but staff motivation in two hospitals did not improve. 5S practice enables the hospitals to improve the quality of services in terms of staff motivation, waiting time and patient satisfaction and it takes as least four years in Uganda. The fourth year since the commencement of 5S can be a threshold to move forward to the next step, Continuous Quality Improvement.

  6. Continuous Personal Improvement.

    Science.gov (United States)

    Emiliani, M. L.

    1998-01-01

    Suggests that continuous improvement tools used in the workplace can be applied to self-improvement. Explains the use of such techniques as one-piece flow, kanban, visual controls, and total productive maintenance. Points out misapplications of these tools and describes the use of fishbone diagrams to diagnose problems. (SK)

  7. Continuous Personal Improvement.

    Science.gov (United States)

    Emiliani, M. L.

    1998-01-01

    Suggests that continuous improvement tools used in the workplace can be applied to self-improvement. Explains the use of such techniques as one-piece flow, kanban, visual controls, and total productive maintenance. Points out misapplications of these tools and describes the use of fishbone diagrams to diagnose problems. (SK)

  8. Continuous research of consumer satisfaction in hotel business

    OpenAIRE

    Jovanović Miloš; Sagić Zorica

    2007-01-01

    Consistent system for management of consumer satisfaction, based on continuous marketing research, contributes to more efficient adaptation of the offering package of a hotel enterprise to the expectations of target marketing segments, achieving higher level of marketing goals realization. By analyzing the degree of satisfaction through history, consumer loyalty, together with the determining factors of satisfaction and developed database on the consumer, it is possible to construct models, w...

  9. Improving Patient Satisfaction with Waiting Time

    Science.gov (United States)

    Eilers, Gayleen M.

    2004-01-01

    Waiting times are a significant component of patient satisfaction. A patient satisfaction survey performed in the author's health center showed that students rated waiting time lowest of the listed categories--A ratings of 58% overall, 63% for scheduled appointments, and 41% for the walk-in clinic. The center used a quality improvement process and…

  10. Lean Manufacturing Improves Emergency Department Throughput and Patient Satisfaction.

    Science.gov (United States)

    Kane, Marlena; Chui, Kristen; Rimicci, Janet; Callagy, Patrice; Hereford, James; Shen, Sam; Norris, Robert; Pickham, David

    2015-09-01

    A multidisciplinary team led by nursing leadership and physicians developed a plan to meet increasing demand and improve the patient experience in the ED without expanding the department's current resources. The approach included Lean tools and engaged frontline staff and physicians. Applying Lean management principles resulted in quicker service, improved patient satisfaction, increased capacity, and reduced resource utilization. Incorporating continuous daily management is necessary for sustainment of continuous improvement activities.

  11. Improving Customer Satisfaction: A People CMM Perspective

    Science.gov (United States)

    2010-10-11

    Work Environment Customer Relationship Management Program 19 Improving Customer Satisfaction: A People CMM Perspective P. Buttles, S. McGraw, D...Professional in 2009 and Customer Care Manager in July 2006. He has a bachelor of arts degree from the University of Pittsburgh and a bachelor of science...conferences throughout the United States and Europe. He has as a bachelor of science degree in management . 4 Improving Customer Satisfaction: A

  12. Continuous research of consumer satisfaction in hotel business

    Directory of Open Access Journals (Sweden)

    Jovanović Miloš

    2007-01-01

    Full Text Available Consistent system for management of consumer satisfaction, based on continuous marketing research, contributes to more efficient adaptation of the offering package of a hotel enterprise to the expectations of target marketing segments, achieving higher level of marketing goals realization. By analyzing the degree of satisfaction through history, consumer loyalty, together with the determining factors of satisfaction and developed database on the consumer, it is possible to construct models, which provide a reliable base for prediction of future consumer behavior, giving to that particular hotel a significant competitive advantage. On the basis of information created in the system for research of satisfaction, it is possible to identify potentially attractive segments of the consumer with whom the hotel should develop very close communication and long-term relationships. .

  13. Satisfaction with a distance continuing education program for health professionals.

    Science.gov (United States)

    Bynum, Ann B; Irwin, Cathy A; Cohen, Betty

    2010-09-01

    This study assessed differences in program satisfaction among health professionals participating in a distance continuing education program by gender, ethnicity, discipline, and community size. A one-group posttest design was used with a sample of 45,996 participants in the University of Arkansas for Medical Sciences, Rural Hospital, Distance Continuing Medical Education Program during 1995-2007. This program provided 2,219 continuing education programs for physicians (n = 7,047), nurses (n = 21,264), allied health (n = 3,230) and dental (n = 305) professionals, pharmacists (n = 4,088), administrators (n = 1,211), and marketing/finance/human resources professionals (n = 343). These programs were provided in Arkansas hospitals, clinics, and area health education centers. Interactive video technology and the Internet were used to deliver these programs. The program satisfaction instrument demonstrated adequate internal consistency reliability (Cronbach's alpha = 0.91) and construct validity. Participants had high levels of satisfaction regarding knowledge and skills, use of information to enhance patient care, program quality, and convenience of the technology (mean total satisfaction score = 4.44, range: 1-5). Results from the t-test for independent samples and one-way analysis of variance indicated that men (p = 0.01), African-Americans and Hispanics (p distance continuing education programs.

  14. Does implementation of ISO standards in hospitals improve patient satisfaction?

    Directory of Open Access Journals (Sweden)

    Vahid Keshtkar

    2017-01-01

    Full Text Available Introduction: Around the world, a large number of projects have been developed with the aim of assessing patient satisfaction especially in hospitals. As an important indicator of the quality of health care system, Patients’ perception of health care has been the center of attention over the recent 20 years. Method: 402 patients who were hospitalized in teaching hospitals affiliated to the Shiraz University of Medical Sciences were investigated. Patients’ satisfactions of the health care services were assessed using the translated and modified version of the KQCAH consisted of 44 questions divided to7 categories of Respect and Caring, Effectiveness and Continuity, Appropriateness, Information, Efficiency, Meals, First Impression, Staff Diversity. All of the patients were asked to fill out the questionnaire (with written informed consents at the time of discharge from the hospitals. Results: Regarding total score of patient satisfaction the ISO-certified hospitals did not show advantages over the uncertified hospitals. The total score of patients’ satisfaction ranged from 66.5 to 77.5 in. Overall, only in one ISO-certified hospital the total score of patient satisfaction representing all dimensions, was significantly higher comparing to other hospitals included in the study. Conclusion: It seems that solitary application of ISO standards could not improve patient satisfaction in hospitals affiliated to Shiraz University of Medical Sciences.

  15. Improving parental satisfaction in pediatric orthopaedics.

    Science.gov (United States)

    Williams, Geraint; Pattison, Giles; Mariathas, Chrishan; Lazar, Joanna; Rashied, Muhammad

    2011-01-01

    No previous studies have attempted to measure parental satisfaction and service quality with regards to pediatric orthopaedic inpatient care. We performed a prospective observational study to identify areas of inpatient care which might be improved to increase overall parental satisfaction. We used the validated Swedish parent satisfaction questionnaire to generate data from 104 pediatric orthopaedic hospital inpatients between August 2009 and May 2010 (49 elective and 55 trauma pediatric orthopaedic admissions; median age range, 2 to 6 y). Questions focused on 8 domains of quality: information on illness, information on routines, accessibility, medical treatment, care processes, staff attitudes, parent participation, and staff work environment. Scores generated a percentage of the maximum achievable for that quality index. Data were analyzed using recognized statistical methods. Overall mean combined scores for the care indices were highest for parents' perception of "medical treatment" (95%) and "staff attitudes" (95%). The medical treatment index includes questions regarding staff member's skill and competence. Lowest scores corresponded to the index "information on routines" (86%). Information on routines applies to parental awareness of ward rounds, to whom questions should be directed and which doctors and nursing staff are responsible for their child's care. Lower scores in relation to this index were substantiated by comments from relatives requesting greater information provision. The information parents required was routinely provided suggesting that retention rather than lack of information is the main issue. Provision of information pamphlets tailored to common injuries or elective procedures might prove an effective method for improving parental satisfaction and overall care. Improving information provision and parental retention of this information is the strategy most likely to improve quality of service and parental satisfaction for pediatric

  16. A study on the continuing education of radiologic technologists: Focused on current status and satisfaction of continuing education

    Energy Technology Data Exchange (ETDEWEB)

    Min, Hye Lim; Choi, In Seok; Nam, So Ra; Kim, Hyun Ji; Yoon, Yong Su; Her, Jae; Han, Seong Gyu; Kim, Jung Min [Dept. of bio-convergence engineering, graduate school, Korea university, Seoul (Korea, Republic of); Ahn, Duck Sun [Korea university college of medicine, Seoul (Korea, Republic of)

    2014-06-15

    In this study, we surveyed the current status, satisfaction and demand of radiologic technologist continuing education for 93 radiologic technologists who participated in the continuing education. To understand the current status and general evaluation and to find out the improvement direction, survey was conducted on 3 categories: participation, satisfaction and demand of continuing education. In addition, we analyzed the continuing education implementation status and the management system by collecting related regulations. As a result, the education completion rates of radiologic technologists from 2010 to 2012 were respectively 42.6%, 43.4% and 34.2%; the rates were similar to other medical technician’s average education completion rates. According to the survey, in case of participation, the most frequent answer was ‘more than five times less than 10 times per year’ with 48.4% and in satisfaction section, the most common answer was ‘Average(3)’ with 34.4%. In demand of continuing education section, 32.8% of the respondents chose ‘Clinical skill training in major field’. In the results of this research, continuing education needs to be managed in the direction of helping radiologists improve their personal ability and self development. Furthermore, to meet the demand of radiologists, the quality of continuing education should be improved to satisfy the educatee.

  17. KAIZEN CONTINUOUS IMPROVEMENT

    OpenAIRE

    Yenque D., Julio; Universidad Nacional Mayor de San Marcos; García P., Manuel; Universidad Nacional Mayor de San Marcos; Raez G., Luis; Universidad Nacional Mayor de San Marcos

    2014-01-01

    Many times we ask the question why Japanese companies are competitive?, Surely many of the answers to this mystery have support in the Kaizen. And the Kaizen is not a simple concept, it is a whole way of life that involves both managers and workers in the pursuit of progressive improvement of enterprises. In his book Kaizen, The Key to Japanese Competitive Advantage, Masaaki Imai explains in simple terms what is the essence of this philosophy: Kaizen means improvement means further progressiv...

  18. Occupational commitment and job satisfaction mediate effort-reward imbalance and the intention to continue nursing.

    Science.gov (United States)

    Satoh, Miho; Watanabe, Ikue; Asakura, Kyoko

    2017-01-01

    Occupational commitment and job satisfaction are major predictors of the intention to continue nursing. This study's purpose was to verify the mediating effects of job satisfaction and three components of occupational commitment on the relationship between effort-reward imbalance and the intention to continue nursing. A self-report questionnaire was distributed to 3977 nurses by the nursing department of 12 hospitals in the Tohoku and Kanto districts of Japan in 2013. Of these, 1531 (response rate: 38.5%) nurses returned the questionnaire by mail and the complete data that were provided by 1241 nurses (valid response rate: 31.2%) were analyzed. Structural equation modeling showed that the effort-reward ratio had negative effects on job satisfaction and affective and normative occupational commitment. Job satisfaction and affective and normative occupational commitment had positive effects on the intention to continue nursing, whereas the effort-reward ratio had no direct effect on the intention to continue nursing. Continuance occupational commitment was not a mediator, but it positively influenced the intention to continue nursing. The findings suggest that it is important to increase job satisfaction and affective and normative occupational commitment in order to enhance their buffering effects on the relationship between job stress and the intention to continue nursing. Measures to increase continuance occupational commitment also would be an effective method of strengthening the intention to continue nursing. Improvements in these areas should contribute to an increase in nurses' intention to continue nursing and prevent the loss of this precious human resource from the health sector. © 2016 Japan Academy of Nursing Science.

  19. Improved Parameterized Algorithms for Constraint Satisfaction

    CERN Document Server

    Kim, Eun Jung

    2010-01-01

    Results from inapproximability provide several sharp thresholds on the approximability of important optimization problems. We give several improved parameterized algorithms for solving constraint satisfaction problems above a tight threshold. Our results include the following: - Improved algorithms for any Constraint Satisfaction Problem: Take any boolean Max-CSP with at most $c$ variables per constraint such that a random assignment satisfies a constraint with probability $p$. There is an algorithm such that for every instance of the problem with $m$ constraints, the algorithm decides whether at least $pm+k$ constraints can be satisfied in $O(2^{(c(c+1)/2) k} m)$ time. This improves on results of [Alon et al., SODA 2010] and [Crowston et al., SWAT 2010]. We observe that an $O(2^{\\eps k + \\eps m})$ time algorithm for every $\\eps > 0$ would imply that 3SAT is in subexponential time, so it seems unlikely that our runtime dependence on $k$ can be significantly improved. Our proof also shows that every Max-$c$-CS...

  20. Evaluation and Improvement of Food Safety Satisfaction Based on QFD

    Directory of Open Access Journals (Sweden)

    Pu Jin

    2015-05-01

    Full Text Available In view of the social phenomenon of people's generally low satisfaction with food safety, we introduced the QFD method to make evaluation and guidance for improvement. Based on scientific and reasonable evaluation index system of food safety satisfaction and the “quality house” of QFD core tool, a food safety satisfaction evaluation model was constructed. On the basis of the evaluation results, we analyzed the public food safety requirements and constructed the quality house between the public food safety requirements and the food safety satisfaction improvement measures, so as to determine the priority of configuration sequence of improvement measures.

  1. ROLE OF WORK-FAMILY ENRICHMENT IN IMPROVING JOB SATISFACTION

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    Ng Swee Fung

    2014-01-01

    Full Text Available The role of work-family enrichment in improving job satisfaction has been given little attention. In this study a mediation model was tested which includes work-family enrichment as the mediator, job characteristics (job autonomy and job involvement as antecedent factors and job satisfaction as the outcome. Data were gathered from 280 public secondary school teachers in Malaysia using self-administered questionnaires. Work-family enrichment partially mediated the relationships between job characteristics and job satisfaction. The results contribute towards understanding how work-family enrichment could help improve job satisfaction.

  2. Evaluation and Improvement of Food Safety Satisfaction Based on QFD

    OpenAIRE

    Pu Jin; Lu Qiang

    2015-01-01

    In view of the social phenomenon of people's generally low satisfaction with food safety, we introduced the QFD method to make evaluation and guidance for improvement. Based on scientific and reasonable evaluation index system of food safety satisfaction and the “quality house” of QFD core tool, a food safety satisfaction evaluation model was constructed. On the basis of the evaluation results, we analyzed the public food safety requirements and constructed the quality house between the publi...

  3. Improving Employee Satisfaction Priority through Performance Control Matrix

    Directory of Open Access Journals (Sweden)

    Shun-Hsing Chen

    2014-11-01

    Full Text Available The study addresses Performance Control Matrix (PCM to determine service quality items of priority for improvement. Most businesses focus on customer satisfaction when undertaking surveys of satisfaction and dissatisfaction, while generally neglecting employee satisfaction. Therefore, this study develops an integrated model to improve service quality in Taiwanese finance industry employees. A questionnaire is designed to determine the priority of improvement objectives derived from certain questionnaire items that fall into the improvement zone of the PCM. Ten items are found to fall into the improvement zone of the PCM. The present results show that the finance industry employees surveyed in Taiwan were dissatisfied with their job security, salaries, annual bonus, and fair distribution of operational profits. The ten improvement items mostly belong to two dimensions - ‘Pay and Benefits’ and ‘Motivation’. The managers of the financial institutions should seek to improve these quality attributes by devoting more resources to these items, thus promoting employee satisfaction.

  4. Improving patient satisfaction with pain management using Six Sigma tools.

    Science.gov (United States)

    DuPree, Erin; Martin, Lisa; Anderson, Rebecca; Kathuria, Navneet; Reich, David; Porter, Carol; Chassin, Mark R

    2009-07-01

    Patient satisfaction as a direct and public measure of quality of care is changing the way hospitals address quality improvement. The feasibility of using the Six Sigma DMAIC (Define, Measure, Analyze, Improve, Control) methodology to improve patient satisfaction as it relates to pain management was evaluated. This project used the DMAIC methodology to improve patients' overall satisfaction with pain management on two inpatient units in an urban academic medical center. Pre- and postintervention patient surveys were conducted. The DMAIC methodology provided a data-driven structure to determine the optimal improvement strategies, as well as a long-term plan for maintaining any improvements. In addition, the Change Acceleration Process (CAP) was used throughout the project's various DMAIC stages to further the work of the team by creating a shared need to meet the objectives of the project. Overall satisfaction with pain management "excellent" ratings increased from 37% to 54%. Both units surpassed the goal of at least 50% of responses in the "excellent" category. Several key drivers of satisfaction with pain management were uncovered in the Analyze phase of the project, and each saw rating increases from the pre-intervention to postintervention surveys. Ongoing monitoring by the hospital inpatient satisfaction survey showed that the pain satisfaction score improved in subsequent quarters as compared with the pre-intervention period. The Six Sigma DMAIC methodology can be used successfully to improve patient satisfaction. The project led to measurable improvements in patient satisfaction with pain management, which have endured past the duration of the Six Sigma project. The Control phase of DMAIC allows the improvements to be incorporated into daily operations.

  5. Resident satisfaction with continuity clinic and career choice in general internal medicine.

    Science.gov (United States)

    Peccoralo, Lauren A; Tackett, Sean; Ward, Lawrence; Federman, Alex; Helenius, Ira; Christmas, Colleen; Thomas, David C

    2013-08-01

    The quality of the continuity clinic experience for internal medicine (IM) residents may influence their choice to enter general internal medicine (GIM), yet few data exist to support this hypothesis. To assess the relationship between IM residents' satisfaction with continuity clinic and interest in GIM careers. Cross-sectional survey assessing satisfaction with elements of continuity clinic and residents' likelihood of career choice in GIM. IM residents at three urban medical centers. Bivariate and multivariate associations between satisfaction with 32 elements of outpatient clinic in 6 domains (clinical preceptors, educational environment, ancillary staff, time management, administrative, personal experience) and likelihood of considering a GIM career. Of the 225 (90 %) residents who completed surveys, 48 % planned to enter GIM before beginning their continuity clinic, whereas only 38 % did as a result of continuity clinic. Comparing residents' likelihood to enter GIM as a result of clinic to likelihood to enter a career in GIM before clinic showed that 59 % of residents had no difference in likelihood, 28 % reported a lower likelihood as a result of clinic, and 11 % reported higher likelihood as a result of clinic. Most residents were very satisfied or satisfied with all clinic elements. Significantly more residents (p ≤ 0.002) were likely vs. unlikely to enter GIM if they were very satisfied with faculty mentorship (76 % vs. 53 %), time for appointments (28 % vs. 11 %), number of patients seen (33 % vs. 15 %), personal reward from work (51 % vs. 23 %), relationship with patients (64 % vs. 42 %), and continuity with patients (57 % vs. 33 %). In the multivariate analysis, being likely to enter GIM before clinic (OR 29.0, 95 % CI 24.0-34.8) and being very satisfied with the continuity of relationships with patients (OR 4.08, 95 % CI 2.50-6.64) were the strongest independent predictors of likelihood to enter GIM as a result of clinic. Resident satisfaction

  6. Integrating patient satisfaction into performance measurement to meet improvement challenges.

    Science.gov (United States)

    Smith, J E; Fisher, D L; Endorf-Olson, J J

    2000-05-01

    A Value Compass has been proposed to guide health care data collection. The "compass corners" represent the four types of data needed to meet health care customer expectations: appropriate clinical outcomes, improved functional status, patient satisfaction, and appropriate costs. Collection of all four types of data is necessary to select processes in need of improvement, guide improvement teams, and monitor the success of improvement efforts. INTEGRATED DATA AT BRYANLGH: BryanLGH Medical Center in Lincoln, Nebraska, has adopted multiple performance measurement systems to collect clinical outcome, financial, and patient satisfaction data into integrated databases. Data integration allows quality professionals at BryanLGH to identify quality issues from multiple perspectives and track the interrelated effects of improvement efforts. A CASE EXAMPLE: Data from the fourth quarter of 1997 indicated the need to improve processes related to cesarean section (C-section) deliveries. An interdisciplinary team was formed, which focused on educating nurses, physicians, and the community about labor support measures. Physicians were given their own rates of C-section deliveries. The C-section rate decreased from 27% to 19%, but per-case cost increased. PickerPLUS+ results indicated that BryanLGH obstetric patients reported fewer problems with receiving information than the Picker norm, but they reported more problems with the involvement of family members and friends. The data collected so far have indicated a decrease in the C-section rate and a need to continue to work on cost and psychosocial issues. A complete analysis of results was facilitated by integrated performance management systems. Successes have been easily tracked over time, and the need for further work on related processes has been clearly identified.

  7. 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)

  8. ROLE OF WORK-FAMILY ENRICHMENT IN IMPROVING JOB SATISFACTION

    OpenAIRE

    Ng Swee Fung; Aminah Ahmad; Zoharah Omar

    2014-01-01

    The role of work-family enrichment in improving job satisfaction has been given little attention. In this study a mediation model was tested which includes work-family enrichment as the mediator, job characteristics (job autonomy and job involvement) as antecedent factors and job satisfaction as the outcome. Data were gathered from 280 public secondary school teachers in Malaysia using self-administered questionnaires. Work-family enrichment partially mediated the relationships between job ch...

  9. Patient satisfaction and barriers to initiating real-time continuous glucose monitoring in early pregnancy in women with diabetes

    DEFF Research Database (Denmark)

    Secher, A L; Madsen, A B; Nielsen, Lene Ringholm;

    2012-01-01

    for 6 days at median 9 (range 6-14) gestational weeks and were asked to answer a semi-structured questionnaire on patient satisfaction. Results: Median HbA(1c) was 49 (range 34-86) mmol/mol) [6.6 (5.3-10.0) %] and duration of diabetes was 12 (0.5-37) years. Continuous glucose monitoring was used for 6......Aim: To evaluate self-reported satisfaction and barriers to initiating real-time continuous glucose monitoring in early pregnancy among women with pregestational diabetes. Methods: Fifty-four women with Type 1 diabetes and 14 women with Type 2 diabetes were offered continuous glucose monitoring...... monitoring during daytime and twelve (18%) during sleep. Many women reported improved diabetes understanding (52%) and would recommend continuous glucose monitoring to others (83%). Twenty-four patients (36%) had continuous glucose monitoring removed earlier than planned (before the intended 6 days...

  10. School satisfaction and social relations: Swedish schoolchildren's improvement suggestions.

    Science.gov (United States)

    Persson, Louise; Haraldsson, Katarina; Hagquist, Curt

    2016-01-01

    The aim was to explore schoolchildren's views on how to increase school satisfaction and improve social relations among peers at school. Improvement suggestions were collected from school children aged 10-12 years with the help of a feedback model developed for the purpose. Qualitative content analysis was used. Two categories emerged from the analysis: 'psychosocial climate', which included the subcategories 'adults' roles and responsibilities' and 'classmates' norms and values'; 'influence', which included the subcategories 'changes in the physical environment' and 'flexible learning'. The categories are seen as important to increase school satisfaction and improve social relations among peers at school. Examining children's opinions is requested and promoted by the UN convention on the Rights of the Child. The findings contribute to the field by showing how school satisfaction and social relations might be improved, if the child perspective is considered in the planning of health promotion activities in school.

  11. Identifying What Matters to Students: Improving Satisfaction and Defining Priorities at Santa Fe Community College

    Science.gov (United States)

    Kress, Anne M.

    2006-01-01

    This chapter describes Santa Fe Community College's use of the Noel-Levitz Student Satisfaction Inventory to guide iterative development of institutional improvements associated with student satisfaction.

  12. Assessing customer satisfaction for improving NOAA's climate products and services

    Science.gov (United States)

    Meyers, J. C.; Hawkins, M. D.; Timofeyeva, M. M.

    2009-12-01

    NOAA's National Weather Service (NWS) Climate Services Division (CSD) is developing a comprehensive climate user requirements process with the ultimate goal of producing climate services that meet the needs of NWS climate information users. An important part of this effort includes engaging users through periodical surveys conducted by the Claes Fornell International (CFI) Group using the American Customer Satisfaction Index (ACSI). The CFI Group conducted a Climate Services Satisfaction (CSS) Survey in May of 2009 to measure customer satisfaction with current products and services and to gain insight on areas for improvement. The CSS Survey rates customer satisfaction on a range of NWS climate services data and products, including Climate Prediction Center (CPC) outlooks, drought monitoring, and ENSO monitoring and forecasts, as well as NWS local climate data services. In addition, the survey assesses the users of the products to give the NWS insight into its climate customer base. The survey also addresses specific topics such as NWS forecast category names, probabilistic nature of climate products, and interpretation issues. The survey results identify user requirements for improving existing NWS climate services and introducing new ones. CSD will merge the survey recommendations with available scientific methodologies and operational capabilities to develop requirements for improved climate products and services. An overview of the 2009 survey results will be presented, such as users' satisfaction with the accuracy, reliability, display and functionality of products and services.

  13. 持续护理质量改进对门诊预检分诊准确率及满意度的影响%Effects of Continuous Nursing Quality Improvement on the Accuracy and Degree of Satisfaction of Preview and Triage in OPD

    Institute of Scientific and Technical Information of China (English)

    杨秀兰; 刘江

    2015-01-01

    Objective:To investigate the effects of continuous nursing quality improvement on the accu-racy and degree of satisfaction of preview and triage in OPD,to elevate the quality of care in OPD.Method:Continuous nursing quality improvement was implemented from Mar.to Aug.2013, 100 patients were ran-domly selected from Jan.to Feb.2013 ( anterior group) and June to July 2013 ( later group) respectively, and the accuracies and degrees of satisfaction of preview and triage in OPD were compared.Result:The ac-curacy of preview and triage in OPD in the patients of the later group was 97.00%, while that of the anterior group was 90.00%, and the difference between the two groups was statistically significant ( P<0.05) .All the scores of the scale of degree of satisfaction in the patient of the later group were significantly higher than those of the anterior group, and the differences were statistically significant (P<0.05).Conclusion: Continuous nursing quality improvement can significantly elevate the accuracy and degree of satisfaction of preview and triage in OPD and elevate the quality of care in OPD.%目的:持续护理质量改进对门诊预检分诊准确率及满意度的影响,提高门诊护理质量。方法:2013年3~8月实施持续护理质量改进措施,分别截取2013年1至2月和2013年6至7月两个时段,每个时间段随机抽取100例患者,比较门诊预检分诊准确率及满意度。结果:实施后组患者门诊预检分诊准确率97.00%,实施前组为90.00%,二者比较差异有统计学意义( P<0.05)。实施后组患者满意度量表各项评分均明显高于实施前组,差异均有统计学意义( P<0.05)。结论:持续护理质量改进够明显提高门诊预检分诊准确率及患者满意度,提高门诊护理质量。

  14. Developing a Continuous Improvement System

    Science.gov (United States)

    2016-09-16

    to ensure that its employees enhance their knowledge, skills and experiences. These improved competencies help them achieve personal and career ...Army’s Career Acquisition Personnel and Position Management In- formation System. This system allows the employee to plan, coordinate, and manage their...The initial chal- lenge was to adapt the prototype equipment to the facilities at CAAA, which received the primary pieces of equipment such as the

  15. Examining the Satisfaction Levels of Continual Professional Development Provided by a Rural Accounting Professional Body

    Science.gov (United States)

    Halabi, Abdel K.

    2014-01-01

    The Society for the Provision of Education in Rural Australia (SPERA) recognises education as a lifelong process, and there is a need for continuing education and training to be available to rural communities. This paper examines the satisfaction levels of accounting continual professional development (CPD) when provided by a rural accounting…

  16. Satisfaction with Appearance and the Desired Treatment to Improve Aesthetics

    Directory of Open Access Journals (Sweden)

    Bader K. Al-Zarea

    2013-01-01

    Full Text Available Objective. To identify participants’ satisfaction with appearance and the desired treatment to improve aesthetics. Materials and Methods. 220 participants (127 males and 93 females, mean age = 21.4 ± 1.5 years were recruited into the study. A structured questionnaire was used to assess patients’ satisfaction with appearance and what treatment they desire to improve aesthetics. Participants scored the level of satisfaction with appearance using visual analogue scale. Results. The VAS mean score of satisfaction with general appearance was 6.8 ± 2.3. Half participants were dissatisfied with tooth appearance and 65.9% were dissatisfied with tooth colour. Higher VAS scores were associated with higher desire for all treatments that improve tooth appearance (. Dissatisfaction with tooth appearance increased with increased dissatisfaction with teeth colour, feeling of poor tooth alignment, presence of fractured anterior teeth, and increased desire for orthodontic, crowns, and dentures treatments (. Dissatisfaction with tooth colour was associated with increased desire for tooth whitening and tooth coloured fillings (. Conclusions. Participants had high levels of dissatisfaction with tooth appearance and tooth colour. Dissatisfaction with tooth colour contributed to the increased dissatisfaction with tooth appearance. Dissatisfaction with tooth appearance, colour, alignment, and condition was significantly related to high desire for aesthetic treatments.

  17. Leveraging information technology to drive improvement in patient satisfaction.

    Science.gov (United States)

    Nash, Mary; Pestrue, Justin; Geier, Peter; Sharp, Karen; Helder, Amy; McAlearney, Ann Scheck

    2010-01-01

    A healthcare organization's commitment to quality and the patient experience requires senior leader involvement in improvement strategies, and accountability for goals. Further, improvement strategies are most effective when driven by data, and in the world of patient satisfaction, evidence is growing that nurse leader rounding and discharge calls are strategic tactics that can improve patient satisfaction. This article describes how The Ohio State University Medical Center (OSUMC) leveraged health information technology (IT) to apply a data-driven strategy execution to improve the patient experience. Specifically, two IT-driven approaches were used: (1) business intelligence reporting tools were used to create a meaningful reporting system including dashboards, scorecards, and tracking reports and (2) an improvement plan was implemented that focused on two high-impact tactics and data to hardwire accountability. Targeted information from the IT systems enabled clinicians and administrators to execute these strategic tactics, and senior leaders to monitor achievement of strategic goals. As a result, OSUMC's inpatient satisfaction scores on the Hospital Consumer Assessment of Healthcare Providers and Systems survey improved from 56% nines and tens in 2006 to 71% in 2009.

  18. Continuous Improvement and Collaborative Improvement: Similarities and Differences

    DEFF Research Database (Denmark)

    Middel, Rick; Boer, Harry; Fisscher, Olaf

    2006-01-01

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

  19. Continual improvement: A bibliography with indexes, 1992-1993

    Science.gov (United States)

    1994-01-01

    This bibliography lists 606 references to reports and journal articles entered into the NASA Scientific and Technical Information Database during 1992 to 1993. Topics cover the philosophy and history of Continual Improvement (CI), basic approaches and strategies for implementation, and lessons learned from public and private sector models. Entries are arranged according to the following categories: Leadership for Quality, Information and Analysis, Strategic Planning for CI, Human Resources Utilization, Management of Process Quality, Supplier Quality, Assessing Results, Customer Focus and Satisfaction, TQM Tools and Philosophies, and Applications. Indexes include subject, personal author, corporate source, contract number, report number, and accession number.

  20. Flipping the classroom to improve student performance and satisfaction.

    Science.gov (United States)

    Missildine, Kathy; Fountain, Rebecca; Summers, Lynn; Gosselin, Kevin

    2013-10-01

    This study aimed to determine the effects of a flipped classroom (i.e., reversal of time allotment for lecture and homework) and innovative learning activities on academic success and the satisfaction of nursing students. A quasi-experimental design was used to compare three approaches to learning: traditional lecture only (LO), lecture and lecture capture back-up (LLC), and the flipped classroom approach of lecture capture with innovative classroom activities (LCI). Examination scores were higher for the flipped classroom LCI group (M = 81.89, SD = 5.02) than for both the LLC group (M = 80.70, SD = 4.25), p = 0.003, and the LO group (M = 79.79, SD = 4.51), p flipped classroom method than with either of the other methods (p classroom activities can result in improved learning but not necessarily improved student satisfaction.

  1. Improving Customer Satisfaction in an R and D Environment

    Science.gov (United States)

    Alexander, Anita; Liou, Y. H. Andrew

    1998-01-01

    Satisfying customer needs is critical to the sustained competitive advantage of service suppliers. It is therefore important to understand the types of customer needs which, if fulfilled or exceeded, add value and contribute to overall customer satisfaction. This study identifies the needs of various research and development (R&D) customers who contract for engineering and design support services. The Quality Function Deployment (QFD) process was used to organize and translate each customer need into performance measures that, if implemented, can improve customer satisfaction. This study also provides specific performance measures that will more accurately guide the efforts of the engineering supplier. These organizations can either implement the QFD methodology presented herein or extract a few performance measures that are specific to the quality dimensions in need of improvement. Listening to 'what' customers talk about is a good first start.

  2. The Expert System Designed to Improve Customer Satisfaction

    CERN Document Server

    Devi, P Isakki alias

    2011-01-01

    Customer Relationship Management becomes a leading business strategy in highly competitive business environment. It aims to enhance the performance of the businesses by improving the customer satisfaction and loyalty. The objective of this paper is to improve customer satisfaction on product's colors and design with the help of the expert system developed by using Artificial Neural Networks. The expert system's role is to capture the knowledge of the experts and the data from the customer requirements, and then, process the collected data and form the appropriate rules for choosing product's colors and design. In order to identify the hidden pattern of the customer's needs, the Artificial Neural Networks technique has been applied to classify the colors and design based upon a list of selected information. Moreover, the expert system has the capability to make decisions in ranking the scores of the colors and design presented in the selection. In addition, the expert system has been validated with a different...

  3. 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.

  4. Continuous Improvement and Collaborative Improvement: Similarities and Differences

    NARCIS (Netherlands)

    Middel, Rick; Boer, Harry; Fisscher, Olaf

    2006-01-01

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

  5. Implementing a customer focused continual business improvement program to improve the maintenance process

    Energy Technology Data Exchange (ETDEWEB)

    Kharshafdjian, G.; Fisher, C.; Beres, T.; Brooks, S.; Forbes, S.; Krause, M.; McAuley, K.; Wendorf, M. [Atomic Energy of Canada Limited, Chalk River, Ontario (Canada)

    2006-07-01

    Global market pressures and increasing competition demands that successful companies establish a continual business improvement program as part of implementing its business strategy. Such programs must be driven by the definition of quality from the customer's perspective. This customer quality focus often requires a change in all aspects of the business including products, services, processes and culture. This paper will describe how Atomic Energy of Canada Limited implemented a Continual Business Improvement Program in their Nuclear Laboratories Business Unit. In particular, to review how the techniques were applied to improve the maintenance process and the status of the project. Customer (internal users of the processes at CRL) feedback has shown repeatedly there is dissatisfaction of the maintenance process. Customers complain about jobs not getting done to schedule or being deferred. A project has been launched with the following goals: to improve the maintenance process customer satisfaction and increase trades wrench time by 30 minutes / trade / day. DMAIC (Define-Measure-Analyze-Improve-Control) methodology was applied to find out the Root Cause(s) of the problem, provide solutions, and implement improvements. The expected Operational Benefits include: Executing work efficiently to quality standards and business performance of the site, improve maintenance efficiencies, reduce cycle time for maintenance process and improve process yield, and improve customer and employee satisfaction. (author)

  6. IMPROVING BANK QUALITY DIMENSIONS TO INCREASE CUSTOMER SATISFACTION

    Directory of Open Access Journals (Sweden)

    Lăcrămioara RADOMIR

    2011-01-01

    Full Text Available The purpose of this study is twofold: 1. examine the relationship betweenservice quality dimensions and customer satisfaction with bank territorialunits; 2. establish which quality measure method out of the four considered inthis study should be applied in order to better determine the areas that needfurther improvement and investment. In this respect, we performed PrincipalComponent Regression (PCR and considered direct importance andperformance measures as well. Our results reveal that human resourceshave the greatest impact on customers’ satisfaction with bank territorial unitsand that both “Convenience and Efficiency” and “Bank personnel” are thedimensions that bank management should consider in their efforts to improveand maintain the service quality level. To the best of our knowledge, this isthe first study which tries to emphasize the relationship between servicequality dimensions and Romanian customers’ satisfaction with bank territorialunits. The main limit of the study lies in the fact that data were collectedamong the customers of a single bank. Nevertheless, it provides valuableinformation about the Romanian market and ought to be considered astarting point for further studies.

  7. Human Resource Management for Continuous Improvement

    DEFF Research Database (Denmark)

    Jørgensen, Frances; Laugen, Bjørge Timenes; Boer, Harry

    2007-01-01

    This paper investigates the relationship between HRM practices and Continuous Improvement (CI) activities in order to gain an understanding of how the HRM function may be utilized to improve CI implementation success, and consequently, company performance. The paper begins with a brief review of ...

  8. Human Resource Management for Continuous Improvement

    DEFF Research Database (Denmark)

    Jørgensen, Frances; Laugen, Bjørge; Boer, Harry

    2006-01-01

    The objective of this paper is to investigate the relationship between HRM practices and Continuous Improvement (CI) activities in order to gain an understanding of how the HRM function may be utilized to improve CI implementation success, and consequently, organizational performance. The paper i...

  9. Human Resource Management for Continuous Improvement

    DEFF Research Database (Denmark)

    Jørgensen, Frances; Laugen, Bjørge Timenes; Boer, Harry

    2007-01-01

    This paper investigates the relationship between HRM practices and Continuous Improvement (CI) activities in order to gain an understanding of how the HRM function may be utilized to improve CI implementation success, and consequently, company performance. The paper begins with a brief review of ...

  10. Continue Service Improvement at CERN Computing Centre

    Science.gov (United States)

    Barroso Lopez, M.; Everaerts, L.; Meinhard, H.; Baehler, P.; Haimyr, N.; Guijarro, J. M.

    2014-06-01

    Using the framework of ITIL best practises, the service managers within CERN-IT have engaged into a continuous improvement process, mainly focusing on service operation. This implies an explicit effort to understand and improve all service management aspects in order to increase efficiency and effectiveness. We will present the requirements, how they were addressed and share our experiences. We will describe how we measure, report and use the data to continually improve both the processes and the services being provided. The focus is not the tool or the process, but the results of the continuous improvement effort from a large team of IT experts providing services to thousands of users, supported by the tool and its local team. This is not an initiative to address user concerns in the way the services are managed but rather an on-going working habit of continually reviewing, analysing and improving the service management processes and the services themselves, having in mind the currently agreed service levels and whose results also improve the experience of the users about the current services.

  11. 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.

  12. INSIDE CONTINUOUS IMPROVEMENT - A LITERATURE REVIEW

    Directory of Open Access Journals (Sweden)

    Daniel Indarto Prajogo

    2000-01-01

    Full Text Available This paper discusses the concept of continuous improvement (CI by looking beyond what traditionally highlighted in literature concerning continuous improvement or Total Quality Management (TQM. The primary argument put forwarded in the discussion is that despite the undeniable positive results from CI practices, the way these activities are implemented, however, will lead to most programs becoming self-limiting. It needs to be asserted here that this paper is not intended to despise CI, rather, its purpose is limited only to provide a balance on the prevailing positive views toward CI.

  13. 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.

  14. Software Maintenance Management Evaluation and Continuous Improvement

    CERN Document Server

    April, Alain

    2008-01-01

    This book explores the domain of software maintenance management and provides road maps for improving software maintenance organizations. It describes full maintenance maturity models organized by levels 1, 2, and 3, which allow for benchmarking and continuous improvement paths. Goals for each key practice area are also provided, and the model presented is fully aligned with the architecture and framework of software development maturity models of CMMI and ISO 15504. It is complete with case studies, figures, tables, and graphs.

  15. Emergency department patient satisfaction: customer service training improves patient satisfaction and ratings of physician and nurse skill.

    Science.gov (United States)

    Mayer, T A; Cates, R J; Mastorovich, M J; Royalty, D L

    1998-01-01

    Customer service initiatives in healthcare have become a popular way of attempting to improve patient satisfaction. This study investigates the effect of clinically focused customer service training on patient satisfaction in the setting of a 62,000-visit emergency department and level I trauma center. Analysis of patient complaints, patient compliments, and a statistically verified patient-satisfaction survey indicate that (1) all 14 key quality characteristics identified in the survey increased dramatically in the study period; (2) patient complaints decreased by over 70 percent from 2.6 per 1,000 emergency department (ED) visits to 0.6 per 1,000 ED visits following customer service training; and (3) patient compliments increased more than 100 percent from 1.1 per 1,000 ED visits to 2.3 per 1,000 ED visits. The most dramatic improvement in the patient satisfaction survey came in ratings of skill of the emergency physician, likelihood of returning, skill of the emergency department nurse, and overall satisfaction. These results show that clinically focused customer service training improves patient satisfaction and ratings of physician and nurse skill. They also suggest that such training may offer a substantial competitive market advantage, as well as improve the patients' perception of quality and outcome.

  16. Human Resource Development's Contribution to Continuous Improvement

    DEFF Research Database (Denmark)

    Jørgensen, Frances; Hyland, Paul

    2007-01-01

    Continuous Improvement (CI) is an approach to organizational change that requires active involvement of skilled and motivated employees, which implies an important role for HRD practitioners. The findings from a literature review and a survey of 168 Danish manufacturing companies indicate however...

  17. Human Resource Development's Contribution to Continuous Improvement

    DEFF Research Database (Denmark)

    Jørgensen, Frances; Hyland, Paul

    Continuous Improvement (CI) is an approach to organizational change that requires active involvement of skilled and motivated employees, which implies an important role for HRD practitioners. The findings from a literature review and a survey of 168 Danish manufacturing companies indicate however...

  18. Human Resource Development's Contribution to Continuous Improvement

    DEFF Research Database (Denmark)

    Jørgensen, Frances; Hyland, Paul

    2007-01-01

    Continuous Improvement (CI) is an approach to organizational change that requires active involvement of skilled and motivated employees, which implies an important role for HRD practitioners. The findings from a literature review and a survey of 168 Danish manufacturing companies indicate however...

  19. Paths to continuous improvement of a CRM strategy

    Directory of Open Access Journals (Sweden)

    Lluís G. Renart

    2008-07-01

    Full Text Available The concept of relationship marketing has led to a paradigm change in marketing. Over the last few decades, numerous studies have analyzed the impact of customer relationship management (CRM programs on customer satisfaction and loyalty. Quite a few CRM programs have been found to have little or no impact. Having already published several articles and cases on the subject, in this paper we set out to answer the following question: assuming a company already has a reasonably successful CRM strategy in place, how can it continuously adapt and improve that strategy? Our recommendation is that such companies implement a continuous improvement process at four different but complementary levels: first, review and reinforce the company’s mission, culture and values; second, reconsider and, if necessary, redesign the CRM strategy; third, manage the various relationship-building activities more effectively; and lastly, review and, if necessary, improve the quality of material and human resources, program execution and process governance. A systematic review of these four levels or “paths” of improvement should help generate and maintain high quality relationships over time.

  20. KEY FACTORS FOR A CONTINUOUS IMPROVEMENT PROCESS

    Directory of Open Access Journals (Sweden)

    Hector Ricardo Formento

    2013-11-01

    Full Text Available The goal of this work was to examine the content of continuous improvement strategies, taking into account the important role they play in building competitiveness. This paper argues that several specific issues must be taken into account in order to reach successful outcomes. This work starts with a literature review on the matter. On this basis, we designed a survey administered to a group of 30 large companies, each of which is renowned leader in Argentina. Finally, we compared the development of continuous improvement process in companies with very effective results and with scarce results. Differences that emerged from this comparison enabled us to identify critical factors for achieving a successful improvement process. As there are no recent researches on continuous improvement programs in Argentina, this paper contributes to recognizing and systematizing what has been done, comparing it with theoretical framework and uncovering research gaps for future studies. However, further research must confirm these findings and move forward on the analysis of intangible factors, like: internal communications, climate, culture, self reflexion, consensus, etc.

  1. A Typology of Continuous Improvement Implementation Processes

    DEFF Research Database (Denmark)

    Rijnders, Sander; Boer, Harry

    2004-01-01

    This article presents a typology of continuous improvement (CI) implementation processes. The typology is based on an empirical study of 26 companies engaged in the implementation of CI. The data underpinning the typology was collected through retrospective interviews guided by a semi-structured ......This article presents a typology of continuous improvement (CI) implementation processes. The typology is based on an empirical study of 26 companies engaged in the implementation of CI. The data underpinning the typology was collected through retrospective interviews guided by a semi......-structured questionnaire. Four different approaches to implementing CI are identified, described and analysed. The resulting typology contributes to the development of CI implementation theory - an underdeveloped area of theory - and is useful for companies considering to engage in, or step up, their CI activities....

  2. Quick and continuous improvement through kaizen blitz.

    Science.gov (United States)

    McNichols, T; Hassinger, R; Bapst, G W

    1999-05-01

    It is our objective to provide you with a step-by-step approach to conducting a kaizen blitz within two days and describe how to achieve dramatic performance improvement with employee buy-in through this process. Kaizen blitz has been used dozens of times by the authors, and in some instances the same area has been blitzed as many as four times, with significant improvements each and every time. Employees have even taken it on themselves to conduct informal blitzes as a continuing improvement effort after a formal blitz has been conducted in their area. Blitzes can succeed in a variety of environments. The morning after the employees of one company attended this presentation, they self initiated a mini-blitz and discovered opportunities for improvement that they enthusiastically presented to management.

  3. Room Service Improves Nutritional Intake and Increases Patient Satisfaction While Decreasing Food Waste and Cost.

    Science.gov (United States)

    McCray, Sally; Maunder, Kirsty; Krikowa, Renee; MacKenzie-Shalders, Kristen

    2017-07-01

    Room service is a foodservice model that has been increasingly implemented across health care facilities in an effort to improve patient satisfaction and reduce food waste. In 2013, Mater Private Hospital Brisbane, Australia, was the first hospital in Australia to implement room service, with the aim of improving patient nutrition care and reducing costs. The aim of this study was to comprehensively evaluate the nutritional intake, plate waste, patient satisfaction, and patient meal costs of room service compared to a traditional foodservice model. A retrospective analysis of quality-assurance data audits was undertaken to assess patient nutritional intake between a facility utilizing a traditional foodservice model and a facility utilizing room service and in a pre-post study design to assess plate waste, patient satisfaction, and patient meal costs before and after the room service implementation. Audit data were collected for eligible adult inpatients in Mater Private Hospital Brisbane and Mater Hospital Brisbane, Australia, between July 2012 and May 2015. The primary outcome measures were nutritional intake, plate waste, patient satisfaction, and patient meal costs. Independent samples t-tests and χ(2) analyses were conducted between pre and post data for continuous data and categorical data, respectively. Pearson χ(2) analysis of count data for sex and reasons for plate waste for data with counts more than five was used to determine asymptotic (two-sided) significance and n-1 χ(2) used for the plate waste analysis. Significance was assessed at Pnutritional intake, improved patient satisfaction, and reduced plate waste and patient meal costs with room service compared to a traditional foodservice model. Comparison of nutritional intake between a traditional foodservice model (n=85) and room service (n=63) showed statistically significant increases with room service in both energy (1,306 kcal/day vs 1,588 kcal/day; P=0.005) and protein (52 g/day vs 66 g

  4. Impact of continuous glucose monitoring on quality of life, treatment satisfaction, and use of medical care resources

    DEFF Research Database (Denmark)

    Hommel, E; Olsen, B; Battelino, T

    2014-01-01

    To investigate the impact of continuous glucose monitoring (CGM) on health-related quality of life (HRQOL), treatment satisfaction (TS) medical resource use, and indirect costs in the SWITCH study. SWITCH was a multicentre, randomized, crossover study. Patients with type 1 diabetes (n = 153) using...... continuous subcutaneous insulin infusion (CSII) were randomized to a 12 month sensor-On/Off or sensor-Off/On sequence (6 months each treatment), with a 4-month washout between periods. HRQOL in children and TS in adults were measured using validated questionnaires. Medical resource utilization data were...... collected. In adults, TS was significantly higher in the sensor-On arm, and there were significant improvements in ratings for treatment convenience and flexibility. There were no clinically significant differences in children's HRQOL or parents' proxy ratings. The incidence of severe hypoglycaemia...

  5. Understanding students’ satisfaction and continuance intention of e-learning: Application of expectation–confirmation model

    Directory of Open Access Journals (Sweden)

    Forouzan Rezaeian Tiyar

    2015-12-01

    Full Text Available The evolution of technologies leads to the great significance of e-learning in the domain of education. Recognition of the crucial factors which influence learners’ aims towards continued use of e-learning would guide teachers, learners and e-learning developers to increase e-learning use. To this end, the present study investigates the Expectation-Confirmation Model (ECM factors of Post-Adoption Expectation (PAE which is explored via using language learners’ post-adoption experiences in the use of e-learning systems. Learning process, tutor interaction, peer interaction, and course design are the four factors identified used for extending the perception of language learners’ experiences in e-learning. The survey method was used to empirically validate the suggested model (ECM of the present study. A total sample of 120 Iranian university students participated in the study. In order to investigate the proposed model, structural equation modelling employing Smart PLS 2.0 was run. The findings indicate that learners’ confirmation of using e-learning has a significant effect on the four aforementioned factors. Learning process and course design are the only two factors that have a significant effect on users’ satisfaction and continuance intention. On the other hand, the results showed that tutor interaction and peer interaction do not have a significant effect on predicting learners’ satisfaction and continuance intention of e-learning systems.

  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. 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.

  8. Building A Competitive advantage Through Staff And Patients` Satisfaction - Improving Performance In A Hospital

    OpenAIRE

    Lukosiute, Zivile

    2008-01-01

    Performance improvement of a hospital or any organization cannot be achieved without having a winning strategy and an improvement of a sustainable competitive advantage. I look at patients` and staff satisfaction as a source of a competitive advantage that has to be maintained and improved constantly. Results of satisfaction surveys allow comparing the performance of a hospital to other hospitals and to seek an improvement in a hospital performance which is dependant on the ability of leaders...

  9. 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

  10. [Continuous nursing education to improve the quality of health care].

    Science.gov (United States)

    Fumić, Nera; Marinović, Marin; Brajan, Dolores

    2014-10-01

    Health care and today's medical and technical achievements and approved standards of treatment provide comprehensive quality, safety and traceability of medical procedures respecting the principles of health protection. Continuous education improves the quality of nursing health care and increases the effectiveness of patient care, consequently maintaining and enhancing patient safety. Patient health problems impose the need of appropriate, planned and timely nursing care and treatment. In providing quality nursing care, attention is focused on the patient and his/her needs in order to maintain and increase their safety, satisfaction, independence and recovery or peaceful death, so the health and nursing practices must be systematized, planned and based on knowledge and experience. Health and nursing care of patients at risk of developing acute and chronic wounds or already suffering from some form of this imply preventive measures that are provided through patient education, motivation, monitoring, early recognition of risk factors and causes, and reducing or removing them through the prescribed necessary medical treatment which is safe depending on the patient health status. Except for preventive measures, nursing care of patients who already suffer from some form of acute or chronic wounds is focused on the care and treatment of damaged tissue by providing appropriate and timely diagnosis, timely and proper evaluation of the wound and patient general status, knowledge and understanding of the wide range of local, oral and parenteral therapy and treatment, aiming to increase patient safety by preventing progression of the patient general condition and local wound status and reducing the possibility of developing infection or other complications of the underlying disease. In the overall patient management, through nursing process, medical interventions are implemented and aimed to maintain and optimize health status, prevent complications of existing diseases and

  11. Asymmetric continuous-time neural networks without local traps for solving constraint satisfaction problems.

    Directory of Open Access Journals (Sweden)

    Botond Molnár

    Full Text Available There has been a long history of using neural networks for combinatorial optimization and constraint satisfaction problems. Symmetric Hopfield networks and similar approaches use steepest descent dynamics, and they always converge to the closest local minimum of the energy landscape. For finding global minima additional parameter-sensitive techniques are used, such as classical simulated annealing or the so-called chaotic simulated annealing, which induces chaotic dynamics by addition of extra terms to the energy landscape. Here we show that asymmetric continuous-time neural networks can solve constraint satisfaction problems without getting trapped in non-solution attractors. We concentrate on a model solving Boolean satisfiability (k-SAT, which is a quintessential NP-complete problem. There is a one-to-one correspondence between the stable fixed points of the neural network and the k-SAT solutions and we present numerical evidence that limit cycles may also be avoided by appropriately choosing the parameters of the model. This optimal parameter region is fairly independent of the size and hardness of instances, this way parameters can be chosen independently of the properties of problems and no tuning is required during the dynamical process. The model is similar to cellular neural networks already used in CNN computers. On an analog device solving a SAT problem would take a single operation: the connection weights are determined by the k-SAT instance and starting from any initial condition the system searches until finding a solution. In this new approach transient chaotic behavior appears as a natural consequence of optimization hardness and not as an externally induced effect.

  12. [Measurement of customer satisfaction and participation of citizens in improving the quality of healthcare services.].

    Science.gov (United States)

    Degrassi, Flori; Sopranzi, Cristina; Leto, Antonella; Amato, Simona; D'Urso, Antonio

    2009-01-01

    Managing quality in health care whilst ensuring equity is a fundamental aspect of the provision of services by healthcare organizations. Measuring perceived quality of care is an important tool for evaluating the quality of healthcare delivery in that it allows the implementation of corrective actions to meet the healthcare needs of patients. The Rome B (ASL RMB) local health authority adopted the UNI EN 10006:2006 norms as a management tool, therefore introducing the evaluation of customer satisfaction as an opportunity to involve users in the creation of quality healthcare services with and for the citizens. This paper presents the activities implemented and the results achieved with regards to shared and integrated continuous improvement of services.

  13. The use of continuous improvement techniques: A survey-based ...

    African Journals Online (AJOL)

    International Journal of Engineering, Science and Technology ... The use of continuous improvement techniques: A survey-based study of current practices ... Prior research has focused mainly on the effect of continuous improvement practices ...

  14. TOOLS OF QUALITY IMPROVEMENT – MEASURING CUSTOMER SATISFACTION

    OpenAIRE

    Catalina Soriana Sitnikov

    2009-01-01

    Nowadays, quality is often divided into service quality and product quality. The dimensions of quality of service are quite different from the quality of product due to the main difference between services and products (service intangibility and the customer who can use it only once). Customer satisfaction is one of the topics related with the quality due to the main measurement of quality is customer service. The main question about quality service is what the customer expects to get from th...

  15. Improvement in cost-effectiveness and customer satisfaction by a quality management system according to EN ISO 9001:2000.

    Science.gov (United States)

    Beholz, Sven; Konertz, Wolfgang

    2005-12-01

    The implementation of a quality management system (QMS) according to EN ISO 9001:2000 has proven to be possible for cardiac surgery departments. However, it remains unclear if a QMS can help to improve quality as indicated by cost-effectiveness and customer satisfaction. To control costs for medical goods and laboratory investigations an internal control system for the allocation of resources was implemented. Laboratory costs and medical goods per open heart procedure were investigated in the years 2000 to 2003. In terms of customer satisfaction, repeated questionnaire-based evaluation of referring physicians was obtained from 2001 to 2003 and the influence of repeated interventions on various aspects of communications was investigated. Costs of medical goods could be reduced by 6.1%, and for laboratory investigations by 35% per operation. Additionally, customer satisfaction could be increased efficiently with respect to accessibility and postoperative communication. By the introduction of a process based QMS, efficient control of the costs of medical goods and laboratory investigations could be achieved. Once a year repeat evaluation of satisfaction of advising physicians has proven to be a valuable tool in the process of continuous improvement.

  16. International Students' Course Satisfaction and Continuance Behavioral Intention in Higher Education Setting: An Empirical Assessment in Malaysia

    Science.gov (United States)

    Shahijan, Milad Kalantari; Rezaei, Sajad; Amin, Muslim

    2016-01-01

    The purpose of this study is to examine the impact of perceived brand orientation, intercultural friendship, and university reputation on international students' course satisfaction and continuance behavioral intention towards the higher education in Malaysia. A total of 348 questionnaires, administered on international students, were collected to…

  17. International Students' Course Satisfaction and Continuance Behavioral Intention in Higher Education Setting: An Empirical Assessment in Malaysia

    Science.gov (United States)

    Shahijan, Milad Kalantari; Rezaei, Sajad; Amin, Muslim

    2016-01-01

    The purpose of this study is to examine the impact of perceived brand orientation, intercultural friendship, and university reputation on international students' course satisfaction and continuance behavioral intention towards the higher education in Malaysia. A total of 348 questionnaires, administered on international students, were collected to…

  18. Program Support and Value of Training in Mentors' Satisfaction and Anticipated Continuation of School-Based Mentoring Relationships

    Science.gov (United States)

    McQuillin, Samuel D.; Straight, Gerald G.; Saeki, Elina

    2015-01-01

    In this study, we tested a theoretical model of training practices in school-based mentoring by comparing the differences between two mentoring programs on mentor-reported program support, value of training, relationship satisfaction, and plans to continue mentoring. The two mentoring programs that we compared were conducted at the same school and…

  19. Program Support and Value of Training in Mentors' Satisfaction and Anticipated Continuation of School-Based Mentoring Relationships

    Science.gov (United States)

    McQuillin, Samuel D.; Straight, Gerald G.; Saeki, Elina

    2015-01-01

    In this study, we tested a theoretical model of training practices in school-based mentoring by comparing the differences between two mentoring programs on mentor-reported program support, value of training, relationship satisfaction, and plans to continue mentoring. The two mentoring programs that we compared were conducted at the same school and…

  20. How to improve patient satisfaction during midazolam sedation for gastrointestinal endoscopy?

    Science.gov (United States)

    Jin, Eun Hyo; Hong, Kyoung Sup; Lee, Young; Seo, Ji Yeon; Choi, Ji Min; Chun, Jaeyoung; Kim, Sang Gyun; Kim, Joo Sung; Jung, Hyun Chae

    2017-02-14

    To determine the procedure-related factors that affect sedation satisfaction and to make a suggestion to improve it. We prospectively enrolled a total of 456 patients who underwent outpatient endoscopy procedures with midazolam sedation between March 2014 and August 2014. All patients completed both pre- and post-endoscopy questionnaires about sedation expectations and satisfaction. The study cohort included 167 (36.6%) patients who underwent esophagogastroduodenoscopy (EGD), 167 (36.6%) who underwent colonoscopy, and 122 (26.8%) who underwent a combined procedure (EGD and colonoscopy). Over 80% of all patients were satisfied with sedation using midazolam. In univariate and multivariate analyses, total procedure time in the EGD group, younger age (≤ 50 years), and longer colonoscopy withdrawal time in the colonoscopy group were related to decreased satisfaction with sedation. However, in active monitoring and intervention group, there was no decrease in grade of satisfaction despite longer procedure time due to more procedures during colonoscopy. Younger age (≤ 50 years), longer inter-procedure time gap, and colonoscopy withdrawal time were related to decreased satisfaction in the combined EGD and colonoscopy group. Midazolam is still a safe and effective sedative for gastrointestinal endoscopy. Satisfaction with sedation depends on several factors including age (≤ 50 years) and procedure time duration. To improve patient satisfaction with sedation, active monitoring of sedation status by the endoscopist should be considered for patients who require long procedure time.

  1. Predicting client improvement from and satisfaction with community mental health center services.

    Science.gov (United States)

    Flynn, T C; Balch, P; Lewis, S B; Katz, B

    1981-06-01

    The present study assesses client improvement from and satisfaction with CMHC services, and attempts to examine the presence of positive bias from responders. Results based on questionnaires mailed to 1,000 former clients indicated both high consumer satisfaction and reported improvement attributable to treatment. Responders and nonresponders did not differ on demographic or treatment variables related to post-treatment improvement. A multiple regression analysis was computed and yielded an estimated index of improvement for responders. No differences obtained on this measure between responders and nonresponders, thereby not supporting the presence of a positive bias in this sample. confidence in therapist, satisfaction with the therapeutic relationship, and number of individual sessions were the most positive improvement correlates, with lack of contact and increasing age most negatively related to improvement. Discussion focuses on the implications for generalization of results based on responders' data.

  2. The Relevance of Relationship Satisfaction and Continuation to the Gender Symmetry Debate

    Science.gov (United States)

    Ackerman, Jeffrey M.

    2012-01-01

    In prior research, Ackerman and Field (2011) found that intimate partner violence (IPV) affects the relationship satisfaction of females more than the relationship satisfaction of males. The current research replicated those findings on a different sample of men and women. In addition to confirming past findings, it also found that gendered…

  3. Human Resource Management for Continuous Improvement

    DEFF Research Database (Denmark)

    Jørgensen, Frances; Laugen, Bjørge; Boer, Harry

    2006-01-01

    includes a brief literature review of HRM and CI and statistical analyses of data collected from the Continuous Innovation Network Survey (2002). The results of the analyses demonstrate that HRM has a significant effect on CI and organizational behavior, with the strongest relationship between HRM, CI...... and performance occurring when company's align their CI activities with their strategic objectives and use of systems, procedures, and processes to measure the results of their CI activities ....

  4. [Impact of Lean methodology to improve care processes and levels of satisfaction in patient care in a clinical laboratory].

    Science.gov (United States)

    Morón-Castañeda, L H; Useche-Bernal, A; Morales-Reyes, O L; Mojica-Figueroa, I L; Palacios-Carlos, A; Ardila-Gómez, C E; Parra-Ardila, M V; Martínez-Nieto, O; Sarmiento-Echeverri, N; Rodríguez, C A; Alvarado-Heine, C; Isaza-Ruget, M A

    2015-01-01

    The application of the Lean methodology in health institutions is an effective tool to improve the capacity and workflow, as well as to increase the level of satisfaction of patients and employees. To optimise the time of outpatient care in a clinical laboratory, by implementing a methodology based on the organisation of operational procedures to improve user satisfaction and reduce the number of complaints for delays in care. A quasi-experimental before and after study was conducted between October 2011 to September 2012. XBar and S charts were used to observe the mean service times and standard deviation. The user satisfaction was assessed using service questionnaires. A reduction of 17 minutes was observed in the time of patient care from arrival to leaving the laboratory, and a decrease of 60% in complaints of delay in care. Despite the high staff turnover and 38% increase in the number of patients seen, a culture of empowerment and continuous improvement was acquired, as well as greater efficiency and productivity in the care process, which was reflected by maintaining standards 12 months after implementation. Lean is a viable methodology for clinical laboratory procedures, improving their efficiency and effectiveness. Copyright © 2015 SECA. Published by Elsevier Espana. All rights reserved.

  5. Heterogeneity Improves Cooperation in Continuous Snowdrift Game

    Institute of Scientific and Technical Information of China (English)

    ZHONG Li-Xin; QIU Tian; XU Jiang-Rong

    2008-01-01

    We study the networking effects on the population divergence and the increased level of cooperation in the continuous snowdrift game (CSG). In the regular world, limited interaction inhibits the occurrence of evolutionary branching. The formation of clusters defends the intermediate-investors from intruding by high- or low-investors. In a rewired network, the collective behaviour is related to the rewiring rules. A linear relationship I = ασ + b between the average investment and the standard deviation of the degree distribution is found.

  6. Metric Development for Continuous Process Improvement

    Science.gov (United States)

    2011-03-01

    improve the bottom line of an organization. The first step of this process is to solicit the key performance indicators ( KPIs ) that best reflect the...organization’s mission. The second step is to use and/or develop metrics based on those KPIs to measure the organization’s mission performance today...The third step is to capture the trends of those KPIs over time to see if the organization is getting better or worse. The final step is to

  7. Continuing education for performance improvement: a creative approach.

    Science.gov (United States)

    Collins, Patti-Ann; Hardesty, Ilana; White, Julie L; Zisblatt, Lara

    2012-10-01

    In an effort to improve patient safety and health care outcomes, continuing medical education has begun to focus on performance improvement initiatives for physician practices. Boston University School of Medicine's (BUSM) Continuing Nursing Education Accredited Provider Unit has begun a creative project to award nursing contact hours for nurses' participation in performance improvement activities. This column highlights its initial efforts.

  8. Loss of relational continuity of care in schizophrenia: associations with patient satisfaction and quality of care

    Science.gov (United States)

    Sanatinia, Rahil; Cowan, Violet; Barnicot, Kirsten; Zalewska, Krysia; Shiers, David; Cooper, Stephen J.

    2016-01-01

    Background Users of mental health service are concerned about changes in clinicians providing their care, but little is known about their impact. Aims To examine associations between changes in staff, and patient satisfaction and quality of care. Method A national cross-sectional survey of 3379 people aged 18 or over treated in secondary care for schizophrenia or schizoaffective disorder. Results Nearly 41.9% reported at least one change in their key worker during the previous 12 months and 10.5% reported multiple changes. Those reporting multiple changes were less satisfied with their treatment and less likely to report having a care plan, knowing how to obtain help when in a crisis or to have had recommended physical health assessments. Conclusions Frequent changes in staff providing care for people with psychosis are associated with poorer quality of care. Greater efforts need to be made to protect relational continuity of care for such patients. Declaration of interest M.J.C. was co-chair of the expert advisory group on the NICE quality standard on Service User Experience in Adult Mental Health. S.J.C. has previously been a member of the Health and Social Care Board Northern Ireland Formulary Committee. D.S. received a speaker’s fee from Janssen Cilag in 2011. He is a topic expert on NICE guideline for psychosis and schizophrenia in children and young people and a board member of National Collaborating Centre for Mental Health. Copyright and usage © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license. PMID:27713834

  9. Continual Improvement In Small Soaps Company

    Directory of Open Access Journals (Sweden)

    Borget Alfred Anoye

    2015-08-01

    Full Text Available Abstract In this paper using quality management tools we track root causes and principal causes of the rising manufacturing cost of the bar soaps and propose solution to solve the problem. First we identify and analyze the roots causes of problem with the Fishbone Diagram. We use multivoting approach to reduce roots causes to main causes from which we identify classify and analyze principal causes using the Pareto Diagram. We then perform a deep analysis of these principal causes using the 5 whys analysis technique. Three principal causes were found amp61480high level of overtime poor machine performance and poor employees performanceamp61481 and were weighing 55 of the problem. For that reason working on these areas was necessary to address the problem of the rising manufacturing cost of the bar soaps. With the result we then use the PDCA 7 steps of TQM method to solve the problem of the rising manufacturing cost by testing whether expanding production capacity leads to performance improvements of these areas. We decide to expand production capacity by adding two more machine groups. Six months after implementation of the proposed solution the result shows an enhanced workload and schedule an increased production capacity an elimination of the overtime issue an increased machines performance and an improved workers performance. Two main savings were achieved as wage costs and maintenance costs. As a result while competitors bar soaps prices increased the company bar soaps price decreased by 50 making the company bar soaps more attractive on market as this performance permitted the company to apply price reduction at the retailer level.

  10. At Your Request((R)) room service dining improves patient satisfaction, maintains nutritional status, and offers opportunities to improve intake

    NARCIS (Netherlands)

    Doorduijn, A.S.; Gameren, Y. van; Vasse, E.; Roos, N.M. de

    2016-01-01

    BACKGROUND: Malnutrition in hospitals may be combatted by improving the meal service. AIM: To evaluate whether At Your Request((R)), a meal service concept by Sodexo with a restaurant style menu card and room service, improved patient satisfaction, nutritional status, and food intake compared to the

  11. Permissive Attitude Towards Drug Use, Life Satisfaction, and Continuous Drug Use Among Psychoactive Drug Users in Hong Kong.

    Science.gov (United States)

    Cheung, N Wt; Cheung, Y W; Chen, X

    2016-06-01

    To examine the effects of a permissive attitude towards regular and occasional drug use, life satisfaction, self-esteem, depression, and other psychosocial variables in the drug use of psychoactive drug users. Psychosocial factors that might affect a permissive attitude towards regular / occasional drug use and life satisfaction were further explored. We analysed data of a sample of psychoactive drug users from a longitudinal survey of psychoactive drug abusers in Hong Kong who were interviewed at 6 time points at 6-month intervals between January 2009 and December 2011. Data of the second to the sixth time points were stacked into an individual time point structure. Random-effects probit regression analysis was performed to estimate the relative contribution of the independent variables to the binary dependent variable of drug use in the last 30 days. A permissive attitude towards drug use, life satisfaction, and depression at the concurrent time point, and self-esteem at the previous time point had direct effects on drug use in the last 30 days. Interestingly, permissiveness to occasional drug use was a stronger predictor of drug use than permissiveness to regular drug use. These 2 permissive attitude variables were affected by the belief that doing extreme things shows the vitality of young people (at concurrent time point), life satisfaction (at concurrent time point), and self-esteem (at concurrent and previous time points). Life satisfaction was affected by sense of uncertainty about the future (at concurrent time point), self-esteem (at concurrent time point), depression (at both concurrent and previous time points), and being stricken by stressful events (at previous time point). A number of psychosocial factors could affect the continuation or discontinuation of drug use, as well as the permissive attitude towards regular and occasional drug use, and life satisfaction. Implications of the findings for prevention and intervention work targeted at

  12. An Improved Whole Life Satisfaction Theory of Happiness

    Directory of Open Access Journals (Sweden)

    Jussi Suikkanen

    2011-01-01

    Full Text Available

    According to the popular Whole Life Satisfaction theories of happiness, an agent is happy when she judges that her life fulfils her ideal life-plan. Fred Feldman has recently argued that such views cannot accommodate the happiness of spontaneous or preoccupied agents who do not consider how well their lives are going. In this paper, I formulate a new Whole Life Satisfaction theory that is not vulnerable to this objection. My proposal is inspired by Michael Smith’s advice-model of desirability. According to it, an agent is happy when a more informed and rational hypothetical version of her would judge that the agent’s actual life matches the best life-plan for her. I will argue that my new Whole Life Satisfaction theory is a flexible model that can avoid many

  13. Child behaviors as a moderator: Examining the relationship between foster parent supports, satisfaction, and intent to continue fostering.

    Science.gov (United States)

    Cooley, Morgan E; Farineau, Heather M; Mullis, Ann K

    2015-07-01

    Foster parents need access to supports and resources in order to be satisfied with their caregiving role and continue providing foster care services. However, they often experience multiple demands in their role as a substitute caregiver that could lead to stress. Child behaviors especially may be a significant factor when considering sources of strain and may be a potential risk factor for negative outcomes such as dissatisfaction or the decision to discontinue providing foster care. The purpose of this study was to examine whether child disruptive behaviors moderated or influenced the nature or strength of the relationship between foster parent supports and satisfaction as a caregiver as well as intent to continue fostering. The sample consisted of 155 licensed foster caregivers from across the United States. Child behaviors served as a significant moderator between some types of supports and satisfaction. Implications for future research, practice, and policy are discussed.

  14. A Smartphone Application Significantly Improved Diabetes Self-Care Activities with High User Satisfaction

    Directory of Open Access Journals (Sweden)

    Yu Jin Kim

    2015-06-01

    Full Text Available BackgroundWe developed for the first time a smartphone application designed for diabetes self-management in Korea and registered a patent for the relevant algorithm. We also investigated the user satisfaction with the application and the change in diabetes related self-care activities after using the application.MethodsWe conducted a questionnaire survey on volunteers with diabetes who were using the application. Ninety subjects responded to the questionnaire between June 2012 and March 2013. A modified version of the Summary of Diabetes Self-Care Activities (SDSCA was used in this study.ResultsThe survey results exhibited a mean subject age of 44.0 years old, and males accounted for 78.9% of the subjects. Fifty percent of the subjects had diabetes for less than 3 years. The majority of respondents experienced positive changes in their clinical course after using the application (83.1% and were satisfied with the structure and completeness of the application (86.7%. Additionally, the respondents' answers indicated that the application was easy to use (96.7% and recommendable to others (97.7% and that they would continue using the application to manage their diabetes (96.7%. After using the Diabetes Notepad application, diabetes related self-care activities assessed by SDSCA displayed statistically significant improvements (P<0.05, except for the number of days of drinking.ConclusionThis smartphone-based application can be a useful tool leading to positive changes in diabetes related self-care activities and increase user satisfaction.

  15. 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.

  16. Reduced fasting time improves comfort and satisfaction of elderly patients undergoing anesthesia for hip fracture

    Directory of Open Access Journals (Sweden)

    Luiz Eduardo Imbelloni

    2015-04-01

    Full Text Available BACKGROUND AND OBJECTIVES: Patient's satisfaction is a standard indicator of care quality. The aim of this study was to evaluate whether a preoperative oral ingestion of 200 mL of a carbohydrate drink can improve comfort and satisfaction with anesthesia in elderly patients with hip fracture. METHOD: Prospective randomized clinical trial conducted in a Brazilian public hospital, with patients ASA I-III undergoing surgery for hip fracture. The control group (NPO received nothing by mouth after 9:00 p.m. the night before, while patients in the experimental group (CHO received 200 mL of a carbohydrate drink 2-4 h before the operation. Patients' characteristics, subjective perceptions, thirst and hunger and satisfaction were determined in four steps. Mann-Whitney U-test and Fisher exact test were used for comparison of control and experimental groups. A p-value <0.05 was considered significant. RESULTS: A total of 100 patients were included in one of the two regimens of preoperative fasting. Fasting time decreased significantly in the study group. Patients drank 200 mL 2:59 h before surgery and showed no hunger (p < 0.00 and thirst on arrival to OR (p < 0.00, resulting in increased satisfaction with the perioperative anesthesia care (p < 0.00. CONCLUSIONS: The satisfaction questionnaire for surgical patient could become a useful tool in assessing the quality of care. In conclusion, CHO significantly reduces preoperative discomfort and increases satisfaction with anesthesia care.

  17. Organizational climate survey: management model tool on continuous improvement promotion in Finantial Institutional Environment

    Directory of Open Access Journals (Sweden)

    Alex Amancio da Silva

    2016-06-01

    Full Text Available The organizational climate survey has been an important tool in the corporate world, the way in which the institutions can assess and ascertain through the results, the degree of satisfaction of its employees and look through plan of action, achieve better results in both performance and production. Through an empirical research, exploratory qualitative research, with collection of secondary data, it was found that the implementation of the organizational climate survey, "Speak Frankly" from Itaú Unibanco, it could analyze data and make a plan of effective action aiming at continuous improvement in the organizational environment, serving as personnel management model. The results were favorable in the period from year 2012 to 2014 with an increase of the degree of satisfaction in four 4% and maintained excellent adherence to answer questions reaching 90% the number of employees.

  18. CONTINUOUS IMPROVEMENT PRACTICE IN LARGE ENTERPRISES: STUDY RESULTS

    Directory of Open Access Journals (Sweden)

    Dorota Stadnicka

    2015-03-01

    Full Text Available Continuous improvement is indispensable for ensuring the company's development and its survival on the constantly changing global market. Continuous improvement is particularly important in the quality and production management systems. A company should deliver a product compliant with a client's requirements in a specified time and at an appropriate price. That is why, continuous improvement refers to different areas of an organization's functioning and it is an integral part of Lean Manufacturing. This article presents the results of the study conducted in production enterprises on a limited area. The aim of the study was the assessment of the implementation of continuous improvement in Lean Manufacturing, and, in particular, employees' involvement in the problem identification and in reporting improvements as well as the way of motivating employees to involve themselves. The authors also tried to identify the factors influencing the elements of a continuous improvement system.

  19. Continuous improvement comparison between Danish and Mexican companies

    DEFF Research Database (Denmark)

    Christiansen, Thomas Bøhm

    2004-01-01

    This article investigates continuous improvement tools that are used in two countries on two continents. For that purpose two surveys were conducted in the metropolitan area of Mexico City and in Denmark using the same scales and having about the same sample size. The continuous improvement tools...

  20. Implementing Continuous Improvement Management (CIM) in the Public Schools.

    Science.gov (United States)

    Borgers, William E.; Thompson, Tommy A.

    This book traces the restructuring of a Texas school district that moved from management by coercion to continuous improvement for quality. In 1990, the Dickinson Independent School District (Texas) began implementation of Continuous Improvement Management (CIM), based on the teachings of W. Edwards Deming, William Glasser, and J. M. Juran.…

  1. AEL Continuous School Improvement Questionnaire. User Manual and Technical Report.

    Science.gov (United States)

    Meehan, Merrill L.; Cowley, Kimberly S.; Craig, James R.; Balow, Nancy; Childers, Robert D.

    The Continuous School Improvement Questionnaire (CSIQ) developed by the AEL helps a school staff gauge its performance on six dimensions related to continuous school improvement. Each member of the staff responds to the CSIQ individually. Although results might be used at the district or regional level, the most widely intended unit for applying…

  2. One-year sobriety improves satisfaction with life, executive functions and psychological distress among patients with polysubstance use disorder.

    Science.gov (United States)

    Hagen, Egon; Erga, Aleksander H; Hagen, Katrin P; Nesvåg, Sverre M; McKay, James R; Lundervold, Astri J; Walderhaug, Espen

    2017-05-01

    Polysubstance use disorder is prevalent in treatment-seeking patients with substance use disorder (SUD), with a higher risk of developing comorbid psychiatric symptoms, more pervasive deficits in cognitive functions, and inferior treatment results. The present study investigates if individuals with polysubstance use disorder who achieve at least one year of abstinence show greater improvements in satisfaction with life, executive functions, and psychological distress, compared to relapsers and controls. The prospective recovery from polysubstance use disorder assessed with broad output indicators remains understudied. A better understanding of the pattern of recovery of the chosen output indicators could shed light on the recovery process for this group of patients. We investigated changes in satisfaction with life, executive functions and psychological distress over a period of 12months in patients who remained abstinent and in those who relapsed. Subjects with polysubstance use disorder (N=115) were recruited from outpatient and residential treatment facilities; healthy controls (N=34) were recruited by posters exhibited at social welfare and GP offices. Executive functions were assessed by the Behaviour Rating Inventory of Executive Function-Adult self-report version (BRIEF-A), psychological distress by the Symptom Checklist-90-R (SCL-90-R), and satisfaction with life by the Satisfaction With Life Scale (SWLS). Substance use was assessed by self-reports on the Alcohol Use Disorders Identification Test (AUDIT) and the Drug Use Disorders Identification Test (DUDIT). Participants were categorized as "relapsers" if they had AUDIT score ≥8, or DUDIT score ≥2 for women and ≥6 for men. Results indicated that the abstinent group had the greatest improvement on all the indicators compared with relapsers and controls. Participants who successfully quit substance use for one year showed improved satisfaction with life, executive functions, and psychological distress

  3. Customer satisfaction survey to improve the European cystic fibrosis external quality assessment scheme.

    Science.gov (United States)

    Berwouts, Sarah; Dequeker, Elisabeth

    2011-08-01

    The Cystic Fibrosis European Network, coordinated from within the Katholieke Universiteit Leuven, is the provider of the European cystic fibrosis external quality assessment (EQA) scheme. The network aimed to seek feedback from laboratories that participated in the cystic fibrosis scheme in order to improve services offered. In this study we analysed responses to an on-line customer satisfaction survey conducted between September and November 2009. The survey was sent to 213 laboratories that participated in the cystic fibrosis EQA scheme of 2008; 69 laboratories (32%) responded. Scores for importance and satisfaction were obtained from a five-point Likert scale for 24 attributes. A score of one corresponded to very dissatisfied/very unimportant and five corresponded to very satisfied/very important. Means were calculated and placed in a two-dimensional grid (importance-satisfaction analysis). Means were subtracted from each other to obtain gap values (gap-analysis). No attribute had a mean score below 3.63. The overall mean of satisfaction was 4.35. Opportunities for improvement enclosed clarity, usefulness and completeness of the general report and individual comments, and user-friendliness of the electronic datasheet. This type of customer satisfaction survey was a valuable instrument to identify opportunities to improve the cystic fibrosis EQA scheme. It should be conducted on a regular basis to reveal new opportunities in the future and to assess effectiveness of actions taken. Moreover, it could be a model for other EQA providers seeking feedback from participants. Overall, the customer satisfaction survey provided a powerful quality of care improvement tool.

  4. Application of continuous quality improvement techniques to the treatment of patients with hypertension.

    Science.gov (United States)

    Waggoner, D M

    1992-01-01

    This article reports how continuous quality improvement (CQI) techniques were applied to physician care of patients with hypertension. A physician task force at an ambulatory care center used CQI methods to address the needs of two important "customer" groups: (1) third party payors and (2) patients with hypertension. Treatment standards were defined that can also serve as a customer-oriented product description. The task force found patients' blood pressures generally well controlled. Future studies will focus on appointment making, giving advice, and the doctor's examination as subprocesses that strongly influence patient satisfaction.

  5. Consumers' Recommendations to Improve Satisfaction with Rehabilitation Services: A Qualitative Study

    Science.gov (United States)

    Hein, Serge; Lustig, Daniel C.; Uruk, Ayse

    2005-01-01

    Understanding consumers' concerns about vocational rehabilitation services is important because of the current emphasis on empowerment and consumer-directed services. This study focused on participants' responses to an open-ended survey question that asked them what they thought could be done to improve their satisfaction with a vocational…

  6. Transformation in Higher Education: A Learner-Needs Segmentation Leads to Improved Learner Satisfaction

    Science.gov (United States)

    Rogers, Gayla; Finley, Donna S.; Patterson, Margaret

    2006-01-01

    Segmentation is a marketing concept that can be applied in a post-secondary context. This article delineates the outcome of applying a learner-needs segmentation that resulted in significantly improved learner satisfaction scores in a professional faculty at a large public university. Our original work described the purpose and value of…

  7. Improving Relationship Satisfaction--Qualitative Insights Derived from Individuals Currently within a Couple Relationship

    Science.gov (United States)

    Coleman, Lester M.

    2011-01-01

    Given the prevalence of relationship breakdown, and the unequivocal association with poor outcomes, ways in which to improve relationship satisfaction are of great importance. Derived from in-depth interviews with 112 individuals in a couple relationship, this study aims to explore and understand different beliefs and perceived capabilities toward…

  8. Improvements to the CONTINUE feature in transient analysis

    Science.gov (United States)

    Pamidi, P. R.

    1989-01-01

    The CONTINUE feature in transient analysis as implemented in the standard release of COSMIC/NASTRAN has inherent errors associated with it. As a consequence, the results obtained by a CONTINUEd restart run do not, in general, match the results that would be obtained in a single run without the CONTINUE feature. These inherent errors were eliminated by improvements to the restart logic that were developed by RPK Corporation and that are available on all RPK-supported versions of COSMIC/NASTRAN. These improvements ensure that the results of a CONTINUEd transient analysis run are the same as those of a non-CONTINUEd run. In addition, the CONTINUE feature was extended to transient analysis involving uncoupled modal equations. The improvements and enhancement were illustrated by examples.

  9. Patients' satisfaction: customer relationship management as a new opportunity for quality improvement in thoracic surgery.

    Science.gov (United States)

    Rocco, Gaetano; Brunelli, Alessandro

    2012-11-01

    Clinical and nonclinical indicators of performance are meant to provide the surgeon with tools to identify weaknesses to be improved. The World Health Organization's Performance Evaluation Systems represent a multidimensional approach to quality measurement based on several categories made of different indicators. Indicators for patient satisfaction may include overall perceived quality, accessibility, humanization and patient involvement, communication, and trust in health care providers. Patient satisfaction is included among nonclinical indicators of performance in thoracic surgery and is increasingly recognized as one of the outcome measures for delivered quality of care. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. Using SERVQUAL for assessing and improving patient satisfaction at a rural health facility in Pakistan.

    Science.gov (United States)

    Shaikh, B T; Mobeen, N; Azam, S I; Rabbani, F

    2008-01-01

    A cross-sectional study of patient satisfaction with care was conducted over a period of 1 year from March 2004 to March 2005 in a secondary-level hospital in a peri-urban area of Karachi, Pakistan. Using the SERVQUAL tool and exit interviews, data were collected quarterly from a total of 1533 patients. Results sharing and capacity-building workshops were arranged during the 4 phases of the survey to sensitize the staff of the hospital to work towards improving patient satisfaction. The level of satisfaction of the patients with the outpatient health services provided showed a gradual increase from 34.4% to 82.0% over the 1-year period.

  11. Improving efficiency and patient satisfaction in a tertiary teaching hospital preoperative clinic.

    Science.gov (United States)

    Harnett, Miriam J P; Correll, Darin J; Hurwitz, Shelley; Bader, Angela M; Hepner, David L

    2010-01-01

    Clinical and organizational aspects of the preoperative visit can have a significant impact on patient satisfaction. The authors' previous work demonstrated that communication of information from the clinician to the patient was found to be the most positively rated component, whereas organizational issues, particularly waiting time, were the most negative. This study compares two yearly cycles of patient satisfaction surveys to assess the process and impact of implementation of changes. The authors distributed a one-page questionnaire, consisting of elements evaluating satisfaction with clinical providers and with organizational aspects of the visit, to patients in their preoperative clinic during two different time periods. Fourteen different questions had five Likert scale options ranging from excellent to poor. Changes implemented included clerical, scheduling, and clinical changes. The overall collection rate of completed questionnaires was 79%. The scores for each question in Cycle 2 were higher for all questions, with 3 of 14 reaching statistical significance (P satisfaction with waiting time. Average waiting time was reduced from 92 to 41 min (P customer service, and implementation of changes in provider roles. These modifications resulted in an improvement in patient satisfaction and a reduction in waiting time with minimal economic impact.

  12. Boost Your Body: Self-Improvement Magazine Messages Increase Body Satisfaction in Young Adults.

    Science.gov (United States)

    Veldhuis, Jolanda; Konijn, Elly A; Knobloch-Westerwick, Silvia

    2017-02-01

    The verbal messages that contextualize exposure to idealized body imagery may moderate media users' body satisfaction. Such contextualizing verbal messages often take the form of social comparison motives in fashion magazines, while body dissatisfaction is an important mechanism underlying various body image-related health issues like depression and unbalanced weight status. Hence, the present study applied social comparison motives as induced through magazine cover messages. Hypotheses were tested in an experimental design with social comparison motives (self-improvement vs. self-evaluation vs. control) and recipient gender as between-subjects factors and body satisfaction as within-subjects factor (N = 150). Results showed that self-improvement messages accompanying ideal body media models increased body satisfaction, compared to control messages and baseline measures. In contrast, the self-evaluation messages did not impact body satisfaction. Results imply that inconsistencies regarding effects from exposure to idealized body imagery are explained by the context in which media images are portrayed, evoking differential social comparison motives. Moreover, the findings imply that health communication interventions can use verbal messages on body improvement as helpful tools, if they draw on social comparison motives effectively.

  13. Implementing Ask Me 3 to improve African American patient satisfaction and perceptions of physician cultural competency.

    Science.gov (United States)

    Michalopoulou, Georgia; Falzarano, Pamela; Arfken, Cynthia; Rosenberg, David

    2010-01-01

    Improve African American patient satisfaction and perceptions of physician cultural competency through the implementation of Ask Me 3 pamphlet which encourages patients to ask questions of physicians. Intervention participants received the pamphlet prior to their visit with the physician. Analysis evaluated differences in patient satisfaction and perceptions of physician cultural competency between intervention participants and controls. Intervention participants who saw their regular physician reported higher satisfaction. All found the questions to be helpful and reported knowing more about their medical condition or illness after the visit. The Ask Me 3 pamphlet is a low cost and logistically feasible tool that could be readily implemented in medical settings to facilitate physician-patient interaction. Improved satisfaction with the visit was found when the pamphlet was implemented during visits with a regular physician. Thus, our research findings suggest implementation of the Ask Me 3 pamphlet has the potential to improve health care behaviors and health outcomes and may ultimately lead to a reduction in health care disparities.

  14. 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...

  15. Modelling the Role of Human Resource Management in Continuous Improvement

    DEFF Research Database (Denmark)

    Jørgensen, Frances; Hyland, Paul; Kofoed, Lise B.

    2006-01-01

    Although it is widely acknowledged that both Human Resource Management (HRM) and Continuous Improvement have the potential to positively influencing organizational performance, very little attention has been given to how certain HRM practices may support CI, and consequently, a company...

  16. Improved apparatus for continuous culture of hydrogen-fixing bacteria

    Science.gov (United States)

    Foster, J. F.; Litchfield, J. H.

    1970-01-01

    Improved apparatus permits the continuous culture of Hydrogenomonas eutropha. System incorporates three essential subsystems - /1/ environmentally isolated culture vessel, /2/ analytical system with appropriate sensors and readout devices, /3/ control system with feedback responses to each analytical measurement.

  17. Continuous improvement and the mini-company concept

    NARCIS (Netherlands)

    de Leede, Jan; Looise, Jan C.

    1999-01-01

    The key issue of continuous improvement (CI) seems to be the problem of combining extensive employee involvement with market orientation and continuation of CI. In this article we review some existing organisational designs for CI on these three essential characteristics of CI. As an alternative to

  18. Continuous improvement process and waste reduction through a QFD tool: the case of a metallurgic plant

    Directory of Open Access Journals (Sweden)

    Leoni Pentiado Godoy

    2013-05-01

    Full Text Available This paper proposes the use of QFD for the continuous improvement of production processes and waste reduction actions. To collect the information we used the simple observation and questionnaire with closed questions applied to employees, representing 88.75% of the population that works in the production processes of an industry of metal-mechanic sector, located inRio Grandedo Sul. QFD is an effective method of quality planning, because it provides a diagnosis that underpins the definition of improvement actions aimed at combating waste. Actions were set providing improved communication between the sectors, enabling the delivery of products with specifications that meet customer requirements, on time and the right amounts, at a minimum cost and satisfaction of those involved with the company. The implementation of these actions reduces waste, minimizes the extra work, maximizes effective labor and increases profitability.

  19. Closing the Loop on a Continuous Program Improvement Process

    Science.gov (United States)

    Booth, Vickie; Booth, Larry

    2010-01-01

    The WebBSIT, a Bachelor of Science in Information Technology, is a fully online degree offered through a consortium of five University System of Georgia institutions. This paper begins by summarizing the change management system developed for continuous program improvement. Analysis of data should drive improvement, closing the loop. The balance…

  20. Why Continuous Improvement Is a Poor Substitute for School Choice

    Science.gov (United States)

    Rose, David C.; Rochester, J. Martin

    2008-01-01

    Efforts to introduce school choice have produced pressures on public schools to improve their performance. As a result, many public schools have embraced the total quality management principle of continuous improvement. In this article we explain that while this may be well intentioned, it may have perverse unintended consequences. A likely…

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

    Directory of Open Access Journals (Sweden)

    Tang Wai Mun

    2013-11-01

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

  2. Improving medical emergency services system by evaluating patient satisfaction: means for health management

    Directory of Open Access Journals (Sweden)

    MR Peyravi

    2014-01-01

    Full Text Available Introduction: One of the important aspects in high quality health care system is delivering health services in an appropriate way which can lead to development of the systems. Patient satisfaction is a quality indicator that has the potential to provide valuable information about the care delivered by an Emergency Medical Services system (EMS. This indicator is considered as an important marker of quality by paramedics. Method: This is a descriptive- analytical study on 1096 patient satisfaction of emergency services suffering from cardiovascular, dyspnea, low level of consciousness and cerebral problems. Variables such as the type of diseases, technicians’ and operators’ behavior, time of response and outcome of the missions were measured with a valid checklist. ANOVA and correlation Pearson were employed as analytical tests. Results: Considering different types of diseases, 4 categories of diseases had positive correlation with satisfaction of the patients and also there was a meaningful correlation between factors which were measured and satisfied patients.( P<0.001 Conclusion: Developing some instructions for technicians and operators focusing on interpersonal skills and enhanced sensitivities and behaviors not only toward patients but also toward bystanders and family members is recommended to improve patient satisfaction and thought quality of delivered care in the prehospital emergency medical systems.

  3. Behavior of Internal Customer in Family Business: Strategies and Actions for Improving Their Satisfaction.

    Science.gov (United States)

    Gutiérrez-Broncano, Santiago; Jiménez-Estévez, Pedro; Del Carmen Zabala-Baños, María

    2017-01-01

    Determining the relevant aspects of family businesses (FBs) that make them increasingly competitive is the main objective of researchers in this field. Despite this, there is little empirical literature on the behavior of the internal customer (IC) in FBs or how businesses increase their satisfaction. Basing our work on psychological theories and with both quantitative and qualitative information from 31 semi-structured interviews, this work establishes certain characteristics of the ICs of the FB and proposes a series of guidelines for increasing their satisfaction, thereby facilitating the continuity of this type of business. FBs that are able to understand that the motivation of their ICs is more important than other qualities, and that this requires a more comprehensive management will be able to get sustainable competitive advantages in the future.

  4. Electronic questionnaires for measuring parent satisfaction and as a basis for quality improvement

    DEFF Research Database (Denmark)

    Ammentorp, Jette; Rasmussen, Anne Mette; Nørgaard, Betty

    2007-01-01

    BACKGROUND: Using paper questionnaires to measure quality of care from the perspective of the patient is a time consuming procedure resulting in very slow feedback. Response rates are low and patients who cannot read the local language are usually excluded. OBJECTIVE: To investigate...... the applicability of an electronic questionnaire by evaluating the response rate. To study whether computer-based continuous monitoring could elucidate reasons for parents being less satisfied with care and treatment and to compare parent satisfaction with the results of a study performed in 2003. METHODS: Parents...... were asked to assess the quality of care and treatment by answering questions on a touch-screen computer. The questions, which were translated into seven languages, corresponded to the indicators selected by the department for monitoring parents' satisfaction. The system was developed in cooperation...

  5. Behavior of Internal Customer in Family Business: Strategies and Actions for Improving Their Satisfaction

    Science.gov (United States)

    Gutiérrez-Broncano, Santiago; Jiménez-Estévez, Pedro; del Carmen Zabala-Baños, María

    2017-01-01

    Determining the relevant aspects of family businesses (FBs) that make them increasingly competitive is the main objective of researchers in this field. Despite this, there is little empirical literature on the behavior of the internal customer (IC) in FBs or how businesses increase their satisfaction. Basing our work on psychological theories and with both quantitative and qualitative information from 31 semi-structured interviews, this work establishes certain characteristics of the ICs of the FB and proposes a series of guidelines for increasing their satisfaction, thereby facilitating the continuity of this type of business. FBs that are able to understand that the motivation of their ICs is more important than other qualities, and that this requires a more comprehensive management will be able to get sustainable competitive advantages in the future. PMID:28790958

  6. The continuous improvement process and ergonomics in ultrasound department.

    Science.gov (United States)

    Coffin, Carolyn T

    2013-01-01

    Continuous improvement processes, such as Lean, Six Sigma and Quality Control Circles, have been implemented in the manufacturing industries in an effort to increase productivity, eliminate waste, and engage employees in problem solving. These processes can be adapted to the healthcare sector as medical facilities strive to improve the patient experience, increase financial returns, and improve worker safety and morale. In the ultrasound department, productivity can be improved and the quality of patient care can be ensured by standardizing exam protocols and decreasing work related musculoskeletal disorders among sonography professionals. This article summarizes the more commonly used continuous improvement processes and provides a description of how one method might be applied to the ultrasound department.

  7. Agile kaizen managing continuous improvement far beyond retrospectives

    CERN Document Server

    Medinilla, Ángel

    2014-01-01

    Agile teams have been struggling with the concept of continuous improvement since the first Agile frameworks were developed, and still very little has been written about the practice of continuous improvement in Agile environments. Although team retrospectives have been prescribed and some practices have been introduced in order to implement and facilitate them, the truth is that most Agile teams are conducting dull retrospectives that end with a list of things that have been done wrong, just to repeat the same list two weeks later at the next meeting.Instead of listing hundreds of Japanese-la

  8. Design of launch systems using continuous improvement process

    Science.gov (United States)

    Brown, Richard W.

    1995-01-01

    The purpose of this paper is to identify a systematic process for improving ground operations for future launch systems. This approach is based on the Total Quality Management (TQM) continuous improvement process. While the continuous improvement process is normally identified with making incremental changes to an existing system, it can be used on new systems if they use past experience as a knowledge base. In the case of the Reusable Launch Vehicle (RLV), the Space Shuttle operations provide many lessons. The TQM methodology used for this paper will be borrowed from the United States Air Force 'Quality Air Force' Program. There is a general overview of the continuous improvement process, with concentration on the formulation phase. During this phase critical analyses are conducted to determine the strategy and goals for the remaining development process. These analyses include analyzing the mission from the customers point of view, developing an operations concept for the future, assessing current capabilities and determining the gap to be closed between current capabilities and future needs and requirements. A brief analyses of the RLV, relative to the Space Shuttle, will be used to illustrate the concept. Using the continuous improvement design concept has many advantages. These include a customer oriented process which will develop a more marketable product and a better integration of operations and systems during the design phase. But, the use of TQM techniques will require changes, including more discipline in the design process and more emphasis on data gathering for operational systems. The benefits will far outweigh the additional effort.

  9. Preconsent video-assisted instruction improves the comprehension and satisfaction in elderly patient visiting pain clinic.

    Science.gov (United States)

    Kim, Sung Hoon; Koh, Won Uk; Rhim, Jin Ho; Karm, Myong Hwan; Yu, Hye Suk; Lee, Bo Yoeng; Shin, Jin Woo; Leem, Jeong Gill

    2012-10-01

    Elderly patients visiting pain clinic may be at greater risk of misunderstanding the explanation because of age-related cognitive decline. Video instruction may provide a consistent from of teaching in a visual and realistic manner. We evaluated the effect of educational video on the patient understanding and satisfaction in a group of geriatric patients visiting pain clinic. Ninety two patients aged more than 60 years old who were scheduled for transforaminal epidural block were recruited. After exposure to either video or paper instruction process, each patient was asked 5-item comprehension questions, overall satisfaction and preference question. During follow-up period, number of outpatient referral-line call for further explanation was counted. We observed significantly better comprehension in the video education compared with paper instruction (P video group (P = 0.015), and patients visiting pain clinic were more preferred video instruction (P Video approach to instruction process before consent improves treatment comprehension in geriatric patient visiting pain clinic.

  10. Patient-centered transfer process for patients admitted through the ED boosts satisfaction, improves safety.

    Science.gov (United States)

    2013-02-01

    To improve safety and patient flow, administrators at Hallmark Health System, based in Melrose, MA, implemented a new patient-centered transfer process for patients admitted through the ED at the health system's two hospitals. Under the new approach, inpatient nurses come down to the ED to take reports on new patients in a process that includes the ED care team as well as family members. The inpatient nurses then accompany the patients up to their designated floors. Since the new patient-transfer process was implemented in June 2012, patient satisfaction has increased by at least one point on patient satisfaction surveys. Administrators anticipate that medical errors or omissions related to the handoff process will show a drop of at least 50%, when data is tabulated.

  11. Eurodish-Continuous Operation, System Improvement and Reference Units

    Energy Technology Data Exchange (ETDEWEB)

    Keck, T.; Schiel, W.; Heller, P.; Reinalter, W.; Gineste, J. M.; Ferriere, A.; Flamant, G.

    2006-07-01

    The 10 kWel Dish/Stirling system EuroDish was enhanced. Newly developed and improved components like the ceramic cavity insulation and the control system are described as well as a novel assembly method for the concentrator and a number of improvements and new features of the control software. Country Reference Units were built in Spain, France and Germany and are continuously operated. Operation experiences and performance data are presented. (Author)

  12. Continuous improvement based on learning capacity of petroleum industry

    Energy Technology Data Exchange (ETDEWEB)

    Filho, C.A.; Silva, E.N.C.; Rodriguez, M.V.R.; Quelhas, O.L.G. [Univ. Federal Fluminense, Rio de Janeiro (Brazil)

    2004-07-01

    Knowledge management is one of the newest strategies for organizations to improve their productivity. Oil companies seeking business sustainability are faced with the challenge of continuously improving their operations. This paper emphasized that in order to improve, companies must gain valuable experience through planning, perseverance, commitment and processes that accumulate results. It presented a visual methodology, based on symbolisms and key words, which is intended to facilitate the assimilation of the continuous improvement program structure from knowledge management. The concepts of Garvin, Nonaka and Takeuchi were presented as means for improving the capacity of an organization seeking a learning atmosphere through the prioritization of actions to facilitate team activities and accumulate knowledge in the individual. It was shown that Japanese companies in the production sector have used 4 processes of knowledge conversion: socialization, exteriorization, internalization and their combinations. The Garvin concept has proposed that continuous improvement of an organization would be more positive if the companies learnt a basic lesson. This paper articulated resulting observations from Garvin and from Nonaka and Takeuchi theories and proposed recommendations based on symbolism for identifying action strategies and achievement objectives. Issues regarding working conditions and the influence on learning were discussed along with different ways to transfer knowledge in terms of competencies and skills. 14 refs., 7 figs.

  13. Jump starting of continuous improvement through self-assessment

    DEFF Research Database (Denmark)

    Jørgensen, Frances; Boer, Harry; Gertsen, Frank

    2004-01-01

    The innumerable accounts of successful implementation of kaizen in Japan during more than 40 years has led to the expectation that continuous improvement (CI) might offer companies a means to gain and maintain a competitive advantage in the turbulent 1980s and 1990s. However, the majority of CI...

  14. Behavioural dynamics in high-performing continuous improvement teams

    NARCIS (Netherlands)

    van Dun, Desirée Hermina; van Eck, Tim; van Vuuren, Hubrecht A.; Wilderom, Celeste P.M.

    2011-01-01

    We have explored from an Organisational-Behavioural perspective, why a Continuous Improvement (CI) team performs well. We report on the first part of a longitudinal study on intra-team behaviour of five, carefully selected, high-performing CI teams in five major Dutch organizations. Not only did we

  15. Jump starting of continuous improvement through self-assessment

    DEFF Research Database (Denmark)

    Jørgensen, Frances; Boer, Harry; Gertsen, Frank

    2004-01-01

    The innumerable accounts of successful implementation of kaizen in Japan during more than 40 years has led to the expectation that continuous improvement (CI) might offer companies a means to gain and maintain a competitive advantage in the turbulent 1980s and 1990s. However, the majority of CI i...

  16. Promoting Continuous Quality Improvement in Online Teaching: The META Model

    Science.gov (United States)

    Dittmar, Eileen; McCracken, Holly

    2012-01-01

    Experienced e-learning faculty members share strategies for implementing a comprehensive postsecondary faculty development program essential to continuous improvement of instructional skills. The high-impact META Model (centered around Mentoring, Engagement, Technology, and Assessment) promotes information sharing and content creation, and fosters…

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

    Science.gov (United States)

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

    2013-08-01

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

  18. Patients report improvement in quality of life and satisfaction after hip resurfacing arthroplasty.

    Science.gov (United States)

    Rahman, Wael A; Greidanus, Nelson V; Siegmeth, Alexander; Masri, Bassam A; Duncan, Clive P; Garbuz, Donald S

    2013-02-01

    A number of reconstructive procedures are available for the management of hip osteoarthritis. Hip resurfacing arthroplasty is now an accepted procedure, with implant survivorship comparable to THA at up to 10 years' followup in certain series. Most reports focus on implant survivorship, surgeon-derived results, or complications. Fewer data pertain to patient-reported results, including validated measures of quality of life (QoL) and satisfaction and baseline measures from which to determine magnitude of improvement. Validated patient-reported results are essential to guide patients and surgeons in the current era of informed and shared decision making. We determined whether patients reported improvement in disease-specific, joint-specific, and generic QoL after hip resurfacing arthroplasty; whether patients were satisfied with the results of the procedure; and latest activity level and return to sport. We retrospectively reviewed 127 patients (100 men, 27 women) who underwent 143 hip resurfacing procedures between 2002 and 2006. Mean patient age was 52 years. Patients completed the WOMAC, Oxford Hip Score, and SF-12 at baseline and again at minimum 2-year followup (mean, 2.5 years; range, 2-6 years). At latest followup, patients completed a validated satisfaction questionnaire and UCLA activity score. All QoL scores improved (normalized to a 0-100 scale, where 100 = best health state). WOMAC improved from 46 to 95, Oxford Hip Score from 42 to 95, SF-12 (physical) from 34 to 54, and SF-12 (mental) from 46 to 56. Patient satisfaction score was 96. UCLA activity score was 8. The majority of patients reported improvement in QoL, were very satisfied with their outcome, and returned to a high level of activity after hip resurfacing arthroplasty. Level IV, therapeutic study. See the Instructions for Authors for a complete description of levels of evidence.

  19. Lean-driven improvements slash wait times, drive up patient satisfaction scores.

    Science.gov (United States)

    2012-07-01

    Administrators at LifePoint Hospitals, based in Brentwood, TN, used lean manufacturing techniques to slash wait times by as much as 30 minutes and achieve double-digit increases in patient satisfaction scores in the EDs at three hospitals. In each case, front-line workers took the lead on identifying opportunities for improvement and redesigning the patient-flow process. As a result of the new efficiencies, patient volume is up by about 25% at all three hospitals. At each hospital, the improvement process began with Kaizen, a lean process that involves bringing personnel together to flow-chart the current system, identify problem areas, and redesign the process. Improvement teams found big opportunities for improvement at the front end of the flow process. Key to the approach was having a plan up front to deal with non-compliance. To sustain improvements, administrators gather and disseminate key metrics on a daily basis.

  20. IMHEX fuel cell repeat component manufacturing continuous improvement accomplishments

    Energy Technology Data Exchange (ETDEWEB)

    Jakaitis, L.A.; Petraglia, V.J.; Bryson, E.S. [M-C Power Corp., Burr Ridge, IL (United States)] [and others

    1996-12-31

    M-C Power is taking a power generation technology that has been proven in the laboratory and is making it a commercially competitive product. There are many areas in which this technology required scale up and refinement to reach the market entry goals for the IMHEX{reg_sign} molten carbonate fuel cell power plant. One of the primary areas that needed to be addressed was the manufacturing of the fuel cell stack. Up to this point, the fuel cell stack and associated components were virtually hand made for each system to be tested. M-C Power has now continuously manufactured the repeat components for three 250 kW stacks. M-C Power`s manufacturing strategy integrated both evolutionary and revolutionary improvements into its comprehensive commercialization effort. M-C Power`s objectives were to analyze and continuously improve stack component manufacturing and assembly techniques consistent with established specifications and commercial scale production requirements. Evolutionary improvements are those which naturally occur as the production rates are increased and experience is gained. Examples of evolutionary (learning curve) improvements included reducing scrap rates and decreasing raw material costs by buying in large quantities. Revolutionary improvements result in significant design and process changes to meet cost and performance requirements of the market entry system. Revolutionary changes often involve identifying new methods and developing designs to accommodate the new process. Based upon our accomplishments, M-C Power was able to reduce the cost of continuously manufactured fuel cell repeat components from the first to third 250 kW stack by 63%. This paper documents the continuous improvement accomplishments realized by M-C Power during IMHEX{reg_sign} fuel cell repeat component manufacturing.

  1. Beyond Customer Satisfaction: Reexamining Customer Loyalty to Evaluate Continuing Education Programs

    Science.gov (United States)

    Hoyt, Jeff E.; Howell, Scott L.

    2011-01-01

    This article provides questionnaire items and a theoretical model of factors predictive of customer loyalty for use by administrators to determine ways to increase repeat purchasing in their continuing education programs. Prior studies in the literature are discussed followed by results of applying the model at one institution and a discussion of…

  2. Beyond Customer Satisfaction: Reexamining Customer Loyalty to Evaluate Continuing Education Programs

    Science.gov (United States)

    Hoyt, Jeff E.; Howell, Scott L.

    2011-01-01

    This article provides questionnaire items and a theoretical model of factors predictive of customer loyalty for use by administrators to determine ways to increase repeat purchasing in their continuing education programs. Prior studies in the literature are discussed followed by results of applying the model at one institution and a discussion of…

  3. Postoperative improvement in acoustic rhinometry measurements after septoplasty correlates with long-term satisfaction

    DEFF Research Database (Denmark)

    Toyserkani, N M; Frisch, Thomas; von Buchwald, Christian

    2013-01-01

    Not much is known about long-term satisfaction of septoplasty. Our goal was to compare pre- and postoperative acoustic rhinometry measurements with satisfaction 11 years after surgery.......Not much is known about long-term satisfaction of septoplasty. Our goal was to compare pre- and postoperative acoustic rhinometry measurements with satisfaction 11 years after surgery....

  4. Factors influencing patient satisfaction with dental appearance and treatments they desire to improve aesthetics

    Directory of Open Access Journals (Sweden)

    Hassan Nurhidayati

    2011-02-01

    Full Text Available Abstract Background We assessed factors influencing patients' satisfaction with their dental appearance and the treatments they desired to improve dental aesthetics. Methods A cross-sectional study was performed out among 235 adult patients who visited the Hospital Universiti Sains Malaysia dental clinic. A structured, interviewer-guided questionnaire was used to identify patient satisfaction with their general dental appearance, cosmetic elements and desired treatments. Results The 235 patients consisted of 70 males (29.8% and 165 females (70.2%, of mean age 31.5 years (SD 13.0. Of these patients, 124 (52.8% were not satisfied with their general dental appearance. In addition, 132 patients (56.2% were not happy with the color of their teeth, 76 (32.3%, regarded their teeth were poorly aligned, 62 (26.4%, as crowded and 56 (23.4% protruded. Dissatisfaction with tooth color was significantly higher in female than in male patients (odds ratio [OR] of 1.99 (95% confidence interval [CI] 1.13-3.50. Tooth whitening was the treatment most desired by patients (48.1%. Results of multiple logistic regression analysis showed that patient dissatisfaction with general dental appearance was significantly associated with female gender (OR = 2.18; 95% CI: 1.18-4.03, unhappiness with tooth color (OR = 3.05; 95% CI: 1.74-5.34 and the opinion that their teeth protruded (OR = 2.91, 95% CI: 1.44-5.91. Conclusions Most patients in this study were not satisfied with their dental appearance with a greater percentage of females expressing dissatisfaction than males. An age was not associated with satisfaction. Unhappiness with tooth color and feelings of having protruding teeth also had a significant negative influence on patient satisfaction with general dental appearance.

  5. The new health-care quality: value, outcomes, and continuous improvement.

    Science.gov (United States)

    O'Connor, S J; Lanning, J A

    1991-01-01

    No longer convinced that their viewpoint on quality is the only one, different stakeholders in the health-care arena are sharing perspectives to piece together the quality picture. Although still preoccupied with the cost of health care, purchasers are concerned about value--efficiency, appropriateness, and effectiveness--as well as price. Faced with evidence of medically unnecessary procedures and unexamined medical theory, practitioners are searching for appropriateness guidelines, useful outcome measures, and methods to elicit informed patient preferences about elective surgeries. Underlying this search for reliable indicators of quality--now expanded to include patient satisfaction--is a new interest in the Japanese notion of "Kaizen" or continuous quality improvement. The end product of this ferment may determine whether good medicine drives out the bad--or vice versa.

  6. How creation of a parent satisfaction questionnaire improved multidisciplinary service delivery in a paediatric day surgery unit.

    Science.gov (United States)

    Bradley, Alison

    2013-01-01

    Auditing patient satisfaction has become a keystone of quality patient centred healthcare. A plethora of patient satisfaction studies exist but only a few studies have been evaluated for their validity, reliability, specificity or psychometric properties. And the majority focus on adult health care. However, if validated tools are not utilised, then inaccurate results could stymie service improvement. The level of satisfaction with the paediatric day surgery service at Tayside Children's Hospital was unknown. Our objective was to measure parent satisfaction with the paediatric day surgery by creating a parent satisfaction questionnaire which has undergone satisfactory testing for validity, reliability, specificity and psychometric properties. A Likert-style questionnaire was constructed through literature review and focus group meetings with professionals, parents and patient groups to establish content validity. Statements worded in positive phrasing were re-worded in negative phrasing to ensure intra-rater reliability. A pilot study was conducted and responses analysed for construct validity and inter-rater agreement. Internal reliability was established using Chronbach's alpha analysis, which produced scores for each part of the questionnaire between 0.7 and 0.9. Overall parent satisfaction was high. 95.48% either strongly agreed or agreed with positively worded statements regarding pre-operative clinic service. In particular 100% satisfaction was reported with the pre-operative phone call which only 70% of participants received. 96.60% strongly agreed or agreed with positive statements regarding service provided on the ward and 87.50% strongly agreed or agreed with positive statements regarding the discharge process. 5% specifically requested improved information giving. In conclusion the parent satisfaction questionnaire was found to have proven validity, reliability, specificity and psychometric properties. Overall parent satisfaction was found to be high

  7. Empowerment and continuous improvement in the United States, Mexico, Poland, and India: predicting fit on the basis of the dimensions of power distance and individualism.

    Science.gov (United States)

    Robert, C; Probst, T M; Martocchio, J J; Drasgow, F; Lawler, J J

    2000-10-01

    Although variations in national cultures predominate as explanation for the belief that universal approaches to management do not exist, there have been few reports of systematic studies. Data from employees of a single firm with operations in the United States, Mexico, Poland, and India were used to test the fit of empowerment and continuous improvement practices with national culture. Using the theoretical constructs of individualism-collectivism and power distance, the authors predicted that the practices would be more congruent in some cultures than in others and that value congruence would result in job satisfaction. Using structural equations modeling, the authors found that empowerment was negatively associated with satisfaction in India but positively associated in the other 3 samples. Continuous improvement was positively associated with satisfaction in all samples. Substantive, theoretical, and methodological implications are discussed.

  8. Reservoir continuous process improvement six sigma methodology implementation

    Energy Technology Data Exchange (ETDEWEB)

    Wannamaker, A.L.

    1996-12-01

    The six sigma methodology adopted by AlliedSignal Inc. for implementing continuous improvement activity was applied to a new manufacturing assignment for Federal Manufacturing & Technologies (FM&T). The responsibility for reservoir development/production was transferred from Rocky Flats to FM&T. Pressure vessel fabrication was new to this facility. No fabrication history for this type of product existed in-house. Statistical tools such as process mapping, failure mode and effects analysis, and design of experiments were used to define and fully characterize the machine processes to be used in reservoir production. Continuous improvement with regard to operating efficiencies and product quality is an ongoing activity at FM&T.

  9. Safety, efficacy and patient satisfaction with continuous daily administration of levonorgestrel/ethinylestradiol oral contraceptives

    Directory of Open Access Journals (Sweden)

    Giuseppe Benagiano

    2009-04-01

    Full Text Available Giuseppe Benagiano, Sabina Carrara, Valentina FilippiDepartment of Gynaecology and Obstetrics, Sapienza University, Rome, ItalyAbstract: The progestational steroid norgestrel was synthesized and tested between 1960 and 1965 through an international cooperation between Wyeth, USA and Schering, Berlin. It is a mixture of two “enantiomers,” with only one form (designated as levonorgestrel biologically active. When taken orally, it is rapidly absorbed, not subjected to a “first-pass” effect and is approximately 90% bioavailable, with a circulating half-life around 15 hours. Its contraceptive action is exerted at the central (hypothalamic and peripheral (cervical mucus and endometrium levels. Levonorgestrel (LNG, alone or in combination with ethinyl estradiol (EE, is the most widely employed contraceptive progestin: it is used in combined oral contraceptives, progestogen-only pills, long-acting contraceptive implants, intrauterine contraceptive systems and in emergency contraception. It is also the steroid of choice for new oral contraceptive regimens aimed at reducing the frequency of bleeding episodes. This novel approach, already tried more than 30 years ago, gained interest around the year 2000 when surveys of women’s attitudes toward monthly menstrual bleeding started to show a major change: more and more women declared that they would welcome a hormonal contraceptive method that reduced bleeding episodes to 4, 2 or even 1 per year. At this point, while the debate on the significance and “usefulness” of menstruation went on, attention focused on new regimens. The first new modality consisted of changing the 7-day medication-free interval, either shortening it to fewer than 7 days, or by the administration of low-dose estrogens during the interval between packages. Then, continuous administration regimens started to be investigated. This, however, did not happen suddenly, since, in specific situations, doctors had for years

  10. At Your Request(®) room service dining improves patient satisfaction, maintains nutritional status, and offers opportunities to improve intake.

    Science.gov (United States)

    Doorduijn, Astrid S; van Gameren, Yvonne; Vasse, Emmelyne; de Roos, Nicole M

    2016-10-01

    Malnutrition in hospitals may be combatted by improving the meal service. To evaluate whether At Your Request(®), a meal service concept by Sodexo with a restaurant style menu card and room service, improved patient satisfaction, nutritional status, and food intake compared to the traditional 3-meals per day service. We prospectively collected data in Hospital Gelderse Vallei (Ede, the Netherlands) before (2011/2012; n = 168, age 63 ± 15 y) and after (2013/2014; n = 169, 66 ± 15 y) implementing At Your Request(®). Patient satisfaction increased after implementing At Your Request(®) from 7.5 to 8.1 (scale 1-10) and from 124.5 to 132.9 points on a nutrition-related quality of life questionnaire (p concept that helps patients to maintain nutritional status. The concept offers options for improving the intake of specific nutrients and foods, which should be evaluated in further studies. Copyright © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  11. Safety, efficacy and patient satisfaction with continuous daily administration of levonorgestrel/ethinylestradiol oral contraceptives

    Science.gov (United States)

    Benagiano, Giuseppe; Carrara, Sabina; Filippi, Valentina

    2009-01-01

    The progestational steroid norgestrel was synthesized and tested between 1960 and 1965 through an international cooperation between Wyeth, USA and Schering, Berlin. It is a mixture of two “enantiomers,” with only one form (designated as levonorgestrel) biologically active. When taken orally, it is rapidly absorbed, not subjected to a “first-pass” effect and is approximately 90% bioavailable, with a circulating half-life around 15 hours. Its contraceptive action is exerted at the central (hypothalamic) and peripheral (cervical mucus and endometrium) levels. Levonorgestrel (LNG), alone or in combination with ethinyl estradiol (EE), is the most widely employed contraceptive progestin: it is used in combined oral contraceptives, progestogen-only pills, long-acting contraceptive implants, intrauterine contraceptive systems and in emergency contraception. It is also the steroid of choice for new oral contraceptive regimens aimed at reducing the frequency of bleeding episodes. This novel approach, already tried more than 30 years ago, gained interest around the year 2000 when surveys of women’s attitudes toward monthly menstrual bleeding started to show a major change: more and more women declared that they would welcome a hormonal contraceptive method that reduced bleeding episodes to 4, 2 or even 1 per year. At this point, while the debate on the significance and “usefulness” of menstruation went on, attention focused on new regimens. The first new modality consisted of changing the 7-day medication-free interval, either shortening it to fewer than 7 days, or by the administration of low-dose estrogens during the interval between packages. Then, continuous administration regimens started to be investigated. This, however, did not happen suddenly, since, in specific situations, doctors had for years empirically utilized various continuous administration regimens. The first extended-cycle oral contraceptive regimen introduced in clinical practice is an 84

  12. Improved continuity of care in a community teaching hospital model.

    Science.gov (United States)

    Mittal, V; David, W; Young, S; McKendrick, A; Gentile, T; Casalou, R

    1999-05-01

    We created an ambulatory resident clinic in a community teaching hospital to improve the continuity of care in a surgery residency program. A retrospective chart review analysis. A community hospital, general surgery residency training program, and its ambulatory practice. Providence Hospital, Southfield, Mich, has established a new model, the Surgical Associates of Michigan, which is an association comprising private practice physicians serving as full-time faculty in the Department of Surgery. In addition to clarification of teaching requirements and reimbursement for educational activities, the most dramatic feature is the relocation of private practice offices and the staff surgical office to one central location within the hospital. The proximity of the staff and private surgical offices facilitates closer interaction of attending physicians, residents, and patients. Compliance rates of continuity of patient care provided by the same resident, as presented by the Surgery Residency Review Committee, including confirmation of diagnosis, provision of preoperative care, discussion with attending physician, selection and provision of intervention, direction of postoperative care, and postdischarge follow-up. Since the inception of this arrangement at our institution, surgical residents have seen 229 staff patients and 465 private patients in the offices under supervision. Compliance rate of continuity of care was defined as patient follow-up with the same senior surgical resident who performed an operation or evaluated the patient on initial presentation to the emergency department or offices. We achieved a compliance rate of 92.8% (169/182) in the staff surgical clinics. A compliance rate of 63.5% (205/323) for private general surgical patients and 70.4% (100/142) for vascular surgical patients was obtained. With the establishment of the teaching faculty group and the relocation of offices, we were able to achieve a dramatic improvement in continuity of care. In

  13. Ergonomics oriented to processes becomes a tool for continuous improvement.

    Science.gov (United States)

    Getty, R L; Getty, J M

    1999-01-01

    A holistic view is essential for quality initiatives such as Total Quality Management (TQM), Standard No. ISO 9001:1994 (International Organization for Standardization [ISO], 1994), Concurrent Engineering, Business Reengineering, and Business Process Improvement. The challenge is knowing how to transition from this theoretical concept to implementation. The relationship between quality interest and an ergonomics program will be the focus of this discussion. An ergonomics oriented improvement program includes (a) ergonomics or fitting the job to the person; (b) integration of operations management, safety engineering, medical management, and employees as co-owners of the process; (c) the emphasis of ergonomic precepts in the engineering of new processes and improvement of current processes; and (d) the emphasis of employees taking responsibility for their own well being and the improvement of their work environment. The parallel between the continuous improvement process delineated by the quality-system requirements in Standard No. ISO 9001:1994 (ISO, 1994) and the improvement contributions of ergonomics are very revealing (Getty, Abbott, & Getty, 1995). It is the contention of this approach that if the precepts of ergonomics were applied to the work environment, it would support the objective of world class quality and productivity, resulting in improved global competitiveness of businesses.

  14. Improving Our Odds: Success through Continuous Risk Management

    Science.gov (United States)

    Greenhalgh, Phillip O.

    2009-01-01

    Launching a rocket, running a business, driving to work and even day-to-day living all involve some degree of risk. Risk is ever present yet not always recognized, adequately assessed and appropriately mitigated. Identification, assessment and mitigation of risk are elements of the risk management component of the "continuous improvement" way of life that has become a hallmark of successful and progressive enterprises. While the application of risk management techniques to provide continuous improvement may be detailed and extensive, the philosophy, ideals and tools can be beneficially applied to all situations. Experiences with the use of risk identification, assessment and mitigation techniques for complex systems and processes are described. System safety efforts and tools used to examine potential risks of the Ares I First Stage of NASA s new Constellation Crew Launch Vehicle (CLV) presently being designed are noted as examples. Recommendations from lessons learned are provided for the application of risk management during the development of new systems as well as for the improvement of existing systems. Lessons learned and suggestions given are also examined for applicability to simple systems, uncomplicated processes and routine personal daily tasks. This paper informs the reader of varied uses of risk management efforts and techniques to identify, assess and mitigate risk for improvement of products, success of business, protection of people and enhancement of personal life.

  15. Self-assessment/continuous improvement: Opportunity or burden?

    Energy Technology Data Exchange (ETDEWEB)

    Ryder, D.E.

    1993-02-01

    Quality assurance is defined in US Department of Energy (DOE) Order 5700.6C as ``actions that provide confidence that quality is achieved.`` Confidence is the key word in this definition. Because of a lackof confidence, Congress has mandated improved performance by DOE and its contractors. DOE Headquarters has responded, in part, by requiring increased oversight of all affected organizations. Self-assessment/continuous improvement (SA/CI) is presented in this paper as a ten-step process to help restore confidence. The SA/CI process begins when you identify your customers. SA/CI then leads to determining customer requirements and establishing performance objectives and criteria against which current processes and performance are evaluated. SA/CI should be performed by managers and supervisors at all levels and should includedirect observation of work in progress in addition to analysis of performance data. Traditional independent assessment processes such as audits and surveillances can be used to provide valuable information for performing the evaluation. SA/CI is an aggressive ``no-fault`` self-assessment process coupled with a continuous improvement process that yields truly cost-effective corrective action and a high level of confidence that process and product quality objectives have been met. This approach should provide customers the evidence needed to increase their confidence in the organization`s activities. The end result should bean improvement in the quality of work life for the organization`s employees and a significant reduction in external oversight (i.e., audits).

  16. Using automated continual performance assessment to improve health care.

    Science.gov (United States)

    Wulff, K R; Westphal, J R; Shray, S L; Hunkeler, E F

    1997-01-01

    Inefficiency in the work of health care providers is evident and contributes to health care costs. In the early 20th century, industrial engineers developed scientific methods for studying work to improve performance (efficiency) by measuring results--i.e., quality, cost, and productivity. In the mid-20th century, business managers developed ways to apply these methods to improve the work process. These scientific methods and management approaches can be applied to improving medical work. Fee-for-service practice has had incentives to maximize productivity, and prepaid practice has had incentives to minimize costs, but no sector of the health care system has systematically pursued the optimization of all performance variables: quality, cost, and productivity. We have reviewed evolving methods for the automation of continual assessment of performance in health care using touch screen and computer telephone, logging and scheduling software, appropriate combinations of generic or disease-specific health status questionnaires, physiologic measurements or laboratory assays from computerized records, and cost and productivity data from computerized registration logs. We propose that the results of outcome assessment be rapidly and continually transmitted to providers, patients, and managers so that health care processes can be progressively improved. The evolving systems we have described are the practical tools that can help us achieve our performance goals.

  17. Applying PPM to ERP Maintenance and Continuous Improvement Initiatives

    DEFF Research Database (Denmark)

    El-Tal, Nada Maria; Fonnesbæk, Majbrit; Kræmmergaard, Pernille

    2006-01-01

    Enterprise Resource Planning Systems (ERP) has been implemented in many companies during the last decade and has gained an increasing significance. For many companies it means that the focus is no longer on how to implement the ERP system, but rather on how to maintain and improve the system...... to gain business benefits from the systems. However the ERP literature on how to do this is limited. The purpose of this article is to explore how Project Portfolio Management (PPM) from the Research and Development (R&D) literature can be applied to an ERP second wave context, when companies...... are to prioritize and select maintenance and continuous improvement initiatives. This is done by reviewing the existing literature in the fields of PPM from R&D literature and then by reviewing the existing literature about maintenance and improvement initiatives in the ERP literature, after which the two...

  18. Deploying continuous improvement across the drug discovery value chain.

    Science.gov (United States)

    Walker, Stephen M; Davies, Barry J

    2011-06-01

    In addressing the challenges facing pharmaceutical R&D one question is frequently asked: how can continuous improvement (CI), delivered through a Lean Sigma approach, be applied in a research environment to deliver overall benefit? We show that taking a value chain approach to improvement projects in a discovery research organization, initially focusing on the drug discovery project delivery level (i.e. middle layer of the value chain), provides the foundation for an effective CI programme. The adaptation of Lean Sigma principles and methodology, combined with the tenacity and creativity of scientists, enabled the delivery of significant improvements in challenging areas, including target selection, project decision making and the compound design-make-test-analyse (DMTA) cycle. Copyright © 2011 Elsevier Ltd. All rights reserved.

  19. Using evidence to improve satisfaction with medication side-effects education on a neuro-medical surgical unit.

    Science.gov (United States)

    Ahrens, Susan L; Wirges, Ashley M

    2013-10-01

    Patient satisfaction is viewed as a significant indicator of quality of care. More specifically, improving patient satisfaction related to communication about medications and potential side effects can improve healthcare outcomes. Patient satisfaction scores related to medication side effects on a neuro-medical surgical unit were monitored following a quality improvement program. These patients frequently experience cognitive impairment and functional difficulties that can affect the way they understand and handle medications. The purpose of this quality improvement practice change was to (a) develop an educational approach for post acute neurosurgical patients and (b) evaluate whether the use of the approach is successful in improving patient satisfaction scores related to medication education on side effects. The quality improvement program interventions included (a) patient informational handouts inserted into admission folders, (b) nurse education about the importance of providing education on side effects to patient and discussion of their involvement with the program, (c) unit flyers with nurse education, and (d) various communications with bedside nurses through personal work mail and emails. The primary focus was for nurses to employ the "teach back" method to review and reinforce the medication side-effect teaching with patients. Evaluation of the data showed an increase in patient satisfaction after the implementation of the "Always Ask" program.

  20. Using lean Six Sigma to improve hospital based outpatient imaging satisfaction.

    Science.gov (United States)

    McDonald, Angelic P; Kirk, Randy

    2013-01-01

    Within the hospital based imaging department at Methodist Willowbrook, outpatient, inpatient, and emergency patients are all performed on the same equipment with the same staff. The critical nature of the patient is the deciding factor as to who gets done first and in what order procedures are performed. After an aggressive adoption of Intentional Tools, the imaging department was finally able to move from a two year mean Press Ganey, outpatient satisfaction average score of 91.2 and UHC percentile ranking of 37th to a mean average of 92.1 and corresponding UHC ranking of 60th percentile. It was at the 60th percentile ranking that the department flat lined. Using the Six Sigma DMAIC process, opportunity for further improvement was identified. A two week focus pilot was conducted specifically on areas identified through the Six Sigma process. The department was able to jump to 88th percentile ranking and a mean of 93.7. With pay for performance focusing on outpatient satisfaction and a financial incentive to improving and maintaining the highest scores, it was important to know where the imaging department should apply its financial resources to obtain the greatest impact.

  1. Surgical treatment of Peyronie's disease: choosing the best approach to improve patient satisfaction

    Institute of Scientific and Technical Information of China (English)

    Paulo H. Egydio

    2008-01-01

    Aim: To discuss important points on medical history, preoperative evaluation, real expectations, and selection of the appropriate surgical procedure to improve patient satisfaction after surgical procedures for Peyronie's disease. Methods:Recent advances in approaches to Peyronie's disease are discussed based on the literature and personal experiences.Issues concerning surgical indication, patient selection, surgical techniques, and grafting are discussed. Lengthening procedures on the convex side of the penile curvature by means of grafting offer the best possible gain from a reconstruction standpoint. Penile rectification and rigidity are required to achieve a completely functional penis. Most patients experience associated erectile dysfunction (ED), and penile straightening alone may not be enough to restore complete function. Twenty-five patients were submitted to total penile reconstruction on length and girth with concomitant penile prosthesis implant. The maximum length restoration was possible and limited by the length of the maintained the penis straight. No infections occurred. Sexual intercourse was restored in all patients and all reported recovered self-esteem. Conclusion: Improving patient satisfaction with the surgical treatment includes proper preoperative evaluation on stable disease, penile shortening, vascular and erectile status, patient decision and selection as well as extensive discussion on surgical technique for restoring functional penis (length and rigidity). Length and girth

  2. Improved understanding and satisfaction with a modified informed consent document: a randomized study

    Directory of Open Access Journals (Sweden)

    Raich PC

    2012-05-01

    Full Text Available Peter C Raich1,2, Ralph L Kennedy1, Chris Vanoni1, William Thorland2, Naamon Owens1, Charles L Bennett31AMC Cancer Research Center, University of Colorado Comprehensive Cancer Center, Denver, 2Denver Health Medical Center, Denver, Colorado, USA; 3Center for Management of Complex Chronic Care, Hines Veterans Administration Hospital, Hines, IL, USABackground: Informed consent documents need to convey crucial information to prospective study participants. We assessed the impact of an informed consent process designed to be understood by persons with low health literacy skills.Methods: We conducted a randomized controlled trial with ethnically and racially diverse male veterans. Participants were randomly assigned to receive and read the standard consent document for the Selenium and Vitamin E Cancer Prevention Trial prostate cancer prevention trial or a culturally tailored, easy-to-read consent document. Telephone interviews were conducted 2 weeks following consent, assessing comprehension, satisfaction, consent anxiety, state anxiety, decisional conflict, and cultural sensitivity.Results: Of 162 male veterans completing the initial telephone interview, 49.7% were African American, 44.1% were Caucasian, and 6.2% were Hispanic. The mean comprehension score for the consent document and process was significantly increased in the intervention arm participants (17.08 versus the standard consent arm (15.06, P < 0.0001. The satisfaction score with the consent information was higher in participants in the intervention arm (3.67 vs 3.42, P = 0.0009, while the consent anxiety score was reduced (1.31 vs 1.56, P = 0.0067.Conclusion: Modifications in the reading level, format, appearance, interactivity, and cultural sensitivity of an informed consent document in the cancer prevention setting significantly improved comprehension of and satisfaction with the consent document, while decreasing consent anxiety.Keywords: health literacy, informed consent, clinical

  3. Impact of the health services utilization and improvement model (HUIM) on self efficacy and satisfaction among a head start population.

    Science.gov (United States)

    Tataw, David B; Bazargan-Hejazi, Shahrzad

    2010-01-01

    The aim of this paper is to evaluate and report the impact of the Health Services Utilization Improvement Model (HUIM) on utilization and satisfaction with care, as well as knowledge regarding prevention, detection, and treatment of asthma, diabetes, tuberculosis, and child injury among low income health services consumers. HUIM outcomes data shows that the coupling of parental education and ecological factors (service linkage and provider orientation) impacts the health services utilization experience of low income consumers evidenced by improved self-efficacy (knowledge and voice), and satisfaction with care from a child's regular provider. Participation in HUIM activities also improved the low income consumer's knowledge of disease identification, self-care and prevention.

  4. Improvements in staff quality of work life and family satisfaction following the move to single-family room NICU design.

    Science.gov (United States)

    Watson, Jo; DeLand, Marion; Gibbins, Sharyn; MacMillan York, Elizabeth; Robson, Kate

    2014-04-01

    The purpose of this study was to determine whether there were differences in staff quality of work life and parent satisfaction when a neonatal intensive care unit moved from an open-bay design to a single-room model of care. This descriptive study measured staff quality of work life and family satisfaction before and at 2 time periods after the relocation of a perinatal centre and the introduction of single-family room care. Differences in work life quality and satisfaction were determined using 2-sample t-tests. There were improvements in staff quality of work life and family satisfaction at both time periods following the move. Lessons learned may be of value to other units considering such a move. A neonatal intensive care unit designed to contribute to parental and staff well-being is a model to be considered for future neonatal designs.

  5. Self-esteem, readiness for self-improvement and life satisfaction in Indian and Polish female students

    Directory of Open Access Journals (Sweden)

    Zawadzka Anna Maria

    2016-06-01

    Full Text Available The study examines the question of how personal self-esteem, collective self-esteem and readiness for self-improvement are linked to satisfaction with life in women from countries differing with regard to level of collectivism. Our study participants were Polish (less collectivistic and Indian (more collectivistic female students. The obtained results indicate that personal self-esteem plays a very important role in satisfaction with life of women from the two countries. However, collective self-esteem is not directly related to satisfaction with life among women from the two cultures analyzed. Structural Equation Modeling showed that: a in the Indian group readiness for self-improvement is more important for satisfaction with life than in the Polish group and it is significantly related to satisfaction with life through collectivistic self-esteem, b the direct influence of both personal and collective self-esteem on satisfaction with life is more significant in the Polish group than in the Indian group.

  6. Lifetime Impact Identification for Continuous Improvement of Wind Farm Performance

    DEFF Research Database (Denmark)

    Petersen, Kristian R.; Ruitenburg, Richard J.; Madsen, Erik Skov;

    2015-01-01

    To become profitable, the cost of offshore windfarms must be reduced. Optimization of the Operations & Maintenance process offers a great potential for cost reductions, especially for existing windfarm. As Continuous Improvement may deliver these cost reductions, this paper aims at fostering CI...... in the offshore wind industry. In order to identify where to focus CI efforts, we turn to the theory of Asset Life Cycle Management which shows that a shared multidisciplinary understanding of the complete lifetime of a windfarm is critical. Based on a case study at a leading offshore wind farm company...

  7. Self-assessment/continuous improvement: Opportunity or burden

    Energy Technology Data Exchange (ETDEWEB)

    Ryder, D.E.

    1993-02-01

    Quality assurance is defined in US Department of Energy (DOE) Order 5700.6C as actions that provide confidence that quality is achieved.'' Confidence is the key word in this definition. Because of a lackof confidence, Congress has mandated improved performance by DOE and its contractors. DOE Headquarters has responded, in part, by requiring increased oversight of all affected organizations. Self-assessment/continuous improvement (SA/CI) is presented in this paper as a ten-step process to help restore confidence. The SA/CI process begins when you identify your customers. SA/CI then leads to determining customer requirements and establishing performance objectives and criteria against which current processes and performance are evaluated. SA/CI should be performed by managers and supervisors at all levels and should includedirect observation of work in progress in addition to analysis of performance data. Traditional independent assessment processes such as audits and surveillances can be used to provide valuable information for performing the evaluation. SA/CI is an aggressive no-fault'' self-assessment process coupled with a continuous improvement process that yields truly cost-effective corrective action and a high level of confidence that process and product quality objectives have been met. This approach should provide customers the evidence needed to increase their confidence in the organization's activities. The end result should bean improvement in the quality of work life for the organization's employees and a significant reduction in external oversight (i.e., audits).

  8. A comprehensive medical student career development program improves medical student satisfaction with career planning.

    Science.gov (United States)

    Zink, Brian J; Hammoud, Maya M; Middleton, Eric; Moroney, Donney; Schigelone, Amy

    2007-01-01

    In 1999, the University of Michigan Medical School (UMMS) initiated a new career development program (CDP). The CDP incorporates the 4-phase career development model described by the Association of American Medical Colleges (AAMC) Careers in Medicine (CiM). The CDP offers self-assessment exercises with guidance from trained counselors for 1st- and 2nd-year medical students. Career exploration experiences include Career Seminar Series luncheons, shadow experiences with faculty, and a shadow program with second-year (M2) and fourth-year (M4) medical students. During the decision-making phase, students work with trained faculty career advisors (FCA). Mandatory sessions are held on career selection, preparing the residency application, interviewing, and program evaluation. During the implementation phase, students meet with deans or counselors to discuss residency application and matching. An "at-risk plan" assists students who may have difficulty matching. The CiM Web site is extensively used during the 4 stages. Data from the AAMC and UMMS Graduation Questionnaires (GQ) show significant improvements for UMMS students in overall satisfaction with career planning services and with faculty mentoring, career assessment activities, career information, and personnel availability. By 2003, UMMS students had significantly higher satisfaction in all measured areas of career planning services when compared with all other U.S. medical students.

  9. The Students Satisfaction Oriented: Academic Service Improvement Strategy, Department of Aquatic Resources Management, Bogor Agricultural University, Indonesia

    Science.gov (United States)

    Widaryanti; Daryanto, Arief; Fauzi, Anas Miftah

    2016-01-01

    Higher education institutions must have a strategy change management in the increasingly competitive business environment. A continous performance improvement should be made accordingly. This study was conducted with the case of MSP-IPB, to analyze the priority of academic services improvement which were oriented in student satisfaction. This…

  10. Continued Development and Improvement of Pneumatic Heavy Vehicles

    Energy Technology Data Exchange (ETDEWEB)

    Robert J. Englar

    2005-07-15

    The objective of this applied research effort led by Georgia Tech Research Institute is the application of pneumatic aerodynamic technology previously developed and patented by us to the design of an appropriate Heavy Vehicle (HV) tractor-trailer configuration, and experimental confirmation of this pneumatic configuration's improved aerodynamic characteristics. In Phases I to IV of our previous DOE program (Reference 1), GTRI has developed, patented, wind-tunnel tested and road-tested blown aerodynamic devices for Pneumatic Heavy Vehicles (PHVs) and Pneumatic Sports Utility Vehicles (PSUVs). To further advance these pneumatic technologies towards HV and SUV applications, additional Phase V tasks were included in the first year of a continuing DOE program (Reference 2). Based on the results of the Phase IV full-scale test programs, these Phase V tasks extended the application of pneumatic aerodynamics to include: further economy and performance improvements; increased aerodynamic stability and control; and safety of operation of Pneumatic HVs. Continued development of a Pneumatic SUV was also conducted during the Phase V program. Phase V was completed in July, 2003; its positive results towards development and confirmation of this pneumatic technology are reported in References 3 and 4. The current Phase VI of this program was incrementally funded by DOE in order to continue this technology development towards a second fuel economy test on the Pneumatic Heavy Vehicle. The objectives of this current Phase VI research and development effort (Ref. 5) fall into two categories: (1) develop improved pneumatic aerodynamic technology and configurations on smaller-scale models of the advanced Pneumatic Heavy Vehicle (PHV); and based on these findings, (2) redesign, modify, and re-test the modified full-scale PHV test vehicle. This second objective includes conduct of an on-road preliminary road test of this configuration to prepare it for a second series of SAE Type

  11. Framework for continuous performance improvement in small drinking water systems.

    Science.gov (United States)

    Bereskie, Ty; Haider, Husnain; Rodriguez, Manuel J; Sadiq, Rehan

    2017-01-01

    Continuous performance improvement (CPI) can be a useful approach to overcome water quality problems impacting small communities. Small drinking water systems (SDWSs) struggle to meet regulatory requirements and often lack the economic and human resource flexibility for immediate improvement. A CPI framework is developed to provide SDWS managers and operators an approach to gauge their current performance against similar systems and to track performance improvement from the implementation of the new technologies or innovations into the future. The proposed CPI framework incorporates the use of a water quality index (WQI) and functional performance benchmarking to evaluate and compare drinking water quality performance of an individual water utility against that of a representative benchmark. The results are then used to identify and prioritize the most vulnerable water quality indicators and subsequently identify and prioritize performance improvement strategies. The proposed CPI framework has been demonstrated using data collected from SDWSs in the province of Newfoundland and Labrador (NL), Canada and using the Canadian Council of Ministers of the Environment (CCME) WQI.

  12. Dental esthetic satisfaction, received and desired dental treatments for improvement of esthetics

    Directory of Open Access Journals (Sweden)

    Akarslan Zuhre

    2009-01-01

    Full Text Available Aim: The purposes of this research were to investigate factors influencing patients′ satisfaction with their present dental esthetic, received previous dental treatments on anterior teeth and basic treatments that they wanted to undergo to improve their dental appearance. Materials and Methods: A total of 1014 patients who attended a dental school in a major city in Turkey participated in the study. The participants were surveyed with a questionnaire containing questions about gender, age, education level, self-reported tooth appearance, received previous dental treatments on anterior teeth and desired basic esthetic dental treatments. Statistical analysis of the verifying data was made with descriptive statistics, χ2 test and multiple logistic regression analyses. Results: According to the analyses of the verifying data, 55.1% of the patients were dissatisfied with the color of their teeth, 42.7% with dental appearance, 29.9% with crowding of anterior teeth, 23.3% were hiding teeth while smiling, 16.1% had non-esthetic restorations and 11.9% thought that their anterior teeth were protruding. Esthetic restoration was found to be the most-performed treatment recently (29.0% and whitening of teeth was the most-desired dental treatment (49.0%. Gender, age and education level had an effect on satisfaction and received previous and desired dental treatments for improvement of esthetics. Conclusion: Many of the Turkish patients surveyed in the study were dissatisfied and desired the improvement of dental esthetics. Therefore, dentists should consider this as an important dimension in their practice.

  13. Improvement of Continuous Hydrologic Models and HMS SMA Parameters Reduction

    Science.gov (United States)

    Rezaeian Zadeh, Mehdi; Zia Hosseinipour, E.; Abghari, Hirad; Nikian, Ashkan; Shaeri Karimi, Sara; Moradzadeh Azar, Foad

    2010-05-01

    Hydrological models can help us to predict stream flows and associated runoff volumes of rainfall events within a watershed. There are many different reasons why we need to model the rainfall-runoff processes of for a watershed. However, the main reason is the limitation of hydrological measurement techniques and the costs of data collection at a fine scale. Generally, we are not able to measure all that we would like to know about a given hydrological systems. This is very particularly the case for ungauged catchments. Since the ultimate aim of prediction using models is to improve decision-making about a hydrological problem, therefore, having a robust and efficient modeling tool becomes an important factor. Among several hydrologic modeling approaches, continuous simulation has the best predictions because it can model dry and wet conditions during a long-term period. Continuous hydrologic models, unlike event based models, account for a watershed's soil moisture balance over a long-term period and are suitable for simulating daily, monthly, and seasonal streamflows. In this paper, we describe a soil moisture accounting (SMA) algorithm added to the hydrologic modeling system (HEC-HMS) computer program. As is well known in the hydrologic modeling community one of the ways for improving a model utility is the reduction of input parameters. The enhanced model developed in this study is applied to Khosrow Shirin Watershed, located in the north-west part of Fars Province in Iran, a data limited watershed. The HMS SMA algorithm divides the potential path of rainfall onto a watershed into five zones. The results showed that the output of HMS SMA is insensitive with the variation of many parameters such as soil storage and soil percolation rate. The study's objective is to remove insensitive parameters from the model input using Multi-objective sensitivity analysis. Keywords: Continuous Hydrologic Modeling, HMS SMA, Multi-objective sensitivity analysis, SMA Parameters

  14. Innovative Outcome Assessment in Graduate Business Education and Continuous Improvement

    Directory of Open Access Journals (Sweden)

    Chattopadhyay Satya P.

    2014-11-01

    Full Text Available The changed environment of global economy with painful austerity and restructuring measures causing severe economic dislocations in many diverse parts of the world have brought into focus the usefulness and value of management education in general and graduate management education in particular. The various accrediting bodies in America, Europe and Asia in recent years have shifted their emphasis to ensuring that learning outcomes of students in the program are tied to the goals and missions of the academic institution and meet the needs of the external partners of the academic enterprise that the students go on to serve. This has resulted in rapid advances in the field of innovative outcome assessment, and measurement of competency in performing higher order tasks as well as demonstration of traits related to successful transition into the business world and contribution to the success of the enterprise where the students are employed. The mere assessment/measurement of traits is not the end, but rather the first step in the cycle of continuous improvement in the tradition of the Plan-Do-Study-Act tradition of TQM. The goal is to identify shortcomings or opportunities for improvement via the assessment process and then to “close the loop” by introducing planned changes to improve system performance.

  15. Ergonomics, quality and continuous improvement--conceptual and empirical relationships in an industrial context.

    Science.gov (United States)

    Eklund, J

    1997-10-01

    This paper reviews the literature comparing the fields of ergonomics and quality, mainly in an industrial context, including mutual influences, similarities and differences. Relationships between ergonomics and the factors: work conditions, product design, ISO 9000, continuous improvements and TQM are reviewed in relation to the consequence, application, and process domains. The definitions of ergonomics and quality overlap substantially. Quality deficiencies, human errors and ergonomics problems often have the same cause, which in many cases can be traced to the design of work, workplace and environment e.g. noise, light, postures, loads, pace and work content. In addition, the possibility of performing to a high standard at work is an important prerequisite for satisfaction and well-being. Contradictions between the two fields have been identified in the view of concepts such as standardization, reduction of variability and copying of best practice, requiring further research. The field of quality would gain by incorporating ergonomics knowledge, especially in the areas of work design and human capability, since these factors are decisive for human performance and also therefore the performance of the systems involved. The field of ergonomics, on the other hand, would benefit from developing a stronger emphasis on methodologies and structures for improvement processes, including a clearer link with leadership and company strategies. Just as important is a further development of practicable participative ergonomics methods and tools for use at workplaces by the workers themselves, in order to integrate the top-down and the bottom-up processes and achieve better impact. Using participative processes for problem-solving and continuous improvement, focusing ergonomics and quality jointly has a great potential for improving working conditions and quality results simultaneously, and satisfying most of the interested parties.

  16. Improving job satisfaction of Chinese doctors: the positive effects of perceived organizational support and psychological capital.

    Science.gov (United States)

    Fu, J; Sun, W; Wang, Y; Yang, X; Wang, L

    2013-10-01

    The huge population basic and the transformational changes to healthcare system in China have gained wide public attention in recent years. Along with these issues is a growing literature about doctor's job satisfaction; however, more is known about its negative related factors. Thus, this study was an attempt to assess the level of job satisfaction among Chinese doctors and to explore factors that enhance their job satisfaction. Cross-sectional questionnaire-based survey. A cross-sectional study was conducted during the period of September/October 2010. A questionnaire containing job satisfaction assessed by Minnesota Satisfaction Questionnaire (MSQ), demographic characteristics, work conditions, psychological capital (PsyCap) and perceived organizational support (POS) was distributed to 1300 registered doctors in Liaoning province. A total of 984 respondents became our subjects (effective response rate 75.7%). Hierarchical regression was performed to explore the factors associated with satisfaction. The average MSQ score was 65.86 (level ranking for MSQ, 20-100) in our study population. Hierarchical regression analysis showed that POS (β = 0.412, P job satisfaction. The job satisfaction of Chinese doctors was at a moderate level. POS and PsyCap seemed to be the most crucial factors in relation to job satisfaction. Therefore, efficient measures such as building a supportive work environment and developing doctors' PsyCap should be considered by health administrators in order to promote job satisfaction among Chinese doctors. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  17. Modelling the Role of Human Resource Management in Continuous Improvement

    DEFF Research Database (Denmark)

    Jørgensen, Frances; Hyland, Paul; Kofoed, Lise B.

    2006-01-01

    Although it is widely acknowledged that both Human Resource Management (HRM) and Continuous Improvement have the potential to positively influencing organizational performance, very little attention has been given to how certain HRM practices may support CI, and consequently, a company...... developed by de Leede and Looise (2005) serve as the framework for examining how specific bundles of HRM practices utilized during different phases of the CI implementation process may contribute to sustained organizational performance and enhanced operational performance. The primary contribution...... of the paper is theoretical in nature, as the model developed provides a greater understanding of how HRM can contribute to CI; however, the model also has practical value in that it suggests important relationships between various HRM practices and the behaviors necessary for successful CI. The paper...

  18. Organizational culture, continuous quality improvement, and medication administration error reporting.

    Science.gov (United States)

    Wakefield, B J; Blegen, M A; Uden-Holman, T; Vaughn, T; Chrischilles, E; Wakefield, D S

    2001-01-01

    This study explores the relationships among measures of nurses' perceptions of organizational culture, continuous quality improvement (CQI) implementation, and medication administration error (MAE) reporting. Hospital-based nurses were surveyed using measures of organizational culture and CQI implementation. These data were combined with previously collected data on perceptions of MAE reporting. A group-oriented culture had a significant positive correlation with CQI implementation, whereas hierarchical and rational culture types were negatively correlated with CQI implementation. Higher barriers to reporting MAE were associated with lower perceived reporting rates. A group-oriented culture and a greater extent of CQI implementation were positively (but not significantly) associated with the estimated overall percentage of MAEs reported. We conclude that health care organizations have implemented CQI programs, yet barriers remain relative to MAE reporting. There is a need to assess the reliability, validity, and completeness of key quality assessment and risk management data.

  19. Development of the Continued Improvement System for Nuclear Safety Culture

    Energy Technology Data Exchange (ETDEWEB)

    Park, H. C.; Park, H. G.; Park, Y. W.; Park, J. Y. [KAIST, Daejeon (Korea, Republic of)

    2016-05-15

    It has been found that almost 80 % of the incidents and accidents occurred recently, such as the Fukushima Daiichi disaster and Domestic SBO accident etc. were analyzed to be caused from human errors. (IAEA NES NG-G-2.1) Which strongly claims the importance of the safety culture system. Accordingly, it should be away from a cursory approach like one-off field survey or Snap shop which were being conducted at present for the continued improvement of safety culture. This study introduces an analytical methodology which approaches the generic form of the safety both consciously and unconsciously expressed with behavior, thoughts, and attitude etc. This study was implemented only for open materials such as Inspection report, incidents and accidents reports, QA documents because of the limitation in accessibility to data. More effective use with securing operational data will be possible in future.

  20. 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.

  1. Integrated insulin pump therapy with continuous glucose monitoring for improved adherence: technology update

    Directory of Open Access Journals (Sweden)

    Tumminia A

    2015-09-01

    Full Text Available Andrea Tumminia,1 Laura Sciacca,1 Lucia Frittitta,1 Sebastiano Squatrito,1 Riccardo Vigneri,2 Rosario Le Moli,1 Letizia Tomaselli2 1Endocrinology, Department of Clinical and Experimental Medicine, University of Catania, Garibaldi-Nesima Hospital, Catania, Italy; 2Endocrinology, Garibaldi-Nesima Hospital, Catania, Italy Abstract: Insulin pump therapy combined with real-time continuous glucose monitoring, known as sensor-augmented pump (SAP therapy, has been shown to improve metabolic control and to reduce the rate of hypoglycemia in adults with type 1 diabetes compared to multiple daily injections or standard continuous subcutaneous insulin infusion. Glycemic variability is also reduced in patients on SAP therapy. This approach allows patients to monitor their glucose levels being informed of glycemic concentration and trend. Trained diabetic patients, therefore, can appropriately modify insulin infusion and/or carbohydrate intake in order to prevent hypo- or hyperglycemia. For these reasons, SAP therapy is now considered the gold standard for type 1 diabetes treatment. To be clinically effective, however, devices and techniques using advanced technology should not only have the potential to theoretically ameliorate metabolic control, but also be well accepted by patients in terms of satisfaction and health-related quality of life, because these factors will improve treatment adherence and consequently overall outcome. SAP therapy is generally well tolerated by patients; however, many clinical trials have identified significant noncompliance in the use of this device, most notably in the pediatric and adolescent populations. In this review we aim to analyze the main reasons for good or poor adherence to SAP therapy and to provide useful tips in order to fully benefit from this kind of novel therapeutic approach. Keywords: sensor-augmented insulin pump therapy, type 1 diabetes, quality of life, patient adherence, continuous subcutaneous insulin

  2. Development of the physician satisfaction survey instrument.

    Science.gov (United States)

    Soo Hoo, W E; Ramer, L

    1998-01-01

    Continuous quality improvement (CQI) activities depend on valid and reliable instruments to generate data. An evaluation of internal and external customer satisfaction is one of the pillars of the CQI process. This article describes the development of a valid and reliable instrument for measuring physicians' satisfaction with the orthopedic nursing units at a major medical trauma center. The physician satisfaction survey instrument was found to be internally consistent (alpha = .95). Confirmatory factor analysis revealed that 68% of the variance in physician satisfaction scores (eigenvalue = 8.14) was explained by using a single-factor model.

  3. Permissive attitude towards drug use, life satisfaction, and continuous drug use among psychoactive drug users in Hong Kong

    National Research Council Canada - National Science Library

    Cheung, Nicole WT; Cheung, Yuet-Wah; Chen, Xi

    2016-01-01

    Objectives: To examine the effects of a permissive attitude towards regular and occasional drug use, life satisfaction, self-esteem, depression, and other psychosocial variables in the drug use of psychoactive drug users...

  4. Improvement of job satisfaction and organisational commitment through work group identification: an examination of the quantity surveyors in Hong Kong

    Directory of Open Access Journals (Sweden)

    Wai Yee Betty Chiu

    2013-09-01

    Full Text Available Though extant literatures in other sectors indicatethat job satisfaction and organizational commitment are important fordetermining individual and organisational outcomes, limited related researchhas been conducted amongst quantity surveyors in Hong Kong. Given cooperativeworking arrangement in the quantity surveying profession, work groupidentification is regarded as an important antecedent for determining jobsatisfaction and organisational commitment. The aim of this study is to examinewhether work group identification improves job satisfaction and organisationalcommitment. A questionnaire survey is conducted to collect data from quantitysurveyors working in private sector. A total of 71 valid responses are obtainedfrom 509 contacted quantity surveyors in Hong Kong. Bivariate correlation andmultiple regression analyses are performed to find the significance ofrelationships among the variables. Data analysis results support mosthypotheses. Work group identification is found to have significant positiveeffect on job satisfaction, affective and normative commitment. The finding isa bold step for quantity surveying companies to improve their quantity surveyors’job satisfaction and commitment level. The role of other contextual and organisationalfactors on job satisfaction and organisational commitment needs to becomplemented for future research.

  5. An application of importance satisfaction analysis (ISA) method in improving the internship programme for Malaysia Higher Learning Institution

    Science.gov (United States)

    Hamid, Mohamad Shukri Abdul; Ahad, Nor Aishah; Jamil, Jastini Mohd.; Zulkifli, Malina; Yusof, Zahayu Md.

    2015-12-01

    Nowadays most of the university students are required to undergo internship as a requirement before graduation. Internship is very important for students to practice what they have learned in the classroom. During internship students are exposed to the actual situation of how to deal with customers and suppliers which can provide added value to the students. In the choice of company for internship, students also consider a number of things such as internship allowances, work environment, interesting work, stable work shift and other fridge benefits. Study on the importance and satisfaction of students is important to improve the internship program. Importance means how students feel important to the attributes and satisfaction means how students feel after undergoing internship. The aim of this study is to investigate the gaps between students' important and satisfaction on the internship programme and to identify the internship experience factors that need to be improved. Gap analysis has been used to show the difference between how important attributes are to the studentss and how satisfied they are with those attributes. Result shows that the attributes that has high importance and satisfaction to the students are good peer relationship, broad work experience, competitive fringe benefits, interesting work, work environment, sufficient supervisory support, appreciation and praise from manager, feeling of being a team members, able to identify self-strength and able to develop technical skills. In contrast, three attributes are considered importance but low satisfaction. These attributes are internship allowances, opportunity for self-development, and able to develop interests through practice.

  6. The efficacy of staff training on improving internal customer satisfaction in a rural health setting.

    Science.gov (United States)

    Hartley, R; Turner, R

    1995-09-01

    The NSW Health Department is 3 years into its customer satisfaction initiative. North West Health Service, one of the largest rural health districts, was among the first centres to embrace the customer satisfaction philosophy starting with compulsory training of all staff. This paper reports on changes in staff morale (internal satisfaction) as a result of that training. The data suggest that training per se has had minimal effect and argues for management development, particularly regarding leadership, rather than fiscal skills.

  7. Improved complexity bounds for real root isolation using Continued Fractions

    CERN Document Server

    Tsigaridas, Elias

    2010-01-01

    We consider the problem of isolating the real roots of a square-free polynomial with integer coefficients using (variants of) the continued fraction algorithm (CF). We introduce a novel way to compute a lower bound on the positive real roots of univariate polynomials. This allows us to derive a worst case bound of $\\sOB(d^6 + d^4\\tau^2 + d^3\\tau^2)$ for isolating the real roots of a polynomial with integer coefficients using the classic variant of CF, where $d$ is the degree of the polynomial and $\\tau$ the maximum bitsize of its coefficients. This improves the previous bound by Sharma \\cite{sharma-tcs-2008} by a factor of $d^3$ and matches the bound derived by Mehlhorn and Ray \\cite{mr-jsc-2009} for another variant of CF; it also matches the worst case bound of the subdivision-based solvers. We present a new variant of CF, we call it iCF, that isolates the real roots of a polynomial with integer coefficients in $\\sOB(d^5+d^4\\tau)$, thus improving the current known bound for the problem by a factor of $d$. If...

  8. Improved complexity bounds for real root isolation using Continued Fractions

    CERN Document Server

    Tsigaridas, Elias

    2010-01-01

    We consider the problem of isolating the real roots of a square-free polynomial with integer coefficients using (variants of) the continued fraction algorithm (CF). We introduce a novel way to compute a lower bound on the positive real roots of univariate polynomials. This allows us to derive a worst case bound of $\\sOB( d^6 + d^4\\tau^2 + d^3\\tau^2)$ for isolating the real roots of a polynomial with integer coefficients using the classic variant of CF, where $d$ is the degree of the polynomial and $\\tau$ the maximum bitsize of its coefficients. This improves the previous bound by Sharma \\cite{sharma-tcs-2008} by a factor of $d^3$ and matches the bound derived by Mehlhorn and Ray \\cite{mr-jsc-2009} for another variant of CF; it also matches the worst case bound of the subdivision-based solvers. We present a new variant of CF, we call it iCF, that isolates the real roots of a polynomial with integer coefficients in $\\sOB(d^5+d^4\\tau)$, thus improving the current known bound for the problem by a factor of $d$. I...

  9. Initiatives for the improvement of continuous management training

    Directory of Open Access Journals (Sweden)

    Jon Landeta

    2015-03-01

    Full Text Available Purpose. This work aims to present, from the company viewpoint, a structured account of management proposals and practices directed toward improving the intensity and effectiveness of continuous management training (CMT. Design/methodology/approach. The article takes as its main theoretical referents the Theory of Human Capital, the Resource-Based Vision and the contributions made via the new institutional economy with regard to the problems of information asymmetry between companies, employees and training providers and completes the proposals that derive from this theoretical approach. To do this, experience-based contributions are collected from a selection of company training and HR managers from twelve Basque companies characterised by their strong investment in management training. The methodology used was qualitative and obtained by different qualitative techniques: Focus Groups, Nominal Groups and the Delphi Method, which make up the so-called Hybrid Delphi. Findings and implications. The proposals are aimed at the main agents in training activity: training providers, associations and public agents engaged in management training and, particularly, companies themselves. The initiatives seek above all to increase training market transparency, to improve mutual commitments between companies and managers, and to link training and development with culture and strategic management, so that firms make optimal investment in management training. Originality/value. The methodology used is original, and the contributions are consistent with the theory, have a proven practical utility, and are presented in a hierarchy, which facilitates decision making.

  10. Improving Consumer Satisfaction with Addiction Treatment: An Analysis of Alumni Preferences

    National Research Council Canada - National Science Library

    Sanghani, Ruchi M; Moler, Alexander K

    2015-01-01

    Objective. The primary objective of this investigation is to determine which individual and aggregate factors of residential addiction treatment centers are most significant influencers of alumni satisfaction. Design...

  11. The Empirical Relationship among Organisational Learning, Continuous Improvement and Performance Improvement

    Science.gov (United States)

    Sun, Hongyi; Ho, Kario; Ni, Wenbin

    2008-01-01

    There are still many questions remain unanswered about the relationship between Organisational Learning (OL) and Continuous Improvement (CI). For example, how do OL and CI contribute to business performance? Are OL and CI equal? Do OL and CI support each other? Should OL and CI be implemented separately or together? If together, how to integrate…

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

    NARCIS (Netherlands)

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

    2004-01-01

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

  13. A case study using a patient satisfaction survey to improve the delivery and effectiveness of drug addiction treatment services: marketing implications and organizational impact.

    Science.gov (United States)

    Hogan, Beth; Hershey, Lewis; Ritchey, Steven

    2007-01-01

    Drug abuse and addiction continues to negatively impact many lives in this country. The United States health care system has grappled with how to best serve this vulnerable population. Since the personal and societal costs of addiction are high, all recent iterations of the United States strategic health plans (such as Healthy People 2010) have prioritized this area for improvement. At the local level, health care providers who care for those with addictions are challenged with shrinking insurance coverage for services, a difficult patient population, lack of treatment options, growing ranks of indigent patients, as well as a plethora of additional management challenges. It is known that successful treatment is integrally linked with patient satisfaction with services. The most critical factors in successful addiction treatment (from a patient's perspective) are (1) their belief that the counselor cares about them and, (2) their belief that they can recover. This paper reports a case study in the use of a patient satisfaction survey as a quality management/service refinement tool within a methadone treatment setting. Results indicate that the use of the survey itself provides patients with a tangible cue supporting the presence of the critical success factors. Further, the use of a survey provides a baseline for future measurements and trending. The paper concludes with a discussion of the marketing and organizational implications of incorporating the patient satisfaction survey into the ongoing delivery program for addiction services.

  14. Search for continuous gravitational waves: Improving robustness versus instrumental artifacts

    Science.gov (United States)

    Keitel, David; Prix, Reinhard; Papa, Maria Alessandra; Leaci, Paola; Siddiqi, Maham

    2014-03-01

    The standard multidetector F-statistic for continuous gravitational waves is susceptible to false alarms from instrumental artifacts, for example monochromatic sinusoidal disturbances ("lines"). This vulnerability to line artifacts arises because the F-statistic compares the signal hypothesis to a Gaussian-noise hypothesis, and hence is triggered by anything that resembles the signal hypothesis more than Gaussian noise. Various ad-hoc veto methods to deal with such line artifacts have been proposed and used in the past. Here we develop a Bayesian framework that includes an explicit alternative hypothesis to model disturbed data. We introduce a simple line model that defines lines as signal candidates appearing only in one detector. This allows us to explicitly compute the odds between the signal hypothesis and an extended noise hypothesis, resulting in a new detection statistic that is more robust to instrumental artifacts. We present and discuss results from Monte-Carlo tests on both simulated data and on detector data from the fifth LIGO science run. We find that the line-robust statistic retains the detection power of the standard F-statistic in Gaussian noise. In the presence of line artifacts it is more sensitive, even compared to the popular F-statistic consistency veto, over which it improves by as much as a factor of two in detectable signal strength.

  15. 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.

  16. 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.

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

    Science.gov (United States)

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

    1993-01-01

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

  18. Continued SOFC cell and stack technology and improved production methods

    Energy Technology Data Exchange (ETDEWEB)

    Wandel, M.; Brodersen, K.; Phair, J. (and others)

    2009-05-15

    Within this project significant results are obtained on a number of very diverse areas ranging from development of cell production, metallic creep in interconnect to assembling and test of stacks with foot print larger than 500 cm2. Out of 38 milestones 28 have been fulfilled and 10 have been partly fulfilled. This project has focused on three main areas: 1) The continued cell development and optimization of manufacturing processes aiming at production of large foot-print cells, improving cell performance and development environmentally more benign production methods. 2) Stack technology - especially stacks with large foot print and improving the stack design with respect to flow geometry and gas leakages. 3) Development of stack components with emphasis on sealing (for 2G as well as 3G), interconnect (coat, architecture and creep) and test development. Production of cells with a foot print larger than 500 cm2 is very difficult due to the brittleness of the cells and great effort has been put into this topic. Eight cells were successfully produced making it possible to assemble and test a real stack thereby giving valuable results on the prospects of stacks with large foot print. However, the yield rate is very low and a significant development to increase this yield lies ahead. Several lessons were learned on the stack level regarding 'large foot print' stacks. Modelling studies showed that the width of the cell primarily is limited by production and handling of the cell whereas the length (in the flow direction) is limited by e.g. pressure drop and necessary manifolding. The optimal cell size in the flow direction was calculated to be between approx20 cm and < 30 cm. From an economical point of view the production yield is crucial and stacks with large foot print cell area are only feasible if the cell production yield is significantly enhanced. Co-casting has been pursued as a production technique due to the possibilities in large scale production

  19. Continuous Quality Improvement in Student Affairs: A Survey of Staff Opinions on the Work Environment.

    Science.gov (United States)

    Malaney, Gary D.; Osit, Carla J.

    1998-01-01

    Analyzes the results of a survey which queried student affairs staff members about their opinions on the importance of and their satisfaction with 37 aspects of their work environments. Discusses results of the survey and addresses efforts to improve the work climate. (Contains 18 references.) (Author/GCP)

  20. MANUFACTURING AND CONTINUOUS IMPROVEMENT AREAS USING PARTIAL LEAST SQUARE PATH MODELING WITH MULTIPLE REGRESSION COMPARISON

    Directory of Open Access Journals (Sweden)

    Carlos Monge Perry

    2014-07-01

    Full Text Available Structural equation modeling (SEM has traditionally been deployed in areas of marketing, consumer satisfaction and preferences, human behavior, and recently in strategic planning. These areas are considered their niches; however, there is a remarkable tendency in empirical research studies that indicate a more diversified use of the technique.  This paper shows the application of structural equation modeling using partial least square (PLS-SEM, in areas of manufacturing, quality, continuous improvement, operational efficiency, and environmental responsibility in Mexico’s medium and large manufacturing plants, while using a small sample (n = 40.  The results obtained from the PLS-SEM model application mentioned, are highly positive, relevant, and statistically significant. Also shown in this paper, for purposes of validity, reliability, and statistical power confirmation of PLS-SEM, is a comparative analysis against multiple regression showing very similar results to those obtained by PLS-SEM.  This fact validates the use of PLS-SEM in areas of untraditional scientific research, and suggests and invites the use of the technique in diversified fields of the scientific research

  1. An investigation into the effects of quality improvement method on patients' satisfaction: a semi experimental research in Iran.

    Science.gov (United States)

    Navipour, Hasan; Nayeri, Nahid Dehghan; Hooshmand, Abbas; Zargar, Marjaneh Taghavi

    2011-01-01

    Today, to increase effectiveness is a Strategy for success of organizations and their viability. In health care organization not only service cost- effectiveness is a major problem for productivity and organizational management but also customer-centred is in first priority. Because of these reasons, most of health organization trend to patient satisfaction for their viability. If complex process implemented for viability without attention to patient satisfaction, this is no success result. The FOCUS PDCA process is a new strategy for effectiveness of service quality. To this reason, the recent research done and its objective is to assess effect of FOCUS PDCA process strategy on patient satisfaction in surgery units of hospitals affiliated to Tehran Medical University. This research is a semi experimental with non- equivalent design. The sample was all of patients who hospitalized in two selected surgery units. Self-report was method of data gathering. Patient satisfaction assessed with questionnaire in pre and posttest. Then manipulation implemented as post-operation care process selected. Modelling and opportunity statement Diagrams prepared and improvement team organized. Flow process, convergences and cause- effect charts used to prepare list of items to be improved. Executive program was written. This include personnel training, standard implementation, election and training of quality control nurses (Q.C Ns), daily QC of caring and providing appropriate feed back to personnel, forming group session for determining corrective actions. Then after 1 month patient satisfaction was assessed. Statistical analysis shows this process increase patient satisfaction and it leads to care effectiveness. The findings of the pre-intervention phase indicated that the satisfaction level had been low in both groups and it is not significantly different in the two groups (P> 0.05). There was a significant difference before and after following intervention in the case study

  2. An Investigation into the Effects of Quality Improvement Method on Patients' Satisfaction: A Semi Experimental Research in Iran

    Directory of Open Access Journals (Sweden)

    Hasan Navipour

    2011-01-01

    Full Text Available Today, to increase effectiveness is a Strategy for success of organizations and their viability. In health care organization not only service cost- effectiveness is a major problem for productivity and organizational management but also customer-centred is in first priority. Because of these reasons, most of health organization trend to patient satisfaction for their viability. If complex process implemented for viability without attention to patient satisfaction, this is no success result. The FOCUS PDCA process is a new strategy for effectiveness of service quality. To this reason, the recent research done and its objective is to assess effect of FOCUS PDCA process strategy on patient satisfaction in surgery units of hospitals affiliated to Tehran Medical University. This research is a semi experimental with non- equivalent design. The sample was all of patients who hospitalized in two selected surgery units. Self-report was method of data gathering. Patient satisfaction assessed with questionnaire in pre and posttest. Then manipulation implemented as post-operation care process selected. Modelling and opportunity statement Diagrams prepared and improvement team organized. Flow process, convergences and cause- effect charts used to prepare list of items to be improved. Executive program was written. This include personnel training, standard implementation, election and training of quality control nurses (Q.C Ns, daily QC of caring and providing appropriate feed back to personnel, forming group session for determining corrective actions. Then after 1 month patient satisfaction was assessed. Statistical analysis shows this process increase patient satisfaction and it leads to care effectiveness. The findings of the pre-intervention phase indicated that the satisfaction level had been low in both groups and it is not significantly different in the two groups (P> 0.05. There was a significant difference before and after following intervention in

  3. Does job satisfaction improve the health of workers? New evidence using panel data and objective measures of health.

    Science.gov (United States)

    Fischer, Justina A V; Sousa-Poza, Alfonso

    2009-01-01

    This paper evaluates the relationship between job satisfaction and measures of health of workers using the German Socio-Economic Panel. Methodologically, it addresses two important design problems encountered frequently in the literature: (a) cross-sectional causality problems and (b) the absence of objective measures of physical health that complement self-reported measures of health status. Not only does using the panel structure with individual fixed effects mitigate the bias from omitting unobservable personal psycho-social characteristics, but employing more objective health measures such as health-system contacts and disability addresses such measurement problems relating to self-report assessments of health status.We find a positive link between job satisfaction (and changes over time therein) and subjective health measures (and changes therein); that is, employees with higher or improved job satisfaction levels feel healthier and are more satisfied with their health. This observation also holds true for more objective measures of health. Particularly, improvements in job satisfaction over time appear to prevent workers from (further) health deterioration. Copyright (c) 2008 John Wiley & Sons, Ltd.

  4. Measure to Succeed: How to Improve Employee Participation in Continuous Improvement

    OpenAIRE

    Daniel Jurburg; Elisabeth Viles; Martin Tanco; Ricardo Mateo; Alvaro Lleó

    2016-01-01

    Purpose: Achieving employee participation in continuous improvement (CI) systems is considered as one of the success factors for the sustainability of those systems. Yet, it is also very difficult to obtain because of the interaction of many critical factors that affect employee participation. Therefore, finding ways of measuring all these critical factors can help practitioners manage the employee participation process accordingly. Design/methodology/approach: Based upon the existing lit...

  5. Improving masticatory performance, bite force, nutritional state and patient's satisfaction with implant overdentures: a systematic review of the literature.

    Science.gov (United States)

    Boven, G C; Raghoebar, G M; Vissink, A; Meijer, H J A

    2015-03-01

    Oral function with removable dentures is improved when dental implants are used for support. A variety of methods is used to measure change in masticatory performance, bite force, patient's satisfaction and nutritional state. A systematic review describing the outcome of the various methods to assess patients' appreciation has not been reported. The objective is to systematically review the literature on the possible methods to measure change in masticatory performance, bite force, patient's satisfaction and nutritional state of patients with removable dentures and to describe the outcome of these. Medline, Embase and The Cochrane Central Register of Controlled Trials were searched (last search July 1, 2014). The search was completed by hand to identify eligible studies. Two reviewers independently assessed the articles. Articles should be written in English. Study design should be prospective. The outcome should be any assessment of function/satisfaction before and at least 1 year after treatment. Study population should consist of fully edentulous subjects. Treatment should be placement of any kind of root-form implant(s) to support a mandibular and/or maxillary overdenture. Fifty-three of 920 found articles fulfilled the inclusion criteria. A variety of methods was used to measure oral function; mostly follow-up was 1 year. Most studies included mandibular overdentures, three studies included maxillary overdentures. Implant-supported dentures were accompanied by high patient's satisfaction with regard to denture comfort, but this high satisfaction was not always accompanied by improvement in general quality of life (QoL) and/or health-related QoL. Bite force improved, masseter thickness increased and muscle activity in rest decreased. Patients could chew better and eat more tough foods. No changes were seen in dietary intake, BMI and blood markers. Improvements reported after 1 year apparently decreased slightly with time, at least on the long run. Treating

  6. Success beyond success : The ‘Golden Triangle’ of continuous performance improvement

    NARCIS (Netherlands)

    2009-01-01

    The main subject of the article is continuous performance improvement (CPI). More specifically, the author seeks to understand the most important management challenges under that heading. An extensive empirical study determines companies' most important continuous performance improvement roots.

  7. Success beyond success : The ‘Golden Triangle’ of continuous performance improvement

    NARCIS (Netherlands)

    2009-01-01

    The main subject of the article is continuous performance improvement (CPI). More specifically, the author seeks to understand the most important management challenges under that heading. An extensive empirical study determines companies' most important continuous performance improvement roots.

  8. Client satisfaction as a driver of quality improvement in services for older people: a Western Australian case study.

    Science.gov (United States)

    Boldy, Duncan; Davison, Maria; Duggan, Ravani

    2015-03-01

    This paper aims to describe a practical example of the use of adapted versions of a resident satisfaction questionnaire for quality improvement purposes in a large aged care service organisation. Residential care and home care questionnaires each covered 11 aspects, the 'housing' questionnaire nine. Each aspect included Likert scale-type satisfaction questions. Questionnaires were distributed for completion by residents or by a friend/family member where a resident was unable to self-complete (e.g. because of dementia). Over the six separate customer satisfaction surveys conducted by the organisation since 1999, the analysis scheme has been refined and forms the basis of a report to the Board highlighting major findings and making recommendations regarding future actions. Most recently, the Board has decided to focus on three main areas, with actions identified for each, namely satisfaction with staff (e.g. enhanced staff training), social activities and involvement (e.g. increased occupational therapy), and opportunities for enhanced feedback. © 2014 AJA Inc.

  9. Entrepreneurship Education: Non-Linearity in the SatisfactionContinuation Relationship = Podjetniško izobraževanje: nelineranost v razmerju med zadovoljstvom in nadaljevanjem izobraževanja

    National Research Council Canada - National Science Library

    Boštjan Antoncic; Barbara Hvalic Erzetic; Otmar Zorn; Robert D. Hisrich

    2007-01-01

    ... (entrepreneurial maturity) of potential and practicing entrepreneurs. By using the cusp catastrophe model we propose that relationship between education satisfaction and continuation tends to be linear for less experienced entrepreneurs (pre-entrepreneurs...

  10. A Dynamic Model of the Duration of the Customer's Relationship with a Continuous Service Provider: The Role of Satisfaction

    OpenAIRE

    Ruth N. Bolton

    1998-01-01

    Many service organizations have embraced relationship marketing with its focus on maximizing customer lifetime value. Recently, there has been considerable controversy about whether there is a link between customer satisfaction and retention. This research question is important to researchers who are attempting to understand how customers' assessments of services influence their subsequent behavior. However, it is equally vital to managers who require a better understanding of the relationshi...

  11. Customer satisfaction.

    Science.gov (United States)

    Vukmir, Rade B

    2006-01-01

    This paper seeks to present an analysis of the literature examining objective information concerning the subject of customer service, as it applies to the current medical practice. Hopefully, this information will be synthesized to generate a cogent approach to correlate customer service with quality. Articles were obtained by an English language search of MEDLINE from January 1976 to July 2005. This computerized search was supplemented with literature from the author's personal collection of peer-reviewed articles on customer service in a medical setting. This information was presented in a qualitative fashion. There is a significant lack of objective data correlating customer service objectives, patient satisfaction and quality of care. Patients present predominantly for the convenience of emergency department care. Specifics of satisfaction are directed to the timing, and amount of "caring". Demographic correlates including symptom presentation, practice style, location and physician issues directly impact on satisfaction. It is most helpful to develop a productive plan for the "difficult patient", emphasizing communication and empathy. Profiling of the customer satisfaction experience is best accomplished by examining the specifics of satisfaction, nature of the ED patient, demographic profile, symptom presentation and physician interventions emphasizing communication--especially with the difficult patient. The current emergency medicine customer service dilemmas are a complex interaction of both patient and physician factors specifically targeting both efficiency and patient satisfaction. Awareness of these issues particular to the emergency patient can help to maximize efficiency, minimize subsequent medicolegal risk and improve patient care if a tailored management plan is formulated.

  12. 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

  13. Using and understanding consumer satisfaction to effect an improvement in mental health service delivery.

    Science.gov (United States)

    Brunero, S; Lamont, S; Fairbrother, G

    2009-04-01

    Consumer satisfaction is today, widely accepted as a measure of the level and quality of service received by consumers. The aim of this survey-based study is to explore consumer satisfaction with quality of care, staff, environment and discharge in a south eastern Sydney adult acute inpatient mental health unit. A cross-sectional analysis is pursued in order to identify aspects of the patient stay, which form an associative relationship with an overall rating of consumer satisfaction on a 10-point scale. During the survey period, there were 182 discharges. Seventy questionnaires (38.5%) were returned from this group. The survey results highlight a number of areas of identified need, enabling the service to prioritize organizational systems around meeting these needs. Multiple regression analysis identified three items in the survey, which were independently significant associates of overall consumer satisfaction. They included being happy with the service provided by the consumer support worker, having support for services on discharge and feeling safe and secure on the ward. The model containing these three items accounted for 50% of the variation in overall satisfaction. Two primary interventions have been developed because survey administration which, it is hoped, will address issues raised in the survey. The interventions were the development of an admission and discharge pathway and a ward-based psychosocial intervention programme, which includes the involvement of consumer support workers.

  14. Improving Consumer Satisfaction with Addiction Treatment: An Analysis of Alumni Preferences.

    Science.gov (United States)

    Sanghani, Ruchi M; Moler, Alexander K

    2015-01-01

    Objective. The primary objective of this investigation is to determine which individual and aggregate factors of residential addiction treatment centers are most significant influencers of alumni satisfaction. Design. Survey targeted alumni of residential addiction treatment facilities. Alumni were queried through a survey, which utilized Likert-scale matrices and binary response options: 379 respondents met the completion threshold. Alumni rated amenities and individual and group counseling factors; additionally, respondents provided feedback on two satisfaction proxies: cost worthiness and future recommendations. Descriptive and relational analyses were conducted, with the latter utilizing logistic regression models. Results. Individual factors' scores of group counseling, and overall aggregate group counseling score, are most enthusiastically positive. Group counseling is also the most significant influencer of satisfaction. Other significant influencers of satisfaction are met expectations for individual counseling and psychiatric care offerings. Conclusions. While individual counseling and facility amenities should not be ignored, group counseling may be the most significant influencer of alumni satisfaction. Long-term outcomes are not single-faceted; however, treatment providers should be encouraged to invest in high-quality group counseling offerings in order to best satisfy, and thereby empower, clients.

  15. Improving Consumer Satisfaction with Addiction Treatment: An Analysis of Alumni Preferences

    Directory of Open Access Journals (Sweden)

    Ruchi M. Sanghani

    2015-01-01

    Full Text Available Objective. The primary objective of this investigation is to determine which individual and aggregate factors of residential addiction treatment centers are most significant influencers of alumni satisfaction. Design. Survey targeted alumni of residential addiction treatment facilities. Alumni were queried through a survey, which utilized Likert-scale matrices and binary response options: 379 respondents met the completion threshold. Alumni rated amenities and individual and group counseling factors; additionally, respondents provided feedback on two satisfaction proxies: cost worthiness and future recommendations. Descriptive and relational analyses were conducted, with the latter utilizing logistic regression models. Results. Individual factors’ scores of group counseling, and overall aggregate group counseling score, are most enthusiastically positive. Group counseling is also the most significant influencer of satisfaction. Other significant influencers of satisfaction are met expectations for individual counseling and psychiatric care offerings. Conclusions. While individual counseling and facility amenities should not be ignored, group counseling may be the most significant influencer of alumni satisfaction. Long-term outcomes are not single-faceted; however, treatment providers should be encouraged to invest in high-quality group counseling offerings in order to best satisfy, and thereby empower, clients.

  16. Strengthen the servant leadership to enhance the nurses’ job satisfaction

    Directory of Open Access Journals (Sweden)

    Yun-xia HAO

    2014-11-01

    Full Text Available Objective: Continue to improve and implement the service concept of "taking patients as the center" through enhancing nurses’ job satisfaction. Methods: Strengthen clinic functions of nursing department, which is guided by the demands of clinical nurses. Results: Clinical nurses’ job satisfaction keeps at a high level. Conclusion: Service-oriented mode of nursing management can make the nurses to keep good work experience and satisfaction.

  17. ThedaCare's business performance system: sustaining continuous daily improvement through hospital management in a lean environment.

    Science.gov (United States)

    Barnas, Kim

    2011-09-01

    For 2003-2008, ThedaCare, a community health system in Wisconsin, achieved significant improvements in quality and the elimination of waste through the development of an improvement system, which included Value Stream analysis, rapid improvement events, and projects applied to specific processes. However, to meet its continuous daily improvement goals, particularly the goal of increasing productivity by 10% annually, ThedaCare needed to change the way its managers and leaders (in its hospital division) conduct and manage their daily work. Accordingly, it developed its Business Performance System (BPS) to achieve and sustain continuous daily improvement. BUILDING THE BPS: ThedaCare devised a multipart pilot project, consisting of "learning to see" and then, "problem solving." On completion of the 15-week alpha phase (6 units) in July 2009, the BPS was spread to the beta pilot (12 units; September 2009-January 2010) and then to cohort 3 (10 units; September 2010-January 2011). Each alpha unit improved performance on (1) the key driver metric of increasing productivity from 2008 to year-end 2009 (by 1%-11%) and (2) its respective safety/ quality drivers over the respective 2008 baselines. For 2010, improvements across the alpha, beta, and cohort 3 units were found for 11 of the 14 safety/quality drivers-85% of the 11 customer satisfaction drivers, 83% of 6 people engagement drivers; and 48% of 23 financial stewardship drivers. The tools developed for the BPS have enabled teams to see, prioritize, and pursue continuous daily improvement opportunities. Unit leaders now have a structured management reporting system to reduce variation in their management styles. Leaders all now follow leadership standard work, and their daily work is now consistently aligned with the hospital and system strategy.

  18. Improving the Relationship between Continuing Education Leadership and Marketing Directors

    Science.gov (United States)

    Fong, Jim

    2009-01-01

    In this economy, college and university continuing education units will not automatically reap the benefits of returning adult learners as in past recessions: this economy caused a drastic reduction of resources available to the workforce and for personal revenue. As a result of decreased personal income and workforce training funding, competition…

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

    Directory of Open Access Journals (Sweden)

    Perić Ružica

    2009-01-01

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

  20. Measure to succeed: How to improve employee participation in continuous improvement

    Directory of Open Access Journals (Sweden)

    Daniel Jurburg

    2016-12-01

    Full Text Available Purpose: Achieving employee participation in continuous improvement (CI systems is considered as one of the success factors for the sustainability of those systems. Yet, it is also very difficult to obtain because of the interaction of many critical factors that affect employee participation. Therefore, finding ways of measuring all these critical factors can help practitioners manage the employee participation process accordingly. Design/methodology/approach: Based upon the existing literature, this paper presents a 4-Phase (9 steps diagnostic tool to measure the main determinants associated with the implementation of CI systems affecting employee participation in improvement activities. Findings: The tool showed its usefulness to detect the main weaknesses and improvement opportunities for improving employee participation in CI through the application in two different cases. Practical implications: This diagnostic tool could be particularly interesting for companies adopting CI and other excellence frameworks, which usually include a pillar related to people development inside the organization, but do not include tools to diagnose the state of this pillar. Originality/value: This diagnostic tool presents a user’s perspective approach, ensuring that the weaknesses and improvement opportunities detected during the diagnose come directly from the users of the CI system, which in this case are the employees themselves. Given that the final objective is to identify reasons and problems hindering employee participation, adopting this user’s perspective approach seem more relevant than adopting other more traditional approaches, based on gathering information from the CI system itself or from the CI managers.

  1. Determining customer satisfaction in anatomic pathology.

    Science.gov (United States)

    Zarbo, Richard J

    2006-05-01

    Measurement of physicians' and patients' satisfaction with laboratory services has become a standard practice in the United States, prompted by national accreditation requirements. Unlike other surveys of hospital-, outpatient care-, or physician-related activities, no ongoing, comprehensive customer satisfaction survey of anatomic pathology services is available for subscription that would allow continual benchmarking against peer laboratories. Pathologists, therefore, must often design their own local assessment tools to determine physician satisfaction in anatomic pathology. To describe satisfaction survey design that would elicit specific information from physician customers about key elements of anatomic pathology services. The author shares his experience in biannually assessing customer satisfaction in anatomic pathology with survey tools designed at the Henry Ford Hospital, Detroit, Mich. Benchmarks for physician satisfaction, opportunities for improvement, and characteristics that correlated with a high level of physician satisfaction were identified nationally from a standardized survey tool used by 94 laboratories in the 2001 College of American Pathologists Q-Probes quality improvement program. In general, physicians are most satisfied with professional diagnostic services and least satisfied with pathology services related to poor communication. A well-designed and conducted customer satisfaction survey is an opportunity for pathologists to periodically educate physician customers about services offered, manage unrealistic expectations, and understand the evolving needs of the physician customer. Armed with current information from physician customers, the pathologist is better able to strategically plan for resources that facilitate performance improvements in anatomic pathology laboratory services that align with evolving clinical needs in health care delivery.

  2. The Effect of Formative Program Evaluation on Continuous Program Improvement: A Case Study of a Clinical Training Program in Lao PDR.

    Science.gov (United States)

    Yoon, Hyun Bae; Shin, Jwa-Seop; Lee, Seung-Hee; Kim, Do-Hwan; Hwang, Jinyoung; Kim, Eun Jung; Bouphavanh, Ketsomsouk

    2015-12-01

    This study aimed to evaluate the effect of the formative program evaluation on the continuous improvement of a clinical training program for Lao health professionals. The training program was conducted 4 times consecutively for total 48 health professionals, and the formative program evaluation was carried out during the whole process. To evaluate the satisfaction and the transfer of the trainees, the questionnaire survey, the focus group interview, and the trainees' medical records were used. After the end of each batch of the program, the evaluation data were analyzed, and its results were shared with the training management committee and the trainers, who, based on the results, reached a consensus on how to improve the program. The evaluation results and the comparison of them among the four batches of the program showed that there was a continuous increase of the satisfaction and the transfer of the trainees, especially in the early period of the program. The formative program evaluation which was conducted during the whole process of the clinical training program had a positive effect on the improvement of the program, especially in the early phase, by increasing the satisfaction and transfer of the trainees.

  3. Lean management: innovative tools for engaging teams in continuous quality improvement.

    Science.gov (United States)

    Perreault, Lucille; Vaillancourt, Lise; Filion, Catherine; Hadj, Camélia

    2014-01-01

    Lean management has proven to be a sustainable method to ensure a high level of patient care through innovation and teamwork. It involves a set of six tools that allow for visual management shared among team members. The team focuses their efforts on the improvement of organizational indicators in a standardized and engaging way, resulting in the sustainability of improvements. This article outlines the program's rollout at Montfort Hospital (l'Hôpital Montfort). In only a few months, two pilot units accomplished close to 50 improvements each. In addition, the organizational employee satisfaction questionnaire showed very positive results.

  4. Linking customer satisfaction, quality, and strategic planning

    OpenAIRE

    Reis,Dayr; Peña,Leticia

    2000-01-01

    By acknowledging and dissecting the interconnected roles of customer satisfaction, quality, and strategic planning, this paper provides an analytical framework for creating a customer-driven organization and culture. It shows how quality starts and ends with the customer. Companies that are achieving long-term continuous improvement in quality tailored to customer satisfaction possess lasting characteristics such as customer orientation, customer consciousness, and customer responsiveness. In...

  5. TOURISTS’ SATISFACTION WITH INNOVATION IN ROMANIAN HOTELS

    OpenAIRE

    Maria-Cristina IORGULESCU; Anamaria Sidonia RÃVAR

    2013-01-01

    As competition in the hospitality industry grows more intense, accommodation facilities face the challenge of continuously adapting, improving, changing and renewing their offer of services, structure and ways of doing business. Thus, innovation plays an ever increasing role in the hospitality industry, although its impact on customer satisfaction and ultimately on the overall business performance remains little discussed. The purpose of this article is to investigate consumers’ satisfaction ...

  6. AN IMPROVED ANT COLONY ALGORITHM IN CONTINUOUS OPTIMIZATION

    Institute of Scientific and Technical Information of China (English)

    Ling CHEN; Jie SHEN; Ling QIN; Hongjian CHEN

    2003-01-01

    A modified ant colony algorithm for solving optimization problem with continuous parameters is presented. In the method, groups of candidate values of the components are constructed, and each value in the group has its trail information. In each iteration of the ant colony algorithm, the method first chooses initial values of the components using the trail information. Then GA operations of crossover and mutation can determine the values of the components in the solution. Our experimental results on the problem of nonlinear programming show that our method has a much higher convergence speed and stability than those of simulated annealing (SA) and GA.

  7. Relationship between Improvements in Physical Measures and Patient Satisfaction in Rehabilitation after Total Knee Arthroplasty

    Science.gov (United States)

    Nazzal, Mahmoud I.; Bashaireh, Khaldoon H.; Alomari, Mahmoud A.; Nazzal, Mohammad S.; Maayah, Mikhled F.; Mesmar, Mohammad

    2012-01-01

    The aim of this study was to examine patient satisfaction with rehabilitation after total knee arthroplasty (TKA). Fifty-six patients, aged 45-77 years, were enrolled in a post-TKA comprehensive therapy program focusing on knee strengthening and functional activities. The program lasted 3 months and was conducted for 1 h, twice a day, 5 days per…

  8. Improving Service Delivery: Investigating the Role of Information Sharing, Job Characteristics, and Employee Satisfaction

    Science.gov (United States)

    Bontis, Nick; Richards, David; Serenko, Alexander

    2011-01-01

    Purpose: The purpose of this study is to propose and test a model designed to investigate the impact of job characteristics, employee satisfaction, and information sharing on two key indicators of quality service delivery, such as worker perceptions of their efficiency and customer focus. Design/methodology/approach: During the project, 9,060…

  9. Improving Service Delivery: Investigating the Role of Information Sharing, Job Characteristics, and Employee Satisfaction

    Science.gov (United States)

    Bontis, Nick; Richards, David; Serenko, Alexander

    2011-01-01

    Purpose: The purpose of this study is to propose and test a model designed to investigate the impact of job characteristics, employee satisfaction, and information sharing on two key indicators of quality service delivery, such as worker perceptions of their efficiency and customer focus. Design/methodology/approach: During the project, 9,060…

  10. Catch It If You Can: How Contagious Motivation Improves Group Projects and Course Satisfaction

    Science.gov (United States)

    Krishen, Anjala S.

    2013-01-01

    This article proposes a theory-based contagious motivation model focusing on enhancing student perceptions of group projects and ultimately course satisfaction. Moreover, drawing from both pedagogical and organizational behavior literatures, a model is presented that ties together intrinsic motivation theory with social contagion and…

  11. Improving Undergraduate Student Satisfaction with the Consumer Behavior Course: Will Interactive Technology Help?

    Science.gov (United States)

    Eastman, Jacqueline K.; Iyer, Rajesh; Eastman, Kevin L.

    2011-01-01

    In this paper, we measure the impact of interactive technology on student satisfaction and find support for the hypothesis that students who find a class is more interesting because of the use of interactive technology will be more satisfied with the course. The results also support the hypothesis that if students like the course, they will be…

  12. Continuity of care by a primary midwife (caseload midwifery) increases women's satisfaction with antenatal, intrapartum and postpartum care: results from the COSMOS randomised controlled trial.

    Science.gov (United States)

    Forster, Della A; McLachlan, Helen L; Davey, Mary-Ann; Biro, Mary Anne; Farrell, Tanya; Gold, Lisa; Flood, Maggie; Shafiei, Touran; Waldenström, Ulla

    2016-02-03

    Continuity of care by a primary midwife during the antenatal, intrapartum and postpartum periods has been recommended in Australia and many hospitals have introduced a caseload midwifery model of care. The aim of this paper is to evaluate the effect of caseload midwifery on women's satisfaction with care across the maternity continuum. Pregnant women at low risk of complications, booking for care at a tertiary hospital in Melbourne, Australia, were recruited to a randomised controlled trial between September 2007 and June 2010. Women were randomised to caseload midwifery or standard care. The caseload model included antenatal, intrapartum and postpartum care from a primary midwife with back-up provided by another known midwife when necessary. Women allocated to standard care received midwife-led care with varying levels of continuity, junior obstetric care, or community-based general practitioner care. Data for this paper were collected by background questionnaire prior to randomisation and a follow-up questionnaire sent at two months postpartum. The primary analysis was by intention to treat. A secondary analysis explored the effect of intrapartum continuity of carer on overall satisfaction rating. Two thousand, three hundred fourteen women were randomised: 1,156 to caseload care and 1,158 to standard care. The response rate to the two month survey was 88% in the caseload group and 74% in the standard care group. Compared with standard care, caseload care was associated with higher overall ratings of satisfaction with antenatal care (OR 3.35; 95% CI 2.79, 4.03), intrapartum care (OR 2.14; 95% CI 1.78, 2.57), hospital postpartum care (OR 1.56, 95% CI 1.32, 1.85) and home-based postpartum care (OR 3.19; 95% CI 2.64, 3.85). For women at low risk of medical complications, caseload midwifery increases women's satisfaction with antenatal, intrapartum and postpartum care. Australian New Zealand Clinical Trials Registry ACTRN012607000073404 (registration complete 23rd

  13. 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)

  14. Continuous Improvement in California Education: Data Systems and Policy Learning

    Science.gov (United States)

    Loeb, Susanna; Plank, David N.

    2007-01-01

    The "Getting Down to Facts" (GDTF) studies released in March 2007 offered a clear diagnosis of the issues facing California's education system. Now, as California moves beyond the facts and begins the search for ways to improve the performance of California schools and students, the state faces a critical policy dilemma. On the one hand,…

  15. [Effect of using an instrument for continuous evaluation of nursing quality in terms of employment satisfaction and of their affective implications].

    Science.gov (United States)

    Maes, Blandine; Fontanaud, Nelly; Pronost, Anne-Marie

    2010-09-01

    Medical staff are directly concerned by improving the quality of care. The goal of this study is to assess qualitatively the effects of the application of a Global Assessment Instrument for the Quality of Care on thirty nurses divided in two groups: an experimental group--who participated in the IGE-QSI--and another "witness" group--who participated in another project. The theory developed with the research involves the affective implication and satisfaction at work. Affective implication is the emotional attachment of the employee vis-a-vis the hospital. Satisfaction at work is a positive answer of the worker to their professional environment. The results of the research show that satisfaction in the workplace could be the result of professional experience and maturity. Hence, there could be a link between personal values and attitude that could encourage the implication of the staff in management. Responsibilities, recognition and the feeling of belonging to a group are part of the positive incentives and help develop management objectives.

  16. Search for continuous gravitational waves: improving robustness versus instrumental artifacts

    CERN Document Server

    Keitel, David; Papa, Maria Alessandra; Leaci, Paola; Siddiqi, Maham

    2013-01-01

    The standard multi-detector F-statistic for continuous gravitational waves is susceptible to false alarms from instrumental artifacts, for example monochromatic sinusoidal disturbances (lines). This vulnerability to line artifacts arises because the F-statistic compares the signal hypothesis to a Gaussian-noise hypothesis, and hence is triggered by anything that resembles the signal hypothesis more than Gaussian noise. Various ad-hoc veto methods to deal with such line artifacts have been proposed and used in the past. Here we develop a Bayesian framework that includes an explicit alternative hypothesis to model disturbed data. We introduce a simple line model that defines lines as signal candidates appearing only in one detector. This allows us to explicitly compute the odds between the signal hypothesis and an extended noise hypothesis, resulting in a new detection statistic that is more robust to instrumental artifacts. We present and discuss results from Monte-Carlo tests on both simulated data and on det...

  17. Improved SOFC performance with continuously graded anode functional layer

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Zhenhua; Xu, Ping [Department of Chemistry, Harbin Institute of Technology, Harbin 150001 (China); Zhang, Naiqing; Sun, Kening [Academy of Fundamental and Interdisciplinary Sciences, Harbin Institute of Technology, Harbin, Heilongjiang 150001 (China); Qiao, Jinshuo [Academy of Fundamental and Interdisciplinary Sciences, Harbin Institute of Technology, Harbin, Heilongjiang 150001 (China); Post-doctoral Research Center of Civil Engineering, Harbin Institute of Technology, Harbin, Heilongjiang 150001 (China)

    2009-06-15

    Continuously graded anode functional layers (CG-AFLs) were fabricated on the Ni-YSZ anode substrates by electrophoretic co-deposition (EPD) technique. The microstructure and composition of the CG-AFLs were investigated. The result showed that uniform and graded structure in AFL was obtained. The single cells were constructed on the basis of CG-AFLs, with a maximum output power density greater than 1.10 W cm{sup -2} obtained at 800 C for the cell with 9.8 {mu}m-thick CG-AFL. Electrochemical impedance spectroscopy (EIS) indicated that the excellent cell performance was contributed to the enlargement of triple phase boundary (TPB) by adding the CG-AFL. (author)

  18. [Strategies for patient participation in continuing improvement of clinical safety].

    Science.gov (United States)

    Saturno, Pedro J

    2009-06-01

    Strategies for patient participation in quality improvement, as an active part of processes or providing relevant information when asked, have progressed to a great extent for the last few years, influenced by the emphasis on patient-focused care as a key dimension for quality and, lately, by the emphasis on patient safety -a dimension for which the patient contribution can not be ignored. However, these strategies have not been fully implemented and used in most quality management systems. This article aims to make it easier to select the appropriate strategies for a given context, by describing them, grouped in three main themes (mobilising patients for patient safety; promoting active participation of patients in the prevention of safety incidents; requesting and using the relevant information for quality improvement that patients can provide), illustrating them with examples, and pointing out some of the obstacles for implementing them.

  19. Matrix Wings: Continuous Process Improvement an Operator Can Love

    Science.gov (United States)

    2016-01-01

    from “Lean, Six Sigma, Theory of Con- straints, and Business Process Reengineering,” and its seven-year phased approach reminds one of the extensive...Nature of the Military Mission If a business process is to apply to the operational military, it must meet yet a third criterion. It should be able to...sense. No exper- tise in process improvement methodologies , analytical processes , or other CPI tools and techniques are necessary to create a smart

  20. Continuous Process Improvement at Tinker Air Logistics Complex

    Science.gov (United States)

    2013-03-01

    essential to improving business practices (Deming, 1982; Garvin , 1993). Lander and Liker define this construct as “a no blame environment where... defined variables to test our hypotheses based on the 14 principles of the TPS described in The Toyota Way and other quality management principles...become leaner by reducing Work In Progress (WIP) inventory, reducing flow times, and increasing product quality to meet aircraft and engine demand

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

    Science.gov (United States)

    Griffith, Louise Ann

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

  2. 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/.

  3. Continuous improvement processes using Lean Management tools. A case study

    Directory of Open Access Journals (Sweden)

    Pârv Luminița

    2017-01-01

    Full Text Available The paper describes how Lean Management may be applied in the university setting to improve the management processes. The correlation of didactic, educational and research activities with the stakeholders needs is one of the main objectives of the university. In this respect, an indicator used to analyse a university, for the purposes of fulfilling its mission, respectively for the purposes of streamlining its didactic and scientific activity, is related to the number of graduates on the labour market, acting in their area of specialization. This work presents a best practice of Lean Management at Transilvania University of Brasov, Romania.

  4. Does work-site physical activity improve self-reported psychosocial workplace factors and job satisfaction?

    DEFF Research Database (Denmark)

    Roessler, K K; Rugulies, R; Bilberg, R

    2013-01-01

    , with 199 participants in the training group and 228 in the control group. Influence at work, sense of community, time pressure, and job satisfaction were measured with the Copenhagen Psychosocial Questionnaire at baseline and post-intervention after 20 weeks. RESULTS: There was no statistically significant...... change in any of the four variables in the training group from baseline to follow-up (all p ≥ 0.39). When we used MANOVA to test for between-group effects over time, we did not find any statistically significant result (all p > 0.14). CONCLUSIONS: This study does not provide evidence for an effect......PURPOSE: To investigate whether a work-site strength-training program has a positive effect on self-reported psychosocial workplace factors and job satisfaction. METHODS: We conducted a randomized controlled trial among laboratory technicians implementing neck and shoulder exercises for pain relief...

  5. Hyaluronic acid dermal fillers: can adjunctive lidocaine improve patient satisfaction without decreasing efficacy or duration?

    Science.gov (United States)

    Smith, Lynnelle; Cockerham, Kimberly

    2011-03-14

    Hyaluronic acid (HA) dermal fillers are the most widely used injectables to augment facial volume without surgery. HA dermal fillers are popular because of their ease of administration, predictable effectiveness, good safety profile, and quick patient recovery. The most common patient complaint is pain. Our goal is to review the current literature on HA fillers and compare outcomes with and without lidocaine. We found adjunctive lidocaine significantly decreases pain during injection and postinjection with corresponding increased patient satisfaction. The efficacy and safety profile appears unchanged. Rare complications with HA fillers and those associated with constituents of the product, contaminants, and lidocaine are reviewed. The corrective effects of HA fillers are temporary; repeat treatment is required to maintain results. Minimizing pain is crucial to optimize patient satisfaction.

  6. Improving patient satisfaction through the consistent use of scripting by the nursing staff.

    Science.gov (United States)

    Mustard, Lewis W

    2003-09-01

    An exploratory developmental model proposes a new method for responding to patient satisfaction on the basis of the hospital nurse obtaining subjective patient information at the patient's bedside during the first 24 hours of hospital admission and the day before discharge. The personal interview by the nurse uses a guided script, the Voice of the Patient (Figure 1), which is the front sheet in the medical record and a part of the critical medical care documents common to all hospital medical records. The information recorded in the Voice of the Patient actually comprises one-sentence quotes from the patient used by the hospital caregivers in responding to patient satisfaction during hospitalization, when care flaws can be corrected.

  7. Positioning Continuing Education: Boundaries and Intersections between the Domains Continuing Education, Knowledge Translation, Patient Safety and Quality Improvement

    Science.gov (United States)

    Kitto, Simon; Bell, Mary; Peller, Jennifer; Sargeant, Joan; Etchells, Edward; Reeves, Scott; Silver, Ivan

    2013-01-01

    Public and professional concern about health care quality, safety and efficiency is growing. Continuing education, knowledge translation, patient safety and quality improvement have made concerted efforts to address these issues. However, a coordinated and integrated effort across these domains is lacking. This article explores and discusses the…

  8. Positioning Continuing Education: Boundaries and Intersections between the Domains Continuing Education, Knowledge Translation, Patient Safety and Quality Improvement

    Science.gov (United States)

    Kitto, Simon; Bell, Mary; Peller, Jennifer; Sargeant, Joan; Etchells, Edward; Reeves, Scott; Silver, Ivan

    2013-01-01

    Public and professional concern about health care quality, safety and efficiency is growing. Continuing education, knowledge translation, patient safety and quality improvement have made concerted efforts to address these issues. However, a coordinated and integrated effort across these domains is lacking. This article explores and discusses the…

  9. Improving Consumer Satisfaction with Addiction Treatment: An Analysis of Alumni Preferences

    OpenAIRE

    Sanghani, Ruchi M.; Moler, Alexander K.

    2015-01-01

    Objective. The primary objective of this investigation is to determine which individual and aggregate factors of residential addiction treatment centers are most significant influencers of alumni satisfaction. Design. Survey targeted alumni of residential addiction treatment facilities. Alumni were queried through a survey, which utilized Likert-scale matrices and binary response options: 379 respondents met the completion threshold. Alumni rated amenities and individual and group counseling ...

  10. Improved Continuous-Time Higher Harmonic Control Using Hinfinity Methods

    Science.gov (United States)

    Fan, Frank H.

    The helicopter is a versatile aircraft that can take-off and land vertically, hover efficiently, and maneuver in confined space. This versatility is enabled by the main rotor, which also causes undesired harmonic vibration during operation. This unwanted vibration has a negative impact on the practicality of the helicopter and also increases its operational cost. Passive control techniques have been applied to helicopter vibration suppression, but these methods are generally heavy and are not robust to changes in operating conditions. Feedback control offers the advantages of robustness and potentially higher performance over passive control techniques, and amongst the various feedback schemes, Shaw's higher harmonic control algorithm has been shown to be an effective method for attenuating harmonic disturbance in helicopters. In this thesis, the higher harmonic disturbance algorithm is further developed to achieve improved performance. One goal in this thesis is to determine the importance of periodicity in the helicopter rotor dynamics for control synthesis. Based on the analysis of wind tunnel data and simulation results, we conclude the helicopter rotor can be modeled reasonably well as linear and time-invariant for control design purposes. Modeling the helicopter rotor as linear time-invariant allows us to apply linear control theory concepts to the higher harmonic control problem. Another goal in this thesis is to find the limits of performance in harmonic disturbance rejection. To achieve this goal, we first define the metrics to measure the performance of the controller in terms of response speed and robustness to changes in the plant dynamics. The performance metrics are incorporated into an Hinfinity control problem. For a given plant, the resulting Hinfinity controller achieves the maximum performance, thus allowing us to identify the performance limitation in harmonic disturbance rejection. However, the Hinfinity controllers are of high order, and may

  11. Adhesion improvement of fibres by continuous plasma treatment at atmospheric pressure

    DEFF Research Database (Denmark)

    Kusano, Yukihiro; Løgstrup Andersen, Tom; Sørensen, Bent F.

    2013-01-01

    Carbon fibres and ultra-high-molecular-weight polyethylene (UHMWPE) fibres were continuously treated by a dielectric barrier discharge plasma at atmospheric pressure for adhesion improvement with epoxy resins. The plasma treatment improved wettability, increased the oxygen containing polar...

  12. Improving maternal care with a continuous quality improvement strategy: a report from the Interventions to Minimize Preterm and Low Birth Weight Infants through Continuous Improvement Techniques (IMPLICIT) Network.

    Science.gov (United States)

    Bennett, Ian M; Coco, Andrew; Anderson, Janice; Horst, Michael; Gambler, Angela S; Barr, Wendy Brooks; Ratcliffe, Stephen

    2009-01-01

    Maternal medical care (prenatal and postpartum) involves a set of clinical interventions addressing risk factors associated with important maternal and infant outcomes. Programs to increase the rate of delivery of these interventions in clinical practice have not been widely implemented. A practice-based research network focused on developing continuous quality improvement (CQI) processes for maternal care among 10 family medicine residency training sites in the northeastern United States (the IMPLICIT Network) from January 2003 through September 2007. Documented delivery of 5 standard maternal care interventions was assessed before and after initiating a program to increase their frequency. Proportion chart analyses were conducted comparing the period before and after implementation of the CQI interventions. Data were available for 3936 pregnancies during the course of the study period. Results varied across the clinical interventions. Significant improvement in care processes was seen for 3 screening activities: (1) prenatal depression symptomatology (by 15 weeks' gestation); (2) screening for smoking at 30 weeks' gestation; (3) and postpartum contraception planning. Screening for smoking by 15 weeks' gestation and testing for asymptomatic bacteriuria were already conducted >90% of the time during the baseline period and did not increase significantly after initiating the CQI program. Screening for postpartum depression symptomatology was recorded in 50% to 60% of women before the CQI program and did not increase significantly. A practice-based research network of family medicine residency practices focused on CQI outcomes was successful in increasing the delivery of some maternal care interventions.

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

    Science.gov (United States)

    Aldowaisan, Tariq; Allahverdi, Ali

    2016-01-01

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

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

    Science.gov (United States)

    Aldowaisan, Tariq; Allahverdi, Ali

    2016-01-01

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

  15. Improved student engagement, satisfaction, and learning outcomes in a "flipped" large-lecture setting

    Science.gov (United States)

    Ward, A. S.; Bettis, E. A., III; Russell, J. E.; Van Horne, S.; Rocheford, M. K.; Sipola, M.; Colombo, M. R.

    2014-12-01

    Large lecture courses are traditional teaching practices of most large institutions of public higher education. They have historically provided an efficient way to deliver content information to the large number of students with the least amount of faculty resources. However, research of student learning indicates that the traditional lecture format does not provide the best learning experience for students, and students learn better in the active learning environments in which students engage in meaningful learning activities rather than just listening. In this study, we compare two offerings of Introduction to Environmental Science, a large-lecture general education course, offered in two formats by the same instructors in subsequent years. In the first offering (Spring 2013) the course was offered as a traditional large-lecture course, with lecture to large audiences and a limited number of exams for assessment. In the second offering (Spring 2014), the course included small-group discussion periods, peer-review of writing assignments, guest lectures, and online learning with limited traditional lecture. Our primary objective was to quantify differences in student engagement and learning outcomes between the two course offerings. Results of our study show that the students in the transformed course indicated higher interest, engagement level, and satisfaction than the students in the traditional lecture course. Furthermore, students in the transformed course reported increased behavior, emotional, and cognitive engagement over those in the traditional course, and also increased satisfaction with the course.

  16. Hyaluronic acid dermal fillers: can adjunctive lidocaine improve patient satisfaction without decreasing efficacy or duration?

    Directory of Open Access Journals (Sweden)

    Lynnelle Smith

    2011-03-01

    Full Text Available Lynnelle Smith1, Kimberly Cockerham21Ophthalmology Department, Loma Linda University, Loma Linda, CA, USA; 2Ophthalmology Department, Stanford University, Palo Alto, CA, USAAbstract: Hyaluronic acid (HA dermal fillers are the most widely used injectables to augment facial volume without surgery. HA dermal fillers are popular because of their ease of administration, predictable effectiveness, good safety profile, and quick patient recovery. The most common patient complaint is pain. Our goal is to review the current literature on HA fillers and compare outcomes with and without lidocaine. We found adjunctive lidocaine significantly decreases pain during injection and postinjection with corresponding increased patient satisfaction. The efficacy and safety profile appears unchanged. Rare complications with HA fillers and those associated with constituents of the product, contaminants, and lidocaine are reviewed. The corrective effects of HA fillers are temporary; repeat treatment is required to maintain results. Minimizing pain is crucial to optimize patient satisfaction.Keywords: hyaluronic acid, lidocaine, drug toxicity, hypersensitivity, collagen, herpes simplex

  17. Can blended learning and the flipped classroom improve student learning and satisfaction in Saudi Arabia?

    Science.gov (United States)

    Sajid, Muhammad R; Laheji, Abrar F; Abothenain, Fayha; Salam, Yezan; AlJayar, Dina; Obeidat, Akef

    2016-09-04

    To evaluate student academic performance and perception towards blended learning and flipped classrooms in comparison to traditional teaching. This study was conducted during the hematology block on year three students. Five lectures were delivered online only. Asynchronous discussion boards were created where students could interact with colleagues and instructors. A flipped classroom was introduced with application exercises. Summative assessment results were compared with previous year results as a historical control for statistical significance. Student feedback regarding their blended learning experience was collected. A total of 127 responses were obtained. Approximately 22.8% students felt all lectures should be delivered through didactic lecturing, while almost 35% felt that 20% of total lectures should be given online. Students expressed satisfaction with blended learning as a new and effective learning approach. The majority of students reported blended learning was helpful for exam preparation and concept clarification. However, a comparison of grades did not show a statistically significant increase in the academic performance of students taught via the blended learning method. Learning experiences can be enriched by adopting a blended method of instruction at various stages of undergraduate and postgraduate education. Our results suggest that blended learning, a relatively new concept in Saudi Arabia, shows promising results with higher student satisfaction. Flipped classrooms replace passive lecturing with active student-centered learning that enhances critical thinking and application, including information retention.

  18. A model for continuous improvement at a South African minerals benefication plant

    Directory of Open Access Journals (Sweden)

    Ras, Eugene Ras

    2015-05-01

    Full Text Available South Africa has a variety of mineral resources, and several minerals beneficiation plants are currently in operation. These plants must be operated effectively to ensure that the end-users of its products remain internationally competitive. To achieve this objective, plants need a sustainable continuous improvement programme. Several frameworks for continuous improvement are used, with variable success rates, in beneficiation plants around the world. However, none of these models specifically addresses continuous improvement from a minerals-processing point of view. The objective of this research study was to determine which factors are important for a continuous improvement model at a minerals beneficiation plant, and to propose a new model using lean manufacturing, six sigma, and the theory of constraints. A survey indicated that managers in the industry prefer a model that combines various continuous improvement models.

  19. Software Process Improvement Framework Based on CMMI Continuous Model Using QFD

    Directory of Open Access Journals (Sweden)

    Yonghui Cao

    2013-01-01

    Full Text Available In the rapid technological innovation and changes era, the key to the survival company is the continuous improvement of its process. In this paper, we introduce Software Process Improvement (SPI and Quality Function Deployment (QFD; and for combining also the staged model and the continuous model in CMMI, the Software Process Improvement framework with CMMI has two parts: 1 Software Process Improvement framework with CMMI staged model based on QFD and 2 SPI framework for C MI Mbased on QFD continuous model. Finally, we also draw conclusions.

  20. Entrepreneurship Education: Non-Linearity in the SatisfactionContinuation Relationship = Podjetniško izobraževanje: nelineranost v razmerju med zadovoljstvom in nadaljevanjem izobraževanja

    Directory of Open Access Journals (Sweden)

    Boštjan Antoncic

    2007-06-01

    Full Text Available In this paper we propose one possible explanation of the interrelationships between education continuation or avoidance, satisfaction level, and experience (entrepreneurial maturity of potential and practicing entrepreneurs. By using the cusp catastrophe model we propose that relationship between education satisfaction and continuation tends to be linear for less experienced entrepreneurs (pre-entrepreneurs, whereas for more experienced entrepreneurs the relationship is proposed to be positive but non-linear (s-shaped. Data were collected with a structured questionnaire from 122 participants in management and entrepreneurship education and training programs. The proposed model was tested with linear and non-linear regression equations. The relationship between satisfaction and continuation (loyalty was found to be positive for all entrepreneurial and nonentrepreneurial groups. The appropriate functional form for the satisfaction-continuation relationship discovered for non-entrepreneurs and people that are only thinking about entrepreneurship (maybe-entrepreneurs is close to linear and less steep than for more entrepreneurial groups. By contrast, prospective entrepreneurs (people in the process of pre-start up and practicing entrepreneurs tend to be more sensitive to their education satisfaction in their future education continuation decisions. The appropriate functional form for these entrepreneurial groups tends to be cubical, which is close to the s-shaped function proposed in the cusp model. The study provided evidence that the relationships between entrepreneurial maturity, education satisfaction and education continuation may be modeled as a cusp catastrophe model. The proposed model can be helpful for education and for training providers (and marketers in explaining and predicting of education loyalty or the switching behavior of entrepreneurs.

  1. Customer satisfaction and business excellence

    DEFF Research Database (Denmark)

    Kristensen, Kai; Martensen, Anne; Grønholdt, Lars

    , customer loyalty and performance, and optimal customer satisfaction is characterized which will help management choose the right quality parameters for improvement. Second, the paper describes empirical evidence that customer satisfaction measures, based on a modelling approach, have impact on economic......The topic for this paper is the link between customer satisfaction and business performance, which makes it possible to use customer satisfaction measures as basis for creating business excellence. First, the paper presents microeconomic models for the relationship between customer satisfaction...

  2. Customer satisfaction and business excellence

    DEFF Research Database (Denmark)

    Kristensen, Kai; Martensen, Anne; Grønholdt, Lars

    The topic for this paper is the link between customer satisfaction and business performance, which makes it possible to use customer satisfaction measures as basis for creating business excellence. First, the paper presents microeconomic models for the relationship between customer satisfaction......, customer loyalty and performance, and optimal customer satisfaction is characterized which will help management choose the right quality parameters for improvement. Second, the paper describes empirical evidence that customer satisfaction measures, based on a modelling approach, have impact on economic...

  3. A fixed-dose combination of adapalene 0.1%-BPO 2.5% allows an early and sustained improvement in quality of life and patient treatment satisfaction in severe acne.

    Science.gov (United States)

    Brodell, Robert T; Schlosser, Bethanee J; Rafal, Elyse; Toth, Darryl; Tyring, Stephen; Wertheimer, Albert; Kerrouche, Nabil; Bucher, Delphine

    2012-02-01

    Acne has a significant negative impact on quality of life (QoL): lack of self-confidence, depressive symptoms and suicidal thoughts. The objective was to assess the impact of an initial and continued therapy in severe acne patients through patient-related outcomes (PRO). In two sequential double-blind randomized studies, patients received either adapalene 0.1% and benzoyl peroxide 2.5% (A-BPO) or vehicle, associated with doxycycline 100 mg for 12 weeks. Patients having obtained at least a good improvement according to investigator global assessment were re-randomized for a 24-week therapy with A-BPO or vehicle. PROs were assessed using the Acne-QoL and a patient treatment satisfaction questionnaire. QoL was improved at week 12 in all domains with a significant difference for the Acne-symptoms domain (p Acne-symptoms. In the vehicle arm, QoL significantly worsened for all domains (p < 0.03). At weeks 12 and 36, a significantly higher proportion of patients receiving A-BPO vs. vehicle reported high satisfaction for five out of six treatment satisfaction items. The early and sustained improvement of these PROs is correlated to the fast onset of action of A-BPO, the treatment effectiveness and a good safety profile.

  4. Does Spanish instruction for emergency medicine resident physicians improve patient satisfaction in the emergency department and adherence to medical recommendations?

    Science.gov (United States)

    Stoneking, L R; Waterbrook, A L; Garst Orozco, J; Johnston, D; Bellafiore, A; Davies, C; Nuño, T; Fatás-Cabeza, J; Beita, O; Ng, V; Grall, K H; Adamas-Rappaport, W

    2016-01-01

    After emergency department (ED) discharge, Spanish-speaking patients with limited English proficiency are less likely than English-proficient patients to be adherent to medical recommendations and are more likely to be dissatisfied with their visit. To determine if integrating a longitudinal medical Spanish and cultural competency curriculum into emergency medicine residency didactics improves patient satisfaction and adherence to medical recommendations in Spanish-speaking patients with limited English proficiency. Our ED has two Emergency Medicine Residency Programs, University Campus (UC) and South Campus (SC). SC program incorporates a medical Spanish and cultural competency curriculum into their didactics. Real-time Spanish surveys were collected at SC ED on patients who self-identified as primarily Spanish-speaking during registration and who were treated by resident physicians from both residency programs. Surveys assessed whether the treating resident physician communicated in the patient's native Spanish language. Follow-up phone calls assessed patient satisfaction and adherence to discharge instructions. Sixty-three patients self-identified as primarily Spanish-speaking from August 2014 to July 2015 and were initially included in this pilot study. Complete outcome data were available for 55 patients. Overall, resident physicians spoke Spanish 58% of the time. SC resident physicians spoke Spanish with 66% of the patients versus 45% for UC resident physicians. Patients rated resident physician Spanish ability as very good in 13% of encounters - 17% for SC versus 5% for UC. Patient satisfaction with their ED visit was rated as very good in 35% of encounters - 40% for SC resident physicians versus 25% for UC resident physicians. Of the 13 patients for whom Spanish was the language used during the medical encounter who followed medical recommendations, ten (77%) of these encounters were with SC resident physicians and three (23%) encounters were with UC

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

    Science.gov (United States)

    Aldowaisan, Tariq; Allahverdi, Ali

    2016-07-01

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

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

    Science.gov (United States)

    Kakyo, Tracy Alexis; Xiao, Lily Dongxia

    2017-06-01

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

  7. 患者满意度调查对改善护理质量的作用%The effect of patients' satisfaction survey to nursing quality improvement

    Institute of Scientific and Technical Information of China (English)

    张艳; 杨婷

    2010-01-01

    Objective To observe the effect of patients' satisfaction survey to nursing quality improvement. Methods The patients' satisfaction was surveyed in order to find the weakness of nursing,establish improvable measures and compare the changes of patients' satisfaction after intervention. Results The degrees of satisfaction in all the observed items were improved. The differences in the service awareness, health education, initiative service and general satisfaction were significantly(P<0.05). Conclusions Practicing the "patient-based nursing" idea is helpful to improve the nursing service quality.%目的 观察患者满意度调查对改善护理质量的影响.方法 通过对住院患者进行满意度调查,发现护理工作的薄弱环节,制定针对性的改进措施,比较实施后满意度变化.结果 实施后与实施前相比,患者满意度均有提高,其中服务意识、健康宣教、主动服务和总体满意的提高差异具有统计学意义(P<0.05).结论 实施"以患者为中心"护理理念有助于提高护理工作质量.

  8. Integrating Essential Components of Quality Improvement into a New Paradigm for Continuing Education

    Science.gov (United States)

    Van Hoof, Thomas J.; Meehan, Thomas P.

    2011-01-01

    Continuing education (CE) that strives to improve patient care in a complex health care system requires a different paradigm than CE that seeks to improve clinician knowledge and competence in an educational setting. A new paradigm for CE is necessary in order to change clinician behavior and to improve patient outcomes in an increasingly…

  9. An action research study; cultural differences impact how manufacturing organizations receive continuous improvement

    Science.gov (United States)

    Kattman, Braden R.

    National culture and organizational culture impact how continuous improvement methods are received, implemented and deployed by suppliers. Previous research emphasized the dominance of national culture over organizational culture. The countries studied included Poland, Mexico, China, Taiwan, South Korea, Estonia, India, Canada, the United States, the United Kingdom, and Japan. The research found that Canada was most receptive to continuous improvement, with China being the least receptive. The study found that organizational culture was more influential than national culture. Isomorphism and benchmarking is driving continuous-improvement language and methods to be more universally known within business. Business and management practices are taking precedence in driving change within organizations.

  10. 78 FR 21879 - Improving 9-1-1 Reliability; Reliability and Continuity of Communications Networks, Including...

    Science.gov (United States)

    2013-04-12

    ... From the Federal Register Online via the Government Publishing Office FEDERAL COMMUNICATIONS COMMISSION 47 CFR Chapter I Improving 9-1-1 Reliability; Reliability and Continuity of Communications Networks, Including Broadband Technologies AGENCY: Federal Communications Commission. ACTION: Notice...

  11. How Effective is Cultural Competence Training of Healthcare Providers on Improving Patient Satisfaction of Minority Groups? A Systematic Review of Literature.

    Science.gov (United States)

    Govere, Linda; Govere, Ephraim M

    2016-12-01

    With the rapid growth of minority populations in the United States, the need to train healthcare providers to give culturally competent care has never been greater. Extensive research on cultural competence of healthcare providers has been conducted, but no systematic review specifically focused on the effect of cultural competence training on patient satisfaction of clients from minority groups. To search and critically appraise published research articles that evaluated the effectiveness of cultural competence training of healthcare providers on improving patient satisfaction of clients from minority groups. Using MeSH entry terms: Competency, Cultural; Cultural Competencies; Cultural Competence; Competence, Cultural; Satisfaction, Patient; and non-MeSh text words: Cultural Awareness, Cultural Sensitivity, Cultural Competence Training, Cultural Sensitivity Training, and Cultural Awareness Training, a comprehensive literature search of peer-reviewed articles from 2002 to 2014 in CINAHL, Cochrane, PsycINFO, PubMed, and Web of Science databases was conducted. Original studies that reported cultural competence training and measured its impact on patient satisfaction were included. Quality of the reviewed studies was assessed on the basis of methodological limitations related to experimental design, sample size and sampling approaches, and ethnic spread of the participants. Seven studies met the inclusion criteria. Six studies revealed that cultural competence training intervention significantly increased the cultural competence level of healthcare providers. Five studies demonstrated that cultural competence training of healthcare providers was significantly associated with increased patient satisfaction. Cultural competence training is an effective intervention that enables healthcare providers to give culturally competent care that increases satisfaction of patients from minority groups. However, more research with better research designs, large sample sizes, and

  12. ?HY-CHANGE?: AN HYBRID METHODOLOGY FOR CONTINUOUS PERFORMANCE IMPROVEMENT OF MANUFACTURING PROCESSES

    OpenAIRE

    Dassisti, Michele

    2010-01-01

    Abstract An hybrid methodology based on the joint recourse of Business Process An hybrid methodology for Continuous Performance Improvement (CPI) is presented, basically funded on the joint recourse of Business Process Reengineering (BPR) and Continuous Quality Improvement (CQI) principles and tools. The methodology (called HY-CHANGE) is conceived as a logical and technical support to the decision maker. It results in a number of recursive phases, where the rational and synchronous...

  13. Does Spanish instruction for emergency medicine resident physicians improve patient satisfaction in the emergency department and adherence to medical recommendations?

    Directory of Open Access Journals (Sweden)

    Stoneking LR

    2016-08-01

    Full Text Available LR Stoneking,1 AL Waterbrook,1 J Garst Orozco,2 D Johnston,1 A Bellafiore,1 C Davies,3 T Nuño,1 J Fatás-Cabeza,4 O Beita,5 V Ng,1 KH Grall,6 W Adamas-Rappaport7 1Department of Emergency Medicine, University of Arizona, Tucson, AZ, 2Department of Emergency Medicine, Sinai Health System, Chicago, IL, 3Department of Emergency Medicine, Maricopa Medical Center, Phoenix, AZ, 4Department of Spanish and Portuguese, University of Arizona, Tucson, AZ, 5Department of Family and Community Medicine, University of Arizona, Tucson, AZ, 6Department of Emergency Medicine, Regions Hospital, St Paul, MN, 7Department of Surgery, University of Arizona, Tucson, AZ, USA Background: After emergency department (ED discharge, Spanish-speaking patients with limited English proficiency are less likely than English-proficient patients to be adherent to medical recommendations and are more likely to be dissatisfied with their visit.Objectives: To determine if integrating a longitudinal medical Spanish and cultural competency curriculum into emergency medicine residency didactics improves patient satisfaction and adherence to medical recommendations in Spanish-speaking patients with limited English proficiency.Methods: Our ED has two Emergency Medicine Residency Programs, University Campus (UC and South Campus (SC. SC program incorporates a medical Spanish and cultural competency curriculum into their didactics. Real-time Spanish surveys were collected at SC ED on patients who self-identified as primarily Spanish-speaking during registration and who were treated by resident physicians from both residency programs. Surveys assessed whether the treating resident physician communicated in the patient’s native Spanish language. Follow-up phone calls assessed patient satisfaction and adherence to discharge instructions.Results: Sixty-three patients self-identified as primarily Spanish-speaking from August 2014 to July 2015 and were initially included in this pilot study

  14. Building a Culture of Continuous Quality Improvement in an Academic Radiology Department.

    Science.gov (United States)

    Katzman, Gregory L; Paushter, David M

    2016-04-01

    As we enter a new era of health care in the United States, radiologists must be adequately prepared to prove, and continually improve, our value to our customers. This goal can be achieved in large part by providing high-quality services. Although quality efforts on the national and international levels provide a framework for improving radiologic quality, some of the greatest opportunities for quality improvement can be found at the departmental level, through the implementation of total quality management programs. Establishing such a program requires not only strong leadership and employee engagement, but also a firm understanding of the multiple total quality management tools and continuous quality improvement strategies available. In this article, we discuss key tools and strategies required to build a culture of continuous quality improvement in an academic department, based on our experience. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  15. Social capital among healthcare professionals: A prospective study of its importance for job satisfaction, work engagement and engagement in clinical improvements.

    Science.gov (United States)

    Strömgren, Marcus; Eriksson, Andrea; Bergman, David; Dellve, Lotta

    2016-01-01

    Social capital can be an important resource to facilitate the needed improvements in quality of care and efficiency in hospitals. To assess the importance of social capital (recognition, vertical trust, horizontal trust and reciprocity) for job satisfaction, work engagement and engagement in clinical improvements. A prospective cohort design was used. Intensive care units and emergency, surgical and medical units at five Swedish hospitals with ongoing development of their processes of care. Healthcare professionals (physicians, registered nurses, assistant nurses) at five Swedish midsize hospitals. The participants answered a questionnaire at two occasions, NN=1602 at baseline and NN=1548 at one-year follow-up. Mean hospital response rate was 53% at baseline and 59% at follow-up. Univariate, multivariate and logistic regression analyses were performed, and the prospective analysis was based on 477 respondents. Social capital was associated with healthcare professionals' general work engagement and job satisfaction. Analysis showed positive associations between all measured aspects of social capital and engagement in clinical improvements of patient safety and quality of care. The prospective analysis showed that increased social capital predicted increased job satisfaction, work engagement and engagement in clinical improvements of patient safety. Social capital is strongly related to job satisfaction and active engagement with clinical improvements. The findings contribute to a deeper knowledge of social capital as a predictive factor that influences patient safety and health among healthcare staff. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Continuing Professional Development for doctors, certification, licensure and quality improvement. A model to follow?

    Directory of Open Access Journals (Sweden)

    Alejandro Aparicio

    2015-01-01

    The article concludes with a reference to the research evidence in support of the effectiveness of CME/CPD and the impact that Continuous Quality Improvement and Performance Improvement have had on CME/CPD, on the new program to maintain specialty certification and on the proposed new licensure framework, and how they all interact.

  17. The RISE Framework: Using Learning Analytics to Automatically Identify Open Educational Resources for Continuous Improvement

    Science.gov (United States)

    Bodily, Robert; Nyland, Rob; Wiley, David

    2017-01-01

    The RISE (Resource Inspection, Selection, and Enhancement) Framework is a framework supporting the continuous improvement of open educational resources (OER). The framework is an automated process that identifies learning resources that should be evaluated and either eliminated or improved. This is particularly useful in OER contexts where the…

  18. Creating Sustainable Education Projects in Roatán, Honduras through Continuous Process Improvement

    Science.gov (United States)

    Raven, Arjan; Randolph, Adriane B.; Heil, Shelli

    2010-01-01

    The investigators worked together with permanent residents of Roatán, Honduras on sustainable initiatives to help improve the island's troubled educational programs. Our initiatives focused on increasing the number of students eligible and likely to attend a university. Using a methodology based in continuous process improvement, we developed…

  19. Secondary School Reading: Using the Quality Principle of Continuous Improvement To Build an Exemplary Program.

    Science.gov (United States)

    Weller, L. David; Weller, Sylvia J.

    1999-01-01

    POWER (Providing Opportunities with Everyday Reading), stressing reading in the content areas, is a program for high schoolers driven by continuous improvement and teamwork. Improved test scores and enhanced attitudes toward reading result from high teacher commitment and sustained interest achieved through this teacher-led program's design. (MLH)

  20. Using marital status and continuous marital satisfaction ratings to predict depressive symptoms in married and unmarried women with systemic sclerosis: A Canadian Scleroderma Research Group Study

    NARCIS (Netherlands)

    Levis, B.; Rice, D.B.; Kwakkenbos, C.M.C.; Steele, R.J.; Hagedoorn, M.; Hudson, M.; Baron, M.; Thombs, B.D.

    2016-01-01

    Objective: Married persons have, on average, better mental health than nonmarried persons. Among married persons, marital satisfaction is associated with better mental health. Studies on mental health in married and nonmarried persons that consider marital satisfaction have categorized patients as s

  1. Using Marital Status and Continuous Marital Satisfaction Ratings to Predict Depressive Symptoms in Married and Unmarried Women With Systemic Sclerosis : A Canadian Scleroderma Research Group Study

    NARCIS (Netherlands)

    Levis, Brooke; Rice, Danielle B.; Kwakkenbos, Linda; Steele, Russell J.; Hagedoorn, Mariet; Hudson, Marie; Baron, Murray; Thombs, Brett D.

    2016-01-01

    Objective. Married persons have, on average, better mental health than nonmarried persons. Among married persons, marital satisfaction is associated with better mental health. Studies on mental health in married and nonmarried persons that consider marital satisfaction have categorized patients as s

  2. Enablers and inhibitors for sustainability of continuous improvement: A study in the automotive industry suppliers in the Valencia Region

    OpenAIRE

    Marin-Garcia, Juan A.; Julio J. Garcia-Sabater

    2009-01-01

    In recent years it has been widely discussed the use of continuous improvement in all kind of business and particularly in companies belonging to the automotive industry. Many authors mention improvements, in key indicators of production through the use of continuous improvement tools. At the same time, different authors talk about how to sustain the continuous improvement over time, and try to identify inhibitors and enablers for the sustainability of continuous improvement. But despite this...

  3. Analysis of Customer Loyalty through Total Quality Service, Customer Relationship Management and Customer Satisfaction

    Science.gov (United States)

    Binsar Kristian P., Feliks Anggia; Panjaitan, Hotman

    2014-01-01

    This research talks about total quality service and customer relationship management effects toward customer satisfaction and its impact on customer loyalty. Fast food restaurant KFC, always strives to continue to make improvements in total quality service, so that customer satisfaction can be maintained, which in turn will have an impact on…

  4. Continuous rotary motor electro-hydraulic servo system based on the improved repetitive controller

    Institute of Scientific and Technical Information of China (English)

    WANG Xiao-jing; JIANG ji-hai; LI Shang-yi

    2010-01-01

    In order to suppress the periodic interference of the continuous rotary electro-hydraulic servo motor,this paper makes the motor tracking the periodic signals with high accuracy,and improves the influence of friction interference to the performance of continuous rotary electro-hydraulic servo motor.The mathematic model of the electro-hydraulic position servo system of the continuous rotary motor was established,and the compound control method was adopted based on the repetitive control,feed forward and PID to suppress the friction interference.Through the simulation,the result confirms that the compound control method decreases the tracking error of the system,increases the robust performance of the system and improves the performance of the continuous rotary electro-hydraulic servo motor.

  5. Career satisfaction among general surgeons in Canada: a qualitative study of enablers and barriers to improve recruitment and retention in general surgery.

    Science.gov (United States)

    Ahmed, Najma; Conn, Lesley Gotlib; Chiu, Mary; Korabi, Bochra; Qureshi, Adnan; Nathens, Avery B; Kitto, Simon

    2012-11-01

    To understand what influences career satisfaction among general surgeons in urban and rural areas in Canada in order to improve recruitment and retention in general surgery. Semistructured interviews were conducted with 32 general surgeons in 2010 who were members of the Canadian Association of General Surgeons and who currently practice in either an urban or rural area. Interviews explored factors contributing to career satisfaction, as well as suggestions for preventive, screening, or management strategies to support general surgery practice. Findings revealed that both urban and rural general surgeons experienced the most satisfaction from their ability to resolve patient problems quickly and effectively, enhancing their sense of the meaningfulness of their clinical practice. The supportive relationships with colleagues, trainees, and patients was also cited as a key source of career satisfaction. Conversely, insufficient access to resources and a perceived disconnect between hospital administration and clinical practice priorities were raised as key "systems-level" problems. As a result, many participants felt alienated from their work by these systems-level barriers that were perceived to hinder the provision of high-quality patient care. Career satisfaction among both urban and rural general surgeons was influenced positively by the social aspects of their work, such as patient and colleague relationships, as well as a perception of an increasing amount of control and autonomy over their professional commitments. The modern general surgeon values a balance between professional obligations and personal time that may be difficult to achieve given the current system constraints.

  6. Improvement in medical students' communication and interpersonal skills as evaluated by patient satisfaction questionnaire after curriculum reform.

    Science.gov (United States)

    Oda, Yasutomo; Onishi, Hirotaka; Sakemi, Takanobu; Fujimoto, Kazuma; Koizumi, Shunzo

    2014-07-01

    Fifteen years of undergraduate medical education curriculum reform at Saga Medical School was evaluated by measuring medical students' communication and interpersonal skills with a patient satisfaction questionnaire developed by the American Board of Internal Medicine. A multiphase cross-sectional study was conducted at the General Medicine Clinic of Saga Medical School Hospital in phase I (1998-1999), phase II (2001-2002), and phase III (2009-2010). A total of 1,963 patient ratings for 437 medical students' performance was analyzed. The average scores of phases II and III were significantly higher than for phase I. The average score of female students showed a significant difference between phases I and II, but no difference between phases II and III. The average score of male students showed no difference between phases I and II, but significant difference between phases II and III. The phase II curriculum introduced basic clinical skills and examination and improved female students' performance. The phase III curriculum was effective for male students because it emphasized the clinical skill program more and introduced problem-based learning. Curriculum reform at Saga Medical School is considered to have made good progress in improving students' clinical competence and patient-centered attitudes.

  7. ZAPP! in Education: How Empowerment Can Improve the Quality of Instruction, and Student and Teacher Satisfaction.

    Science.gov (United States)

    Byham, William C.; And Others

    In a previous book entitled "Zapp! The Lightening of Empowerment", a new system for motivating employees and improving productivity in a corporate setting was presented. This book adapts that empowerment guide to the classroom with workable, hands-on suggestions to help educators motivate their students and themselves. Empowerment in…

  8. Humana looks to ISO registration to address quality improvement and customer satisfaction.

    Science.gov (United States)

    2003-01-01

    Seeking new ways to improve standardization of clinical operations and customer focus, Louisville, KY-based Humana, Inc. announced in November that it has become the first healthcare company to be registered in the U.S. under ISO 9001:2000, a quality management standard published by the International Organization for Standardization (ISO).

  9. Problem Lah! Learning to Tell the Story of Continuous Assessment and Improvement

    OpenAIRE

    Hanken, Tamera

    2014-01-01

    To succeed organizations rely on the purposeful application of the management functions, planning, organizing, leading and controlling, i.e., assessment. Assessment involves the collection and analysis of service and performance data to inform planning, organizing and leading-- opening the door to a culture of assessment and continuous improvement. Like other organizations responding to ever challenging economies and ever changing customer expectations, libraries are examining continuous impr...

  10. Improving GOOGLE'S Cartographer 3d Mapping by Continuous-Time Slam

    Science.gov (United States)

    Nüchter, A.; Bleier, M.; Schauer, J.; Janotta, P.

    2017-02-01

    This paper shows how to use the result of Google's SLAM solution, called Cartographer, to bootstrap our continuous-time SLAM algorithm. The presented approach optimizes the consistency of the global point cloud, and thus improves on Google's results. We use the algorithms and data from Google as input for our continuous-time SLAM software. We also successfully applied our software to a similar backpack system which delivers consistent 3D point clouds even in absence of an IMU.

  11. Digitalization of inspection data:a means for enhancing learning and continuous improvements?

    OpenAIRE

    Lundkvist, Robert; Meiling, John; Vennström, Anders

    2010-01-01

    According to Total Quality Management (TQM), Lean Production and Six Sigma literature, companies should develop organisational arrangements that foster learning from experience and base decisions on facts, since continuous improvements require continuous experience feedback in some form. In Sweden every construction project is checked in several inspections, and data about defects are collected in paper-based "punch lists", but what happens to these data after the defects have been corrected ...

  12. Identifying priority actions for improving patient satisfaction with outpatient cancer care.

    Science.gov (United States)

    Gesell, Sabina B; Gregory, Nancy

    2004-01-01

    In parallel to developing new cancer therapies, the healthcare community has the responsibility of creating positive treatment experiences for patients. Data from 5907 cancer outpatients treated at 23 hospitals across the United States were analyzed to identify the top priorities for service improvement in outpatient cancer treatment facilities. They included meeting patients' emotional needs, providing information to patients and family members, reducing waiting times, and providing convenience and coordinated care among physicians and other care providers.

  13. On measures to improve customer satisfaction of the Wuling Automobile%浅谈五菱汽车如何提高客户满意度

    Institute of Scientific and Technical Information of China (English)

    黄小武; 陈峰; 周永达

    2013-01-01

      增进客户的满意,可以拥有更多的忠诚客户,可以增强市场竞争力,是企业生存和发展的基础。五菱汽车通过提高产品质量,提高售后服务人员的整体素质,树立客户第一的理念来提高客户满意度,加速企业快速发展。%  improve customer satisfaction ,can have more loyal customers, can enhance the competitiveness of the market, is the enterprise survival and the development foundation .Wuling Automobile through the improvement of product quality, improve the overall quality customer service staff, establish the customer first philosophy to improve customer satisfaction ,fast and accelerate the development of enterprise.

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

    Directory of Open Access Journals (Sweden)

    José Anselmo Mayer

    2016-08-01

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

  15. Sustainability of continuous improvement systems in industry: Survey of BAC and Navarre

    Directory of Open Access Journals (Sweden)

    Carmen Jaca García

    2010-02-01

    Full Text Available This article will examine the level of sustainability for companies in Continuous Improvement Management and the factors which are supporting sustainability during time, through a survey to 350 companies of Basque Autonomous Community and Navarra in June of 2009. The study presents some data about the development of the improvement systems. Then, factors that companies have related to the abandonment of improvement systems are analysed. Since improvement systems are based on workers’ participation, this study characterizes this participation. Finally, the elements which have been used in the improvement systems by the companies are analyzed, and how objectives and indicators are used in their management system. To conclude, the following key issues are emphasized: a higher involvement of workforce in improvement systems, the integration of improvement system in the management system and the establishment of associated indicators to the system.

  16. THE SEARCH OF SATISFACTION OF TOURISTS IN ORDER TO IMPROVE THE QUALITY OF MONTENEGRO TOURISM

    Directory of Open Access Journals (Sweden)

    Andela Jaksic Stojanovic

    2012-12-01

    Full Text Available This paper is based on the survey that was conducted from June to September 2012 in Montenegro. The results of the survey are presented in public for the first time. The survey itself seeks to reach the expectation, needs and desires of tourists, to understand their attitudes and beliefs, as well as to highlight the main advantages and disadvantages of tourist offer in order to improve the quality of Montenegrin tourism and suggest the main marketing- management strategies for positioning of Montenegro as an attractive, unique, desired whole year destination with a recognizable image on global market.

  17. Tumescent Local Anesthesia for Hand Surgery: Improved Results, Cost Effectiveness, and Wide-Awake Patient Satisfaction

    Directory of Open Access Journals (Sweden)

    Donald Lalonde

    2014-07-01

    Full Text Available This is a review article of the wide-awake approach to hand surgery. More than 95% of all hand surgery can now be performed without a tourniquet. Epinephrine is injected with lidocaine for hemostasis and anesthesia instead of a tourniquet and sedation. This is sedation-free surgery, much like a visit to a dental office. The myth of danger of using epinephrine in the finger is reviewed. The wide awake technique is greatly improving results in tendon repair, tenolysis, and tendon transfer. Here, we will explain its advantages.

  18. Socio-economic position has no effect on improvement in health-related quality of life and patient satisfaction in total hip and knee replacement: a cohort study.

    Directory of Open Access Journals (Sweden)

    J Christiaan Keurentjes

    Full Text Available INTRODUCTION: Considerable evidence suggests that patients with more advantaged Socio-Economic Positions undergo Total Hip and Knee Replacement (THR/TKR more often, despite having a lower need. We questioned whether more disadvantaged Socio-Economic Position is associated with an lower improvement in Health-Related Quality of Life (HRQoL and a lower patient satisfaction after THR/TKR. METHODS: Patients who underwent primary THR/TKR in one academic and three community hospitals between 2005 and 2009, were eligible for inclusion. The highest completed levels of schooling were aggregated to index social class. We compared the improvement in HRQoL and postoperative satisfaction with surgery (measured using the Short-Form 36 (SF36 and an 11-point numeric rating scale of satisfaction between the aggregated groups of highest completed levels of schooling, using linear mixed model analysis, with center as a random effect and potential confounders (i.e. age, gender, Body Mass Index and Charnley's comorbidity classification as fixed effects. RESULTS: 586 THR patients and 400 TKR patients (40% of all eligible patients agreed to participate and completed all questionnaires sufficiently. We found no differences in HRQoL improvement in any dimension of the SF36 in THR patients. Patients with a higher completed level of schooling had a larger improvement in role-physical (9.38 points, 95%-CI:0.34-18.4, a larger improvement in general health (3.67 points, 95%-CI:0.56-6.79 and a smaller improvement in mental health (3.60 points, 95%-CI:0.82-6.38 after TKR. Postoperative patient satisfaction did not differ between different highest completed level of schooling groups. DISCUSSION: Completed level of schooling has no effect on the improvement in HRQoL and patient satisfaction in a Dutch THR population and a small effect in a similar TKR population. Undertreatment of patients with more disadvantaged Socio-Economic Position cannot be justified, given the similar

  19. Same day admission for elective cardiac surgery: how to improve outcome with satisfaction and decrease expenses.

    Science.gov (United States)

    Silvay, George; Goldberg, Andrew; Gutsche, Jacob T; T Augoustides, John G

    2016-06-01

    Admission on the day of surgery for elective cardiac and non-cardiac surgery has been established as a prevalent, critical practice. This approach realizes medical, logistical, psychological and fiscal benefits, and its success is predicated on an effective outpatient pre-operative evaluation. The establishment of a highly functional pre-operative clinic with a comprehensive set-up and efficient logistical pathways is invaluable. This notion has been expanded in recent years to include the entire peri-operative period and the concept of a 'peri-operative anesthesia/surgical home' is gaining popularity and support. Evaluating patients prior to admission for surgery, anesthesiologists can place themselves at the forefront of reducing unnecessary pre-operative hospital admissions, excess lab tests, unneeded consultations, and ultimately decrease the cancellations on the day of surgery. Furthermore, by taking a leadership role in the pre-operative clinic, anesthesiologists place themselves squarely at the forefront of the burgeoning movement for the peri-operative surgical home and continue to cement the indispensability of the anesthesiologist during the entire peri-operative course. The authors present this review as a follow-up describing the successful implementation of a pre-operative same-day cardiac surgery clinic and offer these experiences over the last 8 years as a guide to helping other anesthesiologists do the same.

  20. Job satisfaction among Australian doctors: the use of latent class analysis.

    Science.gov (United States)

    Joyce, Catherine; Wang, Wei Chun

    2015-10-01

    To identify patterns of job satisfaction among Australian doctors using latent class analysis, and to determine the relationships of these patterns to personal and professional characteristics so as to improve satisfaction and minimize medical wastage. MABEL (Medicine in Australia: Balancing Employment and Life) data in 2011 were used. The study collected information on 5764 doctors about their job satisfaction, demographic characteristics, their health, country of medical training, opportunities for professional development and social interaction, taking time off work, views of patients' expectations, unpredictable working hours, hours worked per week, preference to reduce hours and intention to leave the medical workforce. Four latent classes of job satisfaction were identified: 5.8% had high job satisfaction; 19.4% had low satisfaction with working hours; 16.1% had high satisfaction with working hours but felt undervalued; and 6.5% had low job satisfaction. Low job satisfaction was associated with reporting poor health, having trained outside Australia, having poor opportunities for professional development and working longer hours. Low satisfaction was associated with a preference to reduce work hours and an intention to leave the medical workforce. To improve job satisfaction and minimize medical wastage, policies need to address needs of overseas trained doctors, provide continuing professional development and provide good health care for doctors. © The Author(s) 2015.

  1. FACTORS AFFECTING EMPLOYEE JOB SATISFACTION OF PHARMACEUTICAL SECTOR

    Directory of Open Access Journals (Sweden)

    Mosammod Mahamuda Parvin

    2011-10-01

    Full Text Available The Pharmaceutical sector plays a vital role in underpinning the economic development of a country. This study attempts to evaluate job satisfaction of employees in different pharmaceutical companies. It focuses on the relative importance of job satisfaction factors and their impacts on the overall job satisfaction of employees. It also investigates the impacts of pharmaceutical type, work experience, age, and sex differences on the attitudes toward job Satisfaction. The result shows that salary, efficiency in work, fringe supervision, and co-worker relation are the most important factors contributing to job satisfaction. The overall job satisfaction of the employees in pharmaceutical sector is at the positive level. The nature of business operation, the work culture and the level of job satisfaction have undergone sea change for the pharmaceutical companies. As a business proposition initiated huge investment whereas majority of their stocks is going down bringing a high level of apprehension related to job security among its employees. This research paper highlights some of these problems and presents a picture of level of job satisfaction among employees of pharmaceutical companies. It also identifies unique issues of job satisfaction in the companies. Pharmaceuticals Companies are selected for the research because they are currently undergoing continued expansion. In order to gain competitive advantage and adapt to the dramatic changing environment, it is important for them to achieve management efficiency by increasing employee satisfaction in the organisation. Hence this research was mainly undertaken to investigate on the significance of factors such as working conditions, pay and promotion, job security, fairness, relationship with co-workers and supervisors in affecting the job satisfaction. This paper presents a comprehensive diagnosis of job satisfaction indices of pharmaceutical business, the factors causing the dissatisfaction

  2. The use of performance improvement methods to enhance emergency department patient satisfaction in the United States: a critical review of the literature and suggestions for future research.

    Science.gov (United States)

    Boudreaux, Edwin D; Cruz, Brian L; Baumann, Brigitte M

    2006-07-01

    The authors reviewed the evidence on performance improvement methods for increasing emergency department (ED) patient satisfaction to provide evidence-based suggestions for clinical practice. Data sources consisted of searches through MEDLINE, CINAHL, PSYCHINFO, Cochrane Library, and Emergency Medicine Abstracts and a manual search of references. Articles were included if they reported a performance improvement intervention targeting patient satisfaction in the ED setting. Articles on studies not conducted in the United States or that failed to provide enough details to allow critical evaluation of the study were excluded. Two authors used structured evaluation criteria to independently review each retained study. Nineteen articles met all selection criteria. Three studies found varying levels of support for multicomponent interventions, predominantly focused on implementation of clinical practice guidelines for specific presenting complaints and process redesign. Sixteen studies evaluated single-component interventions, with the following having at least one supportive study: using alternating patient assignment to provider teams rather than "zone"-based assignment, enhancing provider communication and customer service skills, incorporating information delivery interventions (e.g., pamphlets, video) that target patient expectations, using preformatted charts, and establishing ED-based observation units for specific conditions such as asthma and chest pain. There is modest evidence supporting a range of performance improvement interventions for improving ED patient satisfaction. Further work is needed before specific, evidence-based recommendations can be made regarding which process changes are most effective. Recommendations are made for improving the quality of performance improvement efforts in the ED setting.

  3. Assessment of Beee and Bepe Program as Part of Continual Quality Improvement

    OpenAIRE

    Farah Hani Nordin,; Ungku Anisa Ungku Amirulddin; Fazrena Azlee Hamid; Azrul Mohd Ariffin; Chau Chien Fat

    2014-01-01

    Continual Quality Improvement (CQI) involves analyzing the Program Educational Objectives (PEO) and Program Outcomes (PO) which helps an academic institution to reflect on the quality of the programs offered where recommendations for improvements can be made. As part of the CQI process, this paper presents the attainments and feedbacks on the PEO and PO for the Bachelor of Electrical and Electronics Engineering (BEEE) and Bachelor of Electrical Power Engineering (BEPE) which are obtained thro...

  4. Customer satisfaction measurement

    Directory of Open Access Journals (Sweden)

    Maričić Branko R.

    2012-01-01

    Full Text Available Customer satisfaction is important in business management as a basis for long-term profitability of a single line of products and services and the company as a whole. Customer satisfaction in modern market conditions is characterized by a large number of alternatives that can satisfy the same need or desire of consumers, and are a prerequisite for the retention, loyalty, and positive verbal communication between companies and vendors on one hand and consumers on the other. Companies are investing more and more investment and management efforts in improving customer satisfaction. Improving customer satisfaction and its measurement involves the taking of appropriate marketing strategies and tactics, as well as corrective measures. This paper presents the well-known attempts to measure customers' satisfaction at the macro and micro level of marketing analysis. The index of consumer satisfaction is an important indicator of achieved quality and market performance of companies and can be measured on a micro and macro level. National customer satisfaction indexes are useful framework for analyzing the competitiveness of national economies, industries and individual companies and are used for a variety of other aspects of observation and analysis. Standardization of consumer satisfaction indexes in different countries allows comparability of the data, giving a new quality of analysis in the era of globalization and internationalization of business.

  5. The Discussion of Reader Satisfaction and Its Improvement%读者满意度及其提高策略探析

    Institute of Scientific and Technical Information of China (English)

    喻华林

    2011-01-01

    提高读者满意度是高校图书馆服务工作的关键所在。本文在总结图书馆读者满意度内涵的基础上,分析了文献资源的丰富程度和可获取性,信息系统界面友好程度及响应速度,馆员的服务态度、能力和水平等因素对图书馆读者满意度的影响,并就如何提高探讨了若干对策。%Improving the reader' s satisfaction degree is the key of University library service. Bases the connotation of reader' s satisfaction degree, the text analysis Rich degree and acquisition of literature resources, friendliness of interfaces and the response speed for Information System, Service attitude, ability and level of the Librarianin in reader' s satisfaction, and the corresponding countermeasures should be provided about how to improve the Reader' s Satisfaction Degree.

  6. Patient satisfaction

    Directory of Open Access Journals (Sweden)

    Bhanu Prakash

    2010-01-01

    Full Text Available Patient satisfaction is an important and commonly used indicator for measuring the quality in health care. Patient satisfaction affects clinical outcomes, patient retention, and medical malpractice claims. It affects the timely, efficient, and patient-centered delivery of quality health care. Patient satisfaction is thus a proxy but a very effective indicator to measure the success of doctors and hospitals. This article discusses as to how to ensure patient satisfaction in dermatological practice.

  7. Job satisfaction

    OpenAIRE

    Podroužková, Lucie

    2013-01-01

    Bachelor thesis deals with job satisfaction. It is often given to a context with the attitude to work which is very much connected to job satisfaction. Thesis summarises all the pieces of information about job satisfacion, factors that affect it negatively and positively, interconnection of work satisfaction and work motivation, work behaviour and performance of workers, relationship of a man and work and at last general job satisfaction and its individual aspects. In the thesis I shortly pay...

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

    Science.gov (United States)

    Pietz, Victoria Lynn

    2014-01-01

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

  9. Beyond the Numbers: Data Use for Continuous Improvement of Programs Serving Disconnected Youth

    Science.gov (United States)

    Pate, Austin; Lerner, Jennifer Brown; Browning, Andrea

    2012-01-01

    This publication is a series of in-depth case studies to examine how three programs which serve a disconnected youth population are utilizing data as a tool for continuous program improvement and ongoing accountability. The report features the following programs: (1) Roca, an organization in Massachusetts which engages the highest-risk youth in…

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Science.gov (United States)

    Pietz, Victoria Lynn

    2014-01-01

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

  12. Continuous quality improvement in home care: do it right the first time.

    Science.gov (United States)

    Foreman, J T

    1993-10-01

    Continuous quality improvement is a movement from the standard definitions of quality, which looked back at work already done, to a method of prevention. This involves defining and meeting customer needs, leading to exemplary service. But this increase in competitive ability has to start from cooperation within the agency--cooperation for prevention.

  13. Continuous improvement in managing R&D: A TQM approach at SkogForsk, Sweden

    Science.gov (United States)

    Magnus Larsson

    1999-01-01

    Continuous improvement is an imperative process for any organization) even in the R&D field) who wants to stay competitive and alive. Our experience is that the most important ingredients in this process are engagement and participation by everybody) shared visions) and a holistic view of the organization. Structural changes and quick fixes cannot accomplish this....

  14. Motivational Interviewing (MINT) Improves Continuous Positive Airway Pressure (CPAP) Acceptance and Adherence: A Randomized Controlled Trial

    Science.gov (United States)

    Olsen, Sara; Smith, Simon S.; Oei, Tian P. S.; Douglas, James

    2012-01-01

    Objective: Adherence to continuous positive airway pressure (CPAP) therapy for obstructive sleep apnoea (OSA) is poor. We assessed the effectiveness of a motivational interviewing intervention (motivational interview nurse therapy [MINT]) in addition to best practice standard care to improve acceptance and adherence to CPAP therapy in people with…

  15. Demystifying Data: Designing and Implementing Data-Driven Systems and Practices for Continuous Quality Improvement

    Science.gov (United States)

    Krugly, Andrew; Stein, Amanda; Centeno, Maribel G.

    2014-01-01

    Data-based decision making should be the driving force in any early care and education setting. Data usage compels early childhood practitioners and leaders to make decisions on the basis of more than just professional instinct. This article explores why early childhood schools should be using data for continuous quality improvement at various…

  16. Continuous Quality Improvement as an Innovation: Which Nursing Facilities Adopt It?

    Science.gov (United States)

    Lucas, Judith A.; Avi-Itzhak, Tamara; Robinson, Joanne P.; Morris, Catherine G.; Koren, Mary Jane; Reinhard, Susan C.

    2005-01-01

    Purpose: We identify environmental and organizational predictors that best discriminate between formal continuous quality improvement (CQI) adopters and nonadopters in nursing homes (NHs) and create a diagnostic profile for facility administrators and policy makers to promote CQI. Design and Methods: We performed a cross-sectional survey of…

  17. Continuous improvement in manufacturing and inspection of fuel; Mejora continua en fabricacion e inspeccion de combustible

    Energy Technology Data Exchange (ETDEWEB)

    Domingon, A.; Ruiz, R.

    2015-07-01

    The manufacturing and inspection process of fuel assemblies in ENUSA is characterized by its robustness acquired over the last thirty years of experience in manufacturing. The reliability of these processes is based on a qualified processes and continuous improvement in the design and upgrading of equipment and optimization of software and manufacturing processes. Additionally, management and quality control systems have been improved in both software and measuring business objectives. this article emphasizes the improvements made over the past five years in management, production and inspection of fuel assemblies. (Author)

  18. Towards a new approach of continuous process improvement based on CMMI and PMBOK

    Directory of Open Access Journals (Sweden)

    Rdiouat Yassine

    2012-11-01

    Full Text Available A process-centric approach helps an organization to improve the way it works with. It allows scalability and provides a way to capitalize knowledge on best practices. It also makes better use of resources and helps to understand trends. PMBOK is a project management methodology, while CMMI is a model for process improvement. In this paper, we conduct a study on PMBOK and CMMI frameworks to show that they can be converged and complementary. We expect this paper research will be useful for organizations to deploy a new approach of continuous process improvement based on pooling CMMI and PMBOK.

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

    Directory of Open Access Journals (Sweden)

    Susan Colby

    2016-12-01

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

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

    Science.gov (United States)

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

    2017-01-01

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

  1. Continuous improvement and TQM in health care: an emerging operational paradigm becomes a strategic imperative.

    Science.gov (United States)

    Swinehart, K; Green, R F

    1995-01-01

    Argues that US health care is in a state of crisis. Escalating costs account for 13 per cent of GNP, making health care the third largest industry in the USA, and spending is expected to increase. Claims health-care providers need to control rising costs, improve productivity and flexibility, adopt appropriate technologies, and maintain competitive levels of quality and value. States that TQM may provide an environment that will focus on quality of patient care and continuous quality improvement at all levels of the organization including the governing body, the administrative, managerial, and clinical areas. Any new national or state health-care plan will force providers to be more efficient while maintaining quality standards. Concludes that it will be strategically imperative that health-care providers ranging from family physicians to major medical centres and suppliers ranging from laboratories to pharmaceutical firms establish methods for making rapid continuous improvement and total quality management the cornerstone of the strategic planning process.

  2. Improvement of two-way continuous-variable quantum key distribution with virtual photon subtraction

    Science.gov (United States)

    Zhao, Yijia; Zhang, Yichen; Li, Zhengyu; Yu, Song; Guo, Hong

    2017-08-01

    We propose a method to improve the performance of two-way continuous-variable quantum key distribution protocol by virtual photon subtraction. The virtual photon subtraction implemented via non-Gaussian post-selection not only enhances the entanglement of two-mode squeezed vacuum state but also has advantages in simplifying physical operation and promoting efficiency. In two-way protocol, virtual photon subtraction could be applied on two sources independently. Numerical simulations show that the optimal performance of renovated two-way protocol is obtained with photon subtraction only used by Alice. The transmission distance and tolerable excess noise are improved by using the virtual photon subtraction with appropriate parameters. Moreover, the tolerable excess noise maintains a high value with the increase in distance so that the robustness of two-way continuous-variable quantum key distribution system is significantly improved, especially at long transmission distance.

  3. Structured nursing communication on interdisciplinary acute care teams improves perceptions of safety, efficiency, understanding of care plan and teamwork as well as job satisfaction

    Directory of Open Access Journals (Sweden)

    Gausvik C

    2015-01-01

    Full Text Available Christian Gausvik,1 Ashley Lautar,2 Lisa Miller,2 Harini Pallerla,3 Jeffrey Schlaudecker4,5 1University of Cincinnati College of Medicine, 2The Christ Hospital, Cincinnati, OH, USA; 3Department of Family and Community Medicine, 4Division of Geriatric Medicine, University of Cincinnati, Cincinnati, OH, USA; 5Geriatric Medicine Fellowship Program, University of Cincinnati/The Christ Hospital, Cincinnati, OH, USA Abstract: Efficient, accurate, and timely communication is required for quality health care and is strongly linked to health care staff job satisfaction. Developing ways to improve communication is key to increasing quality of care, and interdisciplinary care teams allow for improved communication among health care professionals. This study examines the patient- and family-centered use of structured interdisciplinary bedside rounds (SIBR on an acute care for the elderly (ACE unit in a 555-bed metropolitan community hospital. This mixed methods study surveyed 24 nurses, therapists, patient care assistants, and social workers to measure perceptions of teamwork, communication, understanding of the plan for the day, safety, efficiency, and job satisfaction. A similar survey was administered to a control group of 38 of the same staff categories on different units in the same hospital. The control group units utilized traditional physician-centric rounding. Significant differences were found in each category between the SIBR staff on the ACE unit and the control staff. Nurse job satisfaction is an important marker of retention and recruitment, and improved communication may be an important aspect of increasing this satisfaction. Furthermore, improved communication is key to maintaining a safe hospital environment with quality patient care. Interdisciplinary team rounds that take place at the bedside improve both nursing satisfaction and related communication markers of quality and safety, and may help to achieve higher nurse retention and safer

  4. Improving treatment satisfaction and other patient-reported outcomes in people with type 2 diabetes: the role of once-daily insulin glargine.

    Science.gov (United States)

    Bradley, C; Gilbride, C J B

    2008-07-01

    Insulin therapy becomes essential for many people with type 2 diabetes. After starting insulin, people with diabetes that is poorly controlled with oral agents typically report improved well-being and treatment satisfaction. However, healthcare professionals and people with type 2 diabetes are often reluctant to begin insulin treatment, citing concerns such as time/resources needed to educate patients, increased risks of hypoglycaemia and fear of injections, which lead them to focus on intensifying conventional oral therapy. Insulin glargine, which offers people with diabetes a once-a-day injection regimen with low risk of hypoglycaemia, is more likely to overcome such initial barriers than other more complex insulin regimens. Once-daily insulin glargine, in combination with modern glucose-dependent oral agents that do not need to be chased with food to prevent hypoglycaemia, does not require the fixed mealtimes and set amounts of carbohydrates necessary with twice-daily injection mixes and older sulphonylureas. We know that it is such dietary restrictions that cause the most damage to quality of life (QoL). To avoid damaging QoL unnecessarily and to ensure optimal satisfaction with treatment, it is important to evaluate the effects of treatment on QoL, treatment satisfaction and other patient-reported outcomes (PROs) using questionnaires validated for this purpose, such as the widely used Diabetes Treatment Satisfaction Questionnaire and the Audit of Diabetes-Dependent Quality of Life measure. A systematic electronic literature search identified reports of studies evaluating PROs associated with insulin glargine in comparison with other treatments. The studies show that insulin glargine is usually associated with greater improvements in treatment satisfaction and other PROs compared with intensifying oral therapy or alternative insulin regimens.

  5. Does an information leaflet about surgical site infection (SSI) improve recollection of information and satisfaction of patients? A randomized trial in patients scheduled for digestive surgery.

    Science.gov (United States)

    Merle, Véronique; Marini, Hélène; Rongère, Julie; Tavolacci, Marie-Pierre; Scotté, Michel; Czernichow, Pierre

    2011-06-01

    A previous study suggested that most surgical patients do not remember having received information about surgical site infection (SSI). In other fields, written information has been suggested to improve patient satisfaction and recollection of information. Our objective was to assess if providing patients with written information about SSI, in addition to oral information, could influence patient satisfaction, recall of information, and opinion regarding SSI. A total of 207 patients scheduled for digestive surgery at a university hospital were randomized between usual oral information about SSI, plus an information leaflet about SSI (group O/L), or usual oral information alone (group O). Patients were interviewed 5 weeks after surgery to assess their recall and satisfaction regarding information, opinion regarding SSI, and declared intention of seeking legal action in case of SSI. Surgeons and interviewer were blinded to patients' group allocation. Recruitment occurred between October 2005 and August 2006. Of the original 207 patients, 161 patients (O/L=87, O=74) underwent operation and were interviewed as scheduled. Satisfaction was higher in group O/L (67% vs. O: 43%; P=0.003). The recall of having received information (O/L: 39% vs. O: 31%; P=0.29), was similar between the two groups. Judging SSI as always preventable was more frequent in group O/L (28% vs. O: 9%; P=0.004) with a trend toward a more frequent intention of seeking legal action (O/L: 10% vs. O: 3%; P=0.055). The leaflet did not improve patient recall of information about SSI, but it was associated with an increased level of satisfaction. The association between the leaflet and judging SSI as always preventable was unexpected.

  6. Improving patient education by an in-service communication training for health care providers at a cancer ward: communication climate, patient satisfaction and the need of lasting implementation.

    Science.gov (United States)

    Visser, Adriaan; Wysmans, Michel

    2010-03-01

    To show the effects of an in-service communication training for health care providers at a cancer ward, to improve the quality and quantity of the patient education, and patient satisfaction with the care received. A 3-year in-service communication training was held at a cancer ward. Pre- and post-data were collected about the quality and quantity of the communication of nurses, physicians and other health care providers (HCPs) towards patients and colleagues (n=22) as well as the satisfaction of the patients with the quality of care (n=90). The communication training raised significantly the quality and quantity of the communication towards patients and with colleagues. Also patient satisfaction with the quality of care increased. However, the long-term implementation of the benefits was proved disappointing. In-service communication training is an important means for the long-term improvement of the quality of patient education at nursing departments in hospitals. Lasting implementation of the benefits however requires attention to organizational obstacles, budgetary conditions, leadership factors at the ward, and the application of an organizationally oriented theoretical framework. Improvement of patient education at nursing wards does not only require educational means, organizational facilities and professional training, but can be improved too by in-service communication training, which increases the quality of the patient-centered care. An organizational oriented change-strategy is needed to ensure the implementation produces lasting effects. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  7. Results from a clinical yoga program for veterans: yoga via telehealth provides comparable satisfaction and health improvements to in-person yoga.

    Science.gov (United States)

    Schulz-Heik, R Jay; Meyer, Hilary; Mahoney, Louise; Stanton, Michael V; Cho, Rachael H; Moore-Downing, Danae P; Avery, Timothy J; Lazzeroni, Laura C; Varni, Joanne M; Collery, Linda Martin; Bayley, Peter J

    2017-04-04

    Yoga is increasingly popular, though little data regarding its implementation in healthcare settings is available. Similarly, telehealth is being utilized more frequently to increase access to healthcare; however we know of no research on the acceptability or effectiveness of yoga delivered through telehealth. Therefore, we evaluated the feasibility, acceptability, and patient-reported effectiveness of a clinical yoga program at a Veterans Affairs Medical Center and assessed whether these outcomes differed between those participating in-person and those participating via telehealth. Veterans who attended a yoga class at the VA Palo Alto Health Care System were invited to complete an anonymous program evaluation survey. 64 Veterans completed the survey. Participants reported high satisfaction with the classes and the instructors. More than 80% of participants who endorsed a problem with pain, energy level, depression, or anxiety reported improvement in these symptoms. Those who participated via telehealth did not differ from those who participated in-person in any measure of satisfaction, overall improvement (p = .40), or improvement in any of 16 specific health problems. Delivering yoga to a wide range of patients within a healthcare setting appears to be feasible and acceptable, both when delivered in-person and via telehealth. Patients in this clinical yoga program reported high levels of satisfaction and improvement in multiple problem areas. This preliminary evidence for the effectiveness of a clinical yoga program complements prior evidence for the efficacy of yoga and supports the use of yoga in healthcare settings.

  8. An innovative nonpharmacological intervention combined with intravenous patient-controlled analgesia increased patient global improvement in pain and satisfaction after major surgery

    Science.gov (United States)

    Chuang, Chia-Chun; Lee, Chien-Ching; Wang, Li-Kai; Lin, Bor-Shyh; Wu, Wen-Ju; Ho, Chung-Han; Chen, Jen-Yin

    2017-01-01

    Purpose This study aimed to evaluate whether a nonpharmacological approach through implementation of a communication improvement program (named CICARE for Connect, Introduce, Communicate, Ask, Respond and Exit) into standard operating procedure (SOP) in acute pain service (APS) improved satisfaction in patients receiving intravenous patient-controlled analgesia (IV-PCA). Patients and methods This was a nonrandomized before–after study. Adult patients (aged between 20 and 80 years) who received IV-PCA after major surgery were included. Implementing CICARE into SOP was conducted in APS. Anonymous questionnaires were used to measure outcomes in this prospective two-part survey. The first part completed by APS nurses contained patients’ characteristics, morphine dosage, delivery/demand ratios, IV-PCA side effects and pain at rest measured with an 11-point numeric rating scale (NRS, 0–10). A score of NRS ≥4 was defined as inadequately treated pain. The ten-question second part was completed by patients voluntarily after IV-PCA was discontinued. Each question was assessed with a 5-point Likert scale (1: extremely poor; 5: excellent). Patients were separated into “before” and “after” CICARE groups. Primary outcomes were patient global impression of improvement in pain (PGI-Improvement) and patient satisfaction. Secondary outcomes included quality of communication skills, instrument proficiency and accessibility/availability of IV-PCA. Results The response rate was 55.3%, with 187 usable questionnaires. CICARE effectively improved patient global impression of improvement in pain, patient satisfaction, communication skills and accessibility/availability of IV-PCA. No significant differences were noted in instrument proficiency, morphine dosage, delivery/demand ratios, rates of inadequately treated pain at rest and side effects of IV-PCA between groups. Paradoxical findings were noted between the rates of inadequately treated pain/side effects and PGI-Improvement

  9. Integrating essential components of quality improvement into a new paradigm for continuing education.

    Science.gov (United States)

    Van Hoof, Thomas J; Meehan, Thomas P

    2011-01-01

    Continuing education (CE) that strives to improve patient care in a complex health care system requires a different paradigm than CE that seeks to improve clinician knowledge and competence in an educational setting. A new paradigm for CE is necessary in order to change clinician behavior and to improve patient outcomes in an increasingly patient-centered, quality-oriented care context. The authors assert that a new paradigm should focus attention on an expanded and prioritized list of educational outcomes, starting with those that directly affect patients. Other important components of the paradigm should provide educational leaders with guidance about what interventions work, reasons why interventions work, and what contextual factors may influence the impact of interventions. Once fully developed, a new paradigm will be helpful to educators in designing and implementing more effective CE, an essential component of quality improvement efforts, and in supporting policy trends and in promoting CE scholarship. The purpose of this article is to rekindle interest in CE theory and to suggest key components of a new paradigm. Copyright © 2010 The Alliance for Continuing Medical Education, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education.

  10. How Visual Management for Continuous Improvement Might Guide and Affect Hospital Staff: A Case Study.

    Science.gov (United States)

    Ulhassan, Waqar; von Thiele Schwarz, Ulrica; Westerlund, Hugo; Sandahl, Christer; Thor, Johan

    2015-01-01

    Visual management (VM) tools such as whiteboards, often employed in Lean thinking applications, are intended to be helpful in improving work processes in different industries including health care. It remains unclear, however, how VM is actually applied in health care Lean interventions and how it might influence the clinical staff. We therefore examined how Lean-inspired VM using whiteboards for continuous improvement efforts related to the hospital staff's work and collaboration. Within a case study design, we combined semistructured interviews, nonparticipant observations, and photography on 2 cardiology wards. The fate of VM differed between the 2 wards; in one, it was well received by the staff and enhanced continuous improvement efforts, whereas in the other ward, it was not perceived to fit in the work flow or to make enough sense in order to be sustained. Visual management may enable the staff and managers to allow communication across time and facilitate teamwork by enabling the inclusion of team members who are not present simultaneously; however, its adoption and value seem contingent on finding a good fit with the local context. A combination of continuous improvement and VM may be helpful in keeping the staff engaged in the change process in the long run.

  11. Evaluation of a school-based program designed to improve body image satisfaction, global self-esteem, and eating attitudes and behaviors: a replication study.

    Science.gov (United States)

    McVey, Gail L; Davis, Ron; Tweed, Stacey; Shaw, Brian F

    2004-07-01

    The purpose of the current study was to evaluate the effectiveness of a life-skills promotion program designed to improve body image satisfaction and global self-esteem, while reducing negative eating attitudes and behaviors and feelings of perfectionism, all of which have been identified as predisposing factors to disordered eating. A total of 258 girls with a mean age of 11.8 years (intervention group = 182 and control group = 76) completed questionnaires before, and 1 week after, the six-session school-based program, and again 6 and 12 months later. The intervention was successful in improving body image satisfaction and global self-esteem and in reducing dieting attitude scores at post intervention only. The gains were not maintained at the 12-month follow-up. The need to assess the influence of health promotion programs on predisposing risk factors, compared with problem-based outcome measures, is discussed. Copyright 2004 by Wiley Periodicals, Inc.

  12. 人性化服务提高患者满意度的探讨%The Study of Human Services for the Improvment of Patient Satisfaction

    Institute of Scientific and Technical Information of China (English)

    张灿萍

    2013-01-01

    Significantly improves the ef ect are summarized in this hospital since 2012, the implementation of humanistic nursing service satisfaction of patients, including several measures, analysis of ef ect evaluation and discuss, think of humanized nursing service is conducive to building a harmonious relationship between nurses and patients, improve patient satisfaction.%总结本院自2012年以来实施人性化护理服务后患者满意度有明显的提高效果,包括具体的几项措施,效果评价及讨论分析,认为人性化护理服务有利于构建和谐的护患关系,提高患者满意度。

  13. 76 FR 44351 - Proposed Renewal of Information Collection: 1090-0008, American Customer Satisfaction Index (ACSI...

    Science.gov (United States)

    2011-07-25

    ... Satisfaction Index (ACSI) E-Government Website Customer Satisfaction Survey AGENCY: National Business Center... is soliciting comments concerning the American Customer Satisfaction Index (ACSI) E-Government Website Customer Satisfaction Survey used by numerous Federal agencies to continuously assess and...

  14. Successful treatment of Depot Medroxyprogesterone acetate-related vaginal bleeding improves continuation rates in Adolescents

    Directory of Open Access Journals (Sweden)

    Kristin M. Rager

    2006-01-01

    Full Text Available High discontinuation rates for depot medroxyprogesterone acetate (DMPA in adolescents may contribute to the number of unintended pregnancies. Many cite vaginal bleeding as a reason for discontinuing DMPA use. In this study, we attempted to determine if treating DMPA-associated vaginal bleeding with monophasic oral contraceptive pills (OCP raised continuation rates. A total of 131 patients who reported vaginal bleeding while on DMPA were included in this study and 83 were treated with monophasic OCP. Of those who received OCP, 38.7% reported that vaginal bleeding stopped completely, 51.8% reported that vaginal bleeding stopped temporarily, and 6.0% reported no change. Overall, 94% of enrolled patients who received OCP as a treatment for DMPA-associated vaginal bleeding continued DMPA use. Our findings indicate that vaginal bleeding due to DMPA can be successfully treated, leading to improvement in continuation rates.

  15. An improved continuous flow analysis system for high-resolution field measurements on ice cores.

    Science.gov (United States)

    Kaufmann, Patrik R; Federer, Urs; Hutterli, Manuel A; Bigler, Matthias; Schüpbach, Simon; Ruth, Urs; Schmitt, Jochen; Stocker, Thomas F

    2008-11-01

    Continuous flow analysis (CFA) is a well-established method to obtain information about impurity contents in ice cores as indicators of past changes in the climate system. A section of an ice core is continuously melted on a melter head supplying a sample water flow which is analyzed online. This provides high depth and time resolution of the ice core records and very efficient sample decontamination as only the inner part of the ice sample is analyzed. Here we present an improved CFA system which has been totally redesigned in view of a significantly enhanced overall efficiency and flexibility, signal quality, compactness, and ease of use. These are critical requirements especially for operations of CFA during field campaigns, e.g., in Antarctica or Greenland. Furthermore, a novel deviceto measure the total air content in the ice was developed. Subsequently, the air bubbles are now extracted continuously from the sample water flow for subsequent gas measurements.

  16. Continuous improvement, burnout and job engagement: a study in a Dutch nursing department.

    Science.gov (United States)

    Benders, Jos; Bleijerveld, Hans; Schouteten, Roel

    2016-05-27

    Continuous improvement (CI) programs are potentially powerful means to improve the quality of care. The more positive nurses perceive these programs' effects, the better they may be expected to cooperate. Crucial to this perception is how nurses' quality of working life is affected. We studied this in a nursing department, using the job demands-resources model. We found that two job demands improved, and none of the job resources. Job engagement did not change significantly, while the burnout risk decreased slightly. Overall, the nurses felt the impact to be small yet the changes were in a positive direction. CI can thus be used to improve nurses' working lives and, by restructuring the work processes, the quality of care. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  17. Development of a team-based framework for conducting self-assessment of Continuous Improvement

    DEFF Research Database (Denmark)

    Jørgensen, Frances; Gertsen, Frank; Boer, Harry

    2004-01-01

    The study presented in this article is based on two basic premises. First, successful continuous improvement (CI) is dependent on shop floor level involvement and participation in improvement efforts. Second, the term "self-assessment" clearly implies that those whose performance is being measure......, the study shows how these principles relate to the teams' own work processes, and a deeper understanding of their organization's strategy and objectives......., and who are involved in conducting the assessment process. Excerpts from longitudinal case studies in a single Danish manufacturing organization demonstrate how teams involved in the process of conducting self-assessment of CI developed a better understanding of the basic principles of CI. Furthermore...

  18. Continuous Plasma Treatment of Ultra-High-Molecular-Weight Polyethylene (UHMWPE) Fibres for Adhesion Improvement

    DEFF Research Database (Denmark)

    Teodoru, Steluta; Kusano, Yukihiro; Rozlosnik, Noemi

    2009-01-01

    A dielectric barrier discharge in Ar, He, He/O2, N2 or O2 at atmospheric pressure was used for the continuous plasma treatment of UHMWPE fibres. The influence of the input power of the discharge and the gas flow rate on surface modification is studied with the aim of adhesion improvement. Surface...... characterization using X-ray photoelectron spectroscopy and atomic force microscopy shows a significant increase in polar functional groups and roughness at the surfaces after plasma treatment, indicating that adhesive properties can be improved....

  19. Organisational learning and continuous improvement of health and safety in certified manufacturers

    DEFF Research Database (Denmark)

    Granerud, Lise; Rocha, Robson Sø

    2011-01-01

    and raise goals within health and safety on a continuous basis. The article examines how certified occupational and health management systems influence this process to evaluate how far they hinder or support learning. It presents a model with which it is possible to identify and analyse improvement...... that certified health and safety management does not obstruct learning, and can support advanced learning. Improvement practices with regard to health and safety are mainly dependent upon the firm’s overall organisational processes and do not automatically arise from the standard alone....

  20. Development of a team-based framework for conducting self-assessment of Continuous Improvement

    DEFF Research Database (Denmark)

    Jørgensen, Frances; Gertsen, Frank; Boer, Harry

    2004-01-01

    The study presented in this article is based on two basic premises. First, successful continuous improvement (CI) is dependent on shop floor level involvement and participation in improvement efforts. Second, the term "self-assessment" clearly implies that those whose performance is being measure......, the study shows how these principles relate to the teams' own work processes, and a deeper understanding of their organization's strategy and objectives......., and who are involved in conducting the assessment process. Excerpts from longitudinal case studies in a single Danish manufacturing organization demonstrate how teams involved in the process of conducting self-assessment of CI developed a better understanding of the basic principles of CI. Furthermore...

  1. Iso9000 Based Advanced Quality Approach for Continuous Improvement of Manufacturing Processes

    OpenAIRE

    Deeb, Salah; Iung, Benoît

    2006-01-01

    International audience; The continuous improvement in TQM is considered as the core value by which organisation could maintain a competitive edge. Several techniques and tools are known to support this core value but most of the time these techniques are informal and without modelling the interdependence between the core value and tools. Thus, technique formalisation is one of TQM challenges for increasing efficiency of quality process implementation. In that way, the paper proposes and exper...

  2. Measuring of customer satisfaction on example of Delta DMD

    Directory of Open Access Journals (Sweden)

    Kostić Ela

    2010-01-01

    Full Text Available Companies which do business in today's competitive environment, has to continuously work on improvement of theirs products and services, based on customers' needs. Most widely used method for examine customer expectations and measuring satisfaction is researches, which goal is to evaluate company performance from customer angle and to give management tool for strategic planning. Surveys results have to be used as a base for defining improvements areas. In this article is shown example of company Delta DMD which do customer satisfaction researches twice a year, since 2007, and results of latest researches with guidelines for further improvements in company. .

  3. Adhesion improvement of fibres by continuous plasma treatment at atmospheric pressure

    Energy Technology Data Exchange (ETDEWEB)

    Kusano, Y.; Andersen, Tom L.; Soerensen, B.F.; Toftegaard, H.L.; Teodoru, S. [Technical Univ. of Denmark. DTU Wind Energy, Risoe Campus, Roskilde (Denmark); Hansen, Charles M. [Hoersholm (Denmark)

    2013-09-01

    Carbon fibres and ultra-high-molecular-weight polyethylene (UHMWPE) fibres were continuously treated by a dielectric barrier discharge plasma at atmospheric pressure for adhesion improvement with epoxy resins. The plasma treatment improved wettability, increased the oxygen containing polar functional groups at the surface, and subsequently improved adhesion to the epoxy and fracture resistance of epoxy composites. Hansen solubility parameters (HSP), quantitatively describing physical interactions among molecules, were measured for the UHMWPE fibre surfaces. The result identifies two distinct types of surfaces in both the plasma treated and the untreated fibres. One type is typical of polyethylene polymers while the other is characteristic of the oxygenated surface at much higher values of HSP. (Author)

  4. Kaizen - continuous improvement of high voltage products; Kaizen - kontinuierliche Verbesserung bei Hochspannungsprodukten

    Energy Technology Data Exchange (ETDEWEB)

    Schwarz, M. [ABB Calor Emag Schaltanlagen AG, Hanau-Grossauheim (Germany); Goessmann, T. [ABB Calor Emag Schaltanlagen AG, Mannheim (Germany)

    1999-07-12

    In the actual global competition only the company can survive who cares for the continuous improvement of all business activities. The ABB Calor Emag Schaltanlagen AG at his production site in Hanau-Grossauheim has installed a specific improvement programm called KVP what is based on the ideas of Kaizen. Aim is the improvement of processes, mainly in production, concerning quality, dates, costs and environment by activating all colleagues. (orig.) [Deutsch] Im heutigen globalen Wettbewerb kann sich nur der behaupten, der sich kontinuierlich in allen Unternehmensbereichen weiterentwickelt. Die ABB Calor Emag Schaltanlagen AG hat in ihrem Werk Hanau-Grossauheim nach den Ideen des Kaizen ein werkspezifisches Programm zur kontinuierlichen Verbesserung der Prozesse in der Fertigung eingefuehrt. Ziel ist die stetige Verbesserung von Fertigungsparametern, wie Qualitaet, Termine, Kosten und Umwelt unter Einbeziehung aller Mitarbeiter. (orig.)

  5. Studv on the Strategies to Improve Nurses' Job Satisfaction%提高护士工作满意度的策略研究

    Institute of Scientific and Technical Information of China (English)

    魏雪梅; 李雪平; 何剑; 李铁; 吕洪雅

    2011-01-01

    影响护士工作满意度的四大因素是护士的个体差异、工作本身、工作环境、医院的政策和制度,因此,提高护士工作满意度的策略是加强护士自身因素的完善、完善工作本身、改善工作环境、提高医院的管理水平.%The four influential variables in nurses' job satisfaction are individual differences, job itself, working environment, and hosital policy and system. Therefore, the strategies promoting nurses' job satisfaction are to advance nurses themselves, to enhance job itself, to improve the working environment, and to elevate hospital management level.

  6. Perceived Values,Satisfaction and Continuance:An Empirical Examination of Users of 3G Services%感知价值、满意度与继续使用意向——基于3G用户的实证研究

    Institute of Scientific and Technical Information of China (English)

    吴晓波; 周浩军; 胡敏; 李俊

    2012-01-01

    image are not mediated by satisfaction but direcdy affect continuance intention.The unique explanatory contributions of perceived usefulness, perceived ease of use,perceived image and perceived cost to continuance intention are 1.5%,1.3%,2.1%and 2.8%respectively. These explanatory contributions are small,compared with the unique explanatory contribution of satisfaction which explains 13.3%of the variance of continuance intention.Therefore,satisfaction has the largest unique explanatory contribution to continuance intention.Although the unique explanatory contributions of four dimensions of perceived values are not very high,the whole explanatory contribution of them is 34.9%,which is larger than 13.3%. The results from this research has important practical implications.Firstly it examined the relative contributions of each determinant of 3G users' continuance intention,which laid a foundation for telecommunication operators to enhance users' continuance intention. Secondly,the results indicate that satisfaction is the strongest predictor of user' s continuance intention,so improving satisfaction is an important way to enhance users' continuance intention.Thirdly,the perceived cost has the greatest effect on continuance intention among four dimensions of perceived values,which means that the fees for using 3G services are perceived high by 3G users in China. The pricing strategies of telecommunication operators will have a fundamental impact on the development pace of the 3G market and the allocation of market shares among telecommunication operators.

  7. The association between event learning and continuous quality improvement programs and culture of patient safety.

    Science.gov (United States)

    Mazur, Lukasz; Chera, Bhishamjit; Mosaly, Prithima; Taylor, Kinley; Tracton, Gregg; Johnson, Kendra; Comitz, Elizabeth; Adams, Robert; Pooya, Pegah; Ivy, Julie; Rockwell, John; Marks, Lawrence B

    2015-01-01

    To present our approach and results from our quality and safety program and to report their possible impact on our culture of patient safety. We created an event learning system (termed a "good catch" program) and encouraged staff to report any quality or safety concerns in real time. Events were analyzed to assess the utility of safety barriers. A formal continuous quality improvement program was created to address these reported events and make improvements. Data on perceptions of the culture of patient safety were collected using the Agency for Health Care Research and Quality survey administered before, during, and after the initiatives. Of 560 good catches reported, 367 could be ascribed to a specific step on our process map. The calculated utility of safety barriers was highest for those embedded into the pretreatment quality assurance checks performed by physicists and dosimetrists (utility score 0.53; 93 of 174) and routine checks done by therapists on the initial day of therapy. Therapists and physicists reported the highest number of good catches (24% each). Sixty-four percent of events were caused by performance issues (eg, not following standardized processes, including suboptimal communications). Of 31 initiated formal improvement events, 26 were successfully implemented and sustained, 4 were discontinued, and 1 was not implemented. Most of the continuous quality improvement program was conducted by nurses (14) and therapists (7). Percentages of positive responses in the patient safety culture survey appear to have increased on all dimensions (p quality improvement programs can be successfully implemented and that there are contemporaneous improvements in the culture of safety. Copyright © 2015 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

  8. CIOs' Transformational Leadership Behaviors in Community Colleges: A Comparison-Based Approach to Improving Job Satisfaction of Information Technology Workers

    Science.gov (United States)

    Abouelenein, Mahmoud S.

    2012-01-01

    The purpose of this quantitative, descriptive research study was to determine, through statistical analysis, any correlation between the perceived transformational leadership traits of CIOs at two-year community colleges in Kansas and measures of the job satisfaction among IT workers at those community colleges. The objectives of this research…

  9. The Links among Perceived Adherence to the System of Care Philosophy, Consumer Satisfaction, and Improvements in Child Functioning

    Science.gov (United States)

    Graves, Kelly N.

    2005-01-01

    The present study investigated the associations among perceived adherence to the system of care philosophy, changes in internalizing and externalizing behaviors, and consumer satisfaction with services. Participants included 98 families, interviewed at two time points across a one-year period. Hierarchical multiple regressions indicated that the…

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

    Science.gov (United States)

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

    2015-01-01

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

  11. The Effect of Utilizing Organizational Culture Improvement Model of Patient Education on Coronary Artery Bypass Graft Patients’ Anxiety and Satisfaction: Theory Testing

    Science.gov (United States)

    Farahani, Mansoureh Ashghali; Ghaffari, Fatemeh; Norouzinezhad, Faezeh; Orak, Roohangiz Jamshidi

    2016-01-01

    Introduction Due to the increasing prevalence of arteriosclerosis and the mortality caused by this disease, Coronary Artery Bypass Graft (CABG) has become one of the most common surgical procedures. Utilization of patient education is approved as an effective solution for increasing patient survival and outcomes of treatment. However, failure to consider different aspects of patient education has turned this goal into an unattainable one. The objective of this research was to determine the effect of utilizing the organizational culture improvement model of patient education on CABG patients’ anxiety and satisfaction. Methods The present study is a randomized controlled trial. This study was conducted on eighty CABG patients. The patients were selected from the CCU and Post-CCU wards of a hospital affiliated with Iran University of Medical Sciences in Tehran, Iran, during 2015. Eshpel Burger’s Anxiety Inventory and Patients’ Satisfaction Questionnaire were used to collect the required information. Levels of anxiety and satisfaction of patients before intervention and at the time of release were measured. The intervention took place after preparing a programmed package based on the organizational culture improvement model for the following dimensions: effective communication, participatory decision-making, goal setting, planning, implementation and recording, supervision and control, and improvement of motivation. After recording the data, it was analyzed in the chi-square test, t-independent and Mann-Whitney U tests. The significance level of tests was assumed to be 0.05. SPSS version 18 was also utilized for data analysis. Results Research results revealed that variations in the mean scores of situational and personality anxiety of the control and experiment group were descending following the intervention, but the decrease was higher in the experiment group (p≤0.0001). In addition, the variations of the mean scores of patients’ satisfaction with

  12. Exploring the relationship between treatment satisfaction, perceived improvements in functioning and well-being and gambling harm reduction among clients of pathological gambling treatment programs.

    Science.gov (United States)

    Monnat, Shannon M; Bernhard, Bo; Abarbanel, Brett L L; St John, Sarah; Kalina, Ashlee

    2014-08-01

    The objective of this study was to evaluate the relationship between treatment service quality, perceived improvement in social, functional, and material well-being and reduction in gambling behaviors among clients of Nevada state-funded pathological gambling treatment programs. Utilizing survey data from 361 clients from 2009 to 2010, analyses revealed that client satisfaction with treatment services is positively associated with perceived improvements in social, functional, and material well-being, abstinence from gambling, reduction in gambling thoughts and reduction in problems associated with gambling, even after controlling for various respondent characteristics. These findings can be useful to treatment program staff in managing program development and allocating resources.

  13. Improvement production of bacterial cellulose by semi-continuous process in molasses medium.

    Science.gov (United States)

    Cakar, Fatih; Ozer, Işılay; Aytekin, A Özhan; Sahin, Fikrettin

    2014-06-15

    Bacterial cellulose (BC) has unique properties such as structural, functional, physical and chemical. The mass production of BC for industrial application has recently become attractive to produce more economical and high productive cellulose. In this study, to improve the productivity of bacterial cellulose (BC), BC production by Gluconacetobacter xylinus FC01 was investigated in molasses medium with static semi-continuous operation mode. Cell dry weight, polysaccharide, sugar and cellulose concentrations were monitored and cellulose was characterized by Fourier transform infrared spectroscopy (FT-IR) and scanning electron microscopy (SEM). The highest cellulose yield (1.637 g/L) was obtained in SCP50-7d, which molasses of 1/2 ratio for 7 days by static semi-continuous operation mode. The results show that BC can be highly produced by G. xylinus in molasses with static semi-continuous process than batch process. We claimed that low-cost medium with semi-continuous operation mode in static culture is a good candidate for industrial scale BC productions.

  14. Continuous quality improvement: a survey of American and Canadian healthcare executives.

    Science.gov (United States)

    Chan, Y C; Ho, S J

    1997-01-01

    The continuous quality improvement (CQI) movement, while experiencing great popularity years ago, has been declining in interest across other industries. This article studied American and Canadian hospital executives who have embraced the concept of CQI and will continue to be committed to CQI efforts in the future. Executives of CQI hospitals strongly believe that CQI is not a fad and is essential to their organizations' survival. The majority of the hospital executives in the sample have a good understanding of CQI. The drive to provide quality service to both internal and external customers is the primary motivation for being involved with CQI. Some unsuccessful CQI efforts can be attributed to a lack of CQI skills, poor planning, and insufficient staffing. Close to 90 percent of the respondents expected their involvement with CQI to increase significantly in the future. This result implies that CQI is still being considered and will maintain its role as an effective management tool in the healthcare sector.

  15. A System for Continual Quality Improvement of Normal Tissue Delineation for Radiation Therapy Treatment Planning

    Energy Technology Data Exchange (ETDEWEB)

    Breunig, Jennifer; Hernandez, Sophy; Lin, Jeffrey; Alsager, Stacy; Dumstorf, Christine; Price, Jennifer; Steber, Jennifer; Garza, Richard; Nagda, Suneel; Melian, Edward; Emami, Bahman [Department of Radiation Oncology, Loyola University Medical Center, Maywood, Illinois (United States); Roeske, John C., E-mail: jroeske@lumc.edu [Department of Radiation Oncology, Loyola University Medical Center, Maywood, Illinois (United States)

    2012-08-01

    Purpose: To implement the 'plan-do-check-act' (PDCA) cycle for the continual quality improvement of normal tissue contours used for radiation therapy treatment planning. Methods and Materials: The CT scans of patients treated for tumors of the brain, head and neck, thorax, pancreas and prostate were selected for this study. For each scan, a radiation oncologist and a diagnostic radiologist, outlined the normal tissues ('gold' contours) using Radiation Therapy Oncology Group (RTOG) guidelines. A total of 30 organs were delineated. Independently, 5 board-certified dosimetrists and 1 trainee then outlined the same organs. Metrics used to compare the agreement between the dosimetrists' contours and the gold contours included the Dice Similarity Coefficient (DSC), and a penalty function using distance to agreement. Based on these scores, dosimetrists were re-trained on those organs in which they did not receive a passing score, and they were subsequently re-tested. Results: Passing scores were achieved on 19 of 30 organs evaluated. These scores were correlated to organ volume. For organ volumes <8 cc, the average DSC was 0.61 vs organ volumes {>=}8 cc, for which the average DSC was 0.91 (P=.005). Normal tissues that had the lowest scores included the lenses, optic nerves, chiasm, cochlea, and esophagus. Of the 11 organs that were considered for re-testing, 10 showed improvement in the average score, and statistically significant improvement was noted in more than half of these organs after education and re-assessment. Conclusions: The results of this study indicate the feasibility of applying the PDCA cycle to assess competence in the delineation of individual organs, and to identify areas for improvement. With testing, guidance, and re-evaluation, contouring consistency can be obtained across multiple dosimetrists. Our expectation is that continual quality improvement using the PDCA approach will ensure more accurate treatments and dose

  16. A quality control method enhancement concept-Continual improvement of regulatory approved QC methods.

    Science.gov (United States)

    Åsberg, Dennis; Nilsson, Mikael; Olsson, Susanne; Samuelsson, Jörgen; Svensson, Olof; Klick, Silke; Ennis, Julie; Butterworth, Paul; Watt, Denise; Iliadou, Stavroula; Karlsson, Angelica; Walker, Joanne T; Arnot, Kate; Ealer, Norb; Hernqvist, Kerstin; Svensson, Karin; Grinell, Ali; Quist, Per-Ola; Karlsson, Anders; Fornstedt, Torgny

    2016-09-10

    Quality Control methods (QC-methods) play an important role in the overall control strategy for drug manufacturing. However, efficient life-cycle management and continual improvement are hindered due to a variety of post-approval variation legislations across territories and a lack of harmonization of the requirements. As a result, many QC-methods fall behind the technical development. Developing the QC-method in accordance with the Quality by Design guidelines gives the possibility to do continual improvements inside the original Method Operable Design Region (MODR). However, often it is necessary to do changes outside the MODR, e.g. to incorporate new technology that was not available at the time the original method was development. Here, we present a method enhancement concept which allows minor adjustments, within the same measuring principle, outside the original MODR without interaction with regulatory agencies. The feasibility of the concept is illustrated by a case study of a QC-method based on HPLC, assumed to be developed before the introduction of UHPLC, where the switch from HPLC to UHPLC is necessary as a continual improvement strategy. The concept relies on the assumption that the System Suitability Test (SST) and failure modes are relevant for other conditions outside the MODR as well when the same measuring principle is used. It follows that it should be possible to move outside the MODR as long as the SST has passed. All minor modifications of the original, approved QC-method must be re-validated according to a template given in the original submission and a statistical equivalence should be shown between the original and modified QC-methods. To summarize, revalidation is handled within the pharmaceutical quality control system according to internal change control procedures, but without interaction with regulating agencies.

  17. 提高院前急救满意度的若干建议%Some suggestions to improve the satisfaction of pre hospital first aid

    Institute of Scientific and Technical Information of China (English)

    杜敏

    2013-01-01

    Objective To analyze the satisfaction of pre hospital first aid and to put forward some suggestions to improve the satisfaction . Methods Analyze based on the random sampling survey by using the 4884 patients’ data from information management database. Results In the questionnaire, the item of “vehicle stability” got the highest score of 7.98, whereas the item of “Charge rationality” got the lowest score of 6.81. The satisfaction scores were 7.76、7.51、7.52 and 7.50 from 2008 to 2011. Final average satisfaction score was 7.57. Conclusion Emergency Center should improve the satisfaction of pre hospital first aid from improving service fee transparency, shortening pre hospital average reaction time, regularly carrying out first aid training, and strengthening internal management etc.%目的:分析院前急救满意度情况并提出提高满意度的若干建议。方法通过随机抽样的调查方式,从120信息管理系统抽取4884份患者(家属)数据进行“满意度”调查,分析院前急救满意度情况。结果满意度调查结果为:车辆平稳性的满意度最高为7.98分,收费合理性的满意度最低为6.81分。2008年至2011年总体满意度分别为7.76分、7.51分、7.52分和7.50分,最终平均满意度为7.57分。结论建议从提高服务收费的透明度、缩短院前急救平均反应时间、定期开展急救能力培训、加强内部绩效管理等几方面来提高院前急救满意度。

  18. On improving the convergence rate of linear continuous-time systems subject to asymmetrically constrained control

    Directory of Open Access Journals (Sweden)

    A. Baddou

    2006-01-01

    Full Text Available This paper solves the problem of controlling linear continuous-time systems subject to control signals constrained in magnitude (maybe asymmetrically. A controller design methodology is proposed, based on using an asymmetric Lyapunov function, that avoids the discontinuities in the control vector components resulting from the application of a piecewise linear control law previously proposed. The proposed method gives improved speed of convergence without discontinuities of the control vector components, respecting always the imposed asymmetric constraints. An example illustrates the approach.

  19. Improving the maximum transmission distance of continuous-variable quantum key distribution using a noiseless amplifier

    Energy Technology Data Exchange (ETDEWEB)

    Blandino, Rémi; Etesse, Jean; Grangier, Philippe [Laboratoire Charles Fabry, Institut d' Optique, CNRS, Université Paris-Sud, 2 avenue Augustin Fresnel, 91127 Palaiseau Cedex (France); Leverrier, Anthony [Institute for Theoretical Physics, ETH Zurich, 8093 Zurich, Switzerland and INRIA Paris-Rocquencourt, 78153 Le Chesnay Cedex (France); Barbieri, Marco [Laboratoire Charles Fabry, Institut d' Optique, CNRS, Université Paris-Sud, 2 avenue Augustin Fresnel, 91127 Palaiseau Cedex, France and Clarendon Laboratory, Department of Physics, University of Oxford, OX1 3PU (United Kingdom); Tualle-Brouri, Rosa [Laboratoire Charles Fabry, Institut d' Optique, CNRS, Université Paris-Sud, 2 avenue Augustin Fresnel, 91127 Palaiseau Cedex, France and Institut Universitaire de France, 103 boulevard St. Michel, 75005, Paris (France)

    2014-12-04

    We show that the maximum transmission distance of continuous-variable quantum key distribution in presence of a Gaussian noisy lossy channel can be arbitrarily increased using a heralded noiseless linear amplifier. We explicitly consider a protocol using amplitude and phase modulated coherent states with reverse reconciliation. Assuming that the secret key rate drops to zero for a line transmittance T{sub lim}, we find that a noiseless amplifier with amplitude gain g can improve this value to T{sub lim}/g{sup 2}, corresponding to an increase in distance proportional to log g. We also show that the tolerance against noise is increased.

  20. Method of Improving the Navigation Accuracy of SINS by Continuous Rotation

    Institute of Scientific and Technical Information of China (English)

    YANG Yong; MIAO Ling-juan; SHEN Jun

    2005-01-01

    A method of improving the navigation accuracy of strapdown inertial navigation system (SINS) is studied. The particular technique discussed involves the continuous rotation of gyros and accelerometers cluster about the vertical axis of the vehicle. Then the errors of these sensors will have periodic variation corresponding to components along the body frame. Under this condition, the modulated sensor errors produce reduced system errors. Theoretical analysis based on a new coordinate system defined as sensing frame and test results are presented, and they indicate the method attenuates the navigation errors brought by the gyros' random constant drift and the accelerometer's bias and their white noise compared to the conventional method.

  1. Analyzing Environmental Continuous Improvement for Sustainable Supply Chain Management: Focusing on Its Performance and Information Disclosure

    Directory of Open Access Journals (Sweden)

    Koichi Murata

    2016-12-01

    Full Text Available This study analyzes the relationship between the implementation and information disclosure of environmental continuous improvement (e-CI in sustainable supply chain management. The analyzed data relates to e-CI delivered from 19 manufacturing industry types in Japan. A degenerated Charnes-Cooper-Rhodes model, a proposed model for data envelopment analysis, is also used for the analysis. The obtained result is a classification of types of manufacturing industries from the perspective of their capabilities in both e-CI implementation and information disclosure to systematically discover emphatic indicators of these two activities in each manufacturing industry type.

  2. IMPROVED ERROR ESTIMATES FOR MIXED FINITE ELEMENT FOR NONLINEAR HYPERBOLIC EQUATIONS: THE CONTINUOUS-TIME CASE

    Institute of Scientific and Technical Information of China (English)

    Yan-ping Chen; Yun-qing Huang

    2001-01-01

    Improved L2-error estimates are computed for mixed finite element methods for second order nonlinear hyperbolic equations. Results are given for the continuous-time case. The convergence of the values for both the scalar function and the flux is demonstrated. The technique used here covers the lowest-order Raviart-Thomas spaces, as well as the higherorder spaces. A second paper will present the analysis of a fully discrete scheme (Numer.Math. J. Chinese Univ. vol.9, no.2, 2000, 181-192).

  3. Improving the fidelity of continuous-variable quantum teleportation by tuning displacement gain

    Institute of Scientific and Technical Information of China (English)

    Jinming Liu(刘金明); Jian Li(李剑); Guangcan Guo(郭光灿)

    2003-01-01

    The fidelity of teleportation of continuous quantum variables can be improved by tuning the local displace-ment gain. We investigate the optimization of the fidelity for the teleportation of Schrodinger cat states,and of coherent states. It is found that the gain corresponding to the maximum fidelity is not equal to onefor the two input states in the case of the small squeezing degree of the entanglement resource, while unitydisplacement gain is the best choice for teleporting arbitrary quantum states in the case of large squeezing.

  4. Sexual Satisfaction and its Relation to Marital Happiness in Iranians

    Directory of Open Access Journals (Sweden)

    A Rahmani

    2009-12-01

    Full Text Available "nBackground: Marital satisfaction is affected by many factors. Satisfaction with one's sexual life tends to be a pivotal factor in marital satisfaction. In Iran, Socio-cultural and political limitations are obstacles for sexuality-related studies, therefore, in­sufficient information is available in the area. Unique in its own, in this paper we report how sexual relationships relate to mari­tal satisfaction among Iranians."nMethods: This descriptive-correlation study was conducted in 2007 in Tehran, continuous sampling was used to recruit 292 mar­ried men, and women aged 19-58 yr from selected hospitals in Tehran while visiting their hospitalized relatives. Some­times the participants were couple too. Three questionnaires were used for data collection. The data were analyzed using de­scriptive and inferential statistics (x2، Fisher and Anova with SPSS."nResults: Marital satisfaction significantly relates to sexual satisfaction (P= 0/00. There was also a significant relation be­tween sexual satisfaction and the following variables: age difference of couples (P= 0.04, length of marital life (P= 0.05, and a drug abused participant (P= 0.007. Of these variables, only the age difference of couples significantly relates to mari­tal satisfaction (0.00."nConclusion: Findings suggest that sexual satisfaction plays a seminal role in marital satisfaction of Iranians. Therefore, we need to develop culturally appropriate practical strategies to improve Iranian couples' awareness in sexuality issues as well as training them in communication skills through their sexual encounters.

  5. Patient satisfaction constructs.

    Science.gov (United States)

    Rahman, Muhammad Sabbir; Osmangani, Aahad M

    2015-01-01

    The purpose of this paper is to examine the five-factor structure of patients' satisfaction constructs toward private healthcare service providers. This research is a cross-sectional study. A questionnaire-based survey was conducted with previous and current Bangladeshi patients. Exploratory factor analysis was employed to extract the underlying constructs. Five underlying dimensions that play a significant role in structuring the satisfaction perceived by Bangladeshi private healthcare patients are identified in this study. Practical implications - The main contribution of this study is identifying the dimensions of satisfaction perceived by Bangladeshi patients regarding private healthcare service providers. Healthcare managers adopt the five identified underlying construct items in their business practices to improve their respective healthcare efficiency while ensuring overall customer satisfaction.

  6. An innovative nonpharmacological intervention combined with intravenous patient-controlled analgesia increased patient global improvement in pain and satisfaction after major surgery

    Directory of Open Access Journals (Sweden)

    Chuang CC

    2017-04-01

    Full Text Available Chia-Chun Chuang,1 Chien-Ching Lee,1,2 Li-Kai Wang,1 Bor-Shyh Lin,2 Wen-Ju Wu,1 Chung-Han Ho,3 Jen-Yin Chen1,4 1Department of Anesthesiology, Chi Mei Medical Center, 2Department of Imaging and Biomedical Photonics, National Chiao Tung University, 3Department of Medical Research, Chi Mei Medical Center, 4Department of the Senior Citizen Service Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan, Republic of China Purpose: This study aimed to evaluate whether a nonpharmacological approach through implementation of a communication improvement program (named CICARE for Connect, Introduce, Communicate, Ask, Respond and Exit into standard operating procedure (SOP in acute pain service (APS improved satisfaction in patients receiving intravenous patient-controlled analgesia (IV-PCA.Patients and methods: This was a nonrandomized before–after study. Adult patients (aged between 20 and 80 years who received IV-PCA after major surgery were included. Implementing CICARE into SOP was conducted in APS. Anonymous questionnaires were used to measure outcomes in this prospective two-part survey. The first part completed by APS nurses contained patients’ characteristics, morphine dosage, delivery/demand ratios, IV-PCA side effects and pain at rest measured with an 11-point numeric rating scale (NRS, 0–10. A score of NRS ≥4 was defined as inadequately treated pain. The ten-question second part was completed by patients voluntarily after IV-PCA was discontinued. Each question was assessed with a 5-point Likert scale (1: extremely poor; 5: excellent. Patients were separated into “before” and “after” CICARE groups. Primary outcomes were patient global impression of improvement in pain (PGI-Improvement and patient satisfaction. Secondary outcomes included quality of communication skills, instrument proficiency and accessibility/availability of IV-PCA.Results: The response rate was 55.3%, with 187 usable questionnaires. CICARE

  7. Pilot study for evidence-based nursing management: improving the levels of job satisfaction, organizational commitment, and intent to leave among nurses in Turkey.

    Science.gov (United States)

    Arslan Yurumezoglu, Havva; Kocaman, Gulseren

    2012-06-01

    Because of the nursing shortage problem, an important goal for nurse managers is preventing nurses from leaving the organization. This study analyzed the effect of evidence-based nursing management practices on nurses' levels of job satisfaction, organizational commitment, and intent to leave using the Promoting Action Research Implementation in Health Service framework as a guide. This study employed a single-group, quasi-experimental, pretest-post-test design with repeated measures. Data were collected using the Minnesota Job Satisfaction Questionnaire and the Organizational Commitment Scale. The study was conducted at a 127-bed private, accredited hospital. The sample was composed of 58 nurses who participated in all three measurements. Data analysis was conducted using repeated-measures anova and the Cochrane Q-test. An improvement was observed in the nurses' intrinsic, extrinsic, and total satisfaction levels, and in the degree of normative commitment. Nurse managers stated that they benefited from this study. In order to find effective and long-lasting solutions to the nursing shortage problem, evidence-based recommendations should be used in nursing management.

  8. Organisational learning and continuous improvement of health and safety in certified manufacturers

    DEFF Research Database (Denmark)

    Granerud, Lise; Rocha, Robson Sø

    2011-01-01

    Certified management systems have increasingly been applied by firms in recent decades and now cover the management of health and safety, principally through the OHSAS 18001 standard. In order to become certified, firms must not only observe the relevant legislation, but also improve performance...... processes. The model is applied to five cases from a qualitative study of Danish manufacturers with certified health and safety management systems. The cases illustrate the wide variation in health and safety management among certified firms. Certification is found to support lower levels of continuous...... that certified health and safety management does not obstruct learning, and can support advanced learning. Improvement practices with regard to health and safety are mainly dependent upon the firm’s overall organisational processes and do not automatically arise from the standard alone....

  9. Modular Approach for Continuous Cell-Level Balancing to Improve Performance of Large Battery Packs: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Muneed ur Rehman, M.; Evzelman, M.; Hathaway, K.; Zane, R.; Plett, G. L.; Smith, K.; Wood, E.; Maksimovic, D.

    2014-10-01

    Energy storage systems require battery cell balancing circuits to avoid divergence of cell state of charge (SOC). A modular approach based on distributed continuous cell-level control is presented that extends the balancing function to higher level pack performance objectives such as improving power capability and increasing pack lifetime. This is achieved by adding DC-DC converters in parallel with cells and using state estimation and control to autonomously bias individual cell SOC and SOC range, forcing healthier cells to be cycled deeper than weaker cells. The result is a pack with improved degradation characteristics and extended lifetime. The modular architecture and control concepts are developed and hardware results are demonstrated for a 91.2-Wh battery pack consisting of four series Li-ion battery cells and four dual active bridge (DAB) bypass DC-DC converters.

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

    Science.gov (United States)

    Sewell, N

    1997-01-01

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

  11. Worm-improved estimators in continuous-time quantum Monte Carlo

    Science.gov (United States)

    Gunacker, P.; Wallerberger, M.; Ribic, T.; Hausoel, A.; Sangiovanni, G.; Held, K.

    2016-09-01

    We derive the improved estimators for general interactions and employ these for the continuous-time quantum Monte Carlo method. Using a worm algorithm we show how measuring higher-ordered correlators leads to an improved high-frequency behavior in irreducible quantities such as the one-particle self-energy or the irreducible two-particle vertex for non-density-density interactions. A good knowledge of the asymptotics of the two-particle vertex is essential for calculating nonlocal electronic correlations using diagrammatic extensions to the dynamical mean field theory as well as for calculating susceptibilities. We test our algorithm against analytic results for the multiorbital atomic limit and the Falicov-Kimball model.

  12. Continuous Auditory Feedback of Eye Movements: An Exploratory Study toward Improving Oculomotor Control

    Directory of Open Access Journals (Sweden)

    Eric O. Boyer

    2017-04-01

    Full Text Available As eye movements are mostly automatic and overtly generated to attain visual goals, individuals have a poor metacognitive knowledge of their own eye movements. We present an exploratory study on the effects of real-time continuous auditory feedback generated by eye movements. We considered both a tracking task and a production task where smooth pursuit eye movements (SPEM can be endogenously generated. In particular, we used a visual paradigm which enables to generate and control SPEM in the absence of a moving visual target. We investigated whether real-time auditory feedback of eye movement dynamics might improve learning in both tasks, through a training protocol over 8 days. The results indicate that real-time sonification of eye movements can actually modify the oculomotor behavior, and reinforce intrinsic oculomotor perception. Nevertheless, large inter-individual differences were observed preventing us from reaching a strong conclusion on sensorimotor learning improvements.

  13. 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.

  14. Extraordinary improvement of the graphitic structure of continuous carbon nanofibers templated with double wall carbon nanotubes.

    Science.gov (United States)

    Papkov, Dimitry; Beese, Allison M; Goponenko, Alexander; Zou, Yan; Naraghi, Mohammad; Espinosa, Horacio D; Saha, Biswajit; Schatz, George C; Moravsky, Alexander; Loutfy, Raouf; Nguyen, Sonbinh T; Dzenis, Yuris

    2013-01-22

    Carbon nanotubes are being widely studied as a reinforcing element in high-performance composites and fibers at high volume fractions. However, problems with nanotube processing, alignment, and non-optimal stress transfer between the nanotubes and surrounding matrix have so far prevented full utilization of their superb mechanical properties in composites. Here, we present an alternative use of carbon nanotubes, at a very small concentration, as a templating agent for the formation of graphitic structure in fibers. Continuous carbon nanofibers (CNF) were manufactured by electrospinning from polyacrylonitrile (PAN) with 1.2% of double wall nanotubes (DWNT). Nanofibers were oxidized and carbonized at temperatures from 600 °C to 1850 °C. Structural analyses revealed significant improvements in graphitic structure and crystal orientation in the templated CNFs, with the largest improvements observed at lower carbonization temperatures. In situ pull-out experiments showed good interfacial bonding between the DWNT bundles and the surrounding templated carbon matrix. Molecular Dynamics (MD) simulations of templated carbonization confirmed oriented graphitic growth and provided insight into mechanisms of carbonization initiation. The obtained results indicate that global templating of the graphitic structure in fine CNFs can be achieved at very small concentrations of well-dispersed DWNTs. The outcomes reveal a simple and inexpensive route to manufacture continuous CNFs with improved structure and properties for a variety of mechanical and functional applications. The demonstrated improvement of graphitic order at low carbonization temperatures in the absence of stretch shows potential as a promising new manufacturing technology for next generation carbon fibers.

  15. Staff empowerment: a medical record department's preliminary experiences with continuous quality improvement.

    Science.gov (United States)

    Markon, E

    1992-11-01

    After observing the results of continuous quality improvement, no one would argue against its value in the workplace. However, learning to apply the concepts requires change on everyone's part, and the challenge lies in effecting this change. Not everyone will want to work in this type of environment and, if the organization is truly committed to continuous quality improvement, those individuals may have to make hard decisions as to whether the organization is the right place for them to work. Certain skills are required for staff empowerment to be successful, and training in these skills is essential. The medical record department staff learned early in this process that, although the group possessed job skills, interaction and team skills were lacking. The Development Dimensions International program helped the managers and staff identify the weaknesses of the group and provided educational tools for improvement. The changes often are so subtle, the group does not realize anything has changed. It was not until recently, when the medical record department staff was requested by administration to identify department quality improvement projects, that the group looked back at where the process started and realized how different things are today from three years ago--now staff members lead team meetings, work-groups are redesigning their job processes, and teams update the rest of the department staff on its progress at department meetings. Everyone expressed a sense of pride and accomplishment that the group had indeed responded to the challenge. The experiences of the medical record department thus far clearly support empowerment of employees.(ABSTRACT TRUNCATED AT 250 WORDS)

  16. Continuous improvement in the Netherlands: current practices and experiences in Dutch manufacturing industry (awarded with ANBAR Citation of excellence)

    NARCIS (Netherlands)

    Gieskes, J.F.B.; Baudet, F.C.M.; Baudet, Frank; Schuring, R.W.; Boer, Harm

    1997-01-01

    In order to get insight into the current continuous-improvement practices in European industry, EuroCINet carried out a survey in its member countries. In this article, continuous-improvement activities in a sample of 135 Dutch industrial companies are described. The results show that CI is a

  17. Patients' experience of Chinese Medicine Primary Care Services: Implications on Improving Coordination and Continuity of Care.

    Science.gov (United States)

    Chung, Vincent Ch; Yip, Benjamin Hk; Griffiths, Sian M; Yu, Ellen Lm; Liu, Siya; Ho, Robin St; Wu, Xinyin; Leung, Albert Wn; Sit, Regina Ws; Wu, Justin Cy; Wong, Samuel Ys

    2015-12-21

    Chinese medicine (CM) is major form of traditional and complementary medicine used by Chinese populations. Evaluation on patients' experience on CM service is essential for improving service quality. This cross sectional study aims (i) to assess how CM clinics with different administrative model differ in terms of quality from patients' perspective; and (ii) to investigate how quality varies with patients' demographic and health characteristics. Five hundred and sixteen patients were sampled from charity and semi-public CM clinics in Hong Kong, and were invited to assess their experience using the Primary Care Assessment Tool (PCAT). Results indicated that overall mean PCAT scoring is satisfactory, achieving 70.7% (91.26/129) of total score. Ratings were lower in areas of "coordination of patient information", "continuity of care", and "range of service provided". Impact of administrative models, including involvement of tax-funded healthcare system and outreach delivery, were minimal after adjusting for patient characteristics. Demographic and health characteristics of patients did not contribute to substantial variations in scoring. To improve patient experience, policy makers should consider strengthening care coordination, continuity and comprehensiveness in CM primary care services. Sharing of electronic records and establishing referral system are potential solutions for linking CM and conventional healthcare services.

  18. Patients’ experience of Chinese Medicine Primary Care Services: Implications on Improving Coordination and Continuity of Care

    Science.gov (United States)

    Chung, Vincent CH; Yip, Benjamin HK; Griffiths, Sian M; Yu, Ellen LM; Liu, Siya; Ho, Robin ST; Wu, Xinyin; Leung, Albert WN; Sit, Regina WS; Wu, Justin CY; Wong, Samuel YS

    2015-01-01

    Chinese medicine (CM) is major form of traditional and complementary medicine used by Chinese populations. Evaluation on patients’ experience on CM service is essential for improving service quality. This cross sectional study aims (i) to assess how CM clinics with different administrative model differ in terms of quality from patients’ perspective; and (ii) to investigate how quality varies with patients’ demographic and health characteristics. Five hundred and sixteen patients were sampled from charity and semi-public CM clinics in Hong Kong, and were invited to assess their experience using the Primary Care Assessment Tool (PCAT). Results indicated that overall mean PCAT scoring is satisfactory, achieving 70.7% (91.26/129) of total score. Ratings were lower in areas of “coordination of patient information”, “continuity of care”, and “range of service provided”. Impact of administrative models, including involvement of tax-funded healthcare system and outreach delivery, were minimal after adjusting for patient characteristics. Demographic and health characteristics of patients did not contribute to substantial variations in scoring. To improve patient experience, policy makers should consider strengthening care coordination, continuity and comprehensiveness in CM primary care services. Sharing of electronic records and establishing referral system are potential solutions for linking CM and conventional healthcare services. PMID:26686267

  19. Strategic planning as a focus for continuous improvement. A case study

    Science.gov (United States)

    Oneill, John W.; Gordon-Winkler, Lyn

    What do most of the successful people and organizations in our world have in common? Instead of worrying about the future, they work to create it. They have a plan, or a vision of what they want to accomplish and they focus their efforts on success. Strategic planning has been described as a disciplined, ongoing process to produce fundamental decisions and actions that shape what an organization is, what it does, and how it will respond to a changing environment. This case study discussion will evaluate the relationship between strategic planning and Total Quality Management (TQM), or continuous improvement, through the experience of the NASA Johnson Space Center in developing a strategy for the future. That experience clearly illustrates the value of strategic planning in setting the framework and establishing the overall thrust of continuous improvement initiatives. Equally significant, the fundamentals of a quality culture such as strong customer and supplier partnerships, participative involvement, open communications, and ownership were essential in overcoming the challenges inherent in the planning process. A reinforced management commitment to the quality culture was a clear, long-term benefit.

  20. Improving Residential Satisfaction of University Dormitories through Post-Occupancy Evaluation in China: A Socio-Technical System Approach

    Directory of Open Access Journals (Sweden)

    Yan Ning

    2016-10-01

    Full Text Available Residential satisfaction of university dormitories serves as one of the significant aspects in the framework of sustainability in higher education. This study aims to develop a framework for post-occupancy evaluation (POE of university dormitories in China grounded on the socio-technical systems approach and to identify factors contributing to students’ residential satisfaction. Two focus groups were carried out to build the socio-technical framework. A case study was undertaken to evaluate the post-occupancy status of university dormitories, and structured-questionnaire was used to collect the data. The results show that university dormitories are equipped with quality physical facilities. However, they failed to provide satisfied services and supporting infrastructure. This indicates that “hardware” could generally meet students’ requirements, while the “software” is still less competent. It is also found that the socio-technical systems approach has the feature of being embedded into the social, regulatory and geographic contexts. In order to enhance post-occupancy satisfaction, occupants’ participation would be helpful. This study contributes to the body of knowledge by presenting a socio-technical framework of POE and its embeddedness feature. Implications for research and practices are also provided.

  1. Enabling Continuous Quality Improvement in Practice: The Role and Contribution of Facilitation

    Science.gov (United States)

    Harvey, Gillian; Lynch, Elizabeth

    2017-01-01

    Facilitating the implementation of continuous quality improvement (CQI) is a complex undertaking. Numerous contextual factors at a local, organizational, and health system level can influence the trajectory and ultimate success of an improvement program. Some of these contextual factors are amenable to modification, others less so. As part of planning and implementing healthcare improvement, it is important to assess and build an understanding of contextual factors that might present barriers to or enablers of implementation. On the basis of this initial diagnosis, it should then be possible to design and implement the improvement intervention in a way that is responsive to contextual barriers and enablers, often described as “tailoring” the implementation approach. Having individuals in the active role of facilitators is proposed as an effective way of delivering a context-sensitive, tailored approach to implementing CQI. This paper presents an overview of the facilitator role in implementing CQI. Drawing on empirical evidence from the use of facilitator roles in healthcare, the type of skills and knowledge required will be considered, along with the type of facilitation strategies that can be employed in the implementation process. Evidence from both case studies and systematic reviews of facilitation will be reviewed and key lessons for developing and studying the role in the future identified. PMID:28275594

  2. Continuous Flushing of the Bladder in Rodents Reduces Artifacts and Improves Quantification in Molecular Imaging

    Directory of Open Access Journals (Sweden)

    Steven Deleye

    2014-07-01

    Full Text Available In this study, we evaluated the partial volume effect (PVE of 2-deoxy-2-[18F]fluoro-D-glucose (18F-FDG tracer accumulation in the bladder on the positron emission tomographic (PET image quantification in mice and rats suffering from inflammatory bowel disease. To improve the accuracy, we implemented continuous bladder flushing procedures. Female mice and rats were scanned using microPET/computed tomography (CT at baseline and after induction of acute colitis by injecting 2,4,6-trinitrobenzene sulfonic acid (TNBS intrarectally. During the scans, the bladder was continuously flushed in one group, whereas in the other group, no bladder flushing was performed. As a means of in vivo and ex vivo validation of the inflammation, animals also underwent colonoscopy and were sacrificed for gamma counting (subpopulation and to score the colonic damage both micro- and macroscopically as well as biochemically. At baseline, the microPET signal in the colon of both mice and rats was significantly higher in the nonflushed group compared to the flushed group, caused by the PVE of tracer activity in the bladder. Hence, the colonoscopy and postmortem analyses showed no significant differences at baseline between the flushed and nonflushed animals. TNBS induced significant colonic inflammation, as revealed by colonoscopic and postmortem scores, which was not detected by microPET in the mice without bladder flushing, again because of spillover of bladder activity in the colonic area. MicroPET in bladder-flushed animals did reveal a significant increase in 18F-FDG uptake. Correlations between microPET and colonoscopy, macroscopy, microscopy, and myeloperoxidase yielded higher Spearman rho values in mice with continuously flushed bladders during imaging. Comparable, although somewhat less pronounced, results were shown in the rat. Continuous bladder flushing reduced image artifacts and is mandatory for accurate image quantification in the pelvic region for both mice

  3. Continuous flushing of the bladder in rodents reduces artifacts and improves quantification in molecular imaging.

    Science.gov (United States)

    Deleye, Steven; Heylen, Marthe; Deiteren, Annemie; De Man, Joris; Stroobants, Sigrid; De Winter, Benedicte; Staelens, Steven

    2014-01-01

    In this study, we evaluated the partial volume effect (PVE) of 2-deoxy-2-[18F]fluoro-d-glucose (18F-FDG) tracer accumulation in the bladder on the positron emission tomographic (PET) image quantification in mice and rats suffering from inflammatory bowel disease. To improve the accuracy, we implemented continuous bladder flushing procedures. Female mice and rats were scanned using microPET/computed tomography (CT) at baseline and after induction of acute colitis by injecting 2,4,6-trinitrobenzene sulfonic acid (TNBS) intrarectally. During the scans, the bladder was continuously flushed in one group, whereas in the other group, no bladder flushing was performed. As a means of in vivo and ex vivo validation of the inflammation, animals also underwent colonoscopy and were sacrificed for gamma counting (subpopulation) and to score the colonic damage both micro- and macroscopically as well as biochemically. At baseline, the microPET signal in the colon of both mice and rats was significantly higher in the nonflushed group compared to the flushed group, caused by the PVE of tracer activity in the bladder. Hence, the colonoscopy and postmortem analyses showed no significant differences at baseline between the flushed and nonflushed animals. TNBS induced significant colonic inflammation, as revealed by colonoscopic and postmortem scores, which was not detected by microPET in the mice without bladder flushing, again because of spillover of bladder activity in the colonic area. MicroPET in bladder-flushed animals did reveal a significant increase in 18F-FDG uptake. Correlations between microPET and colonoscopy, macroscopy, microscopy, and myeloperoxidase yielded higher Spearman rho values in mice with continuously flushed bladders during imaging. Comparable, although somewhat less pronounced, results were shown in the rat. Continuous bladder flushing reduced image artifacts and is mandatory for accurate image quantification in the pelvic region for both mice and rats. We

  4. An analysis of the new norwegian customer satisfaction barometer (new NCSB in a brazilian supermarket context.

    Directory of Open Access Journals (Sweden)

    Valter Afonso Vieira

    2007-09-01

    Full Text Available A lot of consumer satisfaction barometers have been proposed by the literature. However, a dilemma is that the validity, the reliability, and the methods used to assess customer satisfaction and related constructs continue to learn, to adapt, and to improve over time. Thus, this paper tries to understand the modifications and improvements proposed by the new NCSB in Brazil. New NCSB is considers one of the last satisfaction barometers projected by the literature. The results showed support to seven from twelve hypotheses proposed by the model. Conclusions and general comments end the paper.

  5. Improvement of the accuracy of continuous GPS/Acoustic measurement using a slackly moored buoy

    Science.gov (United States)

    Imano, M.; Kido, M.; Ohta, Y.; Takahashi, N.; Fukuda, T.; Ochi, H.; Honsho, C.; Hino, R.

    2016-12-01

    For the real-time detection of seafloor crustal movement and tsunami associated with large earthquakes, it is necessary to monitor them continuously in their source regions. For this purpose, Tohoku University, JAMSTEC, and JAXA have co-developed a continuous GPS/Acoustic (GPS/A) measurement system using a moored buoy, and the third sea-trial is ongoing for a year in Kumano-nada, Nankai Trough. In this presentation, we report of the positioning accuracy of the continuous GPS/Acoustic measurement in the buoy system. We have adopted the array positioning technique developed by researchers at the Scripps Institute of Oceanography with some improvements. The advantage of this method is that errors in assumed sound velocity and array geometry (relative positions of individual seafloor transponders) little affect positioning results when measurements are conducted in the vicinity of the array center. However, the GPS/A measurement using a moored buoy is generally conducted under much worse condition than the conventional one using a research vessel. In our system, the mooring cable length was determined to be 1.5 times the water depth for safety reasons against strong current. Therefore, the buoy is drifting within a relatively wide area by the wind and the current, and measurements are randomly performed at various points within the area. These features can lead to significant systematic errors in the array positioning, because the effect of errors in pre-defined array geometry increases as the observation point goes farther from the array center. At the moments, the positioning accuracy of GPS/A measurement using a moored buoy is estimated as 0.6/0.7 m, for the EW/NS components, respectively, from the data obtained during the third sea-trial. It is considered that errors in the assumed array geometry result in considerable errors in the array positioning. Therefore, it is necessary to determine the array geometry more precisely in order to improve the accuracy of GPS

  6. Customer satisfaction and consumer responsibility: toward an alternative model of medical service quality.

    Science.gov (United States)

    Pinto, M B; Barber, J C

    1999-01-01

    In the increasingly competitive environment of medical services and patient care, physicians feel a strong pressure for increasing efforts to improve patient satisfaction with the goal of creating a loyal patient base. These steps to promote patient satisfaction have typically involved developing new programs and services, as medical offices seek to attract and keep their patients by continually enhancing service features. While patient satisfaction is a worthy goal, this paper argues that we often make mistakes and incur expensive costs in pursuing satisfaction as an end unto itself. This paper proposes an alternative model, based on creating a doctor-patient therapeutic alliance which has the dual benefits of enhancing patient satisfaction while improving the critical personal relationship between doctors and their patients, so necessary for the delivery of optimal care.

  7. Change leadership behaviors to change performance results: the foundation of top customer satisfaction.

    Science.gov (United States)

    Sherman, Stephanie G

    2002-01-01

    Raising customer satisfaction in health-care organizations has been a priority for the past 5 years or more. Articles and books continue to be written on the topic and speeches and presentations are given to eager audiences of professionals who have a deep desire to improve customer satisfaction. Yet research indicates that customer satisfaction, on average, in the health-care industry barely has improved. This column will examine why some organizations, using the same best practice techniques and approaches for top customer satisfaction, achieve wonderful results as most others achieve meager results, at best. The answer to achieving top customer satisfaction lies in the leadership of the organization. When leaders change their thinking and behaviors, results will change.

  8. [Customer satisfaction with a quality management system according to DIN EN ISO 9001:2000: Increase in the satisfaction of cooperating clinics].

    Science.gov (United States)

    Beholz, Sven; Konertz, Wolfgang

    2006-01-01

    The evaluation of customers' satisfaction is elementary for any quality management system. In our university cardiac surgery unit that has been certified according to DIN EN ISO 9001:2000 the influence of repeated evaluation of the referring physicians' satisfaction conducted in the course of three consecutive years on structures and processes in the scope of the quality management system was examined. Customers' satisfaction with the possibility of access to the department could be increased by targeted interventions. Further interventions in the field of documentation led to a measurable increase in satisfaction with postoperative communication. Repeated annual evaluation of the satisfaction of referring physicians has proved to be a valuable tool in the process of continuous quality improvement.

  9. A combined continuous and interval aerobic training improves metabolic syndrome risk factors in men

    Directory of Open Access Journals (Sweden)

    Sari-Sarraf V

    2015-05-01

    Full Text Available Vahid Sari-Sarraf,1 Akbar Aliasgarzadeh,2 Mohammad-Mahdi Naderali,3 Hamid Esmaeili,1 Ebrahim K Naderali4 1Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tabriz, 2Bone Research Centre, Endocrine Unit, Department of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran; 3The School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, 4Faculty of Science, Liverpool Hope University, Liverpool, UK Abstract: Individuals with metabolic syndrome have significantly higher risk of cardiovascular disease and type 2 diabetes leading to premature death mortality. Metabolic syndrome has a complex etiology; thus, it may require a combined and multi-targeted aerobic exercise regimen to improve risk factors associated with it. Therefore, the aim of this study was to evaluate the effect of combined continuous and interval aerobic training on patients with metabolic syndrome. Thirty adult male with metabolic syndrome (54±8 years were randomly divided into two groups: test training group (TTG; n=15 and control group (CG; n=15. Subjects in TTG performed combined continuous and interval aerobic training using a motorized treadmill three times per week for 16 weeks. Subjects in CG were advised to continue with their normal activities of life. Twenty-two men completed the study (eleven men in each group. At the end of the study, in TTG, there were significant (for all, P<0.05 reductions in total body weight (-3.2%, waist circumference (-3.43 cm, blood pressure (up to -12.7 mmHg, and plasma insulin, glucose, and triacylglyceride levels. Moreover, there were significant (for all, P<0.05 increases VO2max (-15.3% and isometric strength of thigh muscle (28.1% and high-density lipoprotein in TTG. None of the above indices were changed in CG at the end of 16-week study period. Our study suggests that adoption of a 16-week combined continuous and interval aerobic training regimen in men

  10. A Knowledge Tree Model and Its Application for Continuous Management Improvement

    Science.gov (United States)

    Lu, Yun; Bao, Zhen-Qiang; Zhao, Yu-Qin; Wang, Yan; Wang, Gui-Jun

    This chapter analyzes the relationship of organizational knowledge and brings forward that organizational knowledge consists of three layers: core knowledge, structural knowledge, and implicit knowledge. According to the principle of knowledge maps, a dynamic management model of organizational knowledge based on knowledge tree is introduced and the definition of the value of knowledge node is given so that the quantitative management on knowledge is realized, which lays a foundation for performance evaluation of knowledge management. We also carefully study the application of knowledge tree in service quality management of hospital organizations and management innovation process and give the example of cooperation in endoscopic surgery to establish a knowledge tree about operational cooperation degree, which states the principle of organizational knowledge management and the knowledge innovation process of continuous management improvement.

  11. THEORY OF REASONED ACTION FOR CONTINUOUS IMPROVEMENT CAPABILITIES: A BEHAVIORAL APPROACH

    Directory of Open Access Journals (Sweden)

    Janaina Siegler

    2012-09-01

    Full Text Available The importance of interaction between Operations Management (OM and Human Behavior has been recently re-addressed. This paper introduced the Reasoned Action Theory suggested by Froehle and Roth (2004 to analyze Operational Capabilities exploring the suitability of this model in the context of OM. It also seeks to discuss the behavioral aspects of operational capabilities from the perspective of organizational routines. This theory was operationalized using Fishbein and Ajzen (F/A behavioral model and a multi-case strategy was employed to analyze the Continuous Improvement (CI capability. The results posit that the model explains partially the CI behavior in an operational context and some contingency variables might influence the general relationsamong the variables involved in the F/A model. Thus intention might not be the determinant variable of behavior in this context.

  12. IMPROVED ROBUST H-INFINITY ESTIMATION FOR UNCERTAIN CONTINUOUS-TIME SYSTEMS

    Institute of Scientific and Technical Information of China (English)

    Aiguo WU; Huafeng DONG; Guangren DUAN

    2007-01-01

    The design of full-order robust estimators is investigated for continuous-time polytopic uncertain systems. The main purpose is to obtain a stable linear estimator such that the estimation error system remains robustly stable with a prescribed H∞ attenuation level. Firstly, a simple alterna- tive proof is given for an improved LMI representation of H∞ performance proposed recently. Based on the performance criterion which keeps the Lyapunov matrix out of the product of the system dynamic matrices, a sufficient condition for the existence of the robust estimator is provided in terms oflinear matrix inequalities. It is shown that the proposed design strategy allows the use of parameter-dependent Lyapunov functions and hence it is less conservative than the earlier results. A numericalexample is employed to illustrate the feasibility and advantage of the proposed design.

  13. A Marketing approach on how continuous processes improvement can contribute to hotel business Organic Growth

    Directory of Open Access Journals (Sweden)

    Ioana-Simona IVASCIUC

    2015-12-01

    Full Text Available Generating sustainable growth and profits is like finding a unicorn for most managers. Organic growth should be considered as an alternative for long-term growth in the hotel business. Designing the service process to deliver what customers expect from the hotel offer is a crucial component of encounter marketing. Hotels need to embrace the changes and ensure that their internal processes are aligned not just to current trends, but also to the expected future changes. Keeping up with global changes and trends of any kind, evaluating their impact on your business, continuous improving of the services using PDCA cycle, Six Sigma or Lean principles, are the keys to long-term organic growth.

  14. Improved dichotomous search frequency offset estimator for burst-mode continuous phase modulation

    Institute of Scientific and Technical Information of China (English)

    翟文超; 李赞; 司江勃; 柏均

    2015-01-01

    A data-aided technique for carrier frequency offset estimation with continuous phase modulation (CPM) in burst-mode transmission is presented. The proposed technique first exploits a special pilot sequence, or training sequence, to form a sinusoidal waveform. Then, an improved dichotomous search frequency offset estimator is introduced to determine the frequency offset using the sinusoid. Theoretical analysis and simulation results indicate that our estimator is noteworthy in the following aspects. First, the estimator can operate independently of timing recovery. Second, it has relatively low outlier, i.e., the minimum signal-to-noise ratio (SNR) required to guarantee estimation accuracy. Finally, the most important property is that our estimator is complexity-reduced compared to the existing dichotomous search methods: it eliminates the need for fast Fourier transform (FFT) and modulation removal, and exhibits faster convergence rate without accuracy degradation.

  15. Integrating the development of continuous improvement andinnovation capabilities into engineering education

    DEFF Research Database (Denmark)

    Jørgensen, Frances; Kofoed, Lise B.

    2007-01-01

    In this paper, a study is presented in which engineering students at a Danish university developed Continuous Improvement (CI) and innovation capabilities through action research and experientiallearning methods. The paper begins with a brief overview of the literature on CI and innovation......, followed by an account of how the students designed and implemented solutions to self-identified problems within their educational program using the principles of CI, and how these learning activities facilitated the development of basic innovation capabilities. The paper concludes with insights regarding...... how such an innovative design of teaching methods based on learning-by-doing may not only support the development of CI and innovation in engineering students, which is increasingly demanded by industry, but also represent a way in which to enhance sustainability and innovation of the education itself....

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

    Science.gov (United States)

    Burkoski, Vanessa; Yoon, Jennifer

    2013-01-01

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

  17. Improving the Syllable-Synchronous Network Search Algorithm for Word Decoding in Continuous Chinese Speech Recognition

    Institute of Scientific and Technical Information of China (English)

    郑方; 武健; 宋战江

    2000-01-01

    The previously proposed syllable-synchronous network search (SSNS) algorithm plays a very important role in the word decoding of the continuous Chinese speech recognition and achieves satisfying performance. Several related key factors that may affect the overall word decoding effect are carefully studied in this paper, including the perfecting of the vocabulary, the big-discount Turing re-estimating of the N-Gram probabilities, and the managing of the searching path buffers. Based on these discussions, corresponding approaches to improving the SSNS algorithm are proposed. Compared with the previous version of SSNS algorithm, the new version decreases the Chinese character error rate (CCER) in the word decoding by 42.1% across a database consisting of a large number of testing sentences (syllable strings).

  18. Continuing medical education, quality improvement, and organizational change: implications of recent theories for twenty-first-century CME.

    Science.gov (United States)

    Price, David

    2005-05-01

    Healthcare providers and systems are being asked to measure and improve the quality of care delivered to their patients. Additionally, the American Board of Medical Specialties now requires physicians to participate in systems-based practice and practice-based learning and improvement activities as part of maintenance of specialty board certification. These changing paradigms provide opportunities for continuing medical education to become more aligned with health system goals and help prepare clinicians to practice in this new environment. Organizational change and quality improvement principles have much in common with continuing medical education planning processes. Medical education can play a role in helping organizations improve. Continuing medical education must move beyond delivering content to individual clinicians towards becoming a facilitator of organizational improvement. Research is needed to determine the effect of integrating continuing medical education with organizational change approaches on professional competence, organizational processes and patient outcomes.

  19. 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

  20. Evaluation of Patient Satisfaction

    Directory of Open Access Journals (Sweden)

    Ioana GĂDĂLEAN

    2011-12-01

    Full Text Available Introduction: Patient satisfaction is an element of psychological health which influence the results of the medical care and their impact. Patient experience can be quantified from their questioning or direct observation. Objectives: The purpose of this paper is to analyze and evaluate the satisfaction of nursing activities closely related to the patients admitted in ICU ward Institute of Oncology Prof. Dr. Ion Chiricuţă Cluj-Napoca. Materials and Methods: This paper describes a prospective study conducted on a sample of 106 patients hospitalized in the intensive care unit of the Institute of Oncology Prof. Dr. Ion Chiricuţă Cluj-Napoca in June 2011 - August 2011. The results were obtained using descriptive and analytical statistical technique of SPSS software. To detect relationships / associations between qualitative variables the Chi-Square test was used (statistically significant association if p ≤ 0.05. Patients received an anonymous questionnaire applied at 24 hours after discharge from the IT department so that the responses would be most sincerely. Results: Patients selected only two degrees of satisfaction, 53.8% very satisfied, respectively 46.2% satisfied. Dissatisfaction factors that may affect satisfaction were communication, accommodation facilities, factors arising from the lack of personal, pain and lack of sleep. Conclusions: Satisfaction “score” is influenced by education level and diagnosis. Resumption of the questionnaire is required periodically to assess the results of our section. It is also necessary to continue to compare results with other departments in the country.

  1. Developing a monitoring method facilitating continual improvements in the sorting of waste at recycling centres.

    Science.gov (United States)

    Krook, Joakim; Eklund, Mats

    2010-01-01

    Beneficial use of waste relies on efficient systems for collection and separation. In Sweden, a bring system involving recycling centres for collection of bulky, electr(on)ic and hazardous waste has been introduced. A significant share of this waste is incorrectly sorted, causing downstream environmental implications. At present, however, there is a lack of affordable and accurate monitoring methods for providing the recycling centres with the necessary facts for improving the sorting of waste. The aim of this study was therefore to evaluate the usability of a simplified and potentially more suitable waste monitoring method for recycling centres. This method is based on standardised observations where the occurrence of incorrect sorting is monitored by taking digital pictures of the waste which then are analysed according to certain guidelines. The results show that the developed monitoring method could offer a resource-efficient and useful tool for proactive quality work at recycling centres, involving continuous efforts in developing and evaluating measures for improved sorting of waste. More research is however needed in order to determine to what extent the obtained results from the monitoring method are reliable.

  2. APPLICATION OF QC TOOLS FOR CONTINUOUS IMPROVEMENT IN AN EXPENSIVE SEAT HARDFACING PROCESS USING TIG WELDING

    Directory of Open Access Journals (Sweden)

    Mohammed Yunus

    2016-09-01

    Full Text Available The present study is carried out to improve quality level by identifying the prime reasons of the quality related problems in the seat hardfacing process involving the deposition of cobalt based super alloy in I.C. Engine valves using TIG welding process. During the Process, defects like stellite deposition overflow, head melt, non-uniform stellite merging, etc., are observed and combining all these defects, the rejection level was in top position in Forge shop. We use widely referred QC tools of the manufacturing field to monitor the complete operation and continuous progressive process improvement to ensure ability and efficiency of quality management system of any firm. The work aims to identify the various causes for the rejection by the detailed study of the operation, equipment, materials and the various process parameters that are very important to get defects-free products. Also, to evolve suitable countermeasures for reducing the rejection percentage using seven QC tools. To further understand and validate the obtained results, we need to address other studies related to motivations, advantages, and disadvantages of applying quality control tools.

  3. Evidence-based practice barriers and facilitators from a continuous quality improvement perspective: an integrative review.

    Science.gov (United States)

    Solomons, Nan M; Spross, Judith A

    2011-01-01

    The purpose of the present study is to examine the barriers and facilitators to evidence-based practice (EBP) using Shortell's framework for continuous quality improvement (CQI). EBP is typically undertaken to improve practice. Although there have been many studies focused on the barriers and facilitators to adopting EBP, these have not been tied explicitly to CQI frameworks. CINAHL, Academic Search Premier, Medline, Psych Info, ABI/Inform and LISTA databases were searched using the keywords: nurses, information literacy, access to information, sources of knowledge, decision making, research utilization, information seeking behaviour and nursing practice, evidence-based practice. Shortell's framework was used to organize the barriers and facilitators. Across the articles, the most common barriers were lack of time and lack of autonomy to change practice which falls within the strategic and cultural dimensions in Shortell's framework. Barriers and facilitators to EBP adoption occur at the individual and institutional levels. Solutions to the barriers need to be directed to the dimension where the barrier occurs, while recognizing that multidimensional approaches are essential to the success of overcoming these barriers. The findings of the present study can help nurses identify barriers and implement strategies to promote EBP as part of CQI. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

  4. Employing continuous quality improvement in community-based substance abuse programs.

    Science.gov (United States)

    Chinman, Matthew; Hunter, Sarah B; Ebener, Patricia

    2012-01-01

    This article aims to describe continuous quality improvement (CQI) for substance abuse prevention and treatment programs in a community-based organization setting. CQI (e.g., plan-do-study-act cycles (PDSA)) applied in healthcare and industry was adapted for substance abuse prevention and treatment programs in a community setting. The authors assessed the resources needed, acceptability and CQI feasibility for ten programs by evaluating CQI training workshops with program staff and a series of three qualitative interviews over a nine-month implementation period with program participants. The CQI activities, PDSA cycle progress, effort, enthusiasm, benefits and challenges were examined. Results indicated that CQI was feasible and acceptable for community-based substance abuse prevention and treatment programs; however, some notable resource challenges remain. Future studies should examine CQI impact on service quality and intended program outcomes. The study was conducted on a small number of programs. It did not assess CQI impact on service quality and intended program outcomes. Practical implications- This project shows that it is feasible to adapt CQI techniques and processes for community-based programs substance abuse prevention and treatment programs. These techniques may help community-based program managers to improve service quality and achieve program outcomes. This is one of the first studies to adapt traditional CQI techniques for community-based settings delivering substance abuse prevention and treatment programs.

  5. Continued improvement of cardiovascular mortality in Hungary - impact of increased cardio-metabolic prescriptions

    Directory of Open Access Journals (Sweden)

    Jozan Peter

    2010-07-01

    Full Text Available Abstract Background During the last 35 years the poor ranking of Hungary on the list of life expectancy at birth among European countries, has not changed. In 1970 our lag behind the leading European countries was the smallest. The gap was growing between 1970 and 1993 but from 1994 onwards the life expectancy at birth in Hungary has increased continuously and somewhat faster than in other European countries. The aim of this study was to analyze the association between decreasing cardiovascular mortality rates, as a main cause of death and the increase in cardio-metabolic prescriptions and possible changes in lifestyle behavior. Methods Analyses were conducted on national data concerning cardiovascular mortality and the number of cardio-metabolic drug prescription per capita. The association between yearly rates of cardiovascular events and changes in antihypertensive, antilipidemic and antidiabetic prescription rates was analyzed. The changes in other cardiovascular risk factors, like lifestyle were also considered. Results We observed a remarkable decline of mortality due to stroke and acute myocardial infarction (AMI. The fall was significantly associated with all prescription rates. The proportion of each treatment type responsible for suppression of specific mortality rates is different. All treatment types comparably improved stroke mortality, while antilipidemic therapy improved AMI outcome. Conclusions These results emphasize the importance of a comprehensive strategy that maximizes the population coverage of effective treatments. Hungary appears to be at the beginning of the fourth stage of epidemiologic transition, i.e. it has entered the stage of delayed chronic noninfectious diseases.

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

    Science.gov (United States)

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

    1990-10-01

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

  7. Continuous Non-Invasive Arterial Pressure Technique Improves Patient Monitoring during Interventional Endoscopy

    Directory of Open Access Journals (Sweden)

    Sylvia Siebig, Felix Rockmann, Karl Sabel, Ina Zuber-Jerger, Christine Dierkes, Tanja Brünnler, Christian E. Wrede

    2009-01-01

    Full Text Available Introduction: Close monitoring of arterial blood pressure (BP is a central part of cardiovascular surveillance of patients at risk for hypotension. Therefore, patients undergoing diagnostic and therapeutic procedures with the use of sedating agents are monitored by discontinuous non-invasive BP measurement (NIBP. Continuous non-invasive BP monitoring based on vascular unloading technique (CNAP®, CN Systems, Graz may improve patient safety in those settings. We investigated if this new technique improved monitoring of patients undergoing interventional endoscopy. Methods: 40 patients undergoing interventional endoscopy between April and December 2007 were prospectively studied with CNAP® in addition to standard monitoring (NIBP, ECG and oxygen saturation. All monitoring values were extracted from the surveillance network at one-second intervals, and clinical parameters were documented. The variance of CNAP® values were calculated for every interval between two NIBP measurements. Results: 2660 minutes of monitoring were recorded (mean 60.1±34.4 min/patient. All patients were analgosedated with midazolam and pethidine, and 24/40 had propofol infusion (mean 90.9±70.3 mg. The mean arterial pressure for CNAP® was 102.4±21.2 mmHg and 106.8±24.8 mmHg for NIBP. Based on the first NIBP value in an interval between two NIBP measurements, BP values determined by CNAP® showed a maximum increase of 30.8±21.7% and a maximum decrease of 22.4±28.3% (mean of all intervals. Discussion: Conventional intermittent blood pressure monitoring of patients receiving sedating agents failed to detect fast changes in BP. The new technique CNAP® improved the detection of rapid BP changes, and may contribute to a better patient safety for those undergoing interventional procedures.

  8. Does continuing education improve physical therapists' effectiveness in treating neck pain? A randomized clinical trial.

    Science.gov (United States)

    Cleland, Joshua A; Fritz, Julie M; Brennan, Gerard P; Magel, Jake

    2009-01-01

    Physical therapists often attend continuing education (CE) courses to improve their overall clinical performance and patient outcomes. However, evidence suggests that CE courses may not improve the outcomes for patients receiving physical therapy for the management of neck pain. The purpose of this study was to investigate the effectiveness of an ongoing educational intervention for improving the outcomes for patients with neck pain. The study participants were 19 physical therapists who attended a 2-day CE course focusing on the management of neck pain. All patients treated by the therapists in this study completed the Neck Disability Index (NDI) and a pain rating scale at the initial examination and at their final visit. Therapists from 11 clinics were invited to attend a 2-day CE course on the management of neck pain. After the CE course, the therapists were randomly assigned to receive either ongoing education consisting of small group sessions and an educational outreach session or no further education. Clinical outcomes achieved by therapists who received ongoing education and therapists who did not were compared for both pretraining and posttraining periods. The effects of receiving ongoing education were examined by use of linear mixed-model analyses with time period and group as fixed factors; improvements in disability and pain as dependent variables; and age, sex, and the patient's initial NDI and pain rating scores as covariates. Patients treated by therapists who received ongoing education experienced significantly greater reductions in disability during the study period (pretraining to posttraining) than those treated by therapists who did not receive ongoing training (mean difference=4.2 points; 95% confidence interval [CI]=0.69, 7.7). Changes in pain did not differ for patients treated by the 2 groups of therapists during the study period (mean difference=0.47 point; 95% CI=-0.11, 1.0). Therapists in the ongoing education group also used fewer

  9. Patient satisfaction: focusing on "excellent".

    Science.gov (United States)

    Otani, Koichiro; Waterman, Brian; Faulkner, Kelly M; Boslaugh, Sarah; Burroughs, Thomas E; Dunagan, W Claiborne

    2009-01-01

    In an emerging competitive market such as healthcare, managers should focus on achieving excellent ratings to distinguish their organization from others. When it comes to customer loyalty, "excellent" has a different meaning. Customers who are merely satisfied often do not come back. The purpose of this study was to find out what influences adult patients to rate their overall experience as "excellent." The study used patient satisfaction data collected from one major academic hospital and four community hospitals. After conducting a multiple logistic regression analysis, certain attributes were shown to be more likely than others to influence patients to rate their experiences as excellent. The study revealed that staff care is the most influential attribute, followed by nursing care. These two attributes are distinctively stronger drivers of overall satisfaction than are the other attributes studied (i.e., physician care, admission process, room, and food). Staff care and nursing care are under the control of healthcare managers. If improvements are needed, they can be accomplished through training programs such as total quality management or continuous quality improvement, through which staff employees and nurses learn to be sensitive to patients' needs. Satisfying patients' needs is the first step toward having loyal patients, so hospitals that strive to ensure their patients are completely satisfied are more likely to prosper.

  10. An investigation of customer satisfaction and loyalty in projects of mini-hotels

    OpenAIRE

    Левыкин, Виктор Макарович; Дэвон, Валерия Викторовна

    2015-01-01

    The hospitality industry continues to evolve and improve in terms of Ukrainian realities of political and economic instability; managers of mini-hotels are experiencing difficulties with the implementation of repeat sales, increasing the number of loyal customers and the preservation of loyal customers, maintaining a high level of consumer loyalty and customer satisfaction.The article reveals the concept of satisfaction and loyalty of mini-hotels customers. It is schematically represented the...

  11. Lean thinking transformation of the unsedated upper gastrointestinal endoscopy pathway improves efficiency and is associated with high levels of patient satisfaction.

    Science.gov (United States)

    Hydes, Theresa; Hansi, Navjyot; Trebble, Timothy M

    2012-01-01

    Upper gastrointestinal (UGI) endoscopy is a routine healthcare procedure with a defined patient pathway. The objective of this study was to redesign this pathway for unsedated patients using lean thinking transformation to focus on patient-derived value-adding steps, remove waste and create a more efficient process. This was to form the basis of a pathway template that was transferrable to other endoscopy units. A literature search of patient expectations for UGI endoscopy identified patient-derived value. A value stream map was created of the current pathway. The minimum and maximum time per step, bottlenecks and staff-staff interactions were recorded. This information was used for service transformation using lean thinking. A patient pathway template was created and implemented into a secondary unit. Questionnaire studies were performed to assess patient satisfaction. In the primary unit the patient pathway reduced from 19 to 11 steps with a reduction in the maximum lead time from 375 to 80 min following lean thinking transformation. The minimum value/lead time ratio increased from 24% to 49%. The patient pathway was redesigned as a 'cellular' system with minimised patient and staff travelling distances, waiting times, paperwork and handoffs. Nursing staff requirements reduced by 25%. Patient-prioritised aspects of care were emphasised with increased patient-endoscopist interaction time. The template was successfully introduced into a second unit with an overall positive patient satisfaction rating of 95%. Lean thinking transformation of the unsedated UGI endoscopy pathway results in reduced waiting times, reduced staffing requirements and improved patient flow and can form the basis of a pathway template which may be successfully transferred into alternative endoscopy environments with high levels of patient satisfaction.

  12. Fully automated whole-head segmentation with improved smoothness and continuity, with theory reviewed.

    Science.gov (United States)

    Huang, Yu; Parra, Lucas C

    2015-01-01

    Individualized current-flow models are needed for precise targeting of brain structures using transcranial electrical or magnetic stimulation (TES/TMS). The same is true for current-source reconstruction in electroencephalography and magnetoencephalography (EEG/MEG). The first step in generating such models is to obtain an accurate segmentation of individual head anatomy, including not only brain but also cerebrospinal fluid (CSF), skull and soft tissues, with a field of view (FOV) that covers the whole head. Currently available automated segmentation tools only provide results for brain tissues, have a limited FOV, and do not guarantee continuity and smoothness of tissues, which is crucially important for accurate current-flow estimates. Here we present a tool that addresses these needs. It is based on a rigorous Bayesian inference framework that combines image intensity model, anatomical prior (atlas) and morphological constraints using Markov random fields (MRF). The method is evaluated on 20 simulated and 8 real head volumes acquired with magnetic resonance imaging (MRI) at 1 mm3 resolution. We find improved surface smoothness and continuity as compared to the segmentation algorithms currently implemented in Statistical Parametric Mapping (SPM). With this tool, accurate and morphologically correct modeling of the whole-head anatomy for individual subjects may now be feasible on a routine basis. Code and data are fully integrated into SPM software tool and are made publicly available. In addition, a review on the MRI segmentation using atlas and the MRF over the last 20 years is also provided, with the general mathematical framework clearly derived.

  13. Fully automated whole-head segmentation with improved smoothness and continuity, with theory reviewed.

    Directory of Open Access Journals (Sweden)

    Yu Huang

    Full Text Available Individualized current-flow models are needed for precise targeting of brain structures using transcranial electrical or magnetic stimulation (TES/TMS. The same is true for current-source reconstruction in electroencephalography and magnetoencephalography (EEG/MEG. The first step in generating such models is to obtain an accurate segmentation of individual head anatomy, including not only brain but also cerebrospinal fluid (CSF, skull and soft tissues, with a field of view (FOV that covers the whole head. Currently available automated segmentation tools only provide results for brain tissues, have a limited FOV, and do not guarantee continuity and smoothness of tissues, which is crucially important for accurate current-flow estimates. Here we present a tool that addresses these needs. It is based on a rigorous Bayesian inference framework that combines image intensity model, anatomical prior (atlas and morphological constraints using Markov random fields (MRF. The method is evaluated on 20 simulated and 8 real head volumes acquired with magnetic resonance imaging (MRI at 1 mm3 resolution. We find improved surface smoothness and continuity as compared to the segmentation algorithms currently implemented in Statistical Parametric Mapping (SPM. With this tool, accurate and morphologically correct modeling of the whole-head anatomy for individual subjects may now be feasible on a routine basis. Code and data are fully integrated into SPM software tool and are made publicly available. In addition, a review on the MRI segmentation using atlas and the MRF over the last 20 years is also provided, with the general mathematical framework clearly derived.

  14. The program of continuous improvements in factory in Juzbado; El programa de mejora continua en la Fabrica de Juzbado

    Energy Technology Data Exchange (ETDEWEB)

    Prieto, M.

    2015-07-01

    This articles describes the historical development of the continuous improvement program at Juzbado Factory, since its beginning to nowadays. The evolution throughout the ideas of Total Quality, ISO, EFQM, Six Sigma, and so on, leading to the present situation in which all these tools and methodologies live together is shown. all this has led to a philosophy and business culture focused on safety, quality and continuous improvement. (Author)

  15. A randomised controlled trial to improve the role of the general practitioner in cancer rehabilitation: effect on patients’ satisfaction with their general practitioners

    DEFF Research Database (Denmark)

    Bergholdt, Stinne Holm; Gilså Hansen, Dorte; Larsen, Pia Veldt

    2013-01-01

    OBJECTIVE: To test whether a complex intervention facilitating early cancer rehabilitation by involvement of the general practitioner (GP) soon after diagnosis improves patients' satisfaction with their GPs. DESIGN: A cluster randomised controlled trial. All general practices in Denmark were...... hospital (Vejle Hospital, Denmark) were included between May 2008 and February 2009. A total of 955 patients registered with 323 practices were included, of which 486 patients were allocated to the intervention group and 469 to the control group. INTERVENTION: The intervention included a patient interview...... assessing the need for rehabilitation, improved information from the hospital to GPs including information on the patients' current needs along with information about needs of patients with cancer in general. Further, GPs were encouraged to proactively contact the patients and facilitate the patients...

  16. Improved methodologies for continuous-flow analysis of stable water isotopes in ice cores

    Science.gov (United States)

    Jones, Tyler R.; White, James W. C.; Steig, Eric J.; Vaughn, Bruce H.; Morris, Valerie; Gkinis, Vasileios; Markle, Bradley R.; Schoenemann, Spruce W.

    2017-02-01

    Water isotopes in ice cores are used as a climate proxy for local temperature and regional atmospheric circulation as well as evaporative conditions in moisture source regions. Traditional measurements of water isotopes have been achieved using magnetic sector isotope ratio mass spectrometry (IRMS). However, a number of recent studies have shown that laser absorption spectrometry (LAS) performs as well or better than IRMS. The new LAS technology has been combined with continuous-flow analysis (CFA) to improve data density and sample throughput in numerous prior ice coring projects. Here, we present a comparable semi-automated LAS-CFA system for measuring high-resolution water isotopes of ice cores. We outline new methods for partitioning both system precision and mixing length into liquid and vapor components - useful measures for defining and improving the overall performance of the system. Critically, these methods take into account the uncertainty of depth registration that is not present in IRMS nor fully accounted for in other CFA studies. These analyses are achieved using samples from a South Pole firn core, a Greenland ice core, and the West Antarctic Ice Sheet (WAIS) Divide ice core. The measurement system utilizes a 16-position carousel contained in a freezer to consecutively deliver ˜ 1 m × 1.3 cm2 ice sticks to a temperature-controlled melt head, where the ice is converted to a continuous liquid stream and eventually vaporized using a concentric nebulizer for isotopic analysis. An integrated delivery system for water isotope standards is used for calibration to the Vienna Standard Mean Ocean Water (VSMOW) scale, and depth registration is achieved using a precise overhead laser distance device with an uncertainty of ±0.2 mm. As an added check on the system, we perform inter-lab LAS comparisons using WAIS Divide ice samples, a corroboratory step not taken in prior CFA studies. The overall results are important for substantiating data obtained from LAS

  17. Relationship Between the maturity of continuous improvement and the certification of quality management system in automotive sector in Brazil

    Directory of Open Access Journals (Sweden)

    Alexandra de Fatima Chiaradia Valadão

    2013-06-01

    Full Text Available The present paper aims to identify the relationship between the maturity of continuous improvement and the certification of the quality management system within a company in the Autoparts industry located in the South of Minas Gerais State. Continuous improvement has become the element of greatest importance for the development of all kinds of organizations, whether in production operations or when providing services, with the ends of reaching the objective of the present paper, where the following propositions shall be verified. The time necessary to implement the Quality Management System in certified companies brings forth implications with regards to the maturity of continuous improvement. The continuous improvement process is a gradual organization learning process. With the purpose of dealing with this issue, the explanatory qualitative Case Study method was chosen, through the use of the triangulation method where interviews with representatives were used, with direct observation and survey and analysis of historical facts. The approach taken is primarily descriptive/qualitative, where it was sought to analyze, classify, and interpret facts without research interference. As a result, it was observed that within the research unit the certification time did not show to be the principal factor for the advance in continuous improvement maturity levels. Organizational learning significantly contributes to the maturation of the continuous improvement system, especially when found deeply taking root in the company´s culture.

  18. Customer satisfaction and competencies

    DEFF Research Database (Denmark)

    Gritti, Paola; Foss, Nicolai Juul

    this by analyzing data collected on 2,105 customers of 118 branches of one of the biggest banks of an Italian banking group. We find that customer satisfaction impacts loyalty, which in turn has a direct effect on financial and non-financial customer value/total customer value/complex customer value. Moreover......We empirically address how customer satisfaction and loyalty in the banking industry may affect profitability. This helps to identify the strategy and competencies necessary to benefit from customer relationships which are important sources for improved performance in the banking. We do...

  19. Application of Bone Trauma Patients Used the Concept of Continuous Quality Improvement in Pain Management%骨创伤患者疼痛管理中持续质量改进理念的运用

    Institute of Scientific and Technical Information of China (English)

    季建芹

    2015-01-01

    目的:探究在对骨创伤患者进行治疗期间,对疼痛管理进行持续质量改进理念的应用及临床价值。方法回顾分析我院2014年3月~2014年7月收治的110例骨创伤患者的临床资料,针对患者出现疼痛的原因制定有效的疼痛管理模式,分析其经过质量改进后的疼痛控制情况。结果患者接受质量改进的疼痛管理后,其疼痛情况有了明显改善,护理的满意度也大大提升。结论对患者进行持续质量改进的疼痛管理,可以缓解患者的疼痛,提高护理满意度。%Objective To explore clinical value patients with bone trauma pain management application of the concept of continuous quality improvement during the period of treatment.Methods Selected 110 patients with bone trauma from 2014 March to 2014 July in our hospital and analysis of the clinical data retrospectively. Make effective pain management model for the cause of pain and analyze after the quality improvement of pain control. Resultspatient pain had significantly improved and the nursing satisfaction also improve greatly after accept the pain management in the quality improvement.Conclusion Patients with continuous quality improvement of pain management can reduce the pain of patients and improve nursing satisfaction.

  20. Evaluation of a guided continuous quality improvement program in community pharmacies.

    Science.gov (United States)

    Chinthammit, Chanadda; Rupp, Michael T; Armstrong, Edward P; Modisett, Tara; Snead, Rebecca P; Warholak, Terri L

    2017-01-01

    The importance of creating and sustaining a strong culture of patient safety has been recognized as a critical component of safe medication use. This study aims to assess changes in attitudes toward patient safety culture and frequency of quality-related event (QRE) reporting after guided implementation of a continuous quality improvement (CQI) program in a panel of community pharmacies in the United States (U.S.). Twenty-one community pharmacies volunteered to participate in the project and were randomly assigned to intervention or control groups. Pharmacy staff in the intervention group received guided training to ensure full implementation of a CQI program while those in the control group partially implemented the program. Pharmacy staff in both groups completed retrospective pre-post safety culture questionnaires and reported medication errors and near misses that occurred in their practices. Rasch analysis was applied to assess questionnaire validity and reliability and to confirm if the ordinal level data approximated interval level measures. Paired t-tests and repeated measure analysis of covariance tests were subsequently used to compare observed changes in the attitudes of subjects and frequency of QREs reporting in intervention and control groups. Sixty-nine employees completed the questionnaire, a 43.9% response rate. Improvement in attitudes toward patient safety was statistically significant in the intervention group in six domains: staff, training, and skill (p = 0.017); patient counseling (p = 0.043); communication about mistakes (p patient safety perceptions (p = 0.033). No significant differences were observed in QRE reporting rates between intervention and control groups. However, differences were observed in the types of QREs reported (e.g., incorrect safety cap) and the point in the prescription processing workflow where a QRE was detected (e.g., partner check station, and drug utilization review station) in the intervention group (p

  1. Continuous quality improvement in daily clinical practice: a proof of concept study.

    Directory of Open Access Journals (Sweden)

    Jonathan A Lorch

    Full Text Available Continuous Quality Improvement (CQI is an iterative process of: planning to improve a product or process, plan implementation, analyzing and comparing results against those expected, and corrective action on differences between actual and expected results. It is little used in clinical medicine. Anemia, a complex problem in End Stage Renal Disease patients, served to test the ability of an unique electronic medical record (EMR optimized for daily care to empower CQI in practice. We used data collected during daily care, stored in the EMR, and organized to display temporal relationships between clinical, laboratory, and therapeutic events. Our aims were optimal hemoglobin with minimum epoetin, and maintaining stable hemoglobin and epoetin. The study was done on 250 patients treated by maintenance hemodialysis (HD, receiving epoetin prior to February 1, 2010 and followed to July 31, 2011. Repleting iron, ensuring iron sufficiency, slow epoetin reduction, and decision support tools enabling data display over long periods in patient-centered reports were key elements. Epoetin dose, adjusted 6-8 weekly, was based on current clinical conditions and past responses. Hemoglobin increased by months 1-2; epoetin decreased from month 4. By months 16-18, epoetin had decreased 42% to 9,720 units/week while hemoglobin increased 8% to 123.6 g/L. Hemoglobin and epoetin were stable from month 7 onward. New epoetin orders decreased 83%. Transferrin saturation increased after the study start. Individual patient hemoglobin variation decreased by 23%, range by 27%. Mortality, 11.78 per 100 patient years, was 42% less than United States dialysis patient mortality. Allowable epoetin charges decreased by $15.33 per treatment and were $22.88 less than current Medicare allowance. The study validates the hypothesis that an EMR optimized for daily patient care can empower CQI in clinical medicine and serve to monitor medical care quality and cost.

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

    Science.gov (United States)

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

    2016-12-01

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

  3. 基于双因素理论对提高合同制护士满意度的策略研究%Study of the strategies on contract nurses' job satisfaction improvement based on double- factor theory

    Institute of Scientific and Technical Information of China (English)

    魏雪梅; 李雪平; 李铁; 崔丽君

    2011-01-01

    Job satisfaction of contract nurses has been an important subject on modern hospital HR management. It has been the base of hospital service and its sustainable development and turned to be the main part to facilitate the patients' satisfaction and loyalty. Therefore, it is imperative to improve the satisfaction of contract nurses. Based on Herzberg's Double-factor Theory, this essay analyzed the key elements that affect contract nurses' job satisfaction. Moreover, it also studied two main strategies for the improvement of contract nurses' satisfaction. The first is the theory of exerting the factor of health care, which helps divert contract nurses from dissatisfaction to satisfaction without any incompatibility. The second is to enhance the effect of motive factor, diverting contract nurses from satisfaction absence to highly rated satisfaction.%合同制护士满意度已经成为现代医院人力资源管理的一个重要课题,是医院运行和持续发展的基石,也是促进患者满意度和忠诚度的主力军.可见,提高合同制护士满意度势在必行.基于赫茨伯格的双因素理论,分析影响合同制护士满意度的主要因素及提高合同制护士满意度的两大策略:一是运用保健因素原理,使合同制护士由不满意转向没有不满意;二是增强激励因素的作用,使合同制护士由没有满意度转向高满意度.

  4. Customer satisfaction

    DEFF Research Database (Denmark)

    Eskildsen, Jacob Kjær; Kristensen, Kai

    2007-01-01

    & Westlund, 2003) as well as the structure of the framework (Eskildsen et al., 2004). We know however very little about how the structure of the individual markets with respect to, for instance, how the transparency of products and services affects customer satisfaction. The aim of this article is to analyze...... the effect of the transparency of products and services on customer satisfaction with respect to Danish mobile phone companies, banks and supermarkets from 2004 based on the authors' experiences from the various analyses conducted within the EPSI rating initiative....

  5. APPLICATION OF FAILURE MODE & EFFECT ANALYSIS (FMEA FOR CONTINUOUS QUALITY IMPROVEMENT - MULTIPLE CASE STUDIES IN AUTOMOBILE SMES

    Directory of Open Access Journals (Sweden)

    Jigar Doshi

    2017-06-01

    Full Text Available Failure Mode and Effects Analysis (FMEA is a quality tool used to identify potential failures and related effects on processes and products, so continuous improvement in quality can be achieved by reducing them. The purpose of this research paper is to showcase the contribution of FMEA to achieve Continuous Quality Improvement (CQI by multiple case study research. The outcome research conducted by implementing FMEA; one of the Auto Core Tools (ACTs, in the automobile Small and Medium Enterprises (SMEs in Gujarat, India is presented in this paper which depict various means of Continuous Quality Improvements. The case study based research was carried out in four automobile SMEs; all of them are supplied to automotive Original Equipment Manufacturer (OEM. The FMEA was implemented with the help of Cross Functional Team (CFT to identify the potential failure modes and effects, in overall effect on Continuous Quality Improvement. The outcome of FMEA at four companies' reveals the scope of improvement exists in the manufacturing process. Implementation of those improvement points shows the definite signs of continuous improvement of the quality of process and product as well. The FMEA and subsequent implementations had reduced the quality rejections around 3% to 4% in case companies.

  6. Customer satisfaction and competencies

    DEFF Research Database (Denmark)

    Gritti, Paola; Foss, Nicolai Juul

    this by analyzing data collected on 2,105 customers of 118 branches of one of the biggest banks of an Italian banking group. We find that customer satisfaction impacts loyalty, which in turn has a direct effect on financial and non-financial customer value/total customer value/complex customer value. Moreover......, loyalty is a mediator between financial and not-financial customer value and two sources of customer satisfaction, namely relationships with the front office and the branch, on the one hand, and the products offered, on the other.......We empirically address how customer satisfaction and loyalty in the banking industry may affect profitability. This helps to identify the strategy and competencies necessary to benefit from customer relationships which are important sources for improved performance in the banking. We do...

  7. Significant improvements in self-reported gastrointestinal tolerability, quality of life, patient satisfaction, and adherence with lopinavir/ritonavir tablet formulation compared with soft gel capsules

    Directory of Open Access Journals (Sweden)

    Parekh Paras

    2008-09-01

    Full Text Available Abstract Background The tablet formulation of ritonavir-boosted lopinavir (LPV/r; Kaletra® has many advantages over the soft gel capsule (SGC formulation, including lower pill count, no refrigeration requirement, and no dietary restrictions. These advantages may help improve patient compliance and therefore increase adherence to treatment. However, there are limited data regarding patient preferences and only recently was the comparative efficacy and tolerability data of LPV/r SGC versus tablet formulation presented at an international conference. To address this deficit, we conducted a market research survey to assess potential tolerability benefits, patient satisfaction, changes in adherence, and formulation preference in patients switching from SGCs to the tablet formulation. Data from 332 patients who switched from LPV/r SGCs twice-daily (BID to tablets BID and 41 patients who switched from LPV/r SGCs BID or once daily (QD to tablets QD were analyzed. Results Switching from SGCs to a tablet formulation of LPV/r was associated with increased patient satisfaction, tolerability and self-reported adherence to treatment; gastrointestinal side effects were reduced. In addition, respondents indicated that they preferred the tablet formulation to the SGC. Conclusion The LPV/r tablet formulation provides HIV-infected patients with multiple benefits over the SGC in terms of tolerability and convenience. Additional assessments to further define the tolerability profile of the LPV/r tablet, including studies using once-daily dosing, are warranted.

  8. 网购时代提升快递业顾客满意度的措施%Research on Improving Customer Satisfaction Degree of Online Shopping Era

    Institute of Scientific and Technical Information of China (English)

    王帆; 顾华明

    2012-01-01

    我国网络购物的迅速升温促进了快递业的迅猛发展,随之各种有关快递的投诉量也直线上升。我国快递业顾客满意度不高的主要原因为快件延误、快件丢失、短少或损毁、索赔难和快递人员专业素质与服务态度较差。快递企业应当加强信息化建设和企业整合,实行包装分类并加强监管,建立快件到达时间分类机制以及加强快递业员工培训等改进措施提高顾客满意度。%The boom in Chinese online shopping helps to promote the development of express industry,however,the number of related complaints dramatically rises.The main causes of the low customer satisfaction of express industry are express delay,express loss,shortage or damage,difficulty to claim for compensation and poor professional quality and service attitude,express enterprise should strengthen information construction and enterprise integration,execute package classification and strengthen supervision,establish express arrival time classification mechanism and strengthen the express industry staff training to improve customer satisfaction.

  9. Research on Improving Customer's Satisfaction to Express Logistics Enterprises%快递物流企业提升客户满意度研究

    Institute of Scientific and Technical Information of China (English)

    刘明; 杨路明

    2015-01-01

    如何提升客户满意度是快递物流企业必须关注的热点, 服务的可靠性、 有形性、 保障性、 响应性和移情性是普遍的提升渠道. 但随着行业的发展, 消费者对服务质量一定会提出新的需求. 文章首先参考SERVQUAL模型和国家邮政局的《快递服务》 国家标准, 初步构建快递物流企业服务质量的评价指标体系; 再依据该体系借助李克特量表法(Likert Scale)设计调查问卷并发放; 回收问卷后使用SPSS19进行数据分析, 采用因子分析法对预先构建的质量评价指标体系进行调整和修改, 最终从确定后的评价体系中发现新的问题并提出相应的改进措施和建议. 研究得出只有对该问题引起足够重视并不断改善, 才能增加快递物流企业的服务附加值, 促进行业的健康良性发展.%How to improve the customer's satisfaction is a hot spot that the express logistics enterprises have to focus on. The"reli-ability", "responsiveness", "assurance", "empathy" and the"tangible" are the ways to achieve the purpose. With the development of the China's e-business, customer will provide the new suggestions. The paper reviews the SERVQUAL mode and the national standard of Express Service by State Post Bureau and constructs the evaluation index system of express logistics enterprises service quality. Then, the paper designs the questionnaires according to Likert Scale and distributes them. After getting all the questionnaires, the paper analyzes the data by SPSS19 and adjusts and revises of the quality evaluation index system by factor analysis. Finally, the paper discovers the new problem from the certified evaluation system and puts forward corresponding corrective measures and suggestions. It is found that only with enough attention and continuous improvement, we could increase the value-added of express logistics enterprises, and promote the healthy development of this industry.

  10. Improving the TNM classification: findings from a 10-year continuous literature review.

    Science.gov (United States)

    Webber, Colleen; Gospodarowicz, Mary; Sobin, Leslie H; Wittekind, Christian; Greene, Frederick L; Mason, Malcolm D; Compton, Carolyn; Brierley, James; Groome, Patti A

    2014-07-15

    The Union for International Cancer Control's (UICC) TNM classification is a globally accepted system to describe the anatomic extent of malignant tumors. Since its development seventy years ago, the TNM classification has undergone significant revisions to reflect the current understanding of extent of disease and its role in prognosis. To ensure that revisions are evidence-based, the UICC implemented a process for continuous improvement of the TNM classification that included a formalized system for submitting proposals for revisions directly to the UICC and an annual review of the scientific literature on staging that assessed, criticized or made suggestions for changes. The process involves review of the proposals and literature by a group of international, multidisciplinary Expert Panels. The process has been in place for 10 years and informed the development of the 7th edition of the TNM classification published in 2009. The purpose of this article is to provide a description of the annual literature review process, including the search strategy, article selection process and the roles and requirements of the Expert Panels in the review of the literature. Since 2002, 147 Expert Panel members in 11 cancer sites have reviewed over 770 articles. The results of the annual literature reviews, Expert Panel feedback and documentation and dissemination of results are described.

  11. Regularised Model Identification Improves Accuracy of Multisensor Systems for Noninvasive Continuous Glucose Monitoring in Diabetes Management

    Directory of Open Access Journals (Sweden)

    Mattia Zanon

    2013-01-01

    Full Text Available Continuous glucose monitoring (CGM by suitable portable sensors plays a central role in the treatment of diabetes, a disease currently affecting more than 350 million people worldwide. Noninvasive CGM (NI-CGM, in particular, is appealing for reasons related to patient comfort (no needles are used but challenging. NI-CGM prototypes exploiting multisensor approaches have been recently proposed to deal with physiological and environmental disturbances. In these prototypes, signals measured noninvasively (e.g., skin impedance, temperature, optical skin properties, etc. are combined through a static multivariate linear model for estimating glucose levels. In this work, by exploiting a dataset of 45 experimental sessions acquired in diabetic subjects, we show that regularisation-based techniques for the identification of the model, such as the least absolute shrinkage and selection operator (better known as LASSO, Ridge regression, and Elastic-Net regression, improve the accuracy of glucose estimates with respect to techniques, such as partial least squares regression, previously used in the literature. More specifically, the Elastic-Net model (i.e., the model identified using a combination of and norms has the best results, according to the metrics widely accepted in the diabetes community. This model represents an important incremental step toward the development of NI-CGM devices effectively usable by patients.

  12. A three-year comparative study of continuation rates, bleeding patterns and satisfaction in Australian women using a subdermal contraceptive implant or progestogen releasing-intrauterine system.

    Science.gov (United States)

    Weisberg, Edith; Bateson, Deborah; McGeechan, Kevin; Mohapatra, Lita

    2014-02-01

    BACKGROUND Long-acting reversible contraceptive methods (LARCs) are safe, highly effective, readily reversible, and require no action on the part of the user following insertion. Early discontinuation may put women at increased risk of unintended pregnancy. METHODS Following insertion of a progestogen-only subdermal implant or intrauterine system (IUS) at Family Planning NSW, women 18 years and older completed a questionnaire about their choice. At 6 weeks, 6, 12, 24 and 36 months by telephone or online they completed a questionnaire about bleeding patterns, side effects, satisfaction, and reasons for discontinuation. RESULTS Two hundred IUS users and 149 implant users were enrolled. The former were generally older, married or in a de-facto relationship, and had children. Forty-seven percent of implant users discontinued within three years compared to 27% of IUS users (p = 0.002). In the first two years amenorrhoea was more frequent in implant users. Frequent bleeding/spotting was more prevalent in the first year of IUS use but over time was twice as prevalent in implant users. Infrequent bleeding/spotting was more common in IUS users. CONCLUSION Both devices are highly effective and acceptable cost-effective methods. While LARCs should be promoted to women of all ages seeking contraception, early discontinuation due to unacceptable bleeding highlights the need for pre-insertion counselling.

  13. Occupants' satisfaction toward building environmental quality: structural equation modeling approach.

    Science.gov (United States)

    Kamaruzzaman, Syahrul Nizam; Egbu, C O; Zawawi, Emma Marinie Ahmad; Karim, Saipol Bari Abd; Woon, Chen Jia

    2015-05-01

    It is accepted that occupants who are more satisfied with their workplace's building internal environment are more productive. The main objective of the study was to measure the occupants' level of satisfaction and the perceived importance of the design or refurbishment on office conditions. The study also attempted to determine the factors affecting the occupants' satisfaction with their building or office conditions. Post-occupancy evaluations were conducted using a structured questionnaire developed by the Built Environment Research Group at the University of Manchester, UK. Our questionnaires incorporate 22 factors relating to the internal environment and rate these in terms of "user satisfaction" and "degree of importance." The questions were modified to reflect the specific setting of the study and take into consideration the local conditions and climate in Malaysia. The overall mean satisfaction of the occupants toward their office environment was 5.35. The results were measured by a single item of overall liking of office conditions in general. Occupants were more satisfied with their state of health in the workplace, but they were extremely dissatisfied with the distance away from a window. The factor analysis divided the variables into three groups, namely intrusion, air quality, and office appearance. Structural equation modeling (SEM) was then used to determine which factor had the most significant influence on occupants' satisfaction: appearance. The findings from the study suggest that continuous improvement in aspects of the building's appearance needs to be supported with effective and comprehensive maintenance to sustain the occupants' satisfaction.

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

    Science.gov (United States)

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

    2017-01-01

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

  15. 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…

  16. Randomized Trial of the Availability, Responsiveness and Continuity (ARC) Organizational Intervention for Improving Youth Outcomes in Community Mental Health Programs

    Science.gov (United States)

    Glisson, Charles; Hemmelgarn, Anthony; Green, Philip; Williams, Nathaniel J.

    2013-01-01

    Objectives: The primary objective of the study was to assess whether the Availability, Responsiveness and Continuity (ARC) organizational intervention improved youth outcomes in community based mental health programs. The second objective was to assess whether programs with more improved organizational social contexts following the 18-month ARC…

  17. Survey of sustainability of continuous improvement systems: a comparison of two manufacturing communities in Spain and Mexico

    Directory of Open Access Journals (Sweden)

    Carmen Jaca

    2011-04-01

    Full Text Available Purpose: During the last 50 years industrial companies have adopted continuous improvement systems to improve their competitiveness. However, the maintenance of improvement systems is not an easy matter. Some companies, after an initial period of one to two years, abandon the system for various reasons. This article aims to examine the level of application of Continuous Improvement Systems and the factors which support sustainability over time in two different regions.Design/methodology/approach: In order to obtain a comparative result between two different regions, a survey was conducted in two industrial zones—one in the north of Spain and another in Mexico—that are important industrial clusters these countries. The study was conducted through the analysis of survey data. Specifically, the survey was directed at large industrial enterprises who had participated in activities supported by local foundations for the promotion of quality and improvement.Findings and Originality/value: We suggest the following three keys for sustainable improvement: greater involvement of task forces in the improvement program, a PDCA improvement cycle for improvement and a clear purpose for continuous improvement, integration of the continuous improvement system in the organization, and the establishment of indicators associated with the system.Research limitations/implications: The comparative study focused on only two industrial zones in Spain and Mexico. In that sense, the findings of the research are limited to the Basque zone and geographical zone of Toluca-Lerma.Practical implications: Some of the companies have started to apply some continuous improvement techniques in a sustainability way. Therefore, these findings could be very useful for general and operation managers that are involved in continuous improvement systems in industrial companies in Spain and Mexico.Social implications: As a consequence, slow and small transformations in certain

  18. The construction and evaluation of Continuing Care Satisfaction Scale for premature infants' parents%早产儿家长延续性护理服务满意度量表的构建与评价

    Institute of Scientific and Technical Information of China (English)

    钱小芳; 刘桂华; 欧萍; 徐玉英; 姜芳; 谢燕钦

    2014-01-01

    目的:研制并评价早产儿家长延续性护理服务满意度量表。方法:运用文献回顾法、质性研究法和德尔菲函询法初步确定早产儿家长延续性护理服务满意度指标体系,对180例早产儿家长进行测评,检验量表的内容效度、结构效度、内在一致性信度和重测信度。结果:构建了涵盖护士的仪表和服务态度、护士的延续性护理业务能力、护士的人文素养和对延续性护理服务的总体评价4个因子共21个条目的早产儿家长延续性护理服务满意度量表,量表内容效度指数为0.964,主成分提取4个公因子,累计解释变异量为60.57%,总量表的Cronbach’sα系数为0.910,重测信度系数为0.807。结论:早产儿家长延续性护理服务满意度量表能体现延续性护理服务的内涵,具有较好的信度、效度,可作为早产儿院外延续性护理服务的测量工具。%Objectives:To develop and evaluate the reliability and validity of the Continuing Care Satisfaction Scale for premature infants' parents. Methods:We initially established the Continuing care satisfaction index system by literature review, qualitative research and Delphi consulting method. The content validity, construct validity, internal consistency reliability and test-retest reliability of the scale were tested in 180 parents of premature infants. Results:The scale consisted of 4 factors and 21 speciifc items. The 4 factors were the appearance and attitude of nurses, nurses' competency of Continuing care, humanistic attainment of nurses, and overall evaluation of Continuing care. The content validity index for the scale was 0.964. Four factors were extracted using principal components extraction and totally explained 60.57%of the variance. The Cronbach's alpha coefifcient was 0.910 and the test-retest reliability coefifcient was 0.807. Conclusion:The Continuing Care Satisfaction Scale for premature infants' parents could embody

  19. A Pilot Study on Measuring Customer’s Satisfaction Level

    Directory of Open Access Journals (Sweden)

    Vide Boltez

    2013-01-01

    Full Text Available RQ: Determine the level of customer satisfaction of a company’s products and services to obtain information on needed improvements.Purpose: The purpose of measuring customer’s satisfaction level is to obtain information directly from the final buyer that bought our product. The next step is to analyze the information obtained and to take the results into consideration to improve the working process in production and in other departments of the company.Method: The method used for the pilot study to measure customer satisfaction was a short questionnaire that was given to 10 customers of our product and 10 completed questionnaires were obtained.Results: The results showed the level of satisfaction of final buyers of roof tiles and roofs that the company has achieved through their products and services. The results facilitate the production, logistics, purchasing and sales department to obtain information on positive satisfaction levels and areas that need change. At the same time, the final buyer was identified (i.e., name, surname, address, and so forth, which up until now had not been.Organization: The organization will save time and money in the future, because it will continuously measure customer satisfaction to improve production and other departments in the organization towards creating satisfied customers.Society: Final buyers of roofs are, and will be, more satisfied with their decisions, because the organization carries out after-sales satisfaction levels.Originality: The research was original, because up to this date the organization has not conducted research in such a manner.Limitations: The pilot study used 10 completed questionnaires that represent a very small sample to make any generalizations.

  20. [Managing a health research institute: towards research excellence through continuous improvement].

    Science.gov (United States)

    Olmedo, Carmen; Buño, Ismael; Plá, Rosa; Lomba, Irene; Bardinet, Thierry; Bañares, Rafael

    2015-01-01

    Health research institutes are a strategic commitment considered the ideal environment to develop excellence in translational research. Achieving quality research requires not only a powerful scientific and research structure but also the quality and integrity of management systems that support it. The essential instruments in our institution were solid strategic planning integrated into and consistent with the system of quality management, systematic evaluation through periodic indicators, measurement of key user satisfaction and internal audits, and implementation of an innovative information management tool. The implemented management tools have provided a strategic thrust to our institute while ensuring a level of quality and efficiency in the development and management of research that allows progress towards excellence in biomedical research. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

  1. Physical function continues to improve when clinical remission is sustained in rheumatoid arthritis patients.

    Science.gov (United States)

    Radner, Helga; Alasti, Farideh; Smolen, Josef S; Aletaha, Daniel

    2015-08-11

    To investigate the course of functional status assessed by health assessment questionnaire (HAQ) in rheumatoid arthritis (RA) patients with sustained clinical remission (REM). In recent RA clinical trials, we identified patients with subsequent visits of ≥24 weeks in clinical REM according to the disease activity score using 28-joint counts including C-reactive protein (DAS28) (≤2.6), or simplified disease activity index (SDAI) (≤3.3). Area under the curve (AUC) and mean HAQ scores throughout the time in sustained REM were compared using t test, analyses of variance (ANOVA) and adjusted general linear modeling (GLM) with repeated measures. In Cox regression analyses, the time to regain full physical function was modeled. Sensitivity analyses were performed in patients of sustained SDAI low disease activity (LDA; SDAI ≤11). A total of 610 out of 4364 patients achieved sustained DAS28 REM (14%) and 252 SDAI REM (5.8%). ANOVA testing for linear trend showed significant decrease of mean HAQ from week 0 (start of REM) to week 24, regardless of REM criteria used. AUC of HAQ throughout 24 weeks of REM was higher in DAS28 compared to SDAI REM (p ≤0.01). GLM adjusting for covariates showed significant decrease of monthly HAQ scores from week 0 to 24 (DAS28: 0.276, 0.243, 0.229, 0.222, 0.219, 0.209 to 0.199; p = 0.0001; SDAI: 0.147, 0.142, 0.149, 0.129, 0.123, 0.117 to 0.114; p = 0.029). Similarly, a decrease of HAQ over time was found in patients of sustained SDAI LDA. In DAS28 REM, the chance of regaining full physical function was higher for female (hazard ratio HR [95% confidence interval]: 1.41 [1.13-1.76]) and early RA patients (disease duration ≤2 years: HR 1.29 [1.01-1.65]); in SDAI REM no significant differences were found. Physical function continues to improve if the target of REM or LDA is sustained. The stringency of the remission criteria determines achievement of the best possible functional improvement.

  2. Fortifier and Cream Improve Fat Delivery in Continuous Enteral Infant Feeding of Breast Milk

    Directory of Open Access Journals (Sweden)

    Mika Tabata

    2015-02-01

    Full Text Available Premature and high-risk infants require accurate delivery of nutrients to promote appropriate growth. Continuous enteral feeding methods may result in significant fat and micronutrient loss. This study evaluated fat loss in enteral nutrition using current strategies for providing high-risk infants fortified human milk (HM. The fat content of HM was measured by IR analyzer in a simulated feeding system using the Kangaroo epumpTM and the MedFusionTM 2010 pump. Comparisons in fat loss were made between HM, HM supplemented with donor HM-derived fortifier Prolacta + H2MFTM (H2MF, and HM supplemented with H2MF and donor HM-derived cream ProlactCRTM (cream. When using the Kangaroo epumpTM, the addition of H2MF and cream to HM increased fat delivery efficiency from 75.0% ± 1.2% to 83.7% ± 1.0% (p < 0.0001. When using the MedFusionTM 2010 pump, the addition of H2MF to HM increased fat delivery efficiency from 83.2% ± 2.8% to 88.8% ± 0.8% (p < 0.05, and the addition of H2MF and cream increased fat delivery efficiency to 92.0% ± 0.3% (p < 0.01. The addition of H2MF and cream to HM provides both the benefits of bioactive elements from mother’s milk and increased fat delivery, making the addition of H2MF and cream an appropriate method to improve infant weight gain.

  3. The sustainability of improvements from continuing professional development in pharmacy practice and learning behaviors.

    Science.gov (United States)

    McConnell, Karen J; Delate, Thomas; Newlon, Carey L

    2015-04-25

    To assess the long-term sustainability of continuing professional development (CPD) training in pharmacy practice and learning behaviors. This was a 3-year posttrial survey of pharmacists who had participated in an unblinded randomized controlled trial of CPD. The online survey assessed participants' perceptions of pharmacy practice, learning behaviors, and sustainability of CPD. Differences between groups on the posttrial survey responses and changes from the trial's follow-up survey to the posttrial survey responses within the intervention group were compared. Of the 91 pharmacists who completed the original trial, 72 (79%) participated in the sustainability survey. Compared to control participants, a higher percentage of intervention participants reported in the sustainability survey that they had utilized the CPD concept (45.7% vs 8.1%) and identified personal learning objectives (68.6% vs 43.2%) during the previous year. Compared to their follow-up survey responses, lower percentages of intervention participants reported identifying personal learning objectives (94.3% vs 68.6%), documenting their learning plan (82.9% vs 22.9%) and participating in learning by doing (42.9% vs 14.3%) in the sustainability survey. In the intervention group, many of the improvements to pharmacy practice items were sustained over the 3-year period but were not significantly different from the control group. Sustainability of a CPD intervention over a 3-year varied. While CPD-trained pharmacists reported utilizing CPD concepts at a higher rate than control pharmacists, their CPD learning behaviors diminished over time.

  4. 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.

  5. Improving the performance of a continuous process for the production of ethanol from starch.

    Science.gov (United States)

    Trovati, Joubert; Giordano, Roberto C; Giordano, Raquel L C

    2009-05-01

    In a previous work, a continuous simultaneous saccharification and fermentation process to produce ethanol from cassava starch was studied, using a set of fixed-bed reactors. The biocatalyst consisted of glucoamylase immobilized in silica particles and co-immobilized with S. cerevisiae in pectin gel. Using 3.8 U mL(-1) (reactor) and 0.05 g(wet yeast) mL(-1) (reactor) at start-up, starch hydrolysis was the rate-limiting step. Maximum ethanol productivity was 5.8 g(ethanol) L(-1) h(-1), with 94.0% conversion of total reducing sugars (TRS) and 83.0% of the ethanol theoretical yield. In this work, the molar mass of the substrate and the biocatalyst particle size were reduced in an attempt to improve the bioreactor performance. The diameters of silica and pectin gel particles were reduced from 100 mum and 3-4 mm, respectively, to 60 mum and 1-1.5 mm, and the degree of substrate prehydrolysis by alpha-amylase was increased. The bioreactor performance was assessed for different loads of immobilized glucoamylase (2.1, 2.8, and 3.8 U mL(-1) (reactor)), for the same initial cell concentration (0.05 g(wet yeast.)mL(-1) (reactor)). Feeding with 154.0 g L(-1) of TRS and using 3.8 U mL(-1) (reactor), fermentation became the rate-limiting step. Productivity reached 11.7 g L(-1) h(-1), with 97.0% of TRS conversion and 92.0% of the ethanol theoretical yield. The reactor was operated during 275 h without any indication of destabilization.

  6. A randomised controlled trial to improve the role of the general practitioner in cancer rehabilitation: effect on patients’ satisfaction with their general practitioners

    DEFF Research Database (Denmark)

    Bergholdt, Stinne Holm; Gilså Hansen, Dorte; Larsen, Pia Veldt

    2013-01-01

    OBJECTIVE: To test whether a complex intervention facilitating early cancer rehabilitation by involvement of the general practitioner (GP) soon after diagnosis improves patients' satisfaction with their GPs. DESIGN: A cluster randomised controlled trial. All general practices in Denmark were...... randomised to an intervention or a control group before the start of the study. Patients included those with cancer who were subsequently allocated to either group based on the randomisation status of their GP. PARTICIPANTS: Adult patients with cancer treated for incident cancer at the public regional...... hospital (Vejle Hospital, Denmark) were included between May 2008 and February 2009. A total of 955 patients registered with 323 practices were included, of which 486 patients were allocated to the intervention group and 469 to the control group. INTERVENTION: The intervention included a patient interview...

  7. Procedural Portfolio Planning in Plastic Surgery, Part 1: Strategic Changes in Clinical Practice to Increase Physician Revenue, Improve Operative Throughput, and Maintain Patient Satisfaction.

    Science.gov (United States)

    Hultman, Charles Scott

    2016-06-01

    Portfolio planning in health care represents the strategic prioritization of services that permits an organization to better achieve its goals of margin and mission. Because of recent volatility in the economy, declining reimbursement, and rising costs of providing care, such strategic planning has become increasingly important if physicians want to remain leaders in health care. This project assesses the financial impact of procedural portfolio planning on an academic plastic surgery practice from the physician's perspective. We tracked the top 50 procedures, defined as total charges per CPT code, that were performed in our baseline year, for 6 providers in a stable plastic surgery practice. At the end of the first year, we implemented 3 types of strategic changes: growth of areas with high contribution margin (laser resurfacing of burn scars), curtailment of high-risk procedures with negative contribution margin (panniculectomy in smokers), and improved efficiency of mission-critical services with high resource consumption (free-flap breast reconstruction). During the 2-year study period, we had no turnover in faculty, did not pursue any formal marketing, did not change our surgical fees or billing system, provided care independent of payer mix, and maintained our commitment to indigent care. Outcome measures included procedural charges and revenue, collection rates, work relative value units, operating room times, idle times (room time less case time), receipts/minute in operating room, uncompensated charity care, and patient satisfaction (Press-Gainey scores). Before the study period, annual incremental growth in our practice was 1% to 2%, in terms of charges and receipts. After implementation of the portfolio planning project, the financial position of our division improved significantly, with patient satisfaction rates increasing from 85.5% to 94.1% and charity care remaining constant at US $400,000 per year. Encounters, work relative value units, charges

  8. Intrinsic job satisfaction, overall satisfaction, and intention to leave the job among nursing assistants in nursing homes.

    Science.gov (United States)

    Decker, Frederic H; Harris-Kojetin, Lauren D; Bercovitz, Anita

    2009-10-01

    We examined predictors of intrinsic job satisfaction, overall satisfaction, and intention to leave the job among nursing assistants (NAs). The study focused on NAs who worked 30 or more hours per week in a nursing home. Data on 2,146 NAs meeting this criterion came from the 2004 National Nursing Assistant Survey, the first telephone interview survey of NAs nationwide. Regression equations were calculated in which intrinsic satisfaction, overall satisfaction, and intention to leave were dependent variables. NA attributes (e.g., job tenure and education) and extrinsic job factors (e.g., assessment of supervisor behavior, pay satisfaction, and benefits) were exogenous variables. A positive assessment of the supervisor's behavior had the strongest association with intrinsic satisfaction. Pay satisfaction had the second strongest association with intrinsic satisfaction. Predictors with the strongest associations with intention to leave were overall and intrinsic satisfaction. Assessment of the supervisor was not associated directly with intention to leave. Assessments of the supervisor and pay may affect overall satisfaction and intention to leave in part through their direct effects on intrinsic satisfaction. Some facility and NA attributes were related to intrinsic satisfaction but not to overall satisfaction, suggesting that intrinsic satisfaction may be an intervening variable in the impact of these attributes on overall satisfaction. Intrinsic satisfaction and extrinsic job factors amenable to change appear central to NAs' overall satisfaction and intention to leave. A facility may be able to improve extrinsic job factors that improve NAs' job-related affects, including intrinsic satisfaction.

  9. The impact of quality management on patient satisfaction in a hospital: brief report

    Directory of Open Access Journals (Sweden)

    Ali Mohammad Mosadeghrad

    2017-06-01

    Full Text Available Background: Patient satisfaction is an important indicator of healthcare quality and effectiveness. Quality management as an organizational strategy enhances the quality of hospital services through continuously improving hospital structures and processes. This study aimed to examine the impact of quality management on patient satisfaction. Methods: A participatory action research was conducted in respiratory intensive care unit, at Labafinejad hospital, Tehran, Iran, in 2013. A quality improvement team was established. Operational processes were improved using a quality management model. The quality improvement team standardized processes, identified quality goals for the processes and improved them until achieved quality goals. Patients’ satisfaction data was collected before and after the intervention using a valid and reliable questionnaire. Results: Patients’ satisfaction was 75 percent at the beginning of the study. Patients were mostly dissatisfied with the nutrition services, amenities, lack of attention to their personal needs and lack of involving them in their treatment processes. An action plan was developed for improving patient satisfaction. After the quality management intervention, patient satisfaction reached to 81 percent at the end of this study. The quality management model improved the quality of services by 54.5 percent and consequently increased patient satisfaction by 7.2 percent. Almost half of the patients at the beginning of this study were definitely willing to recommend the hospital to their friends and relatives. This figure increased to 76 percent. The rest of patients stated that they may recommend the hospital to others. Conclusion: Implementing an appropriate quality management model appropriately in a supportive environment helps improve the quality of services and enhance patient satisfaction and loyalty.

  10. 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.

  11. Harnessing the genetics of the modern dairy cow to continue improvements in feed efficiency.

    Science.gov (United States)

    VandeHaar, M J; Armentano, L E; Weigel, K; Spurlock, D M; Tempelman, R J; Veerkamp, R

    2016-06-01

    Feed efficiency, as defined by the fraction of feed energy or dry matter captured in products, has more than doubled for the US dairy industry in the past 100 yr. This increased feed efficiency was the result of increased milk production per cow achieved through genetic selection, nutrition, and management with the desired goal being greater profitability. With increased milk production per cow, more feed is consumed per cow, but a greater portion of the feed is partitioned toward milk instead of maintenance and body growth. This dilution of maintenance has been the overwhelming driver of enhanced feed efficiency in the past, but its effect diminishes with each successive increment in production relative to body size and therefore will be less important in the future. Instead, we must also focus on new ways to enhance digestive and metabolic efficiency. One way to examine variation in efficiency among animals is residual feed intake (RFI), a measure of efficiency that is independent of the dilution of maintenance. Cows that convert feed gross energy to net energy more efficiently or have lower maintenance requirements than expected based on body weight use less feed than expected and thus have negative RFI. Cows with low RFI likely digest and metabolize nutrients more efficiently and should have overall greater efficiency and profitability if they are also healthy, fertile, and produce at a high multiple of maintenance. Genomic technologies will help to identify these animals for selection programs. Nutrition and management also will continue to play a major role in farm-level feed efficiency. Management practices such as grouping and total mixed ration feeding have improved rumen function and therefore efficiency, but they have also decreased our attention on individual cow needs. Nutritional grouping is key to helping each cow reach its genetic potential. Perhaps new computer-driven technologies, combined with genomics, will enable us to optimize management for

  12. Predicting core losses and efficiency of SRM in continuous current mode of operation using improved analytical technique

    Energy Technology Data Exchange (ETDEWEB)

    Parsapour, Amir, E-mail: amirparsapour@gmail.com [Department of Electrical Engineering, University of Isfahan, Isfahan (Iran, Islamic Republic of); Dehkordi, Behzad Mirzaeian, E-mail: mirzaeian@eng.ui.ac.ir [Department of Electrical Engineering, University of Isfahan, Isfahan (Iran, Islamic Republic of); Moallem, Mehdi, E-mail: moallem@cc.iut.ac.ir [Department of Electrical Engineering, Isfahan University of Technology, Isfahan (Iran, Islamic Republic of)

    2015-03-15

    In applications in which the high torque per ampere at low speed and rated power at high speed are required, the continuous current method is the best solution. However, there is no report on calculating the core loss of SRM in continuous current mode of operation. Efficiency and iron loss calculation which are complex tasks in case of conventional mode of operation is even more involved in continuous current mode of operation. In this paper, the Switched Reluctance Motor (SRM) is modeled using finite element method and core loss and copper loss of SRM in discontinuous and continuous current modes of operation are calculated using improved analytical techniques to include the minor loop losses in continuous current mode of operation. Motor efficiency versus speed in both operation modes is obtained and compared. - Highlights: • Continuous current method for Switched Reluctance Motor (SRM) is explained. • An improved analytical technique is presented for SRM core loss calculation. • SRM losses in discontinuous and continuous current operation modes are presented. • Effect of mutual inductances on SRM performance is investigated.

  13. Constraint satisfaction problems CSP formalisms and techniques

    CERN Document Server

    Ghedira, Khaled

    2013-01-01

    A Constraint Satisfaction Problem (CSP) consists of a set of variables, a domain of values for each variable and a set of constraints. The objective is to assign a value for each variable such that all constraints are satisfied. CSPs continue to receive increased attention because of both their high complexity and their omnipresence in academic, industrial and even real-life problems. This is why they are the subject of intense research in both artificial intelligence and operations research. This book introduces the classic CSP and details several extensions/improvements of both formalisms a

  14. Engineering graduates' skill sets in the MENA region: a gap analysis of industry expectations and satisfaction

    Science.gov (United States)

    Ramadi, Eric; Ramadi, Serge; Nasr, Karim

    2016-01-01

    This study explored gaps between industry expectations and perceptions of engineering graduates' skill sets in the Middle East and North Africa (MENA) region. This study measured the importance that managers of engineers placed on 36 skills relevant to engineers. Also measured was managers' satisfaction with engineering graduates' skill sets. Importance and satisfaction were used to calculate skill gaps for each skill. A principal components analysis was then performed, consolidating the 36 skills into 8 categories. The means of importance, satisfaction, and skill gaps were ranked to determine the areas in which graduates needed improvement. Results showed significant gaps between managers' expectations of and satisfaction with all 36 skills. The areas in which managers felt that graduates needed most improvement were communication, time management, and continuous learning. Managers reported that recent engineering graduates exhibited low overall preparedness for employment. These findings may help to inform curricular reform in engineering education.

  15. Continuous improvement programs as processes for organizational learning: A case study of a company in the food products industry.

    Directory of Open Access Journals (Sweden)

    André Luiz Fischer

    2010-05-01

    Full Text Available This article intends to show the relationships between quality practices and the process of organizational learning. When we look at the literature about programs of continuous improvement we see that theoreticians consider that the process of organizational learning is a superior stage in the quality culture adopted by companies. To investigate this possibility, we put together a series of indicators taken from classic authors who have written about organizational learning. Adopting a multiple methodology, we applied these indicators to two plants belonging to the Nestlé food product company which have introduced continuous improvement programs over the last two years

  16. Improving customer satisfaction and quality: hospitals recognized by J.D. power and associates share insights on meeting patient and employee needs.

    Science.gov (United States)

    2003-08-01

    For 35 years, J.D. Power and Associates has presented its much-coveted awards recognizing product and service quality and customer satisfaction in a variety of industries. This year, the company added a new category: hospitals. To better understand patients' reactions to their hospital experiences, the company looked at five key drivers of customer satisfaction: dignity and respect, speed and efficiency, comfort, information and communication, and emotional support. This issue looks at five hospitals recognized by the company for their service excellence and why they emphasize employee satisfaction as well as patient satisfaction.

  17. Unlocking the Doors to Patient Satisfaction in Pediatric Orthopaedics.

    Science.gov (United States)

    Peng, Frederick B; Burrows, James F; Shirley, Eric D; Rosen, Paul

    2016-07-20

    Despite efforts to enhance the patient experience, many health care providers continue to struggle to improve patient satisfaction as the identification of tangible quality improvement areas remains difficult. This dilemma is particularly relevant in pediatric settings, where patient satisfaction measures have not been as thoroughly studied in subspecialties such as orthopaedics. We investigate this issue to identify the major drivers of patient satisfaction in pediatric orthopaedics, which has significant financial and professional implications for both hospital administrators and health care providers. Although recent patient experience studies emphasize on improving access to care and nurturing hospitality by facilities upgrades or staff development, we hypothesized that the patient-physician relationship remains the most important factor in patients' assessment of their experiences. Patient satisfaction surveys were collected from outpatient visits to pediatric orthopaedic practices at 5 locations in 3 states. Data were aggregated as monthly percentages of responses on a 5-point Likert scale. Month over month Pearson product-moment correlation coefficients were generated between top responses for "Likelihood of Your Recommending Our Practice to Others" (LTR) and other variables. In total, 6195 families completed satisfaction surveys. The variables most predictive of likelihood to recommend the practice were "Staff Worked Together" (r=0.82), "Friendliness/Courtesy of Care Provider" (r=0.80), "Cheerfulness of Practice" (r=0.80), "Likelihood of Recommending Care Provider" (r=0.80), and "Care Provider's Information about Medications" (r=0.78). Measurements of the patient-physician relationship, along with overall cheerfulness and staff collaboration, have the strongest relationships to LTR. These results suggest that patient satisfaction is influenced by more than just the patient-physician relationship, and may have significance in aiding pediatric orthopaedic

  18. Energy Efficiency and Renewable Energy Network (EREN): Customer satisfaction survey

    Energy Technology Data Exchange (ETDEWEB)

    Anderson, A.V. [Information International Associates, Inc., Oak Ridge, TN (United States); Henderson, D.P. [Dept. of Energy, Oak Ridge, TN (United States). Office of Scientific and Technical Information

    1996-04-22

    The Energy Efficiency and Renewable Energy Network (EREN) Customer Satisfaction Survey was developed and executed in support of EREN`s continuous quality improvement (CQI) plan. The study was designed to provide information about the demographic make up of EREN users, the value or benefits they derive from EREN, the kinds and quality of services they want, their levels of satisfaction with existing services, their preferences in both the sources of service and the means of delivery, and to provide benchmark data for the establishment of continuous quality improvement measures. The survey was performed by soliciting voluntary participation from members of the EREN Users Group. It was executed in two phases; the first being conducted by phone using a randomly selected group; and the second being conducted electronically and which was open to all of the remaining members of the Users Group. The survey results are described.

  19. 品管圈活动在提高住院患者满意度中的应用%QCC in improving patients'satisfaction degree of application

    Institute of Scientific and Technical Information of China (English)

    曹俊霞; 杨爱春

    2014-01-01

    目的:探讨品管圈活动对提高我科住院患者满意度的效果。方法成立品管圈活动小组,确定以提高住院患者满意度为活动主题,通过收集2012年和2013年1月份到6月份同期住院患者满意度调查表,分析科室住院患者满意度不高的主要原因,通过PDCA的程序来进行。结果我科住院患者满意度从品管圈活动前的91.7%上升到活动后的98.4%。结论品管圈活动在提高住院患者满意度中的应用,取得了满意效果。%Objectives Explore the QCC to improve our hospital patient satisfaction results.Methods Founded QCC team de-termined to improve inpatient satisfaction theme,by collecting 2012 and January 2013 to June over the same period in hospital patient satisfaction surveys,department hospitalized patient satisfaction is not high, mainly due to the analysis, carried out by the PDCA process.Results I inpatient patient satisfaction increased from 91.7 percent QCC ago to 98.4% after the event.Conclusions QCC in improving hospital patient satisfaction in the application,and achieved satisfactory results.

  20. 论临床路径实施中的持续质量改进%Continuous Quality Improvement by Using Clinical Pathways in Hospitals

    Institute of Scientific and Technical Information of China (English)

    江芹; 张振忠; 赵颖旭; 于丽华; 郎婧婧; 张智国; 常欢欢

    2012-01-01

    The implementation of clinical pathway in some places has made a lot of good experiences, i. e. : integration of medical resources, medical institutions and medical staff to improve work efficiency ; reduce medical costs; improving the quality of medical care, increased patient satisfaction and etc. But currently domestic hospital management and technical level of the in China vary remarkably, in the process of implementation of the clinical pathway also encountered many difficulties, such as the design of clinical pathways and the lack of evidence - based standards development process support, inadequate preparation with limited resource mobilization , lack of effective implementation of the results of scientific evaluation and improvement of coping mechanisms. Need to improve the clinical pathway system design to achieve good clinical pathways to improve the basic conditions , to grasp the critical aspects of clinical pathways and other multi - angle control for continuous improvement.%临床路径的实施在一些地方取得了不错的经验,如整合医疗资源、提高医疗机构和医务人员的工作效率、降低医疗成本;通过提高病种的医疗护理质量,提高了病人满意度.但国内医院目前的管理和技术水平良莠不齐,在推行临床路径的过程中也遇到了不少困难,比如在临床路径设计和流程标准制定上缺乏循证支持,准备不足,医疗机构内部的资源动员有限,缺乏科学有效的实施效果评价和完善机制等等.需要从完善临床路径制度的设计、改善临床路径的基础条件、把握临床路径关键环节的控制等多角度进行持续改进.

  1. Sildenafil versus continuous positive airway pressure for erectile dysfunction in men with obstructive sleep apnea: a comparative study of their efficacy and safety and the patient's satisfaction with treatment%比较西地那非与连续气道正压通气治疗阻塞性睡眠呼吸暂停患者的勃起功能障碍:疗效、安全性和患者满意度

    Institute of Scientific and Technical Information of China (English)

    Petros Perimenis; Kyriakos Karkoulias; Angelis Konstantinopoulos; Paraskevi P. Perimeni; George Katsenis; Anastasios Athanasopoulos; Konstantinos Spyropoulos

    2007-01-01

    Aim: To assess the efficacy of sildenafil and continuous positive airway pressure (CPAP) in the treatment of concurrent erectile dysfunction (ED) with obstructive sleep apnea (OSA), and to gauge the level of treatment satisfaction in patients and their partners. Methods: Forty men were treated for 12 weeks with sildenafil 100 mg (20 men) or CPAP during nighttime sleep (20 men). Treatment efficacy was assessed by the rate of successful intercourse attempts,and satisfaction with treatment was assessed by patients' and partners' answers to question 1 of the Erectile Dysfunction Inventory of Treatment Satisfaction. Results: Under sildenafil, 128 of 249 (51.4%) intercourse attempts were successful; under CPAP, 51 of 193 (26.9%) attempts were successful (Cp < 0.001). Erectile function was improved in both groups. After sildenafil and CPAP treatment, the mean International Index for Erectile Function domain scores were 14.3 and 10.8, respectively (Bp = 0.025), compared to 7.8 and 7 at baseline, respectively. CPAP and sildenafil were well tolerated. Sporadic episodes of nasal dryness under CPAP and transient headache and flushing under sildenafil were not significant. Fifty percent of patients treated with sildenafil and 25% with CPAP were satisfied with the treatment, and their partners were equally satisfied. The satisfaction scores for both patients and partners under sildenafil were superior to those under CPAP (Cp < 0.002). Conclusion: Both sildenafil 100 mg and CPAP, used separately, had positive therapeutic impact but sildenafil was superior. Patients and their partners were more satisfied with sildenafil for the treatment of ED. However, because of the high proportion of dissatisfied men and partners, new therapeutic agents or a combination of the two methods must be studied further.

  2. Decreasing catheter-related infection and hospital costs by continuous quality improvement.

    Science.gov (United States)

    Civetta, J M; Hudson-Civetta, J; Ball, S

    1996-10-01

    a) To reduce the rate of catheter-related infection, using improved skin preparation and catheters impregnated with silver sulfadiazine and chlorhexidine; b) to decrease the number of unnecessary guidewire exchanges of existing catheters by substituting suspected catheter-related sepsis for fever alone as an indication to change an indwelling catheter; and c) to decrease the hospital costs associated with guidewire exchanges and new catheter insertions. Sequential, prospective, descriptive studies using a continuous quality management approach. A 20-bed trauma intensive care unit at a university teaching hospital. Patients (n = 147) admitted from July 1 to December 31, 1992 (phase 1); 34 patients admitted in June and September 1993 (phase 2); and 156 patients admitted between January 1 and June 30, 1994 (phase 3). Phase 1: Proportions of catheter-related infections and catheter-related bacteremia were compared with our prior reported results. Indications for guidewire exchange were analyzed, and the rate of catheter-related infection for each indication was derived. Phase 2: The rate of catheter-related infection was determined for a trial group of triple-lumen catheters impregnated with silver sulfadiazine and chlorhexidine. Phase 3: Four components were altered. Impregnated triple-lumen catheters were used instead of unprotected catheters. Chlorhexidine skin cleanser was substituted for povidone-iodine solution during initial aseptic preparation during catheter insertion and subsequent guidewire exchange. Suspected catheter-related sepsis was substituted for fever as an indication for guidewire exchange. The "safe" period (the time before considering changing a catheter because catheter-related sepsis was suspected) was extended from 2 to 4 days. The overall rate of catheter-related infection in phase 1 was 15% (15% for triple-lumen catheters and 16% for introducers). Catheters changed for site inflammation had a 46% rate of catheter-related infection

  3. Life Improvement of Pot Hardware in Continuous Hot Dipping Processes Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Xingbo Liu

    2006-01-18

    The process of continuous galvanizing of rolled sheet steel includes immersion into a bath of molten zinc/aluminum alloy. The steel strip is dipped in the molten bath through a series of driving motors and rollers which control the speed and tension of the strip, with the ability to modify both the amount of coating applied to the steel as well as the thickness and width of the sheet being galvanized. There are three rolls used to guide the steel strip through the molten metal bath. The rolls that operate in the molten Zn/Al are subject to a severely corrosive environment and require frequent changing. The performance of this equipment, the metallic hardware submerged in the molten Zn/Al bath, is the focus of this research. The primary objective of this research is to extend the performance life of the metallic hardware components of molten Zn/Al pot hardware by an order of magnitude. Typical galvanizing operations experience downtimes on the order of every two weeks to change the metallic hardware submerged in the molten metal bath. This is an expensive process for industry which takes upwards of 3 days for a complete turn around to resume normal operation. Each roll bridle consists of a sink, stabilizer, and corrector roll with accompanying bearing components. The cost of the bridle rig with all components is as much as $25,000 dollars just for materials. These inefficiencies are of concern to the steel coating companies and serve as a potential market for many materials suppliers. This research effort served as a bridge between the market potential and industry need to provide an objective analytical and mechanistic approach to the problem of wear and corrosion of molten metal bath hardware in a continuous sheet galvanizing line. The approach of the investigators was to provide a means of testing and analysis that was both expeditious and cost effective. The consortium of researchers from West Virginia University and Oak Ridge National Laboratory developed

  4. A Model of Continuous Improvement in High Schools: A Process for Research, Innovation Design, Implementation, and Scale

    Science.gov (United States)

    Cohen-Vogel, Lora; Cannata, Marisa; Rutledge, Stacey A.; Socol, Allison Rose

    2016-01-01

    This chapter describes a model for continuous improvement that guides the work of the National Center on Scaling Up Effective Schools, or NCSU. NCSU is a research and development center funded by the Institute for Education Sciences, the research arm of the United States Department of Education. At the core of the Center's work is an innovative…

  5. The Use of System Thinking Concepts in Order to Assure Continuous Improvement of Project Based Learning Courses

    Science.gov (United States)

    Arantes do Amaral, Joao Alberto; Gonçalves, Paulo

    2015-01-01

    This case study describes a continuous improvement experience, conducted from 2002 to 2014 in Sao Paulo, Brazil, within 47 Project-Based Learning MBA courses, involving approximately 1,400 students. The experience report will focus on four themes: (1) understanding the main dynamics present in MBA courses; (2) planning a systemic intervention in…

  6. [Progress in improvement of continuous monoculture cropping problem in Panax ginseng by controlling soil-borne disease management].

    Science.gov (United States)

    Wang, Rui; Dong, Lin-Lin; Xu, Jiang; Chen, Jun-Wen; Li, Xi-Wen; Chen, Shi-Lin

    2016-11-01

    The continuous monoculture cropping problem severely has hindered the land resource of Panax ginseng cultivation and threatened the sustainable development of ginseng industry. There are comprehensive factors causing the continuous monoculture cropping problem, such as deterioration of soil physical and chemical properties, accumulation of allelochemical, increase of pesticide residue and heavy metal, imbalance of rhizospheric micro-ecosystem, and increase of soil-borne diseases. Among soil-borne disease was one of the key factors. More than 40 soil-borne diseases have been reported in the ginseng cultivation, especially, the diseases were more serious in the ginseng replanting land. Here main soil-borne diseases and their prevention way have been summarized, and we try to provide the effective improvement strategy of continuous monoculture cropping problem focusing on the disease control and offer reference for overcoming the ginseng continuous monoculture cropping problem. Copyright© by the Chinese Pharmaceutical Association.

  7. Continuous water-quality monitoring to improve lake management at Lake Mattamuskeet National Wildlife Refuge

    Science.gov (United States)

    Michelle Moorman; Tom Augspurger

    2016-01-01

    The U.S. Fish and Wildlife Service has partnered with U.S. Geological Survey to establish 2 continuous water-quality monitoring stations at Lake Mattamuskeet. Stations on the east and west side of the lake measure water level, clarity, dissolved oxygen, pH, temperature, salinity, and conductivity.

  8. Continuous quality improvement based on Lean Six Sigma in manufacturing small and medium sized enterprises

    NARCIS (Netherlands)

    Timans, Werner

    2014-01-01

    Kleine en middelgrote bedrijven uit de maakindustrie ervaren toenemende eisen met betrekking tot de kwaliteit van producten en processen. Om in competitie te blijven is voortdurend verbeteren van cruciaal belang, en de Lean Six Sigma benadering biedt veelbelovende mogelijkheden om continu verbeteren

  9. The ‘devils triangle’ of MSC certification: Balancing credibility, accessibility and continuous improvement

    NARCIS (Netherlands)

    Bush, S.R.; Toonen, H.M.; Oosterveer, P.J.M.; Mol, A.P.J.

    2013-01-01

    The Marine Stewardship Council (MSC) has continued to strengthen its position in the market based on its credibility as a transparent, accountable and science-based third party certification scheme. However, the consolidation of MSC's credibility risks being undermined by the poor representation of

  10. Continuous quality improvement based on Lean Six Sigma in manufacturing small and medium sized enterprises

    NARCIS (Netherlands)

    Timans, Werner

    2014-01-01

    Kleine en middelgrote bedrijven uit de maakindustrie ervaren toenemende eisen met betrekking tot de kwaliteit van producten en processen. Om in competitie te blijven is voortdurend verbeteren van cruciaal belang, en de Lean Six Sigma benadering biedt veelbelovende mogelijkheden om continu verbeteren

  11. Direct Measurement and Evaluation for Mechanical Engineering Programme Outcomes: Impact on Continuous Improvement

    Science.gov (United States)

    Tahir, Mohd Faizal Mat; Khamis, Nor Kamaliana; Wahid, Zaliha; Ihsan, Ahmad Kamal Ariffin Mohd; Ghani, Jaharah Ab; Sabri, Mohd Anas Mohd; Sajuri, Zainuddin; Abdullah, Shahrum; Sulong, Abu Bakar

    2013-01-01

    Universiti Kebangsaan Malaysia (UKM) is a research university that continuously undergoes an audit and accreditation process for the management of its courses. The Faculty of Engineering and the Built Environment (FKAB) is subjected to such processes, one of them is the auditing conducted by the Engineering Accreditation Council (EAC), which gives…

  12. Public Relations in Catholic Secondary Schools: Nearly 40 Years of Continuous Improvement

    Science.gov (United States)

    James, John T.

    2004-01-01

    This article traces the phenomenal improvement in public relations efforts over the past 40 years made by Catholic secondary schools. The improvements were brought about by crises, a theological paradigm shift, professional lay involvement, a growing awareness and appreciation of public relations, competition, and increasing financial need. The…

  13. Intermittent But Not Continuous Static Stretching Improves Subsequent Vertical Jump Performance In Flexibility-Trained Athletes.

    Science.gov (United States)

    Bogdanis, Gregory C; Donti, Olyvia; Tsolakis, Charilaos; Smilios, Ilias; Bishop, David J

    2017-02-23

    This study examined changes in countermovement jump (CMJ) height after an intermittent or a continuous static stretching protocol of equal total duration. Sixteen male, elite-level gymnasts performed 90 s of intermittent (3 x 30 s with 30 s rest) or continuous stretching (90 s) of the quadriceps muscle. A single-leg stretching and jumping design was used, with the contra-lateral limb serving as a control. The same individuals performed both conditions with alternate legs in a randomized, counterbalanced order. One leg CMJ height was measured for the stretched and the control leg after warm-up, immediately after stretching, and at regular intervals for 10 min after stretching. Range of motion (ROM) of the hip and knee joints was measured before, after, and 10 min post-stretching. Compared to the control leg, intermittent stretching increased CMJ height by 8.1±2.0%, 4 min into recovery (+2.2±2.0 cm, 95%CI: 1.0-3.4 cm, p=0.001), while continuous stretching decreased CMJ height by 17.5±3.3% immediately after (-2.9±1.7 cm, 95%CI: -2.0 to -3.7 cm, p=0.001) and by 12.0±2.7% one min after stretching (-2.2±2.1 cm, 95%CI: -1.2 to -3.2 cm, p=0.001). The increases in hip (2.9 and 3.6, p=0.001. d=2.4) and knee joint ROM (5.1 and 6.1, p=0.001. d=0.85) after the intermittent and continuous stretching protocols were not different. The opposite effects of intermittent vs. continuous stretching on subsequent CMJ performance suggests that stretching mode is an important variable when examining the acute effects of static stretching on performance in flexibility-trained athletes.

  14. Slovenska »mala« inovativnost: nenehno izboljševanje ali trajna stagnacija? = Slovenian Employee Suggestion Systems: A Continuous Improvement Or a Continuous Stagnation?

    Directory of Open Access Journals (Sweden)

    Peter Fatur

    2010-12-01

    Full Text Available The operations management theory emphasizes the management ofincremental innovations as one of the cornerstones for continuous improvementof a firm’s operational efficiency. Also in Slovenia, the companiesfollow the foreign practices in this field as well as developingtheir own solutions. Unfortunately, the introduction of employee suggestionsystems very often turns out to be a failure. The paper aimsto analyze the incremental innovation management systems, in particularthe employee suggestion systems, on a sample of Sloveniancompanies from the automotive and fabricated metal products industry.Based on the key output indices, two groups of companies are definedwith a different ability to introduce innovations. The main differencesin the organization of the employee suggestions managementbetween the two groups are presented. As such, the research resultsmay contribute to an improvement and further growth of these systemsin Slovenian companies.

  15. The continuous improvement of the Internal Audits Process assurance the effective compliance of ISO 17025:2005 requirements

    Directory of Open Access Journals (Sweden)

    Carina Di Candia

    2011-04-01

    Full Text Available Continuous Improvement Process started in LATU in 1996. The Impact was so important that covered all the organization. Nowadays LATU has almost all its processes certificated and most than 200 tests accredited. The Internal Audits process began in 1996 with an annual planning for all the laboratory's areas. For the UKAS accreditation in 1998, LATU improves the internal audits planning auditing not only the system but also the tests. In 1999 LATU was certified by SQS and accredited the calibrations by DKD. Since 2004 internal audits was managed as a process; in order to that was defined objectives, indicators, achievements and the necessary resources of the internal audit programme and process. The internal audit programme has a pre defined tri annual planning that includes all the laboratory areas. The results of the measures obtained till now demonstrate the improvement in the internal audit and all the laboratory processes. Auditors final staff increase their technical competence. As a consequence of managing the internal audits as a process, the internal communication has an important relevance to feedback the continuous improvement of the laboratory. This was evidence in a decrease of the documentaries non conformities, improvement of the calibrations and maintenance programme, optimization trainings and qualifications of the staff, common internal trainings, creation of a quality assurance team to improvement the tests control, improvement in the relationship with the support areas. Most of this requirements are included in ISO 17025:2005; that assurance the effective compliance of this standard.

  16. Meaningful work and mental health: job satisfaction as a moderator.

    Science.gov (United States)

    Allan, Blake A; Dexter, Chelsea; Kinsey, Rebecca; Parker, Shelby

    2016-11-12

    Depression, anxiety and stress are common problems for modern workers. Although having meaningful work, or work that is significant, facilitates personal growth, and contributes to the greater good, has been linked to better mental health, people's work might also need to be satisfying or enjoyable to improve outcomes. The purpose of the present study was to examine meaningful work's relation to mental health (i.e. depression, anxiety and stress) and investigate job satisfaction as a moderator of this relation. The study hypotheses were tested with a large, diverse sample recruited from an online source. Partially supporting hypotheses, when controlling for job satisfaction, meaningful work negatively correlated with depression but did not have a significant relation with anxiety and stress. Similarly, job satisfaction negatively predicted depression and stress. Furthermore, the relations between meaningful work and both anxiety and stress were moderated by job satisfaction. Specifically, only people perceiving their work as meaningful and satisfying reported less anxiety and stress. Although continued research is needed, employers and employees may have to target both the meaningfulness and job satisfaction to address the issues of stress and anxiety among working adults.

  17. An Experimental Investigation to Facilitate an Improvement in the Design of an Electromagnetic Continuous Casting Mould

    Directory of Open Access Journals (Sweden)

    Lintao Zhang

    2016-04-01

    Full Text Available An electromagnetic continuous casting mould designed is proposed with a non-uniform slit distribution structure. This design has aimed to reduce the number of slits so that the mould’s strength is enhanced, whilst maintaining a similar metallurgy effect. In this paper, the metallurgy effect for the designed mould is investigated through the magnetic field distribution along the casting direction, the uniformity feature in the vicinity of the meniscus region, the temperature variation of the molten alloy pool and the mould wall. The results show that the designed mould achieved a similar effect as compared to the original mould; however, the configuration is simplified. This research highlights the topic of mould structure optimization, which would enable the Electromagnetic continuous casting (EMCC technique to be utilized with greater ease by industry.

  18. Improving the maximum transmission distance of continuous-variable quantum key distribution using a noiseless amplifier

    CERN Document Server

    Blandino, Rémi; Barbieri, Marco; Etesse, Jean; Grangier, Philippe; Tualle-Brouri, Rosa

    2012-01-01

    We show that the maximum transmission distance of continuous-variable quantum key distribution in presence of a Gaussian noisy lossy channel can be arbitrarily increased using a linear noiseless amplifier. We explicitly consider a protocol using amplitude and phase modulated coherent states with reverse reconciliation. We find that a noiseless amplifier with amplitude gain g can increase the maximum admissible losses by a factor 1/g^2.

  19. Improvement of sensitivity in continuous wave near infra-red spectroscopy systems by using silicon photomultipliers.

    Science.gov (United States)

    Pagano, Roberto; Libertino, Sebania; Sanfilippo, Delfo; Fallica, Giorgio; Lombardo, Salvatore

    2016-04-01

    We experimentally analyze the signal-to-noise ratio of continuous wave (CW) near infrared spectroscopy (NIRS) reflectance systems based on light emitting diodes and silicon photomultipliers for high performance low cost NIRS biomedical systems. We show that under suitable experimental conditions such systems exhibit a high SNR, which allows an SDS of 7 cm, to our knowledge the largest ever demonstrated in a CW-NIRs system.

  20. Improvement of Inventory Control Using Continuous Review Policy in A Local Hospital at Bandung City, Indonesia

    Directory of Open Access Journals (Sweden)

    Fina Hafnika

    2016-12-01

    Full Text Available Abstract. This research was aimed to analyze the excess inventories issue in pharmacy and medical equipment unit at a local hospital in Bandung which affected the service level of the hospital. As one of the busy hospital in Java, proven by the higher amount of the patient/year than in other average Java typical hospital, the hospital needs to concern about the pharmaceutical and medical equipment inventories in order to fulfill patients’ needs and in the same time keeping the inventory level under control. Therefore, an inventory control evaluation was conducted to determine the appropriate number of inventories and time of order to avoid the excessive goods in central warehouse of the hospital. By using probabilistic inventory model and continuous review policy, the pharmaceutical inventory in the hospital was calculated to compare the ideal and actual amount of the average inventory level (AIL. ABC (Always, Better, Control classification also classified in this research to identify the proper item which potentially can be reduced from the inventory. From the analysis, we have discovered that the hospital potentially able to reduce almost Rp 830 million or 57% from the overstock inventory level by using continuous review policy as the basis of inventory control calculation system. Keywords: Continuous review policy, inventory control, EOQ, ROP, AIL

  1. Practice and Experience of the Establishment of Long Term Mechanism of Continuous Quality Improvement%建立医疗质量持续改进长效机制的实践与体会

    Institute of Scientific and Technical Information of China (English)

    谭天林; 欧兵玺; 廖世川; 罗力; 李雪

    2011-01-01

    探讨建立医疗质量持续改进长效机制,确保患者医疗安全,提高患者满意度.坚持将健全组织、完善制度、优化流程、全员培训、全面监控、加强沟通、整改到位等措施,贯穿于基础质量控制、环节质量控制和终末质量控3个环节,是建立医疗质量持续改进长效机制的有效方法.%The establishment of long-term mechanism for continuous improvement of health care quality is explored to ensure the safety of patients, and to improve patient satisfaction. Adhering to a sound organization, improving the system, streamlining business process, training all staff, and enhancing comprehensive monitoring and communication are needed in place corrective measures, such as quality control throughout the base, part of quality control and quality control of the three terminal links, and are effective ways of continuous quality improvement of establishing long-term mechanism.

  2. Analysis of employee satisfaction

    OpenAIRE

    Cikrytová, Kateřina

    2009-01-01

    The thesis contains analysis of job satisfaction employees of call center. In the theoretical part is defined conception of job satisfaction, are described deteminants of job satisfaction and relationship between job satisfaction and work motivation. In the practical part are analysed results of questionnaire survey and there are presented suggestions measures to increas job satisfaction. The respondents were asked about satisfaction with the content of work, remuneration, work organization, ...

  3. The Importance of Trust for Satisfaction, Motivation, and Academic Performance in Student Learning Groups

    Science.gov (United States)

    Ennen, Nicole L.; Stark, Emily; Lassiter, Andrea

    2015-01-01

    Educators are continuing to investigate ways to improve student learning through collaboration. This study examined one avenue of increasing student group effectiveness: trust. A model of trust in student workgroups was proposed, where trust mediates the relationships between perceived similarity and individual outcomes (grades and satisfaction).…

  4. A Modified Challenge-Based Learning Approach in a Capstone Course to Improve Student Satisfaction and Engagement

    Directory of Open Access Journals (Sweden)

    Scott E. Gabriel

    2014-08-01

    Full Text Available Advanced Biochemistry, a senior capstone course for biochemistry majors, was first offered in 2011. The course objectives focused on students’ ability to access and use primary literature. Despite engaging conversation and excellent student presentations, evaluations of the course content were lower than what this instructor usually receives (3.65/5 compared to 4.3/5 from the previous semester. However, the evaluation of just the instructor was equivalent to historical results.  In an effort to improve the course, a challenge-based learning (CBL design was implemented in 2013 to frame the course around four big questions relevant to our world and local community. This change was made to test if a CBL course design would increase student engagement in the course and therefore their achievement of learning outcomes. Collected data show an improvement in students’ perception of the course. Most significantly, course evaluation results increased when compared to the previous year (4.5/5 as compared to 3.65/5 in 2011. Students also rated the CBL approach as highly effective in achieving core course outcomes and related skills (all queried outcomes averaged 4.2/5 at midterm.

  5. An Intervention to Improve the Comfort And Satisfaction of Nurses in the Telephone Triage of Child Maltreatment Calls.

    Science.gov (United States)

    Hunter, Julie

    2015-01-01

    Nurses are mandated reporters of actual or suspected child maltreatment or the threat thereof. The purpose of this quality improvement project was to determine the knowledge and comfort of nurses in telephone triage in pediatric clinics when dealing with suspected or actual child abuse calls. Nurses (N = 17) from three pediatric primary care clinics and one specialty care orthopedic clinic were surveyed. Based on results of the survey showing a lack of knowledge and adequate referral resources perceived by the nursing staff, resources and staff education were developed, along with a script for guiding maltreatment calls toward standardization of care. Following the intervention, nurses reported an increased comfort level when doing telephone triage for child maltreatment calls, an increase in knowledge of risk factors for county resources. Further, they reported a substantial shift in opinion about the need for a standardized script when responding to child maltreatment telephone calls. Nurses undertaking telephone triage of high-risk child maltreatment calls can improve their comfort and knowledge through a survey of their needs and directed education and resource development for the management of child maltreatment telephone triage.

  6. The efficacy of a continuous quality improvement (CQI) method in a radiological department: comparison with non-CQI control material

    Energy Technology Data Exchange (ETDEWEB)

    Laurila, J. [Oulu Univ. Central Hospital (Finland). Dept. of Radiology; Standertskjoeld-Nordenstam, C.G. [Helsinki Univ. Central Hospital (Finland). Dept. of Radiology; Suramo, I. [Oulu Univ. Central Hospital (Finland). Dept. of Radiology; Tolppanen, E.M. [Helsinki Univ. (Finland). Dept. of Public Health; Tervonen, O. [Oulu Univ. Central Hospital (Finland). Dept. of Radiology; Korhola, O. [Helsinki Univ. Central Hospital (Finland). Dept. of Radiology; Brommels, M. [Helsinki Univ. (Finland). Dept. of Public Health

    2000-01-01

    To study the efficacy of continuous quality improvement (CQI) compared to ordinary management in an on-duty radiology department. Because of complaints regarding delivery of on-duty radiological services, an improvement was initiated simultaneously at two hospitals, at the HUCH (Helsinki University Central Hospital) utilising the CQI-method, and at the OUH (Oulu University Hospital) with a traditional management process. For the CQI project, a team was formed to evaluate the process with flow-charts, cause and effect diagrams, Pareto analysis and control charts. Interventions to improve the process were based on the results of these analyses. The team at the HUCH implemented the following changes: A radiologist was added to the evening shift between 15:00 - 22:00 and a radiographer was moved from the morning shift to 15:00 - 22:00. A clear improvement was achieved in the turn-around time, but in the follow-up some of the gains were lost. Only minimal changes were achieved at the OUH, where the intervention was based on traditional management processes. CQI was an effective method for improving the quality of performance of a radiology department compared with ordinary management methods, but some of this improvement may be subsequently lost without a continuous measurement system.

  7. Continuous Exercise but Not High Intensity Interval Training Improves Fat Distribution in Overweight Adults

    Directory of Open Access Journals (Sweden)

    Shelley E. Keating

    2014-01-01

    Full Text Available Objective. The purpose of this study was to assess the effect of high intensity interval training (HIIT versus continuous aerobic exercise training (CONT or placebo (PLA on body composition by randomized controlled design. Methods. Work capacity and body composition (dual-energy X-ray absorptiometry were measured before and after 12 weeks of intervention in 38 previously inactive overweight adults. Results. There was a significant group × time interaction for change in work capacity (P<0.001, which increased significantly in CONT (23.8±3.0% and HIIT (22.3±3.5% but not PLA (3.1±5.0%. There was a near-significant main effect for percentage trunk fat, with trunk fat reducing in CONT by 3.1±1.6% and in PLA by 1.1±0.4%, but not in HIIT (increase of 0.7±1.0% (P=0.07. There was a significant reduction in android fat percentage in CONT (2.7±1.3% and PLA (1.4±0.8% but not HIIT (increase of 0.8±0.7% (P=0.04. Conclusion. These data suggest that HIIT may be advocated as a time-efficient strategy for eliciting comparable fitness benefits to traditional continuous exercise in inactive, overweight adults. However, in this population HIIT does not confer the same benefit to body fat levels as continuous exercise training.

  8. Satisfaction with nursing education, job satisfaction, and work intentions of new graduate nurses.

    Science.gov (United States)

    Kenny, Patricia; Reeve, Rebecca; Hall, Jane

    2016-01-01

    In the context of predictions of future shortages of nurses, retaining new graduate nurses in the nursing workforce is essential to ensure sufficient nurses in the future. This paper investigates the links between satisfaction with nursing education and job satisfaction, and job dissatisfaction and intentions to leave a nursing job. It uses survey data from a cohort study of nursing students recruited through two Australian universities and followed after graduation and workforce entry. Structural equation modeling (SEM) was used to simultaneously estimate the impact of educational satisfaction (work preparation component) on job satisfaction and the impact of job satisfaction on the expectation of leaving the current job. Two job satisfaction sub-scales were identified: 1) work environment satisfaction and 2) work hours and wages satisfaction. Work preparation satisfaction was significantly and positively associated with both job satisfaction scales but only work environment satisfaction was significantly associated with the expectation to stay in the job; a one standard deviation increase in work environment satisfaction was associated with a 13.5 percentage point reduction in the probability of expecting to leave. The estimated effect of satisfaction with education on expecting to leave, occurring indirectly through job satisfaction, was small (reducing the probability by less than 3 percentage points for a 1 point increase in work preparation satisfaction). Participating in a graduate transition program had the largest effect, reducing the probability of expecting to leave by 26 percentage points, on average. The study results suggest policies which focus on improving satisfaction with the work environment would be more effective at retaining nurses early in their career than improvements to conditions such as work hours and wages. Investment in new graduate transition programs would potentially have the largest impact on retention. Copyright © 2015 Elsevier

  9. Continuous Energy Improvement in Motor Driven Systems - A Guidebook for Industry

    Energy Technology Data Exchange (ETDEWEB)

    Gilbert A. McCoy and John G. Douglass

    2014-02-01

    This guidebook provides a step-by-step approach to developing a motor system energy-improvement action plan. An action plan includes which motors should be repaired or replaced with higher efficiency models, recommendations on maintaining a spares inventory, and discussion of improvements in maintenance practices. The guidebook is the successor to DOE’s 1997 Energy Management for Motor Driven Systems. It builds on its predecessor publication by including topics such as power transmission systems and matching driven equipment to process requirements in addition to motors.

  10. Gastrocnemius Recession Leads to Increased Ankle Motion and Improved Patient Satisfaction After 2 Years of Follow-Up

    DEFF Research Database (Denmark)

    Holtmann, Julia Alessandra; Südkamp, Norbert P; Schmal, Hagen

    2017-01-01

    The isolated gastrocnemius contracture present in neurologic healthy patients results in a significant limitation of ankle dorsiflexion causing pathologic gait patterns and a greater risk of further foot disorders. Gastrocnemius recession is an established procedure to increase ankle dorsiflexion....... However, little evidence is available of the use of gastrocnemius recession in these patients. Complication rates, recurrence of gastrocnemius contracture, and the prevalence of additional foot disorders needs further evaluation. A study group of 64 operated limbs undergoing gastrocnemius recession...... had improved significantly from 65.4 ± 26.5 points to 33.4 ± 19.5 points (p contracture seem to have a high prevalence of symptomatic foot disorders. At a mid-term follow-up examination, gastrocnemius recession (Strayer) was shown to be an effective...

  11. Modern trends in improvement of steel heating technology in continuous furnaces

    Science.gov (United States)

    Timoshpolskiy, V. I.; Temlyantsev, M. V.; Trusova, I. A.

    2016-09-01

    The principles and approaches in the development and improvement of steel heating technology in the furnaces of rolling manufacture of various structural design, based on the systematic study of thermal physical and technological processes, including mathematical modeling, industrial experiments, development of rational temperature-thermal modes.

  12. Dot Hill reports third quarter 2001 results operating results continue to improve

    CERN Multimedia

    2001-01-01

    Dot Hill Systems Corp., a leading supplier of carrier-class data storage and storage area network solutions announced slighly improved financial results for the period ending Sept. 30, 2001. Of their products, SANnet Axis and the SANnet 7100 Fibre Channel storage system were selected as the essential storage components for the GRID demonstration at the High Performance Networking Forum Conference at CERN.

  13. Improving Genetics Education in Graduate and Continuing Health Professional Education: Workshop Summary

    Science.gov (United States)

    Berger, Adam C.; Johnson, Samuel G.; Beachy, Sarah H.; Olson, Steve

    2015-01-01

    Many health care providers do not have either the knowledge or the tools they need in order to apply genetic information in their day-to-day practices. This lack of support is contributing to a substantial delay in the translation of genetic research findings, when appropriate, into improvement in patient outcomes within the health care system.…

  14. Implementing TQM at Oregon State University: Moving Continuous Quality Improvement Practices into Higher Education.

    Science.gov (United States)

    Rudolph, Jacquelyn T.; Howard, Nancy Lee

    1996-01-01

    The evolution of an award-winning Total Quality Management (TQM) program for administrative and academic staff development at Oregon State University is chronicled. Special attention is given to application of TQM for faculty and corporate interaction, instructional improvement, and curriculum development. Special challenges for implementation of…

  15. Using a Client Survey to Support Continuous Improvement: An Australian Case Study in Managing Change

    Science.gov (United States)

    Besch, Janice

    2014-01-01

    With the arrival of online survey tools that are low-cost, readily available and easy to administer, all organizations have access to one of the most effective mechanisms for determining quality improvement priorities and measuring progress towards achieving those priorities over time. This case study outlines the use made of this simple tool by a…

  16. Improving Genetics Education in Graduate and Continuing Health Professional Education: Workshop Summary

    Science.gov (United States)

    Berger, Adam C.; Johnson, Samuel G.; Beachy, Sarah H.; Olson, Steve

    2015-01-01

    Many health care providers do not have either the knowledge or the tools they need in order to apply genetic information in their day-to-day practices. This lack of support is contributing to a substantial delay in the translation of genetic research findings, when appropriate, into improvement in patient outcomes within the health care system.…

  17. Implementing TQM at Oregon State University: Moving Continuous Quality Improvement Practices into Higher Education.

    Science.gov (United States)

    Rudolph, Jacquelyn T.; Howard, Nancy Lee

    1996-01-01

    The evolution of an award-winning Total Quality Management (TQM) program for administrative and academic staff development at Oregon State University is chronicled. Special attention is given to application of TQM for faculty and corporate interaction, instructional improvement, and curriculum development. Special challenges for implementation of…

  18. Healthy Students 2000: An Agenda for Continuous Improvement in America's Schools.

    Science.gov (United States)

    Allensworth, Diane DeMuth; Symons, Cynthia Wolford; Olds, R. Scott

    This publication is a project replication kit for practitioners who want to improve their school health programs. The project used a multidisciplinary model of comprehensive school health education in three secondary schools within the Cleveland School District, Ohio. Based on the Healthy People 2000 initiative, this publication focuses on six…

  19. Learning What Works: Continuous Improvement in California's Education System. Policy Brief 08-4

    Science.gov (United States)

    Loeb, Susanna; Plank, David N.

    2008-01-01

    What will it take to bring about dramatic improvements in the performance of California's education system? The fact is, everyone does not know. California does not know how to collect the kind of educational data that would allow it to accurately measure the performance of schools and students, or to evaluate the effectiveness of different…

  20. 78 FR 12221 - National School Lunch Program: Direct Certification Continuous Improvement Plans Required by the...

    Science.gov (United States)

    2013-02-22

    ... require all local educational agencies (LEAs) that participate in the NSLP and/or School Breakfast Program... able to adapt to improved data sources. It is important to point out that there is already some built... attend NSLP schools. Also, it is important to remember that the benchmarks are not set at 100%; and...