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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. Improving customer satisfaction

    OpenAIRE

    Wei, Yu

    2011-01-01

    Today, the competition among enterprises is growing in intensity and organizations of all types and sizes have increasingly come to understand the importance of customer satisfaction and good services. The purpose of this study is to investigate the present level of customer satisfaction with language training institutes and find out any possible areas of improvement. This thesis will discuss and analyze the factors that influence the customer’s level of satisfaction and assist the case compa...

  3. Developing a Continuous Improvement System

    Science.gov (United States)

    2016-09-16

    disagree that continuous improvement is critical to an organization’s suc-cess, since conducting business using a status quo philosophy will not work...for implementing one of these processes include: better operational efficiency, increased customer satisfaction, improved employee morale ...when a problem in reliability or maintenance may become the greatest opportunity. As described in the January-February 2011 issue of Defense AT&L

  4. Continual improvement plan

    Science.gov (United States)

    1994-01-01

    NASA's approach to continual improvement (CI) is a systems-oriented, agency-wide approach that builds on the past accomplishments of NASA Headquarters and its field installations and helps achieve NASA's vision, mission, and values. The NASA of the future will fully use the principles of continual improvement in every aspect of its operations. This NASA CI plan defines a systematic approach and a model for continual improvement throughout NASA, stressing systems integration and optimization. It demonstrates NASA's constancy of purpose for improvement - a consistent vision of NASA as a worldwide leader in top-quality science, technology, and management practices. The CI plan provides the rationale, structures, methods, and steps, and it defines NASA's short term (1-year) objectives for improvement. The CI plan presents the deployment strategies necessary for cascading the goals and objectives throughout the agency. It also provides guidance on implementing continual improvement with participation from top leadership and all levels of employees.

  5. 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)

  6. Continuous quality improvement

    NARCIS (Netherlands)

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

    2002-01-01

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

  7. Continuous quality improvement

    International Nuclear Information System (INIS)

    Bourne, P.B.

    1985-01-01

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

  8. 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.

  9. Improving patient satisfaction in glaucoma care

    Directory of Open Access Journals (Sweden)

    Islam S

    2017-12-01

    Full Text Available Samsul Islam, Ahmad Salha, Saeed Azizi Faculty of Medicine, St George’s Hospital Medical School, London, UKWe read the article by Foo et al1 with great interest. We were intrigued by the factors influencing satisfaction rates among glaucoma patients. It made us question what changes could be made in the future attempting to improve patient satisfaction.\tSimilar to Foo et al,1 we were also surprised to find a lower end-point intraocular pressure was linked with increased patient dissatisfaction. As stated by Foo et al,1 other studies exploring clinical outcomes and patient satisfaction found that a positive clinical state was linked to higher patient satisfaction. Prakash2 proposes a three-way association between patient satisfaction, increased compliance, and better clinical outcomes. Hence, in attempting to investigate patient satisfaction, it would be appropriate to assess patient compliance and clinical outcomes.View the original paper by Foo and colleagues.

  10. 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…

  11. 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.

  12. 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

  13. Factors associated with resident satisfaction with their continuity experience.

    Science.gov (United States)

    Serwint, Janet R; Feigelman, Susan; Dumont-Driscoll, Marilyn; Collins, Rebecca; Zhan, Min; Kittredge, Diane

    2004-01-01

    To identify factors associated with resident satisfaction concerning residents' continuity experience. Continuity directors distributed questionnaires to residents at their respective institutions. Resident satisfaction was defined as satisfied or very satisfied on a Likert scale. The independent variables included 60 characteristics of the continuity experience from 7 domains: 1) patient attributes, 2) continuity and longitudinal issues, 3) responsibility as primary care provider, 4) preceptor characteristics, 5) educational opportunities, 6) exposure to practice management, and 7) interaction with other clinic and practice staff. A stepwise logistic regression model and the Generalized Estimating Equations approach were used. Thirty-six programs participated. Of 1155 residents (71%) who provided complete data, 67% (n = 775) stated satisfaction with their continuity experience. The following characteristics (adjusted odds ratio [OR] and 95% confidence interval [CI]) were found to be most significant: preceptor as good role model, OR = 7.28 ( CI = 4.2, 12.5); appropriate amount of teaching, OR = 3.25 (CI = 2.1, 5.1); involvement during hospitalization, OR = 2.61 (CI = 1.3, 5.2); exposure to practice management, OR = 2.39 (CI = 1.5, 3.8); good balance of general pediatric patients, OR = 2.34 (CI = 1.5, 3.6); resident as patient advocate, OR = 1.74 (CI = 1.2, 2.4); and appropriate amount of nursing support, OR = 1.65 (CI = 1.1, 2.6). Future career choice, type of continuity site, and level of training were not found to be statistically significant. Pediatric resident satisfaction was significantly associated with 7 variables, the most important of which were the ability of the preceptor to serve as a role model and teacher. The type of continuity site was not significant. Residency programs may use these data to develop interventions to enhance resident satisfaction, which may lead to enhanced work performance and patient satisfaction.

  14. 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 affect satisfaction with distance continuing education programs.

  15. KAIZEN CONTINUOUS IMPROVEMENT

    OpenAIRE

    Yenque D., Julio; García P., Manuel; Raez G., Luis

    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...

  16. 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. .

  17. Partnership for Continuous Improvement

    Science.gov (United States)

    1990-01-01

    The proceedings are presented of the sixth annual conference on quality control between NASA and its contractors. The emphasis is placed on a commitment to quality and excellence that guarantees mission success. A forum is provided for representatives from government, industry, and academia to exchange ideas and experiences, encouraging total quality performance that results in high quality products and services. Key points are highlighted from the presentations and activities are described that have resulted in a broad range of improvements in products and services from government, industry, and academia. Long term commitment to quality is an essential requirement that ensures future success. That commitment reinterates the dedication to excellence in space exploration and to national quality and productivity improvement.

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

    International Nuclear Information System (INIS)

    Min, Hye Lim; Choi, In Seok; Nam, So Ra; Kim, Hyun Ji; Yoon, Yong Su; Her, Jae; Han, Seong Gyu; Kim, Jung Min; Ahn, Duck Sun

    2014-01-01

    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

  19. Perspectives: The Continuous Improvement Trap

    Science.gov (United States)

    Arnold, David L.

    2011-01-01

    Accrediting agencies, legislators, pundits, and even higher educational professionals have become enamored with applying the language of continuous improvement to learning outcomes. The Southern Association of Colleges and Schools Commission on Colleges specifically uses the term "continuing improvement" in Core Standard 2.5, one of its…

  20. Factors Affecting Resident Satisfaction in Continuity Clinic-a Systematic Review.

    Science.gov (United States)

    Stepczynski, J; Holt, S R; Ellman, M S; Tobin, D; Doolittle, Benjamin R

    2018-05-07

    In recent years, with an increasing emphasis on time spent in ambulatory training, educators have focused attention on improving the residents' experience in continuity clinic. The authors sought to review the factors associated with physician trainee satisfaction with outpatient ambulatory training. A systematic literature review was conducted for all English language articles published between January 1980 and December 2016 in relevant databases, including Medline (medicine), CINAHL (nursing), PSYCHinfo (psychology), and the Cochrane Central Register of Controlled Clinical Trials. Search terms included internship and residency, satisfaction, quality of life, continuity of care, ambulatory care, and medical education. We included studies that directly addressed resident satisfaction in the ambulatory setting through interventions that we considered reproducible. Three hundred fifty-seven studies were reviewed; 346 studies were removed based on exclusion criteria with 11 papers included in the final review. Seven studies emphasized aspects of organizational structure such as block schedules, working in teams, and impact on resident-patient continuity (continuity between resident provider and patient as viewed from the provider's perspective). Four studies emphasized the importance of a dedicated faculty for satisfaction. The heterogeneity of the studies precluded aggregate analysis. Clinic structures that limit inpatient and outpatient conflict and enhance continuity, along with a dedicated outpatient faculty, are associated with greater resident satisfaction. Implications for further research are discussed.

  1. Baseline budgeting for continuous improvement.

    Science.gov (United States)

    Kilty, G L

    1999-05-01

    This article is designed to introduce the techniques used to convert traditionally maintained department budgets to baseline budgets. This entails identifying key activities, evaluating for value-added, and implementing continuous improvement opportunities. Baseline Budgeting for Continuous Improvement was created as a result of a newly named company president's request to implement zero-based budgeting. The president was frustrated with the mind-set of the organization, namely, "Next year's budget should be 10 to 15 percent more than this year's spending." Zero-based budgeting was not the answer, but combining the principles of activity-based costing and the Just-in-Time philosophy of eliminating waste and continuous improvement did provide a solution to the problem.

  2. [Clinical laboratory medicine: continuous amelioration with a book of objectives and satisfaction survey].

    Science.gov (United States)

    Reix, Nathalie; Agin, Arnaud; Bahram, Seiamak; Dali-Youcef, Nassim; Grucker, Daniel; Jaulhac, Benoît; Lepiller, Quentin; Lessinger, Jean-Marc; Mauvieux, Laurent; Monier, Laurie; Schramm, Frédéric; Stoll-Keller, Françoise; Vallat, Laurent; Ludes, Bertrand; Candolfi, Ermanno; Filisetti, Denis

    2015-01-01

    We report in this publication the use of two educational tools, a questionnaire of satisfaction and a training book, to improve the training of students during their internship in clinical laboratory at the "Pôle de biologie des Hôpitaux universitaires de Strasbourg" in France. First, the ongoing training was assessed by the interns with a questionnaire measuring satisfaction. The analysis of this questionnaire identified four key points to improve: 1) define the teaching objectives, 2) organize the training with a schedule, 3) revise certain teaching methods and 4) ensure better integration of the students in the team of medical biologists. After this assessment, we implemented a training book to answer these four points. Indeed, the training book presents the objectives, the schedule of training, and how to validate the educational objectives. A new assessment was performed again using the same methodology. Results showed an improvement in student satisfaction from 74 to 88 %. The questionnaire of satisfaction and the training book are presented in this article. The aim of the assessment of training combined with the training book is to incite the actors of the training (students and teachers) to continually improve the training. The objectives of the Pôle de Biologie are to obtain an 80 % satisfaction rate during the 6 months trainings and to reduce or eliminate dissatisfaction, and finally to ensure the validation by students of 80 to 100 % of their predetermined objectives.

  3. Patients Provide Recommendations for Improving Patient Satisfaction.

    Science.gov (United States)

    Moore, Angelo D; Hamilton, Jill B; Krusel, Jessica L; Moore, LeeAntoinette G; Pierre-Louis, Bosny J

    2016-04-01

    National Committee for Quality Assurance recommends patient-centered medical homes incorporate input from patient populations; however, many health care organizations do not. This qualitative study used two open-ended questions from 148 active duty Army Soldiers and their family members to illicit recommendations for primary care providers and clinic leadership that would improve their health care experiences. Content analysis and descriptive statistics were used to analyze responses. Participant responses were related to four major themes: Access to Care, Interpersonal Interaction, Satisfaction of Care, and Quality of Care. Participants were overall satisfied with their care; however, spending less time waiting for appointments and to see the provider or specialist were the most frequently requested improvements related to Access to Care. For Interpersonal Interaction, 82% of the responses recommended that providers be more attentive listeners, courteous, patient, caring, and respectful. Decreasing wait times and improving interpersonal skills would improve health care experiences and patient satisfaction. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  4. Continuous improvement of pump seals

    International Nuclear Information System (INIS)

    Wong, W.; Eyvindson, A.; Rhodes, D.B.

    2003-01-01

    Pump seal reliability continues to be an area needing improvement and ongoing vigilance. Methods have been developed for identifying and assessing factors relating to seal performance, selecting the most relevant ones for a specific station, and then focusing on the most significant aspects and how to improve. Discussion invariably addresses maintenance practices, seal design, monitoring capabilities, operating conditions, transients, and pump and motor design. Success in reliability improvement requires ongoing dialogue among the station operators, pump manufacturers and seal designers. AECL CAN-seals lead the nuclear industry in reliability and seal life. They effectively save operators millions of dollars in outage time and person-rem. This paper describes some of the significant developments in AECL's ongoing program in seal R and D, as well as recent new installations following the most demanding seal qualification programs to date. (author)

  5. Sustaining motivation for continuous improvement

    DEFF Research Database (Denmark)

    Jørgensen, Frances; Kofoed, Lise Busk

    2007-01-01

    The objective of this article is to explore possibilities for improving motivation for participation in Continuous Improvement (CI). Due to a number of issues, for example, challenges with measuring outcomes of CI activities on performance, the inherent slower, incremental rather than big bang...... activities is an important issue for managers. The paper begins with a short description of CI, with an emphasis on barriers to successful implementation cited in the literature. Thereafter, a number of widely-acknowledged-albeit perhaps somewhat dated-theories of motivation are explored in relation...... to the elements of CI in practice. Based on their own experiences with CI implementation in numerous action-research based studies, the authors propose a scenario for motivating CI participation through emphasis on factors common to the presented motivational theories. The paper ends with insights into future...

  6. Continuous improvement of software quality

    International Nuclear Information System (INIS)

    Sivertsen, Terje

    1999-04-01

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

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

    OpenAIRE

    Al-Zarea, Bader K.

    2013-01-01

    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 ...

  8. 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.

  9. 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.

  10. Measuring and improving customer satisfaction with government services

    Science.gov (United States)

    Glen D. Alexander

    1995-01-01

    Two years ago, Ohio State Park developed a methodology of measuring customer satisfaction, to gauge the effectiveness of our customer service. What follows is a discussion of our installation of systems to measure and improve customer satisfaction, the interpretation of the data, and the positive results we have enjoyed.

  11. 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.

  12. Continuous Improvement in Schools: Understanding the Practice

    Science.gov (United States)

    Anderson, Stephen; Kumari, Roshni

    2009-01-01

    This article investigates conceptually and practically what it means for schools to engage in the practice of continuous improvement. The analysis draws upon prior research and discussion to predict core elements of the practice of continuous improvement in schools. The predictions are then applied to a case study of continuous improvement efforts…

  13. Teamwork, Leadership, and Continuous Improvement

    NARCIS (Netherlands)

    Keijser, Wouter Alexander; Glaudemans, Andor; Medema, Jitze; Dierckx, Rudi; Ahaus, Kees

    2017-01-01

    In this chapter, we describe the enhanced TeamSTEPPS® curriculum as fundament to creating a “culture of continuous improvement” in nuclear medicine. This evidence-based and modular teamwork system is deployed in concordance with a novel medical leadership development program. It provides a

  14. CTE's Focus on Continuous Improvement

    Science.gov (United States)

    Foster, John; Kelley, Patricia; Pritz, Sandy; Hodes, Carol

    2011-01-01

    Just one of the ways career and technical education (CTE) is revamping its image is through increased attention to data-driven instructional techniques as a means of improving and focusing instruction on what matters most. Accountability and data have increasingly become a core focus of research, news, and commentary about education in recent…

  15. Association between Continuing Education and Job Satisfaction of Nurses Employed in Long-Term Care Facilities.

    Science.gov (United States)

    Robertson, Ethel M.; Higgins, Leslie; Rozmus, Cathy; Robinson, James P.

    1999-01-01

    Continuing-education participation and job satisfaction of 85 licensed practical nurses and 25 registered nurses in long-term care were compared. There were no differences between full- and part-time staff. Nurses with higher family incomes participated more frequently. Registered nurses participated more and had greater job satisfaction. (SK)

  16. Running Head: Improving Pharmacy Customer Satisfaction

    Science.gov (United States)

    2006-06-29

    move to a prospective payment system. As part of measuring appropriate resource utilization, customer or * - patient satisfaction has been introduced...the consumer . If a patient does not like the manner in how the care was delivered [regardless of the caliber of care, they may choose to take their...features of a health care plan to patients . The rising cost of healthcare and pharmaceuticals causes many to closely Fevaluate the plans they choose

  17. Satisfaction with appearance and the desired treatment to improve aesthetics.

    Science.gov (United States)

    Al-Zarea, Bader K

    2013-01-01

    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 (P feeling of poor tooth alignment, presence of fractured anterior teeth, and increased desire for orthodontic, crowns, and dentures treatments (P desire for tooth whitening and tooth coloured fillings (P desire for aesthetic treatments.

  18. Generating Gratitude in the Workplace to Improve Faculty Job Satisfaction.

    Science.gov (United States)

    Stegen, Amy; Wankier, Jamie

    2018-06-01

    The current nursing shortage affects all settings. In an effort to promote retention of nursing faculty, an "attitude of gratitude" was cultivated to improve job satisfaction and increase collaboration in one school of nursing. This was a quantitative study using a convenience sample of faculty at one school of nursing. A presurvey of faculty on perceived gratitude levels and job satisfaction was administered prior to the start of the school year. Multiple gratitude interventions were implemented throughout the year and a postsurvey was administered to measure the effectiveness of interventions. The findings of this study show an improvement of 17.9% in overall job satisfaction, which is consistent with other studies on the topic. Collaboration was not affected by gratitude interventions. Implementing gratitude is a cost-effective and easy way to improve job satisfaction to increase faculty retention rates. [J Nurs Educ. 2018;57(6):375-378.]. Copyright 2018, SLACK Incorporated.

  19. Continuous Improvement and Collaborative Improvement: Similarities and Differences

    DEFF Research Database (Denmark)

    Middel, Rick; Boer, Harry; Fisscher, Olaf

    2006-01-01

    the similarities and differences between key components of continuous and collaborative improvement by assessing what is specific for continuous improvement, what for collaborative improvement, and where the two areas of application meet and overlap. The main conclusions are that there are many more similarities...... between continuous and collaborative improvement. The main differences relate to the role of hierarchy/market, trust, power and commitment to collaboration, all of which are related to differences between the settings in which continuous and collaborative improvement unfold....

  20. Improving patient satisfaction through physician education, feedback, and incentives.

    Science.gov (United States)

    Banka, Gaurav; Edgington, Sarah; Kyulo, Namgyal; Padilla, Tony; Mosley, Virgie; Afsarmanesh, Nasim; Fonarow, Gregg C; Ong, Michael K

    2015-08-01

    Patient satisfaction has been associated with improved outcomes and become a focus of reimbursement. Evaluate an intervention to improve patient satisfaction. Nonrandomized, pre-post study that took place from 2011 to 2012. Large tertiary academic medical center. Internal medicine (IM) resident physicians, non-IM resident physicians, and adult patients of the resident physicians. IM resident physicians were provided with patient satisfaction education through a conference, real-time individualized patient satisfaction score feedback, monthly recognition, and incentives for high patient-satisfaction scores. Patient satisfaction on physician-related and overall satisfaction questions on the HCAHPS survey. We conducted a difference-in-differences regression analysis comparing IM and non-IM patient responses, adjusting for differences in patient characteristics. In our regression analysis, the percentage of patients who responded positively to all 3 physician-related Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) questions increased by 8.1% in the IM and 1.5% in the control cohorts (absolute difference 6.6%, P = 0.04). The percentage of patients who would definitely recommend this hospital to friends and family increased by 7.1% in the IM and 1.5% in the control cohorts (absolute difference 5.6%, P = 0.02). The national average for the HCAHPS outcomes studied improved by no more than 3.1%. This study was nonrandomized and was conducted at a single site. To our knowledge, this is the first intervention associated with a significant improvement in HCAHPS scores. This may serve as a model to increase patient satisfaction, hospital revenue, and train resident physicians. © 2015 Society of Hospital Medicine.

  1. Continuous quality improvement for the clinical decision unit.

    Science.gov (United States)

    Mace, Sharon E

    2004-01-01

    Clinical decision units (CDUs) are a relatively new and growing area of medicine in which patients undergo rapid evaluation and treatment. Continuous quality improvement (CQI) is important for the establishment and functioning of CDUs. CQI in CDUs has many advantages: better CDU functioning, fulfillment of Joint Commission on Accreditation of Healthcare Organizations mandates, greater efficiency/productivity, increased job satisfaction, better performance improvement, data availability, and benchmarking. Key elements include a database with volume indicators, operational policies, clinical practice protocols (diagnosis specific/condition specific), monitors, benchmarks, and clinical pathways. Examples of these important parameters are given. The CQI process should be individualized for each CDU and hospital.

  2. 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.

  3. [Recommendations for the evaluation and follow-up of the continuous quality improvement].

    Science.gov (United States)

    Maurellet-Evrard, S; Daunizeau, A

    2013-06-01

    Continual improvement of the quality in a medical laboratory is based on the implementation of tools for systematically evaluate the quality management system and its ability to meet the objectives defined. Monitoring through audit and management review, addressing complaints and nonconformities and performing client satisfaction survey are the key for the continual improvement.

  4. Strategy for continuous improvement in IC manufacturability, yield, and reliability

    Science.gov (United States)

    Dreier, Dean J.; Berry, Mark; Schani, Phil; Phillips, Michael; Steinberg, Joe; DePinto, Gary

    1993-01-01

    Continual improvements in yield, reliability and manufacturability measure a fab and ultimately result in Total Customer Satisfaction. A new organizational and technical methodology for continuous defect reduction has been established in a formal feedback loop, which relies on yield and reliability, failed bit map analysis, analytical tools, inline monitoring, cross functional teams and a defect engineering group. The strategy requires the fastest detection, identification and implementation of possible corrective actions. Feedback cycle time is minimized at all points to improve yield and reliability and reduce costs, essential for competitiveness in the memory business. Payoff was a 9.4X reduction in defectivity and a 6.2X improvement in reliability of 256 K fast SRAMs over 20 months.

  5. 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.

  6. Teacher Research as Continuous Process Improvement

    Science.gov (United States)

    Ellis, Charles; Castle, Kathryn

    2010-01-01

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

  7. Managerial implications for improving continuous production processes

    DEFF Research Database (Denmark)

    Capaci, Francesca; Vanhatalo, Erik; Bergquist, Bjarne

    2017-01-01

    . In this article we highlight SPC and DoE implementation challenges described in the literature for managers, researchers and practitioners interested in continuous production process improvement. The results may help managers support the implementation of these methods and make researchers and practitioners aware......Data analytics remains essential for process improvement and optimization. Statistical process control and design of experiments are among the most powerful process and product improvement methods available. However, continuous process environments challenge the application of these methods...... of methodological challenges in continuous process environments...

  8. 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…

  9. Determinants of continuance intention in a post-adoption satisfaction evaluation of a clinical information system.

    Science.gov (United States)

    Hadji, Brahim; Dupuis, Isabelle; Leneveut, Laurence; Heudes, Didier; Wagner, Jean-François; Degoulet, Patrice

    2014-01-01

    The evaluation of end-user satisfaction is an essential part of any clinical information system (CIS) project. The purpose of this study is to evaluate the determinants of CIS continuance intention in a late post-adoption phase at the Georges Pompidou University Hospital (HEGP) in Paris. We designed an electronic survey instrument based on an IT post-adoption model (ITPAM) developed from three previous models, i.e., the Delone and McLean Information Success Model, the Davis TAM model and the Bhattacherjee information system continuance intention model. 419 questionnaires were collected from CIS users directly involved in patient care. The perceived CIS quality, usefulness and user satisfaction are significantly lower for medical professions than other professional groups. Continuance intention is very high within all professional subgroups. In a multiple regression analysis, the global satisfaction (R(2) = .780) was positively and significantly correlated with CIS quality, confirmation of expectations and perceived CIS usefulness. The continuance intention (R(2) = .392) was positively and significantly correlated with perceived CIS usefulness, confirmation of expectations and global satisfaction. In a late post-adoption CIS deployment phase, continuance intention does not significantly depend on individual end user characteristics but is significantly associated with the perceived CIS usefulness, confirmation of expectations and global satisfaction.

  10. Continuous Improvement and Collaborative Improvement: Similarities and Differences

    NARCIS (Netherlands)

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

    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

  11. 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.

  12. Occupational Analysis: A Continuous Improvement Approach

    National Research Council Canada - National Science Library

    Duffy, Tom

    1998-01-01

    .... In doing so, the Air Force has implemented "Quality Air Force (QAF)" (AF Handbook 90-502). QAF is a leadership commitment that inspires trust, teamwork, and continuous improvement everywhere in the Air Force...

  13. Continuous improvement methods in the nuclear industry

    International Nuclear Information System (INIS)

    Heising, Carolyn D.

    1995-01-01

    The purpose of this paper is to investigate management methods for improved safety in the nuclear power industry. Process improvement management, methods of business process reengineering, total quality management, and continued process improvement (KAIZEN) are explored. The anticipated advantages of extensive use of improved process oriented management methods in the nuclear industry are increased effectiveness and efficiency in virtually all tasks of plant operation and maintenance. Important spin off include increased plant safety and economy. (author). 6 refs., 1 fig

  14. [Job satisfaction and improvement factors in primary care professionals].

    Science.gov (United States)

    Pérez-Ciordia, I; Guillén-Grima, F; Brugos, A; Aguinaga, I

    2013-09-06

    The quality of services in a health system is related to the level of satisfaction of its professionals. The aim of this article is to determine job satisfaction in primary care professionals and rank those factors capable of improving it. Descriptive study carried out in Navarre in 2010. A validated questionnaire was sent by post to the population of the study: primary care doctors, pediatricians and nurses. Variables on socio-demographic data were collected and job satisfaction was self-evaluated on a scale of 1 to 10. Respondents were asked to rank 10 factors that could improve the previously mentioned satisfaction. Averages were compared and bivariate analysis was carried out using the chi-square test, studying the association between variables through the Odds Ratio (OR). The adjusted analysis was realized through unconditional logistic regression. We collected 432 questionnaires (77.5%). Average satisfaction was 6.7 (scale of 1 to 10), higher in nursing. Women showed a higher average than men (6.90:6.34). The workers at urban health centers (OR: 1.71; CI: 1.10-2.65) showed a higher risk of dissatisfaction with respect to professionals at rural centers. The training activities of the professional is the most highly valued item, followed by economic questions and questions of care pressure, with no differences found by profession. Job satisfaction is a dimension of quality management in primary care and its study enables identification of problems or opportunities for improvement with an impact on the quality of the services offered.

  15. Human Resource Management for Continuous Improvement

    DEFF Research Database (Denmark)

    Jørgensen, Frances; Boer, Harry; Laugen, Bjørge

    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...

  16. 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 the HRM and CI literature and then presents statistical analyses of data collected from the Continuous Improvement Network Survey (2003), which demonstrate that HRM has a significant effect on CI behaviour and company performance, with the strongest relationship between HRM, CI and performance occurring...

  17. Preoperative patient education: can we improve satisfaction and reduce anxiety?

    Directory of Open Access Journals (Sweden)

    Jaime Ortiz

    2015-02-01

    Full Text Available BACKGROUND AND OBJECTIVES: Patients' knowledge deficits concerning anesthesia and the anesthesiologist's role in their care may contribute to anxiety. The objective of this study was to develop anesthesia patient education materials that would help improve patient's satisfaction regarding their knowledge of the perioperative process and decrease anxiety in a community hospital with a large Spanish-speaking population. METHODS: A survey (Survey A in English and Spanish was administered to all adult anesthesiology preoperative clinic patients during a 4-week period. The data were analyzed and then a patient education handout was developed in both English and Spanish to assist with our patients' major concerns. A second survey (Survey B was administered that was completed after the education handout had been put into use at the clinic. The survey asked for basic demographic information and included questions on satisfaction with regard to understanding of anesthesia as well as worries regarding surgery and pain. RESULTS: In the patients who received the handout, statistically significant improvement was found in the questions that asked about satisfaction with regard to understanding of type of anesthesia, options for pain control, what patients are supposed to do on the day of surgery, and the amount of information given with regard to anesthetic plan. There was no difference in anxiety related to surgery in patients who received the educational handout compared to those patients who did not. CONCLUSIONS: Patient education handouts improved patient's satisfaction regarding their knowledge of the perioperative process but did not reduce anxiety related to surgery.

  18. 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.

  19. 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. © 2010 National Association for Healthcare Quality.

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

    International Nuclear Information System (INIS)

    Kharshafdjian, G.; Fisher, C.; Beres, T.; Brooks, S.; Forbes, S.; Krause, M.; McAuley, K.; Wendorf, M.

    2006-01-01

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

  1. 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)

  2. Continue service improvement at CERN computing centre

    International Nuclear Information System (INIS)

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

    2014-01-01

    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.

  3. Communication Skills Training for Physicians Improves Patient Satisfaction.

    Science.gov (United States)

    Boissy, Adrienne; Windover, Amy K; Bokar, Dan; Karafa, Matthew; Neuendorf, Katie; Frankel, Richard M; Merlino, James; Rothberg, Michael B

    2016-07-01

    Skilled physician communication is a key component of patient experience. Large-scale studies of exposure to communication skills training and its impact on patient satisfaction have not been conducted. We aimed to examine the impact of experiential relationship-centered physician communication skills training on patient satisfaction and physician experience. This was an observational study. The study was conducted at a large, multispecialty academic medical center. Participants included 1537 attending physicians who participated in, and 1951 physicians who did not participate in, communication skills training between 1 August 2013 and 30 April 2014. An 8-h block of interactive didactics, live or video skill demonstrations, and small group and large group skills practice sessions using a relationship-centered model. Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CGCAHPS), Jefferson Scale of Empathy (JSE), Maslach Burnout Inventory (MBI), self-efficacy, and post course satisfaction. Following the course, adjusted overall CGCAHPS scores for physician communication were higher for intervention physicians than for controls (92.09 vs. 91.09, p communication scores (83.95 vs. 82.73, p = 0.22). Physicians reported high course satisfaction and showed significant improvement in empathy (116.4 ± 12.7 vs. 124 ± 11.9, p communication skills training improved patient satisfaction scores, improved physician empathy, self-efficacy, and reduced physician burnout. Further research is necessary to examine longer-term sustainability of such interventions.

  4. 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...

  5. Why Doesn't He Leave? Relationship Continuity and Satisfaction among Male Domestic Violence Offenders

    Science.gov (United States)

    Henning, Kris; Connor-Smith, Jennifer

    2011-01-01

    In contrast to the extensive literature on women's decisions to leave violent relationships, there is little research examining relationship continuity from the offending male's perspective. Similarly, research exploring relationship satisfaction in men arrested for intimate partner violence (IPV) is lacking, despite the fact that dissatisfaction…

  6. 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.

  7. Student performance and satisfaction in continuous learning pathways in Dutch VET

    OpenAIRE

    Biemans, H.J.A.

    2012-01-01

    An important trend in the Vocational Education and Training (VET) system in the Netherlands is the design of continuous learning pathways enclosing more than one school type level. These continuous learning pathways are characterized by different design formats. In this study, the relations between these design formats and student performance and satisfaction were examined. Five coordinators and 161 students of five so-called Green Lycea (GL) in the life sciences domain, in which the elements...

  8. 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.

  9. A Continuous Improvement Capital Funding Model.

    Science.gov (United States)

    Adams, Matt

    2001-01-01

    Describes a capital funding model that helps assess facility renewal needs in a way that minimizes resources while maximizing results. The article explains the sub-components of a continuous improvement capital funding model, including budgeting processes for finish renewal, building performance renewal, and critical outcome. (GR)

  10. Continuous Improvement in State Funded Preschool Programs

    Science.gov (United States)

    Jackson, Sarah L.

    2012-01-01

    State funded preschool programs were constantly faced with the need to change in order to address internal and external demands. As programs engaged in efforts towards change, minimal research was available on how to support continuous improvement efforts within the context unique to state funded preschool programs. Guidance available had…

  11. Trends in patient satisfaction in Dutch university medical centers: room for improvement for all

    NARCIS (Netherlands)

    Kleefstra, Sophia M.; Zandbelt, Linda C.; de Haes, Hanneke J. C. J. M.; Kool, Rudolf B.

    2015-01-01

    Results of patient satisfaction research provide hospitals areas for quality improvement. Although it may take several years to achieve such improvement, not all hospitals analyze changes in patient satisfaction over time structurally. Consequently, they lack information from patients' perspective

  12. 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.

  13. Satisfaction

    NARCIS (Netherlands)

    van der Voordt, Theo; Brunia, Sandra; Appel - Meulenbroek, Rianne; Jensen, P.A.; van der Voordt, T.

    2016-01-01

    This chapter presents some findings from surveys on employee satisfaction in different work environments in the Netherlands and various other European countries. It first discusses why employee satisfaction is relevant for organisations and which factors may influence employee satisfaction. Then the

  14. 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.

  15. Continuous improvement: A win-win process

    International Nuclear Information System (INIS)

    Lawrence, T.M.; Wichert, A.

    1992-01-01

    The strategies used within PanCanadian Petroleum Limited's production division to successfully introduce the continuous improvement (CI) process are discussed. Continuous improvement is an operating philosophy and management style which allows all employees to participate in and improve the way an organization performs its day-to-day business. In the CI work environment the supervisor's traditional role changes from one of monitoring and controlling, to one of inspiring, motivating and leading people by communicating a clear vision. Employees at all levels in the work environment are organized into teams and armed with a good working knowledge of the problem-solving tools which allow them to pursue and implement improvement initiatives. The outcome of the process is an ongoing win-win situation for both PanCanadian and its people. Employees are gaining more trust, eliminating job irritants, and enjoying their work in a team environment. The company is benefiting through increased production, improved safety and reduced operating expenses, thanks to the many innovative ideas introduced by employees. 4 refs

  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...... that HRD is rarely integrated with CI. The paper contributes by offering a model that depicts how HR and HRD functions could be exploited to support successful CI development and implementation....

  17. 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.

  18. 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.

  19. The Influence of Service Quality on Satisfaction and Information System Continuance Intention

    Directory of Open Access Journals (Sweden)

    Semina Halilović

    2015-06-01

    Full Text Available The expectation-confirmation model of IS continuance (ECM-IS explains determinants affecting the behavior of information system (IS users which can also have an impact on their decision whether to continue or discontinue the IS use. Service quality is considered a potential motivator which can influence users’ IS behavior. Likewise, one may expect service quality to be a motivator of users’ IS continuance intention influencing their future behavior after the initial IS use, and to be an important factor of IS success in general. In this study, an extension of the ECM-IS has been proposed in order to examine whether the perception of service quality by users plays an important role in shaping IS user behavior, as well as whether it affects the level of satisfaction with and the decision to either continue or discontinue the IS use. The Extended ECM-IS (EECM-IS has explained 66% of the variance dependent variable of IS continuance. Findings of this study confirm that perceived usefulness, satisfaction and perceived service quality are significant predictors of users’ IS continuance intention.

  20. Measuring maternal satisfaction with maternity care: A systematic integrative review: What is the most appropriate, reliable and valid tool that can be used to measure maternal satisfaction with continuity of maternity care?

    Science.gov (United States)

    Perriman, Noelyn; Davis, Deborah

    2016-06-01

    The objective of this systematic integrative review is to identify, summarise and communicate the findings of research relating to tools that measure maternal satisfaction with continuity of maternity care models. In so doing the most appropriate, reliable and valid tool that can be used to measure maternal satisfaction with continuity of maternity care will be determined. A systematic integrative review of published and unpublished literature was undertaken using selected databases. Research papers were included if they measured maternal satisfaction in a continuity model of maternity care, were published in English after 1999 and if they included (or made available) the instrument used to measure satisfaction. Six hundred and thirty two unique papers were identified and after applying the selection criteria, four papers were included in the review. Three of these originated in Australia and one in Canada. The primary focus of all papers was not on the development of a tool to measure maternal satisfaction but on the comparison of outcomes in different models of care. The instruments developed varied in terms of the degree to which they were tested for validity and reliability. Women's satisfaction with maternity services is an important measure of quality. Most satisfaction surveys in maternity appear to reflect fragmented models of care though continuity of care models are increasing in line with the evidence demonstrating their effectiveness. It is important that robust tools are developed for this context and that there is some consistency in the way this is measured and reported for the purposes of benchmarking and quality improvement. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  1. Record of Assessment Moderation Practice (RAMP): Survey Software as a Mechanism of Continuous Quality Improvement

    Science.gov (United States)

    Johnson, Genevieve Marie

    2015-01-01

    In higher education, assessment integrity is pivotal to student learning and satisfaction, and, therefore, a particularly important target of continuous quality improvement. This paper reports on the preliminary development and application of a process of recording and analysing current assessment moderation practices, with the aim of identifying…

  2. Continuous Improvement in Action: Educators' Evidence Use for School Improvement

    Science.gov (United States)

    Cannata, Marisa; Redding, Christopher; Rubin, Mollie

    2016-01-01

    The focus of the article is the process educators use to interpret data to turn it into usable knowledge (Honig & Coburn, 2008) while engaging in a continuous improvement process. The authors examine the types of evidence educators draw upon, its perceived relevance, and the social context in which the evidence is examined. Evidence includes…

  3. 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.

  4. Applying Lean/Toyota production system principles to improve phlebotomy patient satisfaction and workflow.

    Science.gov (United States)

    Melanson, Stacy E F; Goonan, Ellen M; Lobo, Margaret M; Baum, Jonathan M; Paredes, José D; Santos, Katherine S; Gustafson, Michael L; Tanasijevic, Milenko J

    2009-12-01

    Our goals were to improve the overall patient experience and optimize the blood collection process in outpatient phlebotomy using Lean principles. Elimination of non-value-added steps and modifications to operational processes resulted in increased capacity to handle workload during peak times without adding staff. The result was a reduction of average patient wait time from 21 to 5 minutes, with the goal of drawing blood samples within 10 minutes of arrival at the phlebotomy station met for 90% of patients. In addition, patient satisfaction increased noticeably as assessed by a 5-question survey. The results have been sustained for 10 months with staff continuing to make process improvements.

  5. Physician Order Entry Clerical Support Improves Physician Satisfaction and Productivity.

    Science.gov (United States)

    Contratto, Erin; Romp, Katherine; Estrada, Carlos A; Agne, April; Willett, Lisa L

    2017-05-01

    To examine the impact of clerical support personnel for physician order entry on physician satisfaction, productivity, timeliness with electronic health record (EHR) documentation, and physician attitudes. All seven part-time physicians at an academic general internal medicine practice were included in this quasi-experimental (single group, pre- and postintervention) mixed-methods study. One full-time clerical support staff member was trained and hired to enter physician orders in the EHR and conduct previsit planning. Physician satisfaction, productivity, timeliness with EHR documentation, and physician attitudes toward the intervention were measured. Four months after the intervention, physicians reported improvements in overall quality of life (good quality, 71%-100%), personal balance (43%-71%), and burnout (weekly, 43%-14%; callousness, 14%-0%). Matched for quarter, productivity increased: work relative value unit (wRVU) per session increased by 20.5% (before, April-June 2014; after, April-June 2015; range -9.2% to 27.5%). Physicians reported feeling more supported, more focused on patient care, and less stressed and fatigued after the intervention. This study supports the use of physician order entry clerical personnel as a simple, cost-effective intervention to improve the work lives of primary care physicians.

  6. Predictors of foster parents' satisfaction and intent to continue to foster.

    Science.gov (United States)

    Denby, R; Rindfleisch, N; Bean, G

    1999-03-01

    The United States General Accounting Office (United States General Accounting Office [USGAO], 1989) report on out-of-home care affirmed that the foster care system is in crisis. To shed light on some factors that influence retention, the study reported here asked "What factors influence the satisfaction of foster parents?" and "What factors influence the intent of licensed foster parents to continue to foster?" A sample of 539 foster parents in eight urban counties in a large Midwestern state completed questionnaires aimed at addressing these questions. Some of the factors exerting the strongest influence on satisfaction were: feeling competent to handle the children who were placed; wanting to take in children who needed loving parents; no regrets about investment in foster children; foster mother's age; and agency social worker providing information and showing approval for a job well done. An example of factors exerting influence on intent to continue to foster include overall satisfaction, readiness to phone the social worker, number of foster boys in the home, being treated like one needed help oneself, and agency affiliation (private). Efforts to increase the supply of foster homes through recruitment is not enough. The support, training, and professional regard given to parents after they have begun the fostering task is of greater need. Based on analysis of the findings, implications for practice, programming, and policy are offered.

  7. Can Team-Based Care Improve Patient Satisfaction? A Systematic Review of Randomized Controlled Trials

    Science.gov (United States)

    Wen, Jin; Schulman, Kevin A.

    2014-01-01

    Background Team-based approaches to patient care are a relatively recent innovation in health care delivery. The effectiveness of these approaches on patient outcomes has not been well documented. This paper reports a systematic review of the relationship between team-based care and patient satisfaction. Methods We searched MEDLINE, EMBASE, Cochrane Library, CINAHL, and PSYCHOINFO for eligible studies dating from inception to October 8, 2012. Eligible studies reported (1) a randomized controlled trial, (2) interventions including both team-based care and non-team-based care (or usual care), and (3) outcomes including an assessment of patient satisfaction. Articles with different settings between intervention and control were excluded, as were trial protocols. The reference lists of retrieved papers were also evaluated for inclusion. Results The literature search yielded 319 citations, of which 77 were screened for further full-text evaluation. Of these, 27 articles were included in the systematic review. The 26 trials with a total of 15,526 participants were included in this systematic review. The pooling result of dichotomous data (number of studies: 10) showed that team-based care had a positive effect on patient satisfaction compared with usual care (odds ratio, 2.09; 95% confidence interval, 1.54 to 2.84); however, combined continuous data (number of studies: 7) demonstrated that there was no significant difference in patient satisfaction between team-based care and usual care (standardized mean difference, −0.02; 95% confidence interval, −0.40 to 0.36). Conclusions Some evidence showed that team-based care is better than usual care in improving patient satisfaction. However, considering the pooling result of continuous data, along with the suboptimal quality of included trials, further large-scale and high-quality randomized controlled trials comparing team-based care and usual care are needed. PMID:25014674

  8. Continuous improvement: A win... win process

    International Nuclear Information System (INIS)

    Lawrence, T.; Wichert, A.

    1993-01-01

    Implementing a continuous improvement (CI) process within PanCanadian's oil and gas production operations might have been a simple assignment if one were not also trying to capture the hearts and imaginations of the people in a changing work environment. Meeting the challenge is resulting in big payoffs to both the organization and its people. The plan used within the Company's Production Division to successfully introduce the CI process is discussed. A brief insight is provided on the process philosophy, with emphasis placed on planning, training and coaching used to launch the process. Also reviewed at length are the impediments to change and the challenges faced when changing an organization's culture. In a CI work environment, the supervisor's traditional role changes from one of monitoring and controlling to one of inspiring, motivating and leading people by communicating a clear vision. Employees at all levels in the work environment are organized into teams and armed with a good working knowledge of the problem solving tools which allow them to pursue and implement improvement initiatives. The outcome of the process is an ongoing 'win-win' situation for both the Company and its people. Employees are gaining more trust, eliminating job irritants and enjoying their work more in a team environment. The Company is winning through increased production, improved safety and reduced operating expenses, thanks to many innovative ideas which the employees have implemented. 4 refs

  9. Continuous quality improvement in the ambulatory endoscopy center.

    Science.gov (United States)

    Johanson, John F

    2002-04-01

    of improvement. Second, learning must be viewed as a process. A quality improvement plan that is successful in one setting may not be as favorable in another situation. Clinicians must be able to focus on their individual situations and adapt what others have implemented to their own practice. Third, the most important aspect of the quality improvement is the implementation step. It matters little if elegant studies of endoscopic complications or patient satisfaction are completed if the information is not used to improve the delivery of health care to every single patient. The delivery of medical care continues to evolve. Resources are becoming increasingly scarce and the progressive rise of health care expenditures suggests a need for control. In this zeal for cost constraint, quality must not be sacrificed. This new-found attention to quality must be extended to the level of the individual practitioner to ensure that individual patients' interests are protected and the best possible care is delivered regardless of the economic implications. As providers of health care, endoscopists need to take an active role in these efforts both in understanding and implementing the techniques of quality assessment into their practices. If physicians are not actively involved in data collection and measurement to improve the quality and value of their own work, someone else will undoubtedly assume this role.

  10. A Report Card on Continuous Quality Improvement

    Science.gov (United States)

    Blumenthal, David; Kilo, Charles M.

    1998-01-01

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

  11. Management strategies to improve job satisfaction of principals in primary schools / Khumalo M.G.

    OpenAIRE

    Khumalo, Mapula Gertrude.

    2012-01-01

    The aim of this study is to optimise aspects of job satisfaction in the work environment to improve the effectiveness of primary school principals. Job dissatisfaction seems to be a worldwide problem in the education sector, even in South Africa a number of researches were conducted on job satisfaction. In this research the focus is on the following research questions: What is the nature of job satisfaction? Which factors contribute to the job satisfaction/dissatisfaction of primary school...

  12. How can we recognize continuous quality improvement?

    Science.gov (United States)

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

    2014-02-01

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

  13. Satisfaction and improvement of clinical experiment of student radiotechnologists

    International Nuclear Information System (INIS)

    Lyu, Kwang Yeul; Kim, Hyun Soo

    2006-01-01

    Clinical experiment is a set of experience to help student acquire technic, attitude and knowledge by participating in the clinical work. The radiotechnologists who are employed in departments of radiology serve as clinical instructors. Their responsibilities include teaching students them to become competent radiotechnologist. Clinical instructors often have no formal preparation in teaching student. The purpose of this study is to review some principals that will help clinical instructors support and foster the professional development of student radiotechnologists. The clinical instructor should be able to identify the qualities of instructor, the characteristics of feedback and use facilitation skills when is evaluated student performance. And the survey was performed to evaluate the satisfaction of student participated in clinical experiment, the purpose of this research is to fine the problems and improvements in clinical experiment of student radiotechnologist in Korea

  14. Assessment of and recommendations to improve pharmacy faculty satisfaction and retention.

    Science.gov (United States)

    Spivey, Christina A; Chisholm-Burns, Marie A; Murphy, John E; Rice, Laura; Morelli, Christopher

    2009-01-01

    The level of job satisfaction and items associated with job satisfaction are examined among pharmacy faculty in the United States. An Internet-based survey was developed and distributed via e-mail to randomly selected faculty. The survey questionnaire was developed based on items used in previous surveys related to faculty job satisfaction and included a seven-item job satisfaction measure, satisfaction with work- and career-related items, items regarding the work environment, and demographic information. Analysis of variance and Pearson's correlation coefficient were used to analyze the relationship among variables. Out of 1000 faculty members who received the survey, 266 responded. The mean +/- S.D. level of global job satisfaction for faculty was 3.82 +/- 0.77. Global satisfaction and salary satisfaction were associated with higher salary level (p satisfaction were found for several work and career items. Female faculty members were less satisfied with time for family and personal needs compared with male faculty (p job satisfaction, there are several work and career and work environment areas in which improvement in satisfaction is needed. Provision of competitive salaries and development of a stimulating, supportive institutional culture may increase job satisfaction and facilitate improved faculty retention.

  15. Continuous improvement projects: an authorship bibliometric analysis.

    Science.gov (United States)

    Gonzalez Aleu, Fernando; Van Aken, Eileen M

    2017-06-12

    Purpose The purpose of this paper is to describe the current research on hospital continuous improvement projects (CIPs) from an author characteristics' perspective. This work addresses the following questions: who are the predominant research authors in hospital CIPs? To what extent are the research communities collaborating in distinct research groups? How internationalized has hospital CIPs research become with respect to author location? Design/methodology/approach A systematic literature review was conducted, identifying 302 academic publications related to hospital CIPs. Publications were analyzed using: author, quantity, diversity, collaboration, and impact. Findings Hospital CIPs are increasingly attracting new scholars each year. Based on the authors' analysis, authors publishing in this area can be described as a relatively new international community given the countries represented. Originality/value This paper describes the current hospital CIP research by assessing author characteristics. Future work should examine additional attributes to characterize maturity such as how new knowledge is being created and to what extent new knowledge is being disseminated to practitioners.

  16. Job satisfaction and career commitment among Alzheimer's care providers: addressing turnover and improving staff empowerment.

    Science.gov (United States)

    Coogle, Constance L; Parham, Iris A; Rachel, Colleen A

    2011-11-01

    This study investigated the relation between job satisfaction and career commitment among 262 Alzheimer's care staff working in long-term and community-based care settings. It was anticipated that the results would suggest whether career commitment could be enhanced to positively influence job satisfaction, and conversely, if improvements in job satisfaction might contribute to a deepened sense of vocational empowerment. Participants attended dementia-specific training and completed 2 short work-related questionnaires that measured job satisfaction and career commitment. The results of stepwise regression revealed interrelations between the 2 constructs. Congruence appeared to be reciprocal with respect to the overall scale scores and the intrinsic job satisfaction measure. Unexpected relations appeared in analyses of the extrinsic job satisfaction measure and the career planning subscale. Results are indicative of the fundamental distinction between job satisfaction and career commitment. Implications for efforts to reduce turnover and improve staff empowerment are also considered.

  17. The impact of work-life balance on employees' job satisfaction and turnover intention: the moderating role of continuance commitment

    OpenAIRE

    Aslani, Farshad; Fayyazi, Marjan

    2015-01-01

    Work-life imbalance has several negative impacts on employees' attitudes and behaviors and consequently influences organizations' performance and effectiveness. The purpose of this article is to investigate the impact of work-life balance (WLB) on employees' job satisfaction and turnover intention. Moreover, we study the moderating role of continuance commitment on job satisfaction - turnover intention relationship. Regression analysis was used to analyze the data collected from 265 questionn...

  18. Improving job satisfaction and enlarging the role of technicians.

    Science.gov (United States)

    Spooner, S H; Britton, M E; Erskine, L M; Verschoor, B A; Williams, P A

    1991-01-01

    The process used in preparing this administrative report provided the means of documenting departmental support of technician task expansion, cost benefits, increased availability of professional time, and the need for a dynamic department. Some of the benefits to St. Luke's Regional Medical Center and its Pharmacy Department were an increase in technician job satisfaction, improved quality of patient care attributable to the increased scope of pharmacy service, and up to 8554 hours per year of professional time available for more clinically oriented responsibilities. If technician turnover were decreased by half, technician pricing errors eliminated, and technicians assumed the identified technical tasks, potential monetary benefits could be as much as +116,900 per year. The departmental cost of implementing these recommendations would be an additional 4.16 technician FTEs, and the professional time for training, supervising, and coordinating technicians and functions. These recommendations were well received by pharmacy administration, and the committee was asked to develop a list of priorities and an implementation plan for administrative approval.

  19. Case Studies in Continuous Process Improvement

    Science.gov (United States)

    Mehta, A.

    1997-01-01

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

  20. The impact of a quality improvement program on employee satisfaction in an academic microsystem.

    Science.gov (United States)

    Varkey, Prathibha; Karlapudi, Sudhakar P; Hensrud, Donald D

    2008-01-01

    Quality improvement is a potential method to enhance employee satisfaction. This study describes the impact of a program instituted to enhance employee satisfaction using the principles of high-performing microsystems. A shared leadership committee, participatory meetings, suggestion boxes, and quality improvement projects were implemented as part of the program. A follow-up survey 1 year after implementation of the program demonstrated an increase in employee perception of the division's desire to improve service (16%), opportunities to expand skills (17%), involvement in work decisions (25%), and the institution's interest in employee well-being (17%). Key drivers of discretionary effort (4 of 5), job satisfaction (2 of 6), and overall satisfaction (1 of 8) with the institution showed statistically significant improvement in the study division as compared with the other divisions in which no such program was implemented. Further research is needed to study systems changes that enhance employee satisfaction and their impact on patient and financial outcomes.

  1. Improved specifications for continuous emission monitoring

    International Nuclear Information System (INIS)

    Dene, C.E.; Eggleston, T.E.; Gray, W.C. Jr.; Bisha, R.M.

    1988-01-01

    Continuous emission monitoring (CEM) in the electric utility industry historically has been plagued by poor performance and inconsistent system reliability. These problems have, in part, been caused by the complexity and diversity of the various systems available, and the dissimilarity of continuous emission monitors CEMs relative to conventional power plant instrumentation. Recognizing the problems faced by the utility industry in implementing CEM programs, the Electric Power Research Institute (EPRI) initiated a multi-phase project to define the current state of technology for CEMs and to provide a comprehensive guide for the purchase and installation of a CEM system. The second phase of this project was the application of these guidelines to the actual purchase, installation, and operation of a CEM system for an electric utility generating station. Through this application of the guidelines it has been possible to determine further research needs and areas of the manual which require clarification or enhancement. This paper describes the development of the guidelines and modifications to the guidelines, and discusses EPRI's plans for future activities in the area of continuous emission monitoring

  2. 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

    2018-02-01

    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 P<0.05. This study reported an increased nutritional 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

  3. Existe una relación entre los programas de mejora de la calidad y la satisfacción de usuarias de atención prenatal?: experiencia en hospitales del Perú Is there a link between continuous quality improvement programs and health service users' satisfaction with prenatal care? An experience in Peruvian hospitals

    Directory of Open Access Journals (Sweden)

    Juan A. Seclen-Palacín

    2004-09-01

    .OBJECTIVES: 1. To compare the level of health service user satisfaction (US with antenatal care in hospitals where a program of continuous quality improvement (CQI was implemented, in comparison to a reference group of patients seen at hospitals that did not participate in the program. 2. To compare the reasons for dissatisfaction in both groups of users. 3. To identify the factors associated with US. METHODS: A quasi-experimental study of a representative sample of pregnant women attending prenatal care services. The women in the intervention group (n = 191 and the reference group (n = 185 were interviewed on leaving the prenatal care clinic. The dependent variable was satisfaction with prenatal care, and the independent variables were satisfaction of expectations, amiability, level of health information, perception of the equipment, waiting time, cleanliness and comfort. Descriptive and multivariate statistics were calculated. RESULTS: The intervention group showed higher rates of US (67.5% versus 55.1% in the reference group, P = 0,014. The main reasons for dissatisfaction were long waiting times and discourteous treatment, which were more frequent in the reference group. The multivariate analysis identified cordiality of the health professionals, information provided during the visit, satisfaction of expectations and implementation of the CQI program as the factors that were significantly associated with US. CONCLUSIONS: Our findings show that the CQI program in maternal and perinatal health services was positively associated with US. These results reinforce the need for cordiality during prenatal care contacts with providers, and the need to provide appropriate information to the user, in order to help increase acceptability of and adhesion to health care recommendations among pregnant women.

  4. Continuous improvement in teams : The (mis)fit between improvement and operational activities of improvement teams

    NARCIS (Netherlands)

    Ros, D.J.

    1999-01-01

    Since the 1970s and 1980s, increasing attention has been paid to the Japanese ways of organising production. One of the subjects often discussed is the importance of continuous incremental improvements. Nowadays, for many organisations, continuous improvement has become an important topic; many

  5. 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.

  6. 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

    of initial monitoring). Ten women (15%) did not wish to use continuous glucose monitoring again in pregnancy. Main causes behind early removal of continuous glucose monitoring were self-reported skin irritation, technical problems and continuous glucose monitoring inaccuracy. No differences were found......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...

  7. Involving vendors in continuous quality improvement efforts.

    Science.gov (United States)

    McDevitt, M C

    1995-03-01

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

  8. 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.

  9. 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. Copyright 2012, SLACK Incorporated.

  10. Does Privatization Improve Job Satisfaction? The Case of Ghana

    NARCIS (Netherlands)

    Asiedu, K.F.; Folmer, H.

    2007-01-01

    This paper analyzes the impacts of privatization in Ghana on the basis of a survey of 300 workers in privatized and state-owned enterprises. The findings indicate a significant positive relationship between privatization and job satisfaction. Whereas monthly wage is an important determinant of job

  11. Does privatization improve job satisfaction? The case of Ghana

    NARCIS (Netherlands)

    Asiedu, Kofi Fred; Folmer, Henk

    2007-01-01

    This paper analyzes the impacts of privatization in Ghana on the basis of a survey of 300 workers in privatized and state-owned enterprises. The findings indicate a significant positive relationship between privatization and job satisfaction. Whereas monthly wage is an important determinant of job

  12. Patients report better satisfaction with part-time primary care physicians, despite less continuity of care and access.

    Science.gov (United States)

    Panattoni, Laura; Stone, Ashley; Chung, Sukyung; Tai-Seale, Ming

    2015-03-01

    The growing number of primary care physicians (PCPs) reducing their clinical work hours has raised concerns about meeting the future demand for services and fulfilling the continuity and access mandates for patient-centered care. However, the patient's experience of care with part-time physicians is relatively unknown, and may be mediated by continuity and access to care outcomes. We aimed to examine the relationships between a physicians' clinical full-time equivalent (FTE), continuity of care, access to care, and patient satisfaction with the physician. We used a multi-level structural equation estimation, with continuity and access modeled as mediators, for a cross-section in 2010. The study included family medicine (n = 104) and internal medicine (n = 101) physicians in a multi-specialty group practice, along with their patient satisfaction survey responses (n = 12,688). Physician level FTE, continuity of care received by patients, continuity of care provided by physician, and a Press Ganey patient satisfaction with the physician score, on a 0-100 % scale, were measured. Access to care was measured as days to the third next-available appointment. Physician FTE was directly associated with better continuity of care received (0.172% per FTE, p part-time PCPs in practice redesign efforts and initiatives to meet the demand for primary care services.

  13. 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…

  14. 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…

  15. [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.

  16. What makes a successful volunteer Expert Patients Programme tutor? Factors predicting satisfaction, productivity and intention to continue tutoring of a new public health workforce in the United Kingdom.

    Science.gov (United States)

    Macdonald, Wendy; Kontopantelis, Evangelos; Bower, Peter; Kennedy, Anne; Rogers, Anne; Reeves, David

    2009-04-01

    Better management of chronic conditions is a challenge for public health policy. The Expert Patients Programme was introduced into the United Kingdom to improve self-care in people with long-term conditions. To deliver self-care courses, the programme relies on the recruitment and continued commitment to delivering the courses of volunteer lay tutors who have long-term conditions. Ensuring the tutor workforce is productive, satisfied in their role and retained long-term is central to the viability of the programme. This exploratory study aimed to determine what factors predict productivity, intention to continue tutoring, and satisfaction in a sample of volunteer tutors from the Expert Patients Programme. A cross-sectional survey of 895 tutors was carried out and 518 (58%) responded. The questionnaire was designed to describe the characteristics, productivity, intention to continue tutoring, and satisfaction of tutors. Multiple linear regression analyses were used to examine the determinants of productivity, intention to continue tutoring, and satisfaction, such as patient demographics, attitudes, physical and mental health, mastery and self-esteem. Attitudes relating to personal goals, and better health were significant predictors of satisfaction with the tutor role. Only a small proportion of the variance in productivity was accounted for, and tutors were more likely to be productive when they were single, homeowners, car owners, and had lower scores on the depression scale. Overall satisfaction and personal goals were predictors of intention to continue tutoring. Demographic factors, health measures and attitudes each predicted different aspects of the experience of work conducted by the volunteer tutors. The results should prove useful for planning interventions to enhance the success of this new workforce initiative. Attempts to increase participation in courses by people from deprived backgrounds are likely to be enhanced if tutors come from similar

  17. 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 applicabi......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...... that the nurses did not have enough time. Significant improvements in satisfaction had occurred as compared to a study from 2003. CONCLUSION: By using electronic questionnaires, it was possible to focus on the small percentage of parents not satisfied, to identify reasons for being less satisfied and to respond...

  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. Improving Patient Satisfaction in a Midsize Pediatric Hematology-Oncology Outpatient Clinic.

    Science.gov (United States)

    Fustino, Nicholas J; Kochanski, Justin J

    2015-09-01

    The study of patient satisfaction is a rapidly emerging area of importance within health care. High levels of patient satisfaction are associated with exceptional physician-patient communication, superior patient compliance, reduced risk of medical malpractice, and economic benefit in the value-based purchasing era. To our knowledge, no previous reports have evaluated methods to improve the patient experience within the pediatric hematology-oncology (PHO) outpatient clinic. Patient satisfaction was measured using returned Press-Ganey surveys at Blank Children's Hospital PHO outpatient clinic (UnityPoint Health). The aim of this study was to raise the overall patient satisfaction score to the 75th percentile and raise the care provider score (CP) to the 90th percentile nationally. After analyzing data from 2013, interventions were implemented in January 2014, including weekly review of returned surveys, review of goals and progress at monthly staff meetings, distribution of written materials addressing deficiencies, score transparency among providers, provider use of Web-based patient satisfaction training modules, devotion of additional efforts to address less satisfied demographics (new patient consultations), and more liberal use of service recovery techniques. In the PHO outpatient clinic, overall patient satisfaction improved from the 56th to 97th percentile. Care provider scores improved from the 70th to 99 th percentile. For new patients, overall satisfaction improved from the 27th to 92 nd percentile, and care provider scores improved from the 29th to 98 th percentile. Patient satisfaction was improved in a midsize PHO clinic by implementing provider- and staff-driven initiatives. A combination of minor behavioral changes among care providers and staff in conjunction with systems-related modifications drove improvement. Copyright © 2015 by American Society of Clinical Oncology.

  20. Expanding Continuous Quality Improvement Capacity in the Medical Intensive Care Unit: Prehealth Volunteers as a Solution.

    Science.gov (United States)

    Priest, Kelsey C; Lobingier, Hannah; McCully, Nancy; Lombard, Jackie; Hansen, Mark; Uchiyama, Makoto; Hagg, Daniel S

    2016-01-01

    Health care delivery systems are challenged to support the increasing demands for improving patient safety, satisfaction, and outcomes. Limited resources and staffing are common barriers for making significant and sustained improvements. At Oregon Health & Science University, the medical intensive care unit (MICU) leadership team faced internal capacity limitations for conducting continuous quality improvement, specifically for the implementation and evaluation of the mobility portion of an evidence-based care bundle. The MICU team successfully addressed this capacity challenge using the person power of prehealth volunteers. In the first year of the project, 52 trained volunteers executed an evidence-based mobility intervention for 305 critically ill patients, conducting more than 200 000 exercise repetitions. The volunteers contributed to real-time evaluation of the project, with the collection of approximately 26 950 process measure data points. Prehealth volunteers are an untapped resource for effectively expanding internal continuous quality improvement capacity in the MICU and beyond.

  1. Improving older people's life satisfaction via social networking site use: Evidence from China.

    Science.gov (United States)

    Zhou, Junjie

    2018-03-01

    This study aimed to examine the pathways by which social networking sites (SNSs) can improve older people's life satisfaction. We conducted an online survey in China that lasted eight weeks. Respondents were required to report their demographic characteristics and feelings regarding SNS use. Data were analysed using SPSS 20 and Amos 21. We collected 596 valid samples. The empirical results show that SNS use improves older people's life satisfaction by reducing their loneliness and improving their self-efficacy. Social support alleviates the negative effect of loneliness and enhances the positive effect of self-efficacy on life satisfaction. Sex differences and education differences were significant. Men and less educated people had higher levels of life satisfaction. Policymakers should offer support to SNSs targeting older people and encourage them to provide more useful services. SNS operators should encourage social support among older users and pay attention to sex differences and education differences. © 2018 AJA Inc.

  2. 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…

  3. 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.

  4. Continuous Improvement and its Barriers in Electrical and Electronic Industry

    Directory of Open Access Journals (Sweden)

    Ahmad Md Fauzi

    2017-01-01

    Full Text Available Continuous improvement is one of the core strategies for manufacturing excellent and it is considered vital in today’s business environment. Continuous improvement is an important factor in TQM implementation. However, manufacturers in Electrical and Electronic Industry is facing variety of challenges such as, time constraint, quality issue, headcount issue, human issue and competition in domestic as well as the global market. This paper presents total quality management practices in Electrical and Electronic (EE Industry. These manufacturers have to keep improving in key activities and processes to cope the challenges. Therefore, EE industry realize the importance of continuous improvement in helping the industries by setting clear goals and priorities for the area of improvement. The aims of this study are to determine the main factor in implementing continuous improvement practices, identify tools of continuous improvement that have been used and their obstacle in implementing continuous improvement practices. 200 questionnaires had been distributed to the employees in Electrical and Electronic Industry located at Bayan Lepas, Penang, Malaysia. A total of 41 questionnaires were answered which represented about 20.5% response rates. Survey result shows that teamwork and training and learning are respectively the importance factor and the most practices factor in Electrical and Electronic Industry. Most of the Electrical and Electronic Industry emphasis is on using Lean Manufacturing as the tool of continuous improvement practices. Besides that, Electrical and Electronic Industry faced the problems of lack of budget and lack of worker commitment.

  5. Internal marketing in the function of improvement of consumers satisfaction

    Directory of Open Access Journals (Sweden)

    Ratković Milijanka

    2009-01-01

    Full Text Available Changes in environment inflict the new conditions which need to be adjusted to, but which should be exploited too. Internal marketing is an area which provides possibilities for effective usage of personnel potentials and as such presents potential source of competitive advantage. The concept of internal marketing directs attention toward employees' satisfaction and maintaining good, longlasting relations with them. In order to use the potential of its employees, a company has to know them very well, to motivate them, and conduct appropriate educational programmes in order to create and deliver high quality service. .

  6. Establishing a Nurse Mentor Program to Improve Nurse Satisfaction and Intent to Stay.

    Science.gov (United States)

    Jones, Sara Jane

    Mentoring is an intervention to foster development and socialization of new registered nurses to an organization or unit. A nurse mentor program was developed and implemented with the purpose to improve new registered nurse satisfaction and intent to stay. A pre- and postintervention design was used in a rural emergency department to evaluate nurse job satisfaction and intent to stay in the job. Intent to stay in the job mean scores increased, and the registered nurse participants reported program satisfaction through verbal and written feedback.

  7. 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.

  8. Service quality that improves customer satisfaction in a university: a case study in Institut Teknologi Indonesia

    Science.gov (United States)

    Theresia, L.; Bangun, R.

    2017-12-01

    Universities should provide better service quality to get more customers. The purpose of this study was to find service quality which has impact on the increasing of customer satisfaction in a university. This study is a case study in Institut Teknologi Indonesia (ITI). The result of the study will help ITI to improve its service quality to increase customer satisfaction. This study employs path analysis technique. The data were collected through questionnaires developed from the literature. Questionnaires have two parts namely 1) service quality and 2) customer satisfaction. Service quality is measured through 22 questions with five service quality dimensions: 1) Tangibles, 2) Reliability, 3) Responsiveness, 4) Assurance and 5) Empathy. Customer Satisfaction is measured through 4 questions. The data then are processed by SPSS. The results showed that the students preferred to tangible quality improvement than intangible aspect.

  9. A continuous quality improvement program to focus a college of pharmacy on programmatic advancement.

    Science.gov (United States)

    Hall, Philip D; Dipiro, Joseph T; Rowen, Randall C; McNair, David

    2013-08-12

    To enhance the achievement of a college of pharmacy's goals for education, research, and service missions by implementing an excellence program based on the Studer Group model for continuous quality improvement. The Studer model was combined with university strategic planning for a comprehensive quality-improvement program that was implemented over 5 years. The program included identifying and measuring key performance indicators, establishing specific "pillar" goals, aligning behaviors with goals and values, and training leaders. Assessment of key performance indicators over 5 years demonstrated progress toward achieving college goals for student and faculty satisfaction, research funding, numbers of students seeking formal postgraduate training, and private giving. Implementation of a continuous quality-improvement program based on the Studer program enabled the college to focus on and meet its yearly and strategic goals for all components of its mission.

  10. Can Schools Meet the Promise of Continuous Improvement?

    Science.gov (United States)

    Elgart, Mark A.

    2018-01-01

    Continuous improvement is "an embedded behavior within the culture of a school that constantly focuses on the conditions, processes, and practices that will improve teaching and learning." The phrase has been part of the lexicon of school improvement for decades, but real progress is rare. Based on its observations of about 5,000…

  11. [Improving the continuous care process in primary care during weekends and holidays: redesigning and FMEA].

    Science.gov (United States)

    Cañada Dorado, A; Cárdenas Valladolid, J; Espejo Matorrales, F; García Ferradal, I; Sastre Páez, S; Vicente Martín, I

    2010-01-01

    To describe a project carried out in order to improve the process of Continuous Health Care (CHC) on Saturdays and bank holidays in Primary Care, area number 4, Madrid. The aim of this project was to guarantee a safe and error-free service to patients receiving home health care on weekends. The urgent need for improving CHC process was identified by the Risk Management Functional Unit (RMFU) of the area. In addition, some complaints had been received from the nurses involved in the process as well as from their patients. A SWOT (Strengths, Weaknesses, Opportunities and Threats) analysis performed in 2009 highlighted a number of problems with the process. As a result, a project for improvement was drawn up, to be implemented in the following stages: 1. Redesigning and improving the existing process. 2. Application of failure mode and effect analysis (FMEA) to the new process. 3. Follow up, managing and leading the project. 4. Nurse training. 5. Implementing the process in the whole area. 6. CHC nurse satisfaction surveys. After carrying out this project, the efficiency and level of automation improved considerably. Since implementation of the process enhancement measures, no complaints have been received from patients and surveys show that CHC nurse satisfaction has improved. By using FMEA, errors were given priority and enhancement steps were taken in order to: Inform professionals, back-up personnel and patients about the process. Improve the specialist follow-up report. Provide training in ulcer patient care. The process enhancement, and especially its automation, has resulted in a significant step forward toward achieving greater patient safety. FMEA was a useful tool, which helped in taking some important actions. Finally, CHC nurse satisfaction has clearly improved. Copyright © 2009 SECA. Published by Elsevier Espana. All rights reserved.

  12. 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

  13. Continuous Improvement Implementation in the Nottingham University Hospitals NHS Trust: A Case Study of a Continuous Improvement Programme & Project

    OpenAIRE

    Velzen, Jeena

    2012-01-01

    This paper aims at identifying the extent to which the Nottingham University Hospitals NHS Trust has fulfilled literature requirements for successful continuous improvement as exemplified by its Better for You programme and chemotherapy service improvement project. Both the theory and ideals of the continuous improvement programme, along with the actualization of these philosophies and methodologies in the context of the particular project,were compared against a framework for the enabling...

  14. Continuous quality improvement intervention for adolescent and young adult HIV testing services in Kenya improves HIV knowledge.

    Science.gov (United States)

    Wagner, Anjuli D; Mugo, Cyrus; Bluemer-Miroite, Shay; Mutiti, Peter M; Wamalwa, Dalton C; Bukusi, David; Neary, Jillian; Njuguna, Irene N; O'Malley, Gabrielle; John-Stewart, Grace C; Slyker, Jennifer A; Kohler, Pamela K

    2017-07-01

    To determine whether continuous quality improvement (CQI) improves quality of HIV testing services for adolescents and young adults (AYA). CQI was introduced at two HIV testing settings: Youth Centre and Voluntary Counseling and Testing (VCT) Center, at a national referral hospital in Nairobi, Kenya. Primary outcomes were AYA satisfaction with HIV testing services, intent to return, and accurate HIV prevention and transmission knowledge. Healthcare worker (HCW) satisfaction assessed staff morale. T tests and interrupted time series analysis using Prais-Winsten regression and generalized estimating equations accounting for temporal trends and autocorrelation were conducted. There were 172 AYA (Youth Centre = 109, VCT = 63) during 6 baseline weeks and 702 (Youth Centre = 454, VCT = 248) during 24 intervention weeks. CQI was associated with an immediate increase in the proportion of AYA with accurate knowledge of HIV transmission at Youth Centre: 18 vs. 63% [adjusted risk difference (aRD) 0.42,95% confidence interval (CI) 0.21 to 0.63], and a trend at VCT: 38 vs. 72% (aRD 0.30, 95% CI -0.04 to 0.63). CQI was associated with an increase in the proportion of AYA with accurate HIV prevention knowledge in VCT: 46 vs. 61% (aRD 0.39, 95% CI 0.02-0.76), but not Youth Centre (P = 0.759). In VCT, CQI showed a trend towards increased intent to retest (4.0 vs. 4.3; aRD 0.78, 95% CI -0.11 to 1.67), but not at Youth Centre (P = 0.19). CQI was not associated with changes in AYA satisfaction, which was high during baseline and intervention at both clinics (P = 0.384, P = 0.755). HCW satisfaction remained high during intervention and baseline (P = 0.746). CQI improved AYA knowledge and did not negatively impact HCW satisfaction. Quality improvement interventions may be useful to improve adolescent-friendly service delivery.

  15. The soul of the machine: continual improvement in ISO 14001

    NARCIS (Netherlands)

    Brouwer, M.A.C.; van Koppen, C.S.A.

    2008-01-01

    Continual improvement is a key component of ISO 14001, but in contrast to most other specifications in the standard, it is difficult to assess. Based on interviews with 19 certified companies in the chemical, food, and environmental services sectors, this article explores the dynamics of continual

  16. The soul of the machine: continual improvement in ISO 14001.

    NARCIS (Netherlands)

    Brouwer, M.A.C.; Koppen, van C.S.A.

    2008-01-01

    Continual improvement is a key component of ISO 14001, but in contrast to most other specifications in the standard, it is difficult to assess. Based on interviews with 19 certified companies in the chemical, food, and environmental services sectors, this article explores the dynamics of continual

  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 and its Barriers in Electrical and Electronic Industry

    OpenAIRE

    Ahmad Md Fauzi; Yan Toh Li; Wei Chan Shiau; Aizat Ahmad Ahmad Nur; Raja Mohd Rasi Raja Zuraidah; Abdul Rahman Nor Aida; Muhd Nor Nik Hisyamudin; Hassan Mohd Fahrul; Hashim Fatan Adibah

    2017-01-01

    Continuous improvement is one of the core strategies for manufacturing excellent and it is considered vital in today’s business environment. Continuous improvement is an important factor in TQM implementation. However, manufacturers in Electrical and Electronic Industry is facing variety of challenges such as, time constraint, quality issue, headcount issue, human issue and competition in domestic as well as the global market. This paper presents total quality management practices in Electric...

  19. The program of continuous improvements in factory in Juzbado

    International Nuclear Information System (INIS)

    Prieto, M.

    2015-01-01

    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)

  20. Improvement of the customer satisfaction through Quality Assurance Matrix and QC-Story methods: A case study from automotive industry

    Science.gov (United States)

    Sicoe, G. M.; Belu, N.; Rachieru, N.; Nicolae, E. V.

    2017-10-01

    Presently, in the automotive industry, the tendency is to adapt permanently to the changes and introduce the market tendency in the new products that leads of the customer satisfaction. Many quality techniques were adopted in this field to continuous improvement of product and process quality and advantages were also gained. The present paper has focused on possibilities that offers the use of Quality Assurance Matrix (QAM) and Quality Control Story (QC Story) to provide largest protection against nonconformities in the production process, throughout a case study in the automotive industry. There is a direct relationship from the QAM to a QC Story analysis. The failures identified using QAM are treated with QC Story methodology. Using this methods, will help to decrease the PPM values and will increase the quality performance and the customer satisfaction.

  1. 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

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

    Science.gov (United States)

    Mark, Melvin M.; Pines, Edward

    1995-01-01

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

  3. Continuous Improvement in Schools and Districts: Policy Considerations

    Science.gov (United States)

    Best, Jane; Dunlap, Allison

    2014-01-01

    Discussions about improving public education often focus on outcomes without considering how schools and districts can accomplish those outcomes. Research shows that using a continuous improvement process has proven successful in healthcare, manufacturing, and technology, and may hold potential for use in education as well. This brief defines and…

  4. 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…

  5. Creating a Cycle of Continuous Improvement through Instructional Rounds

    Science.gov (United States)

    Meyer-Looze, Catherine L.

    2015-01-01

    Instructional Rounds is a continuous improvement strategy that focuses on the technical core of educational systems as well as educators collaborating side-by-side. Concentrating on collective learning, this process only makes sense within an overall strategy of improvement. This case study examined the Instructional Rounds process in a northern…

  6. The Keys to Effective Schools: Educational Reform as Continuous Improvement

    Science.gov (United States)

    Hawley, Willis D., Ed.

    2006-01-01

    Working in tandem with the powerful National Education Association's KEYS initiative (Keys to Excellence in Your Schools), this second edition focuses on how to change a school's organizational structure and culture to improve the quality of teaching and learning. Each chapter, revised and updated to address continuous improvement and narrowing…

  7. Evaluation of medical staff and patient satisfaction of Chinese hospitals and measures for improvement.

    Science.gov (United States)

    Li, Min; Huang, Chengyu; Lu, Xiangchan; Chen, Siyuan; Zhao, Pan; Lu, Hongzhou

    2015-06-01

    Our goal is to establish criteria for evaluating satisfaction of medical staff and patients of Chinese hospitals and propose measures for improvement. A survey was conducted among medical staff and patients of infectious disease hospitals in three locations, i.e., Shanghai, Chongqing, and Nanning. The analyses included item analysis, factor analysis, reliability analysis, Pearson correlation and one-way analysis of variance. For the patient group, Kaiser-Meyer-Olkin (KMO) = 0.973, Cronbach's α = 0.962 and the Pearson correlation coefficients among the five dimensions of satisfaction ranged from 0.583 to 0.795. For the medical staff group, KMO = 0.972, Cronbach's α = 0.970, and the Pearson correlation coefficients among the five dimensions of satisfaction ranged from 0.603 to 0.854. The means on the five dimensions of satisfaction for the patient group were 0.74 to 1.34, 0.81 to 1.17, 0.78 to 1.07, 0.89 to 1.34, and 0.71 to 1.10. The means on the five dimensions of satisfaction for the medical staff group were 0.17 to 1.03, ‒ 0.16 to 0.60, ‒ 0.18 to 0.74, 0.23 to 0.72, and ‒ 0.39 to 0.37. The clinicians were less satisfied with the hospitals than the patients. Medical staff and patients in Shanghai were relatively more satisfied. Improving the evaluation criteria and survey methods with respect to medical staff and patient satisfaction with Chinese hospitals may increase clinician and patient satisfaction and improve the health care environment in China.

  8. 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.

  9. 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.

  10. Improving Patient Satisfaction Through Computer-Based Questionnaires.

    Science.gov (United States)

    Smith, Matthew J; Reiter, Michael J; Crist, Brett D; Schultz, Loren G; Choma, Theodore J

    2016-01-01

    Patient-reported outcome measures are helping clinicians to use evidence-based medicine in decision making. The use of computer-based questionnaires to gather such data may offer advantages over traditional paper-based methods. These advantages include consistent presentation, prompts for missed questions, reliable scoring, and simple and accurate transfer of information into databases without manual data entry. The authors enrolled 308 patients over a 16-month period from 3 orthopedic clinics: spine, upper extremity, and trauma. Patients were randomized to complete either electronic or paper validated outcome forms during their first visit, and they completed the opposite modality at their second visit, which was approximately 7 weeks later. For patients with upper-extremity injuries, the Penn Shoulder Score (PSS) was used. For patients with lower-extremity injuries, the Foot Function Index (FFI) was used. For patients with lumbar spine symptoms, the Oswestry Disability Index (ODI) was used. All patients also were asked to complete the 36-Item Short Form Health Survey (SF-36) Health Status Survey, version 1. The authors assessed patient satisfaction with each survey modality and determined potential advantages and disadvantages for each. No statistically significant differences were found between the paper and electronic versions for patient-reported outcome data. However, patients strongly preferred the electronic surveys. Additionally, the paper forms had significantly more missed questions for the FFI (P<.0001), ODI (P<.0001), and PSS (P=.008), and patents were significantly less likely to complete these forms (P<.0001). Future research should focus on limiting the burden on responders, individualizing forms and questions as much as possible, and offering alternative environments for completion (home or mobile platforms). Copyright 2016, SLACK Incorporated.

  11. Marital stability, satisfaction and well-being in old age: variability and continuity in long-term continuously married older persons.

    Science.gov (United States)

    Margelisch, Katja; Schneewind, Klaus A; Violette, Jeanine; Perrig-Chiello, Pasqualina

    2017-04-01

    Recent research shows that the well-documented positive effects of marital stability on well-being and health outcomes are conditional upon the quality of marriage. To date, few studies have explored the relationship between marital satisfaction, well-being and health among very long-term married individuals. This study aims at identifying groups of long-term married persons with respect to marital satisfaction and comparing them longitudinally concerning their well-being outcomes, marital stressors, personality and socio-demographic variables. Data are derived from a survey (data collection 2012 and 2014) with 374 continuously married individuals at wave 1 (mean age: 74.2 years, length of marriage: 49.2 years) and 252 at wave 2. Cluster analyses were performed comparing the clusters with regard to various well-being outcomes. The predictive power of cluster affiliation and various predictors at wave 1 on well-being outcomes at wave 2 was tested using regression analyses. Two groups were identified, one happily the other unhappily married, with the happily married scoring higher on all well-being and health outcomes. Regression analyses revealed that group affiliation at wave 1 was not any longer predictive of health, emotional loneliness and hopelessness two years later, when taking into account socio-demographic variables, psychological resilience and marital strain, whereas it remained an important predictor of life satisfaction and social loneliness. Marital satisfaction is associated with health and well-being in older couples over time, whereas psychological resilience and marital strain are major predictors explaining the variance of these outcomes.

  12. 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.

  13. 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.

  14. 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

  15. 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.

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

    Science.gov (United States)

    2016-09-01

    key processes in our normal operations. In addition to the almost inevitable resistance to change, one of the points of pushback is that members of...Fall 2016 | 9 Matrix Wings Continuous Process Improvement an Operator Can Love Dr. A. J. Briding, Colonel, USAF, Retired Disclaimer: The views and...Operations for the 21st Century (AFSO21), the latest comprehensive effort at finding the right ap- proach for implementing a continuous process

  17. 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

  18. 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...... comprise such concepts as TQM, Kaizen, Six Sigma and Lean Manufacturing. The paper shows the results of the analysis and a comparison of how and to what degree such tools are used in different places, which allow us to address similarities and dissimilarities of the application. The results are discussed...

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

    Science.gov (United States)

    Laverentz, Delois Meyer; Kumm, Sharon

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

  20. 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.

  1. Improving family satisfaction and participation in decision making in an intensive care unit.

    Science.gov (United States)

    Huffines, Meredith; Johnson, Karen L; Smitz Naranjo, Linda L; Lissauer, Matthew E; Fishel, Marmie Ann-Michelle; D'Angelo Howes, Susan M; Pannullo, Diane; Ralls, Mindy; Smith, Ruth

    2013-10-01

    Background Survey data revealed that families of patients in a surgical intensive care unit were not satisfied with their participation in decision making or with how well the multidisciplinary team worked together. Objectives To develop and implement an evidence-based communication algorithm and evaluate its effect in improving satisfaction among patients' families. Methods A multidisciplinary team developed an algorithm that included bundles of communication interventions at 24, 72, and 96 hours after admission to the unit. The algorithm included clinical triggers, which if present escalated the algorithm. A pre-post design using process improvement methods was used to compare families' satisfaction scores before and after implementation of the algorithm. Results Satisfaction scores for participation in decision making (45% vs 68%; z = -2.62, P = .009) and how well the health care team worked together (64% vs 83%; z = -2.10, P = .04) improved significantly after implementation. Conclusions Use of an evidence-based structured communication algorithm may be a way to improve satisfaction of families of intensive care patients with their participation in decision making and their perception of how well the unit's team works together.

  2. Does receiving a copy of correspondence improve patients' satisfaction with their out-patient consultation?

    NARCIS (Netherlands)

    Saunders, N. C.; Georgalas, C.; Blaney, S. P. A.; Dixon, H.; Topham, J. H.

    2003-01-01

    It is standard practice to write to a patient's general practitioner (GP) following an out-patients consultation. This study set out to assess whether sending a copy of this letter to the patient improves their satisfaction with the consultation. Two hundred patients were randomly assigned to

  3. Do Bedside Visual Tools Improve Patient and Caregiver Satisfaction? A Systematic Review of the Literature.

    Science.gov (United States)

    Goyal, Anupama A; Tur, Komalpreet; Mann, Jason; Townsend, Whitney; Flanders, Scott A; Chopra, Vineet

    2017-11-01

    Although common, the impact of low-cost bedside visual tools, such as whiteboards, on patient care is unclear. To systematically review the literature and assess the influence of bedside visual tools on patient satisfaction. Medline, Embase, SCOPUS, Web of Science, CINAHL, and CENTRAL. Studies of adult or pediatric hospitalized patients reporting physician identification, understanding of provider roles, patient-provider communication, and satisfaction with care from the use of visual tools were included. Outcomes were categorized as positive, negative, or neutral based on survey responses for identification, communication, and satisfaction. Two reviewers screened studies, extracted data, and assessed the risk of study bias. Sixteen studies met the inclusion criteria. Visual tools included whiteboards (n = 4), physician pictures (n = 7), whiteboard and picture (n = 1), electronic medical record-based patient portals (n = 3), and formatted notepads (n = 1). Tools improved patients' identification of providers (13/13 studies). The impact on understanding the providers' roles was largely positive (8/10 studies). Visual tools improved patient-provider communication (4/5 studies) and satisfaction (6/8 studies). In adults, satisfaction varied between positive with the use of whiteboards (2/5 studies) and neutral with pictures (1/5 studies). Satisfaction related to pictures in pediatric patients was either positive (1/3 studies) or neutral (1/3 studies). Differences in tool format (individual pictures vs handouts with pictures of all providers) and study design (randomized vs cohort) may explain variable outcomes. The use of bedside visual tools appears to improve patient recognition of providers and patient-provider communication. Future studies that include better design and outcome assessment are necessary before widespread use can be recommended. © 2017 Society of Hospital Medicine

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

    Science.gov (United States)

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

    2015-01-01

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

  5. Caring for inpatient boarders in the emergency department: improving safety and patient and staff satisfaction.

    Science.gov (United States)

    Bornemann-Shepherd, Melanie; Le-Lazar, Jamie; Makic, Mary Beth Flynn; DeVine, Deborah; McDevitt, Kelly; Paul, Marcee

    2015-01-01

    Hospital capacity constraints lead to large numbers of inpatients being held for extended periods in the emergency department. This creates concerns with safety, quality of care, and dissatisfaction of patients and staff. The aim of this quality-improvement project was to improve satisfaction and processes in which nurses provided care to inpatient boarders held in the emergency department. A quality-improvement project framework that included the use of a questionnaire was used to ascertain employee and patient dissatisfaction and identify opportunities for improvement. A task force was created to develop action plans related to holding and caring for inpatients in the emergency department. A questionnaire was sent to nursing staff in spring 2012, and responses from the questionnaire identified improvements that could be implemented to improve care for inpatient boarders. Situation-background-assessment-recommendation (SBAR) communications and direct observations were also used to identify specific improvements. Post-questionnaire results indicated improved satisfaction for both staff and patients. It was recognized early that the ED inpatient area would benefit from the supervision of an inpatient director, managers, and staff. Outcomes showed that creating an inpatient unit within the emergency department had a positive effect on staff and patient satisfaction. Copyright © 2015 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  6. 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.

  7. Methods and Conditions for Achieving Continuous Improvement of Processes

    OpenAIRE

    Florica BADEA; Catalina RADU; Ana-Maria GRIGORE

    2010-01-01

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

  8. 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...... longer during the sensor-On arm. Regarding indirect costs, children with >70 % sensor usage missed fewer school days, compared with the sensor-Off arm (P = 0.0046) but there was no significant difference in the adults days of work off. The addition of CGM to CSII resulted in better metabolic control...

  9. Improvement of customer satisfaction evaluation for quality management system and accreditation in Nuclear Malaysia

    International Nuclear Information System (INIS)

    Fazila Said; Noriah Ali; Siti Mariam Ibrahim

    2010-01-01

    Malaysian Nuclear Agency (Nuclear Malaysia) possesses seven certification of Quality Management System, namely ISO 9001:2008, and two certification of Malaysia Laboratory Accreditation Scheme, namely ISO/IEC 17025:2005. General Requirement of Standard for those two certifications needs customer satisfaction evaluation to be conducted every year. Thus, the Innovation Management Centre (IMC) undertakes improvement action to harmonise and coordinate the formulation of questionnaires in Nuclear Malaysia based on data analysis for 2009. The newly developed questionnaire that applies to all processes and laboratories that have received or awaiting certification have value addition in terms of analytical methods that are more concise, precise, simple and focus on effective action plan to enhance customer satisfaction. Methods such as Importance-Performance Analysis (IPA), Customer Satisfaction Index (CSI) and Service Quality Dimension (SERVQUAL) will be used in this research. (author)

  10. Introduction of a Surgical Navigator in the Perioperative Process Improves Patient Satisfaction

    Directory of Open Access Journals (Sweden)

    Brett G Marshall

    2017-03-01

    Full Text Available Background: Patients who had received surgical services at Bellin Hospital reported anxiety with the surgical flow. This study tested the hypothesis that the introduction of a surgical navigator, someone who guided the patient and their accompanying others throughout the surgical process, would improve patient satisfaction. Methods: Ambulatory surgical patients were randomized to control and study groups. The study group patients were assigned a surgical navigator. Prior to discharge from the hospital, patients were asked to complete a patient satisfaction survey. Results: The study group had significantly higher mean scores (P value ≤ 0.026, top box scores (P value ≤ 0.021, and positive comments. Conclusion: The addition of a surgical navigator to the perioperative process significantly enhanced patient satisfaction in ambulatory surgical patients.

  11. 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.

  12. THE EFFECTS OF ROOM SERVICE TO IMPROVE PATIENTS’ FOOD SATISFACTION AND FOOD ACCEPTANCE

    Directory of Open Access Journals (Sweden)

    Muhammad Iqbal

    2017-01-01

    Full Text Available The improvement of patients’ food satisfaction and acceptance in the hospitals is primarily needed in the food service  system.  Room service is a new concept in the food service area. This study aims to compare the effects of two different types of food service systems; room service and conventional service system. The study with quasi-experimental design is conducted to the subject of 66 inpatients who were taken using a quota sampling method. Subjects were divided into different groups, the treatment groups (room service and control groups (conventional. Leftover food between groups was compared for 9 large meals to determine acceptability. Food satisfaction is measured on the last day with using questionnaire. The study was conducted in April-June 2014. Chi-Square test and logistic regression were used for analysis of research data. There were significant differences food satisfaction (RR=4.6; p=0.0001 and food acceptance (RR=1.94; p=0.0488 between control and treatment group. The logistic regression test showed that room service group had higher food satisfaction and food acceptance level than control group after controlling confounding factors, which were 12,11 times (95% CI 3,593 – 37,219 and 2,38 times (95% CI 0,68-8,31, respectively. The room service increases food satisfaction and food acceptance of patients compared with conventional systems.

  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 i...

  14. From Continuous Improvement to Organisational Learning: Developmental Theory.

    Science.gov (United States)

    Murray, Peter; Chapman, Ross

    2003-01-01

    Explores continuous improvement methods, which underlie total quality management, finding barriers to implementation in practice that are related to a one-dimensional approach. Suggests a multiple, unbounded learning cycle, a holistic approach that includes adaptive learning, learning styles, generative learning, and capability development.…

  15. Sustainable production. The ultimate result of a continuous improvement

    NARCIS (Netherlands)

    Ron, de A.J.

    1998-01-01

    To fulfil market requirements, companies have introduced cost awareness, quality programs and techniques to become flexible. These items should be handled as a continuous process of improvement. The cost awareness implies that e.g. material waste is avoided during production, the quality programs

  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. The Continuous Improvement Model: A K-12 Literacy Focus

    Science.gov (United States)

    Brown, Jennifer V.

    2013-01-01

    The purpose of the study was to determine if the eight steps of the Continuous Improvement Model (CIM) provided a framework to raise achievement and to focus educators in identifying high-yield literacy strategies. This study sought to determine if an examination of the assessment data in reading revealed differences among schools that fully,…

  18. Infrastructure under construction: continuous improvement and learning in projects

    NARCIS (Netherlands)

    Gieskes, J.F.B.; ten Broeke, André M.

    2000-01-01

    Continuous improvement and learning are popular concepts in management literature and practice. Often they are situated in an environment where the work is of a repetitive nature. However, there are a lot of organisations where (part of) the primary processes are carried out by means of projects. An

  19. Continuous restraint control systems: safety improvement for various occupants

    NARCIS (Netherlands)

    Laan, E. van der; Jager, B. de; Veldpaus, F.; Steinbuch, M.; Nunen, E. van; Willemsen, D.

    2009-01-01

    Occupant safety can be significantly improved by continuous restraint control systems. These restraint systems adjust their configuration during the impact according to the actual operating conditions, such as occupant size, weight, occupant position, belt usage and crash severity. In this study,

  20. 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.

  1. Continuous improvement in pursuit of quality (presidential address to the Midland Institute Branch of the Institute of Mining Engineers)

    Energy Technology Data Exchange (ETDEWEB)

    Siddall, R G [British Coal Corporation (United Kingdom). South Yorkshire Group

    1993-03-01

    The author considers that quality must be a central element in the future strategy of the UK coal mining industry. This quality approach should be all embracing and extend beyond physical performance to include safety, effective use of capital, customer satisfaction, environmental pressures and overall image. The address discusses, the current position in British Coal; strategic planning; the need for continuous improvement; and productivity and production problems.

  2. 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.

  3. Feedback intervention to doctors improves patient satisfaction among outpatients in Inner Mongolia Autonomous Region, China.

    Science.gov (United States)

    Qiao, T; Geater, A F; Chongsuvivatwong, V; Fan, Y; Guo, Z

    2017-11-01

    The doctor-patient relationship (DPR) in China is known to be tense. We tested whether an intervention program providing individualized feedback to doctors by patients could improve patients' satisfaction in an outpatient setting. A non-randomized controlled prepost intervention study in a tertiary hospital. Six surgery clinics were chosen as the intervention group and eight internal medicine clinics as the control group. Before the program started, patients attending each group of clinics were asked to fill in the Short-Form Patient Satisfaction Questionnaire (PSQ-18). In the experimental period, patients attending the intervention clinics were requested to rate their perception of the doctor's quality of care in various domains on an 8-question feedback card immediately after exiting from the examination room and to drop the completed card into the feedback box for the particular doctor. The cards were then collected by the doctor confidentially at the end of each day. There was no feedback in the control clinics. After the experimental period ended, the doctors in both groups of clinics were reassessed by a new series of patients using PSQ-18. The PSQ-18 scores were compared within the same group of clinics over time, and the changes in satisfaction score compared between intervention and control clinics. There were 189 and 190 responders in the intervention group and 190 and 200 in the control group, before and after the intervention period, respectively. Scores in all domains increased significantly (P patient satisfaction scores in the intervention clinics compared with the control clinics was confirmed by mixed-effects linear regression controlling for the effects of gender, age, marital status, education, and household income in the domains of general satisfaction, technical quality, communication, and accessibility and convenience. Timely feedback to doctors of patients' perception of quality of care received can improve outpatient satisfaction in a

  4. Continuous improvement in manufacturing and inspection of fuel

    International Nuclear Information System (INIS)

    Domingon, A.; Ruiz, R.

    2015-01-01

    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)

  5. Organisational learning: A tool for continuous improvement of the organization

    International Nuclear Information System (INIS)

    Santos, J. L.; Esteban, M. J.

    2013-01-01

    We are used to hear a success company in today's world is not possible unless a continuous improvement is developed. How can we be successful in the nuclear plant? We have to achieve safety for workers, people and environment in the first step, and for the second step availability and reliability for systems and components to avoid failure of components that could reduce availability. The aim is to search for new measures to reach this way. One of the improvements implemented in the plants to improve continuously was mainly Operating Experience activities, which was based in event analysis in the plants, causes identification, and to implement corrective actions. For External Operating Experience the aim was to learn from others to avoid occurrence of events in our plants. This was the lessons learned from Three Mile Island event. This was the learning process implemented so far, to get a continuous improvement. So far, the developed capabilities for process improvement follow the Operating Experience process that could be considered classical and will be revitalized nowadays. (Author)

  6. Applying PPM to ERP Maintenance and Continuous Improvement Initiatives

    DEFF Research Database (Denmark)

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

    2006-01-01

    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...... are compared and discussed using three case-studies. The paper contributes with a discussion on how PPM from R&D can be applied to maintenance and continuous improvement initiatives in the second wave of ERP. The paper ends with arguing that emphasis needs to be given to this field, since a conscious...

  7. 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.

  8. Using measures to guide the continuous improvement journey: a partnership between quality assurance and toxicology.

    Science.gov (United States)

    Gentry, P E; Sites, D L

    1994-03-01

    It has been said that you cannot improve what you cannot measure. At Eli Lilly and Company, measurement is one of the five pillars of Total Quality. Quality Assurance and Toxicology have partnered in the use of measures to drive improvements in both areas. Quality Assurance and Toxicology have embarked on a journey in Total Quality to achieve customer satisfaction and drive continuous improvement. Measurement in the research and development world has traditionally not been well received. Contrary to popular belief, we have found that many processes can be measured in the research and development environment. Measurement is critical to the continuous improvement of processes because improvements are made using data. In Quality Assurance and Toxicology, the initial measures were put in place to gather baseline data. As we learned from our measures, we customized them to align with all of our processes. This article describes the journey of measuring Quality Assurance and Toxicology, including highlights of implementation strategies and lessons learned along the way.

  9. Continuous improvement in the Netherlands: A survey-based study into the current practices of continuous improvement

    NARCIS (Netherlands)

    Middel, H.G.A.; op de Weegh, S.; Gieskes, J.F.B.; Schuring, R.W.

    2004-01-01

    Continuous Improvement is a well-known and consolidated concept in literature and practice and is considered vital in today¿s business environment. In 2003 a survey, as part of the international CINet survey, has been performed in the Netherlands in order to gain insight into the current practices

  10. Customization of electronic medical record templates to improve end-user satisfaction.

    Science.gov (United States)

    Gardner, Carrie Lee; Pearce, Patricia F

    2013-03-01

    Since 2004, increasing importance has been placed on the adoption of electronic medical records by healthcare providers for documentation of patient care. Recent federal regulations have shifted the focus from adoption alone to meaningful use of an electronic medical record system. As proposed by the Technology Acceptance Model, the behavioral intention to use technology is determined by the person's attitude toward usage. The purpose of this quality improvement project was to devise and implement customized templates into an existent electronic medical record system in a single clinic and measure the satisfaction of the clinic providers with the system before and after implementation. Provider satisfaction with the electronic medical record system was evaluated prior to and following template implementation using the current version 7.0 of the Questionnaire for User Interaction Satisfaction tool. Provider comments and improvement in the Questionnaire for User Interaction Satisfaction levels of rankings following template implementation indicated a positive perspective by the providers in regard to the templates and customization of the system.

  11. Continuous improvement program in ENUSA: personnel participation and six sigma

    International Nuclear Information System (INIS)

    Montes Navarro, J.

    1998-01-01

    Since the beginning of its activities ENUSA has been a company committed with the quality of its products and services. To talk about quality is something inherent in ENUSA's daily work ENUSA's position in the market depends on its capacity to satisfy customers expectations with the best products and services, as a result of an efficient management of its processes. The word quality in its broadest sense, means that any activity can be improved. ENUSA has implemented a continuous improvement program as part of its company change project. That program consists of six basic steps: 1.- Managers commitment. 2.- Organization for continuous improvement. 3.- Quality goals. 4.- Training and informing. 5.- Personnel participation. 6.- Methodology. ENUSA has introduced these six steps during 1997-98 period. It is important to point out the commitment degree at all the company levels, focusing the organization to the continuous improvement in a multifunctional way, following the business processes: - Board of Directors - Quality Steering Committee - Quality Improvement Groups (GMC) - Quality Operative Groups (GOC) - Suggestions Mailboxes The following GMC's have been set up and are operative. - Manufacturing GMC - Supplies GMC - Installation GMC - Design GMC - Quality System GM - Projects GMC - Administrative GMC These GMC's have established thirty-six Quality Operative Groups which carry out the improvement projects. The methodology chosen by ENUSA is known as ''SIX SIGMA''. Six sigma programs have proved their huge power in big companies as MOTOROLA and, recently, GE being recognized in all the quality fields. It is, by itself, a change program in which a quality improvement methods is structured with an excellent view of processes, products and services. (Author)

  12. House of Quality (HoQ) as a tool for improvement customer satisfaction

    International Nuclear Information System (INIS)

    Fazila Said; Noriah Mod Ali; Siti Mariam Ibrahim

    2010-01-01

    Full-text: Improvements to the customer satisfaction level is an important agenda today for the preservation of a quality certification. This study shows where the critical attributes or Voice of Customers, VOC-interest analysis of the results of Importance Performance Analysis (IPA). Questionnaires from our four customer service centers at Malaysian Nuclear Agency has been used in developing the House of Quality (HoQ). The innovation of HoQ is one of the simple and attractive services that display comprehensive information covering the needs of customers (VOC), the technical response, the correlation of technical, communication matrix, technical and planning division. Therefore, the information obtained from HoQ can be used in assisting the top management planning in accordance with the priority improvement activities to improve customer satisfaction levels in the near future. (author)

  13. Patients' satisfaction ratings and their desire for care improvement across oncology settings from France, Italy, Poland and Sweden.

    Science.gov (United States)

    Brédart, A; Robertson, C; Razavi, D; Batel-Copel, L; Larsson, G; Lichosik, D; Meyza, J; Schraub, S; von Essen, L; de Haes, J C J M

    2003-01-01

    There has been an increasing interest in patient satisfaction assessment across nations recently. This paper reports on a cross-cultural comparison of the comprehensive assessment of satisfaction with care (CASC) response scales. We investigated what proportion of patients wanted care improvement for the same level of satisfaction across samples from oncology settings in France, Italy, Poland and Sweden, and whether age, gender, education level and type of items affected the relationships found. The CASC addresses patient's satisfaction with the care received in oncology hospitals. Patients are invited to rate aspects of care and to mention for each of these aspects, whether they would want improvement.One hundred and forty, 395, 186 and 133 consecutive patients were approached in oncology settings from France, Italy, Poland and Sweden, respectively. Across country settings, an increasing percentage of patients wanted care improvement for decreasing levels of satisfaction. However, in France a higher percentage of patients wanted care improvement for high-satisfaction ratings whereas in Poland a lower percentage of patients wanted care improvement for low-satisfaction ratings. Age and education level had a similar effect across countries. Confronting levels of satisfaction with desire for care improvement appeared useful in comprehending the meaning of response choice labels for the CASC across oncology settings from different linguistic and cultural background. Linguistic or socio-cultural differences were suggested for explaining discrepancies between countries. Copyright 2002 John Wiley & Sons, Ltd.

  14. Continuous Improvement in Education. Advancing Teaching--Improving Learning. White Paper

    Science.gov (United States)

    Park, Sandra; Hironaka, Stephanie; Carver, Penny; Nordstrum, Lee

    2013-01-01

    In recent years, "continuous improvement" has become a popular catchphrase in the field of education. However, while continuous improvement has become commonplace and well-documented in other industries, such as healthcare and manufacturing, little is known about how this work has manifested itself in education. This white paper attempts…

  15. Teaching emergency medicine with workshops improved medical student satisfaction in emergency medicine education.

    Science.gov (United States)

    Sricharoen, Pungkava; Yuksen, Chaiyaporn; Sittichanbuncha, Yuwares; Sawanyawisuth, Kittisak

    2015-01-01

    There are different teaching methods; such as traditional lectures, bedside teaching, and workshops for clinical medical clerkships. Each method has advantages and disadvantages in different situations. Emergency Medicine (EM) focuses on emergency medical conditions and deals with several emergency procedures. This study aimed to compare traditional teaching methods with teaching methods involving workshops in the EM setting for medical students. Fifth year medical students (academic year of 2010) at Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand participated in the study. Half of students received traditional teaching, including lectures and bedside teaching, while the other half received traditional teaching plus three workshops, namely, airway workshop, trauma workshop, and emergency medical services workshop. Student evaluations at the end of the clerkship were recorded. The evaluation form included overall satisfaction, satisfaction in overall teaching methods, and satisfaction in each teaching method. During the academic year 2010, there were 189 students who attended the EM rotation. Of those, 77 students (40.74%) were in the traditional EM curriculum, while 112 students were in the new EM curriculum. The average satisfaction score in teaching method of the new EM curriculum group was higher than the traditional EM curriculum group (4.54 versus 4.07, P-value workshop, bedside teaching, and emergency medical services workshop. The mean (standard deviation) satisfaction scores of those three teaching methods were 4.70 (0.50), 4.63 (0.58), and 4.60 (0.55), respectively. Teaching EM with workshops improved student satisfaction in EM education for medical students.

  16. Student performance and satisfaction in continuous learning pathways in Dutch VET

    NARCIS (Netherlands)

    Biemans, H.J.A.

    2012-01-01

    An important trend in the Vocational Education and Training (VET) system in the Netherlands is the design of continuous learning pathways enclosing more than one school type level. These continuous learning pathways are characterized by different design formats. In this study, the relations between

  17. Improved USGS methodology for assessing continuous petroleum resources

    Science.gov (United States)

    Charpentier, Ronald R.; Cook, Troy A.

    2010-01-01

    This report presents an improved methodology for estimating volumes of continuous (unconventional) oil and gas resources within the United States and around the world. The methodology is based on previously developed U.S. Geological Survey methodologies that rely on well-scale production data. Improvements were made primarily to how the uncertainty about estimated ultimate recoveries is incorporated in the estimates. This is particularly important when assessing areas with sparse or no production data, because the new methodology allows better use of analog data from areas with significant discovery histories.

  18. Successful integration of ergonomics into continuous improvement initiatives.

    Science.gov (United States)

    Monroe, Kimberly; Fick, Faye; Joshi, Madina

    2012-01-01

    Process improvement initiatives are receiving renewed attention by large corporations as they attempt to reduce manufacturing costs and stay competitive in the global marketplace. These initiatives include 5S, Six Sigma, and Lean. These programs often take up a large amount of available time and budget resources. More often than not, existing ergonomics processes are considered separate initiatives by upper management and struggle to gain a seat at the table. To effectively maintain their programs, ergonomics program managers need to overcome those obstacles and demonstrate how ergonomics initiatives are a natural fit with continuous improvement philosophies.

  19. Development and psychometric pilot-testing of a questionnaire for the evaluation of satisfaction with continuing education in infection control nurses.

    Science.gov (United States)

    Meng, Michael; Peter, Daniel; Mattner, Frauke; Igel, Christoph; Kugler, Christiane

    2018-05-16

    Satisfaction with continuing education can be defined as positive attitudes towards educational programs, which has potential to strengthen learning outcomes. A multi-dimensional construct may enhance continuing education program evaluation processes. The objective is to describe the development and psychometric testing of the 'affective - behavioral - cognitive - satisfaction questionnaire' (ABC-SAT) for assessing participants' satisfaction with a continuing education program for nurses in infection control. The multi-staged development of a satisfaction questionnaire comprised of three subscales. The pilot tool was administered to a nationwide sample of 126 infection control nurses to assess satisfaction after participating in a continuing education program. Satisfaction scores were calculated and psychometric testing was performed to determine reliability, using Cronbach's alpha, face validity, objectivity, and economy. A principle component analysis using varimax rotation and Kaiser normalization was performed. The analysis led to a three-factor solution of the questionnaire with 11 items, explaining 61.4% of the variance. Internal consistency of three scales using Cronbach's alpha was 0.83, 0.60, and 0.66, respectively. Selectivity coefficients varied between 0.39 and 0.70. Participants needed approximately three minutes to complete the questionnaire. Initial findings refer to a satisfying scale structure and internal consistency of the 3-dimensional ABC-SAT questionnaire. Further research is required to confirm the questionnaires' psychometric properties. Copyright © 2018 Elsevier Ltd. All rights reserved.

  20. Teaching emergency medicine with workshops improved medical student satisfaction in emergency medicine education

    Directory of Open Access Journals (Sweden)

    Sricharoen P

    2015-02-01

    workshop, bedside teaching, and emergency medical services workshop. The mean (standard deviation satisfaction scores of those three teaching methods were 4.70 (0.50, 4.63 (0.58, and 4.60 (0.55, respectively. Conclusion: Teaching EM with workshops improved student satisfaction in EM education for medical students. Keywords: emergency medicine education, workshop, student satisfaction

  1. 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.

  2. 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

  3. 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 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.

  4. Continuous improvement of the BNFL transport integrated management system

    International Nuclear Information System (INIS)

    Hale, J.A.

    1998-01-01

    The integrated Management System of BNFL Transport and Pacific Nuclear Transport Limited (PNTL) is subject to continuous improvement by the application of established improvement techniques adopted by BNFL. The technique currently being used is the application of a Total Quality Management (TQM) philosophy, involving the identification of key processes, benchmarking against existing measures, initiating various improvement projects and applying process changes within the Company. The measurement technique being used is based upon the European Foundation for Quality Management Model (EFQM). A major initiative was started in 1996 to include the requirements of the Environmental Management Systems standard ISO 14001 within the existing integrated management system. This resulted in additional activities added to the system, modification to some existing activities and additional training for personnel. The system was audited by a third party certification organisation, Lloyds Register Quality Assurance (LRQA), during 1997. This paper describes the arrangements to review and update the integrated management system of BNFL Transport and PNTL to include the requirements of the environmental standard ISO 14001 and it also discusses the continuous improvement process adopted by BNFL Transport. (authors)

  5. 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.

  6. Patients' satisfaction ratings and their desire for care improvement across oncology settings from France, Italy, Poland and Sweden

    NARCIS (Netherlands)

    Brédart, A.; Robertson, C.; Razavi, D.; Batel-Copel, L.; Larsson, G.; Lichosik, D.; Meyza, J.; Schraub, S.; von Essen, L.; de Haes, J. C. J. M.

    2003-01-01

    There has been an increasing interest in patient satisfaction assessment across nations recently. This paper reports on a cross-cultural comparison of the comprehensive assessment of satisfaction with care (CASC) response scales. We investigated what proportion of patients wanted care improvement

  7. Increasing clinical, satisfaction, and financial performance through nurse-driven process improvement.

    Science.gov (United States)

    Sims, Caroline E

    2003-02-01

    Providers and regulatory agencies are increasing their demands for hospitals to document clinical quality and customer satisfaction at a decreased cost. Nurse leaders search for ways to meet these requirements while retaining their most valuable resource: healthcare workers (especially nurses). First-line leadership struggles with balancing quality, cost-effectiveness, and staff retention. The author discusses the planning, methodology, implementation, and outcomes of a staff driven process improvement initiative.

  8. A Health Care Project Management Office's Strategies for Continual Change and Continuous Improvement.

    Science.gov (United States)

    Lavoie-Tremblay, Mélanie; Aubry, Monique; Richer, Marie-Claire; Cyr, Guylaine

    Health care organizations need project and change management support in order to achieve successful transformations. A project management office (PMO) helps support the organizations through their transformations along with increasing their capabilities in project and change management. The aim of the present study was to extend understanding of the continuous improvement mechanisms used by PMOs and to describe PMO's strategies for continual change and continuous improvement in the context of major transformation in health care. This study is a descriptive case study design with interviews conducted from October to December 2015 with PMO's members (3 managers and 1 director) and 3 clients working with the PMO after a major redevelopment project ended (transition to the new facility). Participants suggested a number of elements including carefully selecting the members of the PMO, having a clear mandate for the PMO, having a method and a discipline at the same time as allowing openness and flexibility, clearly prioritizing projects, optimizing collaboration, planning for everything the PMO will need, not overlooking organizational culture, and retaining the existing support model. This study presents a number of factors ensuring the sustainability of changes.

  9. 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.

  10. Effect of Work Improvement for Promotion of Outpatient Satisfaction on CT scan

    Energy Technology Data Exchange (ETDEWEB)

    Han, Man Seok; Kim, Tae Hyung [Dept. of Radiological Science, Kangwon National University, Chuncheon (Korea, Republic of); Lee, Seung Youl; Lee, Myeong Goo; Jeon, Min Cheol [Dept. of Radiology, Chungnam National University Hospital, Daejeon (Korea, Republic of); Cho, Jae Hwan [Dept. of Radiological Science, Gyeongsan University College, Daegu (Korea, Republic of)

    2012-03-15

    Nowadays, most of the hospital serves 'one stop service' for CT scan. The patients could be taken the CT scan in the day they register for scan. On the contrary to the time convenience, patients are not satisfied with long waiting time and unkindness of staff. The objective of this study is to improve the patient's satisfaction for the CT scan, by analyzing inconvenience factors and improving the service qualities. From April 1 to August 30 in 2011, we investigated the satisfaction of patients who did examined abdomen CT scan with contrast media. We analyzed the 89 questionnaires before and after the service improvements from them. The worker's kindness, the environment of CT room and understanding about CT scan were answered by questionnaire and the waiting time of a day CT scan was drawn by medical information statistics. Also, the period before improvement was from April to June and the period after improvement was from July to September. And these questionnaire was analyzed through SPSS V. 15.0. In this study, kindness of staff, environment of CT room, intelligibility for CT scan and waiting time was explored and analyzed by SPSS V.15.0. The score of kindness was improved by 32%, satisfaction level of the environment was improved by 52.54%. The understanding level about CT scan was improved by 52.36% and the waiting time of a day CT was shortened by 21% through our service enhancement programs. Consequentially, it is considered that these efforts would contribute to increase the revenue of hospital.

  11. Effect of Work Improvement for Promotion of Outpatient Satisfaction on CT scan

    International Nuclear Information System (INIS)

    Han, Man Seok; Kim, Tae Hyung; Lee, Seung Youl; Lee, Myeong Goo; Jeon, Min Cheol; Cho, Jae Hwan

    2012-01-01

    Nowadays, most of the hospital serves 'one stop service' for CT scan. The patients could be taken the CT scan in the day they register for scan. On the contrary to the time convenience, patients are not satisfied with long waiting time and unkindness of staff. The objective of this study is to improve the patient's satisfaction for the CT scan, by analyzing inconvenience factors and improving the service qualities. From April 1 to August 30 in 2011, we investigated the satisfaction of patients who did examined abdomen CT scan with contrast media. We analyzed the 89 questionnaires before and after the service improvements from them. The worker's kindness, the environment of CT room and understanding about CT scan were answered by questionnaire and the waiting time of a day CT scan was drawn by medical information statistics. Also, the period before improvement was from April to June and the period after improvement was from July to September. And these questionnaire was analyzed through SPSS V. 15.0. In this study, kindness of staff, environment of CT room, intelligibility for CT scan and waiting time was explored and analyzed by SPSS V.15.0. The score of kindness was improved by 32%, satisfaction level of the environment was improved by 52.54%. The understanding level about CT scan was improved by 52.36% and the waiting time of a day CT was shortened by 21% through our service enhancement programs. Consequentially, it is considered that these efforts would contribute to increase the revenue of hospital.

  12. 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…

  13. Compression planning for continuous improvement in quality programs

    International Nuclear Information System (INIS)

    Willis, Y.A.; Hood, F.C.

    1992-01-01

    This paper describes Compression Planning, an innovative approach for planning in groups. This participative and structured approach is especially suitable for technical and highly regulated organizations. Compression Planning was applied to the first organization-wide effort at training integration for regulatory compliance, at Battelle Pacific Northwest Laboratory (PNL), a multi-program national laboratory. The planning process was judged as measurably superior to PNL's customary planning. Within 10 days a training policy was issued and an action plan drafted. The participants produced a report identifying and prioritizing 33 key training issues; began to data gather and solicit input from personnel Lab-wide, producing a 2-volume training inventory; and formulated 14 recommendations for implementation. Two years later the plan is still evolving, as PNL training continues to develop, consistent with Continuous Improvement Process objectives

  14. Risk reduction and TQM: A corporate culture of continuous improvement

    International Nuclear Information System (INIS)

    Nau, D.C.

    1992-01-01

    A company supplying products and services to the nuclear industry that implements a cultural commitment to continuous improvement, in addition to providing higher quality products and services, also represents a significant reduction in operational risk to that industry. The implementation of a culture of total quality management (TQM), initiated by Sorrento Electronics (SE) in 1989, involves total commitment to the basic TQM principles: continuous improvement, people performing the work are the best sources of how to do it better, and employees must be empowered to make the improvements. What this means to the nuclear industry is a significant reduction in operational risk through: (1) products based on simpler, standardized, proven designs with established operational track records, enhancing confidence that they will perform as expected; (2) the highest confidence that products and supporting documentation are delivered with zero defects; (3) critical power plant schedules can be supported through the shortest possible equipment delivery times; (4) highly motivated employees with extremely positive attitudes, working together in cross-functional teams, virtually eliminate the possibility of deliberate product tampering or sabotage

  15. R and D techniques and how to continuously improve them?

    International Nuclear Information System (INIS)

    Massaut, V.; Collard, G.

    2005-01-01

    Although decommissioning of nuclear installations has been carried out successfully in different countries, and decommissioning is sometimes considered as a mature industrial activity, Research and Development can still improve the operations, and is also needed to keep the current know how. The research and development can bring reduction of costs, limitation of radioactive waste generation, and improve the safety and radioprotection aspects. When one consider that less than 100 facilities are currently in decommissioning for more than 800 reactors (power plants and research reactors, almost half and half) worldwide, the present used technology can be considered as the prehistory of D and D. The paper will focus on the needs for improvements and developments, on the attached constraints and restriction, and will then look at the potential ways to continue R and D and technology improvement. Regarding the rather recent development of the D and D technology and the large remaining market for D and D of nuclear installations, there is still a large field of open development for techniques and technologies for the dismantling of nuclear installations worldwide. Although D and D of all kinds of nuclear installations have proven to be feasible, improvements are surely needed to reduce the costs and waste of D and D, therefore reducing the burden to the plant owners, and to improve the radioprotection of the operations. The same applies for the improvement of the overall operators safety during such operations. There are different ways to go in this direction and the groups to gather the necessary experience and technological data are existing, but the will has to be present to go forward, in a competitive environment. It is difficult to believe that such improvements in the technologies and the approach of decommissioning can rely only on commercial and private initiatives. Therefore, organized international R and D should be promoted wherever it is possible, enhancing

  16. La Hague Continuous Improvement Program: Enhancement of the Vitrification Throughput

    International Nuclear Information System (INIS)

    Petitjean, V.; De Vera, R.; Hollebecque, J.F.; Tronche, E.; Flament, T.; Pereira Mendes, F.; Prod'homme, A.

    2006-01-01

    The vitrification of high-level liquid waste produced from nuclear fuel reprocessing has been carried out industrially for over 25 years by AREVA/COGEMA, with two main objectives: containment of the long lived fission products and reduction of the final volume of waste. At the 'La Hague' plant, in the 'R7' and 'T7' facilities, vitrified waste is obtained by first evaporating and calcining the nitric acid feed solution-containing fission products in calciners. The product-named calcinate- is then fed together with glass frit into induction-heated metallic melters to produce the so-called R7/T7 glass, well known for its excellent containment properties. Both facilities are equipped with three processing lines. In the near future the increase of the fuel burn-up will influence the amount of fission product solutions to be processed at R7/T7. As a consequence, in order to prepare these changes, it is necessary to feed the calciner at higher flow-rates. Consistent and medium-term R and D programs led by CEA (French Atomic Energy Commission, the AREVA/COGEMA's R and D and R and T provider), AREVA/COGEMA (Industrial Operator) and AREVA/SGN (AREVA/COGEMA's Engineering), and associated to the industrial feed back of AREVA/COGEMA operations, have allowed continuous improvement of the process since 1998: - The efficiency and limitation of the equipment have been studied and solutions for technological improvements have been proposed whenever necessary, - The increase of the feeding flow-rate has been implemented on the improved CEA test rig (so called PEV, Evolutional Prototype of Vitrification) and adapted by AREVA/SGN for the La Hague plant using their modeling studies; the results obtained during this test confirmed the technological and industrial feasibility of the improvements achieved, - After all necessary improved equipments have been implemented in R7/T7 facilities, and a specific campaign has been performed on the R7 facility by AREVA/COGEMA. The flow-rate to the

  17. Evaluating the impact of continuous quality improvement methods at hospitals in Tanzania: a cluster-randomized trial.

    Science.gov (United States)

    Kamiya, Yusuke; Ishijma, Hisahiro; Hagiwara, Akiko; Takahashi, Shizu; Ngonyani, Henook A M; Samky, Eleuter

    2017-02-01

    To evaluate the impact of implementing continuous quality improvement (CQI) methods on patient's experiences and satisfaction in Tanzania. Cluster-randomized trial, which randomly allocated district-level hospitals into treatment group and control group, was conducted. Sixteen district-level hospitals in Kilimanjaro and Manyara regions of Tanzania. Outpatient exit surveys targeting totally 3292 individuals, 1688 in the treatment and 1604 in the control group, from 3 time-points between September 2011 and September 2012. Implementation of the 5S (Sort, Set, Shine, Standardize, Sustain) approach as a CQI method at outpatient departments over 12 months. Cleanliness, waiting time, patient's experience, patient's satisfaction. The 5S increased cleanliness in the outpatient department, patients' subjective waiting time and overall satisfaction. However, negligible effects were confirmed for patient's experiences on hospital staff behaviours. The 5S as a CQI method is effective in enhancing hospital environment and service delivery; that are subjectively assessed by outpatients even during the short intervention period. Nevertheless, continuous efforts will be needed to connect CQI practices with the further improvement in the delivery of quality health care. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  18. 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

  19. 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. Copyright © 2016 Elsevier B.V. All rights reserved.

  20. 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.

  1. Improving Reference Service: The Case for Using a Continuous Quality Improvement Method.

    Science.gov (United States)

    Aluri, Rao

    1993-01-01

    Discusses the evaluation of library reference service; examines problems with past evaluations, including the lack of long-term planning and a systems perspective; and suggests a method for continuously monitoring and improving reference service using quality improvement tools such as checklists, cause and effect diagrams, Pareto charts, and…

  2. Practice Change From Intermittent Medication Boluses to Bolusing From a Continuous Infusion in Pediatric Critical Care: A Quality Improvement Project.

    Science.gov (United States)

    Hochstetler, Jessica L; Thompson, A Jill; Ball, Natalie M; Evans, Melissa C; Frame, Shaun C; Haney, A Lauren; Little, Amelia K; O'Donnell, Jaime L; Rickett, Bryna M; Mack, Elizabeth H

    2018-04-12

    To determine whether implementing a guideline to bolus medications from continuous infusions in PICUs affects nursing satisfaction, patient safety, central line entries, medication utilization, or cost. This is a pre- and postimplementation quality improvement study. An 11-bed ICU and 14-bed cardiac ICU in a university-affiliated children's hospital. Patients less than 18 years old admitted to the PICU or pediatric cardiac ICU receiving a continuous infusion of dexmedetomidine, midazolam, fentanyl, morphine, vecuronium, or cisatracurium from May 2015 to May 2016, excluding November 2015 (washout period), were eligible for inclusion. Change in practice from administering bolus doses from an automated dispensing machine to administering bolus medications from continuous infusion in PICUs. Timing studies were conducted pre- and post implementation in 29 and 26 occurrences, respectively. The median time from the decision to give a bolus until it began infusing decreased by 169 seconds (p 0.05). Annualized cost avoidance was $124,160. Implementation of bolus medications from continuous infusion in PICUs significantly decreased time to begin a bolus dose and increased nursing satisfaction. The practice change also improved medication utilization without negatively impacting patient safety.

  3. Steam generator replacement: a story of continuous improvement

    International Nuclear Information System (INIS)

    Sills, M.S.; Wilkerson, R.

    2009-01-01

    This paper provides a review of the history of steam generator replacement in the US focusing on the last five years. From the early replacements in the 1980s, there have been major technology improvements resulting in dramatically shorter outages and reduced radiological exposure for workers. Even though the changes for the last five years have been less dramatic, the improvement trend continues. No two steam generator replacement (SGR) projects are the same and there are some major differences including; the access path for the components to containment (is a construction opening in containment required), type of containment, number of steam generators, one piece or two piece replacement, plant type (Westinghouse, CE or B and W) and plant layout. These differences along with other variables such as delays due to plant operations and other activities not related to the steam generator replacement make analysis of performance data difficult. However, trends in outage performance and owner expectations can be identified. How far this trend will go is also discussed. Along with the trend of improved performance, there is also a significant variation in performance. Some of the contributors to this variation are identified. This paper addresses what is required for a successful outage, meeting the increasing expectations and setting new records. The authors will discuss various factors that contribute to the success of a steam generator replacement. These factors include technical issues and, equally important, organizational interface and the role the customer plays. Recommendations are provided for planning a successful steam generator replacement outage. (author)

  4. Improving continuing medical education by enhancing interactivity: lessons from Iran.

    Science.gov (United States)

    Faghihi, Seyed Aliakbar; Khankeh, Hamid Reza; Hosseini, Seyed Jalil; Soltani Arabshahi, Seyed Kamran; Faghih, Zahra; Parikh, Sagar V; Shirazi, Mandana

    2016-04-01

    Continuing Medical Education (CME) has been considered as a lifelong commitment for doctors to provide the optimal care for patients. Despite a long history of creating CME programs, outcomes are far from ideal. The present qualitative study aims to clarify the barriers affecting effectiveness of the CME programs in Iran based on the experiences of general practitioners. Sixteen general practitioners were recruited to participate in in-depth interviews and field observations concerning experiences with CME. The study was performed using a qualitative content analysis method. The codes, categories and themes were explored through an inductive process in which the researchers moved from specific to general. The participants' experiences identified a number of barriers, particularly insufficient interaction with the instructors; additional problems included the teachers' use of an undifferentiated approach; unreal and abstract CME; and ignorance of the diverse reasons to participate in CME. Based on the study results, there are multiple barriers to effective implementation of CME in Iran. The key barriers include insufficient interaction between the trainees and providers, which must be considered by other stakeholders and program designers. Such interactions would facilitate improved program design, invite more specific tailoring of the education to the participants, allow for more effective educational methods and set the stage for outcome evaluation from the learners actually applying their new knowledge in practice. Replication of these findings with another sample would improve confidence in these recommendations, but these findings are broadly consistent with findings in the educational literature on improving the efficacy of CME.

  5. Performance indicators: A tool for continuous quality improvement

    Directory of Open Access Journals (Sweden)

    Nidhi M Bhatnagar

    2016-01-01

    Full Text Available Background: Performance monitoring is an important tool which can be used for setting priorities for process improvement. At our centre, we have been monitoring every step in the processes, right from inventory of consumables (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. Materials and Methods: The present study was a retrospective study where the performance indicator (PI data of blood bank was analyzed for over four years. For certain parameters, benchmarks or thresholds were set that represented warning limits or action limits. The yearly data were collated from monthly data. "Shifts" or "Trends", if any, were identified and Corrective and Preventive Action (CAPA taken accordingly. At the end, outcomes of the analysis were charted. Results: After the yearly data evaluation, outcomes obtained were used to plan, correct and amend processes and systems in the blood center. It was observed that the workload of the center showed an upward trend. This helped us to plan for the purchase of consumables and management of manpower. The monitoring of usage and discard of blood helped in the efficient management of blood stocks. The need for any new equipment could also be judged by the trends in workload. Conclusion: Performance indicators are indispensible tools which various stakeholders in the Blood Transfusion centres should implement to improve on quality performance.

  6. Performance indicators: A tool for continuous quality improvement.

    Science.gov (United States)

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

    2016-01-01

    Performance monitoring is an important tool which can be used for setting priorities for process improvement. At our centre, we have been monitoring every step in the processes, right from inventory of consumables (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). The present study was a retrospective study where the performance indicator (PI) data of blood bank was analyzed for over four years. For certain parameters, benchmarks or thresholds were set that represented warning limits or action limits. The yearly data were collated from monthly data. Shifts or Trends, if any, were identified and Corrective and Preventive Action (CAPA) taken accordingly. At the end, outcomes of the analysis were charted. After the yearly data evaluation, outcomes obtained were used to plan, correct and amend processes and systems in the blood center. It was observed that the workload of the center showed an upward trend. This helped us to plan for the purchase of consumables and management of manpower. The monitoring of usage and discard of blood helped in the efficient management of blood stocks. The need for any new equipment could also be judged by the trends in workload. Performance indicators are indispensible tools which various stakeholders in the Blood Transfusion centres should implement to improve on quality performance.

  7. 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.

  8. 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.

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

    Science.gov (United States)

    Vogelsang, J

    1999-04-01

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

  10. Can therapy dogs improve pain and satisfaction after total joint arthroplasty? A randomized controlled trial.

    Science.gov (United States)

    Harper, Carl M; Dong, Yan; Thornhill, Thomas S; Wright, John; Ready, John; Brick, Gregory W; Dyer, George

    2015-01-01

    The use of animals to augment traditional medical therapies was reported as early as the 9th century but to our knowledge has not been studied in an orthopaedic patient population. The purpose of this study was to evaluate the role of animal-assisted therapy using therapy dogs in the postoperative recovery of patients after THA and TKA. We asked: (1) Do therapy dogs have an effect on patients' perception of pain after total joint arthroplasty as measured by the VAS? (3) Do therapy dogs have an effect on patients' satisfaction with their hospital stay after total joint arthroplasty as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS)? A randomized controlled trial of 72 patients undergoing primary unilateral THA or TKA was conducted. Patients were randomized to a 15-minute visitation with a therapy dog before physical therapy or standard postoperative physical therapy regimens. Both groups had similar demographic characteristics. Reduction in pain was assessed using the VAS after each physical therapy session, beginning on postoperative Day 1 and continuing for three consecutive sessions. To ascertain patient satisfaction, the proportion of patients selecting top-category ratings in each subsection of the HCAHPS was compared. Patients in the treatment group had lower VAS scores after each physical therapy session with a final VAS score difference of 2.4 units (animal-assisted therapy VAS, 1.7; SD, 0.97 [95% CI, 1.4-2.0] versus control VAS, 4.1; SD, 0.97 [95% CI, 3.8-4.4], pphysical therapy session. Patients in the treatment group had a higher proportion of top-box HCAHPS scores in the following fields: nursing communication (33 of 36, 92% [95% CI, 78%-98%] versus 69%, 25 of 36 [95% CI, 52%-84%], p=0.035; risk ratio, 1.3 [95% CI of risk ratio, 1.0-1.7]; risk difference, 23% [95% CI of risk difference, 5%-40%]), pain management (34 of 36, 94% [95% CI, 81%-99%], versus 26 of 36, 72% [95% CI, 55%-86%], p=0.024; risk ratio, 1.3 [95

  11. 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....

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

    International Nuclear Information System (INIS)

    Park, H. C.; Park, H. G.; Park, Y. W.; Park, J. Y.

    2016-01-01

    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

  13. 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...

  14. Pump Early, Pump Often: A Continuous Quality Improvement Project.

    Science.gov (United States)

    Spatz, Diane L; Froh, Elizabeth B; Schwarz, Jessica; Houng, Kathy; Brewster, Isabel; Myers, Carey; Prince, Judy; Olkkola, Michelle

    2015-01-01

    Research demonstrates that although many mothers initiate pumping for their critically ill children, few women are successful at maintaining milk supply throughout their infants' entire hospital stay. At the Garbose Family Special Delivery Unit (SDU) at the Children's Hospital of Philadelphia, we care for mothers who have critically ill infants born with complex cardiac and congenital anomalies. Human milk is viewed as a medical intervention at our institution. Therefore, nurses on the SDU wanted to ensure best practice in terms of pumping initiation. This article describes a continuous quality improvement project that ensured mothers pumped early and often. Childbirth educators can play a key role in preparing mothers who are anticipating an infant who will require hospitalization immediately post-birth.

  15. 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.

  16. Continuous improvement of environmental aspect in Juzbado factory

    International Nuclear Information System (INIS)

    2005-01-01

    ENUSA's Fuel Assembly Factory in Juzbado (Salamanca), conscious of its responsibilities with the environment where its activities are carried out, has an Environmental Management System (EMS) certified by AENOR (N. CGM-99/31) according to the requirements of Standard UNE E N-ISO 14001 and afterwards, as a result of compromise with continuous improvement of its environmental performance, joined the European Regulation 761/2001(EMAS), which has allowed the EMS to achieve levels of excellence in environmental management, doing it in a much more transparent and participative way and letting the public and other interested parts to have access to the information referring its environmental activities, as demanded by society, by the elaboration and verification of an Environmental Statement (VDM-03/010) on a yearly basis. (Author)

  17. THE EFFECTS OF ROOM SERVICE TO IMPROVE PATIENTS’ FOOD SATISFACTION AND FOOD ACCEPTANCE

    OpenAIRE

    Muhammad Iqbal; Susetyowati Susetyowati; Martalena Br Purba

    2017-01-01

    The improvement of patients’ food satisfaction and acceptance in the hospitals is primarily needed in the food service  system.  Room service is a new concept in the food service area. This study aims to compare the effects of two different types of food service systems; room service and conventional service system. The study with quasi-experimental design is conducted to the subject of 66 inpatients who were taken using a quota sampling method. Subjects were divided into different groups, th...

  18. Using Hierarchical Machine Learning to Improve Player Satisfaction in a Soccer Videogame

    OpenAIRE

    Collins, Brian; Rovatsos, Michael

    2006-01-01

    This paper describes an approach to using a hierarchical machine learning model in a two player 3D physics-based soccer video game to improve human player satisfaction. Learning is accomplished at two layers to form a complete game-playing agent such that higher level strategy learning is dependent on lower-level learning of basic behaviors.Supervised learning is used to train neural networks on human data to model the basic behaviors. The reinforcement learning algorithms Sarsa (λ) and Q(λ) ...

  19. Continuous improvement of the MHTGR safety and competitive performance

    International Nuclear Information System (INIS)

    Eichenberg, T.W.; Etzel, K.T.; Mascaro, L.L.; Rucker, R.A.

    1992-05-01

    An increase in reactor module power from 350 to 450 MW(t) would markedly improve the economics of the Modular High Temperature Gas-Cooled Reactor (MHTGR). The higher power level was recommended as the result of an in-depth cost reduction study undertaken to compete with the declining price of fossil fuel. The safety assessment confirms that the high level of safety, which relies on inherent characteristics and passive features, is maintained at the elevated power level. Preliminary systems, nuclear, and safety performance results are discussed for the recommended 450 MW(t) design. Optimization of plant parameters and design modifications accommodated the operation of the steam generator and circulator at the higher power level. Events in which forced cooling is lost, designated as conduction cooldowns are described in detail. For the depressurized conduction cooldown, without full helium inventory, peak fuel temperatures are significantly lowered. A more negative temperature coefficient of reactivity was achieved while maintaining an adequate fuel cycle and reactivity control. Continual improvement of the MHTGR delivers competitive performance without relinquishing the high safety margins demanded of the next generation of power plants

  20. Continuous quality improvement using intelligent infusion pump data analysis.

    Science.gov (United States)

    Breland, Burnis D

    2010-09-01

    The use of continuous quality-improvement (CQI) processes in the implementation of intelligent infusion pumps in a community teaching hospital is described. After the decision was made to implement intelligent i.v. infusion pumps in a 413-bed, community teaching hospital, drug libraries for use in the safety software had to be created. Before drug libraries could be created, it was necessary to determine the epidemiology of medication use in various clinical care areas. Standardization of medication administration was performed through the CQI process, using practical knowledge of clinicians at the bedside and evidence-based drug safety parameters in the scientific literature. Post-implementation, CQI allowed refinement of clinically important safety limits while minimizing inappropriate, meaningless soft limit alerts on a few select agents. Assigning individual clinical care areas (CCAs) to individual patient care units facilitated customization of drug libraries and identification of specific CCA compliance concerns. Between June 2007 and June 2008, there were seven library updates. These involved drug additions and deletions, customization of individual CCAs, and alterations of limits. Overall compliance with safety software use rose over time, from 33% in November 2006 to over 98% in December 2009. Many potentially clinically significant dosing errors were intercepted by the safety software, prompting edits by end users. Only 4-6% of soft limit alerts resulted in edits. Compliance rates for use of infusion pump safety software varied among CCAs over time. Education, auditing, and refinement of drug libraries led to improved compliance in most CCAs.

  1. 2003 Stewardship progress report : committed to continuous improvement

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2003-12-01

    The stewardship initiative is a mandatory requirement for members of the Canadian Association of Petroleum Producers (CAPP). It involves performance management and benchmarking, voluntary audits and verification, as well as training and improved communication inside and outside the industry. This fourth annual progress report describes the environment, health, safety and socio-economic stewardship initiative. This report presents an aggregate of industry performance. Stewardship of Excellence awards were presented in 2003, celebrating outstanding performance by members who demonstrated their commitment to responsible development and continuous improvement within a business framework. The awards were presented in three categories, namely environment, health and safety, and socio-economic. Northrock Resources was presented with the award in the environment category for its voluntary waste gas reduction. The health and safety recognition went to Burlington Resources Canada Ltd. for superior office ergonomics, while the award in the socio-economic category was presented to Suncor Energy Inc. for Aboriginal business development. A brief overview of the achievements of each of these three companies was presented. tabs., figs.

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

    Science.gov (United States)

    Akarslan, Zühre Zafersoy; Sadik, Burak; Erten, Hüya; Karabulut, Erdem

    2009-01-01

    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. 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, chi2 test and multiple logistic regression analyses. 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. 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.

  3. Improving student satisfaction of Andalas University Dormitory through Service Quality and Importance Performance Analysis

    Science.gov (United States)

    Putri, Nilda Tri; Anggraini, Larisa

    2018-03-01

    Residential satisfaction of university dormitories serve as one of the significant aspects in the framework of sustainability in higher education. This research investigated the quality of dormitory services in Andalas University Dormitory based on student’s satisfaction. According to management residential, the enrollment of residential student has increased gradually in Andalas University. In 2016, capacity of residential student is 1686, but only 1081 students can stay at dormitory because some rooms in bad condition. There are a lot of problems and complaints regarding dormitory’s service quality i.e water problems, leaky rooms and bathrooms, cleanliness and inadequate facilities in residential college. In addition, there are 20% of last year student’s residential check out before the time of contract runs out. The aim of this research are understanding the level of GAP exists between expectation and perception students’ residential in the content of service quality and evaluating the improvement priority services using Importance Performance Analysis. This study is measuring service quality by using Responsiveness, Assurance, Empathy, Reliability and Tangible dimension. A negative GAP indicates that the actual services are than what was expected and the GAP is highlighted area for improvement. Based on IPA, management should improve this following dimension services : responsiveness, tangible and assurance dimension.

  4. Shared medical appointments: improving access, outcomes, and satisfaction for patients with chronic cardiac diseases.

    Science.gov (United States)

    Bartley, Kelly Bauer; Haney, Rebecca

    2010-01-01

    Improving access to care, health outcomes, and patient satisfaction are primary objectives for healthcare practices. This article outlines benefits, concerns, and possible challenges of shared medical appointments (SMAs) for patients and providers. The SMA model was designed to support providers' demanding schedules by allowing patients with the same chronic condition to be seen in a group setting. By concentrating on patient education and disease management, interactive meetings provide an opportunity for patients to share both successes and struggles with others experiencing similar challenges. Studies demonstrated that SMAs improved patient access, enhanced outcomes, and promoted patient satisfaction. This article describes the potential benefits of SMAs for patients with chronic heart disease, which consumes a large number of healthcare dollars related to hospital admissions, acute exacerbations, and symptom management. Education for self-management of chronic disease can become repetitive and time consuming. The SMA model introduces a fresh and unique style of healthcare visits, allowing providers to devote more time and attention to patients and improve productivity. The SMA model provides an outstanding method for nurse practitioners to demonstrate their role as a primary care provider, by leading patients in group discussions and evaluating their current health status. Patient selection, preparation, and facilitation of an SMA are discussed to demonstrate the complementary nature of an SMA approach in a healthcare practice.

  5. 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.

  6. Continuous quality improvement in nephrology: a systematic review.

    Science.gov (United States)

    Nunes, Julie Wright; Seagull, F Jacob; Rao, Panduranga; Segal, Jonathan H; Mani, Nandita S; Heung, Michael

    2016-11-24

    Continuous quality improvement (CQI) has been successfully applied in business and engineering for over 60 years. While using CQI techniques within nephrology has received increased attention, little is known about where, and with what measure of success, CQI can be attributed to improving outcomes within nephrology care. This is particularly important as payors' focus on value-based healthcare and reimbursement is tied to achieving quality improvement thresholds. We conducted a systematic review of CQI applications in nephrology. Studies were identified from PubMed, MEDLINE, Scopus, Web of Science, CINAHL, Google Scholar, ProQuest Dissertation Abstracts and sources of grey literature (i.e., available in print/electronic format but not controlled by commercial publishers) between January 1, 2004 and October 13, 2014. We developed a systematic evaluation protocol and pre-defined criteria for review. All citations were reviewed by two reviewers with disagreements resolved by consensus. We initially identified 468 publications; 40 were excluded as duplicates or not available/not in English. An additional 352 did not meet criteria for full review due to: 1. Not meeting criteria for inclusion = 196 (e.g., reviews, news articles, editorials) 2. Not nephrology-specific = 153, 3. Only available as abstracts = 3. Of 76 publications meeting criteria for full review, the majority [45 (61%)] focused on ESRD care. 74% explicitly stated use of specific CQI tools in their methods. The highest number of publications in a given year occurred in 2011 with 12 (16%) articles. 89% of studies were found in biomedical and allied health journals and most studies were performed in North America (52%). Only one was randomized and controlled although not blinded. Despite calls for healthcare reform and funding to inspire innovative research, we found few high quality studies either rigorously evaluating the use of CQI in nephrology or reporting best practices. More rigorous

  7. 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.

  8. Patient perspectives about bariatric surgery unveil experiences, education, satisfaction, and recommendations for improvement.

    Science.gov (United States)

    Groller, Karen D; Teel, Cynthia; Stegenga, Kristin H; El Chaar, Maher

    2018-02-17

    Following bariatric surgery, up to 35% of patients struggle with strict regimens and experience weight recidivism within 2 years [1-5]. Accredited weight management centers (WMC) must provide educational programs and support patients in lifestyle changes before and after surgery. Educational programs, however, may not be evidence-based or patient-centered and may vary in curriculum, approach, and educator type [6]. To obtain patient descriptions about the weight loss surgery (WLS) experience, including education, satisfaction, and recommendations for improvement. Participants were recruited from a university hospital-based WMC in Pennsylvania. This qualitative descriptive study used purposive sampling and inductive content analysis. A NEW ME-VERSION 2.0, encompassed themes from semistructured interviews with 11 participants (36% male). Theme 1: Programming and Tools, explained how individuals undergoing WLS found support through educational programming. Theme 2: Updates and Upgrades, identified issues surrounding quality of life and challenges before and after surgery. Theme 3: Lessons Learned and Future Considerations, identified satisfaction levels and recommendations for improving the WLS experience. Participants reported positive experiences, acknowledging educational programs and extensive WMC resources, yet also offered recommendations for improving educational programming. Patient narratives provided evidence about the WLS experience. Achievement of weight goals, adherence to rules, and improved health status contributed to perceptions of WLS success. Participants encouraged educators to identify expected outcomes of educational programming, monitor holistic transformations, foster peer support, and use technology in WMC programming. Results also validated the need for the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program's education requirement (standard 5.1). Future educational research could help develop best practices in WLS

  9. 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.

  10. The Development and User Satisfaction Evaluation of Internet-Based N-Screen Healthcare Walking Content to Increase Continuous Usage Motivation.

    Science.gov (United States)

    Youm, Sekyoung

    2015-08-01

    The purpose of the current study is (1) to apply Internet-based N-Screen (this is used like the term "emultiscreen"; as the technology that provides services of shared content or application via N devices, it includes all screens such as personal computers [PCs], TV, and mobile devices) services to healthcare services by developing games for improving one's health and (2) to present ways to activate the use of health promotion contents in the future by investigating user satisfaction and whether there is any intention to accept the contents and/or use the services continuously. In order to evaluate the customized health maintenance content provided by the healthcare walking system developed in the current study, 98 adult men and women residing in Seoul, Korea, were instructed to use 10 minutes' worth of the walking content. Perceived quality, level of trust in the results, effectiveness of the exercise, and overall satisfaction were measured in regard to the N-Screen-based walking content, including those for the cell phone, PC, and Internet protocol TV (IPTV). Walking contents using N-Screen services were perceived with high levels of trust in the results of the exercise, the effectiveness of the exercise, and overall satisfaction. In terms of the usability of N-Screen services, the younger the participants, the more usable they found the mobile or PC programs. The older the participants, the more usable they found the IPTV screens, although they still struggled with using the content given; operating IPTVs proved to be difficult for them. Furthermore, participants who were engaged in exercise on a regular basis were less satisfied with the program, in general. The present study has developed a walking system using N-Screen programs to make the most common and effective forms of exercise-walking and running-accessible indoors. This may increase motivation to exercise by offering services that boost one's interest in exercising, such as personal monitoring and real

  11. 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.

  12. 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.

  13. A formula for continued improvement: Audit follow-up

    International Nuclear Information System (INIS)

    Maday, J.H. Jr.

    1989-10-01

    In his book Management Audits, Allan J. Sayle states, ''QA standards stipulate that corrective action, required as a result of performing an audit, be followed up and closed out. There would, indeed, be little point in performing audits, requiring corrective action, or having a QA system at all if the auditee knows that the auditor will never verify that the corrective action has been efficaciously implemented.'' The QA auditor has an obligation to include follow-up in the overall audit planning. All too often the auditor will go to great lengths to plan and perform an audit only to have a recurring finding in the next audit. The proposed corrective action was only promissory and was not designed to stop the problem from recurring or to identify its root cause. Auditors do a disservice to the overall QA program and particularly to the customer when they fail to follow up and verify that an audit corrective action has been effectively implemented. In this paper, the techniques used by the quality assurance auditors at the Pacific Northwest Laboratory (PNL) will be presented. Although PNL is a research and development laboratory, the techniques outlined in this paper could be applied to any industry conducting quality assurance audits. Most important, they provide a formula for continued improvement by assuring that audit follow-up is timely, meaningful, and permanent

  14. 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.

  15. 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

  16. 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.

  17. Alternative Outpatient Chemotherapy Scheduling Method to Improve Patient Service Quality and Nurse Satisfaction.

    Science.gov (United States)

    Huang, Yu-Li; Bryce, Alan H; Culbertson, Tracy; Connor, Sarah L; Looker, Sherry A; Altman, Kristin M; Collins, James G; Stellner, Winston; McWilliams, Robert R; Moreno-Aspitia, Alvaro; Ailawadhi, Sikander; Mesa, Ruben A

    2018-02-01

    Optimal scheduling and calendar management in an outpatient chemotherapy unit is a complex process that is driven by a need to focus on safety while accommodating a high degree of variability. Primary constraints are infusion times, staffing resources, chair availability, and unit hours. We undertook a process to analyze our existing management models across multiple practice settings in our health care system, then developed a model to optimize safety and efficiency. The model was tested in one of the community chemotherapy units. We assessed staffing violations as measured by nurse-to-patient ratios throughout the workday and at key points during treatment. Staffing violations were tracked before and after the implementation of the new model. The new model reduced staffing violations by nearly 50% and required fewer chairs to treat the same number of patients for the selected clinic day. Actual implementation results indicated that the new model leveled the distribution of patients across the workday with an 18% reduction in maximum chair utilization and a 27% reduction in staffing violations. Subsequently, a positive impact on peak pharmacy workload reduced delays by as much as 35 minutes. Nursing staff satisfaction with the new model was positive. We conclude that the proposed optimization approach with regard to nursing resource assignment and workload balance throughout a day effectively improves patient service quality and staff satisfaction.

  18. 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.

  19. Explanation of Psychological Capital Effects on Improvement of Farmers’ Job Satisfaction of the Ardabil County

    Directory of Open Access Journals (Sweden)

    Vakil Heidari sraban

    2017-07-01

    Full Text Available Positive Psychological Capital is defined as the positive and developmental state of an individual as characterized by high self-efficacy, optimism, hope and resiliency. The main purpose of this paper is to explain the psychological capital effects on improvement of village farmer’s job satisfactions in the Ardabil County. The study sample consists of farmers in the Ardabil Province and 380 people were selected by convenience sampling. The sample size was determined based on Cochran's formula and the required data was collected through questionnaires. A questionnaire was used for data collection. The questionnaires face and content validity were confirmed by professors and experts, and its reliability was confirmed based on Cronbach's alpha (0.71-0.82. For data analysis, the SPSS software was used. The results of Pearson correlation test showed that there was a significant correlation between all research variables and job satisfactions with the reliability of %95. Moreover, the variables of optimism, resiliency and self-efficacy contained %41 of dependent variables in linear multiple regression test. Finally, according to the results of analysis, practical suggestions are presented.

  20. 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…

  1. Drivers of Dashboard Development (3-D): A Curricular Continuous Quality Improvement Approach.

    Science.gov (United States)

    Shroyer, A Laurie; Lu, Wei-Hsin; Chandran, Latha

    2016-04-01

    Undergraduate medical education (UME) programs are seeking systematic ways to monitor and manage their educational performance metrics and document their achievement of external goals (e.g., Liaison Committee on Medical Education [LCME] accreditation requirements) and internal objectives (institution-specific metrics). In other continuous quality improvement (CQI) settings, summary dashboard reports have been used to evaluate and improve performance. The Stony Brook University School of Medicine UME leadership team developed and implemented summary dashboard performance reports in 2009 to document LCME standards/criteria compliance, evaluate medical student performance, and identify progress in attaining institutional curricular goals and objectives. Key performance indicators (KPIs) and benchmarks were established and have been routinely monitored as part of the novel Drivers of Dashboard Development (3-D) approach to curricular CQI. The systematic 3-D approach has had positive CQI impacts. Substantial improvements over time have been documented in KPIs including timeliness of clerkship grades, midclerkship feedback, student mistreatment policy awareness, and student satisfaction. Stakeholder feedback indicates that the dashboards have provided useful information guiding data-driven curricular changes, such as integrating clinician-scientists as lecturers in basic science courses to clarify the clinical relevance of specific topics. Gaining stakeholder acceptance of the 3-D approach required clear communication of preestablished targets and annual meetings with department leaders and course/clerkship directors. The 3-D approach may be considered by UME programs as a template for providing faculty and leadership with a CQI framework to establish shared goals, document compliance, report accomplishments, enrich communications, facilitate decisions, and improve performance.

  2. Report: EPA Needs to Improve Continuity of Operations Planning

    Science.gov (United States)

    Report #10-P-0017, October 27, 2009. EPA has limited assurance that it can successfully maintain continuity of operations and execute its mission essential functions during a significant national event such as a pandemic influenza outbreak.

  3. Studying Implementation within a Continuous Continuous-Improvement Process: What Happens When We Design with Adaptations in Mind?

    Science.gov (United States)

    Tichnor-Wagner, Ariel; Allen, Danielle; Socol, Allison Rose; Cohen-Vogel, Lora; Rutledge, Stacey A.; Xing, Qi W.

    2018-01-01

    Background/Context: This study examines the implementation of an academic and social-emotional learning innovation called Personalization for Academic and Social-Emotional Learning, or PASL. The innovation was designed, tested, and implemented using a continuous continuous-improvement model. The model emphasized a top-and-bottom process in which…

  4. Course Development Cycle Time: A Framework for Continuous Process Improvement.

    Science.gov (United States)

    Lake, Erinn

    2003-01-01

    Details Edinboro University's efforts to reduce the extended cycle time required to develop new courses and programs. Describes a collaborative process improvement framework, illustrated data findings, the team's recommendations for improvement, and the outcomes of those recommendations. (EV)

  5. Room service improves patient food intake and satisfaction with hospital food.

    Science.gov (United States)

    Williams, R; Virtue, K; Adkins, A

    1998-07-01

    Cancer therapy causes side effects that interfere with oral intake. Frequently, patients undergoing such therapy suffer from anorexia, nausea, vomiting, food aversions, dysgeusia, and xerostomia, all which adversely affect oral intake. Adequate nutrition intake is an important part of therapy for the cancer patient, especially when that patient is a child. Children who are well nourished are better able to withstand infection and tolerate therapy. Parents and staff at our hospital have worked diligently to improve patient's oral intake with limited success. Hence, a multidisciplinary team was organized to develop a new approach to food services that would improve patients' oral intake. The team initiated patient "room service," and patients were allowed to call the kitchen when they were ready to eat. The system works much like room service in a hotel. After the introduction of room service, patients' caloric intake improved significantly (P = .008), and protein intake increased by 18%. Patient satisfaction with hospital food service also improved; excellent ratings increased by as much as 35%. We conclude that room service is a viable alternative to traditional food services in the pediatric oncology setting and may be useful in other patient populations, such as maternity and general pediatrics.

  6. Improving pediatric immunization rates: description of a resident-led clinical continuous quality improvement project.

    Science.gov (United States)

    Jones, Kyle Bradford; Gren, Lisa H; Backman, Richard

    2014-09-01

    Increased emphasis is being placed on the continuous quality improvement (CQI) education of residents of all specialties. This article describes a resident-led continuous quality improvement (CQI) project, based on a novel curriculum, to improve the immunization rates of children under 2 years old at the Madsen Family Health Center (MHC). All third-year residents were trained in the FOCUS-PDSA CQI methodology through concurrent didactic lectures and experience leading the CQI team. The CQI team included clinical staff led by a third-year family medicine resident and mentored by a member of the family medicine faculty. Immunization records were distributed to provider-medical assistant teamlets daily for each pediatric patient scheduled in clinic as the intervention. Compliance with the intervention (process measure), as well as immunization rates at 2 and 5 months post-intervention (outcome measure), were monitored. Immunization records were printed on 84% of clinic days from October 24, 2011 to March 31, 2012. The percentage of patients immunized at baseline was 66%. The percentage immunized as of December 31, 2011 was 96% and was 91% as of March 31, 2012. An important educational experience was organized for third-year family medicine residents through learning CQI skills, leading a CQI team, and directing a CQI project to completion. Significant improvement in the percentage of patients under 2 years old immunized at the MHC was achieved by presenting provider-medical assistant teamlets with immunization records of all pediatric patients on the daily clinic schedule.

  7. 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

  8. Family Friendly Policies and Performance-Based Pay in Companies' Employment Management in Japan : Its Effect on Work Life Balance Satisfaction and Willingness to Job continuity

    OpenAIRE

    菅原, 佑香

    2012-01-01

    The Purpose of this paper is to examine the influence of firm's family friendly policies and also the recent introduction of as performance based wage system on employee's motivation. The motivation was measured in terms of work life balance satisfaction and willingness to continuity to work at the same workplace. To analyze these effects, I used probit model and ordinary least squares (OLS), and two step least squares. The main findings is as follows (1) Introduction of various family friend...

  9. 78 FR 40625 - National School Lunch Program: Direct Certification Continuous Improvement Plans Required by the...

    Science.gov (United States)

    2013-07-08

    ... National School Lunch Program: Direct Certification Continuous Improvement Plans Required by the Healthy... Continuous Improvement Plans Required by the Healthy, Hunger-Free Kids Act of 2010'' on February 22, 2013... performance benchmarks and to develop and implement continuous improvement plans if they fail to do so. The...

  10. Use of a Dog Visitation Program to Improve Patient Satisfaction in Trauma Patients.

    Science.gov (United States)

    Stevens, Penelope; Kepros, John P; Mosher, Benjamin D

    Clinical staff members all recognize the importance of attaining high patient satisfaction scores. Although there are many variables that contribute to patient satisfaction, implementation of a dog visitation program has been shown to have positive effects on patient satisfaction in total joint replacement patients. This innovative practice had not previously been studied in trauma patients. The purpose of this quasi-experimental study was to determine whether dog visitation to trauma inpatients increased patient satisfaction scores with the trauma physicians. A team consisting of a dog and handler visited 150 inpatients on the trauma service. Patient satisfaction was measured using a preexisting internal tool for patients who had received dog visitation and compared with other trauma patients who had not received a visit. This study demonstrated that patient satisfaction on four of the five measured scores was more positive for the patients who had received a dog visit.

  11. 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.

  12. 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…

  13. Nasal continuous positive airway pressure: does bubbling improve gas exchange?

    Science.gov (United States)

    Morley, C J; Lau, R; De Paoli, A; Davis, P G

    2005-07-01

    In a randomised crossover trial, 26 babies, treated with Hudson prong continuous positive airway pressure (CPAP) from a bubbling bottle, received vigorous, high amplitude, or slow bubbling for 30 minutes. Pulse oximetry, transcutaneous carbon dioxide, and respiratory rate were recorded. The bubbling rates had no effect on carbon dioxide, oxygenation, or respiratory rate.

  14. 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.

  15. 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.

  16. The Social Intelligence of Principals: Links to Teachers' Continuous Improvement

    Science.gov (United States)

    McQuade, Joan

    2013-01-01

    Despite multiple efforts to reform 21st education to better meet the needs of all students, school improvement successes have been sporadic and debatable. Research suggests that significant improvement lies within the purview of teachers and principals, and this current research provided the underpinnings for the study. Based on neuroscience…

  17. Assessment of prostatic fiducial marker introduction: patient morbidity, staff satisfaction and improved treatment field placement

    International Nuclear Information System (INIS)

    Brown, Simon; Lehman, Margot; Ferrari-Anderson, Janet; Glyde, Alan; Burmeister, Elizabeth; Nicol, David

    2011-01-01

    Increased accuracy when using fiducial markers for prostate localisation is well documented. This project aimed to establish the improvement in accuracy when using gold markers for daily prostate localisation, to assess patient satisfaction and morbidity from the transrectal implantation of gold seed markers and establish staff attitudes towards the newly introduced processes. Twenty patients with prostate cancer had three gold seeds implanted into the base, apex and central zone of the prostate transrectally using ultrasound guidance. Surveys were conducted to assess staff and patient satisfaction with the process of gold seed localisation. The gold markers were used to localise the prostate on a daily basis using megavoltage electronic portal imaging. Measurements were taken to establish the increase in accuracy when using gold fiducial markers compared with using the surrounding bony anatomy. Inter-fraction motion (1 standard deviation (SD)) of the fiducial markers was 2.20, 4.28 and 4.27 mm in the LR, SI and AP directions, respectively. Intra-fraction prostate motion (1 SD) was measured as 0.8 mm LR, 1.1 mm SI and 2.0 mm AP. The patient survey showed that the insertion and associated side effects were acceptable, with 5% of patients stating that the seed insertion was worse than the prostate biopsy, and 23.1% of patients experienced short duration (1–2 days) haematuria. The staff survey showed that daily online image guidance was achievable without affecting patient throughput. Thirty percent of treatment staff believed that performing online daily localisation did not add any extra time to a standard treatment, and the remaining 70% thought that the added time was minimal (2–4 min). Gold fiducial markers are an accurate, reliable and tolerable method of daily prostate localisation.

  18. A strategy for improving worker satisfaction and job attitudes in a repetitive industrial task: application of production standards and performance feedback.

    Science.gov (United States)

    Shikdar, Ashraf A; Das, Biman

    2003-04-15

    Worker satisfaction improved significantly as a consequence of the provision of the assigned and participative standards with performance feedback in a repetitive industrial production task. The maximum improvement in worker satisfaction was found for the participative standard and feedback condition. Only this condition had a significant positive effect on worker job attitudes. Monetary incentive, when provided with an assigned or participative standard with feedback, added no incremental worker satisfaction or job attitudes gain. The participative standard with feedback condition emerges as the optimum strategy for improving worker satisfaction and job attitudes in a repetitive industrial production task.

  19. Process Evaluation and Continuous Improvement in Community Youth Programs

    Directory of Open Access Journals (Sweden)

    Jennifer V. Trachtenberg

    2008-06-01

    Full Text Available A method of using process evaluation to provide improvement plans in order to promote community youth programs is described. The core elements of this method include the following: (1 collection and analysis of baseline data, (2 feedback provided to programs describing their strengths and limitations, (3 programs provided with assistance in preparing improvement plans in regard to their baseline data, and (4 follow-up evaluation assessed program changes based on their improvement plans and baseline data. A case study of an inner-city neighborhood youth center is used to demonstrate this method.

  20. Observations of human factors as a continuous improvement tool

    International Nuclear Information System (INIS)

    Almeida, P.

    2015-01-01

    Principles for Excellence in Human Performance should promote behaviors throughout an organization that support safety and reliable operation of the plant. Such behaviors must be clearly defined, communicated and reinforced by managers, on a continuous basis. To identify if workers behaviors are in compliance with those expected is paramount to have an observations program in place, which in one hand identifies deviations from expectations to correct them, and on the other promotes the desired behaviors through positive reinforcement. (Author)

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

    Energy Technology Data Exchange (ETDEWEB)

    Jurburg, M.; Viles, E.; Tanco, M.; Mateo, R.; Lleó, A.

    2016-07-01

    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 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.

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

    International Nuclear Information System (INIS)

    Jurburg, M.; Viles, E.; Tanco, M.; Mateo, R.; Lleó, A.

    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 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.

  3. Multidisciplinary Prerounding Meeting as a Continuous Quality Improvement Tool: Leveraging to Reduce Continuous Benzodiazepine Use at an Academic Medical Center.

    Science.gov (United States)

    Flannery, Alexander H; Thompson Bastin, Melissa L; Montgomery-Yates, Ashley; Hook, Corrine; Cassity, Evan; Eaton, Phillip M; Morris, Peter E

    2018-01-01

    Evidence-based medicine often has many barriers to overcome prior to implementation in practice, hence the importance of continuous quality improvement. We report on a brief (≤10 minutes) multidisciplinary meeting prior to rounds to establish a dashboard for continuous quality improvement and studied the success of this meeting on a particular area of focus: continuous infusion benzodiazepine minimization. This was a prospective observational study of patients admitted to the medical intensive care unit (MICU) of a large academic medical center over a 4-month period. A morning multidisciplinary prerounding meeting was implemented to report on metrics required to establish a dashboard for MICU care for the previous 24 hours. Fellows and nurse practitioners on respective teams reported on key quality metrics and other important data related to patient census. Continuous benzodiazepines were tracked daily as the number of patients per team who had orders for a continuous benzodiazepine infusion. The aim of this report is to describe the development of the morning multidisciplinary prerounding meeting and its impact on continuous benzodiazepine use, along with associated clinical outcomes. The median number of patients prescribed a continuous benzodiazepine daily decreased over this time period and demonstrated a sustained reduction at 1 year. Furthermore, sedation scores improved, corresponding to a reduction in median duration of mechanical ventilation. The effectiveness of this intervention was mapped post hoc to conceptual models used in implementation science. A brief multidisciplinary meeting to review select data points prior to morning rounds establishes mechanisms for continuous quality improvement and may serve as a mediating factor for successful implementation when initiating and monitoring practice change in the ICU.

  4. 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.

  5. Professional Learning Communities: Teachers Working Collaboratively for Continuous Improvement

    Science.gov (United States)

    Griffith, Louise Ann

    2009-01-01

    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…

  6. With Scale in Mind: A Continuous Improvement Model for Implementation

    Science.gov (United States)

    Redding, Christopher; Cannata, Marisa; Taylor Haynes, Katherine

    2017-01-01

    The conventional approach to scaling up educational reforms considers the development and testing phases to be distinct from the work of implementing at scale. Decades of research suggest that this approach yields inconsistent and often disappointing improvements for schools most in need. More recent scholarship on scaling school improvement…

  7. Cyberbullying: Assessment of Student Experience for Continuous Improvement Planning

    Science.gov (United States)

    Strom, Paris S.; Strom, Robert D.; Wingate, Julius J.; Kraska, Marie F.; Beckert, Troy E.

    2012-01-01

    This study examines the use of polling students to improve conditions of learning in their school. Students from three schools (N = 2,006) in Grades 5, 6, 7, and 8 completed an online poll about how cyberbullying affects their personal lives. Principals' impressions about the benefits of student polling are explained along with the Cyberbullying…

  8. Patient Satisfaction and Prognosis for Functional Improvement and Deterioration, Institutionalization, and Death Among Medicare Beneficiaries Over 2 Years.

    Science.gov (United States)

    Bogner, Hillary R; de Vries McClintock, Heather F; Kurichi, Jibby E; Kwong, Pui L; Xie, Dawei; Hennessy, Sean; Streim, Joel E; Stineman, Margaret G

    2017-01-01

    To examine how patient satisfaction with care coordination and quality and access to medical care influence functional improvement or deterioration (activity limitation stage transitions), institutionalization, or death among older adults. National representative sample with 2-year follow-up. Medicare Current Beneficiary Survey from calendar years 2001 to 2008. Community-dwelling adults (N=23,470) aged ≥65 years followed for 2 years. Not applicable. A multinomial logistic regression model taking into account the complex survey design was used to examine the association between patient satisfaction with care coordination and quality and patient satisfaction with access to medical care and activities of daily living (ADL) stage transitions, institutionalization, or death after 2 years, adjusting for baseline socioeconomics and health-related characteristics. Out of 23,470 Medicare beneficiaries, 14,979 (63.8% weighted) remained stable in ADL stage, 2508 (10.7% weighted) improved, 3210 (13.3% weighted) deteriorated, 582 (2.5% weighted) were institutionalized, and 2281 (9.7% weighted) died. Beneficiaries who were in the top quartile of satisfaction with care coordination and quality were less likely to be institutionalized (adjusted relative risk ratio [RRR], .68; 95% confidence interval [CI], .54-.86). Beneficiaries who were in the top quartile of satisfaction with access to medical care were less likely to functionally deteriorate (adjusted RRR, .87; 95% CI, .79-.97), be institutionalized (adjusted RRR, .72; 95% CI, .56-.92), or die (adjusted RRR, .86; 95% CI, .75-.98). Knowledge of patient satisfaction with medical care and risk of functional deterioration may be helpful for monitoring and addressing disability-related health care disparities and the effect of ongoing policy changes among Medicare beneficiaries. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  9. Economy of Force: Continuous Process Improvement And The Air Service

    Science.gov (United States)

    2017-06-01

    CPI to fix the delinquent areas. Paragraph 1.5.11.3 states that “Functional Managers will . . . Take appropriate actions to correct identified...the power of data-driven decisions to include Statistical Quality Control (SQL), Acceptable Quality Level (AQL), and the Plan-Do-Check-Act (PDCA... statistical analysis and process improvement from Shewhart while working at Bell Telephone Laboratories, and Deming put his mark on the world when he

  10. Satisfaction with Dental Appearance and Attitude toward improving Dental Esthetics among Patients attending a Dental Teaching Center.

    Science.gov (United States)

    Maghaireh, Ghada A; Alzraikat, Hanan; Taha, Nessrin A

    2016-01-01

    The aim of this study was to evaluate the factors influencing the satisfaction of dental appearance and attitude toward treatments to improve dental esthetics among patients attending a dental teaching center. A questionnaire was used to collect data of four background variables among 450 patients attended a dental teaching center in the city of Irbid in Jordan. The questionnaire enclosed self-reported questions about the appearance of anterior teeth, received esthetic treatment and desired treatment for improving esthetics. Descriptive, multiple logistic regression and Chi-square tests were used for data analysis (p ≤ 0.05). The 450 participants consisted of (66.2%) male and (33.8%) female. Of these, 69.3% were satisfied with their dental appearance and 58.0% with the color of their teeth. Esthetic restorations were the most received treatment (39.8%) and whitening of teeth was the most desired treatment (55.3%). The patients' satisfaction with dental appearance was influenced by teeth color, crowding and receiving whitening (p < 0.05. r = 0.561, r(2) = 0.315). The most desired esthetic treatments influenced by the satisfaction with dental appearance were esthetic restorations and orthodontics (p < 0.05. r = 0.223, r(2) = 0.05). Significantly more female reported having esthetic restorations and orthodontics (p = 0.008, 0.000) and desired to have orthodontic, crowns or veneers and esthetic restorations (p = 0.000, 0.015, 0.028). Satisfaction with dental appearance was affected by teeth color, feeling teeth are crowded, desire for esthetic restorations and orthodontic treatment. A high percentage of patients were not satisfied with the color of their teeth. Recognizing the factors that affect patients' satisfaction with their present dental appearance and attitude toward treatments to improve dental esthetic can guide clinicians to strategies to improve esthetics.

  11. Novel combined patient instruction and discharge summary tool improves timeliness of documentation and outpatient provider satisfaction

    Directory of Open Access Journals (Sweden)

    Meredith Gilliam

    2017-03-01

    Full Text Available Background: Incomplete or delayed access to discharge information by outpatient providers and patients contributes to discontinuity of care and poor outcomes. Objective: To evaluate the effect of a new electronic discharge summary tool on the timeliness of documentation and communication with outpatient providers. Methods: In June 2012, we implemented an electronic discharge summary tool at our 145-bed university-affiliated Veterans Affairs hospital. The tool facilitates completion of a comprehensive discharge summary note that is available for patients and outpatient medical providers at the time of hospital discharge. Discharge summary note availability, outpatient provider satisfaction, and time between the decision to discharge a patient and discharge note completion were all evaluated before and after implementation of the tool. Results: The percentage of discharge summary notes completed by the time of first post-discharge clinical contact improved from 43% in February 2012 to 100% in September 2012 and was maintained at 100% in 2014. A survey of 22 outpatient providers showed that 90% preferred the new summary and 86% found it comprehensive. Despite increasing required documentation, the time required to discharge a patient, from physician decision to discharge note completion, improved from 5.6 h in 2010 to 4.1 h in 2012 (p = 0.04, and to 2.8 h in 2015 (p < 0.001. Conclusion: The implementation of a novel discharge summary tool improved the timeliness and comprehensiveness of discharge information as needed for the delivery of appropriate, high-quality follow-up care, without adversely affecting the efficiency of the discharge process.

  12. 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 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.

  13. 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.

  14. 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. Copyright © 2014 Longwoods Publishing.

  15. 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

    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......, 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...... of a work-site strength-training program on self-reported psychosocial workplace factors and job satisfaction....

  16. The innovation scorecard for continuous improvement applied to translational science.

    Science.gov (United States)

    Kotarba, Joseph A; Wooten, Kevin

    2017-10-01

    This paper reports on the baseline stage of a qualitative evaluation of the application of the Innovative Scorecard (ISC) to the Clinical and Translational Science Award (CTSA) at the University of Texas Medical Branch (UTMB) at Galveston. The ISC is adopted from the established Balanced Scorecard system for strategic planning and performance management. In formulating the evaluation, we focused on the organizational identity literature. The initial evaluation consisted of a series of semi-structured interviews with 22 participants of the ISC Boot Camp conducted in July 2015. The logic of grounded theory pointed to the clustering of perceptions of the ISC around respondents' occupational locations at UTMB. Administrators anticipate the expansion of planning activities to include a wider range of participants under the current CTSA award period (2015-2020) than under our first CTSA approval period (2009-2014). A common viewpoint among the senior scientists was that the scientific value of their work will continue to speak for itself without requiring the language of business. Junior scientists looked forward to the ISC's emphasis on increasingly horizontal leadership that will give them more access to and more control over their work and resources. Postdocs and senior staff welcomed increased involvement in the total research process at UTMB. The report concludes with strategies for future follow-up.

  17. A calculation technique to improve continuous monitoring of containment integrity

    International Nuclear Information System (INIS)

    Dick, J.E.

    1990-01-01

    The containment envelope of nuclear plants is a passive and extremely effective safety feature. World experience indicates, however, that inadvertent breaches of envelope integrity can go undetected for substantial time periods. Consequently, continuous monitoring of integrity is being closely examined by many containment designers and operators. The most promising approach is to use sensors and systems that automatically measure changes in the mass of air in containment, time integrate any known air mass flow rates across containment boundaries, and perform a mass balance to obtain the air mass leaked. As fluctuations in such measurements are typically too large to enable leakage to be calculated to the desired precision, filtering and statistical techniques must be used to filter out random and time-dependent fluctuations. Current approaches cannot easily deal with nonrandom or systematic fluctuations in the measurements, including pressure changes within the containment. As a result, sampling periods must be kept short, or data measured during periods of varying containment pressure must be discarded. The technique described allows for much longer sampling periods under conditions of fluctuating containment pressure and eliminates the invalidation of data when the containment pressure fluctuation is nonrandom. It should therefore yield a much more precise value for the containment leakage characteristic. It also promises to be able to distinguish the presence of systematic errors unrelated to systematic pressure changes and to establish whether the containment leakage characteristic is laminar or turbulent

  18. 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

  19. 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

  20. 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.

  1. 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…

  2. Identifying continuous quality improvement publications: what makes an improvement intervention ‘CQI’?

    Science.gov (United States)

    Hempel, Susanne; Lim, Yee-Wei; Danz, Marjorie S; Foy, Robbie; Suttorp, Marika J; Shekelle, Paul G; Rubenstein, Lisa V

    2011-01-01

    Background The term continuous quality improvement (CQI) is often used to refer to a method for improving care, but no consensus statement exists on the definition of CQI. Evidence reviews are critical for advancing science, and depend on reliable definitions for article selection. Methods As a preliminary step towards improving CQI evidence reviews, this study aimed to use expert panel methods to identify key CQI definitional features and develop and test a screening instrument for reliably identifying articles with the key features. We used a previously published method to identify 106 articles meeting the general definition of a quality improvement intervention (QII) from 9427 electronically identified articles from PubMed. Two raters then applied a six-item CQI screen to the 106 articles. Results Per cent agreement ranged from 55.7% to 75.5% for the six items, and reviewer-adjusted intra-class correlation ranged from 0.43 to 0.62. ‘Feedback of systematically collected data’ was the most common feature (64%), followed by being at least ‘somewhat’ adapted to local conditions (61%), feedback at meetings involving participant leaders (46%), using an iterative development process (40%), being at least ‘somewhat’ data driven (34%), and using a recognised change method (28%). All six features were present in 14.2% of QII articles. Conclusions We conclude that CQI features can be extracted from QII articles with reasonable reliability, but only a small proportion of QII articles include all features. Further consensus development is needed to support meaningful use of the term CQI for scientific communication. PMID:21727199

  3. Identifying continuous quality improvement publications: what makes an improvement intervention 'CQI'?

    Science.gov (United States)

    O'Neill, Sean M; Hempel, Susanne; Lim, Yee-Wei; Danz, Marjorie S; Foy, Robbie; Suttorp, Marika J; Shekelle, Paul G; Rubenstein, Lisa V

    2011-12-01

    The term continuous quality improvement (CQI) is often used to refer to a method for improving care, but no consensus statement exists on the definition of CQI. Evidence reviews are critical for advancing science, and depend on reliable definitions for article selection. As a preliminary step towards improving CQI evidence reviews, this study aimed to use expert panel methods to identify key CQI definitional features and develop and test a screening instrument for reliably identifying articles with the key features. We used a previously published method to identify 106 articles meeting the general definition of a quality improvement intervention (QII) from 9427 electronically identified articles from PubMed. Two raters then applied a six-item CQI screen to the 106 articles. Per cent agreement ranged from 55.7% to 75.5% for the six items, and reviewer-adjusted intra-class correlation ranged from 0.43 to 0.62. 'Feedback of systematically collected data' was the most common feature (64%), followed by being at least 'somewhat' adapted to local conditions (61%), feedback at meetings involving participant leaders (46%), using an iterative development process (40%), being at least 'somewhat' data driven (34%), and using a recognised change method (28%). All six features were present in 14.2% of QII articles. We conclude that CQI features can be extracted from QII articles with reasonable reliability, but only a small proportion of QII articles include all features. Further consensus development is needed to support meaningful use of the term CQI for scientific communication.

  4. Effectiveness of “Marital Skills training for mastectomy women” in improving marital satisfaction of husbands

    Directory of Open Access Journals (Sweden)

    Bahman Bahmani

    2017-09-01

    Full Text Available One of the health issues related to patients suffering from cancer is paying attention to mental health of the patients and their families. This research was carried out to determine the effect of teaching marital life skills for mastectomy women in the increase of marital satisfaction of this group of patients as well as its direct effect on their spouses’ satisfaction. This was a quasi-experimental research designed as pretest/posttest with random assignment and control group. 22 women suffering from breast cancer, undergoing mastectomy, treated by radiotherapy and having marital satisfaction lower than the moderate level based on the short form (40-question of the ENRICH (evaluation and nurturing relationship issues, communication and happiness questionnaire were selected via purposive sampling and divided into experimental and control groups using random assignment. The pretest was carried out on experimental and control groups and the husbands. The intervention was performed during 12 didactic sessions, two a week, for women of the experimental group in the absence of their husbands. Results indicated that the mean score of marital satisfaction in mastectomy women and their husbands in the experimental group was higher than that of the control group, and the difference was statistically significant. In conclusion, the combined intervention method used in this research was effective in increasing marital satisfaction of mastectomy women, and had also a positive effect on their husbands’ marital satisfaction.

  5. Protocol for a randomised crossover trial to evaluate patient and nurse satisfaction with electronic and elastomeric portable infusion pumps for the continuous administration of antibiotic therapy in the home: the Comparing Home Infusion Devices (CHID) study.

    Science.gov (United States)

    Hobbs, Jodie G; Ryan, Melissa K; Ritchie, Brett; Sluggett, Janet K; Sluggett, Andrew J; Ralton, Lucy; Reynolds, Karen J

    2017-07-31

    Previous studies comparing satisfaction with electronic and elastomeric infusion pumps are limited, and improvements in size and usability of electronic pumps have since occurred. The Comparing Home Infusion Devices (CHID) study plans to assess patient and nurse satisfaction with an elastomeric and electronic pump for delivering intravenous antibiotic treatment in the home. Secondary objectives are to determine pump-related complications and actual antibiotic dose administered, evaluate temperature variation and compare pump operating costs. The CHID study will be a randomised, crossover trial. A trained research nurse will recruit patients with infectious disease aged ≥18 years and prescribed ≥8 days of continuous intravenous antibiotic therapy from the Royal Adelaide Hospital (RAH) (Adelaide, Australia). Patients will be randomised to receive treatment at home via an elastomeric (Baxter Infusor) or an electronic (ambIT Continuous) infusion pump for 4-7 days, followed by the other for a further 4-7 days. Patient satisfaction will be assessed by a 10-item survey to be completed at the end of each arm. Nurse satisfaction will be assessed by a single 24-item survey. Patient logbooks and case notes from clinic visits will be screened to identify complications. Pumps/infusion bags will be weighed to estimate the volume of solution delivered. Temperature sensors will record skin and ambient temperatures during storage and use of the pumps throughout the infusion period. Costs relating to pumps, consumables, antibiotics and servicing will be determined. Descriptive statistics will summarise study data. This study has been approved by the RAH Human Research Ethics Committee (HREC/16/RAH/133 R20160420, version 6.0, 5 September 2016). Study results will be disseminated through peer-reviewed publications and conference presentations. The CHID study will provide key insights into patient and provider satisfaction with elastomeric and electronic infusion pumps and inform

  6. Improving prehospital trauma care in Rwanda through continuous quality improvement: an interrupted time series analysis.

    Science.gov (United States)

    Scott, John W; Nyinawankusi, Jeanne D'Arc; Enumah, Samuel; Maine, Rebecca; Uwitonze, Eric; Hu, Yihan; Kabagema, Ignace; Byiringiro, Jean Claude; Riviello, Robert; Jayaraman, Sudha

    2017-07-01

    Injury is a major cause of premature death and disability in East Africa, and high-quality pre-hospital care is essential for optimal trauma outcomes. The Rwandan pre-hospital emergency care service (SAMU) uses an electronic database to evaluate and optimize pre-hospital care through a continuous quality improvement programme (CQIP), beginning March 2014. The SAMU database was used to assess pre-hospital quality metrics including supplementary oxygen for hypoxia (O2), intravenous fluids for hypotension (IVF), cervical collar placement for head injuries (c-collar), and either splinting (splint) or administration of pain medications (pain) for long bone fractures. Targets of >90% were set for each metric and daily team meetings and monthly feedback sessions were implemented to address opportunities for improvement. These five pre-hospital quality metrics were assessed monthly before and after implementation of the CQIP. Met and unmet needs for O2, IVF, and c-collar were combined into a summative monthly SAMU Trauma Quality Scores (STQ score). An interrupted time series linear regression model compared the STQ score during 14 months before the CQIP implementation to the first 14 months after. During the 29-month study period 3,822 patients met study criteria. 1,028 patients needed one or more of the five studied interventions during the study period. All five endpoints had a significant increase between the pre-CQI and post-CQI periods (pRwanda. This programme may be used as an example for additional efforts engaging frontline staff with real-time data feedback in order to rapidly translate data collection efforts into improved care for the injured in a resource-limited setting. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Occupational therapy consultation for case managers in community mental health: exploring strategies to improve job satisfaction and self-efficacy.

    Science.gov (United States)

    Chapleau, Ann; Seroczynski, A D; Meyers, Susan; Lamb, Kristen; Haynes, Susan

    2011-01-01

    The purpose of this study was 2-fold: (1) to examine to what extent case managers' job satisfaction and self-efficacy were impacted by the addition of an occupational therapy consultation model and (2) to identify factors that both positively and negatively impacted the occupational therapy consultation services. The study was conducted at a mental health community support program in a local homeless center. In a 2-year study, a mixed-methods design was used to study changes over time in job satisfaction and perceived self-efficacy among 14 case managers who received ongoing occupational therapy consultation. Job satisfaction and self-efficacy data were obtained using standardized questionnaires. Qualitative data related to factors impacting the consultation program were obtained using open-ended written questions, focus groups, and individual interviews. Statistically significant differences in job satisfaction and perceptions of self-efficacy were found 18 months into the study, when case managers were more actively seeking occupational therapy consultation services and were reporting improved client outcomes from occupational therapy intervention. In addition, themes related to both positive and negative factors impacting the occupational therapy consultation program were identified and provided useful data for development of future consultation services. IMPLICATION FOR CASE MANAGEMENT PRACTICE: Results suggest that ongoing training and professional support for case managers who are paraprofessionals and/or new to mental health practice may improve job satisfaction and efficacy. Occupational therapy consultation may be helpful in developing services for health promotion, including self-care management, cognitive assessments, activity-based programming, and home safety evaluation and modification. In addition, new graduates and paraprofessional case managers working with clients who are high utilizers of services may benefit from smaller caseloads and support

  8. Using Small Tests of Change to Improve PMTCT Services in Northern Nigeria: Experiences From Implementation of a Continuous Quality Improvement and Breakthrough Series Program.

    Science.gov (United States)

    Osibo, Bamidele; Oronsaye, Frank; Alo, Oluwafemi D; Phillips, Abimbola; Becquet, Renaud; Shaffer, Nathan; Ogirima, Francis; Imarhiagbe, Collins; Ameh, Bernice; Ezebuka, Obioma; Sodzi-Tettey, Sodzi; Obi, Adaobi; Afolabi, Olusegun T; Inedu, Abutu; Anyaike, Chukwuma; Oyeledun, Bolanle

    2017-06-01

    Continuous Quality Improvement (CQI) is a process where health teams systematically collect and regularly reflect on local data to inform decisions and modify local practices and so improve delivery of services. We implemented a cluster randomized trial to examine the effects of CQI interventions on Prevention of Mother-to-Child Transmission (PMTCT) services. Here, we report our experiences and challenges establishing CQI in 2 high HIV prevalence states in northern Nigeria. Facility-based teams were trained to implement CQI activities, including structured assessments, developing change packages, and participation in periodic collaborative learning sessions. Locally evolved solutions (change ideas) were tested and measured using process data and intermediate process indicators were agreed including overall time spent accessing services, client satisfaction, and quality of data. Health workers actively participated in clinic activities and in the collaborative learning sessions. During the study, the mean difference in time spent accessing services during clinic visits increased by 40 minutes (SD = 93.4) in the control arm and decreased by 44 minutes (SD = 73.7) in the intervention arm. No significant difference was recorded in the mean client satisfaction assessment score by study arm. The quality of data was assessed using a standardized tool scored out of 100; compared with baseline data, quality at the end of study had improved at intervention sites by 6 points (95% CI: 2.0 to 10.1). Health workers were receptive to CQI process. A compendium of "change ideas" compiled into a single change package can be used to improve health care delivery.

  9. Does Person-Centered Care Improve Residents' Satisfaction With Nursing Home Quality?

    Science.gov (United States)

    Poey, Judith L; Hermer, Linda; Cornelison, Laci; Kaup, Migette L; Drake, Patrick; Stone, Robyn I; Doll, Gayle

    2017-11-01

    Person-centered care (PCC) is meant to enhance nursing home residents' quality of life (QOL). Including residents' perspectives is critical to determining whether PCC is meeting residents' needs and desires. This study examines whether PCC practices promote satisfaction with QOL and quality of care and services (QOC and QOS) among nursing home residents. A longitudinal, retrospective cohort study using an in-person survey. Three hundred twenty nursing homes in Kansas enrolled or not enrolled in a pay-for-performance program, Promoting Excellent Alternatives in Kansas (PEAK 2.0), to promote PCC in nursing homes. A total of 6214 nursing home residents in 2013-2014 and 5538 residents in 2014-2015, with a Brief Interview for Mental Status score ≥8, participated in face-to-face interviews. Results were aggregated to the nursing home level. My InnerView developed a Resident Satisfaction Survey for Kansas composed of 32 questions divided into QOL, QOC, QOS, and global satisfaction subdomains. After controlling for facility characteristics, satisfaction with overall QOL and QOC was higher in homes that had fully implemented PCC. Although some individual measures in the QOS domain (eg, food) showed greater satisfaction at earlier levels of implementation, high satisfaction was observed primarily in homes that had fully implemented PCC. These findings provide evidence for the effectiveness of PCC implementation on nursing home resident satisfaction. The PEAK 2.0 program may provide replicable methods for nursing homes and states to implement PCC systematically. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  10. 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...

  11. 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.

  12. 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.

  13. 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.

  14. [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.

  15. 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…

  16. Organizational structure and continuous improvement and learning: Moderating effects of cultural endorsement of participative leadership

    OpenAIRE

    Xiaowen Huang; Joseph C Rode; Roger G Schroeder

    2011-01-01

    Building upon the culturally endorsed implicit theory of leadership, we investigated the moderating effects of national culture on the relationship between organizational structure and continuous improvement and learning. We propose that the relationship between organic organizations (characterized by flat, decentralized structures with a wide use of multifunctional employees) and continuous improvement and learning will be stronger when national cultural endorsement for participative leaders...

  17. Provider-Initiated Patient Satisfaction Reporting Yields Improved Physician Ratings Relative to Online Rating Websites.

    Science.gov (United States)

    Ricciardi, Benjamin F; Waddell, Brad S; Nodzo, Scott R; Lange, Jeffrey; Nocon, Allina A; Amundsen, Spencer; Tarity, T David; McLawhorn, Alexander S

    2017-09-01

    Recently, providers have begun to publicly report the results of patient satisfaction surveys from their practices. However, these outcomes have never been compared with the findings of commercial online physician rating websites. The goals of the current study were to (1) compare overall patient satisfaction ratings for orthopedic surgeons derived from provider-based third-party surveys with existing commercial physician rating websites and (2) determine the association between patient ratings and provider characteristics. The authors identified 12 institutions that provided publicly available patient satisfaction outcomes derived from third-party surveys for their orthopedic surgeons as of August 2016. Orthopedic surgeons at these institutions were eligible for inclusion (N=340 surgeons). Provider characteristics were recorded from publicly available data. Four high-traffic commercial online physician rating websites were identified: Healthgrades.com, UCompareHealthCare.com, Vitals.com, and RateMDs.com. For each surgeon, overall ratings (on a scale of 1-5), total number of ratings, and percentage of negative ratings were compared between provider-initiated internal ratings and each commercial online website. Associations between baseline factors and overall physician ratings and negative ratings were assessed. Provider-initiated internal patient satisfaction ratings showed a greater number of overall patient ratings, higher overall patient satisfaction ratings, and a lower percentage of negative comments compared with commercial online physician rating websites. A greater number of years in practice had a weak association with lower internal ratings, and an academic practice setting and a location in the Northeast were protective factors for negative physician ratings. Compared with commercial online physician rating websites, provider-initiated patient satisfaction ratings of orthopedic surgeons appear to be more favorable, with greater numbers of responses

  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. 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.

  20. 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…

  1. An Assessment of Customer Satisfaction: Using Patient Information for Quality Improvement Tripler Army Medical Center Hawaii

    Science.gov (United States)

    1993-05-01

    consumers . The primary external customers of a hospital are the patients , third party...34ultimate consumer " of health care -- the patient (Labovitz, 1991). Therefore, this study focused on the " patient " as the basis for measuring the needs...overlooked. Measuring Customer Satisfaction McMillan (1987) cautions health care organizations that the lack of patient complaints does not necessarily

  2. 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…

  3. 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…

  4. 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…

  5. 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.

  6. 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.

  7. 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

    ' rehabilitation course. OUTCOME MEASURES: 6 months after inclusion of the patient, patient satisfaction with their GP during the last 12 months in five different dimensions of GP care was assessed using the Danish version of the EuroPEP (European Patients Evaluate General Practice Care) questionnaire (DanPEP). 14....... Subgroup analysis of the patients with breast cancer showed statistically significant improvement of satisfaction with the GP in two of the five DanPEP dimensions. CONCLUSIONS: This complex intervention aiming at improving GPs' services in cancer rehabilitation had no impact on patient satisfaction. TRIAL...

  8. 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.

  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. 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...

  11. An application of TOPSIS for selection of appropriate e-Governance practices to improve customer satisfaction

    Directory of Open Access Journals (Sweden)

    Ajinkya Joshi

    2017-08-01

    Full Text Available E-governance practices and standardization of processes are significant factors affecting the per-formance of government organizations and undertakings in India. Customer is the backbone of any organization and customer satisfaction is the key for ensuring the success. Using a multiple-criteria decision analysis method named TOPSIS, we attempt to study the impact of e-governance practices on customer satisfaction of Maharashtra Housing and Area Development Authority (MHADA. The method determines the ranking and contribution of different elements in an attempt to determine a suitable strategy for every customer segment. Results show that cus-tomers belonging to Higher Income Group (HIG and Middle Income Group (MIG are more satisfied with the Online Mitra Service while the customers of Lower Income Group (LIG and Economic Weaker Section (EWS are more inclined towards Process Standardization. In order to remove bias and obtain fairly accurate results the data were collected through questionnaire from every customer segment.

  12. Patient perspectives of patient-controlled analgesia (PCA) and methods for improving pain control and patient satisfaction.

    Science.gov (United States)

    Patak, Lance S; Tait, Alan R; Mirafzali, Leela; Morris, Michelle; Dasgupta, Sunavo; Brummett, Chad M

    2013-01-01

    This study aimed to (1) identify patient-controlled analgesia (PCA) attributes that negatively impact patient satisfaction and ability to control pain while using PCA and (2) obtain data on patient perceptions of new PCA design features. We conducted a prospective survey study of postoperative pain control among patients using a PCA device. The survey was designed to evaluate patient satisfaction with pain control, understanding of PCA, difficulties using PCA, lockout-period management, and evaluation of new PCA design features. A total of 350 eligible patients completed the survey (91%). Patients who had difficulties using PCA were less satisfied (P PCA. Forty-nine percent of patients reported not knowing if they would receive medicine when they pushed the PCA button, and of these, 22% believed that this uncertainty made their pain worse. The majority of patients preferred the proposed PCA design features for easier use, including a light on the button, making it easier to find (57%), and a PCA button that vibrates (55%) or lights up (70%), alerting the patient that the PCA pump is able to deliver more medicine. A majority of patients, irrespective of their satisfaction with PCA, preferred a new PCA design. Certain attributes of current PCA technology may negatively impact patient experience, and modifications could potentially address these concerns and improve patient outcomes.

  13. How to improve innovation practice through the rise of job satisfaction ?

    OpenAIRE

    Biner, Anton Josh

    2015-01-01

    Nowadays, companies are facing difficult times, where in order to survive they have to adapt their processes to the volatile environment. Therefore, such organisations have to innovate wherever is possible to achieve a sustainable competitive advantage. There exist many kinds of innovations that can be analysed from different perspectives. It is clear, that job satisfaction has a positive influence on how a company is able to innovate. Therefore, this study examines the optimum ways in which ...

  14. Job Satisfaction

    African Journals Online (AJOL)

    Administrator

    Job Satisfaction: Rural Versus Urban Primary Health Care Workers'. Perception in ... doing it well, and being suitably rewarded for one's efforts. Several ... community recognition of their work and improved staff relationship. ..... study found important differences about attractors to ... their work, work-life balance, bureaucracy.

  15. Analysis of Patient's Satisfaction with Phlebotomy Services in NABH Accredited Neuropsychiatric Hospital: An Effective Tool for Improvement.

    Science.gov (United States)

    Gupta, Anshu; Dwivedi, Tanima; Sadhana; Chaudhary, Raju

    2017-09-01

    Patient's satisfaction is the need of the hour and one of the most important quality indicators in the laboratory medicine. To assess the patient's satisfaction with phlebotomy services in a neuropsychiatric hospital by a structured questionnaire with grading scale. Also, identify the problems causing dissatisfactions and to undertake necessary Corrective and Preventative Action (CAPA). Total 1200 patients were randomly selected over a period of two months (June and July 2016). A structured self designed questionnaire (feedback form) was devised in both Hindi and English languages containing ten questions with a grading scale for each question. It also included suggestions from the users. All the selected patients or their attendants filled up this questionnaire. At the same time, they were also interviewed by phlebotomy staff. A statistical analysis was conducted using SPSS version 16.0 software and Likert scale. A total of 94% of the patients were satisfied with the phlebotomy services. Almost 30.0% patients found the phlebotomy services to be very good, but the majority of them (40.5%) found it to be good and another 23.5% found it to be satisfactory while, 4% found the services to be poor and 2% found it to be very poor. The highest rate of satisfaction (4.21) was noted in case of parameter-ease to find collection sample room and lowest rate of satisfaction (3.92) was scored by the parameter-staff's wearing proper uniform. Depending upon the deficient areas some corrective actions were suggested such as strict compliance of personal protective equipments, regular training to improve technical skill, knowledge and behaviour with emphasis on cleanliness of work area. Even though the overall patient's satisfaction was high, there were areas which needed our attention such as waiting time for phlebotomy procedure, lack of proper sitting arrangement, techniques of sample collection, knowledge of universal precautions etc. Appropriate corrective and preventive

  16. 78 FR 69018 - Improving the Resiliency of Mobile Wireless Communications Networks; Reliability and Continuity...

    Science.gov (United States)

    2013-11-18

    ... consumers value overall network reliability and quality in selecting mobile wireless service providers, they...-125] Improving the Resiliency of Mobile Wireless Communications Networks; Reliability and Continuity... (Reliability NOI) in 2011 to ``initiate a comprehensive examination of issues regarding the reliability...

  17. Government/contractor partnerships for continuous improvement. A Goddard Space Flight Center example

    Science.gov (United States)

    Tagler, Richard C.

    1992-01-01

    The efforts of a government organization and its major contractors to foster a continuous improvement environment which transcends the traditional government/contractor relationship is discussed. This relationship is aimed at communication, partnership, and trust - creating benefits for all involved.

  18. 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

  19. 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.

    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

  20. Examining the Impact of Patient-Reported Hope for Improvement and Patient Satisfaction with Clinician/Treatment on the Outcome of Major Depressive Disorder Treatment.

    Science.gov (United States)

    IsHak, Waguih William; Vilhauer, Jennice; Kwock, Richard; Wu, Fan; Gohar, Sherif; Collison, Katherine; Thomas, Shannon Nicole; Naghdechi, Lancer; Elashoff, David

    This analysis aims at examining if patient-reported variables such as hope for improvement and patient satisfaction with clinician/treatment could influence the outcome major depressive disorder (MDD) treatment, namely depression remission, in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial. Retrospective cohort study. The STAR*D study was conducted at 18 primary care and 23 psychiatric care settings in the United States from 2001-2007 and was funded by the National Institute of Mental health (NIMH). The analysis contained in this manuscript was conceptualized at the Cedars-Sinai Department of Psychiatry and Behavioral Neurosciences and performed at the UCLA School of Public Health. Using data from STAR*D, the current study used logistic regression and survival analyses to examine the relationship between depressive symptoms remission and two sets of self-reported factors: Hope for improvement and, Patient satisfaction with treatment/clinician. First, more than 90% of STAR*D patients reported having high hope for improvement (agree or strongly agree) and more than 66% endorsed high satisfaction with clinicians and more than 50% expressed high satisfaction with treatments (very or mostly satisfied). Second, hope for improvement was predictive of depression remission (pdepression remission in contrast to satisfaction with clinician/treatment. Future studies should prospectively incorporate patients' subjective attitudes regarding hope for improvement and satisfaction with clinicians and treatments as mediators and moderators of MDD treatment success.

  1. Impact of a hospital improvement initiative in Bangladesh on patient experiences and satisfaction with services: two cross-sectional studies

    Directory of Open Access Journals (Sweden)

    Omer Khalid

    2011-12-01

    Full Text Available Abstract Background The Bangladesh government implemented a pilot Hospital Improvement Initiative (HII in five hospitals in Sylhet division between 1998 and 2003. This included management and behaviour change training for staff, waste disposal and procurement, and referral arrangements. Two linked cross-sectional surveys in 2000 and 2003 assessed the impact of the HII, assessing both patients' experience and satisfaction and public views and use of the hospitals. Methods In each survey we asked 300 consecutive outpatients and a stratified random sample of 300 inpatients in the five hospitals about waiting and consultation time, use of an agent for admission, and satisfaction with privacy, cleanliness, and staff behaviour. The field teams observed cleanliness and privacy arrangements, and visited a sample of households in communities near the hospitals to ask about their opinions and use of the hospital services. Analysis examined changes over time in patients' experience and views. Multivariate analysis took account of other variables potentially associated with the outcomes. Survey managers discussed the survey findings with gender stratified focus groups in each sample community. Results Compared with 2000, an outpatient in three of the hospitals in 2003 was more likely to be seen within 10 minutes and for at least five minutes by the doctor, but outpatients were less likely to report receiving all the prescribed medicines from the hospital. In 2003, inpatients were more likely to have secured admission without using an agent. Although patients’ satisfaction with several aspects of care improved, most changes were not statistically significant. Households in 2003 were significantly more likely to rate the hospitals as good than in 2000. Use of the hospitals did not change, except that more households used the medical college hospital for inpatient care in 2003. Focus groups confirmed criticisms of services and suggested improvements

  2. 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.

  3. Improving critical thinking and clinical reasoning with a continuing education course.

    Science.gov (United States)

    Cruz, Dina Monteiro; Pimenta, Cibele Mattos; Lunney, Margaret

    2009-03-01

    Continuing education courses related to critical thinking and clinical reasoning are needed to improve the accuracy of diagnosis. This study evaluated a 4-day, 16-hour continuing education course conducted in Brazil.Thirty-nine nurses completed a pretest and a posttest consisting of two written case studies designed to measure the accuracy of nurses' diagnoses. There were significant differences in accuracy from pretest to posttest for case 1 (p = .008) and case 2 (p = .042) and overall (p = .001). Continuing education courses should be implemented to improve the accuracy of nurses' diagnoses.

  4. Using a multimedia presentation to improve patient understanding and satisfaction with informed consent for minimally invasive vascular procedures.

    Science.gov (United States)

    Bowers, N; Eisenberg, E; Montbriand, J; Jaskolka, J; Roche-Nagle, G

    2017-02-01

    As vascular procedures become more complex, patient understanding of their treatment(s) can become more difficult. We wished to evaluate the utility of multimedia presentations (MPs) to improve patient understanding of their vascular interventions. Patients undergoing endovascular aneurysm repair (EVAR), peripheral angioplasty, Hickman catheter and peripherally inserted central catheter (PICC) insertion were randomized into a control group receiving traditional verbal consent, and a MP group that were shown a two minute simplified video of their procedure on an iPad™ computer in addition to the traditional verbal consent. After obtaining consent, all patients completed a questionnaire assessing their comprehension of the procedure, and satisfaction with the consent process. Satisfaction was rated on a 5 point Likert scale with 5 being 'very helpful' in understanding the procedure. Ninety-three patients were recruited for this study, 62% of which were male. The intervention significantly increased total comprehension in all procedure types controlling for procedure type (multimedia vs. control; F = 9.14, P = .003). A second ANOVA showed there was a significant main effect by intervention (F = 44.06, p consent process to be helpful in patient understanding and that there is improved satisfaction. Given the rapid rate of innovation in vascular interventions, increased regular use of MPs to help patients understand their procedures would be beneficial in the care of patients undergoing vascular interventions. Copyright © 2015 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  5. 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.

  6. 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…

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

    NARCIS (Netherlands)

    Benders, J.G.J.M.; Bleijerveld, H.; Schouteten, R.L.J.

    2017-01-01

    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

  8. Using Surveys of Students' Social-Emotional Learning and School Climate for Accountability and Continuous Improvement

    Science.gov (United States)

    Hough, Heather; Kalogrides, Demetra; Loeb, Susanna

    2017-01-01

    The research featured in this paper is part of the CORE-PACE Research Partnership, through which Policy Analysis for California Education (PACE) has partnered with the CORE districts to conduct research designed to support them in continuous improvement while simultaneously helping to improve policy and practice in California and nationwide.…

  9. 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…

  10. 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.

  11. Identifying elements of job satisfaction to improve retention rates in healthcare.

    Science.gov (United States)

    Lamberth, Becky; Comello, Robert J

    2005-01-01

    According to the American Hospital Association, by the year 2010, the United States will need 1,000,000 qualified nurses to care for patients, an additional 75,000 licensed radiologic technologists, and several other ancillary medical staff employees. A number of health professionals question why there is such a significant shortage--especially considering that many facilities; are implementing cost initiatives and insurance companies are decreasing the length of patient hospital stays. One specific factor may not be fully appreciated: Although the length of stay is decreasing,the acuity level of the patient is increasing. The number and types of available opportunities also contribute to the staffing shortage. Hospitals and healthcare facilities are now working diligently to address the crisis and answer that one very important question: How can they keep employees satisfied and willing commit long-term to the organization? This review focuses on identifying those key variables of job satisfaction that will lead to long-term retention of healthcare workers, including money, work environment, performance feedback, advancement opportunities, group cohesion, and relationships with management. It also discusses the effects of demographic characteristics such as age and gender on job satisfaction.

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

    Science.gov (United States)

    Sajid, Muhammad R.; Abothenain, Fayha; Salam, Yezan; AlJayar, Dina; Obeidat, Akef

    2016-01-01

    Objectives To evaluate student academic performance and perception towards blended learning and flipped classrooms in comparison to traditional teaching. Methods 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. Results 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. Conclusions 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.  PMID:27591930

  13. RESEARCH ON CUSTOMER SATISFACTION DEGREE AT THE STORE MOBEXPERT PITEŞTI, IN ORDER TO IMPROVE THE SALES RESULTS

    Directory of Open Access Journals (Sweden)

    BRUTU MĂDĂLINA

    2015-07-01

    Full Text Available This paper presents a detailed research of customer satisfaction at the store Mobexpert Pitesti, in order to identify the main causes that led to their possible dissatisfaction. Starting from these results, the paper also aims at identifying a range of solutions designed to improve sales activity. Therefore we defined the research purpose and objectives, designed the questionnaire, defined the variables and established the research hypotheses. The sample of research consisted of the customers of the store Mobexpert Pitesti, men and women aged between 18 and over 55, with middle, high and very high incomes. A single operator collected the data inside Mobexpert Piteşti for two days, using a 3 minute questionnaire. Analyzing the research results, we conclude that there is a high degree of customer satisfaction for the store Mobexpert Piteşti, that it can be further increased by applying the following improvement directions: increasing service quality, better customer understanding, training the sales force through e-learning, motivating the sales force more effectively through a satisfactory system of salaries and bonuses and, not least, increasing the impact of marketing actions.

  14. Three success factors for continual improvement in healthcare: an analysis of the reports of improvement team members.

    Science.gov (United States)

    Brandrud, Aleidis Skard; Schreiner, Ada; Hjortdahl, Per; Helljesen, Gro Sævil; Nyen, Bjørnar; Nelson, Eugene C

    2011-03-01

    The objectives of the Breakthrough Series Collaborative are to close the gap between what we know and what we do, and to contribute to continuous quality improvement (CQI) of healthcare through collaborative learning. The improvement efforts are guided by a systematic approach, combining professional and improvement knowledge. To explore what the improvement teams have learnt from participating in the collaborative and from dealing with promoting and inhibiting factors encountered. Qualitative interviews with 19 team members were conducted in four focus groups, using the Critical Incident Technique. A critical incident is one that makes significant contributions, either positively or negatively, to an activity. The elements of a culture of improvement are revealed by the critical incidents, and reflect the eight domains of knowledge, as a product of collaborative learning. The improvement knowledge and skills of individuals are important elements, but not enough to achieve sustainable changes. 90% of the material reflects the need for a system of CQI to solve the problems that organisations experience in trying to make lasting improvements. A pattern of three success factors for CQI emerges: (1) continuous and reliable information, including measurement, about best and current practice; (2) engagement of everybody in all phases of the improvement work: the patient and family, the leadership, the professional environment and the staff; and (3) an infrastructure based on improvement knowledge, with multidisciplinary teams, available coaching, learning systems and sustainability systems.

  15. [Application of a continual improvement approach to selecting diagnostic markers for acute pancreatitis in an emergency department].

    Science.gov (United States)

    Salinas, María; Flores, Emilio; López-Garrigós, Maite; Díaz, Elena; Esteban, Patricia; Leiva-Salinas, Carlos

    2017-01-01

    To apply a continual improvement model to develop an algorithm for ordering laboratory tests to diagnose acute pancreatitis in a hospital emergency department. Quasi-experimental study using the continual improvement model (plan, do, check, adjust cycles) in 2 consecutive phases in emergency patients: amylase and lipase results were used to diagnose acute pancreatitis in the first phase; in the second, only lipase level was first determined; amylase testing was then ordered only if the lipase level fell within a certain range. We collected demographic data, number amylase and lipase tests ordered and the findings, final diagnosis, and the results of a questionnaire to evaluate satisfaction with emergency care. The first phase included 517 patients, of whom 20 had acute pancreatitis. For amylase testing sensitivity was 0.70; specificity, 0.85; positive predictive value (PPV), 17; and negative predictive value (NPV), 0.31. For lipase testing these values were sensitivity, 0.85; specificity, 0.96; PPV, 21, and NPV, 0.16. When both tests were done, sensitivity was 0.85; specificity 0.99; PPV, 85; and NPV, 0.15. The second phase included data for 4815 patients, 118 of whom had acute pancreatitis. The measures of diagnostic yield for the new algorithm were sensitivity, 0.92; specificity, 0.98; PPV, 46; and NPV, 0.08]. This study demonstrates a process for developing a protocol to guide laboratory testing in acute pancreatitis in the hospital emergency department. The proposed sequence of testing for pancreatic enzyme levels can be effective for diagnosing acute pancreatitis in patients with abdominal pain.

  16. CONTINUOUS QUALITY IMPROVEMENT (CQI FRAMEWORK: A CASE OF INDUSTRIAL ENGINEERING DEPARTMENT

    Directory of Open Access Journals (Sweden)

    Tooba Sikander

    2017-06-01

    Full Text Available This paper aims to present an educational framework for outcomes based continuous quality improvement. Well defined program outcomes, program educational objectives and assessment process have been developed to ensure graduates’ outcomes achievement. Direct and indirect tools have been used for assessment process. Course evaluation surveys, alumni surveys, and employer surveys have been deployed for indirect outcome assessment. Exams, quizzes, assignments and projects, on the other hand, have been used for direct outcome assessment. In developed framework, the educational processes committees and facilities committees have been integrated to continuously evaluate and monitor the educational processes. Furthermore, program outcomes and course learning outcomes are proposed to be evaluated and continuously monitored by programs goals committee and continuous course improvement committee respectively. Forms and procedures have been developed to assess student outcomes.

  17. Durable improvements in efficiency, safety, and satisfaction in the operating room.

    Science.gov (United States)

    Heslin, Martin J; Doster, Barbara E; Daily, Sandra L; Waldrum, Michael R; Boudreaux, Arthur M; Smith, A Blair; Peters, Glenn; Ragan, Debbie B; Buchalter, Scott; Bland, Kirby I; Rue, Loring W

    2008-05-01

    Enhanced productivity and efficiency in the operating room must be balanced with patient safety and staff satisfaction. In December 2004, transition to an expanded replacement hospital resulted in mandatory overtime, unpredictable work hours, and poor morale among operating room (OR) staff. A staff-retention crisis resulted, which threatened the viability of the OR and the institution. We report the changes implemented to efficiently deliver safe patient care in a supportive environment for surgeons and OR staff. University of Alabama at Birmingham University Hospital OR data were evaluated for fiscal year 2004 and compared with fiscal years 2005 and 2006. Case volumes, number of operational ORs, and on-time case starts were evaluated. OR adverse events were tabulated. Percentage of registered nurse hires and staff departures served as a proxy for staff satisfaction. Short, intermediate, and longterm strategies were implemented by an engaged OR management committee with the guidance of surgical, anesthesia, and hospital leadership. These included new block time release policies; use of traveling nurses until new staff could be hired and trained; and incentive-based, voluntary, employee-scheduled overtime. Mandatory nursing education time was blocked weekly. Enforcement of the National Patient Safety Goals were implemented and adjudicated with a "surgeon-of-the-day" system providing backup for nurse management. We demonstrated an increase in operations per year, on-time starts, and registered nurse hires in fiscal years 2005 and 2006. During this same time, we were able to markedly decrease the number of adverse events, admitting delays, and staff departures. Change is difficult to accept but essential when vital clinical activities are impaired and at risk. To maintain important clinical environments like the OR in an academic center, we developed and implemented effective, data-driven changes. This allowed us to retain critical human resources and restore a

  18. 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...

  19. Visual Acuity Improvement in Continuous vs Divided Occlusion in Anisometropic Amblyopia.

    Science.gov (United States)

    Irfani, Irawati; Feriyanto, Feri; Oktarima, Primawita; Kartasasmita, Arief

    2018-01-01

    To compare visual acuity improvement between continuous and split part-time occlusion for the treatment of moderate and severe anisometropic amblyopia. Randomised clinical trials in 6 - 13 y.o children with moderate and severe anisometropic amblyopia. Each patient was consecutively selected with continuous or split part-time occlusion. Best corrected visual acuity's improvement was followed up to six weeks and statistical data were analyzed using chi square and unpaired t-test. Best corrected visual acuity's improvement was comparable between continuous and split part-time occlusion (0.20±0.27 vs 0.21±0.25; p = 0.79). Split part-time occlusion may be considered as an alternative treatment for moderate and severe anisometropic amblyopia treatment.

  20. A modified Continuous Quality Improvement approach to improve culturally and socially inclusive care within rural health services.

    Science.gov (United States)

    Mitchell, Olivia; Malatzky, Christina; Bourke, Lisa; Farmer, Jane

    2018-03-23

    The sickest Australians are often those belonging to non-privileged groups, including Indigenous Australians, gay, lesbian, bisexual, transsexual, intersex and queer people, people from culturally and linguistically diverse backgrounds, socioeconomically disadvantaged groups, and people with disabilities and low English literacy. These consumers are not always engaged by, or included within, mainstream health services, particularly in rural Australia where health services are limited in number and tend to be generalist in nature. The aim of this study was to present a new approach for improving the sociocultural inclusivity of mainstream, generalist, rural, health care organisations. This approach combines a modified Continuous Quality Improvement framework with Participatory Action Research principles and Foucault's concepts of power, discourse and resistance to develop a change process that deconstructs the power relations that currently exclude marginalised rural health consumers from mainstream health services. It sets up processes for continuous learning and consumer responsiveness. The approach proposed could provide a Continuous Quality Improvement process for creating more inclusive mainstream health institutions and fostering better engagement with many marginalised groups in rural communities to improve their access to health care. The approach to improving cultural inclusion in mainstream rural health services presented in this article builds on existing initiatives. This approach focuses on engaging on-the-ground staff in the need for change and preparing the service for genuine community consultation and responsive change. It is currently being trialled and evaluated. © 2018 National Rural Health Alliance Ltd.

  1. Effect of musculoskeletal pain of care workers on job satisfaction.

    Science.gov (United States)

    Kim, DeokJu

    2018-01-01

    [Purpose] The purpose of this study was to examine the musculoskeletal pain of care workers and investigate its effect on their job satisfaction. [Subjects and Methods] Subjects were 87 care workers working at C elderly care service center in P region. The average age of men was 62.5 ± 3.4 years and that of women was 57.3 ± 2.7 years. The 'Guidelines for Risk Factor Survey on Tasks with Musculoskeletal Burden' of the KOSHA CODE (H-30-2003) of the Korea Occupational Safety and Health Agency (KOSHA) was used for measurement of musculoskeletal pain. This survey tool for job satisfaction consisted of 12 questions including the areas of wage satisfaction, professional satisfaction, job performance satisfaction, and relationship satisfaction. [Results] Study results showed that musculoskeletal pain varied depending on professional satisfaction, job performance satisfaction, and relationship satisfaction. The correlation between the areas of musculoskeletal pain and job satisfaction was examined and the following was revealed. Professional satisfaction was correlated with arm/elbow pain and lower back pain, job performance satisfaction with lower back pain, and relationship satisfaction with shoulder pain and lower back pain. [Conclusion] In this study, subjects were older and could have been easily exposed to diseases because of their age. To improve job efficiency among care workers, continuing education related to the job should take precedence. In addition, social support is required that can alleviate the heavy workload related to physical activity support, which is among the responsibilities of care workers. Moreover, application standards and coverage of industrial insurance for the treatment of musculoskeletal disorders of care workers should be extended further to relieve the burden of medical costs. A series of such measures will have a positive effect on improving the job satisfaction of care workers.

  2. Customer satisfaction research

    Energy Technology Data Exchange (ETDEWEB)

    Tormasi, T

    1987-03-01

    A review of four aspects of the Gas and Fuel Corporation of Victoria's study of customer satisfaction covers: (1) corporate goals to meet its responsibility as a public utility and operate as a successful marketing organization, (2) the history of customer satisfaction research by GFC, (3) measurements of customer satisfaction through expectations research, and (4) case studies involving domestic appliance maintenance and gas mains renewal. Continuous validation of GFC's policies and procedures is the basis for future growth and success. 3 tables.

  3. An integrated approach to hospital strategic planning, quality assurance, and continuous quality improvement.

    Science.gov (United States)

    Day, G; Gardner, S; Herba, C

    1995-01-01

    Like many other healthcare organizations today, the authors' facility, a 306-bed acute care community hospital in Michigan, strives to visualize and make a transition from traditional quality assurance to continuous quality improvement. The Juran Trilogy provided the insight that strategic planning, measurement, and continuous improvement must exist side by side. At the authors' facility, this realization resulted in the hospital quality plan, which treats each of these components as part of the foundation for quality. The authors explain this model and the reporting and communication mechanisms that support it.

  4. PDCA cycle as a part of continuous improvement in the production company - a case study

    Directory of Open Access Journals (Sweden)

    Marta Jagusiak-Kocik

    2017-04-01

    Full Text Available The paper presents a case study of the practical use of Deming cycle in a manufacturing company, from the plastics processing industry, from the sector of small and medium-sized enterprises. The paper is a study of literature in the field of continuous improvement and characterized by a cycle of continuous improvement, called the Deming cycle, or PDCA cycle. This cycle was used as a solution to quality problems which occurred during production of photo frames: discolorations and scorches on the surface of the frame. When measures were introduced to reduce the number of nonconformities, a decrease by more than 60% was observed.

  5. The continuous improvement system of nuclear power plant of Laguna Verde

    International Nuclear Information System (INIS)

    Rivera C, A.

    2009-10-01

    This paper describes the continuous improvement system of nuclear power plant of Laguna Verde and the achievements in implementing the same and additionally two study cases are presents. In February 2009 is noteworthy because the World Association of Nuclear Operators we identified as a learning organization, qualification which shows that the continuous improvement system has matured, and this system will expose as I get to learn to capitalize on our own experiences and external experiences diffused by the nuclear industry. In 2007 the management of nuclear power plants integrates its improvement systems and calls it continuous improvement system and is presented in the same extensive report that won the National Quality Award. This system is made up of 5 subsystems operating individually and are also related 1) human performance; 2) referential comparison or benchmarking; 3) self-assessment; 4) corrective action and 5) external operating experience. Five subsystems that plan, generate, capture, manage, communicate and protect the knowledge generated during the processes execution of nuclear power plant of Laguna Verde, as well as from external sources. The target set in 2007 was to increase the intellectual capital to always give response to meeting the security requirements, but creating a higher value to quality, customer, environment protection and society. In brief each of them, highlighting the objective, expectations management, implementation and some benefits. At the end they will describe two study cases selected to illustrate these cases as the organization learns by their continuous improvement system. (Author)

  6. Continuing medical education, continuing professional development, and knowledge translation: improving care of older patients by practicing physicians.

    Science.gov (United States)

    Thomas, David C; Johnston, Bree; Dunn, Kathel; Sullivan, Gail M; Brett, Belle; Matzko, Marilyn; Levine, Sharon A

    2006-10-01

    Many community-based internists and family physicians lack familiarity with geriatrics knowledge and best practices, but they face overwhelming fiscal and time barriers to expanding their skills and improving their behavior in the care of older people. Traditional lecture-and-slide-show continuing medical education (CME) programs have been shown to be relatively ineffective in changing this target group's practice. The challenge for geriatrics educators, then, is to devise CME programs that are highly accessible to practicing physicians, that will have an immediate and significant effect on practitioners' behavior, and that are financially viable. Studies of CME have shown that the most effective programs for knowledge translation in these circumstances involve what is known as active-mode learning, which relies on interactive, targeted, and multifaceted techniques. A systematic literature review, supplemented by structured interviews, was performed to inventory active-mode learning techniques for geriatrics knowledge and skills in the United States. Thirteen published articles met the criteria, and leaders of 28 active-mode CME programs were interviewed. This systematic review indicates that there is a substantial experience in geriatrics training for community-based physicians, much of which is unpublished and incompletely evaluated. It appears that the most effective methods to change behaviors involved multiple educational efforts such as written materials or toolkits combined with feedback and strong communication channels between instructors and learners.

  7. Modifying the Toyota Production System for continuous performance improvement in an academic children's hospital.

    Science.gov (United States)

    Stapleton, F Bruder; Hendricks, James; Hagan, Patrick; DelBeccaro, Mark

    2009-08-01

    The Toyota Production System (TPS) has become a successful model for improving efficiency and eliminating errors in manufacturing processes. In an effort to provide patients and families with the highest quality clinical care, our academic children's hospital has modified the techniques of the TPS for a program in continuous performance improvement (CPI) and has expanded its application to educational and research programs. Over a period of years, physicians, nurses, residents, administrators, and hospital staff have become actively engaged in a culture of continuous performance improvement. This article provides background into the methods of CPI and describes examples of how we have applied these methods for improvement in clinical care, resident teaching, and research administration.

  8. Management of continual improvement for facilities and activities: A structured approach

    International Nuclear Information System (INIS)

    2006-04-01

    In recent years there has been an upward trend in the safety and operational performance of nuclear installations. Safe, efficient operation is their goal. Continual improvement of the processes of organizations has led to enhanced safety performance and efficiency benefits such as cost reductions and improved cycle times. Many organizations have experienced significant cost improvement largely by or through better financial management and a common drive to reduce costs brought on by commercial pressures. Without the use of a structured methodology to identify and implement improvements, changes to an organization to reduce costs through cutting staff and activities could eventually fail to produce the desired changes and even have a negative effect on safety and overall performance. The following fundamental principles are considered essential to the effective introduction of structured continual improvement: - Long term commitment from senior management throughout the entire organization; - The implementation in the organization of a process management approach such as that advocated by IAEA Safety Standards, ISO 9001, Malcolm Baldridge National Quality Award and European Foundation for Quality Management Business Excellence model; - The alignment of the processes with the objectives of the organization through the organization's business plan; - The utilization by Management of the process information as an input to managing the organization; - The employment of the information derived from the process performance to identify and prioritize the processes that require improvement; - The active participation of all staff of the organization to using its processes in order to contribute to continual process improvement (CPI). This publication defines a structured approach for continual improvement and focuses on the way an organization can improve its processes. It is recognized that there are many different approaches and methods available in the marketplace to

  9. Continuous Improvement and Employee Engagement, Part 2: Design, Implementation, and Outcomes of a Daily Management System.

    Science.gov (United States)

    Maurer, Marsha; Browall, Pamela; Phelan, Cynthia; Sanchez, Sandra; Sulmonte, Kimberlyann; Wandel, Jane; Wang, Allison

    2018-04-01

    A daily management system (DMS) can be used to implement continuous quality improvement and advance employee engagement. It can empower staff to identify problems in the care environment that impact quality or work flow and to address them on a daily basis. Through a DMS, improvement becomes the work of everyone, every day. The authors of this 2-part series describe their work to develop a DMS. Part 2 describes the implementation and outcomes of the program.

  10. Can there be mutual support between hospital marketing and continuous quality improvement?

    Science.gov (United States)

    Weiland, D E

    1992-01-01

    Marketing the results of continuous quality improvement in hospitals builds a growing bank of loyal customers in an increasingly competitive and quality-oriented environment: If healthcare institutions want to survive and flourish, they must develop a lasting relationship with their customers. The long-term goal of CQI is to provide quality products and services. If marketing managers can sell these improved services, hospitals will build a solid client foundation.

  11. Improved nurse job satisfaction and job retention with the transition from a "mandatory consultation" model to a "semiclosed" surgical intensive care unit: a 1-year prospective evaluation.

    Science.gov (United States)

    Haut, Elliott R; Sicoutris, Corinna P; Meredith, Denise M; Sonnad, Seema S; Reilly, Patrick M; Schwab, C William; Hanson, C William; Gracias, Vicente H

    2006-02-01

    The change from a "mandatory consultation" to a "semiclosed" surgical intensive care unit (SICU) model will impact nurses considerably. We hypothesize that nurse job satisfaction, job turnover rates, and hospital costs for temporary agency nurses will improve and these improvements will be more dramatic in SICU sections with greater involvement of a dedicated surgical critical care service (SCCS). Prospective longitudinal survey. Tertiary-care university hospital. SICU staff nurses. Change from mandatory consultation to semiclosed SICU. We surveyed SICU nurses during the year-long transition to a semiclosed SICU service (five time points, 3-month intervals). The first four surveys included ten questions on nurse job satisfaction. The final survey included two additional questions. All questions were on a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree). Nurse job turnover rates and money spent on agency nurses were compared over time; 503 of a possible 914 surveys were completed (55% overall return rate). Nurse job satisfaction scores significantly improved over time for all questions (p job turnover rate dropped from 25% to 16% (p = .15). The scores for both year-end statements ("I am more satisfied with my job now than 1 year ago" and "The SCCS management of all orders has improved my job satisfaction") were significantly higher in sections with greater SCCS involvement (p = .0070 and p job satisfaction improved significantly with the transition to a semiclosed SICU. This higher satisfaction was associated with a significant decrease in spending on temporary agency nurses and a trend toward increased staff nurse job retention. SICU sections with greater SCCS involvement had more dramatic improvements. This semiclosed SICU model may help retain SICU nurses in a competitive job market in which experienced nurses are in short supply.

  12. 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...

  13. 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…

  14. (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…

  15. Continuous Improvement: A Way of Integrating Student Enrollment, Advising, and Retention Systems in a Metropolitan University.

    Science.gov (United States)

    Beeler, Karl J.; Moehl, Pamela J.

    1996-01-01

    The University of Missouri-St. Louis has discovered the value of continuous quality improvement methods in upgrading its core student-related administrative processes. As a result, it is increasing efficiency and personalizing a traditionally bureaucratic system of student service. Concurrent goals are to increase retention and decrease time to…

  16. 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....

  17. Using Reflective Learning to Improve the Impact of Continuing Education in the Context of Work Rehabilitation

    Science.gov (United States)

    Vachon, Brigitte; Durand, Marie-Jose; LeBlanc, Jeannette

    2010-01-01

    Reflective learning has been described as a promising approach for ameliorating the impact of continuing education (CE) programs. However, there are still very few studies that have investigated how occupational therapists use reflection to improve the integration of CE program content in their decision-making processes. The study objectives were…

  18. 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…

  19. Using Data to Drive Success in Educator Prep: Massachusetts and Endicott College Collaborate for Continuous Improvement

    Science.gov (United States)

    Data Quality Campaign, 2016

    2016-01-01

    For educator preparation programs (EPPs) to produce effective teachers, they must engage in a process of continuous improvement using timely, high-quality information about the performance of their respective graduates in the classroom as measured by student outcomes. While states have the capacity to provide this information through their…

  20. Re-Culturing Educator Preparation Programs: A Collaborative Case Study of Continuous Improvement

    Science.gov (United States)

    Snow, Jennifer; Dismuke, Sherry; Zenkert, A. J.; Loffer, Carolyn

    2017-01-01

    Teacher educators at one institution of higher education collaborated to reculture systems for a focus on continuous improvement even within mounting accountability pressures. A framework of social network theory allowed for themes to develop around layered interactions of faculty, processes, and professional capital. Findings focused on people,…

  1. A Study of Leadership and Continuous Improvement at Leadership Preparatory Academy

    Science.gov (United States)

    Medina Araujo, Jacqueline

    2013-01-01

    This capstone project examines how an elementary school principal and her leadership team transformed Leadership Prep Academy in Capital City into a collaborative, high performing community school. This five-year process of continuous improvement involved engaging students, staff, parents, and members of the community in developing a culture of…

  2. 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...

  3. Validation of the Spanish version of the questionnaire «Benefit, satisfaction and willingness to continue the treatment» in patients with overactive bladder.

    Science.gov (United States)

    Jiménez, M A; Cambronero, J

    2013-09-01

    To perform the linguistic and psychometric validation of the Spanish version of the BSW (Benefit, Satisfaction and Willingness to continue) questionnaire. Epidemiologic, observational, multicenter, prospective (October 2008-February 2009) study in patients ≥40 years old with de novo overactive bladder syndrome who start treatment with antimuscarinics by physicians assessment. Data was recorded at baseline (face-to-face) and the follow-up of the study after 1 and 3 months (closed surveys by phone). Morisky-Green questionnaire was used to assess compliance. Bladder Control Self-assessment Questionnaire (B-SAQ) and BSW questionnaire were completed, performing the validation of BSW. 312 evaluable patients were recruited, 93 remained until the 3 months visit. 65% and 71% of patients were not compliant with treatment at 1 and 3 months, respectively. The correlation between the BSW and the B-SAQ questionnaires after 1 and 3 months was moderate and statistically significant. The internal consistency between the BSW questionnaire items was high (Cronbach alpha: 0,89 at 1 month and 0,84 at 3 months). 92% of patients understood the questions and 84% were able to fill the BSW questionnaire without need of previous instructions (N=25). The BSW questionnaire has been shown to be a feasible, valid and reliable tool to know the patient self-assessment of the treatment, according to its psychometric properties. Copyright © 2013 AEU. Published by Elsevier Espana. All rights reserved.

  4. 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...

  5. Job Satisfaction of Nursing Managers

    OpenAIRE

    Petrosova, Liana; Pokhilenko, Irina

    2015-01-01

    The aim of the study was to research levels of job satisfaction, factors affecting job satisfaction/dissatisfaction, and ways to improve job satisfaction among nursing managers. The purposes of the study were to extend knowledge in the field of healthcare management, to raise awareness about factors that affect job satisfaction in nursing management career, and to provide suggestions regarding how to increase job satisfaction among nursing managers. The method of this study is literature r...

  6. Proactive behaviour towards strength use and deficit improvement, hope and efficacy as predictors of life satisfaction amongst first-year university students

    Directory of Open Access Journals (Sweden)

    Frederick W. Stander

    2015-06-01

    Full Text Available Orientation: The orientation of this study is towards proactive behaviour towards strength use (PBSU and proactive behaviour towards deficit improvement (PBDI and their relationship with hope, efficacy and life satisfaction of first-year university students. Research purpose: To (1 determine whether PBSU and PBDI predict life satisfaction, (2 determine whether PBSU and PBDI predict hope and efficacy and (3 investigate a structural model where hope and efficacy mediate the relationship between PBSU and PBDI and life satisfaction. Motivation for the study: To validate the use of PBSU and PBDI as resources that will assist first-year university student to attain life satisfaction and to delineate the need for universities to incorporate interventions that promote PBSU and PBDI amongst these students. This supports the case for positive organisational behaviour. Research design, approach and method: A convenience sample of 566 first-year students from a university in Gauteng was used with a cross-sectional research design. Structural equation modelling was used to establish the validity of the measurement model, fit for the structural model and to test the mediating effects. Main findings: The results indicated that PBSU was a significant predictor of hope, efficacy and life satisfaction and that PBDI was a significant predictor of hope and efficacy. Hope mediated the relationship between PBSU, PBDI and life satisfaction. Efficacy mediated the relationship between PBSU and life satisfaction. Practical/managerial implications: Evidence suggests that PBSU was a predictor of life satisfaction. This was not the case with PBDI, which in fact negatively correlated with life satisfaction. Both PBSU and PBDI, however, predicted hope and efficacy. On a practical level this reveals that universities should, in line with positive organisational behaviour, introduce interventions that develop PBSU and PBDI amongst first-year students. It further suggests that

  7. Building district-level capacity for continuous improvement in maternal and newborn health.

    Science.gov (United States)

    Stover, Kim Ethier; Tesfaye, Solomon; Frew, Aynalem Hailemichael; Mohammed, Hajira; Barry, Danika; Alamineh, Lamesgin; Teshome, Abebe; Hepburn, Kenneth; Sibley, Lynn M

    2014-01-01

    The Maternal and Newborn Health in Ethiopia Partnership (MaNHEP) adapted a collaborative improvement strategy to develop woreda (district) leadership capacity to support and facilitate continuous improvement of community maternal and neonatal health (CMNH) and to provide a model for other woredas, dubbed "lead" woredas. Community-level quality improvement (QI) teams tested solutions to improve CMNH care supported by monthly coaching and regular meetings to share experiences. This study examines the extent of the capacity built to support continuous improvement in CMNH care. Surveys and in-depth interviews assessed the extent to which MaNHEP developed improvement capacity. A survey questionnaire evaluated woreda culture, leadership support, motivation, and capacity for improvement activities. Interviews focused on respondents' understanding and perceived value of the MaNHEP improvement approach. Bivariate analyses and multivariate linear regression models were used to analyze the survey data. Interview transcripts were organized by region, cadre, and key themes. Respondents reported significant positive changes in many areas of woreda culture and leadership, including involving a cross-section of community stakeholders (increased from 3.0 to 4.6 on 5-point Likert scale), using improvement data for decision making (2.8-4.4), using locally developed and tested solutions to improve CMNH care (2.5-4.3), demonstrating a commitment to improve the health of women and newborns (2.6-4.2), and creating a supportive environment for coaches and QI teams to improve CMNH (2.6-4.0). The mean scores for capacity were 3.7 and higher, reflecting respondents' agreement that they had gained capacity in improvement skills. Interview respondents universally recognized the capacity built in the woredas. The themes of community empowerment and focused improvement emerged strongly from the interviews. MaNHEP was able to build capacity for continuous improvement and develop lead woredas. The

  8. 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)

  9. Infant massage improves attitudes toward childbearing, maternal satisfaction and pleasure in parenting.

    Science.gov (United States)

    Vicente, Sónia; Veríssimo, Manuela; Diniz, Eva

    2017-11-01

    The first year of motherhood is a period of growth and adaptation in women's lives with several challenges such as identifying the baby's needs and giving appropriate answers, so that mother and baby get to know each other and form a strong bond. Infant massage is one of the approaches that make an important contribution to the psychological and physiological wellbeing of both baby and mother, helping to form a harmonious relationship. This longitudinal study assessed the benefits of infant massage in the relationship between mother and baby, from birth to 12 months old. Comprising 194 dyads of mothers and their babies the subjects were divided into two groups of 97 dyads each. The Experimental group (EG) comprised mothers who undertook infant massage in a postnatal program with a physical therapist once a week. The Control group (CG) comprised mothers who did not attend any postnatal program and did not perform infant massage. Self-reported measures of attitudes concerning motherhood (CAQ-P), experience associated to motherhood (WBPB), parental satisfaction (PSS) and maternal separation anxiety (MSAS) were evaluated. Results showed that mothers in the experimental group were better adapted to motherhood, had greater confidence in their abilities and received more support from their mothers and husbands than mothers in the control group and were therefore more confident in their abilities. The EG group experienced a stronger relationship with their babies and described it as more positive than mothers in the control group. This longitudinal study suggests that mothers who learned how to perform infant massage had more positive attitudes towards the experience of motherhood in helping to increase the level of knowledge, regulation and proximity in the dyad. These findings can in turn help mothers to develop strategies that enable them to better cope with motherhood. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. 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

  11. Development of a method of continuous improvement of services using the Business Intelligence tools

    Directory of Open Access Journals (Sweden)

    Svetlana V. Kulikova

    2018-01-01

    Full Text Available The purpose of the study was to develop a method of continuous improvement of services using the Business Intelligence tools.Materials and methods: the materials are used on the concept of the Deming Cycle, methods and Business Intelligence technologies, Agile methodology and SCRUM.Results: the article considers the problem of continuous improvement of services and offers solutions using methods and technologies of Business Intelligence. In this case, the purpose of this technology is to solve and make the final decision regarding what needs to be improved in the current organization of services. In other words, Business Intelligence helps the product manager to see what is hidden from the “human eye” on the basis of received and processed data. Development of a method based on the concept of the Deming Cycle and Agile methodologies, and SCRUM.The article describes the main stages of development of method based on activity of the enterprise. It is necessary to fully build the Business Intelligence system in the enterprise to identify bottlenecks and justify the need for their elimination and, in general, for continuous improvement of the services. This process is represented in the notation of DFD. The article presents a scheme for the selection of suitable agile methodologies.The proposed concept of the solution of the stated objectives, including methods of identification of problems through Business Intelligence technology, development of the system for troubleshooting and analysis of results of the introduced changes. The technical description of the project is given.Conclusion: following the work of the authors there was formed the concept of the method for the continuous improvement of the services, using the Business Intelligence technology with the specifics of the enterprises, offering SaaS solutions. It was also found that when using this method, the recommended development methodology is SCRUM. The result of this scientific

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

    Science.gov (United States)

    Gausvik, Christian; Lautar, Ashley; Miller, Lisa; Pallerla, Harini; Schlaudecker, Jeffrey

    2015-01-01

    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 patient care. These results point to the interconnectedness and dual benefit to both job satisfaction and patient quality of care that can come from enhancements to team communication.

  13. Independent assessment to continue improvement: Implementing statistical process control at the Hanford Site

    International Nuclear Information System (INIS)

    Hu, T.A.; Lo, J.C.

    1994-11-01

    A Quality Assurance independent assessment has brought about continued improvement in the PUREX Plant surveillance program at the Department of Energy's Hanford Site. After the independent assessment, Quality Assurance personnel were closely involved in improving the surveillance program, specifically regarding storage tank monitoring. The independent assessment activities included reviewing procedures, analyzing surveillance data, conducting personnel interviews, and communicating with management. Process improvement efforts included: (1) designing data collection methods; (2) gaining concurrence between engineering and management, (3) revising procedures; and (4) interfacing with shift surveillance crews. Through this process, Statistical Process Control (SPC) was successfully implemented and surveillance management was improved. The independent assessment identified several deficiencies within the surveillance system. These deficiencies can be grouped into two areas: (1) data recording and analysis and (2) handling off-normal conditions. By using several independent assessment techniques, Quality Assurance was able to point out program weakness to senior management and present suggestions for improvements. SPC charting, as implemented by Quality Assurance, is an excellent tool for diagnosing the process, improving communication between the team members, and providing a scientific database for management decisions. In addition, the surveillance procedure was substantially revised. The goals of this revision were to (1) strengthen the role of surveillance management, engineering and operators and (2) emphasize the importance of teamwork for each individual who performs a task. In this instance we believe that the value independent assessment adds to the system is the continuous improvement activities that follow the independent assessment. Excellence in teamwork between the independent assessment organization and the auditee is the key to continuing improvement

  14. 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.

  15. 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.

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

    Science.gov (United States)

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

    2018-05-01

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

  17. Ongoing Evaluation of Clinical Ethics Consultations as a Form of Continuous Quality Improvement.

    Science.gov (United States)

    Volpe, Rebecca

    2017-01-01

    Ongoing evaluation of a clinical ethics consultation service (ECS) allows for continuous quality improvement, a process-based, data-driven approach for improving the quality of a service. Evaluations by stakeholders involved in a consultation can provide real-time feedback about what is working well and what might need to be improved. Although numerous authors have previously presented data from research studies on the effectiveness of clinical ethics consultation, few ECSs routinely send evaluations as an ongoing component of their everyday clinical activities. The primary purpose of this article is to equip and encourage others to engage in ongoing evaluation of their own ECS. Toward that end, the following resources are shared: (1) the survey tool used to gather the evaluation data, (2) the procedure used to elicit and collate responses, and (3) how the resulting data are used to support continuous quality improvement and justify the continued financial support of the ECS to hospital administration. Copyright 2017 The Journal of Clinical Ethics. All rights reserved.

  18. Keeping the "continuous" in continuous quality improvement: exploring perceived outcomes of CQI program use in community pharmacy.

    Science.gov (United States)

    Boyle, Todd A; Bishop, Andrea C; Duggan, Kellie; Reid, Carolyn; Mahaffey, Thomas; MacKinnon, Neil J; Mahaffey, Amelia

    2014-01-01

    Given the significant potential of continuous quality improvement (CQI) programs in enhancing overall levels of patient safety, community pharmacies in North America are under increasing pressure to have a formal and documented CQI program in place. However, while such initiatives may seem great on paper, in practice the outcomes of such programs to community pharmacy practice remain unclear. To explore the perceived outcomes identified by community pharmacies that adopted and actively used a standardized (i.e., common across pharmacies) CQI program for at least 1 year and to develop a framework for how such outcomes were achieved. A multi-site study of SafetyNET-Rx, a standardized and technologically sophisticated (e.g., online reporting of medication errors to a national database) CQI program, involving community pharmacies in Nova Scotia, Canada, was performed. During the summer and fall of 2011, 22 interviews were conducted with the CQI facilitators in 12 Nova Scotia community pharmacies; equally split between independent/banners and corporate chains. Of the CQI facilitators, 14 were pharmacists, while the remaining eight were pharmacy technicians. Thematic analysis following the procedures presented by Braun and Clarke was adopted to identify and explore the major outcomes. Results of the thematic analysis highlighted a number of perceived outcomes from the use of a standardized CQI program in community pharmacies, specifically: (1) perceived reduction in the number of medication errors that were occurring in the pharmacy, (2) increased awareness/confidence of individual actions related to dispensing, (3) increased understanding of the dispensing and related processes/workflow, (4) increased openness to talking about medication errors among pharmacy staff, and (5) quality and safety becoming more entrenched in the workflow (e.g., staff is more aware of their roles and responsibilities in patient safety and confident that the dispensing processes are safe and

  19. Evolution of Technology for Continuous Renal Replacement Therapy: Forty Years of Improvement.

    Science.gov (United States)

    Ronco, Claudio

    2018-01-01

    Continuous arteriovenous hemofiltration (CAVH) was proposed in 1977 as an alternative treatment for acute renal failure in patients in whom peritoneal dialysis or hemodialysis was clinically or technically precluded. In the mid-1980s, this technique was extended to infants and children. CAVH presented important advantages in the areas of hemodynamic stability, control of circulating volume, and nutritional support. However, there were serious shortcomings such as the need for arterial cannulation and limited solute clearance. These problems were solved by the introduction of continuous arteriovenous hemodiafiltration and continuous arteriovenous hemodialysis, where uremic control could be achieved by increasing countercurrent dialysate flow rates to 1.5 or 2 L/h as necessary, or by venovenous techniques utilizing a double-lumen central venous catheter for vascular access. Thus, continuous venovenous hemofiltration replaced CAVH because of its improved performance and safety. From the initial adoptive technology, specific machines have been designed to permit safe and reliable performance of the therapy. These new machines have progressively undergone a series of technological steps that have resulted in the evolution of highly sophisticated equipment utilized today. A significant number of advances have taken place since the time continuous renal replacement therapy was initiated. In particular, there have been successful experiments with high-volume hemofiltration and high-permeability hemofiltration. The additional and combined use of sorbent has also been tested successfully. Progress has been made in the technology as well as the understanding of the pathophysiology of acute kidney injury. Today, new biomaterials and new devices are available and new frontiers are on the horizon. Although improvements have been made, a lot remains to be done. Critical care nephrology is expected to further evolve in the near future, especially in the area of information and

  20. Identifying effective pathways in a successful continuous quality improvement programme: the GEDAPS study.

    Science.gov (United States)

    Bodicoat, Danielle H; Mundet, Xavier; Gray, Laura J; Cos, Xavier; Davies, Melanie J; Khunti, Kamlesh; Cano, Juan-Franciso

    2014-12-01

    Continuous quality improvement programmes often target several aspects of care, some of which may be more effective meaning that resources could be focussed on these. The objective was to identify the effective and ineffective aspects of a successful continuous quality improvement programme for individuals with type 2 diabetes in primary care. Data were from a series of cross-sectional studies (GEDAPS) in primary care, Catalonia, Spain, in 55 centres (2239 participants) in 1993, and 92 centres (5819 participants) in 2002. A structural equation modelling approach was used. The intervention was associated with improved microvascular outcomes through microalbuminuria and funduscopy screening, which had a direct effect on microvascular outcomes, and through attending 2-4 nurse visits and having ≥1 blood pressure measurement, which acted through reducing systolic blood pressure. The intervention was associated with improved macrovascular outcomes through blood pressure measurement and attending 2-4 nurse visits (through systolic blood pressure) and having ≥3 education topics, ≥1 HbA1c measurement and adequate medication (through HbA1c). Cholesterol measurement, weight measurement and foot examination did not contribute towards the effectiveness of the intervention. The pathways through which a continuous quality improvement programme appeared to act to reduce microvascular and macrovascular complications were driven by reductions in systolic blood pressure and HbA1c, which were attained through changes in nurse and education visits, measurement and medication. This suggests that these factors are potential areas on which future quality improvement programmes should focus. © 2014 John Wiley & Sons, Ltd.

  1. 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 continuous 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.

  2. 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......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...

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

    Science.gov (United States)

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

    2018-01-01

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

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

    Science.gov (United States)

    Benders, Jos; Bleijerveld, Hans; Schouteten, Roel

    2017-10-01

    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.

  5. Air quality continued to improve in 2014, but progress are still needed

    International Nuclear Information System (INIS)

    Le Moullec, Aurelie

    2015-09-01

    The improvement in air quality that began some years ago continued. Average concentrations of pollutants decreased and exceedance of thresholds for protection of health was observed in fewer areas. Progress was, notably, the result of efforts made to reduce emissions, something made more difficult by the number and variety of sources of pollution. These improvements were, however, fragile as they were partially dependent on weather conditions. 2014 was, thus, marked by an important episode of particulate pollution. In addition, the progress made was not sufficient to bring France into full compliance with European standards, as was also the case for other European countries. (author)

  6. The continuous improvement in quality management for nuclear fuel manufacturing in CNNC

    International Nuclear Information System (INIS)

    Wang Xiaoling

    2004-01-01

    The nuclear fuel plant has been keeping good records in quality. Only one pot failure has been found in the fuels loaded in the reactors at more than ten years. The paper describes quality management in nuclear fuel manufacturing and focuses on the continuous improvement on quality system and process by running the quality management system, process by quality control group, and data analyze, the requirements and the improvements for the quality system, the measurement system and the standardization system, the importance of clearance system. It also describes the future plans in quality management

  7. 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 measured......, 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...

  8. Embracing technology? Using change management strategies to improve the use of continuous lateral rotation therapy.

    Science.gov (United States)

    Cybulski, Pamela; Zantinge, Johanna; Abbott-McNeil, Deanna

    2006-01-01

    The purpose of this quality improvement initiative was to improve the utilization of continuous lateral rotation therapy (CLRT) in a nine-bed community hospital ICU within the context of a nurse-driven protocol. Nursing focus groups, analyzed using a strength, weakness, opportunity, threat (SWOT) approach, resulted in the implementation of four interventions over seven weeks. Change management strategies guided all aspects of the project. Results showed a modest increase in the utilization of CLRT. This initiative demonstrates that change management strategies may assist with the incorporation of technology into nursing practice by increasing empowerment and creating an attachment to and responsibility for outcomes.

  9. AutoMOPS--B2B and B2C in mask making: mask manufacturing performance and customer satisfaction improvement through better information flow management

    Science.gov (United States)

    de Ridder, Luc; Filies, Olaf; Rodriguez, Ben; Kuijken, Aart

    2001-04-01

    Through application of modern supply chain concepts in combination with state-of-the-art information technology, mask manufacturing performance and customer satisfaction can be improved radically. The AutoMOPS solution emphasizes on the elimination of the order verification through paperless, electronically linked information sharing/exchange between chip design, mask production and prototype production stages.

  10. Organizational learning perspective on continuous improvement and innovation in product realization

    DEFF Research Database (Denmark)

    Møller, Christina Villefrance

    with cross-functional collaboration in solving problems that subsequently restraining continuous improvement and innovation (CII) in product realization. This research project apply an organizational learning perspective on cross-functional problem solving in product realization processes. The research...... project has two main objectives, first to develop and test a CIIprogram that integrates cross-functional work practices into product realization. The second objective is to enhance understanding of organizational learning processes in cross-functional and multilevel settings within manufacturing....

  11. Overcoming institutional challenges through continuous professionalism improvement: the University of Washington experience.

    Science.gov (United States)

    Fryer-Edwards, Kelly; Van Eaton, Erik; Goldstein, Erika A; Kimball, Harry R; Veith, Richard C; Pellegrini, Carlos A; Ramsey, Paul G

    2007-11-01

    The University of Washington (UW) School of Medicine is in the midst of an emerging ecology of professionalism. This initiative builds on prior work focusing on professionalism at the student level and moves toward the complete integration of a culture of professionalism within the UW medical community of including staff, faculty, residents, and students. The platform for initiating professionalism as institutional culture is the Committee on Continuous Professionalism Improvement, established in November 2006. This article reviews three approaches to organizational development used within and outside medicine and highlights features that are useful for enhancing an institutional culture of professionalism: organizational culture, safety culture, and appreciative inquiry. UW Medicine has defined professional development as a continuous process, built on concrete expectations, using mechanisms to facilitate learning from missteps and highlighting strengths. To this end, the school of medicine is working toward improvements in feedback, evaluation, and reward structures at all levels (student, resident, faculty, and staff) as well as creating opportunities for community dialogues on professionalism issues within the institution. Throughout all the Continuous Professionalism Improvement activities, a two-pronged approach to cultivating a culture of professionalism is taken: celebration of excellence and attention to accountability.

  12. Learning science as a potential new source of understanding and improvement for continuing education and continuing professional development.

    Science.gov (United States)

    Van Hoof, Thomas J; Doyle, Terrence J

    2018-01-15

    Learning science is an emerging interdisciplinary field that offers educators key insights about what happens in the brain when learning occurs. In addition to explanations about the learning process, which includes memory and involves different parts of the brain, learning science offers effective strategies to inform the planning and implementation of activities and programs in continuing education and continuing professional development. This article provides a brief description of learning, including the three key steps of encoding, consolidation and retrieval. The article also introduces four major learning-science strategies, known as distributed learning, retrieval practice, interleaving, and elaboration, which share the importance of considerable practice. Finally, the article describes how learning science aligns with the general findings from the most recent synthesis of systematic reviews about the effectiveness of continuing medical education.

  13. Comprehensive Evaluation on Employee Satisfaction of Mine Occupational Health and Safety Management System Based on Improved AHP and 2-Tuple Linguistic Information

    Directory of Open Access Journals (Sweden)

    Jiangdong Bao

    2017-01-01

    Full Text Available In order to comprehensively evaluate the employee satisfaction of mine occupational health and safety management system, an analytic method based on fuzzy analytic hierarchy process and 2-tuple linguistic model was established. Based on the establishment of 5 first-grade indicators and 20 second-grade ones, method of improved AHP and the time-ordered Weighted Averaging Operator (T-OWA model is constructed. The results demonstrate that the employee satisfaction of the mine occupational health and safety management system is of the ‘general’ rank. The method including the evaluation of employee satisfaction and the quantitative analysis of language evaluation information ensures the authenticity of the language evaluation information.

  14. Correlations between increased erection hardness and improvements in emotional well-being and satisfaction outcomes in men treated with sildenafil citrate for erectile dysfunction.

    Science.gov (United States)

    King, R; Juenemann, K-P; Levinson, I P; Stecher, V J; Creanga, D L

    2007-01-01

    To explore relationships between erection hardness and other outcomes in men with erectile dysfunction (ED). Pooled analyses were conducted on 27 randomized, double-blind, placebo-controlled trials and six open-label trials from the worldwide sildenafil database. Outcomes included erection hardness graded subjectively, hardness and sexual satisfaction questions from the International Index of Erectile Function, general and sexually-specific emotional well-being from the self-esteem and relationship questionnaire, and the erectile dysfunction inventory of treatment satisfaction. Hardness outcomes improved (with a possible dose-response relationship for the achievement of fully hard and rigid erections) and correlated positively with the other outcomes. Sildenafil 100 mg produced optimal erection hardness (fully hard and rigid erections) in a substantial proportion of men with ED. Because optimal erection hardness correlated positively with some emotional well-being and satisfaction outcomes, sildenafil 100 mg may be the most appropriate dosage for treatment of ED for most men.

  15. 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.

  16. Sustained participation in annual continuous quality improvement activities improves quality of care for Aboriginal and Torres Strait Islander children.

    Science.gov (United States)

    McAullay, Daniel; McAuley, Kimberley; Bailie, Ross; Mathews, Veronica; Jacoby, Peter; Gardner, Karen; Sibthorpe, Beverly; Strobel, Natalie; Edmond, Karen

    2018-02-01

    To determine whether participation in the continuous quality improvement (CQI) Audit and Best Practice for Chronic Disease programme improved care and outcomes for Indigenous children. Data were collected from 59 Australian primary health-care centres providing services to Indigenous people and participating in the programme (February 2008 and December 2013). Indigenous children aged less than 2 years and centres that completed three or more consecutive annual audits within the 6-year study period were included. Crude and adjusted logistic generalised estimating equation models were used to examine the effect of year of audit on the delivery of care. Odds ratio (OR) and 95% confidence interval (CI) were calculated. Outcomes were related to age-relevant health issues, including prevention and early intervention. These included administrative, health check, anticipatory guidance and specific health issues. During the audit period, there were 2360 files from 59 centres. Those that had a recall recorded, improved from 84 to 95% (OR 2.44, 95% CI 1.44-4.11). Hearing assessments improved from 52 to 89% (OR 1.37, 95% CI 1.22-1.54). Improvement in anticipatory guidance, treatment and follow-up of medical conditions was almost universal. We documented significant improvements in quality of care of Indigenous children. Outcomes and their corresponding treatment and follow-ups improved over time. This appears to be related to services participating in annual CQI activities. However, these services may be more committed to CQI than others and therefore possibly better performing. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

  17. Expanding Educators' Contributions to Continuous Quality Improvement of American Board of Medical Specialties Maintenance of Certification.

    Science.gov (United States)

    Nora, Lois Margaret; Pouwels, Mellie Villahermosa; Irons, Mira

    2016-01-01

    The American Board of Medical Specialties board certification has transformed into a career-long process of learning, assessment, and performance improvement through its Program for Maintenance of Certification (MOC). Medical educators across many medical professional organizations, specialty societies, and other institutions have played important roles in shaping MOC and tailoring its overarching framework to the needs of different specialties. This Commentary addresses potential barriers to engagement in work related to MOC for medical school (MS) and academic health center (AHC) educators and identifies reasons for, and ways to accomplish, greater involvement in this work. The authors present ways that medical and other health professions educators in these settings can contribute to the continuous improvement of the MOC program including developing educational and assessment activities, engaging in debate about MOC, linking MOC with institutional quality improvement activities, and pursuing MOC-related scholarship. MS- and AHC-based educators have much to offer this still-young and continually improving program, and their engagement is sought, necessary, and welcomed.

  18. 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.

  19. 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…

  20. 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)

  1. Advancing obstetric and neonatal care in a regional hospital in Ghana via continuous quality improvement.

    Science.gov (United States)

    Srofenyoh, Emmanuel; Ivester, Thomas; Engmann, Cyril; Olufolabi, Adeyemi; Bookman, Laurel; Owen, Medge

    2012-01-01

    To reduce maternal and neonatal death at a large regional hospital through the use of quality improvement methodologies. In 2007, Kybele and the Ghana Health Service formed a partnership to analyze systems and patient care processes at a regional hospital in Accra, Ghana. A model encompassing continuous assessment, implementation, advocacy, outputs, and outcomes was designed. Key areas for improvement were grouped into "bundles" based on personnel, systems management, and service quality. Primary outcomes included maternal and perinatal mortality, and case fatality rates for hemorrhage and hypertensive disorders. Implementation and outcomes were evaluated tri-annually between 2007 and 2009. During the study period, there was a 34% decrease in maternal mortality despite a 36% increase in patient admission. Case fatality rates for pre-eclampsia and hemorrhage decreased from 3.1% to 1.1% (Pcontinuous quality improvement were developed and employed. Copyright © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  2. An improved method of continuous LOD based on fractal theory in terrain rendering

    Science.gov (United States)

    Lin, Lan; Li, Lijun

    2007-11-01

    With the improvement of computer graphic hardware capability, the algorithm of 3D terrain rendering is going into the hot topic of real-time visualization. In order to solve conflict between the rendering speed and reality of rendering, this paper gives an improved method of terrain rendering which improves the traditional continuous level of detail technique based on fractal theory. This method proposes that the program needn't to operate the memory repeatedly to obtain different resolution terrain model, instead, obtains the fractal characteristic parameters of different region according to the movement of the viewpoint. Experimental results show that the method guarantees the authenticity of landscape, and increases the real-time 3D terrain rendering speed.

  3. 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.)

  4. Method and apparatus for improved melt flow during continuous strip casting

    Science.gov (United States)

    Follstaedt, Donald W.; King, Edward L.; Schneider, Ken C.

    1991-11-12

    The continuous casting of metal strip using the melt overflow process is improved by controlling the weir conditions in the nozzle to provide a more uniform flow of molten metal across the width of the nozzle and reducing the tendency for freezing of metal along the interface with refractory surfaces. A weir design having a sloped rear wall and tapered sidewalls and critical gap controls beneath the weir has resulted in the drastic reduction in edge tearing and a significant improvement in strip uniformity. The floor of the container vessel is preferably sloped and the gap between the nozzle and the rotating substrate is critically controlled. The resulting flow patterns observed with the improved casting process have reduced thermal gradients in the bath, contained surface slag and eliminated undesirable solidification near the discharge area by increasing the flow rates at those points.

  5. Role of continual environmental performance improvement in achieving sustainability in uranium production

    International Nuclear Information System (INIS)

    Jarrell, J.P.; Chad, G.M.S.

    2002-01-01

    Although the term sustainable development is commonly used today, there is not yet a commonly accepted definition. Various ways of measuring sustainability have been proposed. To show how these issues are being effectively addressed in modern uranium developments, we will review some methods of defining the environmental component of sustainable development in the mining and mineral-processing sector. Environmental impacts associated with uranium extraction and processing in modern facilities are modest. Air and water emissions are well controlled. Waste materials are subject to comprehensive management programmes. The size of the impacted area is smaller than in other energy sectors, providing good opportunity to minimize land impact. Experience over the past three decades facilitated gradual, persistent, but cumulatively significant environmental improvements in the uranium production sector. Cameco's uranium mining and processing facilities exemplify these improvements. These improvements can be expected to continue, supporting our argument of Cameco's environmental sustainability. (author)

  6. Indigenous health: effective and sustainable health services through continuous quality improvement.

    Science.gov (United States)

    Bailie, Ross S; Si, Damin; O'Donoghue, Lyn; Dowden, Michelle

    2007-05-21

    The Australian government's Healthy for Life program is supporting capacity development in Indigenous primary care using continuous quality improvement (CQI) techniques. An important influence on the Healthy for Life program has been the ABCD research project. The key features contributing to the success of the project are described. The ABCD research project: uses a CQI approach, with an ongoing cycle of gathering data on how well organisational systems are functioning, and developing and then implementing improvements; is guided by widely accepted principles of community-based research, which emphasise participation; and adheres to the principles and values of Indigenous health research and service delivery. The potential for improving health outcomes in Aboriginal and Torres Strait Islander communities using a CQI approach should be strengthened by clear clinical and managerial leadership, supporting service organisations at the community level, and applying participatory-action principles.

  7. Employees Motivation and Openness for Continuous Improvement: Comparative Study in Polish and Japanese Companies

    Directory of Open Access Journals (Sweden)

    Stadnicka Dorota

    2017-09-01

    Full Text Available Currently, companies must change and evolve to keep pace with the changing environment, customers’ requirements and to be better than their competitors. The changes result from the need to adapt the products to new customers’ requirements as well as to maintain competitive prices of their products. Therefore, companies should be flexible to guarantee short lead time and minimalize their costs to offer a good price for the customers. At the same time, companies should create good work environment for their employees in order to get them involved in improvement processes. In order to survive and develop companies should motivate and involve their employees into a continuous improvement process in different areas of the company. Unfortunately, as based on the companies’ practice and previous research, in many cases employees are not willing to engage in the company development. Continuous improvement is the basis of the philosophy of Quality Management and Lean Manufacturing, which come from Toyota Production System (TPS. The TPS eventually spread throughout the world, and it is held up as an example of the proper management of a production system. The assumptions of TPS system were used to build systems in other companies, but not always with the same success as it was in Toyota. For this reason, the authors of this paper seek to answer the question of whether there are differences in engagement in a continuous improvement process between employees in a Japanese company and a Polish company operating in the same industry and realizing the similar manufacturing. In order to verify this, the research was conducted in two manufacturing companies which operate in the automotive industry. The results of the study and their analysis are presented in the work.

  8. Using Surgeon-Specific Outcome Reports and Positive Deviance for Continuous Quality Improvement.

    Science.gov (United States)

    Ivanovic, Jelena; Anstee, Caitlin; Ramsay, Tim; Gilbert, Sebastien; Maziak, Donna E; Shamji, Farid M; Sundaresan, R Sudhir; Villeneuve, P James; Seely, Andrew J E

    2015-10-01

    Using the thoracic morbidity and mortality classification to document all postoperative adverse events between October 2012 and February 2014, we created surgeon-specific outcome reports (SSORs) to promote self-assessment and to implement a divisional continuous quality improvement (CQI) program, on the construct of positive deviance, to improve individual surgeon's clinical performance. Mixed-methods study within a division of six thoracic surgeons, involving (1) development of real-time, Web-based, risk-adjusted SSORs; (2) implementation of CQI seminars (n = 6; September 2013 to June 2014) for evaluation of results, collegial discussion on quality improvement based on identification of positive outliers, and selection of quality indicators for future discussion; and (3) in-person interviews to identify facilitators and barriers to using SSORs and CQI. Interview transcripts were analyzed using thematic analysis. Interviews revealed enthusiastic support for SSORs as a means to improve patient care through awareness of personal outcomes with blinded divisional comparison for similar operations and diseases, and apply the learning objectives to continuous professional development and maintenance of certification. Perceived limitations of SSORs included difficulty measuring surgeon expertise, limited understanding of risk adjustment, resistance to change, and belief that knowledge of sensitive data could lead to punitive actions. All surgeons believed CQI seminars led to collegial discussions, whereas perceived limitations included quorum participation and failing to circle back on actionable items. Real-time performance feedback using SSORs can motivate surgeons to improve their practice, and CQI seminars offer the opportunity to review and interpret results and address issues in a supportive environment. Whether SSORs and CQI can lead to improvements in rates of postoperative adverse events is a matter of ongoing research. Copyright © 2015 The Society of Thoracic

  9. Promoting Continuous Quality Improvement in the Alabama Child Health Improvement Alliance Through Q-Sort Methodology and Learning Collaboratives.

    Science.gov (United States)

    Fifolt, Matthew; Preskitt, Julie; Rucks, Andrew; Corvey, Kathryn; Benton, Elizabeth Cason

    Q-sort methodology is an underutilized tool for differentiating among multiple priority measures. The authors describe steps to identify, delimit, and sort potential health measures and use selected priority measures to establish an overall agenda for continuous quality improvement (CQI) activities within learning collaboratives. Through an iterative process, the authors vetted a list of potential child and adolescent health measures. Multiple stakeholders, including payers, direct care providers, and organizational representatives sorted and prioritized measures, using Q-methodology. Q-methodology provided the Alabama Child Health Improvement Alliance (ACHIA) an objective and rigorous approach to system improvement. Selected priority measures were used to design learning collaboratives. An open dialogue among stakeholders about state health priorities spurred greater organizational buy-in for ACHIA and increased its credibility as a statewide provider of learning collaboratives. The integrated processes of Q-sort methodology, learning collaboratives, and CQI offer a practical yet innovative way to identify and prioritize state measures for child and adolescent health and establish a learning agenda for targeted quality improvement activities.

  10. Hyperlink-Embedded Journal Articles Improve Statistical Knowledge and Reader Satisfaction

    Science.gov (United States)

    Saxon, David; Pearson, Alexander T.; Wu, Peter

    2015-01-01

    Background To practice evidence-based medicine, physicians should have a solid understanding of fundamental epidemiological and biostatistical concepts. Research suggests that only a minority of physicians have such an understanding of biostatistics. Objective To collect pilot data on a novel biostatistical educational tool, a hyperlink-embedded journal article, which is aimed at improving knowledge in biostatistics. Methods Forty-four physicians-in-training participated in this pilot study. Participants completed a pretest consisting of 5 questions about biostatistical terms that would be encountered in the article. They were randomized to either an unmodified journal article or to the same article with hyperlinked biostatistical terms. All participants then completed a posttest that was identical to the pretest. Results Having access to hyperlinked information had a positive association with the number of improved test answers (P = .05). Use of hyperlinks varied, and were seemingly dependent on user comfort with terms; well-understood definitions (“average”) were clicked on a few times (5.5% of participants), whereas more obscure method terms (“Lexis diagram”) were clicked on by 94% of participants. While only 42% of participants stated they would have looked up definitions of the biostatistical terms if they had not been provided in the hyperlinked article, 94% of participants identified the hyperlink tool as something they would use if readily available to them when reading journal articles. Conclusions Results of this pilot study of a novel educational intervention suggest that embedded hyperlinks within journal articles may be a useful tool to teach biostatistical terms to physicians. PMID:26692981

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

    Science.gov (United States)

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

    2014-10-01

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

  12. 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. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. Exploration, analysis and explanation of 'employee satisfaction' as an organization development and general improvement tool for the it sector of Pakistan

    International Nuclear Information System (INIS)

    Ahsan, A.; Kiani, H.S.; Khurshid, O.

    2011-01-01

    using necessary qualitative and quantitative research methods. The paper also explains all the important issues (As identified in PhD Thesis of Ahsan) arising due to underprivileged employee satisfaction. As a result of detailed analysis performed, the paper finally identifies important recommendations for improving employee satisfaction. The study analyzes the major causes of employee satisfaction / dissatisfaction and the impact of employee satisfaction on various organizational parameters (for instance quality, productivity etc). (author)

  14. 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

  15. 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.

  16. Improvements of PKU PMECRIS for continuous hundred hours CW proton beam operation

    International Nuclear Information System (INIS)

    Peng, S. X.; Ren, H. T.; Zhang, T.; Zhang, J. F.; Xu, Y.; Guo, Z. Y.; Zhang, A. L.; Chen, J. E.

    2016-01-01

    In order to improve the source stability, a long term continuous wave (CW) proton beam experiment has been carried out with Peking University compact permanent magnet 2.45 GHz ECR ion source (PKU PMECRIS). Before such an experiment a lot of improvements and modifications were completed on the source body, the Faraday cup and the PKU ion source test bench. At the beginning of 2015, a continuous operation of PKU PMECRIS for 306 h with more than 50 mA CW beam was carried out after success of many short term tests. No plasma generator failure or high voltage breakdown was observed during that running period and the proton source reliability is near 100%. Total beam availability, which is defined as 35-keV beam-on time divided by elapsed time, was higher than 99% [S. X. Peng et al., Chin. Phys. B 24(7), 075203 (2015)]. A re-inspection was performed after another additional 100 h operation (counting time) and no obvious sign of component failure was observed. Counting the previous source testing time together, this PMECRs longevity is now demonstrated to be greater than 460 h. This paper is mainly concentrated on the improvements for this long term experiment

  17. Improvements of PKU PMECRIS for continuous hundred hours CW proton beam operation

    Science.gov (United States)

    Peng, S. X.; Zhang, A. L.; Ren, H. T.; Zhang, T.; Zhang, J. F.; Xu, Y.; Guo, Z. Y.; Chen, J. E.

    2016-02-01

    In order to improve the source stability, a long term continuous wave (CW) proton beam experiment has been carried out with Peking University compact permanent magnet 2.45 GHz ECR ion source (PKU PMECRIS). Before such an experiment a lot of improvements and modifications were completed on the source body, the Faraday cup and the PKU ion source test bench. At the beginning of 2015, a continuous operation of PKU PMECRIS for 306 h with more than 50 mA CW beam was carried out after success of many short term tests. No plasma generator failure or high voltage breakdown was observed during that running period and the proton source reliability is near 100%. Total beam availability, which is defined as 35-keV beam-on time divided by elapsed time, was higher than 99% [S. X. Peng et al., Chin. Phys. B 24(7), 075203 (2015)]. A re-inspection was performed after another additional 100 h operation (counting time) and no obvious sign of component failure was observed. Counting the previous source testing time together, this PMECRs longevity is now demonstrated to be greater than 460 h. This paper is mainly concentrated on the improvements for this long term experiment.

  18. Improvements of PKU PMECRIS for continuous hundred hours CW proton beam operation

    Energy Technology Data Exchange (ETDEWEB)

    Peng, S. X., E-mail: sxpeng@pku.edu.cn; Ren, H. T.; Zhang, T.; Zhang, J. F.; Xu, Y.; Guo, Z. Y. [State Key Laboratory of Nuclear Physics and Technology and Institute of Heavy Ion Physics, School of Physics, Peking University, Beijing 100871 (China); Zhang, A. L.; Chen, J. E. [State Key Laboratory of Nuclear Physics and Technology and Institute of Heavy Ion Physics, School of Physics, Peking University, Beijing 100871 (China); University of Chinese Academy of Sciences, Beijing 100049 (China)

    2016-02-15

    In order to improve the source stability, a long term continuous wave (CW) proton beam experiment has been carried out with Peking University compact permanent magnet 2.45 GHz ECR ion source (PKU PMECRIS). Before such an experiment a lot of improvements and modifications were completed on the source body, the Faraday cup and the PKU ion source test bench. At the beginning of 2015, a continuous operation of PKU PMECRIS for 306 h with more than 50 mA CW beam was carried out after success of many short term tests. No plasma generator failure or high voltage breakdown was observed during that running period and the proton source reliability is near 100%. Total beam availability, which is defined as 35-keV beam-on time divided by elapsed time, was higher than 99% [S. X. Peng et al., Chin. Phys. B 24(7), 075203 (2015)]. A re-inspection was performed after another additional 100 h operation (counting time) and no obvious sign of component failure was observed. Counting the previous source testing time together, this PMECRs longevity is now demonstrated to be greater than 460 h. This paper is mainly concentrated on the improvements for this long term experiment.

  19. 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

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

    International Nuclear Information System (INIS)

    Breunig, Jennifer; Hernandez, Sophy; Lin, Jeffrey; Alsager, Stacy; Dumstorf, Christine; Price, Jennifer; Steber, Jennifer; Garza, Richard; Nagda, Suneel; Melian, Edward; Emami, Bahman; Roeske, John C.

    2012-01-01

    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 assessment in

  1. Assessing the impact of continuous quality improvement/total quality management: concept versus implementation.

    Science.gov (United States)

    Shortell, S M; O'Brien, J L; Carman, J M; Foster, R W; Hughes, E F; Boerstler, H; O'Connor, E J

    1995-01-01

    OBJECTIVE: This study examines the relationships among organizational culture, quality improvement processes and selected outcomes for a sample of up to 61 U. S. hospitals. DATA SOURCES AND STUDY SETTING: Primary data were collected from 61 U. S. hospitals (located primarily in the midwest and the west) on measures related to continuous quality improvement/total quality management (CQI/TQM), organizational culture, implementation approaches, and degree of quality improvement implementation based on the Baldrige Award criteria. These data were combined with independently collected data on perceived impact and objective measures of clinical efficiency (i.e., charges and length of stay) for six clinical conditions. STUDY DESIGN: The study involved cross-sectional examination of the named relationships. DATA COLLECTION/EXTRACTION METHODS: Reliable and valid scales for the organizational culture and quality improvement implementation measures were developed based on responses from over 7,000 individuals across the 61 hospitals with an overall completion rate of 72 percent. Independent data on perceived impact were collected from a national survey and independent data on clinical efficiency from a companion study of managed care. PRINCIPAL FINDINGS: A participative, flexible, risk-taking organizational culture was significantly related to quality improvement implementation. Quality improvement implementation, in turn, was positively associated with greater perceived patient outcomes and human resource development. Larger-size hospitals experienced lower clinical efficiency with regard to higher charges and higher length of stay, due in part to having more bureaucratic and hierarchical cultures that serve as a barrier to quality improvement implementation. CONCLUSIONS: What really matters is whether or not a hospital has a culture that supports quality improvement work and an approach that encourages flexible implementation. Larger-size hospitals face more difficult

  2. Continuous Improvement and the Safety Case for the Waste Isolation Pilot Plant Geologic Repository - 13467

    Energy Technology Data Exchange (ETDEWEB)

    Van Luik, Abraham; Patterson, Russell; Nelson, Roger [US Department of Energy, Carlsbad Field Office, 4021 S. National parks Highway, Carlsbad, NM 88220 (United States); Leigh, Christi [Sandia National Laboratories Carlsbad Operations, 4100 S. National parks Highway, Carlsbad, NM 88220 (United States)

    2013-07-01

    The Waste Isolation Pilot Plant (WIPP) is a geologic repository 2150 feet (650 m) below the surface of the Chihuahuan desert near Carlsbad, New Mexico. WIPP permanently disposes of transuranic waste from national defense programs. Every five years, the U.S. Department of Energy (DOE) submits an application to the U.S. Environmental Protection Agency (EPA) to request regulatory-compliance re-certification of the facility for another five years. Every ten years, DOE submits an application to the New Mexico Environment Department (NMED) for the renewal of its hazardous waste disposal permit. The content of the applications made by DOE to the EPA for re-certification, and to the NMED for permit-renewal, reflect any optimization changes made to the facility, with regulatory concurrence if warranted by the nature of the change. DOE points to such changes as evidence for its having taken seriously its 'continuous improvement' operations and management philosophy. Another opportunity for continuous improvement is to look at any delta that may exist between the re-certification and re-permitting cases for system safety and the consensus advice on the nature and content of a safety case as being developed and published by the Nuclear Energy Agency's Integration Group for the Safety Case (IGSC) expert group. DOE at WIPP, with the aid of its Science Advisor and teammate, Sandia National Laboratories, is in the process of discerning what can be done, in a reasonably paced and cost-conscious manner, to continually improve the case for repository safety that is being made to the two primary regulators on a recurring basis. This paper will discuss some aspects of that delta and potential paths forward to addressing them. (authors)

  3. A story of success: continuous quality improvement in cystic fibrosis care in the USA.

    Science.gov (United States)

    Quon, Bradley S; Goss, Christopher H

    2011-12-01

    Continuous quality improvement (CQI) in healthcare can be described as a reiterative approach to improving processes to reduce unexpected variation in health outcomes. CQI represents one model to achieve quality improvement (QI) and has long been recognized as a key to success in the manufacturing industry with companies like Toyota leading the way. Healthcare, and specifically pulmonary, critical care and sleep medicine represent ideal settings for the application of CQI. This opinion piece will describe QI and CQI initiatives in the US Cystic fibrosis (CF) population. QI in CF care in the United States has been ongoing since inception of the US CF Foundation (CFF) in 1955. This effort has included work to improve the quality of clinical care provided at CF centers and work to improve clinical outcomes in CF. More recently, QI methods have been applied to the conduct of clinical research. The CF community has become a leader in the area of QI and has pointed out the opportunities for others to follow in the area of lung diseases.

  4. Impact of continuous quality improvement initiatives on clinical outcomes in peritoneal dialysis.

    Science.gov (United States)

    Yu, Yusheng; Zhou, Yan; Wang, Han; Zhou, Tingting; Li, Qing; Li, Taoyu; Wu, Yan; Liu, Zhihong

    2014-06-01

    We evaluated the role of a quality improvement initiative in improving clinical outcomes in peritoneal dialysis (PD). In a retrospective analysis of 6 years of data from a hospital registry, the period between 1 July 2005 and 30 June 2008 (control group) provided baseline data from before implementation of systemic outcomes monitoring, and the period between 1 July 2008 and 30 June 2011 [continuous quality improvement (CQI) group] represented the time when a CQI program was in place. Peritonitis incidence, patient and technique survival, cardiovascular status, causes of death, and drop-out were compared between the groups. In the 370 patients of the CQI group and the 249 patients of the control group, the predominant underlying kidney diseases were chronic glomerulonephritis and diabetic nephropathy. After implementation of the CQI initiative, the peritonitis rate declined to 1 episode in 77.25 patient-months from 1 episode in 22.86 patient-months. Ultrasound parameters of cardiac structure were generally unchanged in the CQI group, but significant increases in cardiothoracic ratio and interventricular septal thickness were observed in the control group (both p improve technique survival rates: 95.6%, 92.6%, and 92.6% in the CQI group compared with 89.6%, 79.2%, and 76.8% in the control group (p improve the quality of therapy and its outcomes. Copyright © 2014 International Society for Peritoneal Dialysis.

  5. Environmental assessment, continual improvement and adaptive management within the AREVA sustainable development framework

    International Nuclear Information System (INIS)

    Rosaasen, A.; Frostad, S.

    2006-01-01

    COGEMA Resources Inc. (which is part of the AREVA Group) is a Canadian company with its head office in Saskatoon, Saskatchewan. It owns and operates mining and milling facilities in northern Saskatchewan, which produce uranium concentrate. The McClean Lake Operation commenced production in 1999 and its environmental management system represents an integrated approach to environmental assessment, continual improvement and adaptive management based on operational results. In Canada, sustainable development is promoted through the application of the Canadian Environmental Assessment Act (CEAA). Environmental Assessment (EA) is a planning tool, which incorporates environmental considerations before irrevocable decisions are taken. The basic tenet of the Act is the determination of whether the potential environmental effects of a project are adverse, significant and likely, taking into consideration mitigation measures. Thus, project planning and design entails an iterative process that incorporates mitigation measures to minimize potentially significant adverse effects. As part of the EA process conservative approaches are taken to predict potential effects. Several important elements are generated through the EA process including: a set of environmental effects predictions, a compliance and environmental effects monitoring program, a follow-up program to address uncertainties in the prediction of environmental effects, and the identification of contingency measures that could be implemented should non-conservative assumptions be identified in the original assessment framework. The challenge is to integrate each of these elements into the environmental management framework of the operating facility and develop an iterative mechanism to evaluate operational performance relative to what was originally predicted. In Saskatchewan, a requirement of operational licenses is the periodic evaluation of the 'Status of the Environment' surrounding operational facilities. These

  6. POSSIBILITIES AND LIMITS OF THE CYCLE OF CONTINUOUS IMPROVEMENT -PDCA AS AN ELEMENT OF LEARNING

    Directory of Open Access Journals (Sweden)

    Celso Machado Junior

    2013-08-01

    Full Text Available The aim of this study is to investigate the possibilities and limits of the use of continuous improvement cycle, PDCA, as a tool that contributes to the development of individual learning in the organization. It is a qualitative, descriptive end uses the case study as a method. It was observed that the practice proposed by PDCA, can be used in the process of knowledge creation in line with the authors in the field, constituting a form of knowledge management within the organization, enabling the creation of tacit knowledge and its explicit transformation were not observed limits for their use.

  7. Continual summing-up, deepening the related researches and improving the interventional nursing

    International Nuclear Information System (INIS)

    Xu Xiufang; Zhang Xiumei; Ding Yue

    2011-01-01

    With the development of the medical technique in the field of clinical interventional radiology, the relevant interventional nursing team has also gradually grown and expanded. At present, there are certain differences in the development situation of interventional nursing between China and foreign countries. The experts in nursing fields in China should learn the matured experience from abroad to open up the features and superiorities of Chinese interventional nursing. Therefore, the nursing workers in China should continually to make summing-up, exert oneself to deepen the related researches and effectively improve the interventional nursing level. (authors)

  8. Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health Outcomes

    Science.gov (United States)

    McCalman, Janya; Bailie, Ross; Bainbridge, Roxanne; McPhail-Bell, Karen; Percival, Nikki; Askew, Deborah; Fagan, Ruth; Tsey, Komla

    2018-01-01

    Continuous quality improvement (CQI) processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10–20% of gain in health outcomes is contributed by health-care services; a much larger share is determined by social and cultural factors. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. Referring to the Aboriginal and Torres Strait Islander Australian context as an example, the authors provide a systems framework that includes strategies and conditions to facilitate evidence-based and local decision making by primary health-care services. The framework describes the integration of CQI vertically to improve linkages with governments and community members and horizontally with other sectors to influence the social and cultural determinants of health. Further, government and primary health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally. PMID:29623271

  9. Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health Outcomes

    Directory of Open Access Journals (Sweden)

    Janya McCalman

    2018-03-01

    Full Text Available Continuous quality improvement (CQI processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10–20% of gain in health outcomes is contributed by health-care services; a much larger share is determined by social and cultural factors. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. Referring to the Aboriginal and Torres Strait Islander Australian context as an example, the authors provide a systems framework that includes strategies and conditions to facilitate evidence-based and local decision making by primary health-care services. The framework describes the integration of CQI vertically to improve linkages with governments and community members and horizontally with other sectors to influence the social and cultural determinants of health. Further, government and primary health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally.

  10. Improving physiotherapy services to Indigenous children with physical disability: Are client perspectives missed in the continuous quality improvement approach?

    Science.gov (United States)

    Greenstein, Caroline; Lowell, Anne; Thomas, David Piers

    2016-06-01

    To compare the outcomes of two cycles of continuous quality improvement (CQI) at a paediatric physiotherapy service with findings from interviews with clients and their carers using the service. Case study based at one paediatric physiotherapy service Community-based paediatric allied health service in Northern Australia. Forty-nine clinical records and four staff at physiotherapy service, five Indigenous children with physical disability aged 8-21 years, and nine carers of Indigenous children aged 0-21 years (current or previous clients). The CQI process based on the Audit and Best Practice for Chronic Disease involved a clinical audit; a workshop where clinicians assessed their health care systems, identified weaknesses and strengths, and developed goals and strategies for improvement; and reassessment through a second audit and workshop. Twelve open-ended, in-depth interviews were conducted with previous or current clients selected through purposive and theoretical sampling. CQI and interview results were then compared. Comparison of findings from the two studies Both CQI and interview results highlighted service delivery flexibility and therapists' knowledge, support and advocacy as service strengths, and lack of resources and a child-friendly office environment as weaknesses. However, the CQI results reported better communication and client input into the service than the interview results. The CQI process, while demonstrating improvements in clinical and organisational aspects of the service, did not always reflect or address the primary concerns of Indigenous clients and underlined the importance of including clients in the CQI process. © 2015 National Rural Health Alliance Inc.

  11. Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health Outcomes.

    Science.gov (United States)

    McCalman, Janya; Bailie, Ross; Bainbridge, Roxanne; McPhail-Bell, Karen; Percival, Nikki; Askew, Deborah; Fagan, Ruth; Tsey, Komla

    2018-01-01

    Continuous quality improvement (CQI) processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10-20% of gain in health outcomes is contributed by health-care services; a much larger share is determined by social and cultural factors. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. Referring to the Aboriginal and Torres Strait Islander Australian context as an example, the authors provide a systems framework that includes strategies and conditions to facilitate evidence-based and local decision making by primary health-care services. The framework describes the integration of CQI vertically to improve linkages with governments and community members and horizontally with other sectors to influence the social and cultural determinants of health. Further, government and primary health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally.

  12. The Relationship between Marital and Sexual Satisfaction among Married Women Employees at Golestan University of Medical Sciences, Iran.

    Science.gov (United States)

    Ziaee, Tayebe; Jannati, Yadollah; Mobasheri, Elham; Taghavi, Taraneh; Abdollahi, Habib; Modanloo, Mahnaz; Behnampour, Naser

    2014-01-01

    There are various elements affecting the healthy family such as marital satisfaction. Various factors such as sexual satisfaction have an important impact on satisfaction of marital relationship. The present study aimed to determine the association of marital satisfaction with sexual satisfaction among sexually active employee women. This analytical descriptive study was carried on 140 married women employed at educational and medical centers of Golestan University of Medical Sciences. Questionnaires for data collection included Enrich Marital Satisfaction Questionnaire and self-constructed questionnaire (demographic characteristic and sexual satisfaction). Data were analyzed using descriptive statistics, χ(2) and Spearman statistical test. Statistical significant level was set as 0.05. The findings showed that in marital satisfaction scale, the majority of the participants (63.6%) were very satisfied and none of them were very unsatisfied. In sexual satisfaction scale, most of the participants (56.4%) expressed extremely satisfaction rate and only 0.7% were not satisfied with their sexual relationship. Marital satisfaction was significantly associated with sexual satisfaction (p ≤ 0.001). So with the increase of sexual satisfaction, there was an increase in marital satisfaction accordingly. The findings indicated that there was a significant association between sexual satisfaction and age (p = 0.086). Level of education was associated significantly with the marital satisfaction (p = 0.038). The effects of sexual satisfaction on marital satisfaction were moderated by number of children and the level of education. The findings have implications for improving of couples' marital satisfaction by highlighting the need for awareness of sexual quality. According to the findings, it seems that development of educational programs and pre-marriage counseling is necessary. Continuous education would be helpful after marriage in addressing couples' unique transitional

  13. The Relationship between Marital and Sexual Satisfaction among Married Women Employees at Golestan University of Medical Sciences, Iran

    Science.gov (United States)

    Ziaee, Tayebe; Jannati, Yadollah; Mobasheri, Elham; Taghavi, Taraneh; Abdollahi, Habib; Modanloo, Mahnaz; Behnampour, Naser

    2014-01-01

    Objective: There are various elements affecting the healthy family such as marital satisfaction. Various factors such as sexual satisfaction have an important impact on satisfaction of marital relationship. The present study aimed to determine the association of marital satisfaction with sexual satisfaction among sexually active employee women. Methods: This analytical descriptive study was carried on 140 married women employed at educational and medical centers of Golestan University of Medical Sciences. Questionnaires for data collection included Enrich Marital Satisfaction Questionnaire and self-constructed questionnaire (demographic characteristic and sexual satisfaction). Data were analyzed using descriptive statistics, χ2 and Spearman statistical test. Statistical significant level was set as 0.05. Results: The findings showed that in marital satisfaction scale, the majority of the participants (63.6%) were very satisfied and none of them were very unsatisfied. In sexual satisfaction scale, most of the participants (56.4%) expressed extremely satisfaction rate and only 0.7% were not satisfied with their sexual relationship. Marital satisfaction was significantly associated with sexual satisfaction (p ≤ 0.001). So with the increase of sexual satisfaction, there was an increase in marital satisfaction accordingly. The findings indicated that there was a significant association between sexual satisfaction and age (p = 0.086). Level of education was associated significantly with the marital satisfaction (p = 0.038). The effects of sexual satisfaction on marital satisfaction were moderated by number of children and the level of education. Conclusion: The findings have implications for improving of couples' marital satisfaction by highlighting the need for awareness of sexual quality. According to the findings, it seems that development of educational programs and pre-marriage counseling is necessary. Continuous education would be helpful after marriage in

  14. Job satisfaction and gender differences in job satisfaction of teachers in Serbian primary schools

    Directory of Open Access Journals (Sweden)

    Gligorović Bojana

    2014-01-01

    Full Text Available This paper aims to examine Serbian primary teachers' job satisfaction as well as the differences in job satisfaction between male and female teachers. The participants were 362 teachers from 57 primary schools in Serbia. Nine dimensions of job satisfaction (Pay, Promotion, Supervision, Fringe Benefits, Contingent Rewards, Operating Procedures, Co-Workers, Nature of Work, Communication were measured. The results indicate that from the dimensions of job satisfaction, Serbian primary teachers are most satisfied with the Nature of work, Communication and Supervision, while the major sources of Serbian primary teachers' job dissatisfaction are Fringe benefits, Pay and Operating procedures. When it comes to the gender difference in job satisfaction, T-test analysis shows slightly higher satisfaction among female teachers, while statistically significant difference exists only in two dimensions: Supervision and Nature of work. Serbian policy makers in the field of education as well as school administrators should pay close attention to teachers' job satisfaction and its improvement considering that it is an essential to the continuing growth of school effectiveness.

  15. Improvement of two-way continuous-variable quantum key distribution using optical amplifiers

    International Nuclear Information System (INIS)

    Zhang, Yi-Chen; Yu, Song; Gu, Wanyi; Li, Zhengyu; Sun, Maozhu; Peng, Xiang; Guo, Hong; Weedbrook, Christian

    2014-01-01

    The imperfections of a receiver's detector affect the performance of two-way continuous-variable (CV) quantum key distribution (QKD) protocols and are difficult to adjust in practical situations. We propose a method to improve the performance of two-way CV-QKD by adding a parameter-adjustable optical amplifier at the receiver. A security analysis is derived against a two-mode collective entangling cloner attack. Our simulations show that the proposed method can improve the performance of protocols as long as the inherent noise of the amplifier is lower than a critical value, defined as the tolerable amplifier noise. Furthermore, the optimal performance can approach the scenario where a perfect detector is used. (paper)

  16. 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.

  17. Evaluating online continuing medical education seminars: evidence for improving clinical practices.

    Science.gov (United States)

    Weston, Christine M; Sciamanna, Christopher N; Nash, David B

    2008-01-01

    The purpose of this study was to evaluate the potential for online continuing medical education (CME) seminars to improve quality of care. Primary care physicians (113) participated in a randomized controlled trial to evaluate an online CME series. Physicians were randomized to view either a seminar about type 2 diabetes or a seminar about systolic heart failure. Following the seminar, physicians were presented with 4 clinical vignettes and asked to describe what tests, treatments, counseling, or referrals they would recommend. Physicians who viewed the seminars were significantly more likely to recommend guideline-consistent care to patients in the vignettes. For example, physicians who viewed the diabetes seminar were significantly more likely to order an eye exam for diabetes patients (63%) compared with physicians in the control group (27%). For some guidelines there were no group differences. These results provide early evidence of the effectiveness of online CME programs to improve physician clinical practice.

  18. 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.

  19. Continuing Improvement in the Planetary Ephemeris with VLBA Observations of Cassini

    Science.gov (United States)

    Jones, Dayton L.; Folkner, William M.; Jacobson, Robert A.; Jacobs, Christopher S.; Romney, Jonathan D.; Dhawan, Vivek; Fomalont, Edward B.

    2016-06-01

    During the past decade a continuing series of measurements of the barycentric position of the Saturn system in the inertial International Celestial Reference Frame (ICRF) has led to a significant improvement in our knowledge of Saturn's orbit. This in turn has improved the current accuracy and time range of the solar system ephemeris produced and maintained by the Jet Propulsion Laboratory. Our observing technique involves high-precision astrometry of the radio signal from Cassini with the NRAO Very Long Baseline Array, combined with solutions for the orbital motion of Cassini about the Saturn barycenter from Doppler tracking by the Deep Space Network. Our VLBA astrometry is done in a phase-referencing mode, providing nrad-level relative positions between Cassini and angularly nearby extragalactic radio sources. The positions of those reference radio sources are tied to the ICRF through dedicated VLBI observations by several groups around the world. We will present recent results from our astrometric observations of Cassini through early 2016. This program will continue until the end of the Cassini mission in 2017, although future improvement in Saturn's orbit will be more incremental because we have already covered more that a quarter of Saturn's orbital period. The Juno mission to Jupiter, which will orbit Jupiter for about 1.5 years starting in July 2016, will provide an excellent opportunity for us to apply the same VLBA astrometry technique to improve the orbit of Jupiter by a factor of several. The National Radio Astronomy Observatory is a facility of the National Science Foundation operated under cooperative agreement by Associated Universities, Inc. This work made use of the Swinburne University of Technology software correlator, developed as part of the Australian Major National Research Facilities Program and operated under license. Part of this research was carried out at the Jet Propulsion Laboratory, California Institute of Technology, under contract

  20. Dissemination of performance information and continuous improvement: A narrative systematic review.

    Science.gov (United States)

    Lemire, Marc; Demers-Payette, Olivier; Jefferson-Falardeau, Justin

    2013-01-01

    Developing a performance measure and reporting the results to support decision making at an individual level has yielded poor results in many health systems. The purpose of this paper is to highlight the factors associated with the dissemination of performance information that generate and support continuous improvement in health organizations. A systematic data collection strategy that includes empirical and theoretical research published from 1980 to 2010, both qualitative and quantitative, was performed on Web of Science, Current Contents, EMBASE and MEDLINE. A narrative synthesis method was used to iteratively detail explicative processes that underlie the intervention. A classification and synthesis framework was developed, drawing on knowledge transfer and exchange (KTE) literature. The sample consisted of 114 articles, including seven systematic or exhaustive reviews. Results showed that dissemination in itself is not enough to produce improvement initiatives. Successful dissemination depends on various factors, which influence the way collective actors react to performance information such as the clarity of objectives, the relationships between stakeholders, the system's governance and the available incentives. This review was limited to the process of knowledge dissemination in health systems and its utilization by users at the health organization level. Issues related to improvement initiatives deserve more attention. Knowledge dissemination goes beyond better communication and should be considered as carefully as the measurement of performance. Choices pertaining to intervention should be continuously prompted by the concern to support organizational action. While considerable attention was paid to the public reporting of performance information, this review sheds some light on a more promising avenue for changes and improvements, notably in public health systems.

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

    Science.gov (United States)

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

    2015-05-26

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

  2. Can continuous scans in orthogonal planes improve diagnostic performance of shear wave elastography for breast lesions?

    Science.gov (United States)

    Yang, Pan; Peng, Yulan; Zhao, Haina; Luo, Honghao; Jin, Ya; He, Yushuang

    2015-01-01

    Static shear wave elastography (SWE) is used to detect breast lesions, but slice and plane selections result in discrepancies. To evaluate the intraobserver reproducibility of continuous SWE, and whether quantitative elasticities in orthogonal planes perform better in the differential diagnosis of breast lesions. One hundred and twenty-two breast lesions scheduled for ultrasound-guided biopsy were recruited. Continuous SWE scans were conducted in orthogonal planes separately. Quantitative elasticities and histopathology results were collected. Reproducibility in the same plane and diagnostic performance in different planes were evaluated. The maximum and mean elasticities of the hardest portion, and standard deviation of whole lesion, had high inter-class correlation coefficients (0.87 to 0.95) and large areas under receiver operation characteristic curve (0.887 to 0.899). Without loss of accuracy, sensitivities had increased in orthogonal planes compared with single plane (from 73.17% up to 82.93% at most). Mean elasticity of whole lesion and lesion-to-parenchyma ratio were significantly less reproducible and less accurate. Continuous SWE is highly reproducible for the same observer. The maximum and mean elasticities of the hardest portion and standard deviation of whole lesion are most reliable. Furthermore, the sensitivities of the three parameters are improved in orthogonal planes without loss of accuracies.

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

    Science.gov (United States)

    Oneill, John W.; Gordon-Winkler, Lyn

    1992-01-01

    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.

  4. 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.

  5. Continuous Improvement in Battery Testing at the NASA/JSC Energy System Test Area

    Science.gov (United States)

    Boyd, William; Cook, Joseph

    2003-01-01

    The Energy Systems Test Area (ESTA) at the Lyndon B. Johnson Space Center in Houston, Texas conducts development and qualification tests to fulfill Energy System Division responsibilities relevant to ASA programs and projects. EST A has historically called upon a variety of fluid, mechanical, electrical, environmental, and data system capabilities spread amongst five full-service facilities to test human and human supported spacecraft in the areas of propulsion systems, fluid systems, pyrotechnics, power generation, and power distribution and control systems. Improvements at ESTA are being made in full earnest of offering NASA project offices an option to choose a thorough test regime that is balanced with cost and schedule constraints. In order to continue testing of enabling power-related technologies utilized by the Energy System Division, an especially proactive effort has been made to increase the cost effectiveness and schedule responsiveness for battery testing. This paper describes the continuous improvement in battery testing at the Energy Systems Test Area being made through consolidation, streamlining, and standardization.

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

    International Nuclear Information System (INIS)

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

    2000-01-01

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

  7. Safety implications of standardized continuous quality improvement programs in community pharmacy.

    Science.gov (United States)

    Boyle, Todd A; Ho, Certina; Mackinnon, Neil J; Mahaffey, Thomas; Taylor, Jeffrey M

    2013-06-01

    Standardized continuous quality improvement (CQI) programs combine Web-based technologies and standardized improvement processes, tools, and expectations to enable quality-related events (QREs) occurring in individual pharmacies to be shared with pharmacies in other jurisdictions. Because standardized CQI programs are still new to community pharmacy, little is known about how they impact medication safety. This research identifies key aspects of medication safety that change as a result of implementing a standardized CQI program. Fifty-three community pharmacies in Nova Scotia, Canada, adopted the SafetyNET-Rx standardized CQI program in April 2010. The Institute for Safe Medication Practices (ISMP) Canada's Medication Safety Self-Assessment (MSSA) survey was administered to these pharmacies before and 1 year into their use of the SafetyNET-Rx program. The nonparametric Wilcoxon signed-rank test was used to explore where changes in patient safety occurred as a result of SafetyNETRx use. Significant improvements occurred with quality processes and risk management, staff competence, and education, and communication of drug orders and other information. Patient education, environmental factors, and the use of devices did not show statistically significant changes. As CQI programs are designed to share learning from QREs, it is reassuring to see that the largest improvements are related to quality processes, risk management, staff competence, and education.

  8. 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.

  9. Increasing the use of 'smart' pump drug libraries by nurses: a continuous quality improvement project.

    Science.gov (United States)

    Harding, Andrew D

    2012-01-01

    The use of infusion pumps that incorporate "smart" technology (smart pumps) can reduce the risks associated with receiving IV therapies. Smart pump technology incorporates safeguards such as a list of high-alert medications, soft and hard dosage limits, and a drug library that can be tailored to specific patient care areas. Its use can help to improve patient safety and to avoid potentially catastrophic harm associated with medication errors. But when one independent community hospital in Massachusetts switched from older mechanical pumps to smart pumps, it neglected to assign an "owner" to oversee the implementation process. One result was that nurses were using the smart pump library for only 37% of all infusions.To increase pump library usage percentage-thereby reducing the risks associated with infusion and improving patient safety-the hospital undertook a continuous quality improvement project over a four-month period in 2009. With the involvement of direct care nurses, and using quantitative data available from the smart pump software, the nursing quality and pharmacy quality teams identified ways to improve pump and pump library use. A secondary goal was to calculate the hospital's return on investment for the purchase of the smart pumps. Several interventions were developed and, on the first of each month, implemented. By the end of the project, pump library usage had nearly doubled; and the hospital had completely recouped its initial investment.

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

    Science.gov (United States)

    2011-11-01

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

  11. 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

  12. 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.

  13. Continuous positive airway pressure improves gait control in severe obstructive sleep apnoea: A prospective study.

    Directory of Open Access Journals (Sweden)

    Sébastien Baillieul

    Full Text Available Severe obstructive sleep apnoea (OSA can lead to neurocognitive alterations, including gait impairments. The beneficial effects of continuous positive airway pressure (CPAP on improving excessive daytime sleepiness and daily functioning have been documented. However, a demonstration of CPAP treatment efficacy on gait control is still lacking. This study aims to test the hypothesis that CPAP improves gait control in severe OSA patients.In this prospective controlled study, twelve severe OSA patients (age = 57.2±8.9 years, body mass index = 27.4±3.1 kg·m-2, apnoea-hypopnoea index = 46.3±11.7 events·h-1 and 10 healthy matched subjects were included. Overground gait parameters were recorded at spontaneous speed and stride time variability, a clinical marker of gait control, was calculated. To assess the role of executive functions in gait and postural control, a dual-task paradigm was applied using a Stroop test as secondary cognitive task. All assessments were performed before and after 8 weeks of CPAP treatment.Before CPAP treatment, OSA patients had significantly larger stride time variability (3.1±1.1% vs 2.1±0.5% and lower cognitive performances under dual task compared to controls. After CPAP treatment, stride time variability was significantly improved and no longer different compared to controls. Cognitive performance under dual task also improved after CPAP treatment.Eight weeks of CPAP treatment improves gait control of severe OSA patients, suggesting morphological and functional cerebral improvements. Our data provide a rationale for further mechanistic studies and the use of gait as a biomarker of OSA brain consequences.

  14. 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

  15. Breaking continuous potato cropping with legumes improves soil microbial communities, enzyme activities and tuber yield

    Science.gov (United States)

    Qin, Shuhao; Yeboah, Stephen; Cao, Li; Zhang, Junlian; Shi, Shangli; Liu, Yuhui

    2017-01-01

    This study was conducted to explore the changes in soil microbial populations, enzyme activity, and tuber yield under the rotation sequences of Potato–Common vetch (P–C), Potato–Black medic (P–B) and Potato–Longdong alfalfa (P–L) in a semi–arid area of China. The study also determined the effects of continuous potato cropping (without legumes) on the above mentioned soil properties and yield. The number of bacteria increased significantly (p continuous cropping soils, respectively compared to P–C rotation. The highest fungi/bacteria ratio was found in P–C (0.218), followed by P–L (0.184) and then P–B (0.137) rotation over the different cropping years. In the continuous potato cropping soils, the greatest fungi/bacteria ratio was recorded in the 4–year (0.4067) and 7–year (0.4238) cropping soils and these were significantly higher than 1–year (0.3041), 2–year (0.2545) and 3–year (0.3030) cropping soils. Generally, actinomycetes numbers followed the trend P–L>P–C>P–B. The P–L rotation increased aerobic azotobacters in 2–year (by 26% and 18%) and 4–year (40% and 21%) continuous cropping soils compared to P–C and P–B rotation, respectively. Generally, the highest urease and alkaline phosphate activity, respectively, were observed in P–C (55.77 mg g–1) and (27.71 mg g–1), followed by P–B (50.72 mg mg–1) and (25.64 mg g–1) and then P–L (41.61 mg g–1) and (23.26 mg g–1) rotation. Soil urease, alkaline phosphatase and hydrogen peroxidase activities decreased with increasing years of continuous potato cropping. On average, the P–B rotation significantly increased (p improve soil biology environment, alleviate continuous cropping obstacle and increase potato tuber yield in semi–arid region. PMID:28463981

  16. 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

  17. 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.

  18. 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.

  19. 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...

  20. Patient satisfaction.

    Science.gov (United States)

    Prakash, Bhanu

    2010-09-01

    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.

  1. Continuous quality improvement in a Maltese hospital using logical framework analysis.

    Science.gov (United States)

    Buttigieg, Sandra C; Gauci, Dorothy; Dey, Prasanta

    2016-10-10

    Purpose The purpose of this paper is to present the application of logical framework analysis (LFA) for implementing continuous quality improvement (CQI) across multiple settings in a tertiary care hospital. Design/methodology/approach This study adopts a multiple case study approach. LFA is implemented within three diverse settings, namely, intensive care unit, surgical ward, and acute in-patient psychiatric ward. First, problem trees are developed in order to determine the root causes of quality issues, specific to the three settings. Second, objective trees are formed suggesting solutions to the quality issues. Third, project plan template using logical framework (LOGFRAME) is created for each setting. Findings This study shows substantial improvement in quality across the three settings. LFA proved to be effective to analyse quality issues and suggest improvement measures objectively. Research limitations/implications This paper applies LFA in specific, albeit, diverse settings in one hospital. For validation purposes, it would be ideal to analyse in other settings within the same hospital, as well as in several hospitals. It also adopts a bottom-up approach when this can be triangulated with other sources of data. Practical implications LFA enables top management to obtain an integrated view of performance. It also provides a basis for further quantitative research on quality management through the identification of key performance indicators and facilitates the development of a business case for improvement. Originality/value LFA is a novel approach for the implementation of CQI programs. Although LFA has been used extensively for project development to source funds from development banks, its application in quality improvement within healthcare projects is scant.

  2. The mCME Project: A Randomized Controlled Trial of an SMS-Based Continuing Medical Education Intervention for Improving Medical Knowledge among Vietnamese Community Based Physicians' Assistants.

    Directory of Open Access Journals (Sweden)

    Christopher J Gill

    Full Text Available Community health workers (CHWs provide critical services to underserved populations in low and middle-income countries, but maintaining CHW's clinical knowledge through formal continuing medical education (CME activities is challenging and rarely occurs. We tested whether a Short Message Service (SMS-based mobile CME (mCME intervention could improve medical knowledge among a cadre of Vietnamese CHWs (Community Based Physician's Assistants-CBPAs who are the leading providers of primary medical care for rural underserved populations.The mCME Project was a three arm randomized controlled trial. Group 1 served as controls while Groups 2 and 3 experienced two models of the mCME intervention. Group 2 (passive model participants received a daily SMS bullet point, and were required to reply to the text to acknowledge receipt; Group 3 (interactive model participants received an SMS in multiple choice question format addressing the same thematic area as Group 2, entering an answer (A, B, C or D in their response. The server provided feedback immediately informing the participant whether the answer was correct. Effectiveness was based on standardized examination scores measured at baseline and endline (six months later. Secondary outcomes included job satisfaction and self-efficacy.638 CBPAs were enrolled, randomized, and tested at baseline, with 592 returning at endline (93.7%. Baseline scores were similar across all three groups. Over the next six months, participation of Groups 2 and 3 remained high; they responded to >75% of messages. Group 3 participants answered 43% of the daily SMS questions correctly, but their performance did not improve over time. At endline, the CBPAs reported high satisfaction with the mCME intervention, and deemed the SMS messages highly relevant. However, endline exam scores did not increase over baseline, and did not differ between the three groups. Job satisfaction and self-efficacy scores also did not improve. Average

  3. Customer Relationship Management Influence on Customer Value, Product Quality and Service Quality in Improving Customer Satisfaction and Its Implication on the Customer Loyalty

    OpenAIRE

    Harryani, Sri

    2017-01-01

    The purpose of this research is to determine the influence of Customer Relationship Management (CRM) on the Customer Value (CV), Product Quality (PQ) and Service Quality (SQ) in improving Customer Satisfaction (CS) that will have implications on the Customer Loyalty (CL). The research focuses on corporate banking, where customers serve as the research sample. The data in this research using the primary data and secondary data. Source primary data used questionnaire and source the secondary da...

  4. Prevention of respiratory complications of the surgical patient: actionable plan for continued process improvement.

    Science.gov (United States)

    Ruscic, Katarina J; Grabitz, Stephanie D; Rudolph, Maíra I; Eikermann, Matthias

    2017-06-01

    Postoperative respiratory complications (PRCs) increase hospitalization time, 30-day mortality and costs by up to $35 000. These outcomes measures have gained prominence as bundled payments have become more common. Results of recent quantitative effectiveness studies and clinical trials provide a framework that helps develop center-specific treatment guidelines, tailored to minimize the risk of PRCs. The implementation of those protocols should be guided by a local, respected, and visible facilitator who leads proper implementation while inviting center-specific input from surgeons, anesthesiologists, and other perioperative stakeholders. Preoperatively, patients should be risk-stratified for PRCs to individualize intraoperative choices and postoperative pathways. Laparoscopic compared with open surgery improves respiratory outcomes. High-risk patients should be treated by experienced providers based on locally developed bundle-interventions to optimize intraoperative treatment and ICU bed utilization. Intraoperatively, lung-protective ventilation (procedure-specific positive end-expiratory pressure utilization, and low driving pressure) and moderately restrictive fluid therapy should be used. To achieve surgical relaxation, high-dose neuromuscular blocking agents (and reversal agents) as well as high-dose opioids should be avoided; inhaled anesthetics improve surgical conditions while protecting the lungs. Patients should be extubated in reverse Trendelenburg position. Postoperatively, continuous positive airway pressure helps prevent airway collapse and protocolized, early mobilization improves cognitive and respiratory function.

  5. Improvement in Physical Activity in Persons With Obstructive Sleep Apnea Treated With Continuous Positive Airway Pressure.

    Science.gov (United States)

    Jean, Raymonde E; Duttuluri, Manideep; Gibson, Charlisa D; Mir, Sadaf; Fuhrmann, Katherine; Eden, Edward; Supariwala, Azhar

    2017-03-01

    Exercise improves sleep quality, yet people with untreated obstructive sleep apnea (OSA) may engage in less physical activity (PA) due to fatigue and daytime sleepiness. We examined changes in PA and sleep quality before and after treatment with continuous positive airway pressure (CPAP) in OSA patients. In this prospective longitudinal study, persons with a primary diagnosis of OSA were enrolled at a community-based hospital in New York City. At 3 time intervals pre- and post-CPAP (3-8 months), we measured sleep quality using validated questionnaires, perceived PA using the International Physical Activity Questionnaire (IPAQ), and actual PA using pedometer steps per day. We sought to investigate how CPAP use and changes in sleep quality impacted the number of steps taken, as recorded in pedometer steps. In total, 62 patients were enrolled in the study from March 2012 to July 2014. In all, patients averaged 53 years of age, and 26 patients (42%) were female. Among all participants, 86% of persons had moderate to severe sleep apnea (AHI ≥15). Approximately 73% of participants were compliant with CPAP use. Poor sleep quality correlated with lower actual PA (P = .004) at baseline. At 3 and 7 months, there was significant improvement in sleep quality (Δ -2.63 ± 3.4 and Δ -3.5 ± 3.8; P improvement in sleep quality and actual PA.

  6. 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

  7. Job satisfaction at Company Teija Jousi Viikarit

    OpenAIRE

    Grönlund, Mirka

    2011-01-01

    The objective of this study is to find out the level of job satisfaction in Company Teija Jousi Viikarit. One intention is to find out what the factors affecting employees’ job satisfaction are and how to increase the job satisfaction within these fields. Another intention is to provide for the case company a complete job satisfaction survey package, which they can use continuously to keep their employee satisfaction as high as possible. The theoretical framework was based on the factors of j...

  8. Improvement in headaches with continuous positive airway pressure for obstructive sleep apnea: a retrospective analysis.

    Science.gov (United States)

    Johnson, Karin G; Ziemba, Alexis M; Garb, Jane L

    2013-02-01

    We aimed to identify clinical features in patients with severe headaches that predicted obstructive sleep apnea (OSA) and determine clinical and sleep study characteristics that predicted headache improvement with continuous positive airway pressure (CPAP). Many patients with headaches complain of sleep symptoms and have OSA. There is often improvement of headaches with CPAP treatment. We conducted a retrospective chart review of all patients referred to adult neurology clinic for headaches and sent for polysomnography between January 2008 and December 2009. Follow-up ranged from 18 to 42 months. Eighty-two headache patients (70 females, 12 males) were studied. Mean age was 45±13 years (females 45±13, males 43±11) and mean body mass index was 32±9. Headache types included 17% chronic migraine without aura, 22% episodic migraine without aura, 32% migraine with aura, 21% tension-type headache, 6% chronic post-traumatic headache, 11% medication overuse headache, and 7% other types. All patients were receiving standard treatment for their headaches by their neurologist. Fifty-two patients (63%) had OSA. Increasing age, female gender, and chronic migraine without aura were predictive of OSA. Of the patients with OSA, 33 (63%) used CPAP and 27 (82%) were adherent to CPAP. Headache improvement was reported by 40 patients (49%) due to either standard medical therapy or CPAP. Patients with OSA who were CPAP adherent (21/27) were more likely to have improvement in headaches than patients intolerant of CPAP (2/6), those that did not try CPAP (8/19), and those who did not have OSA (16/30) (P=.045). Of the 33 patients who used CPAP, 13 reported improvement in headaches specifically due to CPAP therapy and 10 additional patients noted benefit in sleep symptoms. The presence of witnessed apneas (P=.045) and male gender (P=.021) predicted improvement in headaches due to CPAP. Headache patients should be evaluated for the presence of OSA. Treating OSA improves headaches in some

  9. 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.

  10. 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.

  11. Achieving continuous improvement in reductions in foodborne listeriosis: A risk-based approach

    DEFF Research Database (Denmark)

    Gram, Lone

    2005-01-01

    likely due to consumption of contaminated soft cheeses such as queso fresco and queso blanco. The International Life Sciences Institute Risk Science Institute Expert Panel concluded that certain foods pose a high risk for causing listeriosis. High-risk foods have all of the following properties: (1) have...... the potential for contamination with L. monocytogenes; (2) support the growth of L. monocytogenes to high numbers; (3) are ready to eat; (4) require refrigeration; and (5) are stored for an extended period of time. Control strategies are needed in the food chain from preharvest through consumption to minimize...... the likelihood that food will become contaminated by L. monocytogenes and to prevent the growth of the organism to high numbers. The Expert Panel identified three main strategies for ensuring continuous improvement in reducing foodborne listeriosis: (1) preventing contamination of foods with L. monocytogenes; (2...

  12. Indicators of the management for the continuous improvement of the radiological safety in a radioactive facility

    International Nuclear Information System (INIS)

    Amador B, Z. H.

    2006-01-01

    The use of safety indicators is common in the nuclear industry. In this work the implementation of indicators for the efficiency analysis of the radiological safety management system of a radioactive installation is presented. Through the same ones the occupational exposure, the training Y authorization of the personnel, the control of practices Y radioactive inventory, the results of the radiological surveillance, the occurrence of radiological events, the aptitude of the monitoring equipment, the management of the radioactive waste, the public exposure, the audits Y the costs of safety are evaluated. Its study is included in the periodic training of the workers. Without this interrelation it is not possible to maintain the optimization of the safety neither to achieve a continuous improvement. (Author)

  13. 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.

  14. Technical integrity and continuous improvement: Key to survival beyond the nineties

    International Nuclear Information System (INIS)

    Thorogood, J.L.

    1994-01-01

    Drilling decisions made before a rig reaches location make a significant contribution to an oil company's financial success. Of value to the company is not the ability to drill wells, but the ability to plan with confidence in the knowledge of what is possible. In spite of this, operators have tended to over-work day to day decisions about drilling out of proportion to their significance. Recognition of this fact has resulted in the present wave of contracting initiatives. A major challenge for the industry is to achieve the necessary transfer of responsibility without compromising the operator's license to operate. These changes will compel the service sector to develop a new culture of technical integrity and continuous improvement. To operate safely, measure performance and manage drilling risk, the transformation will oblige the service sector to adopt many technologies presently owned by oil companies

  15. A toolbox for safety instrumented system evaluation based on improved continuous-time Markov chain

    Science.gov (United States)

    Wardana, Awang N. I.; Kurniady, Rahman; Pambudi, Galih; Purnama, Jaka; Suryopratomo, Kutut

    2017-08-01

    Safety instrumented system (SIS) is designed to restore a plant into a safe condition when pre-hazardous event is occur. It has a vital role especially in process industries. A SIS shall be meet with safety requirement specifications. To confirm it, SIS shall be evaluated. Typically, the evaluation is calculated by hand. This paper presents a toolbox for SIS evaluation. It is developed based on improved continuous-time Markov chain. The toolbox supports to detailed approach of evaluation. This paper also illustrates an industrial application of the toolbox to evaluate arch burner safety system of primary reformer. The results of the case study demonstrates that the toolbox can be used to evaluate industrial SIS in detail and to plan the maintenance strategy.

  16. Engineering Ethics Education on the Basis of Continuous Education to Improve Communication Ability

    Science.gov (United States)

    Takahara, Kenji; Kajiwara, Toshinori

    The paper proposes the engineering ethics education method for students on the basis of continuous education to improve communication ability. First, through a debate, the students acquire the fundamental skills required to marshal their arguments, to construct the rebuttals and to summarize the debates. Secondly, the students study the fundamental techniques to make a presentation on technical subjects related to electrical engineering. Following these classes, in the lecture of engineering ethics, the students probe the cause of each accident and consider the better means for avoiding such an accident, each other. In most cases, the students can express right and commonsensical opinions from an ethical standpoint. However, they can hardly make judgments when the situations such as the human relations in the above accidents are set concretely. During the engineering ethics class, the students come to know that human relations behind the case make the ethical matters more complicated. Furthermore, they come to understand that facilitating daily communications with co-workers and/or bosses is very important in order to avoid the accidents. The recognition of the students is just the results of the continuous education through three years. It can be said that the engineering ethics education thus constructed makes the students raise such spontaneous awareness and their ethical qualities as engineers.

  17. Can outcome-based continuing medical education improve performance of immigrant physicians?

    Science.gov (United States)

    Castel, Orit Cohen; Ezra, Vered; Alperin, Mordechai; Nave, Rachel; Porat, Tamar; Golan, Avivit Cohen; Vinker, Shlomo; Karkabi, Khaled

    2011-01-01

    Immigrant physicians are a valued resource for physician workforces in many countries. Few studies have explored the education and training needs of immigrant physicians and ways to facilitate their integration into the health care system in which they work. Using an educational program developed for immigrant civilian physicians working in military primary care clinics at the Israel Defence Force, we illustrate how an outcome-based CME program can address practicing physicians' needs for military-specific primary care education and improve patient care. Following an extensive needs assessment, a 3-year curriculum was developed. The curriculum was delivered by a multidisciplinary educational team. Pre/post multiple-choice examinations, objective structured clinical examinations (OSCE), and end-of-program evaluations were administered for curriculum evaluation. To evaluate change in learners' performance, data from the 2003 (before-program) and 2006 (after-program) work-based assessments were retrieved retrospectively. Change in the performance of program participants was compared with that of immigrant physicians who did not participate in the program. Out of 28 learners, 23 (82%) completed the program. Learners did significantly better in the annual post-tests compared with the pretests (p educators, facing the challenge of integrating immigrant physicians to fit their health care system, may consider adapting our approach. Copyright © 2011 The Alliance for Continuing Medical Education, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education.

  18. Issues and Challenges in the Establishment of Continuous Improvement in Vietnam

    Directory of Open Access Journals (Sweden)

    Phuong Anh Nguyen

    2015-10-01

    Full Text Available A better understanding of Vietnamese management is important for both practitioners and academics because of the huge and continuing growth of business activity in Vietnam. In particular, information about the Vietnamese use of continuous improvement (CI practices is valuable because these have underpinned the success of both western and Asian companies in recent decades. Using the case-study method based on over 60 in-depth interviews with executives, managers, supervisors, and employees of nine leading companies in Vietnam and information gathered from discussions with 440 business and non-business leaders, practitioners, and academics, this paper shows that Vietnamese organizations face numerous challenges when implementing and sustaining CI practices. The findings highlight the tendency of Vietnamese organizations to pursue “shortcut” strategies that prevent them from competing higher up the value-added chain. Maintaining “face” is vital to the Vietnamese and this is a major cultural challenge for organizations in their CI efforts. The paper recommends that Vietnamese organizations address these challenges by pursuing CI more aggressively and investing in human resource development to build capabilities for the future. The Vietnamese government, which is the main engine of change in the country, should promote the use of CI by funding education and training in its methods.

  19. A Hierarchical structure of key performance indicators for operation management and continuous improvement in production systems.

    Science.gov (United States)

    Kang, Ningxuan; Zhao, Cong; Li, Jingshan; Horst, John A

    2016-01-01

    Key performance indicators (KPIs) are critical for manufacturing operation management and continuous improvement (CI). In modern manufacturing systems, KPIs are defined as a set of metrics to reflect operation performance, such as efficiency, throughput, availability, from productivity, quality and maintenance perspectives. Through continuous monitoring and measurement of KPIs, meaningful quantification and identification of different aspects of operation activities can be obtained, which enable and direct CI efforts. A set of 34 KPIs has been introduced in ISO 22400. However, the KPIs in a manufacturing system are not independent, and they may have intrinsic mutual relationships. The goal of this paper is to introduce a multi-level structure for identification and analysis of KPIs and their intrinsic relationships in production systems. Specifically, through such a hierarchical structure, we define and layer KPIs into levels of basic KPIs, comprehensive KPIs and their supporting metrics, and use it to investigate the relationships and dependencies between KPIs. Such a study can provide a useful tool for manufacturing engineers and managers to measure and utilize KPIs for CI.

  20. An Improved Real-Coded Population-Based Extremal Optimization Method for Continuous Unconstrained Optimization Problems

    Directory of Open Access Journals (Sweden)

    Guo-Qiang Zeng

    2014-01-01

    Full Text Available As a novel evolutionary optimization method, extremal optimization (EO has been successfully applied to a variety of combinatorial optimization problems. However, the applications of EO in continuous optimization problems are relatively rare. This paper proposes an improved real-coded population-based EO method (IRPEO for continuous unconstrained optimization problems. The key operations of IRPEO include generation of real-coded random initial population, evaluation of individual and population fitness, selection of bad elements according to power-law probability distribution, generation of new population based on uniform random mutation, and updating the population by accepting the new population unconditionally. The experimental results on 10 benchmark test functions with the dimension N=30 have shown that IRPEO is competitive or even better than the recently reported various genetic algorithm (GA versions with different mutation operations in terms of simplicity, effectiveness, and efficiency. Furthermore, the superiority of IRPEO to other evolutionary algorithms such as original population-based EO, particle swarm optimization (PSO, and the hybrid PSO-EO is also demonstrated by the experimental results on some benchmark functions.