Total quality management in the hospital setting.

Science.gov (United States)

Ernst, D F

1994-01-01

With the increasing demands on hospitals for improved quality and lower costs, hospitals have been forced to reevaluate their manner of operation and quality assurance (QA) programs. Hospitals have been faced with customer dissatisfaction with services, escalating costs, intense competition, and reduced reimbursement for services. As a result, many hospitals have incorporated total quality management (TQM), also known as continuous quality improvement (CQI) and quality improvement (QI), to improve quality care and decrease costs. This article examines the concept of TQM, its rationale, and how it can be implemented in a hospital. A comparison of TQM and QA is made. Examples of hospital implementation of TQM and problems and issues associated with TQM in the hospital setting are explored.

Total quality in spent fuel pool reracking

International Nuclear Information System (INIS)

Cranston, J.S.; Bradbury, R.B.; Cacciapouti, R.J.

1993-01-01

The nuclear utility environment is one of strict cost control under prescriptive regulations and increasing public scrutiny. This paper presents the results of A Total Quality approach, by a dedicated team, that addresses the need for increased on-site spent fuel storage in this environment. Innovations to spent fuel pool reracking, driven by utilities' specific technical needs and shrinking budgets, have resulted in both product improvements and lower prices. A Total Quality approach to the entire turnkey project is taken, thereby creating synergism and process efficiency in each of the major phases of the project: design and analysis, licensing, fabrication, installation and disposal. Specific technical advances and the proven quality of the team members minimizes risk to the utility and its shareholders and provides a complete, cost effective service. Proper evaluation of spent fuel storage methods and vendors requires a full understanding of currently available customer driven initiatives that reduce cost while improving quality. In all phases of a spent fuel reracking project, from new rack design and analysis through old rack disposal, the integration of diverse experts, at all levels and throughout all phases of a reracking project, better serves utility needs. This Total Quality environment in conjunction with many technical improvements results in a higher quality product at a lower cost

Integrating total quality management in a library setting

CERN Document Server

Jurow, Susan

2013-01-01

Improve the delivery of library services by implementing total quality management (TQM), a system of continuous improvement employing participative management and centered on the needs of customers. Although TQM was originally designed for and successfully applied in business and manufacturing settings, this groundbreaking volume introduces strategies for translating TQM principles from the profit-based manufacturing sector to the library setting. Integrating Total Quality Management in a Library Setting shows librarians how to improve library services by implementing strategies such as employ

Total Quality Management in Higher Education.

Science.gov (United States)

Sherr, Lawrence A.; Lozier, G. Gredgory

1991-01-01

Total Quality Management, based on theories of W. Edward Deming and others, is a style of management using continuous process improvement characterized by mission and customer focus, a systematic approach to operations, vigorous development of human resources, long-term thinking, and a commitment to ensuring quality. The values espoused by this…

Total quality management in hotel industry

OpenAIRE

Mitreva, Elizabeta; Saneva, Dusica; Miteva, Natasa

2017-01-01

Total quality management (TQM) is a systematic management approach aiming at continuous increase of the value offered to consumers through improvement of service quality. In hotel industry, success is achieved through service quality, which stands as a key factor for sustainability in the twenty-first century. Nowadays, quality is the basic factor for survival on the market, better competition, and greater profitability. TQM is a process that starts and ends with the consumer. The aim of this...

Reverse-total shoulder arthroplasty cost-effectiveness: A quality-adjusted life years comparison with total hip arthroplasty.

Science.gov (United States)

Bachman, Daniel; Nyland, John; Krupp, Ryan

2016-02-18

To compare reverse-total shoulder arthroplasty (RSA) cost-effectiveness with total hip arthroplasty cost-effectiveness. This study used a stochastic model and decision-making algorithm to compare the cost-effectiveness of RSA and total hip arthroplasty. Fifteen patients underwent pre-operative, and 3, 6, and 12 mo post-operative clinical examinations and Short Form-36 Health Survey completion. Short form-36 Health Survey subscale scores were converted to EuroQual Group Five Dimension Health Outcome scores and compared with historical data from age-matched patients who had undergone total hip arthroplasty. Quality-adjusted life year (QALY) improvements based on life expectancies were calculated. The cost/QALY was $3900 for total hip arthroplasty and $11100 for RSA. After adjusting the model to only include shoulder-specific physical function subscale items, the RSA QALY improved to 2.8 years, and its cost/QALY decreased to $8100. Based on industry accepted standards, cost/QALY estimates supported both RSA and total hip arthroplasty cost-effectiveness. Although total hip arthroplasty remains the quality of life improvement "gold standard" among arthroplasty procedures, cost/QALY estimates identified in this study support the growing use of RSA to improve patient quality of life.

Total quality approach at ABB Atom Nuclear Fuel - winner of the Swedish quality award 1994

International Nuclear Information System (INIS)

Moorlin, K.; Olsson, S.

1995-01-01

ABB Atom Nuclear Fuel Division received the Swedish Quality Award 1994. The company has since many years a reputation for high product quality and a well implemented quality assurance system. Since some years a total quality approach is applied. For ABB Atom, total quality means continuous improvement of all business processes keeping the customer in focus. This paper elaborates on the improvement tools used at the ABB Atom Nuclear Fuel Division and gives some detailed information of the experience. (author) 6 figs

Gentilly 2 maintenance in a total quality environment

Energy Technology Data Exchange (ETDEWEB)

Ross, M H; Marois, H [Hydro-Quebec, Gentilly (Canada). Gentilly Generating Station

1993-12-31

Comprehensive preventive maintenance programs at Gentilly-2 Nuclear Generating Station are based on a policy that seeks to balance requirements against resources. A commitment to total quality aims at performance improvement and total customer satisfaction. To improve overall performance to an annual availability factor of 90%, planned outages must be limited to 21 days per year, and the preventive maintenance program must be upgraded. A quality improvement team is involved in supporting this initiative. This team will seek to bring a new balance to the program, and eventually optimize it, using reliability-centred maintenance techniques. 24 figs.

Total Quality Management (TQM): Group Dynamics Workshop

Science.gov (United States)

1990-05-15

take for these changes to penetrate most OSD agencies. - The unique organizational culture, structure, and functioning of OSD (i.e., a gigantic size...Performing (group problem solving; Performing diagnosing and solving quality problems and sele2cting and implementing solutions). Total Quality Management...Stage, the quality improvement group diagnoses the quality problem/opportunity, gathers the right kind of quantitative data, and formulates, selects, and

Adapting Total Quality Management (TQM) to Government.

Science.gov (United States)

Swiss, James E.

1992-01-01

Total quality management will not work well in government agencies because of stress on products, not services; on well-defined consumer groups; on inputs/processes, not results; and on preoccupation with quality. An effective revised version emphasizes client feedback, performance monitoring, continuous improvement, and worker participation. (SK)

Total Quality Leadership

Science.gov (United States)

1991-01-01

More than 750 NASA, government, contractor, and academic representatives attended the Seventh Annual NASA/Contractors Conference on Quality and Productivity. The panel presentations and Keynote speeches revolving around the theme of total quality leadership provided a solid base of understanding of the importance, benefits, and principles of total quality management (TQM). The presentations from the conference are summarized.

USING A TOTAL QUALITY STRATEGY IN A NEW PRACTICAL APPROACH FOR IMPROVING THE PRODUCT RELIABILITY IN AUTOMOTIVE INDUSTRY

Directory of Open Access Journals (Sweden)

Cristiano Fragassa

2014-09-01

Full Text Available In this paper a Total Quality Management strategy is proposed, refined and used with the aim at improving the quality of large-mass industrial products far beyond the technical specifications demanded at the end-customer level. This approach combines standard and non-standard tools used for Reliability, Availability and Maintainability analysis. The procedure also realizes a stricter correlation between theoretical evaluation methods and experimental evidences as part of a modern integrated method for strengthening quality in design and process. A commercial Intake Manifold, largely spread in the market, is used as test-case for the validation of the methodology. As general additional result, the research underlines the impact of Total Quality Management and its tools on the development of innovation.

Total Quality Management. A Selected Bibliography

Science.gov (United States)

1994-03-01

and Publow, Mark. "Understanding and Managing Authority Relationships : Guidelines for Supervisors and Sub- ordinates." QUALITY PROGRESS, Vol. 25...NEXT OPERATION AS CUSTOMER (NOAC): HOW TO IMPROVE QUALITY, COST AND CYCLE TIME IN SERVICE OPERATIONS. New York: American Management Association, 1991...Keith. HORIZONTAL MANAGEMENT : BEYOND TOTAL CUSTOMER SATISFACTION. New York: Lexington Books, 1991. 211pp. (HD66 D45 1991) Donnelly, James H., Jr. CLOSE

A longitudinal study of quality of life and functional status in total hip and total knee replacement patients.

Science.gov (United States)

Mandzuk, Lynda L; McMillan, Diana E; Bohm, Eric R

2015-05-01

Primary total hip and primary total knee surgeries are commonly performed to improve patients' quality of life and functional status. This longitudinal retrospective study (N = 851) examined self-reported quality of life and functional status over the preoperative and postoperative periods: 12 months prior to surgery, one month prior to surgery and 12 months following surgery. A linear mixed effects model was used to analyze the changes in quality of life and functional status over the sampling period. Patients in the convenience sample reported improvements in quality of life and functional status utilizing the SF-12 and Oxford Hip and Oxford Knee, although differences were noted by procedure and gender. Total hip patients tended to demonstrate greater improvement than total knee patients and males reported higher levels of physical and mental quality of life as well as functional status when compared to females. Of particular note was that mental health scores were consistently lower in both total hip and total knee replacement patients across the perioperative period and up to one year postoperative. This study identifies an opportunity for health care providers to proactively address the mental health of total hip and total knee replacement patients throughout their joint replacement trajectory. Copyright © 2014 Elsevier Ltd. All rights reserved.

Total quality management and nursing: a shared vision.

Science.gov (United States)

Morey, W

1996-09-01

The application of the Total Quality Management (TQM) philosophy within the health care sector would enhance the development of nursing power, leadership and knowledge. TQM challenges conventional management techniques as it requires a participative management style in order to be effective. There are many potential benefits for nurses, when quality assurance monitoring within a hierarchical management structure, is replaced with a focus on continuous quality improvement by every member of staff. These benefits are described within the context of both organisational and personal commitment to Total Quality Management.

Quality Management Framework for Total Diet Study centres in Europe.

Science.gov (United States)

Pité, Marina; Pinchen, Hannah; Castanheira, Isabel; Oliveira, Luisa; Roe, Mark; Ruprich, Jiri; Rehurkova, Irena; Sirot, Veronique; Papadopoulos, Alexandra; Gunnlaugsdóttir, Helga; Reykdal, Ólafur; Lindtner, Oliver; Ritvanen, Tiina; Finglas, Paul

2018-02-01

A Quality Management Framework to improve quality and harmonization of Total Diet Study practices in Europe was developed within the TDS-Exposure Project. Seventeen processes were identified and hazards, Critical Control Points and associated preventive and corrective measures described. The Total Diet Study process was summarized in a flowchart divided into planning and practical (sample collection, preparation and analysis; risk assessment analysis and publication) phases. Standard Operating Procedures were developed and implemented in pilot studies in five organizations. The flowchart was used to develop a quality framework for Total Diet Studies that could be included in formal quality management systems. Pilot studies operated by four project partners were visited by project assessors who reviewed implementation of the proposed framework and identified areas that could be improved. The quality framework developed can be the starting point for any Total Diet Study centre and can be used within existing formal quality management approaches. Copyright © 2017 Elsevier Ltd. All rights reserved.

Total quality management - It works for aerospace information services

Science.gov (United States)

Erwin, James; Eberline, Carl; Colquitt, Wanda

1993-01-01

Today we are in the midst of information and 'total quality' revolutions. At the NASA STI Program's Center for AeroSpace Information (CASI), we are focused on using continuous improvements techniques to enrich today's services and products and to ensure that tomorrow's technology supports the TQM-based improvement of future STI program products and services. The Continuous Improvements Program at CASI is the foundation for Total Quality Management in products and services. The focus is customer-driven; its goal, to identify processes and procedures that can be improved and new technologies that can be integrated with the processes to gain efficiencies, provide effectiveness, and promote customer satisfaction. This Program seeks to establish quality through an iterative defect prevention approach that is based on the incorporation of standards and measurements into the processing cycle.

NASA total quality management 1989 accomplishments report

Science.gov (United States)

Tai, Betty P. (Editor); Stewart, Lynne M. (Editor)

1990-01-01

NASA and contractor employees achieved many notable improvements in 1989. The highlights of those improvements, described in this seventh annual Accomplishments Report, demonstrate that the people who support NASA's activities are getting more involved in quality and continuous improvement efforts. Their gains solidly support NASA's and this Nation's goal to remain a leader in space exploration and in world-wide market competition, and, when communicated to others through avenues such as this report, foster improvement efforts across government and industry. The principles in practice which led to these process refinements are important cultural elements to any organization's productivity and quality efforts. The categories in this report reflect NASA principles set forth in the 1980's and are more commonly known today as Total Quality Management (TQM): top management leadership and support; strategic planning; focus on the customer; employee training and recognition; employee empowerment and teamwork; measurement and analysis; and quality assurance.

Quality of life after total knee arthroplasty: systematic review.

Science.gov (United States)

da Silva, Robson Rocha; Santos, Ayrton André Melo; de Sampaio Carvalho Júnior, José; Matos, Marcos Almeida

2014-01-01

To review the literature on quality of life among patients who underwent total knee arthroplasty (TKA) and assess the impact of various associated factors. this was a systematic review of the literature in the Medline, Embase, Lilacs and SciELO databases, using the terms: TKA (total knee arthroplasty); TKR (total knee replacement); quality of life; and outcomes. There were no restrictions regarding study design. 31 articles addressing this topic using various quality-of-life evaluation protocols were selected. SF-36/SF-12, WOMAC and Oxford were the ones most frequently used. The studies made it possible to define that TKA is capable of making an overall improvement in patients' quality of life. Pain and function are among the most important predictors of improvement in quality of life, even when function remains inferior to that of healthy patients. The factors associated negatively were obesity, advanced age, comorbidities, persistence of pain after the procedure and a lengthy wait for surgery.

Role of QA in total quality management environment

International Nuclear Information System (INIS)

McCarthy, J.B.; Ayres, R.A.

1992-01-01

A successful company in today's highly competitive business environment must emphasize quality in all activities at all times. For most companies, this requires a major cultural change to establish appropriate operating attitudes and priorities. A total quality environment is required where quality becomes a way of life, and this process must be carefully managed. It will not be accomplished in a few short months with a simple management pronouncement. Instead, it evolves over a period of years through continuous incremental improvement. This evolution towards total quality requires a dramatic change in the quality assurance (QA) function of most companies. Traditionally, quality was automatically equated to QA and its attendant procedures and personnel. Now, quality is becoming a global concept, and QA can play a significant role in the process. The QA profession must, however, recognize and accept a new role as consultant, coach, and partner in today's total quality game. The days of the hard-line enforcer of procedural requirements are gone

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

Science.gov (United States)

Thomas, Elizabeth Anne

2011-06-01

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

Collaborative problem solving with a total quality model.

Science.gov (United States)

Volden, C M; Monnig, R

1993-01-01

A collaborative problem-solving system committed to the interests of those involved complies with the teachings of the total quality management movement in health care. Deming espoused that any quality system must become an integral part of routine activities. A process that is used consistently in dealing with problems, issues, or conflicts provides a mechanism for accomplishing total quality improvement. The collaborative problem-solving process described here results in quality decision-making. This model incorporates Ishikawa's cause-and-effect (fishbone) diagram, Moore's key causes of conflict, and the steps of the University of North Dakota Conflict Resolution Center's collaborative problem solving model.

TOTAL QUALITY AND WORK ORGANISATION IN HEALTH CARE FIRMS

OpenAIRE

Gianfranco Corio

1997-01-01

[The area of organisation is the one to work in so as to improve products/services in health care firms, and to establish the transformation of professional behaviour. The actions and roles of middle management as a strategic entity in the case of the set-up of programs for improvement based on Total Quality. Total Quality as a strategic factor in health care firms with regard to management and as a basic component for "purchasing" decisions made by external customers.

The Paradigm of the Total Quality Management in the Portuguese Higher Education

OpenAIRE

Saraiva, Margarida; Reis, Elizabeth

2006-01-01

Total quality management is a process based on a “to do differently” strategy. This strategy implies trying to achieve continuous improvement by sharing responsibilities reducing misused resource and meeting customer’s expectations. Typically, Total Quality Management is implemented in industry and services using a group of principles. The implementation of such principles guides the organizations towards the improvement of quality standards. Deming contributed to the total qua...

Preanalytical quality improvement : in quality we trust

OpenAIRE

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

2013-01-01

Total quality in laboratory medicine should be defined as the guarantee that each activity throughout the total testing process is correctly performed, providing valuable medical decision-making and effective patient care. In the past decades, a 10-fold reduction in the analytical error rate has been achieved thanks to improvements in both reliability and standardization of analytical techniques, reagents, and instrumentation. Notable advances in information technology, quality control and qu...

Food safety and total quality management

NARCIS (Netherlands)

Barendsz, A.W.

1998-01-01

Food safety is a growing global concern not only because of its continuing importance for public health but also because of its impact on international trade. The application of total quality management (TQM) provides the best possible care by continuously improving products and services to meet or

Comparably improved health-related quality of life after total arterial revascularization versus conventional coronary surgery--Copenhagen arterial revascularization randomized patency and outcome trial

DEFF Research Database (Denmark)

Damgaard, Sune; Lund, Jens T; Lilleør, Nikolaj B

2011-01-01

OBJECTIVE: We compared health-related quality of life up to 11 months after coronary artery bypass grafting using total arterial revascularization versus conventional coronary surgery. METHODS: In this randomized single-center trial, 161 patients underwent total arterial revascularization using.......01). For total arterial revascularization, there were also not statistically significant improvements for 'physical component summary' (P=0.09), 'bodily pain' (P=0.07) and 'vitality' (P=0.08). CONCLUSION: Health-related quality of life up to 1 year after total arterial revascularization is equal or slightly...... of the general Danish population. On all scales of the SF-36, there was statistically significant improvement at 3 and 11 months in both groups. For 'social functioning', the improvement following total arterial revascularization was significantly higher than following conventional revascularization (P=0...

Total quality management program planning

Energy Technology Data Exchange (ETDEWEB)

Thornton, P.T.; Spence, K.

1994-05-01

As government funding grows scarce, competition between the national laboratories is increasing dramatically. In this era of tougher competition, there is no for resistance to change. There must instead be a uniform commitment to improving the overall quality of our products (research and technology) and an increased focus on our customers` needs. There has been an ongoing effort to bring the principles of total quality management (TQM) to all Energy Systems employees to help them better prepare for future changes while responding to the pressures on federal budgets. The need exists for instituting a vigorous program of education and training to an understanding of the techniques needed to improve and initiate a change in organizational culture. The TQM facilitator is responsible for educating the work force on the benefits of self-managed work teams, designing a program of instruction for implementation, and thus getting TQM off the ground at the worker and first-line supervisory levels so that the benefits can flow back up. This program plan presents a conceptual model for TQM in the form of a hot air balloon. In this model, there are numerous factors which can individually and collectively impede the progress of TQM within the division and the Laboratory. When these factors are addressed and corrected, the benefits of TQM become more visible. As this occurs, it is hoped that workers and management alike will grasp the ``total quality`` concept as an acceptable agent for change and continual improvement. TQM can then rise to the occasion and take its rightful place as an integral and valid step in the Laboratory`s formula for survival.

Total Quality Management Continuous Improvement: Is the Philosophy a Reality?

Science.gov (United States)

Walsh, Aidan; Hughes, Helen; Maddox, Daniel P.

2002-01-01

Responses from 72 Irish companies identified 51 using total quality management (TQM); second-survey responses from 28 of the latter showed that 57% of TQM initiatives were successful or very successful; most have a good understanding of comprehensive TQM and value long-term over short-term results. Benefits were experienced throughout…

NASA total quality management 1990 accomplishments report

Science.gov (United States)

1991-01-01

NASA's efforts in Total Quality Management are based on continuous improvement and serve as a foundation for NASA's present and future endeavors. Given here are numerous examples of quality strategies that have proven effective and efficient in a time when cost reduction is critical. These accomplishment benefit our Agency and help to achieve our primary goal, keeping American in the forefront of the aerospace industry.

Employee satisfaction: an integral component of total quality.

Science.gov (United States)

Gvazdinskas, L C; Maffetone, M A

1995-01-01

As part of the Total Quality Management process, the leadership of Rush Medical Laboratories, with a staff of 400, made an initial commitment to focus on their own employees as the most important customers. Only after the employees' development, their help, their support, and their empowerment could Rush Medical Laboratories make the improvements in customer relationships and obtain the operations improvement, cost savings, and productivity necessary to maintain a competitive edge. This article outlines the numerous employee initiatives that have resulted from this commitment. All of these initiatives were successful at some point during the 5 or more years since the incorporation of TQM within Rush Medical Laboratories. In the spirit of continuous improvement, some have been modified or discontinued and replaced by others. This article provides an overview of the many improvements that are possible when employees are provided a forum in which to voice their needs, and it challenges the management and employees of all laboratories to focus on this vital component of total quality.

Selected Aspects of a Total Quality Management in an Army Hospital (Ausgewachlte Aspekte eines Total Quality Management in einem Bundeswehrkrankenhaus)

National Research Council Canada - National Science Library

Brjaun, Guenther

2000-01-01

Total Quality Management is a long-term, integrated concept that covers all aspects and all levels of responsibility, an essential part of which is the continual improvement of how the business is run...

Quality improvement: the nurse's role.

Science.gov (United States)

Moran, M J; Johnson, J E

1992-06-01

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

The University of Santo Tomas Viewed from the Lens of Total Quality Management: Implications to Total Quality Education

Science.gov (United States)

de Guzman, Allan B.; Torres, Josefina R.

2004-01-01

Considered as a major management approach for improving organizational performance and competitive advantage, Total Quality Management (TQM) poses a challenge to dynamic institutions to adopt a systemic philosophy that places emphasis on customer needs and a commitment to a culture of excellence. Higher education institutions (HEIs) as learning…

Quality of life improves for pediatric patients after total pancreatectomy and islet autotransplant for chronic pancreatitis.

Science.gov (United States)

Bellin, Melena D; Freeman, Martin L; Schwarzenberg, Sarah Jane; Dunn, Ty B; Beilman, Gregory J; Vickers, Selwyn M; Chinnakotla, Srinath; Balamurugan, A N; Hering, Bernhard J; Radosevich, David M; Moran, Antoinette; Sutherland, David E R

2011-09-01

Total pancreatectomy (TP) and islet autotransplant (IAT) have been used to treat patients with painful chronic pancreatitis. Initial studies indicated that most patients experienced significant pain relief, but there were few validated measures of quality of life. We investigated whether health-related quality of life improved among pediatric patients undergoing TP/IAT. Nineteen consecutive children (aged 5-18 years) undergoing TP/IAT from December 2006 to December 2009 at the University of Minnesota completed the Medical Outcomes Study 36-item Short Form (SF-36) health questionnaire before and after surgery. Insulin requirements were recorded. Before TP/IAT, patients had below average health-related quality of life, based on data from the Medical Outcomes Study SF-36; they had a mean physical component summary (PCS) score of 30 and mental component summary (MCS) score of 34 (2 and 1.5 standard deviations, respectively, below the mean for the US population). By 1 year after surgery, PCS and MCS scores improved to 50 and 46, respectively (global effect, PCS P Puestow) had lower yields of islets (P = .01) and greater incidence of insulin dependence (P = .04). Quality of life (physical and emotional components) significantly improve after TP/IAT in subsets of pediatric patients with severe chronic pancreatitis. Minimal or no insulin was required for most patients, although islet yield was reduced in patients with previous surgical drainage operations. Copyright © 2011 AGA Institute. Published by Elsevier Inc. All rights reserved.

Total quality management: It works for aerospace information services

Science.gov (United States)

Erwin, James; Eberline, Carl; Colquitt, Wanda

1993-01-01

Today we are in the midst of information and 'total quality' revolutions. At the NASA STI Program's Center for AeroSpace Information (CASI), we are focused on using continuous improvements techniques to enrich today's services and products and to ensure that tomorrow's technology supports the TQM-based improvement of future STI program products and services. The Continuous Improvements Program at CASI is the foundation for Total Quality Management in products and services. The focus is customer-driven; its goal, to identify processes and procedures that can be improved and new technologies that can be integrated with the processes to gain efficiencies, provide effectiveness, and promote customer satisfaction. This Program seeks to establish quality through an iterative defect prevention approach that is based on the incorporation of standards and measurements into the processing cycle. Four projects are described that utilize cross-functional, problem-solving teams for identifying requirements and defining tasks and task standards, management participation, attention to critical processes, and measurable long-term goals. The implementation of these projects provides the customer with measurably improved access to information that is provided through several channels: the NASA STI Database, document requests for microfiche and hardcopy, and the Centralized Help Desk.

Total Quality Management in Educational Organisations

Directory of Open Access Journals (Sweden)

Edvard Konrad

2000-12-01

Full Text Available Movement for Total Quality Management (TQM, which was initially successfully applied in the production of goods, has spread to the service domain including educational organisations. Many of principles and experiences known so far could be creatively transferred to educational situations. Additional research and specific innovations are necessary for successful application of existing knowledge. In this paper we discuss certain topics from the specific nature of the quality of education: the definition of the concept of a consumer, motivation of participants in educational processes, improvement of educational processes, quality of learning and leadership in educational organisations.

Total Quality Management in Libraries. ERIC Digest.

Science.gov (United States)

Masters, Denise G.

Total Quality Management (TQM) is "a system of continuous improvement employing participative management and centered on the needs of customers." Key components of TQM are employee involvement and training, problem-solving teams, statistical methods, long-term goals and thinking, and recognition that the system, not people, produces…

Improvement in Total Joint Replacement Quality Metrics: Year One Versus Year Three of the Bundled Payments for Care Improvement Initiative.

Science.gov (United States)

Dundon, John M; Bosco, Joseph; Slover, James; Yu, Stephen; Sayeed, Yousuf; Iorio, Richard

2016-12-07

In January 2013, a large, tertiary, urban academic medical center began participation in the Bundled Payments for Care Improvement (BPCI) initiative for total joint arthroplasty, a program implemented by the Centers for Medicare & Medicaid Services (CMS) in 2011. Medicare Severity-Diagnosis Related Groups (MS-DRGs) 469 and 470 were included. We participated in BPCI Model 2, by which an episode of care includes the inpatient and all post-acute care costs through 90 days following discharge. The goal for this initiative is to improve patient care and quality through a patient-centered approach with increased care coordination supported through payment innovation. Length of stay (LOS), readmissions, discharge disposition, and cost per episode of care were analyzed for year 3 compared with year 1 of the initiative. Multiple programs were implemented after the first year to improve performance metrics: a surgeon-directed preoperative risk-factor optimization program, enhanced care coordination and home services, a change in venous thromboembolic disease (VTED) prophylaxis to a risk-stratified protocol, infection-prevention measures, a continued emphasis on discharge to home rather than to an inpatient facility, and a quality-dependent gain-sharing program among surgeons. There were 721 Medicare primary total joint arthroplasty patients in year 1 and 785 in year 3; their data were compared. The average hospital LOS decreased from 3.58 to 2.96 days. The rate of discharge to an inpatient facility decreased from 44% to 28%. The 30-day all-cause readmission rate decreased from 7% to 5%; the 60-day all-cause readmission rate decreased from 11% to 6%; and the 90-day all-cause readmission rate decreased from 13% to 8%. The average 90-day cost per episode decreased by 20%. Mid-term results from the implementation of Medicare BPCI Model 2 for primary total joint arthroplasty demonstrated decreased LOS, decreased discharges to inpatient facilities, decreased readmissions, and

Total Quality Management in Libraries: A Sourcebook.

Science.gov (United States)

O'Neil, Rosanna M., Comp.

Total Quality Management (TQM) brings together the best aspects of organizational excellence by driving out fear, offering customer-driven products and services, doing it right the first time by eliminating error, and maintaining inventory control without waste. Libraries are service organizations which are constantly trying to improve service.…

Total Quality Management: Implications for Educational Assessment.

Science.gov (United States)

Rankin, Stuart C.

1992-01-01

Deming's "System of Profound Knowledge" is even more fundamental than his 14-principle system transformation guide and is based on 4 elements: systems theory, statistical variation, a theory of knowledge, and psychology. Management should revamp total system processes so that quality of product is continually improved. Implications for…

Total quality management: A strategy for the 90s

International Nuclear Information System (INIS)

Zollicoffer, W.O.

1993-01-01

A quality improvement process of total quality management (TQM) that focuses on satisfying customer needs has been adopted by Halliburton Company and its Energy Services Group as the basic business strategy. Some of the common issues and questions asked by those seeking quality are reveiwed from the point of view of the experience gained through the learning years at Halliburton. The TQM concept is explained as something beyond traditional quality programs that takes into account not only the company's own processes but also those of its suppliers and customers, and seeing how they all may be managed and integrated for continuous improvement. Comparisons are made with other methods of improvement that focus on productivity and increased inspection. The responsibility for initiating TQM is placed on senior management and some of the principal elements of a successful quality improvement process are outlined. Suggestions are made on how to start a TQM program. 6 refs

Improving NAVFAC's total quality management of construction drawings with CLIPS

Science.gov (United States)

Antelman, Albert

1991-01-01

A diagnostic expert system to improve the quality of Naval Facilities Engineering Command (NAVFAC) construction drawings and specification is described. C Language Integrated Production System (CLIPS) and computer aided design layering standards are used in an expert system to check and coordinate construction drawings and specifications to eliminate errors and omissions.

Competitive Strategy and Total Quality Management Culture in ...

African Journals Online (AJOL)

This paper discusses the elements of competitive strategy, total quality management culture and productivity improvement and their relationship in producing better outputs of goods and services and individual and organizational performance. Production remains fundamental to the sustenance of human existence.

Does total hip replacement affect sexual quality of life?

Science.gov (United States)

Harmsen, Rita Th E; Haanstra, Tsjitske M; Sierevelt, Inger N; Jansma, Elise P; Nolte, Peter A; Nicolai, Melianthe P J; Wall, Peter D H; Van Royen, Barend J

2016-05-04

Total Hip Replacement (THR) is an effective treatment for end-stage hip osteoarthritis. Since the introduction of total joint replacement, the effect on the Sexual Quality of Life (SQoL) following THR has been addressed in scant studies. The aim of our study was to systematically review the literature, to summarise effects of THR on patients' SQoL. We searched PubMed, EMBASE and PsycINFO between January 1970 and February 9th, 2015 with search terms including Total Hip, Osteoarthritis, SQoL, and THR. Eligible studies were identified and two independent authors extracted data including details of SQoL, study quality and risk of bias. There were 12 eligible studies, which included a total of 2099 patients with an age range of 20-85 years. The methodological quality of ten studies was rated as low, and of two as moderate. Amongst the majority of patients, SQoL improved after surgery, both in terms of physical-functional and psychosocial well-being. However, changes between pre-operative and postoperative SQoL ranged extensively: for example, Sexual Dysfunction Δ 8-51% and Sexual Activity (SA) Δ 0-77%. Three studies reported that some patients never resumed SA again after surgery. In over 40 years of THR treatment, scant studies have examined the effect of THR on patients' SQoL. This review suggests that SQol improves after THR, although the magnitude of effects varies highly. However, the quality of the supporting evidence was rated as low to moderate. This suggests a need for more high quality evidence about the effects of THR on SQoL.

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

Science.gov (United States)

Hughes, J M

1992-09-01

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

Olfactory function and quality of life after olfaction rehabilitation in total laryngectomees.

Science.gov (United States)

Santos, Christiane Gouvêa Dos; Bergmann, Anke; Coça, Kaliani Lima; Garcia, Angela Albuquerque; Valente, Tânia Cristina de Oliveira

2016-01-01

To evaluate the effects of olfaction rehabilitation in the olfactory function and quality of life of total laryngectomized patients. Pre-post intervention clinical study conducted with total laryngectomees submitted to olfaction rehabilitation by means of the Nasal Airflow-Inducing Maneuver (NAIM) using the University of Pennsylvania Smell Identification Test (UPSIT), Olfactory Acuity Questionnaires, a Monitoring Questionnaire, and the University of Washington Quality of Life Questionnaire (UW-QOL). Participants were 45 total laryngectomees. Before olfaction rehabilitation, 48.9% of the participants had their olfactic abilities classified as anosmia, 46.8% as microsmia, and 4.4% were considered within the normal range. After olfaction rehabilitation, 4.4% of the participants were classified as anosmia and 31.1% were within the normal range. In the Smell Identification Test, the mean score after rehabilitation showed statistically significant improvement. Reponses to the Olfactory Acuity Questionnaires after rehabilitation showed improvement in the frequency of perception regarding smell, taste, and the ability to smell perfume, food, leaking gas, and smoke, after learning the maneuver. Although the scores in the Quality of Life Questionnaire already indicated good quality of life before the surgery, post-intervention values were statistically significant. Olfaction rehabilitation improves olfactory function and has a positive impact on the activities of daily living and quality of life of total laryngectomized patients.

Schools of Quality: An Introduction to Total Quality Management in Education.

Science.gov (United States)

Bonstingl, John Jay

This book offers an introduction to the basic ideas of Total Quality Management (TQM) in education. Chapter 1 contrasts the American model of the bell-shaped curve with the Japanese concept of "kaizen," which is personal dedication to mutual improvement and the heart of TQM philosophy. Chapter 2 provides an overview of the history of the TQ…

Preanalytical quality improvement: in quality we trust.

Science.gov (United States)

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

2013-01-01

Total quality in laboratory medicine should be defined as the guarantee that each activity throughout the total testing process is correctly performed, providing valuable medical decision-making and effective patient care. In the past decades, a 10-fold reduction in the analytical error rate has been achieved thanks to improvements in both reliability and standardization of analytical techniques, reagents, and instrumentation. Notable advances in information technology, quality control and quality assurance methods have also assured a valuable contribution for reducing diagnostic errors. Nevertheless, several lines of evidence still suggest that most errors in laboratory diagnostics fall outside the analytical phase, and the pre- and postanalytical steps have been found to be much more vulnerable. This collective paper, which is the logical continuum of the former already published in this journal 2 years ago, provides additional contribution to risk management in the preanalytical phase and is a synopsis of the lectures of the 2nd European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)-Becton Dickinson (BD) European Conference on Preanalytical Phase meeting entitled "Preanalytical quality improvement: in quality we trust" (Zagreb, Croatia, 1-2 March 2013). The leading topics that will be discussed include quality indicators for preanalytical phase, phlebotomy practices for collection of blood gas analysis and pediatric samples, lipemia and blood collection tube interferences, preanalytical requirements of urinalysis, molecular biology hemostasis and platelet testing, as well as indications on best practices for safe blood collection. Auditing of the preanalytical phase by ISO assessors and external quality assessment for preanalytical phase are also discussed.

Impact of total quality management on students' academic ...

African Journals Online (AJOL)

Low academic performance of secondary school students in our society has been the greatest challenges facing the educational system in the country. The challenges associated with the country's educational performance especially at the secondary schools could be improved upon if total quality management control is ...

TOTAL QUALITY MANAGEMENT IN HIGH EDUCATION

Directory of Open Access Journals (Sweden)

Hasan SERİN, Alper AYTEKİN

2009-01-01

Full Text Available The approach of Total Quality Management (TQM has been even more common and most recently its use in high education has been discussed. Likewise the enterprises producing various products, universities have also inputs, processes, and outputs. Due to conditions of competition, universities have to improve the qualities of these inputs, processes, and outputs, according to satisfaction, demands, and expectations of internal and external customers. If the TQM has been implemented in the universities with a manner that aims for customer satisfaction (students, lecturers, public and private establishments, and families, supports constant development, ensures participatory approach, and encourages working in groups, it will provide universities with effectiveness, efficiency, dynamics, and economics. In this study, common problems of universities, definitions of quality and TQM in high education, customer concept at universities, and factors affecting the quality of education have been explained. Besides, in order TQM approach to be successfully implemented in the universities, various suggestions have been presented.

AQUILA: assessment of quality in lower limb arthroplasty. An expert Delphi consensus for total knee and total hip arthroplasty.

Science.gov (United States)

Pijls, Bart G; Dekkers, Olaf M; Middeldorp, Saskia; Valstar, Edward R; van der Heide, Huub J L; Van der Linden-Van der Zwaag, Henrica M J; Nelissen, Rob G H H

2011-07-22

In the light of both the importance and large numbers of case series and cohort studies (observational studies) in orthopaedic literature, it is remarkable that there is currently no validated measurement tool to appraise their quality. A Delphi approach was used to develop a checklist for reporting quality, methodological quality and generalizability of case series and cohorts in total hip and total knee arthroplasty with a focus on aseptic loosening. A web-based Delphi was conducted consisting of two internal rounds and three external rounds in order to achieve expert consensus on items considered relevant for reporting quality, methodological quality and generalizability. The internal rounds were used to construct a master list. The first external round was completed by 44 experts, 35 of them completed the second external round and 33 of them completed the third external round. Consensus was reached on an 8-item reporting quality checklist, a 6-item methodological checklist and a 22-item generalizability checklist. Checklist for reporting quality, methodological quality and generalizability for case series and cohorts in total hip and total knee arthroplasty were successfully created through this Delphi. These checklists should improve the accuracy, completeness and quality of case series and cohorts regarding total hip and total knee arthroplasty.

Summary Report of the Seventh Annual NASA/Contractors Conference on Quality and Productivity: "Total Quality Leadership"

Science.gov (United States)

1991-01-01

More than 750 NASA, government, contractor, and academic representatives attended the Seventh Annual NASA/Contractors Conference on Quality and Productivity on October 12-13, 1990, in Grenelefe, Florida. The panel presentations and keynote speeches revolving around the theme of 'Total Quality Leadership" provided a solid base of understanding of the importance, benefits, and principles of total quality management. The implementation of these strategies is critical if we are to effectively pursue our mission of continuous quality improvement and reliability in our products, processes, and services. The annual NASA/contractors conferences serve as catalysts for achieving success in this mission.

Impact Of Total Quality Management (TQM), Activity Based Costing ...

African Journals Online (AJOL)

Time (JIT), and Total Quality Management (TQM) as strategic initiatives lead to improved financial performance in the Turkish textile industry. Strong evidence emerged that there is a strong positive association between using ABC, JIT or TQM ...

Creating a Total Quality Environment (TQE) for Learning

Science.gov (United States)

Freed, Jann E.

2005-01-01

This article describes a model for creating a total quality environment (TQE) for learning in which everyone is considered a learner. The model consists of 11 interrelated characteristics derived from the literature in the areas of continuous improvement, leadership, learning, learning organizations, and spirituality. The characteristics in the…

Qualità totale e mobilità totale Total Quality and Total Mobility

Directory of Open Access Journals (Sweden)

Giuseppe Trieste

2010-05-01

Full Text Available FIABA ONLUS (Italian Fund for Elimination of Architectural Barriers was founded in 2000 with the aim of promoting a culture of equal opportunities and, above all, it has as its main goal to involve public and private institutions to create a really accessible and usable environment for everyone. Total accessibility, Total usability and Total mobility are key indicators to define quality of life within cities. A supportive environment that is free of architectural, cultural and psychological barriers allows everyone to live with ease and universality. In fact, people who access to goods and services in the urban context can use to their advantage time and space, so they can do their activities and can maintain relationships that are deemed significant for their social life. The main aim of urban accessibility is to raise the comfort of space for citizens, eliminating all barriers that discriminate people, and prevent from an equality of opportunity. “FIABA FUND - City of ... for the removal of architectural barriers” is an idea of FIABA that has already affected many regions of Italy as Lazio, Lombardy, Campania, Abruzzi and Calabria. It is a National project which provides for opening a bank account in the cities of referring, in which for the first time, all together, individuals and private and public institutions can make a donation to fund initiatives for the removal of architectural barriers within its own territory for a real and effective total accessibility. Last February the fund was launched in Rome with the aim of achieving a Capital without barriers and a Town European model of accessibility and usability. Urban mobility is a prerequisite to access to goods and services, and to organize activities related to daily life. FIABA promotes the concept of sustainable mobility for all, supported by the European Commission’s White Paper. We need a cultural change in management and organization of public means, which might focus on

Quality control of dosimetry in total body irradiation

International Nuclear Information System (INIS)

Kallinger, W.

1986-11-01

An on-line dose measurement system for the quality control of the treatment of leukemia by means of total body irradiation with Co-60 gamma radiation is introduced. An ionization chamber and 5 diodes arranged on the surface of the patient incorporated with a microprocessor provides useful information and data necessary for the treatment. Following the concerted treatment procedure employing this system, the treatment of leukemia by means of total body irradiation is expected to be improved

Total Quality Management and Organizational Behavior Management: An Integration for Continual Improvement.

Science.gov (United States)

Mawhinney, Thomas C.

1992-01-01

The history and main features of organizational behavior management (OBM) are compared and integrated with those of total quality management (TQM), with emphasis on W.E. Deming's 14 points and OBM's operant-based approach to performance management. Interventions combining OBM, TQM, and statistical process control are recommended. (DB)

PENDEKATAN TOTAL QUALITY MANAGEMENT PRODUK BROILER TOLAKAN

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Zeetpy Maisana

2012-11-01

Full Text Available ABSTRACTThe purpose of this study was to analyze rejected product in slaughterhouse division using total quality management approach. The secondary data were collected from the company archives and judgmental sampling was used to collect primary data from six experienced respondents. The analysis method used was total quality management, include stratification, Pareto diagrams, control charts, fishbone diagrams, and quality function deployment. The findings of this study showed that the use of line production system by the slaughterhouse to produce the product; where products’ redness/bruises, size uniformity, bloodless feature, incorrect delivery, delivery delay, and damaged package were the cause of product rejection. The strategies ordered based on the priority to improve the management quality are: tools repair and replacement, creating quality based projects, build an information system between the production lines, training and seminar. The managerial implications of the study suggested the slaughterhouse to replace or repair the plucker, scalder and automatic weighing machine. It also suggested the slaughterhouse to tighten the span of control in the chilling room to maintain product freshness.Keywords: rejected product analysis, TQM, QFD, chicken slaughterhouse, carcassABSTRAKPenelitian ini bertujuan menganalisis produk tolakan pada rumah potong ayam melalui pendekatan total quality management. Pengumpulan data sekunder penelitian diperoleh dari arsip perusahaan dan judgemental sampling digunakan terhadap enam responden ahli untuk memperoleh data primer penelitian. Metode analisis data yang digunakan total quality management, meliputi stratifikasi, diagram pareto, peta kendali, diagram tulang ikan, dan quality function deployment.  Hasil penelitian menunjukkan penggunaan sistem lini produksi pada proses produksi di perusahaan, dimana memar pada produk, keseragaman ukuran, kesegaran produk, pengiriman tidak sesuai pesanan

[Improvement approaches in the hospital setting: From total quality management to Lean].

Science.gov (United States)

Curatolo, N; Lamouri, S; Huet, J-C; Rieutord, A

2015-07-01

Hospitals have to deal strong with economic constraints and increasing requirements in terms of quality and safety of care. To address these constraints, one solution could be the adoption of approaches from the industry sector. Following the decree of April 6, 2011 on the quality management of the medication use process, some of these approaches, such as risk management, are now part of the everyday work of healthcare professionals. However, other approaches, such as business process improvement, are still poorly developed in the hospital setting. In this general review, we discuss the main approaches of business process improvements that have been used in hospitals by focusing specifically on one of the newest and most currently used: Lean. Copyright © 2014. Published by Elsevier Masson SAS.

Total quality accounting

Directory of Open Access Journals (Sweden)

Andrijašević Maja

2008-01-01

Full Text Available The focus of competitive "battle" shifted from the price towards non-price instruments, above all, towards quality that became the key variable for profitability increase and achievement of better comparative position of a company. Under such conditions, management of a company, which, according to the established and certified system of total quality, strives towards achieving of a better market position, faces the problem of quality cost measurement and determination. Management, above all, cost accounting can help in solving of this problem, but the question is how much of its potential is being used for that purpose.

Application of Total Quality Management System in Thai Primary Schools

Science.gov (United States)

Prueangphitchayathon, Setthiya; Tesaputa, Kowat; Somprach, Kanokorn

2015-01-01

The present study seeks to develop a total quality management (TQM) system that can be applied to primary schools. The approach focuses on customer orientation, total involvement of all constituencies and continuous improvement. TQM principles were studied and synthesized according to case studies of the best practices in 3 primary schools (small,…

A quality improvement management model for renal care.

Science.gov (United States)

Vlchek, D L; Day, L M

1991-04-01

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

Improving Power Quality in AC Supply Grids

Directory of Open Access Journals (Sweden)

Piotr Fabijański

2015-12-01

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

Do Pilates-based exercises following total knee arthroplasty improve postural control and quality of life?

Science.gov (United States)

Karaman, Aysenur; Yuksel, Inci; Kinikli, Gizem Irem; Caglar, Omur

2017-04-01

The aim of this prospective, randomized, controlled study was to investigate the effects of the addition of Pilates-based exercises to standard exercise programs performed after total knee arthroplasty on quality of life and balance. Forty-six volunteers were divided into two groups. The control group (n = 17) was assigned a standard exercise program after discharge; the study group (n = 17) was assigned Pilates-based exercises along with the standard exercise program. We carried out clinical evaluations of all patients on the day of discharge and after the completion of the 6-week exercise program. We also recorded sociodemographic data, Berg Balance test scores, and Short Form-36 (SF-36) health-related quality of life measurements. When we compared the differences between pre- and post-treatment balance scores of the groups, we found a significant change in favor of the Pilates-based exercise group (13.64 ± 1.45; p Pilates-based exercises group were found to be significant in terms of physical function (p = 0.001), physical role restriction (p = 0.01), and physical component score (p = 0.001). Pilates-based exercises performed along with standard exercise programs were more effective for improving balance and quality of life than standard exercise programs alone.

7th Annual NASA/Contractors Conference on Quality and Productivity: "Total Quality Leadership"

Science.gov (United States)

1991-01-01

More than 750 NASA, government, contractor, and academic representatives attended the Seventh Annual NASA/Contractors Conference on Quality and Productivity on October 12-13, 1990, in Grenelefe, Florida. The panel presentations and keynote speeches revolving around the theme of 'Total Quality Leadership' provided a solid base of understanding of the importance, benefits, and principles of total quality management. The implementation of these strategies is critical if we are to effectively pursue our mission of continuous quality improvement and reliability in our products, processess, and services. The annual NASA/contractors conferences serve as catalysts for achieving success in this mission. The conference was highlighted by the announcement of the first recipients of the George M. Low Trophy: NASA's Quality and Excellence Award. My congratulations go out to all nine finalist organizations and to the two recipients of this prestigious honor: Rockwell Space Systems Division and Marotta Scientific Controls, Inc. (the first small business to achieve this honor). These organizations have demonstrated a commitment to quality that is unsurpassed in the aerospace industry. This report summarizes the presentations and is not intended to be a verbatim proceedings document. You are encouraged to contact the speakers with any requests for further information.

T2QM (Teaching and Total Quality Management) for Medical Teachers.

Science.gov (United States)

Bing-You, R. G.

1997-01-01

Explores the potential relationship of teaching and total quality management (TQM) and the subsequent benefits for individual medical teachers. Addresses issues such as defining teaching processes and quality teaching, responding to customers' needs, assessing current teaching practices, and improving one's own teaching. Contains 18 references.…

Project Management and Total Quality Management : Complementary or confused?

Directory of Open Access Journals (Sweden)

Selma KATLANE BEN MLOUKA

2009-01-01

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

Leadership and Total Quality Management

Science.gov (United States)

1992-04-15

leadership and management skills yields increased productivity. This paper will focus on the skills required of senior level leaders (leaders at the...publication until it has been cleared by the appropriate mii..-, service or government agency. Leadership and Total Quality Management An Individual Study...llty Codes fAvti1 and/or DltISpecial Abstract AUTHOR: Harry D. Gatanas, LTC, USA TITLE: Leadership and Total Quality Management FORMAT- Individual

The Role of the Facilitator on Total Quality Management Teams.

Science.gov (United States)

Eakin, William L.

1993-01-01

As Total Quality Management teams work to improve organizational processes, several types of facilitators emerge: the director, the workhorse, and the cheerleader. Experience at the University of Kansas illustrates how different facilitator styles can affect team learning. (MSE)

Quality Improvement with Trustee Commitment.

Science.gov (United States)

Chaffee, Ellen Earle; Seymour, Daniel

1991-01-01

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

Quality Indicators for the Total Testing Process.

Science.gov (United States)

Plebani, Mario; Sciacovelli, Laura; Aita, Ada

2017-03-01

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

Total Quality Management in Higher Education: Applying Deming's Fourteen Points.

Science.gov (United States)

Masters, Robert J.; Leiker, Linda

1992-01-01

This article presents guidelines to aid administrators of institutions of higher education in applying the 14 principles of Total Quality Management. The principles stress understanding process improvements, handling variation, fostering prediction, and using psychology to capitalize on human resources. (DB)

Applying Total Quality Leadership to an aviation squadron

OpenAIRE

Knighton, Edward L.; Melnick, Norbert F.

1991-01-01

Approved for public release; distribution is unlimited The implementation of Total Quality Leadership has been successful in several Department of Defense organizations. However, an aviation squadron provides an unique environment for the application of TQL. This thesis describes an adaptation of the NPRDC TQM process improvement model for a fleet squadron which includes the Shewart Cycle, customer supplier relationships, and mission deployment. Dr. W. Edwards Deming's 14...

Sleep Quality Effects Recovery After Total Knee Arthroplasty (TKA)--A Randomized, Double-Blind, Controlled Study.

Science.gov (United States)

Gong, Long; Wang, ZhenHu; Fan, Dong

2015-11-01

This study examined the effects of sleep quality on early recovery after total knee arthroplasty. A total of 148 patients were randomized 1:1 to receive either zolpidem or placebo for 2 weeks. VAS pain scores (rest, ambulation and night), range of motion (ROM), total amount of opioid analgesics and antiemetics taken, postoperative nausea and vomiting (PONV), sleep efficacy and satisfaction were recorded. It was found that patients taking zolpidem achieved greater improvement in quality of life and reported better satisfaction. Patients in the intervention group had lower pain score and took less antiemetics. Moreover, a significant correlation between sleep quality and ROM was detected. These results demonstrated that improved sleep quality is beneficial to patients' post-TKA recovery. Copyright © 2015. Published by Elsevier Inc.

[Dexmedetomidine combined with ropivacaine for continuous femoral nerve block improved postoperative sleep quality in elderly patients after total knee arthroplasty].

Science.gov (United States)

Wang, X L; Wang, J; Mu, D L; Wang, D X

2018-03-13

Objective: To investigate the effect of dexmedetomidine adding to ropivacaine for continuous femoral nerve block on the improvement of postoperative sleep quality in elderly patients after total knee arthroplasty. Methods: One hundred and sixty patients aged 60 years or older in Jishuitan Hospital scheduled for single total knee arthroplasty between Nov. 2016 and Jun. 2017 were recruited. All patients received spinal anesthesia and were randomized to receive either combined ropivacaine and dexmedetomidine (0.2% ropivacaine 250 ml and 5 μg/kg dexmedetomidine, at a rate of 5 ml/h or 0.1 μg·kg -1 ·h -1 dexmedetomidine, dexmedetomidine group) or only ropivacaine (0.2% ropivacaine, at a rate of 5 ml/h, controlled group) for continuous femoral nerve block as postoperative analgesia after surgery. The severity of postoperative pain was assessed with numeric rating scale at 4, 24, and 48 hours after surgery both at rest and with movement. Subjective sleep quality and delirium were evaluated daily during the first 3 days postoperatively. Results: The subjective sleep quality scores were 2(1-4), 2(1-4) and 4(2-8), 4(2-7) in dexmedetomidine group and controlled group respectively on the 1st and 2nd days after surgery. The scores of dexmedetomidine group were much better than those of controlled group ( Z =-4.597, -4.183, both P quality, postoperative analgesia, and reduce delirium in the elderly after total knee arthroplasty.

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…

Prospective Assessment of Sleep Quality Before and After Primary Total Joint Replacement.

Science.gov (United States)

Manning, Blaine T; Kearns, Sean M; Bohl, Daniel D; Edmiston, Tori; Sporer, Scott M; Levine, Brett R

2017-07-01

Sleep disruption is a common, yet rarely addressed, complaint among patients who have undergone total joint arthroplasty (TJA). This study assessed sleep quality before and after primary TJA. A total of 105 patients who underwent primary total hip arthroplasty (THA) or total knee arthroplasty (TKA) prospectively completed questionnaires during the preoperative, early postoperative, and late postoperative periods. The survey included the Epworth Sleepiness Scale, current sleeping habits, and patient perspectives of sleep quality and duration. In the early postoperative period (4.7±2.0 weeks), patients reported significant increases in sleep disturbance as denoted by increased length of time to fall asleep (P=.006) and mean nightly awakenings (P=.002) compared with the preoperative baseline. At late postoperative follow-up (40.8±19.5 weeks), patients' sleep quality subsequently improved above the preoperative baseline. Approximately 40% of patients tried a new sleeping method postoperatively, the most common being new pillow placement. No significant differences in pre- or postoperative sleeping trends were noted between THA and TKA patients. These findings suggest transient sleep disturbance is common in the early postoperative period, with subsequent improvement by 10-month follow-up after a primary TJA. Given the growing importance of patient satisfaction in health care systems, orthopedic surgeons must manage patients' expectations while working with them to optimize sleep quality after TJA. A multimodal approach with preoperative counseling, early postoperative sleep modifications, and possibly preemptive use of medications may improve transient sleep disturbance among TJA patients. [Orthopedics. 2017; 40(4):e636-e640.]. Copyright 2017, SLACK Incorporated.

Creating the Total Quality Effective School.

Science.gov (United States)

Lezotte, Lawrence W.

This book shows how Deming's Total Quality Management (TQM) theory for organizational management can be integrated with the effective-schools literature. Part 1 compares the 14 principles of TQM with the tenets of effective-schools research. The second part develops a blueprint for creating the total quality effective school. The conceptual…

[Quality assurance and quality improvement. Personal experiences and intentions].

Science.gov (United States)

Roche, B G; Sommer, C

1995-01-01

test, formulate hypotheses of cause, test those hypotheses, apply remedies, and assess the effect of remedies. Total employee involvement is critical. A power comes from enabling all employees to become involved in quality improvement. A great advantage of CQI is the prevention orientation of the concept. The CQI permeated a collegial approach, people learn how to work together to improve. CQI is a time consuming procedure. During our travel we learned the definition of quality as the customer satisfaction. To build a CQI concept in employed time but all employed are involved in quality improvement. Applying CQI we could be able to refuse Quality control programs.

[QUIPS: quality improvement in postoperative pain management].

Science.gov (United States)

Meissner, Winfried

2011-01-01

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

Measuring the impact of total quality management on financial performance of croatian companies

Directory of Open Access Journals (Sweden)

Dubravka Pekanov Starčević

2012-12-01

Full Text Available Changes in the business environment have resulted in increasing the importance of the quality of products and services of a company. Insisting on quality has become a strategic goal of a company and a determiner of competitiveness both in the home and international market. The traditional approach to quality included determination of product quality after production was completed. High costs of testing to determine the quality of products and services concludes that quality assurance must be approached differently. Product controls and tests used until that moment had to be replaced with a more modern, more efficient and more effective approach known as total quality management (TQM. TQM supporters suggest that TQM implementation results in improved product quality, reduced product return, reduced costs of serving unsatisfied customers and other benefits that ultimately lead to improved financial performance of the company. This paper examines the impact of TQM imple- mentation on the financial performance of Croatian companies whose securities are traded within the regulated market. General characteristics of companies were compared in terms of (nonsystematic application of total quality management. Furthermore, the financial performance of the companies that have successfully implemented the method was measured.

The Total Quality Movement in Education.

Science.gov (United States)

Leuenberger, John A.; Whitaker, Sheldon V., Jr.

The total quality movement began as a result of the desire of W. Edwards Deming, an American statistician, to permit the economic system to maintain its edge in a growing global market. The 14 points Deming listed as essential to "total quality management" have recently been adapted to the field of education. The success of the total…

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.

Data collection automation and total quality management: case studies in the health-service industry.

Science.gov (United States)

Smith, Alan D; Offodile, O Felix

2008-01-01

The limitations, immeasurable, and seemly unquantifiable aspects of the healthcare service industry, make it imperative that quality assurance programs include total quality management (TQM) and automatic identification and data capture (AIDC)-related technologies. Most of standards used in TQM and AIDC require data, to measure improvement and achieve standardization. Major difference between managing a service firm and managing a product-manufacturing firm is the difficulty of achieving consistently high quality. Examination of two different healthcare service providers in the Pittsburgh, Pennsylvania area offers different views as to the implementation and practice of total quality management techniques and AIDC integration. Since the healthcare service industry must take into account its high customization needs, there are positive steps to make the hospital structure itself more patient friendly and quality related; hence improving its heath-marketing strategies to the general public.

Total Quality Management: A Mindset and Method to Stimulate Change.

Science.gov (United States)

Mullen, Janet A.

1993-01-01

Provides a review of the total quality management movement and process, and advocates applying it to higher education as a solution to current problems. Customer emphasis, continuous improvement, developing human resources, and using tools for process development are described; and examples from specific academic institutions are included.…

ISO 9000 and the total quality management models

OpenAIRE

Pacios Lozano, Ana Reyes

1997-01-01

Establishes the most outstanding differences between the ISO 9000 norms and total quality management as forms or manners of managing quality used in some information services. Compares two models of total quality: European Foundation far Quality Management and Malcolm Baldrige Awards.

An approach to total quality assurance

International Nuclear Information System (INIS)

Archer, L.G.

1976-01-01

Total Quality Assurance must be based on amalgamating three quality functions: effective quality control, competent inspection, and regularly audited Quality Assurance programmes. In applying these functions the fuel supplier must regard each of his sub-contractors as part of his own works and ensure a common policy of motivated Quality Assurance throughout his own works and those of his suppliers. (author)

Collaborative quality improvement.

Science.gov (United States)

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

2017-07-01

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

Quality Improvement Practices and Trends

DEFF Research Database (Denmark)

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

1998-01-01

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

Records Management in Organization and Total Quality

Directory of Open Access Journals (Sweden)

Fahrettin Özdemirci

1999-06-01

Full Text Available In this article the relationship between total quality management and records managemen t are examined. It has also been indicated that the records mana­gement has vita'ly important part for realizing the total quality management approach.

Total quality management implementation guidelines

Energy Technology Data Exchange (ETDEWEB)

1993-12-01

These Guidelines were designed by the Energy Quality Council to help managers and supervisors in the Department of Energy Complex bring Total Quality Management to their organizations. Because the Department is composed of a rich mixture of diverse organizations, each with its own distinctive culture and quality history, these Guidelines are intended to be adapted by users to meet the particular needs of their organizations. For example, for organizations that are well along on their quality journeys and may already have achieved quality results, these Guidelines will provide a consistent methodology and terminology reference to foster their alignment with the overall Energy quality initiative. For organizations that are just beginning their quality journeys, these Guidelines will serve as a startup manual on quality principles applied in the Energy context.

Improving high quality, equitable maternal health services in Malawi ...

International Development Research Centre (IDRC) Digital Library (Canada)

Improving high quality, equitable maternal health services in Malawi (IMCHA) ... In response, the Ministry of Health implemented a Standards-Based Management and Recognition for Reproductive Health initiative to improve ... Total funding.

The implementation methodology of Total Quality Management in health services, as a best practice operation.

Directory of Open Access Journals (Sweden)

Theodora Malamou

2016-09-01

Full Text Available Total Quality Management – TQM (Total Quality Management-TQM, health services, is a modern management philosophy to improve the quality and efficiency of the organization as a whole, with the involvement of all employees, at all levels. According to the research data, the concept of quality is distinguished in technical, interpersonal quality and hotel infrastructure and focuses on patient satisfaction. The Critical success factors of TQM, organizations for business excellence in continuous competitive changing environment, is the management commitment, customer focus, constant communication with employees, encouragement and reward, education and scientific training, continuous improvement quality of service, interdependent relationships with suppliers, active employee participation, creation of representative indicators, targets and benchmarking, continuous outcome assessment and continuous review, review of program procedures. The purpose of this article is through the review of Greek and international literature, to introduce the methodology of a project TQM, to health services, as everyday best practice, with emphasis on quality of service. According to the literature review, TQM contributes to improving the quality of health services, the cultivation of team spirit, cooperation between health professionals and leadership, with a view to satisfy all. TQM is purely anthropocentric theory of organization and administration. We need comprehensive effort approach to improving the quality of leadership and the introduction of the culture of workers.

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

Science.gov (United States)

Dunagan, Pamela B

2017-12-01

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

Standardizing Care and Improving Quality under a Bundled Payment Initiative for Total Joint Arthroplasty.

Science.gov (United States)

Froemke, Cecily C; Wang, Lian; DeHart, Matthew L; Williamson, Ronda K; Ko, Laura Matsen; Duwelius, Paul J

2015-10-01

Increasing demands for episodic bundled payments in total hip and knee arthroplasty are motivating providers to wring out inefficiencies and coordinate services. This study describes a care pathway and gainshare arrangement as the mechanism by which improvements in efficiency were realized under a bundled payment pilot. Analysis of cut-to-close time, LOS, discharge destination, implant cost, and total allowed claims between pre-pilot and pilot cohorts showed an 18% reduction in average LOS (70.8 to 58.2 hours) and a shift from home health and skilled nursing facility discharge to home self-care (54.1% to 63.7%). No significant differences were observed for cut-to-close time and implant cost. Improvements resulted in a 6% reduction in the average total allowed claims per case. Copyright © 2015 Elsevier Inc. All rights reserved.

Teaching quality improvement.

Science.gov (United States)

Murray, Marry Ellen; Douglas, Stephen; Girdley, Diana; Jarzemsky, Paula

2010-08-01

Practicing nurses are required to engage in quality improvement work as a part of their clinical practice, but few undergraduate nursing education programs offer course work and applied experience in this area. This article presents a description of class content and teaching strategies, assignments, and evaluation strategies designed to achieve the Quality and Safety Education in Nursing competencies related to quality improvement and interdisciplinary teams. Students demonstrate their application of the quality improvement process by designing and implementing a small-scale quality improvement project that they report in storyboard format on a virtual conference Web site.

Quality-of-life outcomes in Graves disease patients after total thyroidectomy.

Science.gov (United States)

Kus, Lukas H; Hopman, Wilma M; Witterick, Ian J; Freeman, Jeremy L

2017-01-01

Historically, research into surgical treatment of Graves disease has assessed subtotal rather than total thyroidectomy. Most clinicians now recommend total thyroidectomy, but little information is available regarding quality-of-life (QOL) outcomes for this procedure. Our aim was to assess QOL after total thyroidectomy. This is a retrospective, pilot study of patients with Graves disease who underwent total thyroidectomy from 1991 to 2007 at a high-volume tertiary referral center in Toronto, Canada. Questionnaires addressing disease-specific symptoms and global QOL concerns were sent to 54 patients. Analyses included parametric and nonparametric tests to assess the differences between perception of symptoms and global QOL before and after surgery. Forty patients responded (response rate: 74%) at a median of 4.8 years postoperatively. On a 10-point scale, overall wellness improved from 4.1 preoperatively to 8.7 postoperatively (p total thyroidectomy. Patients experienced marked and rapid improvement in QOL postoperatively. These findings suggest that total thyroidectomy is a safe and effective treatment.

Perceptions of Community College Presidents: Total Quality Management Performance Measures at Their Colleges

Science.gov (United States)

Riccardi, Mark T.

2009-01-01

Continuous Quality Improvement (CQI) measures such as Total Quality Management (TQM), Strategic Planning, Six Sigma, and the Balanced Scorecard are often met with skepticism among leaders of higher education. This study attempts to fill a gap in the literature regarding the study of relationships among specific variables, or building blocks,…

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.…

Uncut Esophagojejunostomy with Double Jejunal Pouch: An Alternative Reconstruction Method that Improves the Quality of Life of Patients after Total Gastrectomy.

Science.gov (United States)

Gong, Jia Qing; Cao, Yong Kuan; Zhang, Guo Hu; Wang, Pei Hong; Luo, Guo De

2017-04-01

Currently, there is no optimal digestive tract reconstruction technique well recognized by scholars after total gastrectomy. In this study, a new reconstruction method, which is modified from the classic Roux-en-Y procedure, an uncut jejunal esophageal anastomosis with double jejunal pouch (UJEA-DJP) was established, and its advantages for improving the quality of life of patients who undergo total gastrectomy were analyzed. Altogether 160 patients with gastric cancer enrolled in our center from September 2009 to March 2012 received radical D2 total gastrectomy. According to the reconstruction methods used, these patients were divided into three groups: UJEA-DJP (n = 63), Roux-en-Y (n = 45), and P-loop with Roux-en-Y esophagojejunostomy (P-RY; n = 52). The operation time for reconstruction, complications, prognostic nutritional index (PNI), and the Visick classification among the three groups were analyzed. We found that UJEA-DJP has advantages over Roux-en-Y and P-RY regarding the time of digestive tract reconstruction, incidence rates for long-term complications, postoperative nutritional index, body weight recovery, and the Visick classification for subjective feelings (p quality of life of patients after surgical procedure.

Activity and Quality of Life after Total Hip Arthroplasty.

Science.gov (United States)

Świtoń, Anna; Wodka-Natkaniec, Ewa; Niedźwiedzki, Łukasz; Gaździk, Tadeusz; Niedźwiedzki, Tadeusz

2017-10-31

Coxarthrosis is a chronic musculoskeletal condition that causes severe pain and considerable limi-tation of the patient's motor performance. Total hip arthroplasty is one of the most common and effective methods used in the treatment of advanced degenerative changes. The aim of the present study was to evaluate the activity and quality of life of patients after unilateral total hip arthroplasty. The study was conducted in a group of 189 patients who had undergone unilateral total hip arthroplasty. Goniometry was used to determine the range of motion of both hip joints. Patients' physical ability and pain severity were assessed based on the Harris Hip Score (HHS) questionnaire. The examination of the range of motion in the lower extremities revealed statistically significant diffe-rences in flexion (p<0.01), abduction (p=<0.01), adduction (p<0.01) and external rotation (p<0.01) between the operated and the healthy extremity. The greatest limitation of motion was demonstrated for external rotation (<14°). Approximately 14% of the patients were not able to perform this motion in their healthy hip joint, while 17.5% of them could not do so in the affected hip joint. Analysis of HHS results (mean = 79 pts) revealed that more than 50% of the patients described their functional ability and quality of life as good and excellent. It was demonstrated that 54% of patients did not suffer from pain, whereas minor or mild pain was noted in 35%. 1. A subjective clinical assessment of patients after total hip arthroplasty showed that their quality of life had improved. 2. It is necessary to perform physiotherapy after total hip arthroplasty, on both the operated and healthy side. 3. Exacerbation of pain and impaired activity in patients after total hip arthroplasty were associated with the female sex to a considerable extent.

Fostering Quality Improvement in EHDI Programs

Science.gov (United States)

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

2011-01-01

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

The comparison of clinical features and quality of life after total knee replacement.

Science.gov (United States)

Lee, Jiyeon; Kim, Jung-Hee; Jung, Eun-Jung; Lee, Byoung-Hee

2017-06-01

[Purpose] The purpose of this study is to provide fundamental information for efficient management of patients after a total knee replacement (TKR) through the evaluation of changes of range of motion, pain, functional level, and quality of life. [Subjects and Methods] For a total of 63 knee osteoarthritis patients, VAS, KSKS, KSFS, HSS, WOMAC scores and quality of life were evaluated for functional levels at pre-operation, post-operation, six months after operation, and 12 months after operation. [Results] After the TKR operations, participants showed significant improvement in KSKS, KSFS, WOMAC, and SF-36 scores when compared to pre-operation. [Conclusion] After a TKR operation, ROM, and pain management, along with a therapeutic program for improvement of function, should be conducted 6 months after the operation.

Total Quality Management Seminar.

Science.gov (United States)

Massachusetts Career Development Inst., Springfield.

This booklet is one of six texts from a workplace literacy curriculum designed to assist learners in facing the increased demands of the workplace. The booklet contains seven sections that cover the following topics: (1) meaning of total quality management (TQM); (2) the customer; (3) the organization's culture; (4) comparison of management…

Concepts of total quality management in radiology

International Nuclear Information System (INIS)

Pratik Kumar

2003-01-01

Quality is one of the touch-stones to determine the competitive advantage for a service, product or company. Total Quality Management has a large ambit, which encompasses not only the quality of images and services producing these images, but also the customers satisfaction. In health care patients satisfaction is divided into three parts: patient quality, professional quality and management quality

Benchmarking, Total Quality Management, and Libraries.

Science.gov (United States)

Shaughnessy, Thomas W.

1993-01-01

Discussion of the use of Total Quality Management (TQM) in higher education and academic libraries focuses on the identification, collection, and use of reliable data. Methods for measuring quality, including benchmarking, are described; performance measures are considered; and benchmarking techniques are examined. (11 references) (MES)

Ninety to Nothing: a PDSA quality improvement project.

Science.gov (United States)

Prybutok, Gayle Linda

2018-05-14

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

Association of Changes in Diet Quality with Total and Cause-Specific Mortality.

Science.gov (United States)

Sotos-Prieto, Mercedes; Bhupathiraju, Shilpa N; Mattei, Josiemer; Fung, Teresa T; Li, Yanping; Pan, An; Willett, Walter C; Rimm, Eric B; Hu, Frank B

2017-07-13

Few studies have evaluated the relationship between changes in diet quality over time and the risk of death. We used Cox proportional-hazards models to calculate adjusted hazard ratios for total and cause-specific mortality among 47,994 women in the Nurses' Health Study and 25,745 men in the Health Professionals Follow-up Study from 1998 through 2010. Changes in diet quality over the preceding 12 years (1986-1998) were assessed with the use of the Alternate Healthy Eating Index-2010 score, the Alternate Mediterranean Diet score, and the Dietary Approaches to Stop Hypertension (DASH) diet score. The pooled hazard ratios for all-cause mortality among participants who had the greatest improvement in diet quality (13 to 33% improvement), as compared with those who had a relatively stable diet quality (0 to 3% improvement), in the 12-year period were the following: 0.91 (95% confidence interval [CI], 0.85 to 0.97) according to changes in the Alternate Healthy Eating Index score, 0.84 (95 CI%, 0.78 to 0.91) according to changes in the Alternate Mediterranean Diet score, and 0.89 (95% CI, 0.84 to 0.95) according to changes in the DASH score. A 20-percentile increase in diet scores (indicating an improved quality of diet) was significantly associated with a reduction in total mortality of 8 to 17% with the use of the three diet indexes and a 7 to 15% reduction in the risk of death from cardiovascular disease with the use of the Alternate Healthy Eating Index and Alternate Mediterranean Diet. Among participants who maintained a high-quality diet over a 12-year period, the risk of death from any cause was significantly lower - by 14% (95% CI, 8 to 19) when assessed with the Alternate Healthy Eating Index score, 11% (95% CI, 5 to 18) when assessed with the Alternate Mediterranean Diet score, and 9% (95% CI, 2 to 15) when assessed with the DASH score - than the risk among participants with consistently low diet scores over time. Improved diet quality over 12 years was

Effect of culture levels, ultrafiltered retentate addition, total solid levels and heat treatments on quality improvement of buffalo milk plain set yoghurt.

Science.gov (United States)

Yadav, Vijesh; Gupta, Vijay Kumar; Meena, Ganga Sahay

2018-05-01

Studied the effect of culture (2, 2.5 and 3%), ultrafiltered (UF) retentate addition (0, 11, 18%), total milk solids (13, 13.50, 14%) and heat treatments (80 and 85 °C/30 min) on the change in pH and titratable acidity (TA), sensory scores and rheological parameters of yoghurt. With 3% culture levels, the required TA (0.90% LA) was achieved in minimum 6 h incubation. With an increase in UF retentate addition, there was observed a highly significant decrease in overall acceptability, body and texture and colour and appearance scores, but there was highly significant increase in rheological parameters of yoghurt samples. Yoghurt made from even 13.75% total solids containing nil UF retentate was observed to be sufficiently firm by the sensory panel. Most of the sensory attributes of yoghurt made with 13.50% total solids were significantly better than yoghurt prepared with either 13 or 14% total solids. Standardised milk heated to 85 °C/30 min resulted in significantly better overall acceptability in yoghurt. Overall acceptability of optimised yoghurt was significantly better than a branded market sample. UF retentate addition adversely affected yoghurt quality, whereas optimization of culture levels, totals milk solids and others process parameters noticeably improved the quality of plain set yoghurt with a shelf life of 15 days at 4 °C.

Japanese style total quality control: A first hand experience

Science.gov (United States)

Cook, S. C.

1991-11-01

The scope, concepts and practices of Total Quality Control (TQC) as operated in Japan today are described. The following mechanisms and elements are introduced: policy deployment, cross functional management, small group activities, suggestion systems, standardization, the TQC promotion department, and TQC education. It is shown on a practical level, how TQC operates in the research and engineering divisions of the aeroengine and space operation at Ishikawajima Harima Industries in Japan. Japanese style TQC is a well developed, well promoted, well structured, common approach to achieving customer satisfaction through continuous improvements. Furthermore, TQC itself is being continuously improved with the Japanese still refining, extending, and developing TQC.

Prospective evaluation of quality of life and sexual functioning after laparoscopic total mesorectal excision.

Science.gov (United States)

Breukink, S O; van der Zaag-Loonen, H J; Bouma, E M C; Pierie, J P E N; Hoff, C; Wiggers, T; Meijerink, W J H J

2007-02-01

This study was designed to investigate how the quality of life of patients with rectal cancer changes with time after laparoscopic total mesorectal excision. Patients completed the Medical Outcomes Study Short Form 36 and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire and a colorectal-specific European Organisation for Research and Treatment of Cancer quality of life questionnaire before laparoscopic total mesorectal excision, on discharge from the hospital and at 3, 6, and 12 months postoperatively. Patients were treated by laparoscopic low anterior resection or laparoscopic abdominoperineal resection. Fifty-one patients (mean age, 64 years; 29 males (57 percent)) participated in this study, of whom 38 (75 percent) underwent laparoscopic low anterior resection and 13 (25 percent) laparoscopic abdominoperineal resection. Compared with preoperative scores on the Medical Outcomes Study Short Form 36, patients reported a deterioration in physical functioning (74 vs. 80; P = 0.009), and improved mental functioning (76 vs. 70; P = 0.007) at three months. Improvement in emotional well-being was reported both on the Medical Outcomes Study Short Form 36 (78 vs. 53; P = 0.006) and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (84 vs. 69; P < 0.001). At one year, improvements in global quality of life (82 vs. 68; P = 0.001) and symptoms, such as fatigue (18 vs. 32; P < 0.001), pain (5 vs. 12; P = 0.009), and appetite loss (3 vs. 13; P = 0.01), were reported. Sexual functioning was worse from three months onward until one year after surgery (47 vs. 66; P = 0.004). Patients who underwent low anterior resection experienced less sexual dysfunction than patients after abdominoperineal resection (21 vs. 56; P = 0.004). One year after laparoscopic total mesorectal excision for rectal cancer, patients reported improvement in some important quality of life outcomes, including global quality

Total Quality Management in Space Shuttle Main Engine manufacturing

Science.gov (United States)

Ding, J.

1992-01-01

The Total Quality Management (TQM) philosophy developed in the Marshall Space Flight Center (MSFC) is briefly reviewed and the ongoing TQM implementation effort which is being pursued through the continuous improvement (CI) process is discussed. TQM is based on organizational excellence which integrates the new supportive culture with the technical tools necessary to identify, assess, and correct manufacturing processes. Particular attention is given to the prime contractor's change to the organizational excellence management philosophy in SSME manufacturing facilities.

Some Operational Aspects Relating to Quality Management and Total Quality Management

OpenAIRE

Sorin GRESOI; Aurelian DIACONU

2013-01-01

The work pass in review a few basic concepts found in quality management focusing on operational aspects of quality assurance in production activity and continue with issues regarding total quality strategy, the vector of competitiveness on the market.

Using spatially detailed water-quality data and solute-transport modeling to improve support total maximum daily load development

Science.gov (United States)

Walton-Day, Katherine; Runkel, Robert L.; Kimball, Briant A.

2012-01-01

Spatially detailed mass-loading studies and solute-transport modeling using OTIS (One-dimensional Transport with Inflow and Storage) demonstrate how natural attenuation and loading from distinct and diffuse sources control stream water quality and affect load reductions predicted in total maximum daily loads (TMDLs). Mass-loading data collected during low-flow from Cement Creek (a low-pH, metal-rich stream because of natural and mining sources, and subject to TMDL requirements) were used to calibrate OTIS and showed spatially variable effects of natural attenuation (instream reactions) and loading from diffuse (groundwater) and distinct sources. OTIS simulations of the possible effects of TMDL-recommended remediation of mine sites showed less improvement to dissolved zinc load and concentration (14% decrease) than did the TMDL (53-63% decrease). The TMDL (1) assumed conservative transport, (2) accounted for loads removed by remediation by subtracting them from total load at the stream mouth, and (3) did not include diffuse-source loads. In OTIS, loads were reduced near their source; the resulting concentration was decreased by natural attenuation and increased by diffuse-source loads during downstream transport. Thus, by not including natural attenuation and loading from diffuse sources, the TMDL overestimated remediation effects at low flow. Use of the techniques presented herein could improve TMDLs by incorporating these processes during TMDL development.

Leadership profiles and the implementation of Total Quality Management for Business Excellence

DEFF Research Database (Denmark)

Dahlgaard, Jens Jørn; Dahlgaard, Su Mi Park; Nørgaard, Anders

1999-01-01

Total Quality Management (TQM) is defined as: "A company culture wich is is characterized by everybody´s paricipation in continuous improvements of customer satisfaction" (Kanji, 1993). In order to build the TQM culture it is important that every staff member - top managers, middle managers...

Diagnosing Total Quality Management. Part I

NARCIS (Netherlands)

Bossink, B.A.G.; Gieskes, J.F.B.; Pas, T.N.M.

1992-01-01

From extensive literature research a total quality management (TQM) model is developed. This model describes the basic elements of the concept of TQM. It also provides the way in which the basic elements can be made operational in practice. Based on this model a quality-diagnostical instrument is

Diagnosing Total Quality Management - part 2

NARCIS (Netherlands)

Bossink, B.A.G.; Gieskes, J.F.B.; Pas, T.N.M.

1993-01-01

From extensive literature research a total quality management (TQM) model is developed. This model describes the basic elements of the concept of TQM. It also provides the way in which the basic elements can be made operational in practice. Based on this model a quality-diagnostical instrument is

Quality of life in penile carcinoma patients - post-total penectomy.

Science.gov (United States)

Sosnowski, Roman; Kulpa, Marta; Kosowicz, Mariola; Wolski, Jan Karol; Kuczkiewicz, Olga; Moskal, Katarzyna; Szymański, Michał; Kalinowski, Tomasz; Demkow, Tomasz

2016-01-01

Total amputation, as a treatment for advanced penile cancer, significantly debilitates the patient's quality of life and sexual function. The aim of the study was to assess the quality of life in patients who had undergone total penectomy. The questionnaires EORTC QLQ C-30, SES, CMNI, and a modified IIEF-15 questionnaire, were sent to 11 patients. A total of 10 patients returned the questionnaires completed. The results of the overall quality of life, the median result in individual domains, as assessed by the EORT QLQ C-30 questionnaire, were clearly lower than the reference results. There were statistically significant differences in the results of the QLQ C-30, concerning the role-functioning domain in relation to age (p = 0.008) and education (p = 0.032), in the domain of emotional functioning in relation to education (p = 0.008) and in the domains of physical functioning in relation to the partner relationship (p = 0.032). A significant number of patients were sexually inactive. Sexual activity as defined by touching the area of the pubic symphysis at the scars of the penis, touching and fondling perianal areas or the scrotum and watching things/people that cause excitement was observed in 2/10, 1/10 and 2/10 of patients respectively. In 5/6 of these patients, partnership relationships did not deteriorate, including one patient for whom the relationship actually improved. The results obtained indicate that total amputation of the penis significantly affects one's sex life and overall quality of life. However, this does not have negative implications in terms of partnership relations, self-assessment or the evaluation of masculinity.

Quality Improvement in Virtual Higher Education: A Grounded Theory Approach

Science.gov (United States)

Mahdiuon, Rouhollah; Masoumi, Davoud; Farasatkhah, Maghsoud

2017-01-01

The article aims to explore the attributes of quality and quality improvement including the process and specific actions associated with these attributes--that contribute enhancing quality in Iranian Virtual Higher Education (VHE) institutions. A total of 16 interviews were conducted with experts and key actors in Iranian virtual higher education.…

Exchanging a few commercial, regularly consumed food items with improved fat quality reduces total cholesterol and LDL-cholesterol: a double-blind, randomised controlled trial.

Science.gov (United States)

Ulven, Stine M; Leder, Lena; Elind, Elisabeth; Ottestad, Inger; Christensen, Jacob J; Telle-Hansen, Vibeke H; Skjetne, Anne J; Raael, Ellen; Sheikh, Navida A; Holck, Marianne; Torvik, Kristin; Lamglait, Amandine; Thyholt, Kari; Byfuglien, Marte G; Granlund, Linda; Andersen, Lene F; Holven, Kirsten B

2016-10-01

The healthy Nordic diet has been previously shown to have health beneficial effects among subjects at risk of CVD. However, the extent of food changes needed to achieve these effects is less explored. The aim of the present study was to investigate the effects of exchanging a few commercially available, regularly consumed key food items (e.g. spread on bread, fat for cooking, cheese, bread and cereals) with improved fat quality on total cholesterol, LDL-cholesterol and inflammatory markers in a double-blind randomised, controlled trial. In total, 115 moderately hypercholesterolaemic, non-statin-treated adults (25-70 years) were randomly assigned to an experimental diet group (Ex-diet group) or control diet group (C-diet group) for 8 weeks with commercially available food items with different fatty acid composition (replacing SFA with mostly n-6 PUFA). In the Ex-diet group, serum total cholesterol (PLDL-cholesterol (Pcholesterol and LDL-cholesterol, respectively. No difference in change in plasma levels of inflammatory markers (high-sensitive C-reactive protein, IL-6, soluble TNF receptor 1 and interferon-γ) was observed between the groups. In conclusion, exchanging a few regularly consumed food items with improved fat quality reduces total cholesterol, with no negative effect on levels of inflammatory markers. This shows that an exchange of a few commercially available food items was easy and manageable and led to clinically relevant cholesterol reduction, potentially affecting future CVD risk.

A Total Quality-Control Plan with Right-Sized Statistical Quality-Control.

Science.gov (United States)

Westgard, James O

2017-03-01

A new Clinical Laboratory Improvement Amendments option for risk-based quality-control (QC) plans became effective in January, 2016. Called an Individualized QC Plan, this option requires the laboratory to perform a risk assessment, develop a QC plan, and implement a QC program to monitor ongoing performance of the QC plan. Difficulties in performing a risk assessment may limit validity of an Individualized QC Plan. A better alternative is to develop a Total QC Plan including a right-sized statistical QC procedure to detect medically important errors. Westgard Sigma Rules provides a simple way to select the right control rules and the right number of control measurements. Copyright © 2016 Elsevier Inc. All rights reserved.

Total quality management practices in Malaysia healthcare industry

Science.gov (United States)

Ahmad, Md Fauzi; Nee, Phoi Soo; Nor, Nik Hisyamudin Muhd; Wei, Chan Shiau; Hassan, Mohd Fahrul; Hamid, Nor Aziati Abdul

2017-10-01

The aim of total quality management (TQM) is to achieve customer satisfaction. Healthcare industry is very important in Malaysia for providing good healthcare services to public. However, failure to improve quality and efficiency is a big challenge in a healthcare industry in order to increase quality healthcare services. The objectives of this research are to identify the extent level of TQM implementation; and to determine the impact of TQM implementation on business sustainable in healthcare industry. Quantitative approach has been chosen as the methodology of this study. The survey respondents targeted in this research are staffs in Malaysia private clinic. 70 respondents have participated in this research. Data were analysed by Statistical Package Social Science (SPSS). Analysis result showed that there was a positive significant relationship between TQM practices and business sustainable (r=0.774, Prelationship with business sustainable factors. The findings of this research will help healthcare industry to understand a better and deeper valuable information on the impact of TQM implementation towards business sustainable in Malaysia healthcare industry.

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)

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

Science.gov (United States)

Murali, Swetha; Ponmalar, V.

2017-07-01

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

Total Quality Management Implementation and Guest Satisfaction in Hospitality

Directory of Open Access Journals (Sweden)

Miroslav Knežević

2017-02-01

Full Text Available Total quality management (TQM has become a modern system of constant improvement of the quality of all company activities. The purpose of this study is to measure the expectations and satisfaction of the guests concerning the attribute quality of the hotel product. Furthermore obtained results were compared in such a way as to analyse particularly the reviews of hotels which have implemented TQM and have the ISO 9001 certificates with reviews from hotels which have not implemented TQM and do not have the ISO 9001 certificates. The conducted analysis included 55 hotels in Serbia belonging to the 4- and 5-star categories, i.e. 1308 guests who have stayed in them. The results show that between the observed groups of guests there are fewer differences in expectations than in perception, and that generally speaking guests who have stayed in the hotels that have implemented TQM are more satisfied. The biggest difference concerning the guest satisfaction with the quality of service in the observed hotels is noticeable in relation to the employees and the value-for-money.

Total Quality Management Master Plan

Science.gov (United States)

1989-01-01

Enhanced competitiveness in the private . public and international sectors - Increased cash flow, influenced by contractor’s contributions to quality I...the project applies novel public- sector compensation concepts gleaned from the best in the private sector . Major employee development opportunities...management must strive to upgrade the quality of worklife which will also contribute to an environment which fosters continuous improvement. Individuals

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

Total Quality Service and the Business College

OpenAIRE

James Perotti

1995-01-01

Moving a business college to commit to a total quality service approach is much more difficult than the literature suggests. The commitment to customer satisfaction is the essential focus of total quality service. It is unlikely to occur in business colleges. While small incremental change is readily possible, the values and culture of the faculty and administration prevent the requisite acceptance by the faculty of students as their customers, and acceptance of the faculty as customers of th...

Quality of Life After Total Proctocolectomy With Ileostomy or IPAA: A Systematic Review.

Science.gov (United States)

Murphy, Patrick B; Khot, Zaid; Vogt, Kelly N; Ott, Michael; Dubois, Luc

2015-09-01

The standard surgical treatment for ulcerative colitis involves either a total proctocolectomy and end ileostomy or an IPAA. Both treatments result in similar control of disease but differ in terms of patient experience and daily functioning. The aim of this systematic review was to determine whether one surgical approach was superior with regard to health-related quality of life. An electronic literature search of PubMed, MEDLINE, EMBASE, and the Cochrane Database of Collected Reviews was performed for dates from 1978 to 2014. The search included the following terms: "inflammatory bowel disease," "colitis," "colectomy," and "ileal pouch-anal anastomosis." Studies were included if they reported on a comparison of total proctocolectomy and end ileostomy with an IPAA and evaluated some aspect of quality of life. All of the studies were systematically reviewed. No meta-analysis was performed secondary to significant heterogeneity across studies in different health-related quality-of-life measures. End points were a mixture of global, generic, and disease-specific measures of quality of life. Thirteen studies reporting a total of 1604 patients who underwent total proctocolectomy with ileostomy (N = 820) or IPAA (N = 783) were included for review. Neither procedure was found to be clearly superior with regard to health-related quality of life. The conclusions of this review were limited by small study sample size, significant between-study heterogeneity, observational designs, and limited follow-up. Despite being limited by poor study quality, both total proctocolectomy with ileostomy and IPAA appear equivalent in terms of overall health-related quality of life. Most patients are satisfied with their choice regardless of procedure. Most of the improvement in quality of life after surgery is related to the control of disease-related symptoms. These findings indicate that both IPAA and permanent ileostomy should be discussed in detail with patients preoperatively to help

Kennedy Space Center's NASA/Contractor Team-Centered Total Quality Management Seminar: Results, methods, and lessons learned

Science.gov (United States)

Kinlaw, Dennis C.; Eads, Jeannette

1992-01-01

It is apparent to everyone associated with the Nation's aeronautics and space programs that the challenge of continuous improvement can be reasonably addressed only if NASA and its contractors act together in a fully integrated and cooperative manner that transcends the traditional boundaries of proprietary interest. It is, however, one thing to assent to the need for such integration and cooperation; it is quite another thing to undertake the hard tasks of turning such a need into action. Whatever else total quality management is, it is fundamentally a team-centered and team-driven process of continuous improvement. The introduction of total quality management at KSC, therefore, has given the Center a special opportunity to translate the need for closer integration and cooperation among all its organizations into specific initiatives. One such initiative that NASA and its contractors have undertaken at KSC is a NASA/Contractor team-centered Total Quality Management Seminar. It is this seminar which is the subject of this paper. The specific purposes of this paper are to describe the following: Background, development, and evolution of Kennedy Space Center's Total Quality Management Seminar; Special characteristics of the seminar; Content of the seminar; Meaning and utility of a team-centered design for TQM training; Results of the seminar; Use that one KSC contractor, EG&G Florida, Inc. has made of the seminar in its Total Quality Management initiative; and Lessons learned.

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.

The Eighth Annual NASA/Contractors Conference and 1991 National Symposium on Quality and Productivity: Extending the boundaries of total quality management

Science.gov (United States)

Templeton, Geoffrey B. (Editor); Stewart, Lynne M. (Editor); Still, William T. (Editor)

1992-01-01

The Eighth Annual NASA/Contractors Conference and 1991 National Symposium on Quality and Productivity provided a forum to exchange knowledge and experiences in these areas of continuous improvement. The more than 1,100 attendees from government, industry, academia, community groups, and the international arena had a chance to learn about methods, tools, and strategies for excellence and to discuss continuous improvement strategies, successes, and failures. This event, linked via satellite to concurrent conferences hosted by the NASA Goddard Space Flight Center in Greenbelt, Maryland, and Martin Marietta Astronautics Group in Denver, Colorado, also explored extending the boundaries of Total Quality Management to include partnerships for quality within communities and encouraged examination, evaluation, and change to incorporate the principles of continuous improvement.

Just In Time Value Chain Total Quality Management Part Of Technical Strategic Management Accounting

Directory of Open Access Journals (Sweden)

Lesi Hertati

2015-08-01

Full Text Available This article aims to determine Just In Time Value Chain Total Quality Management tqm as a technique in management accounting stategis.Tujuan Just In Time value chain or value chain Total Quality Management TQM is strategic for customer satisfaction in the long term obtained from the information. Quality information is the way to continuous improvement in order to increase the companys financial performance in the long term to increase competitive advantage. Strategic Management Accounting process gather competitor information explore opportunities to reduce costs integrate accounting with emphasis on the strategic position of the competition is a great plan. An overall strategic plan interrelated and serves as the basis for achieving targets or goals ahead.

Efficiency Improvement and Quality Initiatives Application in Financial Institutions

Directory of Open Access Journals (Sweden)

MSc. Ajtene Avdullahi

2015-06-01

Full Text Available Financial institutions in today’s economy have no longer the luxury to improve profit simply by increasing revenue. These firms, due to the significant measuring reductions in the financial services industry needed to improve operational efficiencies and merely support existing processes with fewer resources. This paper explains the benefits of Lean, Six Sigma, Total Quality Management and Lean Six Sigma that have improved organization's performance, by cutting costs and waste, improving their products or services, increasing profitability as well as enhancing customer satisfaction. The applicability of quality management practices in financial institutions in Kosovo is presented and also their efficiency and effectiveness. By analyzing data from Raiffeisen Bank Kosovo, this paper highlights the benefits of Individual and Micro companies customer segment as the result of organizational change and successful application of quality initiatives from financial institutions in Kosovo.

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

Directory of Open Access Journals (Sweden)

Asgar Aghaei Hashjin

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

Application of Total Quality Management (TQM Requirements in Risk Management in Construction Projects in Iraq

Directory of Open Access Journals (Sweden)

Entisar K. Al-Geelawee

2016-06-01

Full Text Available Total quality management considers one of the modern scientific entrances which practiced by productivity service organizations alike to provide appropriate quality required outputs according to the needs and desires of customers manage , enable the organization seeking to continue and grow in light of the increasing competition from the satisfy and provide the appropriate total quality management requirements whenever led to face risks that they may have in a manner in which they can be addressed and find ways to avoid them in the future when repeated. The research has consist of two main parts firstly have included a review of the most important concepts of total quality management in addition to the concept of risk analysis and management in construction projects and how to apply the concept of total quality management in the risk analysis and management. Second part included the practical part of the research, which was open and closed questionnaire for experts in the construction industry to obtain required informations for the application of total quality management requirements in risk management in construction projects in Iraq. One of the main findings of the research is that top management support has a high impact on risk management in addition to continuous improvement, training and education, while the participation of all employees in the organization and constant stimulation and focusing on the customer as one of the total quality management requirements had a moderate impact on risk management.

Quality improvement - the future begins

International Nuclear Information System (INIS)

Boissy, G.J.

1987-01-01

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

Total quality culture in radiotherapy departments across Ontario

International Nuclear Information System (INIS)

Mitera, Gunita; Whitton, Anthony; Gutierrez, Eric; Robson, Sheila

2011-01-01

Purpose: To investigate the prevalence of total quality culture (TQC) within radiation therapy (RT) departments across Ontario, Canada. Methods: A prospective quantitative survey was distributed within RT departments across Ontario, Canada using the Miller Consulting Group Quality Culture survey. Findings: Ninety percent of managers (9/10) and 50% of employees (261/519) participated. There was concordance between managers and staff that overall RT departments exhibit a work culture that somewhat resembles TQC. Both groups scored 55% of the categories as somewhat agree with TQC and 9% of categories as no TQC. There was discordance in views for 36% of the categories, where managers scored a higher prevalence of TQC compared to their therapists. Larger RT departments (>50 employees) had more prevalence of discrepancy between group scores. Conclusions: This is the first study to report on the prevalence of TQC within RT departments. Strategies designed for on-going continuous improvement will benefit staff, RT managers, continuity of patient care and patient safety within RT departments.

W. Edwards Deming and total quality management: an interpretation for nursing practice.

Science.gov (United States)

Williams, T; Howe, R

1992-01-01

The purpose of this article is to introduce nurses to W. Edwards Deming and the 14 points of his management philosophy, the basis of total quality management (TQM) (Deming, 1986). Each of Deming's points has been subject to in-depth analysis from business executives for the past 40 years. Quality improvement is at the very center of TQM. To adopt TQM will require a major thought transformation for many nursing leaders, but the benefits that nurses and the profession as a whole can reap from this revolutionary style of management make the effort to change worthwhile. If you are not satisfied with the status quo and are looking for a better way to conduct business, the information in this article will begin to define quality improvement and will help you strive for the highest possible level of service to your ultimate customer--the patient.

What is Total Quality Management?

Science.gov (United States)

Bryan, William A.

1996-01-01

Provides a general overview of Total Quality Management (TQM) and explains why there is pressure for change in higher education institutions. Defines TQM and the various themes, tools, and beliefs that make it different from other management approaches. Presents 14 principles and how they might be applied to student affairs. (RJM)

Effective interventions on service quality improvement in a physiotherapy clinic.

Science.gov (United States)

Gharibi, Farid; Tabrizi, JafarSadegh; Eteraf Oskouei, MirAli; AsghariJafarabadi, Mohammad

2014-01-01

Service quality is considered as a main domain of quality associ-ated with non-clinical aspect of healthcare. This study aimed to survey and im-proves service quality of delivered care in the Physiotherapy Clinic affiliated with the Tabriz University of Medical Sciences, Tabriz, Iran. A quasi experimental interventional study was conducted in the Physiotherapy Clinic, 2010-2011. Data were collected using a validated and reli-able researcher made questionnaire with participation of 324 patients and their coadjutors. The study questionnaire consisted of 7 questions about demographic factors and 38 questions for eleven aspects of service quality. Data were then analyzed using paired samples t-test by SPSS16. In the pre intervention phase, six aspects of service quality including choice of provider, safety, prevention and early detection, dignity, autonomy and availability achieved non-acceptable scores. Following interventions, all aspects of the service quality improved and also total service quality score improved from 8.58 to 9.83 (PService quality can be improved by problem implementation of appropriate interventions. The acquired results can be used in health system fields to create respectful environments for healthcare customers.

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

Science.gov (United States)

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

2016-04-01

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

Quality of life and deglutition after total laryngectomy

Science.gov (United States)

Pernambuco, Leandro de Araújo; Oliveira, Jabson Herber Profiro de; Régis, Renata Milena Freitas Lima; Lima, Leilane Maria de; Araújo, Ana Maria Bezerra de; Balata, Patrícia Maria Mendes; Cunha, Daniele Andrade da; Silva, Hilton Justino da

2012-01-01

Summary Introduction: Total laryngectomy creates deglutition disorders and causes a decrease in quality of life Aim: To describe the impact of swallowing and quality of life of patients after total laryngectomy. Method: A case series study. Patients completed a Swallowing and Quality of Life questionnaire composed of 44 questions assessing 11 domains related to quality of life (burden, eating duration, eating desire, frequency of symptoms, food selection, communication, fear, mental health, social functioning, sleep, and fatigue). The analysis was performed using descriptive statistics, including measures of central tendency and variability. Results: The sample comprised 15 patients who underwent total laryngectomy and adjuvant radiotherapy. Of these, 66.7% classified their health as good and 73% reported no restrictions on food consistency. The domains “communication” and “fear” represented severe impact and “eating duration” represented moderate impact on quality of life. The items with lower scores were: longer time to eat than others (domain “eating duration”), cough and cough to remove the liquid or food of the mouth when they are stopped (domain “symptom frequency”), difficulties in understanding (domain “communication”) and fear of choking and having pneumonia (domain “fear”). Conclusion: After total laryngectomy, patients report that swallowing issues have moderate to severe impact in “communication,” “fear,” and “eating duration” domains. PMID:25991974

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.

The role of human resource management in the process of total quality management implementation

Directory of Open Access Journals (Sweden)

Milovanović Vesna

2014-01-01

Full Text Available Total quality management (TQM is a holistic philosophy of striving for continuous quality improvement of all processes in the company. This requires the involvement of employees and encouraging them to make proposals, take responsibility and make decisions. Successful implementation of TQM is largely determined by the quality of human resources management (HRM, which should ensure employees' commitment to continuous process improvement. Previous studies worldwide have shown that the effects of this sophisticated philosophy depend on the motivation of employees, which is created through training and rewards, financial and non-financial. The aim of this paper is to present the way in which HRM determines the effectiveness of TQM implementation, and to provide guidelines for improving such effectiveness. The paper presents the results of empirical analysis in hotels in Serbia in order to determine the value of TQM factors related to human resources. The results show that hotels must firstly improve TQM staff factors before taking action to implement TQM philosophy.

Data Quality Assessment and Recommendations to Improve the Quality of Hemodialysis Database

Directory of Open Access Journals (Sweden)

Neda Firouraghi

2018-01-01

Full Text Available Introduction: Since clinical data contain abnormalities, quality assessment and reporting of data errors are necessary. Data quality analysis consists of developing strategies, making recommendations to avoid future errors and improving the quality of data entry by identifying error types and their causes. Therefore, this approach can be extremely useful to improve the quality of the databases. The aim of this study was to analyze hemodialysis (HD patients’ data in order to improve the quality of data entry and avoid future errors. Method: The study was done on Shiraz University of Medical Sciences HD database in 2015. The database consists of 2367 patients who had at least 12 months follow up (22.34±11.52 months in 2012-2014. Duplicated data were removed; outliers were detected based on statistical methods, expert opinion and the relationship between variables; then, the missing values were handled in 72 variables by using IBM SPSS Statistics 22 in order to improve the quality of the database. According to the results, some recommendations were given to improve the data entry process. Results: The variables had outliers in the range of 0-9.28 percent. Seven variables had missing values over 20 percent and in the others they were between 0 and 19.73 percent. The majority of missing values belong to serum alkaline phosphatase, uric acid, high and low density lipoprotein, total iron binding capacity, hepatitis B surface antibody titer, and parathyroid hormone. The variables with displacement (the values of two or more variables were recorded in the wrong attribute were weight, serum creatinine, blood urea nitrogen, systolic and diastolic blood pressure. These variables may lead to decreased data quality. Conclusion: According to the results and expert opinion, applying some data entry principles, such as defining ranges of values, using the relationship between hemodialysis features, developing alert systems about empty or duplicated data and

Improving the hygienic quality of chicken through radiation processing

International Nuclear Information System (INIS)

Torgby-Tetteh, W.

2010-06-01

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

TOTAL QUALITY MANAGEMENT AND CONTEMPORARY HOTEL INDUSTRY

Directory of Open Access Journals (Sweden)

Ivica Batinić

2013-04-01

Full Text Available Strong competition in the market has caused the development of a new management approach known as Total Quality Management (TQM. Due to importance that quality plays in achieving competitive advantage, the hotel industry started to apply TQM. During the introduction of these systems, hotel companies may use different approaches to suit their own buseiness requirements. In doing so, 'TQM standards' can be used, or various international standards and models of business excellence Malcolm Balridge National Quality Award and European Quality Award.

Implementing total quality management in an academic surgery setting: lessons learned.

Science.gov (United States)

Townes, C; Petit, B; Young, B

1995-01-01

Total Quality Management, a philosophy developed by W. Edwards Deming, has been used successfully in many countries and in many types of organizations to improve the quality of processes. The system is based upon the scientific method and provides the ability to solve long-standing, recalcitrant problems. The application of the TQM philosophy to health care, although recommended by many medical economists, is still in its infancy. At our medical center, three departments (Surgery, Anesthesiology, and Operating Room Services) joined forces to implement TQM. Critical activities early in implementation included establishing a Steering Committee, training key employees, providing systems for communicating TQM activities, and developing the leadership, facilitator, and other resources needed to support teams. Two of our first teams studied very different processes (one in the Operating Room, the other in outpatient Surgery clinics), providing many useful insights regarding keys to successful application of the TQM philosophy. We have learned strategies for increasing acceptance of and participation in TQM efforts on the part of staff members and, in particular, physicians, and for initiating the cultural change needed for TQM. Although the teams have met with resistance to behavioral changes and a lack of full support from some upper-level administrators in the Medical Center and the Hospital, most of them have been quite successful in improving the processes under study. We conclude that, with the proper leadership and facilitation, the TQM philosophy can be successfully implemented in the health care environment. Total Quality Management (TQM) as a system for improving the quality of processes has been successful in many countries throughout the world for organizations offering a wide variety of products and services. This article will describe specific TQM endeavors, both successful and unsuccessful, undertaken in an academic surgery department in the United States

PENERAPAN TOTAL QUALITY MANAGEMENT PADA PROGRAM STUDI MPI FAKULTAS TARBIYAH DAN KEGURUAN UIN ALAUDDIN

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Syahid Syahid

2017-12-01

Full Text Available The purpose of this paper is to describe (1 the concept of total quality mana-gement, (2 the theoretical foundation of total quality management, and (3 the application of total quality management in Education management study program at the Faculty of Education and Teaching Science, UIN Alauddin Ma-kassar. There are some theoretical bases to support the implementation of TQM in educational institutions. One is the theory of Deming which can be identified from (a Deming’s chain reaction model, (b Deming’s continuous improvement cycle, (c Deming’s theory of Variance, and (d Deming's fourteen points of management. The application of TQM in Management Studies Program Faculty of Tarbiyah and Teaching Education UIN Alauddin have not maximized. The data indicated that 70.19% respondents said that the implementation of TQM is at a mediocre level, 0.90% respondents said good, and 1.85% respondents said that the implementation of TQM has been very good.

Coordinating Council. Ninth Meeting: Total Quality Management

Science.gov (United States)

1992-01-01

This report summarizes the 9th meeting of the STI Coordinating Council. The council listened to the speakers' understanding of Total Quality Management (TQM) principles and heard stories of successful applications of these principles. Definitions of quality stated were focused on customer satisfaction. Reports presented by the speakers are also included.

Reverse Logistics as Source of Competitive Advantages and its Relationship with Total Quality Management

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Jesús ARTEAGA-ORTIZ

2007-01-01

Full Text Available This paperwork analyze how Reverse Logistics (RL provides greatbenefits like reduction of costs, new opportunities of business and facilitates adaptation to new regulations in the matter of environment, this benefits improves performance of the company and favour their growth. We analyze how companies which have Total Quality Management (TQM and implanting a Reverse Logistics System (RLS improve their recovery activities and reusability of materials and products, reduce its costs and improve its enterprise performance.

Improving Quality of Care in Primary Health-Care Facilities in Rural Nigeria

OpenAIRE

Ugo, Okoli; Ezinne, Eze-Ajoku; Modupe, Oludipe; Nicole, Spieker; Winifred, Ekezie; Kelechi, Ohiri

2016-01-01

Background: Nigeria has a high population density but a weak health-care system. To improve the quality of care, 3 organizations carried out a quality improvement pilot intervention at the primary health-care level in selected rural areas. Objective: To assess the change in quality of care in primary health-care facilities in rural Nigeria following the provision of technical governance support and to document the successes and challenges encountered. Method: A total of 6 states were selected...

Does quality improvement work in neonatology improve clinical outcomes?

Science.gov (United States)

Ellsbury, Dan L; Clark, Reese H

2017-04-01

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

A variation reduction allocation model for quality improvement to minimize investment and quality costs by considering suppliers’ learning curve

Science.gov (United States)

Rosyidi, C. N.; Jauhari, WA; Suhardi, B.; Hamada, K.

2016-02-01

Quality improvement must be performed in a company to maintain its product competitiveness in the market. The goal of such improvement is to increase the customer satisfaction and the profitability of the company. In current practice, a company needs several suppliers to provide the components in assembly process of a final product. Hence quality improvement of the final product must involve the suppliers. In this paper, an optimization model to allocate the variance reduction is developed. Variation reduction is an important term in quality improvement for both manufacturer and suppliers. To improve suppliers’ components quality, the manufacturer must invest an amount of their financial resources in learning process of the suppliers. The objective function of the model is to minimize the total cost consists of investment cost, and quality costs for both internal and external quality costs. The Learning curve will determine how the employee of the suppliers will respond to the learning processes in reducing the variance of the component.

Evolution of hospital industrial engineering: from scientific management to total quality management.

Science.gov (United States)

Sahney, V K

1993-01-01

Industrial engineering applications in the hospital industry first began in 1910. This paper traces the evolution of hospital industrial engineering in five distinct phases. For each of the major phases, this paper presents the contributions made by industrial engineers. Many of the techniques advocated by industrial engineers are now being taught to hospital employees as hospitals introduce total quality management (TQM) within the health-care industry. TQM introduction has meant a new role for industrial engineers, as that of a teacher, coach, and a facilitator. This new role holds much promise for the improvement of quality and productivity in health care.

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

Science.gov (United States)

Raiman, Laura B.

1991-01-01

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

Using Lean to Advance Quality Improvement Research.

Science.gov (United States)

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

2016-01-01

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

Application of Total Quality Management in Education

Science.gov (United States)

Farooq, M. S.; Akhtar, M. S.; Ullah, S. Zia; Memon, R. A.

2007-01-01

The purpose of the paper is to analyzing thoughts of the modern management paradigm "Total Quality Management" (TQM), and its application in the field of education. The basic theme of TQM is participatory approach to address the question(s) of quality in business aswell as in the field of education. Reviewing fresh literature from the internet …

Current concept review: quality and process improvement in orthopedics

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Pinney SJ

2015-12-01

Full Text Available Stephen J Pinney,1 Alexandra E Page,2 David S Jevsevar,3 Kevin J Bozic4 1Department of Orthopaedic Surgery, St Mary's Medical Center, San Francisco, CA, USA; 2Orthopaedic Surgery, AAOS Health Care Systems Committee, San Diego, CA, USA; 3Department of Orthopaedics, Geisel School of Medicine, Dartmouth University, Hanover, NH, USA; 4Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas, Austin, TX, USAAbstract: Multiple health care stakeholders are increasingly scrutinizing musculoskeletal care to optimize quality and cost efficiency. This has led to greater emphasis on quality and process improvement. There is a robust set of business strategies that are increasingly being applied to health care delivery. These quality and process improvement tools (QPITs have specific applications to segments of, or the entire episode of, patient care. In the rapidly changing health care world, it will behoove all orthopedic surgeons to have an understanding of the manner in which care delivery processes can be evaluated and improved. Many of the commonly used QPITs, including checklist initiatives, standardized clinical care pathways, lean methodology, six sigma strategies, and total quality management, embrace basic principles of quality improvement. These principles include focusing on outcomes, optimizing communication among health care team members, increasing process standardization, and decreasing process variation. This review summarizes the common QPITs, including how and when they might be employed to improve care delivery. Keywords: clinical care pathway, musculoskeletal care, outcomes, quality management, six sigma, lean thinking

ANALISIS DIMENSI KUALITAS PELAYANAN TERHADAP KEPUASAN MELALUI TOTAL QUALITY EDUCATION SEBAGAI MEDIATOR

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Laela Atikah

2017-10-01

Full Text Available The purpose of this research is to know the effect of reliability, responsiveness, tangible, empathy, and assurance to student satisfaction through Total Quality Education as mediator variable. Population in this research is students of Universitas Negeri Semarang academic year 2015. Sampling used proportional random sampling with numbers of respondents more 395. Methods of data collection used questionnaires. Analysis methods were partial test and path analysis. The results showed that reliability, responsiveness, empathy, and assurance have positive and significant effect on student satisfaction with significance value 0,05. Reliability has a positive and significant impact on satisfaction through Total Quality Education with total influence of 0,121. Responsiveness has a positive and significant impact on satisfaction through Total Quality Education with total influence of 0,126. Tangible has a positive and significant impact on satisfaction through Total Quality Education with total influence of 0,130. Empathy has a positive and significant impact on satisfaction through Total Quality Education with total influence of 0,272. Assurance has a positive and significant impact on satisfaction through Total Quality Education with total influence of 0,250. It is can be concluced that Total Quality Education is a role as an intervening variable between reliability, responsivenesss, tangible, empathy, and assurance of student satisfaction.

Accelerate Water Quality Improvement

Science.gov (United States)

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

Total Quality Management in a Knowledge Management Perspective.

Science.gov (United States)

Johannsen, Carl Gustav

2000-01-01

Presents theoretical considerations on both similarities and differences between information management and knowledge management and presents a conceptual model of basic knowledge management processes. Discusses total quality management and quality control in the context of information management. (Author/LRW)

Groundwater Quality Assessment Based on Improved Water Quality Index in Pengyang County, Ningxia, Northwest China

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Li Pei-Yue

2010-01-01

Full Text Available The aim of this work is to assess the groundwater quality in Pengyang County based on an improved water quality index. An information entropy method was introduced to assign weight to each parameter. For calculating WQI and assess the groundwater quality, total 74 groundwater samples were collected and all these samples subjected to comprehensive physicochemical analysis. Each of the groundwater samples was analyzed for 26 parameters and for computing WQI 14 parameters were chosen including chloride, sulphate, pH, chemical oxygen demand (COD, total dissolved solid (TDS, total hardness (TH, nitrate, ammonia nitrogen, fluoride, total iron (Tfe, arsenic, iodine, aluminum, nitrite, metasilicic acid and free carbon dioxide. At last a zoning map of different water quality was drawn. Information entropy weight makes WQI perfect and makes the assessment results more reasonable. The WQI for 74 samples ranges from 12.40 to 205.24 and over 90% of the samples are below 100. The excellent quality water area covers nearly 90% of the whole region. The high value of WQI has been found to be closely related with the high values of TDS, fluoride, sulphate, nitrite and TH. In the medium quality water area and poor quality water area, groundwater needs some degree of pretreated before consumption. From the groundwater conservation view of point, the groundwater still need protection and long term monitoring in case of future rapid industrial development. At the same time, preventive actions on the agricultural non point pollution sources in the plain area are also need to be in consideration.

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

Science.gov (United States)

Chow, Shirley L; Shojania, Kaveh G

2017-09-01

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

Evaluation of the effects of a physiotherapy program on quality of life in females after unilateral total knee arthroplasty: a prospective study.

Science.gov (United States)

Hudáková, Zuzana; Zięba, Halina Romualda; Lizis, Paweł; Dvořáková, Vlasta; Cetlová, Lada; Friediger, Teresa; Kobza, Wojciech

2016-05-01

[Purpose] Osteoarthritis is a chronic and degenerative joint disease and is considered to be one of the most common musculoskeletal disorders. This study evaluated the differences in the quality of life of females treated with supervised physiotherapy and a standardized home program after unilateral total knee arthroplasty. [Subjects and Methods] From January 2012 to May 2015, a total of 40 females were examined at the Central Military Hospital in Ruzomberk, Slovakia. Quality of life was assessed with the Short Form-36. Quality of life and intensity of pain after normal daily activity, according to the visual analog scale, were assessed before total knee arthroplasty, immediately after physiotherapy, 3 months after total knee arthroplasty, and 6 months after total knee arthroplasty. [Results] We found statistically significant improvement of the quality of life results and a decreased intensity of pain at each time point compared with before total knee arthroplasty. [Conclusions] The results of this study provide further evidence indicating that patients who undergo total knee arthroplasty for primary osteoarthritis of the knee can achieve a significant improvement in the quality of life by using supervised physiotherapy compared with a standardized home program.

Total quality management of cobalt-60 sources

International Nuclear Information System (INIS)

Malkoske, G.R.

1999-01-01

Total Quality Management of Cobalt-60 sources by a supplier requires a life cycle approach to source management. This covers various aspects, including design, manufacturing, installation, field inspection, source surveillance and return of cobalt-60 sources at the end of their useful life. The Total Quality Management approach demonstrates a strong industry commitment to the beneficial use of gamma technology for industrial irradiation applications in both developed nations and in those nations who are developing their infrastructure and techniques for the beneficial use of this technology. MDS Nordion continues to demonstrate its support and commitment to the industry by developing and implementing state-of-the-art standards for the safe use of cobalt-60 sources

TOTAL QUALITY MANAGEMENT IN ISLAMIC EDUCATION INSTITUTION

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Indriyenni Indriyenni

2018-04-01

Full Text Available There have been five characteristics of a qualified school such as focusing on the customer, total engagement, measurement, commitment, and continuous improvement. Every educational institution including Islamic boarding school (IBS is required to provide the best services to its customers. In this way, IBS need to be supported by a good management system; the existence of a regular mindset (administrative thinking, the implementation of regular activities (administrative behavior, attitude to the task activities well (administrative attitude, and so forth. To answer the various problems that exist in the educational environment the management should have an Integrated or Total Quality Management (TQM. One of its goals is to transform a school institution into a sincere team, without conflict and internal competition to achieve a single goal of satisfying all customers. TQM will provide educators professional solutions to meet today’s challenges and the future. It is because TQM can be used to build alliance between education, business and government. TQM can also shape the community responsive to the changing demands of society in this era of globalization. Besides, TQM form a responsive school and is able to respond to changes that occur in the field of education in order to give satisfaction to stakeholder.

Has compliance with CLIA requirements really improved quality in US clinical laboratories?

Science.gov (United States)

Ehrmeyer, Sharon S; Laessig, Ronald H

2004-08-02

The Clinical Laboratory Improvement Amendments of 1988 (CLIA'88) mandate universal requirements for all U.S. clinical laboratory-testing sites. The intent of CLIA'88 is to ensure quality testing through a combination of minimum quality practices that incorporate total quality management concepts. These regulations do not contain established, objective indicators or measures to assess quality. However, there is an implicit assumption that compliance with traditionally accepted good laboratory practices--following manufacturers' directions, routinely analysing quality control materials, applying quality assurance principles, employing and assessing competent testing personnel, and participating in external quality assessment or proficiency testing (PT)--will result in improved test quality. The CLIA'88 regulations do include PT performance standards, which intentionally or unintentionally, define intra-laboratory performance. Passing PT has become a prime motivation for improving laboratory performance; it can also be used as an objective indicator to assess whether compliance to CLIA has improved intra-laboratory quality. Data from 1994 through 2002 indicate that the percentage of laboratories passing PT has increased. In addition to PT performance, subjective indicators of improved quality--frequency of inspection deficiencies, the number of government sanctions for non-compliance, and customer satisfaction--were evaluated. The results from these subjective indicators are more difficult to interpret but also seem to show improved quality in US clinical laboratories eleven years post-CLIA'88.

Sustainability in the AAP Bronchiolitis Quality Improvement Project.

Science.gov (United States)

Shadman, Kristin A; Ralston, Shawn L; Garber, Matthew D; Eickhoff, Jens; Mussman, Grant M; Walley, Susan C; Rice-Conboy, Elizabeth; Coller, Ryan J

2017-11-01

Adherence to American Academy of Pediatrics (AAP) bronchiolitis clinical practice guideline recommendations improved significantly through the AAP's multiinstitutional collaborative, the Bronchiolitis Quality Improvement Project (BQIP). We assessed sustainability of improvements at participating institutions for 1 year following completion of the collaborative. Twenty-one multidisciplinary hospital-based teams provided monthly data for key inpatient bronchiolitis measures during baseline and intervention bronchiolitis seasons. Nine sites provided data in the season following completion of the collaborative. Encounters included children younger than 24 months who were hospitalized for bronchiolitis without comorbid chronic illness, prematurity, or intensive care. Changes between baseline-, intervention-, and sustainability-season data were assessed using generalized linear mixed-effects models with site-specific random effects. Differences between hospital characteristics, baseline performance, and initial improvement between sites that did and did not participate in the sustainability season were compared. A total of 2275 discharges were reviewed, comprising 995 baseline, 877 intervention, and 403 sustainability- season encounters. Improvements in all key bronchiolitis quality measures achieved during the intervention season were maintained during the sustainability season, and orders for intermittent pulse oximetry increased from 40.6% (95% confidence interval [CI], 22.8-61.1) to 79.2% (95% CI, 58.0- 91.3). Sites that did and did not participate in the sustainability season had similar characteristics. BQIP participating sites maintained improvements in key bronchiolitis quality measures for 1 year following the project's completion. This approach, which provided an evidence-based best-practice toolkit while building the quality-improvement capacity of local interdisciplinary teams, may support performance gains that persist beyond the active phase of the

Total Quality Education: Profiles of Schools That Demonstrate the Power of Deming's Management Principles.

Science.gov (United States)

Schmoker, Michael J.; Wilson, Richard B.

This book presents profiles of schools that have demonstrated the power of Deming's Total Quality Management (TQM) principles. It describes schools that have successfully applied those strategies for change. The book explores what public education needs most--a compelling but flexible action plan for improvement. Chapter 1 offers a rationale for…

Curriculum Transformation through Total Quality Management.

Science.gov (United States)

Edwards, Barbara; Algozzine, Bob

1995-01-01

Describes a massive cultural transformation project at two Charlotte, North Carolina, elementary schools that used Deming's total quality management principles to restructure curricula according to Boyer's eight commonalities of learning. Shows how the FADE (focus, analyze, develop, and execute) model was used to develop a well-coordinated,…

Essentials of total quality management: a meta-analysis.

Science.gov (United States)

Mosadeghrad, Ali Mohammad

2014-01-01

The purpose of this paper is to identify critical successful factors for Total Quality Management (TQM) implementation. A literature review was conducted to explore the critical successful factors for TQM implementation between 1980 and 2010. A successful TQM implementation need sufficient education and training, supportive leadership, consistent support of top management, customer focus, employee involvement, process management and continuous improvement of processes. The review was limited to articles written in English language during the past 30 years. From a practical point of view, the findings of this paper provide managers with a practical understanding of the factors that are likely to facilitate TQM implementation in organisations. Understanding the factors that are likely to promote TQM implementation would enable managers to develop more effective strategies that will enhance the chances of achieving business excellence.

TOTAL QUALITY MANAGEMENT AND CONTEMPORARY HOTEL INDUSTRY

OpenAIRE

Ivica Batinić

2013-01-01

Strong competition in the market has caused the development of a new management approach known as Total Quality Management (TQM). Due to importance that quality plays in achieving competitive advantage, the hotel industry started to apply TQM. During the introduction of these systems, hotel companies may use different approaches to suit their own buseiness requirements. In doing so, 'TQM standards' can be used, or various international standards and models of business ...

Staff Development and Total Quality Management.

Science.gov (United States)

Norris, Gerald L.; Norris, Joye H.

Professional development is an emerging view of faculty development that places teachers in charge of their own professional growth. The emergence of Total Quality Management (TQM) provides a vehicle for designing professional development to meet the needs of individuals and the organizations that employ them. The eight tenets of Deming's theory…

Measuring performance improvement: total organizational commitment or clinical specialization.

Science.gov (United States)

Caron, Aleece; Jones, Paul; Neuhauser, Duncan; Aron, David C

2004-01-01

Resources for hospitals are limited when they are faced with multiple publicly reported performance measures as tools to assess quality. The leadership in these organizations may choose to focus on 1 or 2 of these outcomes. An alternative approach is that the leadership may commit resources or create conditions that result in improved quality over a broad range of measures. We used aggregated data on mortality, length of stay, and obstetrical outcomes from Greater Cleveland Health Quality Choice data to test these theories. We used Pearson correlation analysis to determine of outcomes were correlated with one another. We used repeated-measures ANOVA to determine if an association existed between outcome and time and outcome and hospital. All of the outcomes across all hospitals demonstrate a trend of overall improvement. Both the Pearson and ANOVA result support the hypothesis for the organization-wide approach to quality improvement. Hospital that make improvements in one clinical area trend to make improvements in others. Hospitals that produce improvements in limited clinical or administrative areas may not have completely adopted CQI into their culture or may not have yet realized the benefits of their organizational commitments, but use some of the concepts to improve quality outcomes.

ANALISIS KENDALA POTENSIAL PENERAPAN TOTAL QUALITY MANAGEMENT HOTEL PLAZA SEMARANG

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Hendrajaya -

2010-03-01

Full Text Available Penelitian ini bertujuan untuk menemukan faktor-faktor yang terbentuk dari kendala penerapan Total Quality Management (TQM, sebagai upaya untuk menganalisis masalah-masalah potensial dari penerapan TQM di Hotel Plaza, Semarang. Sampel dari penelitian ini sejumlah 65 karyawan Hotel Plaza, Semarang yang terdiri dari manajer dan staf. Teknik analisis menggunakan Faktor Analisis. Hasil penelitian menunjukkan, bahwa kendala potensial dari implementasi TQM dapat disimpulkan menjadi lima faktor, yaitu faktor inkonsistensi, visi-misi, transformasi budaya, manajerial dan manajemen kualitas. Penelitian ini memberikan rekomendasi bahwa peningkatan fungsi-fungsi korporat melalui optimalisasi kualitas sebagai strategi bisnis dan orientasi pada kepuasan konsumen dengan melibatkan seluruh anggota organisasi, akan menjadi dasar untuk memaksimalkan daya saing perusahaan dalam hal produk, layanan, SDM, lingkungan dan seluruh proses yang dapat mendukung upaya perbaikan produktivitas. This study aims to determine the constraint factors and to analyze the potential problems of TQM implementation of Plaza Semarang Hotel. The sample of 65 employees of TQM implementation of Plaza Semarang Hotel, consist of managers and staffs. Factor analysis is used to achieve the results of the potential constraint implementation of Total Quality Management which can be summarized into five factors, they are: the factor of inconsistencies, the factor of vision and mission, cultural transformation factors, managerial factors and the factors of quality management. In order to increase the corporate functions through the optimization of quality as a business strategy and to achieve customer satisfaction, this study suggests that all members of the organization should be involved by the company as on-going basis to maximize the competitiveness of the organization on products, services, human resources, environment and all processes that support productivity improvement.

The Total Quality Initiative at South Bank University.

Science.gov (United States)

Geddes, Tommy

1993-01-01

Application of the Total Quality Management approach to one aspect of the administration of South Bank University (England), the relationship between student as customer and university as supplier, is described. The technique includes development of service quality standards and agreements for each service, support, and academic department. (MSE)

Structured data quality reports to improve EHR data quality.

Science.gov (United States)

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

2015-12-01

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

Interactional Resources for Quality Improvement: Learning From Participants Through a Qualitative Study.

Science.gov (United States)

Brooks, Joanna Veazey; Gorbenko, Ksenia; Bosk, Charles

Implementing quality improvement in hospitals requires a multifaceted commitment from leaders, including financial, material, and personnel resources. However, little is known about the interactional resources needed for project implementation. The aim of this analysis was to identify the types of interactional support hospital teams sought in a surgical quality improvement project. Hospital site visits were conducted using a combination of observations, interviews, and focus groups to explore the implementation of a surgical quality improvement project. Twenty-six site visits were conducted between October 2012 and August 2014 at a total of 16 hospitals that agreed to participate. All interviews were recorded, transcribed, and coded for themes using inductive analysis. We interviewed 321 respondents and conducted an additional 28 focus groups. Respondents reported needing the following types of interactional support during implementation of quality improvement interventions: (1) a critical outside perspective on their implementation progress; (2) opportunities to learn from peers, especially around clinical innovations; and (3) external validation to help establish visibility for and commitment to the project. Quality improvement in hospitals is both a clinical endeavor and a social endeavor. Our findings show that teams often desire interactional resources as they implement quality improvement initiatives. In-person site visits can provide these resources while also activating emotional energy for teams, which builds momentum and sustainability for quality improvement work. Policymakers and quality improvement leaders will benefit from developing strategies to maximize interactional learning and feedback for quality improvement teams. Further research should investigate the most effective methods for meeting these needs.

Solutions to Improve Educational Management Quality

OpenAIRE

Ramezan Jahanian; Masoomeh Motahari

2013-01-01

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

The power of cross-functional teams in driving total quality

Science.gov (United States)

Mcclung, Tim M.; Mcmaster, Tom J.

1992-01-01

Garrett Canada, a Division of Allied-Signal Aerospace Canada, has been a member of the Canadian aerospace industry for 40 years. Although Garrett Canada has always been a profitable division with a solid market share, the changing and turbulent business environment and globalization of the aerospace industry has created new demands and challenges. The marketplace is demanding faster introduction of new products, as well as shorter leadtimes for repairs and spares. It was recognized that reducing cycle times for new products and for ongoing production would not only satisfy our customers, it would also enhance our business performance through reduced inventories, lower past due, and more responsiveness to change. It was evident that drastic function changes were required if we were to maintain our position as a premier aerospace supplier. The challenge was to convert a stable, somewhat slow-paced work environment with strong functional boundaries into a boundaryless world class team functioning in a total quality environment and focused on customer satisfaction. Complete and uncompromised customer satisfaction has become our driving force, with Total Quality being our engine to continuously improve our processes and increase our speed. The way in which this transition has been brought about is the subject of this presentation.

Review of the quality of total mesorectal excision does not improve the prediction of outcome.

Science.gov (United States)

Demetter, P; Jouret-Mourin, A; Silversmit, G; Vandendael, T; Sempoux, C; Hoorens, A; Nagy, N; Cuvelier, C; Van Damme, N; Penninckx, F

2016-09-01

A fair to moderate concordance in grading of the total mesorectal excision (TME) surgical specimen by local pathologists and a central review panel has been observed in the PROCARE (Project on Cancer of the Rectum) project. The aim of the present study was to evaluate the difference, if any, in the accuracy of predicting the oncological outcome through TME grading by local pathologists or by the review panel. The quality of the TME specimen was reviewed for 482 surgical specimens registered on a prospective database between 2006 and 2011. Patients with a Stage IV tumour, with unknown incidence date or without follow-up information were excluded, resulting in a study population of 383 patients. Quality assessment of the specimen was based on three grades including mesorectal resection (MRR), intramesorectal resection (IMR) and muscularis propria resection (MPR). Using univariable Cox regression models, local and review panel histopathological gradings of the quality of TME were assessed as predictors of local recurrence, distant metastasis and disease-free and overall survival. Differences in the predictions between local and review grading were determined. Resection planes were concordant in 215 (56.1%) specimens. Downgrading from MRR to MPR was noted in 23 (6.0%). There were no significant differences in the prediction error between the two models; local and central review TME grading predicted the outcome equally well. Any difference in grading of the TME specimen between local histopathologists and the review panel had no significant impact on the prediction of oncological outcome for this patient cohort. Grading of the quality of TME as reported by local histopathologists can therefore be used for outcome analysis. Quality control of TME grading is not warranted provided the histopathologist is adequately trained. Colorectal Disease © 2016 The Association of Coloproctology of Great Britain and Ireland.

PENGARUH PENERAPAN PERAN TOTAL QUALITY MANAGEMENT TERHADAP KUALITAS SUMBERDAYA MANUSIA

Directory of Open Access Journals (Sweden)

R. Andi Sularso

2004-01-01

Full Text Available Some ways have been conducted to improve the quality of the human resources. One of them is to apply TQM. The data used in this experiment was primary data obtained from the respondents. Coefficient of determination was used to examine the model fit. t-test had been used to examine the hyphoteses partially and F-test had been used to examine hypotheses secara simultaneously. The result showed that the role of employee, role of leader, relation between leader and emplyoee, aspect of organization and aspect of environment were among variables that have a siqnificantly influence on the improvement of (1 theoretical ability; (2 technical ability; (3 conceptual ability; (4 moral ability; (5 technical skill (6 the quality of human resources. Abstract in Bahasa Indonesia : Telah banyak cara dilakukan untuk meningkatkan kualitas sumberdaya manusia tersebut, salah satunya adalah melalui penerapan TQM. Data yang digunakan dalam penelitian ini adalah data primer yang diperoleh langsung dari responden. Untuk mengetahui ketepatan model yang digunakan, diuji dengan koefisien determinasi, pengujian Hipotesis secara parsial digunakan uji t dan pembuktian hipotesis secara bersama-sama digunakan uji F. Berdasarkan pada analisis data diperoleh hasil sebagai berikut : variabel peran karyawan, variabel peran pimpinan, variabel hubungan pimpinan dan karyawan, variabel aspek organisasi dan variabel aspek lingkungan berpengaruh secara nyata terhadap peningkatan (1 kemampuan teoritis; (2 kemampuan teknis; (3 kemampuan konseptual; (4 kemampuan moral; (5 ketrampilan teknis; (6 kualitas sumberdaya manusia. Kata kunci: Total Quality Management (TQM,Kualitas Sumber Daya Manusia (SDM.

Making Choices: Self-Directed Teams or Total Quality Management?

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Holpp, Lawrence

1992-01-01

Describes differences between total quality management and self-directed teams in terms of job design, decision making, flexibility, supervision, labor relations, quality, customers, and training. Offers suggestions for which method to choose when. (SK)

A Paradigm Shift for Educational Administrators: The Total Quality Movement.

Science.gov (United States)

Hough, M. J.

This paper reviews the major ideas of the seminal total quality management theorists, such as Deming, Crosby, Juran, Ishikawa, and Imai, to illustrate how total quality management is applicable to education. It is argued that there is a need for a paradigm shift in educational administration. The first part reviews current Australian societal…

How to Improve the Quality of Screening Endoscopy in Korea: National Endoscopy Quality Improvement Program.

Science.gov (United States)

Cho, Yu Kyung

2016-07-01

In Korea, gastric cancer screening, either esophagogastroduodenoscopy or upper gastrointestinal series (UGIS), is performed biennially for adults aged 40 years or older. Screening endoscopy has been shown to be associated with localized cancer detection and better than UGIS. However, the diagnostic sensitivity of detecting cancer is not satisfactory. The National Endoscopy Quality Improvement (QI) program was initiated in 2009 to enhance the quality of medical institutions and improve the effectiveness of the National Cancer Screening Program (NCSP). The Korean Society of Gastrointestinal Endoscopy developed quality standards through a broad systematic review of other endoscopic quality guidelines and discussions with experts. The standards comprise five domains: qualifications of endoscopists, endoscopic unit facilities and equipment, endoscopic procedure, endoscopy outcomes, and endoscopic reprocessing. After 5 years of the QI program, feedback surveys showed that the perception of QI and endoscopic practice improved substantially in all domains of quality, but the quality standards need to be revised. How to avoid missing cancer in endoscopic procedures in daily practice was reviewed, which can be applied to the mass screening endoscopy. To improve the quality and effectiveness of NCSP, key performance indicators, acceptable quality standards, regular audit, and appropriate reimbursement are necessary.

Relationship between the total length of the stents and patients' quality of life after percutaneous coronary intervention.

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Liu, Wei; Yang, Xuming; Dong, Pingshuan; Li, Zhijuan

2015-01-01

The aim of this study was to examine the relationship between the total length of the stents and the postoperative life quality of patients with multi-vessel coronary artery disease who undergo percutaneous coronary intervention (PCI). Using the short-form health survey (SF-36) items, we analyzed the data on the postoperative life quality of 166 patients with multi-vessel coronary artery disease who underwent percutaneous transluminal coronary intervention in the Department of Cardiology of the First Affiliated Hospital of Henan University of Science and Technology from September 2011 to September 2013. Follow-up was performed 6 months later. All of the dimensionalities, except general health and mental health, showed significantly higher scores after PCI. No significant relationships were observed between the total length of the stents and the postoperative life quality of patients with multi-vessel coronary artery disease who underwent PCI. PCI can effectively improve the postoperative life quality of patients; however, there was no significant relationship between the total length of the stents and postoperative life quality of patients.

Workers' Objectives in Quality Improvement.

Science.gov (United States)

Brossard, Michel

1990-01-01

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

Creating Quality Improvement Culture in Public Health Agencies

Science.gov (United States)

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

2014-01-01

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

Creating quality improvement culture in public health agencies.

Science.gov (United States)

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

2014-01-01

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

Bundled Payments in Total Joint Replacement: Keeping Our Care Affordable and High in Quality.

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McLawhorn, Alexander S; Buller, Leonard T

2017-09-01

The purpose of this review was to evaluate the literature regarding bundle payment reimbursement models for total joint arthroplasty (TJA). From an economic standpoint, TJA are cost-effective, but they represent a substantial expense to the Centers for Medicare & Medicaid Services (CMS). Historically, fee-for-service payment models resulted in highly variable cost and quality. CMS introduced Bundled Payments for Care Improvement (BPCI) in 2012 and subsequently the Comprehensive Care for Joint Replacement (CJR) reimbursement model in 2016 to improve the value of TJA from the perspectives of both CMS and patients, by improving quality via cost control. Early results of bundled payments are promising, but preserving access to care for patients with high comorbidity burdens and those requiring more complex care is a lingering concern. Hospitals, regardless of current participation in bundled payments, should develop care pathways for TJA to maximize efficiency and patient safety.

Water quality parameters and total aerobic bacterial and vibrionaceae loads in eastern oysters (Crassostrea virginica) from oyster gardening sites

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Oyster gardening is a practice designed to restore habitat for marine life and to improve water quality. This study determined physical and chemical water quality parameters at two oyster gardening sites in the Delaware Inland Bays and compared them with total aerobic bacteria and Vibrionaceae conc...

Do Clinical Practice Guidelines Improve Quality?

Science.gov (United States)

Baldassari, Cristina M

2017-07-01

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

Recommendations for Improving The Quality of Masters and Doctorate Education in Turkey

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Zekai ŞEN

2013-01-01

Full Text Available In Turkey, while academic staff is assessed quantitively, assessment on quality takes place only about students.evaluations are always applied mechanically through western standards without considering our cultural qualities. In this process, the staff member quality standards of Western countries stay outside theTurkish boundarie. Therefore, with every attempt to increase the quality of higher education, students' and research asisstants' quality is improved but the aimed quality is never realised. In fact, the quality improvement in an institution should start from the top so that the reflections of this improvement should be seen in those under their and total quality augmentation Dynamics should arise. InTurkey, instead of total quality, the quality of the lower level workers is thought to be improved and not much is realised as a result of performing all the plans, projects and educational settings without considering the quality of higher ranking academicians. As a consequence of this mentioned situation masters and Ph. D.thesis done in Turkish universities can not provide reflections in international domain. Turkey thinks to compensate the gap by sending its youngsters in an unplanned manner to especially the USA. Even the M.Sc. and PH.D. thesis supervised by those who were educated in the USA and got academic titles there can not gain international quality. By the authorities, the sole reason for this is always clamied to be the inquality of the students. In this study it will be focused that the reson for this problem does not take it's source from the quality of the students but the academic staff eventhough they were educated abroad. It will also be mentioned that the main reasons why the masters and Ph.D. thesis can not gain an international quality are the quality of the academicians is only linked to the academic promotion and eventhough in theory the promotions appear to be scientific , in practice they are usually out of

SQIMSO: Quality Improvement for Small Software Organizations

OpenAIRE

Rabih Zeineddine; Nashat Mansour

2005-01-01

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

Improvement in grain quality characteristics and yield in rice by induced mutation

International Nuclear Information System (INIS)

Govindaswami, S.; Ghosh, A.K.; Misra, S.N.

1975-01-01

Improvement in grain quality has been obtained in two rice cultures CR.75-83 and CR-75-93 (Rexore X Chianan-8) after gamma irradiation. The culture CR.75-83 and R.75-93 have good field resistance for bacterial leaf blight, but have comparatively low yield potential (4-5 tonns/ha) and have defects in grain quality such as low gelatinization temperature of starch and relatively low amylose content with inferior cooking quality since one of their parents was a 'Ponlai' type (Taiwan japonica). Improvement in fineness of the kernel and cooking quality by mutation of genes especially for higher amylose content and intermediate gelatinization temperature have been achieved in CR.75-83 mutants No.1,4,6,7,8,9,11 and 13 under 15Kr., in CR.75-93 in mutant No.2,4 and 10 under 25 Kr. Yield atributes have also improved with a shortening in the total duration by 10 to 20 days. The feasibility of improving the cooking quality especially the geletinization temperature and amylose content in the high yielding varieties by mutagenesis is discussed. (author)

Explaining variation in perceived team effectiveness: results from eleven quality improvement collaboratives.

Science.gov (United States)

Strating, Mathilde M H; Nieboer, Anna P

2013-06-01

Explore effectiveness of 11 collaboratives focusing on 11 different topics, as perceived by local improvement teams and to explore associations with collaborative-, organisational- and team-level factors. Evidence underlying the effectiveness of quality improvement collaboratives is inconclusive and few studies investigated determinants of implementation success. Moreover, most evaluation studies on quality improvement collaboratives are based on one specific topic or quality problem, making it hard to compare across collaboratives addressing different topics. A multiple-case cross-sectional study. Quality improvement teams in 11 quality improvement collaboratives focusing on 11 different topics. Team members received a postal questionnaire at the end of each collaborative. Of the 283 improvement teams, 151 project leaders and 362 team members returned the questionnaire. Analysis of variance revealed that teams varied widely on perceived effectiveness. Especially, members in the Prevention of Malnutrition and Prevention of Medication Errors collaboratives perceived a higher effectiveness than other groups. Multilevel regression analyses showed that educational level of professionals, innovation attributes, organisational support, innovative culture and commitment to change were all significant predictors of perceived effectiveness. In total, 27·9% of the individual-level variance, 57·6% of the team-level variance and 80% of the collaborative-level variance could be explained. The innovation's attributes, organisational support, an innovative team culture and professionals' commitment to change are instrumental to perceived effectiveness. The results support the notion that a layered approach is necessary to achieve improvements in quality of care and provides further insight in the determinants of success of quality improvement collaboratives. Understanding which factors enhance the impact of quality improvement initiatives can help professionals to achieve

Revitalizing Space Operations through Total Quality Management

Science.gov (United States)

Baylis, William T.

1995-01-01

The purpose of this paper is to show the reader what total quality management (TQM) is and how to apply TQM in the space systems and management arena. TQM is easily understood, can be implemented in any type of business organization, and works.

Voice restoration following total laryngectomy by tracheoesophageal prosthesis: Effect on patients' quality of life and voice handicap in Jordan

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Wreikat Mahmoud M

2008-03-01

Full Text Available Abstract Background Little has been reported about the impact of tracheoesophageal (TE speech on individuals in the Middle East where the procedure has been gaining in popularity. After total laryngectomy, individuals in Europe and North America have rated their quality of life as being lower than non-laryngectomized individuals. The purpose of this study was to evaluate changes in quality of life and degree of voice handicap reported by laryngectomized speakers from Jordan before and after establishment of TE speech. Methods Twelve male Jordanian laryngectomees completed the University of Michigan Head & Neck Quality of Life instrument and the Voice Handicap Index pre- and post-TE puncture. Results All subjects showed significant improvements in their quality of life following successful prosthetic voice restoration. In addition, voice handicap scores were significantly reduced from pre- to post-TE puncture. Conclusion Tracheoesophageal speech significantly improved the quality of life and limited the voice handicap imposed by total laryngectomy. This method of voice restoration has been used for a number of years in other countries and now appears to be a viable alternative within Jordan.

Total quality strategy in the formative process of the occupational physician.

Science.gov (United States)

Franco, G; Bisio, S

1999-04-01

Interest in applying the concepts of total quality management to the fields of health care and medical education is growing. This paper analyzes the field of education in occupational medicine to explore the relationships between teaching and the deliverance of a product or a service. Issues such as defining teaching customers, addressing customer needs, teaching processes, and assessing and improving quality teaching are described. The occupational physician is requested to act according to particular competencies. This demand implies the need to meet specific requirements. To assure the achievement of these goals, the implementation of a teaching process must include (i) targeting the learning objectives (the knowledge, skills, and attitudes the specialist should have), (ii) planning the evaluation system (ability of the course to assure the achievement of the objective), (iii) evaluating the curriculum (compliance of the acquired competencies to the needs).

Total quality management (TQM) in diagnostic radiology

International Nuclear Information System (INIS)

Rehani, M.M.

1995-01-01

The branch of quality assurance is now taking a new direction towards total quality management (TQM). Being of industrial origin, the concepts and terminologies in TQM are alien to medical and paramedical professionals. However, the impetus it has already made in other areas of health sciences makes medical physicists left out when diagnostic radiology does not encompass TQM. The purpose of this paper is to introduce the terms used in TQM and some aspects of its application to diagnostic radiology. (author). 12 refs., 1 tab

Lifestyle and health-related quality of life in Asian patients with total hip arthroplasties.

Science.gov (United States)

Fujita, Kimie; Xia, Zhenlan; Liu, Xueqin; Mawatari, Masaaki; Makimoto, Kiyoko

2014-09-01

Total hip arthroplasty reduces pain and restores physical function in patients with hip joint problems. This study examined lifestyle and health-related quality of life before and after total hip arthroplasty in Japanese and Chinese patients. Two hospitals in China recruited 120 patients and 120 Japanese patients matched by age and operative status were drawn from a prospective cohort database. Oxford Hip Score, EuroQol, and characteristics of Asian lifestyle and attitudes toward the operation were assessed. There were no differences between patients from the two countries in quality-of-life-scale scores: postoperative patients had significantly better quality-of-life scores than preoperative patients in both countries. In China, patients who reported that living at home was inconvenient had significantly worse Oxford Hip Scores than those who did not. Mean scores for anxiety items concerning possible dislocation and durability of the implant were significantly higher in Japanese than in Chinese subjects. Our findings suggest that providing information about housing conditions and lifestyles would result in improved quality of life and reduced anxiety in patients with implanted joints. © 2014 Wiley Publishing Asia Pty Ltd.

The use of maca (Lepidium meyenii) to improve semen quality: A systematic review.

Science.gov (United States)

Lee, Myeong Soo; Lee, Hye Won; You, Sooseong; Ha, Ki-Tae

2016-10-01

The aim of this review was to assess the evidence for the effectiveness of maca (Lepidium meyenii) in improving semen quality. We searched 11 databases from their inception to March 2016 and included all clinical trials on the improvement of semen quality parameters in infertile and healthy men, regardless of the study design or the type of maca. The risk of bias for each study was assessed using the Cochrane criteria. The selection of studies, data extraction, and validation were performed independently by the first two authors. Discrepancies were resolved through discussion by the same two authors. Five studies - 3 randomized clinical trials (RCTs) and 2 uncontrolled observational studies (UOSs) - met all of the inclusion criteria. One RCT found favorable effects of maca on sperm mobility in infertile men. The two other RCTs showed positive effects of maca on several semen quality parameters in healthy men. The two UOSs also suggested favorable effects of maca on semen quality. The results of our systematic review provide suggestive evidence for the effectiveness of maca in improving semen quality. However, the total number of trials, the total sample size, and the risk of bias of the included studies prevent the drawing firm conclusions. More rigorous studies are warranted. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Improving Quality of Care in Primary Health-Care Facilities in Rural Nigeria

Science.gov (United States)

Ugo, Okoli; Ezinne, Eze-Ajoku; Modupe, Oludipe; Nicole, Spieker; Kelechi, Ohiri

2016-01-01

Background: Nigeria has a high population density but a weak health-care system. To improve the quality of care, 3 organizations carried out a quality improvement pilot intervention at the primary health-care level in selected rural areas. Objective: To assess the change in quality of care in primary health-care facilities in rural Nigeria following the provision of technical governance support and to document the successes and challenges encountered. Method: A total of 6 states were selected across the 6 geopolitical zones of the country. However, assessments were carried out in 40 facilities in only 5 states. Selection was based on location, coverage, and minimum services offered. The facilities were divided randomly into 2 groups. The treatment group received quality-of-care assessment, continuous feedback, and improvement support, whereas the control group received quality assessment and no other support. Data were collected using the SafeCare Healthcare Standards and managed on the SafeCare Data Management System—AfriDB. Eight core areas were assessed at baseline and end line, and compliance to quality health-care standards was compared. Result: Outcomes from 40 facilities were accepted and analyzed. Overall scores increased in the treatment facilities compared to the control facilities, with strong evidence of improvement (t = 5.28, P = .0004) and 11% average improvement, but no clear pattern of improvement emerged in the control group. Conclusion: The study demonstrated governance support and active community involvement offered potential for quality improvement in primary health-care facilities. PMID:28462280

Novel Strategies Using Total Gastrodin and Gastrodigenin, or Total Gastrodigenin for Quality Control of Gastrodia elata.

Science.gov (United States)

Tang, Chunlan; Wu, Bingchu; Wu, Jinyi; Zhang, Zheng; Yu, Bocheng

2018-01-29

Gastrodia elata Blume ( G. elata ), a traditional Chinese medicine, is widely used for treatment of various neuro dysfunctions. However, its quality control is still limited to the determination of gastrodin. In the present study, two novel strategies based on quantitative evaluation of total gastrodin and gastrodigenin with base hydrolysis and total gastrodigenin with base-enzymatic hydrolysis followed by HPLC-FLD were put forward and successfully applied to evaluate the quality of 47 batches of G. elata from eight localities. Meanwhile, a systematic comparison of the novel strategy with the multiple markers and the Pharmacopeia method was performed. The results showed that the parishins category could be completely hydrolyzed to gastrodin by sodium hydroxide solution, and gastrodin could further utterly hydrolyze to gastrodigenin with β-d-glucosidase buffer solution. The contents of total gastrodin and gastrodigenin ranged from 1.311% to 2.034%, and total gastrodigenin from 0.748% to 1.120% at the eight localities. From the comparison, we can conclude that the two novel strategies can comprehensively reveal the characteristics of overall active ingredients in G. elata for quality control. The present study provides a feasible and credible strategy for the quality control of G. elata , suggesting a revision of the latest Chinese Pharmacopoeia or European Pharmacopoeia methods for the modernization of G. elata use.

Quality of life after total knee arthroplasty.

Science.gov (United States)

Canovas, F; Dagneaux, L

2018-02-01

Total knee arthroplasty (TKA) results in a high degree of patient satisfaction, as it provides patients with considerable medium- and long-term benefits in terms of quality of life, pain relief and function. Nevertheless, the literature reports that up to 30% of patients are dissatisfied. This dissatisfaction is directly related to the patients' quality of life, which they deem insufficient. Their quality of life depends on many physical, behavioural, social and psychological factors that are not taken into account by functional outcome scores. After describing the principles of quality of life evaluation after TKA, we will assess the effects of patient-related factors, the surgical technique and postoperative program through an exhaustive review of the literature. Patient expectations after TKA will then be outlined, particularly return to work and return to sports. Copyright © 2017. Published by Elsevier Masson SAS.

WILL THE IMPLEMENTATION OF A TOTAL QUALITY MANAGEMENT SYSTEM BENEFIT SOUTH AFRICAN CONSTRUCTION COMPANIES?

Directory of Open Access Journals (Sweden)

W. Joubert

2012-01-01

Full Text Available

ENGLISH ABSTRACT: The increased levels of competition experienced in recent times in the construction sector due to globalisation and the economic downturn highlighted the need for South African construction companies to be more competitive. This paper investigates the reasons for poor quality in the South African construction industry and whether the implementation of a Total Quality Management system in this industry will improve the situation.

AFRIKAANSE OPSOMMING: Die hoër vlakke van kompetisie wat gedurende die afgelope tydperk in die konstruksiebedryf ervaar is as gevolg van globalisering en die afswaai in die ekonomie, het die behoefte laat ontstaan dat Suid-Afrikaanse konstruksiemaatskappye meer mededingend moes raak. Hierdie artikel ondersoek die redes vir swak kwaliteit in die Suid-Afrikaanse konstruksiebedryf en of die implementering van ‘n Totale Kwaliteitsbestuurstelsel sal bydra om die situasie te verbeter.

Total Quality Management and Business Excellence: The Best Practices at Toyota Motor Corporation.

Directory of Open Access Journals (Sweden)

Sorin-George Toma

2017-05-01

Full Text Available Today’s rough competition at a global level in all spheres of activity imposes companies worldwide to make sustained efforts in order to improve their products, services and processes. The automotive industry has always provided valuable examples of companies that achieved business excellence by putting quality at the core of their production system such as Toyota Motor Corporation. It has continuously designed, implemented and developed the Toyota Production System that influenced the emergence of the business excellence models. The paper aims to highlight the relationship between the concepts of total quality management and business excellence, and to identify and analyze the best practices related to them at Toyota Motor Corporation, a leader of automotive industry. The information obtained through the direct and personal observation method and from multiple secondary sources of data was collected, processed and analyzed in order to achieve the objectives of the paper. The main results show that the best practices of Toyota Motor Corporation related to total quality management and business excellence derive from the Toyota Production System and these practices are to be found in the attributes of business excellence.

Quality improvement education to improve performance on ulcerative colitis quality measures and care processes aligned with National Quality Strategy priorities.

Science.gov (United States)

Greene, Laurence; Moreo, Kathleen

2015-01-01

Studies on inflammatory bowel disease (IBD) have reported suboptimal approaches to patient care. In the United States, the findings have motivated leading gastroenterology organizations to call for initiatives that support clinicians in aligning their practices with quality measures for IBD and priorities of the National Quality Strategy (NQS). We designed and implemented a quality improvement (QI) education program on ulcerative colitis in which patient charts were audited for 30 gastroenterologists before (n = 300 charts) and after (n = 290 charts) they participated in QI-focused educational activities. Charts were audited for nine measures, selected for their alignment with four NQS priorities: making care safer, ensuring patient engagement, promoting communication, and promoting effective treatment practices. Four of the measures, including guideline-directed vaccinations and assessments of disease type and activity, were part of the CMS Physician Quality Reporting System (PQRS). The other five measures involved counseling patients on various topics in ulcerative colitis management, documentation of side effects, assessment of adherence status, and simplification of dosing. The gastroenterologists also completed baseline and post-education surveys designed to assess qualitative outcomes. One of the educational interventions was a private audit feedback session conducted for each gastroenterologist. The sessions were designed to support participants in identifying measures reflecting suboptimal care quality and developing action plans for improvement. In continuous improvement cycles, follow-up interventions included QI tools and educational monographs. Across the nine chart variables, post-education improvements ranged from 0% to 48%, with a mean improvement of 15.9%. Survey findings revealed improvements in self-reported understanding of quality measures and intentions to apply them to practice, and lower rates of perceived significant barriers to high-quality

Mammography in Norway: Image quality and total performance

International Nuclear Information System (INIS)

Olsen, J.B.; Skretting, A.; Widmark, A.

1997-04-01

This report describes a method for assessing the total performance in mammography based on Receiver Operating Characteristic (ROC) analysis. In the time period from December 1993 to March 1994 the method was applied to assess the total performance of all the 45 Norwegian mammography laboratories operative at that time. Image quality characteristics in each laboratory was established by use of well-known phantoms

Quality improvement and emerging global health priorities

Science.gov (United States)

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

2018-01-01

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

Total quality management: Strengths and barriers to implementation and cultural adaptation

Science.gov (United States)

Siegfeldt, Denise V.; Glenn, Michael; Hamilton, Louise

1992-01-01

NASA/Langley Research Center (LaRC) is in the process of implementing Total Quality Management (TQM) throughout the organization in order to improve productivity and make the Center an even better place to work. The purpose of this project was to determine strengths and barriers to TQM being implemented and becoming a part of the organizational culture of the Human Resources Management Division (HRMD) at Langley. The target population for this project was both supervisory and nonsupervisory staff of the HMRD. In order to generate data on strengths and barriers to TQM implementation and cultural adaptation, a modified nominal group technique was used.

Measuring, evaluating and improving hospital quality parameters/dimensions--an integrated healthcare quality approach.

Science.gov (United States)

Zineldin, Mosad; Camgöz-Akdağ, Hatice; Vasicheva, Valiantsina

2011-01-01

This paper aims to examine the major factors affecting cumulative summation, to empirically examine the major factors affecting satisfaction and to address the question whether patients in Kazakhstan evaluate healthcare similarly or differently from patients in Egypt and Jordan. A questionnaire, adapted from previous research, was distributed to Kazakhstan inpatients. The questionnaire contained 39 attributes about five newly-developed quality dimensions (5Qs), which were identified to be the most relevant attributes for hospitals. The questionnaire was translated into Russian to increase the response rate and improve data quality. Almost 200 usable questionnaires were returned. Frequency distribution, factor analysis and reliability checks were used to analyze the data. The three biggest concerns for Kazakhstan patients are: infrastructure; atmosphere; and interaction. Hospital staffs concern for patients' needs, parking facilities for visitors, waiting time and food temperature were all common specific attributes, which were perceived as concerns. These were shortcomings in all three countries. Improving health service quality by applying total relationship management and the 5Qs model together with a customer-orientation strategy is recommended. Results can be used by hospital staff to reengineer and redesign creatively their quality management processes and help move towards more effective healthcare quality strategies. Patients in three countries have similar concerns and quality perceptions. The paper describes a new instrument and method. The study assures relevance, validity and reliability, while being explicitly change-oriented. The authors argue that patient satisfaction is a cumulative construct, summing satisfaction as five different qualities (5Qs): object; processes; infrastructure; interaction and atmosphere.

Evaluating the Effectiveness of Two Teaching Strategies to Improve Nursing Students' Knowledge, Skills, and Attitudes About Quality Improvement and Patient Safety.

Science.gov (United States)

Maxwell, Karen L; Wright, Vivian H

The purpose of this study was to evaluate two teaching strategies with regard to quality and safety education for nurses content on quality improvement and safety. Two groups (total of 64 students) participated in online learning or online learning in conjunction with a flipped classroom. A pretest/posttest control group design was used. The use of online modules in conjunction with the flipped classroom had a greater effect on increasing nursing students' knowledge of quality improvement than the use of online modules only. There was no statistically significant difference between the groups for safety.

How to Begin a Quality Improvement Project.

Science.gov (United States)

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

2016-05-06

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

IMPROVING CONCEPTUAL DESIGN QUALITY

DEFF Research Database (Denmark)

Bush, Stuart; Robotham, Antony John

1999-01-01

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

A formal model for total quality management

NARCIS (Netherlands)

S.C. van der Made-Potuijt; H.B. Bertsch (Boudewijn); L.P.J. Groenewegen

1996-01-01

textabstractTotal Quality Management (TQM) is a systematic approach to managing a company. TQM is systematic in the sense that it is uses facts through observation, analysis and measurable goals. There are theoretical descriptions of this management concept, but there is no formal model of it. A

Water Quality Assessment and Total Maximum Daily Loads Information (ATTAINS)

Data.gov (United States)

U.S. Environmental Protection Agency — The Water Quality Assessment TMDL Tracking And Implementation System (ATTAINS) stores and tracks state water quality assessment decisions, Total Maximum Daily Loads...

The Impact of Total Quality Management Practices on Non-Financial Performance Perceptions

Directory of Open Access Journals (Sweden)

Fetullah EVLİYAOĞLU

2012-09-01

Full Text Available This study examines the effect of total quality management applications on non-financial performance perceptions of employees. The research applied by surveys on employees in quality departments of five companies which have businesses in the field of tourism, transportation, construction, food and technology. “Leadership and continuous improvement”, “costumer focused” and “stakeholder participation” dimensions for total quality management and “customer perspective”, “innovation and learning perspective” and “internal processes perspective” dimensions for non-financial performance are derived from factor analysis. Customer focus, one of the total quality management, has significant relationship with customer perspective and innovation and learning perspective of non-financial performance. Customer focus dimension of total quality management has a significant negative effect on innovation and learning perspective of non-financial performance. There are no relationships between the rests of the dimensions.

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

Cost and impact of a quality improvement programme in mental health services.

Science.gov (United States)

Beecham, Jennifer; Ramsay, Angus; Gordon, Kate; Maltby, Sophie; Walshe, Kieran; Shaw, Ian; Worrall, Adrian; King, Sarah

2010-04-01

To estimate the cost and impact of a centrally-driven quality improvement initiative in four UK mental health communities. Total costs in year 1 were identified using documentation, a staff survey, semi-structured interviews and discussion groups. Few outcome data were collected within the programme so thematic analysis was used to identify the programme's impact within its five broad underlying principles. The survey had a 40% response. Total costs ranged between pound164,000 and pound458,000 per site, plus staff time spent on workstreams. There was a very hazy view of the resources absorbed and poor recording of expenditure and activity. The initiative generated little demonstrable improvements in service quality but some participants reported changes in attitudes. Given the difficult contexts, short time-scales and capacity constraints, the programme's lack of impact is not surprising. It may, however, represent a worthwhile investment in cultural change which might facilitate improvements in how services are delivered.

Study of Attitude staff in the Field of Total Quality Management by using Fuzzy Logic, Case Study in Teaching Hospitals in Yazd

Directory of Open Access Journals (Sweden)

M ArabBanadaki

2016-03-01

Full Text Available Introduction: In Total Quality Management, Quality is not only an admirable phenomenon but also is a customer inalienable right and will be created through the involvement and participation of all employees, managers and customers of an organization. This study was designed to evaluate staff attitudes in teaching hospitals of Yazd in the field of Total Quality Management by using fuzzy logic. Methods: This was a descriptive, analytical, cross – sectional study. Research population, were all staff in teaching hospitals of Yazd that among them 235 people were randomly Stratified, selected and studied. Data for this study were collected through a questionnaire. Since the theory of fuzzy is more suitable approach for measuring linguistic variables, so this paper determines the attitude of staff in the field of Quality Management by the use of fuzzy logic. Results: Results showed that the dimensions of the “Identification and training of staff," "empowerment and teamwork of Employees" and "support and leadership of the top management organization" respectively ranked first, second and third importance In terms of staff. Conclusion: Criteria of identification and training of staff and teamwork and support and leadership of the top management organization are Important in motivating Total Quality Management. So in total quality management improve programs, these aspects should be prioritized according to the degree of importance and effort to improve the quality of service.

Total Quality Management. ERIC Digest, Number 73.

Science.gov (United States)

Weaver, Tyler

The Japanese success story has made W. Edwards Deming's Total Quality Management (TQM) theory increasingly popular among American managers, from car manufacturers to educational leaders. TQM is based on two tenets: the primacy of customer satisfaction and the necessity of tapping nontraditional sources (especially employee ideas) to institute…

Integrated Communications at America's Leading Total Quality Management Corporations.

Science.gov (United States)

Gronstedt, Anders

1996-01-01

Examines how to create organizational processes that allow communication professionals with a variety of expertise to support each other through coordination and integration. Studies eight of America's leading total quality management corporations, including AT&T, Federal Express, Saturn, and Xerox. Explores how various total quality…

Quality of life and functionality after non-cemented total hiparthroplasty

International Nuclear Information System (INIS)

Shah, Z.A.; Arif, U.; Aslam, M.N.; Bilal, A.; Khan, M.N.B.

2013-01-01

Objectives: To evaluate the functional outcome of non-cemented total hip arthroplasty in terms of pain relief, functional capacity, range of motion and absence of deformity using Harris hip score. Study Design: Descriptive study. Place and Duration of Study: From January 2012 to December 2012, at Nawaz Sharif Social Security Teaching Hospital, Lahore (University College Medicine and Dentistry). Subject and Methods: Thirty patients meeting the inclusion criteria were admitted through orthopedics outpatient department of Nawaz Sharif social security hospital Lahore. Pre operative Harris scoring was done and was compared with the post operative score to find the improvement. Results: Mean age of patients was 52.53 +- 18.21 years, and 17 were males and 13 females. Average pre operative Harris Hip score was 23.77 +- 9.50 and post-operative score 87.90 +- 10.42. Conclusion: It was concluded that THR is a safe surgical procedure with promising results in relieving pain, improving movements and upgrading the quality of life. (author)

Does competition improve health care quality?

Science.gov (United States)

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

2008-12-01

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

Assessing Educational Processes Using Total-Quality-Management Measurement Tools.

Science.gov (United States)

Macchia, Peter, Jr.

1993-01-01

Discussion of the use of Total Quality Management (TQM) assessment tools in educational settings highlights and gives examples of fishbone diagrams, or cause and effect charts; Pareto diagrams; control charts; histograms and check sheets; scatter diagrams; and flowcharts. Variation and quality are discussed in terms of continuous process…

Knowledge Management, Total Quality Management and Innovation: A New Look

Directory of Open Access Journals (Sweden)

Amir Honarpour

2012-09-01

Full Text Available In the present challenging dynamic environment, innovation is considered as a capability that renews the competitive advantage of a company. In recent years, considerable effort has been made to examine the factors that affect innovation in organizations. Knowledge management and total quality management, which play an important role in the contemporary management progress, are among the factors investigated. On the one hand, knowledge management has been recognized as an enabler that can deploy innovation by creating, storing, transferring, and applying knowledge, while on the other hand, the implementation of total quality management practices are addressed as one of the important factors that can influence innovation in a positive way. Lately, although a few researchers have shown some interest in the relationship of total quality management and knowledge management and their have not reached a consensus to conceptualize this relation. Looking at it from the methodological perspective, this problem can be tackled by using the Joint Variance analysis method where it can demonstrate correlation among independent variables and the effect of them on innovation. This study aims to propose a framework that shows how total quality management and knowledge management are reciprocally related to each other and how this affinity can impact innovation.

Total quality index of Agaricus bisporus mushrooms packed in modified atmosphere.

Science.gov (United States)

Djekic, Ilija; Vunduk, Jovana; Tomašević, Igor; Kozarski, Maja; Petrovic, Predrag; Niksic, Miomir; Pudja, Predrag; Klaus, Anita

2017-07-01

The aim of this study was to develop a total quality index and examine the effects of modified atmosphere packaging (MAP) on the quality of Agaricus bisporus mushrooms stored for 22 days at 4 °C. Mushrooms were packaged under three MAPs: high nitrogen packaging (HNP), low carbon dioxide packaging (LCP) and low oxygen packaging (LOP). Passive MAP with air inside initially was used as the atmosphere treatment (AIR). This research revealed two phases in quality deterioration of A. bisporus mushrooms. During the first week, most of the quality parameters were not statistically different. Thereafter, odor intensities were stronger for all four types of packaging. Color difference and browning index values showed significantly lower color changes for AIR and LOP compared with HNP and LCP mushrooms. The best total quality index was calculated for LOP, followed by LCP and AIR. The findings of this study are useful with respect to examining two-component MAPs, separating the limiting factors (O 2 and CO 2 ) and evaluating quality deterioration effects and the total quality index of A. bisporus mushrooms. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

Moving up the Ladder: How Do States Deliver Quality Improvement Supports within Their Quality Rating and Improvement Systems? Brief

Science.gov (United States)

Holod, Aleksandra; Faria, Ann-Marie; Weinberg, Emily; Howard, Eboni

2015-01-01

As national attention has increasingly focused on the potential for high-quality early childhood education (ECE) to improve children's school readiness, states have developed quality rating and improvement systems (QRISs) to document the quality of ECE programs, support systematic quality improvement, and provide clear information to families…

Using Quality Tools and Methodologies to Improve a Hospital's Quality Position.

Science.gov (United States)

Branco, Daniel; Wicks, Angela M; Visich, John K

2017-01-01

The authors identify the quality tools and methodologies most frequently used by quality-positioned hospitals versus nonquality hospitals. Northeastern U.S. hospitals in both groups received a brief, 12-question survey. The authors found that 93.75% of the quality hospitals and 81.25% of the nonquality hospitals used some form of process improvement methodologies. However, there were significant differences between the groups regarding the impact of quality improvement initiatives on patients. The findings indicate that in quality hospitals the use of quality improvement initiatives had a significantly greater positive impact on patient satisfaction and patient outcomes when compared to nonquality hospitals.

The impact of leadership qualities on quality management improvement

Directory of Open Access Journals (Sweden)

Ph. D. Radoslaw Wolniak

2011-05-01

Full Text Available Currently, the importance of leadership is considered more and more often in quality management. The need of an appropriate leader has been already emphasized in ISO 9000 standards, in TQM philosophy as well as in different models of improvement which are used in the methodologies of prizing quality. Yet, it is in the concept of TQL where the attitude based on the need of leadership in an organization has achieved its best-developed, full shape. On the basis of the conducted studies, the following publication presents the analysis of the dependence between leadership qualities of managers and the improvement of quality management. There has been an attempt to define the qualities, which a manager being responsible for quality management, should have.

The impact of leadership qualities on quality management improvement

Directory of Open Access Journals (Sweden)

Radoslaw Wolniak

2011-12-01

Full Text Available Currently, the importance of leadership is considered more and more often in quality management. The need of an appropriate leader has been already emphasized in ISO 9000 standards, in TQM philosophy as well as in different models of improvement which are used in the methodologies of prizing quality. Yet, it is in the concept of TQL where the attitude based on the need of leadership in an organization has achieved its best-developed, full shape. On the basis of the conducted studies, the following publication presents the analysis of the dependence between leadership qualities of managers and the improvement of quality management. There has been an attempt to define the qualities, which a manager being responsible for quality management, should have.

Achieving Improvement Through Nursing Home Quality Measurement

OpenAIRE

Harris, Yael; Clauser, Steven B.

2002-01-01

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

Defining Instructional Quality by Employing the Total Quality Management (TQM) Method: A Research Project.

Science.gov (United States)

Croker, Robert E.; And Others

The feasibility of using W. E. Deming's total quality management (TQM) method to define instructional quality was examined by surveying three groups of students attending Idaho State University's College of Education and School of Applied Technology: 31 students seeking cosmetology certification; 75 undergraduates pursuing degrees in corporate…

Total Quality Management (TQM) Awareness Seminar. Revision 8

Science.gov (United States)

1990-04-18

is underway. * Balances of power are shifting. * What you don’t know can hurt you. E.g., the real rate of obsolescence in equipment and methods has...us with skiled labor. 0 1-6 TOTAL QUALITY MANAGEMENT Awareness Seminar Problems (continued) Trade Deficit. From positive trade balance in 1980 to $154...repair assessment to obtain customer feedback. - Established a Quality of Worklife Committee. * IRS. Ogden Service Center - Adopted Juran approach to

Improving the quality of care for patients with hypertension in Moshupa District, Botswana: Quality improvement cycle

Directory of Open Access Journals (Sweden)

Cathy Kande

2014-01-01

Full Text Available Background: Although there are no prevalence studies on hypertension in Botswana, this condition is thought to be common and the quality of care to be poor.Aim: The aim of this project was to assess and improve the quality of primary care forhypertension.Setting: Moshupa clinic and catchment area, Botswana.Methods: Quality improvement cycle.Results: Two hundred participants were included in the audit. Sixty-eight per cent were women with a mean age of 55 years. In the baseline audit none of the target standards were met. During the re-audit six months later, six out of nine structural target standards, five out of 11 process target standards and one out of two outcome target standards were achieved. Statistically-significant improvement in performance (p < 0.05 was shown in 10 criteria although the target standard was not always met. In the re-audit, the target of achieving blood pressure control (< 140/90 in 70% of patients was achieved.Conclusion: The quality of care for hypertension was suboptimal in our setting. Simple interventions were designed and implemented to improve the quality of care. These interventions led to significant improvement in structural and process criteria. A corresponding significant improvement in the control of blood pressure was also seen.

Practical Approaches to Quality Improvement for Radiologists.

Science.gov (United States)

Kelly, Aine Marie; Cronin, Paul

2015-10-01

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

Total quality at source

International Nuclear Information System (INIS)

Chiandone, A.C.

1990-01-01

The Total Quality at Source philosophy is based on optimizing the effectiveness of people in achieving ZERO-DEFECT results. In this paper a philosophy of what, I have come to perceive, it takes to get people to perform to the very best of their abilities and thereby achieve the best results they can, is presented. In the examples I shall describe I have played an instrumental role since it has become my belief that any job can always be done better provided that the people doing it can themselves become convinced that they can do better. Clearly there are many ideas on how to do this. The philosophy that I am presenting in this paper is based on my own experience, where I have both participated and observed it being applied; its effectiveness may be judged by the results. (author)

Study on Total Quality Management Activities in Taiwan Tourism Factories

Directory of Open Access Journals (Sweden)

Yi-Chan Chung

2016-08-01

Full Text Available As competition becomes increasingly fierce, how to integrate the concept of information technology involvement into total quality management activities and better serve the customers, thus increasing the effectiveness of their services, has become an important focus for many tourism factories in their selection of an appropriate operational strategy. With the tourism factories in Taiwan as the subjects, this study was therefore set out to investigate the impact of operational strategies, information technology involvement and motivation on the executive degree of total quality management (TQM activities, as well as the correlation between the executive degree of TQM activities and operational performance. This research was conducted from March to April 2016 using 56 effective questionnaires through a questionnaire survey method. According to the research findings, the higher the executive degree of TQM activities was, the more significant a positive impact it would have on operational performance; the execution of differentiation strategies would have a positive impact on the execution of TQM activities; the more a company was involved in information technology, the more significant a positive impact it would have on the execution of TQM activities; the higher the intrinsic motivation was, the more significant a positive impact it would have on the executive degrees of TQM activities. It is therefore advisable for tourism factories to implement TQM activities, adopt differentiation strategies, seek greater information technology involvement and become more strongly motivated toward TQM implementation in order to improve operational performance.

Ways of improving the quality of planning radiotherapy with modulated intensity

International Nuclear Information System (INIS)

Khvorostenko, M.I.; Kikhtenko, I.N.; Khvorostenko, Yu.M.; Volokitin, S.V.; Sklyar, N.V.

2017-01-01

3D planning standards do not exclude the presence of sections of the tumor with absorbed dose less than planned, which is considered as a prerequisite for relapse. To improve radiation therapy outcomes in cancer patients through the enhancing (intensity-modulated radiation therapy (IMRT) radiation planning quality, identifying areas of the tumor with minimal optical density exposed to lower absorbed dose in comparison with the planned one and assessment of the ways to eliminate it. Due to identified locations with a minimum optical density and the absorbed dose lower than the planned one, the ''resale'' was carried out. It was aimed to achieve the values recorded in the plan. The percentage of coverage isodose GTV and PTV was increased; on the area, where the total focal dose was lower than the planned, the dose absorbed was increased in comparison with the recorded one. Assessment of the tumor areas with minimal optical density makes it possible to detect areas with likely lower value of the total focal dose in comparison with the target on; correction of the total focal dose in these areas will improve the quality of radiation therapy.

Total Quality Management and Media Services: The Deming Method.

Science.gov (United States)

Richie, Mark L.

1992-01-01

W. Edwards Deming built a 40-year record of quality management in Japan known as Total Quality Management (TQM). His 14 points require a change in the belief system of managers and media directors, but their implementation in government agencies and schools will produce increased time for better services, better communications, and new programs.…

Quality of life: patient-reported outcomes after total replacement of the temporomandibular joint.

Science.gov (United States)

Kunjur, J; Niziol, R; Matthews, N S

2016-09-01

Since publication of the UK guidelines on total replacement of the temporomandibular joint (TMJ) in 2008 by the British Association of Oral and Maxillofacial Surgeons (BAOMS), pain scores, mouth opening, and diet have been used as markers of success. We have looked at quality of life (QoL) as another. We analysed the data from a single surgeon on patients who had had joints replaced and devised a questionnaire to find out about the subjective, functional, psychological, and social aspects of TMJ disease. A total of 18 patients who had the same operation were included (mean (range) age 50 (33 - 73) years, mean (range) follow up 30 (18 - 48) months). Jaw function and facial aesthetics had improved, and patients needed less analgesia. Overall, they reported a better QoL with improvements in mood and social interaction, and the activities of daily life were easier. The NHS uses QoL questionnaires to measure success in fields such as orthopaedic surgery, but currently we know of no nationally accepted questionnaire that measures success after total replacement of the TMJ. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Isolation of high-quality total RNA from leaves of Myrciaria dubia "CAMU CAMU".

Science.gov (United States)

Gómez, Juan Carlos Castro; Reátegui, Alina Del Carmen Egoavil; Flores, Julián Torres; Saavedra, Roberson Ramírez; Ruiz, Marianela Cobos; Correa, Sixto Alfredo Imán

2013-01-01

Myrciaria dubia is a main source of vitamin C for people in the Amazon region. Molecular studies of M. dubia require high-quality total RNA from different tissues. So far, no protocols have been reported for total RNA isolation from leaves of this species. The objective of this research was to develop protocols for extracting high-quality total RNA from leaves of M. dubia. Total RNA was purified following two modified protocols developed for leaves of other species (by Zeng and Yang, and by Reid et al.) and one modified protocol developed for fruits of the studied species (by Silva). Quantity and quality of purified total RNA were assessed by spectrophotometric and electrophoretic analysis. Additionally, quality of total RNA was evaluated with reverse-transcription polymerase chain reaction (RT-PCR). With these three modified protocols we were able to isolate high-quality RNA (A260nm/A280nm >1.9 and A260nm/A230nm >2.0). Highest yield was produced with the Zeng and Yang modified protocol (384±46µg ARN/g fresh weight). Furthermore, electrophoretic analysis showed the integrity of isolated RNA and the absence of DNA. Another proof of the high quality of our purified RNA was the successful cDNA synthesis and amplification of a segment of the M. dubia actin 1 gene. We report three modified protocols for isolation total RNA from leaves of M. dubia. The modified protocols are easy, rapid, low in cost, and effective for high-quality and quantity total RNA isolation suitable for cDNA synthesis and polymerase chain reaction.

QUALITY MANAGEMENT AND INTEGRATED TOTAL QUALITY IN SPANISH MINING: RESULTS OF AN EMPIRICAL STUDY

OpenAIRE

ESCANCIANO, CARMEN; IGLESIAS-RODRÍGUEZ, FRANCISCO-JAVIER

2012-01-01

This paper presents the results of an empirical study conducted in Spain among mining companies that hold ISO 9001 certification. This study aimed at reflecting upon quality management in Spanish mining; and discovering whether the certification of a quality management system provides companies with a framework for integrating total quality management with other management systems, such as environmental management or occupational health and safety management. En este artículo se presentan ...

Quality Improvement Initiatives in Inflammatory Bowel Disease.

Science.gov (United States)

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

2017-08-01

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

Development of Performance Measures for the Implementation of Total Quality Management in Indian Industry

OpenAIRE

Perminderjit Singh; Sukhvir Singh

2015-01-01

Total Quality Management (TQM) refers to management methods used to enhance quality and productivity in business organizations. Total Quality Management (TQM) has become a frequently used term in discussions concerning quality. Total Quality management has brought rise in demands on the organizations policy and the customers have gained more importance in the organizations focus. TQM is considered as an important management tool, which helps the organizations to satisfy their customers. In pr...

Quality control related to total quality: why not to nuclear area too?

International Nuclear Information System (INIS)

Vasques, R.J.

1992-01-01

We're living in a new economical age, where quality, productivity, competence, competitiveness and costumer satisfaction are necessary. We must develop our capacity more and more, daily, for could survive and to excel in this new age. Only through Total Quality Control (TQC) is that we'll go to achieve these requirements. TQC is expanding all over the world and is already, the new universal language. Why not get the TQC's benefits to nuclear area too? We must stay within this reality. With our quality assurance systems turned to TQC, certainly we'll get best results. This is the intention of this paper: to call the nuclear professionals attention to knowledge, application and commitment to TQC's philosophy. (author)

Process safety improvement-Quality and target zero

Energy Technology Data Exchange (ETDEWEB)

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

2008-11-15

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

Process safety improvement-Quality and target zero

International Nuclear Information System (INIS)

Van Scyoc, Karl

2008-01-01

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

Process safety improvement--quality and target zero.

Science.gov (United States)

Van Scyoc, Karl

2008-11-15

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

Intermediate and long-term quality of life after total knee replacement: a systematic review and meta-analysis.

Science.gov (United States)

Shan, Leonard; Shan, Bernard; Suzuki, Arnold; Nouh, Fred; Saxena, Akshat

2015-01-21

Total knee replacement is a highly successful and frequently performed operation. Technical outcomes of surgery are excellent, with favorable early postoperative health-related quality of life. This study reviews intermediate and long-term quality of life after surgery. A systematic review and meta-analysis of all studies published from January 2000 onward was performed to evaluate health-related quality of life after primary total knee replacement for osteoarthritis in patients with at least three years of follow-up. Key outcomes were postoperative quality of life, function, and satisfaction compared with the preoperative status. Strict inclusion and exclusion criteria were applied. Quality appraisal and data tabulation were performed with use of predefined criteria. Data were synthesized by narrative review and random-effects meta-analysis utilizing standardized mean differences. Heterogeneity was assessed with the tau(2) and I(2) statistics. Nineteen studies were included in the review. Intermediate and long-term postoperative quality of life was superior to the preoperative level in qualitative and quantitative analyses. The pooled effect in combined WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) and KSS (Knee Society Score) outcomes was a marked improvement from baseline with respect to the total score (2.17; 95% CI [confidence interval], 1.13 to 3.22; p Total knee replacement confers significant intermediate and long-term benefits with respect to both disease-specific and generic health-related quality of life, especially pain and function, leading to positive patient satisfaction. Recommendations for necessary future studies are provided. Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

Comparison of approaches to Total Quality Management. Including an examination of the Department of Energy`s position on quality management

Energy Technology Data Exchange (ETDEWEB)

Bennett, C.T.

1994-03-01

This paper presents a comparison of several qualitatively different approaches to Total Quality Management (TQM). The continuum ranges from management approaches that are primarily standards -- with specific guidelines, but few theoretical concepts -- to approaches that are primarily philosophical, with few specific guidelines. The approaches to TQM discussed in this paper include the International Organization for Standardization (ISO) 9000 Standard, the Malcolm Baldrige National Quality Award, Senge`s the Learning Organization, Watkins and Marsick`s approach to organizational learning, Covey`s Seven Habits of Highly Successful People, and Deming`s Fourteen Points for Management. Some of these approaches (Deming and ISO 9000) are then compared to the DOE`s official position on quality management and conduct of operations (DOE Orders 5700.6C and 5480.19). Using a tabular format, it is shown that while 5700.6C (Quality Assurance) maps well to many of the current approaches to TQM, DOE`s principle guide to management Order 5419.80 (Conduct of Operations) has many significant conflicts with some of the modern approaches to continuous quality improvement.

Implementing Total Quality Management in a University Setting.

Science.gov (United States)

Coate, L. Edwin

1991-01-01

Oregon State University implemented Total Quality Management in nine phases: exploration; establishing a pilot study team; defining customer needs; adopting the breakthrough planning process; performing breakthrough planning in divisions; forming daily management teams; initiating cross-functional pilot projects; implementing cross-functional…

Total Quality Management and the System Safety Secretary

Science.gov (United States)

Elliott, Suzan E.

1993-01-01

The system safety secretary is a valuable member of the system safety team. As downsizing occurs to meet economic constraints, the Total Quality Management (TQM) approach is frequently adopted as a formula for success and, in some cases, for survival.

Quality Improvement and Learning in Productive Systems

OpenAIRE

Charles H. Fine

1986-01-01

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

Improving care at cystic fibrosis centers through quality improvement.

Science.gov (United States)

Kraynack, Nathan C; McBride, John T

2009-10-01

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

Statistical methods for quality improvement

National Research Council Canada - National Science Library

Ryan, Thomas P

2011-01-01

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

Quality improvement in neurological surgery graduate medical education.

Science.gov (United States)

Parker, Scott L; McGirt, Matthew J; Asher, Anthony L; Selden, Nathan R

2015-04-01

There has been no formal, standardized curriculum for neurosurgical resident education in quality improvement. There are at least 2 reasons to integrate a formalized quality improvement curriculum into resident education: (1) increased emphasis on the relative quality and value (cost-effectiveness) of health care provided by individual physicians, and (2) quality improvement principles empower broader lifelong learning. An integrated quality improvement curriculum should comprise specific goals and milestones at each level of residency training. This article discusses the role and possible implementation of a national program for quality improvement in neurosurgical resident education. Copyright © 2015 Elsevier Inc. All rights reserved.

Improve strategic supplier performance using DMAIC to develop a Quality Improvement Plan

Science.gov (United States)

Jardim, Kevin P.

Supplier performance that meets the requirements of the customer has long plagued quality professionals. Despite the vast efforts by organizations to improve supplier performance, little has been done to standardize the plan to improve performance. This project presents a guideline and problem-solving strategy using a Define, Measure, Analyze, Improve, and Control (DMAIC) structured tool that will assist in the management and improvement of supplier performance. An analysis of benchmarked Quality Improvement Plans indicated that this topic needs more focus on how to accomplish improved supplier performance. This project is part of a growing body of supplier continuous improvement efforts. With the input of Zodiac Aerospace quality professionals this project's results provide a solution to Quality Improvement Plans and show objective evidence of its benefits. This project contributes to the future research on similar topics.

The role of metrics and measurements in a software intensive total quality management environment

Science.gov (United States)

Daniels, Charles B.

1992-01-01

Paramax Space Systems began its mission as a member of the Rockwell Space Operations Company (RSOC) team which was the successful bidder on a massive operations consolidation contract for the Mission Operations Directorate (MOD) at JSC. The contract awarded to the team was the Space Transportation System Operations Contract (STSOC). Our initial challenge was to accept responsibility for a very large, highly complex and fragmented collection of software from eleven different contractors and transform it into a coherent, operational baseline. Concurrently, we had to integrate a diverse group of people from eleven different companies into a single, cohesive team. Paramax executives recognized the absolute necessity to develop a business culture based on the concept of employee involvement to execute and improve the complex process of our new environment. Our executives clearly understood that management needed to set the example and lead the way to quality improvement. The total quality management policy and the metrics used in this endeavor are presented.

Quality-improvement initiatives focused on enhancing customer service in the outpatient pharmacy.

Science.gov (United States)

Poulin, Tenley J; Bain, Kevin T; Balderose, Bonnie K

2015-09-01

The development and implementation of quality-improvement initiatives to enhance customer service in an outpatient pharmacy of a Veterans Affairs (VA) medical center are described. Historically low customer service satisfaction rates with the outpatient pharmacy at the Philadelphia Veterans Affairs Medical Center prompted this quality-improvement project. A three-question survey was designed to be easily and quickly administered to veterans in the outpatient pharmacy waiting area. Using 5-point Likert scale, veterans were asked to rate (1) their overall experience with the outpatient pharmacy service and (2) their satisfaction with the customer service provided by the pharmacy department. They were also asked how they thought the pharmacy department could improve its customer service. After receiving feedback from the survey, several quality-improvement initiatives were developed. The initiatives were categorized as environmental, personnel, communicative, and technological. For each initiative, one or more tasks were developed and the initiatives were subsequently implemented over eight months. After each task was completed, veterans were surveyed to measure the impact of the change. A total of 79 veterans were surveyed before the implementation of the quality-improvement initiatives, and 49% and 68% rated their experience with the outpatient pharmacy and customer service favorably, respectively. Twenty-five veterans were surveyed after the implementation of numerous quality-improvement interventions, with 44% and 72% rating their experience with the outpatient pharmacy and customer service favorably. Customer service satisfaction with an outpatient pharmacy service at a VA medical center was enhanced through the implementation of various quality-improvement initiatives. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Partial and total fish meal replacement by agricultural products in the diets improve sperm quality in African catfish (Clarias gariepinus)

NARCIS (Netherlands)

Nyina-wamwiza, L.; Milla, S.; Pierrard, M.A.; Rurangwa, E.; Mandiki, S.N.M.; Look, van K.J.W.; Kestemont, P.

2012-01-01

This study investigated the long-term effects of total and partial replacement of dietary fish meal (FM) by a mixture of agricultural products on sperm quality of African catfish Clarias gariepinus. Four isonitrogenous and isoenergetic diets were formulated containing graded levels of either 50% FM

Improving Family Meetings in Intensive Care Units: A Quality Improvement Curriculum.

Science.gov (United States)

Gruenewald, David A; Gabriel, Michelle; Rizzo, Dorothy; Luhrs, Carol A

2017-07-01

Family meetings in the intensive care unit are associated with beneficial outcomes for patients, their families, and health care systems, yet these meetings often do not occur in a timely, effective, reliable way. The Department of Veterans Affairs Comprehensive End-of-Life Care Implementation Center sponsored a national initiative to improve family meetings in Veterans Affairs intensive care units across the United States. Process measures of success for the initiative were identified, including development of a curriculum to support facility-based quality improvement projects to implement high-quality family meetings. Identified curriculum requirements included suitability for distance learning and applicability to many clinical intensive care units. Curriculum modules were cross-mapped to the "Plan-Do-Study-Act" model to aid in planning quality improvement projects. A questionnaire was e-mailed to users to evaluate the curriculum's effectiveness. Users rated the curriculum's effectiveness in supporting and achieving aims of the initiative as 3.6 on a scale of 0 (not effective) to 4 (very effective). Users adapted the curriculum to meet local needs. The number of users increased from 6 to 17 quality improvement teams in 2 years. All but 3 teams progressed to implementation of an action plan. Users were satisfied with the effectiveness and adaptability of a family-meeting quality improvement curriculum to support implementation of a quality improvement project in Veterans Affairs intensive care units. This tool may be useful in facilitating projects to improve the quality of family meetings in other intensive care units. ©2017 American Association of Critical-Care Nurses.

From misconception to a must. The measured merits of total quality management and accreditation in INAA

International Nuclear Information System (INIS)

Bode, P.

1997-01-01

Increasingly governmental bodies and industry require that supporting analytical laboratories have their quality assurance program implemented in a quality system by international standards such as derived from the ISO-25 guide. Neutron activation analysis (NAA) laboratories may have to deal with this trend too. In universities and research laboratories the need for it, and the implications of total quality management system are sometimes misconceived by unfamiliarity with the issue. The laboratory for INAA in Delft has been accredited for its quality system since 1993. Some of the tangible improvements since the introduction of quality management are presented. Four strategical considerations are given to consider the introduction of quality management at NAA laboratories, viz. with respect to the role of NAA for the validation of other methods, the role of NAA in the certification of reference materials, the preservation of knowledge and the acceptance of NAA as a respectable method. (author)

Total Data Quality Management: A Study of Bridging Rigor and Relevance

NARCIS (Netherlands)

Wijnhoven, Alphonsus B.J.M.; Boelens, R.; Middel, H.G.A.; Louissen, K.

2007-01-01

Ensuring data quality is of crucial importance to organizations. The Total Data Quality Management (TDQM) theory provides a methodology to ensure data quality. Although well researched, the TDQM methodology is not easy to apply. In the case of Honeywell Emmen, we found that the application of the

Assessing the Total Economic Value of Improving Water Quality to Inform Water Resources Management: Evidence and Challenges from Southeast Asia

Science.gov (United States)

Jalilov, S.; Fukushi, K.

2016-12-01

Population growth, high rates of economic development and rapid urbanization in the developing countries of Southeast Asia (SEA) have resulted in degradation and depletion of natural resources, including water resources and related ecosystem services. Many urban rivers in the region are highly polluted with domestic, industrial and agricultural wastes. Policymakers are often aware of the direct value of water resources for domestic and industrial consumption, but they often underestimate the indirect value of these functions, since they are not exchanged in the market and do not appear in national income accounts. Underestimation of pollution and over-exploitation of water resources result in a loss of these benefits and have adverse impacts on nearby residents, threatening the long-term sustainable development of natural resources in the region. Behind these constraints lies a lack of knowledge (ignorance) from governments that a clean water environment could bring significant economic benefits. This study has been initiated to tackle this issue and to foster a more rational approach for sustainable urban development in Metro Manila in the Philippines. We applied a Contingent Valuation Method (CVM) based on Computer-Assisted Personal Interviewing (CAPI) technique. Results show that users are willing to pay up to PHP 102.42 (2.18) monthly to improve quality of urban waterbodies whereas nonusers are willing to pay up to PHP 366.53 (7.80) as one-time payment towards water quality improvement. The estimated monetary value of water quality improvements would be a useful variable in cost-benefit analyses of various water quality-related policies, in both public and private sectors in Metro Manila. This survey design could serve as a useful template for similar water quality studies in other SEA countries.

The Evaluation of Teachers' Job Performance Based on Total Quality Management (TQM)

Science.gov (United States)

Shahmohammadi, Nayereh

2017-01-01

This study aimed to evaluate teachers' job performance based on total quality management (TQM) model. This was a descriptive survey study. The target population consisted of all primary school teachers in Karaj (N = 2917). Using Cochran formula and simple random sampling, 340 participants were selected as sample. A total quality management…

Methods of multicriterion estimations in system total quality management

Directory of Open Access Journals (Sweden)

Nikolay V. Diligenskiy

2011-05-01

Full Text Available In this article the method of multicriterion comparative estimation of efficiency (Data Envelopment Analysis and possibility of its application in system of total quality management is considered.

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

Science.gov (United States)

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

2015-11-01

We assessed the effectiveness of an asthma educational programme based on a repeated short intervention (AEP-RSI) to improve asthma control (symptom control and future risk) and quality of life. A total of 230 adults with mild-to-moderate persistent uncontrolled asthma participated in a 1-year cluster randomised controlled multicentre study. The AEP-RSI was given in four face-to-face sessions at 3-month intervals, and included administration of a written personalised action plan and training on inhaler technique. Centres were randomised to the AEP-RSI (intervention) group or usual clinical practice group. Specialised centres using a standard educational programme were the gold standard group. A significant improvement in the Asthma Control Test score was observed in all three groups (pQuality of Life Questionnaire scores (0.95±1.04 and 0.89±0.84 versus 0.52±0.97, respectively). The AEP-RSI was effective in improving asthma symptom control, future risk and quality of life. Copyright ©ERS 2015.

The Total Quality Management Model Department of Personnel State of Colorado,

Science.gov (United States)

A panel of three members will present the Total Quality Management model recently designed for the Department of Personnel, State of Colorado. This model was selected to increase work quality and productivity of the Department and to exemplify Governor Romer’s commitment to quality work within state government.

Quality improvement through multiple response optimization

International Nuclear Information System (INIS)

Noorossana, R.; Alemzad, H.

2003-01-01

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

Power theories for improved power quality

CERN Document Server

Pasko, Marian

2012-01-01

Power quality describes a set of parameters of electric power and the load’s ability to function properly under specific conditions. It is estimated that problems relating to power quality costs the European industry hundreds of billions of Euros annually. In contrast, financing for the prevention of these problems amount to fragments of these costs. Power Theories for Improved Power Quality addresses this imbalance by presenting and assessing a range of methods and problems related to improving the quality of electric power supply. Focusing particularly on active compensators and the DSP based control algorithms, Power Theories for Improved Power Quality introduces the fundamental problems of electrical power. This introduction is followed by chapters which discuss: •‘Power theories’ including their historical development and application to practical problems, •operational principles of active compensator’s DSP control based algorithms using examples and results from laboratory research, and •t...

Public health dental hygiene: an option for improved quality of care and quality of life.

Science.gov (United States)

Olmsted, Jodi L; Rublee, Nancy; Zurkawski, Emily; Kleber, Laura

2013-10-01

The purpose of this research was to document quality of life (QoL) and quality of care (QoC) measures for families receiving care from dental hygienists within public health departments, and to consider if oral health for families with economic disparities and cultural differences was improved. A descriptive research study using a retrospective record review was conducted considering QoC. A review of state epid "Do preventive oral health programs based in local health departments provide quality care services, thus impacting QoL for underserved populations?" A dental hygienist working in public health made significant contributions to improving access to care and QoL in a rural, socioeconomically disadvantaged community. A total of 2,364 children received education, 1,745 received oral screenings and 1,511 received dental sealants. Of these, 804 children with caries were referred, with 463 receiving restorations and follow-up care. QoL metrics basis assessed Health Outcomes & Health Determinants. Initial QoL data was ranked in the bottom half of the state, while 70% of original determinant data was also ranked in the bottom half of reported metrics. Dental hygienists in public health settings can positively affect patients offering preventive care outreach services. Education and sealant placement were considered effective as measured by access, delivery and, when required, referral for restorative care. Improvement in QoL for individuals was noted through improved health outcomes and determinant metrics.

Developing a composite weighted quality metric to reflect the total benefit conferred by a health plan.

Science.gov (United States)

Taskler, Glen B; Braithwaite, R Scott

2015-03-01

To improve individual health quality measures, which are associated with varying degrees of health benefit, and composite quality metrics, which weight individual measures identically. We developed a health-weighted composite quality measure reflecting the total health benefit conferred by a health plan annually, using preventive care as a test case. Using national disease prevalence, we simulated a hypothetical insurance panel of individuals aged 25 to 84 years. For each individual, we estimated the gain in life expectancy associated with 1 year of health system exposure to encourage adherence to major preventive care guidelines, controlling for patient characteristics (age, race, gender, comorbidity) and variation in individual adherence rates. This personalized gain in life expectancy was used to proxy for the amount of health benefit conferred by a health plan annually to its members, and formed weights in our health-weighted composite quality measure. We aggregated health benefits across the health insurance membership panel to analyze total health system performance. Our composite quality metric gave the highest weights to health plans that succeeded in implementing tobacco cessation and weight loss. One year of compliance with these goals was associated with 2 to 10 times as much health benefit as compliance with easier-to-follow preventive care services, such as mammography, aspirin, and antihypertensives. For example, for women aged 55 to 64 years, successful interventions to encourage weight loss were associated with 2.1 times the health benefit of blood pressure reduction and 3.9 times the health benefit of increasing adherence with screening mammography. A single health-weighted quality metric may inform measurement of total health system performance.

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

Science.gov (United States)

Schwartz, Stephanie P; Rehder, Kyle J

2017-01-01

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

A comparative study of total quality management of health care system in India and Iran

Directory of Open Access Journals (Sweden)

Heidari Gorji Ali

2011-12-01

Full Text Available Abstract Background Total quality management (TQM has a great potential to address quality problems in a wide range of industries and improve the organizational performance. The growing need to take initiatives by hospitals in countries like India and Iran to improve the service quality and reduce wastage of resources has inspired the authors to develop a survey instrument to measure health care quality and performance in the two countries. Methods Based on the Baldrige health care criteria for performance excellence 2009-2010 and the guidelines proposed by the American Hospitals Association for hospitals in pursuit of excellence, compared health care services in three countries. The data are collected from the capital cities and their nearby places in India and Iran. Using ANOVAs, three groups in quality planning and performance have been compared. Result Results showed there is significantly difference between groups and in no case the hospitals from India and Iran are found scoring close to the benchmarks. The average scores of Indian and Iranian hospitals on different constructs of the IHCQPM model are compared with the major results achieved by the recipients of the MBNQ award. Conclusion In no case the hospitals from India and Iran are found scoring close to the benchmarks (Baldrige health care criteria for performance excellence 2009-2010 and the guidelines proposed by the American Hospitals Association for hospitals. These results suggested to health care services more attempt to achieve high quality in management and performance.

A comparative study of total quality management of health care system in India and Iran.

Science.gov (United States)

Heidari Gorji, Ali Morad; Farooquie, Jamal A

2011-12-28

Total quality management (TQM) has a great potential to address quality problems in a wide range of industries and improve the organizational performance. The growing need to take initiatives by hospitals in countries like India and Iran to improve the service quality and reduce wastage of resources has inspired the authors to develop a survey instrument to measure health care quality and performance in the two countries. Based on the Baldrige health care criteria for performance excellence 2009-2010 and the guidelines proposed by the American Hospitals Association for hospitals in pursuit of excellence, compared health care services in three countries. The data are collected from the capital cities and their nearby places in India and Iran. Using ANOVAs, three groups in quality planning and performance have been compared. Results showed there is significantly difference between groups and in no case the hospitals from India and Iran are found scoring close to the benchmarks. The average scores of Indian and Iranian hospitals on different constructs of the IHCQPM model are compared with the major results achieved by the recipients of the MBNQ award. In no case the hospitals from India and Iran are found scoring close to the benchmarks (Baldrige health care criteria for performance excellence 2009-2010 and the guidelines proposed by the American Hospitals Association for hospitals). These results suggested to health care services more attempt to achieve high quality in management and performance.

Total Quality Management: Empirical, Conceptual, and Practical Issues.

Science.gov (United States)

Hackman, J. Richard; Wageman, Ruth

1995-01-01

Total quality management (TQM) has become a U.S. social movement. This commentary analyzes the writings of W. Edwards Deming, Joseph Juran, and Kaoru Ishikawa to assess TQM's coherence, distinctiveness, and likely perseverance. Rhetoric is winning over substance, unrelated interventions are being herded under the TQM banner, and research is not…

Investigating the impact of Total Quality Management (TQM) on ...

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Investigating the impact of Total Quality Management (TQM) on innovation in iranian oil companies. ... Journal of Fundamental and Applied Sciences ... for competing with rival's organized management and to survive in the cycle of change.

Total Quality Management Implementation: Selected Readings

Science.gov (United States)

1989-04-01

Investigation of the Method of Accumulation Analysis by George Box and Stephen Jones. A discussion of Taguchi’s method for analyzing ordered categorical data. 1...P., Quality Control for Management, Prentice-Hall, Englewood Grant E L and Leavenworth. R.S. Statistical Quahtu Control, Mc- Cliffs, NJ., 1967. Graw ... Stephen A. Maguire, Ingalis Shipbuiiding which, in turn, improve the ability to anticipate productio: It is ei-couraging to see full-scale application

Total Quality Management of Information System for Quality Assessment of Pesantren Using Fuzzy-SERVQUAL

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Faizah, Arbiati; Syafei, Wahyul Amien; Isnanto, R. Rizal

2018-02-01

This research proposed a model combining an approach of Total Quality Management (TQM) and Fuzzy method of Service Quality (SERVQUAL) to asses service quality. TQM implementation was as quality management orienting on customer's satisfaction by involving all stakeholders. SERVQUAL model was used to measure quality service based on five dimensions such as tangible, reliability, responsiveness, assurance, and empathy. Fuzzy set theory was to accommodate subjectivity and ambiguity of quality assessment. Input data consisted of indicator data and quality assessment aspect. Input data was, then, processed to be service quality assessment questionnaires of Pesantren by using Fuzzy method to get service quality score. This process consisted of some steps as follows : inputting dimension and questionnaire data to data base system, filling questionnaire through system, then, system calculated fuzzification, defuzzification, gap of quality expected and received by service receivers, and calculating each dimension rating showing quality refinement priority. Rating of each quality dimension was, then, displayed at dashboard system to enable users to see information. From system having been built, it could be known that tangible dimension had the highest gap, -0.399, thus it needs to be prioritized and gets evaluation and refinement action soon.

Diet Quality Associated with Total Sodium Intake among US Adults Aged ≥18 Years-National Health and Nutrition Examination Survey, 2009-2012.

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Mercado, Carla I; Cogswell, Mary E; Perrine, Cria G; Gillespie, Cathleen

2017-10-25

Diet quality or macronutrient composition of total daily sodium intake (dNa) <2300 mg/day in the United States (US) is unknown. Using data from 2011-2014 NHANES (National Health and Nutrition Examination Survey), we examined 24-h dietary recalls ( n = 10,142) from adults aged ≥18 years and investigated how diet composition and quality are associated with dNa. Diet quality was assessed using components of macronutrients and Healthy Eating Index 2010 (HEI-2010). Associations were tested using linear regression analysis adjusted for total energy (kcal), age, gender, and race/ethnicity. One-day dNa in the lower quartiles were more likely reported among women, older adults (≥65 years old), and lower quartiles of total energy (kcal) ( p -values ≤ 0.001). With increasing dNa, there was an increase in the mean protein, fiber, and total fat densities, while total carbohydrates densities decreased. As dNa increased, meat protein, refined grains, dairy, and total vegetables, greens and beans densities increased; while total fruit and whole fruit densities decreased. Modified HEI-2010 total score (total score without sodium component) increased as dNa increased (adjusted coefficient: 0.11, 95% confidence interval = 0.07, 0.15). Although diet quality, based on modified HEI-2010 total score, increased on days with greater dNa, there is much room for improvement with mean diet quality of about half of the optimal level.

Promoting Quality in Education. Schools Can Use Total Quality Management Concepts to Boost Student Performance.

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Schargel, Franklin P.

1991-01-01

Schools must establish the same quality standards and techniques used by businesses to achieve Total Quality Management (TMQ). TMQ can help public education to respond to the challenges typical of inner-city schools: a high transfer rate; aging faculty; and students with poor reading and math skills, lack of motivation, low self-esteem, and a…

Limits on quality of life in communication after total laryngectomy.

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Chaves, Adriana Di Donato; Pernambuco, Leandro de Araújo; Balata, Patrícia Maria Mendes; Santos, Veridiana da Silva; de Lima, Leilane Maria; de Souza, Síntia Ribeiro; da Silva, Hilton Justino

2012-10-01

 Among people affected by cancer, the impairment of quality of life of people affected by cancer can cause have devastating effects. The self-image of patients after post-laryngectomyzed patients may be find themselves compromised, affecting the quality of life in this population.  To characterize quality of life in related to communication in people who have undergone went total laryngectomy surgery.  This is an observational study, with a cross-sectional and descriptive series. Design of series study. The sample were comprised 15 patients interviewed the period from January to February of 2011. We used the Quality Protocol for Life Communication in Post-laryngectomy adapted from Bertocello (2004); which this questionnaire contains 55 questions. The protocol was organized from the nature of using responses classified as positive and negative aspects, proposals in with respect to five 5 communication domains: family relationships, social relationships, personal analysis; morphofunctional aspect, and use of writing. To promote and guarantee the autonomy of the respondents, was examiners made use of used assistive technology with the Visual Response Scale.  The responses that total laryngectomy compromises the quality of life in communication amounted to 463 occurrences (65.7%), and that who responses suggesting good quality of life were represented with amounted to 242 occurrences (34.3%), from a total of 705 occurrencesresponses. From Among the five 5 Communication domains, four 4 had percentages of above 63% for occurrences of negative content for impact on communication. Appearance Morphofunctional appearance gave the had the highest percentage of negative content, amounting to 77.3% of cases.  The results showed important limitations of a personal and social nature due to poor communication with their peers. Thus, there is a need for multidisciplinary interventions that aim to minimize the entrapment of negative impact on these people communication

Does a quality assurance training course on chest radiography for radiological technologists improve their performance in Laos?

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Akihiro Ohkado

2017-01-01

Full Text Available Background: It is of critical importance to improve and maintain the quality of chest radiography (CXR to avoid faulty diagnosis of respiratory diseases. The study aims to determine the effectiveness of a training program in improving the quality of CXR among radiological technologists (RTs in Laos. Design: This was a cross-sectional study, conducted through on-site investigation of X-ray facilities, assessment of CXR films in Laos, both before and after a training course in November 2013. Methods: Each RT prospectively selected 6 recent CXR films, taken both before and within approximately 6 months of attending the training course. Consequently, 12 CXR films per RT were supposed to be collected for assessment. The quality of the CXR films was assessed using the “Assessment Sheet for Imaging Quality of Chest Radiography.” Results: Nineteen RTs from 19 facilities at 16 provinces in Laos participated in the training course. Among them, 17 RTs submitted the required set of CXR films (total: 204 films. A wide range of X-ray machine settings had been used as tube voltage ranged from 40 to 130 kV. The assessment of the CXR films indicated that the training was effective in improving the CXR quality regarding contrast (P = 0.005, sharpness (P = 0.004, and the total score on the 6 assessment factors (P = 0.009. Conclusions: The significant improvement in the total score on the 6 assessment factors, in contrast, and in sharpness, strongly suggests that the training course had a positive impact on the quality of CXR among a sample trainees of RTs in Laos.

Total Quality Management Practices in Turkish Primary Schools

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Toremen, Fatih; Karakus, Mehmet; Yasan, Tezcan

2009-01-01

Purpose: The purpose of this paper is to determine the extent of total quality management (TQM) practices in primary schools based on teachers' perceptions, and how their perceptions are related to different variables. Design/methodology/approach: In this study, a survey based descriptive scanning model was used. This study was carried out in…

TOTAL QUALITY MANAGEMENT SYSTEM (TQMS IN SMALL WINERY AND BAKERY IN CYPRUS. A CASE STUDY.

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ANTONIS A. ZORPAS

2012-06-01

Full Text Available Quality of products and production affects the welfare, efficiency and competitiveness of the business entity. Total Quality Management System (TQMS represent the organizational structure of enterprise, application of methods, tools and processes used for the implantation, maintenance and improvement of activities and their outcomes as well as the organization takes all the necessary actions for its environmental performance and safety.The aim of the implementing TQMS in company is to create a good relation of employees to quality and safety as a fundamental category of the market economy and make them produce this quality and on the other and to provide good relationbetween SMEs and governmental authorities. QMS determine the prior characteristics of products, through which the company meets the identified needs of the market. The paper presents a case study of the implementation of aTQMS in small winery and bakery industry from Cyprus. The TQMS include the implementation of ISO 9001:2008, ISO 14001:2004 and ISO 22000:2005.

Integration of quality improvement and cost-efficiency through industrial improvement techniques

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Vink JP

2016-06-01

Full Text Available Jasper P Vink,1 Maxime T Rigaudy,1,2 Karl O Elmqvist11Imperial College Business School, Imperial College London, London, 2Hull York Medical School, York, UKIn this journal, Crema and Verbano1 discussed the importance of defining quality of health care and how quality can be improved through various industrial instruments and techniques. Quality of health care is a heavily debated topic that requires a wide scope of considerations across the many stakeholders of the health system. We acknowledge Crema and Verbano’s arguments that patient safety is a basic pillar of quality, upon which we would like to expand by highlighting the clinical effectiveness and patient-reported outcomes, which are the two further crucial components of quality. The arguments made regarding quality improvement techniques and cost efficiency in health care provision are insightful, yet appear to make a distinction between efforts to improve quality, eliminate waste from processes, and cut costs in health care provision. We would argue that in fact these achievements are all closely related and can be achieved simultaneously, if the industrial techniques of quality management are applied adequately.View the original paper by Crema and Verbano.

Strategi Kepemimpinan Pendidikan dalam Pengembangan MAN Propinsi DIY Perspektif Total Quality Management (TQM

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Subiyantoro

2016-11-01

Full Text Available To date, the management of educational empowerment particularly in madrasah (Islamic schools is still struggling in finding its precise form. The madrasahs are commonly managed base on merely the managers’ personal experience, without proper scientific co nception. This happens due to unhealthy condition in which the managers are repressed and burdened by complicated bureaucratic matters. On the other hand, they are also required to compete in ever growing critical society. The main purpose of this researc h is to obtain the description of the Islamic educational empowerment strategies based on the Total Quality Management perspective, particularly in light of the educational leadership toward the development of the Madrasah Aliyah Negeri (State Islamic Seni or High Schools in the Province of Yogyakarta. Three methods of data gathering are employed in this research, namely in depth interview, participant observation, and documentation. The results show that, in empowering the Madrasah Aliyah, the leaders 1 r ely on personal experience obtained from previous workplace, either being teacher or school principal; 2 perceive comparative study involving educational stakeholders, such as school committee, supervisors, and educational staff at Province level, as an e ffective tool in developing the madrasahs; 3 attend trainings or workshops held by the ministry of education; and 4 read books related to managerial tasks. Overall, the Total Quality Management can be observed through continuous improvement, culture chan ge, reversed organization, costumers - organization good relationship, focus on costumers and the quality of teaching - learning process.

The Relationship between Cost Leadership Strategy, Total Quality Management Applications and Financial Performance

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Ali KURT

2016-03-01

Full Text Available Firms need to implement some competition strategies and total quality management applications to overcome the fierce competition among others. The purpose of this study is to show the relationship between cost leadership strategy, total quality management applications and firms’ financial performance with literature review and empirical analysis. 449 questionnaires were conducted to the managers of 142 big firms. The data gathered was assessed with AMOS. As a result, the relationship between cost leadership strategy, total quality management applications and firms’ financial performance has been gathered. In addition, the relationship between TQM applications and financial performance has also been gathered.

Improving and monitoring air quality.

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DuPont, André

2018-05-01

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

Total quality index of ultrasound-treated blueberry and cranberry juices and nectars.

Science.gov (United States)

Režek Jambrak, Anet; Šimunek, Marina; Djekic, Ilija

2018-01-01

The influence of ultrasound in combination with elevated temperature (thermosonication) is important in inactivation effects on microorganisms. However, overall quality of these products can be deteriorated. The aim of this study was to examine the use of a single quality index in evaluating effects of ultrasound technology on quality characteristics of blueberry and cranberry juices and nectars. For the purpose of this study based on 10 quality parameters, two mathematical models for calculating a single total quality index have been introduced. Samples were treated according to the experimental design, with high power ultrasound frequency of 20 kHz under various conditions (treatment time: 3, 6 and 9 min, sample temperature: 20 ℃, for thermosonication: 40 and 60 ℃ and amplitude: 60, 90 and 120 µm). Mathematical index of total quality index in order to evaluate total quality of ultrasound-treated juices and nectars was established. For cranberry juices, treatments '11' (amplitude 120 µm) and '16' (amplitude 60 µm) both for 9 min and the temperature of 20 ℃ were best scored for both models. Treatment '6' (amplitude 120 µm, 3 min treatment time and the sample temperature of 20 ℃) for cranberry nectars was among the best for both models. Ultrasound treatments '6' of amplitude 120 µm, 3 min and the temperature of 20 ℃ and '11' same amplitude 120 µm and temperature, but 9 min were best scored blueberry juices for both models. Blueberry nectar had best total quality index for treatments '5' (amplitude 120 µm, 6 min treatment time and the sample temperature of 40 ℃) and '6' (amplitude 120 µm, 3 min treatment time and the sample temperature of 20 ℃).

Image Quality Improvement after Implementation of a CT Accreditation Program

International Nuclear Information System (INIS)

Kim, You Sung; Jung, Seung Eun; Choi, Byung Gil; Shin, Yu Ri; Hwang, Seong Su; Ku, Young Mi; Lim, Yeon Soo; Lee, Jae Mun

2010-01-01

The purpose of this study was to evaluate any improvement in the quality of abdominal CTs after the utilization of the nationally based accreditation program. Approval was obtained from the Institutional Review Board, and informed consent was waived. We retrospectively analyzed 1,011 outside abdominal CTs, from 2003 to 2007. We evaluated images using a fill-up sheet form of the national accreditation program, and subjectively by grading for the overall CT image quality. CT scans were divided into two categories according to time periods; before and after the implementation of the accreditation program. We compared CT scans between two periods according to parameters pertaining to the evaluation of images. We determined whether there was a correlation between the results of a subjective assessment of the image quality and the evaluation scores of the clinical image. The following parameters were significantly different after the implementation of the accreditation program: identifying data, display parameters, scan length, spatial and contrast resolution, window width and level, optimal contrast enhancement, slice thickness, and total score. The remaining parameters were not significantly different between scans obtained from the two different periods: scan parameters, film quality, and artifacts. After performing the CT accreditation program, the quality of the outside abdominal CTs show marked improvement, especially for the parameters related to the scanning protocol

Quality assessment of systematic reviews on total hip or knee arthroplasty using mod-AMSTAR.

Science.gov (United States)

Wu, Xinyu; Sun, Huan; Zhou, Xiaoqin; Wang, Ji; Li, Jing

2018-03-16

Increasing numbers of systematic reviews (SRs) on total knee arthroplasty (TKA) and total hip arthroplasty (THA) have been published in recent years, but their quality has been unclear. The purpose of this study is to evaluate the methodological quality of SRs on TKA and THA. We searched Ovid-Medline, Ovid-Embase, Cochrane Databases (including HTA, DARE, and CDSR), CBM, CNKI, Wang Fang, and VIP, from January 2014 to December 2015 for THA and TKA. The quality of SRs was assessed using the modified 25-item "Assessment of Multiple Systematic Reviews" (mod-AMSTAR) tool, which was based on the AMSTAR scale. A T-test, nonparametric test, and linear regression were conducted to assess the relationship between bibliographical characteristics and methodological quality. Sixty-three SRs were included, from which the majority of SRs (50, 79.4%) were conducted in Asia. Only 4 reviews were rated as high quality, and most were weak in providing a priori design (6, 9.5%), not limiting the publication type (8, 13%), providing an excluded primary studies list (4, 6.3%) and reporting support for the included primary studies (1, 1.6%). Reviews published in English journals performed better than did Chinese journals in duplicate data extraction (81.3% vs 46.7%, p = 0.017; 70.8% vs 33.3%, p = 0.009) and providing source of support for the SR (87.5% vs 33.3%, P quality of the included SRs is far from satisfactory. Authors of SRs should conform to the recommendations outlined in the mod-AMSTAR items. Areas needing improvement were providing a priori design, not limiting the publication type, providing an excluded primary studies list, and reporting conflicts of interest.

SOME ASPECTS OF TOTAL QUALITY MANAGEMENT: USING THE DEMING CYCLE IN THE MANAGEMENT OF TAXES

OpenAIRE

DANIELA-LIDIA ROMAN

2012-01-01

Activity for establishing, collecting and tracking collecting of taxes (AFECTCT) is important for public finances because the taxes provide most of the public funds, and, at the same time, they are important levers which the state influence the behavior of entrepreneurs and consumers. Because the economic literature are few attempts to improve the activities in the taxes area through the Total Quality Management (TQM) by applying Deming model, in this paper, using the four sequential processe...

Improving Quality of Care in Primary Health-Care Facilities in Rural Nigeria: Successes and Challenges.

Science.gov (United States)

Ugo, Okoli; Ezinne, Eze-Ajoku; Modupe, Oludipe; Nicole, Spieker; Winifred, Ekezie; Kelechi, Ohiri

2016-01-01

Nigeria has a high population density but a weak health-care system. To improve the quality of care, 3 organizations carried out a quality improvement pilot intervention at the primary health-care level in selected rural areas. To assess the change in quality of care in primary health-care facilities in rural Nigeria following the provision of technical governance support and to document the successes and challenges encountered. A total of 6 states were selected across the 6 geopolitical zones of the country. However, assessments were carried out in 40 facilities in only 5 states. Selection was based on location, coverage, and minimum services offered. The facilities were divided randomly into 2 groups. The treatment group received quality-of-care assessment, continuous feedback, and improvement support, whereas the control group received quality assessment and no other support. Data were collected using the SafeCare Healthcare Standards and managed on the SafeCare Data Management System-AfriDB. Eight core areas were assessed at baseline and end line, and compliance to quality health-care standards was compared. Outcomes from 40 facilities were accepted and analyzed. Overall scores increased in the treatment facilities compared to the control facilities, with strong evidence of improvement ( t = 5.28, P = .0004) and 11% average improvement, but no clear pattern of improvement emerged in the control group. The study demonstrated governance support and active community involvement offered potential for quality improvement in primary health-care facilities.

Evaluation of the Quality of Life and Psychiatric Symptoms of Patients with Primary Coxarthrosis after Total Hip Arthroplasty.

Science.gov (United States)

Balik, M S; Hocaoğlu, Ç; Erkut, A; Güvercin, Y; Keskin, D

2017-01-01

PURPOSE OF THE STUDY In this study, it was aimed to examine the preoperative and postoperative quality of life and psychiatric symptoms of the patients with primary coxarthrosis after total hip arthroplasty. MATERIAL AND METHODS 150 patients undergone total hip arthroplasty were involved in this study. The socio-demographical data form prepared by the researchers was utilized before and after the operation in order to demonstrate disease-related socio-demographical characteristics of the patient. The Quality of Life Scale Short Form (SF-36), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Harris Hip Score (HHS) and Visual Analog Scale (VSA) were implemented in the preoperative period and at 6th and 12th week after the operation. RESULTS Of the patients involved in study, 28.7% were male and 71.3% were female. Their mean age was 58.34±11.92 year. While statistically significant differences were found between the preoperative and postoperative periods in terms of physical function, physical role limitation, emotional role limitation, energy, social function, pain, and general health subscales of SF-36, no significant differences were found relating mental health subscale. In BAI, BDI, VAS, and HHS comparison, statistically significant differences were found between the preoperative and postoperative periods, except for BAI. CONCLUSIONS In this study, it was determined that primary coxarthrosis affects significantly the quality of the patients' lives in a negative way and can be accompanied by mental symptoms. After total hip arthroplasty, significant improvement was observed in quality of life, depression and pain scores. Key words: total hip prosthesis, quality of life, mental symptoms.

Quality improvement activity for improving pain management in acute extremity injuries in the emergency department.

Science.gov (United States)

Chang, Hyung Lan; Jung, Jin Hee; Kwak, Young Ho; Kim, Do Kyun; Lee, Jin Hee; Jung, Jae Yun; Kwon, Hyuksool; Paek, So Hyun; Park, Joong Wan; Shin, Jonghwan

2018-03-01

The aim of this study was to investigate the effectiveness of a quality improvement activity for pain management in patients with extremity injury in the emergency department (ED). This was a retrospective interventional study. The patient group consisted of those at least 19 years of age who visited the ED and were diagnosed with International Classification of Diseases codes S40-S99 (extremity injuries). The quality improvement activity consisted of three measures: a survey regarding activities, education, and the triage nurse's pain assessment, including change of pain documentation on electronic medical records. The intervention was conducted from January to April in 2014 and outcome was compared between May and August in 2013 and 2014. The primary outcome was the rate of analgesic prescription, and the secondary outcome was the time to analgesic prescription. A total of 1,739 patients were included, and 20.3% of 867 patients in the pre-intervention period, and 28.8% of 872 patients in the post-intervention period received analgesics (P< 0.001). The prescription rate of analgesics for moderate-to-severe injuries was 36.4% in 2013 and 44.5% in 2014 (P=0.026). The time to analgesics prescription was 116.6 minutes (standard deviation 225.6) in 2013 and 64 minutes (standard deviation 75.5) in 2014 for all extremity injuries. The pain scoring increased from 1.4% to 51.6%. ED-based quality improvement activities including education and change of pain score documentation can improve the rate of analgesic prescription and time to prescription for patients with extremity injury in the ED.

Improvement of Hand Hygiene Quality and Compliance Using Bioburden Measurement and Online Feedback in Germany.

Science.gov (United States)

Günther, Frank; Rudolph, Kai; Frank, Uwe; Mutters, Nico T

2017-01-01

To improve compliance with hand hygiene, a novel method with inclusion of an online reporting system was developed, comprising measurement of total hand bioburden, anonymous online feedback, and onsite training. The intervention significantly improved both compliance and quality of hand hygiene and reduced Staphylococcus aureus incidence. Infect Control Hosp Epidemiol 2016;1-4.

42 CFR 441.474 - Quality assurance and improvement plan.

Science.gov (United States)

2010-10-01

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

Development of total quality management technology for the establishment of better-quality R and D system

International Nuclear Information System (INIS)

Lee, Young Keun; Lim, Kap Soon; Chang, Ho Il; Kim, Sung Ki; Kim, Jong Suk; Nam, Ji Hee; Kwon, Hyuk Il; Lim, Nam Jin; Cho, Moon Sung; Choi, Se Jin

1996-01-01

The existing total quality management technology(TGMT) has been surveyed to establish R and D quality system by upgrading such TGMT and deploying the concept of quality management. However, there has been a variety of differences on the quality management environments between R and D institutes in advanced countries and KAERI. So the case studies of quality management in advanced countries and those in domestic corporations have been analyzed. Finally, based on this analysis, the questionnaire for all KAERI staff-members has been drawn up for applying TQM to KAERI. 4 tabs., 13 figs., 21 refs. (Author)

Methodology of quality improvement projects for the Texas Medicare population.

Science.gov (United States)

Pendergrass, P W; Abel, R L; Bing, M; Vaughn, R; McCauley, C

1998-07-01

The Texas Medical Foundation, the quality improvement organization for the state of Texas, develops local quality improvement projects for the Medicare population. These projects are developed as part of the Health Care Quality Improvement Program undertaken by the Health Care Financing Administration. The goal of a local quality improvement project is to collaborate with providers to identify and reduce the incidence of unintentional variations in the delivery of care that negatively impact outcomes. Two factors are critical to the success of a quality improvement project. First, as opposed to peer review that is based on implicit criteria, quality improvement must be based on explicit criteria. These criteria represent key steps in the delivery of care that have been shown to improve outcomes for a specific disease. Second, quality improvement must be performed in partnership with the health care community. As such, the health care community must play an integral role in the design and evaluation of a quality improvement project and in the design and implementation of the resulting quality improvement plan. Specifically, this article provides a historical perspective for the transition from peer review to quality improvement. It discusses key steps used in developing and implementing local quality improvement projects including topic selection, quality indicator development, collaborator recruitment, and measurement of performance/improvement. Two Texas Medical Foundation projects are described to highlight the current methodology and to illustrate the impact of quality improvement projects.

PENERAPAN TOTAL QUALITY MANAGEMENT PADA PROGRAM STUDI MPI FAKULTAS TARBIYAH DAN KEGURUAN UIN ALAUDDIN

OpenAIRE

Syahid Syahid

2017-01-01

The purpose of this paper is to describe (1) the concept of total quality mana-gement, (2) the theoretical foundation of total quality management, and (3) the application of total quality management in Education management study program at the Faculty of Education and Teaching Science, UIN Alauddin Ma-kassar. There are some theoretical bases to support the implementation of TQM in educational institutions. One is the theory of Deming which can be identified from (a) Deming’s chain reaction mo...

IN QUEST OF TOTAL QUALITY MANAGEMENT PRINCIPLES IN ARCHITECTURAL DESIGN SERVICES: EVIDENCE FROM TURKEY

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Umut Durmus

2010-12-01

Full Text Available Proposal: Architectural design companies increasingly recognize that time spent on management is not at the expense of their production and there are always better ways to organize business. Although architects have long placed a traditional emphasis on quality, quality management is still a new concept for the majority of architectural design companies, which have to organize relatively more complicated operations nowadays to meet their clients’ expectations. This study aims to understand how architectural design companies define quality and explores the extent to which Total Quality Management (TQM principles like continual improvement, employee involvement, customer satisfaction and others can be pertinent in these companies. Adopting a qualitative research strategy, the authors interviewed with the owner-managers of 10 widely-recognized architectural design companies of different size in Istanbul. The results from the content analysis of semi-structured interview data suggest that i TQM principles cannot be directly applied in architectural design companies without an appropriate translation; ii special characteristics of design services are important to explain quality-related perceptions of owner-managers; iii the owner-managers feel the pressure from the changing internal and external environmental conditions, however few of them adopt a systematic and documented approach to quality management. Architectural design offices which aim to establish a quality management system can benefit from this study to understand potential problem areas on their road.

Water Quality Improvement through Reductions of Pollutant Loads on Small Scale of Bioretention System

Science.gov (United States)

Elyza Muha, Norshafa; Mohd Sidek, Lariyah; Jajarmizadeh, Milad

2016-03-01

Bioretention system is introduced as an important topic namely Urban Storm Water Management Manual for Malaysia (MSMA) by the Department of Irrigation and Drainage Malaysia (DID) in May 2012. The main objective of this paper is to evaluate the performance of water quality for small scale bioretention system under tropical climate via MUSIC model. Two bioretention systems 1 and 2 are observed based on the difference media depth. The result of bioretention system is compared with a reference model which has infrastructure with Urban Stormwater Improvement Conceptualisation (MUSIC) for pollutants load reduction and water quality results. Assessment of results via MUSIC software indicates a significant percentage of reduction for Total Suspended Solid (TSS), Total Phosphorus (TP) and Total Nitrogen (TN). The prediction of pollutant reduction via using MUSIC has the harmony for requirement in MSMA. TSS pollutant reduction is more than 80%, while for TP and TN more than 50%. The outcome of this study can be helpful for improvement of the existing MSMA guidelines for application of bioretention systems in Malaysia.

Diet Quality Associated with Total Sodium Intake among US Adults Aged ≥18 Years—National Health and Nutrition Examination Survey, 2009–2012

Directory of Open Access Journals (Sweden)

Carla I. Mercado

2017-10-01

Full Text Available Diet quality or macronutrient composition of total daily sodium intake (dNa <2300 mg/day in the United States (US is unknown. Using data from 2011–2014 NHANES (National Health and Nutrition Examination Survey, we examined 24-h dietary recalls (n = 10,142 from adults aged ≥18 years and investigated how diet composition and quality are associated with dNa. Diet quality was assessed using components of macronutrients and Healthy Eating Index 2010 (HEI-2010. Associations were tested using linear regression analysis adjusted for total energy (kcal, age, gender, and race/ethnicity. One-day dNa in the lower quartiles were more likely reported among women, older adults (≥65 years old, and lower quartiles of total energy (kcal (p-values ≤ 0.001. With increasing dNa, there was an increase in the mean protein, fiber, and total fat densities, while total carbohydrates densities decreased. As dNa increased, meat protein, refined grains, dairy, and total vegetables, greens and beans densities increased; while total fruit and whole fruit densities decreased. Modified HEI-2010 total score (total score without sodium component increased as dNa increased (adjusted coefficient: 0.11, 95% confidence interval = 0.07, 0.15. Although diet quality, based on modified HEI-2010 total score, increased on days with greater dNa, there is much room for improvement with mean diet quality of about half of the optimal level.

Effectiveness of a quality improvement curriculum for medical students

Directory of Open Access Journals (Sweden)

Kimberly M. Tartaglia

2015-05-01

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

Can Quality Improvement System Improve Childcare Site Performance in School Readiness?

Science.gov (United States)

Ma, Xin; Shen, Jianping; Lu, Xuejin; Brandi, Karen; Goodman, Jeff; Watson, Grace

2013-01-01

The authors evaluated the effectiveness of the Quality Improvement System (QIS) developed and implemented by Children's Services Council of Palm Beach County (Florida) as a voluntary initiative to improve the quality of childcare and education. They adopted a growth model approach to investigate whether childcare sites that participated in QIS…

Improving Indoor Air Quality

Science.gov (United States)

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

Improving PSA quality of KSNP PSA model

International Nuclear Information System (INIS)

Yang, Joon Eon; Ha, Jae Joo

2004-01-01

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

Modalities of hemodialysis: Quality improvement

Directory of Open Access Journals (Sweden)

Ayman Karkar

2012-01-01

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

The yellow brick road: total quality management and the restructuring of organizational culture

OpenAIRE

Tuckman, A

1994-01-01

The paper offers a critique of Total Quality Management . It is essentially in three parts: the first examines the rise of TQM through the western experience of Japanese development, second it examine the nature of TQM's promised cultural change and, finally questioning the very notion of 'quality'. It explores this development as - taking a metaphor from the work of Philip Crosby one of the 'guru's of Total Quality - a journey down the yellow brick road. The development of TQM being rich in ...

Preliminary probe of quality indicators and quality specification in total testing process in 5753 laboratories in China.

Science.gov (United States)

Fei, Yang; Kang, Fengfeng; Wang, Wei; Zhao, Haijian; He, Falin; Zhong, Kun; Wang, Zhiguo; Chen, Wenxiang

2016-08-01

The aim of the study was to promote the establishment and implementation of quality indicators (QIs) in clinical laboratories, catch up with the state of art, and provide preliminary quality specifications for established QIs. Clinical laboratories from different provinces in China were included in this QIs survey in 2015. All participants were asked to collect data related to QIs and complete QIs questionnaires. Defect percentages and sigma values were calculated for each QI. The 25th percentile, median, and the 75th percentile of defect percentages and TATs were calculated as optimum, desirable and minimum quality specifications. While 25th, median, and 75th of sigma values were calculated as minimum, desirable and optimum quality specifications, respectively. Five thousand seven hundred and fifty-three clinical laboratories from 28 provinces in China participated in this survey. Median defect percentages of pre-examination QIs varied largely from 0.01% (incorrect sample container) to 0.57% (blood culture contamination) with sigma values varied from 4.0σ to 5.1σ. Median defect percentages of examination phase QIs were all really high. The most common problem in examination phase was test uncovered by inter-laboratory comparison (86.67%). Defect percentages of critical values notification and timely critical values notification were all 0.00% (6.0σ). While the median of defect percentages of incorrect laboratory reports was only 0.01% (5.4σ). Improvements are needed in all phases of total testing process (TTP) in laboratories in China, especially in examination phase. More attention should be paid when microbiology specimens are collected and results are reported. Quality specifications can provide directions for laboratories to make effort for.

45 CFR 1304.60 - Deficiencies and quality improvement plans.

Science.gov (United States)

2010-10-01

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

Improving patient safety through quality assurance.

Science.gov (United States)

Raab, Stephen S

2006-05-01

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

Evaluation of fruit quality, bioactive compounds and total antioxidant activity of flat peach cultivars.

Science.gov (United States)

Di Vaio, Claudio; Marallo, Nadia; Graziani, Giulia; Ritieni, Alberto; Di Matteo, Antonio

2015-08-15

Fruit quality traits (fresh weight, dry weight, soluble solids content, titratable acidity and firmness) as well as the content of bioactive compounds (phenolic compounds) and total antioxidant activity were evaluated in four commercial cultivars of peach (Greta, Ufo 4, Rome Star and Ufo 6) and four of nectarine (Neve, Planet 1, Maria Carla and Mesembrina) differing in fruit shape (standard or flat) and flesh colour (white or yellow), important cultivars of the Italian and foreign market. The higher fruit organoleptic quality and nutritional profile of flat peach and nectarine cultivars make them candidates for exploiting new market opportunities and the chance to improve profits of farmers. The results showed that assayed quality parameters differed greatly among cultivars. In particular, flesh color and fruit shape accounted for most of the variation in traits underlying organoleptic and nutritional quality. Overall data suggested that the flat white-fleshed nectarine Planet 1, the yellow-fleshed nectarine Mesembrina and the yellow-fleshed peach Ufo 6, because of their profiles in terms of soluble solids content, titratable acidity and bioactive compounds, have the greatest potential to meet current consumer requirements. © 2014 Society of Chemical Industry.

A randomized controlled trial of an educational video to improve quality of bowel preparation for colonoscopy.

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Park, Jin-Seok; Kim, Min Su; Kim, HyungKil; Kim, Shin Il; Shin, Chun Ho; Lee, Hyun Jung; Lee, Won Seop; Moon, Soyoung

2016-06-17

High-quality bowel preparation is necessary for colonoscopy. A few studies have been conducted to investigate improvement in bowel preparation quality through patient education. However, the effect of patient education on bowel preparation has not been well studied. A randomized and prospective study was conducted. All patients received regular instruction for bowel preparation during a pre-colonoscopy visit. Those scheduled for colonoscopy were randomly assigned to view an educational video instruction (video group) on the day before the colonoscopy, or to a non-video (control) group. Qualities of bowel preparation using the Ottawa Bowel Preparation Quality scale (Ottawa score) were compared between the video and non-video groups. In addition, factors associated with poor bowel preparation were investigated. A total of 502 patients were randomized, 250 to the video group and 252 to the non-video group. The video group exhibited better bowel preparation (mean Ottawa total score: 3.03 ± 1.9) than the non-video group (4.21 ± 1.9; P educational video could improve the quality of bowel preparation in comparison with standard preparation method. Clinical Research Information Service KCT0001836 . The date of registration: March, 08(th), 2016, Retrospectively registered.

Harmonization activities of Noklus - a quality improvement organization for point-of-care laboratory examinations.

Science.gov (United States)

Stavelin, Anne; Sandberg, Sverre

2018-05-16

Noklus is a non-profit quality improvement organization that focuses to improve all elements in the total testing process. The aim is to ensure that all medical laboratory examinations are ordered, performed and interpreted correctly and in accordance with the patients' needs for investigation, treatment and follow-up. For 25 years, Noklus has focused on point-of-care (POC) testing in primary healthcare laboratories and has more than 3100 voluntary participants. The Noklus quality system uses different tools to obtain harmonization and improvement: (1) external quality assessment for the pre-examination, examination and postexamination phase to monitor the harmonization process and to identify areas that need improvement and harmonization, (2) manufacturer-independent evaluations of the analytical quality and user-friendliness of POC instruments and (3) close interactions and follow-up of the participants through site visits, courses, training and guidance. Noklus also recommends which tests that should be performed in the different facilities like general practitioner offices, nursing homes, home care, etc. About 400 courses with more than 6000 delegates are organized annually. In 2017, more than 21,000 e-learning programs were completed.

Analysis of Management Practices in Lagos State Tertiary Institutions through Total Quality Management Structural Framework

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AbdulAzeez, Abbas Tunde

2016-01-01

This research investigated total quality management practices and quality teacher education in public tertiary institutions in Lagos State. The study was therefore designed to analyse management practices in Lagos state tertiary institutions through total quality management structural framework. The selected public tertiary institutions in Lagos…

The Mediating Effect of Kaizen between Total Quality Management (TQM) and Business Performance

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Shan, Ang Wei; Fauzi Ahmad, Mohd; Hisyamudin Muhd Nor, Nik

2016-11-01

Every customer preference is different but yet important. The global market is shifting rapidly, organizations are needed to continuously identify new opportunity to obtain competitive advantages. Literature suggested that manufacturing companies are needed to differentiate themselves through emphasize on quality and continuous improvement in product and services as a crucial part to secure and success in the future. The Total Quality Management (TQM) practices has developed a strong bearing on growth and competitiveness in market. Therefore, a proper continuous improvement (Kaizen) practice is needed to eliminate waste and value added in production to remain competitiveness and retained the potential customer. However, based on the previous study it had indicated an inconsistent result between TQM and BP. Besides that, researcher also less emphasized on mediator in previous work. Therefore, the purpose of this paper is to recommend the relationship between TQM and business performance with a mediator's effect of Kaizen. This proposed model attempt to create knowledge to both academician and company players to acquire a better understanding among the TQM and Kaizen practices. Consequently, the Structural Equation Modelling (SEM) techniques is applying to identify and evaluate the relationship among TQM, Kaizen, and business performance in developing a new TQM model.

Association between intake of total vs added sugar on diet quality: a systematic review.

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Louie, Jimmy Chun Yu; Tapsell, Linda C

2015-12-01

Given its potential effect on nutrient and energy density, the sugar content of the diet is a subject of controversy. The aim of this review was to examine the cross-sectional or prospective evidence for associations between the intake of total sugar or added sugar (high vs low intakes) and diet quality or nutrient intakes in the general population. The following databases were searched for English-language articles published between 1972 and 2012: CINAHL Plus, EBM Reviews, ERIC, MEDLINE, PREMEDLINE, PsycINFO, PubMed, and ScienceDirect. The search identified studies that examined the association between intake of total sugar and/or added sugar and diet quality (n = 22) or nutrient intakes (n = 30). The following data were extracted: sample size and population, dietary assessment method, source of added sugar data, source of funding, comparator, association between total sugar or added sugar and diet quality, and the direction and magnitude of the association. Of 22 studies, all except 1 found a higher intake of added sugar to be associated with poorer diet quality, and the exceptional study did not adjust for total energy intake. Twenty-one of 30 studies found a negative association between added sugar and micronutrient intakes. The same association was not found for total sugar intake. Any negative association between dietary sugar and diet quality is better exposed by referring to added sugar rather than total sugar. There was substantial variation in features of study quality, including sample size, so the magnitude of the observed effect was generally small and may not be of clinical significance. Furthermore, the positive influence that core foods such as fruit and milk exert on total sugar values may bias the association between total sugar and diet quality. © The Author(s) 2015. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

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

Science.gov (United States)

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

2012-11-01

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

An Analysis of the State of Total Quality In Academia

Science.gov (United States)

1991-12-01

sense, quality is anything that can be improved." [Imai, 1986] 3. Joseph M. Juran "Quality is fitness for use." [Juran, 19891 4. Kaoru Ishikawa ...121 v L m 1111 X. INTRODUCTION "Quality Control begins with education and ends with education" Karou Ishikawa [ Ishikawa , 1985...revolution, the magnitude of which has been compared to that of the industrial revolution. [ Ishikawa , 1985, Deming, 1982] Dramatic changes are

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.

The eighth NASA total quality management accomplishments report, 1990

Science.gov (United States)

1990-01-01

The eighth annual accomplishments report provides numerous examples of quality strategies that have proven effective and efficient in a time when cost reduction is critical. NASA's continuous improvement efforts can provide insight for others to succeed in their own endeavors. The report covers: top management leadership and support, strategic planning, focus on the customer, employee training and recognition, employee empowerment and teamwork, measurement and analysis, and quality assurance.

Influences of continuous femoral nerve block on knee function and quality of life in patients following total knee arthroplasty.

Science.gov (United States)

Wang, Fen; Zhou, Yingjie; Sun, Jiajun; Yang, Chunxi

2015-01-01

Continuous femoral nerve block (CFNB), guided by ultrasound combined nerve stimulations, offers advantages for both sides and provides effective postoperative analgesia after total knee arthroplasty (TKA). The objective of this study was to evaluate the medium-term impact of continuous femoral nerve block on knee function and quality of life in patients following TKA. This was a follow-up study. Total 168 adult patients scheduled for elective TKA were randomly allocated to receive postoperative continuous femoral nerve block guided by ultrasound combined nerve stimulator (group CFNB, n = 82) or patient-controlled epidural analgesia (group PCEA, n = 86). Quality of life, knee function, patient satisfaction, pain medication and associated adverse effects were compared at 1, 3, 6, and 12 months postoperatively. Quality of life was assessed using the Medical Outcomes Study Short Form-36 Health Survey (MOS SF-36), and clinical results were assessed using the Hospital for Special Surgery (HSS) Knee Scoring System. Patient satisfaction scores were divided into four categories. A total of 162 patients completed the 12-month follow-up. The CFNB group patients had significantly improved SF-36 scores and physical function at 1 month postoperatively (P quality of life in patients at one month postoperatively. Continuous femoral nerve block is a good choice for postoperative analgesia after TKA.

Electronic health records improve clinical note quality.

Science.gov (United States)

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

2015-01-01

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

The Perioperative Surgical Home: Improving the Value and Quality of Care in Total Joint Replacement.

Science.gov (United States)

Chimento, George F; Thomas, Leslie C

2017-09-01

The perioperative surgical home (PSH) is a patient-centered, physician-led, multidisciplinary care pathway developed to deliver value-based care based on shared decision-making. Physician and hospital reimbursement will be tied to providing quality care at lower cost, and the PSH model has been used in providing care to patients undergoing lower extremity arthroplasty. The purpose of this review is to discuss the rationale, definition, development, current state, and future direction of the PSH. The PSH model guides the patient throughout the pre and perioperative process and into the postoperative phase. It has been shown in multiple studies to decrease length of stay, improve functional outcomes, allow more home discharges, and lower costs. There is no increase in complications or readmission rates. The PSH pathway is a safe and effective method of providing value-based care to patients undergoing hip and knee arthroplasty.

Orally administered Chrysin improves post-thawed sperm quality and fertility of rooster.

Science.gov (United States)

Zhandi, M; Ansari, M; Roknabadi, P; Zare Shahneh, A; Sharafi, M

2017-12-01

Chrysin is a bioflavonoid compound found in passion flower, chamomile, propolis and honey at high levels. Post-thawed sperm quality and fertility of Chrysin-fed roosters were assessed in this study. Twenty 40-week-old male broiler breeders were randomly divided into four groups and fed basal diet supplemented with different levels of Chrysin including 0 (Ch-0), 25 (Ch-25), 50 (Ch-50) or 75 (Ch-75) mg/day for 12 consecutive weeks. Semen samples were weekly collected from 6th to 9th week of experiment to evaluate some sperm quality parameters including total and progressive motility, plasma membrane integrity and functionality (in fresh and post-thawed samples) and mitochondrial activity (only in post-thawed samples). Also, collected semen samples from 10th, 11th and 12th week of experiment were frozen and then artificially inseminated to test fertility rate. According to the results, an improvement in both fresh and post-thawed sperm quality including total [fresh: 88.00 ± 0.58 and 87.25 ± 0.67 (p roosters could ameliorate cryopreservation-induced impairment of sperm quality and fertility rate. © 2017 Blackwell Verlag GmbH.

How Quality Improvement Practice Evidence Can Advance the Knowledge Base.

Science.gov (United States)

OʼRourke, Hannah M; Fraser, Kimberly D

2016-01-01

Recommendations for the evaluation of quality improvement interventions have been made in order to improve the evidence base of whether, to what extent, and why quality improvement interventions affect chosen outcomes. The purpose of this article is to articulate why these recommendations are appropriate to improve the rigor of quality improvement intervention evaluation as a research endeavor, but inappropriate for the purposes of everyday quality improvement practice. To support our claim, we describe the differences between quality improvement interventions that occur for the purpose of practice as compared to research. We then carefully consider how feasibility, ethics, and the aims of evaluation each impact how quality improvement interventions that occur in practice, as opposed to research, can or should be evaluated. Recommendations that fit the evaluative goals of practice-based quality improvement interventions are needed to support fair appraisal of the distinct evidence they produce. We describe a current debate on the nature of evidence to assist in reenvisioning how quality improvement evidence generated from practice might complement that generated from research, and contribute in a value-added way to the knowledge base.

Continuous quality improvement in the ambulatory endoscopy center.

Science.gov (United States)

Johanson, John F

2002-04-01

What does quality assessment have to do with the practicing gastroenterologist? Why should one spend the time and effort to incorporate CQI activities into an already busy practice? First and foremost, quality improvement should directly benefit the patient by ensuring that they receive the highest quality of care possible. For example, comparing endoscopic use or outcomes, such as procedure success or complications, with national standards or other endoscopists in the same community may identify physicians who could benefit from additional training. Similar analyses may likewise identify outstanding physicians who might serve as resources for other physicians. Surveys of patient satisfaction may reveal deficiencies, which might be unknown to a physician who is otherwise technically excellent; deficiencies that would never have been uncovered by traditional measures of quality. Second, applying the techniques of CQI to study one's own practice can provide a competitive edge when vying for managed care or corporate contracts. In this regard, CQI can be used to document physician or practice performance through tracking of endoscopic use, procedure success and complication rates, and patient satisfaction. Finally, the rising concern among various patient advocacy groups has led to an increased emphasis on quality improvement, and in most cases it is a required activity as part of the accreditation process. Steps to quality improvement There is more to quality improvement than simply selecting and implementing a performance improvement plan. A number of steps have been suggested to achieve fundamental improvement in the quality of medical care [3]. The first is to use outcomes management for improvement rather than for judgment. One of the major criticisms of QA is that it will be used to judge physicians providing care. It is feared that CQI will be used to identify poor performers who will then be punished. This strategy leads to fear and inhibits an honest pursuit

Technological measures to improve automotive product quality

OpenAIRE

Gladkov, V.; Kruglov, S.

2010-01-01

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

Space Station Freedom - Configuration management approach to supporting concurrent engineering and total quality management. [for NASA Space Station Freedom Program

Science.gov (United States)

Gavert, Raymond B.

1990-01-01

Some experiences of NASA configuration management in providing concurrent engineering support to the Space Station Freedom program for the achievement of life cycle benefits and total quality are discussed. Three change decision experiences involving tracing requirements and automated information systems of the electrical power system are described. The potential benefits of concurrent engineering and total quality management include improved operational effectiveness, reduced logistics and support requirements, prevention of schedule slippages, and life cycle cost savings. It is shown how configuration management can influence the benefits attained through disciplined approaches and innovations that compel consideration of all the technical elements of engineering and quality factors that apply to the program development, transition to operations and in operations. Configuration management experiences involving the Space Station program's tiered management structure, the work package contractors, international partners, and the participating NASA centers are discussed.

Framing quality improvement tools and techniques in healthcare the case of improvement leaders' guides.

Science.gov (United States)

Millar, Ross

2013-01-01

The purpose of this paper is to present a study of how quality improvement tools and techniques are framed within healthcare settings. The paper employs an interpretive approach to understand how quality improvement tools and techniques are mobilised and legitimated. It does so using a case study of the NHS Modernisation Agency Improvement Leaders' Guides in England. Improvement Leaders' Guides were framed within a service improvement approach encouraging the use of quality improvement tools and techniques within healthcare settings. Their use formed part of enacting tools and techniques across different contexts. Whilst this enactment was believed to support the mobilisation of tools and techniques, the experience also illustrated the challenges in distributing such approaches. The paper provides an important contribution in furthering our understanding of framing the "social act" of quality improvement. Given the ongoing emphasis on quality improvement in health systems and the persistent challenges involved, it also provides important information for healthcare leaders globally in seeking to develop, implement or modify similar tools and distribute leadership within health and social care settings.

QUALITY IMPROVEMENT MODEL AT THE MANUFACTURING PROCESS PREPARATION LEVEL

Directory of Open Access Journals (Sweden)

Dusko Pavletic

2009-12-01

Full Text Available The paper expresses base for an operational quality improvement model at the manufacturing process preparation level. A numerous appropriate related quality assurance and improvement methods and tools are identified. Main manufacturing process principles are investigated in order to scrutinize one general model of manufacturing process and to define a manufacturing process preparation level. Development and introduction of the operational quality improvement model is based on a research conducted and results of methods and tools application possibilities in real manufacturing processes shipbuilding and automotive industry. Basic model structure is described and presented by appropriate general algorithm. Operational quality improvement model developed lays down main guidelines for practical and systematic application of quality improvements methods and tools.

Bringing quality improvement into the intensive care unit.

Science.gov (United States)

McMillan, Tracy R; Hyzy, Robert C

2007-02-01

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

Integrating empowerment evaluation and quality improvement to achieve healthcare improvement outcomes

Science.gov (United States)

Wandersman, Abraham; Alia, Kassandra Ann; Cook, Brittany; Ramaswamy, Rohit

2015-01-01

While the body of evidence-based healthcare interventions grows, the ability of health systems to deliver these interventions effectively and efficiently lags behind. Quality improvement approaches, such as the model for improvement, have demonstrated some success in healthcare but their impact has been lessened by implementation challenges. To help address these challenges, we describe the empowerment evaluation approach that has been developed by programme evaluators and a method for its application (Getting To Outcomes (GTO)). We then describe how GTO can be used to implement healthcare interventions. An illustrative healthcare quality improvement example that compares the model for improvement and the GTO method for reducing hospital admissions through improved diabetes care is described. We conclude with suggestions for integrating GTO and the model for improvement. PMID:26178332

Transforming Education through Total Quality Management: A Practitioner's Guide.

Science.gov (United States)

Schargel, Franklin P.

This book illustrates how one school, George Westinghouse Vocational and Technical High School (Brooklyn, New York), has been applying the techniques of total quality management (TQM) to achieve educational change. Following the foreword and introduction, chapter 1 describes TQM, Deming's 14 points, and the challenges of applying TQM to education.…

TQ What?: Applying Total Quality Management to Child Care.

Science.gov (United States)

Hewes, Dorothy

1994-01-01

Discusses the concept of Total Quality Management (TQM), developed by W. Edward Deming and Joseph Juran in 1940s, and its applications for child care centers. Discusses how TQM focuses on customer satisfaction, measuring performance, benchmarking, employee empowerment, and continuous training. Includes a list of suggested readings on TQM. (MDM)

The ReACH Collaborative--improving quality home care.

Science.gov (United States)

Boyce, Patricia Simino; Pace, Karen B; Lauder, Bonnie; Solomon, Debra A

2007-08-01

Research on quality of care has shown that vigorous leadership, clear goals, and compatible incentive systems are critical factors in influencing successful change (Institute of Medicine, 2001). Quality improvement is a complex process, and clinical quality improvement applications are more likely to be effective in organizations that are ready for change and have strong leaders, who are committed to creating and reinforcing a work environment that supports quality goals (Shortell, 1998). Key leadership roles include providing clear and sustained direction, articulating a coherent set of values and incentives to guide group and individual activities, aligning and integrating improvement efforts into organizational priorities, obtaining or freeing up resources to implement improvement activities, and creating a culture of "continuous improvement" that encourages and rewards the pursuit and achievement of shared quality aims (Institute of Medicine, 2001, 70-71). In summary, home health care is a significant and growing sector of the health care system that provides care to millions of vulnerable patients. There seems little doubt that home health agencies want to focus on quality of care issues and provide optimal care to home-based patients. Furthermore, there is a growing awareness of the value for adapting innovative, effective models for improving the culture of home care practice. This awareness stems from the notion that some agencies see quality improvement activities as a way for them to distinguish themselves not only to regulators and customers, but also to meet the cultural and transformational needs to remain viable in a constantly evolving and competitive health care industry.

Total parathyroidectomy with forearm auto-transplantation improves the quality of life and reduces the recurrence of secondary hyperparathyroidism in chronic kidney disease patients.

Science.gov (United States)

Li, Jia-Gen; Xiao, Zhang-Sheng; Hu, Xian-Jie; Li, Yun; Zhang, Xing; Zhang, Song-Ze; Shan, Ai-Qin

2017-12-01

type were the risk factors for the recurrence of chronic kidney disease with SHPT. Total PTX combined with FAT is more effective in improving the quality of life and reducing the recurrence of chronic kidney disease with SHPT than PTX alone.

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

Science.gov (United States)

Godény, Sándor

2012-02-05

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

A Simulation-Based Quality Improvement Initiative Improves Pediatric Readiness in Community Hospitals.

Science.gov (United States)

Whitfill, Travis; Gawel, Marcie; Auerbach, Marc

2017-07-17

The National Pediatric Readiness Project Pediatric Readiness Survey (PRS) measured pediatric readiness in 4149 US emergency departments (EDs) and noted an average score of 69 on a 100-point scale. This readiness score consists of 6 domains: coordination of pediatric patient care (19/100), physician/nurse staffing and training (10/100), quality improvement activities (7/100), patient safety initiatives (14/100), policies and procedures (17/100), and availability of pediatric equipment (33/100). We aimed to assess and improve pediatric emergency readiness scores across Connecticut's hospitals. The aim of this study was to compare the National Pediatric Readiness Project readiness score before and after an in situ simulation-based assessment and quality improvement program in Connecticut hospitals. We leveraged in situ simulations to measure the quality of resuscitative care provided by interprofessional teams to 3 simulated patients (infant septic shock, infant seizure, and child cardiac arrest) presenting to their ED resuscitation bay. Assessments of EDs were made based on a composite quality score that was measured as the sum of 4 distinct domains: (1) adherence to sepsis guidelines, (2) adherence to cardiac arrest guidelines, (3) performance on seizure resuscitation, and (4) teamwork. After the simulation, a detailed report with scores, comparisons to other EDs, and a gap analysis were provided to sites. Based on this report, a regional children's hospital team worked collaboratively with each ED to develop action items and a timeline for improvements. The National Pediatric Readiness Project PRS scores, the primary outcome of this study, were measured before and after participation. Twelve community EDs in Connecticut participated in this project. The PRS scores were assessed before and after the intervention (simulation-based assessment and gap analysis/report-out). The average time between PRS assessments was 21 months. The PRS scores significantly improved 12

The Michigan Spine Surgery Improvement Collaborative: a statewide Collaborative Quality Initiative.

Science.gov (United States)

Chang, Victor; Schwalb, Jason M; Nerenz, David R; Pietrantoni, Lisa; Jones, Sharon; Jankowski, Michelle; Oja-Tebbe, Nancy; Bartol, Stephen; Abdulhak, Muwaffak

2015-12-01

OBJECT Given the scrutiny of spine surgery by policy makers, spine surgeons are motivated to demonstrate and improve outcomes, by determining which patients will and will not benefit from surgery, and to reduce costs, often by reducing complications. Insurers are similarly motivated. In 2013, Blue Cross Blue Shield of Michigan (BCBSM) and Blue Care Network (BCN) established the Michigan Spine Surgery Improvement Collaborative (MSSIC) as a Collaborative Quality Initiative (CQI). MSSIC is one of the newest of 21 other CQIs that have significantly improved-and continue to improve-the quality of patient care throughout the state of Michigan. METHODS MSSIC focuses on lumbar and cervical spine surgery, specifically indications such as stenosis, disk herniation, and degenerative disease. Surgery for tumors, traumatic fractures, deformity, scoliosis, and acute spinal cord injury are currently not within the scope of MSSIC. Starting in 2014, MSSIC consisted of 7 hospitals and in 2015 included another 15 hospitals, for a total of 22 hospitals statewide. A standardized data set is obtained by data abstractors, who are funded by BCBSM/BCN. Variables of interest include indications for surgery, baseline patient-reported outcome measures, and medical history. These are obtained within 30 days of surgery. Outcome instruments used include the EQ-5D general health state score (0 being worst and 100 being the best health one can imagine) and EQ-5D-3 L. For patients undergoing lumbar surgery, a 0 to 10 numeric rating scale for leg and back pain and the Oswestry Disability Index for back pain are collected. For patients undergoing cervical surgery, a 0 to 10 numeric rating scale for arm and neck pain, Neck Disability Index, and the modified Japanese Orthopaedic Association score are collected. Surgical details, postoperative hospital course, and patient-reported outcome measures are collected at 90-day, 1-year, and 2-year intervals. RESULTS As of July 1, 2015, a total of 6397 cases

The application of total quality management principles to spacecraft mission operations

Science.gov (United States)

Sweetin, Maury

1993-03-01

By now, the philosophies of Total Quality Management have had an impact on every aspect of American industrial life. The trail-blazing work of Deming, Juran, and Crosby, first implemented in Japan, has 're-migrated' across the Pacific and now plays a growing role in America's management culture. While initially considered suited only for a manufacturing environment, TQM has moved rapidly into the 'service' areas of offices, sales forces, and even fast-food restaurants. The next logical step has also been taken - TQM has found its way into virtually all departments of the Federal Government, including NASA. Because of this widespread success, it seems fair to ask whether this new discipline is directly applicable to the profession of spacecraft operations. The results of quality emphasis on OAO Corporation's contract at JPL provide strong support for Total Quality Management as a useful tool in spacecraft operations.

The application of total quality management principles to spacecraft mission operations

Science.gov (United States)

Sweetin, Maury

1993-01-01

By now, the philosophies of Total Quality Management have had an impact on every aspect of American industrial life. The trail-blazing work of Deming, Juran, and Crosby, first implemented in Japan, has 're-migrated' across the Pacific and now plays a growing role in America's management culture. While initially considered suited only for a manufacturing environment, TQM has moved rapidly into the 'service' areas of offices, sales forces, and even fast-food restaurants. The next logical step has also been taken - TQM has found its way into virtually all departments of the Federal Government, including NASA. Because of this widespread success, it seems fair to ask whether this new discipline is directly applicable to the profession of spacecraft operations. The results of quality emphasis on OAO Corporation's contract at JPL provide strong support for Total Quality Management as a useful tool in spacecraft operations.

Quality Rating and Improvement System State Evaluations and Research

Science.gov (United States)

Ferguson, Daniel

2016-01-01

A quality rating and improvement system (QRIS) is a method used by states and local jurisdictions to assess the level of quality of child care and early education programs, improve quality, and convey quality ratings to parents and other consumers. A typical QRIS incorporates the following components: quality standards for participating providers;…

Total Quality Management: A Unique Challenge For Behavioral Science Researchers,

Science.gov (United States)

Quality Management (TQM) programs in industry and government. The essence of TQM involves respect for personal choice and the participation of every level of workers in decisions which impact the organization. Typically, structured questionnaires developed by behavioral scientists are designed to be easy to summarize and generally lack any mechanism for personal comments, ideas, and suggestions. New open-ended, interactive, and iterative survey methodologies are needed to enhance creativity, encourage feedback, and foster a sense of participation. Total Quality

Head CT: Image quality improvement of posterior fossa and radiation dose reduction with ASiR - comparative studies of CT head examinations.

Science.gov (United States)

Guziński, Maciej; Waszczuk, Łukasz; Sąsiadek, Marek J

2016-10-01

To evaluate head CT protocol developed to improve visibility of the brainstem and cerebellum, lower bone-related artefacts in the posterior fossa and maintain patient radioprotection. A paired comparison of head CT performed without Adaptive Statistical Iterative Reconstruction (ASiR) and a clinically indicated follow-up with 40 % ASiR was acquired in one group of 55 patients. Patients were scanned in the axial mode with different scanner settings for the brain and the posterior fossa. Objective image quality analysis was performed with signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). Subjective image quality analysis was based on brain structure visibility and evaluation of the artefacts. We achieved 19 % reduction of total DLP and significantly better image quality of posterior fossa structures. SNR for white and grey matter in the cerebellum were 34 % to 36 % higher, respectively, CNR was improved by 142 % and subjective analyses were better for images with ASiR. When imaging parameters are set independently for the brain and the posterior fossa imaging, ASiR has a great potential to improve CT performance: image quality of the brainstem and cerebellum is improved, and radiation dose for the brain as well as total radiation dose are reduced. •With ASiR it is possible to lower radiation dose or improve image quality •Sequentional imaging allows setting scan parameters for brain and posterior-fossa independently •We improved visibility of brainstem structures and decreased radiation dose •Total radiation dose (DLP) was decreased by 19.

Nationwide quality improvement in lung cancer care

DEFF Research Database (Denmark)

Jakobsen, Erik Winther; Green, Anders; Oesterlind, Kell

2013-01-01

To improve prognosis and quality of lung cancer care the Danish Lung Cancer Group has developed a strategy consisting of national clinical guidelines and a clinical quality and research database. The first edition of our guidelines was published in 1998 and our national lung cancer registry...... was opened for registrations in 2000. This article describes methods and results obtained by multidisciplinary collaboration and illustrates how quality of lung cancer care can be improved by establishing and monitoring result and process indicators....

[Professional's expectations to improve quality of care and social services utilization in geriatric oncology].

Science.gov (United States)

Antoine, Valéry; de Wazières, Benoît; Houédé, Nadine

2015-02-01

Coordination of a multidisciplinary and multi-professional intervention is a key issue in the management of elderly cancer patients to improve health status and quality of life. Optimizing the links between professionals is needed to improve care planning, health and social services utilization. Descriptive study in a French University Hospital. A 6-item structured questionnaire was addressed to professionals involved in global and supportive cares of elderly cancer patients (name, location, effective health care and services offered, needs to improve the quality of their intervention). After the analysis of answers, definition of propositions to improve cares and services utilization. The 37 respondents identified a total of 166 needs to improve quality of care in geriatric oncology. Major expectations were concerning improvement of global/supportive cares and health care services utilization, a better coordination between geriatric teams and oncologists. Ten propositions, including a model of in-hospital health care planning, were defined to answer to professional's needs with the aim of optimizing cancer treatment and global cares. Identification of effective services and needs can represent a first step in a continuous program to improve quality of cares, according to the French national cancer plan 2014-2019. It allows federating professionals for a coordination effort, a better organization of the clinical activity in geriatric oncology, to optimize clinical practice and global cares. Copyright © 2014 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

Laboratory quality improvement in Thailand's northernmost provinces.

Science.gov (United States)

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

2010-01-01

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

Key interventions and quality indicators for quality improvement of STEMI care: a RAND Delphi survey.

Science.gov (United States)

Aeyels, Daan; Sinnaeve, Peter R; Claeys, Marc J; Gevaert, Sofie; Schoors, Danny; Sermeus, Walter; Panella, Massimiliano; Coeckelberghs, Ellen; Bruyneel, Luk; Vanhaecht, Kris

2017-12-13

Identification, selection and validation of key interventions and quality indicators for improvement of in hospital quality of care for ST-elevated myocardial infarction (STEMI) patients. A structured literature review was followed by a RAND Delphi Survey. A purposively selected multidisciplinary expert panel of cardiologists, nurse managers and quality managers selected and validated key interventions and quality indicators prior for quality improvement for STEMI. First, 34 experts (76% response rate) individually assessed the appropriateness of items to quality improvement on a nine point Likert scale. Twenty-seven key interventions, 16 quality indicators at patient level and 27 quality indicators at STEMI care programme level were selected. Eighteen additional items were suggested. Experts received personal feedback, benchmarking their score with group results (response rate, mean, median and content validity index). Consequently, 32 experts (71% response rate) openly discussed items with an item-content validity index above 75%. By consensus, the expert panel validated a final set of 25 key interventions, 13 quality indicators at patient level and 20 quality indicators at care programme level prior for improvement of in hospital care for STEMI. A structured literature review and multidisciplinary expertise was combined to validate a set of key interventions and quality indicators prior for improvement of care for STEMI. The results allow researchers and hospital staff to evaluate and support quality improvement interventions in a large cohort within the context of a health care system.

Quality Function Deployment Application for Improving Quality of Education in Business Schools

Science.gov (United States)

Sagnak, Muhittin; Ada, Nesrin; Kazancoglu, Yigit; Tayaksi, Cansu

2017-01-01