Science.gov

Sample records for improving operator quality

  1. Operative blood transfusion quality improvement audit

    PubMed Central

    Al Sohaibani, Mazen; Al Malki, Assaf; Pogaku, Venumadhav; Al Dossary, Saad; Al Bernawi, Hanan

    2014-01-01

    Context: To determine how current anesthesia team handless the identification of surgical anaesthetized patient (right patient). And the check of blood unit before collecting and immediately before blood administration (right blood) in operating rooms where nurses have minimal duties and responsibility to handle blood for transfusion in anaesthetized patients. Aims: To elicit the degree of anesthesia staff compliance with new policies and procedures for anaesthetized surgical patient the blood transfusion administration. Settings and Design: Setting: A large tertiary care reference and teaching hospital. Design: A prospective quality improvement. Elaboration on steps for administration of transfusion from policies and procedures to anaesthetized patients; and analysis of the audit forms for conducted transfusions. Subjects and Methods: An audit form was used to get key performance indicators (KPIs) observed in all procedures involve blood transfusion and was ticked as item was met, partially met, not met or not applicable. Statistical Analysis Used: Descriptive statistics as number and percentage Microsoft excel 2003. Central quality improvement committee presented the results in number percentage and graphs. Results: The degree of compliance in performing the phases of blood transfusion by anesthesia staff reached high percentage which let us feel certain that the quality is assured that the internal policy and procedures (IPP) are followed in the great majority of all types of red cells and other blood products transfusion from the start of requesting the blood or blood product to the prescript of checking the patient in the immediate post-transfusion period. Conclusions: Specific problem area of giving blood transfusion to anaesthetized patient was checking KPI concerning the phases of blood transfusion was audited and assured the investigators of high quality performance in procedures of transfusion. PMID:25886107

  2. Mission operations and command assurance: Flight operations quality improvements

    NASA Technical Reports Server (NTRS)

    Welz, Linda L.; Bruno, Kristin J.; Kazz, Sheri L.; Potts, Sherrill S.; Witkowski, Mona M.

    1994-01-01

    Mission Operations and Command Assurance (MO&CA) is a Total Quality Management (TQM) task on JPL projects to instill quality in flight mission operations. From a system engineering view, MO&CA facilitates communication and problem-solving among flight teams and provides continuous solving among flight teams and provides continuous process improvement to reduce risk in mission operations by addressing human factors. The MO&CA task has evolved from participating as a member of the spacecraft team, to an independent team reporting directly to flight project management and providing system level assurance. JPL flight projects have benefited significantly from MO&CA's effort to contain risk and prevent rather than rework errors. MO&CA's ability to provide direct transfer of knowledge allows new projects to benefit from previous and ongoing flight experience.

  3. (abstract) Mission Operations and Control Assurance: Flight Operations Quality Improvements

    NASA Technical Reports Server (NTRS)

    Welz, Linda L.; Bruno, Kristin J.; Kazz, Sheri L.; Witkowski, Mona M.

    1993-01-01

    Mission Operations and Command Assurance (MO&CA), a recent addition to flight operations teams at JPL. provides a system level function to instill quality in mission operations. MO&CA's primary goal at JPL is to help improve the operational reliability for projects during flight. MO&CA tasks include early detection and correction of process design and procedural deficiencies within projects. Early detection and correction are essential during development of operational procedures and training of operational teams. MO&CA's effort focuses directly on reducing the probability of radiating incorrect commands to a spacecraft. Over the last seven years at JPL, MO&CA has become a valuable asset to JPL flight projects. JPL flight projects have benefited significantly from MO&CA's efforts to contain risk and prevent rather than rework errors. MO&CA's ability to provide direct transfer of knowledge allows new projects to benefit directly from previous and ongoing experience. Since MO&CA, like Total Quality Management (TQM), focuses on continuous improvement of processes and elimination of rework, we recommend that this effort be continued on NASA flight projects.

  4. OPERATION OF WATER QUALITY DISTRIBUTION SYSTEMS TO IMPROVE WATER QUALITY

    EPA Science Inventory

    The quality of drinking water can change between the discharge from the treatment plant and the point of consumption. n order to study these changes in a systematic manner a Cooperative Agreement was initiated between EPA's Drinking Water Research Division and the North Penn Wate...

  5. OPERATION OF WATER DISTRIBUTION SYSTEMS TO IMPROVE WATER QUALITY

    EPA Science Inventory

    The quality of drinking water can change between the discharge from the treatment plant and the point of consumption. In order to study these changes in a systematic manner a Cooperative Agreement was initiated between EPA's Drinking Water Research Division and the North Penn Wat...

  6. NASA Symposium on Productivity and Quality: Strategies for Improving Operations in Government and Industry

    NASA Technical Reports Server (NTRS)

    1984-01-01

    The purpose of the Symposium is to increase the awareness of productivity and quality issues in the United States, and to foster national initiatives through government and industry executive leadership. The Symposium will provide a forum for discussion of white-collar productivity issues by experienced executives from successful organizations and an opportunity to share information learned through Productivity initiatives in govemment, industry and academic organizations. It will focus on white-collar organizational issues that are common to large companies and technology oriented organizations. The Symposium program will include strategies for improving operations in government and industry and will be responsive to the management issues viewed necessary to increase our nation's productivity growth rate.

  7. Introducing Change (Science into the Operating Room): Quality Improvement versus Experimentation

    PubMed Central

    Poullis, Mike

    2009-01-01

    Abstract: Introducing change is sometimes vital on an individual, departmental, and institutional level to improve the quality of care of patients undergoing cardiopulmonary bypass. This review discussed the following areas: cost of poor quality, variation, knowledge, Deming’s red bead experiments and his conclusions, how do you try to improve, measurement, statistics, and quality improvement verses research. Successes and failures with regard to the introduction of change, and strategies to introduce change without creating conflict are discussed with reference to the hospital in which the author works. PMID:20092081

  8. Quality and productivity drive innovation and improvement at United Technologies Aerospace Operations, Inc.

    NASA Technical Reports Server (NTRS)

    Jamar, L. G.

    1986-01-01

    Quality and innovation are the hallmarks of the national space program. In programs that preceded the Shuttle Program the emphasis was on meeting the risks and technical challenges of space with safety, quality, reliability, and success. At United Technologies Aerospace Operations, Inc. (UTAO), the battle has developed along four primary fronts. These fronts include programs to motivate and reward people, development and construction of optimized processes and facilities, implementation of specifically tailored management systems, and the application of appropriate measurement and control systems. Each of these initiatives is described. However, to put this quality and productivity program in perspective, UTAO and its role in the Shuttle Program are described first.

  9. FOCUS: the Society of Cardiovascular Anesthesiologists' initiative to improve quality and safety in the cardiovascular operating room.

    PubMed

    Barbeito, Atilio; Lau, William Travis; Weitzel, Nathaen; Abernathy, James H; Wahr, Joyce; Mark, Jonathan B

    2014-10-01

    The Society of Cardiovascular Anesthesiologists (SCA) introduced the FOCUS initiative (Flawless Operative Cardiovascular Unified Systems) in 2005 in response to the need for a rigorous scientific approach to improve quality and safety in the cardiovascular operating room (CVOR). The goal of the project, which is supported by the SCA Foundation, is to identify hazards and develop evidence-based protocols to improve cardiac surgery safety. A hazard is anything that has the potential to cause a preventable adverse event. Specifically, the strategic plan of FOCUS includes 3 goals: (1) identifying hazards in the CVOR, (2) prioritizing hazards and developing risk-reduction interventions, and (3) disseminating these interventions. Collectively, the FOCUS initiative, through the work of several groups composed of members from different disciplines such as clinical medicine, human factors engineering, industrial psychology, and organizational sociology, has identified and documented significant hazards occurring daily in our CVORs. Some examples of frequent occurrences that contribute to reduce the safety and quality of care provided to cardiac surgery patients include deficiencies in teamwork, poor OR design, incompatible technologies, and failure to adhere to best practices. Several projects are currently under way that are aimed at better understanding these hazards and developing interventions to mitigate them. The SCA, through the FOCUS initiative, has begun this journey of science-driven improvement in quality and safety. There is a long and arduous road ahead, but one we need to continue to travel. PMID:25232690

  10. Reducing the carbon footprint of the operating theatre: a multicentre quality improvement report.

    PubMed

    Southorn, T; Norrish, A R; Gardner, K; Baxandall, R

    2013-06-01

    Currently, there are very few provisions for recycling in theatres. We measured the weight of clinical waste for several orthopaedic operations. This waste was then examined and sorted into domestic waste and clinical waste. With staff education it is possible to reduce the amount of clinical waste generated by the operating theatre by roughly 50%. A greater awareness of disposal options leads to a reduction in waste disposed of by incineration. PMID:23909168

  11. Utilizing Operational and Improved Remote Sensing Measurements to Assess Air Quality Monitoring Model Forecasts

    NASA Astrophysics Data System (ADS)

    Gan, Chuen-Meei

    Air quality model forecasts from Weather Research and Forecast (WRF) and Community Multiscale Air Quality (CMAQ) are often used to support air quality applications such as regulatory issues and scientific inquiries on atmospheric science processes. In urban environments, these models become more complex due to the inherent complexity of the land surface coupling and the enhanced pollutants emissions. This makes it very difficult to diagnose the model, if the surface parameter forecasts such as PM2.5 (particulate matter with aerodynamic diameter less than 2.5 microm) are not accurate. For this reason, getting accurate boundary layer dynamic forecasts is as essential as quantifying realistic pollutants emissions. In this thesis, we explore the usefulness of vertical sounding measurements on assessing meteorological and air quality forecast models. In particular, we focus on assessing the WRF model (12km x 12km) coupled with the CMAQ model for the urban New York City (NYC) area using multiple vertical profiling and column integrated remote sensing measurements. This assessment is helpful in probing the root causes for WRF-CMAQ overestimates of surface PM2.5 occurring both predawn and post-sunset in the NYC area during the summer. In particular, we find that the significant underestimates in the WRF PBL height forecast is a key factor in explaining this anomaly. On the other hand, the model predictions of the PBL height during daytime when convective heating dominates were found to be highly correlated to lidar derived PBL height with minimal bias. Additional topics covered in this thesis include mathematical method using direct Mie scattering approach to convert aerosol microphysical properties from CMAQ into optical parameters making direct comparisons with lidar and multispectral radiometers feasible. Finally, we explore some tentative ideas on combining visible (VIS) and mid-infrared (MIR) sensors to better separate aerosols into fine and coarse modes.

  12. Quality improvement as an investment.

    PubMed

    Weeks, William B

    2002-01-01

    Health care organizations are experiencing increasing internal and external pressures to improve the quality of care that they provide. However, there is not a framework that can be used to help understand the value of quality improvement projects and to prioritize competing projects. By understanding the current processes, costs and outcomes of care, enumerating the costs and benefits of change, anticipating the timing of the costs and benefits, and performing a financial analysis, quality improvement efforts can be evaluated as investments. Only by understanding and adapting to the financial environments in which health care organizations operate can continuous quality improvement in health care succeed. PMID:12512466

  13. Driving Surgical Quality Using Operative Video.

    PubMed

    O'Mahoney, Paul R A; Yeo, Heather L; Lange, Marilyne M; Milsom, Jeffrey W

    2016-08-01

    Recent evidence suggests surgical quality may be demonstrated and evaluated using video capture during surgery. Operative video documentation may also aid in quality improvement initiatives. We discuss how operative video has the potential to help improve patient outcomes and increase professional accountability, patient safety, and surgical quality. PMID:27076573

  14. Mesh Quality Improvement Toolkit

    Energy Science and Technology Software Center (ESTSC)

    2002-11-15

    MESQUITE is a linkable software library to be used by simulation and mesh generation tools to improve the quality of meshes. Mesh quality is improved by node movement and/or local topological modifications. Various aspects of mesh quality such as smoothness, element shape, size, and orientation are controlled by choosing the appropriate mesh qualtiy metric, and objective function tempate, and a numerical optimization solver to optimize the quality of meshes, MESQUITE uses the TSTT mesh interfacemore » specification to provide an interoperable toolkit that can be used by applications which adopt the standard. A flexible code design makes it easy for meshing researchers to add additional mesh quality metrics, templates, and solvers to develop new quality improvement algorithms by making use of the MESQUITE infrastructure.« less

  15. Improving operating room schedules.

    PubMed

    Li, Fei; Gupta, Diwakar; Potthoff, Sandra

    2016-09-01

    Operating rooms (ORs) in US hospitals are costly to staff, generate about 70 % of a hospital's revenues, and operate at a staffed-capacity utilization of 60-70 %. Many hospitals allocate blocks of OR time to individual or groups of surgeons as guaranteed allocation, who book surgeries one at a time in their blocks. The booking procedure frequently results in unused time between surgeries. Realizing that this presents an opportunity to improve OR utilization, hospitals manually reschedule surgery start times one or two days before each day of surgical operations. The purpose of rescheduling is to decrease OR staffing costs, which are determined by the number of concurrently staffed ORs. We formulate the rescheduling problem as a variant of the bin-packing problem with interrelated items, which are the surgeries performed by the same surgeon. We develop a lower bound (LB) construction algorithm and prove that the LB is at least (2/3) of the optimal staffing cost. A key feature of our approach is that we allow hospitals to have two shift lengths. Our analytical results form the basis of a branch-and-bound algorithm, which we test on data obtained from three hospitals. Experiments show that rescheduling saves significant staffing costs. PMID:25687390

  16. Assessment of an aerosol treatment to improve air quality in a swine concentrated animal feeding operation (CAFO).

    PubMed

    Rule, Ana M; Chapin, Amy R; McCarthy, Sheila A; Gibson, Kristen E; Schwab, Kellogg J; Buckley, Timothy J

    2005-12-15

    Poor air quality within swine concentrated animal feeding operations (CAFOs) poses a threat to workers, the surrounding community, and farm production. Accordingly, the current study was conducted to evaluate a technology for reducing air pollution including particulate matter (PM), viable bacteria, and ammonia within such a facility. The technology consists of an acid-oil-alcohol aerosol applied daily. Its effectiveness was evaluated by comparing air quality from before to after treatment and between treated and untreated sides of a barn separated by an impervious partition. On the untreated side, air quality was typical for a swine CAFO, with mean PM2.5 of 0.28 mg/m3 and PM(TOT) of 1.5 mg/m3. The treatment yielded a reduction in PM concentration of 75-90% from before to after treatment. Effectiveness increased with time, application, and particle size (40% reduction for 1 microm and 90% for >10 microm). Airborne bacteria levels (total bacteria, Enterobacteriaceae, and gram-positive cocci) decreased one logarithmic unit after treatment. In contrast, treatment had no effect on ammonia concentrations. These findings demonstrate the effectiveness of an intervention in yielding exposure and emission reductions. PMID:16475347

  17. Improving operational plume forecasts

    NASA Astrophysics Data System (ADS)

    Balcerak, Ernie

    2012-04-01

    Forecasting how plumes of particles, such as radioactive particles from a nuclear disaster, will be transported and dispersed in the atmosphere is an important but computationally challenging task. During the Fukushima nuclear disaster in Japan, operational plume forecasts were produced each day, but as the emissions continued, previous emissions were not included in the simulations used for forecasts because it became impractical to rerun the simulations each day from the beginning of the accident. Draxler and Rolph examine whether it is possible to improve plume simulation speed and flexibility as conditions and input data change. The authors use a method known as a transfer coefficient matrix approach that allows them to simulate many radionuclides using only a few generic species for the computation. Their simulations work faster by dividing the computation into separate independent segments in such a way that the most computationally time consuming pieces of the calculation need to be done only once. This makes it possible to provide real-time operational plume forecasts by continuously updating the previous simulations as new data become available. They tested their method using data from the Fukushima incident to show that it performed well. (Journal of Geophysical Research-Atmospheres, doi:10.1029/2011JD017205, 2012)

  18. Improving the quality of operative notes by implementing a new electronic template for upper limb surgery at the Royal Derby Hospital.

    PubMed Central

    Theivendran, Kanthan; Hassan, Sami; I Clark, David

    2016-01-01

    The RCS has published clear and succinct guidelines dictating the necessity for the documentation of legible and timely surgical operative notes and exactly what should be included. A baseline study within the upper limb unit at our trust showed a 71.1% adherence with the RCS guidelines with an average delay of typing of notes after dictation was 11.6 days. This quality improvement project designed and developed a bespoke electronic surgical notes template built within an existing database driven software within the Trust. After implementation of the templates we found no delays in full operative notes being typed and a 100% adherence with the RCS guidelines. This project significantly improved the quality and timely production of electronic surgical notes within a sustainable electronic software solution. PMID:26893894

  19. Quality improvement techniques to improve patient satisfaction.

    PubMed

    Torres, E Joseph; Guo, Kristina L

    2004-01-01

    This paper describes several approaches for implementing quality improvement initiatives to improve patient satisfaction, which enables health-care organizations to position themselves for success in today's global and increasingly competitive environment. Specifically, measuring the views of patients, improving patient satisfaction through a community-wide effort, and using a Six Sigma program are discussed. Each of these programs can be an effective mechanism for quality improvement. A key component to quality improvement techniques involves collaborative efforts by all health-care professionals and managers as they seek to increase patient satisfaction. PMID:15552388

  20. Good Data Can Be Better Data - How Data Management Maturity Can Help Repositories Improve Operations, Data Quality, And Usability, Helping Researchers

    NASA Astrophysics Data System (ADS)

    Stall, S.

    2015-12-01

    Much earth and space science data and metadata are managed and supported by an infrastructure of repositories, ranging from large agency or instrument facilities, to institutions, to smaller repositories including labs. Scientists face many challenges in this ecosystem both on storing their data and in accessing data from others for new research. Critical for all uses is ensuring the credibility and integrity of the data and conveying that and provenance information now and in the future. Accurate information is essential for future researchers to find (or discover) the data, evaluate the data for use (content, temporal, geolocation, precision) and finally select (or discard) that data as meeting a "fit-for-purpose" criteria. We also need to optimize the effort it takes in describing the data for these determinations, which means making it efficient for the researchers who collect the data. At AGU we are developing a program aimed at helping repositories, and thereby researchers, improve data quality and data usability toward these goals. AGU has partnered with the CMMI Institute to develop their Data Management Maturity (DMM) framework within the Earth and space sciences. The CMMI DMM framework guides best practices in a range of data operations, and the application of the DMM, through an assessment, reveals how repositories and institutions can best optimize efforts to improve operations and functionality throughout the data lifecycle and elevate best practices across a variety of data management operations. Supporting processes like data operations, data governance, and data architecture are included. An assessment involves identifying accomplishment, and weaknesses compared to leading practices for data management. Broad application of the DMM can help improve quality in data and operations, and consistency across the community that will facilitate interoperability, discovery, preservation, and reuse. Good data can be better data. Consistency results in

  1. White-collar productivity and quality issues; Proceedings of the Symposium on Productivity and Quality: Strategies for Improving Operations in Government and Industry, Washington, DC, September 25, 26, 1984

    NASA Technical Reports Server (NTRS)

    Gerard, M. (Editor); Edwards, P. W. (Editor)

    1985-01-01

    Techniques for improving the productivity of white-collar workers while maintaining high product quality are examined in reviews and reports. The emphasis is on the application of strategies developed in the private sector to government-agency and aerospace-industry operations. Topics discussed include international competition, organizational attitudes and orientation, management practices, education and training, renewing large organizations, encouraging innovation, national initiatives, employee involvement, management involvement, and applications of new technology.

  2. Improving productivity, efficiency, product quality and environmental sustainability of aquaculture operations through systemic integration of information and knowledge

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Experts on selective breeding, physiology, genomics and bioinformatics will present and discuss state of the art information and relevant examples from fish and other animal systems. Identify strategies that will foster continuous improvements in experimental design and data gathering, analysis, be...

  3. Data quality improvements for FAA

    SciTech Connect

    Perry, R.; Marlman, K.; Olson, D.; Werner, P.

    1997-09-01

    Effective communication among air safety professionals is only as good as the information being communicated. Data sharing cannot be effective unless the data are relevant to aviation safety problems, and decisions based on faulty data are likely to be invalid. The validity of aviation safety data depends on satisfying two primary characteristics. Data must accurately represent or conform to the real world (conformance), and it must be relevant or useful to addressing the problems at hand (utility). The FAA, in efforts to implement the Safety Performance Analysis System (SPAS), identified significant problems in the quality of the data which SPAS and FAA air safety professionals would use in defining the state of aviation safety in the US. These finding were reinforced by Department of Transportation Inspector General and General Accounting Office investigations into FAA surveillance of air transport operations. Many recent efforts to improve data quality have been centered on technological solutions to the problems. They concentrate on reducing errors in the data (conformance), but they cannot adequately address the relationship of data to need (utility). Sandia National Laboratories, working with the FAA`s Airport and Aircraft Safety Research and Development Division and the Flight Standards Service, has been involved in four programs to assist FAA in addressing their data quality problems. The Sandia approach has been data-driven rather than technology-driven. In other words, the focus has been on first establishing the data requirements by analyzing the FAA`s surveillance and decision-making processes. This process analysis looked at both the data requirements and the methods used to gather the data in order to address both the conformance and utility problems inherent in existing FAA data systems. This paper discusses Sandia`s data quality programs and their potential improvements to the safety analysis processes and surveillance programs of the FAA.

  4. Enhancing quality improvement team effectiveness.

    PubMed

    Mosel, D; Shamp, M J

    1993-01-01

    Quality improvement teams are different from other work groups in their purpose, leadership, membership, training, procedures, and dynamics. To have effective quality improvement teams, health care organizations must focus on six key process variables, with particular attention to group dynamics. Quality improvement teams progress through the "traditional" stages of team development--forming, storming, norming, and performing--with a "special stage" of closing. Within each stage, there are two core dimensions--team process ("relationship" issues) and the project itself ("task" issues)--and critical tasks that need to be performed by the Quality Council, team members, team leader, and the facilitator. PMID:10130709

  5. Quality-control analytical methods: continuous quality improvement.

    PubMed

    Venti, Eden M

    2006-01-01

    It is vital that all compounding pharmacies have a continuous quality improvement program in place by way of standard operating procedures to assure that patients receive high-quality preparations. The program should take into consideration any federal and state regulatory requirements, as well as professional association expectations. Quality control measurements and regular review of those measurements are the foundations of a good quality plan. All pharmacy personnel should be aware of the importance of reporting potential internal quality concerns or problems and should be encouraged to do so without fear of repercussions. Ideally, an error-free compounding pracitice would be the goal. Since this is not practical, quality issues should not be viewed as problems, but as opportunities to improve compounding practices by correcting, before they become pervasive, the processes used in the preparation of prescriptions. PMID:23974418

  6. Preanalytical quality improvement: in quality we trust.

    PubMed

    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. PMID:23072858

  7. Operational Guidelines; Reading Improvement Project.

    ERIC Educational Resources Information Center

    Columbus Public Schools, OH.

    Operational procedures designed to increase the effectiveness of an ESEA/Title I Columbus, Ohio, public schools reading improvement project are presented. The project's three-pronged approach includes direct service to children, staff development, and program development. The rationale and objectives of the project are outlined. The multiple roles…

  8. Mission operations and command assurance: Instilling quality into flight operations

    NASA Astrophysics Data System (ADS)

    Welz, Linda L.; Witkowski, Mona M.; Bruno, Kristin J.; Potts, Sherrill S.

    1993-03-01

    Mission Operations and Command Assurance (MO&CA) is a Total Quality Management (TQM) task on JPL projects to instill quality in flight mission operations. From a system engineering view, MO&CA facilitates communication and problem-solving among flight teams and provides continuous process improvement to reduce the probability of radiating incorrect commands to a spacecraft. The MO&CA task has evolved from participating as a member of the spacecraft team to an independent team reporting directly to flight project management and providing system level assurance. JPL flight projects have benefited significantly from MO&CA's effort to contain risk and prevent rather than rework errors. MO&CA's ability to provide direct transfer of knowledge allows new projects to benefit from previous and ongoing flight experience.

  9. Mission operations and command assurance: Instilling quality into flight operations

    NASA Technical Reports Server (NTRS)

    Welz, Linda L.; Witkowski, Mona M.; Bruno, Kristin J.; Potts, Sherrill S.

    1993-01-01

    Mission Operations and Command Assurance (MO&CA) is a Total Quality Management (TQM) task on JPL projects to instill quality in flight mission operations. From a system engineering view, MO&CA facilitates communication and problem-solving among flight teams and provides continuous process improvement to reduce the probability of radiating incorrect commands to a spacecraft. The MO&CA task has evolved from participating as a member of the spacecraft team to an independent team reporting directly to flight project management and providing system level assurance. JPL flight projects have benefited significantly from MO&CA's effort to contain risk and prevent rather than rework errors. MO&CA's ability to provide direct transfer of knowledge allows new projects to benefit from previous and ongoing flight experience.

  10. 40 CFR 63.175 - Quality improvement program for valves.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 10 2014-07-01 2014-07-01 false Quality improvement program for valves... improvement program for valves. (a) In Phase III, an owner or operator may elect to comply with one of the... § 63.168 and § 63.175. (1) If the owner or operator elects to continue the quality improvement...

  11. 40 CFR 63.175 - Quality improvement program for valves.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 10 2013-07-01 2013-07-01 false Quality improvement program for valves... improvement program for valves. (a) In Phase III, an owner or operator may elect to comply with one of the... §§ 63.168 and 63.175. (1) If the owner or operator elects to continue the quality improvement...

  12. 40 CFR 63.175 - Quality improvement program for valves.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 10 2012-07-01 2012-07-01 false Quality improvement program for valves... improvement program for valves. (a) In Phase III, an owner or operator may elect to comply with one of the... §§ 63.168 and 63.175. (1) If the owner or operator elects to continue the quality improvement...

  13. 40 CFR 63.175 - Quality improvement program for valves.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 9 2011-07-01 2011-07-01 false Quality improvement program for valves... improvement program for valves. (a) In Phase III, an owner or operator may elect to comply with one of the... § 63.168 and § 63.175. (1) If the owner or operator elects to continue the quality improvement...

  14. Human factors and quality improvement.

    PubMed

    Handyside, James; Suresh, Gautham

    2010-03-01

    Human factors analysis (HFE) presents a formidable contribution to quality improvement (QI) in the neonatal intensive care unit (NICU). The science behind the fundamental principles concerning the design of work systems that match the needs of the people who work in them is sound and is applied widely in other safety critical situations. Early application of HFE in NICUs has shown the usefulness of these methods for frontline teams working to improve quality, reliability, and safety. The inclusion of human factors considerations in the design of structure and process has the potential to improve outcomes for patients and families and to improve the comfort and usability of work systems for providers who work in them. New technologies and continual change must be informed and designed through the application of HFE methods and principles to realize the full potential of QI. PMID:20363451

  15. Evaluation of quality improvement programmes.

    PubMed

    Øvretveit, J; Gustafson, D

    2002-09-01

    In response to increasing concerns about quality, many countries are carrying out large scale programmes which include national quality strategies, hospital programmes, and quality accreditation, assessment and review processes. Increasing amounts of resources are being devoted to these interventions, but do they ensure or improve quality of care? There is little research evidence as to their effectiveness or the conditions for maximum effectiveness. Reasons for the lack of evaluation research include the methodological challenges of measuring outcomes and attributing causality to these complex, changing, long term social interventions to organisations or health systems, which themselves are complex and changing. However, methods are available which can be used to evaluate these programmes and which can provide decision makers with research based guidance on how to plan and implement them. This paper describes the research challenges, the methods which can be used, and gives examples and guidance for future research. It emphasises the important contribution which such research can make to improving the effectiveness of these programmes and to developing the science of quality improvement. PMID:12486994

  16. [Multidimensional Qualities to Improve Education.

    ERIC Educational Resources Information Center

    United Nations Educational, Scientific, and Cultural Organization, Santiago (Chile). Regional Office for Education in Latin America and the Caribbean.

    This bulletin contains five essays on the theme of expanding the challenge of improving the quality of education to encompass the curricular, administrative, institutional, and teaching levels. The articles include: (1) "Educational Assessment Systems in Latin America: A Review of Issues and Recent Experience" (Robin Horn; Laurence Wolf; Eduardo…

  17. Culture shock: Improving software quality

    SciTech Connect

    de Jong, K.; Trauth, S.L.

    1988-01-01

    The concept of software quality can represent a significant shock to an individual who has been developing software for many years and who believes he or she has been doing a high quality job. The very idea that software includes lines of code and associated documentation is foreign and difficult to grasp, at best. Implementation of a software quality program hinges on the concept that software is a product whose quality needs improving. When this idea is introduced into a technical community that is largely ''self-taught'' and has been producing ''good'' software for some time, a fundamental understanding of the concepts associated with software is often weak. Software developers can react as if to say, ''What are you talking about. What do you mean I'm not doing a good job. I haven't gotten any complaints about my code yetexclamation'' Coupling such surprise and resentment with the shock that software really is a product and software quality concepts do exist, can fuel the volatility of these emotions. In this paper, we demonstrate that the concept of software quality can indeed pose a culture shock to developers. We also show that a ''typical'' quality assurance approach, that of imposing a standard and providing inspectors and auditors to assure its adherence, contributes to this shock and detracts from the very goal the approach should achieve. We offer an alternative, adopted through experience, to implement a software quality program: cooperative assistance. We show how cooperation, education, consultation and friendly assistance can overcome this culture shock. 3 refs.

  18. Nuclear quality assurance operating philosophy: A quality-oriented approach

    SciTech Connect

    Corcoran, W.R. ); Geiger, J.E. ); Heibel, R.E. ); Cotton, J.B. ); Sabol, A.R. )

    1992-01-01

    Quality assurance programs have been part of the nuclear utility management process since the publication of the draft of 10CFR50 Appendix B in the late 1960s. The unwritten operational philosophy of nuclear quality assurance organizations focused on compliance with federal regulations. Adverse experiences, including operational events and extended shutdowns, prompted the gradual adoption of isolated practices extending beyond compliance orientation. These practices have an orientation that accommodates a definition of quality, a perspective of the role of nuclear quality assurance organizations in the overall concept of defense-in-depth, a definition of the segments of the nuclear quality assurance mission, and recent advances in the understanding of self-assessment. Observation of these practices at various nuclear utilities resulted in a syntheses of practices and approaches into a coherent quality-oriented nuclear quality assurance operating philosophy that is not totally adopted at any one utility.

  19. Thermoelectric Integrated Membrane Evaporation Subsystem operational improvements

    NASA Technical Reports Server (NTRS)

    Dehner, G. F.; Winkler, H. E.; Reysa, R. P.

    1984-01-01

    A three-man preprototype Thermoelectric Integrated Membrane Evaporation Subsystem (TIMES) has been developed to provide high quality water recovery from waste fluids on extended duration space flights. In the most recent effort, a number of improvements have been made to simplify subsystem operation and increase performance. These modifications include changes to the hollow fiber membrane evaporator, the condensing section of the thermoelectric heat pump, and the electronic controller logic and display. This paper describes the results of the test program that was conducted to evaluate the implemented improvements. In addition, an advanced design concept is discussed that will provide lower electrical power consumption, greater water production capacity, lower weight, and a smaller package than the present subsystem configuration.

  20. Defining quality improvement in public health.

    PubMed

    Riley, William J; Moran, John W; Corso, Liza C; Beitsch, Leslie M; Bialek, Ronald; Cofsky, Abbey

    2010-01-01

    Many industries commonly use quality improvement (QI) techniques to improve service delivery and process performance. Yet, there has been scarce application of these proven methods to public health settings and the public health field has not developed a set of shared principles or a common definition for quality improvement. This article discusses a definition of quality improvement in public health and describes a continuum of quality improvement applications for public health departments. Quality improvement is a distinct management process and set of tools and techniques that are coordinated to ensure that departments consistently meet the health needs of their communities. PMID:20009636

  1. Analyses to improve operational flexibility

    SciTech Connect

    Trikouros, N.G.

    1986-01-01

    Operational flexibility is greatly enhanced if the technical bases for plant limits and design margins are fully understood, and the analyses necessary to evaluate the effect of plant modifications or changes in operating modes on these parameters can be performed as required. If a condition should arise that might jeopardize a plant limit or reduce operational flexibility, it would be necessary to understand the basis for the limit or the specific condition limiting operational flexibility and be capable of performing a reanalysis to either demonstrate that the limit will not be violated or to change the limit. This paper provides examples of GPU Nuclear efforts in this regard. Examples of Oyster Creek and Three Mile Island operating experiences are discussed.

  2. 40 CFR 65.116 - Quality improvement program for pumps.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 16 2013-07-01 2013-07-01 false Quality improvement program for pumps... PROGRAMS (CONTINUED) CONSOLIDATED FEDERAL AIR RULE Equipment Leaks § 65.116 Quality improvement program for... or operator shall comply with the following requirements: (1) Pumps that are in food/medical...

  3. 40 CFR 65.116 - Quality improvement program for pumps.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 16 2014-07-01 2014-07-01 false Quality improvement program for pumps... PROGRAMS (CONTINUED) CONSOLIDATED FEDERAL AIR RULE Equipment Leaks § 65.116 Quality improvement program for... or operator shall comply with the following requirements: (1) Pumps that are in food/medical...

  4. 40 CFR 65.116 - Quality improvement program for pumps.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 16 2012-07-01 2012-07-01 false Quality improvement program for pumps... PROGRAMS (CONTINUED) CONSOLIDATED FEDERAL AIR RULE Equipment Leaks § 65.116 Quality improvement program for... or operator shall comply with the following requirements: (1) Pumps that are in food/medical...

  5. Factors Associated With Sleep Quality Among Operating Engineers

    PubMed Central

    Choi, Seung Hee; Terrell, Jeffrey E.; Pohl, Joanne M.; Redman, Richard W.

    2016-01-01

    Blue collar workers generally report high job stress and are exposed to loud noises at work and engage in many of the health behavioral factors, all of which have been associated with poor sleep quality. However, sleep quality of blue collar workers has not been studied extensively, and no studies have focused Operating Engineers (heavy equipment operators) among whom daytime fatigue would place them at high risk for accidents. Therefore, the purpose of this study was to determine variables associated with sleep quality among Operating Engineers. This was a cross-sectional survey design with a dependent variable of sleep quality and independent variables of personal and related health behavioral factors. A convenience sample of 498 Operating Engineers was recruited from approximately 16,000 Operating Engineers from entire State of Michigan in 2008. Linear regression was used to determine personal and related health behavior factors associated with sleep quality. Multivariate analyses showed that personal factors related to poor sleep quality were younger age, female sex, higher pain, more medical comorbidities and depressive symptoms and behavioral factors related to poor sleep quality were nicotine dependence. While sleep scores were similar to population norms, approximately 34% (n=143) showed interest in health services for sleep problems. While many personal factors are not changeable, interventions to improve sleep hygiene as well as interventions to treat pain, depression and smoking may improve sleep quality resulting in less absenteeism, fatal work accidents, use of sick leave, work disability, medical comorbidities, as well as subsequent mortality. PMID:23393021

  6. Improving data quality in neuronal population recordings.

    PubMed

    Harris, Kenneth D; Quiroga, Rodrigo Quian; Freeman, Jeremy; Smith, Spencer L

    2016-08-26

    Understanding how the brain operates requires understanding how large sets of neurons function together. Modern recording technology makes it possible to simultaneously record the activity of hundreds of neurons, and technological developments will soon allow recording of thousands or tens of thousands. As with all experimental techniques, these methods are subject to confounds that complicate the interpretation of such recordings, and could lead to erroneous scientific conclusions. Here we discuss methods for assessing and improving the quality of data from these techniques and outline likely future directions in this field. PMID:27571195

  7. Budget Reform to Improve Higher Education Quality.

    ERIC Educational Resources Information Center

    Folger, John

    A national project designed to examine issues of budget reform and quality improvement in higher education is described. The focus is state-level budget practices and their impact on institutions. Most of the funding for quality improvement has been categorical: a small percent of the budget is set aside to achieve particular quality or…

  8. Handling Qualities Implications for Crewed Spacecraft Operations

    NASA Technical Reports Server (NTRS)

    Bailey, Randall E.; Jackson, E. Bruce; Arthur, J. J.

    2012-01-01

    Abstract Handling qualities embody those qualities or characteristics of an aircraft that govern the ease and precision with which a pilot is able to perform the tasks required in support of an aircraft role. These same qualities are as critical, if not more so, in the operation of spacecraft. A research, development, test, and evaluation process was put into effect to identify, understand, and interpret the engineering and human factors principles which govern the pilot-vehicle dynamic system as they pertain to space exploration missions and tasks. Toward this objective, piloted simulations were conducted at the NASA Langley Research Center and Ames Research Center for earth-orbit proximity operations and docking and lunar landing. These works provide broad guidelines for the design of spacecraft to exhibit excellent handling characteristics. In particular, this work demonstrates how handling qualities include much more than just stability and control characteristics of a spacecraft or aircraft. Handling qualities are affected by all aspects of the pilot-vehicle dynamic system, including the motion, visual and aural cues of the vehicle response as the pilot performs the required operation or task. A holistic approach to spacecraft design, including the use of manual control, automatic control, and pilot intervention/supervision is described. The handling qualities implications of design decisions are demonstrated using these pilot-in-the-loop evaluations of docking operations and lunar landings.

  9. African Primary Care Research: Quality improvement cycles

    PubMed Central

    Mash, Bob

    2014-01-01

    Abstract Improving the quality of clinical care and translating evidence into clinical practice is commonly a focus of primary care research. This article is part of a series on primary care research and outlines an approach to performing a quality improvement cycle as part of a research assignment at a Masters level. The article aims to help researchers design their quality improvement cycle and write their research project proposal. PMID:26245438

  10. How to Begin a Quality Improvement Project.

    PubMed

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

    2016-05-01

    Quality improvement involves a combined effort among health care staff and stakeholders to diagnose and treat problems in the health care system. However, health care professionals often lack training in quality improvement methods, which makes it challenging to participate in improvement efforts. This article familiarizes health care professionals with how to begin a quality improvement project. The initial steps involve forming an improvement team that possesses expertise in the quality of care problem, leadership, and change management. Stakeholder mapping and analysis are useful tools at this stage, and these are reviewed to help identify individuals who might have a vested interest in the project. Physician engagement is a particularly important component of project success, and the knowledge that patients/caregivers can offer as members of a quality improvement team should not be overlooked. After a team is formed, an improvement framework helps to organize the scientific process of system change. Common quality improvement frameworks include Six Sigma, Lean, and the Model for Improvement. These models are contrasted, with a focus on the Model for Improvement, because it is widely used and applicable to a variety of quality of care problems without advanced training. It involves three steps: setting aims to focus improvement, choosing a balanced set of measures to determine if improvement occurs, and testing new ideas to change the current process. These new ideas are evaluated using Plan-Do-Study-Act cycles, where knowledge is gained by testing changes and reflecting on their effect. To show the real world utility of the quality improvement methods discussed, they are applied to a hypothetical quality improvement initiative that aims to promote home dialysis (home hemodialysis and peritoneal dialysis). This provides an example that kidney health care professionals can use to begin their own quality improvement projects. PMID:27016497

  11. Improvement in aircraft performance reduces operating costs

    SciTech Connect

    Not Available

    1982-04-01

    The escalation of jet transport fuel prices has altered traditional economic formulas for commercial airplane operators. This economic change has provided the impetus to develop improvements for existing production run transports such as the Boeing 727, 737, and 747 airplanes. Improvements have been made in drag reduction, propulsion system, weight reduction, and operation.

  12. 40 CFR 65.116 - Quality improvement program for pumps.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... shall be maintained as specified in the quality assurance program. (e) QIP recordkeeping. In addition to... for the period of the quality improvement program for the process unit as specified in paragraphs (e... or operator shall comply with the following requirements: (1) Pumps that are in food/medical...

  13. 40 CFR 63.175 - Quality improvement program for valves.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... paragraph (e)(2) of this section to determine the services, operating or maintenance practices, and valve... alternative quality improvement programs specified in paragraphs (d) and (e) of this section. The decision to... successive months, after repair. (E) Provide for an audit procedure for quality control of...

  14. Accrediting organizations and quality improvement.

    PubMed

    Viswanathan, H N; Salmon, J W

    2000-10-01

    This paper reviews the various organizations in the United States that perform accreditation and establish standards for healthcare delivery. These agencies include the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the National Committee for Quality Assurance (NCQA), the American Medical Accreditation Program (AMAP), the American Accreditation HealthCare Commission/Utilization Review Accreditation Commission (AAHC/URAC), and the Accreditation Association for Ambulatory HealthCare (AAAHC). In addition, the Foundation for Accountability (FACCT) and the Agency for Healthcare Research and Quality (AHRQ) play important roles in ensuring the quality of healthcare. Each of the accrediting bodies is unique in terms of their mission, activities, compositions of their boards, and organizational histories, and each develops their own accreditation process and programs and sets their own accreditation standards. For this reason, certain accrediting organizations are better suited than others to perform accreditation for a specific area in the healthcare delivery system. The trend toward outcomes research is noted as a clear shift from the structural and process measures historically used by accrediting agencies. Accreditation has been generally viewed as a desirable process to establish standards and work toward achieving higher quality care, but it is not without limitations. Whether accrediting organizations are truly ensuring high quality healthcare across the United States is a question that remains to be answered. PMID:11184667

  15. Continuous Quality Improvement: A Roadmap for Rural School Improvement.

    ERIC Educational Resources Information Center

    Kilmer, Lloyd C.

    A case study documented a continuous quality improvement approach to school improvement in a rural Nebraska high school over a 2-year period. Data gathered from surveys, portfolios, pilot results, and test scores indicated that the changes during the 2-year period were not dramatic, but significant and consistent with the Total Quality literature.…

  16. Rethinking Quality and Improvement in Higher Education

    ERIC Educational Resources Information Center

    Houston, Don

    2008-01-01

    Purpose: The purpose of this paper is to critically review dominant conceptions of and approaches to quality in higher education. It suggests an alternative approach with potential to shift the focus of quality activities from accountability and control to improvement. Design/methodology/approach: The applicability and limits of quality concepts…

  17. Lichen recolonization following air quality improvement

    SciTech Connect

    Showman, R.E.

    1981-01-01

    Air quality improvement near a coal-fired power plant led to recolonization of Parmelia caperata (L.) Ach. in a pollution-induced void area. Recolonization was first observed about four years after pollution abatement. Least-affected sites were slowest to recover. After eight years of improved air quality, the distribution of P. caperata has returned to near normal. Lichen biomonitoring is useful not only to detect the effects of poor air quality but to document air quality improvements as well. 5 references, 4 figures.

  18. Improve Quality: Use Tool Kits.

    ERIC Educational Resources Information Center

    Gartner, Sue

    2001-01-01

    Addresses issues of defining quality in both business and community service. Describes the use of a regulatory tool kit containing rules and regulations a child care center must follow to ensure children's health, safety, and well-being. Specific tool kit types described include regulatory, government funded, rating scale, and NAEYC. (SD)

  19. Essentialism: Common Sense Quality Improvement.

    ERIC Educational Resources Information Center

    Wallin, Desna L.; Ryan, John R.

    Essentialism is a trimmed down, action-oriented, user-friendly approach to Total Quality Management (TQM) in education. This book explores the concept of essentialism to describe strategies for implementing TQM in community colleges. Chapter 1 examines the history of the TQM movement and reviews experiences of community college practitioners…

  20. Practical Approaches to Quality Improvement for Radiologists.

    PubMed

    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. PMID:26466176

  1. Narrative methods in quality improvement research

    PubMed Central

    Greenhalgh, T; Russell, J; Swinglehurst, D

    2005-01-01

    

 This paper reviews and critiques the different approaches to the use of narrative in quality improvement research. The defining characteristics of narrative are chronology (unfolding over time); emplotment (the literary juxtaposing of actions and events in an implicitly causal sequence); trouble (that is, harm or the risk of harm); and embeddedness (the personal story nests within a particular social, historical and organisational context). Stories are about purposeful action unfolding in the face of trouble and, as such, have much to offer quality improvement researchers. But the quality improvement report (a story about efforts to implement change), which is common, must be distinguished carefully from narrative based quality improvement research (focused systematic enquiry that uses narrative methods to generate new knowledge), which is currently none. We distinguish four approaches to the use of narrative in quality improvement research—narrative interview; naturalistic story gathering; organisational case study; and collective sense-making—and offer a rationale, describe how data can be collected and analysed, and discuss the strengths and limitations of each using examples from the quality improvement literature. Narrative research raises epistemological questions about the nature of narrative truth (characterised by sense-making and emotional impact rather than scientific objectivity), which has implications for how rigour should be defined (and how it might be achieved) in this type of research. We offer some provisional guidance for distinguishing high quality narrative research in a quality improvement setting from other forms of narrative account such as report, anecdote, and journalism. PMID:16326792

  2. [Clinical governance and continuous quality improvement in surgical organizations].

    PubMed

    Finocchiaro, G; Paparo, D; Gitto, G; Caruso, R; Parisi, A

    2009-01-01

    Recently the awareness had progressively strengthened that the main interest of health care organizations is effectiveness and appropriateness of clinical performance. They have a statutory duty to seek quality improvement through clinical governance. All health care operators are involved in clinical governance implementation, in respect of their organizational positions toward continuous quality improvement. In this way health care organizations, professionals and patients will benefit of outcomes of the change. PMID:19272236

  3. Quality Improvement in Inflammatory Bowel Disease

    PubMed Central

    Siegel, Corey A.

    2013-01-01

    Chronic illnesses such as inflammatory bowel disease (IBD) present a unique opportunity to define and improve the quality of care. Processes of care can be complex, and outcomes of care may vary across different healthcare delivery settings. Patients with IBD are managed over long periods of time and often by the same physician within a single care delivery system. Both patients with Crohn’s disease and ulcerative colitis have variable courses of disease progression that require changes in therapy over time. These factors necessitate multiple areas of potential assessment and improvement of processes and outcomes of care. A current initiative is the development of quality measures. The American Gastroenterological Association has developed accountability measures for the Physician Quality Reporting System, and the Crohn’s and Colitis Foundation of America has developed a set of top 10 recommended processes and outcomes of measurement for high-quality care of patients with IBD. In addition, the pediatric ImproveCareNow collaborative network has collected improvement data from dozens of pediatric centers over the past 5 years and has demonstrated improvement in overall disease activity in their cohort through iterative quality improvement processes. Future directions for quality indicators for adults with IBD will involve implementation of quality-measure reporting, both for purposes of reimbursement as well as improvement of care. These strategies will need to be closely monitored to evaluate the effect of improvement programs on outcomes. PMID:23943663

  4. Surface Operations Systems Improve Airport Efficiency

    NASA Technical Reports Server (NTRS)

    2009-01-01

    With Small Business Innovation Research (SBIR) contracts from Ames Research Center, Mosaic ATM of Leesburg, Virginia created software to analyze surface operations at airports. Surface surveillance systems, which report locations every second for thousands of air and ground vehicles, generate massive amounts of data, making gathering and analyzing this information difficult. Mosaic?s Surface Operations Data Analysis and Adaptation (SODAA) tool is an off-line support tool that can analyze how well the airport surface operation is working and can help redesign procedures to improve operations. SODAA helps researchers pinpoint trends and correlations in vast amounts of recorded airport operations data.

  5. Quality and quality improvement in occupational health nursing.

    PubMed

    Widtfeldt, A K

    1992-07-01

    Donabedian first defined quality as the result of assessing the structures, processes, and outcomes of health care. The emphasis on quality assurance is changing to quality improvement. The definition of quality in health care has expanded to include the expectations and opinion of patients, their representative, and society. As the cost of health care continues to rise at twice the rate of inflation, business wants to know how health care dollars are spent. Occupational health nurses, to add value to the businesses in which they work, must be a part of the trend in measuring the quality of the products and services of their health services. PMID:1616507

  6. Can Technology Improve the Quality of Colonoscopy?

    PubMed

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

    2016-07-01

    In order for screening colonoscopy to be an effective tool in reducing colon cancer incidence, exams must be performed in a high-quality manner. Quality metrics have been presented by gastroenterology societies and now include higher adenoma detection rate targets than in the past. In many cases, the quality of colonoscopy can often be improved with simple low-cost interventions such as improved procedure technique, implementing split-dose bowel prep, and monitoring individuals' performances. Emerging technology has expanded our field of view and image quality during colonoscopy. We will critically review several technological advances in the context of quality metrics and discuss if technology can really improve the quality of colonoscopy. PMID:27255334

  7. Does Competition Improve Health Care Quality?

    PubMed Central

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

    2008-01-01

    Objective To identify the effect of competition on health maintenance organizations' (HMOs) quality measures. Study Design Longitudinal analysis of a 5-year panel of the Healthcare Effectiveness Data and Information Set (HEDIS) and Consumer Assessment of Health Plans Survey® (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. Data Sources NCQA, Interstudy, the Area Resource File, and the Bureau of Labor Statistics. Methods 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. Principal Findings 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. Conclusions 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. PMID:18793214

  8. A Count for Quality: Child Care Center Directors on Rating and Improvement Systems

    ERIC Educational Resources Information Center

    Schulman, Karen; Matthews, Hannah; Blank, Helen; Ewen, Danielle

    2012-01-01

    Quality Rating and Improvement Systems (QRIS)--a strategy to improve families' access to high-quality child care--assess the quality of child care programs, offer incentives and assistance to programs to improve their ratings, and give information to parents about the quality of child care. These systems are operating in a growing number of…

  9. Operating multireservoir hydropower systems for downstream water quality

    SciTech Connect

    Hayes, D.F.

    1990-01-01

    Hydropower reservoir operations often impact tailwater quality and water quality in the stream or river below the impoundment for many miles. Determining optimal operating strategies for a system of hydropower reservoirs involves solving a highly dimensional nonlinear, nonconvex optimization problem. This research adds the additional complexities of downstream water quality considerations within the optimization formulation to determine operating strategies for a system of hydropower reservoirs operating in series (tandem) or parallel. The formulation was used to determine operating strategies for six reservoirs of the upper Cumberland river basin in Tennessee and Kentucky. Significant dissolved oxygen (DO) violations occur just upstream of Nashville, Tennessee below Old Hickory dam during the months of August and September. Daily reservoir releases were determined for the period of June through September which would produce the maximum hydropower revenue while meeting downstream water quality objectives. Optimal releases for three operational strategies were compared to historical operations for the years 1985, 1986, and 1988. These strategies included: spilling as necessary to meet water quality criteria, near normal operation (minimal spills), and drawdown of reservoirs as necessary to meet criteria without spills. Optimization results showed an 8% to 15% hydropower loss may be necessary to meet water quality criteria through spills and a 2% to 9% improvement in DO below Old Hickory may be possible without significant spills. Results also showed that substantial increases in initial headwater elevations would be necessary to meet daily DO criteria and avoid spills. The optimal control theory algorithm used to solve the problem proved to be an efficient and robust solver of this large optimization problem.

  10. Improving the management of operational information for safer and more efficient spacecraft operations

    NASA Astrophysics Data System (ADS)

    Lecouat, F.; de Saint Vincent, A.; Brenot, J. M.; Darroy, J. M.; Gaullier, F.; Pham, P.; Pessah, P.

    Spacecraft control centers are getting more and more sophisticated over time. A lot of advanced software is installed to improve operations safety and efficiency. The data bases required by the control center software tools together with the technical documentation used by operators, is called the Operational Information in this paper. The effectiveness of operations not only depends on the functions of the control center but also on the quality and completeness of the Operational Information. It is thus necessary to develop new methods and tools so that the information generated during spacecraft development is adapted to new operations requirements. In the same time these tools can also improve the spacecraft development process itself by facilitating information assets and validation. This is illustrated by Matra Marconi Space (MMS) experience on recent spacecraft development projects where OPSWARE tools are used both for operations preparation and operations execution.

  11. Linking Planning, Quality Improvement, and Institutional Research

    ERIC Educational Resources Information Center

    Seymour, Daniel; Kelley, John M.; Jasinski, John

    2004-01-01

    External and internal forces are driving institutions not only to create departments and positions that specialize in planning, quality improvement, and institutional research but also to link them within a systems context.

  12. Improving Quality Assurance in Australian Higher Education.

    ERIC Educational Resources Information Center

    Linke, Russell D.

    1995-01-01

    Origins of Australia's university quality improvement program are outlined, and its design is examined. Issues discussed include implications of the program for individual institutions, its proposed method of redistributing research funds, and potential problems associated with performance appraisal. (MSE)

  13. Quality improvement in population health systems.

    PubMed

    Inkelas, Moira; McPherson, Marianne E

    2015-12-01

    Quality improvement methods have achieved large sustainable changes in health care quality and health outcomes. Transforming health care into a population health system requires methods for innovation and improvement that can work across professions and sectors. It may be possible to replicate improvement successes in healthcare settings within and across the broader systems of social, educational, and other human services that influence health outcomes in communities. Improvement methods could translate the rhetoric of collaboration, integration and alignment into practice across the fragmented health and human service sectors in the U.S. PMID:26699349

  14. Harlem River water quality improvement

    NASA Astrophysics Data System (ADS)

    Wang, J.

    2011-12-01

    Harlem River is a navigable tidal strait, which flows 8 miles connecting the Hudson River and the East River. In wet weather condition, there is untreated sewage mixed rainfall discharged to the river directly at CSO's discharge point. These raw sewer contain bacteria such as Fecal Coliform, E. Coli, Entercocci those can cause illness. There are total 37 CSOs dicharge point along the Harlem River. Water samples were collected from five sites and analyzed on a weekly basis in spring from March to May 2011, and on a monthly basis in July and August. Results showed that ammonia concentrations were ranged from 0.25 to 2.2 mg/L, and there was an increased pattern in summer when temperature increases; soluble reactive phosphorus (SRP) ranged from 0.04 to 0.2 mg/L; total P (TP) ranged from 0.03 to 0.7 mg/L; organic P (OP) ranged from 0.006 to 0.5 mg/L. In rain storm (wet weather condition), untreated sewer discharged into the river with distinguished higher nutrient concentrations (ammonia=2.9 mg/L, TP=3.1 mg/L, OP=2.9 mg/L) and extremely high bacteria levels (fecal coliform-millions, countless colonies; E. Coli-thousands). Results showed spatial variations among the five sites, seasonal variations from spring to summer, and variations under different weather conditions (temperature, storms). The raw sewer discharge during heavy rainstorms resulted in higher nutrients and bacteria levels, and the water quality was degraded.

  15. How Can We Improve Teacher Quality?

    ERIC Educational Resources Information Center

    Wilson, Suzanne M.

    2011-01-01

    Research on teacher quality is not definitive. But, we know that developing high-quality teachers requires a multipronged approach: We need to recruit promising teachers. We need to retain and reward effective early career teachers. We need mechanisms to dismiss those who don't improve. We need to focus teacher preparation on the foundations of…

  16. Improving the Quality of Military Education Programs.

    ERIC Educational Resources Information Center

    McQuillen, Charles D.

    1982-01-01

    Briefly describes the evolution of postsecondary military education programs, focusing on certain quality control problems which reduce the effectiveness of the educational effort made by the Department of Defense. Implementation of a market-oriented response to the quality control problem is proposed as a route to program improvement. (Author/JL)

  17. The process of managerial control in quality improvement initiatives.

    PubMed

    Slovensky, D J; Fottler, M D

    1994-11-01

    The fundamental intent of strategic management is to position an organization with in its market to exploit organizational competencies and strengths to gain competitive advantage. Competitive advantage may be achieved through such strategies as low cost, high quality, or unique services or products. For health care organizations accredited by the Joint Commission on Accreditation of Healthcare Organizations, continually improving both processes and outcomes of organizational performance--quality improvement--in all operational areas of the organization is a mandated strategy. Defining and measuring quality and controlling the quality improvement strategy remain problematic. The article discusses the nature and processes of managerial control, some potential measures of quality, and related information needs. PMID:10138526

  18. Operating the plant, quality assurance, and the job of the operating staff, Volume Twelve

    SciTech Connect

    Not Available

    1986-01-01

    Subject matter includes operating the plant (the role of the operator, the control room, plant technical specifications, plant operating procedures, initial startup program, BWR/PWR plant startup, BWR/PWR steady state power operation, BWR/PWR transient operation, emergency operation), quality assurance (what is quality, what is quality control, quality assurance includes quality control, government regulation and quality assurance, administrative controls for nuclear power plants, the necessity of reviews and audits, practical quality assurance), and the job of the operating staff (the plant operating staff, plant safety, first aid and resuscitation, general plant hazards, personnel protective equipment, handling chemicals, handling compressed gas, equipment repair and maintenance, communicating with others.

  19. How to Sustain Change and Support Continuous Quality Improvement.

    PubMed

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

    2016-05-01

    To achieve sustainable change, quality improvement initiatives must become the new way of working rather than something added on to routine clinical care. However, most organizational change is not maintained. In this next article in this Moving Points in Nephrology feature on quality improvement, we provide health care professionals with strategies to sustain and support quality improvement. Threats to sustainability may be identified both at the beginning of a project and when it is ready for implementation. The National Health Service Sustainability Model is reviewed as one example to help identify issues that affect long-term success of quality improvement projects. Tools to help sustain improvement include process control boards, performance boards, standard work, and improvement huddles. Process control and performance boards are methods to communicate improvement results to staff and leadership. Standard work is a written or visual outline of current best practices for a task and provides a framework to ensure that changes that have improved patient care are consistently and reliably applied to every patient encounter. Improvement huddles are short, regular meetings among staff to anticipate problems, review performance, and support a culture of improvement. Many of these tools rely on principles of visual management, which are systems transparent and simple so that every staff member can rapidly distinguish normal from abnormal working conditions. Even when quality improvement methods are properly applied, the success of a project still depends on contextual factors. Context refers to aspects of the local setting in which the project operates. Context affects resources, leadership support, data infrastructure, team motivation, and team performance. For these reasons, the same project may thrive in a supportive context and fail in a different context. To demonstrate the practical applications of these quality improvement principles, these principles are

  20. Forming tool improves quality of tubing flares

    NASA Technical Reports Server (NTRS)

    1966-01-01

    Punch and die set improves the quality of tubing flares for use with standard flared-tube fittings in high-pressure systems. It forges a dimensionally accurate flare in the tubing and forces more tubing material into the high-stress areas to improve the strength and tightness of the tubing connection.

  1. Improving Teaching Quality and the Learning Organisation

    ERIC Educational Resources Information Center

    Collie, Sarah L.; Taylor, Alton L.

    2004-01-01

    This study applied a learning organisation framework to understand academic departments' efforts to improve teaching quality. The theoretical framework was generated from literature on learning organisations, organisations devoted to continuous improvement through continuous learning. Research questions addressed relationships among departments'…

  2. Do English NHS Microbiology laboratories offer adequate services for the diagnosis of UTI in children? Healthcare Quality Improvement Partnership (HQIP) Audit of Standard Operational Procedures.

    PubMed

    McNulty, Cliodna A M; Verlander, Neville Q; Moore, Philippa C L; Larcombe, James; Dudley, Jan; Banerjee, Jaydip; Jadresic, Lyda

    2015-09-01

    The National Institute of Care Excellence (NICE) 2007 guidance CG54, on urinary tract infection (UTI) in children, states that clinicians should use urgent microscopy and culture as the preferred method for diagnosing UTI in the hospital setting for severe illness in children under 3 years old and from the GP setting in children under 3 years old with intermediate risk of severe illness. NICE also recommends that all 'infants and children with atypical UTI (including non-Escherichia coli infections) should have renal imaging after a first infection'. We surveyed all microbiology laboratories in England with Clinical Pathology Accreditation to determine standard operating procedures (SOPs) for urgent microscopy, culture and reporting of children's urine and to ascertain whether the SOPs facilitate compliance with NICE guidance. We undertook a computer search in six microbiology laboratories in south-west England to determine urine submissions and urine reports in children under 3 years. Seventy-three per cent of laboratories (110/150) participated. Enterobacteriaceae that were not E. coli were reported only as coliforms (rather than non-E. coli coliforms) by 61% (67/110) of laboratories. Eighty-eight per cent of laboratories (97/110) provided urgent microscopy for hospital and 54% for general practice (GP) paediatric urines; 61% of laboratories (confidence interval 52-70%) cultured 1 μl volume of urine, which equates to one colony if the bacterial load is 106 c.f.u. l(-1). Only 22% (24/110) of laboratories reported non-E. coli coliforms and provided urgent microscopy for both hospital and GP childhood urines; only three laboratories also cultured a 5 μl volume of urine. Only one of six laboratories in our submission audit had a significant increase in urine submissions and urines reported from children less than 3 years old between the predicted pre-2007 level in the absence of guidance and the 2008 level following publication of the NICE guidance. Less than a

  3. Quality improvement- where do we stand?

    PubMed

    Green, Ben; Janaway, Ben M; Brennan, Peter A

    2016-07-01

    Improvements in quality are commonly used to measure outcome in modern medicine. The drive to improve services nationally and to reduce the financial burden, which is at the forefront of NHS policy, attracts political debate and is constantly the focus of media attention. However, before this can be done in surgery, we need to learn from ongoing work and recognised systems for quality review and implementation, and develop national processes for sustained improvement. As a specialty, Oral and maxillofacial surgery is a good example. PMID:27025233

  4. Improving Service Management in Campus IT Operations

    ERIC Educational Resources Information Center

    Wan, Stewart H. C.; Chan, Yuk-Hee

    2008-01-01

    Purpose: This paper aims at presenting the benefits from implementing IT service management (ITSM) in an organization for managing campus-wide IT operations. In order to improve the fault correlation from business perspectives, we proposed a framework to automate network and system alerts with respect to its business service impact for proactive…

  5. Quality Improvement Efforts in Pediatric Oral Health.

    PubMed

    Ng, Man Wai

    2016-04-01

    Quality improvement (QI) and measurement are increasingly used in health care to improve patient care and outcomes. Despite current barriers in oral health measurement, there are nascent QI and measurement efforts emerging. This paper describes the role that QI and measurement can play in improving oral health care delivery in clinical practice by presenting a QI initiative that aimed to test and implement a chronic disease management approach to address early childhood caries. PMID:27265978

  6. Improve reliability with operator log sheets

    SciTech Connect

    Devender, A.V.; Ganesan, S.T.

    1996-01-01

    Recently, there have been significant improvements in computerized vibration and online performance monitoring systems. However, despite all the developments, the importance of monitoring rotating equipment through operator log sheets must not be overlooked or neglected. Operator log sheets filled out during shifts can be very useful tools in detecting problems early, provided they are diligently completed and evaluated during the operating shift. In most cases, performance deviations can be corrected by measured within the control of the operator. If the operator understands the purpose of log sheets, and knows the cause and effect of deviations in operating parameters, he or she will be motivated to complete the log sheets to increase equipment reliability. Logged data should include any operating data from equipment that reveals its mechanical condition or performance. The most common data logged are pressure, temperature, flow, power and vibration. The purposes of log sheets are to: establish and recognize the normal operating parameters and identify deviations in performance data; perform timely corrective actions on deviations to avoid unplanned shutdowns and catastrophic failures; avoid repetitive failures and increase mean time between failures; and provide base line data for troubleshooting. Two case histories are presented to illustrate the usefulness of logs: a compressor thrust bearing problem and steam turbine blade washing.

  7. Hazmat review reduces risk and improves operations

    SciTech Connect

    Hartley, P.W.; Trecha, S.J.; Patterson, P.

    1996-07-01

    Through its hazardous materials (hazmat) review initiative, Wisconsin Power and Light Co. (WP and L) repositioned itself for better plant operations while reducing the overall risks and costs associated with hazmats. The utility focused on two primary hazmat improvement objectives: (1) ensure plant hazmat operations are meeting regulatory requirements, optimizing the use, storage, and disposal of hazmats; (2) reduce the overall risk and investment associated with hazmat substances on the plant properties. ``Hazardous materials management is often overlooked as an integral component of the overall purchasing and materials management process``, emphasized Jill Doucette, WP and L Strategic Sourcing Initiative manager. ``Improved performance in this area can significantly reduce personnel and company risks, improve customer service and save dollars.``

  8. Quality circles: Organizational adaptations, improvements and results

    NASA Technical Reports Server (NTRS)

    Tortorich, R.

    1985-01-01

    The effective application in industry and government of quality circles work was demonstrated. The results achieved in quality and productivity improvements and cost savings are impressive. The circle process should be institutionalized within industry and government. The stages of circle program growth, innovations that help achieve circle process institutionalization, and the result achieved at Martin Marietta's Michoud Division and within the National Aeronautics and Space Administration (NASA) are addressed.

  9. Engaging with quality improvement in anticoagulation management.

    PubMed

    Barnes, Geoffrey D; Kline-Rogers, Eva

    2015-04-01

    Anticoagulants are highly effective at preventing thrombosis across a variety of clinical indications. However, their use can also lead to devastating effects, including major bleeding and death. Anticoagulation providers strive to balance the benefits of anticoagulant therapy with the risks of major bleeding. A measure of quality care can be used to assess the strengths and potential weaknesses in any system of coordinated care delivery. Quality measures in anticoagulation include patient-centered outcomes (e.g. major bleeding, time in the therapeutic range) and provider- or process-focused outcomes (e.g. compliance with guideline recommendations and response times to out-of-range laboratory values). Engaging in quality improvement activities allows anticoagulation providers to assess their own performance and identify areas for targeted interventions. This review summarizes the justification for engaging in quality improvement for anticoagulation management and describes a number of example programs. Interventions benefiting the management of both warfarin and the direct oral anticoagulants are included. The review also details potential quality measures and resources for any anticoagulation provider looking to begin a quality improvement process. PMID:25772116

  10. 78 FR 7816 - Quality Assurance Program Requirements (Operations)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-04

    ... COMMISSION Quality Assurance Program Requirements (Operations) AGENCY: Nuclear Regulatory Commission. ACTION... issuing for public comment draft regulatory guide (DG), DG-1300, ``Quality Assurance Program Requirements... analysis report. Both sections require compliance with 10 CFR Part 50, Appendix B, ``Quality...

  11. Improving care at cystic fibrosis centers through quality improvement.

    PubMed

    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. PMID:19760542

  12. [Transgenic technology and soybean quality improvement].

    PubMed

    Cheng, Hao; Jin, Hang-Xia; Gai, Jun-Yi; Yu, De-Yue

    2011-05-01

    Soybean is an important source of edible oil, protein and protein diet. The breeding process of high quality soybean can be accelerated via employment of transgenic technology, by which the key genes for soybean quality traits could be directly manipulated. Thus, various soybean varieties could be bred to fulfill different needs for specific consumers. Here, we reviewed the contribution of transgenic technology to improvement of soybean qualities in recent years. We also introduce some newly developed safe transgenic technologies and hope this information could relieve some concerns on the GM food. PMID:21586389

  13. Improving the quality of mass produced maps

    USGS Publications Warehouse

    Simley, J.

    2001-01-01

    Quality is critical in cartography because key decisions are often made based on the information the map communicates. The mass production of digital cartographic information to support geographic information science has now added a new dimension to the problem of cartographic quality, as problems once limited to small volumes can now proliferate in mass production programs. These problems can also affect the economics of map production by diverting a sizeable portion of production cost to pay for rework on maps with poor quality. Such problems are common to general industry-in response, the quality engineering profession has developed a number of successful methods to overcome these problems. Two important methods are the reduction of error through statistical analysis and addressing the quality environment in which people work. Once initial and obvious quality problems have been solved, outside influences periodically appear that cause adverse variations in quality and consequently increase production costs. Such errors can be difficult to detect before the customer is affected. However, a number of statistical techniques can be employed to detect variation so that the problem is eliminated before significant damage is caused. Additionally, the environment in which the workforce operates must be conductive to quality. Managers have a powerful responsibility to create this environment. Two sets of guidelines, known as Deming's Fourteen Points and ISO-9000, provide models for this environment.

  14. Electronic medical records and quality improvement.

    PubMed

    Carter, Jonathan T

    2015-04-01

    Widespread adoption of electronic medical records (EMRs) in the United States is transforming the practice of medicine from a paper-based cottage industry into an integrated health care delivery system. Most physicians and institutions view the widespread use of EMRs to be inevitable. But the transformation has not been painless. Many have questioned whether the substantial investment in electronic health records has really been justified by improved patient outcomes or quality of care. This article describes historical and recent efforts to use EMRs to improve the quality of patient care, and provides a roadmap of EMR uses for the foreseeable future. PMID:25771280

  15. Impacts of organizational context on quality improvement.

    PubMed

    Glasgow, Justin M; Yano, Elizabeth M; Kaboli, Peter J

    2013-01-01

    Variation in how hospitals perform on similar quality improvement (QI) efforts argues for a need to understand how different organizational characteristics affect QI performance. The objective of this study was to use data-mining methods to evaluate relationships between measures of organizational characteristics and hospital QI performance. Organizational characteristics were extracted from 2 surveys and analyzed in 3 separate decision-tree models. The decision trees did not find any predictive associations in this sample of 100 hospitals participating in a national QI collaborative. Further model review identified that measures of QI Experience were associated with an ability to make improvements, whereas measures of Staffing and Culture were associated with an ability to sustain improvements. A key area for future research is to understand the challenges faced as QI teams transition from improving care to sustaining quality and to ascertain what organizational characteristics can best overcome those challenges. PMID:22942122

  16. Quality assurance: Importance of systems and standard operating procedures.

    PubMed

    Manghani, Kishu

    2011-01-01

    It is mandatory for sponsors of clinical trials and contract research organizations alike to establish, manage and monitor their quality control and quality assurance systems and their integral standard operating procedures and other quality documents to provide high-quality products and services to fully satisfy customer needs and expectations. Quality control and quality assurance systems together constitute the key quality systems. Quality control and quality assurance are parts of quality management. Quality control is focused on fulfilling quality requirements, whereas quality assurance is focused on providing confidence that quality requirements are fulfilled. The quality systems must be commensurate with the Company business objectives and business model. Top management commitment and its active involvement are critical in order to ensure at all times the adequacy, suitability, effectiveness and efficiency of the quality systems. Effective and efficient quality systems can promote timely registration of drugs by eliminating waste and the need for rework with overall financial and social benefits to the Company. PMID:21584180

  17. Quality assurance: Importance of systems and standard operating procedures

    PubMed Central

    Manghani, Kishu

    2011-01-01

    It is mandatory for sponsors of clinical trials and contract research organizations alike to establish, manage and monitor their quality control and quality assurance systems and their integral standard operating procedures and other quality documents to provide high-quality products and services to fully satisfy customer needs and expectations. Quality control and quality assurance systems together constitute the key quality systems. Quality control and quality assurance are parts of quality management. Quality control is focused on fulfilling quality requirements, whereas quality assurance is focused on providing confidence that quality requirements are fulfilled. The quality systems must be commensurate with the Company business objectives and business model. Top management commitment and its active involvement are critical in order to ensure at all times the adequacy, suitability, effectiveness and efficiency of the quality systems. Effective and efficient quality systems can promote timely registration of drugs by eliminating waste and the need for rework with overall financial and social benefits to the Company. PMID:21584180

  18. Improving quality: one step at a time.

    PubMed

    Blankson-seck, N; Butta, P

    1999-01-01

    The notion that health care workers have the power to improve the quality of their services is a key to AVSC's efforts worldwide. The COPE process, AVSC's low-cost intervention for improving quality at service sites, brings together supervisors and staff at all levels to identify barriers to quality services and helps them find solutions they can implement with their own resources. For example, a hospital in Tanzania had tried unsuccessfully to obtain the funds to repair or replace broken equipment. Using the COPE process, the hospital used available funds to send a technician for training in maintenance and repair. Now everything from blood pressure equipment to bedsprings is repaired promptly, and quality has improved. Another hospital in Tanzania coped with the problem of broken bedsprings (patients were putting mattresses on the floor) by using readily available wire mesh to make repairs. In Kenya, the lack of running water forced staff to collect water from a cistern, taking time from their other responsibilities. During a COPE meeting to resolve the problem the staff bemoaned the fact that they did not have the funds to replace the water system. Then the gardener told the group that all they needed to do was fix a broken pipe. The repair was made at minimal cost, and the water supply was restored. The COPE process reveals that health care staff not only can identify obstacles to quality, they often know the cause of the problem and can offer the best solutions. PMID:12295155

  19. AQIP and Accreditation: Improving Quality and Performance

    ERIC Educational Resources Information Center

    Spangehl, Stephen D.

    2012-01-01

    For the past 12 years, the Academic Quality Improvement Program (AQIP) has offered an innovative means for colleges and universities to maintain regional accreditation with the Higher Learning Commission (HLC), the only regional U.S. accrediting commission currently providing alternative pathways for maintaining accreditation. Although all HLC…

  20. Quality Improvements in Curricula for Global Studies

    ERIC Educational Resources Information Center

    Bader, Lena; Bereuther, Tabea; Deutsch, Elisabeth; Edlinger, Julia; Fureder, Silvia; Kaspar, Emanuel; Kottstorfer, Marlene; Mautner, Claudia; Rossegger, Christine; Samonig, Alina; Samonig, Stefan; Schuster, Christoph; Witz, Gerhard; Zotter, Victoria; Ahamer, Gilbert

    2013-01-01

    Purpose: Based on an in-depth comparison of 20 multicultural university curricula, this article aims to provide practical and implementable suggestions about how to improve such curricula in order to ensure highest and globally compatible academic quality. The recently founded developmental Master's curriculum "Global Studies" (GS) at the…

  1. Improving the Quality of Think-Alouds

    ERIC Educational Resources Information Center

    Ness, Molly; Kenny, MaryBeth

    2016-01-01

    An essential element in teaching children to effectively comprehend text is the use of teacher-led think alouds. This article presents a three-step model to improve the quality and quantity of think alouds in K-6 classrooms. The article follows elementary teachers who planned, implemented, transcribed, and reflected upon think aloud lessons to…

  2. Fostering Quality Improvement in EHDI Programs

    ERIC Educational Resources Information Center

    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…

  3. Using Quality Concepts to Improve Reference Services.

    ERIC Educational Resources Information Center

    Brown, Janet Dagenais

    1994-01-01

    Discusses how to improve library reference service, especially the effective delivery of accurate answers, based on a program at Wichita State University (Kansas) that used concepts of quality from business and organizational management. Topics addressed include customers and customer service, and methods of reference service evaluation. (Contains…

  4. Training Improves Careers--and Quality.

    ERIC Educational Resources Information Center

    Langham, Barbara A.

    2002-01-01

    Describes training paths for child caregivers, and the incorporation of staff training requirements for facility accreditation by national professional organizations and the development of individual credentials. Describes strategies for improving quality of care, including organizing for higher wages, subsidizing care, and extending free public…

  5. Progress at Fresh Kills improving water quality

    SciTech Connect

    Londres, E.J.

    1991-06-01

    This paper reports that in December 1987, the federal district court in Nevada issued a consent order forcing New York City (NYC) to improve its handling of solid waste and reduce the discharge of solid waste into the surrounding waterway. Implementation of the consent order by NYC resulted in many improvements in the transport of solid waste from the Marine Transfer Station (MTS) to Fresh Kills Landfill. The end result was a marked reduction in solid waste discharge and an improvement in water quality along the New Jersey shore areas.

  6. Engaging Clinical Nurses in Quality Improvement Projects.

    PubMed

    Moore, Susan; Stichler, Jaynelle F

    2015-10-01

    Clinical nurses have the knowledge and expertise required to provide efficient and proficient patient care. Time and knowledge deficits can prevent nurses from developing and implementing quality improvement or evidence-based practice projects. This article reviews a process for professional development of clinical nurses that helped them to define, implement, and analyze quality improvement or evidence-based practice projects. The purpose of this project was to educate advanced clinical nurses to manage a change project from inception to completion, using the Six Sigma DMAIC (Define, Measure, Analyze, Improve, Control) Change Acceleration Process as a framework. One-to-one mentoring and didactic in-services advanced the knowledge, appreciation, and practice of advanced practice clinicians who completed multiple change projects. The projects facilitated clinical practice changes, with improved patient outcomes; a unit cultural shift, with appreciation of quality improvement and evidence-based projects; and engagement with colleagues. Project outcomes were displayed in poster presentations at a hospital exposition for knowledge dissemination. PMID:26430867

  7. Creating Quality Improvement Culture in Public Health Agencies

    PubMed Central

    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

  8. Quality improvements of cell membrane chromatographic column.

    PubMed

    Ding, Xuan; Chen, Xiaofei; Cao, Yan; Jia, Dan; Wang, Dongyao; Zhu, Zhenyu; Zhang, Juping; Hong, Zhanying; Chai, Yifeng

    2014-09-12

    Cell Membrane Chromatography (CMC) is a biological affinity chromatographic method using a silica stationary phase covered with specific cell membrane. However, its short life span and poor quality control was highlighted in a lot of research articles. In this study, special attention has been paid to the disruption, cell load and packing procedure in order to improve the quality of the CMC columns. Hereto, two newly established CMC models, HSC-T6/CMC and SMMC-7721/CMC have been developed and used in this research project. The optimization of the abovementioned parameters resulted in a better reproducibility of the retention time of the compound GFT (RSD<10%) and improved significantly the quality of the CMC columns. 3.5×10(7)cells were the optimal cell load for the preparation of the CMC columns, the disruption condition was optimized to 5 cycles (400W and 20s interval per cycle) by an ultrasonic processor reducing the total time of cell disruption to 1.5min and the packing flow rate was optimized by applying a linear gradient program. Additionally, 4% paraformaldehyde (PFA) was employed to improve the column quality and prolong the column life span. The results showed that the retention time was longer with PFA treated columns than the ones obtained with the control groups. PMID:25115453

  9. MODIS Instrument Operation and Calibration Improvements

    NASA Technical Reports Server (NTRS)

    Xiong, X.; Angal, A.; Madhavan, S.; Link, D.; Geng, X.; Wenny, B.; Wu, A.; Chen, H.; Salomonson, V.

    2014-01-01

    Terra and Aqua MODIS have successfully operated for over 14 and 12 years since their respective launches in 1999 and 2002. The MODIS on-orbit calibration is performed using a set of on-board calibrators, which include a solar diffuser for calibrating the reflective solar bands (RSB) and a blackbody for the thermal emissive bands (TEB). On-orbit changes in the sensor responses as well as key performance parameters are monitored using the measurements of these on-board calibrators. This paper provides an overview of MODIS on-orbit operation and calibration activities, and instrument long-term performance. It presents a brief summary of the calibration enhancements made in the latest MODIS data collection 6 (C6). Future improvements in the MODIS calibration and their potential applications to the S-NPP VIIRS are also discussed.

  10. Improved high operating temperature MCT MWIR modules

    NASA Astrophysics Data System (ADS)

    Lutz, H.; Breiter, R.; Figgemeier, H.; Schallenberg, T.; Schirmacher, W.; Wollrab, R.

    2014-06-01

    High operating temperature (HOT) IR-detectors are a key factor to size, weight and power (SWaP) reduced IR-systems. Such systems are essential to provide infantrymen with low-weight handheld systems with increased battery lifetimes or most compact clip-on weapon sights in combination with high electro-optical performance offered by cooled IR-technology. AIM's MCT standard n-on-p technology with vacancy doping has been optimized over many years resulting in MWIR-detectors with excellent electro-optical performance up to operating temperatures of ~120K. In the last years the effort has been intensified to improve this standard technology by introducing extrinsic doping with Gold as an acceptor. As a consequence the dark current could considerably be suppressed and allows for operation at ~140K with good e/o performance. More detailed investigations showed that limitation for HOT > 140K is explained by consequences from rising dark current rather than from defective pixel level. Recently, several crucial parameters were identified showing great promise for further optimization of HOT-performance. Among those, p-type concentration could successfully be reduced from the mid 1016 / cm3 to the lower 1015/ cm3 range. Since AIM is one of the leading manufacturers of split linear cryocoolers, an increase in operating temperature will directly lead to IR-modules with improved SWaP characteristics by making use of the miniature members of its SX cooler family with single piston and balancer technology. The paper will present recent progress in the development of HOT MWIR-detector arrays at AIM and show electro-optical performance data in comparison to focal plane arrays produced in the standard technology.

  11. Innovative drilling improves THUMS islands operations

    SciTech Connect

    Moore, S.D.

    1983-08-01

    During the last 2 years, THUMS Long Beach Co. has made tremendous improvements in drilling and production efficiencies. The company implemented several innovative ideas which have reduced drilling time by as much as 25%, as well as increased well productivity. THUMS' engineering and drilling staffs should be credited with willingness to explore and to try state-of-the-art technology to improve ongoing operations. The company as one of the first to use computer optimization for well bore planning, measurement-while-drilling (MWD) tools for monitoring directional drilling parameters, and more recently for using the combination of polycrystalline diamond compact (PDC) underreamers and high-torque, low-speed mud motors to underream selected intervals.

  12. 42 CFR 485.917 - Condition of participation: Quality assessment and performance improvement.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... improvements that affect behavioral outcomes, client safety, and person-centered quality of care. (2... of care, CMHC services, and operations. (b) Standard: Program data. (1) The program must use quality... and quality of care. (ii) Identify opportunities and priorities for improvement. (3) The frequency...

  13. Total quality management approach improves medication replacement.

    PubMed

    Anderson, L K

    1994-07-01

    Total quality management (TQM) is based on understanding customer needs, improving key processes that affect customer satisfaction, and creating cross-functional teams to resolve process problems. This article describes application of TQM principles and problem-solving processes to improve one OR's medication exchange system. The problem was excessive monthly pharmacy medication replacement costs. The goal was to reduce the monthly medication replacement costs by 50%. Within four months, monthly medication replacement charges decreased from $656 to $302, and by one year, monthly charges decreased to $160. The new process had fewer steps, fewer staff members involved, and fewer delays in medication replacement. PMID:8085806

  14. In Brief: Improving Mississippi River water quality

    NASA Astrophysics Data System (ADS)

    Showstack, Randy

    2007-10-01

    If water quality in the Mississippi River and the northern Gulf of Mexico is to improve, the U.S. Environmental Protection Agency (EPA) needs to take a stronger leadership role in implementing the federal Clean Water Act, according to a 16 October report from the U.S. National Research Council. The report notes that EPA has failed to use its authority to coordinate and oversee activities along the river. In addition, river states need to be more proactive and cooperative in efforts to monitor and improve water quality, and the river should be monitored and evaluated as a single system, the report indicates. Currently, the 10 states along the river conduct separate and widely varying water quality monitoring programs. ``The limited attention being given to monitoring and managing the Mississippi's water quality does not match the river's significant economic, ecological, and cultural importance,'' said committee chair David A. Dzombak, director of the Steinbrenner Institute for Environmental Education and Research at Carnegie Mellon University, Pittsburgh, Pa. The report notes that while measures taken under the Clean Water Act have successfully reduced much point source pollution, nutrient and sediment loads from nonpoint sources continue to be significant problems. For more information, visit the Web site: http://books.nap.edu/catalog.php?record_id=12051.

  15. Productivity improvement and quality enhancement at NASA

    NASA Technical Reports Server (NTRS)

    Braunstein, D. R.

    1985-01-01

    NASA's Productivity Improvement and Quality Enhancement (PIQE) effort has as its objectives the encouragement of greater employee participation in management decision-making and the identification of impediments as well as opportunities for high productivity. Attempts are also made to try out novel management practices, and to evolve productivity trend analysis techniques. Every effort is made to note, reward, and diffuse successfully instituted PIQE approaches throughout the NASA-contractor organization.

  16. Advanced kick detection systems improve HPHT operations

    SciTech Connect

    Harris, T.W.R.; Hendriks, P.; Surewaard, J.H.G.

    1995-09-01

    Many high-pressure, high-temperature (HPHT) wells are often characterized by the small margins that can exist between pore pressure and formation strength. Therefore, it is not surprising that kicks are far more likely to occur in HPHT wells and that a greater risk of internal blowout exists. The development and application of advanced kick detection systems for HPHT wells can help manage risks and improve drilling efficiency. Such systems enable earlier well shut-in, minimizing both the influx volume and the subsequent well bore pressures. This in turn lowers the risk, time and cost required for well control operations. Carefully considered application of these systems can also justify favorable economic benefits by optimization of the HPHT preliminary casing design. Minimizing kick volume can be important for the critical HPHT hole sections, where a reduced operating margin between pore pressure and fracture gradient exists, defining small design kick tolerance limits to permit safe drilling ahead to reach specified objectives. Kick detection for HPHT wells equivalent to less than 5 bbl of gas influx are often necessary to adequately minimize the risk of internal blowout and obtain the same levels of safety which are applied to conventional wells. This paper reviews these systems for both on-shore and off-shore operations.

  17. Multichannel DBS halftoning for improved texture quality

    NASA Astrophysics Data System (ADS)

    Slavuj, Radovan; Pedersen, Marius

    2015-01-01

    The paper aims to develop a method for multichannel halftoning based on the Direct Binary Search (DBS) algorithm. We integrate specifics and benefits of multichannel printing into the halftoning method in order to further improve texture quality of DBS and to create halftoning that would suit for multichannel printing. Originally, multichannel printing is developed for an extended color gamut, at the same time additional channels can help to improve individual and combined texture of color halftoning. It does so in a similar manner to the introduction of the light colors (diluted inks) in printing. Namely, if one observes Red, Green and Blue inks as the light version of the M+Y, C+Y, C+M combinations, the visibility of the unwanted halftoning textures can be reduced. Analogy can be extent to any number of ink combinations, or Neugebauer Primaries (NPs) as the alternative building blocks. The extended variability of printing spatially distributed NPs could provide many practical solution and improvements in color accuracy, image quality, and could enable spectral printing. This could be done by selection of NPs per dot area location based on the constraint of the desired reproduction. Replacement with brighter NP at the location could induce a color difference where a tradeoff between image quality and color accuracy is created. With multichannel enabled DBS haftoning, we are able to reduce visibility of the textures, to provide better rendering of transitions, especially in mid and dark tones.

  18. Operational Environmental Monitoring Program Quality Assurance Project Plan

    SciTech Connect

    Perkins, C.J.

    1994-08-01

    This Quality Assurance Project Plan addresses the quality assurance requirements for the activities associated with the preoperational and operational environmental monitoring performed by Westinghouse Hanford Company as it implements the Operational Environmental Monitoring program. This plan applies to all sampling and monitoring activities performed by Westinghouse Hanford Company in implementing the Operational Environmental Monitoring program at the Hanford Site.

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

    PubMed

    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. PMID:27484810

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

    PubMed Central

    Cho, Yu Kyung

    2016-01-01

    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. PMID:27484810

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

    PubMed Central

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

    2008-01-01

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

  2. Quality councils as change agents and drivers of quality improvement in healthcare.

    PubMed

    Plumb, Michael; Cowell, John W F

    2006-01-01

    This commentary addresses four key questions raised in the lead paper. We recognize that health quality councils have a delimited range of tools available to bring about needed change. They have neither funding and regulatory powers nor day-to-day operational authority. Nevertheless, based on the Health Quality Council of Alberta's (HQCA) successes to date using a multidimensional change strategy, we are confident that quality councils can play a vital role in driving and sustaining quality improvement in provincial healthcare systems. The provisos are that the councils need to be sufficiently empowered, establish themselves as trusted partners and independent advisors, use effective change strategies, focus on strategic priorities and gain strong stakeholder support for needed changes. We are also convinced that multilevel measurement is an essential tool for learning, priority setting, establishing the imperative for action and assessing progress. Finally, in terms of the value proposition - the relationship between resource inputs and healthcare outcomes - we strongly suggest that health quality councils work collaboratively with service providers to obtain better value for money by improving quality rather than aligning themselves with funders and rely on "pay for quality" incentives to "compel" quality improvement. PMID:16651861

  3. Burnishing of rotatory parts to improve surface quality

    NASA Astrophysics Data System (ADS)

    Celaya, A.; López de Lacalle, L. N.; Albizuri, J.; Alberdi, R.

    2009-11-01

    In this paper, the use of rolling burnishing process to improve the final quality of railway and automotive workpieces is studied. The results are focused on the improvement of the manufacturing processes of rotary workpieces used in railway and automotion industry, attending to generic target of achieving `maximum surface quality with minimal process time'. Burnishing is a finishing operation in which plastic deformation of surface irregularities occurs by applying pressure through a very hard element, a roller or a ceramic ball. This process gives additional advantages to the workpiece such as good surface roughness, increased hardness and high compressive residual stresses. The effect of the initial turning conditions on the final burnishing operation has also been studied. The results show that feeds used in the initial rough turning have little influence in the surface finish of the burnished workpieces. So, the process times of the combined turning and burnishing processes can be reduced, optimizing the shaft's machining process.

  4. Increased Mercury Bioaccumulation Follows Water Quality Improvement

    SciTech Connect

    Bogle, M.A.; Peterson, M.J.; Smith, J.G.; Southworth, G.R.

    1999-09-15

    Changes in physical and chemical characteristics of aquatic habitats made to reduce or eliminate ecological risks can sometimes have unforeseen consequences. Environmental management activities on the U.S. Dept. of Energy reservation in Oak Ridge, Tennessee,have succeeded in improving water quality in streams impacted by discharges fi-om industrial facilities and waste disposal sites. The diversity and abundance of pollution-sensitive components of the benthic macroinvertebrate communities of three streams improved after new waste treatment systems or remedial actions reduced inputs of various toxic chemicals. Two of the streams were known to be mercury-contaminated from historical spills and waste disposal practices. Waterborne mercury concentrations in the third were typical of uncontaminated systems. In each case, concentrations of mercury in fish, or the apparent biological availability of mercury increased over the period during which ecological metrics indicated improved water quality. In the system where waterborne mercury concentrations were at background levels, increased mercury bioaccumulation was probably a result of reduced aqueous selenium concentrations; however, the mechanisms for increased mercury accumulation in the other two streams remain under investigation. In each of the three systems, reduced inputs of metals and inorganic anions was followed by improvements in the health of aquatic invertebrate communities. However, this reduction in risk to aquatic invertebrates was accompanied by increased risk to humans and piscivorous wildlife related to increased mercury concentrations in fish.

  5. Quality management science in clinical chemistry: a dynamic framework for continuous improvement of quality.

    PubMed

    Westgard, J O; Burnett, R W; Bowers, G N

    1990-10-01

    Current quality assurance approaches will not be adequate to satisfy the needs for quality in the next decade. Quality management science (QMS), as evolving in industry today, provides the dynamic framework necessary to provide continuous improvement of quality. QMS emphasizes the importance of defining quality goals based on the needs and expectations (implied needs) of customers. The laboratory can develop customer-friendly goals and measures of quality by recognizing that customers' experiences are represented by a totality of results. Quality goals and measures are best communicated as "total performance" by specifying a limit and percentile of the distribution, rather than a mean and standard deviation. Application of quality goals within the laboratory will usually require partitioning the total performance goal into components and translating those components into specifications to guide the operation and management of production processes. QMS also extends beyond technical processes to people processes and provides guidance for improving the quality of worklife and caring for the laboratory's most essential resource--our people. PMID:2208645

  6. Improved operation of the nonambipolar electron source

    NASA Astrophysics Data System (ADS)

    Longmier, Ben; Hershkowitz, Noah

    2008-09-01

    Significant improvements have been made to the nonambipolar electron source (NES), a radio frequency (rf) plasma-based electron source that does not rely on electron emission at a cathode surface [B. Longmier, S. Baalrud, and N. Hershkowitz, Rev. Sci. Instrum. 77, 113504 (2006)]. A prototype NES has produced 30 A of continuous electron current, using 2 SCCM (SCCM denotes cubic centimeter per minute at STP) Xe, 1300 W rf power at 13.56 MHz, yielding a 180 times gas utilization factor. A helicon mode transition has also been identified during NES operation with an argon propellant, using 15 SCCM Ar, 1000 W rf, and 100 G magnetic field. This NES technology has the ability to replace hollow cathode electron sources and to enable high power electric propulsion missions, eliminating one of the lifetime restrictions that many ion thrusters have previously been faced with.

  7. Wind turbine generator with improved operating subassemblies

    DOEpatents

    Cheney, Jr., Marvin C.

    1985-01-01

    A wind turbine includes a yaw spring return assembly to return the nacelle from a position to which it has been rotated by yawing forces, thus preventing excessive twisting of the power cables and control cables. It also includes negative coning restrainers to limit the bending of the flexible arms of the rotor towards the tower, and stop means on the rotor shaft to orient the blades in a vertical position during periods when the unit is upwind when the wind commences. A pendulum pitch control mechanism is improved by orienting the pivot axis for the pendulum arm at an angle to the longitudinal axis of its support arm, and excessive creep is of the synthetic resin flexible beam support for the blades is prevented by a restraining cable which limits the extent of pivoting of the pendulum during normal operation but which will permit further pivoting under abnormal conditions to cause the rotor to stall.

  8. Improving Air Quality Forecasts with AURA Observations

    NASA Technical Reports Server (NTRS)

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

    2008-01-01

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

  9. Quality improvement in basic histotechnology: the lean approach.

    PubMed

    Clark, David

    2016-01-01

    Lean is a comprehensive system of management based on the Toyota production system (TPS), encompassing all the activities of an organization. It focuses management activity on creating value for the end-user by continuously improving operational effectiveness and removing waste. Lean management creates a culture of continuous quality improvement with a strong emphasis on developing the problem-solving capability of staff using the scientific method (Deming's Plan, Do, Check, Act cycle). Lean management systems have been adopted by a number of histopathology departments throughout the world to simultaneously improve quality (reducing errors and shortening turnround times) and lower costs (by increasing efficiency). This article describes the key concepts that make up a lean management system, and how these concepts have been adapted from manufacturing industry and applied to histopathology using a case study of lean implementation and evidence from the literature. It discusses the benefits, limitations, and pitfalls encountered when implementing lean management systems. PMID:26306714

  10. The Quality Assurance Project: introducing quality improvement to primary health care in less developed countries.

    PubMed

    Nicholas, D D; Heiby, J R; Hatzell, T A

    1991-01-01

    Persistently excessive morbidity and mortality rates in less developed countries (LDCs) served by primary health care systems suggest that the quality of services is inadequate. The PRICOR project, sponsored by the United States Agency for International Development, has designed and implemented methods for quality assessment and problem solving in LDC health systems. After developing comprehensive lists of essential activities and tasks, similar to practice parameters, for seven child survival interventions, PRICOR supported comprehensive quality assessment studies in twelve LDC countries. The studies, yielding over 6000 observations of health worker-client encounters, indicated highly prevalent, serious program deficiencies in areas including diagnosis, treatment, patient education and supervision. To facilitate corrective action, PRICOR assisted managers in conducting operations research to resolve priority problems revealed by the assessments. The recently initiated Quality Assurance Project is building on PRICOR techniques in designing and implementing sustainable continuous quality improvement programs for LDC health systems. PMID:1782383

  11. Project Hanford management contract quality improvement project management plan

    SciTech Connect

    ADAMS, D.E.

    1999-03-25

    On July 13, 1998, the U.S. Department of Energy, Richland Operations Office (DOE-RL) Manager transmitted a letter to Fluor Daniel Hanford, Inc. (FDH) describing several DOE-RL identified failed opportunities for FDH to improve the Quality Assurance (QA) Program and its implementation. In addition, DOE-RL identified specific Quality Program performance deficiencies. FDH was requested to establish a periodic reporting mechanism for the corrective action program. In a July 17, 1998 response to DOE-RL, FDH agreed with the DOE concerns and committed to perform a comprehensive review of the Project Hanford Management Contract (PHMC) QA Program during July and August, 1998. As a result, the Project Hanford Management Contract Quality Improvement Plan (QIP) (FDH-3508) was issued on October 21, 1998. The plan identified corrective actions based upon the results of an in-depth Quality Program Assessment. Immediately following the scheduled October 22, 1998, DOE Office of Enforcement and Investigation (EH-10) Enforcement Conference, FDH initiated efforts to effectively implement the QIP corrective actions. A Quality Improvement Project (QI Project) leadership team was assembled to prepare a Project Management Plan for this project. The management plan was specifically designed to engage a core team and the support of representatives from FDH and the major subcontractors (MSCs) to implement the QIP initiatives; identify, correct, and provide feedback as to the root cause for deficiency; and close out the corrective actions. The QI Project will manage and communicate progress of the process.

  12. Hospice quality improvement programs: an initial examination.

    PubMed

    D'Onofrio, C N

    1998-05-01

    Recognizing that little is known about use of quality improvement (QI) processes to enhance care of the dying, 11 large hospices exchanged information about their QI programs. These hospices reported monitoring from 3 to 50 outcomes measured by various indicators and methods. Agencies that related QI to their organization's mission, goals, and strategic plan were more likely to have dedicated QI staff; a more intense, comprehensive, and participatory QI program; and more QI projects resulting in performance enhancement. Both accomplishments and difficulties were identified in several areas, including establishing benchmarks, involving staff, and using computer technology to manage and analyze QI data. PMID:10179273

  13. NanTroSEIZE Stage 1 operational review: Operational limits and data quality

    NASA Astrophysics Data System (ADS)

    Kuramoto, S.; Kyaw Thu, M.; Masago, H.; Curewitz, D.; Gaillot, P.; Sanada, Y.; Science Party, E.

    2008-12-01

    Nankai Trough Seismogenic Zone Experiment (NanTroSEIZE) Stage 1 is first step in the ambitious, coordinated multistage, multi-expedition project from the Integrated Ocean Drilling Program (IODP). Through out the 138 days of continuous operations in three expeditions, two major challenges caused various problems and delays. The Kuroshio current presented at all sites and more often at 3 knot or greater velocity, and the difficult borehole conditions in this tectonically active faulting environment obviously caused substantial loss of operational time, failure of equipments and loss of toolstring. Several other technical problems, ranging from dynamic positioning system, remotely operated vehicle (ROV) to wait-on-weather, made additional delays as well. During the course of these expeditions, Chikyu was able to test and refine operational techniques and structures, and able to pioneer the use of new tools and equipments not only in the lab area but also at the rig floor coring and logging operations. Those include first-ever and rarely-used logging-while-drilling (LWD) tools in the scientific drilling history, new coring systems and techniques, extensive use of X-ray Computed Tomography (XCT) on whole core sections and several others. Expedition 314 collected 4274 m of LWD logs and conducted 2285.5 m of Measurement-While-Drilling (MWD) logs from pilot holes. Expedition 315 recovered 808 m of core from 1287 m penetration, and Expedition 316 recovered 1340 m of core out of 2103 m penetration. With intention of improving CDEX's expedition planning and science services in the future, major review work is in progress focusing on operational, technological and science services. Review on the non-productive time records found to be 23.5% for overall stage 1, which gradually decreases from 33.7% at the beginning (Exp. 314) to 24.9% during the Exp. 315 and then 11.0% in the Exp. 316. Review on the coring operations and functioning of coring tools in focus of core quality

  14. Improving National Air Quality Forecasts with Satellite Aerosol Observations.

    NASA Astrophysics Data System (ADS)

    Al-Saadi, Jassim; Szykman, James; Pierce, R. Bradley; Kittaka, Chieko; Neil, Doreen; Chu, D. Allen; Remer, Lorraine; Gumley, Liam; Prins, Elaine; Weinstock, Lewis; MacDonald, Clinton; Wayland, Richard; Dimmick, Fred; Fishman, Jack

    2005-09-01

    Accurate air quality forecasts can allow for mitigation of the health risks associated with high levels of air pollution. During September 2003, a team of NASA, NOAA, and EPA researchers demonstrated a prototype tool for improving fine particulate matter (PM2.5) air quality forecasts using satellite aerosol observations. Daily forecast products were generated from a near-real-time fusion of multiple input data products, including aerosol optical depth (AOD) from the Moderate Resolution Imaging Spectroradiometer (MODIS)/ Earth Observing System (EOS) instrument on the NASA Terra satellite, PM2.5 concentration from over 300 state/local/national surface monitoring stations, meteorological fields from the NOAA/NCEP Eta Model, and fire locations from the NOAA/National Environmental Satellite, Data, and Information Service (NESDIS) Geostationary Operational Environmental Satellite (GOES) Wildfire Automated Biomass Burning Algorithm (WF_ABBA) product. The products were disseminated via a Web interface to a small group of forecasters representing state and local air management agencies and the EPA. The MODIS data improved forecaster knowledge of synoptic-scale air pollution events, particularly over oceans and in regions devoid of surface monitors. Forecast trajectories initialized in regions of high AOD offered guidance for identifying potential episodes of poor air quality. The capability of this approach was illustrated with a case study showing that aerosol resulting from wildfires in the northwestern United States and southwestern Canada is transported across the continent to influence air quality in the Great Lakes region a few days later. The timing of this demonstration was selected to help improve the accuracy of the EPA's AIRNow (www.epa.gov/airnow/) air quality index next-day PM2.5 forecast, which began on 1 October 2003. Based on the positive response from air quality managers and forecasters, this prototype was expanded and transitioned to an operational

  15. Improving pre-operative medicines reconciliation

    PubMed Central

    Brunswicker, Annemarie; Yogarajah, Amieth

    2014-01-01

    An audit of 143 surgical admissions showed that only 30% of general surgery and urology patients have complete medication charts on the day of surgery prior to going to theatre, compared to 94% of orthopaedic patients. This was despite having been seen previously in the pre-operative assessment clinic (POAC). These patients went to the wards post-operatively, where many then missed doses of their life-sustaining medications. Orthopaedic patients see a prescribing pharmacist in POAC who undertakes medicines reconciliation; this is performed by junior doctors for surgical patients. We designed three interventions to improve drug chart completion by junior doctors, and gathered prospective data for 22 weeks in the POAC. We also recorded attendance of junior doctors in the POAC and reasons for absence. Daily and weekly percentages of drug chart completion were plotted on a run chart. The baseline completion rate was 43%. This rose to 45% after the first and second interventions, and 51% after the third intervention. However, the completion rate remained markedly below our target of 94%. Junior doctors attended only 44% of POACs. They reported being “too busy to attend” 41% of the time, and could not be contacted on 11% of occasions. Junior doctors reported that they were unable to attend to both unwell inpatients and the POAC, the latter seeming less of a priority. This was despite a rota allocating doctors to attend POAC sessions free from clinical or teaching commitments. We were unable to increase the rate of drug chart completion with the resources available. We therefore recommend the employment of prescribing pharmacists in the POAC for general surgery and urology patients.

  16. 78 FR 37850 - Quality Assurance Program Requirements (Operations)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-24

    ... Register on February 4, 2013 (78 FR 7816) for a 60-day public comment period. The public comment period... COMMISSION Quality Assurance Program Requirements (Operations) AGENCY: Nuclear Regulatory Commission. ACTION... Regulatory Guide (RG) 1.33, ``Quality Assurance Program Requirements (Operations).'' This RG...

  17. Biospecimen Reporting for Improved Study Quality (BRISQ)

    SciTech Connect

    Moore, Ph.D., Helen M.; Kelly Ph.D., Andrea; Jewell Ph.D., Scott D.; McShane Ph.D., Lisa M.; Clark M.D., Douglas P.; Greenspan M.D., Renata; Hayes M.D., Daniel F.; Hainaut Ph.D.,, Pierre; Kim, Paula; Mansfield Ph.D., Elizabeth; Potapova Ph.D., Olga; Riegman Ph.D., Peter; Rubinstein Ph.D., Yaffa; Seijo M.S., Edward; Somiari Ph.D., Stella; Watson M.B., Peter; Weier Ph.D., Heinz-Ulrich; Zhu Ph.D., Claire; Vaught Ph.D., Jim

    2011-04-26

    Human biospecimens are subject to a number of different collection, processing, and storage factors that can significantly alter their molecular composition and consistency. These biospecimen preanalytical factors, in turn, influence experimental outcomes and the ability to reproduce scientific results. Currently, the extent and type of information specific to the biospecimen preanalytical conditions reported in scientific publications and regulatory submissions varies widely. To improve the quality of research utilizing human tissues it is critical that information regarding the handling of biospecimens be reported in a thorough, accurate, and standardized manner. The Biospecimen Reporting for Improved Study Quality (BRISQ) recommendations outlined herein are intended to apply to any study in which human biospecimens are used. The purpose of reporting these details is to supply others, from researchers to regulators, with more consistent and standardized information to better evaluate, interpret, compare, and reproduce the experimental results. The BRISQ guidelines are proposed as an important and timely resource tool to strengthen communication and publications around biospecimen-related research and help reassure patient contributors and the advocacy community that the contributions are valued and respected.

  18. Biospecimen Reporting for Improved Study Quality

    SciTech Connect

    Moore, Ph.D., Helen M.; Kelly, Ph.D., Andrea B.; Jewell, Ph.D., Scott D.; McShane, Ph.D., Lisa M.; Clark, M.D., Douglas P.; Greenspan, M.D., Renata; Hayes, M.D., Daniel F.; Hainaut, Ph.D., Pierre; Kim, Paula; Mansfield, Ph.D., Elizabeth A.; Potapova, Ph.D., Olga; Riegman, Ph.D., Peter; Rubinstein, Ph.D., Yaffa; Seijo, M.S., Edward; Somiari, Ph.D., Stella; Chir., B; Weier, Ph.D., Heinz-Ulrich; Zhu, Ph.D., Claire; Vaught, Ph.D., Jim; Watson,M.B., Peter

    2010-12-27

    Human biospecimens are subjected to collection, processing, and storage that can significantly alter their molecular composition and consistency. These biospecimen preanalytical factors, in turn, influence experimental outcomes and the ability to reproduce scientific results. Currently, the extent and type of information specific to the biospecimen preanalytical conditions reported in scientific publications and regulatory submissions varies widely. To improve the quality of research that uses human tissues, it is crucial that information on the handling of biospecimens be reported in a thorough, accurate, and standardized manner. The Biospecimen Reporting for Improved Study Quality (BRISQ) recommendations outlined herein are intended to apply to any study in which human biospecimens are used. The purpose of reporting these details is to supply others, from researchers to regulators, with more consistent and standardized information to better evaluate, interpret, compare, and reproduce the experimental results. The BRISQ guidelines are proposed as an important and timely resource tool to strengthen communication and publications on biospecimen-related research and to help reassure patient contributors and the advocacy community that their contributions are valued and respected.

  19. Biospecimen Reporting for Improved Study Quality (BRISQ)

    SciTech Connect

    National Cancer Institute; Jewell, Ph.D., Scott D.; Seijo, M.S., Edward; Kelly, Ph.D., Andrea; Somiari, Ph.D., Stella; B.Chir., M.B.; McShane, Ph.D., Lisa M.; Clark, M.D., Douglas; Greenspan, M.D., Renata; Hayes, M.D., Daniel F.; Hainaut, Ph.D., M.S., Pierre; Kim, Paula; Mansfield, Ph.D., Elizabeth; Potapova, Ph.D., Olga; Riegman, Ph.D., Peter; Rubinstein, Ph.D., Yaffa; Weier, Ph.D., Heinz-Ulrich; Zhu, Ph.D., Claire; Moore, Ph.D., Helen M.; Vaught, Ph.D., Jim; Watson, Peter

    2010-09-02

    Human biospecimens are subjected to collection, processing, and storage that can significantly alter their molecular composition and consistency. These biospecimen preanalytical factors, in turn, influence experimental outcomes and the ability to reproduce scientific results. Currently, the extent and type of information specific to the biospecimen preanalytical conditions reported in scientific publications and regulatory submissions varies widely. To improve the quality of research that uses human tissues, it is crucial that information on the handling of biospecimens be reported in a thorough, accurate, and standardized manner. The Biospecimen Reporting for Improved Study Quality (BRISQ) recommendations outlined herein are intended to apply to any study in which human biospecimens are used. The purpose of reporting these details is to supply others, from researchers to regulators, with more consistent and standardized information to better evaluate, interpret, compare, and reproduce the experimental results. The BRISQ guidelines are proposed as an important and timely resource tool to strengthen communication and publications on biospecimen-related research and to help reassure patient contributors and the advocacy community that their contributions are valued and respected.

  20. Operational excellence (six sigma) philosophy: Application to software quality assurance

    SciTech Connect

    Lackner, M.

    1997-11-01

    This report contains viewgraphs on operational excellence philosophy of six sigma applied to software quality assurance. This report outlines the following: goal of six sigma; six sigma tools; manufacturing vs administrative processes; Software quality assurance document inspections; map software quality assurance requirements document; failure mode effects analysis for requirements document; measuring the right response variables; and questions.

  1. Pediatric National Surgical Quality Improvement Program: Useful for Quality Improvement in Craniosynostosis Surgery?

    PubMed

    Lam, Sandi; Fridley, Jared; Desai, Virendra R; Srinivasan, Visish M; Jea, Andrew; Luerssen, Thomas G; Pan, I-Wen

    2016-05-01

    The American College of Surgeons and the American Pediatric Surgical Association collaborate to provide pediatric hospitals with multispeciality surgical outcomes data through the Pediatric National Surgical Quality Improvement Program (NSQIP Peds). The authors used this national multicenter database to describe 30-day outcomes from craniosynostosis surgery and identify associations with perioperative events and blood transfusion.Data from NSQIP Peds were used to describe children undergoing craniosynostosis surgery. The authors examined statistical association of clinical risk factors with the defined end point outcomes of perioperative complications and blood transfusion.Five hundred seventy-two surgeries were included. By Common Procedural Terminology codes, 93 identified as single suture synostosis, the remainder as multiple or unknown suture involvement. Location of the affected suture is not captured. Mean surgical time was 196.84 minutes (SD 113.46). Mean length of stay was 4.22 days (SD 5.04). Sixty-seven percent of patients received blood transfusions. 3.15% were other perioperative occurrences, including infection, wound disruption, unplanned reintubation, stroke/hemorrhage, cardiac arrest, seizures, thromboembolism. 2.8% were readmitted; 2.45% underwent reoperation within 30 days. Duration of surgery and length of hospital stay significantly differed in the presence of blood transfusion versus none. On multivariate analysis, duration from anesthesia start to surgery start, duration from surgery end to anesthesia end, and duration of operation were risk factors for blood transfusion.Pediatric NSQIP gives a national overview of 30-day outcome metrics in craniosynostosis surgery. Perioperative adverse event rate was 3.15%. Duration of surgery and duration of anesthesia were significantly associated with blood transfusion. The authors identified opportunities for pediatric NSQIP database improvement. PMID:27046470

  2. Experience and Operational Improvements, Mixer Pump Performance

    SciTech Connect

    Erian, Fadel F.; Mullen, O Dennis; Kellogg, Michael I.

    2002-03-20

    Millions of gallons of radioactive waste are stored in large underground tanks at DOE sites. The waste is made up of settled solids, in sludge form, at the bottom of the tank and a layer of supernatant liquid on top of it. It is necessary to mix the solids in the sludge layer with the supernatant liquid to facilitate their removal from the storage tanks for remediation. Our goal is to improve the mobilization of the settled solids by optimizing mixing with the supernatant liquid and preserving the mobility of the solids. This report investigates whether time-phase separation between pump head oscillations affects overall sludge mobilization. If a mixing jet from one pump happens to follow temporarily the path of the lead mixing jet, it may be possible to prevent or slow down the resettling of the heavy solid particles, maintaining them in suspension. If a retrieval pump were operating at the same time, it could facilitate removal of such particles. Preliminary experiments were carried out to observe whether time-phase separation has some influence on the overall mobilization. A brief account is presented of the successful mobilization and removal of most of the radioactive waste from Tank D8-2 at the West Valley Demonstration Project using time-phase separation techniques.

  3. Revitalizing Space Operations through Total Quality Management

    NASA Technical Reports Server (NTRS)

    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.

  4. Quality improvement capacity: a survey of hospital quality managers.

    PubMed

    Gagliardi, A R; Majewski, C; Victor, J C; Baker, G R

    2010-02-01

    Background Skilled managers are an important component of quality improvement (QI) infrastructure, but there has been little evaluation of QI infrastructure, which is needed to guide enhancement of this capacity. Methods Quality managers at 97 acute care hospitals in Ontario, Canada, were surveyed by mail to describe how their roles were integrated with QI performance objectives. Binary and scaled responses were analysed quantitatively, and open-ended responses were analysed thematically. Results The response rate was 79.4%. Many QI managers were new to their role and had no support staff despite responsibility for multiple portfolios. Respondents thought that QI objectives should be less reactive to hospital executives or boards, adverse events or demands from government and accreditation bodies, and recommended that dedicated QI managers proactively apply explicit strategic plans and engage executives and clinicians. Findings were consistent regardless of rank, staffing or hospital type. Those with master's training and greater experience were more involved in strategic planning, data analysis and communication. Conclusions QI is not well resourced in most acute care hospitals in Ontario. To develop QI capacity, investment and QI training may be required. Research should empirically establish objective performance measures of QI capacity to guide investment and evaluation. PMID:20172879

  5. How can we recognize continuous quality improvement?

    PubMed Central

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

    2014-01-01

    Objective Continuous quality improvement (CQI) methods are foundational approaches to improving healthcare delivery. Publications using the term CQI, however, are methodologically heterogeneous, and labels other than CQI are used to signify relevant approaches. Standards for identifying the use of CQI based on its key methodological features could enable more effective learning across quality improvement (QI) efforts. The objective was to identify essential methodological features for recognizing CQI. Design Previous work with a 12-member international expert panel identified reliably abstracted CQI methodological features. We tested which features met rigorous a priori standards as essential features of CQI using a three-phase online modified-Delphi process. Setting Primarily United States and Canada. Participants 119 QI experts randomly assigned into four on-line panels. Intervention(s) Participants rated CQI features and discussed their answers using online, anonymous and asynchronous discussion boards. We analyzed ratings quantitatively and discussion threads qualitatively. Main outcome measure(s) Panel consensus on definitional CQI features. Results Seventy-nine (66%) panelists completed the process. Thirty-three completers self-identified as QI researchers, 18 as QI practitioners and 28 as both equally. The features ‘systematic data guided activities,’ ‘designing with local conditions in mind’ and ‘iterative development and testing’ met a priori standards as essential CQI features. Qualitative analyses showed cross-cutting themes focused on differences between QI and CQI. Conclusions We found consensus among a broad group of CQI researchers and practitioners on three features as essential for identifying QI work more specifically as ‘CQI.’ All three features are needed as a minimum standard for recognizing CQI methods. PMID:24311732

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

    PubMed Central

    Nair, Pooja; Barai, Ishani; Prasad, Sunila; Gadhvi, Karishma

    2016-01-01

    Guidelines in the UK require all doctors to actively take part in quality improvement. To ease future doctors into the process, formal quality improvement teaching can be delivered during medical school. PMID:27051330

  7. Early Palliative Care Improves Patients' Quality of Life

    MedlinePlus

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

  8. A Value Management Approach to Improving Quality (ICP/JOU-05-00825)

    SciTech Connect

    James R. Wixson; Howard Stromberg

    2005-07-01

    In October 2001, the Department of Energy’s, Office of Price-Anderson Enforcement determined that the continuous improvement aspect of the INEEL Quality Assurance Program was inadequate. At the request of the INEEL Senior Management, a Quality Assurance Operations (QAO) Task Team was identified and requested to review the INEEL practices to determine whether the INEEL was performing the activities that are required for Quality Implementation. The team consisted of INEEL managers from Operations, Quality Assurance, Document and Records Management, Construction Services, Radiological Control, and Engineering. FAST modeling combined with other analytical techniques were used to identify areas for improvement and resolve the issues related to inadequate continuous improvement efforts.

  9. A report card on continuous quality improvement.

    PubMed

    Blumenthal, D; Kilo, C M

    1998-01-01

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

  10. Foliage Plants for Improving Indoor Air Quality

    NASA Technical Reports Server (NTRS)

    Wolverton, B. C.

    1988-01-01

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

  11. Mask process simulation for mask quality improvement

    NASA Astrophysics Data System (ADS)

    Takahashi, Nobuyasu; Goto, So; Tsunoda, Dai; Shin, So-Eun; Lee, Sukho; Shon, Jungwook; Park, Jisoong

    2015-10-01

    Demand for mask process correction (MPC) is growing facing the 14nm era. We have developed model based MPC and can generate mask contours by using this mask process model. This mask process model consists of EB (development) and etch, which employs a threshold (level set) model and a variable bias model respectively. The model calibration tool accepts both CD measurement results and SEM images. The simulation can generate mask image (contour), runs with distributed computing resources, and has scalable performance. The contour simulation shows the accuracy of the MPC correction visually and provides comprehensive information about hot spots in mask fabrication. Additionally, it is possible to improve lithography simulation quality by providing a simulated mask contour. In this paper, accuracy and computational performance of mask process simulation are shown. The focus is on the difference between the calibration methods using CDs or images.

  12. Oversight on the borderline: Quality improvement and pragmatic research.

    PubMed

    Finkelstein, Jonathan A; Brickman, Andrew L; Capron, Alexander; Ford, Daniel E; Gombosev, Adrijana; Greene, Sarah M; Iafrate, R Peter; Kolaczkowski, Laura; Pallin, Sarah C; Pletcher, Mark J; Staman, Karen L; Vazquez, Miguel A; Sugarman, Jeremy

    2015-10-01

    Pragmatic research that compares interventions to improve the organization and delivery of health care may overlap, in both goals and methods, with quality improvement activities. When activities have attributes of both research and quality improvement, confusion often arises about what ethical oversight is, or should be, required. For routine quality improvement, in which the delivery of health care is modified in minor ways that create only minimal risks, oversight by local clinical or administrative leaders utilizing institutional policies may be sufficient. However, additional consideration should be given to activities that go beyond routine, local quality improvement to first determine whether such non-routine activities constitute research or quality improvement and, in either case, to ensure that independent oversight will occur. This should promote rigor, transparency, and protection of patients' and clinicians' rights, well-being, and privacy in all such activities. Specifically, we recommend that (1) health care organizations should have systematic policies and processes for designating activities as routine quality improvement, non-routine quality improvement, or quality improvement research and determining what oversight each will receive. (2) Health care organizations should have formal and explicit oversight processes for non-routine quality improvement activities that may include input from institutional quality improvement experts, health services researchers, administrators, clinicians, patient representatives, and those experienced in the ethics review of health care activities. (3) Quality improvement research requires review by an institutional review board; for such review to be effective, institutional review boards should develop particular expertise in assessing quality improvement research. (4) Stakeholders should be included in the review of non-routine quality improvement and quality improvement-related research proposals. Only by doing

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

    ERIC Educational Resources Information Center

    Tout, Kathryn; Isner, Tabitha; Zaslow, Martha

    2011-01-01

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

  14. Criteria for the Evaluation of Quality Improvement Programs and the Use of Quality Improvement Data

    ERIC Educational Resources Information Center

    American Psychologist, 2009

    2009-01-01

    This document provides a set of criteria to be used by psychologists in evaluating quality improvement programs (QIPs) that have been promulgated by health care organizations, government agencies, professional associations, or other entities. These criteria also address the privacy and confidentiality issues evoked by the intended use of patient…

  15. Priorities of Higher Education Quality Improvement: Student and Teacher Attitude

    ERIC Educational Resources Information Center

    Savickiene, Izabela

    2006-01-01

    Higher education quality improvement is a constant and continuous university activity and its implementation should be given a priority. This article analyses the most important tasks set at three Lithuanian universities seeking to improve higher education quality: the improvement of higher education quality assurance system, teacher professional…

  16. Ensemble Streamflow Forecast Improvements in NYC's Operations Support Tool

    NASA Astrophysics Data System (ADS)

    Wang, L.; Weiss, W. J.; Porter, J.; Schaake, J. C.; Day, G. N.; Sheer, D. P.

    2013-12-01

    end of high flow periods. These improvements allowed DEP to more effectively manage water quality control and spill mitigation operations immediately after storm events. Later on, post-processed hydrologic forecasts from the National Weather Service (NWS) including the Advanced Hydrologic Prediction Service (AHPS) and the Hydrologic Ensemble Forecast Service (HEFS) were implemented into OST. These forecasts further increased the predictive skill over the initial statistical models as current basin conditions (e.g. soil moisture, snowpack) and meteorological forecasts (with HEFS) are now explicitly represented. With the post-processed HEFS forecasts, DEP may now truly quantify impacts associated with wet weather events on the horizon, rather than relying on statistical representations of current hydrologic trends. This presentation will highlight the benefits of the improved forecasts using examples from actual system operations.

  17. Making the case to improve quality and reduce costs in pediatric health care.

    PubMed

    Sachdeva, Ramesh C; Jain, Shabnam

    2009-08-01

    This article makes a case for the urgent need to improve health care quality and reduce costs. It provides an overview of the importance of the quality movement and the definition of quality, including the concept of clinical and operational quality. Some national drivers for quality improvement as well as drivers of escalating health care costs are discussed, along with the urgency of reducing health care costs. The link between quality and cost is reviewed using the concept of value in health care, which combines quality and cost in the same equation. The article ends with a discussion of future directions of the quality movement, including emerging concepts, such as risk-adjustment, shared responsibility for quality, measuring quality at the individual provider level, and evolving legal implications of the quality movement, as well as the concept of a shared savings model. PMID:19660624

  18. Quality improvement in large healthcare organizations.

    PubMed

    Höög, Elisabet; Lysholm, Jack; Garvare, Rickard; Weinehall, Lars; Nyström, Monica Elisabeth

    2016-03-21

    Purpose - The purpose of this paper is to investigate the obstacles and challenges associated with organizational monitoring and follow-up (M & F) processes related to health care quality improvement (QI) and development. Design/methodology/approach - A longitudinal case study of a large health care organization during a system-wide QI intervention. Content analysis was conducted of repeated interviews with key actors and archival data collected over a period of four years. Findings - The demand for improved M & F strategies, and what and how to monitor were described by the respondents. Obstacles and challenges for achieving M & F strategies that enables system-wide and coherent development were found in three areas: monitoring, processing, and feedback and communication. Also overarching challenges were found. Practical implications - A model of important aspects of M & F systems is presented that can be used for analysis and planning and contribute to shared cognition of such systems. Approaches for systematic analysis and follow-up of identified problems have to be developed and fully incorporated in the organization's measurement systems. A systematic M & F needs analytic and process-oriented competence, and this study highlights the potential in an organizational function with capacity and mandate for such tasks. Originality/value - Most health care systems are flooded with a vast amount of registers, records, and measurements. A key issue is how such data can be processed and refined to reflect the needs and the development process of the health care system and how rich data can be used for improvement purposes. This study presents key organizational actor's view on important factors to consider when building a coherent organizational M & F strategy. PMID:26964854

  19. Improvements in the Teaching of Staged Operations.

    ERIC Educational Resources Information Center

    Golnaraghi, Maryam; And Others

    1985-01-01

    Describes an interactive computer software package that uses graphics to teach staged operations (particularly the McCabe-Thiele method). Criteria used in developing the package and advantages for instructors and students are considered. (JN)

  20. Improving medical handover at the weekend: a quality improvement project.

    PubMed

    Michael, Emma; Patel, Chandni

    2015-01-01

    revealed a high degree of satisfaction with the new weekend handover system. In conclusion we found that a structured, well organised weekend handover meeting together with an effective electronic handover system improves the quality of medical weekend handover. PMID:26734385

  1. Improving Documentation and Communication Using Operative Note Proformas

    PubMed Central

    Mahapatra, Piyush; ieong, edmund

    2016-01-01

    Accurate and detailed documentation of surgical procedures is part of good clinical practice, set out by the General Medical Council (GMC). Knee arthroscopy often involves large data sets which require accurate documentation for future assessment and management. This study assesses the quality of documentation of knee arthroscopy, followed by an evaluation of the implementation of a novel operative proforma. A review of 30 consecutive knee arthroscopy operation notes were analysed for missing information, set against a standardised 30 point criteria. An operation proforma was then introduced, and a further 30 consecutive knee arthroscopy operation notes were analysed. We evaluated allied health professional satisfaction with a Likert point scale survey of 21 allied healthcare professionals (recovery and ward nurses, and physiotherapists) following introduction of the proforma. The mean number of missing items on a 30 point scale was 8.8 (range 0 to 23). Examination under anaesthesia was missed in 43% of cases, tourniquet time in 37% of cases, and wear results in 17% of cases. Following introduction of the proforma, the mean number of missing items was 1.1 (range 0 to 24; p <0.001). This rose to 3.8 after one year (p <0.001) before improvement to 0.7 (p <0.01) with a new and improved proforma. Eighty percent strongly agreed the operation note was clearer, 90% strongly agreed it was more legible, 90% strongly agreed it was more understandable, 50% strongly agreed there was more information recorded, and 100% strongly agreed on the proforma having been improved. Knee arthroscopy is a common procedure with large data sets, which can often be missed or incomplete. A standardised proforma results in a statistically significant improvement in documentation and reduces the incidence of missing information. They are subjectively clearer, more legible, and generally better compared with handwritten notes. This study demonstrates the improvements in healthcare documentation

  2. Improving Documentation and Communication Using Operative Note Proformas.

    PubMed

    Mahapatra, Piyush; Ieong, Edmund

    2016-01-01

    Accurate and detailed documentation of surgical procedures is part of good clinical practice, set out by the General Medical Council (GMC). Knee arthroscopy often involves large data sets which require accurate documentation for future assessment and management. This study assesses the quality of documentation of knee arthroscopy, followed by an evaluation of the implementation of a novel operative proforma. A review of 30 consecutive knee arthroscopy operation notes were analysed for missing information, set against a standardised 30 point criteria. An operation proforma was then introduced, and a further 30 consecutive knee arthroscopy operation notes were analysed. We evaluated allied health professional satisfaction with a Likert point scale survey of 21 allied healthcare professionals (recovery and ward nurses, and physiotherapists) following introduction of the proforma. The mean number of missing items on a 30 point scale was 8.8 (range 0 to 23). Examination under anaesthesia was missed in 43% of cases, tourniquet time in 37% of cases, and wear results in 17% of cases. Following introduction of the proforma, the mean number of missing items was 1.1 (range 0 to 24; p <0.001). This rose to 3.8 after one year (p <0.001) before improvement to 0.7 (p <0.01) with a new and improved proforma. Eighty percent strongly agreed the operation note was clearer, 90% strongly agreed it was more legible, 90% strongly agreed it was more understandable, 50% strongly agreed there was more information recorded, and 100% strongly agreed on the proforma having been improved. Knee arthroscopy is a common procedure with large data sets, which can often be missed or incomplete. A standardised proforma results in a statistically significant improvement in documentation and reduces the incidence of missing information. They are subjectively clearer, more legible, and generally better compared with handwritten notes. This study demonstrates the improvements in healthcare documentation

  3. Team Learning for Healthcare Quality Improvement

    PubMed Central

    Eppstein, Margaret J.; Horbar, Jeffrey D.

    2014-01-01

    In organized healthcare quality improvement collaboratives (QICs), teams of practitioners from different hospitals exchange information on clinical practices with the aim of improving health outcomes at their own institutions. However, what works in one hospital may not work in others with different local contexts because of nonlinear interactions among various demographics, treatments, and practices. In previous studies of collaborations where the goal is a collective problem solving, teams of diverse individuals have been shown to outperform teams of similar individuals. However, when the purpose of collaboration is knowledge diffusion in complex environments, it is not clear whether team diversity will help or hinder effective learning. In this paper, we first use an agent-based model of QICs to show that teams comprising similar individuals outperform those with more diverse individuals under nearly all conditions, and that this advantage increases with the complexity of the landscape and level of noise in assessing performance. Examination of data from a network of real hospitals provides encouraging evidence of a high degree of similarity in clinical practices, especially within teams of hospitals engaging in QIC teams. However, our model also suggests that groups of similar hospitals could benefit from larger teams and more open sharing of details on clinical outcomes than is currently the norm. To facilitate this, we propose a secure virtual collaboration system that would allow hospitals to efficiently identify potentially better practices in use at other institutions similar to theirs without any institutions having to sacrifice the privacy of their own data. Our results may also have implications for other types of data-driven diffusive learning such as in personalized medicine and evolutionary search in noisy, complex combinatorial optimization problems. PMID:25360395

  4. Slag pit practices to improve slag quality

    SciTech Connect

    Mertdogan, A.; Gambol, F.C.; Spaeth, J.R.; Zbos, J.; Batka, R.; Tolliver, D.

    1996-12-31

    Slag quality had deteriorated recently. Without the explicit approval for slag quality by the Illinois Department of Transportation, the slag would not be saleable. Disposal of slag to landfills was going to be an expensive solution and rife with environmental concerns. A slag quality control program embarked on in mid-1994 restored slag quality to desired specifications. This paper describes the changes in slag pit practice adopted following extensive tests performed on cooling slag under controlled conditions.

  5. The impact of flying qualities on helicopter operational agility

    NASA Technical Reports Server (NTRS)

    Padfield, Gareth D.; Lappos, Nick; Hodgkinson, John

    1993-01-01

    Flying qualities standards are formally set to ensure safe flight and therefore reflect minimum, rather than optimum, requirements. Agility is a flying quality but relates to operations at high, if not maximum, performance. While the quality metrics and test procedures for flying, as covered for example in ADS33C, may provide an adequate structure to encompass agility, they do not currently address flight at high performance. This is also true in the fixed-wing world and a current concern in both communities is the absence of substantiated agility criteria and possible conflicts between flying qualities and high performance. AGARD is sponsoring a working group (WG19) title 'Operational Agility' that deals with these and a range of related issues. This paper is condensed from contributions by the three authors to WG19, relating to flying qualities. Novel perspectives on the subject are presented including the agility factor, that quantifies performance margins in flying qualities terms; a new parameter, based on maneuver acceleration is introduced as a potential candidate for defining upper limits to flying qualities. Finally, a probabilistic analysis of pilot handling qualities ratings is presented that suggests a powerful relationship between inherent airframe flying qualities and operational agility.

  6. Timing control improves seabed survey data quality

    SciTech Connect

    Green, R.

    1996-04-01

    Seateam has completed development of and field-proven the Dolphin data acquisition and timing system for high-density surveys offshore. The Dolphin project was initiated to improve quality control of survey sensor data and ensure time synchronization, thus leading to faster turnaround of seabed terrain information. Data received from survey sensors is asynchronous, so the system must provide for data correlation. This includes establishment of data latency, i.e., the time difference between data creation and timing of the message at first-byte arrival at the recording system. Until recently, asynchronous data from multiple sensors was collected by a single computer, regardless of whether it had additional intelligent or non-intelligent serial cards. This computer was fully responsible for time stamping all incoming data, plus associated storage and distribution. Though this initially sufficed and is still applicable to low-density data, increasingly larger data volumes required an associated boost in the capability to time stamp data prior to eventual correction.

  7. Improving Water Quality With Conservation Buffers

    NASA Astrophysics Data System (ADS)

    Lowrance, R.; Dabney, S.; Schultz, R.

    2003-12-01

    Conservation buffer technologies are new approaches that need wider application. In-field buffer practices work best when used in combination with other buffer types and other conservation practices. Vegetative barriers may be used in combination with edge-of-field buffers to protect and improve their function and longevity by dispersing runoff and encouraging sediment deposition upslope of the buffer. It's important to understand how buffers can be managed to help reduce nutrient transport potential for high loading of nutrients from manure land application sites, A restored riparian wetland buffer retained or removed at least 59 percent of the nitrogen and 66 percent of the phosphorus that entered from an adjacent manure land application site. The Bear Creek National Restoration Demonstration Watershed project in Iowa has been the site of riparian forest buffers and filter strips creation; constructed wetlands to capture tile flow; stream-bank bioengineering; in-stream structures; and controlling livestock grazing. We need field studies that test various widths of buffers of different plant community compositions for their efficacy in trapping surface runoff, reducing nonpoint source pollutants in subsurface waters, and enhancing the aquatic ecosystem. Research is needed to evaluate the impact of different riparian grazing strategies on channel morphology, water quality, and the fate of livestock-associated pathogens and antibiotics. Integrating riparian buffers and other conservation buffers into these models is a key objective in future model development.

  8. Optical parametric osicllators with improved beam quality

    DOEpatents

    Smith, Arlee V.; Alford, William J.

    2003-11-11

    An optical parametric oscillator (OPO) having an optical pump, which generates a pump beam at a pump frequency greater than a desired signal frequency, a nonlinear optical medium oriented so that a signal wave at the desired signal frequency and a corresponding idler wave are produced when the pump beam (wave) propagates through the nonlinear optical medium, resulting in beam walk off of the signal and idler waves, and an optical cavity which directs the signal wave to repeatedly pass through the nonlinear optical medium, said optical cavity comprising an equivalently even number of non-planar mirrors that produce image rotation on each pass through the nonlinear optical medium. Utilizing beam walk off where the signal wave and said idler wave have nonparallel Poynting vectors in the nonlinear medium and image rotation, a correlation zone of distance equal to approximately .rho.L.sub.crystal is created which, through multiple passes through the nonlinear medium, improves the beam quality of the OPO output.

  9. Operating Systems. Curriculum Improvement Project. Region II.

    ERIC Educational Resources Information Center

    Wagstaff, Charlene

    This course curriculum is intended for community college instructors and administrators to use in implementing an operating systems course. A student's course syllabus provides this information: credit hours, catalog description, prerequisites, required texts, instructional process, objectives, student evaluation, and class schedule. A student…

  10. Improvements needed in EPA's Inspector General operations

    SciTech Connect

    Bowsher, C.A.

    1983-10-21

    At the request of the Subcommittee on Natural Resources, Agriculture Research and Environment and the Subcommittee on Civil Service, House of Representatives, GAO reviewed the operations of the Office of Inspector General, Environmental Protection Agency, under the leadership of former Inspector General Matthew Novick. GAO found that although most investigations appear to have been handled properly, in some cases all relevant matters were not followed up and consistently addressed. GAO also noted the need to use investigative resources more effectively and to provide more balanced audit coverage. Acting Inspector General Charles Dempsey recognized and made a concerted effort to correct many problems during his tenure. GAO recommends further actions to strengthen inspector general operations at EPA.

  11. Improve safety with pilot operated relief valves

    SciTech Connect

    Emerson, G.

    1996-10-01

    A weakness inherent in balanced bellows pressure relief valves (PRVs) that can cause premature failure can be avoided by using pilot operated PRVs as an alternative. Now better able to handle adverse service conditions, pilot operated PRVs are suitable for a wide range of gas, liquid and mixed-phase services. Traditionally, however, balanced bellows PRVs have been applied as overpressure protection for three notable reasons: a constant PRV set pressure with the presence of variable, superimposed back pressure (at the PRV outlet prior to its opening); valve stability and adequate capacity when built-up back pressure (at the PRV outlet during its relief cycle) exceeds 10%; and spring and guided parts barriered from the process fluid. With these benefits in mind, balanced bellows PRVs have been generally adapted by many hydrocarbon processing companies that have experienced costly, and often dangerous, premature bellows failures. Corrosion, valve instability and/or bellows flutter are causes of these failures.

  12. Nutrition interventions need improved operational capacity

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The Lancet's Child Survival Series was a galvanising manifesto: it focused action plans to improve the well-being of children worldwide. However, the authors did not address in detail the importance of nutrition in child survival, and thus the current Undernutrition Series was born. This welcome n...

  13. Improving Robotic Operator Performance Using Augmented Reality

    NASA Technical Reports Server (NTRS)

    Maida, James C.; Bowen, Charles K.; Pace, John W.

    2007-01-01

    The Special Purpose Dexterous Manipulator (SPDM) is a two-armed robot that functions as an extension to the end effector of the Space Station Robotics Manipulator System (SSRMS), currently in use on the International Space Station (ISS). Crew training for the SPDM is accomplished using a robotic hardware simulator, which performs most of SPDM functions under normal static Earth gravitational forces. Both the simulator and SPDM are controlled from a standard robotic workstation using a laptop for the user interface and three monitors for camera views. Most operations anticipated for the SPDM involve the manipulation, insertion, and removal of any of several types of Orbital Replaceable Unit (ORU), modules which control various ISS functions. Alignment tolerances for insertion of the ORU into its receptacle are 0.25 inch and 0.5 degree from nominal values. The pre-insertion alignment task must be performed within these tolerances by using available video camera views of the intrinsic features of the ORU and receptacle, without special registration markings. Since optimum camera views may not be available, and dynamic orbital lighting conditions may limit periods of viewing, a successful ORU insertion operation may require an extended period of time. This study explored the feasibility of using augmented reality (AR) to assist SPDM operations. Geometric graphical symbols were overlaid on one of the workstation monitors to afford cues to assist the operator in attaining adequate pre-insertion ORU alignment. Twelve skilled subjects performed eight ORU insertion tasks using the simulator with and without the AR symbols in a repeated measures experimental design. Results indicated that using the AR symbols reduced pre-insertion alignment error for all subjects and reduced the time to complete pre-insertion alignment for most subjects.

  14. Advance Directives and Operating: Room for Improvement?

    PubMed

    Hadler, Rachel A; Neuman, Mark D; Raper, Steven; Fleisher, Lee A

    2016-04-01

    Anesthesiologists and surgeons are frequently called on to perform procedures on critically ill patients with advanced directives. We assessed the attitudes of attending and resident surgeons and anesthesiologists at our institution regarding their understanding of and practice around the application of consenting critically ill patients with advance directives in the operating room. To do so, we deployed a survey after interdepartmental grand rounds, featuring a panel discussion of ethically complex cases featuring end-of-life issues. PMID:26599738

  15. Translating improved quality of care into an improved quality of life for patients with inflammatory bowel disease.

    PubMed

    Siegel, Corey A; Allen, John I; Melmed, Gil Y

    2013-08-01

    The term quality of care has been interpreted in different ways in medicine. Skeptics of the quality movement insist that checkboxes and government and payer oversight will not lead to better patient outcomes. Supporters refer to areas in medicine in which quality improvement efforts have led to improved survival, such as in cystic fibrosis and cardiovascular disease. For quality improvement to be effective, the process demands rigorous documentation, analysis, feedback, and behavioral change. This requires valid metrics and mechanisms to provide dynamic point-of-care (or close to point of care) feedback in a manner that drives improvement. For inflammatory bowel disease, work has been performed in Europe and the United States to develop a framework for how practitioners can improve quality of care. Improve Care Now has created a sophisticated quality improvement program for pediatric patients with inflammatory bowel disease. The American Gastroenterology Association has worked within the National Quality Strategy framework to develop quality measures for patients with inflammatory bowel disease that have been incorporated into Federal programs that are moving Medicare reimbursement from a volume-based to a value-based structure. The Crohn's and Colitis Foundation of America is initiating a quality intervention program that can be implemented in community and academic practices to stimulate continual improvement processes for patients with inflammatory bowel disease. All of this work is intended to make quality improvement programs both feasible and useful, with the ultimate goal of improving quality of life for our patients. PMID:23747710

  16. Quality Control, Quality Assurance, and Quality Improvement-What is the Difference and Why Should Compounding Pharmacies Care?

    PubMed

    Cabaleiro, Joe

    2009-01-01

    This article provides scenarios of three different pharmacies in the areas of quality control, quality assurance, and quality improvement. The scenarios show the importance that each pharmacy placed on a problem of dented capsules and the potential impact that an unresolved problem can have on a compounding pharmacy's business. Although this article focuses on one particular procedure, the purpose of th article is to help pharmacists understand the differences between quality control, quality assurance, and quality improvement. PMID:23966522

  17. DEVELOPING WEED SUPPRESSIVE SOILS THROUGH IMPROVED SOIL QUALITY MANAGEMENT

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Sustainable agriculture is based in part on efficient management of soil microorganisms for improving soil quality. However, identification of biological indicators of soil quality for predicting weed suppression in soils has received little attention. We investigated differences in soil microbial ...

  18. State health agencies and quality improvement in perinatal care.

    PubMed

    Johnson, K A; Little, G A

    1999-01-01

    The origin of the federal-state partnership in Maternal and Child Health (MCH) can be traced from the Children's Bureau grants of 1912, through the Sheppard-Towner Act, to the creation of Title V and other programs of today that mandate planning, accountability, and systems development. In the past decade with the transformation of the health care system and the emergence of managed care, there has been a resurgence of interest in public, professional, and governmental interest in quality measurement and accountability. Regional perinatal systems have been implemented in all states with varying levels of involvement by state health agencies and the public sector. This historical framework discusses two primary themes: the decades of evolution in the federal-state partnership, and the emergence in the last three decades of perinatal regional system policy, and suggests that the structure of the federal-state partnership has encouraged state variation. A survey of state MCH programs was undertaken to clarify their operational and perceived role in promoting quality improvement in perinatal care. Data and information from the survey, along with five illustrative state case studies, demonstrate great variation in how individual state agencies function. State efforts in quality improvement, a process to make things better, have four arenas of activity: policy development and implementation, definition and measurement of quality, data collection and analysis, and communication to affect change. Few state health agencies (through their MCH programs and perinatal staff) are taking action in all four arenas. This analysis concludes that there are improvements MCH programs could implement without significant expansion in their authority or resources and points out that there is an opportunity for states to be more proactive as they have the legal authority and responsibility for assuring MCH outcomes. PMID:9917467

  19. Informatics: essential infrastructure for quality assessment and improvement in nursing.

    PubMed Central

    Henry, S B

    1995-01-01

    In recent decades there have been major advances in the creation and implementation of information technologies and in the development of measures of health care quality. The premise of this article is that informatics provides essential infrastructure for quality assessment and improvement in nursing. In this context, the term quality assessment and improvement comprises both short-term processes such as continuous quality improvement (CQI) and long-term outcomes management. This premise is supported by 1) presentation of a historical perspective on quality assessment and improvement; 2) delineation of the types of data required for quality assessment and improvement; and 3) description of the current and potential uses of information technology in the acquisition, storage, transformation, and presentation of quality data, information, and knowledge. PMID:7614118

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

    ERIC Educational Resources Information Center

    Asiyai, Romina Ifeoma

    2015-01-01

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

  1. Improving the Quality of Telephone Reference Service.

    ERIC Educational Resources Information Center

    Quinn, Brian

    1995-01-01

    Discusses telephone reference services in libraries. Topics include characteristics of quality phone reference; policies and guidelines for quality service; a survey of pertinent literature evaluating telephone reference; training; and technology for telephone reference, including cellular and cordless phones, electronic resources, and automated…

  2. Improving the Quality of Teaching in Australia

    ERIC Educational Resources Information Center

    Dinham, Stephen

    2011-01-01

    Australia needs to more effectively attract, train, support, retain, recognize, and reward quality teachers throughout their careers. After a slow start and decades of debate, the pieces of the quality teaching puzzle are now coming together. Increased federal government intervention and financial support, along with state and territorial support…

  3. EPA Pushing Improved Air Quality in Schools.

    ERIC Educational Resources Information Center

    Sack, Joetta L.

    2002-01-01

    Discusses how, in response to the growing problem of poor air quality in schools, the Environmental Protection Agency (EPA) has set new voluntary air-quality guidelines for schools. Addresses common air-related irritants; successful efforts at Guerrero Elementary School in Mesa, Arizona; preventive maintenance; and a sample of the EPA's…

  4. Flight experiments to improve terminal area operations

    NASA Technical Reports Server (NTRS)

    Salmirs, S.; Morello, S. A.

    1978-01-01

    A brief description is given of the objectives and activities of the terminal configured vehicle (TCV) program and of some of the airborne facilities. A short analysis of some particular problems in CTOL operations in the terminal area is also presented to show how the program's technical objectives are related to the defined problems. The test aircraft was flown both manually and automatically with manual monitoring over paths including 130 deg intercepts and 2.0 km and 0.8 km finals. Some statistical data are presented from these and other flight profiles designed to address specific terminal area problems. An overview is presented of research studies receiving emphasis in the next biennium and their application to the terminal area. A description of work undertaken to study the addition of adjacent traffic information to present map displays is also given.

  5. Flight experiments to improve terminal area operations

    NASA Technical Reports Server (NTRS)

    Salmirs, S.; Morello, S. A.

    1978-01-01

    A brief description is given of the objectives and activities of the terminal configured vehicle (TCV) program and of some of the airborne facilities. A short analysis of some particular problems of CTOL operations in the terminal area is also presented to show how the program's technical objectives are related to the defined problems. The test aircraft was flown both manually and automatically with manual monitoring over paths including 130 deg intercepts and 2.0 km (1.1. n. mi.) and 0.8 km (0.44 n. mi.) finals. Some statistical data are presented from these and other flight profiles designed to address specific terminal in the next biennium and their application to the terminal area. A description of work being undertaken to study the addition of adjacent traffic information to present map displays is also given.

  6. Improved Pulsed Laser Operation with Engineered Nanomaterials.

    PubMed

    Latterman, Ryan E; Birrell, Steven; Sullivan, Philip A; Walker, Robert A

    2016-08-01

    The power efficiency of a diode-pumped solid state laser was improved by encasing the Nd:YAG lasing medium with gold nanorod-doped epoxy. Gold nanorods were synthesized with a specific aspect ratio tuned to absorb at the Nd:YAG lasing wavelength of 1064 nm. The surfactant-stabilized nanorods in aqueous solution were then treated with a sequential, two-step functionalization in order to improve nanorod solubility in organic solvents. This process required treating the gold nanorods with a thiol-containing polyethylene glycol (PEG) polymer followed by replacing the PEG-SH polymer with a multidentate thiol containing block copolymer synthesized using RAFT synthesis. With a multidentate polymer, the nanorods were soluble in traditional epoxies that could be used to coat the outside of Nd:YAG rods. By absorbing excess lateral 1064 nm emission, the gold nanorod coating attenuates amplified spontaneous emission (ASE), a parasitic, incoherent process that limits power produced by Q-switch laser designs. Laser power increased by nearly 2-fold with addition of the 1064 nm absorbing gold nanorod coating. Gold nanorod epoxy coatings stand out as attractive materials for attenuating ASE by avoiding the fabrication difficulties of samarium oxide ceramics and the photostability limitations of organic dyes. PMID:27388718

  7. Improvements in sparse matrix operations of NASTRAN

    NASA Technical Reports Server (NTRS)

    Harano, S.

    1980-01-01

    A "nontransmit" packing routine was added to NASTRAN to allow matrix data to be refered to directly from the input/output buffer. Use of the packing routine permits various routines for matrix handling to perform a direct reference to the input/output buffer if data addresses have once been received. The packing routine offers a buffer by buffer backspace feature for efficient backspacing in sequential access. Unlike a conventional backspacing that needs twice back record for a single read of one record (one column), this feature omits overlapping of READ operation and back record. It eliminates the necessity of writing, in decomposition of a symmetric matrix, of a portion of the matrix to its upper triangular matrix from the last to the first columns of the symmetric matrix, thus saving time for generating the upper triangular matrix. Only a lower triangular matrix must be written onto the secondary storage device, bringing 10 to 30% reduction in use of the disk space of the storage device.

  8. A model of continuous quality improvement for health service organisations.

    PubMed

    Thornber, M

    1992-01-01

    Continuous Quality Improvement (or Total Quality Management) is an approach to management originally used in manufacturing and now being applied in the health services. This article describes a model of Continuous Quality Improvement which has been used in NSW public and private hospitals. The model consists of Ten Key Elements. The first driving force of this model is 'defining quality in terms of customer expectations' of quality. The second driving force emphasises that 'quality improvement is a leadership issue'. Leaders are required to: coordinate staff participation in work process analysis; train staff in the customer service orientation; lead effective meetings and negotiate with both internal and external service partners. Increased staff motivation, quality improvement and reduction in running costs are seen to be the benefits of CQI for health service organisations. PMID:10117452

  9. How Quality Improvement Practice Evidence Can Advance the Knowledge Base.

    PubMed

    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. PMID:27584696

  10. Leadership: improving the quality of patient care.

    PubMed

    Clegg, A

    The satisfaction staff achieve from their work is in part determined by the style of management they work under. This article analyses the impact of a proactive leadership style on team performance and the quality of patient care. PMID:11973895

  11. Quality assurance of radiotherapy in cancer treatment: toward improvement of patient safety and quality of care.

    PubMed

    Ishikura, Satoshi

    2008-11-01

    The process of radiotherapy (RT) is complex and involves understanding of the principles of medical physics, radiobiology, radiation safety, dosimetry, radiation treatment planning, simulation and interaction of radiation with other treatment modalities. Each step in the integrated process of RT needs quality control and quality assurance (QA) to prevent errors and to give high confidence that patients will receive the prescribed treatment correctly. Recent advances in RT, including intensity-modulated and image-guided RT, focus on the need for a systematic RTQA program that balances patient safety and quality with available resources. It is necessary to develop more formal error mitigation and process analysis methods, such as failure mode and effect analysis, to focus available QA resources optimally on process components. External audit programs are also effective. The International Atomic Energy Agency has operated both an on-site and off-site postal dosimetry audit to improve practice and to assure the dose from RT equipment. Several countries have adopted a similar approach for national clinical auditing. In addition, clinical trial QA has a significant role in enhancing the quality of care. The Advanced Technology Consortium has pioneered the development of an infrastructure and QA method for advanced technology clinical trials, including credentialing and individual case review. These activities have an impact not only on the treatment received by patients enrolled in clinical trials, but also on the quality of treatment administered to all patients treated in each institution, and have been adopted globally; by the USA, Europe and Japan also. PMID:18952706

  12. Developing a Future Dam Operation Alternative to Mitigate Impact of Climate Change on Water Quality

    NASA Astrophysics Data System (ADS)

    Park, J.; Kim, Y.

    2011-12-01

    There have been few studies on water quality projection considering climate change. South Korea is not an exception. The simple way to mitigate the future water quality change is to alter dam operations in upstream. In this study, a small watershed in South Korea with two multi-purpose dams is considered. A common chained-modeling procedure for the climate change assessment study is applied to the watershed, i.e. water quality projections are made with GCMs and the LARS-WG downscaling method, and the SWAT hydrologic model. The projections uncertainty is quantified by using multiple scenarios of GCMs. With these future water quality projections, this study first examines how vulnerable to the potential climate change the watershed is and then develop a possible dam operation alternative to improve the future water quality. Finally this study also proposes other water management alternatives that can improve the potential water quality change in addition to the dam operation alternative. Keywords: adaptation, dam operation alternative, HEC-5, LARS-WG, SWAT, water quality, uncertainty.

  13. Improving Hospital Quality and Patient Safety an Examination of Organizational Culture and Information Systems

    ERIC Educational Resources Information Center

    Gardner, John Wallace

    2012-01-01

    This dissertation examines the effects of safety culture, including operational climate and practices, as well as the adoption and use of information systems for delivering high quality healthcare and improved patient experience. Chapter 2 studies the influence of both general and outcome-specific hospital climate and quality practices on process…

  14. Water quality improvements of CAFO wastewater after advanced treatment and its reuse potential

    Technology Transfer Automated Retrieval System (TEKTRAN)

    We conducted a study to determine the water quality improvements by an alternative on-farm technology operating at full-scale during a 2-yr evaluation period. In addition, we evaluated water quality changes in the converted lagoon that were compared with an adjacent traditional lagoon with similar p...

  15. Integrating quality improvement into pre-registration education.

    PubMed

    Jones, Aled; Williams, Angela; Carson-Stevens, Andrew

    Healthcare organisations around the world are adopting new strategies to improve the quality of patient care in response to reports of negative patient outcomes and cuts to public service expenditure. However, many nurses lack the knowledge, skills and attitude to improve the systems within which they work, calling for a radical redesign of nursing education to integrate quality improvement science. This article describes the integration of quality improvement education within undergraduate nursing education programmes in Wales through collaboration between higher education institutions, NHS Wales and the UK Institute for Healthcare Improvement Open School. PMID:23634500

  16. Operational air quality forecast guidance for the United States

    NASA Astrophysics Data System (ADS)

    Stajner, Ivanka; Lee, Pius; Tong, Daniel; Pan, Li; McQueen, Jeff; Huang, Jinaping; Djalalova, Irina; Wilczak, James; Huang, Ho-Chun; Wang, Jun; Stein, Ariel; Upadhayay, Sikchya

    2016-04-01

    NOAA provides operational air quality predictions for ozone and wildfire smoke over the United States (U.S.) and predictions of airborne dust over the contiguous 48 states at http://airquality.weather.gov. These predictions are produced using U.S. Environmental Protection Agency (EPA) Community Model for Air Quality (CMAQ) and NOAA's HYSPLIT model (Stein et al., 2015) with meteorological inputs from the North American Mesoscale Forecast System (NAM). The current efforts focus on improving test predictions of fine particulate matter (PM2.5) from CMAQ. Emission inputs for ozone and PM2.5 predictions include inventory information from the U.S. EPA and recently added contributions of particulate matter from intermittent wildfires and windblown dust that rely on near real-time information. Current testing includes refinement of the vertical grid structure in CMAQ and inclusion of contributions of dust transport from global sources into the U.S. domain using the NEMS Global Aerosol Capability (NGAC). The addition of wildfire smoke and dust contributions in CMAQ reduced model underestimation of PM2.5 in summertime. Wintertime overestimation of PM2.5 was reduced by suppressing emissions of soil particles when the terrain is covered by snow or ice. Nevertheless, seasonal biases and biases in the diurnal cycle of PM2.5 are still substantial. Therefore, a new bias correction procedure based on an analog ensemble approach was introduced (Djalalova et al., 2015). It virtually eliminates biases in monthly means or in the diurnal cycle, but it also reduces day-to-day variability in PM2.5 predictions. Refinements to the bias correction procedure are being developed. Upgrades for the representation of wildfire smoke emissions within the domain and from global sources are in testing. Another area of active development includes approaches to scale emission inventories for nitrogen oxides in order to reproduce recent changes observed by the AirNow surface monitoring network and by

  17. Improving UK Air Quality Modelling Through Exploitation of Satellite Observations

    NASA Astrophysics Data System (ADS)

    Pope, R.; Chipperfield, M.; Savage, N.

    2012-12-01

    The Met Office's operational regional Air Quality Unified Model (AQUM) contains a description of atmospheric chemistry/aerosols which allows for the short-term forecast of chemical weather (e.g. high concentrations of ozone or nitrogen dioxide, which can trigger warnings of poor air quality). AQUM's performance has so far only been tested against a network of surface monitoring stations. Therefore, with recent improvements in the quality and quantity of satellite measurements, data products (e.g. tropospheric columns, vertical profiles) from several satellite instruments will be used to test the performance of the model. First comparisons between an AQUM simulation for the UK heatwave event of July 2006 and data from OMI, TES (both on AURA) and MODIS (on AQUA) have identified multiple model-satellite biases. The chemical/aerosol species investigated for this simulation include nitrogen dioxide (NO2), ozone (O3), formaldehyde (HCHO), carbon monoxide (CO) and aerosol optical depth (AOD) at 0.55 microns wavelength. NO2 spatial positive mean biases (AQUM-OMI July 2006 monthly mean tropospheric columns) over north- east England suggest model overestimation in the area's urban regions. Currently, sensitivity tests of the NOx emission datasets are investigating these biases and the model's represent of urban pollution. In the UK O3 monthly mean vertical profile comparisons (AQUM-TES), strong positive mean biases are detected in the upper troposphere/lower stratosphere. Since the AQUM does not use a stratospheric chemistry scheme, the satellite climatological vertical boundary conditions will be investigated (e.g. test the model with new boundary conditions using multiple satellite instruments or perturb existing climatologies). Comparisons of HCHO (AQUM-OMI monthly mean tropospheric columns) biases highlight strong negative biases over continental Europe and sporadic positive biases in the south-east lateral boundary conditions. Therefore, evaluation and development of

  18. Evaluation of a State Initiative to Improve Child Care Quality

    ERIC Educational Resources Information Center

    Roach, Mary A.; Riley, David A.; Adams, Diane; Edie, David

    2005-01-01

    Wisconsin's Early Childhood Excellence Initiative was a $15 million public policy effort designed in 2000 to increase child care quality for low-income children. An evaluation revealed significant improvement in classroom quality, the quality of caregiver interaction, and caregivers' beliefs about children following a complex multi-faceted…

  19. The Efficacy of Quality Improvement Programs in Education.

    ERIC Educational Resources Information Center

    Curley, John R.

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

  20. Improving Quality in Education: Dynamic Approaches to School Improvement

    ERIC Educational Resources Information Center

    Creemers, Bert P. M.; Kyriakides, Leonidas

    2011-01-01

    This book explores an approach to school improvement that merges the traditions of educational effectiveness research and school improvement efforts. It displays how the dynamic model, which is theoretical and empirically validated, can be used in both traditions. Each chapter integrates evidence from international and national studies, showing…

  1. 21 CFR 111.127 - What quality control operations are required for packaging and labeling operations?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false What quality control operations are required for packaging and labeling operations? 111.127 Section 111.127 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION CURRENT GOOD...

  2. 21 CFR 111.127 - What quality control operations are required for packaging and labeling operations?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 2 2014-04-01 2014-04-01 false What quality control operations are required for packaging and labeling operations? 111.127 Section 111.127 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION CURRENT GOOD...

  3. 21 CFR 111.127 - What quality control operations are required for packaging and labeling operations?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 2 2013-04-01 2013-04-01 false What quality control operations are required for packaging and labeling operations? 111.127 Section 111.127 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING,...

  4. 21 CFR 111.127 - What quality control operations are required for packaging and labeling operations?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 2 2012-04-01 2012-04-01 false What quality control operations are required for packaging and labeling operations? 111.127 Section 111.127 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION CURRENT GOOD...

  5. 21 CFR 111.127 - What quality control operations are required for packaging and labeling operations?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 2 2011-04-01 2011-04-01 false What quality control operations are required for packaging and labeling operations? 111.127 Section 111.127 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION CURRENT GOOD...

  6. Handling Qualities Influences on Civil Tiltrotor Terminal Operating Procedure Development

    NASA Technical Reports Server (NTRS)

    Decker, William A.; Simmons, Rickey C.; Tucker, George E.; Aiken, Edwin W. (Technical Monitor)

    1994-01-01

    The potential for tiltrotor aircraft as civil transports has been well recognized. Realization of that potential requires development of operating procedures tailored to take advantage of the tiltrotor's capabilities, including thrust vectoring independent of body pitch attitude and good low-speed control. While the tiltrotor shares flight characteristics with both fixed wing airplanes and helicopters, it must convert between those flight modes, typically within the context of precise terminal operations. A series of piloted simulation experiments has been conducted on the NASA Ames Research Center Vertical Motion Simulator (VMS) to investigate the influence of tiltrotor cockpit design features on developing certification and operating criteria for civil tiltrotor transports. Handling qualities evaluations have shaped cockpit design guidelines and operating procedure development for a civil tiltrotor. In particular, four topics demonstrate the interplay of handling qualities and operations profile in the development of terminal operating procedures and cockpit or control equipment for a civil tiltrotor: conversion (airplane to helicopter mode), final approach path angle, operating profile speeds and speed changes (particularly under instrument conditions), and one engine inoperative operational considerations.

  7. The Role of Accreditation in Directly Improving Educational Quality.

    ERIC Educational Resources Information Center

    Jung, Steven M.

    This study illustrates how the concept of "direct involvement" on the part of the accrediting agency can improve the quality of higher education. "Direct involvement" is defined as action by a representative of an educational agency that resulted in some observable improvement in educational quality. Categories and examples of direct assistance…

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

    ERIC Educational Resources Information Center

    Sims, Margaret; Waniganayake, Manjula

    2015-01-01

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

  9. 42 CFR 423.162 - Quality improvement organization activities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Quality improvement organization activities. 423.162 Section 423.162 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality Improvement Requirements §...

  10. 42 CFR 423.162 - Quality improvement organization activities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Quality improvement organization activities. 423.162 Section 423.162 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality Improvement Requirements §...

  11. 40 CFR 64.8 - Quality improvement plan (QIP) requirements.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 15 2011-07-01 2011-07-01 false Quality improvement plan (QIP) requirements. 64.8 Section 64.8 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) COMPLIANCE ASSURANCE MONITORING § 64.8 Quality improvement plan (QIP) requirements. (a) Based on the results of a...

  12. Does the EUA Institutional Evaluation Programme Contribute to Quality Improvement?

    ERIC Educational Resources Information Center

    Tavares, Diana Amado; Rosa, Maria Joao; Amaral, Alberto

    2010-01-01

    Purpose: This paper aims to reflect on the relevance of the Institutional Evaluation Programme (IEP) of the European University Association (EUA) to universities' quality improvement. It aims to analyse IEP follow-up reports to determine whether the programme contributes to the development of a quality improvement culture.…

  13. 40 CFR 64.8 - Quality improvement plan (QIP) requirements.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  14. Quality Improvement Strategies and Best Practices in Critical Access Hospitals

    ERIC Educational Resources Information Center

    Casey, Michelle M.; Moscovice, Ira

    2004-01-01

    Critical access hospitals (CAHs) face many challenges in implementing quality improvement (QI) initiatives, which include limited resources, low volume of patients, small staffs, and inadequate information technology. A primary goal of the Medicare Rural Hospital Flexibility Program is to improve the quality of care provided by CAHs. This article…

  15. 40 CFR 64.8 - Quality improvement plan (QIP) requirements.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 16 2014-07-01 2014-07-01 false Quality improvement plan (QIP) requirements. 64.8 Section 64.8 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) COMPLIANCE ASSURANCE MONITORING § 64.8 Quality improvement plan (QIP) requirements....

  16. Small Steps, Big Reward: Quality Improvement through Pilot Groups.

    ERIC Educational Resources Information Center

    Bindl, Jim; Schuler, Jim

    1988-01-01

    Because of a need for quality improvement, Wisconsin Power and Light trained two six-person pilot groups in statistical process control, had them apply that knowledge to actual problems, and showed management the dollars-and-cents savings that come from quality improvement. (JOW)

  17. International Accreditations as Drivers of Business School Quality Improvement

    ERIC Educational Resources Information Center

    Bryant, Michael

    2013-01-01

    Business schools are under pressure to implement continuous improvement and quality assurance processes to remain competitive in a globalized higher education market. Drivers for quality improvement include external, environmental pressures, regulatory bodies such as governments, and, increasingly, voluntary accreditation agencies such as AACSB…

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

    PubMed

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

    2016-01-01

    Despite the ubiquity of sleep complaints among individuals with anxiety disorders, few prior studies have examined whether sleep quality improves during anxiety treatment. The current study examined pre- to posttreatment sleep quality improvement during cognitive behavioral therapy (CBT) for panic disorder (PD; n = 26) or generalized anxiety disorder (GAD; n = 24). Among sleep quality indices, only global sleep quality and sleep latency improved significantly (but modestly) during CBT. Sleep quality improvement was greater for treatment responders, but did not vary by diagnosis. Additionally, poor baseline sleep quality was independently associated with worse anxiety treatment outcome, as measured by higher intolerance of uncertainty. Additional intervention targeting sleep prior to or during CBT for anxiety may be beneficial for poor sleepers. PMID:26244485

  19. Does Automated Feedback Improve Writing Quality?

    ERIC Educational Resources Information Center

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

    2014-01-01

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

  20. Improving Regional Air Quality with Wind Energy

    SciTech Connect

    Not Available

    2005-05-01

    This model documentation is designed to assist State and local governments in pursuing wind energy purchases as a control measure under regional air quality plans. It is intended to support efforts to draft State Implementation Plans (SIPs), including wind energy purchases, to ensure compliance with the standard for ground-level ozone established under the Clean Air Act.

  1. Improving forage quality using seedhead management

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Controlling seedhead emergence in perennial grass pastures can extend vegetative growth and high leaf:stem ratios to avoid declines in forage quality during the reproductive development of grasses. There are various management tools for controlling the emergence of seedheads. Pastures can be mowed...

  2. The Benefits of Improving Indoor Environmental Quality

    ERIC Educational Resources Information Center

    Lamping, Jerry

    2012-01-01

    As school funding levels nationwide continue to plummet amid public demands for increased student performance, an expanding body of research in the field of indoor environmental quality (IEQ) is providing greater statistical validity about the relationship between environmental conditions in school facilities and student achievement. Since the…

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

    NASA Astrophysics Data System (ADS)

    Pope, C. Arden; Miner, F. Dean

    1988-05-01

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

  4. Update on the Improving Teacher Quality Program. Report 09-05

    ERIC Educational Resources Information Center

    Humphrey, Karen

    2009-01-01

    The Improving Teacher Quality (ITQ) State Grants Program is currently operating professional development grants for California teachers at 40 sites statewide. This is as large a cadre of projects as the California Postsecondary Education Commission has operated since the ITQ Program began with the passage of the No Child Left Behind Act of 2001.…

  5. WET DEPOSITION AND SNOWPACK MONITORING OPERATIONS AND QUALITY ASSURANCE MANUAL

    EPA Science Inventory

    The manual (user's guide) describes the quality assurance plan and operations protocols for a comparative study of snow collection instruments being conducted on Mt. Evans. Instruments to be compared include the Aerochem Metrics Model 301 wet/dry deposition collector, the Belfort...

  6. Auditing and assessing air quality in concentrated feeding operations

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The potential adverse effects of concentrated animal feeding operations (CAFO) on the environment are a growing concern. The air quality issues of most concerns to CAFO vary, but generally include ammonia, hydrogen sulfide, particulate matter (PM), volatile organic compounds (VOC), green house gase...

  7. The role of safety and quality councils in improving the quality of healthcare: an Australian perspective.

    PubMed

    Barraclough, Bruce

    2006-01-01

    The Australian Council for Safety and Quality in Health Care (the Council) has made considerable advances in gaining acceptance of and commitment to the healthcare safety improvement agenda by all involved in healthcare in Australia. It has provided a focus for national efforts in safety and quality improvement, by raising awareness, building consensus and clarifying areas for priority action. While the Council has set the agenda for change and provides advice in relation to problems, initiatives and actions, it has limited operational capacity and lacks the statutory authority to embed a culture of safety at all levels of the healthcare system. Statutory and regulatory responsibility and accountability for implementation lies with the Australian, State and Territory Governments and organizations in the private sector. Progress depends on coordinating the activities of Departments of Health and Human Services of nine sovereign governments. The "levers for change" available to the Council were leadership, persuasion, advice and example, with the ability to develop strategies, frameworks, standards, tools and guidelines. With the end of the Council's term approaching, a recent review recommended the establishment of an Australian Commission on Safety & Quality in Health Care (the Commission). PMID:16651857

  8. Orion Handling Qualities During ISS Proximity Operations and Docking

    NASA Technical Reports Server (NTRS)

    Stephens, John-Paul; Vos, Gordon A.; Bilimoria, Karl D.; Mueller, Eric R.; Brazzel, Jack; Spehar, Pete

    2011-01-01

    NASA's Orion spacecraft is designed to autonomously rendezvous and dock with many vehicles including the International Space Station. However, the crew is able to assume manual control of the vehicle s attitude and flight path. In these instances, Orion must meet handling qualities requirements established by NASA. Two handling qualities assessments were conducted at the Johnson Space Center to evaluate preliminary designs of the vehicle using a six degree of freedom, high-fidelity guidance, navigation, and control simulation. The first assessed Orion s handling qualities during the last 20 ft before docking, and included both steady and oscillatory motions of the docking target. The second focused on manual acquisition of the docking axis during the proximity operations phase and subsequent station-keeping. Cooper-Harper handling qualities ratings, workload ratings and comments were provided by 10 evaluation pilots for the docking study and 5 evaluation pilots for the proximity operations study. For the docking task, both cases received 90% Level 1 (satisfactory) handling qualities ratings, exceeding NASA s requirement. All ratings for the ProxOps task were Level 1. These evaluations indicate that Orion is on course to meet NASA's handling quality requirements for ProxOps and docking.

  9. Improving the Quality and Scope of EIA Data

    EIA Publications

    2011-01-01

    Section 805(a) of the Energy Independence and Security Act of 2007 (EISA), Public Law 110-1401 requires the U.S. Energy Information Administration (EIA) to establish a five-year plan to enhance the quality and scope of its data collection necessary to ensure that the scope, accuracy, and timeliness of the information needed for efficient functioning of energy markets and related financial operations. This report is in response to section 805(b) of EISA which calls on EIA to submit to Congress the plan established under subsection (a), including a description of any improvements needed to enhance the ability of the Administrator to collect and process energy information in a manner consistent with the needs of energy markets.

  10. How intense quality control improves hydraulic fracturing

    SciTech Connect

    Ely, J.W.

    1996-11-01

    Not unlike the subject of Forced Closure, Intense Quality Control is probably misnamed. What actually is discussed in this article is pilot testing of the fracturing fluids actually pumped at in-situ conditions of temperature and shear. Presented here is development of the need for onsite testing, equipment used, shear and viscosity curves from several jobs showing what went wrong that would otherwise not have been known, and a discussion of borate gel fluids.

  11. Multipulse operation of a high average power, good beam quality zig-zag dye laser

    SciTech Connect

    Mandl, A.; Klimek, D.E.

    1996-03-01

    A laser pumped zig-zag dye laser operating at 568 nm with a pulse length {approximately} 2 {micro}s has been scaled to high power using a MOPA configuration. Pulse energies in excess of 7 J with beam quality < 2 XDL have been achieved under repetitively pulsed, 10 Hz operation. RMS jitter was measured as 0.12 of a 1 XDL spot. The device has operated with over 70 W output for runs up to 5 s. Substantially longer run times and output powers are possible. This device represents an advance in dye laser capabilities. Improvement in pointing accuracy of better than an order of magnitude have been demonstrated. In addition, an improvement in beam quality by about an order of magnitude has been achieved compared to other dye lasers operating in this power range.

  12. Quality improvement in pediatric inflammatory bowel disease: Moving forward to improve outcomes

    PubMed Central

    Quach, Pauline; Nguyen, Geoffrey C; Benchimol, Eric I

    2013-01-01

    In recent years, pediatric health care has embraced the concept of quality improvement to improve patient outcomes. As quality improvement efforts are implemented, network collaboration (where multiple centers and practices implement standardized programs) is a popular option. In a collaborative network, improvement in the conduct of structural, process and outcome quality measures can lead to improvements in overall health, and benchmarks can be used to assess and compare progress. In this review article, we provided an overview of the quality improvement movement and the role of quality indicators in this movement. We reviewed current quality improvement efforts in pediatric inflammatory bowel disease (IBD), as well as other pediatric chronic illnesses. We discussed the need to standardize the development of quality indicators used in quality improvement networks to assess medical care, and the validation techniques which can be used to ensure that process indicators result in improved outcomes of clinical significance. We aimed to assess current quality improvement efforts in pediatric IBD and other diseases, such as childhood asthma, childhood arthritis, and neonatal health. By doing so, we hope to learn from their successes and failures and to move the field forward for future improvements in the care provided to children with IBD. PMID:24151355

  13. Reducing mortality from hip fractures: a systematic quality improvement programme.

    PubMed

    Lisk, Radcliffe; Yeong, Keefai

    2014-01-01

    Hip fracture is one of the most serious consequences of falls in the elderly, with a mortality of 10% at one month and 30% at one year. Elderly patients with hip fractures have complex medical, surgical, and rehabilitation needs, and a well-coordinated multidisciplinary team approach is essential for the best outcome. The model of best practice for hip fracture care is set out in the Orthopaedic Blue Book and is incentivised by the best practice tariff. In 2009 to 2010, only 39.6% of our patients were being operated on within 36 hours, 19% achieved best practice tariff [1], and mortality was 7.8%. We were ranked as one of the worst hospitals to achieve best practice tariff [1] and our mortality was average. The orthogeriatrics team at Ashford & St Peter's NHS Trust (SPH) was implemented in 2010. Through a system redesign, regular governance meetings, audits and quality improvement projects, we have managed to improve care for our patients and reduce mortality. Over the last three years we have successfully achieved best care for our hip fracture patients, demonstrating a steady improvement in our attainment of the best practice tariff and a reduction in mortality to 5.3% in 2013, which ranks us amongst the best trusts nationally. PMID:27493729

  14. Reducing mortality from hip fractures: a systematic quality improvement programme

    PubMed Central

    Lisk, Radcliffe; Yeong, Keefai

    2014-01-01

    Hip fracture is one of the most serious consequences of falls in the elderly, with a mortality of 10% at one month and 30% at one year. Elderly patients with hip fractures have complex medical, surgical, and rehabilitation needs, and a well-coordinated multidisciplinary team approach is essential for the best outcome. The model of best practice for hip fracture care is set out in the Orthopaedic Blue Book and is incentivised by the best practice tariff. In 2009 to 2010, only 39.6% of our patients were being operated on within 36 hours, 19% achieved best practice tariff [1], and mortality was 7.8%. We were ranked as one of the worst hospitals to achieve best practice tariff [1] and our mortality was average. The orthogeriatrics team at Ashford & St Peter's NHS Trust (SPH) was implemented in 2010. Through a system redesign, regular governance meetings, audits and quality improvement projects, we have managed to improve care for our patients and reduce mortality. Over the last three years we have successfully achieved best care for our hip fracture patients, demonstrating a steady improvement in our attainment of the best practice tariff and a reduction in mortality to 5.3% in 2013, which ranks us amongst the best trusts nationally. PMID:27493729

  15. The ethics of using quality improvement methods in health care.

    PubMed

    Lynn, Joanne; Baily, Mary Ann; Bottrell, Melissa; Jennings, Bruce; Levine, Robert J; Davidoff, Frank; Casarett, David; Corrigan, Janet; Fox, Ellen; Wynia, Matthew K; Agich, George J; O'Kane, Margaret; Speroff, Theodore; Schyve, Paul; Batalden, Paul; Tunis, Sean; Berlinger, Nancy; Cronenwett, Linda; Fitzmaurice, J Michael; Dubler, Nancy Neveloff; James, Brent

    2007-05-01

    Quality improvement (QI) activities can improve health care but must be conducted ethically. The Hastings Center convened leaders and scholars to address ethical requirements for QI and their relationship to regulations protecting human subjects of research. The group defined QI as systematic, data-guided activities designed to bring about immediate improvements in health care delivery in particular settings and concluded that QI is an intrinsic part of normal health care operations. Both clinicians and patients have an ethical responsibility to participate in QI, provided that it complies with specified ethical requirements. Most QI activities are not human subjects research and should not undergo review by an institutional review board; rather, appropriately calibrated supervision of QI activities should be part of professional supervision of clinical practice. The group formulated a framework that would use key characteristics of a project and its context to categorize it as QI, human subjects research, or both, with the potential of a customized institutional review board process for the overlap category. The group recommended a period of innovation and evaluation to refine the framework for ethical conduct of QI and to integrate that framework into clinical practice. PMID:17438310

  16. Rotorcraft flying qualities improvement using advanced control

    NASA Technical Reports Server (NTRS)

    Walker, D.; Postlethwaite, I.; Howitt, J.; Foster, N.

    1993-01-01

    We report on recent experience gained when a multivariable helicopter flight control law was tested on the Large Motion Simulator (LMS) at DRA Bedford. This was part of a study into the application of multivariable control theory to the design of full-authority flight control systems for high-performance helicopters. In this paper, we present some of the results that were obtained during the piloted simulation trial and from subsequent off-line simulation and analysis. The performance provided by the control law led to level 1 handling quality ratings for almost all of the mission task elements assessed, both during the real-time and off-line analysis.

  17. IMPROVING WATER AND SOIL QUALITY WITH CONSERVATION

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Conservation buffer technologies are new approaches that need wider application. In-field buffer practices work best when used in combination with other buffer types and other conservation practices. Vegetative barriers may be used in combination with edge-of-field buffers to protect and improve the...

  18. Quality improvement in Vignoles through clonal selection

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Our goal is to select an improved, loose-clustered clone of Vignoles that will contribute to an integrated approach to disease control. Clonal selection has historically proven useful in reducing cluster compactness through a variety of mechanisms, including decreased berry size, lengthening of the ...

  19. It Pays to Improve School Quality

    ERIC Educational Resources Information Center

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

    2016-01-01

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

  20. NASA's Productivity Improvement and Quality Enhancement Initiatives

    NASA Technical Reports Server (NTRS)

    1984-01-01

    The National Aeronautics and Space Administration celebrated its 25th Anniversary in 1983 at the Air and Space Museum in Washington, DC, with President Reagan in attendance. We look back on the accomplishments of these twenty-five years with pride in our missions and our people. NASA captured the world's imagination during the days of the Apollo mission. So much so, that we now talk about the Apollo era. In the l970s, we moved into the Space Transportation business and in the 199Os, we look forward to having a manned Space Station. Each succeeding mission has presented its own challenge in terms of technology and resources. This is especially true today, when we are being asked to do more with less. To ensure that NASA continues to be a productive and quality conscious agency, one of our highest Agency goals is leadership in the development and application of practices which contribute to high productivity and quality. greatest competitive strength, and this country has a solid scientific and engineering foundation. Traditionally we have spent more money on research and development than Japan and Europe combined, and we are the source of most of this century significant innovations. We should build on this solid base and use it more effectively.

  1. The Armstrong Institute: An Academic Institute for Patient Safety and Quality Improvement, Research, Training, and Practice.

    PubMed

    Pronovost, Peter J; Holzmueller, Christine G; Molello, Nancy E; Paine, Lori; Winner, Laura; Marsteller, Jill A; Berenholtz, Sean M; Aboumatar, Hanan J; Demski, Renee; Armstrong, C Michael

    2015-10-01

    Academic medical centers (AMCs) could advance the science of health care delivery, improve patient safety and quality improvement, and enhance value, but many centers have fragmented efforts with little accountability. Johns Hopkins Medicine, the AMC under which the Johns Hopkins University School of Medicine and the Johns Hopkins Health System are organized, experienced similar challenges, with operational patient safety and quality leadership separate from safety and quality-related research efforts. To unite efforts and establish accountability, the Armstrong Institute for Patient Safety and Quality was created in 2011.The authors describe the development, purpose, governance, function, and challenges of the institute to help other AMCs replicate it and accelerate safety and quality improvement. The purpose is to partner with patients, their loved ones, and all interested parties to end preventable harm, continuously improve patient outcomes and experience, and eliminate waste in health care. A governance structure was created, with care mapped into seven categories, to oversee the quality and safety of all patients treated at a Johns Hopkins Medicine entity. The governance has a Patient Safety and Quality Board Committee that sets strategic goals, and the institute communicates these goals throughout the health system and supports personnel in meeting these goals. The institute is organized into 13 functional councils reflecting their behaviors and purpose. The institute works daily to build the capacity of clinicians trained in safety and quality through established programs, advance improvement science, and implement and evaluate interventions to improve the quality of care and safety of patients. PMID:25993278

  2. LP turbine retrofit modernization: Improvements in performance and operation

    SciTech Connect

    Groenedaal, J.C.; Fowls, L.G.; Subbiah, R.; Maxwell, B.P.; Persson, B.

    1996-11-01

    Westinghouse Electric Corporation retrofitted six low pressure (LP) nuclear turbine rotors and associated blade path components at Ringhals 1, a 1960`s vintage English Electric (GEC) unit located near Varobacka, Sweden, and operated by Vattenfall AB. This achieved significant performance improvements and provided improved mechanical features over the original equipment. This paper, discusses design, manufacture, installation, operation and project coordination. The retrofit processes employed for these units can be applied to any potential customers units.

  3. Operational Quality Control of SAR Data under the IDEAS Contract

    NASA Astrophysics Data System (ADS)

    Griffiths, Emma; Haria, Kajal; Meadowws, Peter; Miranda, Nuno

    2010-12-01

    Operational Quality Control (QC) of ERS-1/2 Synthetic Aperture Radar (SAR), Envisat's Advanced Synthetic Aperture Radar (ASAR) and the Phased-Array L-band SAR (PALSAR) on board JAXA's Advanced Land Observing Satellite (ALOS) is currently carried out under the Image Data quality Evaluation and Analysis Service (IDEAS). This paper introduces the concept of IDEAS as it applies to SAR QC including the daily and long-term analysis and shows the interaces to related services, including ESA's user-facing Earth Observation (EO) Help Desk

  4. Quality of Instruction Improved by Evaluation and Consultation of Instructors

    ERIC Educational Resources Information Center

    Rindermann, Heiner; Kohler, Jurgen; Meisenberg, Gerhard

    2007-01-01

    One aim of student evaluation of instruction is the improvement of teaching quality, but there is little evidence that student assessment of instruction alone improves teaching. This study tried to improve the effects of evaluation by combining evaluation with individual counselling in an institutional development approach. Evaluation was…

  5. Cover crops can improve potato tuber yield and quality

    Technology Transfer Automated Retrieval System (TEKTRAN)

    There is the need to develop sustainable systems with higher yields and crop quality. We conducted studies with cover crops grown under limited irrigation (< 200 mm) to assess the effects of certain types of cover crops on tuber yield and quality. On a commercial farm operation prior to the 2006 and...

  6. Evidence-Based Practice and Quality Improvement in Nursing Education.

    PubMed

    Balakas, Karen; Smith, Joan R

    2016-01-01

    For more than a decade, nursing education has experienced several significant changes in response to challenges faced by healthcare organizations. Accrediting organizations have called for improved quality and safety in care, and the Institute of Medicine has identified evidence-based practice and quality improvement as 2 core competencies to include in the curricula for all healthcare professionals. However, the application of these competencies reaches far beyond the classroom setting. For nurses to possess the knowledge, skills, and attitudes to apply evidence-based practice and quality improvement to the real-world setting, academic-clinical institution partnerships are vital. PMID:27465447

  7. Improved Adjoint-Operator Learning For A Neural Network

    NASA Technical Reports Server (NTRS)

    Toomarian, Nikzad; Barhen, Jacob

    1995-01-01

    Improved method of adjoint-operator learning reduces amount of computation and associated computational memory needed to make electronic neural network learn temporally varying pattern (e.g., to recognize moving object in image) in real time. Method extension of method described in "Adjoint-Operator Learning for a Neural Network" (NPO-18352).

  8. Improving the drug quality and safety net.

    PubMed

    Carter, Alan

    2014-07-01

    When large quantities of contaminated, subpotent, or superpotent drugs are introduced into the medical supply pipeline, injury or death of hundreds or thousands of patients can occur. Tracing the origin of substandard and dangerous products and tracking across regions and countries where shipped is quite costly in both money and time. From patients' perspective, timely access to quality product is paramount. Receiving deficient product threatens their survival and creates huge sums of financial cost to both them and the medical system. With the passage of HR 3204 the FDA must now find a way to be proactive in policing the global medical product supply line without restricting market availability. Without a comprehensive, world-focused implementation plan these new regulations will fail to protect the public. PMID:24876419

  9. Do farm audits improve milk quality?

    PubMed

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

    2014-01-01

    Milk quality is assessed using bulk milk analysis and by farm audits in the Netherlands. However, the extent of the effect that dairy farm audits have on milk quality is unknown. Data from over 13,000 audits performed on 12,855 dairy farms from February 2006 to April 2008 were merged with laboratory test results of 325,150 bulk milk samples collected 6 mo before and after the audit. A linear mixed model with the method of restricted maximum likelihood was conducted to study whether the total bacterial counts (TBC) of bulk milk were lower during the periods before and after the dairy farm audit. Results showed that TBC values were 2 to 6% lower (i.e., 0.010 to 0.026 log cfu/mL) for a period from 1.5 to at least 6 mo after an audit. Additionally, several variables were significantly associated with bulk milk TBC values: seasonality, total number of attention points (given if some checklist points were not appropriate), audit type, audit result, and the categories milking equipment maintenance, and utility room-tank maintenance. The TBC values increased with a higher level of attention points. Furthermore, the farms rejected based on the audit results had the highest average TBC values and the approved farms had the lowest values. If dairy farms had an overall negative audit assessment and consequently needed a re-audit in the following year, the TBC values of bulk milk were more likely to be higher. Auditing may provide dairy farmers the opportunity to receive advice about factors that influence bulk milk TBC values, for a period of at least 6 mo following the audit. PMID:24183685

  10. Lead-calcium alloy development: quality improvement

    NASA Astrophysics Data System (ADS)

    Caillerie, J.-L.; Albert, L.

    In the 1980s, most of the European lead producers and battery manufacturers had an interest in the lead-calcium alloys developed in the North American market. Fifteen years later, the alloy is used in most of the automotive and industrial batteries produced in Europe. During this development period, the composition of lead-calcium alloy has been improved. Physical metallurgy and electrochemistry research carried out by the lead industry has established the composition of the lead-calcium for negative grids. Metaleurop, as a lead producer, initiated in 1975 the production of lead-calcium alloys for sealed lead/acid batteries and was quickly convinced of the necessity to improve the performance of the alloy by further fundamental research (in 1980) and supporting customers' efforts. The parameters involved in the production battery plates are well specified. The composition of the alloy is dependent on the equipment used to cast the alloy. Improving the hardness by increasing the calcium content over 0.10 wt.% may not be the solution when melting and cooling conditions should als be adapted. The addition of aluminium to prevent calcium oxidation is efficient, its level being linked to the remelting and casting conditions.

  11. Improving Qubit Quality Factors Through Exotic Materials

    NASA Astrophysics Data System (ADS)

    Norman, Victoria

    In the time since the first qubits were successfully fabricated, the coherence times of superconducting Josephson junction qubits have improved by several orders of magnitude. Yet as the quantum information and computation field moves forward, these coherence times still need further improvement. We are now finding that in some superconducting systems, non-thermal equilibrium quasiparticles are becoming the limiting factor in qubit lifetimes. For SIS superconducting qubits, the T1 and T2* values may be improved by the use of materials with higher superconducting band gap, EG, for which low values may allow for quasiparticles to break up cooper pairs more easily, leading to a shorter lifetime. At this time, Al-Al2Ox3-Al transmons are very well characterized and understood and will therefore serve as an appropriate baseline with which to compare the more exotic junction materials. Using tantalum and niobium, which have Eg values of 3 times and 10 times that of aluminum respectively, we expect the T1 and T2* values to increase significantly for the Al-Al2Ox3-Nb, Al-Al2Ox3-Ta, and Ta-Ta2Ox5-Nb qubits.

  12. Improvements to science operations at Kitt Peak National Observatory

    NASA Astrophysics Data System (ADS)

    Bohannan, Bruce

    1998-07-01

    In recent years Kitt Peak National Observatory has undertaken a number of innovative projects to optimize science operations with the suite of telescopes we operate on Kitt Peak, Arizona. Changing scientific requirements and expectations of our users, evolving technology and declining budgets have motivated the changes. The operations improvements have included telescope performance enhancements--with the focus on the Mayall 4-m--modes of observing and scheduling, telescope control and observing systems, planning and communication, and data archiving.

  13. Pulmonary rehabilitation improves sleep quality in chronic lung disease.

    PubMed

    Soler, Xavier; Diaz-Piedra, Carolina; Ries, Andrew L

    2013-04-01

    Sleep-related disorders are common in patients with chronic obstructive pulmonary disease (COPD) and, possibily, other lung disorders. Exercise has been shown to improve sleep disturbances. In patients with COPD, pulmonary rehabilitation (PR) produces important health benefits with improvement in symptoms, exercise tolerance, and quality of life. However, the effect of PR on sleep quality remains unknown. The aim of this observational study was to evaluate sleep quality in patients with chronic lung disease and the role of PR as a non-pharmacologic treatment to improve sleep. Sixty-four patients with chronic lung disease enrolled in an 8-week comprehensive PR program, and completed the study (48% male; obstructive [72%], restrictive [20%], mixed [8%]; 44% on supplemental oxygen). Baseline spirometry [mean (SD)]: FEV1% pred = 48.9 (17.4), FVC% pred = 72.5 (18.1), and FEV1/FVC% = 53.1 (18.9). Exercise tolerance and questionnaires related to symptoms, health-related quality of life (HRQL), and sleep quality using the Pittsburgh Sleep Quality Index (PSQI) were obtained before and after PR. 58% reported poor sleep quality (PSQI > 5) at baseline. Sleep quality improved by 19% (p = 0.017) after PR, along with significant improvements in dyspnea, exercise tolerance, self-efficacy, and HRQL. Sleep quality in patients with chronic lung disease was poor. In addition to expected improvements in symptoms, exercise tolerance, and HRQL after PR, the subgroup of patients with COPD had a significant improvement in sleep quality. These findings suggest that PR may be an effective, non-pharmacologic treatment option for sleep problems in patients with COPD. PMID:23514215

  14. Improving the Quality of Voluntary Medical Male Circumcision through Use of the Continuous Quality Improvement Approach: A Pilot in 30 PEPFAR-Supported Sites in Uganda

    PubMed Central

    Opio, Alex; Calnan, Jacqueline; Njeuhmeli, Emmanuel

    2015-01-01

    Background Uganda adopted voluntary medical male circumcision (VMMC) (also called Safe Male Circumcision in Uganda), as part of its HIV prevention strategy in 2010. Since then, the Ministry of Health (MOH) has implemented VMMC mostly with support from the United States President’s Emergency Plan for AIDS Relief (PEPFAR) through its partners. In 2012, two PEPFAR-led external quality assessments evaluated compliance of service delivery sites with minimum quality standards. Quality gaps were identified, including lack of standardized forms or registers, lack of documentation of client consent, poor preparedness for emergencies and use of untrained service providers. In response, PEPFAR, through a USAID-supported technical assistance project, provided support in quality improvement to the MOH and implementing partners to improve quality and safety in VMMC services and build capacity of MOH staff to continuously improve VMMC service quality. Methods and Findings Sites were supported to identify barriers in achieving national standards, identify possible solutions to overcome the barriers and carry out improvement plans to test these changes, while collecting performance data to objectively measure whether they had bridged gaps. A 53-indicator quality assessment tool was used by teams as a management tool to measure progress; teams also measured client-level indicators through self-assessment of client records. At baseline (February-March 2013), less than 20 percent of sites scored in the “good” range (>80%) for supplies and equipment, patient counseling and surgical procedure; by November 2013, the proportion of sites scoring “good” rose to 67 percent, 93 percent and 90 percent, respectively. Significant improvement was noted in post-operative follow-up at 48 hours, sexually transmitted infection assessment, informed consent and use of local anesthesia but not rate of adverse events. Conclusion Public sector providers can be engaged to address the quality of

  15. Developing employee ownership of the quality improvement process.

    PubMed

    Oversmith, G E

    1990-08-01

    Developing true employee ownership of quality improvement is a process in itself. It begins with sending clear signals to employees that management fully supports the process and is committed to making it successful. It is reinforced when managers provide for the progressive education of all employees to ensure that job requirements are known and are achievable. Employee ownership of quality improvement continues to develop with ongoing management action that makes it clear that doing things right the first time is a part of the organizational culture. Encouraging the use of prevention--including quality improvement responsibilities in job descriptions and performance appraisals; the use of problem identification systems; and employee involvement in corrective action teams, quality improvement teams, and the management of the process--sends the message to employees that employee ownership of the process is a way of life in the organization. When success of the quality improvement effort is related to and understood as the key to the organization's success, as well as that of individual employees, and when each employee personally accepts the importance of his or her own role in making quality happen, the organization is well on its way to achieving its quality improvement objectives. PMID:10105559

  16. Improvements of Functional Validation by Analysis of Operational Problems

    NASA Astrophysics Data System (ADS)

    Di Nisio, Nicola; Reggestad, Vemund; Fuchs, Joachim

    2015-09-01

    As part of the TRP study “Improvements of Functional Validation by Analysis of Operational Problems”, we will explore the possibility of feeding the experience gained in the operational phase of a space mission into the design, development and verification phase of future missions. This paper will present the background of the problem and provide possible solutions that will be taken into account for the study. Also, a few examples of operational problems that could be used to improve the functional validation of future missions will be provided.

  17. Process safety improvement--quality and target zero.

    PubMed

    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. PMID:18374483

  18. The swiss neonatal quality cycle, a monitor for clinical performance and tool for quality improvement

    PubMed Central

    2013-01-01

    Background We describe the setup of a neonatal quality improvement tool and list which peer-reviewed requirements it fulfils and which it does not. We report on the so-far observed effects, how the units can identify quality improvement potential, and how they can measure the effect of changes made to improve quality. Methods Application of a prospective longitudinal national cohort data collection that uses algorithms to ensure high data quality (i.e. checks for completeness, plausibility and reliability), and to perform data imaging (Plsek’s p-charts and standardized mortality or morbidity ratio SMR charts). The collected data allows monitoring a study collective of very low birth-weight infants born from 2009 to 2011 by applying a quality cycle following the steps ′guideline – perform - falsify – reform′. Results 2025 VLBW live-births from 2009 to 2011 representing 96.1% of all VLBW live-births in Switzerland display a similar mortality rate but better morbidity rates when compared to other networks. Data quality in general is high but subject to improvement in some units. Seven measurements display quality improvement potential in individual units. The methods used fulfil several international recommendations. Conclusions The Quality Cycle of the Swiss Neonatal Network is a helpful instrument to monitor and gradually help improve the quality of care in a region with high quality standards and low statistical discrimination capacity. PMID:24074151

  19. Issues in Measuring and Improving Health Care Quality

    PubMed Central

    Friedman, Maria A.

    1995-01-01

    This issue of the Health Care Financing Review focuses on issues and advances in measuring and improving the quality of care, particularly for Medicare and Medicaid beneficiaries. Discussions of quality-related topics are especially timely, given the growing and widespread interest in improving quality in the organization, financing, and delivery of health care services. This article has several purposes. The first is to provide a brief description of some of the causes underlying the growth of the health care quality movement; the second is to provide a contextual framework for discussion of some of the overarching themes that emerge in this issue. These themes include examining conceptual issues, developing quality measures for specific sites and populations, and creating or adapting data sets for quality-measurement purposes. PMID:10151882

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

    ERIC Educational Resources Information Center

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

    2014-01-01

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

  1. Federal Workforce Quality: Measurement and Improvement. Report of the Advisory Committee on Federal Workforce Quality Assessment.

    ERIC Educational Resources Information Center

    Office of Personnel Management, Washington, DC.

    The Advisory Committee on Federal Workforce Quality Assessment was chartered to examine various work force quality assessment efforts in the federal government and provide advice on their adequacy and suggestions on their improvement or expansion. Objective data in recent research suggested that a universal decline in work force quality might not…

  2. Quality Implementation in Health Physics Unit, Cosenza Hospital. Accreditation Program as Quality Improvement instrument.

    PubMed

    Loizzo, M; Siciliano, R

    2016-01-01

    Achieving high levels of quality in healthcare, which could be measurable, is increasingly important at present and is dictated by the radical changes of the welfare system imposed today by the well known economic constraints. However, even in the ongoing legislation, the practices concerning the verification and review of the quality of health care has had a major impact in the galaxy of Health. On the one hand, the citizen is developing an awareness of the possibilities of choice (Empowerment) between a plurality of providers of healthcare services, on the other hand providers themselves are obliged, within the logic of a global market, to retrain their offers to respond satisfactorily to the needs of citizens. The purpose of this study was to demonstrate how the adoption of Operational Procedures, following the granting of a certificate of accreditation to the Unit of Medical Physics, has changed the approach to the work on the part of health workers, in the direction of a dynamic quality improvement. PMID:27479767

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

    NASA Technical Reports Server (NTRS)

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

    2002-01-01

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

  4. Quality Improvement in Critical Care: Selection and Development of Quality Indicators.

    PubMed

    Chrusch, Carla A; Martin, Claudio M; Project, The Quality Improvement In Critical Care

    2016-01-01

    Background. Caring for critically ill patients is complex and resource intensive. An approach to monitor and compare the function of different intensive care units (ICUs) is needed to optimize outcomes for patients and the health system as a whole. Objective. To develop and implement quality indicators for comparing ICU characteristics and performance within and between ICUs and regions over time. Methods. Canadian jurisdictions with established ICU clinical databases were invited to participate in an iterative series of face-to-face meetings, teleconferences, and web conferences. Eighteen adult intensive care units across 14 hospitals and 5 provinces participated in the process. Results. Six domains of ICU function were identified: safe, timely, efficient, effective, patient/family satisfaction, and staff work life. Detailed operational definitions were developed for 22 quality indicators. The feasibility was demonstrated with the collection of 3.5 years of data. Statistical process control charts and graphs of composite measures were used for data display and comparisons. Medical and nursing leaders as well as administrators found the system to be an improvement over prior methods. Conclusions. Our process resulted in the selection and development of 22 indicators representing 6 domains of ICU function. We have demonstrated the feasibility of such a reporting system. This type of reporting system will demonstrate variation between units and jurisdictions to help identify and prioritize improvement efforts. PMID:27493476

  5. Quality Improvement in Critical Care: Selection and Development of Quality Indicators

    PubMed Central

    Martin, Claudio M.; Project, The Quality Improvement in Critical Care

    2016-01-01

    Background. Caring for critically ill patients is complex and resource intensive. An approach to monitor and compare the function of different intensive care units (ICUs) is needed to optimize outcomes for patients and the health system as a whole. Objective. To develop and implement quality indicators for comparing ICU characteristics and performance within and between ICUs and regions over time. Methods. Canadian jurisdictions with established ICU clinical databases were invited to participate in an iterative series of face-to-face meetings, teleconferences, and web conferences. Eighteen adult intensive care units across 14 hospitals and 5 provinces participated in the process. Results. Six domains of ICU function were identified: safe, timely, efficient, effective, patient/family satisfaction, and staff work life. Detailed operational definitions were developed for 22 quality indicators. The feasibility was demonstrated with the collection of 3.5 years of data. Statistical process control charts and graphs of composite measures were used for data display and comparisons. Medical and nursing leaders as well as administrators found the system to be an improvement over prior methods. Conclusions. Our process resulted in the selection and development of 22 indicators representing 6 domains of ICU function. We have demonstrated the feasibility of such a reporting system. This type of reporting system will demonstrate variation between units and jurisdictions to help identify and prioritize improvement efforts. PMID:27493476

  6. The business case for health-care quality improvement.

    PubMed

    Swensen, Stephen J; Dilling, James A; Mc Carty, Patrick M; Bolton, Jeffrey W; Harper, Charles M

    2013-03-01

    The business case for health-care quality improvement is presented. We contend that investment in process improvement is aligned with patients' interests, the organization's reputation, and the engagement of their workforce. Four groups benefit directly from quality improvement: patients, providers, insurers, and employers. There is ample opportunity, even in today's predominantly pay-for-volume (that is, evolving toward value-based purchasing) insurance system, for providers to deliver care that is in the best interest of the patient while improving their financial performance. PMID:23429226

  7. Measuring and Costing Quality in Education: Using Quality and Productivity Methods To Improve Schools.

    ERIC Educational Resources Information Center

    Spanbauer, Stanley J.

    The Measurement and Costing Model (MCM) described in this book was developed and tested at Fox Valley Technical College (FVTC), Wisconsin, to enhance the college's quality improvement process and to serve as a guide to other institutions interested in improving their quality. The book presents a description of the model and outlines seven steps…

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

    ERIC Educational Resources Information Center

    Jeon, Lieny; Buettner, Cynthia K.

    2015-01-01

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

  9. Managing soil under vegetable production to improve soil quality

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Over the years, soil quality has eroded as soil organic matter has declined on farms across North Carolina. This study is assessing the effects of tillage practice, winter cover cropping and compost use on changes in soil function and improvement in soil quality under vegetable production. The field...

  10. Improving Indoor Air Quality in St. Cloud Schools.

    ERIC Educational Resources Information Center

    Forer, Mike; Haus, El

    2000-01-01

    Describes how the St. Cloud Area School District (Minnesota), using Tools for Schools provided by the U.S. Environmental Protection Agency, managed the improvement of their school building indoor air quality (IAQ). The district goals of the IAQ Management Committee and the policy elements used to maintain high classroom air quality are…

  11. Effects of Quality Improvement System for Child Care Centers

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  12. 40 CFR 63.1035 - Quality improvement program for pumps.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... be maintained as specified in the quality assurance program. (e) QIP recordkeeping. In addition to... specified in paragraphs (e)(1) through (e)(6) of this section. (1) When using a pump quality improvement... service or in polymerizing monomer service shall comply with all requirements except for those...

  13. 40 CFR 63.1035 - Quality improvement program for pumps.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 11 2012-07-01 2012-07-01 false Quality improvement program for pumps... (CONTINUED) National Emission Standards for Equipment Leaks-Control Level 2 Standards § 63.1035 Quality... requirements specified in paragraphs (a)(1) and (a)(2) of this section. (1) Pumps that are in food and...

  14. 40 CFR 63.1035 - Quality improvement program for pumps.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 11 2014-07-01 2014-07-01 false Quality improvement program for pumps... (CONTINUED) National Emission Standards for Equipment Leaks-Control Level 2 Standards § 63.1035 Quality... requirements specified in paragraphs (a)(1) and (a)(2) of this section. (1) Pumps that are in food and...

  15. 40 CFR 63.176 - Quality improvement program for pumps.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 10 2012-07-01 2012-07-01 false Quality improvement program for pumps... National Emission Standards for Organic Hazardous Air Pollutants for Equipment Leaks § 63.176 Quality...) Pumps that are in food/medical service or in polymerizing monomer service shall comply with...

  16. 40 CFR 63.176 - Quality improvement program for pumps.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 10 2013-07-01 2013-07-01 false Quality improvement program for pumps... National Emission Standards for Organic Hazardous Air Pollutants for Equipment Leaks § 63.176 Quality...) Pumps that are in food/medical service or in polymerizing monomer service shall comply with...

  17. 42 CFR 422.152 - Quality improvement program.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... care domain (for example, National Committee for Quality Assurance accreditation measures or medication reconciliation associated with care setting transitions indicators). (iv) Comprehensive health risk assessment as... 42 Public Health 3 2014-10-01 2014-10-01 false Quality improvement program. 422.152 Section...

  18. 42 CFR 422.152 - Quality improvement program.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... care domain (for example, National Committee for Quality Assurance accreditation measures or medication reconciliation associated with care setting transitions indicators). (iv) Comprehensive health risk assessment as... 42 Public Health 3 2013-10-01 2013-10-01 false Quality improvement program. 422.152 Section...

  19. Using Deming To Improve Quality in Colleges and Universities.

    ERIC Educational Resources Information Center

    Cornesky, Robert A.; And Others

    Of all the people known for stressing quality in industry, W. Edwards Deming is the pioneer. He stresses statistical process control (SPC) and a 14-point process for managers to improve quality and productivity. His approach is humanistic and treats people as intelligent human beings who want to do a good job. Twelve administrators in a university…

  20. Improving on-time surgical starts in an operating room

    PubMed Central

    Wright, James G.; Roche, Ann; Khoury, Antoine E.

    2010-01-01

    Background Operating rooms are expensive to run, and hospitals strive to be efficient. The purpose of this study was to evaluate an initiative to improve starting on time in the operating room in an academic pediatric hospital. Methods We used an 8-step approach to transforming an organization. A multidisciplinary team defined on-time starts, identified reasons for delays and instituted changes, including improving the same-day admission process, instituting a huddle of operating room staff each morning and providing feedback about on-time starts to staff. Results The most common reasons for delay were surgeon and anesthesiologist unavailability and lack of preparedness of patients. The percentage of operations that began on time, defined as the patient being in the room, increased from about 6% to 60% over a 9-month period. Conclusion A targeted, multifaceted and multidisciplinary approach can increase the percentage of operations that begin on time in a pediatric hospital. PMID:20507788

  1. Expression Marker-Based Strategy to Improve Beef Quality

    PubMed Central

    Cassar-Malek, Isabelle; Picard, Brigitte

    2016-01-01

    For beef cattle research, a main objective is to control concomitantly the development of muscles and the qualities of beef cuts. Beef quality is a complex phenotype that is only detectable after slaughter and is highly variable. The beef industry is in need of tools to estimate beef quality of live cattle or online in abattoirs, with specific attention towards sensory attributes (tenderness, juiciness, flavour, and colour). Identification of relevant genetic and genomic markers is ongoing, especially for tenderness—a top priority quality attribute. In this paper, we describe the steps of an expression marker-based strategy to improve beef sensory quality, from the discovery of biomarkers that identify consistent beef and the biological functions governing beef tenderness to the integration of the knowledge into detection tests for desirable animals. These tools should soon be available for the management of sensory quality in the beef production chain for meeting market's demands and assuring good quality standards. PMID:27066527

  2. 21 CFR 111.110 - What quality control operations are required for laboratory operations associated with the...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... laboratory operations associated with the production and process control system? 111.110 Section 111.110 Food... OPERATIONS FOR DIETARY SUPPLEMENTS Production and Process Control System: Requirements for Quality Control... production and process control system? Quality control operations for laboratory operations associated...

  3. 21 CFR 111.110 - What quality control operations are required for laboratory operations associated with the...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... laboratory operations associated with the production and process control system? 111.110 Section 111.110 Food... OPERATIONS FOR DIETARY SUPPLEMENTS Production and Process Control System: Requirements for Quality Control... production and process control system? Quality control operations for laboratory operations associated...

  4. Improvement of image quality by polarization mixing

    NASA Astrophysics Data System (ADS)

    Kasahara, Ryosuke; Itoh, Izumi; Hirai, Hideaki

    2014-03-01

    Information about the polarization of light is valuable because it contains information about the light source illuminating an object, the illumination angle, and the object material. However, polarization information strongly depends on the direction of the light source, and it is difficult to use a polarization image with various recognition algorithms outdoors because the angle of the sun varies. We propose an image enhancement method for utilizing polarization information in many such situations where the light source is not fixed. We take two approaches to overcome this problem. First, we compute an image that is the combination of a polarization image and the corresponding brightness image. Because of the angle of the light source, the polarization contains no information about some scenes. Therefore, it is difficult to use only polarization information in any scene for applications such as object detection. However, if we use a combination of a polarization image and a brightness image, the brightness image can complement the lack of scene information. The second approach is finding features that depend less on the direction of the light source. We propose a method for extracting scene features based on a calculation of the reflection model including polarization effects. A polarization camera that has micro-polarizers on each pixel of the image sensor was built and used for capturing images. We discuss examples that demonstrate the improved visibility of objects by applying our proposed method to, e.g., the visibility of lane markers on wet roads.

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

    PubMed

    Mainz, Jan; Kristensen, Solvejg; Bartels, Paul

    2015-12-01

    Denmark has unique opportunities for quality measurement and benchmarking since Denmark has well-developed health registries and unique patient identifier that allow all registries to include patient-level data and combine data into sophisticated quality performance monitoring. Over decades, Denmark has developed and implemented national quality and patient safety initiatives in the healthcare system in terms of national clinical guidelines, performance and outcome measurement integrated in clinical databases for important diseases and clinical conditions, measurement of patient experiences, reporting of adverse events, national handling of patient complaints, national accreditation and public disclosure of all data on the quality of care. Over the years, Denmark has worked up a progressive and transparent just culture in quality management; the different actors at the different levels of the healthcare system are mutually attentive and responsive in a coordinated effort for quality of the healthcare services. At national, regional, local and hospital level, it is mandatory to participate in the quality initiatives and to use data and results for quality management, quality improvement, transparency in health care and accountability. To further develop the Danish governance model, it is important to expand the model to the primary care sector. Furthermore, a national quality health programme 2015-18 recently launched by the government supports a new development in health care focusing upon delivering high-quality health care-high quality is defined by results of value to the patients. PMID:26443814

  6. Rendezvous, proximity operations and capture quality function deployment report

    NASA Technical Reports Server (NTRS)

    Lamkin, Stephen L. (Editor)

    1991-01-01

    Rendezvous, Proximity Operations, and Capture (RPOC) is a missions operations area which is extremely important to present and future space initiatives and must be well planned and coordinated. To support this, a study team was formed to identify a specific plan of action using the Quality Function Deployment (QFD) process. This team was composed of members from a wide spectrum of engineering and operations organizations which are involved in the RPOC technology area. The key to this study's success is an understanding of the needs of potential programmatic customers and the technology base available for system implementation. To this end, the study team conducted interviews with a variety of near term and future programmatic customers and technology development sponsors. The QFD activity led to a thorough understanding of the needs of these customers in the RPOC area, as well as the relative importance of these needs.

  7. Environmental Quality Information Analysis Center (EQIAC) operating procedures handbook

    SciTech Connect

    Walsh, T.E. ); Das, S. )

    1992-08-01

    The Operating Procedures Handbook of the Environmental Quality Information Analysis Center (EQIAC) is intended to be kept current as EQIAC develops and evolves. Its purpose is to provide a comprehensive guide to the mission, infrastructure, functions, and operational procedures of EQIAC. The handbook is a training tool for new personnel and a reference manual for existing personnel. The handbook will be distributed throughout EQIAC and maintained in binders containing current dated editions of the individual sections. The handbook will be revised at least annually to reflect the current structure and operational procedures of EQIAC. The EQIAC provides information on environmental issues such as compliance, restoration, and environmental monitoring do the Air Force and DOD contractors.

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

    ERIC Educational Resources Information Center

    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…

  9. A comprehensive method for GNSS data quality determination to improve ionospheric data analysis.

    PubMed

    Kim, Minchan; Seo, Jiwon; Lee, Jiyun

    2014-01-01

    Global Navigation Satellite Systems (GNSS) are now recognized as cost-effective tools for ionospheric studies by providing the global coverage through worldwide networks of GNSS stations. While GNSS networks continue to expand to improve the observability of the ionosphere, the amount of poor quality GNSS observation data is also increasing and the use of poor-quality GNSS data degrades the accuracy of ionospheric measurements. This paper develops a comprehensive method to determine the quality of GNSS observations for the purpose of ionospheric studies. The algorithms are designed especially to compute key GNSS data quality parameters which affect the quality of ionospheric product. The quality of data collected from the Continuously Operating Reference Stations (CORS) network in the conterminous United States (CONUS) is analyzed. The resulting quality varies widely, depending on each station and the data quality of individual stations persists for an extended time period. When compared to conventional methods, the quality parameters obtained from the proposed method have a stronger correlation with the quality of ionospheric data. The results suggest that a set of data quality parameters when used in combination can effectively select stations with high-quality GNSS data and improve the performance of ionospheric data analysis. PMID:25196005

  10. A Comprehensive Method for GNSS Data Quality Determination to Improve Ionospheric Data Analysis

    PubMed Central

    Kim, Minchan; Seo, Jiwon; Lee, Jiyun

    2014-01-01

    Global Navigation Satellite Systems (GNSS) are now recognized as cost-effective tools for ionospheric studies by providing the global coverage through worldwide networks of GNSS stations. While GNSS networks continue to expand to improve the observability of the ionosphere, the amount of poor quality GNSS observation data is also increasing and the use of poor-quality GNSS data degrades the accuracy of ionospheric measurements. This paper develops a comprehensive method to determine the quality of GNSS observations for the purpose of ionospheric studies. The algorithms are designed especially to compute key GNSS data quality parameters which affect the quality of ionospheric product. The quality of data collected from the Continuously Operating Reference Stations (CORS) network in the conterminous United States (CONUS) is analyzed. The resulting quality varies widely, depending on each station and the data quality of individual stations persists for an extended time period. When compared to conventional methods, the quality parameters obtained from the proposed method have a stronger correlation with the quality of ionospheric data. The results suggest that a set of data quality parameters when used in combination can effectively select stations with high-quality GNSS data and improve the performance of ionospheric data analysis. PMID:25196005

  11. Grid quality improvement by a grid adaptation technique

    NASA Technical Reports Server (NTRS)

    Lee, K. D.; Henderson, T. L.; Choo, Y. K.

    1991-01-01

    A grid adaptation technique is presented which improves grid quality. The method begins with an assessment of grid quality by defining an appropriate grid quality measure. Then, undesirable grid properties are eliminated by a grid-quality-adaptive grid generation procedure. The same concept has been used for geometry-adaptive and solution-adaptive grid generation. The difference lies in the definition of the grid control sources; here, they are extracted from the distribution of a particular grid property. Several examples are presented to demonstrate the versatility and effectiveness of the method.

  12. Galantamine improves sleep quality in patients with dementia.

    PubMed

    Naharci, Mehmet Ilkin; Ozturk, Ahmet; Yasar, Halit; Cintosun, Umit; Kocak, Necmettin; Bozoglu, Ergun; Tasci, Ilker; Doruk, Huseyin

    2015-12-01

    The purpose of the study was to evaluate the influences of cholinesterase inhibitors on sleep pattern and sleep disturbance. A total of 87 mild to moderate stage dementia patients who were not on cholinesterase enzyme inhibitor and memantine treatment were included in the study. The dementia patients were treated with donepezil, galantamine or rivastigmine, depending on the preference of the clinician. Fifty-five dementia patients (63.2 %) completed the study. Twenty-three elderly subjects, who had normal cognitive functions, were included in the study as the control group. The Pittsburgh Sleep Quality Index was used for evaluating the sleep quality at the beginning and at the final assessment. The improvement in sleep quality was better with regard to changes in Pittsburgh Sleep Quality Index scores with galantamine treatment compared to the donepezil and the control groups. A significant decrease in Pittsburgh Sleep Quality Index scores was detected in the galantamine group after treatment. Although statistically not significant, rivastigmine decreased and donepezil increased the Pittsburgh Sleep Quality Index scores after treatment. Dementia patients who had a poor sleep quality (n: 36), the rate of improvement in sleep disturbance was 81.8 % in the galantamine group, 75 % in the rivastigmine, and 50 % in the donepezil group. Galantamine may be the first choice of cholinesterase inhibitor in mild to moderate dementia patients in terms of improving sleep quality. PMID:25777522

  13. Effective Interventions on Service Quality Improvement in a Physiotherapy Clinic

    PubMed Central

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

    2014-01-01

    Background: Service quality is considered as a main domain of quality associ­ated with non-clinical aspect of healthcare. This study aimed to survey and im­proves service quality of delivered care in the Physiotherapy Clinic affiliated with the Tabriz University of Medical Sciences, Tabriz, Iran. Methods: A quasi experimental interventional study was conducted in the Physiotherapy Clinic, 2010-2011. Data were collected using a validated and reli­able researcher made questionnaire with participation of 324 patients and their coadjutors. The study questionnaire consisted of 7 questions about demographic factors and 38 questions for eleven aspects of service quality. Data were then analyzed using paired samples t-test by SPSS16. Results: In the pre intervention phase, six aspects of service quality including choice of provider, safety, prevention and early detection, dignity, autonomy and availability achieved non-acceptable scores. Following interventions, all aspects of the service quality improved and also total service quality score improved from 8.58 to 9.83 (P<0.001). Conclusion: Service quality can be improved by problem implementation of appropriate interventions. The acquired results can be used in health system fields to create respectful environments for healthcare customers. PMID:25097838

  14. Hospital value-based purchasing (VBP) program: measurement of quality and enforcement of quality improvement.

    PubMed

    Szablowski, Katarzyna M

    2014-01-01

    VBP program is a novel medicare payment estimatin tool used to encourage clinical care quality improvement as well as improvement of patient experience as a customer of a health care system. The program utilizes well established tools of measuring clinical care quality and patient satisfaction such as the hospital IQR program and HCAHPS survey to estimate Medicare payments and encourage hospitals to continuosly improve the level of care they provide. PMID:24600783

  15. Initiation of quality improvement activities in mental health services.

    PubMed

    Tobin, M; Chen, L

    1999-06-01

    In the public sector mental health service setting, accountability for quality has often been considered the responsibility of the individual clinician. This presents a particular challenge for introducing an organization-wide quality improvement culture in this setting. The introduction of a systemic view of quality may encounter resistance from individual clinicians reluctant to accept that some clinical autonomy must be subsumed within more standardized patterns of intervention and evaluation. Services must firstly tackle the issue of clinicians' readiness to embrace such a culture, which requires strong direction from the executive level. The area of recently diagnosed psychosis was selected in one public sector mental health service as a starting point for initiating the quality improvement culture. The eventual outcome for the organization has been a positive commitment to improvement, but the journey was long and hard. This paper describes the beginning of this ultimately rewarding journey. PMID:10408753

  16. Measurement of Quality to Improve Care in Sleep Medicine

    PubMed Central

    Morgenthaler, Timothy I.; Aronsky, Amy J.; Carden, Kelly A.; Chervin, Ronald D.; Thomas, Sherene M.; Watson, Nathaniel F.

    2015-01-01

    The Board of Directors of the American Academy of Sleep Medicine (AASM) commissioned a Task Force to develop quality measures as part of its strategic plan to promote high quality patient-centered care. Among many potential dimensions of quality, the AASM requested Workgroups to develop outcome and process measures to aid in evaluating the quality of care of five common sleep disorders: restless legs syndrome, insomnia, narcolepsy, obstructive sleep apnea in adults, and obstructive sleep apnea in children. This paper describes the rationale, background, general methods development, and considerations in implementation for these sleep disorder quality measures. The Workgroup papers are published in this issue under the following titles: Quality Measures for the Care of Adult Patients with Restless Legs Syndrome, Quality Measures for the Care of Patients with Insomnia, Quality Measures for the Care of Patients with Narcolepsy, Quality Measures for the Care of Adult Patients with Obstructive Sleep Apnea, and Quality Measures for the Care of Pediatric Patients with Obstructive Sleep Apnea. Citation: Morgenthaler TI, Aronsky AJ, Carden KA, Chervin RD, Thomas SM, Watson NF. Measurement of quality to improve care in sleep medicine. J Clin Sleep Med 2015;11(3):279–291. PMID:25700883

  17. Using AMLO to Improve the Quality of Teacher Education Outcomes

    ERIC Educational Resources Information Center

    Al-Shammari, Zaid

    2012-01-01

    This study aims to find ways to improve learning outcomes in teacher education courses by using an Analysis Model for Learning Outcomes (AMLO). It addresses the improvement of the quality of teacher education by analyzing learning outcomes and implementing curriculum modifications related to specific learning objectives and their effects on…

  18. Applying GRA and QFD to Improve Library Service Quality

    ERIC Educational Resources Information Center

    Chen, Yen-Ting; Chou, Tsung-Yu

    2011-01-01

    This paper applied Grey Relational Analysis (GRA) to Quality Function Deployment (QFD) to identify service improvement techniques for an academic library. First, reader needs and their importance, and satisfaction degrees were examined via questionnaires. Second, the service improvement techniques for satisfying the reader needs were developed by…

  19. Applying a Continuous Quality Improvement Model To Assess Institutional Effectiveness.

    ERIC Educational Resources Information Center

    Roberts, Keith

    This handbook outlines techniques and processes for improving institutional effectiveness and ensuring continuous quality improvement, based on strategic planning activities at Wisconsin's Milwaukee Area Technical College (MATC). First, institutional effectiveness is defined and 17 core indicators of effectiveness developed by the Wisconsin…

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

    PubMed

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

    2013-08-01

    This is the first in a series of articles describing the application of Lean management systems to Laboratory Medicine. Lean is the term used to describe a principle-based continuous quality improvement (CQI) management system based on the Toyota production system (TPS) that has been evolving for over 70 years. Its origins go back much further and are heavily influenced by the work of W Edwards Deming and the scientific method that forms the basis of most quality management systems. Lean has two fundamental elements--a systematic approach to process improvement by removing waste in order to maximise value for the end-user of the service and a commitment to respect, challenge and develop the people who work within the service to create a culture of continuous improvement. Lean principles have been applied to a growing number of Healthcare systems throughout the world to improve the quality and cost-effectiveness of services for patients and a number of laboratories from all the pathology disciplines have used Lean to shorten turnaround times, improve quality (reduce errors) and improve productivity. Increasingly, models used to plan and implement large scale change in healthcare systems, including the National Health Service (NHS) change model, have evidence-based improvement methodologies (such as Lean CQI) as a core component. Consequently, a working knowledge of improvement methodology will be a core skill for Pathologists involved in leadership and management. PMID:23757036

  1. Workbook for Taguchi Methods for Product Quality Improvement.

    ERIC Educational Resources Information Center

    Zarghami, Ali; Benbow, Don

    Taguchi methods are methods of product quality improvement that analyze major contributions and how they can be controlled to reduce variability of poor performance. In this approach, knowledge is used to shorten testing. Taguchi methods are concerned with process improvement rather than with process measurement. This manual is designed to be used…

  2. An Approach to Bilateral Control System for Improvement of Operationality

    NASA Astrophysics Data System (ADS)

    Tanaka, Hiroyuki; Ohnishi, Kouhei

    Many types of bilateral control architectures to transmit force sensation have been proposed. Some control methods obtain good performance. Operationality is not satisfactory, however, when these methods are implemented in bilateral systems with large inertia and friction force. In this paper, a novel bilateral control method is proposed to improve operationality of bilateral systems with large inertia and friction force. The proposed method is compared with a conventional method, and the effectiveness of the proposed method is demonstrated by coordinate transformation and experiments.

  3. Continuous quality improvement and medical informatics: the convergent synergy.

    PubMed

    Werth, G R; Connelly, D P

    1992-01-01

    Continuous quality improvement (CQI) and medical informatics specialists need to converge their efforts to create synergy for improving health care. Health care CQI needs medical informatics' expertise and technology to build the information systems needed to manage health care organizations according to quality improvement principles. Medical informatics needs CQI's philosophy and methods to build health care information systems that can evolve to meet the changing needs of clinicians and other stakeholders. This paper explores the philosophical basis for convergence of CQI and medical informatics efforts, and then examines a clinical computer workstation development project that is applying a combined approach. PMID:1482948

  4. Bilateral subthalamic nucleus stimulation improves health-related quality of life in Parkinsonian patients.

    PubMed

    Erola, Tuomo; Karinen, Petri; Heikkinen, Esa; Tuominen, Juho; Haapaniemi, Tarja; Koivukangas, John; Myllylä, Vilho

    2005-03-01

    Parkinson's disease (PD) is a common neurological disorder. Recently, bilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN) has become an option in the treatment of severe PD. We measured the health-related quality of life (HRQoL) of 27 parkinsonian patients, who underwent a bilateral STN-operation. The instruments used for the evaluation of the HRQoL were the Parkinson's Disease Questionnaire (PDQ-39) and the Finnish version of the Nottingham Health Profile (NHP). We found that the quality of life significantly improved when measured with both HRQoL scales. Clinical improvement and improvement in HRQoL were positively correlated. PMID:15734666

  5. On Improving Higher Vocational College Education Quality Assessment

    NASA Astrophysics Data System (ADS)

    Wu, Xiang; Chen, Yan; Zhang, Jie; Wang, Yi

    Teaching quality assessment is a judgment process by using the theory and technology of education evaluation system to test whether the process and result of teaching have got to a certain quality level. Many vocational schools have established teaching quality assessment systems of their own characteristics as the basic means to do self-examination and teaching behavior adjustment. Combined with the characteristics and requirements of the vocational education and by analyzing the problems exist in contemporary vocational school, form the perspective of the content, assessment criteria and feedback system of the teaching quality assessment to optimize the system, to complete the teaching quality information net and offer suggestions for feedback channels, to make the institutionalization, standardization of the vocational schools and indeed to make contribution for the overall improvement of the quality of vocational schools.

  6. Ten tips for incorporating scientific quality improvement into everyday work.

    PubMed

    Goldmann, Don

    2011-04-01

    Healthcare personnel often find it challenging to incorporate disciplined quality improvement into their daily work. Planning, managing and completing improvement projects with sufficient rigour to generate credible evidence and potentially publishable knowledge are even more difficult. Nonetheless, careful set-up and agile leveraging of existing resources and expertise can lead to surprisingly robust results. Project designs that integrate data collection with the work itself are especially helpful. Although the general perception is that top-flight journals are loath to publish the results of quality improvement work, accumulating experience suggests that this hurdle can be overcome. The Standards for Quality Improvement Reporting Excellence guidelines provide a promising framework for crafting publications that can meet the exacting standards of peer-reviewed journals. PMID:21450777

  7. Geometrically tuned wettability of dynamic micromechanical sensors for an improved in-liquid operation

    NASA Astrophysics Data System (ADS)

    Peiker, P.; Oesterschulze, E.

    2015-09-01

    Partial wetting is a vital tool to improve the quality factor of dynamic micromechanical sensors operated in liquids owing to the reduced viscous damping. This technique employs meniscus formation which so far could only be stabilized for a hydrophobic sensory surface excluding biosensing applications. Here, we report on the geometrically tuned wettability of particular hybrid bridge resonators (HBR) with an integrated overhang structure. This allows low-loss operation irrespective of the sensory surface material. The impact of the overhang structure on wetting is explained in a simplified model. Experimental evidence is adduced operating the HBR coated with hydrophilic thin films in water. With an in-liquid quality factor Q of 91 and a small mass m ≈ 5 ng of the HBR, the m/Q-ratio, which is proportional to the limit of detection for mass sensing, was significantly improved in comparison to immersed resonators presented so far.

  8. Pediatric collaborative networks for quality improvement and research.

    PubMed

    Lannon, Carole M; Peterson, Laura E

    2013-01-01

    Despite efforts of individual clinicians, pediatric practices, and institutions to remedy continuing deficiencies in pediatric safety and health care quality, multiple gaps and disparities exist. Most pediatric diseases are rare; thus, few practices or centers care for sufficient numbers of children, particularly in subspecialties, to achieve large and representative sample sizes, and substantial between-site variation in care and outcomes persists. Pediatric collaborative improvement networks are multi-site clinical networks that allow practice-based teams to learn from one another, test changes to improve quality, and use their collective experience and data to understand, implement, and spread what works in practice. The model was initially developed in 2002 by an American Board of Pediatrics Workgroup to accelerate the translation of evidence into practice, improve care and outcomes for children, and to serve as the gold standard for the performance in practice component of Maintenance of Certification requirements. Many features of an improvement network derive from the Institute for Healthcare Improvement's collaborative improvement model Breakthrough Series, including focus on a high-impact condition or topic; providing support from clinical content and quality improvement experts; using the Model for Improvement to set aims, use data for feedback, and test changes iteratively; providing infrastructure support for data collection, analysis and reporting, and quality improvement coaching; activities to enhance collaboration; and participation of multidisciplinary teams from multiple sites. In addition, they typically include a population registry of the children receiving care for the improvement topic of interest. These registries provide large and representative study samples with high-quality data that can be used to generate information and evidence, as well as to inform clinical decision making. In addition to quality improvement, networks serve as large

  9. Improved actions, redundant operators and scaling in lattice SU(3)

    NASA Astrophysics Data System (ADS)

    Patel, Apoorva; Gupta, Rajan

    1987-01-01

    Schwinger-Dyson equations are used to systematically calculate redundant operators in lattice QCD and their role in perturbatively improved actions is analyzed. The criteria for improved actions in Monte Carlo simulations are discussed and their usefulness also. In particular the renormalized trajectory is estimated for the b = sqrt(3) renormalization group transformation in a four-parameter space and its scaling behavior is studied for future use in spectrum calculations. J. Robert Oppenheimer Fellow.

  10. 21 CFR 111.117 - What quality control operations are required for equipment, instruments, and controls?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... and Process Control System: Requirements for Quality Control § 111.117 What quality control operations are required for equipment, instruments, and controls? Quality control operations for equipment... 21 Food and Drugs 2 2011-04-01 2011-04-01 false What quality control operations are required...

  11. 21 CFR 111.117 - What quality control operations are required for equipment, instruments, and controls?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 2 2013-04-01 2013-04-01 false What quality control operations are required for... and Process Control System: Requirements for Quality Control § 111.117 What quality control operations are required for equipment, instruments, and controls? Quality control operations for...

  12. 21 CFR 111.117 - What quality control operations are required for equipment, instruments, and controls?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 2 2014-04-01 2014-04-01 false What quality control operations are required for... and Process Control System: Requirements for Quality Control § 111.117 What quality control operations are required for equipment, instruments, and controls? Quality control operations for...

  13. Improving the quality and efficiency of conventional in-center hemodialysis.

    PubMed

    Hingwala, Jay; Tangri, Navdeep; Rigatto, Claudio; Komenda, Paul

    2015-01-01

    There is substantial variability at international, national, and regional levels in how effective dialysis providers are in the implementation of well-accepted interventions to deliver better health outcomes at reduced costs to payers. The growing number of dialysis patients within a finite pool of resources has led to searches for more efficient methods to provide patient care without compromising or diminishing quality. We review here some contemporary concepts surrounding quality improvement and operations research that may provide clinician administrators to both improve efficiency and quality in facility based hemodialysis units. The creation of balanced scorecards, utilization of process mapping techniques, and the application of LEAN principles may readily improve how hemodialysis care is delivered in an environment of increasing patient volumes and reduced operating resources. PMID:25752482

  14. Improving patient flow in pre-operative assessment

    PubMed Central

    Stark, Cameron; Gent, Anne; Kirkland, Linda

    2015-01-01

    Annual patient attendances at a pre-operative assessment department increased by 24.8% from 5659 in 2009, to 7062 in 2012. The unit was staffed by administrative staff, nurses, and health care assistants (HCA). Medical review was accessed via on call medical staff, or notes were sent to anaesthetists for further review. With rising demand, patient waits increased. The average lead time for a patient (time from entering the department to leaving) was 79 minutes. 9.3% of patients attended within two weeks of their scheduled surgery date. 10% of patients were asked to return on a later day, as there was not sufficient capacity to undertake their assessment. There were nine routes of referral in to the department. Patients moved between different clinic rooms and the waiting area several times. Work patterns were uneven, as many attendances were from out-patient clinics which meant peak attendance times were linked to clinic times. There were substantial differences in the approaches of different nurses, making the HCA role difficult. Patients reported dissatisfaction with waits. Using a Lean quality improvement process with rapid PDSA cycles, the service changed to one in which patients were placed in a room, and remained there for the duration of their assessment. Standard work was developed for HCWs and nurses. Rooms were standardised using 5S processes, and set up improved to reduce time spent looking for supplies. A co-ordinator role was introduced using existing staff to monitor flow and to organise the required medical assessments and ECGs. Timing of booked appointments were altered to take account of clinic times. Routes in to the department were reduced from nine to one. Ten months after the work began, the average lead time had reduced to 59 minutes. The proportion of people attending within two weeks of their surgery decreased from 9.3% to 5.3%. Referrals for an anaesthetic opinion decreased from 30% to 20%, and in the month reviewed no one had to return to

  15. Improving patient flow in pre-operative assessment.

    PubMed

    Stark, Cameron; Gent, Anne; Kirkland, Linda

    2015-01-01

    Annual patient attendances at a pre-operative assessment department increased by 24.8% from 5659 in 2009, to 7062 in 2012. The unit was staffed by administrative staff, nurses, and health care assistants (HCA). Medical review was accessed via on call medical staff, or notes were sent to anaesthetists for further review. With rising demand, patient waits increased. The average lead time for a patient (time from entering the department to leaving) was 79 minutes. 9.3% of patients attended within two weeks of their scheduled surgery date. 10% of patients were asked to return on a later day, as there was not sufficient capacity to undertake their assessment. There were nine routes of referral in to the department. Patients moved between different clinic rooms and the waiting area several times. Work patterns were uneven, as many attendances were from out-patient clinics which meant peak attendance times were linked to clinic times. There were substantial differences in the approaches of different nurses, making the HCA role difficult. Patients reported dissatisfaction with waits. Using a Lean quality improvement process with rapid PDSA cycles, the service changed to one in which patients were placed in a room, and remained there for the duration of their assessment. Standard work was developed for HCWs and nurses. Rooms were standardised using 5S processes, and set up improved to reduce time spent looking for supplies. A co-ordinator role was introduced using existing staff to monitor flow and to organise the required medical assessments and ECGs. Timing of booked appointments were altered to take account of clinic times. Routes in to the department were reduced from nine to one. Ten months after the work began, the average lead time had reduced to 59 minutes. The proportion of people attending within two weeks of their surgery decreased from 9.3% to 5.3%. Referrals for an anaesthetic opinion decreased from 30% to 20%, and in the month reviewed no one had to return to

  16. Quality improvement 101 for surgeons: Navigating the alphabet soup.

    PubMed

    Santore, Matthew T; Islam, Saleem

    2015-12-01

    It is a fundamental value of the surgical profession to improve care for its patients. In the last 100 years, the principles of prospective quality improvement have started to work their way into the traditional method of retrospective case review in morbidity and mortality conference. This article summarizes the history of "improvement science" and its intersection with the field of surgery. It attempts to clarify the principles and jargon that may be new or confusing to surgeons with a different vocabulary and experience. This is done to bring the significant power and resources of improvement science to the traditional efforts to improve surgical care. PMID:26653158

  17. Head-aimed vision system improves tele-operated mobility

    NASA Astrophysics Data System (ADS)

    Massey, Kent

    2004-12-01

    A head-aimed vision system greatly improves the situational awareness and decision speed for tele-operations of mobile robots. With head-aimed vision, the tele-operator wears a head-mounted display and a small three axis head-position measuring device. Wherever the operator looks, the remote sensing system "looks". When the system is properly designed, the operator's occipital lobes are "fooled" into believing that the operator is actually on the remote robot. The result is at least a doubling of: situational awareness, threat identification speed, and target tracking ability. Proper system design must take into account: precisely matching fields of view; optical gain; and latency below 100 milliseconds. When properly designed, a head-aimed system does not cause nausea, even with prolonged use.

  18. Reducing electricity generation costs by improving coal quality: Proceedings

    SciTech Connect

    Not Available

    1988-05-01

    The costs of generating electricity at a coal-fired power plant are significantly influenced by the characteristics of the coal that feeds the plant. Upgrading coal quality or assuring a consistent-quality coal can improve plant performance, increase boiler capacity, and raise plant availability. Sixteen papers presented at an EPRI seminar, ''Reducing Electricity Generation Costs by Improving Coal Quality,'' address how to determine which coal to burn to produce the lowest busbar costs. These papers include case histories of utilities that have switched to higher-quality coal. They also describe computer models to assess coal quality effects and estimate coal cleaning costs. In addition, they examine various methods to predict how a given coal will perform in a particular boiler, and how coal quality can reduce emission control costs. This unique gathering of coal quality information was presented by speakers from US utilities, the Electric Power Research Institute, and the electric power industry. The seminar, sponsored by EPRI's Coal Quality Development Center, formerly the Coal Cleaning Test Facility, was held in November 1986. It drew approximately 80 representatives from US utilities, coal companies, and engineering firms.

  19. How to Measure and Interpret Quality Improvement Data.

    PubMed

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

    2016-05-01

    This article will demonstrate how to conduct a quality improvement project using the change idea generated in "How To Use Quality Improvement Tools in Clinical Practice: How To Diagnose Solutions to a Quality of Care Problem" by Dr. Ziv Harel and colleagues in this Moving Points feature. This change idea involves the introduction of a nurse educator into a CKD clinic with a goal of increasing rates of patients performing dialysis independently at home (home hemodialysis or peritoneal dialysis). Using this example, we will illustrate a Plan-Do-Study-Act (PDSA) cycle in action and highlight the principles of rapid cycle change methodology. We will then discuss the selection of outcome, process, and balancing measures, and the practicalities of collecting these data in the clinic environment. We will also introduce the PDSA worksheet as a practical way to oversee the progress of a quality improvement project. Finally, we will demonstrate how run charts are used to visually illustrate improvement in real time, and how this information can be used to validate achievement, respond appropriately to challenges the project may encounter, and prove the significance of results. This article aims to provide readers with a clear and practical framework upon which to trial their own ideas for quality improvement in the clinical setting. PMID:27016496

  20. 'Wading through treacle': quality improvement lessons from the frontline.

    PubMed

    Roueche, Alice; Hewitt, Jocelyn

    2012-03-01

    In a time of financial uncertainty and structural reform, the National Health Service (NHS) in England needs clinical leadership to help improve the quality of patient care. Increasingly, leadership development is being targeted at doctors in postgraduate training to help prepare them for their future leadership roles as consultants and general practitioners. However, there is a risk that we are missing an opportunity here by failing to recognise the role that doctors in training can play now, during their training. As our frontline clinicians they have a unique view of the health service and the inefficiencies therein. The London Deanery has been running an educational programme called Beyond Audit to provide doctors in training with quality improvement skills. During this programme we have been given a unique insight into NHS systems as viewed by junior doctors. They have identified a wide range of small system problems that, when combined, result in large-scale inefficiency and prevent the delivery of high quality patient care. These problems they identify have implications for cost, efficiency, patient safety, team-working and patient experience. Any attempt to improve the quality of care delivered in the NHS needs to look at the system from the point of view of those delivering the care, including our doctors in postgraduate training. By empowering them to make improvements to the systems that they see, there is the potential to make significant improvement in the quality of patient care that they deliver. PMID:22198901

  1. Assessment of foodservice quality and identification of improvement strategies using hospital foodservice quality model

    PubMed Central

    Kim, Kyungjoo; Kim, Minyoung

    2010-01-01

    The purposes of this study were to assess hospital foodservice quality and to identify causes of quality problems and improvement strategies. Based on the review of literature, hospital foodservice quality was defined and the Hospital Foodservice Quality model was presented. The study was conducted in two steps. In Step 1, nutritional standards specified on diet manuals and nutrients of planned menus, served meals, and consumed meals for regular, diabetic, and low-sodium diets were assessed in three general hospitals. Quality problems were found in all three hospitals since patients consumed less than their nutritional requirements. Considering the effects of four gaps in the Hospital Foodservice Quality model, Gaps 3 and 4 were selected as critical control points (CCPs) for hospital foodservice quality management. In Step 2, the causes of the gaps and improvement strategies at CCPs were labeled as "quality hazards" and "corrective actions", respectively and were identified using a case study. At Gap 3, inaccurate forecasting and a lack of control during production were identified as quality hazards and corrective actions proposed were establishing an accurate forecasting system, improving standardized recipes, emphasizing the use of standardized recipes, and conducting employee training. At Gap 4, quality hazards were menus of low preferences, inconsistency of menu quality, a lack of menu variety, improper food temperatures, and patients' lack of understanding of their nutritional requirements. To reduce Gap 4, the dietary departments should conduct patient surveys on menu preferences on a regular basis, develop new menus, especially for therapeutic diets, maintain food temperatures during distribution, provide more choices, conduct meal rounds, and provide nutrition education and counseling. The Hospital Foodservice Quality Model was a useful tool for identifying causes of the foodservice quality problems and improvement strategies from a holistic point of view

  2. Federal efforts to improve quality of care: the Quality Interagency Coordination Task Force (QuIC).

    PubMed

    Eisenberg, J M; Foster, N E; Meyer, G; Holland, H

    2001-02-01

    FORMATION OF THE QUIC: The Quality Interagency Coordination Task Force (QuIC) was established in 1998 to enable the participating federal agencies to coordinate their activities to study, measure, and improve the quality of care delivered by federal health programs; provide people with information to help them in making more informed choices about their care; and develop the research base and infrastructure needed to improve the health care system, including knowledgeable and empowered workers, well-designed systems of care, and useful information systems. STUDY, MEASURE, AND IMPROVE CARE: The QuIC's initial efforts to improve the care delivered in federal health care programs have focused on diabetes, depression, and the effect of working conditions on quality of care. More recently, patient safety efforts are under way to establish a coordinating center that will enable those who are testing methods of reducing errors to share information across their projects and with experts in error reduction. DEVELOP A RESEARCH BASE AND INFRASTRUCTURE: The QuIC has coordinated efforts in credentialing, information on measures of quality, a taxonomy of quality improvement methods, and errors data collection. PROVIDE INFORMATION TO AMERICANS ABOUT HEALTH CARE QUALITY: The QuIC agencies are developing products that will enhance their ability to communicate with the American people about their health care choices: improved gateways for consumer information available from federal agencies, a glossary of commonly used terms, and guidance for producing report cards on quality of care. MOVING THE QUALITY IMPROVEMENT AGENDA FORWARD: Federal efforts to improve quality of care are moving forward in a more integrated fashion on a wide number of fronts. PMID:11221014

  3. Benchmarking: A Method for Continuous Quality Improvement in Health

    PubMed Central

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

    2012-01-01

    Benchmarking, a management approach for implementing best practices at best cost, is a recent concept in the healthcare system. The objectives of this paper are to better understand the concept and its evolution in the healthcare sector, to propose an operational definition, and to describe some French and international experiences of benchmarking in the healthcare sector. To this end, we reviewed the literature on this approach's emergence in the industrial sector, its evolution, its fields of application and examples of how it has been used in the healthcare sector. Benchmarking is often thought to consist simply of comparing indicators and is not perceived in its entirety, that is, as a tool based on voluntary and active collaboration among several organizations to create a spirit of competition and to apply best practices. The key feature of benchmarking is its integration within a comprehensive and participatory policy of continuous quality improvement (CQI). Conditions for successful benchmarking focus essentially on careful preparation of the process, monitoring of the relevant indicators, staff involvement and inter-organizational visits. Compared to methods previously implemented in France (CQI and collaborative projects), benchmarking has specific features that set it apart as a healthcare innovation. This is especially true for healthcare or medical–social organizations, as the principle of inter-organizational visiting is not part of their culture. Thus, this approach will need to be assessed for feasibility and acceptability before it is more widely promoted. PMID:23634166

  4. Implementation of Consolidated HIS: Improving Quality and Efficiency of Healthcare

    PubMed Central

    Choi, Jinwook; Seo, Jeong-Wook; Chung, Chun Kee; Kim, Kyung-Hwan; Kim, Ju Han; Kim, Jong Hyo; Chie, Eui Kyu; Cho, Hyun-Jai; Goo, Jin Mo; Lee, Hyuk-Joon; Wee, Won Ryang; Nam, Sang Mo; Lim, Mi-Sun; Kim, Young-Ah; Yang, Seung Hoon; Jo, Eun Mi; Hwang, Min-A; Kim, Wan Suk; Lee, Eun Hye; Choi, Su Hi

    2010-01-01

    Objectives Adoption of hospital information systems offers distinctive advantages in healthcare delivery. First, implementation of consolidated hospital information system in Seoul National University Hospital led to significant improvements in quality of healthcare and efficiency of hospital management. Methods The hospital information system in Seoul National University Hospital consists of component applications: clinical information systems, clinical research support systems, administrative information systems, management information systems, education support systems, and referral systems that operate to generate utmost performance when delivering healthcare services. Results Clinical information systems, which consist of such applications as electronic medical records, picture archiving and communication systems, primarily support clinical activities. Clinical research support system provides valuable resources supporting various aspects of clinical activities, ranging from management of clinical laboratory tests to establishing care-giving procedures. Conclusions Seoul National University Hospital strives to move its hospital information system to a whole new level, which enables customized healthcare service and fulfills individual requirements. The current information strategy is being formulated as an initial step of development, promoting the establishment of next-generation hospital information system. PMID:21818449

  5. Life in the Atacama: Science autonomy for improving data quality

    NASA Astrophysics Data System (ADS)

    Smith, Trey; Thompson, David R.; Wettergreen, David S.; Cabrol, Nathalie A.; Warren-Rhodes, Kimberley A.; Weinstein, Shmuel J.

    2007-12-01

    ``Science autonomy'' refers to exploration robotics technologies involving onboard science analysis of collected data. These techniques enable a rover to make adaptive decisions about which measurements to collect and transmit. Science autonomy can compensate for limited communications bandwidth by ensuring that planetary scientists receive those images and spectra that best meet mission goals. Here, we present the results of autonomous science experiments performed in the Atacama Desert of Chile during the Life in the Atacama (LITA) rover field campaign. We aim to provide an overview of autonomous science principles and examine their integration into the LITA operations strategy. We present experiments in four specific autonomous science domains: (1) autonomously responding to evidence of life with more detailed measurements; (2) rock detection for site profiling and selective data return; (3) tactical replanning to efficiently map the distribution of life; (4) detecting novel images and geologic unit boundaries in image sequences. In each of these domains we demonstrate improvements in the quality of returned data through autonomous analysis of imagery.

  6. Quality Improvement Methodologies Increase Autologous Blood Product Administration

    PubMed Central

    Hodge, Ashley B.; Preston, Thomas J.; Fitch, Jill A.; Harrison, Sheilah K.; Hersey, Diane K.; Nicol, Kathleen K.; Naguib, Aymen N.; McConnell, Patrick I.; Galantowicz, Mark

    2014-01-01

    Abstract: Whole blood from the heart–lung (bypass) machine may be processed through a cell salvaging device (i.e., cell saver [CS]) and subsequently administered to the patient during cardiac surgery. It was determined at our institution that CS volume was being discarded. A multidisciplinary team consisting of anesthesiologists, perfusionists, intensive care physicians, quality improvement (QI) professionals, and bedside nurses met to determine the challenges surrounding autologous blood delivery in its entirety. A review of cardiac surgery patients’ charts (n = 21) was conducted for analysis of CS waste. After identification of practices that were leading to CS waste, interventions were designed and implemented. Fishbone diagram, key driver diagram, Plan–Do–Study–Act (PDSA) cycles, and data collection forms were used throughout this QI process to track and guide progress regarding CS waste. Of patients under 6 kg (n = 5), 80% had wasted CS blood before interventions, whereas those patients larger than 36 kg (n = 8) had 25% wasted CS before interventions. Seventy-five percent of patients under 6 kg who had wasted CS blood received packed red blood cell transfusions in the cardiothoracic intensive care unit within 24 hours of their operation. After data collection and didactic education sessions (PDSA Cycle I), CS blood volume waste was reduced to 5% in all patients. Identification and analysis of the root cause followed by implementation of education, training, and management of change (PDSA Cycle II) resulted in successful use of 100% of all CS blood volume. PMID:24783313

  7. Maintenance & Operations Solutions: Meeting the Challenge of Improving School Facilities.

    ERIC Educational Resources Information Center

    Association of School Business Officials International, Reston, VA.

    This paper examines the impact current maintenance and operations (M&O) practices have on U.S. school performance and offers possible opportunities for improvement through the judicious use of technology and methodology. The paper also presents a regional comparative analysis of M&O costs across the country. A list of equipment and their service…

  8. Willingness to pay for improvements in drinking water quality

    NASA Astrophysics Data System (ADS)

    Jordan, Jeffrey L.; Elnagheeb, Abdelmoneim H.

    1993-02-01

    In this paper, data from a 1991 survey of Georgia residents were used to study people's willingness to pay (WTP) for improvements in drinking water quality and people's perceptions of potential groundwater contamination. Results showed that 27% of the respondents served by public water supplies rated drinking water quality as poor, and 23% were uncertain about their drinking water quality. The contingent valuation method was used to estimate WTP using a checklist format. The median estimated WTP was 5.49 per month above their current water bills for people on public systems and 7.38 for those using private wells, after rejecting outliers and using the maximum likelihood method. The aggregate WTP for all of Georgia was estimated to be about 111.5 million per year for public water users and 42.3 million per year for private well owners. This aggregate WTP can serve as an estimate of benefits to consumers from improvements in drinking water quality statewide.

  9. Interventions to improve water quality for preventing diarrhoea

    PubMed Central

    Clasen, Thomas F; Alexander, Kelly T; Sinclair, David; Boisson, Sophie; Peletz, Rachel; Chang, Howard H; Majorin, Fiona; Cairncross, Sandy

    2015-01-01

    Background Diarrhoea is a major cause of death and disease, especially among young children in low-income countries. In these settings, many infectious agents associated with diarrhoea are spread through water contaminated with faeces. In remote and low-income settings, source-based water quality improvement includes providing protected groundwater (springs, wells, and bore holes), or harvested rainwater as an alternative to surface sources (rivers and lakes). Point-of-use water quality improvement interventions include boiling, chlorination, flocculation, filtration, or solar disinfection, mainly conducted at home. Objectives To assess the effectiveness of interventions to improve water quality for preventing diarrhoea. Search methods We searched the Cochrane Infectious Diseases Group Specialized Register (11 November 2014), CENTRAL (the Cochrane Library, 7 November 2014), MEDLINE (1966 to 10 November 2014), EMBASE (1974 to 10 November 2014), and LILACS (1982 to 7 November 2014). We also handsearched relevant conference proceedings, contacted researchers and organizations working in the field, and checked references from identified studies through 11 November 2014. Selection criteria Randomized controlled trials (RCTs), quasi-RCTs, and controlled before-and-after studies (CBA) comparing interventions aimed at improving the microbiological quality of drinking water with no intervention in children and adults. Data collection and analysis Two review authors independently assessed trial quality and extracted data. We used meta-analyses to estimate pooled measures of effect, where appropriate, and investigated potential sources of heterogeneity using subgroup analyses. We assessed the quality of evidence using the GRADE approach. Main results Forty-five cluster-RCTs, two quasi-RCTs, and eight CBA studies, including over 84,000 participants, met the inclusion criteria. Most included studies were conducted in low- or middle-income countries (LMICs) (50 studies) with

  10. Patient safety and quality improvement: an overview of QI.

    PubMed

    Schriefer, Jan; Leonard, Michael S

    2012-08-01

    It is important for pediatric providers to be involved in quality improvement (QI) activities to improve children’s health outcomes.• The Model for Improvement asks several key questions related to a process, then uses Plan-Do-Study-Act(PDSA) cycles to implement, test, and spread changes.• Lean and Six Sigma methodologies can improve quality by increasing workflow efficiency and decreasing variation.• Root cause analysis (RCA) is a retrospective quality tool that helps determine factors contributing to errors and adverse events, so that improvements can be implemented.• Failure modes and effects analysis (FMEA) isa prospective quality tool that anticipates system vulnerabilities and helps develop risk reduction strategies.• Evidence-based interventions, such as best-practice guidelines, promote standardization and reduce errors and adverse events, especially in high-risk health-care settings.• Team training can improve communication and situational awareness to create a safer health-care environment. PMID:22855927

  11. Institutions for the elderly operating without a license: quality of care and the surveillance process.

    PubMed

    Fleishman, R; Holzer, I; Walk, D; Mandelson, J; Mizrahi, G; Bar-Giora, M; Yuz, F

    1999-01-01

    In 1992, Israel's Services for the Aged identified private institutions for the elderly operating illegally, which are notorious for poor quality. This article presents the findings of screening visits in 97 "pirate" institutions, as part of a plan to improve surveillance, and evaluates the outcomes as a measure of the effectiveness of intervention. Although a high proportion of deficiencies was found, some institutions showed a significant ability to correct them. PMID:10662099

  12. Integrating New Technology Solutions to Improve Plant Operations

    SciTech Connect

    HEAVIN, ERIC

    2004-06-29

    Continuing advancements in software and hardware technology are providing facilities the opportunity for improvements in the areas of safety, regulatory compliance, administrative control, data collection, and reporting. Implementing these changes to improve plant operating efficiency can also create many challenges which include but are not limited to: justifying cost, planning for scalability, implementing applications across varied platforms, integrating multitudes of proprietary vendor applications, and creating a common vision for diverse process improvement projects. The Defense Programs (DP) facility at the Savannah River Site meets these challenges on a daily basis. Like many other plants, DP, has room for improvement when it comes to effective and clear communication, data entry, data storage, and system integration. Specific examples of areas targeted for improvement include: shift turnover meetings using system status data one to two hours old, lockouts and alarm inhibits performed on points on the Distributed Control System (DCS) and tracked in a paper logbook, disconnected systems preventing preemptive correction of regulatory compliance issues, and countless examples of additional task and data duplication on independent systems. Investment of time, money, and careful planning addressing these issues are already providing returns in the form of increased efficiency, improved plant tracking and reduced cost of implementing the next process improvement. Specific examples of improving plant operations through thoroughly planned Rapid Application Development of new applications are discussed. Integration of dissimilar and independent data sources (NovaTech D/3 DCS, SQL Server, Access, Filemaker Pro, etc.) is also explored. The tangible benefits of the implementation of the different programs to solve the operational problems previously described are analyzed in an in-depth and comparative manner.

  13. Improving Quality of Emergency Care Through Integration of Mental Health.

    PubMed

    Okafor, Martha; Wrenn, Glenda; Ede, Victor; Wilson, Nana; Custer, William; Risby, Emile; Claeys, Michael; Shelp, Frank E; Atallah, Hany; Mattox, Gail; Satcher, David

    2016-04-01

    The goal of this study was to better integrate emergency medical and psychiatric care at a large urban public hospital, identify impact on quality improvement metrics, and reduce healthcare cost. A psychiatric fast track service was implemented as a quality improvement initiative. Data on disposition from the emergency department from January 2011 to May 2012 for patients impacted by the pilot were analyzed. 4329 patients from January 2011 to August 2011 (pre-intervention) were compared with 4867 patients from September 2011 to May 2012 (intervention). There was a trend of decline on overall quality metrics of time to triage and time from disposition to discharge. The trend analysis of the psychiatric length of stay and use of restraints showed significant reductions. Integrated emergency care models are evidence-based approach to ensuring that patients with mental health needs receive proper and efficient treatment. Results suggest that this may also improve overall emergency department's throughput. PMID:26711094

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

    PubMed

    Hawkins, C Matthew

    2014-12-01

    The planning phases of quality improvement projects are commonly overlooked. Disorganized planning and implementation can escalate chaos, intensify resistance to change, and increase the likelihood of failure. Two important steps in the planning phase are (1) assessing local resources available to aid in the quality improvement project and (2) evaluating the culture in which the desired change is to be implemented. Assessing local resources includes identifying and engaging key stakeholders and evaluating if appropriate expertise is available for the scope of the project. This process also involves engaging informaticists and gathering available IT tools to plan and automate (to the extent possible) the data-gathering, analysis, and feedback steps. Culture in a department is influenced by the ability and willingness to manage resistance to change, build consensus, span boundaries between stakeholders, and become a learning organization. Allotting appropriate time to perform these preparatory steps will increase the odds of successfully performing a quality improvement project and implementing change. PMID:25467724

  15. A new quality assessment and improvement system for print media

    NASA Astrophysics Data System (ADS)

    Liu, Mohan; Konya, Iuliu; Nandzik, Jan; Flores-Herr, Nicolas; Eickeler, Stefan; Ndjiki-Nya, Patrick

    2012-12-01

    Print media collections of considerable size are held by cultural heritage organizations and will soon be subject to digitization activities. However, technical content quality management in digitization workflows strongly relies on human monitoring. This heavy human intervention is cost intensive and time consuming, which makes automization mandatory. In this article, a new automatic quality assessment and improvement system is proposed. The digitized source image and color reference target are extracted from the raw digitized images by an automatic segmentation process. The target is evaluated by a reference-based algorithm. No-reference quality metrics are applied to the source image. Experimental results are provided to illustrate the performance of the proposed system. We show that it features a good performance in the extraction as well as in the quality assessment step compared to the state-of-the-art. The impact of efficient and dedicated quality assessors on the optimization step is extensively documented.

  16. Does a quality management system improve quality in primary care practices in Switzerland? A longitudinal study

    PubMed Central

    Goetz, Katja; Hess, Sigrid; Jossen, Marianne; Huber, Felix; Rosemann, Thomas; Brodowski, Marc; Künzi, Beat; Szecsenyi, Joachim

    2015-01-01

    Objectives To examine the effectiveness of the quality management programme—European Practice Assessment—in primary care in Switzerland. Design Longitudinal study with three points of measurement. Setting Primary care practices in Switzerland. Participants In total, 45 of 91 primary care practices completed European Practice Assessment three times. Outcomes The interval between each assessment was around 36 months. A variance analyses for repeated measurements were performed for all 129 quality indicators from the domains: ‘infrastructure’, ‘information’, ‘finance’, and ‘quality and safety’ to examine changes over time. Results Significant improvements were found in three of four domains: ‘quality and safety’ (F=22.81, p<0.01), ‘information’ (F=27.901, p<0.01) and ‘finance’ (F=4.073, p<0.02). The 129 quality indicators showed a significant improvement within the three points of measurement (F=33.864, p<0.01). Conclusions The European Practice Assessment for primary care practices thus provides a functioning quality management programme, focusing on the sustainable improvement of structural and organisational aspects to promote high quality of primary care. The implementation of a quality management system which also includes a continuous improvement process would give added value to provide good care. PMID:25900466

  17. Relationships of physician characteristics to performance quality and improvement.

    PubMed Central

    Payne, B C; Lyons, T F; Neuhaus, E

    1984-01-01

    The quality of ambulatory medical care provided by 1,135 physicians in five separate practice settings in the Midwest was measured using predetermined process criteria. Specialists performed better in their own areas of specialized training than did family/general practitioners or specialists performing outside their specialty areas. Physicians with fewer years of practice performed somewhat better than physicians with more years since medical school graduation. Board certification was not consistently related to performance. Performances of the physicians improved following quality assurance interventions in these sites. Differences in the rates of change in performance quality were not consistently related to any of the physician characteristics studied. PMID:6746295

  18. Evidence of improved quality of life with pediatric palliative care.

    PubMed

    O'Quinn, Lucy P; Giambra, Barbara K

    2014-01-01

    Pediatric nurses provide holistic family-centered care for children with life-limiting illnesses while being sensitive to children's growth and developmental needs. To learn how pediatric palliative care programs benefit children and their families, the following clinical question was asked: Among children with a life-limiting illness, does the use of a palliative care program compared with not using a palliative care program improve quality of life for patients and their families? Evidence from two studies found that palliative care services improve quality of life for children with life-limiting illness and their families in the areas of the child's emotional well-being and parental perception of preparation for the child's end of life, resulting in a low grade for the body of evidence. Future research should include high quality studies with larger sample sizes and control groups, and include children's perspectives--from both patients and siblings--to give a more complete picture of how best to improve their quality of life. A reliable tool is needed that includes a spiritual component and sensitive indicators specific to children with a life-limiting illness. Future research using this tool will more fully answer how palliative care services improve children's quality of life. PMID:25929123

  19. Rapid core measure improvement through a "business case for quality".

    PubMed

    Perlin, Jonathan B; Horner, Stephen J; Englebright, Jane D; Bracken, Richard M

    2014-01-01

    Incentives to improve performance are emerging as revenue or financial penalties are linked to the measured quality of service provided. The HCA "Getting to Green" program was designed to rapidly increase core measure performance scores. Program components included (1) the "business case for quality"-increased awareness of how quality drives financial performance; (2) continuous communication of clinical and financial performance data; and (3) evidence-based clinical protocols, incentives, and tools for process improvement. Improvement was measured by comparing systemwide rates of adherence to national quality measures for heart failure (HF), acute myocardial infarction (AMI), pneumonia (PN), and surgical care (SCIP) to rates from all facilities reporting to the Centers for Medicare and Medicaid Services (CMS). As of the second quarter of 2011, 70% of HCA total measure set composite scores were at or above the 90th percentile of CMS scores. A test of differences in regression coefficients between the CMS national average and the HCA average revealed significant differences for AMI (p = .001), HF (p = .012), PN (p < .001), and SCIP (p = .015). This program demonstrated that presentation of the financial implications of quality, transparency in performance data, and clearly defined goals could cultivate the desire to use improvement tools and resources to raise performance. PMID:22931509

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

    PubMed

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

    2016-08-01

    Coffee is an important crop that provides a livelihood to millions of people living in developing countries. Production of genotypes with improved coffee quality attributes is a primary target of coffee genetic improvement programmes. Advances in genomics are providing new tools for analysis of coffee quality at the molecular level. The recent report of a genomic sequence for robusta coffee, Coffea canephora, is a major development. However, a reference genome sequence for the genetically more complex arabica coffee (C. arabica) will also be required to fully define the molecular determinants controlling quality in coffee produced from this high quality coffee species. Genes responsible for control of the levels of the major biochemical components in the coffee bean that are known to be important in determining coffee quality can now be identified by association analysis. However, the narrow genetic base of arabica coffee suggests that genomics analysis of the wild relatives of coffee (Coffea spp.) may be required to find the phenotypic diversity required for effective association genetic analysis. The genomic resources available for the study of coffee quality are described and the potential for the application of next generation sequencing and association genetic analysis to advance coffee quality research are explored. © 2016 Society of Chemical Industry. PMID:26919810

  1. Survey of methods for improving operator acceptance of computerized aids

    SciTech Connect

    Frey, P. R.; Kisner, R. A.

    1982-04-01

    The success of current attempts to improve the operational performance and safety of nuclear power plants by installing computerized operational aids in the control rooms is dependent, in part, on the operator's attitude toward the aid. Utility experience with process computer systems indicates that problems may already exist with operator acceptance of computerized aids. The growth of the role that computers have in nuclear power plants makes user acceptance of computer technology an important issue for the nuclear industry. The purpose of this report is to draw from the literature factors related to user acceptance of computerized equipment that may also be applicable to the acceptance of computerized aids used in the nuclear power plant control room.

  2. USING SEQUENCING TO IMPROVE OPERATIONAL EFFICIENCY AND RELIABILITY

    SciTech Connect

    D OTTAVIO,T.; NIEDZIELA, J.

    2007-10-15

    Operation of an accelerator requires the efficient and reproducible execution of many different types of procedures. Some procedures, like beam acceleration, magnet quench recovery, and species switching can be quite complex. To improve accelerator reliability and efficiency, automated execution of procedures is required. Creation of a single robust sequencing application permits the streamlining of this process and offers many benefits in sequence creation, editing, and control. In this paper, we present key features of a sequencer application commissioned at the Collider-Accelerator Department of Brookhaven National Laboratory during the 2007 run. Included is a categorization of the different types of sequences in use, a discussion of the features considered desirable in a good sequencer, and a description of the tools created to aid in sequence construction and diagnosis. Finally, highlights from our operational experience are presented, with emphasis on Operations control of the sequencer, and the alignment of sequence construction with existing operational paradigms.

  3. Rational protection of subjects in research and quality improvement activities.

    PubMed

    Goldman, Beth; Dixon, Lisa B; Adler, David A; Berlant, Jeffrey; Dulit, Rebecca A; Hackman, Ann; Oslin, David W; Siris, Samuel G; Valenstein, Marcia

    2010-02-01

    This Open Forum illuminates shortcomings with the basis for determining degree of oversight of health services research and quality improvement activities. Using a federally regulated definition of research rather than a direct appraisal of risk to patients can misallocate effort from activities with higher risk for patients to those with lower risk. The case of the Johns Hopkins multicenter study of central line safety checklists in intensive care units is cited. Definitions of research promulgated by the Office of Human Research Protection are reviewed, and an alternative model based on patient risk is proposed. Suggestions for how quality improvement work fits into the larger paradigm of research are made. PMID:20123824

  4. Improving quality and efficiency of postpartum hospital education.

    PubMed

    Buchko, Barbara L; Gutshall, Connie H; Jordan, Elizabeth T

    2012-01-01

    The purpose of this study was to investigate the implementation of an evidence-based, streamlined, education process (comprehensive education booklet, individualized education plan, and integration of education into the clinical pathway) and nurse education to improve the quality and efficiency of postpartum education during hospitalization. A one-group pretest-posttest design was used to measure the quality of discharge teaching for new mothers and efficiency of the education process for registered nurses before and after implementation of an intervention. Results indicated that a comprehensive educational booklet and enhanced documentation can improve efficiency in the patient education process for nurses. PMID:23997552

  5. Improving Mississippi water quality: CAFO regulations and nutrient TMDLs

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Confined Animal Feeding Operations (CAFOs) are regulated to reduce nutrient discharges to local waters, although nutrient water quality standards do not yet exist. At first, it may seem that there is some discontinuity between requiring CAFOs to limit nutrient discharges without knowing what levels...

  6. How the ESRD Quality Incentive Program Could Potentially Improve Quality of Life for Patients on Dialysis

    PubMed Central

    Davison, Sara N.

    2015-01-01

    For over 20 years, the quality of medical care of the Medicare ESRD Program has been a concern. The Centers for Medicare and Medicaid Services have implemented the ESRD Quality Incentive Program, which uses the principles of value-based purchasing; dialysis providers are paid for performance on predefined quality measures, with a goal of improving patient outcomes and the quality of patient care. The ESRD Quality Incentive Program measures have been criticized, because they are largely disease oriented and use easy-to-obtain laboratory-based indicators, such as Kt/V and hemoglobin, that do not reflect outcomes that are most important to patients and have had a minimal effect on survival or quality of life. A key goal of improving quality of care is to enhance quality of life, a patient-important quality measure that matters more to many patients than even survival. None of the ESRD Quality Incentive Program measures assess patient-reported quality of life. As outlined in the National Quality Strategy, the Centers for Medicare and Medicaid Services are holding providers accountable in six priority domains, in which quality measures have been and are being developed for value-based purchasing. Three measures—patient experience and engagement, clinical care, and care coordination—are particularly relevant to quality care in the ESRD Program; the 2014 ESRD Quality Incentive Program includes six measures, none of which provide data from a patient-centered perspective. Value-based purchasing is a well intentioned step to improve care of patients on dialysis. However, the Centers for Medicare and Medicaid Services need to implement significant change in what is measured for the ESRD Quality Incentive Program to be patient centered and aligned with patients’ values, preferences, and needs. This paper provides examples of potential quality measures for patient experience and engagement, clinical care, and care coordination, which if implemented, would be much more

  7. Using Operational Analysis to Improve Access to Pulmonary Function Testing.

    PubMed

    Ip, Ada; Asamoah-Barnieh, Raymond; Bischak, Diane P; Davidson, Warren J; Flemons, W Ward; Pendharkar, Sachin R

    2016-01-01

    Background. Timely pulmonary function testing is crucial to improving diagnosis and treatment of pulmonary diseases. Perceptions of poor access at an academic pulmonary function laboratory prompted analysis of system demand and capacity to identify factors contributing to poor access. Methods. Surveys and interviews identified stakeholder perspectives on operational processes and access challenges. Retrospective data on testing demand and resource capacity was analyzed to understand utilization of testing resources. Results. Qualitative analysis demonstrated that stakeholder groups had discrepant views on access and capacity in the laboratory. Mean daily resource utilization was 0.64 (SD 0.15), with monthly average utilization consistently less than 0.75. Reserved testing slots for subspecialty clinics were poorly utilized, leaving many testing slots unfilled. When subspecialty demand exceeded number of reserved slots, there was sufficient capacity in the pulmonary function schedule to accommodate added demand. Findings were shared with stakeholders and influenced scheduling process improvements. Conclusion. This study highlights the importance of operational data to identify causes of poor access, guide system decision-making, and determine effects of improvement initiatives in a variety of healthcare settings. Importantly, simple operational analysis can help to improve efficiency of health systems with little or no added financial investment. PMID:27445545

  8. Using Operational Analysis to Improve Access to Pulmonary Function Testing

    PubMed Central

    Ip, Ada; Asamoah-Barnieh, Raymond; Bischak, Diane P.; Davidson, Warren J.; Flemons, W. Ward; Pendharkar, Sachin R.

    2016-01-01

    Background. Timely pulmonary function testing is crucial to improving diagnosis and treatment of pulmonary diseases. Perceptions of poor access at an academic pulmonary function laboratory prompted analysis of system demand and capacity to identify factors contributing to poor access. Methods. Surveys and interviews identified stakeholder perspectives on operational processes and access challenges. Retrospective data on testing demand and resource capacity was analyzed to understand utilization of testing resources. Results. Qualitative analysis demonstrated that stakeholder groups had discrepant views on access and capacity in the laboratory. Mean daily resource utilization was 0.64 (SD 0.15), with monthly average utilization consistently less than 0.75. Reserved testing slots for subspecialty clinics were poorly utilized, leaving many testing slots unfilled. When subspecialty demand exceeded number of reserved slots, there was sufficient capacity in the pulmonary function schedule to accommodate added demand. Findings were shared with stakeholders and influenced scheduling process improvements. Conclusion. This study highlights the importance of operational data to identify causes of poor access, guide system decision-making, and determine effects of improvement initiatives in a variety of healthcare settings. Importantly, simple operational analysis can help to improve efficiency of health systems with little or no added financial investment. PMID:27445545

  9. Agents and Daemons, automating Data Quality Monitoring operations

    NASA Astrophysics Data System (ADS)

    Lopera, Luis I.; DQM Group

    2012-12-01

    Since 2009 when the LHC came back to active service, the Data Quality Monitoring (DQM) team was faced with the need to homogenize and automate operations across all the different environments within which DQM is used. The main goal of automation is to reduce the operator intervention at the minimum possible level, especially in the area of DQM files management, where long-term archival presented the greatest challenges. Manually operated procedures cannot cope with the constant increase in luminosity, datasets and uptime of the CMS detector. Therefore a solid and reliable set of sophisticated scripts, the agents, has been designed since the beginning to manage all DQM-related workflows. This allows to fully exploiting all available resources in every condition, maximizing the performance and reducing the latency in making data available for validation and certification. The agents can be easily fine-tuned to adapt to current and future hardware constraints and proved to be flexible enough to include unforeseen features, like an ad-hoc quota management and a real time sound alarm system.

  10. High-quality remote interactive imaging in the operating theatre

    NASA Astrophysics Data System (ADS)

    Grimstead, Ian J.; Avis, Nick J.; Evans, Peter L.; Bocca, Alan

    2009-02-01

    We present a high-quality display system that enables the remote access within an operating theatre of high-end medical imaging and surgical planning software. Currently, surgeons often use printouts from such software for reference during surgery; our system enables surgeons to access and review patient data in a sterile environment, viewing real-time renderings of MRI & CT data as required. Once calibrated, our system displays shades of grey in Operating Room lighting conditions (removing any gamma correction artefacts). Our system does not require any expensive display hardware, is unobtrusive to the remote workstation and works with any application without requiring additional software licenses. To extend the native 256 levels of grey supported by a standard LCD monitor, we have used the concept of "PseudoGrey" where slightly off-white shades of grey are used to extend the intensity range from 256 to 1,785 shades of grey. Remote access is facilitated by a customized version of UltraVNC, which corrects remote shades of grey for display in the Operating Room. The system is successfully deployed at Morriston Hospital, Swansea, UK, and is in daily use during Maxillofacial surgery. More formal user trials and quantitative assessments are being planned for the future.

  11. Improved Wide Operating Temperature Range of Li-Ion Cells

    NASA Technical Reports Server (NTRS)

    Smart, Marshall C.; Bugga, Ratnakumar V.

    2013-01-01

    Future NASA missions aimed at exploring the Moon, Mars, and the outer planets require rechargeable batteries that can operate over a wide temperature range (-60 to +60 C) to satisfy the requirements of various applications including landers, rovers, penetrators, CEV, CLV, etc. This work addresses the need for robust rechargeable batteries that can operate well over a wide temperature range. The Department of Energy (DoE) has identified a number of technical barriers associated with the development of Liion rechargeable batteries for PHEVs. For this reason, DoE has interest in the development of advanced electrolytes that will improve performance over a wide range of temperatures, and lead to long life characteristics (5,000 cycles over a 10-year life span). There is also interest in improving the high-voltage stability of these candidate electrolyte systems to enable the operation of up to 5 V with high specific energy cathode materials. Currently, the state-of-the-art lithium-ion system has been demonstrated to operate over a wide range of temperatures (-40 to +40 C); however, the rate capability at the lower temperatures is very poor. In addition, the low-temperature performance typically deteriorates rapidly upon being exposed to high temperatures. A number of electrolyte formulations were developed that incorporate the use of electrolyte additives to improve the high-temperature resilience, low-temperature power capability, and life characteristics of methyl propionate (MP)-based electrolyte solutions. These electrolyte additives include mono-fluoroethylene carbonate (FEC), lithium oxalate, vinylene carbonate (VC), and lithium bis(oxalate borate) (LiBOB), which have previously been shown to result in improved high-temperature resilience of all carbonate-based electrolytes. These MP-based electrolytes with additives have been shown to have improved performance in experiments with MCMB-LiNiCoAlO2 cells.

  12. Getting started with the model for improvement: psychology and leadership in quality improvement.

    PubMed

    Pratap, J Nick; Varughese, Anna M; Adler, Elena; Kurth, C Dean

    2013-02-01

    Although the case for quality in hospitals is compelling, doctors are often uncertain how to achieve it. This article forms the third and final part of a series providing practical guidance on getting started with a first quality improvement project. Introduction. PMID:23411980

  13. Improving the quality factor of cantilevers in viscous fluids by the adaptation of their interface

    NASA Astrophysics Data System (ADS)

    Linden, J.; Oesterschulze, E.

    2012-03-01

    The adaptation of the fluid-microresonator interface enables the operation of cantilevers with high quality factor in viscous fluids. Partial wetting was proposed to implement the adapted interface by meniscus formation. An excellent quality factor of 79 was achieved in water applying the concept of partial wetting to thin film silicon nitride cantilevers. Compared to the quality factor calculated from Sader's theory of the hydrodynamic damping of fully immersed cantilevers, this is an improvement by more than one decade. As a first application the partially wetted cantilevers were employed as mass sensors in water revealing a sensitivity of 2.77 fg/Hz.

  14. Radionuclide calibrator comparisons and quality improvement in nuclear medicine.

    PubMed

    Oropesa, P; Woods, M J; Olsovcová, V; dos Santos, J A

    2008-03-01

    The traceability of activity measurements performed during the development phase of the radiopharmaceutical and in its clinical application is essential for establishing the comparability of clinical results reported in the nuclear medicine field. This paper presents and discusses the evaluation over time of the quality of activity measurement results obtained in Cuban nuclear medicine, on the basis of statistical samples taken during the radionuclide calibrator comparison program. An attempt is also made to evaluate the role played by such comparisons in quality measurement improvement in nuclear medicine, on the basis of results obtained in a number of countries and published by several authors over a period of time. Specifically, improvements of the measurement performance over time assessed by such exercises were found dissimilar in magnitudes for different countries. Two phases could be distinguished in the improvement process over time. Firstly, a fast improvement can be obtained resulting from the improvement in measurement accuracy of devices. After that, the achievement of new and sustained improvements goes slowly and requires an application of quality assurance programs where the qualification upgrading of personnel become an essential point. PMID:17855099

  15. Using mobile technology to improve healthcare service quality.

    PubMed

    Chao, Chia Chen; Jen, Wen Yuan; Li, Yu-Chuan; Chi, Y P; Chen, Chang-I; Feng, Chen Chjeh

    2005-01-01

    Improving healthcare service quality for illness of treatment, illness prevention and patient service is difficult for most hospitals because the hospitals are lack adequate resources and labor. In order to provide better healthcare service quality for patients, mobile technology can be used to manage healthcare in a way that provides the optimal healthcare service for patients. Pursuing utilization of mobile technology for better patient service, Taipei Medical University Municipal W. F. Teaching Hospital has implemented a mobile healthcare service (m-HS) system to increase healthcare service quality. The m-HS system improves the quality of medical care as well as healthcare service. The m-HS is a multi-functional healthcare management agent, meets the mobile tendency of the present society. This study seeks to discuss the m-HS architecture and workflow processes. We believe the m-HS does have the potential to improve healthcare service quality. Finally, the conclusions and suggestions for the m-HS are given. PMID:16160283

  16. Quality of care in reproductive health programmes: education for quality improvement.

    PubMed

    Kwast, B E

    1998-09-01

    The provision of high quality maternity care will make the difference between life and death or lifelong maiming for millions of pregnant women. Barriers preventing access to affordable, appropriate, acceptable and effective services, and lack of facilities providing high quality obstetric care result in about 1600 maternal deaths every day. Education in its broadest sense is required at all levels and sectors of society to enhance policy formulation that will strengthen programme commitment, improve services with a culturally sensitive approach and ensure appropriate delegation of responsibility to health staff at peripheral levels. This paper is the second in series of three which addresses quality of care. The first (Kwast 1998) contains an overview of concepts, assessments, barriers and improvements of quality of care. The third article will describe selected aspects of monitoring and evaluation of quality of care. PMID:9856019

  17. Benchmarking and audit of breast units improves quality of care

    PubMed Central

    van Dam, P.A.; Verkinderen, L.; Hauspy, J.; Vermeulen, P.; Dirix, L.; Huizing, M.; Altintas, S.; Papadimitriou, K.; Peeters, M.; Tjalma, W.

    2013-01-01

    Quality Indicators (QIs) are measures of health care quality that make use of readily available hospital inpatient administrative data. Assessment quality of care can be performed on different levels: national, regional, on a hospital basis or on an individual basis. It can be a mandatory or voluntary system. In all cases development of an adequate database for data extraction, and feedback of the findings is of paramount importance. In the present paper we performed a Medline search on “QIs and breast cancer” and “benchmarking and breast cancer care”, and we have added some data from personal experience. The current data clearly show that the use of QIs for breast cancer care, regular internal and external audit of performance of breast units, and benchmarking are effective to improve quality of care. Adherence to guidelines improves markedly (particularly regarding adjuvant treatment) and there are data emerging showing that this results in a better outcome. As quality assurance benefits patients, it will be a challenge for the medical and hospital community to develop affordable quality control systems, which are not leading to excessive workload. PMID:24753926

  18. Benchmarking and audit of breast units improves quality of care.

    PubMed

    van Dam, P A; Verkinderen, L; Hauspy, J; Vermeulen, P; Dirix, L; Huizing, M; Altintas, S; Papadimitriou, K; Peeters, M; Tjalma, W

    2013-01-01

    Quality Indicators (QIs) are measures of health care quality that make use of readily available hospital inpatient administrative data. Assessment quality of care can be performed on different levels: national, regional, on a hospital basis or on an individual basis. It can be a mandatory or voluntary system. In all cases development of an adequate database for data extraction, and feedback of the findings is of paramount importance. In the present paper we performed a Medline search on "QIs and breast cancer" and "benchmarking and breast cancer care", and we have added some data from personal experience. The current data clearly show that the use of QIs for breast cancer care, regular internal and external audit of performance of breast units, and benchmarking are effective to improve quality of care. Adherence to guidelines improves markedly (particularly regarding adjuvant treatment) and there are data emerging showing that this results in a better outcome. As quality assurance benefits patients, it will be a challenge for the medical and hospital community to develop affordable quality control systems, which are not leading to excessive workload. PMID:24753926

  19. Dramatic Improvements in Beach Water Quality Following Gull Removal

    EPA Science Inventory

    Gulls are often cited as important contributors of fecal contamination to surface waters, and some recreational beaches have used gull control measures to improve microbial water quality. In this study, gulls were chased from a Lake Michigan beach using specially trained dogs, a...

  20. Improving Lecture Quality through Training in Public Speaking

    ERIC Educational Resources Information Center

    Mowbray, Robert; Perry, Laura B.

    2015-01-01

    Lecturing is a common instructional format but poor lecturing skills can detract from students' learning experiences and outcomes. As lecturing is essentially a form of public communication, training in public speaking may improve lecture quality. Twelve university lecturers in Malaysia participated in a six-week public speaking skills…

  1. ACHIEVING IRRIGATION RETURN FLOW QUALITY CONTROL THROUGH IMPROVED LEGAL SYSTEMS

    EPA Science Inventory

    The key to irrigated agricultural return flow quality control is proper utilization and management of the resource itself, and an accepted tool in out society is the law. This project is designed to develop legal alternatives that will facilitate the implementation of improved wa...

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

    NASA Technical Reports Server (NTRS)

    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.

  3. Guiding and Modelling Quality Improvement in Higher Education Institutions

    ERIC Educational Resources Information Center

    Little, Daniel

    2015-01-01

    The article considers the process of creating quality improvement in higher education institutions from the point of view of current organisational theory and social-science modelling techniques. The author considers the higher education institution as a functioning complex of rules, norms and other organisational features and reviews the social…

  4. Continuous Quality Improvement: Making the Transition to Education.

    ERIC Educational Resources Information Center

    Hubbard, Dean L., Ed.

    This book is a collection of case studies by 27 educational and industrial leaders describing the implementation of specific Total Quality Management techniques which have demonstrated their value. Essays and their authors are as follows: "Process Improvements Using Team Environments" (Scot M. Faulkner); "Team Effectiveness" (Robert S. Winter);…

  5. Using Marketing Research Techniques To Improve Quality and Service.

    ERIC Educational Resources Information Center

    Rahilly, Tony

    Marketing in the business world has long used focus group interviews and survey techniques to explore the attitudes, behaviors, and perceptions of their customers. In the college setting, these same techniques are now being used to improve program quality, assess the effectiveness of publications, and explore the image of the college. At Durham…

  6. 42 CFR 441.474 - Quality assurance and improvement plan.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Quality assurance and improvement plan. 441.474 Section 441.474 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: REQUIREMENTS AND LIMITS APPLICABLE TO SPECIFIC SERVICES Optional Self-Directed...

  7. 42 CFR 441.474 - Quality assurance and improvement plan.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Quality assurance and improvement plan. 441.474 Section 441.474 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: REQUIREMENTS AND LIMITS APPLICABLE TO SPECIFIC SERVICES Optional Self-Directed...

  8. 40 CFR 63.176 - Quality improvement program for pumps.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 9 2011-07-01 2011-07-01 false Quality improvement program for pumps. 63.176 Section 63.176 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES National Emission Standards for Organic Hazardous...

  9. Improving the quality of asphalt coating with carbon nanomodifiers

    NASA Astrophysics Data System (ADS)

    Larisa, Urkhanova; Nikolay, Shestakov; Aleksandr, Semenov; Natalya, Smirnyagina; Irina, Semenova

    2015-07-01

    This article deals with the possibility of modifying the binder by adding carbon nanomodifier to bitumen to improve the quality of asphalt. Addition of 0.05%-0.5% of nanomodifier significantly changes the properties of bitumen. Asphalt with this astringent has increased strength, heat resistance and shear resistance.

  10. Making Departments Distinctive: The Continuous Quality Improvement (CQI) Mindset.

    ERIC Educational Resources Information Center

    Chambliss, Catherine

    The Continuous Quality Improvement (CQI) approach has provided many corporations with a tool for adapting to ongoing shifts in demands and resources, and it can offer academic settings similar assistance. CQI offers a mechanism for building a collaborative process that can help departments define their unique strengths and cultivate a distinctive…

  11. 42 CFR 422.152 - Quality improvement program.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... selected indicators must be based on systematic ongoing collection and analysis of valid and reliable data... must conduct a quality improvement program that— (1) Provides for the collection, analysis, and...) Measures the effectiveness of its model of care through the collection, aggregation, analysis,...

  12. Faculty Development on Item Writing Substantially Improves Item Quality

    ERIC Educational Resources Information Center

    Naeem, Naghma; van der Vleuten, Cees; Alfaris, Eiad Abdelmohsen

    2012-01-01

    The quality of items written for in-house examinations in medical schools remains a cause of concern. Several faculty development programs are aimed at improving faculty's item writing skills. The purpose of this study was to evaluate the effectiveness of a faculty development program in item development. An objective method was developed and used…

  13. Using Quality Function Deployment To Improve Academic Advising Processes.

    ERIC Educational Resources Information Center

    Barrows, Richard; Murray, Bruce

    1997-01-01

    Quality Function Deployment, a set of concepts and tools used in manufacturing engineering to link consumer needs with product design, can also improve academic advising systems and processes. The technique promotes structured, logical examination of students' advising needs and their relationship to advising system design, processes, methods,…

  14. 42 CFR 422.152 - Quality improvement program.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... (including local and regional PPOs, contracts with exclusively SNP benefit packages, private fee-for-service... evaluation and approval, in accordance with CMS guidance. A SNP must conduct a quality improvement program... the SNP model of care as evidenced by measures of care structure and process from the continuity...

  15. Improving Handover Quality in 4G Mobile Systems

    NASA Astrophysics Data System (ADS)

    Kim, Dongwook; Lee, Hanjin; Kim, Namgi; Yoon, Hyunsoo

    In this paper, we propose a new handover algorithm to guarantee handover quality in 4G mobile systems. The proposed algorithm limits the handover interruption time by improving the HARQ retransmission latency of the first packet transmitted from new serving cell. Through the simulations, we proved that our algorithm meets the requirement of handover interruption time for TCP services with high rate.

  16. Improved electrode gives high-quality biological recordings

    NASA Technical Reports Server (NTRS)

    Day, J. L.; Lippitt, M. W.

    1964-01-01

    To obtain high quality waveforms from a subject engaged in physical activity, an improved electrode assembly has been devised. This consists of a cup containing an electrically conductive paste and a silver electrode. The paste maintains contact between the skin and the plate.

  17. IMPROVING NATIONAL AIR QUALITY FORECASTS WITH SATELLITE AEROSOL OBSERVATIONS

    EPA Science Inventory

    Air quality forecasts for major US metropolitan areas have been provided to the public through a partnership between the US Environmental Protection Agency and state and local air agencies since 1997. Recent years have witnessed improvement in forecast skill and expansion of fore...

  18. Assessing effectiveness of winter cover crops to improve water quality

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Winter cover crops are an important conservation practice with potential to improve water quality by reducing excess nitrogen (N), remaining during the winter/early spring in soil, from leaching, runoff, and sediment loss into surface waters after harvest of summer crops. Throughout the Chesapeake B...

  19. Software quality and process improvement in scientific simulation codes

    SciTech Connect

    Ambrosiano, J.; Webster, R.

    1997-11-01

    This report contains viewgraphs on the quest to develope better simulation code quality through process modeling and improvement. This study is based on the experience of the authors and interviews with ten subjects chosen from simulation code development teams at LANL. This study is descriptive rather than scientific.

  20. “Putting It All Together” to Improve Resuscitation Quality

    PubMed Central

    Sutton, Robert M.; Nadkarni, Vinay; Abella, Benjamin S.

    2013-01-01

    Cardiac arrest is a major public health problem affecting thousands of individuals each year in both the before hospital and in-hospital settings. However, although the scope of the problem is large, the quality of care provided during resuscitation attempts frequently does not meet quality of care standards, despite evidence-based cardiopulmonary resuscitation (CPR) guidelines, extensive provider training, and provider credentialing in resuscitation medicine. Although this fact may be disappointing, it should not be surprising. Resuscitation of the cardiac arrest victim is a highly complex task requiring coordination between various levels and disciplines of care providers during a stressful and relatively infrequent clinical situation. Moreover, it requires a targeted, high-quality response to improve clinical outcomes of patients. Therefore, solutions to improve care provided during resuscitation attempts must be multifaceted and targeted to the diverse number of care providers to be successful. PMID:22107978

  1. CONSTRUCTED WETLAND TREATMENT SYSTEMS FOR WATER QUALITY IMPROVEMENT

    SciTech Connect

    Nelson, E.

    2010-07-19

    The Savannah River National Laboratory implemented a constructed wetland treatment system (CWTS) in 2000 to treat industrial discharge and stormwater from the Laboratory area. The industrial discharge volume is 3,030 m{sup 3} per day with elevated toxicity and metals (copper, zinc and mercury). The CWTS was identified as the best treatment option based on performance, capital and continuing cost, and schedule. A key factor for this natural system approach was the long-term binding capacity of heavy metals (especially copper, lead, and zinc) in the organic matter and sediments. The design required that the wetland treat the average daily discharge volume and be able to handle 83,280 m{sup 3} of stormwater runoff in a 24 hour period. The design allowed all water flow within the system to be driven entirely by gravity. The CWTS for A-01 outfall is composed of eight one-acre wetland cells connected in pairs and planted with giant bulrush to provide continuous organic matter input to the system. The retention basin was designed to hold stormwater flow and to allow controlled discharge to the wetland. The system became operational in October of 2000 and is the first wetland treatment system permitted by South Carolina DHEC for removal of metals. Because of the exceptional performance of the A-01 CWTS, the same strategy was used to improve water quality of the H-02 outfall that receives discharge and stormwater from the Tritium Area of SRS. The primary contaminants in this outfall were also copper and zinc. The design for this second system required that the wetland treat the average discharge volume of 415 m{sup 3} per day, and be able to handle 9,690 m{sup 3} of stormwater runoff in a 24 hour period. This allowed the building of a system much smaller than the A-01 CWTS. The system became operational in July 2007. Metal removal has been excellent since water flow through the treatment systems began, and performance improved with the maturation of the vegetation during

  2. Using quality improvement methods to improve public health emergency preparedness: PREPARE for Pandemic Influenza.

    PubMed

    Lotstein, Debra; Seid, Michael; Ricci, Karen; Leuschner, Kristin; Margolis, Peter; Lurie, Nicole

    2008-01-01

    Many public health departments seek to improve their capability to respond to large-scale events such as an influenza pandemic. Quality improvement (QI), a structured approach to improving performance, has not been widely applied in public health. We developed and tested a pilot QI collaborative to explore whether QI could help public health departments improve their pandemic preparedness. We demonstrated that this is a promising model for improving public health preparedness and may be useful for improving public health performance overall. Further efforts are needed, however, to encourage the robust implementation of QI in public health. PMID:18628274

  3. Theory and implementation of summarization: Improving sensor interpretation for spacecraft operations

    NASA Astrophysics Data System (ADS)

    Swartwout, Michael Alden

    New paradigms in space missions require radical changes in spacecraft operations. In the past, operations were insulated from competitive pressures of cost, quality and time by system infrastructures, technological limitations and historical precedent. However, modern demands now require that operations meet competitive performance goals. One target for improvement is the telemetry downlink, where significant resources are invested to acquire thousands of measurements for human interpretation. This cost-intensive method is used because conventional operations are not based on formal methodologies but on experiential reasoning and incrementally adapted procedures. Therefore, to improve the telemetry downlink it is first necessary to invent a rational framework for discussing operations. This research explores operations as a feedback control problem, develops the conceptual basis for the use of spacecraft telemetry, and presents a method to improve performance. The method is called summarization, a process to make vehicle data more useful to operators. Summarization enables rational trades for telemetry downlink by defining and quantitatively ranking these elements: all operational decisions, the knowledge needed to inform each decision, and all possible sensor mappings to acquire that knowledge. Summarization methods were implemented for the Sapphire microsatellite; conceptual health management and system models were developed and a degree-of-observability metric was defined. An automated tool was created to generate summarization methods from these models. Methods generated using a Sapphire model were compared against the conventional operations plan. Summarization was shown to identify the key decisions and isolate the most appropriate sensors. Secondly, a form of summarization called beacon monitoring was experimentally verified. Beacon monitoring automates the anomaly detection and notification tasks and migrates these responsibilities to the space segment. A

  4. Quality assurance in operating a multielement ICP emission spectrometer

    NASA Astrophysics Data System (ADS)

    Botto, Robert I.

    In the industrial laboratory environment, quality assurance in the operation of a multielement inductively coupled plasma emission spectrometer (ICPES) must often be entrusted to laboratory technicians with little or no technical background in spectrochemical analysis. Therefore, to be successful, a quality assurance program must be reduced to a simple, routine practice. Essential components of the quality assurance program described in this paper are (1) An atom-to-ion emission intensity ratio for multielement optimization and for reproducing optimum analysis conditions. (2) A concise, easily applied specification for sensitivity and for precision. (3) A regimen for monitoring of, and correcting for, calibration and background drift. (4) A set of comprehensive spectral interference calibrations maintained using the emission intensity ratio. (5) A high resolution spectrometer for minimizing spectral interferences. (6) A program of long term performance monitoring and maintenance/record keeping. Each of these components is described in detail. Adherence to this program enhances analytical reliability by helping to ensure that raw concentrations are generated consistently under optimum instrumental conditions, and that corrections for spectral interferences are applied accurately even though interference calibrations may be several months old. The importance of adequate resolution and the proper choice of positions for off-line background measurements is borne out by a detailed study of the determination of toxic trace elements in National Bureau of Standards fly ash samples. As, Be, Cd, Pb, Sb, and Se were determined accurately without isolation/preconcentration from the aluminosilicate matrix. Several determinations required corrections for residual spectral interferences amounting to 100-500% of the resultant concentration, underscoring the accuracy of the interference correction procedures.

  5. Guided imagery: an innovative approach to improving maternal sleep quality.

    PubMed

    Schaffer, Linda; Jallo, Nancy; Howland, Lois; James, Kathy; Glaser, Dale; Arnell, Kathy

    2013-01-01

    Mothers of preterm infants are at risk for poor sleep quality, which may adversely affect their health, maternal-infant attachment, and infant caretaking activities. This study examined the relationship of an 8-week relaxation guided imagery intervention on sleep quality and the association between sleep quality and maternal distress (perceived stress, depressive symptoms, and state anxiety) in 20 mothers of hospitalized preterm infants. Mothers received a CD (compact disc) with three 20-minutes recordings and were asked to listen to at least 1 recording daily for 8 weeks. This analysis used self-report data gathered at baseline and 8 weeks. Pearson correlations were used to examine the relationships between mean cumulative relaxation guided imagery use and measures of maternal distress and sleep quality scores at 8 weeks. Complete data on 19 mothers were available for analysis. At 8 weeks, higher mean relaxation guided imagery use was inversely correlated with sleep quality scores (r = -0.30); sleep quality scores were positively correlated with stress (r = 0.42), depressive symptoms (r = 0.34), and anxiety (r = 0.39) scores. In mothers of preterm infants, sleep quality was negatively affected by mental distress and may be improved by a guided imagery intervention. PMID:23618936

  6. Operational water quality forecasting with EnKF data assimilation in the Yeongsan river basin, Korea

    NASA Astrophysics Data System (ADS)

    Shin, Changmin; Kim, Kyunghyun; Min, Joong-Hyuk; Na, Eunhye; Park, Suyoung; Song, Hyunoh

    2016-04-01

    National institute of environmental research(NIER) have been operating the water quality forecasting to prevent water quality deterioration for the major rivers in South Korea through WQFS-NIER(Water Quality Forecasting System) which developed based on Delft-FEWS system by the international joint research with NIER and Deltares from 2011 to 2013 The coupled the Hydrologic Simulation Program Fortran(HSPF) and the Environmental Fluid Dynamic Code(EFDC) models are being used to quantitatively predict the water quality. HSPF watershed model are used to generate the flows and water quality loads of the major tributaries which are used as the boundary conditions for EFDC model. The uncertainties in water quality forecasting are contributed by various factors such as input uncertainty, model structure uncertainty, parametric uncertainty, initial conditions uncertainty, of which to reduce uncertainty on the initial conditions is relatively effective in improving accuracy of short term water quality forecast. To reduce initial conditions uncertainties, ensemble Kalman filter(EnKF) data assimilation(DA) techniques are applied to the EFDC models. DA is to condition the model state on the observations to get a better estimate of state. Model error is assumed to come from uncertainties of the boundary conditions of EFDC model. The case study for Yeongsan river demonstrate that EnKF is successful in bringing the algae concentrations closer to the observations.

  7. A Framework for Improving the Quality of Research in the Biological Sciences.

    PubMed

    Casadevall, Arturo; Ellis, Lee M; Davies, Erika W; McFall-Ngai, Margaret; Fang, Ferric C

    2016-01-01

    The American Academy of Microbiology convened a colloquium to discuss problems in the biological sciences, with emphasis on identifying mechanisms to improve the quality of research. Participants from various disciplines made six recommendations: (i) design rigorous and comprehensive evaluation criteria to recognize and reward high-quality scientific research; (ii) require universal training in good scientific practices, appropriate statistical usage, and responsible research practices for scientists at all levels, with training content regularly updated and presented by qualified scientists; (iii) establish open data at the timing of publication as the standard operating procedure throughout the scientific enterprise; (iv) encourage scientific journals to publish negative data that meet methodologic standards of quality; (v) agree upon common criteria among scientific journals for retraction of published papers, to provide consistency and transparency; and (vi) strengthen research integrity oversight and training. These recommendations constitute an actionable framework that, in combination, could improve the quality of biological research. PMID:27578756

  8. A Framework for Improving the Quality of Research in the Biological Sciences

    PubMed Central

    Ellis, Lee M.; Davies, Erika W.; McFall-Ngai, Margaret; Fang, Ferric C.

    2016-01-01

    ABSTRACT The American Academy of Microbiology convened a colloquium to discuss problems in the biological sciences, with emphasis on identifying mechanisms to improve the quality of research. Participants from various disciplines made six recommendations: (i) design rigorous and comprehensive evaluation criteria to recognize and reward high-quality scientific research; (ii) require universal training in good scientific practices, appropriate statistical usage, and responsible research practices for scientists at all levels, with training content regularly updated and presented by qualified scientists; (iii) establish open data at the timing of publication as the standard operating procedure throughout the scientific enterprise; (iv) encourage scientific journals to publish negative data that meet methodologic standards of quality; (v) agree upon common criteria among scientific journals for retraction of published papers, to provide consistency and transparency; and (vi) strengthen research integrity oversight and training. These recommendations constitute an actionable framework that, in combination, could improve the quality of biological research. PMID:27578756

  9. The Physician Quality Improvement Initiative: Engaging Physicians in Quality Improvement, Patient Safety, Accountability and their Provision of High-Quality Patient Care.

    PubMed

    Wentlandt, Kirsten; Degendorfer, Niki; Clarke, Cathy; Panet, Hayley; Worthington, Jim; McLean, Richard F; Chan, Charlie K N

    2016-01-01

    University Health Network has been working to become a high-reliability organization, with a focus on safe, quality patient care. In response, the Medical Affairs Department has implemented several strategic initiatives to drive accountability, quality improvement and engagement with our physician population. One of these initiatives, the Physician Quality Improvement Initiative (PQII) is a physician-led project designed to provide active medical staff, in collaboration with their physician department chiefs, a comprehensive approach to focused and practical quality improvement in their practice. In this document, we outline the project, including its implementation strategy, logic model and outcomes, and provide discussion on how it fits into UHN's global strategy to provide safe, quality patient care. PMID:27009706

  10. The 'Alternative Quality Contract,' based on a global budget, lowered medical spending and improved quality.

    PubMed

    Song, Zirui; Safran, Dana Gelb; Landon, Bruce E; Landrum, Mary Beth; He, Yulei; Mechanic, Robert E; Day, Matthew P; Chernew, Michael E

    2012-08-01

    Seven provider organizations in Massachusetts entered the Blue Cross Blue Shield Alternative Quality Contract in 2009, followed by four more organizations in 2010. This contract, based on a global budget and pay-for-performance for achieving certain quality benchmarks, places providers at risk for excessive spending and rewards them for quality, similar to the new Pioneer Accountable Care Organizations in Medicare. We analyzed changes in spending and quality associated with the Alternative Quality Contract and found that the rate of increase in spending slowed compared to control groups, more so in the second year than in the first. Overall, participation in the contract over two years led to savings of 2.8 percent (1.9 percent in year 1 and 3.3 percent in year 2) compared to spending in nonparticipating groups. Savings were accounted for by lower prices achieved through shifting procedures, imaging, and tests to facilities with lower fees, as well as reduced utilization among some groups. Quality of care also improved compared to control organizations, with chronic care management, adult preventive care, and pediatric care within the contracting groups improving more in year 2 than in year 1. These results suggest that global budgets with pay-for-performance can begin to slow underlying growth in medical spending while improving quality of care. PMID:22786651

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

    ERIC Educational Resources Information Center

    Aluri, Rao

    1993-01-01

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

  12. Evaluation of coal quality impacts on power plant operation

    SciTech Connect

    Doherty, M.B.

    1996-12-31

    The purpose of this presentation is to have the opportunity to discuss the relationships between coal quality and steam generation. American Electric Power (AEP) is the nations largest burner of coal, consuming approximately 55 million annual tons for its own use and that of companies for which it has management responsibilities. The System has a wide variety of steam generators representing many different steam conditions and boiler configurations. In addition, the company annually mines over 7.5 million tons of coal from its own reserves and operates a highly integrated coal transportation network of river barges, rail cars and terminal transfer facilities. AEP`s approach to evaluating fuels is to first match the fuel being considered to the needs of the steam generator. This includes meeting the environmental control requirements of the unit. Our objective is to supply the fuel to a unit that will enable the unit to operate at the lowest bus bar price. This concept acknowledges that the lowest price of coal per ton may not be synonymous with the lowest cost of production per net KWH.

  13. Quality Improvement on the Acute Inpatient Psychiatry Unit Using the Model for Improvement

    PubMed Central

    Singh, Kuldeep; Sanderson, Joshua; Galarneau, David; Keister, Thomas; Hickman, Dean

    2013-01-01

    Background A need exists for constant evaluation and modification of processes within healthcare systems to achieve quality improvement. One common approach is the Model for Improvement that can be used to clearly define aims, measures, and changes that are then implemented through a plan-do-study-act (PDSA) cycle. This approach is a commonly used method for improving quality in a wide range of fields. The Model for Improvement allows for a systematic process that can be revised at set time intervals to achieve a desired result. Methods We used the Model for Improvement in an acute psychiatry unit (APU) to improve the screening incidence of abnormal involuntary movements in eligible patients—those starting or continuing on standing neuroleptics—with the Abnormal Involuntary Movement Scale (AIMS). Results After 8 weeks of using the Model for Improvement, both of the participating inpatient services in the APU showed substantial overall improvement in screening for abnormal involuntary movements using the AIMS. Conclusion Crucial aspects of a successful quality improvement initiative based on the Model for Improvement are well-defined goals, process measures, and structured PDSA cycles. Success also requires communication, organization, and participation of the entire team. PMID:24052768

  14. An Improved Artificial Bee Colony Algorithm for Solving Hybrid Flexible Flowshop With Dynamic Operation Skipping.

    PubMed

    Li, Jun-Qing; Pan, Quan-Ke; Duan, Pei-Yong

    2016-06-01

    In this paper, we propose an improved discrete artificial bee colony (DABC) algorithm to solve the hybrid flexible flowshop scheduling problem with dynamic operation skipping features in molten iron systems. First, each solution is represented by a two-vector-based solution representation, and a dynamic encoding mechanism is developed. Second, a flexible decoding strategy is designed. Next, a right-shift strategy considering the problem characteristics is developed, which can clearly improve the solution quality. In addition, several skipping and scheduling neighborhood structures are presented to balance the exploration and exploitation ability. Finally, an enhanced local search is embedded in the proposed algorithm to further improve the exploitation ability. The proposed algorithm is tested on sets of the instances that are generated based on the realistic production. Through comprehensive computational comparisons and statistical analysis, the highly effective performance of the proposed DABC algorithm is favorably compared against several presented algorithms, both in solution quality and efficiency. PMID:26126292

  15. Improving the Quality of Imaging in the Emergency Department.

    PubMed

    Blackmore, C Craig; Castro, Alexandra

    2015-12-01

    Imaging is critical for the care of emergency department (ED) patients. However, much of the imaging performed for acute care today is overutilization, creating substantial cost without significant benefit. Further, the value of imaging is not easily defined, as imaging only affects outcomes indirectly, through interaction with treatment. Improving the quality, including appropriateness, of emergency imaging requires understanding of how imaging contributes to patient care. The six-tier efficacy hierarchy of Fryback and Thornbury enables understanding of the value of imaging on multiple levels, ranging from technical efficacy to medical decision-making and higher-level patient and societal outcomes. The imaging efficacy hierarchy also allows definition of imaging quality through the Institute of Medicine (IOM)'s quality domains of safety, effectiveness, patient-centeredness, timeliness, efficiency, and equitability and provides a foundation for quality improvement. In this article, the authors elucidate the Fryback and Thornbury framework to define the value of imaging in the ED and to relate emergency imaging to the IOM quality domains. PMID:26568040

  16. Breeding and biotechnology for improving berry nutritional quality.

    PubMed

    Scalzo, Jessica; Battino, Maurizio; Costantini, Elisa; Mezzetti, Bruno

    2005-01-01

    Breeding and biotechnological approaches are currently used to increase the content of specific bioactive components of plants, but the manipulation of plant metabolism is still not easy to address. There is an increasing awareness that multiple genetic and environmental factors affect production and accumulation of bioactive compounds, but these factors are rarely taken into account when fruit is marketed. Rigorous and unprejudiced evaluation of scientific evidence requires a defined set of criteria and methods of evaluation, particularly when breeding and biotech programs are aimed of producing new varieties with improved nutritional values combined with high plant production efficiency and fruit quality. In order to develop new genotypes and commercial cultivars the availability of new sources of Quality Attributes (QA) and Nutritional Attributes (NA) should be explored. In the strawberry, wild species such as F. virginiana glauca and F. vesca are good sources of bioactive compounds, but in raspberries the introduction of the wild germplasm (R. parvifolium) did not improve the nutritional quality of fruit. The methods available for detecting fruit TAC, combined with TPH and other quality parameters such as sugars, total acidity and fruit color, can be proposed as excellent tools for developing a fast and reliable program for screening large breeding populations for high nutritional quality genotypes. Furthermore, NA can represent a useful tool to facilitate analysis of "substantial equivalence" of transgenic and control derived fruit. PMID:16498208

  17. Statistical process management: An essential element of quality improvement

    SciTech Connect

    Buckner, M.R.

    1992-09-01

    Successful quality improvement requires a balanced program involving the three elements that control quality: organization, people and technology. The focus of the SPC/SPM User`s Group is to advance the technology component of Total Quality by networking within the Group and by providing an outreach within Westinghouse to foster the appropriate use of statistic techniques to achieve Total Quality. SPM encompasses the disciplines by which a process is measured against its intrinsic design capability, in the face of measurement noise and other obscuring variability. SPM tools facilitate decisions about the process that generated the data. SPM deals typically with manufacturing processes, but with some flexibility of definition and technique it accommodates many administrative processes as well. The techniques of SPM are those of Statistical Process Control, Statistical Quality Control, Measurement Control, and Experimental Design. In addition, techniques such as job and task analysis, and concurrent engineering are important elements of systematic planning and analysis that are needed early in the design process to ensure success. The SPC/SPM User`s Group is endeavoring to achieve its objectives by sharing successes that have occurred within the member`s own Westinghouse department as well as within other US and foreign industry. In addition, failures are reviewed to establish lessons learned in order to improve future applications. In broader terms, the Group is interested in making SPM the accepted way of doing business within Westinghouse.

  18. Statistical process management: An essential element of quality improvement

    NASA Astrophysics Data System (ADS)

    Buckner, M. R.

    Successful quality improvement requires a balanced program involving the three elements that control quality: organization, people and technology. The focus of the SPC/SPM User's Group is to advance the technology component of Total Quality by networking within the Group and by providing an outreach within Westinghouse to foster the appropriate use of statistic techniques to achieve Total Quality. SPM encompasses the disciplines by which a process is measured against its intrinsic design capability, in the face of measurement noise and other obscuring variability. SPM tools facilitate decisions about the process that generated the data. SPM deals typically with manufacturing processes, but with some flexibility of definition and technique it accommodates many administrative processes as well. The techniques of SPM are those of Statistical Process Control, Statistical Quality Control, Measurement Control, and Experimental Design. In addition, techniques such as job and task analysis, and concurrent engineering are important elements of systematic planning and analysis that are needed early in the design process to ensure success. The SPC/SPM User's Group is endeavoring to achieve its objectives by sharing successes that have occurred within the member's own Westinghouse department as well as within other US and foreign industry. In addition, failures are reviewed to establish lessons learned in order to improve future applications. In broader terms, the Group is interested in making SPM the accepted way of doing business within Westinghouse.

  19. Statistical process management: An essential element of quality improvement

    SciTech Connect

    Buckner, M.R.

    1992-01-01

    Successful quality improvement requires a balanced program involving the three elements that control quality: organization, people and technology. The focus of the SPC/SPM User's Group is to advance the technology component of Total Quality by networking within the Group and by providing an outreach within Westinghouse to foster the appropriate use of statistic techniques to achieve Total Quality. SPM encompasses the disciplines by which a process is measured against its intrinsic design capability, in the face of measurement noise and other obscuring variability. SPM tools facilitate decisions about the process that generated the data. SPM deals typically with manufacturing processes, but with some flexibility of definition and technique it accommodates many administrative processes as well. The techniques of SPM are those of Statistical Process Control, Statistical Quality Control, Measurement Control, and Experimental Design. In addition, techniques such as job and task analysis, and concurrent engineering are important elements of systematic planning and analysis that are needed early in the design process to ensure success. The SPC/SPM User's Group is endeavoring to achieve its objectives by sharing successes that have occurred within the member's own Westinghouse department as well as within other US and foreign industry. In addition, failures are reviewed to establish lessons learned in order to improve future applications. In broader terms, the Group is interested in making SPM the accepted way of doing business within Westinghouse.

  20. Bee pollination improves crop quality, shelf life and commercial value.

    PubMed

    Klatt, Björn K; Holzschuh, Andrea; Westphal, Catrin; Clough, Yann; Smit, Inga; Pawelzik, Elke; Tscharntke, Teja

    2014-01-22

    Pollination improves the yield of most crop species and contributes to one-third of global crop production, but comprehensive benefits including crop quality are still unknown. Hence, pollination is underestimated by international policies, which is particularly alarming in times of agricultural intensification and diminishing pollination services. In this study, exclusion experiments with strawberries showed bee pollination to improve fruit quality, quantity and market value compared with wind and self-pollination. Bee-pollinated fruits were heavier, had less malformations and reached higher commercial grades. They had increased redness and reduced sugar-acid-ratios and were firmer, thus improving the commercially important shelf life. Longer shelf life reduced fruit loss by at least 11%. This is accounting for 0.32 billion US$ of the 1.44 billion US$ provided by bee pollination to the total value of 2.90 billion US$ made with strawberry selling in the European Union 2009. The fruit quality and yield effects are driven by the pollination-mediated production of hormonal growth regulators, which occur in several pollination-dependent crops. Thus, our comprehensive findings should be transferable to a wide range of crops and demonstrate bee pollination to be a hitherto underestimated but vital and economically important determinant of fruit quality. PMID:24307669

  1. Accreditation and Continuous Quality Improvement In Athletic Training Education

    PubMed Central

    Peer, Kimberly S.; Rakich, Jonathon S.

    2000-01-01

    Objective: To apply the continuous quality improvement model commonly associated with the business sector to entrylevel athletic training education program accreditation. Data Sources: We applied athletic training educational program accreditation as a tool for ensuring quality in the entrylevel athletic training education programs accredited by the Commission on the Accreditation of Allied Health Education Programs. Literature from the business, education, and athletic training fields is integrated to support this paradigm shift in athletic training education. Data Synthesis: The advent of mandated entry-level athletic training educational program accreditation has forced institutions to evaluate their educational programs. Accreditation will promote continuous quality improvement in athletic training education through mechanisms such as control measures and process improvement. Conclusions/Recommendations: Although accreditation of entry-level athletic training education programs has created some dissonance among athletic training professionals, it will strengthen the profession as a whole. Athletic training educators must capture the synergy generated from this change to ensure quality educational experiences for all our students as we move forward to secure a strong position in the allied health care market. PMID:16558629

  2. Nutritional quality of Australian breakfast cereals. Are they improving?

    PubMed

    Louie, Jimmy Chun Yu; Dunford, Elizabeth K; Walker, Karen Z; Gill, Timothy P

    2012-10-01

    The nutritional quality of Australian breakfast cereals is not systematically monitored despite the importance of breakfast for general health. We examined whether the nutritional quality of Australian breakfast cereals has improved between 2004 and 2010, and whether any change could be detected after the introduction of Daily Intake Guide (DIG) front-of-pack labelling. Supermarket surveys were conducted in 2004 and 2010 using the same methodology to collect information from the nutrition information panels of Australian breakfast cereals and the nutrient content of cereals was compared by year. Breakfast cereals with and without DIG labelling in 2010 were also compared. Nutritional quality was assessed using UK Traffic Light criteria. No significant difference was detected in nutritional composition of breakfast cereals between 2004 and 2010. There was no notable improvement in nutritional composition of breakfast cereals marketed as the same product in both years. Overall there has been little improvement in the nutritional quality of Australian breakfast cereals in the 6 year period. A large proportion of Australian breakfast cereals were considered high sugar. In conclusion, the introduction of DIG labelling does not appear to have promoted product reformulation, and breakfast cereals carrying DIG labels were not consistently healthier. PMID:22728950

  3. Improving Volunteered Geographic Data Quality Using Semantic Similarity Measurements

    NASA Astrophysics Data System (ADS)

    Vandecasteele, A.; Devillers, R.

    2013-05-01

    Studies have analysed the quality of volunteered geographic information (VGI) datasets, assessing the positional accuracy of features and the completeness of specific attributes. While it has been shown that VGI can, in some context, reach a high positional accuracy, these works have also highlighted a large spatial heterogeneity in positional accuracy, completeness but also with regards to the semantics of the objects. Such high semantic heterogeneity of VGI datasets becomes a significant obstacle to a number of possible uses that could be made of the data. This paper proposes an approach for both improving the semantic quality and reducing the semantic heterogeneity of VGI dat asets. The improvement of the semantic quality is achieved by automatically suggesting attributes to contributors during the editing process. The reduction of semantic heterogeneity is achieved by automatically notifying contributors when two attributes are too similar or too dissimilar. The approach was implemented into a plugin for OpenStreetMap and different examples illustrate how this plugin can be used to improve the quality of VGI data.

  4. Bee pollination improves crop quality, shelf life and commercial value

    PubMed Central

    Klatt, Björn K.; Holzschuh, Andrea; Westphal, Catrin; Clough, Yann; Smit, Inga; Pawelzik, Elke; Tscharntke, Teja

    2014-01-01

    Pollination improves the yield of most crop species and contributes to one-third of global crop production, but comprehensive benefits including crop quality are still unknown. Hence, pollination is underestimated by international policies, which is particularly alarming in times of agricultural intensification and diminishing pollination services. In this study, exclusion experiments with strawberries showed bee pollination to improve fruit quality, quantity and market value compared with wind and self-pollination. Bee-pollinated fruits were heavier, had less malformations and reached higher commercial grades. They had increased redness and reduced sugar–acid–ratios and were firmer, thus improving the commercially important shelf life. Longer shelf life reduced fruit loss by at least 11%. This is accounting for 0.32 billion US$ of the 1.44 billion US$ provided by bee pollination to the total value of 2.90 billion US$ made with strawberry selling in the European Union 2009. The fruit quality and yield effects are driven by the pollination-mediated production of hormonal growth regulators, which occur in several pollination-dependent crops. Thus, our comprehensive findings should be transferable to a wide range of crops and demonstrate bee pollination to be a hitherto underestimated but vital and economically important determinant of fruit quality. PMID:24307669

  5. Improving the quality of health care: what's taking so long?

    PubMed

    Chassin, Mark R

    2013-10-01

    Nearly fourteen years ago the Institute of Medicine's report, To Err Is Human: Building a Safer Health System, triggered a national movement to improve patient safety. Despite the substantial and concentrated efforts that followed, quality and safety problems in health care continue to routinely result in harm to patients. Desired progress will not be achieved unless substantial changes are made to the way in which quality improvement is conducted. Alongside important efforts to eliminate preventable complications of care, there must also be an effort to seriously address the widespread overuse of health services. That overuse, which places patients at risk of harm and wastes resources at the same time, has been almost entirely left out of recent quality improvement endeavors. Newer and much more effective strategies and tools are needed to address the complex quality challenges confronting health care. Tools such as Lean, Six Sigma, and change management are proving highly effective in tackling problems as difficult as hand-off communication failures and patient falls. Finally, the organizational culture of most American hospitals and other health care organizations must change. To create a culture of safety, leaders must eliminate intimidating behaviors that suppress the reporting of errors and unsafe conditions. Leaders must also hold everyone accountable for adherence to safe practices. PMID:24101066

  6. Integrating empowerment evaluation and quality improvement to achieve healthcare improvement outcomes

    PubMed Central

    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

  7. Quality and productivity improvement program (PPKP) from alumni perspective

    NASA Astrophysics Data System (ADS)

    Ruza, Nadiah; Mustafa, Zainol

    2013-04-01

    Defining the quality of the university education system is not easy. Institutions of higher education, through curriculum are hoped to provide the knowledge, wisdom and personality of students. It is questionable of how far Quality and Productivity Improvement Program (PPKP) are capable to ensure the courses offered relevant and effective in preparing the students for job market. The effectiveness of a university to undertake responsibilities and the impact given to students even after they graduate can be a measure of education quality at university. So, the quality of education can be enhanced and improved from time to time. In general, this study is aims to determine the effectiveness of PPKP's education system from the perspective of their alumni as well as their satisfaction and the importance level based on how PPKP be able to meet their needs. In overall, summary of open-ended questions from the questionnaire, Importance-Performance analysis and correlation analysis were conducted for this study. Based on result, it appears that there are still some deficiencies that can be improve, particularly in terms of teaching skills and PPKP's relationships with external organizations to enable knowledge be channel effectively. Importance-Performance analysis highlights some topics or courses that should be offered by PPKP based on their importance in industrial practice. Summary of the results of correlation analysis was found that women are more positive and not too demanding compared to men. In addition, it is found that the responsibilities and workload of the older generations, higher income and a high level of experience demands them to use and practice what they have learned during their studies at PPKP. Results of this study are hoped could be used to improve the quality of education system at PPKP.

  8. Combined quality function deployment and logical framework analysis to improve quality of emergency care in Malta.

    PubMed

    Buttigieg, Sandra Catherine; Dey, Prasanta Kumar; Cassar, Mary Rose

    2016-03-14

    Purpose - The purpose of this paper is to develop an integrated patient-focused analytical framework to improve quality of care in accident and emergency (A & E) unit of a Maltese hospital. Design/methodology/approach - The study adopts a case study approach. First, a thorough literature review has been undertaken to study the various methods of healthcare quality management. Second, a healthcare quality management framework is developed using combined quality function deployment (QFD) and logical framework approach (LFA). Third, the proposed framework is applied to a Maltese hospital to demonstrate its effectiveness. The proposed framework has six steps, commencing with identifying patients' requirements and concluding with implementing improvement projects. All the steps have been undertaken with the involvement of the concerned stakeholders in the A & E unit of the hospital. Findings - The major and related problems being faced by the hospital under study were overcrowding at A & E and shortage of beds, respectively. The combined framework ensures better A & E services and patient flow. QFD identifies and analyses the issues and challenges of A & E and LFA helps develop project plans for healthcare quality improvement. The important outcomes of implementing the proposed quality improvement programme are fewer hospital admissions, faster patient flow, expert triage and shorter waiting times at the A & E unit. Increased emergency consultant cover and faster first significant medical encounter were required to start addressing the problems effectively. Overall, the combined QFD and LFA method is effective to address quality of care in A & E unit. Practical/implications - The proposed framework can be easily integrated within any healthcare unit, as well as within entire healthcare systems, due to its flexible and user-friendly approach. It could be part of Six Sigma and other quality initiatives. Originality/value - Although QFD has been extensively deployed in

  9. Quality work improvement groups: from paper to reality.

    PubMed

    Smith, G B; Hukill, E

    1994-07-01

    Continuous quality improvement has resulted in the need for the development of new and exciting skills in group dynamics and in the facilitation of small group interactions. Leaders of quality work groups must use the understanding of group dynamics and leadership to maintain high performance work teams. To be effective, the team leaders and members must be aware of what is being said (content) and how things are being said (processes). Team leaders and groups can not be guaranteed effectiveness. However, development of the necessary skills in team building will ensure the likelihood of effective group processes and positive outcomes. PMID:7919437

  10. Standards, Guidance and Practices for Improved Data Quality

    SciTech Connect

    Martin B. Sattison

    2010-06-01

    Since the mid 1980s, the Idaho National Laboratory (INL) has been involved with numerous projects to collect operational reactor data, develop data tools, and trend and analyze that data for the U.S. Nuclear Regulatory Commission (NRC). Because the data are used in subsequent risk analyses, the NRC must have confidence in the quality of the data delivered. The NRC tasked the INL to establish a comprehensive data quality assurance program. A key element of that effort was to establish a set of requirements based on industry and government standards, guidance and good practices. This paper discusses where these were found, the process of extracting the requirements and recommendations from the source materials, and the consolidation of them into a concise set of 22 standards, guidance and practices for technical data quality. While this set was created specifically for the data programs within the NRC’s Office of Research, they have broad application to many high-technology industries.

  11. The maturing of the quality improvement paradigm in the SEL

    NASA Technical Reports Server (NTRS)

    Basili, Victor R.

    1993-01-01

    The Software Engineering Laboratory uses a paradigm for improving the software process and product, called the quality improvement paradigm. This paradigm has evolved over the past 18 years, along with our software development processes and product. Since 1976, when we first began the SEL, we have learned a great deal about improving the software process and product, making a great many mistakes along the way. Quality improvement paradigm, as it is currently defined, can be broken up into six steps: characterize the current project and its environment with respect to the appropriate models and metrics; set the quantifiable goals for successful project performance and improvement; choose the appropriate process model and supporting methods and tools for this project; execute the processes, construct the products, and collect, validate, and analyze the data to provide real-time feedback for corrective action; analyze the data to evaluate the current practices, determine problems, record findings, and make recommendations for future project improvements; and package the experience gained in the form of updated and refined models and other forms of structured knowledge gained from this and prior projects and save it in an experience base to be reused on future projects.

  12. Quality-based financial incentives in health care: can we improve quality by paying for it?

    PubMed

    Conrad, Douglas A; Perry, Lisa

    2009-01-01

    This article asks whether financial incentives can improve the quality of health care. A conceptual framework drawn from microeconomics, agency theory, behavioral economics, and cognitive psychology motivates a set of propositions about incentive effects on clinical quality. These propositions are evaluated through a synthesis of extant peer-reviewed empirical evidence. Comprehensive financial incentives--balancing rewards and penalties; blending structure, process, and outcome measures; emphasizing continuous, absolute performance standards; tailoring the size of incremental rewards to increasing marginal costs of quality improvement; and assuring certainty, frequency, and sustainability of incentive payoffs--offer the prospect of significantly enhancing quality beyond the modest impacts of prevailing pay-for-performance (P4P) programs. Such organizational innovations as the primary care medical home and accountable health care organizations are expected to catalyze more powerful quality incentive models: risk- and quality-adjusted capitation, episode of care payments, and enhanced fee-for-service payments for quality dimensions (e.g., prevention) most amenable to piece-rate delivery. PMID:19296779

  13. Enhancement of pressurizer safety valve operability by seating design improvement

    SciTech Connect

    Moisidis, N.T.; Ratiu, M.D.

    1994-12-31

    Operating conditions specific to Pressurizer Safety Valves (PSVs) have led to numerous problems and have caused industry and NRC concerns regarding the adequacy of spring loaded self-actuated safety valves for Reactor Coolant System (RCS) overpressure protection. Specific concerns are: setpoint drift, spurious actuations and leakage. Based on testing and valve construction analysis of a Crosby model 6M6 PSV, it was established that the primary contributor to the valve problems is a susceptibility to weak seating. To eliminate spring instability, a new spring washer was designed, which guides the spring and precludes its rotation from the reference installed position. Results of tests performed on a prototype PSV equipped with the modified upper spring washer has shown significant improvements in valve operability and a consistent setpoint reproducibility to less than {+-}1% of the PSV setpoint (testing of baseline, unmodified valve, resulted in a setpoint drift of {+-}2%). Enhanced valve operability will result in a significant decrease in operating and maintenance costs associated with valve maintenance and testing. In addition, the enhanced setpoint reproducibility will allow the development of a nitrogen to steam correlation for future in-house PSV testing which will result in further reductions in costs associated with valve testing.

  14. Enhancement of pressurizer safety valve operability by seating design improvement

    SciTech Connect

    Moisidis, N.T.; Ratiu, M.D.

    1995-08-01

    Operating conditions specific to pressurizer safety valves (PSVs) have led to numerous problems and have caused industry and NRC concerns regarding the adequacy of spring-loaded self-actuated safety valves for reactor coolant system (RCS) overpressure protection. Specific concerns are: setpoint drift, spurious actuations, and pressure protection. Specific concerns are: setpoint drift, spurious actuations, and leakage. Based on testing and valve construction analysis of a Crosby model 6M6 PSV (Moisidis and Ratiu, 1992), it was established that the primary contributor to the valve problems is a susceptibility to weak seating. To eliminate spring instability, a new spring washer was designed, which guides the spring and precludes its rotation from the reference installed position. Results of tests performed on a prototype PSV equipped with the modified upper spring washer has shown significant improvements in valve operability and a consistent setpoint reproducibility to less than {+-}1% of the PSV setpoint (testing of baseline, unmodified valve, resulted in a setpoint drift of {+-} 2%). Enhanced valve operability will result in a significant decrease in operating and maintenance costs associated with valve maintenance and testing. In addition, the enhanced setpoint reproducibility will allow the development of a nitrogen to steam correlation for future in-house PSV testing which will result in further reductions in costs associated with valve testing.

  15. Highlights of contractor initiatives in quality enhancement and productivity improvement

    NASA Technical Reports Server (NTRS)

    1986-01-01

    The NASA/Contractor Team efforts are presented as part of NASA's continuing effort to facilitate the sharing of quality and productivity improvement ideas among its contractors. This complilation is not meant to be a comprehensive review of contractor initiative nor does it necessarily express NASA's views. The submissions represent samples from a general survey, and were not edited by NASA. The efforts are examples of quality and productivity programs in private industry, and as such, highlight company efforts in individual areas. Topics range from modernization of equipment, hardware, and technology to management of human resources. Of particular interest are contractor initiatives which deal with measurement and evaluation data pertaining to quality and productivity performance.

  16. Teaching Evaluation: A Critical Measure for Improving the Quality of Education

    ERIC Educational Resources Information Center

    Ji, Zhou

    2009-01-01

    In the coming period, the main task for China's higher education system is to improve the quality of education, and the key to improving the quality of education is to improve the quality of teaching. Teaching evaluations are a critical measure for improving the quality of teaching. The work of evaluating teaching at institutions of higher…

  17. 42 CFR 475.103 - Requirements for performing quality improvement initiatives.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Requirements for performing quality improvement initiatives. 475.103 Section 475.103 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS QUALITY IMPROVEMENT ORGANIZATIONS Quality Improvement Organizations...

  18. Yarn Quality Prediction Based on Improved BP Neural Network

    NASA Astrophysics Data System (ADS)

    Yang, Jian-Guo; Xiong, Jing-Wei; Xun, Lan

    Aiming at the key quality indexes xbt in spinning processing is caused by many complex and interactions factors. A xbt prediction model is put forward based on the PSO-BP neural network, which adjusts weights of BP neural network using particle swarm optimization (PSO) rather than the traditional gradient descent method, is used to improve the convergence speed of neural network and the ability of getting the global optimal solution. As the object of a large number of field detection data in a spinning workshop, the results show that, compared with the traditional BP algorithm and GA-BP algorithm, the PSO-BP neural network can obvious improve yarn quality prediction model precision and stability.

  19. IMPROVING (SOFTWARE) PATENT QUALITY THROUGH THE ADMINISTRATIVE PROCESS

    PubMed Central

    Rai, Arti K.

    2014-01-01

    The available evidence indicates that patent quality, particularly in the area of software, needs improvement. This Article argues that even an agency as institutionally constrained as the U.S. Patent and Trademark Office (“PTO”) could implement a portfolio of pragmatic, cost-effective quality improvement strategies. The argument in favor of these strategies draws upon not only legal theory and doctrine but also new data from a PTO software examination unit with relatively strict practices. Strategies that resolve around Section 112 of the patent statute could usefully be deployed at the initial examination stage. Other strategies could be deployed within the new post-issuance procedures available to the agency under the America Invents Act. Notably, although the strategies the Article discusses have the virtue of being neutral as to technology, they are likely to have a very significant practical impact in the area of software. PMID:25221346

  20. IMPROVING (SOFTWARE) PATENT QUALITY THROUGH THE ADMINISTRATIVE PROCESS.

    PubMed

    Rai, Arti K

    2013-11-24

    The available evidence indicates that patent quality, particularly in the area of software, needs improvement. This Article argues that even an agency as institutionally constrained as the U.S. Patent and Trademark Office ("PTO") could implement a portfolio of pragmatic, cost-effective quality improvement strategies. The argument in favor of these strategies draws upon not only legal theory and doctrine but also new data from a PTO software examination unit with relatively strict practices. Strategies that resolve around Section 112 of the patent statute could usefully be deployed at the initial examination stage. Other strategies could be deployed within the new post-issuance procedures available to the agency under the America Invents Act. Notably, although the strategies the Article discusses have the virtue of being neutral as to technology, they are likely to have a very significant practical impact in the area of software. PMID:25221346

  1. Processes for quality improvements in radiation oncology clinical trials.

    PubMed

    FitzGerald, T J; Urie, Marcia; Ulin, Kenneth; Laurie, Fran; Yorty, Jeffrey; Hanusik, Richard; Kessel, Sandy; Jodoin, Maryann Bishop; Osagie, Gani; Cicchetti, M Giulia; Pieters, Richard; McCarten, Kathleen; Rosen, Nancy

    2008-01-01

    Quality assurance in radiotherapy (RT) has been an integral aspect of cooperative group clinical trials since 1970. In early clinical trials, data acquisition was nonuniform and inconsistent and computational models for radiation dose calculation varied significantly. Process improvements developed for data acquisition, credentialing, and data management have provided the necessary infrastructure for uniform data. With continued improvement in the technology and delivery of RT, evaluation processes for target definition, RT planning, and execution undergo constant review. As we move to multimodality image-based definitions of target volumes for protocols, future clinical trials will require near real-time image analysis and feedback to field investigators. The ability of quality assurance centers to meet these real-time challenges with robust electronic interaction platforms for imaging acquisition, review, archiving, and quantitative review of volumetric RT plans will be the primary challenge for future successful clinical trials. PMID:18406943

  2. Essentials of navigating and teaching surgical quality improvement.

    PubMed

    Raval, Mehul V; Kenney, Brian D

    2015-12-01

    Quality improvement (QI) has become a focus of contemporary surgical practice. The purpose of this review is to provide a framework of working knowledge regarding QI for the practicing surgeon. QI design, implementation methods, measurement tactics, statistical analysis, and presentation tools based on the Institute of Healthcare Improvement model are reviewed. Additional principles to optimize QI success such as fostering communication, building a culture of QI, leadership involvement, and financial planning are also explored. Lastly, resources for QI education and teaching are provided for those interested in learning more about this expanding field. PMID:26653159

  3. Using continuous quality improvement to implement evidence-based medicine.

    PubMed

    Quick, Barbara; Nordstrom, Sue; Johnson, Kevin

    2006-01-01

    The importance of implementing evidence-based medicine is being driven by public reporting of outcome data and linking these measures to reimbursement. Most hospitals are faced with many challenges in gaining sponsorship, staffing, creating tools, and reporting of evidence-based outcome measures. This article describes the use of the SSM Health Care (SSMHC) Continuous Quality Improvement model in implementing evidence-based practices at SSM DePaul Health Center, a community hospital member of SSMHC, including successes, opportunities for improvement, and lessons learned. Specifically, the article includes two different processes for data collection and interventions with staff, process requirements for each, and outcome data associated with each model. PMID:17135874

  4. Improving Quality of Seal Leak Test Product using Six Sigma

    NASA Astrophysics Data System (ADS)

    Luthfi Malik, Abdullah; Akbar, Muhammad; Irianto, Dradjad

    2016-02-01

    Seal leak test part is a polyurethane material-based product. Based on past data, defect level of this product was 8%, higher than the target of 5%. Quality improvement effort was done using six sigma method that included phases of define, measure, analyse, improve, and control. In the design phase, a Delphi method was used to identify factors that were critical to quality. In the measure phase, stability and process capability was measured. Fault tree analysis (FTA) and failure mode and effect analysis (FMEA) were used in the next phase to analize the root cause and to determine the priority issues. Improve phase was done by compiling, selecting, and designing alternative repair. Some improvement efforts were identified, i.e. (i) making a checklist for maintenance schedules, (ii) making written reminder form, (iii) modifying the SOP more detail, and (iv) performing a major service to the vacuum machine. To ensure the continuity of improvement efforts, some control activities were executed, i.e. (i) controlling, monitoring, documenting, and setting target frequently, (ii) implementing reward and punishment system, (iii) adding cleaning tool, and (iv) building six sigma organizational structure.

  5. The Mark III IR FEL: Improvements in performance and operation

    SciTech Connect

    Barnett, G.A.; Madey, J.M.J.; Straub, K.D.

    1995-12-31

    The Mark III IR FEL has been upgraded by the installation of a new thermionic microwave gun. The new gun yields a reduced emittance and allows operation at a higher repetition rate and an increased electron macropulse length. The RF system of the Mark III has also been phase-locked to the RF systemof the adjacent storage ring driver for the laboratory`s short-wavelength FEL sources, making possible two-color UV-IR pump probe experiments. In this paper, the design and performance of the new gun are presented and the implications of the improvements investigated.

  6. Imaging quality full chip verification for yield improvement

    NASA Astrophysics Data System (ADS)

    Yang, Qing; Zhou, CongShu; Quek, ShyueFong; Lu, Mark; Foong, YeeMei; Qiu, JianHong; Pandey, Taksh; Dover, Russell

    2013-04-01

    Basic image intensity parameters, like maximum and minimum intensity values (Imin and Imax), image logarithm slope (ILS), normalized image logarithm slope (NILS) and mask error enhancement factor (MEEF) , are well known as indexes of photolithography imaging quality. For full chip verification, hotspot detection is typically based on threshold values for line pinching or bridging. For image intensity parameters it is generally harder to quantify an absolute value to define where the process limit will occur, and at which process stage; lithography, etch or post- CMP. However it is easy to conclude that hot spots captured by image intensity parameters are more susceptible to process variation and very likely to impact yield. In addition these image intensity hot spots can be missed by using resist model verification because the resist model normally is calibrated by the wafer data on a single resist plane and is an empirical model which is trying to fit the resist critical dimension by some mathematic algorithm with combining optical calculation. Also at resolution enhancement technology (RET) development stage, full chip imaging quality check is also a method to qualify RET solution, like Optical Proximity Correct (OPC) performance. To add full chip verification using image intensity parameters is also not as costly as adding one more resist model simulation. From a foundry yield improvement and cost saving perspective, it is valuable to quantify the imaging quality to find design hot spots to correctly define the inline process control margin. This paper studies the correlation between image intensity parameters and process weakness or catastrophic hard failures at different process stages. It also demonstrated how OPC solution can improve full chip image intensity parameters. Rigorous 3D resist profile simulation across the full height of the resist stack was also performed to identify a correlation to the image intensity parameter. A methodology of post-OPC full

  7. Observation Leads to Improved Operations in Nuclear Medicine.

    PubMed

    Religioso, Deo G

    2016-01-01

    The concept of observation--going out and seeing what is happening in daily operations---would seem like a normal management activity, but the reality in practice of the philosophy and technique is often underutilized. Once an observation has been determined, the next steps are to test and validate any discoveries on paper. For process change to be implemented, numerical data is needed to back-up observations in order to be heard and taken seriously by the executive team. Boca Raton Regional Hospital saw an opportunity to improve the process for radiopharmaceutical standing orders within its nuclear imaging department. As a result of this observation, the facility realized improved savings and an increase in employee motivation. PMID:27172652

  8. Partnering health disparities research with quality improvement science in pediatrics.

    PubMed

    Lion, K Casey; Raphael, Jean L

    2015-02-01

    Disparities in pediatric health care quality are well described in the literature, yet practical approaches to decreasing them remain elusive. Quality improvement (QI) approaches are appealing for addressing disparities because they offer a set of strategies by which to target modifiable aspects of care delivery and a method for tailoring or changing an intervention over time based on data monitoring. However, few examples in the literature exist of QI interventions successfully decreasing disparities, particularly in pediatrics, due to well-described challenges in developing, implementing, and studying QI with vulnerable populations or in underresourced settings. In addition, QI interventions aimed at improving quality overall may not improve disparities, and in some cases, may worsen them if there is greater uptake or effectiveness of the intervention among the population with better outcomes at baseline. In this article, the authors review some of the challenges faced by researchers and frontline clinicians seeking to use QI to address health disparities and propose an agenda for moving the field forward. Specifically, they propose that those designing and implementing disparities-focused QI interventions reconsider comparator groups, use more rigorous evaluation methods, carefully consider the evidence for particular interventions and the context in which they were developed, directly engage the social determinants of health, and leverage community resources to build collaborative networks and engage community members. Ultimately, new partnerships between communities, providers serving vulnerable populations, and QI researchers will be required for QI interventions to achieve their potential related to health care disparity reduction. PMID:25560436

  9. Remote Sensing and Modeling for Improving Operational Aquatic Plant Management

    NASA Technical Reports Server (NTRS)

    Bubenheim, Dave

    2016-01-01

    The California Sacramento-San Joaquin River Delta is the hub for California’s water supply, conveying water from Northern to Southern California agriculture and communities while supporting important ecosystem services, agriculture, and communities in the Delta. Changes in climate, long-term drought, water quality changes, and expansion of invasive aquatic plants threatens ecosystems, impedes ecosystem restoration, and is economically, environmentally, and sociologically detrimental to the San Francisco Bay/California Delta complex. NASA Ames Research Center and the USDA-ARS partnered with the State of California and local governments to develop science-based, adaptive-management strategies for the Sacramento-San Joaquin Delta. The project combines science, operations, and economics related to integrated management scenarios for aquatic weeds to help land and waterway managers make science-informed decisions regarding management and outcomes. The team provides a comprehensive understanding of agricultural and urban land use in the Delta and the major water sheds (San Joaquin/Sacramento) supplying the Delta and interaction with drought and climate impacts on the environment, water quality, and weed growth. The team recommends conservation and modified land-use practices and aids local Delta stakeholders in developing management strategies. New remote sensing tools have been developed to enhance ability to assess conditions, inform decision support tools, and monitor management practices. Science gaps in understanding how native and invasive plants respond to altered environmental conditions are being filled and provide critical biological response parameters for Delta-SWAT simulation modeling. Operational agencies such as the California Department of Boating and Waterways provide testing and act as initial adopter of decision support tools. Methods developed by the project can become routine land and water management tools in complex river delta systems.

  10. Potential for luminosity improvement for low-energy RHIC operation

    SciTech Connect

    Fedotov A. V.

    2012-05-20

    At the Brookhaven National Laboratory, a physics program, motivated by the search of the QCD phase transition critical point, requires operation of the Relativistic Heavy Ion Collider (RHIC) with heavy ions at very low beam energies corresponding to 2.5-20 GeV/n. Several physics runs were already successfully performed at these low energies. However, the luminosity is very low at lowest energies of interest (< 10 GeV/n) limited by the intra-beam scattering and space-charge, as well as by machine nonlinearities. At these low energies, electron cooling could be very effective in counteracting luminosity degradation due to the IBS, while it is less effective against other limitations. Overall potential luminosity improvement for low-energy RHIC operation from cooling is summarized for various energies, taking into account all these limitations as well as beam lifetime measured during the low-energy RHIC runs. We also explore a possibility of further luminosity improvement under the space-charge limitation.

  11. [Improvement of routine works and quality control in mycobacterial laboratory].

    PubMed

    Suzuki, Katsuhiro; Higuchi, Takeshi

    2007-03-01

    Many new methods have been introduced into routine laboratory works in microbiology since 1990. Molecular biology, in particular, opened a new era and promoted a technician's skill much. PCR and hybridization technique have been ordinary one in many laboratories. Since old techniques such as smear and culture are still needed, amount of routine works is increasing gradually. Thus, improving efficiency and keeping quality of routine works are becoming more and more important issues. This symposium focused on such points, and four skilled technicians around Japan presented their own tips. 1. Coexistence of M. tuberculosis and M. avium complex (MAC) in the MGIT culture system: Yasushi WATANABE (Clinical Laboratory Division, NHO Nishi-Niigata Chuo National Hospital). Sputum samples of some tuberculosis patients yielded only MAC in the MGIT culture system. Such co-infected cases presented problems to mislead proper treatment and infection control. The detection rate of MAC was significantly high, and the growth speed of MAC was significantly rapid in the MGIT culture system, compared to those of M. tuberculosis. Additionally, M. tuberculosis was not detected with even more quantity than MAC in the small amount of mixed samples. Higher sensitivity and growth speed of MAC are the important characteristics of the MGIT system. 2. Internal quality control with ordinary examination results: Akio AONO (Department of Clinical Examination, Double-Barred Cross Hospital, Japan Anti-Tuberculosis Association). Our laboratory utilizes ordinary examination results as the internal quality control for specimen pretreatment, culture, and drug susceptibility testing. The contamination rate of MGIT culture system is useful for the evaluation of the decontamination process. It was 6.3% on average in our laboratory in 2005. The number of drug resistant strains is also useful to assess the performance of drug susceptibility testing. The incidence of each anti-tuberculosis drug resistance

  12. Detection of High Quality Rainfall Data to Improve Flood Resilience

    NASA Astrophysics Data System (ADS)

    Hoang, T. C.; Tchiguirinskaia, I.; Schertzer, D. J.; Lovejoy, S.

    2012-12-01

    European flood management systems require reliable rainfall statistics, e.g. the Intensity-duration-Frequency curves for shorter and shorter durations and for a larger and larger range of return periods. Preliminary studies showed that the number of floods depends on the quality of available data, e.g. the time resolution quality. These facts suggest that a particular attention should be paid to the rainfall data quality in order to adequately investigate flood risk aiming to achieve flood resilience. The potential consequences of changes in measuring and recording techniques have been somewhat discussed in the literature with respect to a possible introduction of artificial inhomogeneities in time series. In this direction, we developed a first version of a SERQUAL procedure to automatically detect the effective time resolution of highly mixed data. We show that most of the rainfall time series have a lower recording frequency than that is assumed. This question is particularly important for operational hydrology, because an error on the effective recording high frequency introduces biases in the corresponding statistics. It is therefore essential to quantify the quality of the rainfall time series before their use. Due to the fact that the multiple scales and possible scaling behaviour of hydrological data are particularly important for many applications, including flood resilience research, this paper first investigates the sensitivity of the scaling estimates and methods to the deficit of short duration rainfall data, and consequently propose a few simple criteria for a reliable evaluation of the data quality. The SERQUAL procedure enable us to extract high quality sub-series from longer time series that will be much more reliable to calibrate and/or validate short duration quantiles and hydrological models.

  13. Method and apparatus for operating an improved thermocline storage unit

    DOEpatents

    Copeland, Robert J.

    1985-01-01

    A method and apparatus for operating a thermocline storage unit in which an insulated barrier member is provided substantially at the interface region between the hot and cold liquids in the storage tank. The barrier member physically and thermally separates the hot and cold liquids substantially preventing any diffusing or mixing between them and substantially preventing any heat transfer therebetween. The barrier member follows the rise and fall of the interface region between the liquids as the tank is charged and discharged. Two methods of maintaining it in the interface region are disclosed. With the structure and operation of the present invention and in particular the significant reduction in diffusing or mixing between the hot and cold liquids as well as the significant reduction in the thermal heat transfer between them, the performance of the storage tank is improved. More specifically, the stability of the interface region or thermocline is enhanced and the thickness of the thermocline is reduced producing a corresponding increase in the steepness of the temperature gradient across the thermocline and a more efficiently operating thermocline storage unit.

  14. Method and apparatus for operating an improved thermocline storage unit

    DOEpatents

    Copeland, R.J.

    1982-09-30

    A method and apparatus for operating a thermocline storage unit in which an insulated barrier member is provided substantially at the interface region between the hot and cold liquids in the storage tank. The barrier member physically and thermally separates the hot and cold liquids substantially preventing any diffusing or mixing between them and substantially preventing any heat transfer there between. The barrier member follows the rise and fall of the interface region between the liquids as the tank is charged and discharged. Two methods of maintaining it in the interface region are disclosed. With the structure and operation of the present invention and in particular the significant reduction in diffusing or mixing between the hot and cold liquids as well as the significant reduction in the thermal heat transfer between them, the performance of the storage tank is improved. More specifically, the stability of the interface region or thermocline is enhanced and the thickness of the thermocline is reduced producing a corresponding increase in the steepness of the temperature gradient across the thermocline and a more efficiently operating thermocline storage unit.

  15. Understanding the "How" of Quality Improvement: Lessons from the Rhode Island Program Quality Intervention

    ERIC Educational Resources Information Center

    Devaney, Elizabeth; Smith, Charles; Wong, Kenneth

    2012-01-01

    Over the past 10 years, afterschool and youth development programming has moved from providing childcare for working parents to being an integral component of the learning day, supporting the academic, social, and emotional development of young people. An important part of that transition has been a growing emphasis on improving program quality.…

  16. Global partnerships: A collaborative effort to improve air quality in developing countries

    SciTech Connect

    Calkins, D.L.

    1998-12-31

    Since 1970, the World Health Organization (WHO) and the United Nations Environmental Programme (UNEP) has coordinated the operation of a worldwide air pollution monitoring program, formerly known as the Global Environmental Monitoring System/Air (GEMS/Air) and now a part of the WHO`s Air Management Information Systems (AMIS). GEMS/Air has operated more than 250 ambient air monitoring stations in more than 50 nations since 1970. The focus has been on improving air quality data and emission inventories in developing countries, ultimately leading to setting appropriate health standards and developing national plans for air quality improvements. As funding is often limited in these countries, WHO has established the twinning concept of matching air pollution agencies in Europe and the United States with those developing countries needing assistance. The notion is for a donor agency to provide used air monitors and technical assistance to a sister city or country. Such monitors, though not necessarily state-of-the-art in the United States but clearly operational, would provide improved monitoring data in many developing countries, thus leading to a better understanding of the worldwide impacts of air pollution on public health and natural resources. This paper will describe the process, participation, and the ultimate goals of developing a Global Air Quality Partnership among the participants. It addresses worldwide air quality problems, especially in the megacities of the world. Finally, it discusses problems encountered in providing technical assistance to developing countries and how international organizations, such as A and WMA, might help improved air quality management in these areas.

  17. Improving the quality of handover in a liaison psychiatry team

    PubMed Central

    Brook, Jennifer; Amaro Calcia, Marilia

    2016-01-01

    Handover is a high risk point for errors in clinical care, in many cases leading to adverse events or near misses. The timely transfer of accurate and useful information between professionals is vital to ensure quality and safety, and to ensure the transfer of accountability for care. In this project standards were developed for quality handover between doctors in a liaison psychiatry department. The aim of these were to ensure adequate identification of patients, clear communication of tasks to be completed and relevant risk issues, as well as a guide to the priority of jobs. We measured compliance with these standards for all patients documented in the handover book during three week periods in 2013, 2014 (following delivery of education and guidance on handover to all doctors), and finally in 2015 after implementation of a proforma for handover. Handover documentation prior to the implementation of standards was of poor quality with significant absences of information. Key information to identify patients was frequently absent, for example hospital number was only recorded in 1% of cases. Only 81% of entries included the reason for the patient's referral, and 27% made no mention of the outstanding tasks for completion. Despite guidance and education of all doctors regarding the standards, there was no consistent improvement in compliance. It was particularly concerning that risk issues were only mentioned in 18% of cases, even when assessed immediately after education was given. Following introduction of the proforma compliance increased with overall completeness of handover improving from 40% to 71%. Without guidelines handover between shifts is of a poor quality, and often lacks key information to allow colleagues to identify patients and prioritise need. Education of those performing these handovers did not produce any benefits, either immediately following its delivery or in longer term follow up. The implementation of a template to aid clinicians in

  18. Improvement in quality of life measures after laparoscopic antireflux surgery.

    PubMed Central

    Trus, T L; Laycock, W S; Waring, J P; Branum, G D; Hunter, J G

    1999-01-01

    OBJECTIVE: To determine if patients with gastroesophageal reflux "well controlled medically" had a different quality of life from those with residual symptoms receiving aggressive medical therapy, and to determine whether laparoscopic antireflux surgery significantly altered quality of life in patients with gastroesophageal reflux. SUMMARY BACKGROUND DATA: Clinical determinants of outcome may not adequately reflect the full impact of therapy. The medical outcomes study short form (SF-36) is a well-validated questionnaire that assays eight specific health concepts in three general fields. It may provide a more sensitive tool for judging the success of antireflux therapy. METHODS: A total of 345 patients undergoing laparoscopic antireflux surgery completed at least one questionnaire during the study period. Preoperative questionnaires were completed by 290 patients, 223 completed a questionnaire 6 weeks after surgery, and 50 completed the same questionnaire 1 year after surgery. A subgroup of 70 patients was divided before surgery into two groups on the basis of their response to standard medical therapy. RESULTS: Preoperative scores were extremely low. All eight SF-36 health categories improved significantly 6 weeks and 1 year after surgery. In the 70-patient subgroup, 53 patients (76%) underwent laparoscopic antireflux surgery because of symptoms refractory to medical therapy and 17 patients (24%) reported that their symptoms were well controlled but elected to have surgery because they wished to be medication-free. The preoperative quality of life scores of these two patient groups were equivalent in all but one category. Postoperative scores were significantly improved in all categories and indistinguishable between the two groups. CONCLUSIONS: Laparoscopic antireflux surgery is an effective therapy for patients with gastroesophageal reflux and may be more effective than medical therapy at improving quality of life. PMID:10077044

  19. Improving the quality of handover in a liaison psychiatry team.

    PubMed

    Brook, Jennifer; Amaro Calcia, Marilia

    2016-01-01

    Handover is a high risk point for errors in clinical care, in many cases leading to adverse events or near misses. The timely transfer of accurate and useful information between professionals is vital to ensure quality and safety, and to ensure the transfer of accountability for care. In this project standards were developed for quality handover between doctors in a liaison psychiatry department. The aim of these were to ensure adequate identification of patients, clear communication of tasks to be completed and relevant risk issues, as well as a guide to the priority of jobs. We measured compliance with these standards for all patients documented in the handover book during three week periods in 2013, 2014 (following delivery of education and guidance on handover to all doctors), and finally in 2015 after implementation of a proforma for handover. Handover documentation prior to the implementation of standards was of poor quality with significant absences of information. Key information to identify patients was frequently absent, for example hospital number was only recorded in 1% of cases. Only 81% of entries included the reason for the patient's referral, and 27% made no mention of the outstanding tasks for completion. Despite guidance and education of all doctors regarding the standards, there was no consistent improvement in compliance. It was particularly concerning that risk issues were only mentioned in 18% of cases, even when assessed immediately after education was given. Following introduction of the proforma compliance increased with overall completeness of handover improving from 40% to 71%. Without guidelines handover between shifts is of a poor quality, and often lacks key information to allow colleagues to identify patients and prioritise need. Education of those performing these handovers did not produce any benefits, either immediately following its delivery or in longer term follow up. The implementation of a template to aid clinicians in

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

    PubMed

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

    2015-01-01

    Significant gaps in healthcare quality and outcomes can be reduced via quality improvement collaboratives (QICs), which improve care by leveraging data and experience from multiple organizations.The Children's Hospital Neonatal Consortium Collaborative Initiatives for Quality Improvement team developed an infrastructure for neonatal QICs. We describe the structure and components of an effective multi-institutional neonatal QIC that implemented the "SLUG Bug" project designed to reduce central line-associated bloodstream infections (CLABSIs).The operational infrastructure of SLUG Bug involved 17 tertiary care neonatal intensive care units with a goal to reduce CLABSI in high-risk neonates. Clinical Practice Recommendations were produced, and the Institute of Healthcare Improvement Breakthrough Series provided the framework for the collaborative. Process measures studied the effectiveness of the collaborative structure.CLABSI rates decreased by 20% during a 12-month study period. Compliance bundle reporting exceeded 80%. A QIC score of 2.5 or more ("improvement") was achieved by 94% of centers and a score 4 or more ("significant improvement") was achieved by 35%.Frequent interactive project meetings, well-defined project metrics, continual shared learning opportunities, and individual team coaching were key QIC success components. Through a coordinated approach and committed leadership, QICs can effectively implement change and improve the care of neonates with complex diagnoses and rare diseases. PMID:25919608

  1. Method and apparatus for improving the quality and efficiency of ultrashort-pulse laser machining

    DOEpatents

    Stuart, Brent C.; Nguyen, Hoang T.; Perry, Michael D.

    2001-01-01

    A method and apparatus for improving the quality and efficiency of machining of materials with laser pulse durations shorter than 100 picoseconds by orienting and maintaining the polarization of the laser light such that the electric field vector is perpendicular relative to the edges of the material being processed. Its use is any machining operation requiring remote delivery and/or high precision with minimal collateral dames.

  2. Context Matters: Practitioner Perspectives on Immunization Delivery Quality Improvement Efforts.

    PubMed

    Gingold, Janet A; Briccetti, Christine; Zook, Kathleen; Gillespie, Catherine W; Gubernick, Ruth S; Moon, Rachel Y; Fu, Linda Y

    2016-08-01

    Uneven adherence to immunization guidelines might leave some communities vulnerable to outbreaks of vaccine-preventable diseases. To examine factors related to implementation of immunization delivery best practices, we analyzed responses to monthly surveys and debriefing interviews from 16 diverse pediatric practices engaged in a year-long virtual learning collaborative. The collaborative provided a toolkit, online learning sessions, performance feedback, and conference calls with a quality improvement coach. Participants used iterative plan-do-study-act cycles to implement self-selected changes in immunization practices. Descriptive statistics were applied to quantitative data; qualitative data were analyzed using a framework approach. Impediments to implementing guidelines included difficulties with electronic record systems, rigid management structures, competing priorities, and parental resistance. Facilitators included linkage with regional immunization registries, positive social interactions, and performance feedback. Findings suggest that improving immunization delivery requires not only awareness of recommendations and training in improvement methods but also efforts to ameliorate contextual factors that impede immunization delivery. PMID:26743455

  3. Building Perinatal Case Manager Capacity Using Quality Improvement

    PubMed Central

    Fitzgerald, Elaine

    2015-01-01

    ABSTRACT Improving breastfeeding rates among Black women is a potential strategy to address disparities in health outcomes that disproportionately impact Black women and children. This quality improvement (QI) initiative aimed to improve perinatal case manager knowledge and self-efficacy to promote breastfeeding among Black, low-income women who use services through Boston Healthy Start Initiative. QI methodology was used to develop and test a two-part strategy for perinatal case managers to promote and support breastfeeding. A positive change was observed in infant feeding knowledge and case manager self-efficacy to promote breastfeeding. Among the 24 mothers participating in this QI initiative, 100% initiated and continued breastfeeding at 1 week postpartum, and 92% were breastfeeding at 2 weeks postpartum. PMID:26937160

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

    PubMed

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

    2016-01-01

    In this quality improvement project, our health system developed a comprehensive, patient-centered approach to improving inpatient pain management and assessed its impact on patient satisfaction across 21 medical centers. Using human-centered design principles, a bundle of 6 individual and team nursing practices was developed. Patient satisfaction with pain management, as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems pain composite score, increased from the 25th to just under the 75th national percentile. PMID:26447343

  5. Ethnographic process evaluation of a quality improvement project to improve transitions of care for older people

    PubMed Central

    Sutton, Elizabeth; Dixon-Woods, Mary; Tarrant, Carolyn

    2016-01-01

    Objectives Quality improvement projects to address transitions of care across care boundaries are increasingly common but meet with mixed success for reasons that are poorly understood. We aimed to characterise challenges in a project to improve transitions for older people between hospital and care homes. Design Independent process evaluation, using ethnographic observations and interviews, of a quality improvement project. Setting and participants An English hospital and two residential care homes for older people. Data 32 hours of non-participant observations and 12 semistructured interviews with project members, hospital and care home staff. Results A hospital-based improvement team sought to reduce unplanned readmissions from residential care homes using interventions including a community-based geriatric team that could be accessed directly by care homes and a communication tool intended to facilitate transfer of information between homes and hospital. Only very modest (if any) impacts of these interventions on readmission rates could be detected. The process evaluation identified multiple challenges in implementing interventions and securing improvement. Many of these arose because of lack of consensus on the nature of the problem and the proper solutions: while the hospital team was keen to reduce readmissions and saw the problems as lying in poor communication and lack of community-based support for care homes, the care home staff had different priorities. Care home staff were unconvinced that the improvement interventions were aligned with their needs or addressed their concerns, resulting in compromised implementation. Conclusions Process evaluations have a valuable role in quality improvement. Our study suggests that a key task for quality improvement projects aimed at transitions of care is that of developing a shared view of the problem to be addressed. A more participatory approach could help to surface assumptions, interpretations and interests

  6. Improving urban air quality in China: Beijing case study

    SciTech Connect

    Jiming Hao; Litao Wang

    2005-09-01

    China is undergoing rapid urbanization because of unprecedented economic growth. As a result, many cities suffer from air pollution. Two-thirds of China's cities have not attained the ambient air quality standards applicable to urban residential areas (Grade II). Particulate matter (PM), rather than sulfur dioxide (SO{sub 2}), is the major pollutant reflecting the shift from coal burning to mixed source pollution. In 2002, 63.2 and 22.4% of the monitored cities have PM and SO{sub 2} concentrations exceeding the Grade II standard, respectively. Nitrogen oxides (NOx) concentration kept a relatively stable level near the Grade II standard in the last decade and had an increasing potential in recent years because of the rapid motorization. In general, the air pollutants emission did not increase as quickly as the economic growth and energy consumption, and air quality in Chinese cities has improved to some extent. Beijing, a typical representative of rapidly developing cities, is an example to illustrate the possible options for urban air pollution control. Beijing's case provides hope that the challenges associated with improving air quality can be met during a period of explosive development and motorization. 21 refs., 19 figs., 6 tabs.

  7. Geocoding coronial data: tools and techniques to improve data quality.

    PubMed

    Freestone, Darren; Williamson, Dianne; Wollersheim, Dennis

    2012-01-01

    Clinical, administrative and demographic health information is fundamental to understanding the nature of health and evaluating the effectiveness of efforts to reduce morbidity and mortality of the population. The demographic data item 'location' is an integral part of any injury surveillance tool or injury prevention strategy. The true value of location data can only be realised once these data have been appropriately classified and quality assured. Geocoding as a means of classifying location is increasingly used in various health fields to enable spatial analysis of data. This article reports on research carried out in Australia at the National Coroners Information System (NCIS). Trends in the use of NCIS location-based data by researchers were identified. The research also aimed to establish the factors that impacted on the quality of geocoded data and the extent of this impact. A systematic analysis of the geocoding process identified source documentation, data cleaning, and software settings as key factors impacting on data quality. Understanding and application of these processes can improve data quality and therefore inform the analysis and interpretation of these data by researchers. PMID:23087078

  8. Overarching goals: a strategy for improving healthcare quality and safety?

    PubMed

    Nanji, Karen C; Ferris, Timothy G; Torchiana, David F; Meyer, Gregg S

    2013-03-01

    The management literature reveals that many successful organisations have strategic plans that include a bold 'stretch-goal' to stimulate progress over a ten-to-thirty-year period. A stretch goal is clear, compelling and easily understood. It serves as a unifying focal point for organisational efforts. The ambitiousness of such goals has been emphasised with the phrase Big Hairy Audacious Goal ('BHAG'). President Kennedy's proclamation in 1961 that 'this Nation should commit itself to achieving the goal, before this decade is out, of landing a man on the moon and returning him safely to earth' provides a famous example. This goal energised the US National Aeronautics and Space Administration, and it captured the attention of the American public and resulted in one of the largest accomplishments of any organisation. The goal set by Sony, a small, cash-strapped electronics company in the 1950s, to change the poor image of Japanese products around the world represents a classic BHAG. Few examples of quality goals that conform to the BHAG definition exist in the healthcare literature. However, the concept may provide a useful framework for organisations seeking to transform the quality of care they deliver. This review examines the merits and cautions of setting overarching quality goals to catalyse quality improvement efforts, and assists healthcare organisations with determining whether to adopt these goals. PMID:23204514

  9. Improving the Effectiveness of Libraries through Improvements in the Quality of Working Life.

    ERIC Educational Resources Information Center

    Martell, Charles

    1981-01-01

    The implementation of work redesign techniques described or similar advanced methods of organization and work system design should allow academic libraries to respond more effectively to rapid changes in user demand and improve the quality of working life of their employees. Included are 44 references. (Author/RAA)

  10. Macromolecule Crystal Quality Improvement in Microgravity: The Role of Impurities

    NASA Technical Reports Server (NTRS)

    Judge, Russell A.; Snell, Edward H.; Pusey, Marc L.; Sportiello, Michael G.; Todd, Paul; Bellamy, Henry; Borgstahl, Gloria E.; Pokros, Matt; Cassanto, John M.

    2000-01-01

    While macromolecule impurities may affect crystal size and morphology the over-riding question is; "How do macromolecule impurities effect crystal X-ray quality and diffraction resolution?" In the case of chicken egg white lysozyme, crystals can be grown in the presence of a number of impurities without affecting diffraction resolution. One impurity however, the lysozyme dimer, does negatively impact the X-ray crystal properties. Crystal quality improvement as a result of better partitioning of this impurity during crystallization in microgravity has been reported'. In our recent experimental work dimer partitioning was found to be not significantly different between the two environments. Mosaicity analysis of pure crystals showed a reduced mosaicity and increased signal to noise for the microgravity grown crystals. Dimer incorporation however, did greatly reduce the resolution limit in both ground and microgravity grown crystals. These results indicate that impurity effects in microgravity are complex and may rely on the conditions or techniques employed.

  11. Improving Quality of Life and Depression After Stroke Through Telerehabilitation

    PubMed Central

    Linder, Susan M.; Rosenfeldt, Anson B.; Bay, R. Curtis; Sahu, Komal; Wolf, Steven L.

    2015-01-01

    OBJECTIVE. The aim of this study was to determine the effects of home-based robot-assisted rehabilitation coupled with a home exercise program compared with a home exercise program alone on depression and quality of life in people after stroke. METHOD. A multisite randomized controlled clinical trial was completed with 99 people <6 mo after stroke who had limited access to formal therapy. Participants were randomized into one of two groups, (1) a home exercise program or (2) a robot-assisted therapy + home exercise program, and participated in an 8-wk home intervention. RESULTS. We observed statistically significant changes in all but one domain on the Stroke Impact Scale and the Center for Epidemiologic Studies Depression Scale for both groups. CONCLUSION. A robot-assisted intervention coupled with a home exercise program and a home exercise program alone administered using a telerehabilitation model may be valuable approaches to improving quality of life and depression in people after stroke. PMID:26122686

  12. Quality improvement in nursing: Administrative mandate or professional responsibility?

    PubMed Central

    Izumi, Shigeko

    2012-01-01

    For professionals, providing quality service and striving for excellence are ethical responsibilities. In many hospitals in the U.S., however, there is evidence indicating current quality improvement (QI) involving nurses is not always driven by their professional accountability and professional values. QI has become more an administrative mandate than an ethical standard for nurses. In this paper, the tension between QI as nurses’ professional ethics and an administrative mandate will be described, and the implicit ideal-reality gap of QI will be examined. The threat to professional nursing posed by the current approach to QI will be examined, and ways to incorporate nursing professional values in a practical QI effort will be explored. PMID:23127240

  13. Palliative care in COPD: an unmet area for quality improvement.

    PubMed

    Vermylen, Julia H; Szmuilowicz, Eytan; Kalhan, Ravi

    2015-01-01

    COPD is a leading cause of morbidity and mortality worldwide. Patients suffer from refractory breathlessness, unrecognized anxiety and depression, and decreased quality of life. Palliative care improves symptom management, patient reported health-related quality of life, cost savings, and mortality though the majority of patients with COPD die without access to palliative care. There are many barriers to providing palliative care to patients with COPD including the difficulty in prognosticating a patient's course causing referrals to occur late in a patient's disease. Additionally, physicians avoid conversations about advance care planning due to unique communication barriers present with patients with COPD. Lastly, many health systems are not set up to provide trained palliative care physicians to patients with chronic disease including COPD. This review analyzes the above challenges, the available data regarding palliative care applied to the COPD population, and proposes an alternative approach to address the unmet needs of patients with COPD with proactive primary palliative care. PMID:26345486

  14. Infrastructure for Large-Scale Quality-Improvement Projects: Early Lessons from North Carolina Improving Performance in Practice

    ERIC Educational Resources Information Center

    Newton, Warren P.; Lefebvre, Ann; Donahue, Katrina E.; Bacon, Thomas; Dobson, Allen

    2010-01-01

    Introduction: Little is known regarding how to accomplish large-scale health care improvement. Our goal is to improve the quality of chronic disease care in all primary care practices throughout North Carolina. Methods: Methods for improvement include (1) common quality measures and shared data system; (2) rapid cycle improvement principles; (3)…

  15. AN OPERATIONAL EVALUATION OF THE ETA-CMAQ AIR QUALITY FORECAST MODEL

    EPA Science Inventory

    The National Oceanic and Atmospheric Administration (NOAA), in collaboration with the Environmental Protection Agency (EPA), are developing an Air Quality Forecasting Program that will eventually result in an operational Nationwide Air Quality Forecasting System. The initial pha...

  16. Implementing change in perfusion practice: quality improvement vs. experimentation?

    PubMed

    Newland, Richard F; Baker, Robert A

    2009-12-01

    The desire to optimize techniques and interventions that comprise clinical practice will inevitably involve the implementation of change in the process of care. To confirm the intended benefits of instituting clinical change, the process should be undertaken in a scientific manner. Although implementing changes in perfusion practice is limited by the availability of evidence based practice guidelines, we have the opportunity to audit our current practice according to institutional guidelines using quality improvement methods. Current electronic data collection technology is a useful tool available to facilitate the reporting of both clinical and process outcome improvements. The model of clinical effectiveness can be used as a systematic approach to introducing change in clinical practice, which involves reviewing the literature, acquiring appropriate skills and resources, auditing the change, and implementing continuous quality improvement to standardize the process. Finally, reporting the findings allows dissemination of the knowledge that can be generalized. Reporting change strengthens our efforts in clinical effectiveness, highlights the importance of perfusion practice, and increases the influence of the profession. PMID:20092082

  17. Performance indicators: A tool for continuous quality improvement

    PubMed Central

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

    2016-01-01

    Background: Performance monitoring is an important tool which can be used for setting priorities for process improvement. At our centre, we have been monitoring every step in the processes, right from inventory of consumables (both critical and routine) to number of donors reactive for TTI. We conducted a study to measure the impact of monitoring Performance Indicators and how it could be used as a tool for Continuous Quality Improvement (CQI). Materials and Methods: The present study was a retrospective study where the performance indicator (PI) data of blood bank was analyzed for over four years. For certain parameters, benchmarks or thresholds were set that represented warning limits or action limits. The yearly data were collated from monthly data. Shifts or Trends, if any, were identified and Corrective and Preventive Action (CAPA) taken accordingly. At the end, outcomes of the analysis were charted. Results: After the yearly data evaluation, outcomes obtained were used to plan, correct and amend processes and systems in the blood center. It was observed that the workload of the center showed an upward trend. This helped us to plan for the purchase of consumables and management of manpower. The monitoring of usage and discard of blood helped in the efficient management of blood stocks. The need for any new equipment could also be judged by the trends in workload. Conclusion: Performance indicators are indispensible tools which various stakeholders in the Blood Transfusion centres should implement to improve on quality performance. PMID:27011669

  18. Improved Nominal Operating Cell Temperature (NOCT) test procedure

    NASA Technical Reports Server (NTRS)

    Wen, L.; Berns, D.

    1984-01-01

    A procedure is developed to improve testing of Nominal Operating Cell Temperature (NOCT) as it applies to solar energy conversion modules. NOCT is a direct reflection of module thermal design and is closely related to the representative ambient temperature. It is also a key to array energy production and estimates of module lifetimes. Present NOCT test and evaluation procedures are inconsistent, producing significant scatter. Test refinements would specify a clear sky, the addition of 10% to the insolation level for ground reflection, the addition of a ground emission factor of 0.8 (at 30C ground temperature), an effective wind direction of 135 degrees from the North, and a module tilt of 30 degrees from the horizon.

  19. Automatisms in EMIR instrument to improve operation, safety and maintenance

    NASA Astrophysics Data System (ADS)

    Fernández Izquierdo, Patricia; Núñez Cagigal, Miguel; Barreto Rodríguez, Roberto; Martínez Rey, Noelia; Santana Tschudi, Samuel; Barreto Cabrera, Maria; Patrón Recio, Jesús; Garzón López, Francisco

    2014-08-01

    EMIR is the NIR imager and multiobject spectrograph being built as a common user instrument for the 10-m class GTC. Big cryogenic instruments demand a reliable design and a specific hardware and software to increase its safety and productivity. EMIR vacuum, cooling and heating systems are monitored and partially controlled by a Programmable Logic Controller (PLC) in industrial format with a touch screen. The PLC aids the instrument operator in the maintenance tasks recovering autonomously vacuum if required or proposing preventive maintenance actions. The PLC and its associated hardware improve EMIR safety having immediate reactions against eventual failure modes in the instrument or in external supplies, including hardware failures during the heating procedure or failure in the PLC itself. EMIR PLC provides detailed information periodically about status and alarms of vacuum and cooling components or external supplies.

  20. TBDQ: A Pragmatic Task-Based Method to Data Quality Assessment and Improvement.

    PubMed

    Vaziri, Reza; Mohsenzadeh, Mehran; Habibi, Jafar

    2016-01-01

    Organizations are increasingly accepting data quality (DQ) as a major key to their success. In order to assess and improve DQ, methods have been devised. Many of these methods attempt to raise DQ by directly manipulating low quality data. Such methods operate reactively and are suitable for organizations with highly developed integrated systems. However, there is a lack of a proactive DQ method for businesses with weak IT infrastructure where data quality is largely affected by tasks that are performed by human agents. This study aims to develop and evaluate a new method for structured data, which is simple and practical so that it can easily be applied to real world situations. The new method detects the potentially risky tasks within a process, and adds new improving tasks to counter them. To achieve continuous improvement, an award system is also developed to help with the better selection of the proposed improving tasks. The task-based DQ method (TBDQ) is most appropriate for small and medium organizations, and simplicity in implementation is one of its most prominent features. TBDQ is case studied in an international trade company. The case study shows that TBDQ is effective in selecting optimal activities for DQ improvement in terms of cost and improvement. PMID:27192547

  1. TBDQ: A Pragmatic Task-Based Method to Data Quality Assessment and Improvement

    PubMed Central

    Vaziri, Reza; Mohsenzadeh, Mehran; Habibi, Jafar

    2016-01-01

    Organizations are increasingly accepting data quality (DQ) as a major key to their success. In order to assess and improve DQ, methods have been devised. Many of these methods attempt to raise DQ by directly manipulating low quality data. Such methods operate reactively and are suitable for organizations with highly developed integrated systems. However, there is a lack of a proactive DQ method for businesses with weak IT infrastructure where data quality is largely affected by tasks that are performed by human agents. This study aims to develop and evaluate a new method for structured data, which is simple and practical so that it can easily be applied to real world situations. The new method detects the potentially risky tasks within a process, and adds new improving tasks to counter them. To achieve continuous improvement, an award system is also developed to help with the better selection of the proposed improving tasks. The task-based DQ method (TBDQ) is most appropriate for small and medium organizations, and simplicity in implementation is one of its most prominent features. TBDQ is case studied in an international trade company. The case study shows that TBDQ is effective in selecting optimal activities for DQ improvement in terms of cost and improvement. PMID:27192547

  2. Can mental healthcare nurses improve sleep quality for inpatients?

    PubMed

    de Niet, Gerrit; Tiemens, Bea; Hutschemaekers, Giel

    This article describes a pilot study that was carried out to in order to gain an indication as to whether mental healthcare nurses can apply evidence-based interventions for sleep problems effectively in inpatient mental health care. The study had a pre-test/post-test design and a comparison group was used. The study was performed on three psychiatric admission wards, located in three different towns in one province of The Netherlands. The participants were inpatients (18-60 years old) admitted owing to severe mental health problems like psychotic, mood or anxiety disorders. Of the newly admitted patients, 62.8% perceived having a sleep problem. Two brief, evidence-based interventions were introduced on two of the wards: the first with stimulus control (SC) as active component; the second with music-assisted relaxation (MAR). A third ward, with no interventions other than usual care, served as a point of comparison. Sleep quality was monitored using the Richards-Campbell Sleep Questionnaire (RCSQ). The change score means of the treatment groups were compared with the mean score of the comparison group by means of a t-test. Estimates of effect were calculated. The results of this study showed that MAR produced a statistically significant improvement of sleep quality and showed a large effect size. The total RCSQ score did not improve significantly. SC failed to produce statistically significant improvement of sleep quality, nor of the RCSQ total score. This pilot study provided a strong indication that mental health nurses can apply MAR effectively. No such indication was found for stimulus control. PMID:20871513

  3. Using Vision System Technologies to Enable Operational Improvements for Low Visibility Approach and Landing Operations

    NASA Technical Reports Server (NTRS)

    Kramer, Lynda J.; Ellis, Kyle K. E.; Bailey, Randall E.; Williams, Steven P.; Severance, Kurt; Le Vie, Lisa R.; Comstock, James R.

    2014-01-01

    Flight deck-based vision systems, such as Synthetic and Enhanced Vision System (SEVS) technologies, have the potential to provide additional margins of safety for aircrew performance and enable the implementation of operational improvements for low visibility surface, arrival, and departure operations in the terminal environment with equivalent efficiency to visual operations. To achieve this potential, research is required for effective technology development and implementation based upon human factors design and regulatory guidance. This research supports the introduction and use of Synthetic Vision Systems and Enhanced Flight Vision Systems (SVS/EFVS) as advanced cockpit vision technologies in Next Generation Air Transportation System (NextGen) operations. Twelve air transport-rated crews participated in a motion-base simulation experiment to evaluate the use of SVS/EFVS in NextGen low visibility approach and landing operations. Three monochromatic, collimated head-up display (HUD) concepts (conventional HUD, SVS HUD, and EFVS HUD) and two color head-down primary flight display (PFD) concepts (conventional PFD, SVS PFD) were evaluated in a simulated NextGen Chicago O'Hare terminal environment. Additionally, the instrument approach type (no offset, 3 degree offset, 15 degree offset) was experimentally varied to test the efficacy of the HUD concepts for offset approach operations. The data showed that touchdown landing performance were excellent regardless of SEVS concept or type of offset instrument approach being flown. Subjective assessments of mental workload and situation awareness indicated that making offset approaches in low visibility conditions with an EFVS HUD or SVS HUD may be feasible.

  4. Lead/acid batteries in systems to improve power quality

    NASA Astrophysics Data System (ADS)

    Taylor, P.; Butler, P.; Nerbun, W.

    Increasing dependence on computer technology is driving needs for extremely high-quality power to prevent loss of information, material, and workers' time that represent billions of dollars annually. This cost has motivated commercial and Federal research and development of energy storage systems that detect and respond to power-quality failures in milliseconds. Electrochemical batteries are among the storage media under investigation for these systems. Battery energy storage systems that employ either flooded lead/acid or valve-regulated lead/acid battery technologies are becoming commercially available to capture a share of this emerging market. Cooperative research and development between the US Department of Energy and private industry have led to installations of lead/acid-based battery energy storage systems to improve power quality at utility and industrial sites and commercial development of fully integrated, modular battery energy storage system products for power quality. One such system by AC Battery Corporation, called the PQ2000, is installed at a test site at Pacific Gas and Electric Company (San Ramon, CA, USA) and at a customer site at Oglethorpe Power Corporation (Tucker, GA, USA). The PQ2000 employs off-the-shelf power electronics in an integrated methodology to control the factors that affect the performance and service life of production-model, low-maintenance, flooded lead/acid batteries. This system, and other members of this first generation of lead/acid-based energy storage systems, will need to compete vigorously for a share of an expanding, yet very aggressive, power quality market.

  5. Sleep Quality Improves During Treatment With Bryophyllum pinnatum

    PubMed Central

    Hassani, Taziri Al; Müller-Hübenthal, Boris; Pittl, Sandra; Kuck, Angela; Meden, Harald; Eberhard, Jutta; Decker, Michael; Fürer, Karin; von Mandach, Ursula

    2015-01-01

    Hypothesis. Cancer patients frequently suffer from poor sleep quality. Bryophyllum pinnatum is a herbal medication used in anthroposophic medicine, which has been shown to be associated with improvements in sleep quality during pregnancy with only few and minor or moderate side-effects reported. In this study, the sleep quality of cancer patients during treatment with B pinnatum was investigated. Study Design. In this prospective, observational study, cancer patients suffering from sleep problems were treated with B pinnatum (350 mg tablets, corresponding to 50% of leaf pressed juice [Weleda AG, Arlesheim, Switzerland], dosage at physician’s consideration, but most frequently 2 tablets with evening meal and 2 before going to bed). Methods. Sleep quality (Pittsburgh Sleep Quality Index [PSQI]), daily sleepiness (Epworth Sleeping Scale [ESS]), and fatigue (Fatigue Severity Scale [FSS]) were assessed at the beginning of the treatment and after 3 weeks. Possible adverse drug reactions perceived by the patients during the treatment were recorded. From the 28 recruited patients, 20 completed both questionnaires and were considered in the present analysis. Data are expressed as mean ± standard deviation. Results. Patients were 61 ± 10.4 years old and the majority were female (17 out of 20). During treatment with B pinnatum, the PSQI decreased from 12.2 ± 3.62 to 9.1 ± 3.61 (P < .01), and ESS changed from 8.4 ± 3.18 to 7.1 ± 3.98 (P < .05). There was no change in FSS. The treatment was well tolerated by the majority of patients, with only 6 patients reporting discomfort that might have been caused by B pinnatum (fatigue n = 3, dry throat n = 1, agitation n = 1, difficult digestion n = 1). No serious adverse drug reactions were detected. Conclusion. B pinnatum may be a suitable treatment for sleep problems of cancer patients. Controlled, randomized clinical trials of the use of B pinnatum in sleep disorders are urgently needed. PMID:25873294

  6. Building knowledge for quality improvement in healthcare: an introductory glossary.

    PubMed

    Batalden, P B

    1991-01-01

    At the heart of organization-wide quality improvement in healthcare is the need to build knowledge for improvement that complements the subject matter knowledge of healthcare. Dr. W. Edwards Deming, the quality improvement pioneer, has suggested that "profound knowledge," or knowledge required for improvement, consists of four basic dimensions: Knowledge of the organization as a system. At its heart this knowledge is an understanding of the methods of production, the methods of improvement, and the aim of the entire enterprise. This concept was first presented by Deming at Mount Hakone, Japan, in 1950. In his book Out of the Crisis (1986), Deming illustrates the organization as a system. Knowledge of variation. This understanding comes from the awareness that a system of causes is at work producing any result. These sources of the variation, which can be observed in any process, are what must be acted upon to improve the results of the process. Studying the variation in a process can provide clues to the most economical actions that managers can take for improvement. It involves knowledge of the difference between common and special cause variation. Knowledge of psychology. The focus is on an awareness of the power of intrinsic motivation, a sense of self-worth and pride in what is done in the workplace. Theory of knowledge. How is new knowledge built? What is the purpose of knowledge? What is the nature of knowledge? Unless these issues are clear, it will not be easy to build useful knowledge. Deming has provided further insight into this framework in a recent unpublished essay and is currently working to further expand these concepts in additional publications in preparation. This framework helps build the knowledge necessary for the improvement of healthcare. As you work to build that knowledge, however, you will confront a wide variety of terms and a language that may in some ways be unfamiliar. In recognition of that, an introductory glossary is offered for

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

    PubMed

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

    2016-01-01

    This article examines issues related to sustaining Quality Improvement (QI) initiatives in a Canadian subacute care hospital and recommends strategies to address them. The authors define two levels of sustainability, the QI project and the corporate/organizational and how they influence a LEADS (Lead Self, Engage Others, Achieve Results, Develop Coalition and System Transformation) culture. The authors then reflect on the differing factors for QI sustainability and present them under five essential categories of accountability, education, communication, monitoring and reporting, and structure and processes. PMID:26656388

  8. Smart homes to improve the quality of life for all.

    PubMed

    Aiello, Marco; Aloise, Fabio; Baldoni, Roberto; Cincotti, Febo; Guger, Christoph; Lazovik, Alexander; Mecella, Massimo; Pucci, Paolo; Rinsma, Johanna; Santucci, Giuseppe; Taglieri, Massimiliano

    2011-01-01

    A home is smart when, being aware of its own state and that of its users, is capable of controlling itself in order to support the user wishes and thus improving their quality of life. This holds both for users with special needs and for those with ordinary domestic needs. In this paper, we overview the Smart Homes for All project which represents the current state of the art with respect to software control and user interfaces in the smart homes arena. PMID:22254672

  9. FIELD QUALITY IMPROVEMENTS IN SUPERCONDUCTING MAGNETS FOR RHIC.

    SciTech Connect

    GUPTA,R.; JAIN,A.; KAHN,S.; MORGAN,G.; THOMPSON,P.; WANDERER,P.; WILLEN,E.

    1994-06-27

    A number of techniques have been developed and tested to improve the field quality in the superconducting dipole and quadrupole magnets to be used in the Relativistic Heavy Ion Collider (RHIC). These include adjustment in the coil midplane gap to compensate for the allowed and non-allowed harmonics, inclusion of holes and cutouts in the iron yoke to reduce the saturation-induced harmonics, and magnetic tuning shims to correct for the residual errors. We compare the measurements with the calculations to test the validity of these concepts.

  10. [Financial incentives in improving healthcare quality. SESPAS Report 2012].

    PubMed

    Eirea Eiras, Carlos; Ortún Rubio, Vicente

    2012-03-01

    We address the contribution of financial incentives linked to pay for performance (P4P) to improving the quality of care. The situation of P4P is analyzed internationally and in the distinct health services in Spain. The participation of P4P in wage compensation and the effects of the current economic crisis on these incentives is discussed. We review the results of recent studies to clarify the role of these incentive models and assess possible orientations and new proposals. PMID:22305515

  11. Air Quality in Mexico City: Policies Implemented for its Improvement

    NASA Astrophysics Data System (ADS)

    Paramo, V.

    2007-12-01

    Ozone and suspended particles (PM) are two pollutants in the atmosphere of Mexico City Metropolitan Area (MCMA) that still exceed the recommended Mexican health standards. The other criteria pollutants very seldom exceed their corresponding standards. In 2006, the maximum ozone concentrations were above the health standard (0.11 ppm in 1 hour) during 59 percent of the days for an average of 2.2 hours and 130 points of the Air Quality Index (Índice Metropolitano de la Calidad del Aire - IMECA). In contrast, in 1991, 98 percent of the days exceeded the ozone health standard for an average of 6.6 hours and 200 IMECA points. With regards to PM10, in 2006, 80 percent of the sampled concentrations were below the health standard of 120 µg/m3 in 24 hours. However, the annual health standard of 50 µg/m3 is still exceeded. The air quality management in the MCMA is a difficult task due to several adverse factors. The main one is the large population that increased from nearly 15 million in 1992 to more than 18 million at present. As a result, the urban area grows in the adjoined municipalities of the State of Mexico. The vehicular fleet increases also to almost 4 million and the number of industrial facilities is at present 50,000. Consequently, the fuel consumption is very high. The daily energy consumption is estimated to be 44 million liters of equivalent of gasoline. Despite the fact that the air quality has improved in recent years, the related health standards are still exceeded and therefore it is necessary to continue applying the most cost-effective actions to improve the environment quality. Some actions that have contributed most to the reduction of pollutant emissions are the following: Continuous update of the inspection and maintenance program of the vehicular fleet; substitution of the catalytic converters at the end of their useful life; self-regulation of the diesel fleet; use of alternative fuels; update the No-Driving-Day program; establishment of more

  12. Improving operational anodising process performance using simulation approach

    SciTech Connect

    Liong, Choong-Yeun Ghazali, Syarah Syahidah

    2015-10-22

    The use of aluminium is very widespread, especially in transportation, electrical and electronics, architectural, automotive and engineering applications sectors. Therefore, the anodizing process is an important process for aluminium in order to make the aluminium durable, attractive and weather resistant. This research is focused on the anodizing process operations in manufacturing and supplying of aluminium extrusion. The data required for the development of the model is collected from the observations and interviews conducted in the study. To study the current system, the processes involved in the anodizing process are modeled by using Arena 14.5 simulation software. Those processes consist of five main processes, namely the degreasing process, the etching process, the desmut process, the anodizing process, the sealing process and 16 other processes. The results obtained were analyzed to identify the problems or bottlenecks that occurred and to propose improvement methods that can be implemented on the original model. Based on the comparisons that have been done between the improvement methods, the productivity could be increased by reallocating the workers and reducing loading time.

  13. Operation of a tokamak reactor in the radiative improved mode

    NASA Astrophysics Data System (ADS)

    Morozov, D. Kh.; Mavrin, A. A.

    2016-03-01

    The operation of a nuclear fusion reactor has been simulated within a model based on experimental results obtained at the TEXTOR-94 tokamak and other facilities in which quasistationary regimes were achieved with long confinement times, high densities, and absence of the edge-localized mode. The radiative improved mode of confinement studied in detail at the TEXTOR-94 tokamak is the most interesting such regime. One of the most important problems of modern tokamaks is the problem of a very high thermal load on a divertor (or a limiter). This problem is quite easily solved in the radiative improved mode. Since a significant fraction of the thermal energy is reemitted by an impurity, the thermal loading is significantly reduced. As the energy confinement time τ E at high densities in the indicated mode is significantly larger than the time predicted by the scaling of ITERH-98P(y, 2), ignition can be achieved in a facility much smaller than the ITER facility at plasma temperatures below 20 keV. The revealed decrease in the degradation of the confinement time τ E with an increase in the introduced power has been analyzed.

  14. Improving operational anodising process performance using simulation approach

    NASA Astrophysics Data System (ADS)

    Liong, Choong-Yeun; Ghazali, Syarah Syahidah

    2015-10-01

    The use of aluminium is very widespread, especially in transportation, electrical and electronics, architectural, automotive and engineering applications sectors. Therefore, the anodizing process is an important process for aluminium in order to make the aluminium durable, attractive and weather resistant. This research is focused on the anodizing process operations in manufacturing and supplying of aluminium extrusion. The data required for the development of the model is collected from the observations and interviews conducted in the study. To study the current system, the processes involved in the anodizing process are modeled by using Arena 14.5 simulation software. Those processes consist of five main processes, namely the degreasing process, the etching process, the desmut process, the anodizing process, the sealing process and 16 other processes. The results obtained were analyzed to identify the problems or bottlenecks that occurred and to propose improvement methods that can be implemented on the original model. Based on the comparisons that have been done between the improvement methods, the productivity could be increased by reallocating the workers and reducing loading time.

  15. Improving HIV outcomes in resource-limited countries: the importance of quality indicators

    PubMed Central

    2012-01-01

    Background Resource-limited countries increasingly depend on quality indicators to improve outcomes within HIV treatment programs, but indicators of program performance suitable for use at the local program level remain underdeveloped. Methods Using the existing literature as a guide, we applied standard quality improvement (QI) concepts to the continuum of HIV care from HIV diagnosis, to enrollment and retention in care, and highlighted critical service delivery process steps to identify opportunities for performance indicator development. We then identified existing indicators to measure program performance, citing examples used by pivotal donor agencies, and assessed their feasibility for use in surveying local program performance. Clinical delivery steps without existing performance measures were identified as opportunities for measure development. Using National Quality Forum (NQF) criteria as a guide, we developed measurement concepts suitable for use at the local program level that address existing gaps in program performance assessment. Results This analysis of the HIV continuum of care identified seven critical process steps providing numerous opportunities for performance measurement. Analysis of care delivery process steps and the application of NQF criteria identified 24 new measure concepts that are potentially useful for improving operational performance in HIV care at the local level. Conclusion An evidence-based set of program-level quality indicators is critical for the improvement of HIV care in resource-limited settings. These performance indicators should be utilized as treatment programs continue to grow. PMID:23176556

  16. Multi-hospital Community NICU Quality Improvement Improves Survival of ELBW Infants.

    PubMed

    Owens, Jack D; Soltau, Thomas; McCaughn, Danny; Miller, Jason; O'Mara, Patrick; Robbins, Kenny; Temple, David M; Wender, David F

    2015-08-01

    Quality improvement or high reliability in medicine is an evolving science where we seek to integrate evidence-based medicine, structural resources, process management, leadership models, culture, and education. Newborn Associates is a community-based neonatology practice that staffs and manages neonatal intensive care units (NICU's) at Central Mississippi Medical Center, Mississippi Baptist Medical Center, River Oaks Hospital, St Dominic's Hospital and Woman's Hospital within the Jackson, Mississippi, metropolitan area. These hospitals participate in the Vermont-Oxford Neonatal Network (VON), which is a voluntary national network of about 1000 NICU groups that submit data allowing them to benchmark their patient outcome. This network currently holds data on 1.5 million infants. Participation may also include the Newborn Improvement Quality Collaborative (NICQ) which is an intensive quality improvement program where 40-60 of the almost 1000 VON centers participate each year or the iNICQ, which is an internet-based collaborative involving about 150 centers per year. From 2008-2009, our group concentrated efforts on quality improvement which included consolidating resources of three corporately managed hospitals to allow focused care of babies under 800-1000 grams at a single center, expanding participation in the VON NICQ to include all physicians and centers, and establishing a group QI focused committee aimed at sharing practice bundles and adopting quality improvement methodology. The goal of this article is to report the impact of these QI activities on survival of the smallest preterm infants who weigh less than 1500 grams at birth. Two epochs were compared: 2006-2009, and 2010-2013. 551 VLBW (< 1 500 grams) infants from epoch I were compared to 583 VLBW infants from epoch 2. Mortality in this group decreased from 18% to 11.1% (OR 0.62,95% CI 0.44-0.88). Mortality in the 501-750 grams birth weight category decreased from 45.7% to 18% (OR 0.39,95% CI 0

  17. Improving Forecast Skill by Assimilation of Quality Controlled AIRS Version 5 Temperature Soundings

    NASA Technical Reports Server (NTRS)

    Susskind, Joel; Reale, Oreste

    2009-01-01

    The AIRS Science Team Version 5 retrieval algorithm has been finalized and is now operational at the Goddard DAAC in the processing (and reprocessing) of all AIRS data. The AIRS Science Team Version 5 retrieval algorithm contains two significant improvements over Version 4: 1) Improved physics allows for use of AIRS observations in the entire 4.3 micron CO2 absorption band in the retrieval of temperature profile T(p) during both day and night. Tropospheric sounding 15 micron CO2 observations are now used primarily in the generation of cloud cleared radiances R(sub i). This approach allows for the generation of accurate values of R(sub i) and T(p) under most cloud conditions. 2) Another very significant improvement in Version 5 is the ability to generate accurate case-by-case, level-by-level error estimates for the atmospheric temperature profile, as well as for channel-by-channel error estimates for R(sub i). These error estimates are used for Quality Control of the retrieved products. We have conducted forecast impact experiments assimilating AIRS temperature profiles with different levels of Quality Control using the NASA GEOS-5 data assimilation system. Assimilation of Quality Controlled T(p) resulted in significantly improved forecast skill compared to that obtained from analyses obtained when all data used operationally by NCEP, except for AIRS data, is assimilated. We also conducted an experiment assimilating AIRS radiances uncontaminated by clouds, as done operationally by ECMWF and NCEP. Forecast resulting from assimilated AIRS radiances were of poorer quality than those obtained assimilating AIRS temperatures.

  18. Quality Improvement With Discrete Event Simulation: A Primer for Radiologists.

    PubMed

    Booker, Michael T; O'Connell, Ryan J; Desai, Bhushan; Duddalwar, Vinay A

    2016-04-01

    The application of simulation software in health care has transformed quality and process improvement. Specifically, software based on discrete-event simulation (DES) has shown the ability to improve radiology workflows and systems. Nevertheless, despite the successful application of DES in the medical literature, the power and value of simulation remains underutilized. For this reason, the basics of DES modeling are introduced, with specific attention to medical imaging. In an effort to provide readers with the tools necessary to begin their own DES analyses, the practical steps of choosing a software package and building a basic radiology model are discussed. In addition, three radiology system examples are presented, with accompanying DES models that assist in analysis and decision making. Through these simulations, we provide readers with an understanding of the theory, requirements, and benefits of implementing DES in their own radiology practices. PMID:26922594

  19. Improving Efficiency and Quality in a Computerized ICU

    PubMed Central

    Bradshaw, Karen E.; Sittig, Dean F.; Gardner, Reed M.; Pryor, T. Allan; Budd, Marge

    1988-01-01

    Ongoing efforts have been made to improve the efficiency and quality of care available in ICU's at LDS Hospital. ICU's have been computerized, and patient data collection, storage and presentation have been improved. Nurse care plans and charting have been computerized, and effects of these changes have been evaluated. Work sampling studies showed a decrease in direct patient care (49.1% to 43.2%) and an increase in nurse charting (18.2% to 24.2%) after implementation of computerized nurse charting. These changes were accounted for by a decrease in patient severity of illness. Implementation of the computerized nurse charting system had no significant impact on daily ICU nursing activities. Time savings are not automatic, but could be realized through management practices designed to maximize benefits of the nurse charting system and to make best use of available nursing resources.

  20. Prevention of orthopaedic wound infections: a quality improvement project.

    PubMed

    Douglas, P; Asimus, M; Swan, J; Spigelman, A

    2001-12-01

    Using clinical practice improvement methodology, a project was undertaken to reduce the incidence of surgical wound infections following elective hip and knee replacement surgery. A team was established, key measures for improvement were identified, strategies for change were developed and an action plan was implemented. Outcomes for this project included a reduction in the rate of clean surgical wound infection for joint replacement surgery from 28% to zero. Average length of stay for total hip replacement surgery was reduced from 13.9 to 9.3 days and from 14.6 to 10.4 days for total knee replacement surgery. Guidelines for patient selection were developed along with a protocol for the management of preparation to prevent urinary tract infections. Post-discharge surveillance and a preoperative rehabilitation and exercise programme have been implemented. There is potential for wider uptake and implementation of the quality principles described herein. PMID:11856413

  1. Perfusion Quality Improvement and the Reduction of Clinical Variability

    PubMed Central

    Stammers, Alfred H.; Trowbridge, Cody C.; Pezzuto, James; Casale, Alfred

    2009-01-01

    Abstract: The purpose of this study was to describe the development and utilization of a perfusion quality improvement program to reduce perfusion-to-perfusion variability in a large multi-center perfusion practice. Phase I of the study included the establishment of a perfusion database using standard spreadsheet format to serve multiple administrative functions including patient and procedure sequencing, predictive algorithms for yearly caseload, summary statistics, and inter-perfusionist comparison. The database used 236 separate variables, including demographic and clinical procedure-related categories. Forty of these variables are modifiable by perfusion interaction as established via protocol and algorithm. Phase II of the study used a perfusion electronic data recording system to automatically obtain patient data from physiologic monitors and the heart-lung machine. Data were transferred to a central database for perfusionist comparison. Data analysis used logical functions and macros programming, and statistical analysis used both parametric and non-parametric models within the program. Each quarter all variables underwent analysis with summary data established for the most recent 225 patients undergoing CPB. Twenty-five cases from each perfusionist (n = 9) were compared with the aggregate data of the entire staff, with reference to previous quarter’s summary statistics. The results were discussed in monthly staff meetings and methods for improving compliance were discussed. Individual variation (p < .01) varied in 17 of 40 variables (26.0 ± 8.6), with quarterly improvement (27.4 ± 2.3 vs. 24.2 ± 2.1 vs. 17.0 ± 2.1) demonstrated in seven of nine individuals. In Phase II, performance was analyzed using the same variables as in Phase I but it also included the electronically recorded data from which 27 core measures were derived. All results were discussed with the staff at monthly departmental quality improvement meetings. The perfusion quality

  2. All teach, all learn, all improve?: The role of interorganizational learning in quality improvement collaboratives

    PubMed Central

    Nembhard, Ingrid M.

    2016-01-01

    Background Quality improvement collaboratives are an increasingly common strategy for implementing evidence-based practices in health care. However, research shows that many participating organizations do not achieve the level of performance improvement desired. Purpose This study examined the use of interorganizational learning activities (inter-OLAs) as an explanation for mixed performance improvement among collaborative participants. We tested the hypotheses that inter-OLA use is positively associated with participants’ performance improvement and that this relationship is moderated by the use of intraorganizational learning activities (intra-OLAs) and quality-focused human resource (Q-HR) practices. Methodology We conducted a survey of organizational teams participating in 4 Institute for Healthcare Improvement Breakthrough Series collaboratives. Survey responses from 52 teams, regarding the use of inter-OLAs, intra-OLAs and Q-HR practices, were linked to performance improvement data obtained from the Institute for Healthcare Improvement and demographic data obtained from secondary sources. Findings The more collaborative teams used inter-OLAs, the more their organizations’ performance improved. Contrary to our hypothesis, the use of intra-OLAs did not moderate this relationship; teams’ use of intra-OLAs added to, but did not multiply, the effect of inter-OLA use. In contrast, an organization's use of Q-HR practices multiplied the performance benefit of inter-OLA use. Practice Implications Our findings suggest that organizations that participate in collaboratives are more likely to improve their performance if they use the inter-OLAs offered by the collaborative. Our results also suggest that complementing high use of inter-OLAs with intra-OLA use and Q-HR practices enhances performance improvement. For collaborative sponsors, our findings imply that including activities that facilitate interorganizational and intraorganizational learning are worthwhile

  3. Laboratory system strengthening and quality improvement in Ethiopia

    PubMed Central

    Hiwotu, Tilahun M.; Ayana, Gonfa; Mulugeta, Achamyeleh; Kassa, Getachew B.; Kebede, Yenew; Fonjungo, Peter N.; Tibesso, Gudeta; Desale, Adino; Kebede, Adisu; Kassa, Wondwossen; Mekonnen, Tesfaye; Yao, Katy; Luman, Elizabeth T.; Kebede, Amha; Linde, Mary K.

    2015-01-01

    Background In 2010, a National Laboratory Strategic Plan was set forth in Ethiopia to strengthen laboratory quality systems and set the stage for laboratory accreditation. As a result, the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme was initiated in 45 Ethiopian laboratories. Objectives This article discusses the implementation of the programme, the findings from the evaluation process and key challenges. Methods The 45 laboratories were divided into two consecutive cohorts and staff from each laboratory participated in SLMTA training and improvement projects. The average amount of supportive supervision conducted in the laboratories was 68 hours for cohort I and two hours for cohort II. Baseline and exit audits were conducted in 44 of the laboratories and percent compliance was determined using a checklist with scores divided into zero- to five-star rating levels. Results Improvements, ranging from < 1 to 51 percentage points, were noted in 42 laboratories, whilst decreases were recorded in two. The average scores at the baseline and exit audits were 40% and 58% for cohort I (p < 0.01); and 42% and 53% for cohort II (p < 0.01), respectively. The p-value for difference between cohorts was 0.07. At the exit audit, 61% of the first and 48% of the second cohort laboratories achieved an increase in star rating. Poor awareness, lack of harmonisation with other facility activities and the absence of a quality manual were challenges identified. Conclusion Improvements resulting from SLMTA implementation are encouraging. Continuous advocacy at all levels of the health system is needed to ensure involvement of stakeholders and integration with other improvement initiatives and routine activities. PMID:26753129

  4. How Improving Practice Relationships Among Clinicians and Nonclinicians Can Improve Quality in Primary Care

    PubMed Central

    Lanham, Holly J.; McDaniel, Reuben R.; Crabtree, Benjamin F.; Miller, William L.; Stange, Kurt C.; Tallia, Alfred F.; Nutting, Paul A.

    2010-01-01

    Background Understanding the role of relationships in health care organizations (HCOs) offers opportunities for shaping health care delivery. When quality is treated as a property arising from the relationships within HCOs, then different contributors of quality can be investigated and more effective strategies for improvement can be developed. Methods Data were drawn from four large National Institutes of Health (NIH)–funded studies, and an iterative analytic strategy and a grounded theory approach were used to understand the characteristics of relationships within primary care practices. This multimethod approach amassed rich and comparable data sets in all four studies, which were all aimed at primary care practice improvement. The broad range of data included direct observation of practices during work activities and of patient-clinician interactions, in-depth interviews with physicians and other key staff members, surveys, structured checklists of office environments, and chart reviews. Analyses focused on characteristics of relationships in practices that exhibited a range of success in achieving practice improvement. Complex adaptive systems theory informed these analyses. Findings Trust, mindfulness, heedfulness, respectful interaction, diversity, social/task relatedness, and rich/lean communication were identified as important in practice improvement. A model of practice relationships was developed to describe how these characteristics work together and interact with reflection, sensemaking, and learning to influence practice-level quality outcomes. Discussion Although this model of practice relationships was developed from data collected in primary care practices, which differ from other HCOs in some important ways, the ideas that quality is emergent and that relationships influence quality of care are universally important for all HCOs and all medical specialties. PMID:19769206

  5. Data Mining Methods Applied to Flight Operations Quality Assurance Data: A Comparison to Standard Statistical Methods

    NASA Technical Reports Server (NTRS)

    Stolzer, Alan J.; Halford, Carl

    2007-01-01

    In a previous study, multiple regression techniques were applied to Flight Operations Quality Assurance-derived data to develop parsimonious model(s) for fuel consumption on the Boeing 757 airplane. The present study examined several data mining algorithms, including neural networks, on the fuel consumption problem and compared them to the multiple regression results obtained earlier. Using regression methods, parsimonious models were obtained that explained approximately 85% of the variation in fuel flow. In general data mining methods were more effective in predicting fuel consumption. Classification and Regression Tree methods reported correlation coefficients of .91 to .92, and General Linear Models and Multilayer Perceptron neural networks reported correlation coefficients of about .99. These data mining models show great promise for use in further examining large FOQA databases for operational and safety improvements.

  6. Applying Quality Function Deployment Model in Burn Unit Service Improvement.

    PubMed

    Keshtkaran, Ali; Hashemi, Neda; Kharazmi, Erfan; Abbasi, Mehdi

    2014-10-13

    Quality function deployment (QFD) is one of the most effective quality design tools. This study applies QFD technique to improve the quality of the burn unit services in Ghotbedin Hospital in Shiraz, Iran. First, the patients' expectations of burn unit services and their priorities were determined through Delphi method. Thereafter, burn unit service specifications were determined through Delphi method. Further, the relationships between the patients' expectations and service specifications and also the relationships between service specifications were determined through an expert group's opinion. Last, the final importance scores of service specifications were calculated through simple additive weighting method. The findings show that burn unit patients have 40 expectations in six different areas. These expectations are in 16 priority levels. Burn units also have 45 service specifications in six different areas. There are four-level relationships between the patients' expectations and service specifications and four-level relationships between service specifications. The most important burn unit service specifications have been identified in this study. The QFD model developed in the study can be a general guideline for QFD planners and executives. PMID:23884047

  7. Improving the quality of survivorship for older adults with cancer.

    PubMed

    Mohile, Supriya G; Hurria, Arti; Cohen, Harvey J; Rowland, Julia H; Leach, Corinne R; Arora, Neeraj K; Canin, Beverly; Muss, Hyman B; Magnuson, Allison; Flannery, Marie; Lowenstein, Lisa; Allore, Heather G; Mustian, Karen M; Demark-Wahnefried, Wendy; Extermann, Martine; Ferrell, Betty; Inouye, Sharon K; Studenski, Stephanie A; Dale, William

    2016-08-15

    In May 2015, the Cancer and Aging Research Group, in collaboration with the National Cancer Institute and the National Institute on Aging through a U13 grant, convened a conference to identify research priorities to help design and implement intervention studies to improve the quality of life and survivorship of older, frailer adults with cancer. Conference attendees included researchers with multidisciplinary expertise and advocates. It was concluded that future intervention trials for older adults with cancer should: 1) rigorously test interventions to prevent the decline of or improve health status, especially interventions focused on optimizing physical performance, nutritional status, and cognition while undergoing cancer treatment; 2) use standardized care plans based on geriatric assessment findings to guide targeted interventions; and 3) incorporate the principles of geriatrics into survivorship care plans. Also highlighted was the need to integrate the expertise of interdisciplinary team members into geriatric oncology research, improve funding mechanisms to support geriatric oncology research, and disseminate high-impact results to the research and clinical community. In conjunction with the 2 prior U13 meetings, this conference provided the framework for future research to improve the evidence base for the clinical care of older adults with cancer. Cancer 2016;122:2459-68. © 2016 American Cancer Society. PMID:27172129

  8. SQUIRE 2.0 (Standards for QUality Improvement Reporting Excellence)

    PubMed Central

    Ogrinc, Greg; Davies, Louise; Goodman, Daisy; Batalden, Paul; Davidoff, Frank; Stevens, David

    2015-01-01

    In the past several years, the science of health care improvement has advanced considerably. In this article, we describe the development of SQUIRE 2.0 and its key components. We undertook the revision between 2012 and 2015 using (1) interviews and focus groups to evaluate SQUIRE 1.0 plus feedback from an international steering group, (2) face-to-face consensus meetings to develop interim drafts, and (3) pilot testing with authors and a public comment period. SQUIRE 2.0 emphasizes 3 key components of systematic efforts to improve the quality, value, and safety of health care: formal and informal theory in planning, implementing, and evaluating improvement work; the context in which the work is done; and the study of the intervention(s). SQUIRE 2.0 is intended for reporting the range of methods used to improve health care, recognizing that they can be complex and multidimensional. It provides common ground to share these discoveries in the scholarly literature (www.squire-statement.org). PMID:26497490

  9. Health benefits of improving air quality in Taiyuan, China.

    PubMed

    Tang, Deliang; Wang, Cuicui; Nie, Jiesheng; Chen, Renjie; Niu, Qiao; Kan, Haidong; Chen, Bingheng; Perera, Frederica

    2014-12-01

    Since 2000, the government in Shanxi province has mounted several initiatives and mandated factory shutdowns with the goal of reducing coal burning emissions and the environmental impacts of industrialization. We estimated the health benefits associated with air quality improvement from 2001 to 2010 in Taiyuan, Shanxi Province, using disability-adjusted life years (DALYs) and monetized the health benefits using value of statistical life (VOSL). Data were collected on annual average concentrations of particulate matter less than 10 μm in aerodynamic diameter (PM10) and relevant health outcomes in Taiyuan from 2001 to 2010. Selected exposure-response functions were used to calculate the cases of death or disease attributable to PM10 annually over a 10-year period. These were summed to calculate the DALYs lost and their monetary value associated with PM10 each year between 2001 and 2010. Air quality improvement from 2001 to 2010 was estimated to have prevented 2810 premature deaths, 951 new cases of chronic bronchitis, 141,457 cases of outpatient visits, 969 cases of emergency-room visits and 31,810 cases of hospital admissions. The DALYs (VOSL) decreased by 56.92% (52.68%) from 52,937 (7274 million Yuan) in 2001 to 22,807 (3442 million Yuan) in 2010. Premature deaths accounted for almost 95% of the total DALYs. Our analysis demonstrates that air pollution abatement during the last decade in Taiyuan has generated substantial health benefits. PMID:25168129

  10. Appreciative Inquiry for Quality Improvement in Primary Care Practices

    PubMed Central

    Ruhe, Mary C.; Bobiak, Sarah N.; Litaker, David; Carter, Caroline A.; Wu, Laura; Schroeder, Casey; Zyzanski, Stephen; Weyer, Sharon M.; Werner, James J.; Fry, Ronald E.; Stange, Kurt C.

    2014-01-01

    Purpose To test the effect of an Appreciative Inquiry (AI) quality improvement strategy, on clinical quality management and practice development outcomes. AI enables discovery of shared motivations, envisioning a transformed future, and learning around implementation of a change process. Methods Thirty diverse primary care practices were randomly assigned to receive an AI-based intervention focused on a practice-chosen topic and on improving preventive service delivery (PSD) rates. Medical record review assessed change in PSD rates. Ethnographic fieldnotes and observational checklist analysis used editing and immersion/crystallization methods to identify factors affecting intervention implementation and practice development outcomes. Results PSD rates did not change. Field note analysis suggested that the intervention elicited core motivations, facilitated development of a shared vision, defined change objectives and fostered respectful interactions. Practices most likely to implement the intervention or develop new practice capacities exhibited one or more of the following: support from key leader(s), a sense of urgency for change, a mission focused on serving patients, health care system and practice flexibility, and a history of constructive practice change. Conclusions An AI approach and enabling practice conditions can lead to intervention implementation and practice development by connecting individual and practice strengths and motivations to the change objective. PMID:21192206

  11. Method to improve optical parametric oscillator beam quality

    DOEpatents

    Smith, Arlee V.; Alford, William J.; Bowers, Mark S.

    2003-11-11

    A method to improving optical parametric oscillator (OPO) beam quality having an optical pump, which generates a pump beam at a pump frequency greater than a desired signal frequency, a nonlinear optical medium oriented so that a signal wave at the desired signal frequency and a corresponding idler wave are produced when the pump beam (wave) propagates through the nonlinear optical medium, resulting in beam walk off of the signal and idler waves, and an optical cavity which directs the signal wave to repeatedly pass through the nonlinear optical medium, said optical cavity comprising an equivalently even number of non-planar mirrors that produce image rotation on each pass through the nonlinear optical medium. Utilizing beam walk off where the signal wave and said idler wave have nonparallel Poynting vectors in the nonlinear medium and image rotation, a correlation zone of distance equal to approximately .rho.L.sub.crystal is created which, through multiple passes through the nonlinear medium, improves the beam quality of the OPO output.

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

    NASA Technical Reports Server (NTRS)

    Ruda, R. R.

    1985-01-01

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

  13. National Endoscopy Quality Improvement Program Remains Suboptimal in Korea

    PubMed Central

    Cha, Jae Myung; Moon, Jeong Seop; Chung, Il-Kwun; Kim, Jin-Oh; Im, Jong Pil; Cho, Yu Kyung; Kim, Hyun Gun; Lee, Sang Kil; Lee, Hang Lak; Jang, Jae Young; Kim, Eun Sun; Jung, Yunho; Moon, Chang Mo; Kim, Yeol; Park, Bo Young

    2016-01-01

    Background/Aims We evaluated the characteristics of the National Cancer Screening Program (NCSP) and opinions regarding the National Endoscopy Quality Improvement Program (NEQIP). Methods We surveyed physicians performing esophagogastroduodenoscopy and/or colonoscopy screenings as part of the NCSP via e-mail between July and August in 2015. The 32-item survey instrument included endoscopic capacity, sedation, and reprocessing of endoscopes as well as opinions regarding the NEQIP. Results A total of 507 respondents were analyzed after the exclusion of 40 incomplete answers. Under the current capacity of the NCSP, the typical waiting time for screening endoscopy was less than 4 weeks in more than 90% of endoscopy units. Performance of endoscopy reprocessing was suboptimal, with 28% of respondents using unapproved disinfectants or not knowing the main ingredient of their disinfectants and 15% to 17% of respondents not following reprocessing protocols. Agreement with the NEQIP was optimal, because only 5.7% of respondents did not agree with NEQIP; however, familiarity with the NEQIP was suboptimal, because only 37.3% of respondents were familiar with the NEQIP criteria. Conclusions The NEQ-IP remains suboptimal in Korea. Given the suboptimal performance of endoscopy reprocessing and low familiarity with the NEQIP, improved quality in endoscopy reprocessing and better understanding of the NEQIP should be emphasized in Korea. PMID:27282270

  14. 21 CFR 111.110 - What quality control operations are required for laboratory operations associated with the...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 2 2013-04-01 2013-04-01 false What quality control operations are required for laboratory operations associated with the production and process control system? 111.110 Section 111.110 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION CURRENT...

  15. Improving the quality of parameter estimates obtained from slug tests

    USGS Publications Warehouse

    Butler, J.J., Jr.; McElwee, C.D.; Liu, W.

    1996-01-01

    The slug test is one of the most commonly used field methods for obtaining in situ estimates of hydraulic conductivity. Despite its prevalence, this method has received criticism from many quarters in the ground-water community. This criticism emphasizes the poor quality of the estimated parameters, a condition that is primarily a product of the somewhat casual approach that is often employed in slug tests. Recently, the Kansas Geological Survey (KGS) has pursued research directed it improving methods for the performance and analysis of slug tests. Based on extensive theoretical and field research, a series of guidelines have been proposed that should enable the quality of parameter estimates to be improved. The most significant of these guidelines are: (1) three or more slug tests should be performed at each well during a given test period; (2) two or more different initial displacements (Ho) should be used at each well during a test period; (3) the method used to initiate a test should enable the slug to be introduced in a near-instantaneous manner and should allow a good estimate of Ho to be obtained; (4) data-acquisition equipment that enables a large quantity of high quality data to be collected should be employed; (5) if an estimate of the storage parameter is needed, an observation well other than the test well should be employed; (6) the method chosen for analysis of the slug-test data should be appropriate for site conditions; (7) use of pre- and post-analysis plots should be an integral component of the analysis procedure, and (8) appropriate well construction parameters should be employed. Data from slug tests performed at a number of KGS field sites demonstrate the importance of these guidelines.

  16. Corporatization as a means of improving water quality: the experience in Victoria, Australia.

    PubMed

    Martin, Narelle

    Factors including fragmentation, a lack of direction, poor accountability, poor water quality, and a sizable state government subsidy contributed to the rural water industry in Victoria, Australia, in 1993. In 1993 the state government set out parameters for reform to change the size, structure, performance, and culture of the water industry. The path taken was not privatization, but corporatization. Tools used included amalgamation of organizations; separating water provisions from local government; changing the composition and reporting mechanisms of the boards; establishing clear benchmarks and performance criteria; making information publicly available; and providing a commercial orientation. The outcomes of the reforms were to be a focus on water quality and effluent management. In 2001, 15 water authorities were in place. There were significant improvements in accountability, finances, and performance. The authorities provided information on performance to both the state and the public. Reductions of operating costs have been in the range of 20-35%, with savings put back into new infrastructure. Water quality has significantly improved in a number of parameters and effluent management has also improved. This paper describes the challenges faced before the reform process, the reforms initiated, and the outcomes. It argues that privatization is not the only path to improvement: Developing a corporate structure and accountability can also deliver substantial improvements. PMID:15371224

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

    PubMed

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

    2016-05-01

    Background Patient-physician communication is an integral part of high-quality patient care and an expectation of the Clinical Learning Environment Review program. Objective This quality improvement initiative evaluated the impact of an educational audit and feedback intervention on the frequency of use of 2 tools-business cards and white boards-to improve provider identification. Methods This before-after study utilized patient surveys to determine the ability of those patients to name and recognize their physicians. The before phase began in July 2013. From September 2013 to May 2014, physicians received education on business card and white board use. Results We surveyed 378 patients. Our intervention improved white board utilization (72.2% postintervention versus 54.5% preintervention, P < .01) and slightly improved business card use (44.4% versus 33.7%, P = .07), but did not improve physician recognition. Only 20.3% (14 of 69) of patients could name their physician without use of the business card or white board. Data from all study phases showed the use of both tools improved patients' ability to name physicians (OR = 1.72 and OR = 2.12, respectively; OR = 3.68 for both; P < .05 for all), but had no effect on photograph recognition. Conclusions Our educational intervention improved white board use, but did not result in improved patient ability to recognize physicians. Pooled data of business cards and white boards, alone or combined, improved name recognition, suggesting better use of these tools may increase identification. Future initiatives should target other barriers to usage of these types of tools. PMID:27168887

  18. [Company Wide Quality Control (total quality): methodological principles and intervention techniques for step-by-step improvement].

    PubMed

    Corbara, F; Di Cristofaro, E

    1996-01-01

    quality and ongoing improvement. The Authors describe for each of the previous criteria approaching methods and best operative techniques, according C.W.Q.C. PMID:8682262

  19. Improving the acute care of COPD patients across Gloucestershire: a quality improvement project.

    PubMed

    Miller, Craig; Cushley, Claire; Redler, Kasey; Mitchell, Claire; Aynsley Day, Elizabeth; Mansfield, Helen; Nye, Abigail

    2015-01-01

    Admissions for exacerbations of chronic obstructive pulmonary disease (COPD) present a significant proportion of patients in the acute medical take. The British Thoracic Society (BTS) provides guidelines for time specific interventions, that should be delivered to those with an acute exacerbation of COPD through the admission care bundle. These include correct diagnosis, correct assessment of oxygenation, early administration of treatment, recognition of respiratory failure, and specialist review. Gloucestershire Hospitals NHS Foundation Trust (GHNHSFT) chose improvement in acute COPD care to be a local Commissioning for Quality and Innovation (CQUIN) scheme, which enables commissioners to reward excellence by linking a proportion of English healthcare providers' income to the achievement of local quality improvement goals. The effects of initiatives put in place by senior clinicians had waned, and further improvements were required to meet the CQUIN target. The aim of the scheme was to improve compliance with the BTS guidelines and CQUIN scheme for patients admitted with an exacerbation of COPD. Specific bundle paperwork to be used for all patients admitted to the Trust with an exacerbation of COPD was introduced to the Trust in June 2014, with training and education of medical staff at that time. This had improved compliance rates from 10% to 63% by September 2014. Compliance with each intervention was audited through the examination of notes of patients admitted with an exacerbation of COPD. Compliance rates had plateaued over the last three months, and so a focus group involving junior medical staff met in September 2014 to try to increase awareness further, in order to drive greater improvements in care, and meet the CQUIN requirements. Their strategies were implemented, and then compliance with the CQUIN requirements was reaudited as described above. The December 2014 audit results showed a further improvement in overall COPD care, with 73% of patients

  20. Quality of Care Delivered Before versus After A Quality Improvement Intervention for Acute Geriatric Trauma

    PubMed Central

    Min, Lillian; Cryer, Henry; Chan, Chiao-Li; Roth, Carol; Tillou, Areti

    2014-01-01

    Background Older trauma injury patients had improved recovery after we implemented routine geriatric consultation for patients ≥ age 65 at a level-1 academic trauma center. The intervention aimed to improve quality of geriatric care. However, the specific care processes that improved are unknown. Study Design Prospective observation comparing medical care after (December 2007-November 2009) versus before (December 2006-November 2007) implementation of the geriatric consult-based intervention. To measure quality-of-care (QOC) we used 33 previously-validated care-process quality indicators (QIs) from the Assessing the Care of Vulnerable Elders (ACOVE) study, measured by review of medical records for 76 Geriatric Consult [GC] versus 71 control group patients. As pre-specified subgroup analyses, we aggregated QIs by type: geriatric (e.g., delirium screening) versus non-geriatric condition-based care (e.g., thrombosis prophylaxis) and compared QI scores by type of care. Last, we aggregated QI scores into overall, geriatric, and non-geriatric QOC scores for each patient (# QIs passed/# QIs eligible), and compared patient-level QOC for the GC versus control group, adjusting for age, gender, ethnicity, comorbidity, and injury severity. Results 63% of the GC versus 11% of the control group patients received a geriatric consultation. We evaluated 2505 QIs overall (1664 geriatric-type and 841 non-geriatric QIs). In general, fewer geriatric-type QIs were passed than non-geriatric QIs (71% vs 81%, p<.001). We provided better overall-QOC to the GC (77%) than control group patients (73%, p<.05). However, the difference was not statistically significant after multivariable adjustment (p=.08). We improved geriatric-QOC for the GC (74%) compared to the control group (68%, p<.01), a difference that was significant after multivariable adjustment (p=.01). Conclusion Geriatricians and surgeons can collaboratively improve geriatric QOC for older trauma patients. PMID:25840534