IMPROVING EMISSION INVENTORIES FOR EFFECTIVE AIR-QUALITY MANAGMENT ACROSS NORTH AMERICA - A NARSTO ASSESSMENT

EPA Science Inventory

The NARSTO Ozone and Particulate Matter Assessments emphasized that emission inventories are critical to the success of air quality management programs and that emissions inventories in Canada, Mexico, and the United States need improvement to meet expectations for quality, timel...

IMPROVING EMISSION INVENTORIES FOR EFFECTIVE AIR-QUALITY MANAGEMENT ACROSS NORTH AMERICA - A NARSTO ASSESSMENT

EPA Science Inventory

The NARSTO Ozone and Particulate Matter Assessments emphasized that emission inventories are critical to the success of air quality management programs and that emissions inventories in Canada, Mexico, and the United States need improvement to meet expectations for quality, timel...

Does human resource management improve family planning service quality? Analysis from the Kenya Service Provision Assessment 2010.

PubMed

Thatte, Nandita; Choi, Yoonjoung

2015-04-01

Human resource (HR) management is a priority for health systems strengthening in developing countries, yet few studies have empirically examined associations with service quality. The purpose of this study was to assess the relationship between HR management and family planning (FP) service quality. Data came from the 2010 Kenya Service Provision Assessment, a nationally representative health facility assessment. In total, 912 FP consultations from 301 facilities were analysed. Four indices were created to measure quality on reproductive history taking, physical examination, sexually transmitted infections prevention and pill/injectable specific counselling. HR management variables included training in the past year, any and supportive (i.e. with feedback, technical updates and discussion) in-person supervision in the past 6 months and having a written job description. Multivariate linear regression analyses were conducted to estimate coefficients of HR management variables on each of the four quality indices, adjusting for background characteristics of clients, provider and facilities. The level of service quality ranged from 16 to 53 out of a maximum score of 100 across the indices. Fifty-two per cent of consultations were done by providers who received supportive in-person supervision in the previous 6 months. In 23% and 38% of consultations, the provider was trained in the past year and had a written job description, respectively. Multivariate analyses indicated that having a written job description was associated with higher service quality in history taking, physical examination and the pill/injectable specific counselling. Other HR management variables were not significantly associated with service quality. Having a written job description was significantly associated with higher service quality and may be a useful tool for strengthening management practices. The details of such job descriptions and the quality of other management indicators should be explored to better understand the relationship between HR management and FP service quality. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Assessment of multiple management systems in the Upper Midwest

USDA-ARS?s Scientific Manuscript database

Reduced tillage, multi-crop rotations and use of organic fertilizers are characteristically expected to improve soil quality. As measures of soil quality, microbial and soluble C and N were evaluated in an nine-year assessment of management practices alternative to a conventionally managed two-year ...

Instructional Leadership for Quality Learning: An Assessment of the Impact of the Primary School Management Development Project in Botswana

ERIC Educational Resources Information Center

Pansiri, Nkobi Owen

2008-01-01

A descriptive study using questionnaires was conducted in 2004 to assess the effectiveness of instructional leadership displayed by primary school management teams following the implementation of the Primary School Management Project in Botswana. Leadership skills, Coordination of instructional activities, management of curriculum and quality of…

( RTP, NC ) IMPROVING EMISSION INVENTORIES FOR EFFECTIVE AIR-QUALITY MANAGEMENT ACROSS NORTH AMERICA - A NARSTO ASSESSMENT

EPA Science Inventory

The NARSTO Ozone and Particulate Matter Assessments emphasized that emission inventories are critical to the success of air quality management programs and that emissions inventories in Canada, Mexico, and the United States need improvement to meet expectations for quality, timel...

(NEW YORK) IMPROVING EMISSION INVENTORIES FOR EFFECTIVE AIR-QUALITY MANAGEMENT ACROSS NORTH AMERICA - A NARSTO ASSESSMENT

EPA Science Inventory

The NARSTO Ozone and Particulate Matter Assessments emphasized that emission inventories are critical to the success of air quality management programs and that emissions inventories in Canada, Mexico, and the United States need improvement to meet expectations for quality, timel...

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

ERIC Educational Resources Information Center

Macchia, Peter, Jr.

1993-01-01

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

From the traditional concept of safety management to safety integrated with quality.

PubMed

García Herrero, Susana; Mariscal Saldaña, Miguel Angel; Manzanedo del Campo, Miguel Angel; Ritzel, Dale O

2002-01-01

This editorial reviews the evolution of the concepts of safety and quality that have been used in the traditional workplace. The traditional programs of safety are explored showing strengths and weaknesses. The concept of quality management is also viewed. Safety management and quality management principles, stages, and measurement are highlighted. The concepts of quality and safety guarantee are assessed. Total Quality Management concepts are reviewed and applied to safety quality. Total safety management principles are discussed. Finally, an analysis of the relationship between quality and safety from data collected from a company in Spain is presented.

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

NASA Astrophysics Data System (ADS)

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

2018-02-01

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

[The organization of system of quality management in large multitype hospital].

PubMed

Taĭts, B M; Krichmar, G N; Stvolinskiĭ, I Iu; Grandilevskaia, O L

2013-01-01

The article presents the characteristics and assessment of functioning of model of quality management in large multitype hospital. The results of work of the municipal hospital of Saint Venerable martyr Elizabeth of St Petersburg concerning the implementation of system of quality management in 2001-2011 of the foundation of principles of total quality management of medical service and principles of quality management according international standards ISO and their Russian analogues.

Creating Quality Schools.

ERIC Educational Resources Information Center

American Association of School Administrators, Arlington, VA.

This booklet presents information on how total quality management can be applied to school systems to create educational improvement. Total quality management offers education a systemic approach and a new set of assessment tools. Chapter 1 provides a definition and historical overview of total quality management. Chapter 2 views the school…

Final Environmental Assessment. Physical Fitness Center Los Angeles Air Force Base

DTIC Science & Technology

2000-10-13

Coast Air Quality Management District (SCAQMD). 1996. Final 1997 Air Qaulity Management Plan. November. South Coast Air Quality Management District...resources including land use, geology and soils, water resources, biological resources, air quality, noise, traffic and transportation, waste management ...3-8 3.8 Solid and Hazardous Waste Management and Disposal

Quality, management, and the interplay of self-assessment, process assessments, and performance-based observations

NASA Astrophysics Data System (ADS)

Willett, D. J.

1993-04-01

In this document, the author presents his observations on the topic of quality assurance (QA). Traditionally the focus of quality management has been on QA organizations, manuals, procedures, audits, and assessments; quality was measured by the degree of conformance to specifications or standards. Today quality is defined as satisfying user needs and is measured by user satisfaction. The author proposes that quality is the responsibility of line organizations and staff and not the responsibility of the QA group. This work outlines an effective Conduct of Operations program. The author concludes his observations with a discussion of how quality is analogous to leadership.

[Quality assurance and total quality management in residential home care].

PubMed

Nübling, R; Schrempp, C; Kress, G; Löschmann, C; Neubart, R; Kuhlmey, A

2004-02-01

Quality, quality assurance, and quality management have been important topics in residential care homes for several years. However, only as a result of reform processes in the German legislation (long-term care insurance, care quality assurance) is a systematic discussion taking place. Furthermore, initiatives and holistic model projects, which deal with the assessment and improvement of service quality, were developed in the field of care for the elderly. The present article gives a critical overview of essential developments. Different comprehensive approaches such as the implementation of quality management systems, nationwide expert-based initiatives, and developments towards professionalizing care are discussed. Empirically based approaches, especially those emphasizing the assessment of outcome quality, are focused on in this work. Overall, the authors conclude that in the past few years comprehensive efforts have been made to improve the quality of care. However, the current situation still requires much work to establish a nationwide launch and implementation of evidence-based quality assurance and quality management.

Water Quality Assessment and Management

EPA Pesticide Factsheets

Overview of Clean Water Act (CWA) restoration framework including; water quality standards, monitoring/assessment, reporting water quality status, TMDL development, TMDL implementation (point & nonpoint source control)

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

PubMed

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

2015-04-21

To examine the effectiveness of the quality management programme--European Practice Assessment--in primary care in Switzerland. Longitudinal study with three points of measurement. Primary care practices in Switzerland. In total, 45 of 91 primary care practices completed European Practice Assessment three times. 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. 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). 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. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Systematic review of the effects of chronic disease management on quality-of-life in people with chronic obstructive pulmonary disease.

PubMed

Niesink, A; Trappenburg, J C A; de Weert-van Oene, G H; Lammers, J W J; Verheij, T J M; Schrijvers, A J P

2007-11-01

Chronic disease management for patients with chronic obstructive pulmonary disease (COPD) may improve quality, outcomes and access to care. To investigate effectiveness of chronic disease management programmes on the quality-of-life of people with COPD. Medline and Embase (1995-2005) were searched for relevant articles, and reference lists and abstracts were searched for controlled trials of chronic disease management programmes for patients with COPD. Quality-of-life was assessed as an outcome parameter. Two reviewers independently reviewed each paper for methodological quality and extracted the data. We found 10 randomized-controlled trials comparing chronic disease management with routine care. Patient populations, health-care professionals, intensity, and content of the intervention were heterogeneous. Different instruments were used to assess quality of life. Five out of 10 studies showed statistically significant positive outcomes on one or more domains of the quality of life instruments. Three studies, partly located in primary care, showed positive results. All chronic disease management projects for people with COPD involving primary care improved quality of life. In most of the studies, aspects of chronic disease management were applied to a limited extent. Quality of randomized-controlled trials was not optimal. More research is needed on chronic disease management programmes in patients with COPD across primary and secondary care.

Defining and improving quality management in Dutch diabetes care groups and outpatient clinics: design of the study.

PubMed

Campmans-Kuijpers, Marjo J E; Lemmens, Lidwien C; Baan, Caroline A; Gorter, Kees J; Groothuis, Jolanda; van Vuure, Klementine H; Rutten, Guy E H M

2013-04-05

Worldwide, the organisation of diabetes care is changing. As a result general practices and diabetes teams in hospitals are becoming part of new organisations in which multidisciplinary care programs are implemented. In the Netherlands, 97 diabetes care groups and 104 outpatient clinics are working with a diabetes care program. Both types of organisations aim to improve the quality of diabetes care. Therefore, it is essential to understand the comprehensive elements needed for optimal quality management at organisational level. This study aims to assess the current level of diabetes quality management in both care groups and outpatient clinics and its improvement after providing feedback on their quality management system and tailored support. This study is a before-after study with a one-year follow-up comparing the levels of quality management before and after an intervention to improve diabetes quality management. To assess the status of quality management, online questionnaires were developed based on current literature. They consist of six domains: organisation of care, multidisciplinary teamwork, patient centeredness, performance management, quality improvement policy and management strategies. Based on the questionnaires, respondents will receive feedback on their score in a radar diagram and an elucidating table. They will also be granted access to an online toolbox with instruments that proved to be effective in quality of care improvement and with practical examples. If requested, personal support in implementing these tools will be available. After one year quality management will be measured again using the same questionnaire. This study will reveal a nationwide picture of quality management in diabetes care groups and outpatient clinics in the Netherlands and evaluate the effect of offering tailored support. The operationalisation of quality management on organisational level may be of interest for other countries as well.

Air pollution and public health: a guidance document for risk managers.

PubMed

Craig, Lorraine; Brook, Jeffrey R; Chiotti, Quentin; Croes, Bart; Gower, Stephanie; Hedley, Anthony; Krewski, Daniel; Krupnick, Alan; Krzyzanowski, Michal; Moran, Michael D; Pennell, William; Samet, Jonathan M; Schneider, Jurgen; Shortreed, John; Williams, Martin

2008-01-01

This guidance document is a reference for air quality policymakers and managers providing state-of-the-art, evidence-based information on key determinants of air quality management decisions. The document reflects the findings of five annual meetings of the NERAM (Network for Environmental Risk Assessment and Management) International Colloquium Series on Air Quality Management (2001-2006), as well as the results of supporting international research. The topics covered in the guidance document reflect critical science and policy aspects of air quality risk management including i) health effects, ii) air quality emissions, measurement and modeling, iii) air quality management interventions, and iv) clean air policy challenges and opportunities.

Outcomes-Balanced Framework for Emergency Management: A Predictive Model for Preparedness

DTIC Science & Technology

2013-09-01

Management Total Quality Management (TQM) was developed by W. Edwards Deming in the post-World War II reconstruction period in Japan. It ushered in a...FIGURES Figure 1. From Total Quality Management Principles ....................................................30 Figure 2. Outcomes Logic Model (After...THIRA Threat and Hazard Identification and Risk Assessment TQM Total Quality Management UTL Universal Task List xiv ACKNOWLEDGMENTS German

Verification of a quality management theory: using a delphi study.

PubMed

Mosadeghrad, Ali Mohammad

2013-11-01

A model of quality management called Strategic Collaborative Quality Management (SCQM) model was developed based on the quality management literature review, the findings of a survey on quality management assessment in healthcare organisations, semi-structured interviews with healthcare stakeholders, and a Delphi study on healthcare quality management experts. The purpose of this study was to verify the SCQM model. The proposed model was further developed using feedback from thirty quality management experts using a Delphi method. Further, a guidebook for its implementation was prepared including a road map and performance measurement. The research led to the development of a context-specific model of quality management for healthcare organisations and a series of guidelines for its implementation. A proper model of quality management should be developed and implemented properly in healthcare organisations to achieve business excellence.

Verification of a Quality Management Theory: Using a Delphi Study

PubMed Central

Mosadeghrad, Ali Mohammad

2013-01-01

Background: A model of quality management called Strategic Collaborative Quality Management (SCQM) model was developed based on the quality management literature review, the findings of a survey on quality management assessment in healthcare organisations, semi-structured interviews with healthcare stakeholders, and a Delphi study on healthcare quality management experts. The purpose of this study was to verify the SCQM model. Methods: The proposed model was further developed using feedback from thirty quality management experts using a Delphi method. Further, a guidebook for its implementation was prepared including a road map and performance measurement. Results: The research led to the development of a context-specific model of quality management for healthcare organisations and a series of guidelines for its implementation. Conclusion: A proper model of quality management should be developed and implemented properly in healthcare organisations to achieve business excellence. PMID:24596883

The use of on-site visits to assess compliance and implementation of quality management at hospital level.

PubMed

Wagner, C; Groene, O; Dersarkissian, M; Thompson, C A; Klazinga, N S; Arah, O A; Suñol, R

2014-04-01

Stakeholders of hospitals often lack standardized tools to assess compliance with quality management strategies and the implementation of clinical quality activities in hospitals. Such assessment tools, if easy to use, could be helpful to hospitals, health-care purchasers and health-care inspectorates. The aim of our study was to determine the psychometric properties of two newly developed tools for measuring compliance with process-oriented quality management strategies and the extent of implementation of clinical quality strategies at the hospital level. We developed and tested two measurement instruments that could be used during on-site visits by trained external surveyors to calculate a Quality Management Compliance Index (QMCI) and a Clinical Quality Implementation Index (CQII). We used psychometric methods and the cross-sectional data to explore the factor structure, reliability and validity of each of these instruments. The sample consisted of 74 acute care hospitals selected at random from each of 7 European countries. The psychometric properties of the two indices (QMCI and CQII). Overall, the indices demonstrated favourable psychometric performance based on factor analysis, item correlations, internal consistency and hypothesis testing. Cronbach's alpha was acceptable for the scales of the QMCI (α: 0.74-0.78) and the CQII (α: 0.82-0.93). Inter-scale correlations revealed that the scales were positively correlated, but distinct. All scales added sufficient new information to each main index to be retained. This study has produced two reliable instruments that can be used during on-site visits to assess compliance with quality management strategies and implementation of quality management activities by hospitals in Europe and perhaps other jurisdictions.

[Informatics data quality and management].

PubMed

Feng, Rung-Chuang

2009-06-01

While the quality of data affects every aspect of business, it is frequently overlooked in terms of customer data integration, data warehousing, business intelligence and enterprise applications. Regardless of which data terms are used, a high level of data quality is a critical base condition essential to satisfy user needs and facilitate the development of effective applications. In this paper, the author introduces methods, a management framework and the major factors involved in data quality assessment. Author also integrates expert opinions to develop data quality assessment tools.

An empirical model of water quality for use in rapid management strategy evaluation in Southeast Queensland, Australia.

PubMed

de la Mare, William; Ellis, Nick; Pascual, Ricardo; Tickell, Sharon

2012-04-01

Simulation models have been widely adopted in fisheries for management strategy evaluation (MSE). However, in catchment management of water quality, MSE is hampered by the complexity of both decision space and the hydrological process models. Empirical models based on monitoring data provide a feasible alternative to process models; they run much faster and, by conditioning on data, they can simulate realistic responses to management actions. Using 10 years of water quality indicators from Queensland, Australia, we built an empirical model suitable for rapid MSE that reproduces the water quality variables' mean and covariance structure, adjusts the expected indicators through local management effects, and propagates effects downstream by capturing inter-site regression relationships. Empirical models enable managers to search the space of possible strategies using rapid assessment. They provide not only realistic responses in water quality indicators but also variability in those indicators, allowing managers to assess strategies in an uncertain world. Copyright © 2012 Elsevier Ltd. All rights reserved.

Doctors or technicians: assessing quality of medical education

PubMed Central

Hasan, Tayyab

2010-01-01

Medical education institutions usually adapt industrial quality management models that measure the quality of the process of a program but not the quality of the product. The purpose of this paper is to analyze the impact of industrial quality management models on medical education and students, and to highlight the importance of introducing a proper educational quality management model. Industrial quality management models can measure the training component in terms of competencies, but they lack the educational component measurement. These models use performance indicators to assess their process improvement efforts. Researchers suggest that the performance indicators used in educational institutions may only measure their fiscal efficiency without measuring the quality of the educational experience of the students. In most of the institutions, where industrial models are used for quality assurance, students are considered as customers and are provided with the maximum services and facilities possible. Institutions are required to fulfill a list of recommendations from the quality control agencies in order to enhance student satisfaction and to guarantee standard services. Quality of medical education should be assessed by measuring the impact of the educational program and quality improvement procedures in terms of knowledge base development, behavioral change, and patient care. Industrial quality models may focus on academic support services and processes, but educational quality models should be introduced in parallel to focus on educational standards and products. PMID:23745059

Doctors or technicians: assessing quality of medical education.

PubMed

Hasan, Tayyab

2010-01-01

Medical education institutions usually adapt industrial quality management models that measure the quality of the process of a program but not the quality of the product. The purpose of this paper is to analyze the impact of industrial quality management models on medical education and students, and to highlight the importance of introducing a proper educational quality management model. Industrial quality management models can measure the training component in terms of competencies, but they lack the educational component measurement. These models use performance indicators to assess their process improvement efforts. Researchers suggest that the performance indicators used in educational institutions may only measure their fiscal efficiency without measuring the quality of the educational experience of the students. In most of the institutions, where industrial models are used for quality assurance, students are considered as customers and are provided with the maximum services and facilities possible. Institutions are required to fulfill a list of recommendations from the quality control agencies in order to enhance student satisfaction and to guarantee standard services. Quality of medical education should be assessed by measuring the impact of the educational program and quality improvement procedures in terms of knowledge base development, behavioral change, and patient care. Industrial quality models may focus on academic support services and processes, but educational quality models should be introduced in parallel to focus on educational standards and products.

A recreation quality rapid assessment method for visitor capacity management

Treesearch

Kenneth Chilman; Stuart Schneider; Les Wadzinski

2007-01-01

A rapid assessment method for inexpensively obtaining representative samples of place-specific visitor numbers and perceptions of visit quality was tested on Niobrara National Scenic River (NSR). Similar tests have been done on national forest areas in Indiana and Illinois. The data are used in meetings focusing on visitor capacity management. The rapid assessment...

The development of effects-based air quality management regimes

NASA Astrophysics Data System (ADS)

Longhurst, J. W. S.; Irwin, J. G.; Chatterton, T. J.; Hayes, E. T.; Leksmono, N. S.; Symons, J. K.

This paper considers the evolution of attempts to control and manage air pollution, principally but not exclusively focussing upon the challenge of managing air pollution in urban environments. The development and implementation of a range of air pollution control measures are considered. Initially the measures implemented primarily addressed point sources, a small number of fuel types and a limited number of pollutants. The adequacy of such a source-control approach is assessed within the context of a changing and challenging air pollution climate. An assessment of air quality management in the United Kingdom over a 50-year timeframe exemplifies the range of issues and challenges in contemporary air quality management. The need for new approaches is explored and the development and implementation of an effects-based, risk management system for air quality regulation is evaluated.

A Risk-based Assessment And Management Framework For Multipollutant Air Quality

PubMed Central

Frey, H. Christopher; Hubbell, Bryan

2010-01-01

The National Research Council recommended both a risk- and performance-based multipollutant approach to air quality management. Specifically, management decisions should be based on minimizing the exposure to, and risk of adverse effects from, multiple sources of air pollution and that the success of these decisions should be measured by how well they achieved this objective. We briefly describe risk analysis and its application within the current approach to air quality management. Recommendations are made as to how current practice could evolve to support a fully risk- and performance-based multipollutant air quality management system. The ability to implement a risk assessment framework in a credible and policy-relevant manner depends on the availability of component models and data which are scientifically sound and developed with an understanding of their application in integrated assessments. The same can be said about accountability assessments used to evaluate the outcomes of decisions made using such frameworks. The existing risk analysis framework, although typically applied to individual pollutants, is conceptually well suited for analyzing multipollutant management actions. Many elements of this framework, such as emissions and air quality modeling, already exist with multipollutant characteristics. However, the framework needs to be supported with information on exposure and concentration response relationships that result from multipollutant health studies. Because the causal chain that links management actions to emission reductions, air quality improvements, exposure reductions and health outcomes is parallel between prospective risk analyses and retrospective accountability assessments, both types of assessment should be placed within a single framework with common metrics and indicators where possible. Improvements in risk reductions can be obtained by adopting a multipollutant risk analysis framework within the current air quality management system, e.g. focused on standards for individual pollutants and with separate goals for air toxics and ambient pollutants. However, additional improvements may be possible if goals and actions are defined in terms of risk metrics that are comparable across criteria pollutants and air toxics (hazardous air pollutants), and that encompass both human health and ecological risks. PMID:21209847

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

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

PubMed

Secanell, Mariona; Groene, Oliver; Arah, Onyebuchi A; Lopez, Maria Andrée; Kutryba, Basia; Pfaff, Holger; Klazinga, Niek; Wagner, Cordula; Kristensen, Solvejg; Bartels, Paul Daniel; Garel, Pascal; Bruneau, Charles; Escoval, Ana; França, Margarida; Mora, Nuria; Suñol, Rosa

2014-04-01

This paper provides an overview of the DUQuE (Deepening our Understanding of Quality Improvement in Europe) project, the first study across multiple countries of the European Union (EU) to assess relationships between quality management and patient outcomes at EU level. The paper describes the conceptual framework and methods applied, highlighting the novel features of this study. DUQuE was designed as a multi-level cross-sectional study with data collection at hospital, pathway, professional and patient level in eight countries. We aimed to collect data for the assessment of hospital-wide constructs from up to 30 randomly selected hospitals in each country, and additional data at pathway and patient level in 12 of these 30. A comprehensive conceptual framework was developed to account for the multiple levels that influence hospital performance and patient outcomes. We assessed hospital-specific constructs (organizational culture and professional involvement), clinical pathway constructs (the organization of care processes for acute myocardial infarction, stroke, hip fracture and deliveries), patient-specific processes and outcomes (clinical effectiveness, patient safety and patient experience) and external constructs that could modify hospital quality (external assessment and perceived external pressure). Data was gathered from 188 hospitals in 7 participating countries. The overall participation and response rate were between 75% and 100% for the assessed measures. This is the first study assessing relation between quality management and patient outcomes at EU level. The study involved a large number of respondents and achieved high response rates. This work will serve to develop guidance in how to assess quality management and makes recommendations on the best ways to improve quality in healthcare for hospital stakeholders, payers, researchers, and policy makers throughout the EU.

Air quality evaluation of Rhode Island's incident management program

DOT National Transportation Integrated Search

1997-09-01

The objective of this preliminary air quality analysis was to assess the potential air quality benefits associated with the implementation of Providence's Metropolitan portion of Rhode Island's Incident Management Program. Specifically, the air quali...

[Assessment of financial performance improves the quality of healthcare provided by medical organizations].

PubMed

Afek, Arnon; Meilik, Ahuva; Rotstein, Zeev

2009-01-01

Today, medical organizations have to contend with a highly competitive environment, an atmosphere saturated with a multitude of innovative new technologies and ever-increasing costs. The ability of these organizations to survive and to develop and expand their services mandates adoption of management guidelines based on the world of finance/commerce, adapted to make them relevant to the world of medical service. In this article the authors chose to present a management administration assessment which is a process that ensures that the management will effectively administer the organization's resources, and meet the goals set by the organization. The system demands that hospital "centers of responsibility" be defined, a management information system be set up, activities be priced, budget be defined and the expenses assessed. These processes make it possible to formulate a budget and assess any possible deviation between the budget and the actual running costs. An assessment of deviations will reveal any possible deviation of the most significant factor--efficiency. Medical organization managers, with the cooperation of the directors of the "centers of responsibility", can assess subunit activities and gain an understanding of the significance of management decisions and thus improve the quality of management, and the medical organization. The goal of this management system is not only to Lower costs and to meet the financial goals that were set; it is a tool that ensures quality. Decreasing expenditure is important in this case, but is only secondary in importance and will be a result of reducing the costs incurred by services lacking in quality.

Uniform Federal Policy for Quality Assurance Project Plans: Evaluating, Assessing, and Documenting Environmental Data Collection and Use Programs. Part 1. UFP-QAPP Manual

DTIC Science & Technology

2004-07-01

sampler, project manager, data reviewer, statistician , risk assessor, assessment personnel, and laboratory QC manager. In addition, a complete copy of...sample • Corrective actions to be taken if the QC sample fails these criteria • A description of how the QC data and results are to be documented and...Intergovernmental Data Quality Task Force Uniform Federal Policy for Quality Assurance Project Plans Evaluating, Assessing, and Documenting

The Imprecise Science of Evaluating Scholarly Performance: Utilizing Broad Quality Categories for an Assessment of Business and Management Journals

ERIC Educational Resources Information Center

Lange, Thomas

2006-01-01

In a growing number of countries, government-appointed assessment panels develop ranks on the basis of the quality of scholarly outputs to apportion budgets in recognition of evaluated performance and to justify public funds for future R&D activities. When business and management journals are being grouped in broad quality categories, a recent…

How do we know? An assessment of integrated community case management data quality in four districts of Malawi.

PubMed

Yourkavitch, Jennifer; Zalisk, Kirsten; Prosnitz, Debra; Luhanga, Misheck; Nsona, Humphreys

2016-11-01

The World Health Organization contracted annual data quality assessments of Rapid Access Expansion (RAcE) projects to review integrated community case management (iCCM) data quality and the monitoring and evaluation (M&E) system for iCCM, and to suggest ways to improve data quality. The first RAcE data quality assessment was conducted in Malawi in January 2014 and we present findings pertaining to data from the health management information system at the community, facility and other sub-national levels because RAcE grantees rely on that for most of their monitoring data. We randomly selected 10 health facilities (10% of eligible facilities) from the four RAcE project districts, and collected quantitative data with an adapted and comprehensive tool that included an assessment of Malawi's M&E system for iCCM data and a data verification exercise that traced selected indicators through the reporting system. We rated the iCCM M&E system across five function areas based on interviews and observations, and calculated verification ratios for each data reporting level. We also conducted key informant interviews with Health Surveillance Assistants and facility, district and central Ministry of Health staff. Scores show a high-functioning M&E system for iCCM with some deficiencies in data management processes. The system lacks quality controls, including data entry verification, a protocol for addressing errors, and written procedures for data collection, entry, analysis and management. Data availability was generally high except for supervision data. The data verification process identified gaps in completeness and consistency, particularly in Health Surveillance Assistants' record keeping. Staff at all levels would like more training in data management. This data quality assessment illuminates where an otherwise strong M&E system for iCCM fails to ensure some aspects of data quality. Prioritizing data management with documented protocols, additional training and approaches to create efficient supervision practices may improve iCCM data quality. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Notification: Preliminary Research to Evaluate EPA's Use of and Adherence to Quality Management Policies in Chemical Risk Assessments

EPA Pesticide Factsheets

Project #OPE-FY14-0012, December 19, 2013. The Office of Inspector General (OIG) is starting preliminary research on the U.S. Environmental Protection Agency’s (EPA’s) use of and adherence to quality management policies in chemical risk assessments.

Soil quality evaluation using Soil Management Assessment Framework (SMAF) in Brazilian oxisols with contrasting texture

USDA-ARS?s Scientific Manuscript database

To ensure current land use strategies and management practices are economically, environmentally, and socially sustainable, tools and techniques for assessing and quantifying changes in soil quality/health (SQ) need to be developed through rigorous research and potential use by consultants, and othe...

Effectiveness of a quality management program in dental care practices.

PubMed

Goetz, Katja; Campbell, Stephen M; Broge, Björn; Brodowski, Marc; Wensing, Michel; Szecsenyi, Joachim

2014-04-28

Structured quality management is an important aspect for improving patient dental care outcomes, but reliable evidence to validate effects is lacking. We aimed to examine the effectiveness of a quality management program in primary dental care settings in Germany. This was an exploratory study with a before-after-design. 45 dental care practices that had completed the European Practice Assessment (EPA) accreditation scheme twice (intervention group) were selected for the study. The mean interval between the before and after assessment was 36 months. The comparison group comprised of 56 dental practices that had undergone their first assessment simultaneously with follow-up assessment in the intervention group. Aggregated scores for five EPA domains: 'infrastructure', 'information', 'finance', 'quality and safety' and 'people' were calculated. In the intervention group, small non-significant improvements were found in the EPA domains. At follow-up, the intervention group had higher scores on EPA domains as compared with the comparison group (range of differences was 4.2 to 10.8 across domains). These differences were all significant in regression analyses, which controlled for relevant dental practice characteristics. Dental care practices that implemented a quality management program had better organizational quality in contrast to a comparison group. This may reflect both improvements in the intervention group and a selection effect of dental practices volunteering for the first round of EPA practice assessment.

Defining and improving quality management in Dutch diabetes care groups and outpatient clinics: design of the study

PubMed Central

2013-01-01

Background Worldwide, the organisation of diabetes care is changing. As a result general practices and diabetes teams in hospitals are becoming part of new organisations in which multidisciplinary care programs are implemented. In the Netherlands, 97 diabetes care groups and 104 outpatient clinics are working with a diabetes care program. Both types of organisations aim to improve the quality of diabetes care. Therefore, it is essential to understand the comprehensive elements needed for optimal quality management at organisational level. This study aims to assess the current level of diabetes quality management in both care groups and outpatient clinics and its improvement after providing feedback on their quality management system and tailored support. Methods/design This study is a before-after study with a one-year follow-up comparing the levels of quality management before and after an intervention to improve diabetes quality management. To assess the status of quality management, online questionnaires were developed based on current literature. They consist of six domains: organisation of care, multidisciplinary teamwork, patient centeredness, performance management, quality improvement policy and management strategies. Based on the questionnaires, respondents will receive feedback on their score in a radar diagram and an elucidating table. They will also be granted access to an online toolbox with instruments that proved to be effective in quality of care improvement and with practical examples. If requested, personal support in implementing these tools will be available. After one year quality management will be measured again using the same questionnaire. Discussion This study will reveal a nationwide picture of quality management in diabetes care groups and outpatient clinics in the Netherlands and evaluate the effect of offering tailored support. The operationalisation of quality management on organisational level may be of interest for other countries as well. PMID:23561032

Air quality risk management.

PubMed

Williams, Martin L

2008-01-01

Rather than attempt to provide a comprehensive account of air quality risk assessment, as might be found in a textbook or manual, this article discusses some issues that are of current importance in the United Kingdom and the rest of Europe, with special emphasis on risk assessment in the context of policy formulation, and emerging scientific knowledge. There are two pollutants of particular concern and that both pose challenges for risk assessment and policy, and they are particulate matter (PM) and ozone. The article describes some issues for health risk assessment and finally some forward-looking suggestions for future approaches to air quality management.

Useful measures and models for analytical quality management in medical laboratories.

PubMed

Westgard, James O

2016-02-01

The 2014 Milan Conference "Defining analytical performance goals 15 years after the Stockholm Conference" initiated a new discussion of issues concerning goals for precision, trueness or bias, total analytical error (TAE), and measurement uncertainty (MU). Goal-setting models are critical for analytical quality management, along with error models, quality-assessment models, quality-planning models, as well as comprehensive models for quality management systems. There are also critical underlying issues, such as an emphasis on MU to the possible exclusion of TAE and a corresponding preference for separate precision and bias goals instead of a combined total error goal. This opinion recommends careful consideration of the differences in the concepts of accuracy and traceability and the appropriateness of different measures, particularly TAE as a measure of accuracy and MU as a measure of traceability. TAE is essential to manage quality within a medical laboratory and MU and trueness are essential to achieve comparability of results across laboratories. With this perspective, laboratory scientists can better understand the many measures and models needed for analytical quality management and assess their usefulness for practical applications in medical laboratories.

The creation, management, and use of data quality information for life cycle assessment.

PubMed

Edelen, Ashley; Ingwersen, Wesley W

2018-04-01

Despite growing access to data, questions of "best fit" data and the appropriate use of results in supporting decision making still plague the life cycle assessment (LCA) community. This discussion paper addresses revisions to assessing data quality captured in a new US Environmental Protection Agency guidance document as well as additional recommendations on data quality creation, management, and use in LCA databases and studies. Existing data quality systems and approaches in LCA were reviewed and tested. The evaluations resulted in a revision to a commonly used pedigree matrix, for which flow and process level data quality indicators are described, more clarity for scoring criteria, and further guidance on interpretation are given. Increased training for practitioners on data quality application and its limits are recommended. A multi-faceted approach to data quality assessment utilizing the pedigree method alongside uncertainty analysis in result interpretation is recommended. A method of data quality score aggregation is proposed and recommendations for usage of data quality scores in existing data are made to enable improved use of data quality scores in LCA results interpretation. Roles for data generators, data repositories, and data users are described in LCA data quality management. Guidance is provided on using data with data quality scores from other systems alongside data with scores from the new system. The new pedigree matrix and recommended data quality aggregation procedure can now be implemented in openLCA software. Additional ways in which data quality assessment might be improved and expanded are described. Interoperability efforts in LCA data should focus on descriptors to enable user scoring of data quality rather than translation of existing scores. Developing and using data quality indicators for additional dimensions of LCA data, and automation of data quality scoring through metadata extraction and comparison to goal and scope are needed.

[Integrated Quality Management System (IQMS): a model for improving the quality of reproductive health care in rural Kenya].

PubMed

Herrler, Claudia; Bramesfeld, Anke; Brodowski, Marc; Prytherch, Helen; Marx, Irmgard; Nafula, Maureen; Richter-Aairijoki, Heide; Musyoka, Lucy; Marx, Michael; Szecsenyi, Joachim

2015-01-01

To develop a model aiming to improve the quality of services for reproductive health care in rural Kenya and designed to measure the quality of reproductive health services in such a way that allows these services to identify measures for improving their performance. The Integrated Quality Management System (IQMS) was developed on the basis of a pre-existing and validated model for quality promotion, namely the European Practice Assessment (EPA). The methodology for quality assessment and feedback of assessment results to the service teams was adopted from the EPA model. Quality assessment methodology included data assessment through staff, patient surveys and service visitation. Quality is assessed by indicators, and so indicators had to be developed that were appropriate for assessing reproductive health care in rural Kenya. A search of the Kenyan and international literature was conducted to identify potential indicators. These were then rated for their relevance and clarity by a panel of Kenyan experts. 260 indicators were rated as relevant and assigned to 29 quality dimensions and 5 domains. The implementation of IQMS in ten facilities showed that IQMS is a feasible model for assessing the quality of reproductive health services in rural Kenya. IQMS enables these services to identify quality improvement targets and necessary improvement measures. Both strengths and limitations of IQMS will be discussed. Copyright © 2015. Published by Elsevier GmbH.

Quality assessment of urban environment

NASA Astrophysics Data System (ADS)

Ovsiannikova, T. Y.; Nikolaenko, M. N.

2015-01-01

This paper is dedicated to the research applicability of quality management problems of construction products. It is offered to expand quality management borders in construction, transferring its principles to urban systems as economic systems of higher level, which qualitative characteristics are substantially defined by quality of construction product. Buildings and structures form spatial-material basis of cities and the most important component of life sphere - urban environment. Authors justify the need for the assessment of urban environment quality as an important factor of social welfare and life quality in urban areas. The authors suggest definition of a term "urban environment". The methodology of quality assessment of urban environment is based on integrated approach which includes the system analysis of all factors and application of both quantitative methods of assessment (calculation of particular and integrated indicators) and qualitative methods (expert estimates and surveys). The authors propose the system of indicators, characterizing quality of the urban environment. This indicators fall into four classes. The authors show the methodology of their definition. The paper presents results of quality assessment of urban environment for several Siberian regions and comparative analysis of these results.

Evaluating Quality Management in University Departments

ERIC Educational Resources Information Center

Becket, Nina; Brookes, Maureen

2006-01-01

Purpose: Despite the abundance of research on quality management there is no universal consensus on how best to measure quality in higher education. This paper undertakes a critical evaluation of the different methods used to assess the quality of provision in higher education departments in the UK. Design/methodology/approach: Drawing on relevant…

AIR EMISSION INVENTORIES IN NORTH AMERICA: A CRITICAL ASSESSMENT

EPA Science Inventory

Although emission inventories are the foundation of air quality management and have supported substantial improvements in North American air quality, they have a number of shortcomings that can potentially lead to ineffective air quality management strategies. New technologies fo...

42 CFR 438.240 - Quality assessment and performance improvement program.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Quality assessment and performance improvement program. 438.240 Section 438.240 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Quality Assessment and...

42 CFR 438.240 - Quality assessment and performance improvement program.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Quality assessment and performance improvement program. 438.240 Section 438.240 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Quality Assessment and...

42 CFR 438.240 - Quality assessment and performance improvement program.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Quality assessment and performance improvement program. 438.240 Section 438.240 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Quality Assessment and...

42 CFR 438.240 - Quality assessment and performance improvement program.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Quality assessment and performance improvement program. 438.240 Section 438.240 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Quality Assessment and...

[Application of risk grading and classification for occupational hazards in risk management for a shipbuilding project].

PubMed

Zeng, Wenfeng; Tan, Qiang; Wu, Shihua; Deng, Yingcong; Liu, Lifen; Wang, Zhi; Liu, Yimin

2015-12-01

To investigate the application of risk grading and classification for occupational hazards in risk management for a shipbuilding project. The risk management for this shipbuilding project was performed by a comprehensive application of MES evaluation, quality assessment of occupational health management, and risk grading and classification for occupational hazards, through the methods of occupational health survey, occupational health testing, and occupational health examinations. The results of MES evaluation showed that the risk of occupational hazards in this project was grade 3, which was considered as significant risk; Q value calculated by quality assessment of occupational health management was 0.52, which was considered to be unqualified; the comprehensive evaluation with these two methods showed that the integrated risk rating for this shipbuilding project was class D, and follow- up and rectification were needed with a focus on the improvement in health management. The application of MES evaluation and quality assessment of occupational health management in risk management for occupational hazards can achieve objective and reasonable conclusions and has good applicability.

40 CFR 35.917-5 - Public participation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... coordination between the appropriate Water Quality Management public participation program under subpart G of... for coordination between the appropriate Water Quality Management agency public participation program... become involved in the following: (1) The assessment of local water quality problems and needs; (2) The...

Quality assessment of practice nurse communication with type 2 diabetes patients.

PubMed

Mulder, Bob C; van Belzen, Milou; Lokhorst, Anne Marike; van Woerkum, Cees M J

2015-02-01

Nurse self-management support for type 2 diabetes patients may benefit from applying theory-based behavior change counseling. The 5As model was used to assess if, and how, nurses applied the five key elements of self-management support in standard care. Seven practice nurses audio-recorded consultations with 66 patients. An existing instrument for assessing counseling quality was used to determine if the 5As were applied. Applied As were compared with quality criteria, to provide an in-depth assessment. In almost every consultation, nurses assessed health behaviors, and arranged a follow-up meeting. However, nurses advised behavior change in less than half of the consultations, while setting goals and assisting patients to overcome barriers were used even less. Comparing applied As with quality criteria revealed several issues that could be improved. Nurses consistently discussed health behaviors with patients, but important elements of self-management support were not applied. Self-management support may benefit from training nurses in performing assessments that form the base for specific advice, setting goals, and addressing barriers to behavior change. Nurses also have to learn how to combine being medical expert and behavioral counselor. Clarifying both roles to patients may facilitate communication and establishing a collaborative relationship. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

SEEING THE LIGHT: A WATER CLARITY INDEX FOR INTEGRATED WATER QUALITY ASSESSMENTS

EPA Science Inventory

Smith, Lisa M. and Linda C. Harwell. In press. Seeing the Light: A Water Clarity Index for Integrated Water Quality Assessments (Abstract). To be presented at EMAP Symposium 2004: Integrated Monitoring & Assessment for Effective Water Quality Management. 1 p. (ERL,GB R970).
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Primary care physicians' use of family history for cancer risk assessment

PubMed Central

2010-01-01

Background Family history (FH) assessment is useful in identifying and managing patients at increased risk for cancer. This study assessed reported FH quality and associations with physician perceptions. Methods Primary care physicians practicing in two northeastern U.S. states were surveyed (n = 880; 70% response rate). Outcome measures of FH quality were extent of FH taken and ascertaining age at cancer diagnosis for affected family members. Predictors of quality measured in this survey included: perceived advantages and disadvantages of collecting FH information, knowledge of management options, access to supportive resources, and confidence in ability to interpret FH. Results Reported collection of information regarding second degree blood relatives and age of diagnosis among affected relatives was low. All hypothesized predictors were associated with measures of FH quality, but not all were consistent independent predictors. Perceived advantages of taking a family history, access to supportive resources, and confidence in ability to identify and manage higher risk patients were independent predictors of both FH quality measures. Perceived disadvantages of taking a family history was independently associated one measure of FH quality. Knowledge of management options was not independently associated with either quality measure. Conclusions Modifiable perception and resource factors were independently associated with quality of FH taking in a large and diverse sample of primary care physicians. Improving FH quality for identification of high risk individuals will require multi-faceted interventions. PMID:20525302

Primary care physicians' use of family history for cancer risk assessment.

PubMed

Flynn, Brian S; Wood, Marie E; Ashikaga, Takamaru; Stockdale, Alan; Dana, Greg S; Naud, Shelly

2010-06-03

Family history (FH) assessment is useful in identifying and managing patients at increased risk for cancer. This study assessed reported FH quality and associations with physician perceptions. Primary care physicians practicing in two northeastern U.S. states were surveyed (n = 880; 70% response rate). Outcome measures of FH quality were extent of FH taken and ascertaining age at cancer diagnosis for affected family members. Predictors of quality measured in this survey included: perceived advantages and disadvantages of collecting FH information, knowledge of management options, access to supportive resources, and confidence in ability to interpret FH. Reported collection of information regarding second degree blood relatives and age of diagnosis among affected relatives was low. All hypothesized predictors were associated with measures of FH quality, but not all were consistent independent predictors. Perceived advantages of taking a family history, access to supportive resources, and confidence in ability to identify and manage higher risk patients were independent predictors of both FH quality measures. Perceived disadvantages of taking a family history was independently associated one measure of FH quality. Knowledge of management options was not independently associated with either quality measure. Modifiable perception and resource factors were independently associated with quality of FH taking in a large and diverse sample of primary care physicians. Improving FH quality for identification of high risk individuals will require multi-faceted interventions.

Competency in health care management: a training model in epidemiologic methods for assessing and improving the quality of clinical practice through evidence-based decision making.

PubMed

Hudak, R P; Jacoby, I; Meyer, G S; Potter, A L; Hooper, T I; Krakauer, H

1997-01-01

This article describes a training model that focuses on health care management by applying epidemiologic methods to assess and improve the quality of clinical practice. The model's uniqueness is its focus on integrating clinical evidence-based decision making with fundamental principles of resource management to achieve attainable, cost-effective, high-quality health outcomes. The target students are current and prospective clinical and administrative executives who must optimize decision making at the clinical and managerial levels of health care organizations.

Quality and Usability of Arthritic Pain Self-Management Apps for Older Adults: A Systematic Review.

PubMed

Bhattarai, Priyanka; Newton-John, T R O; Phillips, Jane L

2018-03-01

To appraise the quality and usability of currently available pain applications that could be used by community-dwelling older adults to self-manage their arthritic pain. A systematic review. Searches were conducted in App Store and Google Play to identify pain self-management apps relevant to arthritic pain management. English language pain management apps providing pain assessment and documentation function and pain management education were considered for inclusion. A quality evaluation audit tool based on the Stanford Arthritis Self-Management Program was developed a priori to evaluate app content quality. The usability of included apps was assessed using an established usability evaluation tool. Out of the 373 apps that were identified, four met the inclusion criteria. The included apps all included a pain assessment and documentation function and instructions on medication use, communication with health professionals, cognitive behavioral therapy-based pain management, and physical exercise. Management of mood, depression, anxiety, and sleep were featured in most apps (N = 3). Three-quarters (N = 3) of the apps fell below the acceptable moderate usability score (≥3), while one app obtained a moderate score (3.2). Few of the currently available pain apps offer a comprehensive pain self-management approach incorporating evidence-based strategies in accordance with the Stanford Arthritis Self-Management Program. The moderate-level usability across the included apps indicates a need to consider the usability needs of the older population in future pain self-management app development endeavors.

Ninth Annual NASA/Contractors Conference on Quality and Productivity. World Class Excellence: The Journey Continues. Conference presentations

NASA Technical Reports Server (NTRS)

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

1992-01-01

The topics covered include the following: The George M. Low Trophy; total quality assessment and measurement; using award criteria to improve organizational effectiveness; results--keeping an eye on the bottom line; capturing customer satisfaction; moving from management to leadership; leadership versus management; transforming the management team; leadership success stories; success stories in the quest for excellence; small business successes; education success stories; government success stories; tools and techniques for total quality management (TQM) integration; planning and organizing for TQM integration; successful stories for implementing system level TQM/CI tools; assessing TQM results; establishing an environment for continuous improvement at NASA; empowerment; synergism of partnering; and partnerships in education.

Engineering Quality Software: 10 Recommendations for Improved Software Quality Management

DTIC Science & Technology

2010-04-27

lack of user involvement • Inadequate Software Process Management & Control By Contractors • No “Team” of Vendors and users; little SME participation...1990 Quality Perspectives • Process Quality ( CMMI ) • Product Quality (ISO/IEC 2500x) – Internal Quality Attributes – External Quality Attributes... CMMI /ISO 9000 Assessments – Capture organizational knowledge • Identify best practices, lessons learned Know where you are, and where you need to be

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

PubMed Central

Secanell, Mariona; Groene, Oliver; Arah, Onyebuchi A.; Lopez, Maria Andrée; Kutryba, Basia; Pfaff, Holger; Klazinga, Niek; Wagner, Cordula; Kristensen, Solvejg; Bartels, Paul Daniel; Garel, Pascal; Bruneau, Charles; Escoval, Ana; França, Margarida; Mora, Nuria; Suñol, Rosa; Klazinga, N; Kringos, DS; Lopez, MA; Secanell, M; Sunol, R; Vallejo, P; Bartels, P; Kristensen, S; Michel, P; Saillour-Glenisson, F; Vlcek, F; Car, M; Jones, S; Klaus, E; Bottaro, S; Garel, P; Saluvan, M; Bruneau, C; Depaigne-Loth, A; Shaw, C; Hammer, A; Ommen, O; Pfaff, H; Groene, O; Botje, D; Wagner, C; Kutaj-Wasikowska, H; Kutryba, B; Escoval, A; Lívio, A; Eiras, M; Franca, M; Leite, I; Almeman, F; Kus, H; Ozturk, K; Mannion, R; Arah, OA; Chow, A; DerSarkissian, M; Thompson, CA; Wang, A; Thompson, A

2014-01-01

Introduction and Objective This paper provides an overview of the DUQuE (Deepening our Understanding of Quality Improvement in Europe) project, the first study across multiple countries of the European Union (EU) to assess relationships between quality management and patient outcomes at EU level. The paper describes the conceptual framework and methods applied, highlighting the novel features of this study. Design DUQuE was designed as a multi-level cross-sectional study with data collection at hospital, pathway, professional and patient level in eight countries. Setting and Participants We aimed to collect data for the assessment of hospital-wide constructs from up to 30 randomly selected hospitals in each country, and additional data at pathway and patient level in 12 of these 30. Main outcome measures A comprehensive conceptual framework was developed to account for the multiple levels that influence hospital performance and patient outcomes. We assessed hospital-specific constructs (organizational culture and professional involvement), clinical pathway constructs (the organization of care processes for acute myocardial infarction, stroke, hip fracture and deliveries), patient-specific processes and outcomes (clinical effectiveness, patient safety and patient experience) and external constructs that could modify hospital quality (external assessment and perceived external pressure). Results Data was gathered from 188 hospitals in 7 participating countries. The overall participation and response rate were between 75% and 100% for the assessed measures. Conclusions This is the first study assessing relation between quality management and patient outcomes at EU level. The study involved a large number of respondents and achieved high response rates. This work will serve to develop guidance in how to assess quality management and makes recommendations on the best ways to improve quality in healthcare for hospital stakeholders, payers, researchers, and policy makers throughout the EU. PMID:24671120

Walking the Talk: Continuous Improvement of a Quality Management Field Exercise

ERIC Educational Resources Information Center

Coy, Steven; Adams, Jeffery

2012-01-01

This article provides results from a three semester case study of the pedagogical efficacy of an innovative quality management field exercise. A series of direct and indirect measures were used to assess the extent to which the field exercise met a set of learning objectives. The results indicate that the assessment framework is useful in…

Health, Quality of Care and Quality of Life: A Case of Frail Older Adults

ERIC Educational Resources Information Center

Hsieh, Chang-Ming

2009-01-01

This study explores the relationship between health, quality of care of geriatric case management and quality of life for the purpose of furthering the understanding of the relationship between quality of life and geriatric case management. Using survey data from a group of frail older adults, this study assesses the relative merit of two…

Progress on the Journey to Total Quality Management: Using the Myers-Briggs Type Indicator and the Adjective Check List in Management Development.

ERIC Educational Resources Information Center

Mani, Bonnie G.

1995-01-01

In an Internal Revenue Service office using total quality management (TQM), the management development program uses Myers Briggs Type Indicator and Adjective Check List for manager self-assessment. Because management commitment is essential to TQM, the process is a way of enhancing leadership skills and demonstrating appreciation of diversity. (SK)

The imprecise science of evaluating scholarly performance: utilizing broad quality categories for an assessment of business and management journals.

PubMed

Lange, Thomas

2006-08-01

In a growing number of countries, government-appointed assessment panels develop ranks on the basis of the quality of scholarly outputs to apportion budgets in recognition of evaluated performance and to justify public funds for future R&D activities. When business and management journals are being grouped in broad quality categories, a recent study has noted that this procedure was placing the same journals in essentially the same categories. Drawing on journal quality categorizations by several German- and English-speaking business departments and academic associations, the author performs nonparametric tests and correlations to analyze whether this claim can be substantiated. In particular, he examines the ability of broad quality categorizations to add value to governmental, administrative, and academic decision making by withstanding the criticism traditionally levied at research quality assessments.

Final Environmental Assessment: Demolition of Barracks (Building T-2) at Ipswich Antenna Test Facility

DTIC Science & Technology

2011-12-01

EIAP), managed the preparation and was the primary author of this environmental assessment. QAULITY ASSURANCE LEADER Cravedi, Gregory. 66 ABG/CE...BMP Best Management Practice CEQ Council on Environmental Quality CERCLA Comprehensive Environmental Response, Compensation, and Liability Act...Assessment EMCS Energy Management Control System ESC Electronic Systems Center FEMA Federal Emergency Management Agency FIRM Federal

Development of Management Methodology for Engineering Production Quality

NASA Astrophysics Data System (ADS)

Gorlenko, O.; Miroshnikov, V.; Borbatc, N.

2016-04-01

The authors of the paper propose four directions of the methodology developing the quality management of engineering products that implement the requirements of new international standard ISO 9001:2015: the analysis of arrangement context taking into account stakeholders, the use of risk management, management of in-house knowledge, assessment of the enterprise activity according to the criteria of effectiveness

AIR QUALITY MODELING AT NEIGHBORHOOD SCALES TO IMPROVE HUMAN EXPOSURE ASSESSMENT

EPA Science Inventory

Air quality modeling is an integral component of risk assessment and of subsequent development of effective and efficient management of air quality. Urban areas introduce of fresh sources of pollutants into regional background producing significant spatial variability of the co...

Upper Illinois River basin

USGS Publications Warehouse

Friedel, Michael J.

1998-01-01

During the past 25 years, industry and government made large financial investments that resulted in better water quality across the Nation; however, many water-quality concerns remain. Following a 1986 pilot project, the U.S. Geological Survey began implementation of the National Water-Quality Assessment (NAWQA) Program in 1991. This program differs from other national water-quality assessment studies in that the NAWQA integrates monitoring of surface- and ground-water quality with the study of aquatic ecosystems. The goals of the NAWQA Program are to (1) describe current water-quality conditions for a large part of the Nation's freshwater streams and aquifers (water-bearing sediments and rocks), (2) describe how water quality is changing over time, and (3) improve our understanding of the primary natural and human factors affecting water quality.The Upper Illinois River Basin National Water- Quality Assessment (NAWQA) study will increase the scientific understanding of surface- and ground-water quality and the factors that affect water quality in the basin. The study also will provide information needed by water-resource managers to implement effective water-quality management actions and evaluate long-term changes in water quality.

Chronically ill patients' self-management abilities to maintain overall well-being: what is needed to take the next step in the primary care setting?

PubMed

Cramm, Jane Murray; Nieboer, Anna Petra

2015-09-15

Although widespread problems in patient-professional interaction and insufficient support of patients' self-management abilities have been recognized, research investigating the relationships among care quality, productive interaction, and self-management abilities to maintain overall well-being is lacking. Furthermore, studies have revealed differences in these characteristics among certain groups (e.g., less-educated and older patients). This longitudinal study thus aimed to identify relationships among background characteristics, quality of care, productivity of patient-professional interaction, and self-management abilities to maintain overall well-being in chronically ill patients participating in 18 Dutch disease management programs. This longitudinal study included patients participating in 18 Dutch disease management programs. Surveys were administered in 2011 (T1; n = 2191 (out of 4693), 47 % response rate) and 2012 (T2: n = 1722 (out of 4350), 40 % response rate). A total of 1279 patients completed questionnaires at both timepoints (T1 and T2) (27 % response rate). Self-management abilities to maintain well-being were measured using the short (18-item) version of the Self-Management Ability Scale (SMAS-S), patients' perceptions of the productivity of interactions with health care professionals were assessed with the relational coordination instrument and the short (11-item) version of the Patient Assessment of Chronic Illness Care (PACIC-S) was used to assess patients' perceptions of the quality of chronic care delivery. Perceived and objective quality of care and the productivity of patient-professional interaction were found to be related to patients' self-management abilities to maintain overall well-being. These abilities were related negatively to and significantly predicted by low educational level, single status, and older age, despite the mediating role of productive interaction in their relationship with patients' perceptions of care quality. These findings suggest that patient-professional interaction is not yet sufficiently productive to successfully protect against the deterioration of self-management abilities in some groups of chronically ill patients, although such interaction and high-quality care are important factors in such protection. Improvement of the quality of chronic care delivery should thus always be accompanied by investment in high-quality communication and patient-professional relationships.

The Role of the Quality Enhancement Plan in Engendering a Culture of Assessment

ERIC Educational Resources Information Center

Loughman, Thomas P.; Hickson, Joyce; Sheeks, Gina L.; Hortman, J. William

2008-01-01

During the past two decades, colleges and universities have used best practices from corporate management such as total quality management, strategic planning, management by objectives, benchmarking, data warehousing, and performance indicators. Many institutions of higher learning now have adopted comprehensive and multifaceted approaches to…

Patient Experience Shows Little Relationship with Hospital Quality Management Strategies

PubMed Central

Groene, Oliver; Arah, Onyebuchi A.; Klazinga, Niek S.; Wagner, Cordula; Bartels, Paul D.; Kristensen, Solvejg; Saillour, Florence; Thompson, Andrew; Thompson, Caroline A.; Pfaff, Holger; DerSarkissian, Maral; Sunol, Rosa

2015-01-01

Objectives Patient-reported experience measures are increasingly being used to routinely monitor the quality of care. With the increasing attention on such measures, hospital managers seek ways to systematically improve patient experience across hospital departments, in particular where outcomes are used for public reporting or reimbursement. However, it is currently unclear whether hospitals with more mature quality management systems or stronger focus on patient involvement and patient-centered care strategies perform better on patient-reported experience. We assessed the effect of such strategies on a range of patient-reported experience measures. Materials and Methods We employed a cross-sectional, multi-level study design randomly recruiting hospitals from the Czech Republic, France, Germany, Poland, Portugal, Spain, and Turkey between May 2011 and January 2012. Each hospital contributed patient level data for four conditions/pathways: acute myocardial infarction, stroke, hip fracture and deliveries. The outcome variables in this study were a set of patient-reported experience measures including a generic 6-item measure of patient experience (NORPEQ), a 3-item measure of patient-perceived discharge preparation (Health Care Transition Measure) and two single item measures of perceived involvement in care and hospital recommendation. Predictor variables included three hospital management strategies: maturity of the hospital quality management system, patient involvement in quality management functions and patient-centered care strategies. We used directed acyclic graphs to detail and guide the modeling of the complex relationships between predictor variables and outcome variables, and fitted multivariable linear mixed models with random intercept by hospital, and adjusted for fixed effects at the country level, hospital level and patient level. Results Overall, 74 hospitals and 276 hospital departments contributed data on 6,536 patients to this study (acute myocardial infarction n = 1,379, hip fracture n = 1,503, deliveries n = 2,088, stroke n = 1,566). Patients admitted for hip fracture and stroke had the lowest scores across the four patient-reported experience measures throughout. Patients admitted after acute myocardial infarction reported highest scores on patient experience and hospital recommendation; women after delivery reported highest scores for patient involvement and health care transition. We found no substantial associations between hospital-wide quality management strategies, patient involvement in quality management, or patient-centered care strategies with any of the patient-reported experience measures. Conclusion This is the largest study so far to assess the complex relationship between quality management strategies and patient experience with care. Our findings suggest absence of and wide variations in the institutionalization of strategies to engage patients in quality management, or implement strategies to improve patient-centeredness of care. Seemingly counterintuitive inverse associations could be capturing a scenario where hospitals with poorer quality management were beginning to improve their patient experience. The former suggests that patient-centered care is not yet sufficiently integrated in quality management, while the latter warrants a nuanced assessment of the motivation and impact of involving patients in the design and assessment of services. PMID:26151864

Patient Experience Shows Little Relationship with Hospital Quality Management Strategies.

PubMed

Groene, Oliver; Arah, Onyebuchi A; Klazinga, Niek S; Wagner, Cordula; Bartels, Paul D; Kristensen, Solvejg; Saillour, Florence; Thompson, Andrew; Thompson, Caroline A; Pfaff, Holger; DerSarkissian, Maral; Sunol, Rosa

2015-01-01

Patient-reported experience measures are increasingly being used to routinely monitor the quality of care. With the increasing attention on such measures, hospital managers seek ways to systematically improve patient experience across hospital departments, in particular where outcomes are used for public reporting or reimbursement. However, it is currently unclear whether hospitals with more mature quality management systems or stronger focus on patient involvement and patient-centered care strategies perform better on patient-reported experience. We assessed the effect of such strategies on a range of patient-reported experience measures. We employed a cross-sectional, multi-level study design randomly recruiting hospitals from the Czech Republic, France, Germany, Poland, Portugal, Spain, and Turkey between May 2011 and January 2012. Each hospital contributed patient level data for four conditions/pathways: acute myocardial infarction, stroke, hip fracture and deliveries. The outcome variables in this study were a set of patient-reported experience measures including a generic 6-item measure of patient experience (NORPEQ), a 3-item measure of patient-perceived discharge preparation (Health Care Transition Measure) and two single item measures of perceived involvement in care and hospital recommendation. Predictor variables included three hospital management strategies: maturity of the hospital quality management system, patient involvement in quality management functions and patient-centered care strategies. We used directed acyclic graphs to detail and guide the modeling of the complex relationships between predictor variables and outcome variables, and fitted multivariable linear mixed models with random intercept by hospital, and adjusted for fixed effects at the country level, hospital level and patient level. Overall, 74 hospitals and 276 hospital departments contributed data on 6,536 patients to this study (acute myocardial infarction n = 1,379, hip fracture n = 1,503, deliveries n = 2,088, stroke n = 1,566). Patients admitted for hip fracture and stroke had the lowest scores across the four patient-reported experience measures throughout. Patients admitted after acute myocardial infarction reported highest scores on patient experience and hospital recommendation; women after delivery reported highest scores for patient involvement and health care transition. We found no substantial associations between hospital-wide quality management strategies, patient involvement in quality management, or patient-centered care strategies with any of the patient-reported experience measures. This is the largest study so far to assess the complex relationship between quality management strategies and patient experience with care. Our findings suggest absence of and wide variations in the institutionalization of strategies to engage patients in quality management, or implement strategies to improve patient-centeredness of care. Seemingly counterintuitive inverse associations could be capturing a scenario where hospitals with poorer quality management were beginning to improve their patient experience. The former suggests that patient-centered care is not yet sufficiently integrated in quality management, while the latter warrants a nuanced assessment of the motivation and impact of involving patients in the design and assessment of services.

EVERGLADES ECOSYSTEM ASSESSMENT: WATER MANAGEMENT AND QUALITY, EUTROPHICATION, MERCURY CONTAMINATION, SOILS AND HABITAT: MONITORING FOR ADAPTIVE MANAGEMENT: A R-EMAP STATUS REPORT

EPA Science Inventory

The United States Environmental Protection Agency’s Everglades Ecosystem Assessment Program is a long-term research, monitoring and assessment effort. Its goal is to provide critical, timely, scientific information needed for management decisions on the Everglades ecosystem and i...

Assessing quality in volcanic ash soils

Treesearch

Terry L. Craigg; Steven W. Howes

2007-01-01

Forest managers must understand how changes in soil quality resulting from project implementation affect long-term productivity and watershed health. Volcanic ash soils have unique properties that affect their quality and function; and which may warrant soil quality standards and assessment techniques that are different from other soils. We discuss the concept of soil...

Surface water-quality assessment of the lower Kansas River basin, Kansas and Nebraska: analysis of available water-quality data through 1986

USGS Publications Warehouse

Jordan, P.R.; Stamer, J.K.

1991-01-01

Beginning in 1986, the U.S. Congress appropriated funds for the U.S. Geological Survey to test and refine concepts for a National Water-Quality Assessment (NAWQA) Program. The long-term goals of the full-scale program are to: (1) provide a nationally consistent description of current water-quality conditions for a large part of the Nation's surface- and ground-water resources; (2) define long-term trends (or lack of trends) in water quality; and (3) identify, describe, and explain, insofar as possible, the major factors that affect current conditions and trends in water quality. This information, obtained on a continuing basis, will be made available to water managers, policy makers, and the public to provide an improved scientific basis for evaluating the effectiveness of water-quality-management programs and for predicting the likely effects of contemplated changes in land-and water-management practices. At present (1990), the assessment program is in a pilot phase in seven areas that represent diverse hydrologic environments and water-quality conditions.This report completes one of the first activities undertaken as part of the lower Kansas River basin pilot study, which was to compile, screen, and interpret available water-quality data for the study unit through 1986. The report includes information on the sources and types of water-quality data available, the utility of available water-quality data for assessment purposes, and a description of current water-quality conditions and trends and their relation to natural and human factors.

A management-oriented framework for selecting metrics used to assess habitat- and path-specific quality in spatially structured populations

USGS Publications Warehouse

Nicol, Sam; Wiederholt, Ruscena; Diffendorfer, James E.; Mattsson, Brady; Thogmartin, Wayne E.; Semmens, Darius J.; Laura Lopez-Hoffman,; Norris, Ryan

2016-01-01

Mobile species with complex spatial dynamics can be difficult to manage because their population distributions vary across space and time, and because the consequences of managing particular habitats are uncertain when evaluated at the level of the entire population. Metrics to assess the importance of habitats and pathways connecting habitats in a network are necessary to guide a variety of management decisions. Given the many metrics developed for spatially structured models, it can be challenging to select the most appropriate one for a particular decision. To guide the management of spatially structured populations, we define three classes of metrics describing habitat and pathway quality based on their data requirements (graph-based, occupancy-based, and demographic-based metrics) and synopsize the ecological literature relating to these classes. Applying the first steps of a formal decision-making approach (problem framing, objectives, and management actions), we assess the utility of metrics for particular types of management decisions. Our framework can help managers with problem framing, choosing metrics of habitat and pathway quality, and to elucidate the data needs for a particular metric. Our goal is to help managers to narrow the range of suitable metrics for a management project, and aid in decision-making to make the best use of limited resources.

THE USE OF HYPERSPECTRAL REMOTE SENSING FOR THE DEVELOPMENT OF OPTICAL WATER QUALITY INDICATORS IN THE OHIO RIVER BASIN

EPA Science Inventory

Hyperspectral remote sensing for the assessment of inland water quality can be used in enhancing the capabilities of resource managers to monitor water bodies in a timely and cost-effective manner. The key factor in assessing the accuracy of water quality assessments based on re...

Ambient air quality programmes for health impact assessment in the WHO European region.

PubMed

Mücke, H G

2000-06-01

An important aim of air quality assessment is to provide information about population exposure and health impact assessment. Numerous epidemiological studies have already shown that exposure to excessive levels of ambient air pollutants are associated with either acute or chronic health effects. Until recently, the adequacy of monitoring population exposure in relation to quantitative assessment of health effects of air pollution was rarely considered in ambient air monitoring strategies. This made the formulation of health-related recommendations to risk management difficult and weakens preventive and other measures to reduce adverse health effects of air pollution. To improve local and national capacities for health impact assessment, the European Centre for Environment and Health of the World Health Organization has prepared methodology guidelines concerning selected aspects of air monitoring. The WHO Collaborating Centre for Air Quality Management and Air Pollution Control support efforts in line with international programmes on quality assurance and control for Europe.

Analysis of air quality management with emphasis on transportation sources

NASA Technical Reports Server (NTRS)

English, T. D.; Divita, E.; Lees, L.

1980-01-01

The current environment and practices of air quality management were examined for three regions: Denver, Phoenix, and the South Coast Air Basin of California. These regions were chosen because the majority of their air pollution emissions are related to mobile sources. The impact of auto exhaust on the air quality management process is characterized and assessed. An examination of the uncertainties in air pollutant measurements, emission inventories, meteorological parameters, atmospheric chemistry, and air quality simulation models is performed. The implications of these uncertainties to current air quality management practices is discussed. A set of corrective actions are recommended to reduce these uncertainties.

Total Quality Management (TQM), an Overview

DTIC Science & Technology

1991-09-01

Quality Management (TQM). It discusses the reasons TQM is a current growth industry, what it is, and how one implements it. It describes the basic analytical tools, statistical process control, some advanced analytical tools, tools used by process improvement teams to enhance their own operations, and action plans for making improvements. The final sections discuss assessing quality efforts and measuring the quality to knowledge

Quality indicators for the assessment and management of pain in the emergency department: a systematic review.

PubMed

Stang, Antonia Schirmer; Hartling, Lisa; Fera, Cassandra; Johnson, David; Ali, Samina

2014-01-01

Evidence indicates that pain is undertreated in the emergency department (ED). The first step in improving the pain experience for ED patients is to accurately and systematically assess the actual care being provided. Identifying gaps in the assessment and treatment of pain and improving patient outcomes requires relevant, evidence-based performance measures. To systematically review the literature and identify quality indicators specific to the assessment and management of pain in the ED. Four major bibliographical databases were searched from January 1980 to December 2010, and relevant journals and conference proceedings were manually searched. Original research that described the development or collection of data on one or more quality indicators relevant to the assessment or management of pain in the ED was included. The search identified 18,078 citations. Twenty-three articles were included: 15 observational (cohort) studies; three before-after studies; three audits; one quality indicator development study; and one survey. Methodological quality was moderate, with weaknesses in the reporting of study design and methodology. Twenty unique indicators were identified, with the majority (16 of 20) measuring care processes. Overall, 91% (21 of 23) of the studies reported indicators for the assessment or management of presenting pain, as opposed to procedural pain. Three of the studies included children; however, none of the indicators were developed specifically for a pediatric population. Gaps in the existing literature include a lack of measures reflecting procedural pain, patient outcomes and the pediatric population. Future efforts should focus on developing indicators specific to these key areas.

A survey-based benchmarking approach for health care using the Baldrige quality criteria.

PubMed

Jennings, K; Westfall, F

1994-09-01

Since 1988, manufacturing and service industries have been using the Malcolm Baldrige National Quality Award to assess their management processes (for example, leadership, information, and analysis) against critical performance criteria. Recognizing that the typical Baldrige assessment is time intensive and dependent on intensive training, The Pacer Group, a consulting firm in Dayton, Ohio, developed a self-assessment tool based on the Baldrige criteria which provides a snapshot assessment of an organization's management practices. The survey was administered at 25 hospitals within a health care system. Hospitals were able to compare their scores with other hospitals in the system, as well as the scores of a Baldrige award winner. Results were also analyzed on a systemwide basis to identify strengths and weaknesses across the system. For all 25 hospitals, the following areas were identified as strengths: management of process quality, leadership, and customer focus and satisfaction. Weaknesses included lack of employee involvement in the quality planning process, poor design of quality systems, and lack of cross-departmental cooperation. One of the surveyed hospitals launched improvement initiatives in knowledge of improvement tools and methods and in a patient satisfaction focus. A team was formed to improve the human resource management system. Also, a new unit was designed using patient-centered care principles. A team re-evaluated every operation that affected patients on the unit. A survey modeled after the Baldrige Award criteria can be useful in benchmarking an organization's quality improvement practices.

An assessment model for quality management

NASA Astrophysics Data System (ADS)

Völcker, Chr.; Cass, A.; Dorling, A.; Zilioli, P.; Secchi, P.

2002-07-01

SYNSPACE together with InterSPICE and Alenia Spazio is developing an assessment method to determine the capability of an organisation in the area of quality management. The method, sponsored by the European Space Agency (ESA), is called S9kS (SPiCE- 9000 for SPACE). S9kS is based on ISO 9001:2000 with additions from the quality standards issued by the European Committee for Space Standardization (ECSS) and ISO 15504 - Process Assessments. The result is a reference model that supports the expansion of the generic process assessment framework provided by ISO 15504 to nonsoftware areas. In order to be compliant with ISO 15504, requirements from ISO 9001 and ECSS-Q-20 and Q-20-09 have been turned into process definitions in terms of Purpose and Outcomes, supported by a list of detailed indicators such as Practices, Work Products and Work Product Characteristics. In coordination with this project, the capability dimension of ISO 15504 has been revised to be consistent with ISO 9001. As contributions from ISO 9001 and the space quality assurance standards are separable, the stripped down version S9k offers organisations in all industries an assessment model based solely on ISO 9001, and is therefore interesting to all organisations, which intend to improve their quality management system based on ISO 9001.

Is having quality as an item on the executive board agenda associated with the implementation of quality management systems in European hospitals: a quantitative analysis

PubMed Central

Botje, Daan; Klazinga, N.S.; Suñol, R.; Groene, O.; Pfaff, H.; Mannion, R.; Depaigne-Loth, A.; Arah, O.A.; Dersarkissian, M.; Wagner, C.; Klazinga, N.; Kringos, D.S.; Lombarts, M.J.M.H.; Plochg, T.; Lopez, M.A.; Vallejo, P.; Saillour-Glenisson, F.; Car, M.; Jones, S.; Klaus, E.; Bottaro, S.; Garel, P.; Saluvan, M.; Bruneau, C.; Depaigne-Loth, A.; Hammer, A.; Ommen, O.; Pfaff, H.; Botje, D.; Escoval, A.; Lívio, A.; Eiras, M.; Franca, M.; Leite, I.; Almeman, F.; Kus, H.; Ozturk, K.; Mannion, R.; Wang, A.; Thompson, A.

2014-01-01

Objective To assess whether there is a relationship between having quality as an item on the board's agenda, perceived external pressure (PEP) and the implementation of quality management in European hospitals. Design A quantitative, mixed method, cross-sectional study in seven European countries in 2011 surveying CEOs and quality managers and data from onsite audits. Participants One hundred and fifty-five CEOs and 155 quality managers. Setting One hundred and fifty-five randomly selected acute care hospitals in seven European countries (Czech Republic, France, Germany, Poland, Portugal, Spain and Turkey). Main outcome measure(s) Three constructs reflecting quality management based on questionnaire and audit data: (i) Quality Management System Index, (ii) Quality Management Compliance Index and (iii) Clinical Quality Implementation Index. The main predictor was whether quality performance was on the executive board's agenda. Results Discussing quality performance at executive board meetings more often was associated with a higher quality management system score (regression coefficient b = 2.53; SE = 1.16; P = 0.030). We found a trend in the associations of discussing quality performance with quality compliance and clinical quality implementation. PEP did not modify these relationships. Conclusions Having quality as an item on the executive board's agenda allows them to review and discuss quality performance more often in order to improve their hospital's quality management. Generally, and as this study found, having quality on the executive board's agenda matters. PMID:24550260

Is having quality as an item on the executive board agenda associated with the implementation of quality management systems in European hospitals: a quantitative analysis.

PubMed

Botje, Daan; Klazinga, N S; Suñol, R; Groene, O; Pfaff, H; Mannion, R; Depaigne-Loth, A; Arah, O A; Dersarkissian, M; Wagner, C

2014-04-01

To assess whether there is a relationship between having quality as an item on the board's agenda, perceived external pressure (PEP) and the implementation of quality management in European hospitals. A quantitative, mixed method, cross-sectional study in seven European countries in 2011 surveying CEOs and quality managers and data from onsite audits. One hundred and fifty-five CEOs and 155 quality managers. One hundred and fifty-five randomly selected acute care hospitals in seven European countries (Czech Republic, France, Germany, Poland, Portugal, Spain and Turkey). Main outcome measure(s) Three constructs reflecting quality management based on questionnaire and audit data: (i) Quality Management System Index, (ii) Quality Management Compliance Index and (iii) Clinical Quality Implementation Index. The main predictor was whether quality performance was on the executive board's agenda. Discussing quality performance at executive board meetings more often was associated with a higher quality management system score (regression coefficient b = 2.53; SE = 1.16; P = 0.030). We found a trend in the associations of discussing quality performance with quality compliance and clinical quality implementation. PEP did not modify these relationships. Having quality as an item on the executive board's agenda allows them to review and discuss quality performance more often in order to improve their hospital's quality management. Generally, and as this study found, having quality on the executive board's agenda matters.

Development of a military competency checklist for case management.

PubMed

Stanton, Marietta P; Swanson, Carol; Baker, Rebecca D

2005-01-01

This presentation will discuss the design, implementation, and evaluation of a competency-based checklist in military nursing network. The checklist was initiated to help assess case manager competency where background and preparation for the case manager role were quite diverse. The checklist assisted initially with the assessment of learning needs; later, it served as a self-assessment for case managers to determine their areas for improvement. Finally, the assessment was used not only to verify competency by the case management supervisor, but also to establish systemwide quality in case management.

Quality measures for the diagnosis and non-operative management of carpal tunnel syndrome in occupational settings.

PubMed

Nuckols, Teryl; Harber, Philip; Sandin, Karl; Benner, Douglas; Weng, Haoling; Shaw, Rebecca; Griffin, Anne; Asch, Steven

2011-03-01

Providing higher quality medical care to workers with occupationally associated carpal tunnel syndrome (CTS) may reduce disability, facilitate return to work, and lower the associated costs. Although many workers' compensation systems have adopted treatment guidelines to reduce the overuse of unnecessary care, limited attention has been paid to ensuring that the care workers do receive is high quality. Further, guidelines are not designed to enable objective assessments of quality of care. This study sought to develop quality measures for the diagnostic evaluation and non-operative management of CTS, including managing occupational activities and functional limitations. Using a variation of the well-established RAND/UCLA Appropriateness Method, we developed draft quality measures using guidelines and literature reviews. Next, in a two-round modified-Delphi process, a multidisciplinary panel of 11 U.S. experts in CTS rated the measures on validity and feasibility. Of 40 draft measures, experts rated 31 (78%) valid and feasible. Nine measures pertained to diagnostic evaluation, such as assessing symptoms, signs, and risk factors. Eleven pertain to non-operative treatments, such as the use of splints, steroid injections, and medications. Eleven others address assessing the association between symptoms and work, managing occupational activities, and accommodating functional limitations. These measures will complement existing treatment guidelines by enabling providers, payers, policymakers, and researchers to assess quality of care for CTS in an objective, structured manner. Given the characteristics of previous measures developed with these methods, greater adherence to these measures will probably lead to improved patient outcomes at a population level.

Environmental Assessment for Airborne Laser Debris Management Vandenberg Air Force Base, California

DTIC Science & Technology

2008-07-01

hazardous waste management, water resources, air quality, and biological resources. Based on the analysis of the Proposed Action and No-Action...aesthetics, hazardous materials management, soils and geology, noise, cultural resources, and environmental justice. The resources analyzed in more detail...include: health and safety, hazardous waste management, water resources, air quality, and biological resources. Environmental Effects Under the

SYN-OP-SYS™: A Computerized Management Information System for Quality Assurance and Risk Management

PubMed Central

Thomas, David J.; Weiner, Jayne; Lippincott, Ronald C.

1985-01-01

SYN·OP·SYS™ is a computerized management information system for quality assurance and risk management. Computer software for the efficient collection and analysis of “occurrences” and the clinical data associated with these kinds of patient events is described. The system is evaluated according to certain computer design criteria, and the system's implementation is assessed.

Managing Change to a Quality Philosophy: A Partnership Perspective.

ERIC Educational Resources Information Center

Snyder, Karolyn J.; Acker-Hocevar, Michele

Within the past 5 years there has been an international movement to adapt the principles and practices of Total Quality Management work environments to school-restructuring agendas. This paper reports on the development of a model called the Educational Quality System, a benchmark assessment tool for identifying the essential elements of quality…

[Implementation of quality management in medical rehabilitation--current challenges for rehabilitation facilities].

PubMed

Enge, M; Koch, A; Müller, T; Vorländer, T

2010-12-01

The legal responsibilities imposed upon rehabilitation facilities under section 20 (2a) SGB IX, necessitate fundamental decisions to be taken regarding the development of quality management systems over and above the existing framework. This article is intended to provide ideas and suggestions to assist rehabilitation facilities in implementing a quality management system, which is required in addition to participation in the quality assurance programmes stipulated by the rehabilitation carriers. In this context, the additional internal benefit a functioning quality management system can provide for ensuring a high level of quality and for maintaining the competitiveness of the rehabilitation facility should be taken into account. The core element of these observations, hence, is a list of requirements which enables assessment of the quality of consultants' performance in setting up a quality management system. © Georg Thieme Verlag KG Stuttgart · New York.

Water resources management strategies and its implications on hydrodynamic and hydrochemical changes of costal groundwater: Case of Grombalia shallow aquifer, NE Tunisia

NASA Astrophysics Data System (ADS)

Lachaal, Fethi; Chekirbane, Anis; Chargui, Sameh; Sellami, Haykel; Tsujimura, Maki; Hezzi, Hmida; Faycel, Jelassi; Mlayah, Ammar

2016-12-01

Information on groundwater quantity as well as quality is required by water managers and decision-makers for defining a sustainable management strategy. This requires a comprehensive assessment of the surface water and groundwater resources. This paper provides an assessment of water resources management strategy in the Grombalia region (Northeast Tunisia) and its impact on quantity and quality evolution of groundwater resources based on an approach that combines (i) hydro-climatic data, (ii) field monitoring, (iii) historic piezometric records, and (iv) geochemical and stable isotopes (δ18O and δ2H) analyses. We apply this approach to identify the origin of the various water resources and outline how the actual water management impact the quantity and quality of the groundwater in the region. As consequence of poor water resources management, the shallow groundwater levels have been disrupted: a groundwater rise is observed in the centre and a piezometric drawdown is observed in the upstream regions. Groundwater quality degradation was registered especially in the centre and downstream zones.

Quality of care in patients with psoriasis: an initial clinical study of an international disease management programme.

PubMed

de Korte, J; Van Onselen, J; Kownacki, S; Sprangers, M A G; Bos, J D

2005-01-01

Patients with psoriasis have to cope with their disease for many years or even throughout their entire life. To provide optimal care, a disease management programme was developed. This programme consisted of disease education, disease management training, and psychological support, together with topical treatment. To test a disease management programme in dermatological practice, to assess patients' satisfaction with this programme, and adherence to topical treatment. Additionally, disease severity and quality of life were assessed. An initial clinical investigation was conducted in 10 European treatment centres. A total of 330 patients were included. Patient satisfaction, adherence, disease severity and quality of life were measured with study-specific and standardized self-report questionnaires. Patients reported a high degree of satisfaction with the programme, and a high degree of adherence to topical treatment. Disease severity and quality of life significantly improved. The programme was well received by the participating professionals. The disease management programme was found to be a useful tool in the management of psoriasis, providing patients with relief from the burden of psoriasis in everyday life. A full-scale evaluation is recommended.

75 FR 1802 - Termination of the Environmental Impact Statement for the General Management Plan, Gila Cliff...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-13

... Management Plan because it has determined that an Environmental Assessment (EA) is the more appropriate... Assessment was approved by the Chief of the NPS Environmental Quality Division on November 4, 2009. The draft general management plan and Environmental Assessment is expected to be distributed for a 30 day public...

Assessing the Culture and Climate for Quality Improvement in the Work Environment. AIR 1994 Annual Forum Paper.

ERIC Educational Resources Information Center

Cameron, Kim; And Others

This study attempted to develop a reliable and valid instrument for assessing work environment and continuous quality improvement efforts in the non-academic sectors of colleges and universities particularly those institutions who have adopted Total Quality Management programs. A model of a work environment for continuous quality improvement was…

24 CFR 901.1 - Purpose, program scope and applicability.

Code of Federal Regulations, 2010 CFR

2010-04-01

... receivership agreement, if applicable). (5) To ensure quality management results from a contract between an AME... URBAN DEVELOPMENT PUBLIC HOUSING MANAGEMENT ASSESSMENT PROGRAM § 901.1 Purpose, program scope and applicability. (a) Purpose. This part establishes the Public Housing Management Assessment Program (PHMAP) to...

24 CFR 902.5 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Housing Quality Standards. (ii) Management Assessment Score. A PHA will receive an assessment score on the... RMCs and AMEs. This part applies to PHAs, Resident Management Corporations (RMCs) and Alternate Management Entities (AMEs), as described in this section. As described in this section, this part is also...

Development, evaluation, and application of sediment quality targets for assessing and managing contaminated sediments in Tampa Bay, Florida

USGS Publications Warehouse

MacDonald, D.D.; Carr, R.S.; Eckenrod, D.; Greening, H.; Grabe, S.; Ingersoll, C.G.; Janicki, S.; Janicki, T.; Lindskoog, R.A.; Long, E.R.; Pribble, R.; Sloane, G.; Smorong, D.E.

2004-01-01

Tampa Bay is a large, urban estuary that is located in west central Florida. Although water quality conditions represent an important concern in this estuary, information from numerous sources indicates that sediment contamination also has the potential to adversely affect aquatic organisms, aquatic-dependent wildlife, and human health. As such, protecting relatively uncontaminated areas of the bay from contamination and reducing the amount of toxic chemicals in contaminated sediments have been identified as high-priority sediment management objectives for Tampa Bay. To address concerns related to sediment contamination in the bay, an ecosystem-based framework for assessing and managing sediment quality conditions was developed that included identification of sediment quality issues and concerns, development of ecosystem goals and objectives, selection of ecosystem health indicators, establishment of metrics and targets for key indicators, and incorporation of key indicators, metrics, and targets into watershed management plans and decision-making processes. This paper describes the process that was used to select and evaluate numerical sediment quality targets (SQTs) for assessing and managing contaminated sediments. These SQTs included measures of sediment chemistry, whole-sediment and pore-water toxicity, and benthic invertebrate community structure. In addition, the paper describes how the SQTs were used to develop site-specific concentration-response models that describe how the frequency of adverse biological effects changes with increasing concentrations of chemicals of potential concern. Finally, a key application of the SQTs for defining sediment management areas is discussed.

Effects of a One-to-One Fatigue Management Course for People With Chronic Conditions and Fatigue.

PubMed

Van Heest, Katy N L; Mogush, Ashley R; Mathiowetz, Virgil G

We assessed the impact of a one-to-one fatigue management course on participants' fatigue, self-efficacy, quality of life, and energy conservation behaviors. This observational study used a one-group, pretest-posttest, follow-up design. Forty-nine people with chronic conditions and fatigue participated in the one-to-one fatigue management course in outpatient and community-based settings. The Functional Assessment of Chronic Illness Therapy-Fatigue Scale was used to measure fatigue; the Functional Assessment of Cancer Therapy-General measured quality of life; and the Self-Efficacy for Performing Energy Conservation Strategies Assessment was used to measure self-efficacy. Participants showed significant reductions in fatigue and significant increases in self-efficacy and quality of life at posttest. These beneficial effects were maintained at follow-up. The Social Well-Being subscale was the only measure on which outcomes did not change significantly. The one-to-one fatigue management course is a beneficial intervention for people with chronic conditions and fatigue. Copyright © 2017 by the American Occupational Therapy Association, Inc.

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

[The German program for disease management guidelines: evaluation by use of quality indicators].

PubMed

Kopp, Ina B; Geraedts, Max; Jäckel, Wilfried H; Altenhofen, Lutz; Thomeczek, Christian; Ollenschläger, Günter

2007-08-15

The Program for National Disease Management Guidelines (German DM-CPG Program) in Germany aims at the implementation of best-practice recommendations for prevention, acute care, rehabilitation and chronic care in the setting of disease management programs and integrated health-care systems. Like other guidelines, DM-CPG need to be assessed regarding their influence on structures, processes and outcomes of care. However, quality assessment in integrated health-care systems is challenging. On the one hand, a multitude of potential domains for measurement, actors and perspectives need to be considered. On the other hand, measures need to be identified that assess the function of the diagnostic and therapeutic chain in terms of cooperation and coordination of care. The article reviews methods and use of quality indicators in the context of the German DM-CPG Program.

Self-Assessment for Managers of Health Care. How Can I Be a Better Manager? WHO Offset Publication No. 97.

ERIC Educational Resources Information Center

Rotem, Arie; Fay, Joe

This booklet is intended to assist midlevel health care managers in assessing and improving their health care management skills. The first chapter uses the story of one health care manager's recognition of his own weaknesses and subsequent self-improvement to illustrate the qualities and skills that make a good manager. The second chapter, which…

Assessment of the quality of medical care among patients with early stage prostate cancer undergoing expectant management in the United States.

PubMed

Ritchey, Jamie; Gay, E Greer; Spencer, Benjamin A; Miller, David C; Wallner, Lauren P; Stewart, Andrew K; Dunn, Rodney L; Litwin, Mark S; Wei, John T

2012-09-01

Given the increased attention to the quality and cost of medical care, the Institute of Medicine and Centers for Medicare and Medicaid Services have called for performance measurement and reporting. The clinical management of prostate cancer has been outlined, yet is not intended to describe quality prostate cancer care. Therefore, RAND researchers developed quality indicators for early stage prostate cancer. The ACoS (American College of Surgeons) used these indicators to perform the first national assessment to our knowledge of the quality of care among men with early stage prostate cancer undergoing expectant management. Information from medical records was abstracted for evidence of compliance with the RAND indicators (structure and process). Weighted and stratified proportions were calculated to assess indicator compliance. Logistic regression models were fit and evaluated by hospital type and patient factors. A weighted and stratified total of 13,876 early stage prostate cancer cases on expectant management in 2000 to 2001 were investigated. Compliance with structural indicators was high (greater than 80%) and compliance with process indicators varied (19% to 87%). Differences in process indicators were observed from models by hospital type and comorbid conditions, but not for age, race or insurance status. Using the RAND quality indicators this study revealed several process areas for quality improvement among men with early stage prostate cancer on expectant management in the United States. Efforts to improve the quality of early stage prostate cancer care need to move beyond the paradigm of age, race and insurance status. Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Hospital implementation of health information technology and quality of care: are they related?

PubMed

Restuccia, Joseph D; Cohen, Alan B; Horwitt, Jedediah N; Shwartz, Michael

2012-09-27

Recently, there has been considerable effort to promote the use of health information technology (HIT) in order to improve health care quality. However, relatively little is known about the extent to which HIT implementation is associated with hospital patient care quality. We undertook this study to determine the association of various HITs with: hospital quality improvement (QI) practices and strategies; adherence to process of care measures; risk-adjusted inpatient mortality; patient satisfaction; and assessment of patient care quality by hospital quality managers and front-line clinicians. We conducted surveys of quality managers and front-line clinicians (physicians and nurses) in 470 short-term, general hospitals to obtain data on hospitals' extent of HIT implementation, QI practices and strategies, assessments of quality performance, commitment to quality, and sufficiency of resources for QI. Of the 470 hospitals, 401 submitted complete data necessary for analysis. We also developed measures of hospital performance from several publicly data available sources: Hospital Compare adherence to process of care measures; Medicare Provider Analysis and Review (MEDPAR) file; and Hospital Consumer Assessment of Healthcare Providers and Systems HCAHPS® survey. We used Poisson regression analysis to examine the association between HIT implementation and QI practices and strategies, and general linear models to examine the relationship between HIT implementation and hospital performance measures. Controlling for potential confounders, we found that hospitals with high levels of HIT implementation engaged in a statistically significant greater number of QI practices and strategies, and had significantly better performance on mortality rates, patient satisfaction measures, and assessments of patient care quality by hospital quality managers; there was weaker evidence of higher assessments of patient care quality by front-line clinicians. Hospital implementation of HIT was positively associated with activities intended to improve patient care quality and with higher performance on four of six performance measures.

When Measurement Benefits the Measured

DTIC Science & Technology

2014-04-23

manage how you estimate your work and how you manage the quality of our work. Knowledge workers manage themselves with data. Software engineers...development, coaching, and training. His current research and development interests include data quality assessment and improvement, project...was an engineer and manager at Boeing in Seattle. He has a Masters Degree in Systems Engineering and is a senior member of IEEE. Mark is a certified

TU-AB-BRD-04: Development of Quality Management Program

DOE Office of Scientific and Technical Information (OSTI.GOV)

Thomadsen, B.

2015-06-15

Current quality assurance and quality management guidelines provided by various professional organizations are prescriptive in nature, focusing principally on performance characteristics of planning and delivery devices. However, published analyses of events in radiation therapy show that most events are often caused by flaws in clinical processes rather than by device failures. This suggests the need for the development of a quality management program that is based on integrated approaches to process and equipment quality assurance. Industrial engineers have developed various risk assessment tools that are used to identify and eliminate potential failures from a system or a process before amore » failure impacts a customer. These tools include, but are not limited to, process mapping, failure modes and effects analysis, fault tree analysis. Task Group 100 of the American Association of Physicists in Medicine has developed these tools and used them to formulate an example risk-based quality management program for intensity-modulated radiotherapy. This is a prospective risk assessment approach that analyzes potential error pathways inherent in a clinical process and then ranks them according to relative risk, typically before implementation, followed by the design of a new process or modification of the existing process. Appropriate controls are then put in place to ensure that failures are less likely to occur and, if they do, they will more likely be detected before they propagate through the process, compromising treatment outcome and causing harm to the patient. Such a prospective approach forms the basis of the work of Task Group 100 that has recently been approved by the AAPM. This session will be devoted to a discussion of these tools and practical examples of how these tools can be used in a given radiotherapy clinic to develop a risk based quality management program. Learning Objectives: Learn how to design a process map for a radiotherapy process Learn how to perform failure modes and effects analysis analysis for a given process Learn what fault trees are all about Learn how to design a quality management program based upon the information obtained from process mapping, failure modes and effects analysis and fault tree analysis. Dunscombe: Director, TreatSafely, LLC and Center for the Assessment of Radiological Sciences; Consultant to IAEA and Varian Thomadsen: President, Center for the Assessment of Radiological Sciences Palta: Vice President of the Center for the Assessment of Radiological Sciences.« less

An investigation of perceptions of programme quality support of adult basic education programmes.

PubMed

Udouj, Gary; Grover, Kenda; Belcher, Greg; Kacirek, Kit

2017-04-01

This study was designed to identify the degree to which the directors of adult basic education programs perceive they have program quality support, as evidenced by a well-defined mission and role in the community, a management system, human resources management, and a suitable learning environment. NSCALL's Evidence-based program self-assessment (2006) was modified and administered electronically to administrators of adult education programs in a mid-southern state. Findings indicated that most directors perceive they are implementing the indicators of program quality support in all of the areas surveyed. A research-based annual self-study that considers the quality indicators is recommended, leaving a need for an update to the NCSALL assessment for use as a program assessment instrument. Copyright © 2016 Elsevier Ltd. All rights reserved.

NARSTO EMISSION INVENTORY ASSESSMENT

EPA Science Inventory

The NARSTO Ozone and Particulate Matter Assessments emphasized that emission inventories are critical to the success of air quality management programs and that emissions inventories in Canada, Mexico, and the United States need improvement to meet expectations for quality, timel...

Can Deming's Concept of Total Quality Management Be Applied to Education?

ERIC Educational Resources Information Center

Sevick, Charles

This paper explores the meaning of Total Quality Management (TQM), examines the development of the concept, and assesses the application of TQM to education. In summary, TQM has the following points of relevance for education: (1) The interest and welfare of every student must be a primary concern; (2) the authoritarian management model does not…

Market-Based Approaches to Quality Assessment and Management of Higher Education in the Republic of Kazakhstan

ERIC Educational Resources Information Center

Valikhanova, Zarina

2015-01-01

This article considers the problems of the definition of quality in the educational sphere. Alternative approaches to the concept of quality of education and its evaluation are determined given the different approaches of scientists and experts. The most important criteria in assessing the quality is distinguished and formed in the matrix for…

ASSESSMENT OF THE IMPACTS OF GLOBAL CHANGE ON REGIONAL U.S. AIR QUALITY: A SYNTHESIS OF CLIMATE CHANGE IMPACTS ON GROUND-LEVEL OZONE (AN INTERIM REPORT OF THE U.S. EPA GLOBAL CHANGE RESEARCH PROGRAM)

EPA Science Inventory

The Air Quality Assessment Final Report is intended for managers and scientists working on air quality to provide them with information on the potential effects of climate change on regional air quality in the United States.

Planning and design of studies for river-quality assessment in the Truckee and Carson River basins, California and Nevada

USGS Publications Warehouse

Nowlin, Jon O.; Brown, W.M.; Smith, L.H.; Hoffman, R.J.

1980-01-01

The objectives of the Geological Survey 's river-quality assessment in the Truckee and Carson River basins in California and Nevada are to identify the significant resource management problems; to develop techniques to assess the problems; and to effectively communicate results to responsible managers. Six major elements of the assessment to be completed by October 1981 are (1) a detailing of the legal, institutional, and structural development of water resources in the basins and the current problems and conflicts; (2) a compilation and synthesis of the physical hydrology of the basins; (3) development of a special workshop approach to involve local management in the direction and results of the study; (4) development of a comprehensive streamflow model emcompassing both basins to provide a quantitative hydrologic framework for water-quality analysis; (5) development of a water-quality transport model for selected constituents and characteristics on selected reaches of the Truckee River; and (6) a detailed examination of selected fish habitats for specified reaches of the Truckee River. Progress will be periodically reported in reports, maps, computer data files, mathematical models, a bibliography, and public presentations. In building a basic framework to develop techniques, the basins were viewed as a single hydrologic unit because of interconnecting diversion structures. The framework comprises 13 hydrographic subunits to facilitate modeling and sampling. Several significant issues beyond the scope of the assessment were considered as supplementary proposals; water-quality loadings in Truckee and Carson Rivers, urban runoff in Reno and management alternatives, and a model of limnological processes in Lahontan Reservoir. (USGS)

Effect of soil in nutrient cycle assessment at dairy farms

NASA Astrophysics Data System (ADS)

van Leeuwen, Maricke; de Boer, Imke; van Dam, Jos; van Middelaar, Corina; Stoof, Cathelijne

2016-04-01

Annual farm nutrient cycle assessments give valuable insight in the nutrient cycles and nutrient losses at dairy farms. It describes nutrient use efficiencies for the entire farm and for the underlying components cattle, manure, crops and soil. In many modelling studies, soil is kept as a constant factor, while soil quality is vital for soil functioning of the ecosystem. Improving soil quality will improve the nutrient cycle, and will also have positive effect on the soil functions crop production, water cycling and greenhouse gas mitigation. Spatial variation of soil properties within a farm, however, are not included in annual nutrient cycle assessments. Therefore it is impossible to identify fields where most profit can be gained by improving farm management at field level, and it is not possible to identify and to quantify nutrient flow path ways. The aim of this study is to develop a framework to improve the annual nutrient cycle assessment at Dutch dairy farms, by including soil properties and their spatial variation within farms. Soil type and soil quality will be described by visual soil assessment of soil quality characteristics. The visual observations will be linked to the nutrient cycle assessment, using soil-hydrological model SWAP. We will demonstrate how soil quality at field level can impact on crop production, eutrophication potential and greenhouse gas potential at farm level. Also, we will show how this framework can be used by farmers to improve their farm management. This new approach is focusing on annual nutrient cycle assessment, but could also be used in life cycle assessment. It will improve understanding of soil functioning and dairy farm management.

Effect of quality chronic disease management for alcohol and drug dependence on addiction outcomes.

PubMed

Kim, Theresa W; Saitz, Richard; Cheng, Debbie M; Winter, Michael R; Witas, Julie; Samet, Jeffrey H

2012-12-01

We examined the effect of the quality of primary care-based chronic disease management (CDM) for alcohol and/or other drug (AOD) dependence on addiction outcomes. We assessed quality using (1) a visit frequency based measure and (2) a self-reported assessment measuring alignment with the chronic care model. The visit frequency based measure had no significant association with addiction outcomes. The self-reported measure of care-when care was at a CDM clinic-was associated with lower drug addiction severity. The self-reported assessment of care from any healthcare source (CDM clinic or elsewhere) was associated with lower alcohol addiction severity and abstinence. These findings suggest that high quality CDM for AOD dependence may improve addiction outcomes. Quality measures based upon alignment with the chronic care model may better capture features of effective CDM care than a visit frequency measure. Copyright © 2012 Elsevier Inc. All rights reserved.

Application of advanced data collection and quality assurance methods in open prospective study - a case study of PONS project.

PubMed

Wawrzyniak, Zbigniew M; Paczesny, Daniel; Mańczuk, Marta; Zatoński, Witold A

2011-01-01

Large-scale epidemiologic studies can assess health indicators differentiating social groups and important health outcomes of the incidence and mortality of cancer, cardiovascular disease, and others, to establish a solid knowledgebase for the prevention management of premature morbidity and mortality causes. This study presents new advanced methods of data collection and data management systems with current data quality control and security to ensure high quality data assessment of health indicators in the large epidemiologic PONS study (The Polish-Norwegian Study). The material for experiment is the data management design of the large-scale population study in Poland (PONS) and the managed processes are applied into establishing a high quality and solid knowledge. The functional requirements of the PONS study data collection, supported by the advanced IT web-based methods, resulted in medical data of a high quality, data security, with quality data assessment, control process and evolution monitoring are fulfilled and shared by the IT system. Data from disparate and deployed sources of information are integrated into databases via software interfaces, and archived by a multi task secure server. The practical and implemented solution of modern advanced database technologies and remote software/hardware structure successfully supports the research of the big PONS study project. Development and implementation of follow-up control of the consistency and quality of data analysis and the processes of the PONS sub-databases have excellent measurement properties of data consistency of more than 99%. The project itself, by tailored hardware/software application, shows the positive impact of Quality Assurance (QA) on the quality of outcomes analysis results, effective data management within a shorter time. This efficiency ensures the quality of the epidemiological data and indicators of health by the elimination of common errors of research questionnaires and medical measurements.

The creation, management, and use of data quality information for life cycle assessment

EPA Science Inventory

Despite growing access to data, questions of “best fit” data and the appropriate use of results in supporting decision making still plague the life cycle assessment (LCA) community. This discussion paper addresses revisions to assessing data quality captured in a new US Environme...

Principles of disease management in neonatology.

PubMed

Bowen, F W; Gwiazdowski, S

1998-06-01

This article emphasizes the emerging facets of disease-management practice that impact directly on establishing a measured care system that can produce the information needed to establish a continuous quality improvement program. The areas discussed are risk assessment, clinical management guidelines and carepaths, and the measurement of system output known as clinical outcomes. The remainder of the article details the aspects of risk assessment, guideline function, and outcome assessment, critical in a disease-managed measured care system.

Acceptability of quality reporting and pay for performance among primary health centers in Lebanon.

PubMed

Saleh, Shadi S; Alameddine, Mohamad S; Natafgi, Nabil M

2013-01-01

Primary health care (PHC) is emphasized as the cornerstone of any health care system. Enhancing PHC performance is considered a strategy to enhance effective and equitable access to care. This study assesses the acceptability of and factors associated with quality reporting among PHC centers (PHCCs) in Lebanon. The managers of 132 Lebanese Ministry of Health PHCCs were surveyed using a cross-sectional design. Managers' willingness to report quality, participate in comparative quality assessments, and endorse pay-for-performance schemes was evaluated. Collected data were matched to the infrastructural characteristics and services database. Seventy-six percent of managers responded to the questionnaire, 93 percent of whom were willing to report clinical performance. Most expressed strong support for peer-performance comparison and pay-for-performance schemes. Willingness to report was negatively associated with the religious affiliation of centers and presence of health care facilities in the catchment area and favorably associated with use of information systems and the size of population served. The great willingness of PHCC managers to employ quality-enhancing initiatives flags a policy priority for PHC stakeholders to strengthen PHCC infrastructure and to enable reporting in an easy, standardized, and systematic way. Enhancing equity necessitates education and empowerment of managers in remote areas and those managing religiously affiliated centers.

Higher Education and the Panopticon Paradigm: Quality Assessment as "Disciplinary Technology."

ERIC Educational Resources Information Center

Shore, Cris; Roberts, Stephen

This paper explores the function and effects of recent government reform of higher education in the United Kingdom particularly on quality assurance and quality assessment. The reforms have aimed to make institutions more akin to business and have used the language and techniques of "management." It is argued, in agreement with Michel…

Integrating sentinel watershed-systems into the monitoring and assessment of Minnesota's (USA) waters quality.

PubMed

Magner, J A; Brooks, K N

2008-03-01

Section 303(d) of the Clean Water Act requires States and Tribes to list waters not meeting water quality standards. A total maximum daily load must be prepared for waters identified as impaired with respect to water quality standards. Historically, the management of pollution in Minnesota has been focused on point-source regulation. Regulatory effort in Minnesota has improved water quality over the last three decades. Non-point source pollution has become the largest driver of conventional 303(d) listings in the 21st century. Conventional pollutants, i.e., organic, sediment and nutrient imbalances can be identified with poor land use management practices. However, the cause and effect relationship can be elusive because of natural watershed-system influences that vary with scale. Elucidation is complex because the current water quality standards in Minnesota were designed to work best with water quality permits to control point sources of pollution. This paper presents a sentinel watershed-systems approach (SWSA) to the monitoring and assessment of Minnesota waterbodies. SWSA integrates physical, chemical, and biological data over space and time using advanced technologies at selected small watersheds across Minnesota to potentially improve understanding of natural and anthropogenic watershed processes and the management of point and non-point sources of pollution. Long-term, state-of-the-art monitoring and assessment is needed to advance and improve water quality standards. Advanced water quality or ecologically-based standards that integrate physical, chemical, and biological numeric criteria offer the potential to better understand, manage, protect, and restore Minnesota's waterbodies.

Assessing BMP Performance Using Microtox Toxicity Analysis

EPA Science Inventory

Best Management Practices (BMPs) have been shown to be effective in reducing runoff and pollutants from urban areas and thus provide a mechanism to improve downstream water quality. Currently, BMP performance regarding water quality improvement is assessed through measuring each...

Groundwater quality assessment plan for single-shell waste management area B-BX-BY at the Hanford Site

DOE Office of Scientific and Technical Information (OSTI.GOV)

SM Narbutovskih

2000-03-31

Pacific Northwest National Laboratory conducted a first determination groundwater quality assessment at the Hanford Site. This work was performed for the US Department of Energy, Richland Operations Office, in accordance with the Federal Facility Compliance Agreement during the time period 1996--1998. The purpose of the assessment was to determine if waste from the Single-Shell Tank (SST) Waste Management Area (WMA) B-BX-BY had entered the groundwater at levels above the drinking water standards (DWS). The resulting assessment report documented evidence demonstrating that waste from the WMA has, most likely, impacted groundwater quality. Based on 40 CFR 265.93 [d] paragraph (7), themore » owner-operator must continue to make the minimum required determinations of contaminant level and of rate/extent of migrations on a quarterly basis until final facility closure. These continued determinations are required because the groundwater quality assessment was implemented prior to final closure of the facility.« less

QUALITY ASSURANCE/QUALITY CONTROL OF A PROJECT INVOLVING COOPERATIVE AGREEMENTS, INTRA-AGENCY AGREEMENTS, AGENCY STAFF AND CONTRACTS TO CONDUCT RESEARCH: ECOLOGICAL MONITORING AND ASSESSMENT OF THE GREAT RIVERS ECOSYSTEMS IN THE CENTRAL BASIN OF THE UNITED STATES (EMAP-GRE)

EPA Science Inventory

While condition reports are useful to managers, demonstrating how to implement a monitoring and assessment program in the future is also an important project goal. Better monitoring methods will make more information more widely available to better manage the nation's great rive...

[Risk management--a new aspect of quality assessment in intensive care medicine: first results of an analysis of the DIVI's interdisciplinary quality assessment research group].

PubMed

Stiletto, R; Röthke, M; Schäfer, E; Lefering, R; Waydhas, Ch

2006-10-01

Patient security has become one of the major aspects of clinical management in recent years. The crucial point in research was focused on malpractice. In contradiction to the economic process in non medical fields, the analysis of errors during the in-patient treatment time was neglected. Patient risk management can be defined as a structured procedure in a clinical unit with the aim to reduce harmful events. A risk point model was created based on a Delphi process and founded on the DIVI data register. The risk point model was evaluated in clinically working ICU departments participating in the register data base. The results of the risk point evaluation will be integrated in the next data base update. This might be a step to improve the reliability of the register to measure quality assessment in the ICU.

An assessment of the quality of care for children in eighteen randomly selected district and sub-district hospitals in Bangladesh

PubMed Central

2012-01-01

Background Quality hospital care is important in ensuring that the needs of severely ill children are met to avert child mortality. However, the quality of hospital care for children in developing countries has often been found poor. As the first step of a country road map for improving hospital care for children, we assessed the baseline situation with respect to the quality of care provided to children under-five years age in district and sub-district level hospitals in Bangladesh. Methods Using adapted World Health Organization (WHO) hospital assessment tools and standards, an assessment of 18 randomly selected district (n=6) and sub-district (n=12) hospitals was undertaken. Teams of trained assessors used direct case observation, record review, interviews, and Management Information System (MIS) data to assess the quality of clinical case management and monitoring; infrastructure, processes and hospital administration; essential hospital and laboratory supports, drugs and equipment. Results Findings demonstrate that the overall quality of care provided in these hospitals was poor. No hospital had a functioning triage system to prioritise those children most in need of immediate care. Laboratory supports and essential equipment were deficient. Only one hospital had all of the essential drugs for paediatric care. Less than a third of hospitals had a back-up power supply, and just under half had functioning arrangements for safe-drinking water. Clinical case management was found to be sub-optimal for prevalent illnesses, as was the quality of neonatal care. Conclusion Action is needed to improve the quality of paediatric care in hospital settings in Bangladesh, with a particular need to invest in improving newborn care. PMID:23268650

Development and Validity Testing of an Arthritis Self-Management Assessment Tool.

PubMed

Oh, HyunSoo; Han, SunYoung; Kim, SooHyun; Seo, WhaSook

Because of the chronic, progressive nature of arthritis and the substantial effects it has on quality of life, patients may benefit from self-management. However, no valid, reliable self-management assessment tool has been devised for patients with arthritis. This study was conducted to develop a comprehensive self-management assessment tool for patients with arthritis, that is, the Arthritis Self-Management Assessment Tool (ASMAT). To develop a list of qualified items corresponding to the conceptual definitions and attributes of arthritis self-management, a measurement model was established on the basis of theoretical and empirical foundations. Content validity testing was conducted to evaluate whether listed items were suitable for assessing arthritis self-management. Construct validity and reliability of the ASMAT were tested. Construct validity was examined using confirmatory factor analysis and nomological validity. The 32-item ASMAT was developed with a sample composed of patients in a clinic in South Korea. Content validity testing validated the 32 items, which comprised medical (10 items), behavioral (13 items), and psychoemotional (9 items) management subscales. Construct validity testing of the ASMAT showed that the 32 items properly corresponded with conceptual constructs of arthritis self-management, and were suitable for assessing self-management ability in patients with arthritis. Reliability was also well supported. The ASMAT devised in the present study may aid the evaluation of patient self-management ability and the effectiveness of self-management interventions. The authors believe the developed tool may also aid the identification of problems associated with the adoption of self-management practice, and thus improve symptom management, independence, and quality of life of patients with arthritis.

Leveraging EHRs to improve hospital performance: the role of management.

PubMed

Adler-Milstein, Julia; Woody Scott, Kirstin; Jha, Ashish K

2014-11-01

Recent studies fail to find a consistent relationship between adoption of electronic health records (EHRs) and improved hospital performance. We sought to examine whether the quality of hospital management modifies the association between EHR adoption and outcomes related to cost and quality. Retrospective study of a random sample of US acute care hospitals. Management quality was assessed via phone interviews with clinical managers predominantly from cardiac units in a random sample of 325 hospitals using a validated scale of management practices in 4 areas: operations, performance monitoring, target setting, and talent management. American Hospital Association InformationTechnology Supplement data captured whether or not these hospitals had at least a basic EHR. Acute myocardial infarction (AMI) outcomes included risk-adjusted 30-day mortality, average length-of-stay, and average payment per discharge measured using MedPAR data. Ordinary least squares regressions assessed whether management quality modifies the relationship between EHR adoption and AMI outcomes. While we found no association between EHR adoption and our outcomes, management quality modified the relationship in the predicted direction. For length of stay, the coefficient on the interaction between EHR and management was -1.48 (P = .05) and for payment, it was -7786.74 (P = .014). We did not find strong evidence of effect modification for mortality (coefficient = -0.05; P = .37). Coupled with ongoing policy efforts to achieve nationwide EHR adoption is a growing unease that our national investment may not result in better, more efficient care. Our study is among the first to offer empirical evidence that management quality may help explain why some hospitals see substantial gains from EHR adoption while others do not.

DCCC Takes the TQM Plunge...And Tells How.

ERIC Educational Resources Information Center

Entner, Donald

1993-01-01

Activities at Delaware County Community College (Pennsylvania) in implementing Total Quality Management are examined and compared with criteria used by the United States Chamber of Commerce for making quality awards to businesses. Assessed areas include management leadership, strategic planning, customer focus, employee development, teamwork,…

40 CFR 51.852 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... manager means the Federal agency or the Federal official charged with direct responsibility for management... requirements of the Act. Areawide air quality modeling analysis means an assessment on a scale that includes the entire nonattainment or maintenance area which uses an air quality dispersion model to determine...

A Cultural Assessment of Tripler Regional Medical Center.

DTIC Science & Technology

1997-05-15

add value to the beneficiaries. The path Tripler Regional Medical Center has chosen to achieve the level of service quality required to sustain or grow...employing TQM management methods. The goals of this training include improvement in management, service quality , and in employee satisfaction, among

Cognitive function and living situation in COPD: is there a relationship with self-management and quality of life?

PubMed

Dulohery, Megan M; Schroeder, Darrell R; Benzo, Roberto P

2015-01-01

Cognitive impairment is increasingly being found to be a common comorbidity in chronic obstructive pulmonary disease (COPD). This study sought to understand the relationship of comprehensively measured cognitive function with COPD severity, quality of life, living situation, health care utilization, and self-management abilities. Subjects with COPD were recruited from the outpatient pulmonary clinic. Cognitive function was assessed using the Montreal Cognitive Assessment (MOCA). Self-management abilities were measured using the Self Management Ability Score 30. Quality of life was measured using the Chronic Respiratory Disease Questionnaire. Pearson correlation was used to assess the bivariate association of the MOCA with other study measures. Multivariate analysis was completed to understand the interaction of the MOCA and living situation on COPD outcomes of hospitalization, quality of life, and self-management ability. This study included 100 participants of mean age 70±9.4 years (63% male, 37% female) with COPD (mean FEV1 [forced expiratory volume in 1 second] percentage predicted 40.4±16.7). Mean MOCA score was 23.8±3.9 with 63% of patients having mild cognitive impairment. The MOCA was negatively correlated with age (r=-0.28, P=0.005) and positively correlated with education (r=+0.24, P=0.012). There was no significant correlation between cognitive function and exacerbations, emergency room (ER) visits, or hospitalizations. There was no association between the MOCA score and self-management abilities or quality of life. We tested the interaction of living situation and the MOCA with self-management abilities and found statistical significance (P=0.017), indicating that individuals living alone with higher cognitive function report lower self-management abilities. Cognitive impairment in COPD does not appear to be meaningfully associated with COPD severity, health outcomes, or self-management abilities. The routine screening for cognitive impairment due to a diagnosis of COPD may not be indicated. Living alone significantly affects the interaction between self-management abilities and cognitive function.

Assessing the Relationship of Knowledge Management Effectiveness and Assessment Quality Improvement

ERIC Educational Resources Information Center

Ringhand, Darlene Gail

2009-01-01

Administrators at post-secondary institutions have found that national or regional accreditation is necessary to remain competitive in the higher education market with evidence of assessment considered a positive measure for accreditation. This quantitative study examined the correlation between the ranked levels of knowledge management within…

Case management for high-intensity service users: towards a relational approach to care co-ordination.

PubMed

McEvoy, Phil; Escott, Diane; Bee, Penny

2011-01-01

This study is based on a formative evaluation of a case management service for high-intensity service users in Northern England. The evaluation had three main purposes: (i) to assess the quality of the organisational infrastructure; (ii) to obtain a better understanding of the key influences that played a role in shaping the development of the service; and (iii) to identify potential changes in practice that may help to improve the quality of service provision. The evaluation was informed by Gittell's relational co-ordination theory, which focuses upon cross-boundary working practices that facilitate task integration. The Assessment of Chronic Illness Care Survey was used to assess the organisational infrastructure and qualitative interviews with front line staff were conducted to explore the key influences that shaped the development of the service. A high level of strategic commitment and political support for integrated working was identified. However, the quality of care co-ordination was variable. The most prominent operational factor that appeared to influence the scope and quality of care co-ordination was the pattern of interaction between the case managers and their co-workers. The co-ordination of patient care was much more effective in integrated co-ordination networks. Key features included clearly defined, task focussed, relational workspaces with interactive forums where case managers could engage with co-workers in discussions about the management of interdependent care activities. In dispersed co-ordination networks with fewer relational workspaces, the case managers struggled to work as effectively. The evaluation concluded that the creation of flexible and efficient task focused relational workspaces that are systemically managed and adequately resourced could help to improve the quality of care co-ordination, particularly in dispersed networks. © 2010 Blackwell Publishing Ltd.

The WHO AFRO external quality assessment programme (EQAP): Linking laboratory networks through EQA programmes.

PubMed

Boeras, Debrah I; Peeling, Rosanna W; Onyebujoh, Philip; Yahaya, Ali A; Gumede-Moeletsi, Hieronyma N; Ndihokubwayo, Jean B

2016-01-01

External Quality Assessment (EQA) surveys performed by the World Health Organization Regional Office for Africa (WHO AFRO) revealed the need for the strengthening of public health microbiology laboratories, particularly for testing of epidemic-prone diseases in the African Region. These surveys revealed common issues such as supply chain management, skilled personnel, logistical support and overall lack of quality standards. For sustainable improvements to health systems as well as global health security, deficiencies identified need to be actively corrected through robust quality assurance programmes and implementation of laboratory quality management systems. Given all the pathogens of public health importance, an external quality assessment programme with a focus on vaccine-preventable diseases and emerging and re-emerging dangerous pathogens is important, and should not be stand-alone, but integrated within laboratory networks as seen in polio, measles, yellow fever and rubella. In 2015, WHO AFRO collaborated with the US Centers for Disease Control and Prevention, the London School of Hygiene & Tropical Medicine and partners in a series of consultations with countries and national and regional EQA providers for the development of quality assurance models to support HIV point-of-care testing and monitoring. These consultations revealed similar challenges as seen in the WHO AFRO surveys. WHO AFRO brought forth its experience in implementing quality standards for health programmes, and also opened discussions on how lessons learned through such established programmes can be utilised to supporting and strengthening the introduction of early infant diagnosis of HIV and viral load point-of-care testing. An optimised external quality assessment programme will impact the ability of countries to meet core capacities, providing improved quality management systems, improving the confidence of diagnostic network services in Africa, and including capacities to detect events of international public health importance.

Are harmful algal blooms becoming the greatest inland water quality threat to public health and aquatic ecosystems?

PubMed

Brooks, Bryan W; Lazorchak, James M; Howard, Meredith D A; Johnson, Mari-Vaughn V; Morton, Steve L; Perkins, Dawn A K; Reavie, Euan D; Scott, Geoffrey I; Smith, Stephanie A; Steevens, Jeffery A

2016-01-01

In this Focus article, the authors ask a seemingly simple question: Are harmful algal blooms (HABs) becoming the greatest inland water quality threat to public health and aquatic ecosystems? When HAB events require restrictions on fisheries, recreation, and drinking water uses of inland water bodies significant economic consequences result. Unfortunately, the magnitude, frequency, and duration of HABs in inland waters are poorly understood across spatiotemporal scales and differentially engaged among states, tribes, and territories. Harmful algal bloom impacts are not as predictable as those from conventional chemical contaminants, for which water quality assessment and management programs were primarily developed, because interactions among multiple natural and anthropogenic factors determine the likelihood and severity to which a HAB will occur in a specific water body. These forcing factors can also affect toxin production. Beyond site-specific water quality degradation caused directly by HABs, the presence of HAB toxins can negatively influence routine surface water quality monitoring, assessment, and management practices. Harmful algal blooms present significant challenges for achieving water quality protection and restoration goals when these toxins confound interpretation of monitoring results and environmental quality standards implementation efforts for other chemicals and stressors. Whether HABs presently represent the greatest threat to inland water quality is debatable, though in inland waters of developed countries they typically cause more severe acute impacts to environmental quality than conventional chemical contamination events. The authors identify several timely research needs. Environmental toxicology, environmental chemistry, and risk-assessment expertise must interface with ecologists, engineers, and public health practitioners to engage the complexities of HAB assessment and management, to address the forcing factors for HAB formation, and to reduce the threats posed to inland surface water quality. © 2015 SETAC.

The WHO AFRO external quality assessment programme (EQAP): Linking laboratory networks through EQA programmes

PubMed Central

Yahaya, Ali A.; Gumede-Moeletsi, Hieronyma N.

2016-01-01

External Quality Assessment (EQA) surveys performed by the World Health Organization Regional Office for Africa (WHO AFRO) revealed the need for the strengthening of public health microbiology laboratories, particularly for testing of epidemic-prone diseases in the African Region. These surveys revealed common issues such as supply chain management, skilled personnel, logistical support and overall lack of quality standards. For sustainable improvements to health systems as well as global health security, deficiencies identified need to be actively corrected through robust quality assurance programmes and implementation of laboratory quality management systems. Given all the pathogens of public health importance, an external quality assessment programme with a focus on vaccine-preventable diseases and emerging and re-emerging dangerous pathogens is important, and should not be stand-alone, but integrated within laboratory networks as seen in polio, measles, yellow fever and rubella. In 2015, WHO AFRO collaborated with the US Centers for Disease Control and Prevention, the London School of Hygiene & Tropical Medicine and partners in a series of consultations with countries and national and regional EQA providers for the development of quality assurance models to support HIV point-of-care testing and monitoring. These consultations revealed similar challenges as seen in the WHO AFRO surveys. WHO AFRO brought forth its experience in implementing quality standards for health programmes, and also opened discussions on how lessons learned through such established programmes can be utilised to supporting and strengthening the introduction of early infant diagnosis of HIV and viral load point-of-care testing. An optimised external quality assessment programme will impact the ability of countries to meet core capacities, providing improved quality management systems, improving the confidence of diagnostic network services in Africa, and including capacities to detect events of international public health importance. PMID:28879135

Quality of Maternal and Neonatal Care in Albania, Turkmenistan and Kazakhstan: A Systematic, Standard-Based, Participatory Assessment

PubMed Central

Tamburlini, Giorgio; Siupsinskas, Gelmius; Bacci, Alberta

2011-01-01

Background Progress in maternal and neonatal mortality has been slow in many countries despite increasing access to institutional births, suggesting deficiencies in the quality of care. We carried out a systematic assessment of the quality of maternal and newborn care in three CEE/CIS countries, using an innovative approach to identify priority issues and promote action. Methods A standard-based tool, covering over 400 items grouped in 13 main areas ranging from support services to case management, was used to assess a sample of ten maternity hospitals in Albania, Kazakhstan and Turkmenistan. Sources of information were visit to services, medical records, observation of cases, and interviews with staff and mothers. A score (range 0 to 3) was attributed to each item and area of care. The assessment was carried out by a multidisciplinary team of international and national professionals. Local managers and staff provided the necessary information and were involved in discussing the findings and the priority actions. Results Quality of care was found to be substandard in all 13 areas. The lowest scores (between one and two) were obtained by: management of normal labour, delivery, obstetric complications and sick babies; infection prevention; use of guidelines and audits; monitoring and follow-up. Neonatal care as a whole scored better than obstetric care. Interviewed mothers identified lack of information, insufficient support during labour and lack of companionship as main issues. Actions to improve quality of care were identified at facility as well as at central level and framed according to main health system functions. Conclusions Quality of care is a key issue to improve maternal and neonatal outcomes, particularly in countries such as CEE/CIS where access to institutional births is nearly universal. Approaches that involve health professionals and managers in comprehensive, action-oriented assessments of quality of care are promising and should be further supported. PMID:22216110

Do European hospitals have quality and safety governance systems and structures in place?

PubMed

Shaw, C; Kutryba, B; Crisp, H; Vallejo, P; Suñol, R

2009-02-01

Internal systems for quality and safety were assessed in 89 hospitals in six European states, by external teams using standardised criteria and procedures, as part of the Methods of Assessing Response to Quality Improvement Strategies (MARQuIS) project. The assessments were made primarily to identify the current use of quality management systems in the sample hospitals, and also to demonstrate a potential tool for comparable assessment of hospitals in general. The large majority of the hospitals had a formal, documented infrastructure to manage quality and safety, but a significant minority had no designated mission, programme or coordination. In two-thirds of hospitals, the governing body was active in defining policy and programmes for improvement, and received reports on quality, safety and patient satisfaction at least once a year. The brief on-site assessments identified systematic variations, within and between countries, in structures and processes of governance and to document the uptake of best practice. Unacceptable variations in practice could be reduced, to the benefit of consumers and providers, by developing and publishing basic organisational standards relevant to all European states. The simple assessment criteria designed for this project could be developed into a practical tool for self-assessment, peer review or benchmarking of hospitals across national borders. This assessment, combined with explicit, relevant and achievable standards, could provide a vehicle to promote the voluntary uptake of best practice and consistency in quality and safety among hospitals in Europe.

Satisfaction monitoring for quality control in campground management

Treesearch

Wilbur F. LaPage; Malcolm I. Bevins

1981-01-01

A 4-year study of camper satisfaction indicates that satisfaction monitoring is a useful tool for campground managers to assess their performance and achieve a high level of quality control in their service to the public. An indication of camper satisfaction with campground management is gained from a report card on which a small sample of visitors rates 14 elements of...

Comparison of Indoor Air Quality Management Strategies between the School and District Levels in New York State

ERIC Educational Resources Information Center

Lin, Shao; Kielb, Christine L.; Reddy, Amanda L.; Chapman, Bonnie R.; Hwang, Syni-An

2012-01-01

Background: Good school indoor air quality (IAQ) can affect the health and functioning of school occupants. Thus, it is important to assess the degree to which schools and districts employ strategies to ensure good IAQ management. We examined and compared the patterns of IAQ management strategies between public elementary schools and their school…

Improving suicide risk assessment in a managed-care environment.

PubMed

Brown, G S; Jones, Edward R; Betts, Ellen; Wu, Jingyang

2003-01-01

This article describes the quality improvement intervention of a managed behavioral healthcare company to improve the quality of suicide risk assessments by its panel of providers. At-risk cases are identified by the patient's self-reported high frequency of suicidal ideation on a standardized outcome measure. Clinicians also assess severity of suicidal ideation based on clinical interviews. The clinician's assessment is identified as probably erroneous if the patient report indicates a high frequency of suicidal ideation and the clinicians assessment of suicidal ideation is none. The article describes the methods used to encourage clinicians to utilize information from the patient self-report measure as part of the clinical assessment. Probable suicidal ideation assessment errors were subsequently reduced by 29% over a 1-year period of administration.

[Impact of a new regional management for postpartum hemorrhages by an audit of severe cases: a before and after study (2002-2005)].

PubMed

Lefèvre, P; Brucato, S; Mayaud, A; Morello, R; Deneux-Tharaux, C; Bouvier-Colle, M-H; Dreyfus, M

2009-05-01

Postpartum haemorrhage (PPH) is still the first cause of maternal mortality in France. Most of these cases include inappropriate management. In 2004, regional guidelines were diffused to all the birthplaces in Basse-Normandie. To assess the impact of this regional management, an epidemiological study "before-after" (2002-2005) has been performed. Part of this study was the evaluation of the management of severe PPH. This study assessed the quality of care for major PPH and the correct follow-up of the guidelines before and after 2004. A clinical audit has been conducted in all the birthplaces from the region to assess the management of all severe PPH identified during 2002 and 2005. PPH were considered as severe when they presented one or more of the following: blood transfusion, uterine embolisation, hemostatic surgery, difference in hemoglobin rates greater than 4 g / dl, or maternal death. All of these cases have been analysed except those defined by hemoglobin difference. Assessment has been carried out by pairs of practitioners (obstetrician and anesthetist) blinded to the origin of the case. Criteria assessed were the quality of care for major PPH, the correct follow-up of the guidelines and the degree of severity of the PPH which was estimated as moderate or severe on clinical arguments. The number of severe PPH was 34 in 2002 and 63 in 2005. The quality of care was increased with rates of inadequate management falling from 32 to 13% (p < 0,02), respectively. The follow-up of the guidelines was correct in the whole area, most of the criteria having been respected in about 90% of cases in 2005. However, active management of the third stage of delivery was only conducted in 71% of cases. The rates of severe PPH were not significantly different between 2002 (44%) and 2005 (38%). The originality from this study is that the modifications of the practices were conducted at a regional level in order to enhance the management of PPH. The assessment which was performed showed that quality of care was improved all over the area but that there is still place to progress.

Assessment of the Applicability of Total Quality Leadership into the Argentine Army.

DTIC Science & Technology

1995-03-01

Leadership " or TQL (see Chapter III, Section F for further explanation). After analyzing various approaches to quality management , the leaders of the Navy...organizations, learning and change. Theory of knowledge. 18 The Deming Approach to Quality Management E D, EDE (’f’, BI.,, IM0) Figure 3-4. The Deming Approach... managers lack profound knowledge. "Profound knowledge is a lens which provides the needed theory to optimize organizations" [Ref 3:p 94]. According to

A Quality Approach to Writing Assessment.

ERIC Educational Resources Information Center

Andrade, Joanne; Ryley, Helen

1992-01-01

A Colorado elementary school began its Total Quality Management work about a year ago after several staff members participated in an IBM Leadership Training Program addressing applications of Deming's theories. The school's new writing assessment has increased collegiality and cross-grade collaboration. (MLH)

Assessing BMP Performance Using Microtox Toxicity Analysis - Rhode Island

EPA Science Inventory

Best Management Practices (BMPs) have been shown to be effective in reducing runoff and pollutants from urban areas and thus provide a mechanism to improve downstream water quality. Currently, BMP performance regarding water quality improvement is assessed through measuring each...

Assessing BMP Performance Using Microtox® Toxicity Analysis

EPA Science Inventory

Best Management Practices (BMPs) have been shown to be effective in reducing runoff and pollutants from urban areas and thus provide a mechanism to improve downstream water quality. Currently, BMP performance regarding water quality improvement is assessed through measuring each...

Beyond symptom management: Family relations, unmet needs of persons living with severe mental illnesses, and potential implications for social work in South Africa

PubMed Central

Tomita, Andrew; Burns, Jonathan K.; King, Howard; Baumgartner, Joy Noel; Davis, Glen P.; Mtshemla, Sisanda; Nene, Siphumelele; Susser, Ezra

2016-01-01

This study examined the quality of family relationships and its associations with the severity of unmet needs of individuals admitted to a tertiary psychiatric hospital in South Africa. The quality of family relations and perceived unmet needs were assessed using the Lehman Quality of Life Interview and Camberwell Assessment of Needs, respectively. The results show that higher total unmet needs were associated with lower quality of family relations. The main areas of serious unmet needs included accessing government benefits and information, and establishing social relations. The results have implications for hospital-based social workers beyond managing psychiatric symptoms in South Africa. PMID:26731612

Beyond symptom management: Family relations, unmet needs of persons living with severe mental illnesses, and potential implications for social work in South Africa.

PubMed

Tomita, Andrew; Burns, Jonathan K; King, Howard; Baumgartner, Joy Noel; Davis, Glen P; Mtshemla, Sisanda; Nene, Siphumelele; Susser, Ezra

2016-01-01

This study examined the quality of family relationships and its associations with the severity of unmet needs of individuals admitted to a tertiary psychiatric hospital in South Africa. The quality of family relations and perceived unmet needs were assessed using the Lehman Quality of Life Interview and Camberwell Assessment of Needs, respectively. The results show that higher total unmet needs were associated with lower quality of family relations. The main areas of serious unmet needs included accessing government benefits and information, and establishing social relations. The results have implications for hospital-based social workers beyond managing psychiatric symptoms in South Africa.

EFFECT OF QUALITY CHRONIC DISEASE MANAGEMENT FOR ALCOHOL AND DRUG DEPENDENCE ON ADDICTION OUTCOMES

PubMed Central

Kim, Theresa W.; Saitz, Richard; Cheng, Debbie M.; Winter, Michael R; Witas, Julie; Samet, Jeffrey H.

2012-01-01

We examinedthe effect ofthe quality of primary care-basedchronic disease management (CDM)for alcohol and/or other drug (AOD) dependenceonaddiction outcomes.We assessed qualityusing 1)avisit frequencybased measure and 2) a self-reported assessment measuring alignment with the chronic care model. The visit frequency based measure had no significant association with addiction outcomes. Theself-reported measure of care - when care was at a CDM clinic - was associated with lower drug addiction severity.The self-reported assessment of care from any healthcare source (CDM clinic or elsewhere)was associated with lower alcoholaddiction severity and abstinence.These findings suggest that high quality CDM for AOD dependence may improve addiction outcomes.Quality measuresbased upon alignment with the chronic care model may better capture features of effective CDM care than a visitfrequency measure. PMID:22840687

75 FR 15427 - Notice of Intent To Prepare an Environmental Impact Statement/Staff Assessment for the Proposed...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-29

... Management Notice of Intent To Prepare an Environmental Impact Statement/ Staff Assessment for the Proposed... Land Use Plan Amendments AGENCY: Western Area Power Administration, DOE; Bureau of Land Management, DOI... Land Policy and Management Act of 1976 (FLPMA), as amended, and the California Environmental Quality...

Total Quality Management: Implications for Educational Assessment.

ERIC Educational Resources Information Center

Rankin, Stuart C.

1992-01-01

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

Assessment of runoff water quality for an integrated best-management practice system in an agricultural watershed

USDA-ARS?s Scientific Manuscript database

To better understand, implement and integrate best management practices (BMPs) in agricultural watersheds, critical information on their effectiveness is required. A representative agricultural watershed, Beasley Lake, was used to compare runoff water quality draining through an integrated system of...

Defining High-Quality Palliative Care in Oncology Practice: An American Society of Clinical Oncology/American Academy of Hospice and Palliative Medicine Guidance Statement.

PubMed

Bickel, Kathleen E; McNiff, Kristen; Buss, Mary K; Kamal, Arif; Lupu, Dale; Abernethy, Amy P; Broder, Michael S; Shapiro, Charles L; Acheson, Anupama Kurup; Malin, Jennifer; Evans, Tracey; Krzyzanowska, Monika K

2016-09-01

Integrated into routine oncology care, palliative care can improve symptom burden, quality of life, and patient and caregiver satisfaction. However, not all oncology practices have access to specialist palliative medicine. This project endeavored to define what constitutes high-quality primary palliative care as delivered by medical oncology practices. An expert steering committee outlined 966 palliative care service items, in nine domains, each describing a candidate element of primary palliative care delivery for patients with advanced cancer or high symptom burden. Using modified Delphi methodology, 31 multidisciplinary panelists rated each service item on three constructs: importance, feasibility, and scope within medical oncology practice. Panelists endorsed the highest proportion of palliative care service items in the domains of End-of-Life Care (81%); Communication and Shared Decision Making (79%); and Advance Care Planning (78%). The lowest proportions were in Spiritual and Cultural Assessment and Management (35%) and Psychosocial Assessment and Management (39%). In the largest domain, Symptom Assessment and Management, there was consensus that all symptoms should be assessed and managed at a basic level, with more comprehensive management for common symptoms such as nausea, vomiting, diarrhea, dyspnea, and pain. Within the Appropriate Palliative Care and Hospice Referral domain, there was consensus that oncology practices should be able to describe the difference between palliative care and hospice to patients and refer patients appropriately. This statement describes the elements comprising high-quality primary palliative care for patients with advanced cancer or high symptom burden, as delivered by oncology practices. Oncology providers wishing to enhance palliative care delivery may find this information useful to inform operational changes and quality improvement efforts. Copyright © 2016 by American Society of Clinical Oncology.

Performance-based management and quality of work: an empirical assessment.

PubMed

Falzon, Pierre; Nascimento, Adelaide; Gaudart, Corinne; Piney, Cécile; Dujarier, Marie-Anne; Germe, Jean-François

2012-01-01

In France, in the private sector as in the public sector, performance-based management tends to become a norm. Performance-based management is supposed to improve service quality, productivity and efficiency, transparency of allotted means and achieved results, and to better focus the activity of employees and of the whole organization. This text reports a study conducted for the French Ministry of Budget by a team of researchers in ergonomics, sociology and management science, in order to assess the impact of performance-based management on employees, on teams and on work organization. About 100 interviews were conducted with employees of all categories and 6 working groups were set up in order to discuss and validate or amend our first analyses. Results concern several aspects: workload and work intensification, indicators and performance management and the transformation of jobs induced by performance management.

[Quality indicators for National Disease Management Guidelines using the example of the National Disease Management Guideline for "Chronic Heart Failure"].

PubMed

Nothacker, Monika Judith; Langer, Thomas; Weinbrenner, Susanne

2011-01-01

Together with an expert committee a structured approach to determining quality indicators for National Disease Management Guidelines has been developed. The key steps of this approach include: introducing guideline authors to the methodology at an early stage of the process of guideline development, pre-selecting recommendations of the guideline which are potentially measurable by means of quality indicators, assessing the potentially measurable quality indicators in written form using five criteria (including their importance for the health care system and clarity of definitions) and approving them in a formal consensus process. For lack of a database these quality indicators must be regarded as preliminary. For the National Disease Management Guideline "Chronic Heart Failure" nine rate-based indicators have been chosen. The indicators correspond to important strong recommendations (grade of recommendation: A) from the fields of diagnosis (two), general therapeutic strategy (two), specific treatment (three), clinical monitoring (one) and co-ordination of care (one). In a second step, the quality indicators have to be validated within a pilot project. The determination and assessment of the potential quality indicators have revealed room for improvement of guideline development. In particular, there is a need for more health care data and for specification of recommendations.

A residency clinic chronic condition management quality improvement project.

PubMed

Halverson, Larry W; Sontheimer, Dan; Duvall, Sharon

2007-02-01

Quality improvement in chronic disease management is a major agenda for improving health and reducing health care costs. A six-component chronic disease management model can help guide this effort. Several characteristics of the "new model" of family medicine described by the Future of Family Medicine (FFM) Project Leadership Committee are promulgated to foster practice changes that improve quality. Our objective was to implement and assess a quality improvement project guided by the components of a chronic disease management model and FFM new model characteristics. Diabetes was selected as a model chronic disease focus. Multiple practice changes were implemented. A mature electronic medical record facilitated data collection and measurement of quality improvement progress. Data from the diabetes registry demonstrates that our efforts have been effective. Significant improvement occurred in five out of six quality indicators. Multidisciplinary teamwork in a model residency practice guided by chronic disease management principles and the FFM new model characteristics can produce significant management improvements in one important chronic disease.

Assessing the Effects of Grassland Management on Forage Production and Environmental Quality to Identify Paths to Ecological Intensification in Mountain Grasslands.

PubMed

Loucougaray, Grégory; Dobremez, Laurent; Gos, Pierre; Pauthenet, Yves; Nettier, Baptiste; Lavorel, Sandra

2015-11-01

Ecological intensification in grasslands can be regarded as a process for increasing forage production while maintaining high levels of ecosystem functions and biodiversity. In the mountain Vercors massif, where dairy cattle farming is the main component of agriculture, how to achieve forage autonomy at farm level while sustaining environmental quality for tourism and local dairy products has recently stimulated local debate. As specific management is one of the main drivers of ecosystem functioning, we assessed the response of forage production and environmental quality at grassland scale across a wide range of management practices. We aimed to determine which components of management can be harnessed to better match forage production and environmental quality. We sampled the vegetation of 51 grasslands stratified across 13 grassland types. We assessed each grassland for agronomic and environmental properties, measuring forage production, forage quality, and indices based on the abundance of particular plant species such as timing flexibility, apiarian potential, and aromatic plants. Our results revealed an expected trade-off between forage production and environmental quality, notably by stressing the contrasts between sown and permanent grasslands. However, strong within-type variability in both production and environmental quality as well as in flexibility of timing of use suggests possible ways to improve this trade-off at grassland and farm scales. As achieving forage autonomy relies on increasing both forage production and grassland resilience, our results highlight the critical role of the ratio between sown and permanent grasslands as a major path for ecological intensification in mountain grasslands.

[Extraction of management information from the national quality assurance program].

PubMed

Stausberg, Jürgen; Bartels, Claus; Bobrowski, Christoph

2007-07-15

Starting with clinically motivated projects, the national quality assurance program has established a legislative obligatory framework. Annual feedback of results is an important means of quality control. The annual reports cover quality-related information with high granularity. A synopsis for corporate management is missing, however. Therefore, the results of the University Clinics in Greifswald, Germany, have been analyzed and aggregated to support hospital management. Strengths were identified by the ranking of results within the state for each quality indicator, weaknesses by the comparison with national reference values. The assessment was aggregated per clinical discipline and per category (indication, process, and outcome). A composition of quality indicators was claimed multiple times. A coherent concept is still missing. The method presented establishes a plausible summary of strengths and weaknesses of a hospital from the point of view of the national quality assurance program. Nevertheless, further adaptation of the program is needed to better assist corporate management.

Shaping Performance: Do International Accreditations and Quality Management Really Help?

ERIC Educational Resources Information Center

Nigsch, Stefano; Schenker-Wicki, Andrea

2013-01-01

In recent years, international accreditations have become an important form of quality management for business schools all over the world. However, given their high costs and the risk of increasing bureaucratisation and control, accreditations remain highly disputed in academia. This paper uses quantitative data to assess whether accreditations…

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

ERIC Educational Resources Information Center

Hackman, J. Richard; Wageman, Ruth

1995-01-01

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

Horse Training and Management: Program of Excellence.

ERIC Educational Resources Information Center

Lane, Marvin

This report on Lamar Community College's Horse Training and Management (HTM) program assesses the quality of the educational experience provided by the program, the quality of the faculty and students, institutional financial commitment to the program, contribution of the HTM program to state and local economic development, and external funding…

[Construction and implementation of two quality indicators in nursing services].

PubMed

de Moura, Gisela Maria Schebela Souto; Juchem, Beatriz Cavalcanti; Falk, Maria Lucia Rodrigues; de Magalhães, Ana Maria Muller; Suzuki, Lyliam Midori

2009-03-01

Indicators monitor the quality of services and improve the attention offered to the patients. Hospital de Clinicas de Porto Alegre, Rio Grande do Sul, Brazil, has been developing strategies to assess its services according to its institutional management policy of quality The present study aims to report the experience at this university hospital with the construction and implementation of quality indicators in its nursing services. In 2006, four indicators were established: incidence of pressure ulcer, with a goal of < or = 10:1000 patients per day/month and incidence of falls from bed whose goal was established as < or = 2:1000 patients per day/month. Our challenge was to build and implement these indicators as management tools to assess the quality of nursing services, for this is a large hospital.

An evaluation of the content and quality of tinnitus information on websites preferred by General Practitioners

PubMed Central

2012-01-01

Background Tinnitus is a prevalent and complex medical complaint often co-morbid with stress, anxiety, insomnia, depression, and cognitive or communication difficulties. Its chronicity places a major burden on primary and secondary healthcare services. In our recent national survey of General Practitioners (GPs) from across England, many reported that their awareness of tinnitus was limited and as a result were dissatisfied with the service they currently provide. GPs identified 10 online sources of information they currently use in clinical practice, but welcomed further concise and accurate information on tinnitus assessment and management. The purpose of this study was to assess the content, reliability, and quality of the information related to primary care tinnitus assessment and management on these 10 websites. Methods Tinnitus related content on each website was assessed using a summative content analysis approach. Reliability and quality of the information was assessed using the DISCERN questionnaire. Results Quality of information was rated using the validated DISCERN questionnaire. Significant inter-rater reliability was confirmed by Kendall’s coefficient of concordance (Wt) which ranged from 0.48 to 0.92 across websites. The website Map of Medicine achieved the highest overall DISCERN score. However, for information on treatment choice, the British Tinnitus Association was rated best. Content analysis revealed that all websites lacked a number of details relating to either tinnitus assessment or management options. Conclusions No single website provides comprehensive information for GPs on tinnitus assessment and management and so GPs may need to refer to more than one if they want to maximise their coverage of the topic. From those preferred by GPs we recommend several specific websites as the current ‘best’ sources. Our findings should guide healthcare website providers to improve the quality and inclusiveness of the information they publish on tinnitus. In the case of one website, our preliminary findings are already doing so. Such developments will in turn help facilitate best practice in primary care. PMID:22788751

An evaluation of the content and quality of tinnitus information on websites preferred by General Practitioners.

PubMed

Fackrell, Kathryn; Hoare, Derek J; Smith, Sandra; McCormack, Abby; Hall, Deborah A

2012-07-12

Tinnitus is a prevalent and complex medical complaint often co-morbid with stress, anxiety, insomnia, depression, and cognitive or communication difficulties. Its chronicity places a major burden on primary and secondary healthcare services. In our recent national survey of General Practitioners (GPs) from across England, many reported that their awareness of tinnitus was limited and as a result were dissatisfied with the service they currently provide. GPs identified 10 online sources of information they currently use in clinical practice, but welcomed further concise and accurate information on tinnitus assessment and management. The purpose of this study was to assess the content, reliability, and quality of the information related to primary care tinnitus assessment and management on these 10 websites. Tinnitus related content on each website was assessed using a summative content analysis approach. Reliability and quality of the information was assessed using the DISCERN questionnaire. Quality of information was rated using the validated DISCERN questionnaire. Significant inter-rater reliability was confirmed by Kendall's coefficient of concordance (Wt) which ranged from 0.48 to 0.92 across websites. The website Map of Medicine achieved the highest overall DISCERN score. However, for information on treatment choice, the British Tinnitus Association was rated best. Content analysis revealed that all websites lacked a number of details relating to either tinnitus assessment or management options. No single website provides comprehensive information for GPs on tinnitus assessment and management and so GPs may need to refer to more than one if they want to maximise their coverage of the topic. From those preferred by GPs we recommend several specific websites as the current 'best' sources. Our findings should guide healthcare website providers to improve the quality and inclusiveness of the information they publish on tinnitus. In the case of one website, our preliminary findings are already doing so. Such developments will in turn help facilitate best practice in primary care.

Toward utilization of data for program management and evaluation: quality assessment of five years of health management information system data in Rwanda.

PubMed

Nisingizwe, Marie Paul; Iyer, Hari S; Gashayija, Modeste; Hirschhorn, Lisa R; Amoroso, Cheryl; Wilson, Randy; Rubyutsa, Eric; Gaju, Eric; Basinga, Paulin; Muhire, Andrew; Binagwaho, Agnès; Hedt-Gauthier, Bethany

2014-01-01

Health data can be useful for effective service delivery, decision making, and evaluating existing programs in order to maintain high quality of healthcare. Studies have shown variability in data quality from national health management information systems (HMISs) in sub-Saharan Africa which threatens utility of these data as a tool to improve health systems. The purpose of this study is to assess the quality of Rwanda's HMIS data over a 5-year period. The World Health Organization (WHO) data quality report card framework was used to assess the quality of HMIS data captured from 2008 to 2012 and is a census of all 495 publicly funded health facilities in Rwanda. Factors assessed included completeness and internal consistency of 10 indicators selected based on WHO recommendations and priority areas for the Rwanda national health sector. Completeness was measured as percentage of non-missing reports. Consistency was measured as the absence of extreme outliers, internal consistency between related indicators, and consistency of indicators over time. These assessments were done at the district and national level. Nationally, the average monthly district reporting completeness rate was 98% across 10 key indicators from 2008 to 2012. Completeness of indicator data increased over time: 2008, 88%; 2009, 91%; 2010, 89%; 2011, 90%; and 2012, 95% (p<0.0001). Comparing 2011 and 2012 health events to the mean of the three preceding years, service output increased from 3% (2011) to 9% (2012). Eighty-three percent of districts reported ratios between related indicators (ANC/DTP1, DTP1/DTP3) consistent with HMIS national ratios. Conclusion and policy implications: Our findings suggest that HMIS data quality in Rwanda has been improving over time. We recommend maintaining these assessments to identify remaining gaps in data quality and that results are shared publicly to support increased use of HMIS data.

Toward utilization of data for program management and evaluation: quality assessment of five years of health management information system data in Rwanda

PubMed Central

Nisingizwe, Marie Paul; Iyer, Hari S.; Gashayija, Modeste; Hirschhorn, Lisa R.; Amoroso, Cheryl; Wilson, Randy; Rubyutsa, Eric; Gaju, Eric; Basinga, Paulin; Muhire, Andrew; Binagwaho, Agnès; Hedt-Gauthier, Bethany

2014-01-01

Background Health data can be useful for effective service delivery, decision making, and evaluating existing programs in order to maintain high quality of healthcare. Studies have shown variability in data quality from national health management information systems (HMISs) in sub-Saharan Africa which threatens utility of these data as a tool to improve health systems. The purpose of this study is to assess the quality of Rwanda's HMIS data over a 5-year period. Methods The World Health Organization (WHO) data quality report card framework was used to assess the quality of HMIS data captured from 2008 to 2012 and is a census of all 495 publicly funded health facilities in Rwanda. Factors assessed included completeness and internal consistency of 10 indicators selected based on WHO recommendations and priority areas for the Rwanda national health sector. Completeness was measured as percentage of non-missing reports. Consistency was measured as the absence of extreme outliers, internal consistency between related indicators, and consistency of indicators over time. These assessments were done at the district and national level. Results Nationally, the average monthly district reporting completeness rate was 98% across 10 key indicators from 2008 to 2012. Completeness of indicator data increased over time: 2008, 88%; 2009, 91%; 2010, 89%; 2011, 90%; and 2012, 95% (p<0.0001). Comparing 2011 and 2012 health events to the mean of the three preceding years, service output increased from 3% (2011) to 9% (2012). Eighty-three percent of districts reported ratios between related indicators (ANC/DTP1, DTP1/DTP3) consistent with HMIS national ratios. Conclusion and policy implications Our findings suggest that HMIS data quality in Rwanda has been improving over time. We recommend maintaining these assessments to identify remaining gaps in data quality and that results are shared publicly to support increased use of HMIS data. PMID:25413722

The effect of structural empowerment of nurses on quality outcomes in hospitals: a scoping review.

PubMed

Goedhart, Nicole S; van Oostveen, Catharina J; Vermeulen, Hester

2017-04-01

To assess and synthesise studies reporting direct associations between the structural empowerment of frontline nurses and quality outcomes, and to identify gaps in the current literature. The empowerment of nurses seems essential for delivering high-quality patient care. Understanding the relationship between empowerment and quality outcomes would enable nurse managers to make informed choices on improving the quality of care. A scoping review examining the relationship between the structural empowerment of nurses and the quality, effectiveness, safety, efficiency and patient-centredness of care in hospitals. Searching in MEDLINE, CINAHL, Business Source Premier and Embase identified 672 potentially relevant articles. Independent selection, quality assessment, data extraction and analysis were completed. Twelve cross-sectional studies originating from North America were included. These studies showed a variety of quality outcomes and statistics used. All studies reported positive associations between the structural empowerment of nurses, nurse assessed quality of care and patient safety climate, and work and unit effectiveness. Nurses having access to empowering structures positively affects the quality outcomes, i.e. quality, effectiveness, safety, efficiency and patient-centredness of patient care in hospitals. Nurse managers and leaders should ensure empowering work conditions for nurses in order to increase hospitals' quality of patient care. © 2017 John Wiley & Sons Ltd.

Developing a framework of, and quality indicators for, general practice management in Europe.

PubMed

Engels, Yvonne; Campbell, Stephen; Dautzenberg, Maaike; van den Hombergh, Pieter; Brinkmann, Henrik; Szécsényi, Joachim; Falcoff, Hector; Seuntjens, Luc; Kuenzi, Beat; Grol, Richard

2005-04-01

To develop a framework for general practice management made up of quality indicators shared by six European countries. Two-round postal Delphi questionnaire in the setting of general practice in Belgium, France, Germany, The Netherlands, Switzerland and the United Kingdom. Six national expert panels, each consisting of 10 members, primarily primary care practitioners and experts in the field of quality in primary care participated in the study. The main outcome measures were: (a) a European framework with indicators for the organization of primary care; and (b) ratings of the face validity of the usefulness of the indicators by expert panels in six countries. Agreement was reached about a definition of practice management across five domains (infrastructure, staff, information, finance, and quality and safety), and a common set of indicators for the organization of general practice. The panellist response rate was 95%. Sixty-two indicators (37%) were rated face valid by all six panels. Examples include out of hours service, accessibility, the content of doctors' bags and staff involvement in quality improvement. No indicators were rated invalid by all six panels. It proved to be possible to develop a European set of indicators for assessing the quality of practice management, despite the differences in health care systems and cultures in the six different countries. These indicators will now be used in a quality assessment procedure of practice management in nine European countries. While organizational indicators are part of the new GMS contract in the UK, this research shows that many practice management issues within primary care are also of relevance in other European countries.

Manage your human sigma.

PubMed

Fleming, John H; Coffman, Curt; Harter, James K

2005-01-01

If sales and service organizations are to improve, they must learn to measure and manage the quality of the employee-customer encounter. Quality improvement methodologies such as Six Sigma are extremely useful in manufacturing contexts, but they're less useful when it comes to human interactions. To address this problem, the authors have developed a quality improvement approach they refer to as Human Sigma. It weaves together a consistent method for assessing the employee-customer encounter and a disciplined process for managing and improving it. There are several core principles for measuring and managing the employee-customer encounter: It's important not to think like an economist or an engineer when assessing interactions because emotions inform both sides' judgments and behavior. The employee-customer encounter must be measured and managed locally, because there are enormous variations in quality at the work-group and individual levels. And to improve the quality of the employee-customer interaction, organizations must conduct both short-term, transactional interventions and long-term, transformational ones. Employee engagement and customer engagement are intimately connected--and, taken together, they have an outsized effect on financial performance. They therefore need to be managed holistically. That is, the responsibility for measuring and monitoring the health of employee-customer relationships must reside within a single organizational structure, with an executive champion who has the authority to initiate and manage change. Nevertheless, the local manager remains the single most important factor in local group performance. A local manager whose work group shows suboptimal performance should be encouraged to conduct interventions, such as targeted training, performance reviews, action learning, and individual coaching.

Expanding the scope of quality measurement in surgery to include nonoperative care: Results from the American College of Surgeons National Surgical Quality Improvement Program emergency general surgery pilot.

PubMed

Wandling, Michael W; Ko, Clifford Y; Bankey, Paul E; Cribari, Chris; Cryer, H Gill; Diaz, Jose J; Duane, Therese M; Hameed, S Morad; Hutter, Matthew M; Metzler, Michael H; Regner, Justin L; Reilly, Patrick M; Reines, H David; Sperry, Jason L; Staudenmayer, Kristan L; Utter, Garth H; Crandall, Marie L; Bilimoria, Karl Y; Nathens, Avery B

2017-11-01

Patients managed nonoperatively have been excluded from risk-adjusted benchmarking programs, including the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP). Consequently, optimal performance evaluation is not possible for specialties like emergency general surgery (EGS) where nonoperative management is common. We developed a multi-institutional EGS clinical data registry within ACS NSQIP that includes patients managed nonoperatively to evaluate variability in nonoperative care across hospitals and identify gaps in performance assessment that occur when only operative cases are considered. Using ACS NSQIP infrastructure and methodology, surgical consultations for acute appendicitis, acute cholecystitis, and small bowel obstruction (SBO) were sampled at 13 hospitals that volunteered to participate in the EGS clinical data registry. Standard NSQIP variables and 16 EGS-specific variables were abstracted with 30-day follow-up. To determine the influence of complications in nonoperative patients, rates of adverse outcomes were identified, and hospitals were ranked by performance with and then without including nonoperative cases. Two thousand ninety-one patients with EGS diagnoses were included, 46.6% with appendicitis, 24.3% with cholecystitis, and 29.1% with SBO. The overall rate of nonoperative management was 27.4%, 6.6% for appendicitis, 16.5% for cholecystitis, and 69.9% for SBO. Despite comprising only 27.4% of patients in the EGS pilot, nonoperative management accounted for 67.7% of deaths, 34.3% of serious morbidities, and 41.8% of hospital readmissions. After adjusting for patient characteristics and hospital diagnosis mix, addition of nonoperative management to hospital performance assessment resulted in 12 of 13 hospitals changing performance rank, with four hospitals changing by three or more positions. This study identifies a gap in performance evaluation when nonoperative patients are excluded from surgical quality assessment and demonstrates the feasibility of incorporating nonoperative care into existing surgical quality initiatives. Broadening the scope of hospital performance assessment to include nonoperative management creates an opportunity to improve the care of all surgical patients, not just those who have an operation. Care management, level IV; Epidemiologic, level III.

Relationship between environmental management with quality of kampong space room (Case study: RW 3 of Sukun Sub District, Malang City)

NASA Astrophysics Data System (ADS)

Wardhani, D. K.; Azmi, D. S.; Purnamasari, W. D.

2017-06-01

RW 3 Sukun Malang was one of kampong that won the competition kampong environment and had managed to maintain the preservation of the kampong. Society of RW 3 Sukun undertake various activities to manage the environment by optimizing the use of kampong space. Despite RW 3 Sukun had conducted environmental management activities, there are several locations in the kampong space that less well maintained. The purpose of this research was to determine the relation of environmental management with the quality of kampong space in RW 3 Sukun. This research used qualitative and quantitative research approaches. Quantitative research conducted by using descriptive statistical analysis in assessing the quality of kampong space with weighting, scoring, and overlay maps. Quantitative research was also conducted on the relation analysis of environmental management with the quality of kampong space by using typology analysis and pearson correlation analysis. Qualitative research conducted on the analysis of environmental management and the relation analysis of environmental management with the quality of kampong space. Result of this research indicates that environmental management in RW 3 Sukun have relation with the quality of kampong space.

Testing a simple field method for assessing nitrate removal in riparian zones

Treesearch

Philippe Vidon; Michael G. Dosskey

2008-01-01

Being able to identify riparian sites that function better for nitrate removal from groundwater is critical to using efficiently the riparian zones for water quality management. For this purpose, managers need a method that is quick, inexpensive, and accurate enough to enable effective management decisions. This study assesses the precision and accuracy of a simple...

42 CFR 494.110 - Condition: Quality assessment and performance improvement.

Code of Federal Regulations, 2013 CFR

2013-10-01

... improvement. 494.110 Section 494.110 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF... RENAL DISEASE FACILITIES Patient Care § 494.110 Condition: Quality assessment and performance... renal bone disease. (iv) Anemia management. (v) Vascular access. (vi) Medical injuries and medical...

42 CFR 494.110 - Condition: Quality assessment and performance improvement.

Code of Federal Regulations, 2014 CFR

2014-10-01

... improvement. 494.110 Section 494.110 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF... RENAL DISEASE FACILITIES Patient Care § 494.110 Condition: Quality assessment and performance... renal bone disease. (iv) Anemia management. (v) Vascular access. (vi) Medical injuries and medical...

42 CFR 494.110 - Condition: Quality assessment and performance improvement.

Code of Federal Regulations, 2012 CFR

2012-10-01

... improvement. 494.110 Section 494.110 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF... RENAL DISEASE FACILITIES Patient Care § 494.110 Condition: Quality assessment and performance... renal bone disease. (iv) Anemia management. (v) Vascular access. (vi) Medical injuries and medical...

Target for improvement: a cluster randomised trial of public involvement in quality-indicator prioritisation (intervention development and study protocol)

PubMed Central

2011-01-01

Background Public priorities for improvement often differ from those of clinicians and managers. Public involvement has been proposed as a way to bridge the gap between professional and public clinical care priorities but has not been studied in the context of quality-indicator choice. Our objective is to assess the feasibility and impact of public involvement on quality-indicator choice and agreement with public priorities. Methods We will conduct a cluster randomised controlled trial comparing quality-indicator prioritisation with and without public involvement. In preparation for the trial, we developed a 'menu' of quality indicators, based on a systematic review of existing validated indicator sets. Participants (public representatives, clinicians, and managers) will be recruited from six participating sites. In intervention sites, public representatives will be involved through direct participation (public representatives, clinicians, and managers will deliberate together to agree on quality-indicator choice and use) and consultation (individual public recommendations for improvement will be collected and presented to decision makers). In control sites, only clinicians and managers will take part in the prioritisation process. Data on quality-indicator choice and intended use will be collected. Our primary outcome will compare quality-indicator choice and agreement with public priorities between intervention and control groups. A process evaluation based on direct observation, videorecording, and participants' assessment will be conducted to help explain the study's results. The marginal cost of public involvement will also be assessed. Discussion We identified 801 quality indicators that met our inclusion criteria. An expert panel agreed on a final set of 37 items containing validated quality indicators relevant for chronic disease prevention and management in primary care. We pilot tested our public-involvement intervention with 27 participants (11 public representatives and 16 clinicians and managers) and our study instruments with an additional 21 participants, which demonstrated the feasibility of the intervention and generated important insights and adaptations to engage public representatives more effectively. To our knowledge, this study is the first trial of public involvement in quality-indicator prioritisation, and its results could foster more effective upstream engagement of patients and the public in clinical practice improvement. Trial registration NTR2496 (Netherlands National Trial Register, http://www.trialregister.nl). PMID:21554691

Change in quality management in diabetes care groups and outpatient clinics after feedback and tailored support.

PubMed

Campmans-Kuijpers, Marjo J; Baan, Caroline A; Lemmens, Lidwien C; Rutten, Guy E

2015-02-01

To assess the change in level of diabetes quality management in primary care groups and outpatient clinics after feedback and tailored support. This before-and-after study with a 1-year follow-up surveyed quality managers on six domains of quality management. Questionnaires measured organization of care, multidisciplinary teamwork, patient centeredness, performance results, quality improvement policy, and management strategies (score range 0-100%). Based on the scores, responders received feedback and a benchmark and were granted access to a toolbox of quality improvement instruments. If requested, additional support in improving quality management was available, consisting of an elucidating phone call or a visit from an experienced consultant. After 1 year, the level of quality management was measured again. Of the initially 60 participating care groups, 51 completed the study. The total quality management score improved from 59.8% (95% CI 57.0-62.6%) to 65.1% (62.8-67.5%; P < 0.0001). The same applied to all six domains. The feedback and benchmark improved the total quality management score (P = 0.001). Of the 44 participating outpatient clinics, 28 completed the study. Their total score changed from 65.7% (CI 60.3-71.1%) to 67.3% (CI 62.9-71.7%; P = 0.30). Only the results in the domain multidisciplinary teamwork improved (P = 0.001). Measuring quality management and providing feedback and a benchmark improves the level of quality management in care groups but not in outpatient clinics. The questionnaires might also be a useful asset for other diabetes care groups, such as Accountable Care Organizations. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

Managing Chronic Disease in Ontario Primary Care: The Impact of Organizational Factors

PubMed Central

Russell, Grant M.; Dahrouge, Simone; Hogg, William; Geneau, Robert; Muldoon, Laura; Tuna, Meltem

2009-01-01

PURPOSE New approaches to chronic disease management emphasize the need to improve the delivery of primary care services to meet the needs of chronically ill patients. This study (1) assessed whether chronic disease management differed among 4 models of primary health care delivery and (2) identified which practice organizational factors were independently associated with high-quality care. METHODS We undertook a cross-sectional survey with nested qualitative case studies (2 practices per model) in 137 randomly selected primary care practices from 4 delivery models in Ontario Canada: fee for service, capitation, blended payment, and community health centers (CHCs). Practice and clinician surveys were based on the Primary Care Assessment Tool. A chart audit assessed evidence-based care delivery for patients with diabetes, congestive heart failure, and coronary artery disease. Intermediate outcomes were calculated for patients with diabetes and hypertension. Multiple linear regression identified those organizational factors independently associated with chronic disease management. RESULTS Chronic disease management was superior in CHCs. Clinicians in CHCs found it easier than those in the other models to promote high-quality care through longer consultations and interprofessional collaboration. Across the whole sample and independent of model, high-quality chronic disease management was associated with the presence of a nurse-practitioner. It was also associated with lower patient-family physician ratios and when practices had 4 or fewer full-time-equivalent family physicians. CONCLUSIONS The study adds to the literature supporting the value of nurse-practitioners within primary care teams and validates the contributions of Ontario’s CHCs. Our observation that quality of care decreased in larger, busier practices suggests that moves toward larger practices and greater patient-physician ratios may have unanticipated negative effects on processes of care quality. PMID:19597168

[How to assess clinical practice guidelines with AGREE II: The example of neonatal jaundice].

PubMed

Renesme, L; Bedu, A; Tourneux, P; Truffert, P

2016-03-01

Neonatal jaundice is a very frequent condition that occurs in approximately 50-70% of term or near-term (>35 GA) babies in the 1st week of life. In some cases, a high bilirubin blood level can lead to kernicterus. There is no consensus for the management of neonatal jaundice and few countries have published national clinical practice guidelines for the management of neonatal jaundice. The aim of this study was to assess the quality of these guidelines. We conducted a systematic review of the literature for national clinical practice guidelines for the management of neonatal jaundice in term or near-term babies. Four independent reviewers assessed the quality of each guideline using the AGREE II evaluation. For each of the clinical practice guidelines, the management modalities were analyzed (screening, treatment, follow-up, etc.). Seven national clinical practice guidelines were found (South Africa, USA AAP, UK NICE, Canada, Norway, Switzerland, and Israel). The AGREE II score showed widespread variation regarding the quality of these national guidelines. There was no major difference between the guidelines concerning the clinical management of these babies. The NICE guideline is the most valuable guideline regarding the AGREE II score. NICE showed that, despite a strong and rigorous methodology, there is no evidenced-based recommended code of practice (RCP). Comparing RCPs, we found no major differences. The NICE guideline showed the best quality. The AGREE II instrument should be used as a framework when developing clinical practice guidelines to improve the quality of the future guideline. In France, a national guideline is needed for a more standardized management of neonatal jaundice. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Assessment of post-operative pain management among acutely and electively admitted patients - a Swedish ward perspective.

PubMed

Magidy, Mahnaz; Warrén-Stomberg, Margareta; Bjerså, Kristofer

2016-04-01

Swedish health care is regulated to involve the patient in every intervention process. In the area of post-operative pain, it is therefore important to evaluate patient experience of the quality of pain management. Previous research has focused on mapping this area but not on comparing experiences between acutely and electively admitted patients. Hence, the aim of this study was to investigate the experiences of post-operative pain management quality among acutely and electively admitted patients at a Swedish surgical department performing soft-tissue surgery. A survey study design was used as a method based on a multidimensional instrument to assess post-operative pain management: Strategic and Clinical Quality Indicators in Postoperative Pain Management (SCQIPP). Consecutive patients at all wards of a university hospital's surgical department were included. Data collection was performed at hospital discharge. In total, 160 patients participated, of whom 40 patients were acutely admitted. A significant difference between acutely and electively admitted patients was observed in the SCQIPP area of environment, whereas acute patients rated the post-operative pain management quality lower compared with those who were electively admitted. There may be a need for improvement in the areas of post-operative pain management in Sweden, both specifically and generally. There may also be a difference in the experience of post-operative pain quality between acutely and electively admitted patients in this study, specifically in the area of environment. In addition, low levels of the perceived quality of post-operative pain management among the patients were consistent, but satisfaction with analgesic treatment was rated as good. © 2015 John Wiley & Sons, Ltd.

Marginal Lands: Concept, Assessment and Management

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kang, Shujiang; Post, Wilfred M; West, Tristram O.

2013-01-01

Marginal lands have received wide attention for their potential to improve food security and support bioenergy production. However, environmental, ecosystem service, and sustainability concerns have been widely raised over the use of marginal land. Knowledge of the extent, location, and quality of marginal lands as well as their assessment and management are limited and diverse. This paper provides a review of the historical development of marginal concept, its application and assessment. Limitations and priority research needs of marginal land assessment and management were discussed.

Operation quality assessment model for video conference system

NASA Astrophysics Data System (ADS)

Du, Bangshi; Qi, Feng; Shao, Sujie; Wang, Ying; Li, Weijian

2018-01-01

Video conference system has become an important support platform for smart grid operation and management, its operation quality is gradually concerning grid enterprise. First, the evaluation indicator system covering network, business and operation maintenance aspects was established on basis of video conference system's operation statistics. Then, the operation quality assessment model combining genetic algorithm with regularized BP neural network was proposed, which outputs operation quality level of the system within a time period and provides company manager with some optimization advice. The simulation results show that the proposed evaluation model offers the advantages of fast convergence and high prediction accuracy in contrast with regularized BP neural network, and its generalization ability is superior to LM-BP neural network and Bayesian BP neural network.

[Certification, on-the-ground experience of a manager and his team].

PubMed

Thibault, Catherine; Guillouët, Sonia; Havin, Marie-Pierre

2018-03-01

The certification assessment is an important stage in the life of a healthcare facility. However, instilling a quality culture within a team to lead it towards performance is a long-term endeavour. This cannot work without the existence of a partnership between the paramedical and medical teams, nor without the support of the hospital led by senior quality managers. The challenge is to not limit the quality culture to the certification assessment, which aims to highlight the areas in which the institution conforms and those in which it is failing, but rather to adopt a continuous improvement approach. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Flow Control and Design Assessment for Drainage System at McMurdo Station, Antarctica

DTIC Science & Technology

2014-11-24

Council BMP Best Management Practice CASQUA California Storm Water Quality Task Force CRREL Cold Regions Research and Engineering Laboratory DS...ponds The California Storm Water Quality Task Force (CASQUA 1993) defines a sediment basin as “a pond created by excavation or constructing an em...British Standards Institution. California Storm Water Quality Task Force (CASQUA). 1993. ESC41: Check Dams. In Stormwater Best Management Practices

Development of an estuarine assessment scheme for the management of a highly urbanised catchment/estuary system, Sydney estuary, Australia.

PubMed

Birch, G F; Gunns, T J; Chapman, D; Harrison, D

2016-05-01

As coastal populations increase, considerable pressures are exerted on estuarine environments. Recently, there has been a trend towards the development and use of estuarine assessment schemes as a decision support tool in the management of these environments. These schemes offer a method by which complex environmental data is converted into a readily understandable and communicable format for informed decision making and effective distribution of limited management resources. Reliability and effectiveness of these schemes are often limited due to a complex assessment framework, poor data management and use of ineffective environmental indicators. The current scheme aims to improve reliability in the reporting of estuarine condition by including a concise assessment framework, employing high-value indicators and, in a unique approach, employing fuzzy logic in indicator evaluation. Using Sydney estuary as a case study, each of the 15 sub-catchment/sub-estuary systems were assessed using the current scheme. Results identified that poor sediment quality was a significant issue in Blackwattle/Rozelle Bay, Iron Cove and Hen and Chicken Bay while poor water quality was of particular concern in Duck River, Homebush Bay and the Parramatta River. Overall results of the assessment scheme were used to prioritise the management of each sub-catchment/sub-estuary assessed with Blackwattle/Rozelle Bay, Homebush Bay, Iron Cove and Duck River considered to be in need of a high priority management response. A report card format, using letter grades, was employed to convey the results of the assessment in a readily understood manner to estuarine managers and members of the public. Letter grades also provide benchmarking and performance monitoring ability, allowing estuarine managers to set improvement targets and assesses the effectiveness of management strategies. The current assessment scheme provides an effective, integrated and consistent assessment of estuarine health and provides an effective decision support tool to maximise the efficient distribution of limited management resources.

Approaches to quality management and accreditation in a genetic testing laboratory

PubMed Central

Berwouts, Sarah; Morris, Michael A; Dequeker, Elisabeth

2010-01-01

Medical laboratories, and specifically genetic testing laboratories, provide vital medical services to different clients: clinicians requesting a test, patients from whom the sample was collected, public health and medical-legal instances, referral laboratories and authoritative bodies. All expect results that are accurate and obtained in an efficient and effective manner, within a suitable time frame and at acceptable cost. There are different ways of achieving the end results, but compliance with International Organization for Standardization (ISO) 15189, the international standard for the accreditation of medical laboratories, is becoming progressively accepted as the optimal approach to assuring quality in medical testing. We present recommendations and strategies designed to aid genetic testing laboratories with the implementation of a quality management system, including key aspects such as document control, external quality assessment, internal quality control, internal audit, management review, validation, as well as managing the human side of change. The focus is on pragmatic approaches to attain the levels of quality management and quality assurance required for accreditation according to ISO 15189, within the context of genetic testing. Attention is also given to implementing efficient and effective quality improvement. PMID:20720559

Manager traits and quality-of-care performance in hospitals.

PubMed

Aij, Kjeld Harald; Aernoudts, René L M C; Joosten, Gepke

2015-07-06

This paper aims to assess the impact of the leadership traits of chief executive officers (CEOs) on hospital performance in the USA. The effectiveness and efficiency of the CEO is of critical importance to the performance of any organization, including hospitals. Management systems and manager behaviours (traits) are of crucial importance to any organization because of their connection with organizational performance. To identify key factors associated with the quality of care delivered by hospitals, the authors gathered perceptions of manager traits from chief executive officers (CEOs) and followers in three groups of US hospitals delivering different levels of quality of care performance. Three high- and three low-performing hospitals were selected from the top and bottom 20th percentiles, respectively, using a national hospital ranking system based on standard quality of care performance measures. Three lean hospitals delivering intermediate performance were also selected. A survey was used to gather perceptions of manager traits (providing a modern or lean management system inclination) from CEOs and their followers in the three groups, which were compared. Four traits were found to be significantly different (alpha < 0.05) between lean (intermediate-) and low-performing hospitals. The different perceptions between these two hospital groups were all held by followers in the low-performing hospitals and not the CEOs, and all had a modern management inclination. No differences were found between lean (intermediate-) and high-performing hospitals, or between high- and low-performing hospitals. These findings support a need for hospital managers to acquire appropriate traits to achieve lean transformation, support a benefit of measuring manager traits to assess progress towards lean transformation and lend weight to improved quality of care that can be delivered by hospitals adopting a lean system of management.

Quality Management and System Change in Three Suburban Public School Districts.

ERIC Educational Resources Information Center

Obisesan, Anthonia A.

This report examines the potential of Quality Management (QM) to enhance system change by analyzing its implementation in three suburban public school districts. The paper assessed the capacity of QM to increase the efficiency and productivity of the school districts, validated the potential to sustain systemic change in a school organization, and…

Planning and Implementing Total Quality Management in the Royal Australian Air Force: A Multiple Case Study Analysis

DTIC Science & Technology

1990-09-01

change barriers, and necessary checks and balances built into processes. Furthermore, this assessment should address management system variables which...organisation’s 69 immediate product and their worklife . Focus must be maintained on improving RAAF processes. In addition to a quality committee structure as

Effects of Case Manager Feedback on the Quality of Individual Habilitation Plan Objectives.

ERIC Educational Resources Information Center

Horner, Robert H.; And Others

1990-01-01

The functional relation between feedback and improved writing of Individual Habilitation Plan objectives in four adult service agencies serving the retarded was assessed. The agencies improved the quality of their written objectives after receiving feedback from the case manager and maintained those gains 18 months after feedback was terminated.…

Eutrophication of lakes and reservoirs: A framework for making management decisions

USGS Publications Warehouse

Rast, W.; Holland, M.

1988-01-01

The development of management strategies for the protection of environmental quality usually involves consideration both of technical and nontechnical issues. A logical, step-by-step framework for development of such strategies is provided. Its application to the control of cultured eutrophication of lakes and reservoirs illustrates its potential usefulness. From the perspective of the policymaker, the main consideration is that the eutrophication-related water quality of a lake or reservoir can be managed for given water uses. The approach presented here allows the rational assessment of relevant water-quality parameters and establishment of water-quality goals, consideration of social and other nontechnical issues, the possibilities of public involvement in the decision-making process, and a reasonable economic analysis within a management framework.

Chinese Cardiovascular Disease Mobile Apps’ Information Types, Information Quality, and Interactive Functions for Self-Management: Systematic Review

PubMed Central

Xie, Bo; Su, Zhaohui; Zhang, Wenhui

2017-01-01

Background China has a large population with cardiovascular disease (CVD) that requires extensive self-management. Mobile health (mHealth) apps may be a useful tool for CVD self-management. Little is currently known about the types and quality of health information provided in Chinese CVD mobile apps and whether app functions are conducive to promoting CVD self-management. Objective We undertook a systematic review to evaluate the types and quality of health information provided in Chinese CVD mobile apps and interactive app functions for promoting CVD self-management. Methods Mobile apps targeting end users in China with CVD conditions were selected in February 2017 through a multi-stage process. Three frameworks were used to evaluate the selected apps: (1) types of health information offered were assessed using our Health Information Wants framework, which encompasses 7 types of information; (2) quality of information provided in the apps was assessed using the 11 guidelines recommended by the National Library of Medicine of the National Institutes of Health; and (3) types of interactive app functions for CVD self-management were assessed using a 15-item framework adapted from the literature, including our own prior work. Results Of 578 apps identified, 82 were eligible for final review. Among these, information about self-care (67/82, 82%) and information specifically regarding CVD (63/82, 77%) were the most common types of information provided, while information about health care providers (22/82, 27%) and laboratory tests (5/82, 6%) were least common. The most common indicators of information quality were the revealing of apps’ providers (82/82, 100%) and purpose (82/82, 100%), while the least common quality indicators were the revealing of how apps’ information was selected (1/82, 1%) and app sponsorship (0/82, 0%). The most common interactive functions for CVD self-management were those that enabled user interaction with the app provider (57/82, 70%) and with health care providers (36/82, 44%), while the least common interactive functions were those that enabled lifestyle management (13/82, 16%) and psychological health management (6/82, 7%). None of the apps covered all 7 types of health information, all 11 indicators of information quality, or all 15 interactive functions for CVD self-management. Conclusions Chinese CVD apps are insufficient in providing comprehensive health information, high-quality information, and interactive functions to facilitate CVD self-management. End users should exercise caution when using existing apps. Health care professionals and app developers should collaborate to better understand end users’ preferences and follow evidence-based guidelines to develop mHealth apps conducive to CVD self-management. PMID:29242176

Chinese Cardiovascular Disease Mobile Apps' Information Types, Information Quality, and Interactive Functions for Self-Management: Systematic Review.

PubMed

Xie, Bo; Su, Zhaohui; Zhang, Wenhui; Cai, Run

2017-12-14

China has a large population with cardiovascular disease (CVD) that requires extensive self-management. Mobile health (mHealth) apps may be a useful tool for CVD self-management. Little is currently known about the types and quality of health information provided in Chinese CVD mobile apps and whether app functions are conducive to promoting CVD self-management. We undertook a systematic review to evaluate the types and quality of health information provided in Chinese CVD mobile apps and interactive app functions for promoting CVD self-management. Mobile apps targeting end users in China with CVD conditions were selected in February 2017 through a multi-stage process. Three frameworks were used to evaluate the selected apps: (1) types of health information offered were assessed using our Health Information Wants framework, which encompasses 7 types of information; (2) quality of information provided in the apps was assessed using the 11 guidelines recommended by the National Library of Medicine of the National Institutes of Health; and (3) types of interactive app functions for CVD self-management were assessed using a 15-item framework adapted from the literature, including our own prior work. Of 578 apps identified, 82 were eligible for final review. Among these, information about self-care (67/82, 82%) and information specifically regarding CVD (63/82, 77%) were the most common types of information provided, while information about health care providers (22/82, 27%) and laboratory tests (5/82, 6%) were least common. The most common indicators of information quality were the revealing of apps' providers (82/82, 100%) and purpose (82/82, 100%), while the least common quality indicators were the revealing of how apps' information was selected (1/82, 1%) and app sponsorship (0/82, 0%). The most common interactive functions for CVD self-management were those that enabled user interaction with the app provider (57/82, 70%) and with health care providers (36/82, 44%), while the least common interactive functions were those that enabled lifestyle management (13/82, 16%) and psychological health management (6/82, 7%). None of the apps covered all 7 types of health information, all 11 indicators of information quality, or all 15 interactive functions for CVD self-management. Chinese CVD apps are insufficient in providing comprehensive health information, high-quality information, and interactive functions to facilitate CVD self-management. End users should exercise caution when using existing apps. Health care professionals and app developers should collaborate to better understand end users' preferences and follow evidence-based guidelines to develop mHealth apps conducive to CVD self-management. ©Bo Xie, Zhaohui Su, Wenhui Zhang, Run Cai. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 14.12.2017.

Alternate approaches for assessing impacts of oil sands development on air quality: A case study using the First Nation Community of Fort McKay.

PubMed

Davidson, Carla; Spink, David

2018-04-01

Previous analyses of continuously measured compounds in Fort McKay, an indigenous community in the Athabasca Oil Sands, have detected increasing concentrations of nitrogen dioxide (NO 2 ) and total hydrocarbons (THC), but not of sulfur dioxide (SO 2 ), ozone (O 3 ), total reduced sulfur compounds (TRS), or particulate matter (aerodynamic diameter <2.5 μm; PM 2.5 ). Yet the community frequently experiences odors, dust, and reduced air quality. The authors used Fort McKay's continuously monitored air quality data (1998-2014) as a case study to assess techniques for air quality analysis that make no assumptions regarding type of change. Linear trend analysis detected increasing concentrations of higher percentiles of NO 2 , nitric oxide (NO), and nitrogen oxides (NO x ), and THC. However, comparisons of all compounds between an early industrial expansion period (1998-2001) and current day (2011-2014) show that concentrations of NO 2 , SO 2 , THC, TRS, and PM 2.5 have significantly increased, whereas concentrations of O 3 are significantly lower. An assessment of the frequency and duration of periods when concentrations of each compound were above a variety of thresholds indicated that the frequency of air quality events is increasing for NO 2 and THC. Assessment of change over time with odds ratios of the 25th, 50th, 75th, and 90th percentile concentrations for each compound compared with an estimate of natural background variability showed that concentrations of TRS, SO 2 , and THC are dynamic, higher than background, and changes are nonlinear and nonmonotonic. An assessment of concentrations as a function of wind direction showed a clear and generally increasing influence of industry on air quality. This work shows that evaluating air quality without assumptions of linearity reveals dynamic changes in air quality in Fort McKay, and that it is increasingly being affected by oil sands operations. Understanding the nature and types of air quality changes occurring in a community or region is essential for the development of appropriate air quality management policies. Time-series trending of air quality data is a common tool for assessing air quality changes and is often used to assess the effectiveness of current emission management programs. The use of this tool, in the context of oil sands development, has significant limitations, and alternate air quality change analysis approaches need to be applied to ensure that the impact of this development on air quality is fully understood so that appropriate emission management actions can be taken.

A proposed adaptation of the European Foundation for Quality Management Excellence Model to physical activity programmes for the elderly - development of a quality self-assessment tool using a modified Delphi process

PubMed Central

2011-01-01

Background There has been a growing concern in designing physical activity (PA) programmes for elderly people, since evidence suggests that such health promotion interventions may reduce the deleterious effects of the ageing process. Complete programme evaluations are a necessary prerequisite to continuous quality improvements. Being able to refine, adapt and create tools that are suited to the realities and contexts of PA programmes for the elderly in order to support its continuous improvement is, therefore, crucial. Thus, the aim of this study was to develop a self-assessment tool for PA programmes for the elderly. Methods A 3-round Delphi process was conducted via the Internet with 43 national experts in PA for the elderly, management and delivery of PA programmes for the elderly, sports management, quality management and gerontology, asking experts to identify the propositions that they considered relevant for inclusion in the self-assessment tool. Experts reviewed a list of proposed statements, based on the criteria and sub-criteria from the European Foundation for Quality Management Excellence Model (EFQM) and PA guidelines for older adults and rated each proposition from 1 to 8 (disagree to agree) and modified and/or added propositions. Propositions receiving either bottom or top scores of greater than 70% were considered to have achieved consensus to drop or retain, respectively. Results In round 1, of the 196 originally-proposed statements (best practice principles), the experts modified 41, added 1 and achieved consensus on 93. In round 2, a total of 104 propositions were presented, of which experts modified 39 and achieved consensus on 53. In the last round, of 51 proposed statements, the experts achieved consensus on 19. After 3 rounds of rating, experts had not achieved consensus on 32 propositions. The resulting tool consisted of 165 statements that assess nine management areas involved in the development of PA programmes for the elderly. Conclusion Based on experts' opinions, a self-assessment tool was found in order to access quality of PA programmes for the elderly. Information obtained with evaluations would be useful to organizations seeking to improve their services, customer satisfaction and, consequently, adherence to PA programmes, targeting the ageing population. PMID:21958203

European Quality--Adding to the Debate?

ERIC Educational Resources Information Center

Birtwistle, Tim

1996-01-01

Two pilot programs designed to improve and maintain quality in European higher education are described and compared: an audit of universities' procedures for quality assurance; and an assessment of programs of study, including teaching and learning, student characteristics, staff, facilities, and quality management. Both include institutional…

The effectiveness of current approaches to workplace stress management in the nursing profession: an evidence based literature review

PubMed Central

Mimura, C; Griffiths, P

2003-01-01

The effectiveness of current approaches to workplace stress management for nurses was assessed through a systematic review. Seven randomised controlled trials and three prospective cohort studies assessing the effectiveness of a stress management programmes were identified and reviewed. The quality of research identified was weak. There is more evidence for the effectiveness of programmes based on providing personal support than environmental management to reduce stressors. However, since the number and quality of studies is low, the question as to which, if any, approach is more effective cannot be answered definitively. Further research is required before clear recommendations for the use of particular interventions for nursing work related stress can be made. PMID:12499451

What's to Be Done About Laboratory Quality? Process Indicators, Laboratory Stewardship, the Outcomes Problem, Risk Assessment, and Economic Value: Responding to Contemporary Global Challenges.

PubMed

Meier, Frederick A; Badrick, Tony C; Sikaris, Kenneth A

2018-02-17

For 50 years, structure, process, and outcomes measures have assessed health care quality. For clinical laboratories, structural quality has generally been assessed by inspection. For assessing process, quality indicators (QIs), statistical monitors of steps in the clinical laboratory total testing, have proliferated across the globe. Connections between structural and process laboratory measures and patient outcomes, however, have rarely been demonstrated. To inform further development of clinical laboratory quality systems, we conducted a selective but worldwide review of publications on clinical laboratory quality assessment. Some QIs, like seven generic College of American Pathologists Q-Tracks monitors, have demonstrated significant process improvement; other measures have uncovered critical opportunities to improve test selection and result management. The College of Pathologists of Australasia Key Indicator Monitoring and Management System has deployed risk calculations, introduced from failure mode effects analysis, as surrogate measures for outcomes. Showing economic value from clinical laboratory testing quality is a challenge. Clinical laboratories should converge on fewer (7-14) rather than more (21-35) process monitors; monitors should cover all steps of the testing process under laboratory control and include especially high-risk specimen-quality QIs. Clinical laboratory stewardship, the combination of education interventions among clinician test orderers and report consumers with revision of test order formats and result reporting schemes, improves test ordering, but improving result reception is more difficult. Risk calculation reorders the importance of quality monitors by balancing three probabilities: defect frequency, weight of potential harm, and detection difficulty. The triple approach of (1) a more focused suite of generic consensus quality indicators, (2) more active clinical laboratory testing stewardship, and (3) integration of formal risk assessment, rather than competing with economic value, enhances it.

Drinking water quality management: a holistic approach.

PubMed

Rizak, S; Cunliffe, D; Sinclair, M; Vulcano, R; Howard, J; Hrudey, S; Callan, P

2003-01-01

A growing list of water contaminants has led to some water suppliers relying primarily on compliance monitoring as a mechanism for managing drinking water quality. While such monitoring is a necessary part of drinking water quality management, experiences with waterborne disease threats and outbreaks have shown that compliance monitoring for numerical limits is not, in itself, sufficient to guarantee the safety and quality of drinking water supplies. To address these issues, the Australian National Health and Medical Research Council (NHMRC) has developed a Framework for Management of Drinking Water Quality (the Framework) for incorporation in the Australian Drinking Water Guidelines, the primary reference on drinking water quality in Australia. The Framework was developed specifically for drinking water supplies and provides a comprehensive and preventive risk management approach from catchment to consumer. It includes holistic guidance on a range of issues considered good practice for system management. The Framework addresses four key areas: Commitment to Drinking Water Quality Management, System Analysis and System Management, Supporting Requirements, and Review. The Framework represents a significantly enhanced approach to the management and regulation of drinking water quality and offers a flexible and proactive means of optimising drinking water quality and protecting public health. Rather than the primary reliance on compliance monitoring, the Framework emphasises prevention, the importance of risk assessment, maintaining the integrity of water supply systems and application of multiple barriers to assure protection of public health. Development of the Framework was undertaken in collaboration with the water industry, regulators and other stakeholder, and will promote a common and unified approach to drinking water quality management throughout Australia. The Framework has attracted international interest.

European Society of Gynaecologic Oncology Quality Indicators for Advanced Ovarian Cancer Surgery.

PubMed

Querleu, Denis; Planchamp, François; Chiva, Luis; Fotopoulou, Christina; Barton, Desmond; Cibula, David; Aletti, Giovanni; Carinelli, Silvestro; Creutzberg, Carien; Davidson, Ben; Harter, Philip; Lundvall, Lene; Marth, Christian; Morice, Philippe; Rafii, Arash; Ray-Coquard, Isabelle; Rockall, Andrea; Sessa, Cristiana; van der Zee, Ate; Vergote, Ignace; du Bois, Andreas

2016-09-01

The surgical management of advanced ovarian cancer involves complex surgery. Implementation of a quality management program has a major impact on survival. The goal of this work was to develop a list of quality indicators (QIs) for advanced ovarian cancer surgery that can be used to audit and improve the clinical practice. This task has been carried out under the auspices of the European Society of Gynaecologic Oncology (ESGO). Quality indicators were based on scientific evidence and/or expert consensus. A 4-step evaluation process included a systematic literature search for the identification of potential QIs and the documentation of scientific evidence, physical meetings of an ad hoc multidisciplinarity International Development Group, an internal validation of the targets and scoring system, and an external review process involving physicians and patients. Ten structural, process, or outcome indicators were selected. Quality indicators 1 to 3 are related to achievement of complete cytoreduction, caseload in the center, training, and experience of the surgeon. Quality indicators 4 to 6 are related to the overall management, including active participation to clinical research, decision-making process within a structured multidisciplinary team, and preoperative workup. Quality indicator 7 addresses the high value of adequate perioperative management. Quality indicators 8 to 10 highlight the need of recording pertinent information relevant to improvement of quality. An ESGO-approved template for the operative report has been designed. Quality indicators were described using a structured format specifying what the indicator is measuring, measurability specifications, and targets. Each QI was associated with a score, and an assessment form was built. The ESGO quality criteria can be used for self-assessment, for institutional or governmental quality assurance programs, and for the certification of centers. Quality indicators and corresponding targets give practitioners and health administrators a quantitative basis for improving care and organizational processes in the surgical management of advanced ovarian cancer.

Using Remote Sensing Mapping and Growth Response to Environmental Variability to Aide Aquatic Invasive Plant Management

NASA Technical Reports Server (NTRS)

Bubenheim, David L.; Schlick, Greg; Genovese, Vanessa; Wilson, Kenneth D.

2018-01-01

Management of aquatic weeds in complex watersheds and river systems present many challenges to assessment, planning and implementation of management practices for floating and submerged aquatic invasive plants. The Delta Region Areawide Aquatic Weed Project (DRAAWP), a USDA sponsored area-wide project, is working to enhance planning, decision-making and operational efficiency in the California Sacramento-San Joaquin Delta. Satellite and airborne remote sensing are used map (area coverage and biomass density), direct operations, and assess management impacts on plant communities. Archived satellite records enable review of results following previous climate and management events and aide in developing long-term strategies. Examples of remote sensing aiding effectiveness of aquatic weed management will be discussed as well as areas for potential technological improvement. Modeling at local and watershed scales using the SWAT modeling tool provides insight into land-use effects on water quality (described by Zhang in same Symposium). Controlled environment growth studies have been conducted to quantify the growth response of invasive aquatic plants to water quality and other environmental factors. Environmental variability occurs across a range of time scales from long-term climate and seasonal trends to short-term water flow mediated variations. Response time for invasive species response are examined at time scales of weeks, day, and hours using a combination of study duration and growth assessment techniques to assess water quality, temperature (air and water), nitrogen, phosphorus, and light effects. These provide response parameters for plant growth models in response to the variation and interact with management and economic models associated with aquatic weed management. Plant growth models are to be informed by remote sensing and applied spatially across the Delta to balance location and type of aquatic plant, growth response to altered environments and phenology. Initial utilization of remote sensing tools developed for mapping of aquatic invasive plants improved operational efficiency in management practices. These assessment methods provide a comprehensive and quantitative view of aquatic invasive plants communities in the California Delta.

Floristic Quality Index of Restored Wetlands in Coastal Louisiana

DTIC Science & Technology

2017-08-01

been used to monitor and assess project performance, resilience, and adaptive management needs. An emerging tool for performing bioassessments in...condition have been used to monitor and assess project performance, resilience, and adaptive management needs. There are three basic levels of wetland...result of saltwater intrusion and rapid subsidence; nevertheless, multiple hydrologic restoration projects (Naomi Outfall Management BA-03c and

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

PubMed Central

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

2016-01-01

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

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

PubMed

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

2016-01-01

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

Sensitivity, Calibration, and Validation of SWAT in the Choptank River Basin

USDA-ARS?s Scientific Manuscript database

The value of watershed-scale, water quality models to ecosystem management is increasingly evident as more programs adopt these tools to help assess the effectiveness of different management scenarios on the environment. The USDA-Conservation Effects Assessment Project (CEAP) is one such program whi...

Design of Cycle 3 of the National Water-Quality Assessment Program, 2013-2022: Part 1: Framework of Water-Quality Issues and Potential Approaches

USGS Publications Warehouse

Rowe, Gary L.; Belitz, Kenneth; Essaid, Hedeff I.; Gilliom, Robert J.; Hamilton, Pixie A.; Hoos, Anne B.; Lynch, Dennis D.; Munn, Mark D.; Wolock, David W.

2010-01-01

In 1991, the U.S. Congress established the U.S. Geological Survey (USGS) National Water-Quality Assessment (NAWQA) Program to develop long-term, nationally consistent information on the quality of the Nation's streams and groundwater. Congress recognized the critical need for this information to support scientifically sound management, regulatory, and policy decisions concerning the increasingly stressed water resources of the Nation. The long-term goals of NAWQA are to: (1) assess the status of water-quality conditions in the United States, (2) evaluate long-term trends in water-quality conditions, and (3) link status and trends with an understanding of the natural and human factors that affect water quality. These goals are national in scale, include both surface water and groundwater, and include consideration of water quality in relation to both human uses and aquatic ecosystems. Since 1991, NAWQA assessments and findings have fostered and supported major improvements in the availability and use of unbiased scientific information for decisionmaking, resource management, and planning at all levels of government. These improvements have enabled agencies and stakeholders to cost-effectively address a wide range of water-quality issues related to natural and human influences on the quality of water and potential effects on aquatic ecosystems and human health (http://water.usgs.gov/nawqa/xrel.pdf). NAWQA, like all USGS programs, provides policy relevant information that serves as a scientific basis for decisionmaking related to resource management, protection, and restoration. The information is freely available to all levels of government, nongovernmental organizations, industry, academia, and the public, and is readily accessible on the NAWQA Web site and other diverse formats to serve the needs of the water-resource community at different technical levels. Water-quality conditions in streams and groundwater are described in more than 1,700 publications (available online at http://water.usgs.gov/nawqa/bib/), and are documented by more than 14 million data records representing about 7,600 stream sites, 8,100 wells, and 2,000 water-quality and ecological constituents that are available from the NAWQA data warehouse (http://infotrek.er.usgs.gov/traverse/f?p=NAWQA:HOME:0). The Program promotes collaboration and liaison with government officials, resource managers, industry representatives, and other stakeholders to increase the utility and relevance of NAWQA science to decisionmakers. As part of this effort, NAWQA supports integration of data from other organizations into NAWQA assessments, where appropriate and cost-effective, so that more comprehensive findings are available across geographic and temporal scales.

TU-AB-BRD-00: Task Group 100

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

2015-06-15

Current quality assurance and quality management guidelines provided by various professional organizations are prescriptive in nature, focusing principally on performance characteristics of planning and delivery devices. However, published analyses of events in radiation therapy show that most events are often caused by flaws in clinical processes rather than by device failures. This suggests the need for the development of a quality management program that is based on integrated approaches to process and equipment quality assurance. Industrial engineers have developed various risk assessment tools that are used to identify and eliminate potential failures from a system or a process before amore » failure impacts a customer. These tools include, but are not limited to, process mapping, failure modes and effects analysis, fault tree analysis. Task Group 100 of the American Association of Physicists in Medicine has developed these tools and used them to formulate an example risk-based quality management program for intensity-modulated radiotherapy. This is a prospective risk assessment approach that analyzes potential error pathways inherent in a clinical process and then ranks them according to relative risk, typically before implementation, followed by the design of a new process or modification of the existing process. Appropriate controls are then put in place to ensure that failures are less likely to occur and, if they do, they will more likely be detected before they propagate through the process, compromising treatment outcome and causing harm to the patient. Such a prospective approach forms the basis of the work of Task Group 100 that has recently been approved by the AAPM. This session will be devoted to a discussion of these tools and practical examples of how these tools can be used in a given radiotherapy clinic to develop a risk based quality management program. Learning Objectives: Learn how to design a process map for a radiotherapy process Learn how to perform failure modes and effects analysis analysis for a given process Learn what fault trees are all about Learn how to design a quality management program based upon the information obtained from process mapping, failure modes and effects analysis and fault tree analysis. Dunscombe: Director, TreatSafely, LLC and Center for the Assessment of Radiological Sciences; Consultant to IAEA and Varian Thomadsen: President, Center for the Assessment of Radiological Sciences Palta: Vice President of the Center for the Assessment of Radiological Sciences.« less

TU-AB-BRD-03: Fault Tree Analysis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dunscombe, P.

2015-06-15

Current quality assurance and quality management guidelines provided by various professional organizations are prescriptive in nature, focusing principally on performance characteristics of planning and delivery devices. However, published analyses of events in radiation therapy show that most events are often caused by flaws in clinical processes rather than by device failures. This suggests the need for the development of a quality management program that is based on integrated approaches to process and equipment quality assurance. Industrial engineers have developed various risk assessment tools that are used to identify and eliminate potential failures from a system or a process before amore » failure impacts a customer. These tools include, but are not limited to, process mapping, failure modes and effects analysis, fault tree analysis. Task Group 100 of the American Association of Physicists in Medicine has developed these tools and used them to formulate an example risk-based quality management program for intensity-modulated radiotherapy. This is a prospective risk assessment approach that analyzes potential error pathways inherent in a clinical process and then ranks them according to relative risk, typically before implementation, followed by the design of a new process or modification of the existing process. Appropriate controls are then put in place to ensure that failures are less likely to occur and, if they do, they will more likely be detected before they propagate through the process, compromising treatment outcome and causing harm to the patient. Such a prospective approach forms the basis of the work of Task Group 100 that has recently been approved by the AAPM. This session will be devoted to a discussion of these tools and practical examples of how these tools can be used in a given radiotherapy clinic to develop a risk based quality management program. Learning Objectives: Learn how to design a process map for a radiotherapy process Learn how to perform failure modes and effects analysis analysis for a given process Learn what fault trees are all about Learn how to design a quality management program based upon the information obtained from process mapping, failure modes and effects analysis and fault tree analysis. Dunscombe: Director, TreatSafely, LLC and Center for the Assessment of Radiological Sciences; Consultant to IAEA and Varian Thomadsen: President, Center for the Assessment of Radiological Sciences Palta: Vice President of the Center for the Assessment of Radiological Sciences.« less

TU-AB-BRD-01: Process Mapping

DOE Office of Scientific and Technical Information (OSTI.GOV)

Palta, J.

2015-06-15

Current quality assurance and quality management guidelines provided by various professional organizations are prescriptive in nature, focusing principally on performance characteristics of planning and delivery devices. However, published analyses of events in radiation therapy show that most events are often caused by flaws in clinical processes rather than by device failures. This suggests the need for the development of a quality management program that is based on integrated approaches to process and equipment quality assurance. Industrial engineers have developed various risk assessment tools that are used to identify and eliminate potential failures from a system or a process before amore » failure impacts a customer. These tools include, but are not limited to, process mapping, failure modes and effects analysis, fault tree analysis. Task Group 100 of the American Association of Physicists in Medicine has developed these tools and used them to formulate an example risk-based quality management program for intensity-modulated radiotherapy. This is a prospective risk assessment approach that analyzes potential error pathways inherent in a clinical process and then ranks them according to relative risk, typically before implementation, followed by the design of a new process or modification of the existing process. Appropriate controls are then put in place to ensure that failures are less likely to occur and, if they do, they will more likely be detected before they propagate through the process, compromising treatment outcome and causing harm to the patient. Such a prospective approach forms the basis of the work of Task Group 100 that has recently been approved by the AAPM. This session will be devoted to a discussion of these tools and practical examples of how these tools can be used in a given radiotherapy clinic to develop a risk based quality management program. Learning Objectives: Learn how to design a process map for a radiotherapy process Learn how to perform failure modes and effects analysis analysis for a given process Learn what fault trees are all about Learn how to design a quality management program based upon the information obtained from process mapping, failure modes and effects analysis and fault tree analysis. Dunscombe: Director, TreatSafely, LLC and Center for the Assessment of Radiological Sciences; Consultant to IAEA and Varian Thomadsen: President, Center for the Assessment of Radiological Sciences Palta: Vice President of the Center for the Assessment of Radiological Sciences.« less

TU-AB-BRD-02: Failure Modes and Effects Analysis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Huq, M.

2015-06-15

Current quality assurance and quality management guidelines provided by various professional organizations are prescriptive in nature, focusing principally on performance characteristics of planning and delivery devices. However, published analyses of events in radiation therapy show that most events are often caused by flaws in clinical processes rather than by device failures. This suggests the need for the development of a quality management program that is based on integrated approaches to process and equipment quality assurance. Industrial engineers have developed various risk assessment tools that are used to identify and eliminate potential failures from a system or a process before amore » failure impacts a customer. These tools include, but are not limited to, process mapping, failure modes and effects analysis, fault tree analysis. Task Group 100 of the American Association of Physicists in Medicine has developed these tools and used them to formulate an example risk-based quality management program for intensity-modulated radiotherapy. This is a prospective risk assessment approach that analyzes potential error pathways inherent in a clinical process and then ranks them according to relative risk, typically before implementation, followed by the design of a new process or modification of the existing process. Appropriate controls are then put in place to ensure that failures are less likely to occur and, if they do, they will more likely be detected before they propagate through the process, compromising treatment outcome and causing harm to the patient. Such a prospective approach forms the basis of the work of Task Group 100 that has recently been approved by the AAPM. This session will be devoted to a discussion of these tools and practical examples of how these tools can be used in a given radiotherapy clinic to develop a risk based quality management program. Learning Objectives: Learn how to design a process map for a radiotherapy process Learn how to perform failure modes and effects analysis analysis for a given process Learn what fault trees are all about Learn how to design a quality management program based upon the information obtained from process mapping, failure modes and effects analysis and fault tree analysis. Dunscombe: Director, TreatSafely, LLC and Center for the Assessment of Radiological Sciences; Consultant to IAEA and Varian Thomadsen: President, Center for the Assessment of Radiological Sciences Palta: Vice President of the Center for the Assessment of Radiological Sciences.« less

DEMONSTRATION OF A MULTI-SCALE INTEGRATED MONITORING AND ASSESSMENT IN NY/NJ HARBOR

EPA Science Inventory

The Clean Water Act (CWA) requires states and tribes to assess the overall quality of their waters (Sec 305(b)), determine whether that quality is changing over time, identify problem areas and management actions necessary to resolve those problems, and evaluate the effectiveness...

12 CFR 1200.2 - Organization of the Federal Housing Finance Agency.

Code of Federal Regulations, 2014 CFR

2014-01-01

... presence, the division monitors and assesses the amount of risk each Enterprise assumes, the quality of... and assesses their compliance with regulations, the amount of risk they assume, and the quality of... office manages the Freedom of Information, Privacy Act and ethics programs. The Designated Agency Ethics...

12 CFR 1200.2 - Organization of the Federal Housing Finance Agency.

Code of Federal Regulations, 2013 CFR

2013-01-01

... presence, the division monitors and assesses the amount of risk each Enterprise assumes, the quality of... and assesses their compliance with regulations, the amount of risk they assume, and the quality of... office manages the Freedom of Information, Privacy Act and ethics programs. The Designated Agency Ethics...

Rapid Training System Self-Assessment

ERIC Educational Resources Information Center

Flesher, Jeff

2007-01-01

A systematic self-assessment mirrors quality system and certification models, thus making a strong argument for high-quality design, control, and management of the training function. Accomplished for the ongoing betterment of the function, not as a summative judgment of conformance, it discovers strengths and weaknesses and results in a common…

The 3D Elevation Program: summary for Hawaii

USGS Publications Warehouse

Carswell, William J.

2016-01-01

Elevation data are essential to a broad range of applications, including forest resources management, wildlife and habitat management, national security, recreation, and many others. For the State of Hawaii, elevation data are critical for infrastructure and construction management, flood risk management, geologic resource assessment and hazard mitigation, natural resources conservation, coastal zone management, and other business uses. Today, high-density light detection and ranging (lidar) data are the primary sources for deriving elevation models and other datasets. Federal, State, Tribal, U.S. territorial, and local agencies work in partnership to (1) replace data that are older and of lower quality and (2) provide coverage where publicly accessible data do not exist. A joint goal of State and Federal partners is to acquire consistent, statewide coverage to support existing and emerging applications enabled by lidar data.The National Enhanced Elevation Assessment evaluated multiple elevation data acquisition options to determine the optimal data quality and data replacement cycle relative to cost to meet the identified requirements of the user community. The evaluation demonstrated that lidar acquisition at quality level 2 for the conterminous United States, Hawaii, and selected U.S. territories, and quality level 5 interferometric synthetic aperture radar (IfSAR) data for Alaska, all with a 6- to 10-year acquisition cycle, provided the highest benefit/cost ratios. The 3D Elevation Program (3DEP) initiative selected an 8-year acquisition cycle for the respective quality levels. 3DEP, managed by the U.S. Geological Survey, the Office of Management and Budget Circular A–16 lead agency for terrestrial elevation data, responds to the growing need for high-quality topographic data and a wide range of other three-dimensional (3D) representations of the Nation’s natural and constructed features.

DUQuE quality management measures: associations between quality management at hospital and pathway levels.

PubMed

Wagner, Cordula; Groene, Oliver; Thompson, Caroline A; Dersarkissian, Maral; Klazinga, Niek S; Arah, Onyebuchi A; Suñol, Rosa

2014-04-01

The assessment of integral quality management (QM) in a hospital requires measurement and monitoring from different perspectives and at various levels of care delivery. Within the DUQuE project (Deepening our Understanding of Quality improvement in Europe), seven measures for QM were developed. This study investigates the relationships between the various quality measures. It is a multi-level, cross-sectional, mixed-method study. As part of the DUQuE project, we invited a random sample of 74 hospitals in 7 countries. The quality managers of these hospitals were the main respondents. Furthermore, data of site visits of external surveyors assessing the participating hospitals were used. Three measures of QM at hospitals level focusing on integral systems (QMSI), compliance with the Plan-Do-Study-Act quality improvement cycle (QMCI) and implementation of clinical quality (CQII). Four measures of QM activities at care pathway level focusing on Specialized expertise and responsibility (SER), Evidence-based organization of pathways (EBOP), Patient safety strategies (PSS) and Clinical review (CR). Positive significant associations were found between the three hospitals level QM measures. Results of the relationships between levels were mixed and showed most associations between QMCI and department-level QM measures for all four types of departments. QMSI was associated with PSS in all types of departments. By using the seven measures of QM, it is possible to get a more comprehensive picture of the maturity of QM in hospitals, with regard to the different levels and across various types of hospital departments.

Top management leadership style and quality of care in nursing homes.

PubMed

Castle, Nicholas G; Decker, Frederic H

2011-10-01

The purpose of this study was to examine the association of Nursing Home Administrator (NHA) leadership style and Director of Nursing (DON) leadership style with quality of care. Leaders were categorized into 4 groups: consensus managers, consultative autocrats, shareholder managers, or autocrats. This leadership style assessment came from primary data collected from approximately 4,000 NHAs and DONs that was linked to quality information (i.e., Nursing Home Compare Quality Measures and 5-Star rating scores) and nursing home information (i.e., Online Survey, Certification, And Reporting data). A consensus manager leadership style has a strong association with better quality. Top managers using this style solicit and act upon input from their employees. For NHAs exhibiting this leadership style, the coefficients on 5 of the 7 quality indicators are statistically significant, and all 7 are significant when the DON exhibits this style. When the NHA and DON both have a consensus manager leadership style, 6 of the 7 quality indicator coefficients are significantly associated with better quality. The findings indicate that NHA and DON leadership style is associated with quality of care. Leadership strategies are amenable to change; thus, the findings of this study may be used to develop policies for promoting more effective leadership in nursing homes.

A summary of the U.S. Geological Survey National Water-Quality Assessment program

USGS Publications Warehouse

Hirsch, R.M.; Alley, W.M.; Wilber, W.G.

1988-01-01

Beginning in 1986, the Congress appropriated funds for the U.S. Geological Survey to test and refine concepts for a National Water Quality Assessment Program. At present, the program is in a pilot phase with field studies occurring in seven areas around the Nation. In 1990, a committee of the National Academy of Sciences will complete an evaluation of the design and potential utility of the program. A decision about moving to full-scale implementation will be made upon completion of this evaluation. The program is intended to address a wide range of national water quality issues that include chemical contamination, acidification, eutrophication, salinity, sedimentation, and sanitary quality. The goals of the program are to: (1) provide nationally consistent descriptions of current water quality conditions for a large part of the Nation 's water resources; (2) define long-term trends (or lack of trends) in water quality; and (3) identify and describe the relations of both current conditions and trends in water quality to natural and human factors. This information will be provided to water managers, policy makers, and the public to provide an improved scientific basis for evaluating the effectiveness of water quality management programs and for predicting the likely effects of contemplated changes in land- and water-management practices. (USGS)

Quality management and accreditation in a mixed research and clinical hair testing analytical laboratory setting-a review.

PubMed

Fulga, Netta

2013-06-01

Quality management and accreditation in the analytical laboratory setting are developing rapidly and becoming the standard worldwide. Quality management refers to all the activities used by organizations to ensure product or service consistency. Accreditation is a formal recognition by an authoritative regulatory body that a laboratory is competent to perform examinations and report results. The Motherisk Drug Testing Laboratory is licensed to operate at the Hospital for Sick Children in Toronto, Ontario. The laboratory performs toxicology tests of hair and meconium samples for research and clinical purposes. Most of the samples are involved in a chain of custody cases. Establishing a quality management system and achieving accreditation became mandatory by legislation for all Ontario clinical laboratories since 2003. The Ontario Laboratory Accreditation program is based on International Organization for Standardization 15189-Medical laboratories-Particular requirements for quality and competence, an international standard that has been adopted as a national standard in Canada. The implementation of a quality management system involves management commitment, planning and staff education, documentation of the system, validation of processes, and assessment against the requirements. The maintenance of a quality management system requires control and monitoring of the entire laboratory path of workflow. The process of transformation of a research/clinical laboratory into an accredited laboratory, and the benefits of maintaining an effective quality management system, are presented in this article.

Assessment of reservoir system variable forecasts

NASA Astrophysics Data System (ADS)

Kistenmacher, Martin; Georgakakos, Aris P.

2015-05-01

Forecast ensembles are a convenient means to model water resources uncertainties and to inform planning and management processes. For multipurpose reservoir systems, forecast types include (i) forecasts of upcoming inflows and (ii) forecasts of system variables and outputs such as reservoir levels, releases, flood damage risks, hydropower production, water supply withdrawals, water quality conditions, navigation opportunities, and environmental flows, among others. Forecasts of system variables and outputs are conditional on forecasted inflows as well as on specific management policies and can provide useful information for decision-making processes. Unlike inflow forecasts (in ensemble or other forms), which have been the subject of many previous studies, reservoir system variable and output forecasts are not formally assessed in water resources management theory or practice. This article addresses this gap and develops methods to rectify potential reservoir system forecast inconsistencies and improve the quality of management-relevant information provided to stakeholders and managers. The overarching conclusion is that system variable and output forecast consistency is critical for robust reservoir management and needs to be routinely assessed for any management model used to inform planning and management processes. The above are demonstrated through an application from the Sacramento-American-San Joaquin reservoir system in northern California.

Derailing Intragroup Management Conflict.

ERIC Educational Resources Information Center

Bonar, John; Vaughn, Glen

1994-01-01

Discussion of management conflict highlights differing job perceptions held by middle managers. The Malcolm Baldrige National Quality Assessment Program is described, and a management structure that requires members of each group to experience job perceptions and tasks of the other group is recommended for performance improvement. (Contains three…

Quality Management Framework for Total Diet Study centres in Europe.

PubMed

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

2018-02-01

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

Assessments of managed care organizations in the Greater Baton Rouge area by physicians and physicians' office managers.

PubMed

Cassidy, W M; Dyson, T; Grenier, C E

2001-03-01

Health care quality assessment under managed care organizations is usually derived from two sources: (1) consumer satisfaction surveys, and (2) The Health Plan Employer Data Information Set reports. There is little published data regarding physicians' critiques. This study surveyed physicians and office managers as to the quality of healthcare under 10 managed care organizations in the Greater Baton Rouge area. Performance indicators in the physician questionnaire focused on personal satisfaction, perception of patient satisfaction, and mental health coverage. The office managers' checklist included payment and certification issues, telephone time spent gaining certification, level of knowledge among plan enrollees of their benefits, appeal process, and adequacy of reimbursement. Means were calculated for each performance indicator and managed care organizations were ranked. Tukey-Kramer's post-hoc multiple comparisons test was used to confirm rank order validity. Significant differences were found among companies. Significant rank-order agreement by both physicians and office managers was evident. The usefulness of such surveys and performing them annually is discussed.

A conceptual framework for quality assessment and management of biodiversity data.

PubMed

Veiga, Allan Koch; Saraiva, Antonio Mauro; Chapman, Arthur David; Morris, Paul John; Gendreau, Christian; Schigel, Dmitry; Robertson, Tim James

2017-01-01

The increasing availability of digitized biodiversity data worldwide, provided by an increasing number of institutions and researchers, and the growing use of those data for a variety of purposes have raised concerns related to the "fitness for use" of such data and the impact of data quality (DQ) on the outcomes of analyses, reports, and decisions. A consistent approach to assess and manage data quality is currently critical for biodiversity data users. However, achieving this goal has been particularly challenging because of idiosyncrasies inherent in the concept of quality. DQ assessment and management cannot be performed if we have not clearly established the quality needs from a data user's standpoint. This paper defines a formal conceptual framework to support the biodiversity informatics community allowing for the description of the meaning of "fitness for use" from a data user's perspective in a common and standardized manner. This proposed framework defines nine concepts organized into three classes: DQ Needs, DQ Solutions and DQ Report. The framework is intended to formalize human thinking into well-defined components to make it possible to share and reuse concepts of DQ needs, solutions and reports in a common way among user communities. With this framework, we establish a common ground for the collaborative development of solutions for DQ assessment and management based on data fitness for use principles. To validate the framework, we present a proof of concept based on a case study at the Museum of Comparative Zoology of Harvard University. In future work, we will use the framework to engage the biodiversity informatics community to formalize and share DQ profiles related to DQ needs across the community.

A conceptual framework for quality assessment and management of biodiversity data

PubMed Central

Saraiva, Antonio Mauro; Chapman, Arthur David; Morris, Paul John; Gendreau, Christian; Schigel, Dmitry; Robertson, Tim James

2017-01-01

The increasing availability of digitized biodiversity data worldwide, provided by an increasing number of institutions and researchers, and the growing use of those data for a variety of purposes have raised concerns related to the "fitness for use" of such data and the impact of data quality (DQ) on the outcomes of analyses, reports, and decisions. A consistent approach to assess and manage data quality is currently critical for biodiversity data users. However, achieving this goal has been particularly challenging because of idiosyncrasies inherent in the concept of quality. DQ assessment and management cannot be performed if we have not clearly established the quality needs from a data user’s standpoint. This paper defines a formal conceptual framework to support the biodiversity informatics community allowing for the description of the meaning of "fitness for use" from a data user’s perspective in a common and standardized manner. This proposed framework defines nine concepts organized into three classes: DQ Needs, DQ Solutions and DQ Report. The framework is intended to formalize human thinking into well-defined components to make it possible to share and reuse concepts of DQ needs, solutions and reports in a common way among user communities. With this framework, we establish a common ground for the collaborative development of solutions for DQ assessment and management based on data fitness for use principles. To validate the framework, we present a proof of concept based on a case study at the Museum of Comparative Zoology of Harvard University. In future work, we will use the framework to engage the biodiversity informatics community to formalize and share DQ profiles related to DQ needs across the community. PMID:28658288

Comparison of SWAT Model Water Balance Calibration Using NEXRAD and Surface Rain Gauge Data

USDA-ARS?s Scientific Manuscript database

The value of watershed-scale, water quality models to ecosystem management is increasingly evident as more programs adopt these tools to help assess the effectiveness of different management scenarios on the environment. The USDA-Conservation Effects Assessment Project (CEAP) is one such program whi...

Comparison of Flow Calibration Using NEXRAD and Surface Rain Gauge Data in ArcSWAT

USDA-ARS?s Scientific Manuscript database

The value of watershed-scale, water quality models to ecosystem management is increasingly evident as more programs adopt these tools to help assess the effectiveness of different management scenarios on the environment. The USDA-Conservation Effects Assessment Project (CEAP) is one such program whi...

78 FR 52909 - Consumer Financial Protection Bureau Notice of Availability of Final Environmental Assessment...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-27

...: [email protected] . Mail/Hand Delivery/Courier: Michael Davis, Project Manager, Consumer Financial... application of best management practices (BMP) to minimize short term air quality and noise impact during... of Final Environmental Assessment (FINAL EA) and a Finding of No Significant Impact (FONSI) for...

A Primer on the Financial Management of Experiential Learning Assessment Programs.

ERIC Educational Resources Information Center

MacTaggart, Terrence

1983-01-01

The success and failure of experiential learning assessment programs rests not only on their academic quality, but also on their financial management. Types of cost and the meaning of cost-effectiveness are discussed. Break-even analysis, cost-reduction activities, and revenue-enhancement techniques are described. (Author/MLW)

Development of cropland management dataset to support U.S. SWAT assessments

USDA-ARS?s Scientific Manuscript database

The Soil and Water Assessment Tool (SWAT) is a widely used hydrologic/water quality simulation model in the U.S. Process-based models like SWAT require a great deal of data to accurately represent the natural world, including topography, landuse, soils, weather, and management. With the exception ...

Visual quality assessment of alternative silvicultural practices in upland hardwood management

Treesearch

Tim McDonald; Bryce Stokes

1997-01-01

Visual impacts of forest operations are of increasing concern to forest managers. Tools are available for evaluating, and potentially avoiding, problems in visual quality resulting from poorly designed harvest unit boundaries. One of these visualization tools is applied in comparing various harvest unit shape alternatives in an upland hardwood stand on steeply sloping...

Coordination and standardization of federal sedimentation activities

USGS Publications Warehouse

Glysson, G. Douglas; Gray, John R.

1997-01-01

- precipitation information critical to water resources management. Memorandum M-92-01 covers primarily freshwater bodies and includes activities, such as "development and distribution of consensus standards, field-data collection and laboratory analytical methods, data processing and interpretation, data-base management, quality control and quality assurance, and water- resources appraisals, assessments, and investigations." Research activities are not included.

A Retention Assessment Process: Utilizing Total Quality Management Principles and Focus Groups

ERIC Educational Resources Information Center

Codjoe, Henry M.; Helms, Marilyn M.

2005-01-01

Retaining students is a critical topic in higher education. Methodologies abound to gather attrition data as well as key variables important to retention. Using the theories of total quality management and focus groups, this case study gathers and reports data from current college students. Key results, suggestions for replication, and areas for…

Castration-resistant Prostate Cancer: Preservation of Quality of Life and Well-being.

PubMed

Rosario, Derek J; Greasley, Rosa; Bourke, Liam

2016-12-01

Managing optimal health in castrate-resistant prostate cancer is a complex clinical challenge. Quality of life should be assessed with disease-specific validated tools and can be used in clinical practice to assist in considering management options. Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Diabetes quality management in Dutch care groups and outpatient clinics: a cross-sectional study.

PubMed

Campmans-Kuijpers, Marjo J E; Baan, Caroline A; Lemmens, Lidwien C; Rutten, Guy E H M

2014-08-07

In recent years, most Dutch general practitioners started working under the umbrella of diabetes care groups, responsible for the organisation and coordination of diabetes care. The quality management of these new organisations receives growing interest, although its association with quality of diabetes care is yet unclear. The best way to measure quality management is unknown and it has not yet been studied at the level of outpatient clinics or care groups. We aimed to assess quality management of type 2 diabetes care in care groups and outpatient clinics. Quality management was measured with online questionnaires, containing six domains (see below). They were divided into 28 subdomains, with 59 (care groups) and 57 (outpatient clinics) questions respectively. The mean score of the domains reflects the overall score (0-100%) of an organisation. Two quality managers of all Dutch care groups and outpatient clinics were invited to fill out the questionnaire.Sixty care groups (response rate 61.9%) showed a mean score of 59.6% (CI 57.1-62.1%). The average score in 52 outpatient clinics (response rate 50.0%) was 61.9% (CI 57.5-66.8%).Mean scores on the six domains for care groups and outpatient clinics respectively were: 'organisation of care' 71.9% (CI 68.8-74.9%), 76.8% (CI 72.8-80.7%); 'multidisciplinary teamwork' 67.1% (CI 62.4-71.9%), 71.5% (CI 65.3-77.8%); 'patient centeredness' 46.7% (CI 42.6-50.7%), 62.5% (CI 57.7-67.2%); 'performance management' 63.3% (CI 61.2-65.3%), 50.9% (CI 44.2-57.5%); 'quality improvement policy' 52.6% (CI 49.2-56.1%), 50.9% (CI 44.6-57.3%); and 'management strategies' 56.0% (CI 51.4-60.7%), 59.0% (CI 52.8-65.2%). On subdomains, care groups scored highest on 'care program' (83.3%) and 'measured outcomes' (98.3%) and lowest on 'patient safety' (15.1%) and 'patient involvement' (17.7%). Outpatient clinics scored high on the presence of a 'diabetic foot team' (81.6%) and the support in 'self-management' (81.0%) and low on 'patient involvement' (26.8%) and 'inspection of medical file' (28.0%). This nationwide assessment reveals that the level of quality management in diabetes care varies between several subdomains in both diabetes care groups and outpatient clinics.

The Quality Movements in Higher Education in the United States.

ERIC Educational Resources Information Center

Miller, Richard I.

1996-01-01

Discussion of various quality control strategies in American higher education looks at and compares Total Quality Management (TQM), outcomes assessment, Deming's 14 points, the Malcolm Baldrige National Quality Award, the ISO 9000 series, restructuring, reengineering, and performance indicators. It is suggested that colleges and universities will…

Quantity, quality, and support for research in the U.S. Fish and Wildlife Service: An organizational assessment

USGS Publications Warehouse

Ratz, Joan M.; Ponds, Phadrea D.; Neilson, Jennifer R.; Liverca, Joyce; Lamb, Berton Lee

2005-01-01

To develop a clearer picture of the nature, extent and quality of management support available for conducting research within the FWS, we completed investigations to identify organizational units within the U.S. Fish and Wildlife Service (FWS) that conduct research as a significant portion of their mission; identify positions in the FWS that include, in whole or in part, a component of scientific research; and assess the attitudes of employees and managers about the obstacles and opportunities for scientific research existing within the FWS.

Deriving a water quality guideline for protection of aquatic communities exposed to triclosan in the Canadian environment.

PubMed

Hill, Katie L; Breton, Roger L; Manning, Gillian E; Teed, R Scott; Capdevielle, Marie; Slezak, Brian

2018-07-01

Triclosan is an antibacterial and antifungal chemical used in a variety of consumer products, including soaps, detergents, moisturizers, and cosmetics. Aquatic ecosystems may be exposed to triclosan following the release of remaining residues in wastewater effluents and biosolids. In December 2017, Environment and Climate Change Canada (ECCC) released a federal environmental quality guideline (FEQG) report that contained a federal water quality guideline (FWQG) for triclosan. This guideline will be used as an adjunct to the risk assessment and risk management of priority chemicals identified under the Government of Canada's Chemicals Management Plan (CMP). The FWQG value for triclosan (0.47 μg/L) was derived by ECCC using a hazardous concentration for 5% of species (HC5) from a species sensitivity distribution (SSD). We recalculated the FWQG after performing an independent analysis and evaluation of the available aquatic toxicity data for triclosan and compared our results with the ECCC FWQG value. Our independent analysis of the available aquatic toxicity data entailed conducting a literature search of all available and relevant studies, evaluating the quality and reliability of all studies considered using thorough and consistent study evaluation criteria, and thereby generating a data set of high-quality toxicity values. The selected data set includes 22 species spanning 5 taxonomic groups. An SSD was developed using this data set following the ECCC approaches. The HC5 from the SSD derived based on our validated data set is 0.76 μg/L. This HC5 value is slightly greater (i.e., less sensitive) than the value presented in ECCC's final FWQG. Integr Environ Assess Manag 2018;14:437-441. © 2018 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC). © 2018 The Authors. Integrated Environmental Assessment and Management Published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

Novel approaches to assess the quality of fertility data stored in dairy herd management software.

PubMed

Hermans, K; Waegeman, W; Opsomer, G; Van Ranst, B; De Koster, J; Van Eetvelde, M; Hostens, M

2017-05-01

Scientific journals and popular press magazines are littered with articles in which the authors use data from dairy herd management software. Almost none of such papers include data cleaning and data quality assessment in their study design despite this being a very critical step during data mining. This paper presents 2 novel data cleaning methods that permit identification of animals with good and bad data quality. The first method is a deterministic or rule-based data cleaning method. Reproduction and mutation or life-changing events such as birth and death were converted to a symbolic (alphabetical letter) representation and split into triplets (3-letter code). The triplets were manually labeled as physiologically correct, suspicious, or impossible. The deterministic data cleaning method was applied to assess the quality of data stored in dairy herd management from 26 farms enrolled in the herd health management program from the Faculty of Veterinary Medicine Ghent University, Belgium. In total, 150,443 triplets were created, 65.4% were labeled as correct, 17.4% as suspicious, and 17.2% as impossible. The second method, a probabilistic method, uses a machine learning algorithm (random forests) to predict the correctness of fertility and mutation events in an early stage of data cleaning. The prediction accuracy of the random forests algorithm was compared with a classical linear statistical method (penalized logistic regression), outperforming the latter substantially, with a superior receiver operating characteristic curve and a higher accuracy (89 vs. 72%). From those results, we conclude that the triplet method can be used to assess the quality of reproduction data stored in dairy herd management software and that a machine learning technique such as random forests is capable of predicting the correctness of fertility data. Copyright © 2017 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

PDA survey of quality risk management practices in the pharmaceutical, devices, & biotechnology industries.

PubMed

Ahmed, Ruhi; Baseman, Harold; Ferreira, Jorge; Genova, Thomas; Harclerode, William; Hartman, Jeffery; Kim, Samuel; Londeree, Nanette; Long, Michael; Miele, William; Ramjit, Timothy; Raschiatore, Marlene; Tomonto, Charles

2008-01-01

In July 2006 the Parenteral Drug Association's Risk Management Task Force for Aseptic Processes, conducted an electronic survey of PDA members to determine current industry practices regarding implementation of Quality Risk Management in their organizations. This electronic survey was open and publicly available via the PDA website and targeted professionals in our industry who are involved in initiating, implementing, or reviewing risk management programs or decisions in their organizations. One hundred twenty-nine members participated and their demographics are presented in the sidebar "Correspondents Profile". Among the major findings are: *The "Aseptic Processing/Filling" operation is the functional area identified as having the greatest need for risk assessment and quality risk management. *The most widely used methodology in industry to identify risk is Failure Mode and Effects Analysis (FMEA). This tool was most widely applied in assessing change control and for adverse event, complaint, or failure investigations. *Despite the fact that personnel training was identified as the strategy most used for controlling/minimizing risk, the largest contributors to sterility failure in operations are still "Personnel". *Most companies still rely on "Manufacturing Controls" to mitigate risk and deemed the utilization of Process Analytical Technology (PAT) least important in this aspect. *A majority of correspondents verified that they did not periodically assess their risk management programs. *A majority of the correspondents desired to see case studies or examples of risk analysis implementation (as applicable to aseptic processing) in future PDA technical reports on risk management.

Work design and management in the manufacturing sector: development and validation of the Work Organisation Assessment Questionnaire.

PubMed

Griffiths, A; Cox, T; Karanika, M; Khan, S; Tomás, J M

2006-10-01

To examine the factor structure, reliability, and validity of a new context-specific questionnaire for the assessment of work and organisational factors. The Work Organisation Assessment Questionnaire (WOAQ) was developed as part of a risk assessment and risk reduction methodology for hazards inherent in the design and management of work in the manufacturing sector. Two studies were conducted. Data were collected from 524 white- and blue-collar employees from a range of manufacturing companies. Exploratory factor analysis was carried out on 28 items that described the most commonly reported failures of work design and management in companies in the manufacturing sector. Concurrent validity data were also collected. A reliability study was conducted with a further 156 employees. Principal component analysis, with varimax rotation, revealed a strong 28-item, five factor structure. The factors were named: quality of relationships with management, reward and recognition, workload, quality of relationships with colleagues, and quality of physical environment. Analyses also revealed a more general summative factor. Results indicated that the questionnaire has good internal consistency and test-retest reliability and validity. Being associated with poor employee health and changes in health related behaviour, the WOAQ factors are possible hazards. It is argued that the strength of those associations offers some estimation of risk. Feedback from the organisations involved indicated that the WOAQ was easy to use and meaningful for them as part of their risk assessment procedures. The studies reported here describe a model of the hazards to employee health and health related behaviour inherent in the design and management of work in the manufacturing sector. It offers an instrument for their assessment. The scales derived which form the WOAQ were shown to be reliable, valid, and meaningful to the user population.

The NCC project: A quality management perspective

NASA Technical Reports Server (NTRS)

Lee, Raymond H.

1993-01-01

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

[Quality management and strategic consequences of assessing documentation and coding under the German Diagnostic Related Groups system].

PubMed

Schnabel, M; Mann, D; Efe, T; Schrappe, M; V Garrel, T; Gotzen, L; Schaeg, M

2004-10-01

The introduction of the German Diagnostic Related Groups (D-DRG) system requires redesigning administrative patient management strategies. Wrong coding leads to inaccurate grouping and endangers the reimbursement of treatment costs. This situation emphasizes the roles of documentation and coding as factors of economical success. The aims of this study were to assess the quantity and quality of initial documentation and coding (ICD-10 and OPS-301) and find operative strategies to improve efficiency and strategic means to ensure optimal documentation and coding quality. In a prospective study, documentation and coding quality were evaluated in a standardized way by weekly assessment. Clinical data from 1385 inpatients were processed for initial correctness and quality of documentation and coding. Principal diagnoses were found to be accurate in 82.7% of cases, inexact in 7.1%, and wrong in 10.1%. Effects on financial returns occurred in 16%. Based on these findings, an optimized, interdisciplinary, and multiprofessional workflow on medical documentation, coding, and data control was developed. Workflow incorporating regular assessment of documentation and coding quality is required by the DRG system to ensure efficient accounting of hospital services. Interdisciplinary and multiprofessional cooperation is recognized to be an important factor in establishing an efficient workflow in medical documentation and coding.

Quality assurance planning for lunar Mars exploration

NASA Technical Reports Server (NTRS)

Myers, Kay

1991-01-01

A review is presented of the tools and techniques required to meet the challenge of total quality in the goal of traveling to Mars and returning to the moon. One program used by NASA to ensure the integrity of baselined requirements documents is configuration management (CM). CM is defined as an integrated management process that documents and identifies the functional and physical characteristics of a facility's systems, structures, computer software, and components. It also ensures that changes to these characteristics are properly assessed, developed, approved, implemented, verified, recorded, and incorporated into the facility's documentation. Three principal areas are discussed that will realize significant efficiencies and enhanced effectiveness, change assessment, change avoidance, and requirements management.

An evaluation of the total quality management implementation strategy for the advanced solid rocket motor project at NASA's Marshall Space Flight Center. M.S. Thesis - Tennessee Univ.

NASA Technical Reports Server (NTRS)

Schramm, Harry F.; Sullivan, Kenneth W.

1991-01-01

An evaluation of the NASA's Marshall Space Flight Center (MSFC) strategy to implement Total Quality Management (TQM) in the Advanced Solid Rocket Motor (ASRM) Project is presented. The evaluation of the implementation strategy reflected the Civil Service personnel perspective at the project level. The external and internal environments at MSFC were analyzed for their effects on the ASRM TQM strategy. Organizational forms, cultures, management systems, problem solving techniques, and training were assessed for their influence on the implementation strategy. The influence of ASRM's effort was assessed relative to its impact on mature projects as well as future projects at MSFC.

Evaluation and management of orofacial pain.

PubMed

Gilkey, Stephanie Joseph; Plaza-Villegas, Francisco

2017-05-01

Challenging to diagnose and manage, orofacial pain is a common and costly problem with a profound effect on quality of life. Delayed diagnosis and management can lead to prolonged patient suffering and disability. This article describes the background, assessment, differential diagnosis, management, and referral of patients with orofacial pain.

Project officer's perspective: quality assurance as a management tool.

PubMed

Heiby, J

1993-06-01

Advances in the management of health programs in less developed countries (LDC) have not kept pace with the progress of the technology used. The US Agency for International Development mandated the Quality Assurance Project (QAP) to provide quality improvement technical assistance to primary health care systems in LDCs while developing appropriate quality assurance (QA) strategies. The quality of health care in recent years in the US and Europe focused on the introduction of management techniques developed for industry into health systems. The experience of the QAP and its predecessor, the PRICOR Project, shows that quality improvement techniques facilitate measurement of quality of care. A recently developed WHO model for the management of the sick child provides scientifically based standards for actual care. Since 1988, outside investigators measuring how LDC clinicians perform have revealed serious deficiencies in quality compared with the program's own standards. This prompted developed of new QA management initiatives: 1) communicating standards clearly to the program staff; 2) actively monitoring actual performance corresponds to these standards; and 3) taking action to improve performance. QA means that managers are expected to monitor service delivery, undertake problem solving, and set specific targets for quality improvement. Quality improvement methods strengthen supervision as supervisors can objectively assess health worker performance. QA strengthens the management functions that support service delivery, e.g., training, records management, finance, logistics, and supervision. Attention to quality can contribute to improved health worker motivation and effective incentive programs by recognition for a job well done and opportunities for learning new skills. These standards can also address patient satisfaction. QA challenges managers to aim for the optimal level of care attainable.

Managing Air Quality - Human Health, Environmental and Economic Assessments

EPA Pesticide Factsheets

Human health and environmental assessments characterize health and environmental risks associated with exposure to pollution. Economic assessments evaluate the cost and economic impact of a policy or regulation & can estimate economic benefits.

Embedded Formative Assessment and Classroom Process Quality: How Do They Interact in Promoting Science Understanding?

ERIC Educational Resources Information Center

Decristan, Jasmin; Klieme, Eckhard; Kunter, Mareike; Hochweber, Jan; Büttner, Gerhard; Fauth, Benjamin; Hondrich, A. Lena; Rieser, Svenja; Hertel, Silke; Hardy, Ilonca

2015-01-01

In this study we examine the interplay between curriculum-embedded formative assessment--a well-known teaching practice--and general features of classroom process quality (i.e., cognitive activation, supportive climate, classroom management) and their combined effect on elementary school students' understanding of the scientific concepts of…

Quality Management and Self Assessment Tools for Public Libraries.

ERIC Educational Resources Information Center

Evans, Margaret Kinnell

This paper describes a two-year study by the British Library Research and Innovation Centre that examined the potential of self-assessment for public library services. The approaches that formed the basis for the investigation were the Business Excellence Model, the Quality Framework, and the Democratic Approach. Core values were identified by…

QUALITY ASSURANCE AND QUALITY CONTROL IN THE DEVELOPMENT AND APPLICATION OF THE AUTOMATED GEOSPATIAL WATERSHED ASSESSMENT (AGWA) TOOL

EPA Science Inventory

Planning and assessment in land and water resource management are evolving from simple, local-scale problems toward complex, spatially explicit regional ones. Such problems have to be addressed with distributed models that can compute runoff and erosion at different spatial and t...

Defining Strategic and Excellence Bases for the Development of Portuguese Higher Education

ERIC Educational Resources Information Center

Rosa, Maria Joao; Saraiva, Pedro M.; Diz, Henrique

2005-01-01

A self-assessment model was developed for the Portuguese higher education institutions (HEIs) which was based on an empirical study aiming at better understanding their strategic and quality management and innovation practices and tools and on the study of several quality assessment models developed both for HEIs and business organisations. From…

Assessing and Predicting the Effectiveness of Stormwater BMPs on Water Quality, Flow, Thermal Regime, and Substrate Integrity in the Delaware River Basin

EPA Science Inventory

Assessments of the effectiveness of stormwater best management practices (BMPs) have focused on measurement of load or concentration reductions, which can be translated to predict biological impacts based on chemical water quality criteria. However, many of the impacts of develo...

The Ontological Architectures in the Application of a Knowledge Management System for Curricular Assessment

ERIC Educational Resources Information Center

Olson, Brandon D.

2012-01-01

Institutions of higher education are facing increasing pressure to improve the effectiveness and quality of academic programs (Association of Governing Boards, Top public policy issues 2011-2012, 2011). These institutions apply curricular assessment processes as a means to evaluate and improve academic effectiveness and quality. Knowledge…

Measuring Healthcare Providers' Performances Within Managed Competition Using Multidimensional Quality and Cost Indicators.

PubMed

Portrait, France R M; van der Galiën, Onno; Van den Berg, Bernard

2016-04-01

The Dutch healthcare system is in transition towards managed competition. In theory, a system of managed competition involves incentives for quality and efficiency of provided care. This is mainly because health insurers contract on behalf of their clients with healthcare providers on, potentially, quality and costs. The paper develops a strategy to comprehensively analyse available multidimensional data on quality and costs to assess and report on the relative performance of healthcare providers within managed competition. We had access to individual information on 2409 clients of 19 Dutch diabetes care groups on a broad range of (outcome and process related) quality and cost indicators. We carried out a cost-consequences analysis and corrected for differences in case mix to reduce incentives for risk selection by healthcare providers. There is substantial heterogeneity between diabetes care groups' performances as measured using multidimensional indicators on quality and costs. Better quality diabetes care can be achieved with lower or higher costs. Routine monitoring using multidimensional data on quality and costs merged at the individual level would allow a systematic and comprehensive analysis of healthcare providers' performances within managed competition. Copyright © 2015 John Wiley & Sons, Ltd.

Nonprice competition and quality of care in managed care: the New York SCHIP market.

PubMed

Liu, Hangsheng; Phelps, Charles E

2008-06-01

To examine the effect of nonprice competition among managed care plans on the quality of care in the New York SCHIP market. U.S. Census 2000; 2002 New York State Managed Care Plan Performance Report; and 2001 New York State Managed Care Annual Enrollment Report. Each market is defined as a county, and competition is measured as the number of plans in a market. Quality of care is measured in percentages using three Consumer Assessment of Health Plans Survey and three Health Plan Employer Data and Information Set scores. Two-stage least squares is applied to address the endogeneity between competition and the quality of care, using population as an instrument. We find a negative association between competition and quality of care. An additional managed care plan is significantly associated with a decrease of 0.40-2.31 percentage points in four out of six quality measures. After adjusting for production cost, a positive correlation is observed between price and quality measures across different pricing regions. It seems likely that pricing policy is a constraint on quality production, although it may not be interpreted as a causal relationship and further study is needed.

Effects of farm management practices and transport duration on stress response and meat quality traits of suckling goat kids.

PubMed

Alcalde, M J; Suárez, M D; Rodero, E; Álvarez, R; Sáez, M I; Martínez, T F

2017-09-01

Studies aimed to assess up to what extent farming and transport previous to slaughtering might affect physiology and meat quality in young goat kids are needed, with the ultimate purpose of promoting practices that minimize stress in these animals. In this regard the effects of on-farm management and transport duration on some physiological responses and meat quality parameters in goat kids were assessed. Two farms representing 'high' and 'low' welfare-friendly management practices were selected. In total, 32 suckling kids were withdrawn from each farm, transported by road for 2 or 6 h, and then slaughtered. Blood samples were collected both on-farm and in the slaughterhouse, and biochemistry, cell counts and haematocrit were determined. After slaughtering, carcass quality parameters were measured. Longissimus dorsi muscle was dissected and pH, colour parameters, water holding capacity and shear force were measured throughout 8-day ageing period. Results indicate that, regardless its duration, transport caused significant effects on some blood parameters suggesting stress in live animals, like glucose, cortisol or creatine kinase. Despite the marked stress status in animals, this condition was not decisively reflected on L. dorsi quality parameters, but some effects were observed regarding fat cover in carcasses and colour parameters. The results suggest that postmortem changes throughout ageing were more decisive in terms of meat quality than stressful management either on-farm or during transport.

[Endorsement of risk management and patient safety by certification of conformity in health care quality assessment].

PubMed

Waßmuth, Ralf

2015-01-01

Certification of conformity in health care should provide assurance of compliance with quality standards. This also includes risk management and patient safety. Based on a comprehensive definition of quality, beneficial effects on the management of risks and the enhancement of patient safety can be expected from certification of conformity. While these effects have strong face validity, they are currently not sufficiently supported by evidence from health care research. Whether this relates to a lack of evidence or a lack of investigation remains open. Advancing safety culture and "climate", as well as learning from adverse events rely in part on quality management and are at least in part reflected in the certification of healthcare quality. However, again, evidence of the effectiveness of such measures is limited. Moreover, additional factors related to personality, attitude and proactive action of healthcare professionals are crucial factors in advancing risk management and patient safety which are currently not adequately reflected in certification of conformity programs.

HOW GOOD ARE MY DATA? INFORMATION QUALITY ASSESSMENT METHODOLOGY

EPA Science Inventory

Quality assurance techniques used in software development and hardware maintenance/reliability help to ensure that data in a computerized information management system are maintained well. However, information workers may not know the quality of the data resident in their inf...

Clinical governance: bridging the gap between managerial and clinical approaches to quality of care

PubMed Central

Buetow, S. A.; Roland, M.

1999-01-01

Clinical governance has been introduced as a new approach to quality improvement in the UK national health service. This article maps clinical governance against a discussion of the four main approaches to measuring and improving quality of care: quality assessment, quality assurance, clinical audit, and quality improvement (including continuous quality improvement). Quality assessment underpins each approach. Whereas clinical audit has, in general, been professionally led, managers have driven quality improvement initiatives. Quality assurance approaches have been perceived to be externally driven by managers or to involve professional inspection. It is discussed how clinical governance seeks to bridge these approaches. Clinical governance allows clinicians in the UK to lead a comprehensive strategy to improve quality within provider organisations, although with an expectation of greatly increased external accountability. Clinical governance aims to bring together managerial, organisational, and clinical approaches to improving quality of care. If successful, it will define a new type of professionalism for the next century. Failure by the professions to seize the opportunity is likely to result in increasingly detailed external control of clinical activity in the UK, as has occurred in some other countries. PMID:10847876

Expert Assessment of Conditions for Accredited Quality Management System Functioning in Testing Laboratories

NASA Astrophysics Data System (ADS)

Mytych, Joanna; Ligarski, Mariusz J.

2018-03-01

The quality management systems compliant with the ISO 9001:2009 have been thoroughly researched and described in detail in the world literature. The accredited management systems used in the testing laboratories and compliant with the ISO/IEC 17025:2005 have been mainly described in terms of the system design and implementation. They have also been investigated from the analytical point of view. Unfortunately, a low number of studies concerned the management system functioning in the accredited testing laboratories. The aim of following study was to assess the management system functioning in the accredited testing laboratories in Poland. On 8 October 2015, 1,213 accredited testing laboratories were present in Poland. They investigated various scientific areas and substances/objects. There are more and more such laboratories that have various problems and different long-term experience when it comes to the implementation, maintenance and improvement of the management systems. The article describes the results of the conducted expert assessment (survey) carried out to examine the conditions for the functioning of a management system in an accredited laboratory. It also focuses on the characteristics of the accredited research laboratories in Poland. The authors discuss the selection of the external and internal conditions that may affect the accredited management system. They show how the experts assessing the selected conditions were chosen. The survey results are also presented.

A novel framework for assessing metadata quality in epidemiological and public health research settings

PubMed Central

McMahon, Christiana; Denaxas, Spiros

2016-01-01

Metadata are critical in epidemiological and public health research. However, a lack of biomedical metadata quality frameworks and limited awareness of the implications of poor quality metadata renders data analyses problematic. In this study, we created and evaluated a novel framework to assess metadata quality of epidemiological and public health research datasets. We performed a literature review and surveyed stakeholders to enhance our understanding of biomedical metadata quality assessment. The review identified 11 studies and nine quality dimensions; none of which were specifically aimed at biomedical metadata. 96 individuals completed the survey; of those who submitted data, most only assessed metadata quality sometimes, and eight did not at all. Our framework has four sections: a) general information; b) tools and technologies; c) usability; and d) management and curation. We evaluated the framework using three test cases and sought expert feedback. The framework can assess biomedical metadata quality systematically and robustly. PMID:27570670

A novel framework for assessing metadata quality in epidemiological and public health research settings.

PubMed

McMahon, Christiana; Denaxas, Spiros

2016-01-01

Metadata are critical in epidemiological and public health research. However, a lack of biomedical metadata quality frameworks and limited awareness of the implications of poor quality metadata renders data analyses problematic. In this study, we created and evaluated a novel framework to assess metadata quality of epidemiological and public health research datasets. We performed a literature review and surveyed stakeholders to enhance our understanding of biomedical metadata quality assessment. The review identified 11 studies and nine quality dimensions; none of which were specifically aimed at biomedical metadata. 96 individuals completed the survey; of those who submitted data, most only assessed metadata quality sometimes, and eight did not at all. Our framework has four sections: a) general information; b) tools and technologies; c) usability; and d) management and curation. We evaluated the framework using three test cases and sought expert feedback. The framework can assess biomedical metadata quality systematically and robustly.

Perceptions of Physical Inspections as a Tool to Protect Housing Quality and Promote Health Equity.

PubMed

Holtzen, Holly; Klein, Elizabeth G; Keller, Brittney; Hood, Nancy

2016-01-01

Physical inspections that assess how well affordable housing properties meet quality and safety standards help to ensure that low-income tenants live in a healthy built environment. This study was part of a larger Health Impact Assessment (HIA) conducted between January 2012 and November 2013 to inform policymakers about the potential health consequences of a proposed policy decision to align the physical inspections required by housing funding agencies, which would result in a reduction of the frequency of physical inspections. Key informant interviews (n=18) of property managers and tenants were used to explore the inspection process, identification of housing quality issues, and potential effects on the health of affordable housing tenants and the impact on property management practices. Results indicate that physical inspection frequency may be an important trigger for property managers and tenants to adhere to proper maintenance schedules.

Total Quality Management in Space Shuttle Main Engine manufacturing

NASA Technical Reports Server (NTRS)

Ding, J.

1992-01-01

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

Quality Indicators for Continuous Monitoring to Improve Maternal and Infant Health in Maternity Departments: A Modified Delphi Survey of an International Multidisciplinary Panel

PubMed Central

Boulkedid, Rym; Sibony, Olivier; Goffinet, François; Fauconnier, Arnaud; Branger, Bernard; Alberti, Corinne

2013-01-01

Objective Measuring the quality of inpatient obstetrical care using quality indicators is becoming increasingly important for both patients and healthcare providers. However, there is no consensus about which measures are optimal. We describe a modified Delphi method to identify a set of indicators for continuously monitoring the quality of maternity care by healthcare professionals. Methodology and Main Findings An international French-speaking multidisciplinary panel comprising 22 obstetricians-gynaecologists, 12 midwives, and 1 paediatrician assessed potential indicators extracted from a medical literature search, using a two-round Delphi procedure followed by a physical meeting. Each panellist rated each indicator based on validity and feasibility. In the first round, 35 panellists from 5 countries and 20 maternity units evaluated 26 indicators including 15 related to the management of the overall population of pregnant women, 3 to the management of women followed from the first trimester of pregnancy, 2 to the management of low-risk pregnant women, and 6 to the management of neonates. 25 quality indicators were kept for next step. In the second round, 27 (27/35: 77%) panellists selected 17 indicators; the remaining 8 indicators were discussed during a physical meeting. The final set comprised 18 indicators. Conclusion A multidisciplinary panel selected indicators that reflect the quality of obstetrical care. This set of indicators could be used to assess and monitor obstetrical care, with the goal of improving the quality of care in maternity units. PMID:23577143

Front-line management, staffing and nurse-doctor relationships as predictors of nurse and patient outcomes. a survey of Icelandic hospital nurses.

PubMed

Gunnarsdóttir, Sigrún; Clarke, Sean P; Rafferty, Anne Marie; Nutbeam, Don

2009-07-01

To investigate aspects of nurses' work environments linked with job outcomes and assessments of quality of care in an Icelandic hospital. Prior research suggests that poor working environments in hospitals significantly hinder retention of nurses and high quality patient care. On the other hand, hospitals with high retention rates (such as Magnet hospitals) show supportive management, professional autonomy, good inter-professional relations and nurse job satisfaction, reduced nurse burnout and improved quality of patient care. Cross-sectional survey of 695 nurses at Landspitali University Hospital, Reykjavík. Nurses' work environments were measured using the nursing work index-revised (NWI-R) and examined as predictors of job satisfaction, the Maslach burnout inventory (MBI) and nurse-assessed quality of patient care using linear and logistic regression approaches. An Icelandic adaptation of the NWI-R showed a five-factor structure similar to that of Lake (2002). After controlling for nurses' personal characteristics, job satisfaction, emotional exhaustion and nurse rated quality of care were found to be independently associated with perceptions of support from unit-level managers, staffing adequacy, and nurse-doctor relations. The NWI-R measures elements of hospital nurses' work environments that predict job outcomes and nurses' ratings of the quality of patient care in Iceland. Efforts to improve and maintain nurses' relations with nurse managers and doctors, as well as their perceptions of staffing adequacy, will likely improve nurse job satisfaction and employee retention, and may improve the quality of patient care.

Development of pig welfare assessment protocol integrating animal-, environment-, and management-based measures.

PubMed

Renggaman, Anriansyah; Choi, Hong L; Sudiarto, Sartika Ia; Alasaarela, Laura; Nam, Ok S

2015-01-01

Due to increased interest in animal welfare, there is now a need for a comprehensive assessment protocol to be used in intensive pig farming systems. There are two current welfare assessment protocols for pigs: Welfare Quality® Assessment Protocols (applicable in the Europe Union), that mostly focuses on animal-based measures, and the Swine Welfare Assurance Program (applicable in the United States), that mostly focuses on management- and environment-based measures. In certain cases, however, animal-based measures might not be adequate for properly assessing pig welfare status. Similarly, welfare assessment that relies only on environment- and management-based measures might not represent the actual welfare status of pigs. Therefore, the objective of this paper was to develop a new welfare protocol by integrating animal-, environment-, and management-based measures. The background for selection of certain welfare criteria and modification of the scoring systems from existing welfare assessment protocols are described. The developed pig welfare assessment protocol consists of 17 criteria that are related to four main principles of welfare (good feeding, good housing, good health, and appropriate behavior). Good feeding, good housing, and good health were assessed using a 3-point scale: 0 (good welfare), 1 (moderate welfare), and 2 (poor welfare). In certain cases, only a 2-point scale was used: 0 (certain condition is present) or 2 (certain condition is absent). Appropriate behavior was assessed by scan sampling of positive and negative social behaviors based on qualitative behavior assessment and human-animal relationship tests. Modification of the body condition score into a 3-point scale revealed pigs with a moderate body condition (score 1). Moreover, additional criteria such as feed quality confirmed that farms had moderate (score 1) or poor feed quality (score 2), especially those farms located in a high relative humidity region. The developed protocol can be utilized to assess welfare status in an intensive pig farming system. Although further improvements are still needed, this study is a first step in developing a pig welfare assessment protocol that combines animal-, environment-, and management-based measures.

Health related quality of life and perception of deformity in patients with adolescent idiopathic scoliosis.

PubMed

Çolak, Tuğba Kuru; Akgül, Turgut; Çolak, Ilker; Dereli, Elif Elçin; Chodza, Mehmet; Dikici, Fatih

2017-01-01

Quality of life and cosmethic appearance have gained importance as outcomes in AIS treatment. Improving aesthetic appearance and quality of life are defined as the primary aims of scoliosis treatment by health professionals. Studies that assess and compare the different treatment results in the field of quality of life and cosmethics are some what limited. A cross-sectional study was designed to compare quality of life and deformity perception in patients with adolescent idiopathic scoliosis (AIS) received conservative (exercise or exercise + brace) or surgical treatment. A total of 68 (58 females) patients aged 10-18 years with AIS received conservative (exercise or exercise+brace) or surgical treatment were invited to participate in the study. Quality of life (Scoliosis Research Society-23 (SRS-23)) and perception of deformity (Walter Reed Visual Assessment (WRVAS)) were assessed. Conservatively treated patients had significantly superior scores in function domain of SRS-23 than surgically treated patients (exercise/surgery, exercise+brace/surgery; p= 0.009, 0.004). Otherwise, surgically treated patients had significantly superior scores in self-image (p= 0.000, 0.000), and satisfaction with management (p= 0.001, 0.006) domains of SRS-23, and WRVAS (p= 0.000, 0.000) than conservative groups. In addition to radiographic assessments, quality of life, aesthetic perception, functionality, satisfaction with management, psycho-social status should carefully be taken into consideration by health professionals in the teratment of AIS.

Tracking and forecasting the Nation’s water quality - Priorities and strategies for 2013-2023

USGS Publications Warehouse

Rowe, Gary L.; Gilliom, Robert J.; Woodside, Michael D.

2013-01-01

Water-quality issues facing the Nation are growing in number and complexity, and solutions are becoming more challenging and costly. Key factors that affect the quality of our drinking water supplies and ecosystem health include contaminants of human and natural origin in streams and groundwater; excess nutrients and sediment; alteration of natural streamflow; eutrophication of lakes, reservoirs, and coastal estuaries; and changes in surface and groundwater quality associated with changes in climate, land and water use, and management practices. Tracking and forecasting the Nation's water quality in the face of these and other pressing water-quality issues are important goals for 2013-2023, the third decade of the U.S. Geological Survey's National Water-Quality Assessment (NAWQA) program. In consultation with stakeholders and the National Research Council, a new strategic Science Plan has been developed that describes a strategy for building upon and enhancing assessment of the Nation's freshwater quality and aquatic ecosystems. The plan continues strategies that have been central to the NAWQA program's long-term success, but it also makes adjustments to the monitoring and modeling approaches NAWQA will use to address critical data and science information needs identified by stakeholders. This fact sheet describes surface-water and groundwater monitoring and modeling activities that will start in fiscal year 2013. It also provides examples of the types of data and information products planned for the next decade, including (1) restored monitoring for reliable and timely status and trend assessments, (2) maps and models that show the distribution of selected contaminants (such as atrazine, nitrate, and arsenic) in streams and aquifers, and (3) Web-based modeling tools that allow managers to evaluate how water quality may change in response to different scenarios of population growth, climate change, or land-use management.

Standardized quality-assessment system to evaluate pressure ulcer care in the nursing home.

PubMed

Bates-Jensen, Barbara M; Cadogan, Mary; Jorge, Jennifer; Schnelle, John F

2003-09-01

To demonstrate reliability and feasibility of a standardized protocol to assess and score quality indicators relevant to pressure ulcer (PU) care processes in nursing homes (NHs). Descriptive. Eight NHs. One hundred ninety-one NH residents for whom the PU Resident Assessment Protocol of the Minimum Data Set was initiated. Nine quality indicators (two related to screening and prevention of PU, two focused on assessment, and five addressing management) were scored using medical record data, direct human observation, and wireless thigh monitor observation data. Feasibility and reliability of medical record, observation, and thigh monitor protocols were determined. The percentage of participants who passed each of the indicators, indicating care consistent with practice guidelines, ranged from 0% to 98% across all indicators. In general, participants in NHs passed fewer indicators and had more problems with medical record accuracy before a PU was detected (screening/prevention indicators) than they did once an ulcer was documented (assessment and management indicators). Reliability of the medical record protocol showed kappa statistics ranging from 0.689 to 1.00 and percentage agreement from 80% to 100%. Direct observation protocols yielded kappa statistics of 0.979 and 0.928. Thigh monitor protocols showed kappa statistics ranging from 0.609 to 0.842. Training was variable, with the observation protocol requiring 1 to 2 hours, medical records requiring joint review of 20 charts with average time to complete the review of 20 minutes, and the thigh monitor data requiring 1 week for training in data preparation and interpretation. The standardized quality assessment system generated scores for nine PU quality indicators with good reliability and provided explicit scoring rules that permit reproducible conclusions about PU care. The focus of the indicators on care processes that are under the control of NH staff made the protocol useful for external survey and internal quality improvement purposes, and the thigh monitor observational technology provided a method for monitoring repositioning care processes that were otherwise difficult to monitor and manage.

Some Recommendations for Education (and All of Us): Valuing Differences as Collaboration beyond Outcomes Assessment and Total Quality Management/Demingism.

ERIC Educational Resources Information Center

Sadler, Lynn Veach

Recommendations for a national educational agenda that is based on tolerance for cultural diversity and real collaboration are presented in this paper with emphasis on the W. E. Deming model of Total Quality Management, or "Demingism." Two problems in American education are academic performance and the failure of disadvantaged schools. Ten…

Assessing the ecological benefits and opportunity costs of alternative stream management zone widths for eastern hardwoods

Treesearch

Chris B. LeDoux; Ethel Wilkerson

2008-01-01

Leaving buffer zones adjacent to waterways can effectively reduce the water quality concerns associated with timber harvesting. However, riparian areas are also some of the most productive sites and can yield high quality wood. The amount of unharvested timber left in SMZs (Streamside Management Zones) can represent a substantial opportunity cost to landowners. In this...

Assessing the ecological benefits and opportunity costs of alternative stream management zone widths

Treesearch

Chris B. LeDoux; Ethel Wilkerson

2008-01-01

Leaving buffer zones adjacent to waterways can effectively reduce the water quality concerns associated with timber harvesting. However, riparian areas are also some of the most productive sites and can yield high quality wood. The amount of unharvested timber left in SMZs (Streamside Management Zones) can represent a substantial opportunity cost to landowners. In this...

Dysphagia: its nature, assessment and management.

PubMed

Lancaster, John

2015-01-01

Dysphagia impacts on the health and quality of life of individuals and contributes to the cost of health care. This paper summarises current literature regarding the nature, assessment and management of acquired oro-pharyngeal dysphagia in older adults. It examines the aetiology, prevalence and consequences of dysphagia, as well as issues regarding medication administration. Assessment of dysphagia is explored in terms of multidisciplinary screening, speech and language therapist clinical swallowing evaluation and instrumental assessment.

Environmental Assessment for the Implementation of the Integrated Natural Resources Management Plan for 45th Space Wing

DTIC Science & Technology

2008-08-01

the Proposed Action and as a basis for assessing the significance of potential impacts. The areas of environmental consideration were air quality... ENVIRONMENTAL ASSESSMENT FOR THE IMPLEMENTATION OF THE INTEGRATED NATURAL RESOURCES MANAGEMENT PLAN FOR 45th SPACE WING August...DATE AUG 2008 2. REPORT TYPE 3. DATES COVERED 00-00-2008 to 00-00-2008 4. TITLE AND SUBTITLE Environmental Assessment for the Implementation of

Understanding and Managing the Assessment Process

Treesearch

Gene Lessard; Scott Archer; John R. Probst; Sandra Clark

1999-01-01

Taking an ecological approach to management, or ecosystem management, is a developing approach for managing natural resources within the context of large geogaphic scales and over multiple time frames. Recently, the Council on Environmental Quality (CEQ) (IEMTF 1995) defined an ecosystem as "...an interconnected community of living things, including humans, and...

The Formation of Indicators on Engineering Laboratory Management

ERIC Educational Resources Information Center

Yasin, Ruhizan M.; Mohamad, Zunuwanas; Rahman, Mohd Nizam Ab.; Hashim, Mohamad Hisyam Mohd

2012-01-01

This research is a developmental study of Engineering Laboratory Management indicators. It is formed to assess the level of quality management of the polytechnic level laboratory. The purpose of indicators is to help provide input into the management process of an engineering laboratory. Effectiveness of teaching and learning at technical…

Evaluating treatment process redesign by applying the EFQM Excellence Model.

PubMed

Nabitz, Udo; Schramade, Mark; Schippers, Gerard

2006-10-01

To evaluate a treatment process redesign programme implementing evidence-based treatment as part of a total quality management in a Dutch addiction treatment centre. Quality management was monitored over a period of more than 10 years in an addiction treatment centre with 550 professionals. Changes are evaluated, comparing the scores on the nine criteria of the European Foundation for Quality Management (EFQM) Excellence Model before and after a major redesign of treatment processes and ISO certification. In the course of 10 years, most intake, care, and cure processes were reorganized, the support processes were restructured and ISO certified, 29 evidence-based treatment protocols were developed and implemented, and patient follow-up measuring was established to make clinical outcomes transparent. Comparing the situation before and after the changes shows that the client satisfaction scores are stable, that the evaluation by personnel and society is inconsistent, and that clinical, production, and financial outcomes are positive. The overall EFQM assessment by external assessors in 2004 shows much higher scores on the nine criteria than the assessment in 1994. Evidence-based treatment can successfully be implemented in addiction treatment centres through treatment process redesign as part of a total quality management strategy, but not all results are positive.

Advances in public health accreditation readiness and quality improvement: evaluation findings from the National Public Health Improvement Initiative.

PubMed

McLees, Anita W; Thomas, Craig W; Nawaz, Saira; Young, Andrea C; Rider, Nikki; Davis, Mary

2014-01-01

Continuous quality improvement is a central tenet of the Public Health Accreditation Board's (PHAB) national voluntary public health accreditation program. Similarly, the Centers for Disease Control and Prevention launched the National Public Health Improvement Initiative (NPHII) in 2010 with the goal of advancing accreditation readiness, performance management, and quality improvement (QI). Evaluate the extent to which NPHII awardees have achieved program goals. NPHII awardees responded to an annual assessment and program monitoring data requests. Analysis included simple descriptive statistics. Seventy-four state, tribal, local, and territorial public health agencies receiving NPHII funds. NPHII performance improvement managers or principal investigators. Development of accreditation prerequisites, completion of an organizational self-assessment against the PHAB Standards and Measures, Version 1.0, establishment of a performance management system, and implementation of QI initiatives to increase efficiency and effectiveness. Of the 73 responding NPHII awardees, 42.5% had a current health assessment, 26% had a current health improvement plan, and 48% had a current strategic plan in place at the end of the second program year. Approximately 26% of awardees had completed an organizational PHAB self-assessment, 72% had established at least 1 of the 4 components of a performance management system, and 90% had conducted QI activities focused on increasing efficiencies and/or effectiveness. NPHII appears to be supporting awardees' initial achievement of program outcomes. As NPHII enters its third year, there will be additional opportunities to advance the work of NPHII, compile and disseminate results, and inform a vision of high-quality public health necessary to improve the health of the population.

Business Statistics and Management Science Online: Teaching Strategies and Assessment of Student Learning

ERIC Educational Resources Information Center

Sebastianelli, Rose; Tamimi, Nabil

2011-01-01

Given the expected rise in the number of online business degrees, issues regarding quality and assessment in online courses will become increasingly important. The authors focus on the suitability of online delivery for quantitative business courses, specifically business statistics and management science. They use multiple approaches to assess…

Accepting uncertainty, assessing risk: decision quality in managing wildfire, forest resource values, and new technology

Treesearch

Jeffrey G. Borchers

2005-01-01

The risks, uncertainties, and social conflicts surrounding uncharacteristic wildfire and forest resource values have defied conventional approaches to planning and decision-making. Paradoxically, the adoption of technological innovations such as risk assessment, decision analysis, and landscape simulation models by land management organizations has been limited. The...

Lay and health care professional understandings of self-management: A systematic review and narrative synthesis

PubMed Central

Wolfe, Charles DA; McKevitt, Christopher

2014-01-01

Objectives: Self-management is widely promoted but evidence of effectiveness is limited. Policy encourages health care professionals to support people with long-term conditions to learn self-management skills, yet little is known about the extent to which both parties share a common understanding of self-management. Thus, we compared health care professional and lay understandings of self-management of long-term conditions. Methods: Systematic review and narrative synthesis of qualitative studies identified from relevant electronic databases, hand-searching of references lists, citation tracking and recommendations by experts. Results: In total, 55 studies were included and quality was assessed using a brief quality assessment tool. Three conceptual themes, each with two subthemes were generated: traditional and shifting models of the professional–patient relationship (self-management as a tool to promote compliance; different expectations of responsibility); quality of relationship between health care professional and lay person (self-management as a collaborative partnership; self-management as tailored support) and putting self-management into everyday practice (the lived experience of self-management; self-management as a social practice). Conclusion: Self-management was conceptualised by health care professionals as incorporating both a biomedical model of compliance and individual responsibility. Lay people understood self-management in wider terms, reflecting biomedical, psychological and social domains and different expectations of responsibility. In different ways, both deviated from the dominant model of self-management underpinned by the concept of self-efficacy. Different understandings help to explain how self-management is practised and may help to account for limited evidence of effectiveness of self-management interventions. PMID:26770733

George Woodall, Ph.D.

EPA Pesticide Factsheets

Dr. George Woodall has over fifteen years of professional experience. This includes performing assessments of risk from exposure to air pollutants, assessing air quality, and managing research and technical projects.

High quality data: An evaluation of AIM data quality and data quality procedures

USDA-ARS?s Scientific Manuscript database

The goal of every monitoring program is to collect high-quality data which can then be used to provide information to decision makers. The Bureau of Land Management (BLM) Assessment, Inventory, and Monitoring (AIM) program is one such data set which provides rangeland status, condition, and trend in...

Crop, tillage, and landscape effects on near-surface soil quality indices in Indiana

USDA-ARS?s Scientific Manuscript database

Soil quality is considered a link between land management and the quality of adjacent water bodies. We conducted a soil quality assessment within the Cedar Creek Watershed, a part of the larger St. Joseph River Watershed that drains into the Western Lake Erie Basin in northwestern Indiana. The Soil ...

Impact of sampling techniques on measured stormwater quality data for small streams

USDA-ARS?s Scientific Manuscript database

Science-based sampling methodologies are needed to enhance water quality characterization for developing Total Maximum Daily Loads (TMDLs), setting appropriate water quality standards, and managing nonpoint source pollution. Storm event sampling, which is vital for adequate assessment of water qual...

Water-quality assessment and wastewater-management alternatives for Dardenne Creek in St Charles County, Missouri

USGS Publications Warehouse

Berkas, W.R.; Lodderhose, J.R.

1985-01-01

The quality of water in the 15 mile downstream reach of Dardenne Creek in St. Charles County, Missouri, was assessed to determine if it met the Missouri water quality standards. Concentrations of dissolved oxygen and total ammonia failed to meet water quality standards downstream from the Harvester-Dardenne and St. Peters Wastewater-Treatment Plants. The QUAL-II SEMCOG water quality model was calibrated and verified using two independent data sets from Dardenne Creek. Management alternatives using current, design capacity, and future expansion wastewater discharges from the St. Peters Wastewater-Treatment Plant were evaluated. Results of the computer simulation indicate that a nitrification-type advanced-treatment facility installed at the plant would produce a 5-day carbonaceous biochemical oxygen demand of 10 mg/L. An effluent limit of 5.0 mg/L of 5-day carbonaceous biochemical oxygen demand would further improve the water quality of Dardenne Creek; however, an additional treatment process, such as sand filtration, would be needed to meet this criterion. (USGS)

The Role of Reliability, Vulnerability and Resilience in the Management of Water Quality Systems

NASA Astrophysics Data System (ADS)

Lence, B. J.; Maier, H. R.

2001-05-01

The risk based performance indicators reliability, vulnerability and resilience provide measures of the frequency, magnitude and duration of the failure of water resources systems, respectively. They have been applied primarily to water supply problems, including the assessment of the performance of reservoirs and water distribution systems. Applications to water quality case studies have been limited, although the need to consider the length and magnitude of violations of a particular water quality standard has been recognized for some time. In this research, the role of reliability, vulnerability and resilience in water quality management applications is investigated by examining their significance as performance measures for water quality systems and assessing their potential for assisting in decision making processes. The importance of each performance indicator is discussed and a framework for classifying such systems, based on the relative significance of each of these indicators, is introduced and illustrated qualitatively with various case studies. Quantitative examples drawn from both lake and river water quality modeling exercises are then provided.

The pre-audit assessment: A homework assignment for auditors

DOE Office of Scientific and Technical Information (OSTI.GOV)

Marschman, S.C.

1993-02-01

The role of the quality assurance audit is evolving from compliance verification to a much broader assessment of programmatic and management performance. In the past, audits were poorly understood and caused fear and trepidation. Auditees turned an audit into a cat-and-mouse game using coverup strategies and decoy discrepancies. These games were meant to ``give the auditors what they want, namely a few findings that could later be easily corrected. At Pacific Northwest Laboratory (PNL), I observed auditing become a spectator sport. Matching a compliance-oriented auditor against a crafty group of scientists provided hours of entertainment. As a program manager, itmore » was clear these games were neither productive useful nor cost effective. Fortunately, over the past few years several concepts embraced by ``total quality management` have begun to emerge at PNL. These concepts are being adopted by most successful organizations, and based on these concepts new tools and ideas are emerging to help organizations improve productivity and quality. Successful organizations have been and are continuing to develop management strategies that rely on participative approaches to their operations. These approaches encourage the empowerment of organization staff at all levels, with the goal of instilling ownership of quality in every staff member. As management philosophies are changing, so are the responsibilities and expectations of managers. Managers everywhere are experimenting with new tools to help them improve their operations and competitiveness. As the quality audit evolves, managers and other customers of the audit process have developed expectations for the auditing process that never existed in years past. These expectations have added complexity to the audit process. It is no longer adequate to prepare a checklist, perform the audit, and document the results. When viewed as a tool for verifying performance, a quality audit becomes more than a compliance checklist.« less

The pre-audit assessment: A homework assignment for auditors

DOE Office of Scientific and Technical Information (OSTI.GOV)

Marschman, S.C.

1993-02-01

The role of the quality assurance audit is evolving from compliance verification to a much broader assessment of programmatic and management performance. In the past, audits were poorly understood and caused fear and trepidation. Auditees turned an audit into a cat-and-mouse game using coverup strategies and decoy discrepancies. These games were meant to give the auditors what they want, namely a few findings that could later be easily corrected. At Pacific Northwest Laboratory (PNL), I observed auditing become a spectator sport. Matching a compliance-oriented auditor against a crafty group of scientists provided hours of entertainment. As a program manager, itmore » was clear these games were neither productive useful nor cost effective. Fortunately, over the past few years several concepts embraced by total quality management' have begun to emerge at PNL. These concepts are being adopted by most successful organizations, and based on these concepts new tools and ideas are emerging to help organizations improve productivity and quality. Successful organizations have been and are continuing to develop management strategies that rely on participative approaches to their operations. These approaches encourage the empowerment of organization staff at all levels, with the goal of instilling ownership of quality in every staff member. As management philosophies are changing, so are the responsibilities and expectations of managers. Managers everywhere are experimenting with new tools to help them improve their operations and competitiveness. As the quality audit evolves, managers and other customers of the audit process have developed expectations for the auditing process that never existed in years past. These expectations have added complexity to the audit process. It is no longer adequate to prepare a checklist, perform the audit, and document the results. When viewed as a tool for verifying performance, a quality audit becomes more than a compliance checklist.« less

Mozambique's journey toward accreditation of the National Tuberculosis Reference Laboratory.

PubMed

Viegas, Sofia O; Azam, Khalide; Madeira, Carla; Aguiar, Carmen; Dolores, Carolina; Mandlaze, Ana P; Chongo, Patrina; Masamha, Jessina; Cirillo, Daniela M; Jani, Ilesh V; Gudo, Eduardo S

2017-01-01

Internationally-accredited laboratories are recognised for their superior test reliability, operational performance, quality management and competence. In a bid to meet international quality standards, the Mozambique National Institute of Health enrolled the National Tuberculosis Reference Laboratory (NTRL) in a continuous quality improvement process towards ISO 15189 accreditation. Here, we describe the road map taken by the NTRL to achieve international accreditation. The NTRL adopted the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme as a strategy to implement a quality management system. After SLMTA, the Mozambique National Institute of Health committed to accelerate the NTRL's process toward accreditation. An action plan was designed to streamline the process. Quality indicators were defined to benchmark progress. Staff were trained to improve performance. Mentorship from an experienced assessor was provided. Fulfilment of accreditation standards was assessed by the Portuguese Accreditation Board. Of the eight laboratories participating in SLMTA, the NTRL was the best-performing laboratory, achieving a 53.6% improvement over the SLMTA baseline conducted in February 2011 to the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) assessment in June 2013. During the accreditation assessment in September 2014, 25 minor nonconformities were identified and addressed. In March 2015, the NTRL received Portuguese Accreditation Board recognition of technical competency for fluorescence smear microscopy, and solid and liquid culture. The NTRL is the first laboratory in Mozambique to achieve ISO 15189 accreditation. From our experience, accreditation was made possible by institutional commitment, strong laboratory leadership, staff motivation, adequate infrastructure and a comprehensive action plan.

Case management in an acute-care hospital: collaborating for quality, cost-effective patient care.

PubMed

Grootveld, Kim; Wen, Victoria; Bather, Michelle; Park, Joan

2014-01-01

Case management has recently been advanced as a valuable component in achieving quality patient care that is also cost-effective. At St. Michael's Hospital, in Toronto, Ontario, case managers from a variety of professional backgrounds are central to a new care initiative--Rapid Assessment and Planning to Inform Disposition (RAPID)--in the General Internal Medicine (GIM) Unit that is designed to improve patient care and reconcile high emergency department volumes through "smart bed spacing." Involved in both planning and RAPID, GIM's case managers are the link between patient care and utilization management. These stewards of finite resources strive to make the best use of dollars spent while maintaining a commitment to quality care. Collaborating closely with physicians and others across the hospital, GIM's case managers have been instrumental in bringing about significant improvements in care coordination, utilization management and process redesign. Copyright © 2014 Longwoods Publishing.

Development and Evaluation of a Computer-Based Program for Assessing Quality of Family Medicine Teams Based on Accreditation Standards

PubMed Central

Valjevac, Salih; Ridjanovic, Zoran; Masic, Izet

2009-01-01

CONFLICT OF INTEREST: NONE DECLARED SUMMARY Introduction Agency for healthcare quality and accreditation in Federation of Bosnia and Herzegovina (AKAZ) is authorized body in the field of healthcare quality and safety improvement and accreditation of healthcare institutions. Beside accreditation standards for hospitals and primary health care centers, AKAZ has also developed accreditation standards for family medicine teams. Methods Software development was primarily based on Accreditation Standards for Family Medicine Teams. Seven chapters / topics: (1. Physical factors; 2. Equipment; 3. Organization and Management; 4. Health promotion and illness prevention; 5. Clinical services; 6. Patient survey; and 7. Patient’s rights and obligations) contain 35 standards describing expected level of family medicine team’s quality. Based on accreditation standards structure and needs of different potential users, it was concluded that software backbone should be a database containing all accreditation standards, self assessment and external assessment details. In this article we will present the development of standardized software for self and external evaluation of quality of service in family medicine, as well as plans for the future development of this software package. Conclusion Electronic data gathering and storing enhances the management, access and overall use of information. During this project we came to conclusion that software for self assessment and external assessment is ideal for accreditation standards distribution, their overview by the family medicine team members, their self assessment and external assessment. PMID:24109157

Development of quality standards in inflammatory bowel disease management and design of an evaluation tool of nursing care.

PubMed

Torrejón, Antonio; Oltra, Lorena; Hernández-Sampelayo, Paloma; Marín, Laura; García-Sánchez, Valle; Casellas, Francesc; Alfaro, Noelia; Lázaro, Pablo; Vera, María Isabel

2013-01-01

nursing management of inflammatory bowel disease (IBD) is highly relevant for patient care and outcomes. However, there is evidence of substantial variability in clinical practices. The objectives of this study were to develop standards of healthcare quality for nursing management of IBD and elaborate the evaluation tool "Nursing Care Quality in IBD Assessment" (NCQ-IBD) based on these standards. a 178-item healthcare quality questionnaire was developed based on a systematic review of IBD nursing management literature. The questionnaire was used to perform two 2-round Delphi studies: Delphi A included 27 IBD healthcare professionals and Delphi B involved 12 patients. The NCQ-IBD was developed from the list of items resulting from both Delphi studies combined with the Scientific Committee´s expert opinion. the final NCQ-IBD consists of 90 items, organized in13 sections measuring the following aspects of nursing management of IBD: infrastructure, services, human resources, type of organization, nursing responsibilities, nurse-provided information to the patient, nurses training, annual audits of nursing activities, and nursing research in IBD. Using the NCQ-IBD to evaluate these components allows the rating of healthcare quality for nursing management of IBD into 4 categories: A (highest quality) through D (lowest quality). the use of the NCQ-IBD tool to evaluate nursing management quality of IBD identifies areas in need of improvement and thus contribute to an enhancement of care quality and reduction in clinical practice variations.

AN INTEGRATED FRAMEWORK FOR WATERSHED ASSESSMENT AND MANAGEMENT

EPA Science Inventory

Watershed approaches to water quality management have become popular, because they can address multiple point and non-point sources and the influences of land use. Developing technically-sound watershed management strategies can be challenging due to the need to 1) account for mu...

Utility analysis and calibration of QOL assessment in disease management.

PubMed

Liu, Mo

2018-05-02

In clinical trials, the assessment of health-related quality of life (QOL) (or patient-reported outcome [PRO] measure) has become very popular especially for clinical studies conducted for evaluating clinical benefits of patients with chronic, severe, and/or life threatening diseases. Health-related QOL information and PRO measures are useful for disease management for achieving best clinical practice. In this article, we will focus on health-related QOL assessment. The concept, design, and analysis of health-related QOL in clinical trials are reviewed. Validation of the use of health-related QOL instrument in terms of some key performance characteristics such as accuracy, reliability, sensitivity, and responsibility for assuring quality, integrity, and validity of collected QOL data are discussed. The concept of utility analysis and calibration (e.g., with respect to life events) for achieving the optimization of disease management are proposed. The change of the QOL could be translated into different life events for effective disease management. These translations could evaluate the treatment effect by more directly displaying the change of the QOL.

Fluor Hanford, Inc. Groundwater and Technical Integration Support (Master Project) Quality Assurance Management Plan

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fix, N. J.

The scope of the Fluor Hanford, Inc. Groundwater and Technical Integration Support (Master Project) is to provide technical and integration support to Fluor Hanford, Inc., including operable unit investigations at 300-FF-5 and other groundwater operable units, strategic integration, technical integration and assessments, remediation decision support, and science and technology. This Quality Assurance Management Plan provides the quality assurance requirements and processes that will be followed by the Fluor Hanford, Inc. Groundwater and Technical Integration Support (Master Project).

Total Quality Management in Logistics: A Case Study from the Trucking Industry

DTIC Science & Technology

1992-06-01

Quality Management (TQM) movement on the logistics industry as a whole, and, more specifically, its impact within the trucking industry. Its focus then narrows to study the practical aspects of implementing a W. Edwards Deming-based quality program within a particular trucking company, Mason Transporters, Inc. The effectiveness of the company’s implementation effort is assessed using data collected from a survey questionnaire, formal interviews, and personal observations during an on- site visit. Successes and shortcomings of the implementation process are highlighted

The Huaihe Basin Water Resource and Water Quality Management Platform Implemented with a Spatio-Temporal Data Model

NASA Astrophysics Data System (ADS)

Liu, Y.; Zhang, W.; Yan, C.

2012-07-01

Presently, planning and assessment in maintenance, renewal and decision-making for watershed hydrology, water resource management and water quality assessment are evolving toward complex, spatially explicit regional environmental assessments. These problems have to be addressed with object-oriented spatio-temporal data models that can restore, manage, query and visualize various historic and updated basic information concerning with watershed hydrology, water resource management and water quality as well as compute and evaluate the watershed environmental conditions so as to provide online forecasting to police-makers and relevant authorities for supporting decision-making. The extensive data requirements and the difficult task of building input parameter files, however, has long been an obstacle to use of such complex models timely and effectively by resource managers. Success depends on an integrated approach that brings together scientific, education and training advances made across many individual disciplines and modified to fit the needs of the individuals and groups who must write, implement, evaluate, and adjust their watershed management plans. The centre for Hydro-science Research, Nanjing University, in cooperation with the relevant watershed management authorities, has developed a WebGIS management platform to facilitate this complex process. Improve the management of watersheds over the Huaihe basin through the development, promotion and use of a web-based, user-friendly, geospatial watershed management data and decision support system (WMDDSS) involved many difficulties for the development of this complicated System. In terms of the spatial and temporal characteristics of historic and currently available information on meteorological, hydrological, geographical, environmental and other relevant disciplines, we designed an object-oriented spatiotemporal data model that combines spatial, attribute and temporal information to implement the management system. Using this system, we can update, query and analyze environmental information as well as manage historical data, and a visualization tool was provided to help the user interpret results so as to provide scientific support for decision-making. The utility of the system has been demonstrated its values by being used in watershed management and environmental assessments.

Quality and Cultural Sensitivity of Linguistically Appropriate Cardiovascular Disease Information for Chinese Immigrants: A Review of Online Resources From Heart Foundations.

PubMed

Li, Jialin; Lowres, Nicole; Jin, Kai; Zhang, Ling; Neubeck, Lis; Gallagher, Robyn

Chinese immigrants are at an increased risk for cardiovascular diseases (CVDs) compared with Chinese nationals partly because of lifestyle changes and knowledge deficits. Translated patient resources are available on the Internet and are often provided by health professionals; however, the quality and cultural sensitivity of these resources have not been reported. The aim of this study was to assess the availability, quality, and cultural sensitivity of Chinese-language information available from national "Heart Foundations" (cardiac research bodies, nongovernmental organisations) of the 5 most popular destinations of Chinese immigration. This study is a descriptive research in which national "Heart Foundation" websites were systematically searched for Chinese-language CVD patient education resources. Quality (content, identification, structure) was assessed using the Ensuring Quality Information for Patients instrument. Cultural sensitivity was evaluated using the Cultural Sensitivity Assessment Tool. From 107 identified resources, 33 were CVD specific: coronary heart disease (n = 20), arrhythmias (n = 7), and heart failure (n = 6). Quality of resources was adequate (mean Ensuring Quality Information for Patients score, 69%), but scores varied significantly (min, 60%; max, 85%). Although all resources were classified as culturally sensitive (Cultural Sensitivity Assessment Tool score ≥ 2.5), 2 resources scored low (≤2.5) for visual impact, and across all resources, written and visual domains were assessed as least culturally sensitive. Most resources lacked culturally specific references. Chinese-language CVD resources were inconsistent in the supply of key information. Quality and level of cultural sensitivity were adequate, but most resources lacked culturally specific references. Comprehensive, high-quality CVD resources powered by Editorial Manager and ProduXion Manager from Aries Systems Corporation tailored for Chinese immigrants are urgently needed for healthcare providers to support CVD education and care of patients belonging to this population.

The Impact of External Quality Assessment on Universities: The Estonian Experience

ERIC Educational Resources Information Center

Vilgats, Birgit; Heidmets, Mati

2011-01-01

This article seeks to establish what impact external quality assessment had on universities in Estonia between 1997 and 2009. It is based on a study of the analysis of experts' reports of curricula accreditation and interviews with university and programme managers, undertaken between 2007 and 2009. The study included an analysis of 12 curricula…

Quality Self Assessment: A Process of Course Team Development or Contrived Collegiality and Impression Management?

ERIC Educational Resources Information Center

Boocock, Andrew

2011-01-01

Ethnographic research in an FE College (College X) between 2000 and 2005 was designed to uncover the extent to which quality self-assessment processes had effectively utilised productive motivational inputs (i.e. lecturer self-interest, intrinsic motivation, altruism and tacit knowledge) in line with New Labour's agenda of improved skills in…

Quality Management: An "Essential Attributes" Approach. A Case Study towards a Sustainable Model of Course Effectiveness Evaluation

ERIC Educational Resources Information Center

Murphy, Francis S.

2005-01-01

Education of potential professional engineers should take account of the type of employment that they will eventually obtain. The quality of an engineering degree course can be judged by assessing whether the correct balance of "essential attributes" has been effectively obtained. This case study is concerned with assessing the balance…

Assessing the quality of the nation's water resources

USGS Publications Warehouse

Hamilton, Pixie A.

2002-01-01

This issue of IMPACT highlights findings from the first decade of studies (1991 to 2001) by the National Water-Quality Assessment (NAWQA) Program of the U.S. Geological Survey (USGS). The articles also discuss the Program’s approaches and models designed to help understand and estimate the fate and transport of contaminants in different geographic areas and environmental settings and over different time frames. NAWQA was established by Congress in 1991 with a goal of developing long-term, consistent, and comparable science-based information on nationwide water-quality conditions. This information is used to support sound management and policy decisions by decision makers at all levels – local, state, and national – who, every day, face complex regulations and management issues related to water resources.

A Quality Improvement Collaborative Program for Neonatal Pain Management in Japan

PubMed Central

Yokoo, Kyoko; Funaba, Yuuki; Fukushima, Sayo; Fukuhara, Rie; Uchida, Mieko; Aiba, Satoru; Doi, Miki; Nishimura, Akira; Hayakawa, Masahiro; Nishimura, Yutaka; Oohira, Mitsuko

2017-01-01

Background: Neonatal pain management guidelines have been released; however, there is insufficient systematic institutional support for the adoption of evidence-based pain management in Japan. Purpose: To evaluate the impact of a collaborative quality improvement program on the implementation of pain management improvements in Japanese neonatal intensive care units (NICUs). Methods: Seven Japanese level III NICUs participated in a neonatal pain management quality improvement program based on an Institute for Healthcare Improvement collaborative model. The NICUs developed evidence-based practice points for pain management and implemented these over a 12-month period. Changes were introduced through a series of Plan-Do-Study-Act cycles, and throughout the process, pain management quality indicators were tracked as performance measures. Jonckheere's trend test and the Cochran-Armitage test for trend were used to examine the changes in quality indicator implementations over time (baseline, 3 months, 6 months, and 12 months). Findings: Baseline pain management data from the 7 sites revealed substantial opportunities for improvement of pain management, and testing changes in the NICU setting resulted in measurable improvements in pain management. During the intervention phase, all participating sites introduced new pain assessment tools, and all sites developed electronic medical record forms to capture pain score, interventions, and infant responses to interventions. Implications for Practice: The use of collaborative quality improvement techniques played a key role in improving pain management in the NICUs. Implications for Research: Collaborative improvement programs provide an attractive strategy for solving evidence-practice gaps in the NICU setting. PMID:28114148

Quality Indicators for Global Benchmarking of Localized Prostate Cancer Management.

PubMed

Sampurno, Fanny; Zheng, Jia; Di Stefano, Lydia; Millar, Jeremy L; Foster, Claire; Fuedea, Ferran; Higano, Celestia; Hulan, Hartwig; Mark, Stephen; Moore, Caroline; Richardson, Alison; Sullivan, Frank; Wenger, Neil S; Wittmann, Daniela; Evans, Sue

2018-03-01

We sought to develop a core set of clinical indicators to enable international benchmarking of localized prostate cancer management using data available in the TrueNTH (True North) Global Registry. An international expert panel completed an online survey and participated in a face to face meeting. Participants included 3 urologists, 3 radiation oncologists, 2 psychologists, 1 medical oncologist, 1 nurse and 1 epidemiologist with prostate cancer expertise from a total of 7 countries. Current guidelines on prostate cancer treatment and potential quality indicators were identified from a literature review. These potential indicators were refined and developed through a modified Delphi process during which each panelist independently and repeatedly rated each indicator based on importance (satisfying the indicator demonstrated a provision of high quality care) and feasibility (the likelihood that data used to construct the indicator could be collected at a population level). The main outcome measure was items with panel agreement indicted by a disagreement index less 1, median importance 8.5 or greater and median feasibility 9 or greater. The expert panel endorsed 33 indicators. Seven of these 33 prostate cancer quality indicators assessed care relating to diagnosis, 7 assessed primary treatment, 1 assessed salvage treatment and 18 assessed health outcomes. We developed a set of quality indicators to measure prostate cancer care using numerous international evidence-based clinical guidelines. These indicators will be pilot tested in the TrueNTH Global Registry. Reports comparing indicator performance will subsequently be distributed to groups at participating sites with the purpose of improving the consistency and quality of prostate cancer management on a global basis. Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Expanded Quality Management Using Information Power (EQUIP): protocol for a quasi-experimental study to improve maternal and newborn health in Tanzania and Uganda

PubMed Central

2014-01-01

Background Maternal and newborn mortality remain unacceptably high in sub-Saharan Africa. Tanzania and Uganda are committed to reduce maternal and newborn mortality, but progress has been limited and many essential interventions are unavailable in primary and referral facilities. Quality management has the potential to overcome low implementation levels by assisting teams of health workers and others finding local solutions to problems in delivering quality care and the underutilization of health services by the community. Existing evidence of the effect of quality management on health worker performance in these contexts has important limitations, and the feasibility of expanding quality management to the community level is unknown. We aim to assess quality management at the district, facility, and community levels, supported by information from high-quality, continuous surveys, and report effects of the quality management intervention on the utilization and quality of services in Tanzania and Uganda. Methods In Uganda and Tanzania, the Expanded Quality Management Using Information Power (EQUIP) intervention is implemented in one intervention district and evaluated using a plausibility design with one non-randomly selected comparison district. The quality management approach is based on the collaborative model for improvement, in which groups of quality improvement teams test new implementation strategies (change ideas) and periodically meet to share results and identify the best strategies. The teams use locally-generated community and health facility data to monitor improvements. In addition, data from continuous health facility and household surveys are used to guide prioritization and decision making by quality improvement teams as well as for evaluation of the intervention. These data include input, process, output, coverage, implementation practice, and client satisfaction indicators in both intervention and comparison districts. Thus, intervention districts receive quality management and continuous surveys, and comparison districts-only continuous surveys. Discussion EQUIP is a district-scale, proof-of-concept study that evaluates a quality management approach for maternal and newborn health including communities, health facilities, and district health managers, supported by high-quality data from independent continuous household and health facility surveys. The study will generate robust evidence about the effectiveness of quality management and will inform future nationwide implementation approaches for health system strengthening in low-resource settings. Trial registration PACTR201311000681314 PMID:24690284

Expanded Quality Management Using Information Power (EQUIP): protocol for a quasi-experimental study to improve maternal and newborn health in Tanzania and Uganda.

PubMed

Hanson, Claudia; Waiswa, Peter; Marchant, Tanya; Marx, Michael; Manzi, Fatuma; Mbaruku, Godfrey; Rowe, Alex; Tomson, Göran; Schellenberg, Joanna; Peterson, Stefan

2014-04-02

Maternal and newborn mortality remain unacceptably high in sub-Saharan Africa. Tanzania and Uganda are committed to reduce maternal and newborn mortality, but progress has been limited and many essential interventions are unavailable in primary and referral facilities. Quality management has the potential to overcome low implementation levels by assisting teams of health workers and others finding local solutions to problems in delivering quality care and the underutilization of health services by the community. Existing evidence of the effect of quality management on health worker performance in these contexts has important limitations, and the feasibility of expanding quality management to the community level is unknown. We aim to assess quality management at the district, facility, and community levels, supported by information from high-quality, continuous surveys, and report effects of the quality management intervention on the utilization and quality of services in Tanzania and Uganda. In Uganda and Tanzania, the Expanded Quality Management Using Information Power (EQUIP) intervention is implemented in one intervention district and evaluated using a plausibility design with one non-randomly selected comparison district. The quality management approach is based on the collaborative model for improvement, in which groups of quality improvement teams test new implementation strategies (change ideas) and periodically meet to share results and identify the best strategies. The teams use locally-generated community and health facility data to monitor improvements. In addition, data from continuous health facility and household surveys are used to guide prioritization and decision making by quality improvement teams as well as for evaluation of the intervention. These data include input, process, output, coverage, implementation practice, and client satisfaction indicators in both intervention and comparison districts. Thus, intervention districts receive quality management and continuous surveys, and comparison districts-only continuous surveys. EQUIP is a district-scale, proof-of-concept study that evaluates a quality management approach for maternal and newborn health including communities, health facilities, and district health managers, supported by high-quality data from independent continuous household and health facility surveys. The study will generate robust evidence about the effectiveness of quality management and will inform future nationwide implementation approaches for health system strengthening in low-resource settings. PACTR201311000681314.

Development of Quality Indicators to Assess Oral Anticoagulant Management in Community Pharmacies for Patients with Atrial Fibrillation.

PubMed

Chartrand, Mylène; Guénette, Line; Brouillette, Denis; Côté, Stéphane; Huot, Roger; Landry, Jérôme; Martineau, Josée; Perreault, Sylvie; White-Guay, Brian; Williamson, David; Martin, Élisabeth; Gagnon, Marie-Mireille; Lalonde, Lyne

2018-04-01

Few studies have evaluated the quality of oral anticoagulant management by community pharmacists. There is no complete set of quality indicators available for this purpose. To develop a set of specific quality indicators to assess oral anticoagulant management by community pharmacists for patients with atrial fibrillation (AF). Quality indicators were developed in 3 phases. In phase 1, potential quality indicators were generated based on clinical guidelines and a literature review. In phase 2, a modified RAND appropriateness method involving 2 rounds was implemented with 9 experts, who judged the appropriateness of quality indicators generated in phase 1 based on the extent to which they were accurate, based on evidence, relevant, representative of best practices, and measurable in community pharmacies. Phase 3 consisted of a feasibility assessment in 5 community pharmacies on 2 patients each. The final set included 38 quality indicators grouped into 6 categories: documentation (n = 29), risk assessment (n = 3), clinical control (n = 1), clinical follow-up (n = 15), choice of therapy (n = 11), and interaction management (n = 8). The quality indicators referred to process of care (n = 34), clinical outcomes (n = 2), or structure of care (n = 2). There were 24 quality indicators related to vitamin K antagonists (VKAs), and 17 were related to direct oral anticoagulants (DOACs). To assess quality indicators, a questionnaire was developed for completion by community pharmacists for each patient, which included 17 questions about VKA patients and 12 questions about DOAC patients. A first set of quality indicators is now available to assess the quality of oral anticoagulant management by community pharmacists for patients with AF. This research was supported by the Réseau Québécois de recherche sur le médicament (RQRM); the Blueprint for Pharmacy in collaboration with Pfizer Canada; and the Cercle du Doyen of the Faculty of Pharmacy, University of Montreal. The study sponsors were not involved in the study design, data collection, data interpretation, the writing of the article, or the decision to submit the report for publication. Chartrand received a scholarship from the Fonds de Recherche du Québec en Santé (FRQ-S), the Réseau Québécois de recherche sur l'usage des médicaments with Pfizer, and the Faculty of Pharmacy, University of Montreal. Guénette holds a Junior-1 Clinician Researcher Award from the FRQ-S in partnership with the Société québécoise d'hypertension artérielle. Williamson holds a Junior-1 Career Award from the FRQ-S. Côté reported being a medical speaker for Bayer, Boehringer Ingelheim Canada, and Pfizer Canada. The other authors reported no conflicts of interest. Study concept and design were contributed by Lalonde, Chartrand, and Martin. Chartrand, Martin, and Lalonde collected the data, along with Brouillette, Côté, Huot, Landry, Martineau, Perreault, Williamson, and White-Guay. Data interpretation was performed by Chartrand, Gagnon, and Lalonde, along with Guénette and Martin. The manuscript was primarily written by Chartrand, along with Guénette and Lalonde, and revised by Chartrand, Guénette, and Lalonde, along with the other authors. A portion of this study's results was presented at the 4th RQRM Annual Meeting on September 22-23, 2014, in Orford, Quebec, Canada, in the form of an abstract, which was published in the Journal of Population Therapeutics and Clinical Pharmacology, 2014;21(2):e312.

Exploring prostate cancer survivors' self-management behaviours and examining the mechanism effect that links coping and social support to health-related quality of life, anxiety and depression: a prospective longitudinal study.

PubMed

Paterson, Catherine; Robertson, Allison; Nabi, Ghulam

2015-04-01

Little is known about the influence of psycho-social factors on health-related quality of life (HRQoL), anxiety and depression in men affected by prostate cancer. Developing an understanding in this area can help to identify men who are at high risk of inadequate support and suggest directions for appropriately targeted interventions. Moreover, little is known about how men affected by prostate cancer mobilise social support in their self-management behaviours over time. This is the first study to test the effects of coping and social support on HRQoL and emotional outcome, and assessed the self-management behaviours of men affected by prostate cancer overtime. The study population was 74 prostate cancer patients with a mean age of 67.3 (SD 7.9) years and mixed treatment modalities. The EORTC QLQ-C30, PR25 and HADS were used to assess the dependant variables before treatment and at six months follow-up. Statistical analysis was performed in SPSS version 17.0 using parametric tests and non-parametric tests. A significant decline in quality of life was observed at 6 months post diagnosis (p < 0.001). Perceived social support before radical treatment was the most important social support construct that predicted better global quality of life and less depression at six months, explaining approximately 30% of the variance. Despite men's self-management efforts and use of social support overtime, self-management self-efficacy significantly reduced at six months (p < 0.05). These findings provide support towards the development of a psycho-social intervention study to improve quality of life, self-management self-efficacy and improve patients' symptom management. Copyright © 2014 Elsevier Ltd. All rights reserved.

A manufacturing quality assessment model based-on two stages interval type-2 fuzzy logic

NASA Astrophysics Data System (ADS)

Purnomo, Muhammad Ridwan Andi; Helmi Shintya Dewi, Intan

2016-01-01

This paper presents the development of an assessment models for manufacturing quality using Interval Type-2 Fuzzy Logic (IT2-FL). The proposed model is developed based on one of building block in sustainable supply chain management (SSCM), which is benefit of SCM, and focuses more on quality. The proposed model can be used to predict the quality level of production chain in a company. The quality of production will affect to the quality of product. Practically, quality of production is unique for every type of production system. Hence, experts opinion will play major role in developing the assessment model. The model will become more complicated when the data contains ambiguity and uncertainty. In this study, IT2-FL is used to model the ambiguity and uncertainty. A case study taken from a company in Yogyakarta shows that the proposed manufacturing quality assessment model can work well in determining the quality level of production.

Electronic symptom reporting between patient and provider for improved health care service quality: a systematic review of randomized controlled trials. part 2: methodological quality and effects.

PubMed

Johansen, Monika Alise; Berntsen, Gro K Rosvold; Schuster, Tibor; Henriksen, Eva; Horsch, Alexander

2012-10-03

We conducted in two parts a systematic review of randomized controlled trials (RCTs) on electronic symptom reporting between patients and providers to improve health care service quality. Part 1 reviewed the typology of patient groups, health service innovations, and research targets. Four innovation categories were identified: consultation support, monitoring with clinician support, self-management with clinician support, and therapy. To assess the methodological quality of the RCTs, and summarize effects and benefits from the methodologically best studies. We searched Medline, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials, and IEEE Xplore for original studies presented in English-language articles between 1990 and November 2011. Risk of bias and feasibility were judged according to the Cochrane recommendation, and theoretical evidence and preclinical testing were evaluated according to the Framework for Design and Evaluation of Complex Interventions to Improve Health. Three authors assessed the risk of bias and two authors extracted the effect data independently. Disagreement regarding bias assessment, extraction, and interpretation of results were resolved by consensus discussions. Of 642 records identified, we included 32 articles representing 29 studies. No articles fulfilled all quality requirements. All interventions were feasible to implement in a real-life setting, and theoretical evidence was provided for almost all studies. However, preclinical testing was reported in only a third of the articles. We judged three-quarters of the articles to have low risk for random sequence allocation and approximately half of the articles to have low risk for the following biases: allocation concealment, incomplete outcome data, and selective reporting. Slightly more than one fifth of the articles were judged as low risk for blinding of outcome assessment. Only 1 article had low risk of bias for blinding of participants and personnel. We excluded 12 articles showing high risk or unclear risk for both selective reporting and blinding of outcome assessment from the effect assessment. The authors' hypothesis was confirmed for 13 (65%) of the 20 remaining articles. Articles on self-management support were of higher quality, allowing us to assess effects in a larger proportion of studies. All except one self-management interventions were equally effective to or better than the control option. The self-management articles document substantial benefits for patients, and partly also for health professionals and the health care system. Electronic symptom reporting between patients and providers is an exciting area of development for health services. However, the research generally is of low quality. The field would benefit from increased focus on methods for conducting and reporting RCTs. It appears particularly important to improve blinding of outcome assessment and to precisely define primary outcomes to avoid selective reporting. Supporting self-management seems to be especially promising, but consultation support also shows encouraging results.

Electronic Symptom Reporting Between Patient and Provider for Improved Health Care Service Quality: A Systematic Review of Randomized Controlled Trials. Part 2: Methodological Quality and Effects

PubMed Central

Berntsen, Gro K Rosvold; Schuster, Tibor; Henriksen, Eva; Horsch, Alexander

2012-01-01

Background We conducted in two parts a systematic review of randomized controlled trials (RCTs) on electronic symptom reporting between patients and providers to improve health care service quality. Part 1 reviewed the typology of patient groups, health service innovations, and research targets. Four innovation categories were identified: consultation support, monitoring with clinician support, self-management with clinician support, and therapy. Objective To assess the methodological quality of the RCTs, and summarize effects and benefits from the methodologically best studies. Methods We searched Medline, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials, and IEEE Xplore for original studies presented in English-language articles between 1990 and November 2011. Risk of bias and feasibility were judged according to the Cochrane recommendation, and theoretical evidence and preclinical testing were evaluated according to the Framework for Design and Evaluation of Complex Interventions to Improve Health. Three authors assessed the risk of bias and two authors extracted the effect data independently. Disagreement regarding bias assessment, extraction, and interpretation of results were resolved by consensus discussions. Results Of 642 records identified, we included 32 articles representing 29 studies. No articles fulfilled all quality requirements. All interventions were feasible to implement in a real-life setting, and theoretical evidence was provided for almost all studies. However, preclinical testing was reported in only a third of the articles. We judged three-quarters of the articles to have low risk for random sequence allocation and approximately half of the articles to have low risk for the following biases: allocation concealment, incomplete outcome data, and selective reporting. Slightly more than one fifth of the articles were judged as low risk for blinding of outcome assessment. Only 1 article had low risk of bias for blinding of participants and personnel. We excluded 12 articles showing high risk or unclear risk for both selective reporting and blinding of outcome assessment from the effect assessment. The authors’ hypothesis was confirmed for 13 (65%) of the 20 remaining articles. Articles on self-management support were of higher quality, allowing us to assess effects in a larger proportion of studies. All except one self-management interventions were equally effective to or better than the control option. The self-management articles document substantial benefits for patients, and partly also for health professionals and the health care system. Conclusion Electronic symptom reporting between patients and providers is an exciting area of development for health services. However, the research generally is of low quality. The field would benefit from increased focus on methods for conducting and reporting RCTs. It appears particularly important to improve blinding of outcome assessment and to precisely define primary outcomes to avoid selective reporting. Supporting self-management seems to be especially promising, but consultation support also shows encouraging results. PMID:23032363

Sustainable Water Management & Satellite Remote Sensing

EPA Science Inventory

Eutrophication assessment frameworks such as the Australian National Water Quality Management Strategy, Oslo Paris (OSPAR) Commission Common Procedure, Water Framework Directive (WFD) of the European Union, Marine Strategy Framework Directive (MSFD) from the European Commission, ...

Hydrologic and Water Quality Assessment from Managed Turf

USDA-ARS?s Scientific Manuscript database

The potential for nutrients and pesticides to be transported to surface water from turf systems (especially golf courses) is often debated because of limited information on water quality exiting these systems. This four year study quantified the amount and quality of water draining from part of Nort...

Air Pollution Data for Model Evaluation and Application

EPA Science Inventory

One objective of designing an air pollution monitoring network is to obtain data for evaluating air quality models that are used in the air quality management process and scientific discovery.^1.2 A common use is to relate emissions to air quality, including assessing ...

Incident reporting.

PubMed

Wilson, J

Healthcare delivery is a risky business. People view the NHS in the same light as other commercial businesses such as the hotel, retail and airline industries. The White Paper 'The New NHS: Modern, Dependable' (Secretary of State for Health, 1997) places statutory responsibilities on managers and clinicians to provide a quality service and to have accountability for clinical governance and performance management. Quality and risk are two sides of the same coin, i.e. if you have good quality you have low risk, and this firmly supports the clinical effectiveness agenda. Healthcare organizations in all sectors of care delivery need to demonstrate their high levels of achievement and commitment to continuous quality improvements. Risk management is a process for identifying, assessing and evaluating risks which have adverse effects on the quality, safety and effectiveness of service delivery, and taking positive action to eliminate or reduce them. Having an open, honest and blame-free organization which is open to improving processes and systems of care is a big step towards having staff who are committed to quality and getting things right. Near-miss, incident and indicator recording and reporting are cornerstones of any quality and risk management system.

The development of an audit technique to assess the quality of safety barrier management.

PubMed

Guldenmund, Frank; Hale, Andrew; Goossens, Louis; Betten, Jeroen; Duijm, Nijs Jan

2006-03-31

This paper describes the development of a management model to control barriers devised to prevent major hazard scenarios. Additionally, an audit technique is explained that assesses the quality of such a management system. The final purpose of the audit technique is to quantify those aspects of the management system that have a direct impact on the reliability and effectiveness of the barriers and, hence, the probability of the scenarios involved. First, an outline of the management model is given and its elements are explained. Then, the development of the audit technique is described. Because the audit technique uses actual major hazard scenarios and barriers within these as its focus, the technique achieves a concreteness and clarity that many other techniques often lack. However, this strength is also its limitation, since the full safety management system is not covered with the technique. Finally, some preliminary experiences obtained from several test sites are compiled and discussed.

Critical to quality in telemedicine service management: application of DFSS (Design for Six Sigma) and SERVQUAL).

PubMed

Yun, Eun Kyoung; Chun, Kee Moon

2008-01-01

Telemedicine generally refers to the use of communications and information technologies for the delivery of health care. owever, telemedicine is not merely a simple combination of health care and technology. The researchers propose a systematic approach for assessing needs of telemedicine customers, called critical-to-quality (CTQ) in Six Sigma, with a purpose of continuous quality improvement. The combination approach using DFSS (Design for Six Sigma) and SERVQUAL (Service Quality Framework) was applied to define the critical quality attributes of telemedicine service management and to match them with the current telemedicine process. With a step-by-step procedure, telemedicine service process was reviewed and all the important CTQ candidates identified via a case study. The findings suggest that nurses need further understanding and research methods that will improve and manage the quality of health care service in various medical fields.

Negotiating the COAPRT Learning Outcomes Transition Using Quality Management Tools: A Case Study of the COAPRT Beta Test Site

ERIC Educational Resources Information Center

Ellis, Gary D.

2014-01-01

This paper is a case study. It tells the story of the process that the Council on Accreditation for Parks, Recreation, Tourism and Related Professions beta test site created its learning outcomes assessment program. A planning process was used that has evolved from quality management philosophy and practice: DMADV. Use of DMADV required precise…

Cooperative management of riparian forest habitats to maintain biological quality and ecosystem integrity

Treesearch

David Deardorff; Kathryn Wadsworth

1996-01-01

The New Mexico State Land Office has initiated a rare plant survey of state trust land, an inventory and assessment of riparian areas on the trust land, and the development of a biological resources data base and information management system. Some riparian sites that still belong to the trust have been negatively impacted by livestock such that biological quality and...

Environmental Assessment for Routine Basewide Military-Sponsored Training Exercises, Edwards Air Force Base, California

DTIC Science & Technology

2007-02-01

control AVAQMD Antelope Valley Air Quality Management District AQMD Air Quality Management Districts BACT Best Available Control Technology BLM Bureau...Aeronautics NAGPRA Native American Graves Protection and Repatriation Act NASA National Aeronautics and Space Administration NBCC nuclear, biological...support of the National Aeronautics and Space Administration ( NASA ) shuttle program is required to be maintained. This includes rescue, medical evaluation

Ecological Indication, Bioaccumulation, and Phytoremediation as Tools for Environmental Quality Management

DTIC Science & Technology

2004-12-01

ECOLOGICAL INDICATION, BIOACCUMULATION, AND PHYTOREMEDIATION AS TOOLS FOR ENVIRONMENTAL QUALITY MANAGEMENT ELLY P. H. BEST1, HENRY E. TATEM1...subsequent transport to shoots, and degradation, or prevent contaminants from leaving the site in whatever form, such as leachate , runoff, trophic...transfer ( phytoremediation ). We use risk assessment to evaluate the toxicity and need for cleanup. Cleanup costs are expected to greatly exceed the cost

National Water-Quality Assessment Program - Red River of the North

USGS Publications Warehouse

Stoner, J.D.

1991-01-01

In 1991, the U.S. Geological Survey (USGS) began to implement a full-scale National Water-Quality Assessment (NAWQA) program. The long-term goals of the NAWQA program are to describe the status and trends in the quality of a large, representative part of the Nation's surface- and ground-water resources, and to provide a sound scientific understanding of the primary natural and human factors affecting the quality of these resources. The program will produce a wealth of water-quality information that will be useful to policy makers and managers at the national, State, and local levels.

How well does pre-service education prepare midwives for practice: competence assessment of midwifery students at the point of graduation in Ethiopia.

PubMed

Yigzaw, Tegbar; Ayalew, Firew; Kim, Young-Mi; Gelagay, Mintwab; Dejene, Daniel; Gibson, Hannah; Teshome, Aster; Broerse, Jacqueline; Stekelenburg, Jelle

2015-08-14

Midwifery support and care led by midwives is the most appropriate strategy to improve maternal and newborn health. The Government of Ethiopia has recently improved the availability of midwives by scaling up pre-service education. However, the extent to which graduating students acquire core competencies for safe and effective practice is not known. The purpose of this study was to evaluate the quality of midwifery education by assessing the competence of graduating midwifery students. We conducted a cross-sectional study to assess the competence of students who completed basic midwifery education in Ethiopia in 2013. We interviewed students to obtain their perceptions of the sufficiency and quality of teachers and educational resources and processes. We assessed achievement of essential midwifery competencies through direct observation, using a 10-station Objective Structured Clinical Examination (OSCE). We calculated average percentage scores of performance for each station and an average summary score for all stations. Chi-square test, independent sample t test, and linear regression analysis were used to assess the statistical significance of differences and associations. We assessed 484 graduating students from 25 public training institutions. Majority of students rated the learning environment unfavorably on 8 out of 10 questions. Only 32 % of students managed 20 or more births during training, and just 6 % managed 40 or more births. Students' overall average competence score was 51.8 %; scores ranged from 32.2 % for manual vacuum aspiration to 69.4 % for active management of the third stage of labor. Male gender, reporting sufficient clinical experience, and managing greater numbers of births during training were significant predictors of higher competence scores. The quality of pre-service midwifery education needs to be improved, including strengthening of the learning environment and quality assurance systems. In-service training and mentoring to fill competence gaps of new graduates is also essential.

Measuring management's perspective of data quality in Pakistan's Tuberculosis control programme: a test-based approach to identify data quality dimensions.

PubMed

Ali, Syed Mustafa; Anjum, Naveed; Kamel Boulos, Maged N; Ishaq, Muhammad; Aamir, Javariya; Haider, Ghulam Rasool

2018-01-16

Data quality is core theme of programme's performance assessment and many organizations do not have any data quality improvement strategy, wherein data quality dimensions and data quality assessment framework are important constituents. As there is limited published research about the data quality specifics that are relevant to the context of Pakistan's Tuberculosis control programme, this study aims at identifying the applicable data quality dimensions by using the 'fitness-for-purpose' perspective. Forty-two respondents pooled a total of 473 years of professional experience, out of which 223 years (47%) were in TB control related programmes. Based on the responses against 11 practical cases, adopted from the routine recording and reporting system of Pakistan's TB control programme (real identities of patient were masked), completeness, accuracy, consistency, vagueness, uniqueness and timeliness are the applicable data quality dimensions relevant to the programme's context, i.e. work settings and field of practice. Based on a 'fitness-for-purpose' approach to data quality, this study used a test-based approach to measure management's perspective and identified data quality dimensions pertinent to the programme and country specific requirements. Implementation of a data quality improvement strategy and achieving enhanced data quality would greatly help organizations in promoting data use for informed decision making.

Developing a caries risk registry to support caries risk assessment and management for children: A quality improvement initiative.

PubMed

Ruff, Jesley C; Herndon, Jill Boylston; Horton, Roger A; Lynch, Julie; Mathwig, Dawn C; Leonard, Audra; Aravamudhan, Krishna

2017-10-27

Health registries are commonly used in medicine to support public health activities and are increasingly used in quality improvement (QI) initiatives. Illustrations of dental registries and their QI applications are lacking. Within dentistry, caries risk assessment implementation and documentation are vital to optimal patient care. The purpose of this article is to describe the processes used to develop a caries risk assessment registry as a QI initiative to support clinical caries risk assessment, caries prevention, and disease management for children. Developmental steps reflected Agency for Healthcare Research and Quality recommendations for planning QI registries and included engaging "champions," defining the project, identifying registry features, defining performance dashboard indicators, and pilot testing with participant feedback. We followed Standards for Quality Improvement Reporting Excellence guidelines. Registry eligibility is patients aged 0-17 years. QI tools include prompts to register eligible patients; decision support tools grounded in evidence-based guidelines; and performance dashboard reports delivered at the provider and aggregated levels at regular intervals. The registry was successfully piloted in two practices with documented caries risk assessment increasing from 57 percent to 92 percent and positive feedback regarding the potential to improve dental practice patient centeredness, patient engagement and education, and quality of care. The caries risk assessment registry demonstrates how dental registries may be used in QI efforts to promote joint patient and provider engagement, foster shared decision making, and systematically collect patient information to generate timely and actionable data to improve care quality and patient outcomes at the individual and population levels. © 2017 American Association of Public Health Dentistry.

Model development for the assessment of terrestrial and aquatic habitat quality in conservation planning.

PubMed

Terrado, Marta; Sabater, Sergi; Chaplin-Kramer, Becky; Mandle, Lisa; Ziv, Guy; Acuña, Vicenç

2016-01-01

There is a growing pressure of human activities on natural habitats, which leads to biodiversity losses. To mitigate the impact of human activities, environmental policies are developed and implemented, but their effects are commonly not well understood because of the lack of tools to predict the effects of conservation policies on habitat quality and/or diversity. We present a straightforward model for the simultaneous assessment of terrestrial and aquatic habitat quality in river basins as a function of land use and anthropogenic threats to habitat that could be applied under different management scenarios to help understand the trade-offs of conservation actions. We modify the InVEST model for the assessment of terrestrial habitat quality and extend it to freshwater habitats. We assess the reliability of the model in a severely impaired basin by comparing modeled results to observed terrestrial and aquatic biodiversity data. Estimated habitat quality is significantly correlated with observed terrestrial vascular plant richness (R(2)=0.76) and diversity of aquatic macroinvertebrates (R(2)=0.34), as well as with ecosystem functions such as in-stream phosphorus retention (R(2)=0.45). After that, we analyze different scenarios to assess the suitability of the model to inform changes in habitat quality under different conservation strategies. We believe that the developed model can be useful to assess potential levels of biodiversity, and to support conservation planning given its capacity to forecast the effects of management actions in river basins. Copyright © 2015 Elsevier B.V. All rights reserved.

A disease management programme for patients with diabetes mellitus is associated with improved quality of care within existing budgets.

PubMed

Steuten, L M G; Vrijhoef, H J M; Landewé-Cleuren, S; Schaper, N; Van Merode, G G; Spreeuwenberg, C

2007-10-01

To assess the impact of a disease management programme for patients with diabetes mellitus (Type 1 and Type 2) on cost-effectiveness, quality of life and patient self-management. By organizing care in accordance with the principles of disease management, it is aimed to increase quality of care within existing budgets. Single-group, pre-post design with 2-year follow-up in 473 patients. Substantial significant improvements in glycaemic control, health-related quality of life (HRQL) and patient self-management were found. No significant changes were detected in total costs of care. The probability that the disease management programme is cost-effective compared with usual care amounts to 74%, expressed in an average saving of 117 per additional life year at 5% improved HRQL. Introduction of a disease management programme for patients with diabetes is associated with improved intermediate outcomes within existing budgets. Further research should focus on long-term cost-effectiveness, including diabetic complications and mortality, in a controlled setting or by using decision-analytic modelling techniques.

Service quality assessment of workers compensation health care delivery programs in New York using SERVQUAL.

PubMed

Arunasalam, Mark; Paulson, Albert; Wallace, William

2003-01-01

Preferred provider organizations (PPOs) provide healthcare services to an expanding proportion of the U.S. population. This paper presents a programmatic assessment of service quality in the workers' compensation environment using two different models: the PPO program model and the fee-for-service (FFS) payor model. The methodology used here will augment currently available research in workers' compensation, which has been lacking in measuring service quality determinants and assessing programmatic success/failure of managed care type programs. Results indicated that the SERVQUAL tool provided a reliable and valid clinical quality assessment tool that ascertained that PPO marketers should focus on promoting physician outreach (to show empathy) and accessibility (to show reliability) for injured workers.

Nonprice Competition and Quality of Care in Managed Care: The New York SCHIP Market

PubMed Central

Liu, Hangsheng; Phelps, Charles E

2008-01-01

Objective To examine the effect of nonprice competition among managed care plans on the quality of care in the New York SCHIP market. Data Sources U.S. Census 2000; 2002 New York State Managed Care Plan Performance Report; and 2001 New York State Managed Care Annual Enrollment Report. Study Design Each market is defined as a county, and competition is measured as the number of plans in a market. Quality of care is measured in percentages using three Consumer Assessment of Health Plans Survey and three Health Plan Employer Data and Information Set scores. Two-stage least squares is applied to address the endogeneity between competition and the quality of care, using population as an instrument. Principle Findings We find a negative association between competition and quality of care. An additional managed care plan is significantly associated with a decrease of 0.40–2.31 percentage points in four out of six quality measures. After adjusting for production cost, a positive correlation is observed between price and quality measures across different pricing regions. Conclusions It seems likely that pricing policy is a constraint on quality production, although it may not be interpreted as a causal relationship and further study is needed. PMID:18454776

If you can't measure it- you can't change it - a longitudinal study on improving quality of care in hospitals and health centers in rural Kenya.

PubMed

Marx, Michael; Nitschke, Christine; Nafula, Maureen; Nangami, Mabel; Brodowski, Marc; Marx, Irmgard; Prytherch, Helen; Kandie, Charles; Omogi, Irene; Paul-Fariborz, Friederike; Szecsenyi, Joachim

2018-04-05

The Kenyan Ministry of Health- Department of Standards and Regulations sought to operationalize the Kenya Quality Assurance Model for Health. To this end an integrated quality management system based on validated indicators derived from the Kenya Quality Model for Health (KQMH) was developed and adapted to the area of Reproductive and Maternal and Neonatal Health, implemented and analysed. An integrated quality management (QM) approach was developed based on European Practice Assessment (EPA) modified to the Kenyan context. It relies on a multi-perspective, multifaceted and repeated indicator based assessment, covering the 6 World Health Organization (WHO) building blocks. The adaptation process made use of a ten step modified RAND/UCLA appropriateness Method. To measure the 303 structure, process, outcome indicators five data collection tools were developed: surveys for patients and staff, a self-assessment, facilitator assessment, a manager interview guide. The assessment process was supported by a specially developed software (VISOTOOL®) that allows detailed feedback to facility staff, benchmarking and facilitates improvement plans. A longitudinal study design was used with 10 facilities (6 hospitals; 4 Health centers) selected out of 36 applications. Data was summarized using means and standard deviations (SDs). Categorical data was presented as frequency counts and percentages. A baseline assessment (T1) was carried out, a reassessment (T2) after 1.5 years. Results from the first and second assessment after a relatively short period of 1.5 years of improvement activities are striking, in particular in the domain 'Quality and Safety' (20.02%; p < 0.0001) with the dimensions: use of clinical guidelines (34,18%; p < 0.0336); Infection control (23,61%; p < 0.0001). Marked improvements were found in the domains 'Clinical Care' (10.08%; p = 0.0108), 'Management' (13.10%: p < 0.0001), 'Interface In/out-patients' (13.87%; p = 0.0246), and in total (14.64%; p < 0.0001). Exemplarily drilling down the domain 'clinical care' significant improvements were observed in the dimensions 'Antenatal care' (26.84%; p = 0.0059) and 'Survivors of gender-based violence' (11.20%; p = 0.0092). The least marked changes or even a -not significant- decline of some was found in the dimensions 'delivery' and 'postnatal care'. This comprehensive quality improvement approach breathes life into the process of collecting data for indicators and creates ownership among users and providers of health services. It offers a reflection on the relevance of evidence-based quality improvement for health system strengthening and has the potential to lay a solid ground for further certification and accreditation.

An Integrated Risk Management Model for Source Water Protection Areas

PubMed Central

Chiueh, Pei-Te; Shang, Wei-Ting; Lo, Shang-Lien

2012-01-01

Watersheds are recognized as the most effective management unit for the protection of water resources. For surface water supplies that use water from upstream watersheds, evaluating threats to water quality and implementing a watershed management plan are crucial for the maintenance of drinking water safe for humans. The aim of this article is to establish a risk assessment model that provides basic information for identifying critical pollutants and areas at high risk for degraded water quality. In this study, a quantitative risk model that uses hazard quotients for each water quality parameter was combined with a qualitative risk model that uses the relative risk level of potential pollution events in order to characterize the current condition and potential risk of watersheds providing drinking water. In a case study of Taipei Source Water Area in northern Taiwan, total coliforms and total phosphorus were the top two pollutants of concern. Intensive tea-growing and recreational activities around the riparian zone may contribute the greatest pollution to the watershed. Our risk assessment tool may be enhanced by developing, recording, and updating information on pollution sources in the water supply watersheds. Moreover, management authorities could use the resultant information to create watershed risk management plans. PMID:23202770

Quality of Diabetes Management in Saudi Arabia: A Review of Existing Barriers.

PubMed

Almutairi, Khalid M

2015-12-01

Diabetes mellitus is a complex disorder that requires continuous management and medical care. The purpose of this review is to identify and summarize the barriers that affect diabetes management in Saudi Arabia. Studies that have examined the quality of diabetes management in Saudi Arabia were identified through online and manual literature searches. Two researchers independently searched and assessed for inclusion/exclusion criteria. All studies were screened by a specialist for the significance of the review. Studies that were included were evaluated for relevance, methodological rigor, and credibility by giving a quality score based on Russell and Gregory's criteria. This review presents an overview of the quality of diabetes management and issues and barriers concerning the improvement of diabetes care in Saudi Arabia. The online literature search yielded 11 studies which met the inclusion criteria. Factors affecting the quality of diabetes care can be categorized into patient factors (such as adherence, compliance, attitudes, beliefs, knowledge, financial resources and co-morbidities) and healthcare providers' factors (including beliefs, attitudes and knowledge, patient - provider interaction and communication). The identified barriers, both from patients and healthcare providers, will help healthcare authorities to improve diabetes management in Saudi Arabia. Improvement of health awareness about disease and disease management should be tailored through continuous patient education. Continuous training and seminars will also expand providers' knowledge that will ensure quality and effective diabetes management.

MAINTAINING DATA QUALITY IN THE PERFORMANCE OF A LARGE SCALE INTEGRATED MONITORING EFFORT

EPA Science Inventory

Macauley, John M. and Linda C. Harwell. In press. Maintaining Data Quality in the Performance of a Large Scale Integrated Monitoring Effort (Abstract). To be presented at EMAP Symposium 2004: Integrated Monitoring and Assessment for Effective Water Quality Management, 3-7 May 200...

Scale effects of STATSGO and SSURGO databases on flow and water quality predictions

USDA-ARS?s Scientific Manuscript database

Soil information is one of the crucial inputs needed to assess the impacts of existing and alternative agricultural management practices on water quality. Therefore, it is important to understand the effects of spatial scale at which soil databases are developed on water quality evaluations. In the ...

Soil quality parameters for row-crop and grazed pasture systems with agroforestry buffers

USDA-ARS?s Scientific Manuscript database

Incorporation of trees and establishment of buffers are practices that can improve soil quality. Soil enzyme activities and water stable aggregates are sensitive indices for assessing soil quality by detecting early changes in soil management. However, studies comparing grazed pasture and row crop...

Modeling the Effects of Conservation Tillage on Water Quality at the Field Scale

USDA-ARS?s Scientific Manuscript database

The development and application of predictive tools to quantitatively assess the effects of tillage and related management activities should be carefully tested against high quality field data. This study reports on: 1) the calibration and validation of the Root Zone Water Quality Model (RZWQM) to a...

Evaluating participation in water resource management: A review

NASA Astrophysics Data System (ADS)

Carr, G.; BlöSchl, G.; Loucks, D. P.

2012-11-01

Key documents such as the European Water Framework Directive and the U.S. Clean Water Act state that public and stakeholder participation in water resource management is required. Participation aims to enhance resource management and involve individuals and groups in a democratic way. Evaluation of participatory programs and projects is necessary to assess whether these objectives are being achieved and to identify how participatory programs and projects can be improved. The different methods of evaluation can be classified into three groups: (i) process evaluation assesses the quality of participation process, for example, whether it is legitimate and promotes equal power between participants, (ii) intermediary outcome evaluation assesses the achievement of mainly nontangible outcomes, such as trust and communication, as well as short- to medium-term tangible outcomes, such as agreements and institutional change, and (iii) resource management outcome evaluation assesses the achievement of changes in resource management, such as water quality improvements. Process evaluation forms a major component of the literature but can rarely indicate whether a participation program improves water resource management. Resource management outcome evaluation is challenging because resource changes often emerge beyond the typical period covered by the evaluation and because changes cannot always be clearly related to participation activities. Intermediary outcome evaluation has been given less attention than process evaluation but can identify some real achievements and side benefits that emerge through participation. This review suggests that intermediary outcome evaluation should play a more important role in evaluating participation in water resource management.

The role of point of care ultrasound in prehospital critical care: a systematic review.

PubMed

Bøtker, Morten Thingemann; Jacobsen, Lars; Rudolph, Søren Steemann; Knudsen, Lars

2018-06-26

In 2011, the role of Point of Care Ultrasound (POCUS) was defined as one of the top five research priorities in physician-provided prehospital critical care and future research topics were proposed; the feasibility of prehospital POCUS, changes in patient management induced by POCUS and education of providers. This systematic review aimed to assess these three topics by including studies examining all kinds of prehospital patients undergoing all kinds of prehospital POCUS examinations and studies examining any kind of POCUS education in prehospital critical care providers. By a systematic literature search in MEDLINE, EMBASE, and Cochrane databases, we identified and screened titles and abstracts of 3264 studies published from 2012 to 2017. Of these, 65 studies were read in full-text for assessment of eligibility and 27 studies were ultimately included and assessed for quality by SIGN-50 checklists. No studies compared patient outcome with and without prehospital POCUS. Four studies of acceptable quality demonstrated feasibility and changes in patient management in trauma. Two studies of acceptable quality demonstrated feasibility and changes in patient management in breathing difficulties. Four studies of acceptable quality demonstrated feasibility, outcome prediction and changes in patient management in cardiac arrest, but also that POCUS may prolong pauses in compressions. Two studies of acceptable quality demonstrated that short (few hours) teaching sessions are sufficient for obtaining simple interpretation skills, but not image acquisition skills. Three studies of acceptable quality demonstrated that longer one- or two-day courses including hands-on training are sufficient for learning simple, but not advanced, image acquisition skills. Three studies of acceptable quality demonstrated that systematic educational programs including supervised examinations are sufficient for learning advanced image acquisition skills in healthy volunteers, but that more than 50 clinical examinations are required for expertise in a clinical setting. Prehospital POCUS is feasible and changes patient management in trauma, breathing difficulties and cardiac arrest, but it is unknown if this improves outcome. Expertise in POCUS requires extensive training by a combination of theory, hands-on training and a substantial amount of clinical examinations - a large part of these needs to be supervised.

[Implementation of quality standard UNE-EN ISO/IEC 17043 in the External Quality Control Program of the Spanish Society of Infectious Diseases and Clinical Microbiology].

PubMed

Poveda Gabaldón, Marta; Ovies, María Rosario; Orta Mira, Nieves; Serrano, M del Remedio Guna; Avila, Javier; Giménez, Alicia; Cardona, Concepción Gimeno

2011-12-01

The quality standard "UNE-EN-ISO 17043: 2010. Conformity assessment. General requirements for proficiency testing" applies to centers that organize intercomparisons in all areas. In the case of clinical microbiology laboratories, these intercomparisons must meet the management and technical standards required to achieve maximum quality in the performance of microbiological analysis and the preparation of test items (sample, product, data or other information used in the proficiency test) to enable them to be accredited. Once accredited, these laboratories can operate as a tool for quality control laboratories and competency assessment. In Spain, accreditation is granted by the Spanish Accreditation Body [Entidad Nacional de Acreditación (ENAC)]. The objective of this review is to explain how to apply the requirements of the standard to laboratories providing intercomparisons in the field of clinical microbiology (the organization responsible for all the tasks related to the development and operation of a proficiency testing program). This requires defining the scope and specifying the technical requirements (personnel management, control of equipment, facilities and environment, the design of the proficiency testing and data analysis for performance evaluation, communication with participants and confidentiality) and management requirements (document control, purchasing control, monitoring of complaints / claims, non-compliance, internal audits and management reviews). Copyright © 2011 Elsevier España S.L. All rights reserved.

An educational intervention to reduce pain and improve pain management for Malawian people living with HIV/AIDS and their family carers: study protocol for a randomised controlled trial.

PubMed

Nkhoma, Kennedy; Seymour, Jane; Arthur, Antony

2013-07-13

Many HIV/AIDS patients experience pain often due to advanced HIV/AIDS infection and side effects of treatment. In sub-Saharan Africa, pain management for people with HIV/AIDS is suboptimal. With survival extended as a direct consequence of improved access to antiretroviral therapy, the prevalence of HIV/AIDS related pain is increasing. As most care is provided at home, the management of pain requires patient and family involvement. Pain education is an important aspect in the management of pain in HIV/AIDS patients. Studies of the effectiveness of pain education interventions for people with HIV/AIDS have been conducted almost exclusively in western countries. A randomised controlled trial is being conducted at the HIV and palliative care clinics of two public hospitals in Malawi. To be eligible, patient participants must have a diagnosis of HIV/AIDS (stage III or IV). Carer participants must be the individual most involved in the patient's unpaid care. Eligible participants are randomised to either: (1) a 30-minute face-to-face educational intervention covering pain assessment and management, augmented by a leaflet and follow-up telephone call at two weeks; or (2) usual care. Those allocated to the usual care group receive the educational intervention after follow-up assessments have been conducted (wait-list control group). The primary outcome is pain severity measured by the Brief Pain Inventory. Secondary outcomes are pain interference, patient knowledge of pain management, patient quality of life, carer knowledge of pain management, caregiver motivation and carer quality of life. Follow-up assessments are conducted eight weeks after randomisation by palliative care nurses blind to allocation. This randomised controlled trial conducted in sub-Saharan Africa among people living with HIV/AIDS and their carers will assess whether a pain education intervention is effective in reducing pain and improving pain management, quality of life and carer motivation. Current Controlled Trials ISRCTN72861423.

TH-E-19A-01: Quality and Safety in Radiation Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ford, E; Ezzell, G; Miller, B

2014-06-15

Clinical radiotherapy data clearly demonstrate the link between the quality and safety of radiation treatments and the outcome for patients. The medical physicist plays an essential role in this process. To ensure the highest quality treatments, the medical physicist must understand and employ modern quality improvement techniques. This extends well beyond the duties traditionally associated with prescriptive QA measures. This session will review the current best practices for improving quality and safety in radiation therapy. General elements of quality management will be reviewed including: what makes a good quality management structure, the use of prospective risk analysis such as FMEA,more » and the use of incident learning. All of these practices are recommended in society-level documents and are incorporated into the new Practice Accreditation program developed by ASTRO. To be effective, however, these techniques must be practical in a resource-limited environment. This session will therefore focus on practical tools such as the newly-released radiation oncology incident learning system, RO-ILS, supported by AAPM and ASTRO. With these general constructs in mind, a case study will be presented of quality management in an SBRT service. An example FMEA risk assessment will be presented along with incident learning examples including root cause analysis. As the physicist's role as “quality officer” continues to evolve it will be essential to understand and employ the most effective techniques for quality improvement. This session will provide a concrete overview of the fundamentals in quality and safety. Learning Objectives: Recognize the essential elements of a good quality management system in radiotherapy. Understand the value of incident learning and the AAPM/ASTRO ROILS incident learning system. Appreciate failure mode and effects analysis as a risk assessment tool and its use in resource-limited environments. Understand the fundamental principles of good error proofing that extends beyond traditional prescriptive QA measures.« less

Measurement properties of instruments evaluating self-care and related concepts in people with chronic obstructive pulmonary disease: A systematic review.

PubMed

Clari, Marco; Matarese, Maria; Alvaro, Rosaria; Piredda, Michela; De Marinis, Maria Grazia

2016-01-01

The use of valid and reliable instruments for assessing self-care is crucial for the evaluation of chronic obstructive pulmonary disease (COPD) management programs. The aim of this review is to evaluate the measurement properties and theoretical foundations of instruments for assessing self-care and related concepts in people with COPD. A systematic review was conducted of articles describing the development and validation of self-care instruments. The methodological quality of the measurement properties was assessed using the COSMIN checklist. Ten studies were included evaluating five instruments: three for assessing self-care and self-management and two for assessing self-efficacy. The COPD Self-Efficacy Scale was the most studied instrument, but due to poor study methodological quality, evidence about its measurement properties is inconclusive. Evidence from the COPD Self-Management Scale is more promising, but only one study tested its properties. Due to inconclusive evidence of their measurement properties, no instrument can be recommended for clinical use. Copyright © 2016 Elsevier Inc. All rights reserved.

Diagnostic Assessment and Management of Dysphagia in Patients with Alzheimer's Disease.

PubMed

Boccardi, Virginia; Ruggiero, Carmelinda; Patriti, Alberto; Marano, Luigi

2016-01-01

A growing concern in patients affected by Alzheimer's disease (AD) is dysphagia, or swallowing impairment, which leads to malnutrition, dehydration, weight loss, functional decline and fear of eating and drinking, as well as a decrease in the quality of life. Thus the diagnostic assessment of dysphagia in patients with AD is imperative to ensure that they receive effective management, avoiding complications, and reducing comorbidity and mortality in such a growing population. Dysphagia management requires a multidisciplinary approach considering that no single strategy is appropriate for all patients. However, evidence for clinical diagnostic assessment, interventions, and medical management of dysphagia in these patients are still limited: few studies are reporting the evaluation and the management among this group of patients. Here we analyzed the most recent findings in diagnostic assessment and management of swallowing impairment in patients affected by AD.

[The hospital perspective: disease management and integrated health care].

PubMed

Schrappe, Matthias

2003-06-01

Disease Management is a transsectoral, population-based form of health care, which addresses groups of patients with particular clinical entities and risk factors. It refers both to an evidence-based knowledge base and corresponding guidelines, evaluates outcome as a continuous quality improvement process and usually includes active participation of patients. In Germany, the implementation of disease management is associated with financial transactions for risk adjustment between health care assurances [para. 137 f, Book V of Social Code (SGB V)] and represents the second kind of transsectoral care, besides a program designed as integrated health care according to para. 140 a ff f of Book V of Social Code. While in the USA and other countries disease management programs are made available by several institutions involved in health care, in Germany these programs are offered by health care insurers. Assessment of disease management from the hospital perspective will have to consider three questions: How large is the risk to compensate inadequate quality in outpatient care? Are there synergies in internal organisational development? Can the risk of inadequate funding of the global "integrated" budget be tolerated? Transsectoral quality assurance by valid performance indicators and implementation of a quality improvement process are essential. Internal organisational changes can be supported, particularly in the case of DRG introduction. The economic risk and financial output depends on the kind of disease being focussed by the disease management program. In assessing the underlying scientific evidence of their cost effectiveness, societal costs will have to be precisely differentiated from hospital-associated costs.

42 CFR 431.806 - State plan requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... processing assessment system. Except in a State that has an approved Medicaid Management Information System... Medicaid quality control claims processing assessment system that meets the requirements of §§ 431.830...

Assessing Lymphatic Filariasis Data Quality in Endemic Communities in Ghana, Using the Neglected Tropical Diseases Data Quality Assessment Tool for Preventive Chemotherapy.

PubMed

de Souza, Dziedzom K; Yirenkyi, Eric; Otchere, Joseph; Biritwum, Nana-Kwadwo; Ameme, Donne K; Sackey, Samuel; Ahorlu, Collins; Wilson, Michael D

2016-03-01

The activities of the Global Programme for the Elimination of Lymphatic Filariasis have been in operation since the year 2000, with Mass Drug Administration (MDA) undertaken yearly in disease endemic communities. Information collected during MDA-such as population demographics, age, sex, drugs used and remaining, and therapeutic and geographic coverage-can be used to assess the quality of the data reported. To assist country programmes in evaluating the information reported, the WHO, in collaboration with NTD partners, including ENVISION/RTI, developed an NTD Data Quality Assessment (DQA) tool, for use by programmes. This study was undertaken to evaluate the tool and assess the quality of data reported in some endemic communities in Ghana. A cross sectional study, involving review of data registers and interview of drug distributors, disease control officers, and health information officers using the NTD DQA tool, was carried out in selected communities in three LF endemic Districts in Ghana. Data registers for service delivery points were obtained from District health office for assessment. The assessment verified reported results in comparison with recounted values for five indicators: number of tablets received, number of tablets used, number of tablets remaining, MDA coverage, and population treated. Furthermore, drug distributors, disease control officers, and health information officers (at the first data aggregation level), were interviewed, using the DQA tool, to determine the performance of the functional areas of the data management system. The results showed that over 60% of the data reported were inaccurate, and exposed the challenges and limitations of the data management system. The DQA tool is a very useful monitoring and evaluation (M&E) tool that can be used to elucidate and address data quality issues in various NTD control programmes.

The Most Popular Smartphone Apps for Weight Loss: A Quality Assessment

PubMed Central

Cade, Janet E

2015-01-01

Background Advancements in mobile phone technology have led to the development of smartphones with the capability to run apps. The availability of a plethora of health- and fitness-related smartphone apps has the potential, both on a clinical and public health level, to facilitate healthy behavior change and weight management. However, current top-rated apps in this area have not been extensively evaluated in terms of scientific quality and behavioral theory evidence base. Objective The purpose of this study was to evaluate the quality of the most popular dietary weight-loss smartphone apps on the commercial market using comprehensive quality assessment criteria, and to quantify the behavior change techniques (BCTs) incorporated. Methods The top 200-rated Health & Fitness category apps from the free and paid sections of Google Play and iTunes App Store in Australia (n=800) were screened in August 2014. To be included in further analysis, an app had to focus on weight management, include a facility to record diet intake (self-monitoring), and be in English. One researcher downloaded and used the eligible apps thoroughly for 5 days and assessed the apps against quality assessment criteria which included the following domains: accountability, scientific coverage and content accuracy of information relevant to weight management, technology-enhanced features, usability, and incorporation of BCTs. For inter-rater reliability purposes, a second assessor provided ratings on 30% of the apps. The accuracy of app energy intake calculations was further investigated by comparison with results from a 3-day weighed food record (WFR). Results Across the eligible apps reviewed (n=28), only 1 app (4%) received full marks for accountability. Overall, apps included an average of 5.1 (SD 2.3) out of 14 technology-enhanced features, and received a mean score of 13.5 (SD 3.7) out of 20 for usability. The majority of apps provided estimated energy requirements (24/28, 86%) and used a food database to calculate energy intake (21/28, 75%). When compared against the WFR, the mean absolute energy difference of apps which featured energy intake calculations (23/28, 82%) was 127 kJ (95% CI -45 to 299). An average of 6.3 (SD 3.7) of 26 BCTs were included. Conclusions Overall, the most popular commercial apps for weight management are suboptimal in quality, given the inadequate scientific coverage and accuracy of weight-related information, and the relative absence of BCTs across the apps reviewed. With the limited regulatory oversight around the quality of these types of apps, this evaluation provides clinicians and consumers an informed view of the highest-quality apps in the current popular app pool appropriate for recommendation and uptake. Further research is necessary to assess the effectiveness of apps for weight management. PMID:26678569

A Goal Orientation Analysis of Teachers' Motivations to Participate in the School Self-Assessment Processes of a Quality Assurance System in Chile

ERIC Educational Resources Information Center

Montecinos, Carmen; Madrid, Romina; Fernández, María Beatriz; Ahumada, Luis

2014-01-01

The current study examined the goal orientations that could be inferred from how teachers from six municipal schools in Chile described their understandings, emotions, and behaviors during their participation in the assessment phase of the School Management Quality Assurance System. Content analysis of focus group interview transcripts evidenced…

Monitoring and Assessment of Youshui River Water Quality in Youyang

NASA Astrophysics Data System (ADS)

Wang, Xue-qin; Wen, Juan; Chen, Ping-hua; Liu, Na-na

2018-02-01

By monitoring the water quality of Youshui River from January 2016 to December 2016, according to the indicator grading and the assessment standard of water quality, the formulas for 3 types water quality indexes are established. These 3 types water quality indexes, the single indicator index Ai, single moment index Ak and the comprehensive water quality index A, were used to quantitatively evaluate the quality of single indicator, the water quality and the change of water quality with time. The results show that, both total phosphorus and fecal coliform indicators exceeded the standard, while the other 16 indicators measured up to the standard. The water quality index of Youshui River is 0.93 and the grade of water quality comprehensive assessment is level 2, which indicated that the water quality of Youshui River is good, and there is room for further improvement. To this end, several protection measures for Youshui River environmental management and pollution treatment are proposed.

Mobile Apps for Bipolar Disorder: A Systematic Review of Features and Content Quality.

PubMed

Nicholas, Jennifer; Larsen, Mark Erik; Proudfoot, Judith; Christensen, Helen

2015-08-17

With continued increases in smartphone ownership, researchers and clinicians are investigating the use of this technology to enhance the management of chronic illnesses such as bipolar disorder (BD). Smartphones can be used to deliver interventions and psychoeducation, supplement treatment, and enhance therapeutic reach in BD, as apps are cost-effective, accessible, anonymous, and convenient. While the evidence-based development of BD apps is in its infancy, there has been an explosion of publicly available apps. However, the opportunity for mHealth to assist in the self-management of BD is only feasible if apps are of appropriate quality. Our aim was to identify the types of apps currently available for BD in the Google Play and iOS stores and to assess their features and the quality of their content. A systematic review framework was applied to the search, screening, and assessment of apps. We searched the Australian Google Play and iOS stores for English-language apps developed for people with BD. The comprehensiveness and quality of information was assessed against core psychoeducation principles and current BD treatment guidelines. Management tools were evaluated with reference to the best-practice resources for the specific area. General app features, and privacy and security were also assessed. Of the 571 apps identified, 82 were included in the review. Of these, 32 apps provided information and the remaining 50 were management tools including screening and assessment (n=10), symptom monitoring (n=35), community support (n=4), and treatment (n=1). Not even a quarter of apps (18/82, 22%) addressed privacy and security by providing a privacy policy. Overall, apps providing information covered a third (4/11, 36%) of the core psychoeducation principles and even fewer (2/13, 15%) best-practice guidelines. Only a third (10/32, 31%) cited their information source. Neither comprehensiveness of psychoeducation information (r=-.11, P=.80) nor adherence to best-practice guidelines (r=-.02, P=.96) were significantly correlated with average user ratings. Symptom monitoring apps generally failed to monitor critical information such as medication (20/35, 57%) and sleep (18/35, 51%), and the majority of self-assessment apps did not use validated screening measures (6/10, 60%). In general, the content of currently available apps for BD is not in line with practice guidelines or established self-management principles. Apps also fail to provide important information to help users assess their quality, with most lacking source citation and a privacy policy. Therefore, both consumers and clinicians should exercise caution with app selection. While mHealth offers great opportunities for the development of quality evidence-based mobile interventions, new frameworks for mobile mental health research are needed to ensure the timely availability of evidence-based apps to the public.

Assessment and management of obesity and comorbid conditions.

PubMed

Sampsel, Sarah; May, Jeanette

2007-10-01

To better understand obesity, its related conditions and risk factors, and the best assessment and management approaches for the adult population, the Disease Management Association of America and the National Committee for Quality Assurance partnered to conduct a literature review that could inform future initiatives of both organizations as well as others. The goals of the literature review were to: (1) describe the prevalence of obesity and related conditions and their health and financial impacts; (2) illustrate the clinical importance and interrelatedness of the conditions; and, the focus of this article, (3) describe the evidence supporting the different assessment and management options for obesity and comorbid conditions.

Strengthening public health laboratory capacity in Thailand for International Health Regulations (IHR) (2005)

PubMed Central

Peruski, Anne Harwood; Birmingham, Maureen; Tantinimitkul, Chawalit; Chungsamanukool, Ladawan; Chungsamanukool, Preecha; Guntapong, Ratigorn; Pulsrikarn, Chaiwat; Saengklai, Ladapan; Supawat, Krongkaew; Thattiyaphong, Aree; Wongsommart, Duangdao; Wootta, Wattanapong; Nikiema, Abdoulaye; Pierson, Antoine; Peruski, Leonard F; Liu, Xin; Rayfield, Mark A

2015-01-01

Introduction Thailand conducted a national laboratory assessment of core capacities related to the International Health Regulations (IHR) (2005), and thereby established a baseline to measure future progress. The assessment was limited to public laboratories found within the Thai Bureau of Quality and Safety of Food, National Institute of Health and regional medical science centres. Methods The World Health Organization (WHO) laboratory assessment tool was adapted to Thailand through a participatory approach. This adapted version employed a specific scoring matrix and comprised 16 modules with a quantitative output. Two teams jointly performed the on-site assessments in December 2010 over a two-week period, in 17 public health laboratories in Thailand. The assessment focused on the capacity to identify and accurately detect pathogens mentioned in Annex 2 of the IHR (2005) in a timely manner, as well as other public health priority pathogens for Thailand. Results Performance of quality management, budget and finance, data management and communications was considered strong (>90%); premises quality, specimen collection, biosafety, public health functions, supplies management and equipment availability were judged as very good (>70% but ≤90%); while microbiological capacity, staffing, training and supervision, and information technology needed improvement (>60% but ≤70%). Conclusions This assessment is a major step in Thailand towards development of an optimized and standardized national laboratory network for the detection and reporting of infectious disease that would be compliant with IHR (2005). The participatory strategy employed to adapt an international tool to the Thai context can also serve as a model for use by other countries in the Region. The participatory approach probably ensured better quality and ownership of the results, while providing critical information to help decision-makers determine where best to invest finite resources. PMID:26693144

Ground-water quality assessment of the central Oklahoma aquifer, Oklahoma - Analysis of available water-quality data through 1987

USGS Publications Warehouse

Parkhurst, David L.; Christenson, Scott C.; Schlottmann, Jamie L.

1989-01-01

Beginning in 1986, the Congress annually has appropriated funds for the U.S. Geological Survey to test and refine concepts for a National Water-Quality Assessment (NAWQA) Program. The long-term goals of a full-scale program would be to:Provide a nationally consistent description of current water-quality conditions for a large part of the Nation's surface- and ground-water resources;Define long-term trends (or lack of trends) in water quality; andIdentify, describe, and explain, as possible, the major factors that affect the observed water-quality conditions and trends.The results of the NAWQA Program will be made available to water managers, policy makers, and the public, and will provide an improved scientific basis for evaluating the effectiveness of water-quality management programs.At present (1988), the assessment program is in a pilot phase in seven project areas throughout the country that represent diverse hydrologic environments and water-quality conditions. The Central Oklahoma aquifer project is one of three pilot ground-water projects. One of the initial activities performed by each pilot project was to compile, screen, and interpret the large amount of water-quality data available within each study unit.The purpose of this report is to assess the water quality of the Central Oklahoma aquifer using the information available through 1987. The scope of the work includes compiling data from Federal, State, and local agencies; evaluating the suitability of the information for conducting a regional water-quality assessment; mapping regional variations in major-ion chemistry; calculating summary statistics of the available water-quality data; producing maps to show the location and number of samples that exceeded water-quality standards; and performing contingency-table analyses to determine the relation of geologic unit and depth to the occurrence of chemical constituents that exceed water-quality standards. This report provides an initial description of water-quality conditions in the Central Oklahoma aquifer study unit. No attempt was made in this report to determine the causes for regional variations in major-ion chemistry or to examine the reasons that some chemical constituents exceed water-quality standards.

Measuring quality progress

NASA Astrophysics Data System (ADS)

Lambert, Larry D.

The study by the American Productivity & Quality Center (APQC) was commissioned by Loral Space Information Systems, Inc. and the National Aeronautics and Space Administration (NASA) to evaluate internal assessment systems. APQC benchmarked approaches to the internal assessment of quality management systems in three phases. The first phase included work conducted for the International Benchmarking Clearinghouse (IBC) and consisted of an in-depth analysis of the 1991 Malcolm Baldrige National Quality Award criteria. The second phase was also performed for the IBC and compared the 1991 award criteria among the following quality awards: Deming Prize, Malcolm Baldrige National Quality Award, The President's Award for Quality and Productivity Improvement, The NASA Excellence Award (The George M. Lowe Trophy) for Quality and Productivity Improvement and the Shigeo Shingo Award for Excellence in Manufacturing. The third phase compared the internal implementation approaches of 23 companies selected from American industry for their recognized, formal assessment systems.

Measuring quality progress

NASA Technical Reports Server (NTRS)

Lambert, Larry D.

1992-01-01

The study by the American Productivity & Quality Center (APQC) was commissioned by Loral Space Information Systems, Inc. and the National Aeronautics and Space Administration (NASA) to evaluate internal assessment systems. APQC benchmarked approaches to the internal assessment of quality management systems in three phases. The first phase included work conducted for the International Benchmarking Clearinghouse (IBC) and consisted of an in-depth analysis of the 1991 Malcolm Baldrige National Quality Award criteria. The second phase was also performed for the IBC and compared the 1991 award criteria among the following quality awards: Deming Prize, Malcolm Baldrige National Quality Award, The President's Award for Quality and Productivity Improvement, The NASA Excellence Award (The George M. Lowe Trophy) for Quality and Productivity Improvement and the Shigeo Shingo Award for Excellence in Manufacturing. The third phase compared the internal implementation approaches of 23 companies selected from American industry for their recognized, formal assessment systems.

Quality Management Systems Implementation Compared With Organizational Maturity in Hospital.

PubMed

Moradi, Tayebeh; Jafari, Mehdi; Maleki, Mohammad Reza; Naghdi, Seyran; Ghiasvand, Hesam

2015-07-27

A quality management system can provide a framework for continuous improvement in order to increase the probability of customers and other stakeholders' satisfaction. The test maturity model helps organizations to assess the degree of maturity in implementing effective and sustained quality management systems; plan based on the current realities of the organization and prioritize their improvement programs. We aim to investigate and compare the level of organizational maturity in hospitals with the status of quality management systems implementation. This analytical cross sectional study was conducted among hospital administrators and quality experts working in hospitals with over 200 beds located in Tehran. In the first step, 32 hospitals were selected and then 96 employees working in the selected hospitals were studied. The data were gathered using the implementation checklist of quality management systems and the organization maturity questionnaire derived from ISO 10014. The content validity was calculated using Lawshe method and the reliability was estimated using test - retest method and calculation of Cronbach's alpha coefficient. The descriptive and inferential statistics were used to analyze the data using SPSS 18 software. According to the table, the mean score of organizational maturity among hospitals in the first stage of quality management systems implementation was equal to those in the third stage and hypothesis was rejected (p-value = 0.093). In general, there is no significant difference in the organizational maturity between the first and third level hospitals (in terms of implementation of quality management systems). Overall, the findings of the study show that there is no significant difference in the organizational maturity between the hospitals in different levels of the quality management systems implementation and in fact, the maturity of the organizations cannot be attributed to the implementation of such systems. As a result, hospitals should make changes in the quantity and quality of quality management systems in an effort to increase organizational maturity, whereby they improve the hospital efficiency and productivity.

Quality Management Systems Implementation Compared With Organizational Maturity in Hospital

PubMed Central

Moradi, Tayebeh; Jafari, Mehdi; Maleki, Mohammad Reza; Naghdi, Seyran; Ghiyasvand, Hesam

2016-01-01

Background: A quality management system can provide a framework for continuous improvement in order to increase the probability of customers and other stakeholders’ satisfaction. The test maturity model helps organizations to assess the degree of maturity in implementing effective and sustained quality management systems; plan based on the current realities of the organization and prioritize their improvement programs. Objectives: We aim to investigate and compare the level of organizational maturity in hospitals with the status of quality management systems implementation. Materials and Methods: This analytical cross sectional study was conducted among hospital administrators and quality experts working in hospitals with over 200 beds located in Tehran. In the first step, 32 hospitals were selected and then 96 employees working in the selected hospitals were studied. The data were gathered using the implementation checklist of quality management systems and the organization maturity questionnaire derived from ISO 10014. The content validity was calculated using Lawshe method and the reliability was estimated using test - retest method and calculation of Cronbach's alpha coefficient. The descriptive and inferential statistics were used to analyze the data using SPSS 18 software. Results: According to the table, the mean score of organizational maturity among hospitals in the first stage of quality management systems implementation was equal to those in the third stage and hypothesis was rejected (p-value = 0.093). In general, there is no significant difference in the organizational maturity between the first and third level hospitals (in terms of implementation of quality management systems). Conclusions: Overall, the findings of the study show that there is no significant difference in the organizational maturity between the hospitals in different levels of the quality management systems implementation and in fact, the maturity of the organizations cannot be attributed to the implementation of such systems. As a result, hospitals should make changes in the quantity and quality of quality management systems in an effort to increase organizational maturity, whereby they improve the hospital efficiency and productivity. PMID:26493411

Assessment of soil quality index for wheat and sugar beet cropping systems on an entisol in Central Anatolia.

PubMed

Şeker, Cevdet; Özaytekin, Hasan Hüseyin; Negiş, Hamza; Gümüş, İlknur; Dedeoğlu, Mert; Atmaca, Emel; Karaca, Ümmühan

2017-04-01

The sustainable use of agricultural lands is significantly affected by the implemented management and land processing methods. In sugar beet and wheat cropping, because the agronomic characteristics of plants are different, the tillage methods applied also exhibit significant variability. Soil quality concept is used, as a holistic approach to determining the effects of these applications on the sustainable use of soil. Agricultural soil quality evaluation is essential for economic success and environmental stability in rapidly developing regions. At present, a variety of methods are used to evaluate soil quality using different indicators. This study was conducted in one of the most important irrigated agriculture areas of Çumra plain in Central Anatolia, Turkey. In the soil under sugar beet and wheat cultivation, 12 soil quality indicators (aggregate stability (AS), available water capacity (AWC), surface penetration resistance (PR 0-20 ), subsurface penetration resistance (PR 20-40 ), organic matter (OM), active carbon (AC), potentially mineralizable nitrogen (PMN), root health value (RHV), pH, available phosphorus (AP), potassium (K), and macro-micro elements (ME) (Mg, Fe, Mn, and Zn)) were measured and scored according to the Cornell Soil Health Assessment (CSHA) and the Soil Management Assessment Framework (SMAF). The differences among 8 (AS, AWC, PR 0-20 , PR 20-40 , AC, PMN, AP, and ME) of these 12 soil quality characteristics measured in two different plant cultivation were found statistically significant. The result of the soil quality evaluation with scoring function in the examined area revealed a soil quality score of 61.46 in the wheat area and of 51.20 in the sugar beet area, which can be classified as medium and low, respectively. Low soil quality scores especially depend on physical and biological soil properties. Therefore, improvement of soil physical and biological properties with sustainable management is necessary to enhance the soil quality in the study area soils.

Comparison of an enhanced versus a written feedback model on the management of Medicare inpatients with venous thrombosis.

PubMed

Hayes, R; Bratzler, D; Armour, B; Moore, L; Murray, C; Stevens, B R; Radford, M; Fitzgerald, D; Elward, K; Ballard, D J

2001-03-01

A multistate randomized study conducted under the Health Care Financing Administration's (HCFA's) Health Care Quality Improvement Program (HCQIP) offered the opportunity to compare the effect of a written feedback intervention (WFI) with that of an enhanced feedback intervention (EFI) on improving the anticoagulant management of Medicare beneficiaries who present to the hospital with venous thromboembolic disease. Twenty-nine hospitals in five states were randomly assigned to receive written hospital-specific feedback (WFI) of feedback enhanced by the participation of a trained physician, quality improvement tools, and an Anticoagulant Management of Venous Thrombosis (AMVT) project liaison (EFI). Differences in the performance of five quality indicators between baseline and remeasurement were assessed. Quality managers were interviewed to determine perceptions of project implementation. No significant differences in the change from baseline to remeasurement were found between the two intervention groups. Significant improvement in one indicator and significant decline in two indicators were found for one or both groups. Yet 59% of all quality managers perceived the AMVT project as being successful to very successful, and more EFI quality managers perceived success than did WFI managers (71% versus 40%). In the majority of EFI hospitals, physician liaisons played an important role in project implementation. Study results indicated that the addition of a physician liaison, quality improvement tools, and a project liaison did not provide incremental value to hospital-specific feedback for improving quality of care. Future studies with larger sample sizes, lengthier follow-up periods, and interventions that include more of the elements shown to affect practice behavior change are needed to identify an optimal feedback model for use by external quality management organizations.

Performance indicators used to assess the quality of primary dental care.

PubMed

González, Grisel Zacca; Klazinga, Niek; ten Asbroek, Guus; Delnoij, Diana M

2006-12-01

An appropriate quality of medical care including dental care should be an objective of every government that aims to improve the oral health of its population. To determine performance indicators that could be used to assess the quality of primary dental care at different levels of a health care system, the sources for data collection and finally, the dimensions of quality measured by these indicators. An explorative study of the international literature was conducted using medical databases, journals and books, and official websites of organisations and associations. This resulted in a set of 57 indicators, which were classified into the following dimensions for each intended user group: For patients: health outcomes and subjective indicators; for professionals: their performance and the rates of success, failure and complications; for health care system managers and policymakers: their resources, finances and health care utilisation. A set of 57 performance indicators were identified to assess the quality of primary dental care at the levels of patients, professionals and the health care system. These indicators could be used by managers and decision-makers at any level of the health care system according to the characteristics of the services.

Guidelines for Risk-Based Changeover of Biopharma Multi-Product Facilities.

PubMed

Lynch, Rob; Barabani, David; Bellorado, Kathy; Canisius, Peter; Heathcote, Doug; Johnson, Alan; Wyman, Ned; Parry, Derek Willison

2018-01-01

In multi-product biopharma facilities, the protection from product contamination due to the manufacture of multiple products simultaneously is paramount to assure product quality. To that end, the use of traditional changeover methods (elastomer change-out, full sampling, etc.) have been widely used within the industry and have been accepted by regulatory agencies. However, with the endorsement of Quality Risk Management (1), the use of risk-based approaches may be applied to assess and continuously improve established changeover processes. All processes, including changeover, can be improved with investment (money/resources), parallel activities, equipment design improvements, and standardization. However, processes can also be improved by eliminating waste. For product changeover, waste is any activity not needed for the new process or that does not provide added assurance of the quality of the subsequent product. The application of a risk-based approach to changeover aligns with the principles of Quality Risk Management. Through the use of risk assessments, the appropriate changeover controls can be identified and controlled to assure product quality is maintained. Likewise, the use of risk assessments and risk-based approaches may be used to improve operational efficiency, reduce waste, and permit concurrent manufacturing of products. © PDA, Inc. 2018.

Water Quality Assessment in the Vouga Catchment (Portugal) through the Integration of Hydrologic Modeling, Economic Valuation, and Optimization Methods

NASA Astrophysics Data System (ADS)

Hawtree, Daniel; Julich, Stefan; Rocha, João; Roebeling, Peter; Feger, Karl-Heinz

2016-04-01

Hydrologic model assessments of the impacts of land-cover / use change (LCLUC) are fundamental for the development of catchment management plans, which are increasingly needed for meeting water quality standards (i.e. Water Framework Directive). These assessments can be difficult to conduct at the spatial scale required for such plans, due to data limitations and the challenge of up-scaling from field / small scale studies to larger regions. Furthermore, such hydrologic assessments are of limited practical use if the financial impacts of any potential land-cover / management changes on local stakeholders are adequately quantified and taken into planning consideration. To address these challenges, this study presents an approach that integrates hydrologic modeling, economic valuation, and landscape optimization methods. This approach is applied to the Vouga catchment, a large (2,298 km^2) mixed land-use catchment in north-central Portugal. The Vouga has high nutrient (nitrogen and phosphorus) impacts in a number of reaches, which have negative impacts on downstream wetlands and groundwater supplies. To examine potential improvements to water quality, the Soil and Water Assessment Tool (SWAT) was calibrated over a five period (2002 - 2007) to establish the baseline hydrologic and nutrient fluxes. This calibration relies upon the up-scaling of findings from previous field studies (on vegetation and soils), hydrologic assessments, and modeling studies. The agricultural income for local stakeholders was estimated from existing land-cover and management approaches is made, to establish the baseline financial conditions. An optimization algorithm is then applied to the baseline scenario using both the biophysical and financial information, which seeks to determine various (most) optimal states. The preliminary results from this work are presented, and the advantages and challenges of using such an approach for scenario analysis for catchment management are discussed

Assessment of quality of water provided for wildlife in the Central Kalahari Game Reserve, Botswana

NASA Astrophysics Data System (ADS)

Selebatso, Moses; Maude, Glyn; Fynn, Richard W. S.

2018-06-01

Arid and semi-arid environments have low and unpredictable rainfall patterns resulting in limited availability of surface water for wildlife. In the Central Kalahari Game Reserve (CKGR) wildlife populations have lost access to natural surface water through cordon fences, livestock and human encroachment along the access routes. Artificial waterholes have been developed in the reserve to compensate for this loss. However, there have not been any assessments of the quality of water provided for wildlife and how that may be contributing to populations declines in the CKGR. We assessed water quality from 12 artificial waterholes against both Botswana and international livestock standards for drinking. Overall the quality of water provided is poor and poses a health risk to both animals and humans. Eight out of twelve boreholes tested exceeded the maximum acceptable Total Dissolved Solids (TDS) limits while three and four boreholes have toxic levels of lead and arsenic, respectively. Thus, pumping ground water could have more negative than positive impacts on wildlife thus defeating the intended management purpose. Failure to provide water of acceptable quality is a major concern for wildlife management in the CKGR and it may underlie some wildlife declines in the reserve. These findings confirm that restriction of populations from natural water sources create complex management challenges, especially where safe and sustainable alternative sources are scarce. Restriction of access of the population to natural water sources by fences and provision of poor quality water could compromise the overall fitness of wildlife populations and contribute to their decline.

Mozambique’s journey toward accreditation of the National Tuberculosis Reference Laboratory

PubMed Central

Madeira, Carla; Aguiar, Carmen; Dolores, Carolina; Mandlaze, Ana P.; Chongo, Patrina; Masamha, Jessina

2017-01-01

Background Internationally-accredited laboratories are recognised for their superior test reliability, operational performance, quality management and competence. In a bid to meet international quality standards, the Mozambique National Institute of Health enrolled the National Tuberculosis Reference Laboratory (NTRL) in a continuous quality improvement process towards ISO 15189 accreditation. Here, we describe the road map taken by the NTRL to achieve international accreditation. Methods The NTRL adopted the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme as a strategy to implement a quality management system. After SLMTA, the Mozambique National Institute of Health committed to accelerate the NTRL’s process toward accreditation. An action plan was designed to streamline the process. Quality indicators were defined to benchmark progress. Staff were trained to improve performance. Mentorship from an experienced assessor was provided. Fulfilment of accreditation standards was assessed by the Portuguese Accreditation Board. Results Of the eight laboratories participating in SLMTA, the NTRL was the best-performing laboratory, achieving a 53.6% improvement over the SLMTA baseline conducted in February 2011 to the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) assessment in June 2013. During the accreditation assessment in September 2014, 25 minor nonconformities were identified and addressed. In March 2015, the NTRL received Portuguese Accreditation Board recognition of technical competency for fluorescence smear microscopy, and solid and liquid culture. The NTRL is the first laboratory in Mozambique to achieve ISO 15189 accreditation. Conclusions From our experience, accreditation was made possible by institutional commitment, strong laboratory leadership, staff motivation, adequate infrastructure and a comprehensive action plan. PMID:28879162

Utilization Management in Department of Defense Military Treatment Facilities

DTIC Science & Technology

1992-07-01

Health Affairs) Mendez (1992) clearly states that his plan is for the military health services system’s quality assessment and criteria to become more...also worthy of note that second surgical opinions are not part of Assistant Secretary of Defense (Health Affairs) Mendez ’ (1992) memonrandur on...Affairs) Mendez ’ (1992) quality management policy already states that military medical treatment facilities will begin to implement utilization

Water-quality sampling by the U.S. Geological Survey-Standard protocols and procedures

USGS Publications Warehouse

Wilde, Franceska D.

2010-01-01

Thumbnail of and link to report PDF (1.0 MB) The U.S. Geological Survey (USGS) develops the sampling procedures and collects the data necessary for the accurate assessment and wise management of our Nation's surface-water and groundwater resources. Federal and State agencies, water-resource regulators and managers, and many organizations and interested parties in the public and private sectors depend on the reliability, timeliness, and integrity of the data we collect and the scientific soundness and impartiality of our data assessments and analysis. The standard data-collection methods uniformly used by USGS water-quality personnel are peer reviewed, kept up-to-date, and published in the National Field Manual for the Collection of Water-Quality Data (http://pubs.water.usgs.gov/twri9A/).

Electronic medical record system at an opioid agonist treatment programme: study design, pre-implementation results and post-implementation trends.

PubMed

Kritz, Steven; Brown, Lawrence S; Chu, Melissa; John-Hull, Carlota; Madray, Charles; Zavala, Roberto; Louie, Ben

2012-08-01

Electronic medical record (EMR) systems are commonly included in health care reform discussions. However, their embrace by the health care community has been slow. At Addiction Research and Treatment Corporation, an outpatient opioid agonist treatment programme that also provides primary medical care, HIV medical care and case management, substance abuse counselling and vocational services, we studied the implementation of an EMR in the domains of quality, productivity, satisfaction, risk management and financial performance utilizing a prospective pre- and post-implementation study design. This report details the research approach, pre-implementation findings for all five domains, analysis of the pre-implementation findings and some preliminary post-implementation results in the domains of quality and risk management. For quality, there was a highly statistically significant improvement in timely performance of annual medical assessments (P < 0.001) and annual multidiscipline assessments (P < 0.0001). For risk management, the number of events was not sufficient to perform valid statistical analysis. The preliminary findings in the domain of quality are very promising. Should the findings in the other domains prove to be positive, then the impetus to implement EMR in similar health care facilities will be advanced. © 2011 Blackwell Publishing Ltd.

A systematic review of factors influencing knowledge management and the nurse leaders' role.

PubMed

Lunden, Anne; Teräs, Marianne; Kvist, Tarja; Häggman-Laitila, Arja

2017-09-01

To describe factors facilitating or inhibiting the development of registered nurses' competency and nurse leader's role in knowledge management. Nurses' competency directly influences patient safety and the quality and effectiveness of patient care. Challenges of nurse leaders in knowledge management include acquiring, assessing and utilising current knowledge and assessing and enhancing competency. A systematic search was conducted in PubMed, CINAHL, SCOPUS and ERIC databases in April 2015. The search identified 18 relevant research articles published between 2009 and 2015. The quality of the studies was appraised in accordance with study designs. Knowledge management is facilitated by an organisation culture that supports learning, sharing of information and learning together. Leader commitment and competency were factors related to leadership facilitating knowledge management. Nurse leaders need evidence-based interventions to support shared learning and to create infrastructures that facilitate competence development. Future research is especially needed to evaluate connections between knowledge management and patient outcomes. The results of this review can be utilised in enhancing factors to facilitate knowledge management in clinical practice and identifying nurse leaders' role in strengthening nurses' competency. © 2017 John Wiley & Sons Ltd.

Assessment of nutritional status and quality of life in patients treated for head and neck cancer.

PubMed

Prevost, V; Joubert, C; Heutte, N; Babin, E

2014-04-01

The purpose of this study was to identify tools for the assessment of nutritional status in head and neck cancer patients, to evaluate the impact of malnutrition on therapeutic management and quality of life and to propose a simple screening approach adapted to routine clinical practice. The authors conducted a review of the literature to identify tools for the assessment of nutritional status in head and neck cancer patients published in French and English. Articles were obtained from the PubMed database and from the references of these articles and selected journals, using the keywords: "nutritional assessment", and "head and neck" and "cancer". Anthropometric indices, laboratory parameters, dietary intake assessment, clinical scores and nutritional risk scores used in patients with head and neck cancers are presented. The relevance of these tools in clinical practice and in research is discussed, together with the links between nutritional status and quality of life. This article is designed to help teams involved in the management of patients with head and neck cancer to choose the most appropriate tools for assessment of nutritional status according to their resources and their objectives. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

ASSESSMENT AND MANAGEMENT OF WATERSHED MICROBIAL CONTAMINANTS

EPA Science Inventory

Numerous sources of infectious disease causing microorganisms exist in watersheds and can impact recreational and drinking water quality. Organisms of concern include bacteria, viruses, and parasites. The watershed manager is challenged to limit human contact with pathogens, limi...

Case management to increase quality of life after cancer treatment: a randomized controlled trial.

PubMed

Scherz, Nathalie; Bachmann-Mettler, Irène; Chmiel, Corinne; Senn, Oliver; Boss, Nathalie; Bardheci, Katarina; Rosemann, Thomas

2017-03-28

Case management has been shown to be beneficial in phases of cancer screening and treatment. After treatment is completed, patients experience a loss of support due to reduced contact with medical professionals. Case management has the potential to offer continuity of care and ease re-entry to normal life. We therefore aim to investigate the effect of case management on quality of life in early cancer survivors. Between 06/2010 and 07/2012, we randomized 95 patients who had just completed cancer treatment in 11 cancer centres in the canton of Zurich, Switzerland. Patients in the case management group met with a case manager at least three times over 12 months. Patient-reported outcomes were assessed after 3, 6 and 12 months using the Functional Assessment of Cancer Therapy (FACT-G) scale, the Patient Assessment of Chronic Illness Care (PACIC) and the Self-Efficacy scale. The change in FACT-G over 12 months was significantly greater in the case management group than in the control group (16.2 (SE 2.0) vs. 9.2 (SE 1.5) points, P = 0.006). The PACIC score increased by 0.20 (SE 0.14) in the case management group and decreased by 0.29 (SE 0.12) points in the control group (P = 0.009). Self-Efficacy increased by 3.1 points (SE 0.9) in the case management group and by 0.7 (SE 0.8) points in the control group (P = 0.049). Case management has the potential to improve quality of life, to ease re-entry to normal life and to address needs for continuity of care in early cancer survivors. The study has been submitted to the ISRCTN register under the name "Case Management in Oncology Rehabilitation" on the 12th of October 2010 and retrospectively registered under the number ISRCTN41474586 on the 24th of November 2010.

[Process-oriented quality management in the hospital].

PubMed

Wolters, H G

1998-03-01

Procedures and experiences concerning the implementation of quality management in a midsize hospital with 6 medical disciplines are described. Quality of infrastructure was checked with lists and the quality of medical performance assessed by means of standardized numerical audit with all professional groups. Weaknesses were identified by comparing the result to each quality indicator with target standards. As examples, causal relations and consequences of deficiencies in clinical care documentation, scheme of preoperative diagnosis, co-ordination of surgical procedures and handling of complications are given in more detail. Obstacles were rated depending on frequency and risk potential, sometimes cost effectiveness. Members of all professional groups and departments involved participated in trouble solving teams to which external expert assistance was provided. For example, interventions leading to improved co-ordination of surgical activities and their impacts are specified. Improving systematically the quality of clinical procedures is one gateway to establish quality management in hospitals continuously and thoroughly becoming an integrated part of the corporate culture. Investment of resources is necessary but justified by midrange benefits.

Auditing the Quality of Management in the Community College.

ERIC Educational Resources Information Center

Hammons, James O.; Murry, John W. Jr.

1998-01-01

Provides an evaluation of the Community College Management Audit, a system designed to assess the abilities of administrative personnel to perform certain key functions of a manager regardless of their areas of responsibility. Argues that the principles underlying organizational effectiveness apply to both businesses and educational organizations.…

[Quality assurance and quality management in intensive care].

PubMed

Notz, K; Dubb, R; Kaltwasser, A; Hermes, C; Pfeffer, S

2015-11-01

Treatment success in hospitals, particularly in intensive care units, is directly tied to quality of structure, process, and outcomes. Technological and medical advancements lead to ever more complex treatment situations with highly specialized tasks in intensive care nursing. Quality criteria that can be used to describe and correctly measure those highly complex multiprofessional situations have only been recently developed and put into practice.In this article, it will be shown how quality in multiprofessional teams can be definded and assessed in daily clinical practice. Core aspects are the choice of a nursing theory, quality assurance measures, and quality management. One possible option of quality assurance is the use of standard operating procedures (SOPs). Quality can ultimately only be achieved if professional groups think beyond their boundaries, minimize errors, and establish and live out instructions and SOPs.

Assessing the TMDL Approach to Water Quality Management

NASA Astrophysics Data System (ADS)

Aswathanarayana, U.

Every human being on Earth is a stakeholder in water quality management. And so, for that matter, is every animal, domesticated or wild, though they have no constituency Water quality includes not only considerations of water composition for multiple human uses such as drinking and irrigation, but also in terms of its capacity to support systems of aquatic biota in general. This is so because we now realize that our well-being is inseparable from the well-being of, say the aquatic biota. If frogs were dying, we would be next in line!

Quality of child healthcare at primary healthcare facilities: a national assessment of the Integrated Management of Childhood Illnesses in Afghanistan.

PubMed

Mansoor, Ghulam Farooq; Chikvaidze, Paata; Varkey, Sherin; Higgins-Steele, Ariel; Safi, Najibullah; Mubasher, Adela; Yusufi, Khaksar; Alawi, Sayed Alisha

2017-02-01

To assess quality of the national Integrated Management of Childhood Illness (IMCI) program services provided for sick children at primary health facilities in Afghanistan. Mixed methods including cross-sectional study. Thirteen (of thirty-four) provinces in Afghanistan. Observation of case management and re-examination of 177 sick children, exit interviews with caretakers and review of equipment/supplies at 44 health facilities. Introduction and scale up of Integrated Management of Childhood Illnesses at primary health care facilities. Care of sick children according to IMCI guidelines, health worker skills and essential health system elements. Thirty-two (71%) of the health workers were trained in IMCI and five (11%) received supervision in clinical case management during the past 6 months. On average, 5.4 out of 10 main assessment tasks were performed during cases observed, the index being higher in children seen by trained providers than untrained (6.3 vs 3.5, 95% CI 5.8-6.8 vs 2.9-4.1). In all, 74% of the 104 children who needed oral antibiotics received prescriptions, while 30% received complete and correct advice and 30% were overprescribed, and more so by untrained providers. Home care counseling was associated with provider training status (41.3% by trained and 24.5% by untrained). Essential oral and pre-referral injectable medicine and equipment/supplies were available in 66%, 23%, and 45% of health facilities, respectively. IMCI training improved assessment, rational use of antibiotics and counseling; further investment in IMCI in Afghanistan, continuing provider capacity building and supportive supervision for improved quality of care and counseling for sick children is needed, especially given high burden treatable childhood illness. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Quality and the Rise of Value-Added in Education: The Case of Ireland

ERIC Educational Resources Information Center

Brown, Martin; McNamara, Gerry; O'Hara, Joe

2016-01-01

This paper examines the rise of value-added as a measure of quality in education. As a point of departure, the paper begins with an analysis of the rise of the concept of quality in education and discusses how, at times, various contradictory determinants of quality have managed to influence the evaluation and assessment frameworks of most…

The Public Discourse about Land Use and Water Quality: Themes in Newspapers in the Upper Mississippi River Basin

ERIC Educational Resources Information Center

Schmid, Andrea N.; Thompson, Jan R.; Bengston, David N.

2007-01-01

Effective educational and management programs to improve water quality will require an improved understanding of public perceptions of the relationship between land use and water quality. We analyzed a large database of newspaper articles in the Upper Mississippi River Basin to assess the public discourse about water quality and land use, and…

A watershed scale assessment of the impacts of suburban turf management on runoff water quality

NASA Astrophysics Data System (ADS)

Bachman, M.; Inamdar, S. P.; Barton, S.; Duke, J.; Tallamy, D.; Bruck, J.

2014-12-01

Steadily increasing rates of urbanization have raised concerns about the negative impacts of urban runoff on receiving surface water quality. These concerns have been further amplified by landscaping paradigms that encourage high-input, intensively-managed and mono-culture turf and lawn landscapes. We conducted a watershed-scale assessment of turf management practices on water quality vis-à-vis less-intensive management practices that preserve and enhance more diverse and native vegetation. The study treatments with existing/established vegetation and landscaping practices included turf, urban, forest, meadow, and a mixed site with a professional golf course. Stream water sampling was performed during baseflow and storm events. Highest nutrient (nitrate and total nitrogen) concentrations in runoff were observed for the mixed watershed draining the golf course. In contrast, nutrient concentrations in baseflow from the turf watershed were lower than expected and were comparable to those measured in the surrounding meadow and forest sites. Runoff losses from the turf site may have been minimal due to the optimal quality of management implemented. Total nitrogen concentrations from the turf site increased sharply during the first storms following fertilization, suggesting that despite optimal management there exists a risk for nutrient runoff following fertilization. Dissolved organic carbon (DOC) concentrations from the turf site were elevated and aromatic in content while the mixed watershed site yielded more labile DOM. Overall, this study suggests that turf lawns, when managed properly, pose minimal environmental risk to surrounding surface waters. Based on the results of this study, providing homeowners with increased information regarding best management practices for lawn maintenance may serve as a cost-efficient method for reducing suburban runoff pollution.

Quality of antenatal care service provision in health facilities across sub–Saharan Africa: Evidence from nationally representative health facility assessments

PubMed Central

Kanyangarara, Mufaro; Munos, Melinda K; Walker, Neff

2017-01-01

Background Utilization of antenatal care (ANC) services has increased over the past two decades. Continued gains in maternal and newborn health will require an understanding of both access and quality of ANC services. We linked health facility and household survey data to examine the quality of service provision for five ANC interventions across health facilities in sub–Saharan Africa. Methods Using data from 20 nationally representative health facility assessments – the Service Provision Assessment (SPA) and the Service Availability and Readiness Assessment (SARA), we estimated facility level readiness to deliver five ANC interventions: tetanus toxoid vaccine for pregnant women, intermittent preventive treatment for malaria in pregnancy (IPTp), syphilis detection and treatment in pregnancy, iron supplementation and hypertensive disease case management. Facility level indicators were stratified by health facility type, managing authority and location, then linked to estimates of ANC utilization in that stratum from the corresponding Demographic and Health Surveys (DHS) to generate population level estimates of the ‘likelihood of appropriate care’. Finally, the association between estimates of the ‘likelihood of appropriate care’ from the linking approach and estimates of coverage levels from the DHS were assessed. Findings A total of 10 534 health facilities were surveyed in the 20 health facility assessments, of which 8742 reported offering ANC services and were included in the analysis. Health facility readiness to deliver IPTp, iron supplementation, and tetanus toxoid vaccination was higher (median: 84.1%, 84.9% and 82.8% respectively) than readiness to deliver hypertensive disease case management and syphilis detection and treatment (median: 23.0% and 19.9% respectively). Coverage of at least 4 ANC visits ranged from 24.8% to 75.8%. Estimates of the likelihood of appropriate care derived from linking health facility and household survey data showed marked gaps for all interventions, particularly hypertensive disease case management and syphilis detection and treatment. There was fairly good concordance between our estimates of high likelihood of appropriate care and DHS estimates of coverage for iron supplementation, IPTp, and tetanus toxoid vaccination. Conclusion Linking household surveys to health facility assessments revealed marked gaps in population–level coverage of quality ANC interventions and underscored the need for a double–pronged approach to increase ANC utilization and improve the quality of ANC services. PMID:29163936

Quality of antenatal care service provision in health facilities across sub-Saharan Africa: Evidence from nationally representative health facility assessments.

PubMed

Kanyangarara, Mufaro; Munos, Melinda K; Walker, Neff

2017-12-01

Utilization of antenatal care (ANC) services has increased over the past two decades. Continued gains in maternal and newborn health will require an understanding of both access and quality of ANC services. We linked health facility and household survey data to examine the quality of service provision for five ANC interventions across health facilities in sub-Saharan Africa. Using data from 20 nationally representative health facility assessments - the Service Provision Assessment (SPA) and the Service Availability and Readiness Assessment (SARA), we estimated facility level readiness to deliver five ANC interventions: tetanus toxoid vaccine for pregnant women, intermittent preventive treatment for malaria in pregnancy (IPTp), syphilis detection and treatment in pregnancy, iron supplementation and hypertensive disease case management. Facility level indicators were stratified by health facility type, managing authority and location, then linked to estimates of ANC utilization in that stratum from the corresponding Demographic and Health Surveys (DHS) to generate population level estimates of the 'likelihood of appropriate care'. Finally, the association between estimates of the 'likelihood of appropriate care' from the linking approach and estimates of coverage levels from the DHS were assessed. A total of 10 534 health facilities were surveyed in the 20 health facility assessments, of which 8742 reported offering ANC services and were included in the analysis. Health facility readiness to deliver IPTp, iron supplementation, and tetanus toxoid vaccination was higher (median: 84.1%, 84.9% and 82.8% respectively) than readiness to deliver hypertensive disease case management and syphilis detection and treatment (median: 23.0% and 19.9% respectively). Coverage of at least 4 ANC visits ranged from 24.8% to 75.8%. Estimates of the likelihood of appropriate care derived from linking health facility and household survey data showed marked gaps for all interventions, particularly hypertensive disease case management and syphilis detection and treatment. There was fairly good concordance between our estimates of high likelihood of appropriate care and DHS estimates of coverage for iron supplementation, IPTp, and tetanus toxoid vaccination. Linking household surveys to health facility assessments revealed marked gaps in population-level coverage of quality ANC interventions and underscored the need for a double-pronged approach to increase ANC utilization and improve the quality of ANC services.

[Certification assessment and quality and risk management].

PubMed

Papin-Morardet, Maud

2018-03-01

Organised by the French National Health Authority (HAS), certification is an external assessment process which is obligatory for all public and private health facilities, whatever their size or activity. The aim is to independently evaluate the quality of the health care provision of hospitals and clinics in France. This article looks at the investigation methods and the procedure used during the certification assessment of Henri Mondor University Hospitals in 2016. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Lung Cancer Workshop XI: Tobacco-Induced Disease: Advances in Policy, Early Detection and Management.

PubMed

Mulshine, James L; Avila, Rick; Yankelevitz, David; Baer, Thomas M; Estépar, Raul San Jose; Ambrose, Laurie Fenton; Aldigé, Carolyn R

2015-05-01

The Prevent Cancer Foundation Lung Cancer Workshop XI: Tobacco-Induced Disease: Advances in Policy, Early Detection and Management was held in New York, NY on May 16 and 17, 2014. The two goals of the Workshop were to define strategies to drive innovation in precompetitive quantitative research on the use of imaging to assess new therapies for management of early lung cancer and to discuss a process to implement a national program to provide high quality computed tomography imaging for lung cancer and other tobacco-induced disease. With the central importance of computed tomography imaging for both early detection and volumetric lung cancer assessment, strategic issues around the development of imaging and ensuring its quality are critical to ensure continued progress against this most lethal cancer.

Content and quality of websites supporting self-management of chronic breathlessness in advanced illness: a systematic review

PubMed Central

Luckett, Tim; Disler, Rebecca; Hosie, Annmarie; Johnson, Miriam; Davidson, Patricia; Currow, David; Sumah, Anthony; Phillips, Jane

2016-01-01

Chronic breathlessness is a common, burdensome and distressing symptom in many advanced chronic illnesses. Self-management strategies are essential to optimise treatment, daily functioning and emotional coping. People with chronic illness commonly search the internet for advice on self-management. A review was undertaken in June 2015 to describe the content and quality of online advice on breathlessness self-management, to highlight under-served areas and to identify any unsafe content. Google was searched from Sydney, Australia, using the five most common search terms for breathlessness identified by Google Trends. We also hand-searched the websites of national associations. Websites were included if they were freely available in English and provided practical advice on self-management. Website quality was assessed using the American Medical Association Benchmarks. Readability was assessed using the Flesch–Kincaid grades, with grade 8 considered the maximum acceptable for enabling access. Ninety-one web pages from 44 websites met the inclusion criteria, including 14 national association websites not returned by Google searches. Most websites were generated in the USA (n=28, 64%) and focused on breathing techniques (n=38, 86%) and chronic obstructive pulmonary disease (n=27, 61%). No websites were found to offer unsafe advice. Adherence to quality benchmarks ranged from 9% for disclosure to 77% for currency. Fifteen (54%) of 28 written websites required grade ⩾9 reading level. Future development should focus on advice and tools to support goal setting, problem solving and monitoring of breathlessness. National associations are encouraged to improve website visibility and comply with standards for quality and readability. PMID:27225898

A water quality management strategy for regionally protected water through health risk assessment and spatial distribution of heavy metal pollution in 3 marine reserves.

PubMed

Zhang, Yinan; Chu, Chunli; Li, Tong; Xu, Shengguo; Liu, Lei; Ju, Meiting

2017-12-01

Severe water pollution and resource scarcity is a major problem in China, where it is necessary to establish water quality-oriented monitoring and intelligent watershed management. In this study, an effective watershed management method is explored, in which water quality is first assessed using the heavy metal pollution index and the human health risk index, and then by classifying the pollution and management grade based on cluster analysis and GIS visualization. Three marine reserves in Tianjin were selected and analyzed, namely the Tianjin Ancient Coastal Wetland National Nature Reserve (Qilihai Natural Reserve), the Tianjin DaShentang Oyster Reef National Marine Special Reserve (DaShentang Reserve), and the Tianjin Coastal Wetland National Marine Special Reserve (BinHai Wetland Reserve) which is under construction. The water quality and potential human health risks of 5 heavy metals (Pb, As, Cd, Hg, Cr) in the three reserves were assessed using the Nemerow index and USEPA methods. Moreover, ArcGIS10.2 software was used to visualize the heavy metal index and display their spatial distribution. Cluster analysis enabled classification of the heavy metals into 4 categories, which allowed for identification of the heavy metals whose pollution index and health risks were highest, and, thus, whose control in the reserve is a priority. Results indicate that heavy metal pollution exists in the Qilihai Natural Reserve and in the north and east of the DaShentang Reserve; furthermore, human health risks exist in the Qilihai Natural Reserve and in the BinHai Wetland Reserve. In each reserve, the main factor influencing the pollution and health risk were high concentrations of As and Pb that exceed the corresponding standards. Measures must be adopted to control and remediate the pollutants. Furthermore, to protect the marine reserves, management policies must be implemented to improve water quality, which is an urgent task for both local and national governments. Copyright © 2017 Elsevier B.V. All rights reserved.

Embedding systematic quality assessments in supportive supervision at primary healthcare level: application of an electronic Tool to Improve Quality of Healthcare in Tanzania.

PubMed

Mboya, Dominick; Mshana, Christopher; Kessy, Flora; Alba, Sandra; Lengeler, Christian; Renggli, Sabine; Vander Plaetse, Bart; Mohamed, Mohamed A; Schulze, Alexander

2016-10-13

Assessing quality of health services, for example through supportive supervision, is essential for strengthening healthcare delivery. Most systematic health facility assessment mechanisms, however, are not suitable for routine supervision. The objective of this study is to describe a quality assessment methodology using an electronic format that can be embedded in supervision activities and conducted by council health staff. An electronic Tool to Improve Quality of Healthcare (e-TIQH) was developed to assess the quality of primary healthcare provision. The e-TIQH contains six sub-tools, each covering one quality dimension: infrastructure and equipment of the facility, its management and administration, job expectations, clinical skills of the staff, staff motivation and client satisfaction. As part of supportive supervision, council health staff conduct quality assessments in all primary healthcare facilities in a given council, including observation of clinical consultations and exit interviews with clients. Using a hand-held device, assessors enter data and view results in real time through automated data analysis, permitting immediate feedback to health workers. Based on the results, quality gaps and potential measures to address them are jointly discussed and actions plans developed. For illustrative purposes, preliminary findings from e-TIQH application are presented from eight councils of Tanzania for the period 2011-2013, with a quality score <75 % classed as 'unsatisfactory'. Staff motivation (<50 % in all councils) and job expectations (≤50 %) scored lowest of all quality dimensions at baseline. Clinical practice was unsatisfactory in six councils, with more mixed results for availability of infrastructure and equipment, and for administration and management. In contrast, client satisfaction scored surprisingly high. Over time, each council showed a significant overall increase of 3-7 % in mean score, with the most pronounced improvements in staff motivation and job expectations. Given its comprehensiveness, convenient handling and automated statistical reports, e-TIQH enables council health staff to conduct systematic quality assessments. Therefore e-TIQH may not only contribute to objectively identifying quality gaps, but also to more evidence-based supervision. E-TIQH also provides important information for resource planning. Institutional and financial challenges for implementing e-TIQH on a broader scale need to be addressed.

Work design and management in the manufacturing sector: development and validation of the Work Organisation Assessment Questionnaire

PubMed Central

Griffiths, A; Cox, T; Karanika, M; Khan, S; Tomás, J‐M

2006-01-01

Objectives To examine the factor structure, reliability, and validity of a new context‐specific questionnaire for the assessment of work and organisational factors. The Work Organisation Assessment Questionnaire (WOAQ) was developed as part of a risk assessment and risk reduction methodology for hazards inherent in the design and management of work in the manufacturing sector. Method Two studies were conducted. Data were collected from 524 white‐ and blue‐collar employees from a range of manufacturing companies. Exploratory factor analysis was carried out on 28 items that described the most commonly reported failures of work design and management in companies in the manufacturing sector. Concurrent validity data were also collected. A reliability study was conducted with a further 156 employees. Results Principal component analysis, with varimax rotation, revealed a strong 28‐item, five factor structure. The factors were named: quality of relationships with management, reward and recognition, workload, quality of relationships with colleagues, and quality of physical environment. Analyses also revealed a more general summative factor. Results indicated that the questionnaire has good internal consistency and test‐retest reliability and validity. Being associated with poor employee health and changes in health related behaviour, the WOAQ factors are possible hazards. It is argued that the strength of those associations offers some estimation of risk. Feedback from the organisations involved indicated that the WOAQ was easy to use and meaningful for them as part of their risk assessment procedures. Conclusions The studies reported here describe a model of the hazards to employee health and health related behaviour inherent in the design and management of work in the manufacturing sector. It offers an instrument for their assessment. The scales derived which form the WOAQ were shown to be reliable, valid, and meaningful to the user population. PMID:16858081

Preventing Stalled Quality Improvement Teams: A Written Test of Project Selectionability.

ERIC Educational Resources Information Center

Bacdayan, Paul

2002-01-01

Discusses organizations' use of quality improvement teams in total quality management and how they can benefit from training team personnel in how to select projects with a low risk of stalling. Describes an efficient written assessment test of project selection ability designed for those who conduct evaluations of training sessions. (Author/LRW)

Problems of Accreditation and Quality Assurance of Engineering Education in Developing Countries.

ERIC Educational Resources Information Center

Bordia, Surek

2001-01-01

Discusses the relationship between funding, management, and quality assurance in engineering education in developing countries. Presents a few case studies on problems of accreditation and quality assessment in larger developing countries such as India and the Philippines, and also in very small developing countries such as Papua New Guinea, Fiji,…

A flight cylinder bioassay as a simple, effective quality control test for Cydia pomonella

USDA-ARS?s Scientific Manuscript database

Assessment of quality of the sterile male insects that are being mass-reared for release in area-wide integrated pest management programmes that include a sterile insect technique component is crucial for the success of these programmes. Routine monitoring of sterile male quality needs to be carried...

In Search of Teaching Quality of EFL Student Teachers through Teaching Practicum: Lessons from a Teacher Education Program

ERIC Educational Resources Information Center

Azkiyah, Siti Nurul; Mukminin, Amirul

2017-01-01

This study was intended to investigate the teaching quality of student teachers when they conducted their teaching practicum. Teaching quality is conceptualised based on eight classroom factors (orientation, structuring, modelling, application, questioning, building classroom as a learning environment, assessment, and time management) of the…

Quality Assurance and Accreditation in Higher Education: India vis-à-vis European Countries

ERIC Educational Resources Information Center

Dey, Niradhar

2011-01-01

Quality assurance (QA) and accreditation in higher education include the systematic management and assessment of procedures to monitor performance and to address areas of improvement. In the context of globalization, without assuring the quality of higher education programmes it is not possible to ensure credit transfer and student mobility, to…

'How to stop a nosebleed': an assessment of the quality of epistaxis treatment advice on YouTube.

PubMed

Haymes, A T; Harries, V

2016-08-01

Video hosting websites are increasingly being used to disseminate health education messages. This study aimed to assess the quality of advice contained within YouTube videos on the conservative management of epistaxis. YouTube.com was searched using the phrase 'how to stop a nosebleed'. The first 50 videos were screened. Objective advice scores and subjective production quality scores were attributed by independent raters. Forty-five videos were analysed. The mean advice score was 2.0 out of 8 and the mean production quality score was 1.6 out of 3. There were no correlations between a video's advice score and its search results rank (ρ = -0.28, p = 0.068), its view count (ρ = 0.20, p = 0.19) or its number of 'likes' (ρ = 0.21, p = 0.18). The quality of information on conservative epistaxis management within YouTube videos is extremely variable. A high search rank is no indication of video quality. Many videos proffer inappropriate and dangerous 'alternative' advice. We do not recommend YouTube as a source for patient information.

A social media intervention to improve hypoglycemia management at a multicenter hospital: a quality improvement pilot for clinical nurses.

PubMed

De Sousa, Filomena; Jackson, Jennifer; Knight, Ruth; Cloutier, Edith; Basa, Rosemary; Fourney, Anne; Devecseri, Kathleen

2018-02-01

Hypoglycemia poses significant risk to inpatients. Nursing management of hypoglycemia is a challenge, despite established best practice guidelines. Social media is an effective tool for sharing information and could overcome barriers to clinical education at a multicenter hospital. The purpose of this quality improvement intervention was to create and disseminate social media posts about best practices in hypoglycemia management. An unmatched pre-and post-survey assessed nursing knowledge of hypoglycemia management. Social media posts were created to visually outline the steps for hypoglycemia management over 2 weeks, across a nursing social media platform. We assessed the reach of the posts via Facebook and a survey. The posts reached 2962 users during the first week, and 1491 users the second week. A social media intervention can have a substantial reach and distribute information across a multicenter hospital. Additional study is needed to determine what factors could support an increase in nursing knowledge through a social media campaign.

Assessment of aquatic macroinvertebrate communities in the Autauga Creek watershed, Autauga County, Alabama, 2009

USGS Publications Warehouse

Mooty, Will S.; Gill, Amy C.

2011-01-01

Only four families within the Ephemeroptera, Plecoptera, and Trichoptera orders were found during a 1999 survey of aquatic macroinvertebrates in Autauga Creek, Autauga County, Alabama, by the Alabama Department of Environmental Management. The low number of taxa of Ephemeroptera, Plecoptera, and Trichoptera families indicated that the aquatic macroinvertebrate community was in poor condition, and the creek was placed on the Alabama Department of Environmental Management 303(d) list. The U.S. Geological Survey conducted a study in 2009 to provide data for the Alabama Department of Environmental Management and other water management agencies to re-evaluate aquatic macroinvertebrate communities in Autauga Creek to see if they meet Alabama Department of Environmental Management water-quality criteria. Aquatic macroinvertebrate communities were evaluated at three sites in the Autauga Creek watershed. Macroinvertebrates were sampled at two sites on Autauga Creek and one on Bridge Creek, the largest tributary to Autauga Creek. Water-quality field parameters were assessed at 11 sites. During the 2009 sampling, 12 families within the orders of Ephemeroptera, Plecoptera, Trichoptera were found at the Alabama Department of Environmental Management's assessment site whereas only four were found in 1999. The upstream site on Autauga Creek had consistently higher numbers of taxa than the Bridge Creek site and the lower site on Autauga Creek which is the Alabama Department of Environmental Management's assessment site. Chironomid richness was noticeably higher on the two Autauga Creek sites than the Bridge Creek site.

Investigations regarding the evaluation of specific intellectual property production risks within Quality Management System

NASA Astrophysics Data System (ADS)

Pakocs, R.; Lupulescu, N. B.

2016-11-01

This paper is a theoretical research concerning methods for risk assessment of specific intellectual property production risks that are identified in the product achievement stage within the Quality Management System. In order to realize this, we will start by identifying the specific intellectual property production risks and by proposing some new calculating formulas for minimalizing their negative effects. The theoretical model proposed assessment of specific intellectual property production risks, will be realized based on 3 hypothetical situations. This study intends to reduce the intellectual property risks identified in the production process of commercial societies that have an industrial profile.

Quality and safety of integrated community case management of malaria using rapid diagnostic tests and pneumonia by community health workers

PubMed Central

Hamer, Davidson H; Brooks, Erin Twohig; Semrau, Katherine; Pilingana, Portipher; MacLeod, William B; Siazeele, Kazungu; Sabin, Lora L; Thea, Donald M; Yeboah-Antwi, Kojo

2012-01-01

Objectives To assess the quality and safety of having community health workers (CHWs) in rural Zambia use rapid diagnostic tests (RDTs) and provide integrated management of malaria and pneumonia. Design/methods In the context of a cluster-randomized controlled trial of two models for community-based management of malaria and/or non-severe pneumonia in children under 5 years old, CHWs in the intervention arm were trained to use RDTs, follow a simple algorithm for classification and treat malaria with artemether–lumefantrine (AL) and pneumonia with amoxicillin. CHW records were reviewed to assess the ability of the CHWs to appropriately classify and treat malaria and pneumonia, and account for supplies. Patients were also followed up to assess treatment safety. Results During the 12-month study, the CHWs evaluated 1017 children with fever and/or fast/difficult breathing and performed 975 RDTs. Malaria and/or pneumonia were appropriately classified 94–100% of the time. Treatment based on disease classification was correct in 94–100% of episodes. Supply management was excellent with over 98% of RDTs, amoxicillin, and AL properly accounted for. The use of RDTs, amoxicillin, and AL was associated with few minor adverse events. Most febrile children (90%) with negative RDT results recovered after being treated with an antipyretic alone. Conclusions Volunteer CHWs in rural Zambia are capable of providing integrated management of malaria and pneumonia to children safely and at high quality. PMID:22595272

Quality and safety of integrated community case management of malaria using rapid diagnostic tests and pneumonia by community health workers.

PubMed

Hamer, Davidson H; Brooks, Erin Twohig; Semrau, Katherine; Pilingana, Portipher; MacLeod, William B; Siazeele, Kazungu; Sabin, Lora L; Thea, Donald M; Yeboah-Antwi, Kojo

2012-03-01

To assess the quality and safety of having community health workers (CHWs) in rural Zambia use rapid diagnostic tests (RDTs) and provide integrated management of malaria and pneumonia. In the context of a cluster-randomized controlled trial of two models for community-based management of malaria and/or non-severe pneumonia in children under 5 years old, CHWs in the intervention arm were trained to use RDTs, follow a simple algorithm for classification and treat malaria with artemether-lumefantrine (AL) and pneumonia with amoxicillin. CHW records were reviewed to assess the ability of the CHWs to appropriately classify and treat malaria and pneumonia, and account for supplies. Patients were also followed up to assess treatment safety. During the 12-month study, the CHWs evaluated 1017 children with fever and/or fast/difficult breathing and performed 975 RDTs. Malaria and/or pneumonia were appropriately classified 94-100% of the time. Treatment based on disease classification was correct in 94-100% of episodes. Supply management was excellent with over 98% of RDTs, amoxicillin, and AL properly accounted for. The use of RDTs, amoxicillin, and AL was associated with few minor adverse events. Most febrile children (90%) with negative RDT results recovered after being treated with an antipyretic alone. Volunteer CHWs in rural Zambia are capable of providing integrated management of malaria and pneumonia to children safely and at high quality.

Quasi-experimental evaluation of a multifaceted intervention to improve quality of end-of-life care and quality of dying for patients with advanced dementia in long-term care institutions.

PubMed

Verreault, René; Arcand, Marcel; Misson, Lucie; Durand, Pierre J; Kroger, Edeltraut; Aubin, Michèle; Savoie, Maryse; Hadjistavropoulos, Thomas; Kaasalainen, Sharon; Bédard, Annick; Grégoire, Annie; Carmichael, Pierre-Hughes

2018-03-01

Improvement in the quality of end-of-life care for advanced dementia is increasingly recognized as a priority in palliative care. To evaluate the impact of a multidimensional intervention to improve quality of care and quality of dying in advanced dementia in long-term care facilities. Quasi-experimental study with the intervention taking place in two long-term care facilities versus usual care in two others over a 1-year period. The intervention had five components: (1) training program to physicians and nursing staff, (2) clinical monitoring of pain using an observational pain scale, (3) implementation of a regular mouth care routine, (4) early and systematic communication with families about end-of-life care issues with provision of an information booklet, and (5) involvement of a nurse facilitator to implement and monitor the intervention. Quality of care was assessed with the Family Perception of Care Scale. The Symptom Management for End-of-Life Care in Dementia and the Comfort Assessment in Dying scales were used to assess the quality of dying. A total of 193 residents with advanced dementia and their close family members were included (97 in the intervention group and 96 in the usual care group). The Family Perception of Care score was significantly higher in the intervention group than in the usual care group (157.3 vs 149.1; p = 0.04). The Comfort Assessment and Symptom Management scores were also significantly higher in the intervention group. Our multidimensional intervention in long-term care facilities for patients with terminal dementia resulted in improved quality of care and quality of dying when compared to usual care.

Southwest principal aquifers regional ground-water quality assessment

USGS Publications Warehouse

Anning, D.W.; Thiros, Susan A.; Bexfield, L.M.; McKinney, T.S.; Green, J.M.

2009-01-01

The National Water-Quality Assessment (NAWQA) Program of the U.S. Geological Survey is conducting a regional analysis of water quality in the principal aquifers in the southwestern United States. The Southwest Principal Aquifers (SWPA) study is building a better understanding of the susceptibility and vulnerability of basin-fill aquifers in the region to ground-water contamination by synthesizing the baseline knowledge of ground-water quality conditions in 15 basins previously studied by the NAWQA Program. The improved understanding of aquifer susceptibility and vulnerability to contamination is assisting in the development of tools that water managers can use to assess and protect the quality of ground-water resources. This fact sheet provides an overview of the basin-fill aquifers in the southwestern United States and description of the completed and planned regional analyses of ground-water quality being performed by the SWPA study.

Adaptation of the Quality Indicator for Rehabilitative Care (QuIRC) for use in mental health supported accommodation services (QuIRC-SA).

PubMed

Killaspy, Helen; White, Sarah; Dowling, Sarah; Krotofil, Joanna; McPherson, Peter; Sandhu, Sima; Arbuthnott, Maurice; Curtis, Sarah; Leavey, Gerard; Priebe, Stefan; Shepherd, Geoff; King, Michael

2016-04-14

No standardised tools for assessing the quality of specialist mental health supported accommodation services exist. To address this, we adapted the Quality Indicator for Rehabilitative care-QuIRC-that was originally developed to assess the quality of longer term inpatient and community based mental health facilities. The QuIRC, which is completed by the service manager and gives ratings of seven domains of care, has good psychometric properties. Focus groups with staff of the three main types of supported accommodation in the UK (residential care, supported housing and floating outreach services) were carried out to identify potential amendments to the QuIRC. Additional advice was gained from consultation with three expert panels, two of which comprised service users with lived experience of mental health and supported accommodation services. The amended QuIRC (QuIRC-SA) was piloted with a manager of each of the three service types. Item response variance, inter-rater reliability and internal consistency were assessed in a random sample of 52 services. Factorial structure and discriminant validity were assessed in a larger random sample of 87 services. The QuIRC-SA comprised 143 items of which only 18 items showed a narrow range of response and five items had poor inter-rater reliability. The tool showed good discriminant validity, with supported housing services generally scoring higher than the other two types of supported accommodation on most domains. Exploratory factor analysis showed that the QuIRC-SA items loaded onto the domains to which they had been allocated. The QuIRC-SA is the first standardised tool for quality assessment of specialist mental health supported accommodation services. Its psychometric properties mean that it has potential for use in research as well as audit and quality improvement programmes. A web based application is being developed to make it more accessible which will produce a printable report for the service manager about the performance of their service, comparison data for similar services and suggestions on how to improve service quality.

EPA'S WATERSHED MANAGEMENT AND MODELING RESEARCH PROGRAM

EPA Science Inventory

Watershed management presumes that community groups can best solve many water quality and ecosystem problems at the watershed level rather than at the individual site, receiving waterbody, or discharger level. After assessing and ranking watershed problems, and setting environ...

Satellite Remote Sensing for Monitoring and Assessment

EPA Science Inventory

Remote sensing technology has the potential to enhance the engagement of communities and managers in the implementation and performance of best management practices. This presentation will use examples from U.S. numeric criteria development and state water quality monitoring prog...

42 CFR 460.62 - Governing body.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) Management and provision of all services, including the management of contractors. (4) Establishment of... participants. (7) Quality assessment and performance improvement program. (b) Participant advisory committee... provide the liaison to the governing body with meeting minutes that include participant issues. (c...

Vision for Future North American Emission Inventory Programs

EPA Science Inventory

The NARSTO Ozone and Particulate Matter Assessments emphasized that emission inventories are critical to the success of air quality management programs and that emissions inventories in Canada, Mexico, and the United States need improvement to meet expectations for quality, timel...

Assessing air quality impacts of managed lanes.

DOT National Transportation Integrated Search

2010-12-01

Impacts on transit bus performance and air quality were investigated for a case study high-occupancy / toll (HOT) lane project on a corridor of I-95 near Miami. Trends in air pollutant concentration monitoring data in the study area first were analyz...

Assessing air quality impacts of managed lanes

DOT National Transportation Integrated Search

2010-12-01

Impacts on transit bus performance and air quality were investigated for a case study high-occupancy / : toll (HOT) lane project on a corridor of I-95 near Miami. Trends in air pollutant concentration : monitoring data in the study area first were an...

Assessing air quality impacts of managed lanes : summary.

DOT National Transportation Integrated Search

2010-01-01

Researchers at the National Center for Transit Research, University of South Florida, recently studied a segment of I-95 between Ft. Lauderdale and Miami to investigate the impacts of high-occupancy/toll (HOT) lanes on air quality. The project simula...

Comprehensive evaluation of land quality basing on 3S technology and farmers' survey: A case study in Crisscross Region of Wind-drift Sand Regions along the Great Wall and Loess Plateau

NASA Astrophysics Data System (ADS)

Zhang, Yan-yu; Wang, Jing; Shi, Yan-xi; Li, Yu-huan; Lv, Chun-yan

2005-10-01

The Crisscross Region of Wind-drift Sand Regions along the Great Wall and Loess Plateau locates in southern Ordos Plateau and northern Chinese Loess Plateau, where wind erosion and water erosion coexist and specified environmental and socio-economic factors, especially human activities induce serious land degradation. However, there are only a few studies provide an overall assessment consequences. Integrated land quality assessment considering impacts of soil, topography, vegetation, environmental hazards, social-economic factors and land managements are imperative to the regional sustainable land managements. A pilot study was made in Hengshan County (Shanxi Province) with the objective of developing comprehensive land quality evaluation model integrating data from farmers' survey and Remote Sensing. Surveys were carried out in 107 households of study area in 2003 and 2004 to get farmers' perceptions of land quality and to collect correlative information. It was found out that farmers evaluated land quality by slope, water availability, soil texture, yields, amount of fertilizer, crop performance, sandy erosion degree and water erosion degree. Scientists' indicators which emphasize on getting information by RS technology were introduced to reflecting above indicators information for the sake of developing a rapid, efficient and local-fitted land quality assessment model including social-economic, environmental and anthropogenic factors. Data from satellite and surveys were integrated with socio-economic statistic data using geographical information system (GIS) and three indexes, namely Production Press Index (PPI), Land State Index (LSI) and Farmer Behavior Index (FBI) were proposed to measure different aspects of land quality. A model was further derived from the three indexes to explore the overall land quality of the study area. Results suggest that local land prevalently had a poor quality. This paper shows that whilst the model was competent for its work in the study area and evaluation results would supply beneficial information for management decisions.

[FQA: A method for floristic quality assessment based on conservatism of plant species].

PubMed

Cao, Li Juan; He, Ping; Wang, Mi; Xui, Jie; Ren, Ying

2018-04-01

FQA, which uses the conservatism of plant species for particular habitats and the species richness of plant communities, is a rapid method for the assessment of habitat quality. This method is based on species composition of quadrats and coefficients of conservatism for species which assigned by experts. Floristic Quality Index (FQI) that reflects vegetation integrity and degradation of a site can be calculated by a simple formula and be used for space-time comparison of habitat quality. It has been widely used in more than ten countries including the United States and Canada. This paper presented the principle, calculation formulas and application cases of this method, with the aim to provide a simple, repeatable and comparable method to assess habitat quality for ecological managers and researchers.

Benefits of a comprehensive quality program for cryopreserved PBMC covering 28 clinical trials sites utilizing an integrated, analytical web-based portal

PubMed Central

Ducar, Constance; Smith, Donna; Pinzon, Cris; Stirewalt, Michael; Cooper, Cristine; McElrath, M. Juliana; Hural, John

2014-01-01

The HIV Vaccine Trials Network (HVTN) is a global network of 28 clinical trial sites dedicated to identifying an effective HIV vaccine. Cryopreservation of high-quality peripheral blood mononuclear cells (PBMC) is critical for the assessment of vaccine-induced cellular immune functions. The HVTN PBMC Quality Management Program is designed to ensure viable PBMC are processed, stored and shipped for clinical trial assays from all HVTN clinical trial sites. The program has evolved by developing and incorporating best practices for laboratory and specimen quality and implementing automated, web-based tools. These tools allow the site-affiliated processing laboratories and the central Laboratory Operations Unit to rapidly collect, analyze and report PBMC quality data. The HVTN PBMC Quality Management Program includes five key components: 1) Laboratory Assessment, 2) PBMC Training and Certification, 3) Internal Quality Control, 4) External Quality Control (EQC), and 5) Assay Specimen Quality Control. Fresh PBMC processing data is uploaded from each clinical site processing laboratory to a central HVTN Statistical and Data Management Center database for access and analysis on a web portal. Samples are thawed at a central laboratory for assay or specimen quality control and sample quality data is uploaded directly to the database by the central laboratory. Four year cumulative data covering 23,477 blood draws reveals an average fresh PBMC yield of 1.45×106 ±0.48 cells per milliliter of useable whole blood. 95% of samples were within the acceptable range for fresh cell yield of 0.8–3.2×106 cells/ml of usable blood. Prior to full implementation of the HVTN PBMC Quality Management Program, the 2007 EQC evaluations from 10 international sites showed a mean day 2 thawed viability of 83.1% and recovery of 67.5%. Since then, four year cumulative data covering 3338 specimens used in immunologic assays shows that 99.88% had acceptable viabilities (>66%) for use in cellular assays (mean, 91.46% ±4.5%), and 96.2% had acceptable recoveries (50%–130%) with a mean of recovery of 85.8% ±19.12% of the originally cryopreserved cells. EQC testing revealed that since August 2009, failed recoveries dropped from 4.1% to 1.6% and failed viabilities dropped from 1.0% to 0.3%. The HVTN PBMC quality program provides for laboratory assessment, training and tools for identifying problems, implementing corrective action and monitoring for improvements. These data support the benefits of implementing a comprehensive, web-based PBMC quality program for large clinical trials networks. PMID:24709391

The use of health status questionnaires in the management of chronic obstructive pulmonary disease patients in clinical practice.

PubMed

van der Molen, Thys; Diamant, Zuzana; Kocks, Jan Willem H; Tsiligianni, Ioanna G

2014-08-01

Current guidelines recommend chronic obstructive pulmonary disease (COPD) management based on symptoms or health status assessment and lung function parameters. However, COPD is a complex and heterogeneous disease that needs an individualized approach for proper disease management. A structured consultation including health status assessment tools, such as the Clinical COPD Questionnaire and the COPD Assessment Test should improve the quality of the consultation, providing more information than symptoms alone. Both questionnaires are designed to provide the clinician information enabling a more personalized disease approach and subsequent management. Although both Clinical COPD Questionnaire and COPD Assessment Test have good discriminate properties, their use as prognostic markers of severity and their ability to modify disease management has not yet been fully established. New studies are needed to further determine their value on several disease outcomes.

Telecardiology application in jordan: its impact on diagnosis and disease management, patients' quality of life, and time- and cost-savings.

PubMed

Khader, Yousef Saleh; Jarrah, Mohamad Ismail; Al-Shudifat, Abde-Ellah M; Shdaifat, Amjad; Aljanabi, Husham; Al-Fakeh, Shadwan Ismeil; Turk, Elias Emil; Zayed, Khaled Ali; Al Quran, Hanadi A; Ellauzi, Ziad Mohd; Al Tahan, Mohammad

2014-01-01

Objectives. To assess the impact of live interactive telecardiology on diagnosis and disease management, patients' quality of life, and time- and cost-savings. Methods. All consecutive patients who attended or were referred to the teleclinics for suspected cardiac problems in two hospitals in remote areas of Jordan during the study period were included in the study. Patients were interviewed for relevant information and their quality of life was assessed during the first visit and 8 weeks after the last visit. Results. A total of 76 patients were included in this study. Final diagnosis and treatment plan were established as part of the telecardiology consultations in 71.1% and 77.3% of patients, respectively. Patients' travel was avoided for 38 (50.0%) who were managed locally. The majority of patients perceived that the visit to the telecardiology clinic results in less travel time (96.1%), less waiting time (98.1%), and lower cost (100.0%). Telecardiology consultations resulted in an improvement in the quality of life after two months of the first visit. Conclusions. Telecardiology care in remote areas of Jordan would improve the access to health care, help to reach proper diagnosis and establish the treatment plan, and improve the quality of life.

Pancreatic enzyme replacement therapy in patients with exocrine pancreatic insufficiency due to chronic pancreatitis: a 1-year disease management study on symptom control and quality of life.

PubMed

D'Haese, Jan G; Ceyhan, Güralp O; Demir, Ihsan Ekin; Layer, Peter; Uhl, Waldemar; Löhr, Matthias; Rychlik, Reinhard; Pirilis, Konstantinos; Zöllner, York; Gradl, Birgit; Foerster, Douglas; Möbius, Julia; Henniges, Friederike; Friess, Helmut

2014-08-01

Exocrine pancreatic insufficiency (EPI) is frequent in patients with chronic pancreatitis (CP). This 1-year, prospective, multicenter, observational, disease management study aimed to assess symptom improvement and quality of life in patients with CP with EPI who were receiving pancreatic enzyme replacement. Patients with CP and chronic EPI were either assigned to cohort 1 that consisted of patients already taking pancreatin (Kreon; Abbott Arzneimittel GmbH, Hannover, Germany) or cohort 2 that consisted of patients with newly diagnosed EPI without prior pancreatic enzyme treatment. Symptoms were documented, and quality of life was assessed using the gastrointestinal quality of life index (GIQLI) at baseline, 6 months, and 1 year. A total of 294 patients were evaluated (cohort 1, n = 206; cohort 2, n = 88). The proportion of patients experiencing gastrointestinal symptoms and recurrent pain after 1 year was significantly reduced in both cohorts (P < 0.001). The alleviation of symptoms was reflected in GIQLI score improvements at 1 year in both cohorts (P < 0.001), independent of CP severity and etiology. Improvements in GIQLI score were more pronounced in cohort 2 (P < 0.001). Pancreatin demonstrated symptom relief and improvement in quality of life in patients with CP-related EPI in this disease management study.

Telecardiology Application in Jordan: Its Impact on Diagnosis and Disease Management, Patients' Quality of Life, and Time- and Cost-Savings

PubMed Central

Khader, Yousef Saleh; Jarrah, Mohamad Ismail; Al-Shudifat, Abde-Ellah M.; Shdaifat, Amjad; Aljanabi, Husham; Al-Fakeh, Shadwan Ismeil; Turk, Elias Emil; Zayed, Khaled Ali; Al Quran, Hanadi A.; Ellauzi, Ziad Mohd; Al Tahan, Mohammad

2014-01-01

Objectives. To assess the impact of live interactive telecardiology on diagnosis and disease management, patients' quality of life, and time- and cost-savings. Methods. All consecutive patients who attended or were referred to the teleclinics for suspected cardiac problems in two hospitals in remote areas of Jordan during the study period were included in the study. Patients were interviewed for relevant information and their quality of life was assessed during the first visit and 8 weeks after the last visit. Results. A total of 76 patients were included in this study. Final diagnosis and treatment plan were established as part of the telecardiology consultations in 71.1% and 77.3% of patients, respectively. Patients' travel was avoided for 38 (50.0%) who were managed locally. The majority of patients perceived that the visit to the telecardiology clinic results in less travel time (96.1%), less waiting time (98.1%), and lower cost (100.0%). Telecardiology consultations resulted in an improvement in the quality of life after two months of the first visit. Conclusions. Telecardiology care in remote areas of Jordan would improve the access to health care, help to reach proper diagnosis and establish the treatment plan, and improve the quality of life. PMID:25400661

Data for Program Management: An Accuracy Assessment of Data Collected in Household Registers by Community Health Workers in Southern Kayonza, Rwanda.

PubMed

Mitsunaga, Tisha; Hedt-Gauthier, Bethany L; Ngizwenayo, Elias; Farmer, Didi Bertrand; Gaju, Erick; Drobac, Peter; Basinga, Paulin; Hirschhorn, Lisa; Rich, Michael L; Winch, Peter J; Ngabo, Fidele; Mugeni, Cathy

2015-08-01

Community health workers (CHWs) collect data for routine services, surveys and research in their communities. However, quality of these data is largely unknown. Utilizing poor quality data can result in inefficient resource use, misinformation about system gaps, and poor program management and effectiveness. This study aims to measure CHW data accuracy, defined as agreement between household registers compared to household member interview and client records in one district in Eastern province, Rwanda. We used cluster-lot quality assurance sampling to randomly sample six CHWs per cell and six households per CHW. We classified cells as having 'poor' or 'good' accuracy for household registers for five indicators, calculating point estimates of percent of households with accurate data by health center. We evaluated 204 CHW registers and 1,224 households for accuracy across 34 cells in southern Kayonza. Point estimates across health centers ranged from 79 to 100% for individual indicators and 61 to 72% for the composite indicator. Recording error appeared random for all but the widely under-reported number of women on modern family planning method. Overall, accuracy was largely 'good' across cells, with varying results by indicator. Program managers should identify optimum thresholds for 'good' data quality and interventions to reach them according to data use. Decreasing variability and improving quality will facilitate potential of these routinely-collected data to be more meaningful for community health program management. We encourage further studies assessing CHW data quality and the impact training, supervision and other strategies have on improving it.

[The legal awareness of medical workers in the system of medical care quality management].

PubMed

Khodakova, O V; Shil'nikova, N F

2012-01-01

The article presents the results of comprehensive study of the level of legal awareness of medical workers. The knowledge of physicians, paramedical personnel and health administrators concerning the rights of patients was assessed. The role of factor of legal awareness in the system of medical care quality management was analyzed. The effective system of measures of development of legal competence of medical personnel was marked out.

Patient-centeredness and quality management in Dutch diabetes care organizations after a 1-year intervention.

PubMed

Campmans-Kuijpers, Marjo Je; Lemmens, Lidwien C; Baan, Caroline A; Rutten, Guy Ehm

2016-01-01

More focus on patient-centeredness in care for patients with type 2 diabetes requests increasing attention to diabetes quality management processes on patient-centeredness by managers in primary care groups and outpatient clinics. Although patient-centered care is ultimately determined by the quality of interactions between patients and clinicians at the practice level, it should be facilitated at organizational level too. This nationwide study aimed to assess the state of diabetes quality management on patient-centeredness at organizational level and its possibilities to improve after a tailored intervention. This before-after study compares the quality management on patient-centeredness within Dutch diabetes care groups and outpatient clinics before and after a 1-year stepwise intervention. At baseline, managers of 51 diabetes primary care groups and 28 outpatient diabetes clinics completed a questionnaire about the organization's quality management program. Patient-centeredness (0%-100%) was operationalized in six subdomains: facilitating self-management support, individualized care plan support, patients' access to medical files, patient education policy, safeguarding patients' interests, and formal patient involvement. The intervention consisted of feedback and benchmark and if requested a telephone call and/or a consultancy visit. After 1 year, the managers completed the questionnaire again. The 1-year changes were examined by dependent (non) parametric tests. Care groups improved significantly on patient-centeredness (from 47.1% to 53.3%; P =0.002), and on its subdomains "access to medical files" (from 42.0% to 49.4%), and "safeguarding patients' interests" (from 58.1% to 66.2%). Outpatient clinics, which scored higher at baseline (66.7%) than care groups, did not improve on patient-centeredness (65.6%: P =0.54) or its subdomains. "Formal patient involvement" remained low in both care groups (23.2%) and outpatient clinics (33.9%). After a simple intervention, care groups significantly improved their quality management on patient-centeredness, but outpatient clinics did not. Interventions to improve quality management on patient-centeredness in diabetes care organizations should differ between primary and secondary care.

Integrated watershed planning across jurisdictional boundaries

NASA Astrophysics Data System (ADS)

Watts, A. W.; Roseen, R.; Stacey, P.; Bourdeau, R.

2014-12-01

We will present the foundation for an Coastal Watershed Integrated Plan for three communities in southern New Hampshire. Small communities are often challenged by complex regulatory requirements and limited resources, but are wary of perceived risks in engaging in collaborative projects with other communities. Potential concerns include loss of control, lack of resources to engage in collaboration, technical complexity, and unclear benefits. This project explores a multi-town subwatershed application of integrated planning across jurisdictional boundaries that addresses some of today's highest priority water quality issues: wastewater treatment plant upgrades for nutrient removal; green infrastructure stormwater management for developing and re-developing areas; and regional monitoring of ecosystem indicators in support of adaptive management to achieve nutrient reduction and other water quality goals in local and downstream waters. The project outcome is a collaboratively-developed inter-municipal integrated plan, and a monitoring framework to support cross jurisdictional planning and assess attainment of water quality management goals. This research project has several primary components: 1) assessment of initial conditions, including both the pollutant load inputs and the political, economic and regulatory status within each community, 2) a pollutant load model for point and non-point sources, 3) multi-criteria evaluation of load reduction alternatives 4) a watershed management plan optimized for each community, and for Subwatersheds combining multiple communities. The final plan will quantify the financial and other benefits/drawbacks to each community for both inter municipal and individual pollution control approaches. We will discuss both the technical and collaborative aspects of the work, with lessons learned regarding science to action, incorporation of social, economic and water quality assessment parameters, and stakeholder/researcher interaction.

Leadership and globalization: research in health management education.

PubMed

West, Daniel J; Ramirez, Bernardo; Filerman, Gary

2012-01-01

The impact of globalization on graduate health care management education is evident, yet challenging to quantify. The Commission on Healthcare Management Education (CAHME) recently authorized two research studies to gather specific information and answer important questions about accredited graduate programs in the USA and Canada. Two surveys provided the most comprehensive data impacting international health management education efforts by 70 programs. An inventory was made of 22 countries; information was compiled on 21 accrediting or quality improvement organizations. Observations on leadership and the demand for qualified health care professionals is discussed in terms of accreditation, certification, competency models, outcome assessment, improving quality, and the impact of globalization on higher education.

Comprehensive Auditing in Nuclear Medicine Through the International Atomic Energy Agency Quality Management Audits in Nuclear Medicine (QUANUM) Program. Part 1: the QUANUM Program and Methodology.

PubMed

Dondi, Maurizio; Torres, Leonel; Marengo, Mario; Massardo, Teresa; Mishani, Eyal; Van Zyl Ellmann, Annare; Solanki, Kishor; Bischof Delaloye, Angelika; Lobato, Enrique Estrada; Miller, Rodolfo Nunez; Paez, Diana; Pascual, Thomas

2017-11-01

An effective management system that integrates quality management is essential for a modern nuclear medicine practice. The Nuclear Medicine and Diagnostic Imaging Section of the International Atomic Energy Agency (IAEA) has the mission of supporting nuclear medicine practice in low- and middle-income countries and of helping them introduce it in their health-care system, when not yet present. The experience gathered over several years has shown diversified levels of development and varying degrees of quality of practice, among others because of limited professional networking and limited or no opportunities for exchange of experiences. Those findings triggered the development of a program named Quality Management Audits in Nuclear Medicine (QUANUM), aimed at improving the standards of NM practice in low- and middle-income countries to internationally accepted standards through the introduction of a culture of quality management and systematic auditing programs. QUANUM takes into account the diversity of nuclear medicine services around the world and multidisciplinary contributions to the practice. Those contributions include clinical, technical, radiopharmaceutical, and medical physics procedures. Aspects of radiation safety and patient protection are also integral to the process. Such an approach ensures consistency in providing safe services of superior quality to patients. The level of conformance is assessed using standards based on publications of the IAEA and the International Commission on Radiological Protection, and guidelines from scientific societies such as Society of Nuclear Medicine and Molecular Imaging (SNMMI) and European Association of Nuclear Medicine (EANM). Following QUANUM guidelines and by means of a specific assessment tool developed by the IAEA, auditors, both internal and external, will be able to evaluate the level of conformance. Nonconformances will then be prioritized and recommendations will be provided during an exit briefing. The same tool could then be applied to assess any improvement after corrective actions are taken. This is the first comprehensive audit program in nuclear medicine that helps evaluate managerial aspects, safety of patients and workers, clinical practice, and radiopharmacy, and, above all, keeps them under control all together, with the intention of continuous improvement. Copyright © 2017. Published by Elsevier Inc.

Asthma Prevalence, Management, and Education in New York State Elementary Schools: A Survey of School Nurses

ERIC Educational Resources Information Center

Kielb, Christine; Lin, Shao; Hwang, Syni-an

2007-01-01

A survey of school nurses was conducted in New York State elementary schools to assess asthma and asthma management in students. The survey contained questions about asthma morbidity, management and education, obstacles to management, and school indoor air quality. The reported prevalence of asthma among students was 8.5%. Of the students with…

Informational system as an instrument for assessing the performance of the quality management system

NASA Astrophysics Data System (ADS)

Rohan, R.; Roşu, M. M.

2017-08-01

At present there is used a significant number of techniques and methods for diagnosis and management analysis which support the decision-making process. All these methods facilitate reaching the objectives for improving the results through efficiency, quality and customer satisfaction. By developing a methodology for analysing the problems identified in the macro-productive companies there can be brought outstanding benefits to the management and there are offered new perspectives on the critical influencing factors within a system. Through this paper we present an effective management strategy, applicable to an organization with productive profile in order to design an informational system aimed to manage one of its most important and complex systems, namely the coordination of the quality management system. The informational organisation of the quality management system on management principles, ensures an optimization of the informational energy consumption, allowing the management to deal with the following: to ascertain the current situation; to seize the opportunities, but also the potential risks afferent to the organisation policy; to observe the strengths and weaknesses; to take appropriate decisions and then to control the effects obtained. In this way, the decisional factors are able to better understand the available opportunities and to base more efficiently the process of choosing the alternatives.

12 CFR 8.2 - Semiannual assessment.

Code of Federal Regulations, 2010 CFR

2010-01-01

... system (which rates risk management, operational controls, compliance, and asset quality) at its most... follows: If the bank's total assets (consolidated domestic and foreign subsidiaries) are: Over— But not.... The excess is assessed at the marginal rate shown in Column D. (3) The total semiannual assessment is...

Managing water quality under drought conditions in the Llobregat River Basin.

PubMed

Momblanch, Andrea; Paredes-Arquiola, Javier; Munné, Antoni; Manzano, Andreu; Arnau, Javier; Andreu, Joaquín

2015-01-15

The primary effects of droughts on river basins include both depleted quantity and quality of the available water resources, which can render water resources useless for human needs and simultaneously damage the environment. Isolated water quality analyses limit the action measures that can be proposed. Thus, an integrated evaluation of water management and quality is warranted. In this study, a methodology consisting of two coordinated models is used to combine aspects of water resource allocation and water quality assessment. Water management addresses water allocation issues by considering the storage, transport and consumption elements. Moreover, the water quality model generates time series of concentrations for several pollutants according to the water quality of the runoff and the demand discharges. These two modules are part of the AQUATOOL decision support system shell for water resource management. This tool facilitates the analysis of the effects of water management and quality alternatives and scenarios on the relevant variables in a river basin. This paper illustrates the development of an integrated model for the Llobregat River Basin. The analysis examines the drought from 2004 to 2008, which is an example of a period when the water system was quantitative and qualitatively stressed. The performed simulations encompass a wide variety of water management and water quality measures; the results provide data for making informed decisions. Moreover, the results demonstrated the importance of combining these measures depending on the evolution of a drought event and the state of the water resources system. Copyright © 2014 Elsevier B.V. All rights reserved.

American pain society recommendations for improving the quality of acute and cancer pain management: American Pain Society Quality of Care Task Force.

PubMed

Gordon, Debra B; Dahl, June L; Miaskowski, Christine; McCarberg, Bill; Todd, Knox H; Paice, Judith A; Lipman, Arthur G; Bookbinder, Marilyn; Sanders, Steve H; Turk, Dennis C; Carr, Daniel B

2005-07-25

The American Pain Society (APS) set out to revise and expand its 1995 Quality Improvement Guidelines for the Treatment of Acute Pain and Cancer Pain and to facilitate improvements in the quality of pain management in all care settings. Eleven multidisciplinary members of the APS with expertise in quality improvement or measurement participated in the update. Five experts from organizations that focus on health care quality reviewed the final recommendations. MEDLINE and Cumulative Index to Nursing and Allied Health Literature databases were searched (1994-2004) to identify articles on pain quality measurement and quality improvement published after the development of the 1995 guidelines. The APS task force revised and expanded recommendations on the basis of the systematic review of published studies. The more than 3000 members of the APS were invited to provide input, and the 5 experts provided additional comments. The task force synthesized reviewers' comments into the final set of recommendations. The recommendations specify that all care settings formulate structured, multilevel systems approaches (sensitive to the type of pain, population served, and setting of care) that ensure prompt recognition and treatment of pain, involvement of patients and families in the pain management plan, improved treatment patterns, regular reassessment and adjustment of the pain management plan as needed, and measurement of processes and outcomes of pain management. Efforts to improve the quality of pain management must move beyond assessment and communication of pain to implementation and evaluation of improvements in pain treatment that are timely, safe, evidence based, and multimodal.

Assessing public concern for landscape quality: a potential model to identify visual thresholds

Treesearch

Arthur W. Magill

1990-01-01

Considerable public criticism and sometimes legal obstructions have been directed toward landscape management in relation to the extraction of natural resources. Many managers do not understand public concerns for visually attractive resources. Managers need to know when landscape alterations, like clearcuts, attract public attention and become visually objectionable....

Fostering evidence-based quality improvement for patient-centered medical homes: Initiating local quality councils to transform primary care.

PubMed

Stockdale, Susan E; Zuchowski, Jessica; Rubenstein, Lisa V; Sapir, Negar; Yano, Elizabeth M; Altman, Lisa; Fickel, Jacqueline J; McDougall, Skye; Dresselhaus, Timothy; Hamilton, Alison B

Although the patient-centered medical home endorses quality improvement principles, methods for supporting ongoing, systematic primary care quality improvement have not been evaluated. We introduced primary care quality councils at six Veterans Health Administration sites as an organizational intervention with three key design elements: (a) fostering interdisciplinary quality improvement leadership, (b) establishing a structured quality improvement process, and (c) facilitating organizationally aligned frontline quality improvement innovation. Our evaluation objectives were to (a) assess design element implementation, (b) describe implementation barriers and facilitators, and (c) assess successful quality improvement project completion and spread. We analyzed administrative records and conducted interviews with 85 organizational leaders. We developed and applied criteria for assessing design element implementation using hybrid deductive/inductive analytic techniques. All quality councils implemented interdisciplinary leadership and a structured quality improvement process, and all but one completed at least one quality improvement project and a toolkit for spreading improvements. Quality councils were perceived as most effective when service line leaders had well-functioning interdisciplinary communication. Matching positions within leadership hierarchies with appropriate supportive roles facilitated frontline quality improvement efforts. Two key resources were (a) a dedicated internal facilitator with project management, data collection, and presentation skills and (b) support for preparing customized data reports for identifying and addressing practice level quality issues. Overall, quality councils successfully cultivated interdisciplinary, multilevel primary care quality improvement leadership with accountability mechanisms and generated frontline innovations suitable for spread. Practice level performance data and quality improvement project management support were critical. In order to successfully facilitate systematic, sustainable primary care quality improvement, regional and executive health care system leaders should engage interdisciplinary practice level leadership in a priority-setting process that encourages frontline innovation and establish local structures such as quality councils to coordinate quality improvement initiatives, ensure accountability, and promote spread of best practices.

Investigation of priorities in water quality management based on correlations and variations.

PubMed

Boyacıoğlu, Hülya; Gündogdu, Vildan; Boyacıoğlu, Hayal

2013-04-15

The development of water quality assessment strategies investigating spatial and temporal changes caused by natural and anthropogenic phenomena is an important tool in management practices. This paper used cluster analysis, water quality index method, sensitivity analysis and canonical correlation analysis to investigate priorities in pollution control activities. Data sets representing 22 surface water quality parameters were subject to analysis. Results revealed that organic pollution was serious threat for overall water quality in the region. Besides, oil and grease, lead and mercury were the critical variables violating the standard. In contrast to inorganic variables, organic and physical-inorganic chemical parameters were influenced by variations in physical conditions (discharge, temperature). This study showed that information produced based on the variations and correlations in water quality data sets can be helpful to investigate priorities in water management activities. Moreover statistical techniques and index methods are useful tools in data - information transformation process. Copyright © 2013 Elsevier Ltd. All rights reserved.

Factor selection for service quality evaluation: a hospital case study.

PubMed

Ameryoun, Ahmad; Najafi, Seyedvahid; Nejati-Zarnaqi, Bayram; Khalilifar, Seyed Omid; Ajam, Mahdi; Ansarimoghadam, Ahmad

2017-02-13

Purpose The purpose of this paper is to develop a systematic approach to predict service quality dimension's influence on service quality using a novel analysis based on data envelopment and SERVQUAL. Design/methodology/approach To assess hospital service quality in Tehran, expectation and perception of those who received the services were evaluated using SERVQUAL. The hospital service quality dimensions were found by exploratory factor analysis (EFA). To compare customer expectation and perception, perceived service quality index (PSQI) was measured using a new method based on common weights. A novel sensitivity approach was used to test the service quality factor's impact on the PSQI. Findings A new service quality dimension named "trust in services" was found using EFA, which is not an original SERVQUAL factor. The approach was applied to assess the hospital's service quality. Since the PSQI value was 0.76 it showed that improvements are needed to meet customer expectations. The results showed the factor order that affect PSQI. "Trust in services" has the strongest influence on PSQI followed by "tangibles," "assurance," "empathy," and "responsiveness," respectively. Practical implications This work gives managers insight into service quality by following a systematic method; i.e., measuring perceived service quality from the customer viewpoint and service factors' impact on customer perception. Originality/value The procedure helps managers to select the required service quality dimensions which need improvement and predict their effects on customer perception.

Diabetes quality management in Dutch care groups and outpatient clinics: a cross-sectional study

PubMed Central

2014-01-01

Background In recent years, most Dutch general practitioners started working under the umbrella of diabetes care groups, responsible for the organisation and coordination of diabetes care. The quality management of these new organisations receives growing interest, although its association with quality of diabetes care is yet unclear. The best way to measure quality management is unknown and it has not yet been studied at the level of outpatient clinics or care groups. We aimed to assess quality management of type 2 diabetes care in care groups and outpatient clinics. Results Quality management was measured with online questionnaires, containing six domains (see below). They were divided into 28 subdomains, with 59 (care groups) and 57 (outpatient clinics) questions respectively. The mean score of the domains reflects the overall score (0-100%) of an organisation. Two quality managers of all Dutch care groups and outpatient clinics were invited to fill out the questionnaire. Sixty care groups (response rate 61.9%) showed a mean score of 59.6% (CI 57.1-62.1%). The average score in 52 outpatient clinics (response rate 50.0%) was 61.9% (CI 57.5-66.8%). Mean scores on the six domains for care groups and outpatient clinics respectively were: ‘organisation of care’ 71.9% (CI 68.8-74.9%), 76.8% (CI 72.8-80.7%); ‘multidisciplinary teamwork’ 67.1% (CI 62.4-71.9%), 71.5% (CI 65.3-77.8%); ‘patient centeredness’ 46.7% (CI 42.6-50.7%), 62.5% (CI 57.7-67.2%); ‘performance management’ 63.3% (CI 61.2-65.3%), 50.9% (CI 44.2-57.5%); ‘quality improvement policy’ 52.6% (CI 49.2-56.1%), 50.9% (CI 44.6-57.3%); and ‘management strategies’ 56.0% (CI 51.4-60.7%), 59.0% (CI 52.8-65.2%). On subdomains, care groups scored highest on ‘care program’ (83.3%) and ‘measured outcomes’ (98.3%) and lowest on ‘patient safety’ (15.1%) and ‘patient involvement’ (17.7%). Outpatient clinics scored high on the presence of a ‘diabetic foot team’ (81.6%) and the support in ‘self-management’ (81.0%) and low on ‘patient involvement’ (26.8%) and ‘inspection of medical file’ (28.0%). Conclusions This nationwide assessment reveals that the level of quality management in diabetes care varies between several subdomains in both diabetes care groups and outpatient clinics. PMID:25099641

Case study of microarthropod communities to assess soil quality in different managed vineyards

NASA Astrophysics Data System (ADS)

Gagnarli, E.; Goggioli, D.; Tarchi, F.; Guidi, S.; Nannelli, R.; Vignozzi, N.; Valboa, G.; Lottero, M. R.; Corino, L.; Simoni, S.

2015-07-01

Land use influences the abundance and diversity of soil arthropods. The evaluation of the impact of different management strategies on soil quality is increasingly sought, and the determination of community structures of edaphic fauna can represent an efficient tool. In the area of Langhe (Piedmont, Italy), eight vineyards characterized for physical and chemical properties (soil texture, soil pH, total organic carbon, total nitrogen, calcium carbonate) were selected. We evaluated the effect of two types of crop management, organic and integrated pest management (IPM), on abundance and biodiversity of microarthropods living at the soil surface. Soil sampling was carried out in winter 2011 and spring 2012. All specimens were counted and determined up to the order level. The biodiversity analysis was performed using ecological indexes (taxa richness, dominance, Shannon-Wiener, Buzas and Gibson's evenness, Margalef, equitability, Berger-Parker), and the biological soil quality was assessed with the BSQ-ar index. The mesofauna abundance was affected by both the type of management and sampling time. On the whole, a higher abundance was in organic vineyards (N = 1981) than in IPM ones (N = 1062). The analysis performed by ecological indexes showed quite a high level of biodiversity in this environment, particularly in May 2012. Furthermore, the BSQ-ar values registered were similar to those obtained in preserved soils.

Quality of Information Assurance - Assessment, Management and Use (QIAAMU)

DTIC Science & Technology

2013-04-01

106 4.7.3.1 University authentication infrastructure ...Authentication infrastructure ..................................................................................... 107 Figure 49: Complementary...X X X X Architecture & Infrastructure Quality AIQ X X X X X X Deviation from Configuration (Services) SERV STAT X X X X X Deviation from

Northern Gulf of Mexico estuarine coloured dissolved organic matter derived from MODIS data

EPA Science Inventory

Coloured dissolved organic matter (CDOM) is relevant for water quality management and may become an important measure to complement future water quality assessment programmes. An approach to derive CDOM using the Moderate Resolution Imaging Spectroradiometer (MODIS) was developed...

Quality use of antipsychotic medicines inresidential aged care facilities in New Zealand.

PubMed

Ndukwe, Henry C; Nishtala, Prasad S; Wang, Ting; Tordoff, June M

2016-12-01

INTRODUCTION Antipsychotic medicines are used regularly or when required in residential aged care facilities to treat symptoms of dementia, but have been associated with several adverse effects. AIM The aim of this study was to examine 'quality use' of antipsychotic medicines in residential aged care facilities in New Zealand, by surveying nurse managers. METHODS A cross-sectional survey was mailed to 318 nurse managers working in a nationally representative sample of aged care facilities. A purpose-developed, pre-tested, 22-item structured questionnaire was used to explore practice related to the quality use of antipsychotic medicines. RESULTS Overall, 31.4% of nurse managers responded to the survey. They mostly (88%) had ≥ 1 year's relevant work experience and 83% of facilities provided care for those within the range of 21 to 100 residents. Respondents reported that staff education on dementia management occurred early in employment. Two-thirds of participants reported non-pharmacological interventions were commonly used for managing challenging behaviours, while less than half (45%) cited administering antipsychotic medicine. Respondents reported 'managing behavioural symptoms' (81%) as one of the main indications for antipsychotic use. Frequently identified adverse effects of antipsychotic medicines were drowsiness or sedation (64%) and falls (61%). Over 90% reported general practitioners reviewed antipsychotic use with respect to residents' target behaviour 3-monthly, and two-thirds used an assessment tool to appraise residents' behaviour. DISCUSSION Staff education on dementia management soon after employment and resident 3-monthly antipsychotic medicine reviews were positive findings. However, a wider use of behavioural assessment tools might improve the care of residents with dementia and the quality use of antipsychotic medicines.

Semi-annual report of the Department of Energy, Office of Environmental Management, Quality Assessment Program

DOE Office of Scientific and Technical Information (OSTI.GOV)

Greenlaw, P.D.; Minick, S.K.

This Quality Assessment Program (QAP) is designed to test the quality of the environmental measurements being reported to the Department of Energy by its contractors. Since 1976, real or synthetic environmental samples that have been prepared and thoroughly analyzed at the Environmental Measurements Laboratory (EML) have been distributed at first quarterly and then semi-annually to these contractors. Their results, which are returned to EML within 90 days, are compiled with EML`s results and are reported back to the participating contractors 30 days later. This report presents the results from the analysis of the 48th set of environmental quality assessment samplesmore » (QAP XLVIII) that were received on or before June 1, 1998.« less

The Usefulness of Quality Assurance for University Management and Academic Staff: A Case Study of Finland and Iceland

ERIC Educational Resources Information Center

Haapakorpi, Arja; Geirsdóttir, Guðrún; Jóhannsdóttir, Gyða

2013-01-01

With quality assurance related to the Bologna goals, universities are required to fulfil internationally accepted standardized criteria of quality. This tends to reinforce control in assessment. However, control-oriented evaluations seem to lack meaning for academic staff. The article explored the possibilities and space for improvement-oriented…

Assessing and Managing Quality of Information Assurance

DTIC Science & Technology

2010-11-01

such as firewalls, antivirus scanning tools and mechanisms for user authentication and authorization. Advanced mission-critical systems often...imply increased risk to DoD information systems. The Process and Organizational Maturity (POM) class focuses on the maturity of the software and...include architectural quality. Common Weakness Enumeration (CWE) is a recent example that highlights the connection between software quality and

Supporting Staff to Identify Residents in Pain: A Controlled Pretest-Posttest Study in Residential Aged Care.

PubMed

Douglas, Clint; Haydon, Deborah; Wollin, Judy

2016-02-01

Practical strategies are needed to improve pain awareness among aged care staff and promote a systematic approach to pain identification using evidence-based tools. The purpose of this study was to evaluate a pain identification tool for use by nursing and nonprofessional staff in residential aged care facilities (RACFs). A controlled pretest-posttest intervention design was conducted in two RACFs in Brisbane, Australia. Completed surveys were returned by 216 staff and 74 residents at baseline and 218 staff and 94 residents at 3-month follow-up. Chart audits were conducted on 308 residents at baseline and 328 at follow-up. Groups were compared on: (1) staff knowledge and attitudes regarding pain, perceived confidence and skills for pain assessment, and perceived quality of pain management; (2) frequency of pain assessments and use of pain interventions; and (3) residents' perceptions of the quality of pain management. Both groups had high knowledge scores and reported high levels of confidence, skills, and perceived quality of pain management at baseline and follow-up. The intervention group showed significant improvement in routine pain assessment and use of nonpharmacological pain interventions. However, due to unexpected changes in control group conditions, both groups increased episodic pain assessment. Overall, staff believed the intervention was clinically useful and fostered a team approach to pain assessment. We found the introduction of pain identification resources with implementation strategies to support frontline staff was partially effective in improving staff and resident outcomes. Nonetheless, our findings confirm the need for change and importance of translational pain research in RACFs. Copyright © 2016 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

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

PubMed

Cramm, Jane Murray; Nieboer, Anna Petra

2014-01-01

Empirical evidence on sustainability of programs that improve the quality of care delivery over time is lacking. Therefore, this study aims to identify the predictive role of short and long term improvements in quality of chronic care delivery on program sustainability. In this longitudinal study, professionals [2010 (T0): n=218, 55% response rate; 2011 (T1): n=300, 68% response rate; 2012 (T2): n=265, 63% response rate] from 22 Dutch disease-management programs completed surveys assessing quality of care and program sustainability. Our study findings indicated that quality of chronic care delivery improved significantly in the first 2 years after implementation of the disease-management programs. At T1, overall quality, self-management support, delivery system design, and integration of chronic care components, as well as health care delivery and clinical information systems and decision support, had improved. At T2, overall quality again improved significantly, as did community linkages, delivery system design, clinical information systems, decision support and integration of chronic care components, and self-management support. Multilevel regression analysis revealed that quality of chronic care delivery at T0 (p<0.001) and quality changes in the first (p<0.001) and second (p<0.01) years predicted program sustainability. In conclusion this study showed that disease-management programs based on the chronic care model improved the quality of chronic care delivery over time and that short and long term changes in the quality of chronic care delivery predicted the sustainability of the projects. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

Quality transitivity and traceability system of herbal medicine products based on quality markers.

PubMed

Liu, Changxiao; Guo, De-An; Liu, Liang

2018-05-15

Due to a variety of factors to affect the herb quality, the existing quality management model is unable to evaluate the process control. The development of the concept of "quality marker" (Q-marker) lays basis for establishing an independent process quality control system for herbal products. To ensure the highest degree of safety, effectiveness and quality process control of herbal products, it is aimed to establish a quality transitivity and traceability system of quality and process control from raw materials to finished herbal products. Based on the key issues and challenges of quality assessment, the current status of quality and process controls from raw materials to herbal medicinal products listed in Pharmacopoeia were analyzed and the research models including discovery and identification of Q-markers, analysis and quality management of risk evaluation were designed. Authors introduced a few new technologies and methodologies, such as DNA barcoding, chromatographic technologies, fingerprint analysis, chemical markers, bio-responses, risk management and solution for quality process control. The quality and process control models for herbal medicinal products were proposed and the transitivity and traceability system from raw materials to the finished products was constructed to improve the herbal quality from the entire supply and production chain. The transitivity and traceability system has been established based on quality markers, especially on how to control the production process under Good Engineering Practices, as well as to implement the risk management for quality and process control in herbal medicine production. Copyright © 2018 Elsevier GmbH. All rights reserved.

WE-B-BRC-01: Current Methodologies in Risk Assessment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rath, F.

Prospective quality management techniques, long used by engineering and industry, have become a growing aspect of efforts to improve quality management and safety in healthcare. These techniques are of particular interest to medical physics as scope and complexity of clinical practice continue to grow, thus making the prescriptive methods we have used harder to apply and potentially less effective for our interconnected and highly complex healthcare enterprise, especially in imaging and radiation oncology. An essential part of most prospective methods is the need to assess the various risks associated with problems, failures, errors, and design flaws in our systems. Wemore » therefore begin with an overview of risk assessment methodologies used in healthcare and industry and discuss their strengths and weaknesses. The rationale for use of process mapping, failure modes and effects analysis (FMEA) and fault tree analysis (FTA) by TG-100 will be described, as well as suggestions for the way forward. This is followed by discussion of radiation oncology specific risk assessment strategies and issues, including the TG-100 effort to evaluate IMRT and other ways to think about risk in the context of radiotherapy. Incident learning systems, local as well as the ASTRO/AAPM ROILS system, can also be useful in the risk assessment process. Finally, risk in the context of medical imaging will be discussed. Radiation (and other) safety considerations, as well as lack of quality and certainty all contribute to the potential risks associated with suboptimal imaging. The goal of this session is to summarize a wide variety of risk analysis methods and issues to give the medical physicist access to tools which can better define risks (and their importance) which we work to mitigate with both prescriptive and prospective risk-based quality management methods. Learning Objectives: Description of risk assessment methodologies used in healthcare and industry Discussion of radiation oncology-specific risk assessment strategies and issues Evaluation of risk in the context of medical imaging and image quality E. Samei: Research grants from Siemens and GE.« less

WE-B-BRC-00: Concepts in Risk-Based Assessment

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

Prospective quality management techniques, long used by engineering and industry, have become a growing aspect of efforts to improve quality management and safety in healthcare. These techniques are of particular interest to medical physics as scope and complexity of clinical practice continue to grow, thus making the prescriptive methods we have used harder to apply and potentially less effective for our interconnected and highly complex healthcare enterprise, especially in imaging and radiation oncology. An essential part of most prospective methods is the need to assess the various risks associated with problems, failures, errors, and design flaws in our systems. Wemore » therefore begin with an overview of risk assessment methodologies used in healthcare and industry and discuss their strengths and weaknesses. The rationale for use of process mapping, failure modes and effects analysis (FMEA) and fault tree analysis (FTA) by TG-100 will be described, as well as suggestions for the way forward. This is followed by discussion of radiation oncology specific risk assessment strategies and issues, including the TG-100 effort to evaluate IMRT and other ways to think about risk in the context of radiotherapy. Incident learning systems, local as well as the ASTRO/AAPM ROILS system, can also be useful in the risk assessment process. Finally, risk in the context of medical imaging will be discussed. Radiation (and other) safety considerations, as well as lack of quality and certainty all contribute to the potential risks associated with suboptimal imaging. The goal of this session is to summarize a wide variety of risk analysis methods and issues to give the medical physicist access to tools which can better define risks (and their importance) which we work to mitigate with both prescriptive and prospective risk-based quality management methods. Learning Objectives: Description of risk assessment methodologies used in healthcare and industry Discussion of radiation oncology-specific risk assessment strategies and issues Evaluation of risk in the context of medical imaging and image quality E. Samei: Research grants from Siemens and GE.« less

Water quality in the Albemarle-Pamlico drainage basin, North Carolina and Virginia, 1992-95

USGS Publications Warehouse

Spruill, Timothy B.; Harned, Douglas A.; Ruhl, Peter M.; Eimers, Jo Leslie; McMahon, Gerard; Smith, Kelly E.; Galeone, David R.; Woodside, Michael D.

1998-01-01

The NAWQA Program is assessing the water-quality conditions of more than 50 of the Nation's largest river basins and aquifers, known as Study Units. Collectively, these Study Units cover about one-half of the United States and include sources of drinking water used by about 70 percent of the U.S. population. Comprehensive assessments of about one-third of the Study Units are ongoing at a given time. Each Study Unit is scheduled to be revisited every decade to evaluate changes in water-quality conditions. NAWQA assessments rely heavily on existing information collected by the USGS and many other agencies as well as the use of nationally consistent study designs and methods of sampling and analysis. Such consistency simultaneously provides information about the status and trends in water-quality conditions in a particular stream or aquifer and, more importantly, provides the basis to make comparisons among watersheds and improve our understanding of the factors that affect water-quality conditions regionally and nationally. This report is intended to summarize major findings that emerged between 1992 and 1995 from the water-quality assessment of the Albemarle-Pamlico Drainage Study Unit and to relate these findings to water-quality issues of regional and national concern. The information is primarily intended for those who are involved in water-resource management. Indeed, this report addresses many of the concerns raised by regulators, water-utility managers, industry representatives, and other scientists, engineers, public officials, and members of stakeholder groups who provided advice and input to the USGS during this NAWQA Study-Unit investigation. Yet, the information contained here may also interest those who simply wish to know more about the quality of water in the rivers and aquifers in the area where they live.

Surface-water-quality assessment of the Yakima River basin, Washington; project description

USGS Publications Warehouse

McKenzie, S.W.; Rinella, J.F.

1987-01-01

In April 1986, the U.S. Geological Survey began the National Water Quality Assessment program to: (1) provide a nationally consistent description of the current status of water quality, (2) define water quality trends that have occurred over recent decades, and (3) relate past and present water quality conditions to relevant natural features, the history of land and water use, and land management and waste management practices. At present (1987), The National Water Quality Assessment program is in a pilot studies phase, in which assessment concepts and approaches are being tested and modified to prepare for possible full implementation of the program. Seven pilot projects (four surface water projects and three groundwater projects) have been started. The Yakima River basin in Washington is one of the pilot surface water project areas. The Yakima River basin drains in area of 6,155 sq mi and contains about 1,900 river mi of perennial streams. Major land use activities include growing and harvesting timber, dryland pasture grazing, intense farming and irrigated agriculture, and urbanization. Water quality issues that result from these land uses include potentially large concentrations of suspended sediment, bacteria, nutrients, pesticides, and trace elements that may affect water used for human consumption, fish propagation and passage, contact recreation, livestock watering, and irrigation. Data will be collected in a nine year cycle. The first three years of the cycle will be a period of concentrated data acquisition and interpretation. For the next six years, sample collection will be done at a much lower level of intensity to document the occurrence of any gross changes in water quality. This nine year cycle would then be repeated. Three types of sampling activities will be used for data acquisition: fixed location station sampling, synoptic sampling, and intensive reach studies. (Lantz-PTT)

Using National Ambient Air Quality Standards for fine particulate matter to assess regional wildland fire smoke and air quality management.

PubMed

Schweizer, Don; Cisneros, Ricardo; Traina, Samuel; Ghezzehei, Teamrat A; Shaw, Glenn

2017-10-01

Wildland fire is an important ecological process in the California Sierra Nevada. Personal accounts from pre-20th century describe a much smokier environment than present day. The policy of suppression beginning in the early 20th century and climate change are contributing to increased megafires. We use a single particulate monitoring site at the wildland urban interface to explore impacts from prescribed, managed, and full suppression wildland fires from 2006 to 2015 producing a contextual assessment of smoke impacts over time at the landscape level. Prescribed fire had little effect on local fine particulate matter (PM 2.5 ) air quality with readings typical of similar non-fire times; hourly and daily good to moderate Air Quality Index (AQI) for PM 2.5 , maximum hourly concentrations 21-103 μg m -3 , and mean concentrations between 7.7 and 13.2 μg m -3 . Hourly and daily AQI was typically good or moderate during managed fires with 3 h and one day reaching unhealthy while the site remained below National Ambient Air Quality Standards (NAAQS), with maximum hourly concentrations 27-244 μg m -3 , and mean concentrations 6.7-11.7 μg m -3 . The large high intensity fire in this area created the highest short term impacts (AQI unhealthy for 4 h and very unhealthy for 1 h), 11 unhealthy for sensitive days, and produced the only annual value (43.9 μg m -3 ) over the NAAQS 98th percentile for PM 2.5 (35 μg m -3 ). Pinehurst remained below the federal standards for PM 2.5 when wildland fire in the local area was managed to 7800 ha (8-22% of the historic burn area). Considering air quality impacts from smoke using the NAAQS at a landscape level over time can give land and air managers a metric for broader evaluation of smoke impacts particularly when assessing ecologically beneficial fire. Allowing managers to control the amount and timing of individual wildland fire emissions can help lessen large smoke impacts to public health from a megafire. Published by Elsevier Ltd.

Economic value evaluation in disease management programs.

PubMed

Magnezi, Racheli; Reicher, Sima; Shani, Mordechai

2008-05-01

Chronic disease management has been a rapidly growing entity in the 21st century as a strategy for managing chronic illnesses in large populations. However, experience has shown that disease management programs have not been able to demonstrate their financial value. The objectives of disease management programs are to create quality benchmarks, such as principles and guidelines, and to establish a uniform set of metrics and a standardized methodology for evaluating them. In order to illuminate the essence of disease management and its components, as well as the complexity and the problematic nature of performing economic calculations of their profitability and value, we collected data from several reports that dealt with the economic intervention of disease management programs. The disease management economic evaluation is composed of a series of steps, including the following major categories: data/information technology, information generation, assessment/recommendations, actionable customer plans, and program assessment/reassessment. We demonstrate the elements necessary for economic analysis. Disease management is one of the most innovative tools in the managed care environment and is still in the process of being defined. Therefore, objectives should include the creation of quality measures, such as principles and guidelines, and the establishment of a uniform set of metrics and a standardized methodology for evaluating them.

Assessment of data quality and reporting systems for underserved populations: the case of integrated community case management programs in Nigeria.

PubMed

Nyangara, Florence M; Hai, Tajrina; Zalisk, Kirsten; Ozor, Lynda; Ufere, Joy; Isiguzo, Chinwoke; Abubakar, Ibrahim Ndaliman

2018-05-01

Decision makers are searching for reliable data and best practices to support the implementation and scale-up of the integrated community case management (iCCM) programs in underserved areas to reduce under-five mortality in low-income countries. This study assesses data quality and reporting systems of the World Health Organization supported Rapid Access Expansion program implementing iCCM in Abia and Niger States, Nigeria. This cross-sectional study used data from 16 primary health facilities in both states. Data were collected through review of registers and monthly summary reports of 140 community-oriented resource persons (CORPs), assessments of the five dimensions of the data reporting systems and 46 key informant interviews with stakeholders. Data quality was assessed by availability, completeness and consistency. Each component of the reporting system was assessed on a 3-point scale (weak, satisfactory and strong). Results show that both the structure, functions and capabilities, as well as data collection and reporting tools dimensions of the reporting system were strong, scoring (2.80, 2.73) for Abia and (2.88, 2.75) for Niger, respectively. Data management processes and links with national reporting system components scored low 2 s, indicating fair strength. Data availability, completeness and consistency were found to be good, an indication of adequate training and supervision of CORPs and community health extension workers. Indicator definitions and reporting guidelines were the weakest dimension of the system due to lack of data reporting guidelines in both states. In conclusion, the results indicate satisfactory data reporting systems and good quality data during early implementation of iCCM programs in the two states. Hence, countries planning to adopt and implement iCCM programs should first develop structures, establish national standardized tools for collecting and reporting data, provide for adequate training and supervision of community health workers and develop reporting guidelines for all reporting levels to ensure data quality.

Is the introduction of an accreditation program likely to generate organization-wide quality, change and learning?

PubMed

Lanteigne, Gilles; Bouchard, Chantal

2016-07-01

This research assesses whether integration of Accreditation Canada's program brings about change and organizational learning. Two health organizations, the Health Authority of Anguilla and the Ca' Foncella Opetale di Treviso, are studied on three levels: (1) members; (2) accreditation teams; and (3) organization. The methods used to collect data consisted of individual questionnaires administered to team members, semi-formal interviews with team leaders and quality coordinators, a documentation review and periodic assessments of compliance with the standards. The findings indicate that the organizations made strategic, organizational and relational changes. They improved their systems and management practices as well as their internal and external communications. There was also useful learning by individuals, teams and the organizations. Individual learning involved quality practice, client-focused approach, risk management, ethics, participatory management and assessment of services. The "self-assessment" and "make improvements and follow up on recommendations" stages of the accreditation cycle contributed the most to change and organizational learning. The interdisciplinary accreditation teams were the preferred vehicle for achieving these changes and this learning. The Health Authority of Anguilla and Ca' Foncella Opetale di Treviso have gradually improved their level of compliance with the standards in all quality dimensions. However, improvement in the overall compliance level was below the program's minimum requirements to obtain accreditation status without major restrictions. The scope of the changes and learning achieved raises the issue of the capacity of organizations to formalize this new knowledge throughout the organization. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Use of sediment quality guidelines and related tools for the asssessment of contaminated sediments: Executive summary sooklet of a SETAC Pellston Workshop

USGS Publications Warehouse

Wenning, R. J.; Ingersoll, Christopher G.

2002-01-01

This publication summarizes the results of a Pellston Workshop sponsored by the Society of Environmental Toxicology and Chemistry (SETAC), held 17-22 August 2002 in Fairmont, Montana, USA. The full technical proceedings of the workshop will be published separately by SET AC in 2003. Previous SETAC workshops have focused on sediment ecological risk assessment (ERA) (Dickson et al. 1987; Ingersoll et al. 1997) and porewater toxicity testing (Carr and Nipper 2003). Another recent workshop addressed the application of weight-of-evidence (WOE) methods in ERA (Burton et al. 2002). These previous workshops focused on how, when, and why ERAs are needed in sediment assessments. However, more focused discussion among scientists, environmental regulators, and environmental managers is now needed to build on this previous work. Specifically, additional guidance is needed on procedures that can be used to integrate the information derived from multiple chemical and biological lines of evidence (LOE). These LOE, which are developed through the application of different assessment tools, often include the use of chemically based sediment quality guidelines (SQGs) to evaluate sediment contamination and to help practitioners in sediment assessment and management formulate risk management decisions. This workshop focused on evaluation of the scientific foundations supporting different chemically based numeric SQGs and methods to improve the integration of SQGs into different sediment quality assessment frameworks that include information derived from multiple chemical and biological LOE.

Instituting organizational learning for quality improvement through strategic planning nominal group processes.

PubMed

White, D B

2000-01-01

Healthcare managers are faced with unprecedented challenges as characterized by managed care constraints, downsizing, increased client needs, and a society demanding more responsive services. Managers must initiate change for quality, efficiency, and survival. This article provides information and strategies for (a) assessing the change readiness of an organization, (b) conducting an organizational diagnosis, (c) instituting a team culture, (d) developing a change strategy, (e) integrating the strategy with a quality improvement process, and (f) identifying the leadership skills to implement organization renewal. Nominal group processes, namely, SWOT and the Search Conference, are described, and case examples are provided. The implementation strategies have been used successfully in a variety of milieus; practical advice for success is described in detail.

Assuring the Quality of Test Results in the Field of Nuclear Techniques and Ionizing Radiation. The Practical Implementation of Section 5.9 of the EN ISO/IEC 17025 Standard

NASA Astrophysics Data System (ADS)

Cucu, Daniela; Woods, Mike

2008-08-01

The paper aims to present a practical approach for testing laboratories to ensure the quality of their test results. It is based on the experience gained in assessing a large number of testing laboratories, discussing with management and staff, reviewing results obtained in national and international PTs and ILCs and exchanging information in the EA laboratory committee. According to EN ISO/IEC 17025, an accredited laboratory has to implement a programme to ensure the quality of its test results for each measurand. Pre-analytical, analytical and post-analytical measures shall be applied in a systematic manner. They shall include both quality control and quality assurance measures. When designing the quality assurance programme a laboratory should consider pre-analytical activities (like personnel training, selection and validation of test methods, qualifying equipment), analytical activities ranging from sampling, sample preparation, instrumental analysis and post-analytical activities (like decoding, calculation, use of statistical tests or packages, management of results). Designed on different levels (analyst, quality manager and technical manager), including a variety of measures, the programme shall ensure the validity and accuracy of test results, the adequacy of the management system, prove the laboratory's competence in performing tests under accreditation and last but not least show the comparability of test results. Laboratory management should establish performance targets and review periodically QC/QA results against them, implementing appropriate measures in case of non-compliance.

Perceptional and socio-demographic factors associated with household drinking water management strategies in rural Puerto Rico.

PubMed

Jain, Meha; Lim, Yili; Arce-Nazario, Javier A; Uriarte, María

2014-01-01

Identifying which factors influence household water management can help policy makers target interventions to improve drinking water quality for communities that may not receive adequate water quality at the tap. We assessed which perceptional and socio-demographic factors are associated with household drinking water management strategies in rural Puerto Rico. Specifically, we examined which factors were associated with household decisions to boil or filter tap water before drinking, or to obtain drinking water from multiple sources. We find that households differ in their management strategies depending on the institution that distributes water (i.e. government PRASA vs community-managed non-PRASA), perceptions of institutional efficacy, and perceptions of water quality. Specifically, households in PRASA communities are more likely to boil and filter their tap water due to perceptions of low water quality. Households in non-PRASA communities are more likely to procure water from multiple sources due to perceptions of institutional inefficacy. Based on informal discussions with community members, we suggest that water quality may be improved if PRASA systems improve the taste and odor of tap water, possibly by allowing for dechlorination prior to distribution, and if non-PRASA systems reduce the turbidity of water at the tap, possibly by increasing the degree of chlorination and filtering prior to distribution. Future studies should examine objective water quality standards to identify whether current management strategies are effective at improving water quality prior to consumption.

Perceptional and Socio-Demographic Factors Associated with Household Drinking Water Management Strategies in Rural Puerto Rico

PubMed Central

Jain, Meha; Lim, Yili; Arce-Nazario, Javier A.; Uriarte, María

2014-01-01

Identifying which factors influence household water management can help policy makers target interventions to improve drinking water quality for communities that may not receive adequate water quality at the tap. We assessed which perceptional and socio-demographic factors are associated with household drinking water management strategies in rural Puerto Rico. Specifically, we examined which factors were associated with household decisions to boil or filter tap water before drinking, or to obtain drinking water from multiple sources. We find that households differ in their management strategies depending on the institution that distributes water (i.e. government PRASA vs community-managed non-PRASA), perceptions of institutional efficacy, and perceptions of water quality. Specifically, households in PRASA communities are more likely to boil and filter their tap water due to perceptions of low water quality. Households in non-PRASA communities are more likely to procure water from multiple sources due to perceptions of institutional inefficacy. Based on informal discussions with community members, we suggest that water quality may be improved if PRASA systems improve the taste and odor of tap water, possibly by allowing for dechlorination prior to distribution, and if non-PRASA systems reduce the turbidity of water at the tap, possibly by increasing the degree of chlorination and filtering prior to distribution. Future studies should examine objective water quality standards to identify whether current management strategies are effective at improving water quality prior to consumption. PMID:24586302

Tiger Team Assessment of the Ames Laboratory

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1992-03-01

This report documents the Tiger Assessment of the Ames Laboratory (Ames), located in Ames, Iowa. Ames is operated for the US Department of Energy (DOE) by Iowa State University. The assessment was conducted from February 10 to March 5, 1992, under the auspices of the Office of Special Projects, Office of the Assistant Secretary of Environment, Safety and Health, Headquarters, DOE. The assessment was comprehensive, encompassing Environment, Safety, and Health (ES H) disciplines; management practices; and contractor and DOE self-assessments. Compliance with applicable Federal, State of Iowa, and local regulations; applicable DOE Orders; best management practices; and internal requirements atmore » Ames Laboratory were assessed. In addition, an evaluation of the adequacy and effectiveness of DOE and the site contractor's management of ES H/quality assurance program was conducted.« less

Implementation of Good Clinical Laboratory Practice (GCLP) guidelines within the External Quality Assurance Program Oversight Laboratory (EQAPOL).

PubMed

Todd, Christopher A; Sanchez, Ana M; Garcia, Ambrosia; Denny, Thomas N; Sarzotti-Kelsoe, Marcella

2014-07-01

The EQAPOL contract was awarded to Duke University to develop and manage global proficiency testing programs for flow cytometry-, ELISpot-, and Luminex bead-based assays (cytokine analytes), as well as create a genetically diverse panel of HIV-1 viral cultures to be made available to National Institutes of Health (NIH) researchers. As a part of this contract, EQAPOL was required to operate under Good Clinical Laboratory Practices (GCLP) that are traditionally used for laboratories conducting endpoint assays for human clinical trials. EQAPOL adapted these guidelines to the management of proficiency testing programs while simultaneously incorporating aspects of ISO/IEC 17043 which are specifically designed for external proficiency management. Over the first two years of the contract, the EQAPOL Oversight Laboratories received training, developed standard operating procedures and quality management practices, implemented strict quality control procedures for equipment, reagents, and documentation, and received audits from the EQAPOL Central Quality Assurance Unit. GCLP programs, such as EQAPOL, strengthen a laboratory's ability to perform critical assays and provide quality assessments of future potential vaccines. © 2013.

Mobile Apps for Bipolar Disorder: A Systematic Review of Features and Content Quality

PubMed Central

Larsen, Mark Erik; Proudfoot, Judith; Christensen, Helen

2015-01-01

Background With continued increases in smartphone ownership, researchers and clinicians are investigating the use of this technology to enhance the management of chronic illnesses such as bipolar disorder (BD). Smartphones can be used to deliver interventions and psychoeducation, supplement treatment, and enhance therapeutic reach in BD, as apps are cost-effective, accessible, anonymous, and convenient. While the evidence-based development of BD apps is in its infancy, there has been an explosion of publicly available apps. However, the opportunity for mHealth to assist in the self-management of BD is only feasible if apps are of appropriate quality. Objective Our aim was to identify the types of apps currently available for BD in the Google Play and iOS stores and to assess their features and the quality of their content. Methods A systematic review framework was applied to the search, screening, and assessment of apps. We searched the Australian Google Play and iOS stores for English-language apps developed for people with BD. The comprehensiveness and quality of information was assessed against core psychoeducation principles and current BD treatment guidelines. Management tools were evaluated with reference to the best-practice resources for the specific area. General app features, and privacy and security were also assessed. Results Of the 571 apps identified, 82 were included in the review. Of these, 32 apps provided information and the remaining 50 were management tools including screening and assessment (n=10), symptom monitoring (n=35), community support (n=4), and treatment (n=1). Not even a quarter of apps (18/82, 22%) addressed privacy and security by providing a privacy policy. Overall, apps providing information covered a third (4/11, 36%) of the core psychoeducation principles and even fewer (2/13, 15%) best-practice guidelines. Only a third (10/32, 31%) cited their information source. Neither comprehensiveness of psychoeducation information (r=-.11, P=.80) nor adherence to best-practice guidelines (r=-.02, P=.96) were significantly correlated with average user ratings. Symptom monitoring apps generally failed to monitor critical information such as medication (20/35, 57%) and sleep (18/35, 51%), and the majority of self-assessment apps did not use validated screening measures (6/10, 60%). Conclusions In general, the content of currently available apps for BD is not in line with practice guidelines or established self-management principles. Apps also fail to provide important information to help users assess their quality, with most lacking source citation and a privacy policy. Therefore, both consumers and clinicians should exercise caution with app selection. While mHealth offers great opportunities for the development of quality evidence-based mobile interventions, new frameworks for mobile mental health research are needed to ensure the timely availability of evidence-based apps to the public. PMID:26283290

Improving pneumonia case-management in Benin: a randomized trial of a multi-faceted intervention to support health worker adherence to Integrated Management of Childhood Illness guidelines

PubMed Central

Osterholt, Dawn M; Onikpo, Faustin; Lama, Marcel; Deming, Michael S; Rowe, Alexander K

2009-01-01

Background Pneumonia is a leading cause of death among children under five years of age. The Integrated Management of Childhood Illness strategy can improve the quality of care for pneumonia and other common illnesses in developing countries, but adherence to these guidelines could be improved. We evaluated an intervention in Benin to support health worker adherence to the guidelines after training, focusing on pneumonia case management. Methods We conducted a randomized trial. After a health facility survey in 1999 to assess health care quality before Integrated Management of Childhood Illness training, health workers received training plus either study supports (job aids, non-financial incentives and supervision of workers and supervisors) or "usual" supports. Follow-up surveys were conducted in 2001, 2002 and 2004. Outcomes were indicators of health care quality for Integrated Management-defined pneumonia. Further analyses included a graphical pathway analysis and multivariable logistic regression modelling to identify factors influencing case-management quality. Results We observed 301 consultations of children with non-severe pneumonia that were performed by 128 health workers in 88 public and private health facilities. Although outcomes improved in both intervention and control groups, we found no statistically significant difference between groups. However, training proceeded slowly, and low-quality care from untrained health workers diluted intervention effects. Per-protocol analyses suggested that health workers with training plus study supports performed better than those with training plus usual supports (20.4 and 19.2 percentage-point improvements for recommended treatment [p = 0.08] and "recommended or adequate" treatment [p = 0.01], respectively). Both groups tended to perform better than untrained health workers. Analyses of treatment errors revealed that incomplete assessment and difficulties processing clinical findings led to missed pneumonia diagnoses, and missed diagnoses led to inadequate treatment. Increased supervision frequency was associated with better care (odds ratio for recommended treatment = 2.1 [95% confidence interval: 1.1-3.9] per additional supervisory visit). Conclusion Integrated Management of Childhood Illness training was useful, but insufficient, to achieve high-quality pneumonia case management. Our study supports led to additional improvements, although large gaps in performance still remained. A simple graphical pathway analysis can identify specific, common errors that health workers make in the case-management process; this information could be used to target quality improvement activities, such as supervision (ClinicalTrials.gov number NCT00510679). PMID:19712484

Documentary analysis of risk-assessment and safety-planning policies and tools in a mental health context.

PubMed

Higgins, Agnes; Doyle, Louise; Morrissey, Jean; Downes, Carmel; Gill, Ailish; Bailey, Sive

2016-08-01

Despite the articulated need for policies and processes to guide risk assessment and safety planning, limited guidance exists on the processes or procedures to be used to develop such policies, and there is no body of research that examines the quality or content of the risk-management policies developed. The aim of the present study was to analyse the policies of risk and safety management used to guide mental health nursing practice in Ireland. A documentary analysis was performed on 123 documents received from 22 of the 23 directors of nursing contacted. Findings from the analysis revealed a wide variation in how risk, risk assessment, and risk management were defined. Emphasis within the risk documentation submitted was on risk related to self and others, with minimal attention paid to other types of risks. In addition, there was limited evidence of recovery-focused approaches to positive risk taking that involved service users and their families within the risk-related documentation. Many of the risk-assessment tools had not been validated, and lacked consistency or guidance in relation to how they were to be used or applied. The tick-box approach and absence of space for commentary within documentation have the potential to impact severely on the quality of information collected and documented, and subsequent clinical decision-making. Managers, and those tasked with ensuring safety and quality, need to ensure that policies and processes are, where possible, informed by best evidence and are in line with national mental health policy on recovery. © 2016 Australian College of Mental Health Nurses Inc.

Characterization and environmental management of stormwater runoff from road-salt storage facilities.

DOT National Transportation Integrated Search

2004-01-01

The objectives of this study were to assess the quantity and quality of salt-contaminated water generated from stormwater runoff at VDOT's salt storage facilities and to evaluate management/treatment alternatives to reduce costs and better protect th...

48 CFR 2901.603-72 - Administrative procurement management reviews.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Authority, and Responsibilities 2901.603-72 Administrative procurement management reviews. (a) The Senior..., policies, procedures and applicable directives. The reviews are to emphasize the development and... quality reviews and assessment techniques. This system is required to: (1) Evaluate the effectiveness and...

Principles and Practices for Quality Assurance and Quality Control

USGS Publications Warehouse

Jones, Berwyn E.

1999-01-01

Quality assurance and quality control are vital parts of highway runoff water-quality monitoring projects. To be effective, project quality assurance must address all aspects of the project, including project management responsibilities and resources, data quality objectives, sampling and analysis plans, data-collection protocols, data quality-control plans, data-assessment procedures and requirements, and project outputs. Quality control ensures that the data quality objectives are achieved as planned. The historical development and current state of the art of quality assurance and quality control concepts described in this report can be applied to evaluation of data from prior projects.

Management by objectives and its impact on specialist prescription quality at discharge and in external consultations.

PubMed

Olmo, M; Galvan, L; Capdevila, J; Serna, C; Mangues, I; Schoenenberger, J A

2011-01-01

To verify that implementing a policy of management by objectives, based on collaboration between hospital pharmacy, primary care and specialised medical managers, improves prescription quality indicators in specialised care and reduces unwanted "induced" prescriptions (i.e. those issued by specialists, hospital doctors or the patients themselves) in primary care. A four year quasi-experimental controlled intervention study on prescription at discharge and in outpatient hospital consultations was conducted. In hospital A, a quality cycle was applied: assessment, identifying improvement opportunities, implementing corrective actions and re-assessment. However, it was not applied in control hospital B. The indicators chosen were the percentage of generic medicines prescribed, the percentage of prescriptions for new therapies with no added value and the percentage of prescriptions for ACE inhibitors recommended. In hospital A, an increase in indicators 1 and 3 has been observed, both being statistically significant, between the last year of intervention and the year previous to intervention. Hospital A managed to reduce indicator 2 to 4.5%, while this indicator increased in hospital B to 8.8%. Furthermore, a statistically significant difference in indicators between the two hospitals has been registered. Pay-for-Performance programs in prescription practices of hospital physicians are effective actions to improve quality indicators of medication use. Copyright © 2010 SEFH. Published by Elsevier Espana. All rights reserved.

Development and pilot testing of an integrated, web-based self-management program for irritable bowel syndrome (IBS).

PubMed

Dorn, S D; Palsson, O S; Woldeghebriel, M; Fowler, B; McCoy, R; Weinberger, M; Drossman, D A

2015-01-01

Although essential, many medical practices are unable to adequately support irritable bowel syndrome (IBS) patient self-management. Web-based programs can help overcome these barriers. We developed, assessed, and refined an integrated IBS self-management program (IBS Self-care). We then conducted a 12-week pilot test to assess program utilization, evaluate its association with patients' self-efficacy and quality of life, and collect qualitative feedback to improve the program. 40 subjects with generally mild IBS were recruited via the Internet to participate in a 12-week pilot study. Subjects found the website easy to use (93%) and personally relevant (95%), and 90% would recommend it to a friend. Self-rated IBS knowledge increased from an average of 47.1 on a 100-point VAS scale (SD 22.1) at baseline to 77.4 (SD: 12.4) at week 12 (p < 0.0001). There were no significant changes in patient self-efficacy (Patient Activation Measure) or quality of life (IBS -Quality of Life Scale). The IBS Self-Care program was well received by users who after 12 weeks reported improved knowledge about IBS, but no significant changes in self-efficacy or quality of life. If applied to the right population, this low cost solution can overcome some of the deficiencies of medical care and empower individuals to better manage their own IBS. © 2014 John Wiley & Sons Ltd.

Patients' perception of postoperative pain management: validation of the International Pain Outcomes (IPO) questionnaire.

PubMed

Rothaug, Judith; Zaslansky, Ruth; Schwenkglenks, Matthias; Komann, Marcus; Allvin, Renée; Backström, Ragnar; Brill, Silviu; Buchholz, Ingo; Engel, Christoph; Fletcher, Dominique; Fodor, Lucian; Funk, Peter; Gerbershagen, Hans J; Gordon, Debra B; Konrad, Christoph; Kopf, Andreas; Leykin, Yigal; Pogatzki-Zahn, Esther; Puig, Margarita; Rawal, Narinder; Taylor, Rod S; Ullrich, Kristin; Volk, Thomas; Yahiaoui-Doktor, Maryam; Meissner, Winfried

2013-11-01

PAIN OUT is a European Commission-funded project aiming at improving postoperative pain management. It combines a registry that can be useful for quality improvement and research using treatment and patient-reported outcome measures. The core of the project is a patient questionnaire-the International Pain Outcomes questionnaire-that comprises key patient-level outcomes of postoperative pain management, including pain intensity, physical and emotional functional interference, side effects, and perceptions of care. Its psychometric quality after translation and adaptation to European patients is the subject of this validation study. The questionnaire was administered to 9,727 patients in 10 languages in 8 European countries and Israel. Construct validity was assessed using factor analysis. Discriminant validity assessment used Mann-Whitney U tests to detect mean group differences between 2 surgical disciplines. Internal consistency reliability was calculated as Cronbach's alpha. Factor analysis resulted in a 3-factor structure explaining 53.6% of variance. Cronbach's alpha at overall scale level was high (.86), and for the 3 subscales was low, moderate, or high (range, .53-.89). Significant mean group differences between general and orthopedic surgery patients confirmed discriminant validity. The psychometric quality of the International Pain Outcomes questionnaire can be regarded as satisfactory. The International Pain Outcomes questionnaire provides an instrument for postoperative pain assessment and improvement of quality of care, which demonstrated good psychometric quality when translated into a variety of languages in a large European and Israeli patient population. This measure provides the basis for the first comprehensive postoperative pain registry in Europe and other countries. Copyright © 2013. Published by Elsevier Inc.

Development of fuzzy air quality index using soft computing approach.

PubMed

Mandal, T; Gorai, A K; Pathak, G

2012-10-01

Proper assessment of air quality status in an atmosphere based on limited observations is an essential task for meeting the goals of environmental management. A number of classification methods are available for estimating the changing status of air quality. However, a discrepancy frequently arises from the quality criteria of air employed and vagueness or fuzziness embedded in the decision making output values. Owing to inherent imprecision, difficulties always exist in some conventional methodologies like air quality index when describing integrated air quality conditions with respect to various pollutants parameters and time of exposure. In recent years, the fuzzy logic-based methods have demonstrated to be appropriated to address uncertainty and subjectivity in environmental issues. In the present study, a methodology based on fuzzy inference systems (FIS) to assess air quality is proposed. This paper presents a comparative study to assess status of air quality using fuzzy logic technique and that of conventional technique. The findings clearly indicate that the FIS may successfully harmonize inherent discrepancies and interpret complex conditions.

The impact of multidisciplinary team meetings on patient assessment, management and outcomes in oncology settings: A systematic review of the literature.

PubMed

Pillay, Brindha; Wootten, Addie C; Crowe, Helen; Corcoran, Niall; Tran, Ben; Bowden, Patrick; Crowe, Jane; Costello, Anthony J

2016-01-01

Conducting regular multidisciplinary team (MDT) meetings requires significant investment of time and finances. It is thus important to assess the empirical benefits of such practice. A systematic review was conducted to evaluate the literature regarding the impact of MDT meetings on patient assessment, management and outcomes in oncology settings. Relevant studies were identified by searching OVID MEDLINE, PsycINFO, and EMBASE databases from 1995 to April 2015, using the keywords: multidisciplinary team meeting* OR multidisciplinary discussion* OR multidisciplinary conference* OR case review meeting* OR multidisciplinary care forum* OR multidisciplinary tumour board* OR case conference* OR case discussion* AND oncology OR cancer. Studies were included if they assessed measurable outcomes, and used a comparison group and/or a pre- and post-test design. Twenty-seven articles met inclusion criteria. There was limited evidence for improved survival outcomes of patients discussed at MDT meetings. Between 4% and 45% of patients discussed at MDT meetings experienced changes in diagnostic reports following the meeting. Patients discussed at MDT meetings were more likely to receive more accurate and complete pre-operative staging, and neo-adjuvant/adjuvant treatment. Quality of studies was affected by selection bias and the use of historical cohorts impacted study quality. MDT meetings impact upon patient assessment and management practices. However, there was little evidence indicating that MDT meetings resulted in improvements in clinical outcomes. Future research should assess the impact of MDT meetings on patient satisfaction and quality of life, as well as, rates of cross-referral between disciplines. Copyright © 2015 Elsevier Ltd. All rights reserved.

Biological and biochemical soil quality indicators for agricultural management

NASA Astrophysics Data System (ADS)

Bongiorno, Giulia

2017-04-01

Soil quality is defined as the capacity of a soil to perform multiple functions. Agricultural soils can, in principle, sustain a wide range of functions. However, negative pressure exerted by natural and anthropogenic soil threats such as soil erosion, soil organic matter losses and soil compaction have the potential to permanently damage soil quality. Soil chemical, physical and biological parameters can be used as indicators of soil quality. The specific objective of this study is to assess the suitability of novel soil parameters as soil quality indicators. We focus on biological/biochemical parameters, due to the unique role of soil biota in soil functions and to their high sensitivity to disturbances. The novel indicators are assessed in ten European long-term field experiments (LTEs) with different agricultural land use (arable and permanent crops), management regimes and pedo-climatic characteristics. The contrasts in agricultural management are represented by conventional/reduced tillage, organic/mineral fertilization and organic matter addition/no organic matter addition. We measured two different pools of labile organic carbon (dissolved organic carbon (DOC), and permanganate oxidizable carbon (POXC)), and determined DOC quality through its fractionation in hydrophobic and hydrophilic compounds. In addition, total nematode abundance has been assessed with qPCR. These parameters will be related to soil functions which have been measured with a minimum data set of indicators for soil quality (including TOC, macronutrients, and soil respiration). As a preliminary analysis, the Sensitivity Index (SI) for a given LTE was calculated for DOC and POXC according to Bolinder et al., 1999 as the ratio of the soil attribute under modified practices (e.g. reduced tillage) compared to the conventional practices (e.g. conventional tillage). The overall effect of the sustainable management on the indicators has been derived by calculating an average SI for those LTEs which included the sustainable management taken into account. A parametric t-test was used to determine the comprehensive significance of the average SI for a given indicator. Reduced tillage increased DOC and POXC in the 0-10 cm of soil (SI=1.19 and 1.18 respectively) compared to conventional tillage. Organic fertilization increased DOC and POXC in the 0-10 cm compared to mineral fertilization (SI=1.43 and 1.41) and compared to no fertilizer applications (SI=1.27 and 1.17). DOC was slightly more sensitive than POXC, however, the t-test resulted to be significant only for POXC. Preliminary tests revealed a significant correlation between POXC and DOC (Spearman ρ=0.53, p<0.001). POXC was more strongly correlated with TOC (ρ=0.8, p<0.001), soil respiration (ρ=0.5, p<0.001) and total nematode number (ρ=0.25, p<0.001), than DOC (ρ=0.37, p<0.001; ρ=0.28, p<0.001; ρ=0.04, p=0.5, respectively). These preliminary results could indicate the better suitability of POXC as soil quality indicator compared to DOC. Further analyses will be implemented to elucidate these relations (including DOC quality parameters and hot water extractable carbon). In the coming months, nematode community composition and abundance of specific groups will be assessed with molecular techniques (sequencing and qPCR). Together, the results will permit to assess the feasibility of the implementation of novel indicators to monitor the effects of agricultural management on soil functions.

Effects of Grazing and Fire Frequency on Floristic Quality and its Relationship to Indicators of Soil Quality in Tallgrass Prairie

NASA Astrophysics Data System (ADS)

Manning, George C.; Baer, Sara G.; Blair, John M.

2017-12-01

Fire and grazing are widely used to manage grasslands for conservation purposes, but few studies have evaluated the effects of these drivers on the conservation value of plant communities measured by the floristic quality index (FQI). Further, the influence of fire and grazing on soil properties and functions are difficult for land managers and restoration practitioners to assess. The objectives of this study were to: (1) quantify the independent and interactive effects of grazing and fire frequency on floristic quality in native tallgrass prairie to provide potential benchmarks for community assessment, and (2) to explore whether floristic quality can serve as an indicator of soil structure and function for more holistic ecosystem assessments. A factorial combination of fire frequencies (1-2, 4, and 20 years return intervals) and grazing (by bison or ungrazed) treatments were sampled for plant species composition, and for several indicators of soil quality in lowland tallgrass prairie. Floristic quality, diversity, and richness were higher in grazed than ungrazed prairie over all fire frequencies ( P < 0.05). Available inorganic N, microbial biomass N, total N, and soil bulk density were also higher in grazed prairie soil over all fire frequencies ( P < 0.05). Microbial biomass C, total organic C, and total soil N were positively correlated with FQI ( P < 0.05). This study shows that floristic quality and soil N pools are more strongly influenced by grazing than fire and that floristic quality can be an indicator of total soil C and N stocks in never cultivated lowland prairie.

Effects of Grazing and Fire Frequency on Floristic Quality and its Relationship to Indicators of Soil Quality in Tallgrass Prairie.

PubMed

Manning, George C; Baer, Sara G; Blair, John M

2017-12-01

Fire and grazing are widely used to manage grasslands for conservation purposes, but few studies have evaluated the effects of these drivers on the conservation value of plant communities measured by the floristic quality index (FQI). Further, the influence of fire and grazing on soil properties and functions are difficult for land managers and restoration practitioners to assess. The objectives of this study were to: (1) quantify the independent and interactive effects of grazing and fire frequency on floristic quality in native tallgrass prairie to provide potential benchmarks for community assessment, and (2) to explore whether floristic quality can serve as an indicator of soil structure and function for more holistic ecosystem assessments. A factorial combination of fire frequencies (1-2, 4, and 20 years return intervals) and grazing (by bison or ungrazed) treatments were sampled for plant species composition, and for several indicators of soil quality in lowland tallgrass prairie. Floristic quality, diversity, and richness were higher in grazed than ungrazed prairie over all fire frequencies (P < 0.05). Available inorganic N, microbial biomass N, total N, and soil bulk density were also higher in grazed prairie soil over all fire frequencies (P < 0.05). Microbial biomass C, total organic C, and total soil N were positively correlated with FQI (P < 0.05). This study shows that floristic quality and soil N pools are more strongly influenced by grazing than fire and that floristic quality can be an indicator of total soil C and N stocks in never cultivated lowland prairie.

CyAN satellite-derived Cyanobacteria products in support of Public Health Protection

EPA Science Inventory

The timely distribution of satellite-derived cyanoHAB data is necessary for adaptive water quality management decision-making and for targeted deployment of existing government and non-government water quality monitoring resources. The Cyanobacteria Assessment Network (CyAN) is a...

40 CFR 93.152 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... official charged with direct responsibility for management of an area designated as Class I under the Act.... Areawide air quality modeling analysis means an assessment on a scale that includes the entire nonattainment or maintenance area using an air quality dispersion model or photochemical grid model to determine...

The role of hospital managers in quality and patient safety: a systematic review

PubMed Central

Parand, Anam; Dopson, Sue; Renz, Anna; Vincent, Charles

2014-01-01

Objectives To review the empirical literature to identify the activities, time spent and engagement of hospital managers in quality of care. Design A systematic review of the literature. Methods A search was carried out on the databases MEDLINE, PSYCHINFO, EMBASE, HMIC. The search strategy covered three facets: management, quality of care and the hospital setting comprising medical subject headings and key terms. Reviewers screened 15 447 titles/abstracts and 423 full texts were checked against inclusion criteria. Data extraction and quality assessment were performed on 19 included articles. Results The majority of studies were set in the USA and investigated Board/senior level management. The most common research designs were interviews and surveys on the perceptions of managerial quality and safety practices. Managerial activities comprised strategy, culture and data-centred activities, such as driving improvement culture and promotion of quality, strategy/goal setting and providing feedback. Significant positive associations with quality included compensation attached to quality, using quality improvement measures and having a Board quality committee. However, there is an inconsistency and inadequate employment of these conditions and actions across the sample hospitals. Conclusions There is some evidence that managers’ time spent and work can influence quality and safety clinical outcomes, processes and performance. However, there is a dearth of empirical studies, further weakened by a lack of objective outcome measures and little examination of actual actions undertaken. We present a model to summarise the conditions and activities that affect quality performance. PMID:25192876