Multiprocessing on supercomputers for computational aerodynamics

NASA Technical Reports Server (NTRS)

Yarrow, Maurice; Mehta, Unmeel B.

1990-01-01

Very little use is made of multiple processors available on current supercomputers (computers with a theoretical peak performance capability equal to 100 MFLOPs or more) in computational aerodynamics to significantly improve turnaround time. The productivity of a computer user is directly related to this turnaround time. In a time-sharing environment, the improvement in this speed is achieved when multiple processors are used efficiently to execute an algorithm. The concept of multiple instructions and multiple data (MIMD) through multi-tasking is applied via a strategy which requires relatively minor modifications to an existing code for a single processor. Essentially, this approach maps the available memory to multiple processors, exploiting the C-FORTRAN-Unix interface. The existing single processor code is mapped without the need for developing a new algorithm. The procedure for building a code utilizing this approach is automated with the Unix stream editor. As a demonstration of this approach, a Multiple Processor Multiple Grid (MPMG) code is developed. It is capable of using nine processors, and can be easily extended to a larger number of processors. This code solves the three-dimensional, Reynolds averaged, thin-layer and slender-layer Navier-Stokes equations with an implicit, approximately factored and diagonalized method. The solver is applied to generic oblique-wing aircraft problem on a four processor Cray-2 computer. A tricubic interpolation scheme is developed to increase the accuracy of coupling of overlapped grids. For the oblique-wing aircraft problem, a speedup of two in elapsed (turnaround) time is observed in a saturated time-sharing environment.

Impact of PACS on dictation turnaround time and productivity.

PubMed

Lepanto, Luigi; Paré, Guy; Aubry, David; Robillard, Pierre; Lesage, Jacques

2006-03-01

This study was conducted to measure the impact of PACS on dictation turnaround time and productivity. The radiology information system (RIS) database was interrogated to calculate the time interval between image production and dictation for every exam performed during three 90-day periods (the 3 months preceding PACS implementation, the 3 months immediately following PACS deployment, and a 3-month period 1 year after PACS implementation). Data were obtained for three exam types: chest radiographs, abdominal CT, and spine MRI. The mean dictation turnaround times obtained during the different pre- and post-PACS periods were compared using analysis of variance (ANOVA). Productivity was also determined for each period and for each exam type, and was expressed as the number of studies interpreted per full-time equivalent (FTE) radiologist. In the immediate post-PACS period, dictation turnaround time decreased 20% (p < 0.001) for radiography, but increased 13% (ns) for CT and 28% (p < 0.001) for MRI. One year after PACS was implemented, dictation turnaround time decreased 45% (p < 0.001) for radiography and 36% (p < 0.001) for MRI. For CT, 1 year post-PACS, turnaround times returned to pre-PACS levels. Productivity in the immediate post-PACS period increased 3% and 38% for radiography and CT, respectively, whereas a 6% decrease was observed for MRI. One year after implementation, productivity increased 27%, 98%, and 19% in radiography, CT, and MRI, respectively. PACS benefits, namely, shortened dictation turnaround time and increased productivity, are evident 1 year after PACS implementation. In the immediate post-PACS period, results vary with the different imaging modalities.

Performance of Mycobacterium Growth Indicator Tube BACTEC 960 with Lowenstein-Jensen method for diagnosis of Mycobacterium tuberculosis at Ethiopian National Tuberculosis Reference Laboratory, Addis Ababa, Ethiopia.

PubMed

Diriba, Getu; Kebede, Abebaw; Yaregal, Zelalem; Getahun, Muluwork; Tadesse, Mengistu; Meaza, Abyot; Dagne, Zekarias; Moga, Shewki; Dilebo, Jibril; Gudena, Kebebe; Hassen, Mulu; Desta, Kassu

2017-05-10

Bacteriological confirmed active case detection remains the corner stone for diagnosing tuberculosis. Non-radiometric liquid culture system Mycobacterium Growth Indicator Tube with automated interface had been recommended by expert groups in addition to conventional solid culture media such as Lowenstein-Jensen. However in high burden resource limited countries advanced non-radiometric based tuberculosis diagnostic methods such as MGIT 960 is limited. Therefore we have evaluated the performance of MGIT 960 system compared to LJ for recovery of Mycobacterium complex (MTBC) from clinical specimens. A cross sectional study was conducted from a total of 908 samples between January 1st, 2013 to December 31st, 2014. Clinical specimens were processed following standard procedures and the final suspension was inoculated to MGIT tubes and LJ slant. Identification and confirmation of MTBC was done by ZN staining and SD Bioline test. Data was analyzed by SPSS version 20. The sensitivity, specificity, recovery rate and the average turnaround time to recover the organism was computed. From a total of 908 clinical specimens processed using both LJ and BACTEC MGIT liquid culture methods the recovery rate for LJ and MGIT, for smear positive samples was 66.7% (74/111) and 87.4% (97/ 111) respectively while for smear negative samples was 13.4% (108/797) and 17.4% (139/797) for LJ and MGIT methods respectively. The overall recovery rate for MGIT is significantly higher than LJ methods [26% (236/908; vs. 20%, 182/908, P = 0.002)]. The average turnaround time for smear positive samples was 16 and 31 days for MGIT and LJ respectively. Turnaround time for smear negative samples was 20 and 36 days for MGIT and LJ respectively. The overall agreement between MGIT and LJ was fairly good with Kappa value of 0.59 (P < 0.001). In the present study the contamination rate for MGIT is higher than the LJ methods, 15 and 9.3% respectively. The BACTEC MGIT liquid culture system has better MTBC recovery rate with shorter turnaround time for both smear positive and negative clinical specimens compared to Conventional LJ method. However, efforts should be made in order to reduce the high contamination rate in BACTEC MGIT system and to lesser extent to LJ methods.

Root cause analysis of laboratory turnaround times for patients in the emergency department.

PubMed

Fernandes, Christopher M B; Worster, Andrew; Hill, Stephen; McCallum, Catherine; Eva, Kevin

2004-03-01

Laboratory investigations are essential to patient care and are conducted routinely in emergency departments (EDs). This study reports the turnaround times at an academic, tertiary care ED, using root cause analysis to identify potential areas of improvement. Our objectives were to compare the laboratory turnaround times with established benchmarks and identify root causes for delays. Turnaround and process event times for a consecutive sample of hemoglobin and potassium measurements were recorded during an 8-day study period using synchronized time stamps. A log transformation (ln [minutes + 1]) was performed to normalize the time data, which were then compared with established benchmarks using one-sample t tests. The turnaround time for hemoglobin was significantly less than the established benchmark (n = 140, t = -5.69, p < 0.001) and that of potassium was significantly greater (n = 121, t = 12.65, p < 0.001). The hemolysis rate was 5.8%, with 0.017% of samples needing recollection. Causes of delays included order-processing time, a high proportion (43%) of tests performed on patients who had been admitted but were still in the ED waiting for a bed, and excessive laboratory process times for potassium. The turnaround time for hemoglobin (18 min) met the established benchmark, but that for potassium (49 min) did not. Root causes for delay were order-processing time, excessive queue and instrument times for potassium and volume of tests for admitted patients. Further study of these identified causes of delays is required to see whether laboratory TATs can be reduced.

Voice recognition technology implementation in surgical pathology: advantages and limitations.

PubMed

Singh, Meenakshi; Pal, Timothy R

2011-11-01

Voice recognition technology (VRT) has been in use for medical transcription outside of laboratories for many years, and in recent years it has evolved to a level where it merits consideration by surgical pathologists. To determine the feasibility and impact of making a transition from a transcriptionist-based service to VRT in surgical pathology. We have evaluated VRT in a phased manner for sign out of general and subspecialty surgical pathology cases after conducting a pilot study. We evaluated the effect on turnaround time, workflow, staffing, typographical error rates, and the overall ability of VRT to be adapted for use in surgical pathology. The stepwise implementation of VRT has resulted in real-time sign out of cases and improvement in average turnaround time from 4 to 3 days. The percentage of cases signed out in 1 day improved from 22% to 37%. Amendment rates for typographical errors have decreased. Use of templates and synoptic reports has been facilitated. The transcription staff has been reassigned to other duties and is successfully assisting in other areas. Resident involvement and exposure to complete case sign out has been achieved resulting in a positive impact on resident education. Voice recognition technology allows for a seamless workflow in surgical pathology, with improvements in turnaround time and a positive impact on competency-based resident education. Individual practices may assess the value of VRT and decide to implement it, potentially with gains in many aspects of their practice.

Possibilities or Paradoxes? How Aspiring Turnaround Principals Conceptualise Turnaround and Their Place within It

ERIC Educational Resources Information Center

Weiner, Jennie

2016-01-01

This study focuses on how a cohort of participants in a programme aimed at producing "turnaround leaders" came to understand this policy and their role within it. Using a theory of action framework, I find that, over time, participants' espoused theories of turnaround shifted in three key areas: (1) the cause of poor school performance,…

National turnaround time survey: professional consensus standards for optimal performance and thresholds considered to compromise efficient and effective clinical management.

PubMed

McKillop, Derek J; Auld, Peter

2017-01-01

Background Turnaround time can be defined as the time from receipt of a sample by the laboratory to the validation of the result. The Royal College of Pathologists recommends that a number of performance indicators for turnaround time should be agreed with stakeholders. The difficulty is in arriving at a goal which has some evidence base to support it other than what may simply be currently achievable technically. This survey sought to establish a professional consensus on the goals and meaning of targets for laboratory turnaround time. Methods A questionnaire was circulated by the National Audit Committee to 173 lead consultants for biochemistry in the UK. The survey asked each participant to state their current target turnaround time for core investigations in a broad group of clinical settings. Each participant was also asked to provide a professional opinion on what turnaround time would pose an unacceptable risk to patient safety for each departmental category. A super majority (2/3) was selected as the threshold for consensus. Results The overall response rate was 58% ( n = 100) with a range of 49-72% across the individual Association for Clinical Biochemistry and Laboratory Medicine regions. The consensus optimal turnaround time for the emergency department was <1 h with >2 h considered unacceptable. The times for general practice and outpatient department were <24 h and >48 h and for Wards <4 h and >12 h, respectively. Conclusions We consider that the figures provide a useful benchmark of current opinion, but clearly more empirical standards will have to develop alongside other aspects of healthcare delivery.

Operational Efficiency and Productivity Improvement Initiatives in a Large Cardiac Catheterization Laboratory.

PubMed

Reed, Grant W; Hantz, Scott; Cunningham, Rebecca; Krishnaswamy, Amar; Ellis, Stephen G; Khot, Umesh; Rak, Joe; Kapadia, Samir R

2018-02-26

This study sought to report outcomes from an efficiency improvement project in a large cardiac cath lab. Operational inefficiencies are common in the cath lab, yet solutions are challenging. A detailed report describing and providing solutions for these inefficiencies may be valuable in guiding improvements in productivity. In this observational study, the authors report metrics of efficiency before and after a cath lab quality improvement program in June 2014. Main outcomes included lab room start times, room turnaround times, laboratory use, and employee satisfaction. Time series analysis was used to assess trend over time. Chi-square testing and analysis of variance were used to assess change before and after the initiative. The principal changes included implementation of a pyramidal nursing schedule, increased use of an electronic scheduling system, and increased utilization of a preparation and recovery area. Comparing before with after the program, start times improved an average of 17 min, and on-time starts improved from 61.8% to 81.7% (p = 0.0024). Turnaround times improved from 20.5 min to 16.4 min (trend p < 0.0001), and the proportion of days at full lab utilization improved from 7.7% to 77.3% (p < 0.00001). There were no increases in overtime, night, or weekend cases. There was a reduction in full time employees from 36.1 in 2013 to 29.6 in 2016, with an improvement in employee satisfaction. A systematic approach to reducing inefficiencies can improve cath lab start times, turnaround times, and overall productivity. This knowledge may be helpful in assisting other cath labs in similar efficiency improvement initiatives. Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Improving Reports Turnaround Time: An Essential Healthcare Quality Dimension.

PubMed

Khan, Mustafa; Khalid, Parwaiz; Al-Said, Youssef; Cupler, Edward; Almorsy, Lamia; Khalifa, Mohamed

2016-01-01

Turnaround time is one of the most important healthcare performance indicators. King Faisal Specialist Hospital and Research Center in Jeddah, Saudi Arabia worked on reducing the reports turnaround time of the neurophysiology lab from more than two weeks to only five working days for 90% of cases. The main quality improvement methodology used was the FOCUS PDCA. Using root cause analysis, Pareto analysis and qualitative survey methods, the main factors contributing to the delay of turnaround time and the suggested improvement strategies were identified and implemented, through restructuring transcriptionists daily tasks, rescheduling physicians time and alerting for new reports, engaging consultants, consistent coordination and prioritizing critical reports. After implementation; 92% of reports are verified within 5 days compared to only 6% before implementation. 7% of reports were verified in 5 days to 2 weeks and only 1% of reports needed more than 2 weeks compared to 76% before implementation.

A "Neurological Emergency Trolley" reduces turnaround time for high-risk medications in a general intensive care unit.

PubMed

Ajzenberg, Henry; Newman, Paula; Harris, Gail-Anne; Cranston, Marnie; Boyd, J Gordon

2018-02-01

To reduce medication turnaround times during neurological emergencies, a multidisciplinary team developed a neurological emergency crash trolley in our intensive care unit. This trolley includes phenytoin, hypertonic saline and mannitol, as well as other equipment. The aim of this study was to assess whether the cart reduced turnaround times for these medications. In this retrospective cohort study, medication delivery times for two year epochs before and after its implementation were compared. Eligible patients were identified from our intensive care unit screening log. Adults who required emergent use of phenytoin, hypertonic saline or mannitol while in the intensive care unit were included. Groups were compared with nonparametric analyses. 33-bed general medical-surgical intensive care unit in an academic teaching hospital. Time to medication administration. In the pre-intervention group, there were 43 patients with 66 events. In the post-intervention group, there were 45 patients with 80 events. The median medication turnaround time was significantly reduced after implementation of the neurological emergency trolley (25 vs. 10minutes, p=0.003). There was no statistically significant difference in intensive care or 30-day survival between the two cohorts. The implementation of a novel neurological emergency crash trolley in our intensive care unit reduced medication turnaround times. Copyright © 2017 Elsevier Ltd. All rights reserved.

An Efficient Randomized Algorithm for Real-Time Process Scheduling in PicOS Operating System

NASA Astrophysics Data System (ADS)

Helmy*, Tarek; Fatai, Anifowose; Sallam, El-Sayed

PicOS is an event-driven operating environment designed for use with embedded networked sensors. More specifically, it is designed to support the concurrency in intensive operations required by networked sensors with minimal hardware requirements. Existing process scheduling algorithms of PicOS; a commercial tiny, low-footprint, real-time operating system; have their associated drawbacks. An efficient, alternative algorithm, based on a randomized selection policy, has been proposed, demonstrated, confirmed for efficiency and fairness, on the average, and has been recommended for implementation in PicOS. Simulations were carried out and performance measures such as Average Waiting Time (AWT) and Average Turn-around Time (ATT) were used to assess the efficiency of the proposed randomized version over the existing ones. The results prove that Randomized algorithm is the best and most attractive for implementation in PicOS, since it is most fair and has the least AWT and ATT on average over the other non-preemptive scheduling algorithms implemented in this paper.

Computer-aided detection system for chest radiography: reducing report turnaround times of examinations with abnormalities.

PubMed

Kao, E-Fong; Liu, Gin-Chung; Lee, Lo-Yeh; Tsai, Huei-Yi; Jaw, Twei-Shiun

2015-06-01

The ability to give high priority to examinations with pathological findings could be very useful to radiologists with large work lists who wish to first evaluate the most critical studies. A computer-aided detection (CAD) system for identifying chest examinations with abnormalities has therefore been developed. To evaluate the effectiveness of a CAD system on report turnaround times of chest examinations with abnormalities. The CAD system was designed to automatically mark chest examinations with possible abnormalities in the work list of radiologists interpreting chest examinations. The system evaluation was performed in two phases: two radiologists interpreted the chest examinations without CAD in phase 1 and with CAD in phase 2. The time information recorded by the radiology information system was then used to calculate the turnaround times. All chest examinations were reviewed by two other radiologists and were divided into normal and abnormal groups. The turnaround times for the examinations with pathological findings with and without the CAD system assistance were compared. The sensitivity and specificity of the CAD for chest abnormalities were 0.790 and 0.697, respectively, and use of the CAD system decreased the turnaround time for chest examinations with abnormalities by 44%. The turnaround times required for radiologists to identify chest examinations with abnormalities could be reduced by using the CAD system. This system could be useful for radiologists with large work lists who wish to first evaluate the most critical studies. © The Foundation Acta Radiologica 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Surgical pathology extradepartmental consultation practices.

PubMed

Azam, Muhammad; Nakhleh, Raouf E

2002-04-01

To document the practice parameters and case characteristics associated with personal (expert) consultations. We also examine the value, level of participant (customer) satisfaction, turnaround time, and rate of personal consultations. We asked participants in the College of American Pathologists' Q-Probes program to document cases sent for consultation during 4 months or up to 20 cases. They documented patient and specimen characteristics, the turnaround times, and the participants' levels of satisfaction with the consultation experience. One hundred eighty laboratories/surgical pathology practices. One hundred seventy-two (95.6%) were from the United States; the remainder were located in Canada and Australia. Rate and turnaround time of consultations and participant level of satisfaction. A total of 2746 consultation cases were examined for an aggregate consultation rate of 0.5% (median, 0.7%). Institutions with a higher occupied bed size and a greater number of surgical pathology cases both had lower consultation rates (P < or =.05). The median turnaround time (defined as the interval from the date on which the case was sent to the date on which the diagnosis was received) was 6 days. Twenty-nine percent and 68% of cases had a turnaround time within 3 and 7 days, respectively. Fifty-two percent of cases were sent to nationally known experts, and 32% were sent to local experts. Skin (18.0%), hematolymphoid (11.6%), and breast (9.6%) specimens were most commonly sent for consultation. In 70.5% of cases, the consultant confirmed the referring pathologist's original diagnosis, but in 15.9% of cases, the consultant also added significant information. Satisfaction rates were higher with faster turnaround times and verbal reporting. Satisfaction rates were lower for cases in which the patient or the clinician requested the consultation and in which the consultant's diagnosis was ambiguous. This study establishes a multi-institutional consultation rate of 0.5%, defines the nature of surgical pathology consultations, and demonstrates that satisfaction with consultations is associated with a faster turnaround time and receipt of additional, clinically meaningful information.

Ditching the Disc: The Effects of Cloud-Based Image Sharing on Department Efficiency and Report Turnaround Times in Mammography.

PubMed

Morgan, Matthew B; Young, Elizabeth; Harada, Scott; Winkler, Nicole; Riegert, Joanna; Jones, Tony; Hu, Nan; Stein, Matthew

2017-12-01

In screening mammography, accessing prior examination images is crucial for accurate diagnosis and avoiding false-positives. When women visit multiple institutions for their screens, these "outside" examinations must be retrieved for comparison. Traditionally, prior images are obtained by faxing requests to other institutions and waiting for standard mail (film or CD-ROM), which can greatly delay report turnaround times. Recently, advancements in cloud-based image transfer technology have opened up more efficient options for examination transfer between institutions. The objective of this study was to evaluate the effect of cloud-based image transfer on mammography department workflow, time required to obtain prior images, and report turnaround times. Sixty screening examinations requiring prior images were placed into two groups (30 each). The control group used the standard institutional protocol for requesting prior images: faxing requests and waiting for mailed examinations. The experimental group used a cloud-based transfer for both requesting and receiving examinations. The mean number of days between examination request and examination receipt was measured for both groups and compared. The mean number of days from examination request to receipt was 6.08 days (SD 3.50) in the control group compared with 3.16 days (SD 3.95) in the experimental group. Using a cloud-based image transfer to obtain prior mammograms resulted in an average reduction of 2.92 days (P = .0361; 95% confidence interval 0.20-5.65) between examination request and receipt. This improvement in system efficiency is relevant for interpreting radiologists working to improve reporting times and for patients anxious to receive their mammography results. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Efficiency of performing pulmonary procedures in a shared endoscopy unit: procedure time, turnaround time, delays, and procedure waiting time.

PubMed

Verma, Akash; Lee, Mui Yok; Wang, Chunhong; Hussein, Nurmalah B M; Selvi, Kalai; Tee, Augustine

2014-04-01

The purpose of this study was to assess the efficiency of performing pulmonary procedures in the endoscopy unit in a large teaching hospital. A prospective study from May 20 to July 19, 2013, was designed. The main outcome measures were procedure delays and their reasons, duration of procedural steps starting from patient's arrival to endoscopy unit, turnaround time, total case durations, and procedure wait time. A total of 65 procedures were observed. The most common procedure was BAL (61%) followed by TBLB (31%). Overall procedures for 35 (53.8%) of 65 patients were delayed by ≥ 30 minutes, 21/35 (60%) because of "spillover" of the gastrointestinal and surgical cases into the time block of pulmonary procedure. Time elapsed between end of pulmonary procedure and start of the next procedure was ≥ 30 minutes in 8/51 (16%) of cases. In 18/51 (35%) patients there was no next case in the room after completion of the pulmonary procedure. The average idle time of the room after the end of pulmonary procedure and start of next case or end of shift at 5:00 PM if no next case was 58 ± 53 minutes. In 17/51 (33%) patients the room's idle time was >60 minutes. A total of 52.3% of patients had the wait time >2 days and 11% had it ≥ 6 days, reason in 15/21 (71%) being unavailability of the slot. Most pulmonary procedures were delayed due to spillover of the gastrointestinal and surgical cases into the block time allocated to pulmonary procedures. The most common reason for difficulty encountered in scheduling the pulmonary procedure was slot unavailability. This caused increased procedure waiting time. The strategies to reduce procedure delays and turnaround times, along with improved scheduling methods, may have a favorable impact on the volume of procedures performed in the unit thereby optimizing the existing resources.

Sample Language of Modified Contract Elements from Existing CBAs, MOUs, or EWAs to Support Turnaround

ERIC Educational Resources Information Center

Mass Insight Education (NJ1), 2011

2011-01-01

Organized by the key conditions areas for turnaround, "People, Program, Time and Money," this tool offers sample language for each contract element to serve as a model for modifications from a traditional CBA that may support a district's turnaround efforts. Sample language is offered from existing provisions in district-wide collective bargaining…

The Impact of Turnaround Reform on Student Outcomes: Evidence and Insights from the Los Angeles Unified School District

ERIC Educational Resources Information Center

Strunk, Katharine O.; Marsh, Julie A.; Hashim, Ayesha K.; Bush-Mecenas, Susan; Weinstein, Tracey

2016-01-01

We examine the Los Angeles Unified School District's Public School Choice Initiative (PSCI), which sought to turnaround the district's lowest-performing schools. We ask whether school turnaround impacted student outcomes, and what explains variations in outcomes across reform cohorts. We use a Comparative Interrupted Time Series approach using…

Physician Satisfaction With Clinical Laboratory Services: A College of American Pathologists Q-Probes Study of 81 Institutions.

PubMed

McCall, Shannon J; Souers, Rhona J; Blond, Barbara; Massie, Larry

2016-10-01

-Assessment of customer satisfaction is a vital component of the laboratory quality improvement program. -To survey the level of physician satisfaction with hospital clinical laboratory services. -Participating institutions provided demographic information and survey results of physician satisfaction, with specific features of clinical laboratory services individually rated on a scale of 5 (excellent) to 1 (poor). -Eighty-one institutions submitted 2425 surveys. The median overall satisfaction score was 4.2 (10th percentile, 3.6; 90th percentile, 4.6). Of the 16 surveyed areas receiving the highest percentage of excellent/good ratings (combined scores of 4 and 5), quality of results was highest along with test menu adequacy, staff courtesy, and overall satisfaction. Of the 4 categories receiving the lowest percentage values of excellent/good ratings, 3 were related to turnaround time for inpatient "STAT" (tests performed immediately), outpatient STAT, and esoteric tests. The fourth was a new category presented in this survey: ease of electronic order entry. Here, 11.4% (241 of 2121) of physicians assigned below-average (2) or poor (1) scores. The 5 categories deemed most important to physicians included quality of results, turnaround times for inpatient STAT, routine, and outpatient STAT tests, and clinical report format. Overall satisfaction as measured by physician willingness to recommend their laboratory to another physician remains high at 94.5% (2160 of 2286 respondents). -There is a continued trend of high physician satisfaction and loyalty with clinical laboratory services. Physician dissatisfaction with ease of electronic order entry represents a new challenge. Test turnaround times are persistent areas of dissatisfaction, representing areas for improvement.

Implementation and optimization of automated dispensing cabinet technology.

PubMed

McCarthy, Bryan C; Ferker, Michael

2016-10-01

A multifaceted automated dispensing cabinet (ADC) optimization initiative at a large hospital is described. The ADC optimization project, which was launched approximately six weeks after activation of ADCs in 30 patient care unit medication rooms of a newly established adult hospital, included (1) adjustment of par inventory levels (desired on-hand quantities of medications) and par reorder quantities to reduce the risk of ADC supply exhaustion and improve restocking efficiency, (2) expansion of ADC "common stock" (medications assigned to ADC inventories) to increase medication availability at the point of care, and (3) removal of some infrequently prescribed medications from ADCs to reduce the likelihood of product expiration. The purpose of the project was to address organizational concerns regarding widespread ADC medication stockouts, growing reliance on cart-fill medication delivery systems, and suboptimal medication order turnaround times. Leveraging of the ADC technology platform's reporting functionalities for enhanced inventory control yielded a number of benefits, including cost savings resulting from reduced pharmacy technician labor requirements (estimated at $2,728 annually), a substantial reduction in the overall weekly stockout percentage (from 3.2% before optimization to 0.5% eight months after optimization), an improvement in the average medication turnaround time, and estimated cost avoidance of $19,660 attributed to the reduced potential for product expiration. Efforts to optimize ADCs through par level optimization, expansion of common stock, and removal of infrequently used medications reduced pharmacy technician labor, decreased stockout percentages, generated opportunities for cost avoidance, and improved medication turnaround times. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Rapid Multiplex PCR Assay To Identify Respiratory Viral Pathogens: Moving Forward Diagnosing The Common Cold

PubMed Central

Gordon, Sarah M; Elegino-Steffens, Diane U; Agee, Willie; Barnhill, Jason; Hsue, Gunther

2013-01-01

Upper respiratory tract infections (URIs) can be a serious burden to the healthcare system. The majority of URIs are viral in etiology, but definitive diagnosis can prove difficult due to frequently overlapping clinical presentations of viral and bacterial infections, and the variable sensitivity, and lengthy turn-around time of viral culture. We tested new automated nested multiplex PCR technology, the FilmArray® system, in the TAMC department of clinical investigations, to determine the feasibility of replacing the standard viral culture with a rapid turn-around system. We conducted a feasibility study using a single-blinded comparison study, comparing PCR results with archived viral culture results from a convenience sample of cryopreserved archived nasopharyngeal swabs from acutely ill ED patients who presented with complaints of URI symptoms. A total of 61 archived samples were processed. Viral culture had previously identified 31 positive specimens from these samples. The automated nested multiplex PCR detected 38 positive samples. In total, PCR was 94.5% concordant with the previously positive viral culture results. However, PCR was only 63.4% concordant with the negative viral culture results, owing to PCR detection of 11 additional viral pathogens not recovered on viral culture. The average time to process a sample was 75 minutes. We determined that an automated nested multiplex PCR is a feasible alternative to viral culture in an acute clinical setting. We were able to detect at least 94.5% as many viral pathogens as viral culture is able to identify, with a faster turn-around time. PMID:24052914

Impact of SMS/GPRS Printers in Reducing Time to Early Infant Diagnosis Compared With Routine Result Reporting: A Systematic Review and Meta-Analysis

PubMed Central

Markby, Jessica; Boeke, Caroline; Penazzato, Martina; Urick, Brittany; Ghadrshenas, Anisa; Harris, Lindsay; Ford, Nathan; Peter, Trevor

2017-01-01

Background: Despite significant gains made toward improving access, early infant diagnosis (EID) testing programs suffer from long test turnaround times that result in substantial loss to follow-up and mortality associated with delays in antiretroviral therapy initiation. These delays in treatment initiation are particularly impactful because of significant HIV-related infant mortality observed by 2–3 months of age. Short message service (SMS) and general packet radio service (GPRS) printers allow test results to be transmitted immediately to health care facilities on completion of testing in the laboratory. Methods: We conducted a systematic review and meta-analysis to assess the benefit of using SMS/GPRS printers to increase the efficiency of EID test result delivery compared with traditional courier paper–based results delivery methods. Results: We identified 11 studies contributing data for over 16,000 patients from East and Southern Africa. The test turnaround time from specimen collection to result received at the health care facility with courier paper–based methods was 68.0 days (n = 6835), whereas the test turnaround time with SMS/GPRS printers was 51.1 days (n = 6711), resulting in a 2.5-week (25%) reduction in the turnaround time. Conclusions: Courier paper–based EID test result delivery methods are estimated to add 2.5 weeks to EID test turnaround times in low resource settings and increase the risk that infants receive test results during or after the early peak of infant mortality. SMS/GPRS result delivery to health care facility printers significantly reduced test turnaround time and may reduce this risk. SMS/GPRS printers should be considered for expedited delivery of EID and other centralized laboratory test results. PMID:28825941

An Elegant Sufficiency: Load-Aware Differentiated Scheduling of Data Transfers

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

Kettimuthu, Rajkumar; Vardoyan, Gayane; Agrawal, Gagan

2015-11-15

We investigate the file transfer scheduling problem, where transfers among different endpoints must be scheduled to maximize pertinent metrics. We propose two new algorithms that exploit the fact that the aggregate bandwidth obtained over a network or at a storage system tends to increase with the number of concurrent transfers—but only up to a certain limit. The first algorithm, SEAL, uses runtime information and data-driven models to approximate system load and adapt transfer schedules and concurrency so as to maximize performance while avoiding saturation. We implement this algorithm using GridFTP as the transfer protocol and evaluate it using real transfermore » logs in a production WAN environment. Results show that SEAL can improve average slowdowns and turnaround times by up to 25% and worst-case slowdown and turnaround times by up to 50%, compared with the best-performing baseline scheme. Our second algorithm, STEAL, further leverages user-supplied categorization of transfers as either “interactive” (requiring immediate processing) or “batch” (less time-critical). Results show that STEAL reduces the average slowdown of interactive transfers by 63% compared to the best-performing baseline and by 21% compared to SEAL. For batch transfers, compared to the best-performing baseline, STEAL improves by 18% the utilization of the bandwidth unused by interactive transfers. By elegantly ensuring a sufficient, but not excessive, allocation of concurrency to the right transfers, we significantly improve overall performance despite constraints.« less

Psychiatric patients turnaround times in the emergency department

PubMed Central

2005-01-01

Background To analyze the turnaround times of psychiatric patients within the Emergency Department (ED) from registration to discharge or hospitalization in a University Hospital in 2002. Methods Data from a one-year period of psychiatric admissions to the emergency service at a University Hospital were monitored and analyzed focused on turnaround times within the ED. Information on patients variables such as age, sex, diagnosis, consultations and diagnostic procedures were extracted from the patients' charts. Results From 34.058 patients seen in the ED in 2002, 2632 patients were examined by psychiatrists on duty. Mean turnaround time in the ED was 123 (SD 97) minutes (median 95). Patients to be hospitalized on a psychiatric ward stayed shorter within the ED, patients who later were admitted to another faculty, were treated longer in the ED. Patients with cognitive or substance related disorders stayed longer in the ED than patients with other psychiatric diagnoses. The number of diagnostic procedures and consultations increased the treatment time significantly. Conclusion As the number of patients within the examined ED increases every year, the relevant variables responsible for longer or complicated treatments were assessed in order to appropriately change routine procedures without loss of medical standards. Using this basic data, comparisons with the following years and other hospitals will help to define where the benchmark of turnaround times for psychiatric emergency services might be. PMID:16351721

Turnaround Time Modeling for Conceptual Rocket Engines

NASA Technical Reports Server (NTRS)

Nix, Michael; Staton, Eric J.

2004-01-01

Recent years have brought about a paradigm shift within NASA and the Space Launch Community regarding the performance of conceptual design. Reliability, maintainability, supportability, and operability are no longer effects of design; they have moved to the forefront and are affecting design. A primary focus of this shift has been a planned decrease in vehicle turnaround time. Potentials for instituting this decrease include attacking the issues of removing, refurbishing, and replacing the engines after each flight. less, it is important to understand the operational affects of an engine on turnaround time, ground support personnel and equipment. One tool for visualizing this relationship involves the creation of a Discrete Event Simulation (DES). A DES model can be used to run a series of trade studies to determine if the engine is meeting its requirements, and, if not, what can be altered to bring it into compliance. Using DES, it is possible to look at the ways in which labor requirements, parallel maintenance versus serial maintenance, and maintenance scheduling affect the overall turnaround time. A detailed DES model of the Space Shuttle Main Engines (SSME) has been developed. Trades may be performed using the SSME Processing Model to see where maintenance bottlenecks occur, what the benefits (if any) are of increasing the numbers of personnel, or the number and location of facilities, in addition to trades previously mentioned, all with the goal of optimizing the operational turnaround time and minimizing operational cost. The SSME Processing Model was developed in such a way that it can easily be used as a foundation for developing DES models of other operational or developmental reusable engines. Performing a DES on a developmental engine during the conceptual phase makes it easier to affect the design and make changes to bring about a decrease in turnaround time and costs.

A strategy for reducing turnaround time in design optimization using a distributed computer system

NASA Technical Reports Server (NTRS)

Young, Katherine C.; Padula, Sharon L.; Rogers, James L.

1988-01-01

There is a need to explore methods for reducing lengthly computer turnaround or clock time associated with engineering design problems. Different strategies can be employed to reduce this turnaround time. One strategy is to run validated analysis software on a network of existing smaller computers so that portions of the computation can be done in parallel. This paper focuses on the implementation of this method using two types of problems. The first type is a traditional structural design optimization problem, which is characterized by a simple data flow and a complicated analysis. The second type of problem uses an existing computer program designed to study multilevel optimization techniques. This problem is characterized by complicated data flow and a simple analysis. The paper shows that distributed computing can be a viable means for reducing computational turnaround time for engineering design problems that lend themselves to decomposition. Parallel computing can be accomplished with a minimal cost in terms of hardware and software.

Predictable turn-around time for post tape-out flow

NASA Astrophysics Data System (ADS)

Endo, Toshikazu; Park, Minyoung; Ghosh, Pradiptya

2012-03-01

A typical post-out flow data path at the IC Fabrication has following major components of software based processing - Boolean operations before the application of resolution enhancement techniques (RET) and optical proximity correctin (OPC), the RET and OPC step [etch retargeting, sub-resolution assist feature insertion (SRAF) and OPC], post-OPCRET Boolean operations and sometimes in the same flow simulation based verification. There are two objectives that an IC Fabrication tapeout flow manager wants to achieve with the flow - predictable completion time and fastest turn-around time (TAT). At times they may be competing. There have been studies in the literature modeling the turnaround time from historical data for runs with the same recipe and later using that to derive the resource allocation for subsequent runs. [3]. This approach is more feasible in predominantly simulation dominated tools but for edge operation dominated flow it may not be possible especially if some processing acceleration methods like pattern matching or hierarchical processing is involved. In this paper, we suggest an alternative method of providing target turnaround time and managing the priority of jobs while not doing any upfront resource modeling and resource planning. The methodology then systematically either meets the turnaround time need and potentially lets the user know if it will not as soon as possible. This builds on top of the Calibre Cluster Management (CalCM) resource management work previously published [1][2]. The paper describes the initial demonstration of the concept.

Applying Total Quality Management in Cooperative Extension.

ERIC Educational Resources Information Center

Fredendall, Lawrence D.; Lippert, Robert M.

1995-01-01

South Carolina's Agricultural Service Laboratory received responses from 252 of 500 farmers who currently use the soil testing service; 97% were pleased with accuracy, 89% with turnaround time, 18% thought the fee too high. Nonusers (100 of 520) were mainly dissatisfied with turnaround time. Total quality management methods were used to improve…

Ways to reduce patient turnaround time and improve service quality in emergency departments.

PubMed

Sinreich, David; Marmor, Yariv

2005-01-01

Recent years have witnessed a fundamental change in the function of emergency departments (EDs). The emphasis of the ED shifts from triage to saving the lives of shock-trauma rooms equipped with state-of-the-art equipment. At the same time walk-in clinics are being set up to treat ambulatory type patients. Simultaneously ED overcrowding has become a common sight in many large urban hospitals. This paper recognises that in order to provide quality treatment to all these patient types, ED process operations have to be flexible and efficient. The paper aims to examine one major benchmark for measuring service quality--patient turnaround time, claiming that in order to provide the quality treatment to which EDs aspire, this time needs to be reduced. This study starts by separating the process each patient type goes through when treated at the ED into unique components. Next, using a simple model, the impact each of these components has on the total patient turnaround time is determined. This in turn, identifies the components that need to be addressed if patient turnaround time is to be streamlined. The model was tested using data that were gathered through a comprehensive time study in six major hospitals. The analysis reveals that waiting time comprises 51-63 per cent of total patient turnaround time in the ED. Its major components are: time away for an x-ray examination; waiting time for the first physician's examination; and waiting time for blood work. The study covers several hospitals and analyses over 20,000 process components; as such the common findings may serve as guidelines to other hospitals when addressing this issue.

Implementation of a web-based medication tracking system in a large academic medical center.

PubMed

Calabrese, Sam V; Williams, Jonathan P

2012-10-01

Pharmacy workflow efficiencies achieved through the use of an electronic medication-tracking system are described. Medication dispensing turnaround times at the inpatient pharmacy of a large hospital were evaluated before and after transition from manual medication tracking to a Web-based tracking process involving sequential bar-code scanning and real-time monitoring of medication status. The transition was carried out in three phases: (1) a workflow analysis, including the identification of optimal points for medication scanning with hand-held wireless devices, (2) the phased implementation of an automated solution and associated hardware at a central dispensing pharmacy and three satellite locations, and (3) postimplementation data collection to evaluate the impact of the new tracking system and areas for improvement. Relative to the manual tracking method, electronic medication tracking allowed the capture of far more data points, enabling the pharmacy team to delineate the time required for each step of the medication dispensing process and to identify the steps most likely to involve delays. A comparison of baseline and postimplementation data showed substantial reductions in overall medication turnaround times with the use of the Web-based tracking system (time reductions of 45% and 22% at the central and satellite sites, respectively). In addition to more accurate projections and documentation of turnaround times, the Web-based tracking system has facilitated quality-improvement initiatives. Implementation of an electronic tracking system for monitoring the delivery of medications provided a comprehensive mechanism for calculating turnaround times and allowed the pharmacy to identify bottlenecks within the medication distribution system. Altering processes removed these bottlenecks and decreased delivery turnaround times.

Reliability Evaluation of Concentrator Photovoltaic Modules per IEC Qualification Specifications

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

Tamizhmani, Govindasamy

2012-12-05

This project is related to the qualification testing of new generation CPV (concentrator photovoltaics) modules at lower testing costs and lower turnaround time. In this project, the first testing program was completed for two CPV manufacturers, the second testing program was completed for two manufacturers at 65% of the actual testing cost and at less than 3 months of testing turnaround time and the third testing program was completed for two manufacturers at 65% of the actual testing cost and at less than 3 months of testing turnaround time. Due to their financial situation and restructuring, Amonix (one of themore » CPV manufacturers) intermittently terminated the test programs.« less

Financial and workflow analysis of radiology reporting processes in the planning phase of implementation of a speech recognition system

NASA Astrophysics Data System (ADS)

Whang, Tom; Ratib, Osman M.; Umamoto, Kathleen; Grant, Edward G.; McCoy, Michael J.

2002-05-01

The goal of this study is to determine the financial value and workflow improvements achievable by replacing traditional transcription services with a speech recognition system in a large, university hospital setting. Workflow metrics were measured at two hospitals, one of which exclusively uses a transcription service (UCLA Medical Center), and the other which exclusively uses speech recognition (West Los Angeles VA Hospital). Workflow metrics include time spent per report (the sum of time spent interpreting, dictating, reviewing, and editing), transcription turnaround, and total report turnaround. Compared to traditional transcription, speech recognition resulted in radiologists spending 13-32% more time per report, but it also resulted in reduction of report turnaround time by 22-62% and reduction of marginal cost per report by 94%. The model developed here helps justify the introduction of a speech recognition system by showing that the benefits of reduced operating costs and decreased turnaround time outweigh the cost of increased time spent per report. Whether the ultimate goal is to achieve a financial objective or to improve operational efficiency, it is important to conduct a thorough analysis of workflow before implementation.

[Applying the clustering technique for characterising maintenance outsourcing].

PubMed

Cruz, Antonio M; Usaquén-Perilla, Sandra P; Vanegas-Pabón, Nidia N; Lopera, Carolina

2010-06-01

Using clustering techniques for characterising companies providing health institutions with maintenance services. The study analysed seven pilot areas' equipment inventory (264 medical devices). Clustering techniques were applied using 26 variables. Response time (RT), operation duration (OD), availability and turnaround time (TAT) were amongst the most significant ones. Average biomedical equipment obsolescence value was 0.78. Four service provider clusters were identified: clusters 1 and 3 had better performance, lower TAT, RT and DR values (56 % of the providers coded O, L, C, B, I, S, H, F and G, had 1 to 4 day TAT values:

Turnaround Time and Market Capacity in Contract Cheating

ERIC Educational Resources Information Center

Wallace, Melisa J.; Newton, Philip M.

2014-01-01

Contract cheating is the process whereby students auction off the opportunity for others to complete assignments for them. It is an apparently widespread yet under-researched problem. One suggested strategy to prevent contract cheating is to shorten the turnaround time between the release of assignment details and the submission date, thus making…

Emergency radiobioassay preparedness exercises through the NIST radiochemistry intercomparison program.

PubMed

Nour, Svetlana; LaRosa, Jerry; Inn, Kenneth G W

2011-08-01

The present challenge for the international emergency radiobioassay community is to analyze contaminated samples rapidly while maintaining high quality results. The National Institute of Standards and Technology (NIST) runs a radiobioassay measurement traceability testing program to evaluate the radioanalytical capabilities of participating laboratories. The NIST Radiochemistry Intercomparison Program (NRIP) started more than 10 years ago, and emergency performance testing was added to the program seven years ago. Radiobioassay turnaround times under the NRIP program for routine production and under emergency response scenarios are 60 d and 8 h, respectively. Because measurement accuracy and sample turnaround time are very critical in a radiological emergency, response laboratories' analytical systems are best evaluated and improved through traceable Performance Testing (PT) programs. The NRIP provides participant laboratories with metrology tools to evaluate their performance and to improve it. The program motivates the laboratories to optimize their methodologies and minimize the turnaround time of their results. Likewise, NIST has to make adjustments and periodical changes in the bioassay test samples in order to challenge the participating laboratories continually. With practice, radioanalytical measurements turnaround time can be reduced to 3-4 h.

Where the world stands still: turnaround as a strong test of ΛCDM cosmology

NASA Astrophysics Data System (ADS)

Pavlidou, V.; Tomaras, T. N.

2014-09-01

Our intuitive understanding of cosmic structure formation works best in scales small enough so that isolated, bound, relaxed gravitating systems are no longer adjusting their radius; and large enough so that space and matter follow the average expansion of the Universe. Yet one of the most robust predictions of ΛCDM cosmology concerns the scale that separates these limits: the turnaround radius, which is the non-expanding shell furthest away from the center of a bound structure. We show that the maximum possible value of the turnaround radius within the framework of the ΛCDM model is, for a given mass M, equal to (3GM/Λ c2)1/3, with G Newton's constant and c the speed of light, independently of cosmic epoch, exact nature of dark matter, or baryonic effects. We discuss the possible use of this prediction as an observational test for ΛCDM cosmology. Current data appear to favor ΛCDM over alternatives with local inhomogeneities and no Λ. However there exist several local-universe structures that have, within errors, reached their limiting size. With improved determinations of their turnaround radii and the enclosed mass, these objects may challenge the limit and ΛCDM cosmology.

Lean six sigma methodologies improve clinical laboratory efficiency and reduce turnaround times.

PubMed

Inal, Tamer C; Goruroglu Ozturk, Ozlem; Kibar, Filiz; Cetiner, Salih; Matyar, Selcuk; Daglioglu, Gulcin; Yaman, Akgun

2018-01-01

Organizing work flow is a major task of laboratory management. Recently, clinical laboratories have started to adopt methodologies such as Lean Six Sigma and some successful implementations have been reported. This study used Lean Six Sigma to simplify the laboratory work process and decrease the turnaround time by eliminating non-value-adding steps. The five-stage Six Sigma system known as define, measure, analyze, improve, and control (DMAIC) is used to identify and solve problems. The laboratory turnaround time for individual tests, total delay time in the sample reception area, and percentage of steps involving risks of medical errors and biological hazards in the overall process are measured. The pre-analytical process in the reception area was improved by eliminating 3 h and 22.5 min of non-value-adding work. Turnaround time also improved for stat samples from 68 to 59 min after applying Lean. Steps prone to medical errors and posing potential biological hazards to receptionists were reduced from 30% to 3%. Successful implementation of Lean Six Sigma significantly improved all of the selected performance metrics. This quality-improvement methodology has the potential to significantly improve clinical laboratories. © 2017 Wiley Periodicals, Inc.

Identification of blood culture isolates directly from positive blood cultures by use of matrix-assisted laser desorption ionization-time of flight mass spectrometry and a commercial extraction system: analysis of performance, cost, and turnaround time.

PubMed

Lagacé-Wiens, Philippe R S; Adam, Heather J; Karlowsky, James A; Nichol, Kimberly A; Pang, Paulette F; Guenther, Jodi; Webb, Amanda A; Miller, Crystal; Alfa, Michelle J

2012-10-01

Matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry represents a revolution in the rapid identification of bacterial and fungal pathogens in the clinical microbiology laboratory. Recently, MALDI-TOF has been applied directly to positive blood culture bottles for the rapid identification of pathogens, leading to reductions in turnaround time and potentially beneficial patient impacts. The development of a commercially available extraction kit (Bruker Sepsityper) for use with the Bruker MALDI BioTyper has facilitated the processing required for identification of pathogens directly from positive from blood cultures. We report the results of an evaluation of the accuracy, cost, and turnaround time of this method for 61 positive monomicrobial and 2 polymicrobial cultures representing 26 species. The Bruker MALDI BioTyper with the Sepsityper gave a valid (score, >1.7) identification for 85.2% of positive blood cultures with no misidentifications. The mean reduction in turnaround time to identification was 34.3 h (P < 0.0001) in the ideal situation where MALDI-TOF was used for all blood cultures and 26.5 h in a more practical setting where conventional identification or identification from subcultures was required for isolates that could not be directly identified by MALDI-TOF. Implementation of a MALDI-TOF-based identification system for direct identification of pathogens from blood cultures is expected to be associated with a marginal increase in operating costs for most laboratories. However, the use of MALDI-TOF for direct identification is accurate and should result in reduced turnaround time to identification.

Impact of an in-house emergency radiologist on report turnaround time.

PubMed

Lamb, Leslie; Kashani, Paria; Ryan, John; Hebert, Guy; Sheikh, Adnan; Thornhill, Rebecca; Fasih, Najla

2015-01-01

One of the many challenges facing emergency departments (EDs) across North America is timely access to emergency radiology services. Academic institutions, which are typically also regional referral centres, frequently require cross-sectional studies to be performed 24 hours a day with expedited final reports to accelerate patient care and ED flow. The purpose of this study was to determine if the presence of an in-house radiologist, in addition to a radiology resident dedicated to the ED, had a significant impact on report turnaround time. Preliminary and final report turnaround times, provided by the radiology resident and staff, respectively, for patients undergoing computed tomography or ultrasonography of their abdomen/pelvis in 2008 (before the implementation of emergency radiology in-house staff service) were compared to those performed during the same time frame in 2009 and 2010 (after staffing protocols were changed). A total of 1,624 reports were reviewed. Overall, there was no statistically significant decrease in the preliminary report turnaround times between 2008 and 2009 (p = 0.1102), 2009 and 2010 (p = 0.6232), or 2008 and 2010 (p = 0.0890), although times consistently decreased from a median of 2.40 hours to 2.08 hours to 2.05 hours (2008 to 2009 to 2010). There was a statistically significant decrease in final report turnaround times between 2008 and 2009 (p < 0.0001), 2009 and 2010 (p < 0.0011), and 2008 and 2010 (p < 0.0001). Median final report times decreased from 5.00 hours to 3.08 hours to 2.75 hours in 2008, 2009, and 2010, respectively. There was also a significant decrease in the time interval between preliminary and final reports between 2008 and 2009 (p < 0.0001) and 2008 and 2010 (p < 0.0001) but no significant change between 2009 and 2010 (p = 0.4144). Our results indicate that the presence of a dedicated ED radiologist significantly reduces final report turnaround time and thus may positively impact the time to ED patient disposition. Patient care is improved when attending radiologists are immediately available to read complex films, both in terms of health care outcomes and regarding the need for repeat testing. Providing emergency physicians with accurate imaging findings as rapidly as possible facilitates effective and timely management and thus optimizes patient care.

Ozone impact minimization through coordinated scheduling of turnaround operations from multiple olefin plants in an ozone nonattainment area

NASA Astrophysics Data System (ADS)

Ge, Sijie; Wang, Sujing; Xu, Qiang; Ho, Thomas

2018-03-01

Turnaround operations (start-up and shutdown) are critical operations in olefin plants, which emit large quantities of VOCs, NOx and CO. The emission has great potentials to impact the ozone level in ozone nonattainment areas. This study demonstrates a novel practice to minimize the ozone impact through coordinated scheduling of turnaround operations from multiple olefin plants located in Houston, Texas, an ozone nonattainment area. The study considered two olefin plants scheduled to conduct turnaround operations: one start-up and one shutdown, simultaneously on the same day within a five-hour window. Through dynamic simulations of the turnaround operations using ASPEN Plus Dynamics and air quality simulations using CAMx, the study predicts the ozone impact from the combined effect of the two turnaround operations under different starting-time scenarios. The simulations predict that the ozone impact from planned turnaround operations ranges from a maximum of 11.4 ppb to a minimum of 1.4 ppb. Hence, a reduction of up to 10.0 ppb can be achieved on a single day based on the selected two simulation days. This study demonstrates a cost-effective and environmentally benign ozone control practice for relevant stakeholders, including environmental agencies, regional plant operators, and local communities.

Clustering techniques: measuring the performance of contract service providers.

PubMed

Cruz, Antonio Miguel; Perilla, Sandra Patricia Usaquén; Pabón, Nidia Nelly Vanegas

2010-01-01

This paper investigates the use of clustering technique to characterize the providers of maintenance services in a health-care institution according to their performance. A characterization of the inventory of equipment from seven pilot areas was carried out first (including 264 medical devices). The characterization study concluded that the inventory on a whole is old [exploitation time (ET)/useful life (UL) average is 0.78] and has high maintenance service costs relative to the original cost of acquisition (service cost /acquisition cost average 8.61%). A monitoring of the performance of maintenance service providers was then conducted. The variables monitored were response time (RT), service time (ST), availability, and turnaround time (TAT). Finally, the study grouped maintenance service providers into clusters according to performance. The study grouped maintenance service providers into the following clusters. Cluster 0: Identified with the best performance, the lowest values of TAT, RT, and ST, with an average TAT value of 1.46 days; Clusters 1 and 2: Identified with the poorest performance, highest values of TAT, RT, and ST, and an average TAT value of 9.79 days; and Cluster 3: Identified by medium-quality performance, intermediate values of TAT, RT, and ST, and an average TAT value of 2.56 days.

Where the world stands still: turnaround as a strong test of ΛCDM cosmology

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

Pavlidou, V.; Tomaras, T.N., E-mail: pavlidou@physics.uoc.gr, E-mail: tomaras@physics.uoc.gr

Our intuitive understanding of cosmic structure formation works best in scales small enough so that isolated, bound, relaxed gravitating systems are no longer adjusting their radius; and large enough so that space and matter follow the average expansion of the Universe. Yet one of the most robust predictions of ΛCDM cosmology concerns the scale that separates these limits: the turnaround radius, which is the non-expanding shell furthest away from the center of a bound structure. We show that the maximum possible value of the turnaround radius within the framework of the ΛCDM model is, for a given mass M, equalmore » to (3GM/Λ c{sup 2}){sup 1/3}, with G Newton's constant and c the speed of light, independently of cosmic epoch, exact nature of dark matter, or baryonic effects. We discuss the possible use of this prediction as an observational test for ΛCDM cosmology. Current data appear to favor ΛCDM over alternatives with local inhomogeneities and no Λ. However there exist several local-universe structures that have, within errors, reached their limiting size. With improved determinations of their turnaround radii and the enclosed mass, these objects may challenge the limit and ΛCDM cosmology.« less

Assessing School Turnaround: Evidence from Ohio

ERIC Educational Resources Information Center

Player, Daniel; Katz, Veronica

2016-01-01

Policy makers have struggled to find successful approaches to address concentrated, persistent low school achievement. While NCLB and the School Improvement Grant (SIG) program have devoted significant time and attention to turnaround, very little empirical evidence substantiates whether and how these efforts work. This study employs a comparative…

Combining Quick-Turnaround and Batch Workloads at Scale

NASA Technical Reports Server (NTRS)

Matthews, Gregory A.

2012-01-01

NAS uses PBS Professional to schedule and manage the workload on Pleiades, an 11,000+ node 1B cluster. At this scale the user experience for quick-turnaround jobs can degrade, which led NAS initially to set up two separate PBS servers, each dedicated to a particular workload. Recently we have employed PBS hooks and scheduler modifications to merge these workloads together under one PBS server, delivering sub-1-minute start times for the quick-turnaround workload, and enabling dynamic management of the resources set aside for that workload.

Turning Around along the Cosmic Web

NASA Astrophysics Data System (ADS)

Lee, Jounghun; Yepes, Gustavo

2016-12-01

A bound violation designates a case in which the turnaround radius of a bound object exceeds the upper limit imposed by the spherical collapse model based on the standard ΛCDM paradigm. Given that the turnaround radius of a bound object is a stochastic quantity and that the spherical model overly simplifies the true gravitational collapse, which actually proceeds anisotropically along the cosmic web, the rarity of the occurrence of a bound violation may depend on the web environment. Assuming a Planck cosmology, we numerically construct the bound-zone peculiar velocity profiles along the cosmic web (filaments and sheets) around the isolated groups with virial mass {M}{{v}}≥slant 3× {10}13 {h}-1 {M}⊙ identified in the Small MultiDark Planck simulations and determine the radial distances at which their peculiar velocities equal the Hubble expansion speed as the turnaround radii of the groups. It is found that although the average turnaround radii of the isolated groups are well below the spherical bound limit on all mass scales, the bound violations are not forbidden for individual groups, and the cosmic web has an effect of reducing the rarity of the occurrence of a bound violation. Explaining that the spherical bound limit on the turnaround radius in fact represents the threshold distance up to which the intervention of the external gravitational field in the bound-zone peculiar velocity profiles around the nonisolated groups stays negligible, we discuss the possibility of using the threshold distance scale to constrain locally the equation of state of dark energy.

No Time to Lose: Turnaround Leader Performance Assessment

ERIC Educational Resources Information Center

Rhim, Lauren Morando

2012-01-01

Effective leadership is critical to successful school turnaround efforts. Yet, district leaders have historically been hesitant to hold leaders accountable for bold change efforts. As federal and state dollars flow to districts and individual schools charged with embarking upon transformative change efforts, districts must adopt a laser-sharp…

Improving the Discharge Process to Optimize Patient Throughput in an Academic Teaching Hospital and Level I Trauma Center

DTIC Science & Technology

2004-02-22

order to minimize Emergency Center overcrowding and ambulance diversions. The purpose of this study was to identify impeding systematic delays in the...turnaround times. A pilot study was conducted on two medicine and two surgery inpatient nursing units to analyze bed turnaround times and discharge times of...to the BTGH executive leadership who identified a need for this study : Mr. George Masi, Associate Administrator; Ms. Beth De Guzman, Chief Nursing

A point-of-care chemistry test for reduction of turnaround and clinical decision time.

PubMed

Lee, Eui Jung; Shin, Sang Do; Song, Kyoung Jun; Kim, Seong Chun; Cho, Jin Seong; Lee, Seung Chul; Park, Ju Ok; Cha, Won Chul

2011-06-01

Our study compared clinical decision time between patients managed with a point-of-care chemistry test (POCT) and patients managed with the traditional central laboratory test (CLT). This was a randomized controlled multicenter trial in the emergency departments (EDs) of 5 academic teaching hospitals. We randomly assigned patients to POCT or CLT stratified by the Emergency Severity Index. A POCT chemistry analyzer (Piccolo; Abaxis, Inc, Union City, Calif), which is able to test liver panel, renal panel, pancreas enzymes, lipid panel, electrolytes, and blood gases, was set up in each ED. Primary and secondary end point was turnaround time and door-to-clinical-decision time. The total 2323 patients were randomly assigned to the POCT group (n = 1167) or to the CLT group (n = 1156). All of the basic characteristics were similar in the 2 groups. The turnaround time (median, interquartile range [IQR]) of the POCT group was shorter than that of the CLT group (14, 12-19 versus 55, 45-69 minutes; P < .0001). The median (IQR) door-to-clinical-decision time was also shorter in the POCT compared with the CLT group (46, 33-61 versus 86, 68-107 minutes; P < .0001). The proportion of patients who had new decisions within 60 minutes was 72.8% for the POCT group and 12.5% for the CLT group (P < .0001). A POCT chemistry analyzer in the ED shortens the test turnaround and ED clinical decision times compared with CLT. Copyright © 2011 Elsevier Inc. All rights reserved.

Estimating the Turn-around Radii of Six Isolated Galaxy Groups in the Local Universe

NASA Astrophysics Data System (ADS)

Lee, Jounghun

2018-03-01

Estimates of the turn-around radii of six isolated galaxy groups in the nearby universe are presented. From the Tenth Data Release of the Sloan Digital Sky Survey, we first select those isolated galaxy groups at redshifts z ≤ 0.05 in the mass range [0.3–1] × {10}14 {h}-1 {M}ȯ whose nearest-neighbor groups are located at distances larger than 15 times their virial radii. Then, we search for a gravitationally interacting web-like structure around each isolated group, which appears as an inclined streak pattern in the anisotropic spatial distribution of the neighboring field galaxies. Out of 59 isolated groups, only seven are found to possess such web-like structures in their neighbor zones, but one of them turns out to be NGC 5353/4, whose turn-around radius was already measured in a previous work and was thus excluded from our analysis. Applying the Turn-around Radius Estimator algorithm devised by Lee et al. to the identified web-like structures of the remaining six target groups, we determine their turn-around radii and show that three out of the six targets have larger turn-around radii than the spherical bound limit predicted by Planck cosmology. We discuss possible sources of the apparent violations of the three groups, including the underestimated spherical bound limit due to the approximation of the turn-around mass by the virial mass.

Series Overview. Sustaining School Turnaround at Scale. Brief 1

ERIC Educational Resources Information Center

Education Resource Strategies, 2012

2012-01-01

Members of the non-profit organization Education Resource Strategies (ERS) have worked for over a decade with leaders of urban school systems to help them organize talent, time and technology to support great schools at scale. One year into the Federal program they are noticing significant differences in district turnaround approaches, engagement…

Testing ΛCDM cosmology at turnaround: where to look for violations of the bound?

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

Tanoglidis, D.; Pavlidou, V.; Tomaras, T.N., E-mail: dtanogl@physics.uoc.gr, E-mail: pavlidou@physics.uoc.gr, E-mail: tomaras@physics.uoc.gr

In ΛCDM cosmology, structure formation is halted shortly after dark energy dominates the mass/energy budget of the Universe. A manifestation of this effect is that in such a cosmology the turnaround radius—the non-expanding mass shell furthest away from the center of a structure— has an upper bound. Recently, a new, local, test for the existence of dark energy in the form of a cosmological constant was proposed based on this turnaround bound. Before designing an experiment that, through high-precision determination of masses and —independently— turnaround radii, will challenge ΛCDM cosmology, we have to answer two important questions: first, when turnaround-scalemore » structures are predicted to be close enough to their maximum size, so that a possible violation of the bound may be observable. Second, which is the best mass scale to target for possible violations of the bound. These are the questions we address in the present work. Using the Press-Schechter formalism, we find that turnaround structures have in practice already stopped forming, and consequently, the turnaround radius of structures must be very close to the maximum value today. We also find that the mass scale of ∼ 10{sup 13} M{sub ⊙} characterizes the turnaround structures that start to form in a statistically important number density today —and even at an infinite time in the future, since structure formation has almost stopped. This mass scale also separates turnaround structures with qualitatively different cosmological evolution: smaller structures are no longer readjusting their mass distribution inside the turnaround scale, they asymptotically approach their ultimate abundance from higher values, and they are common enough to have, at some epoch, experienced major mergers with structures of comparable mass; larger structures exhibit the opposite behavior. We call this mass scale the transitional mass scale and we argue that it is the optimal for the purpose outlined above. As a corollary, we explain the different accretion behavior of small and larger structures observed in already conducted numerical simulations.« less

Using lean methodology to improve productivity in a hospital oncology pharmacy.

PubMed

Sullivan, Peter; Soefje, Scott; Reinhart, David; McGeary, Catherine; Cabie, Eric D

2014-09-01

Quality improvements achieved by a hospital pharmacy through the use of lean methodology to guide i.v. compounding workflow changes are described. The outpatient oncology pharmacy of Yale-New Haven Hospital conducted a quality-improvement initiative to identify and implement workflow changes to support a major expansion of chemotherapy services. Applying concepts of lean methodology (i.e., elimination of non-value-added steps and waste in the production process), the pharmacy team performed a failure mode and effects analysis, workflow mapping, and impact analysis; staff pharmacists and pharmacy technicians identified 38 opportunities to decrease waste and increase efficiency. Three workflow processes (order verification, compounding, and delivery) accounted for 24 of 38 recommendations and were targeted for lean process improvements. The workflow was decreased to 14 steps, eliminating 6 non-value-added steps, and pharmacy staff resources and schedules were realigned with the streamlined workflow. The time required for pharmacist verification of patient-specific oncology orders was decreased by 33%; the time required for product verification was decreased by 52%. The average medication delivery time was decreased by 47%. The results of baseline and postimplementation time trials indicated a decrease in overall turnaround time to about 70 minutes, compared with a baseline time of about 90 minutes. The use of lean methodology to identify non-value-added steps in oncology order processing and the implementation of staff-recommended workflow changes resulted in an overall reduction in the turnaround time per dose. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

The impact of closed-loop electronic medication management on time to first dose: a comparative study between paper and digital hospital environments.

PubMed

Austin, Jodie A; Smith, Ian R; Tariq, Amina

2018-01-22

Closed-loop electronic medication management systems (EMMS) are recognised as an effective intervention to improve medication safety, yet evidence of their effectiveness in hospitals is limited. Few studies have compared medication turnaround time for a closed-loop electronic versus paper-based medication management environment. To compare medication turnaround times in a paper-based hospital environment with a digital hospital equipped with a closed-loop EMMS, consisting of computerised physician order entry, profiled automated dispensing cabinets packaged with unit dose medications and barcode medication administration. Data were collected during 2 weeks at three private hospital sites (one with closed-loop EMMS) within the same organisation network in Queensland, Australia. Time between scheduled and actual administration times was analysed for first dose of time-critical and non-critical medications located on the ward or sourced via pharmacy. Medication turnaround times at the EMMS site were less compared to the paper-based sites (median, IQR: 35 min, 8-57 min versus 120 min, 30-180 min, P < 0.001). For time-critical medications, 77% were administered within 60 min of scheduled time at the EMMS site versus 38% for the paper-based sites. Similar difference was observed for non-critical medications, 80% were administered within 60 min of their scheduled time at the EMMS site versus 41% at the paper-based facilities. The study indicates medication turnaround times utilising a closed-loop EMMS are less compared to paper-based systems. This improvement may be attributable to increased accessibility of medications using automated dispensing cabinets and electronic medication administration records flagging tasks to nurses in real time. © 2018 Royal Pharmaceutical Society.

Upfront dilution of ferritin samples to reduce hook effect, improve turnaround time and reduce costs.

PubMed

Wu, Shu Juan; Hayden, Joshua A

2018-02-15

Sandwich immunoassays offer advantages in the clinical laboratory but can yield erroneously low results due to hook (prozone) effect, especially with analytes whose concentrations span several orders of magnitude such as ferritin. This study investigated a new approach to reduce the likelihood of hook effect in ferritin immunoassays by performing upfront, five-fold dilutions of all samples for ferritin analysis. The impact of this change on turnaround time and costs were also investigated. Ferritin concentrations were analysed in routine clinical practice with and without upfront dilutions on Siemens Centaur® XP (Siemens Healthineers, Erlang, Germany) immunoanalysers. In addition, one month of baseline data (1026 results) were collected prior to implementing upfront dilutions and one month of data (1033 results) were collected after implementation. Without upfront dilutions, hook effect was observed in samples with ferritin concentrations as low as 86,028 µg/L. With upfront dilutions, samples with ferritin concentrations as high as 126,050 µg/L yielded values greater than the measurement interval and would have been diluted until an accurate value was obtained. The implementation of upfront dilution of ferritin samples led to a decrease in turnaround time from a median of 2 hours and 3 minutes to 1 hour and 18 minutes (P = 0.002). Implementation of upfront dilutions of all ferritin samples reduced the possibility of hook effect, improved turnaround time and saved the cost of performing additional dilutions.

Emergency department usage by community step-down facilities--patterns and recommendations.

PubMed

Lee, S W; Goh, C; Chan, Y H

2003-09-01

This study examines the interface between institutional community step-down facilities (CSDFs) and acute hospital's Emergency Department (ED). It also provides a comprehensive description of the usage of an ED's services by CSDFs in its vicinity. This is a prospective 12-week observational study conducted in the Accident and Emergency Department of Changi General Hospital in Singapore. All patients from CSDFs transferred to the department were eligible for the study. Hospital records were used to extract relevant clinical data after admission for the length of stay and final discharge diagnosis. There was a total of 201 referrals to the ED over the 3-month period. The age of the patients ranged from 32 to 107 years, with a median of 83 years. Ninety-two patients (45.8%) were male residents. There were more referrals from CSDF on weekdays than on weekends. In particular, the number of referrals from CSDFs on Mondays were significantly higher (P < 0.05, Poisson regression) than other days of the week. Fifty-one per cent of the ED visits occurred during regular working hours. Eighty-two per cent of the transfers were admitted. The main complaint was shortness of breath with cough, followed by fever and falls. The most common investigation ordered was chest radiograph, followed by electrocardiogram and other radiographs. The most common treatment procedure in the ED was placement of an intravenous line. For those admitted residents, average length of hospital stay was 8.27 +/- 8.19 days (median, 5 days). Seventeen patients (10.3%) died within 3 days of admission, while 31 patients (18.8%) stayed less than 3 days. The admitted residents had an average turnaround time (from time of registration to time of leaving the ED and proceeding to ward) of 97.94 minutes. For patients discharged from the ED, the average turnaround time (time from registration to time of leaving the ED) was 177 minutes. Residents from CSDFs are transferred to the ED for a variety of medical reasons. The most appropriate role of the ED in evaluation of residents of CSDFs is not yet clearly defined. There is increasing need to streamline processes in acute hospitals to cope with an increasing ageing population and to ensure that quality care is delivered to the institutionalised sick.

Connecting Hearts in the Workplace

ERIC Educational Resources Information Center

Ulrich, Dave; Woodson, Belinda A.

2011-01-01

Lots of talk is taking place in organizations today about turnaround and transformation. Turnaround is not transformation. Turnaround is public statements; transformation is personal commitments. Turnaround focuses on cutting costs; transformation builds an emotional bond. Turnaround changes structures and reporting relationships; transformation…

An improved APU for the Space Shuttle Orbiter

NASA Technical Reports Server (NTRS)

Mckenna, R.; Hagemann, D.; Loken, G.; Jonakin, J.; Baughman, J.

1985-01-01

The Space Shuttle Orbiter Auxiliary Power Unit has operated successfully on all four orbiter vehicles and all missions. The current Auxiliary Power Unit (APU) operational life is limited to 12 missions, and the APU turnaround time between flights is longer than originally anticipated. The objective of the Improved APU program is to increase life to 50 missions, reduce installed vehicle weight by 134 lb., and reduce turnaround time. This paper describes the design changes incorporated into the improved APU and the associated development testing.

Apollo/Saturn 5 space vehicle countdown. Volume 2: Turnaround from scrub

NASA Technical Reports Server (NTRS)

1972-01-01

The procedures required to prepare a space vehicle for subsequent launch attempt after cancelling lift-off activities are presented. The cancellation must occur after the start of cryogenic loading, but prior to initiation of ignition sequences. The sequence of operations necessary to return the space vehicle to a predetermined configuration at which time the launch count can be resumed or rescheduled for following launch opportunities is developed. The considerations and constraints that are the basis for the scrub/turnaround times are described.

Scholars Reaching Outside Education for School Fixes

ERIC Educational Resources Information Center

Viadero, Debra

2007-01-01

In recent years, a handful of education scholars have begun to cast a wider net for advice on how to engineer successful school turnarounds. The need for turnaround strategies that work is more timely than ever. Under the federal No Child Left Behind Act, the list of schools identified to be in need of help grows longer by the year, making…

Implications of Perioperative Team Setups for Operating Room Management Decisions.

PubMed

Doll, Dietrich; Kauf, Peter; Wieferich, Katharina; Schiffer, Ralf; Luedi, Markus M

2017-01-01

Team performance has been studied extensively in the perioperative setting, but the managerial impact of interprofessional team performance remains unclear. We hypothesized that the interplay between anesthesiologists and surgeons would affect operating room turnaround times, and teams that worked together over time would become more efficient. We analyzed 13,632 surgical cases at our hospital that involved 64 surgeons and 48 anesthesiologists. We detrended and adjusted the data for potential confounders including age, American Society of Anesthesiologists physical status, and surgical list (scheduled cases of specific surgical specialties). The surgical lists were categorized as ear, nose, and throat surgery; trauma surgery; general surgery; and gynecology. We assessed the relationship between turnaround times and assignment of different anesthesiologists to specific surgeons using a Monte Carlo simulation. We found significant differences in team performances among the different surgical lists but no team learning. We constructed managerial decision tables for the assignment of anesthesiologists to specific surgeons at our hospital. We defined a decision algorithm based on these tables. Our analysis indicated that had this algorithm been used in staffing the operating room for the surgical cases represented in our data, median turnaround times would have a reduction potential of 6.8% (95% confidence interval 6.3% to 7.1%). A surgeon is usually predefined for scheduled surgeries (surgical list). Allocation of the right anesthesiologist to a list and to a surgeon can affect the team performance; thus, this assignment has managerial implications regarding the operating room efficiency affecting turnaround times and thus potentially overutilized time of a list at our hospital.

Impact of a Rapid Herpes Simplex Virus PCR Assay on Duration of Acyclovir Therapy

PubMed Central

Van, Tam T.; Mongkolrattanothai, Kanokporn; Arevalo, Melissa; Lustestica, Maryann

2017-01-01

ABSTRACT Herpes simplex virus (HSV) infections of the central nervous system (CNS) are associated with significant morbidity and mortality rates in children. This study assessed the impact of a direct HSV (dHSV) PCR assay on the time to result reporting and the duration of acyclovir therapy for children with signs and symptoms of meningitis and encephalitis. A total of 363 patients with HSV PCR results from cerebrospinal fluid (CSF) samples were included in this retrospective analysis, divided into preimplementation and postimplementation groups. For the preimplementation group, CSF testing was performed using a laboratory-developed real-time PCR assay; for the postimplementation group, CSF samples were tested using a direct sample-to-answer assay. All CSF samples were negative for HSV. Over 60% of patients from both groups were prescribed acyclovir. The average HSV PCR test turnaround time for the postimplementation group was reduced by 14.5 h (23.6 h versus 9.1 h; P < 0.001). Furthermore, 79 patients (43.6%) in the postimplementation group had dHSV PCR results reported <4 h after specimen collection. The mean time from specimen collection to acyclovir discontinuation was 17.1 h shorter in the postimplementation group (31.1 h versus 14 h; P < 0.001). The median duration of acyclovir therapy was also significantly reduced in the postimplementation group (29.2 h versus 14.3 h; P = 0.01). Our investigation suggests that implementation of rapid HSV PCR testing can decrease turnaround times and the duration of unnecessary acyclovir therapy. PMID:28275080

Impact of a Rapid Herpes Simplex Virus PCR Assay on Duration of Acyclovir Therapy.

PubMed

Van, Tam T; Mongkolrattanothai, Kanokporn; Arevalo, Melissa; Lustestica, Maryann; Dien Bard, Jennifer

2017-05-01

Herpes simplex virus (HSV) infections of the central nervous system (CNS) are associated with significant morbidity and mortality rates in children. This study assessed the impact of a direct HSV (dHSV) PCR assay on the time to result reporting and the duration of acyclovir therapy for children with signs and symptoms of meningitis and encephalitis. A total of 363 patients with HSV PCR results from cerebrospinal fluid (CSF) samples were included in this retrospective analysis, divided into preimplementation and postimplementation groups. For the preimplementation group, CSF testing was performed using a laboratory-developed real-time PCR assay; for the postimplementation group, CSF samples were tested using a direct sample-to-answer assay. All CSF samples were negative for HSV. Over 60% of patients from both groups were prescribed acyclovir. The average HSV PCR test turnaround time for the postimplementation group was reduced by 14.5 h (23.6 h versus 9.1 h; P < 0.001). Furthermore, 79 patients (43.6%) in the postimplementation group had dHSV PCR results reported <4 h after specimen collection. The mean time from specimen collection to acyclovir discontinuation was 17.1 h shorter in the postimplementation group (31.1 h versus 14 h; P < 0.001). The median duration of acyclovir therapy was also significantly reduced in the postimplementation group (29.2 h versus 14.3 h; P = 0.01). Our investigation suggests that implementation of rapid HSV PCR testing can decrease turnaround times and the duration of unnecessary acyclovir therapy. Copyright © 2017 American Society for Microbiology.

Timeliness “at a glance”: assessing the turnaround time through the six sigma metrics.

PubMed

Ialongo, Cristiano; Bernardini, Sergio

2016-01-01

Almost thirty years of systematic analysis have proven the turnaround time to be a fundamental dimension for the clinical laboratory. Several indicators are to date available to assess and report quality with respect to timeliness, but they sometimes lack the communicative immediacy and accuracy. The six sigma is a paradigm developed within the industrial domain for assessing quality and addressing goal and issues. The sigma level computed through the Z-score method is a simple and straightforward tool which delivers quality by a universal dimensionless scale and allows to handle non-normal data. Herein we report our preliminary experience in using the sigma level to assess the change in urgent (STAT) test turnaround time due to the implementation of total automation. We found that the Z-score method is a valuable and easy to use method for assessing and communicating the quality level of laboratory timeliness, providing a good correspondence with the actual change in efficiency which was retrospectively observed.

Transforming Turnaround Schools in China: A Review

ERIC Educational Resources Information Center

Liu, Peng

2017-01-01

This article reviews the literature on how Chinese turnaround schools are improved in practice. It starts by defining turnaround schools in the Chinese context, and then discusses the essential reasons why such schools exist. Approaches to improving turnaround schools, successful experiences of transforming turnaround schools, and the challenges…

Root Cause Analysis and Subsequent Intervention to Improve First Dose Antibiotic Turnaround Time for Hospitalized Pediatric Patients

PubMed Central

Dee, Abigail A.; Kelly, Brian; Hampp, Christian

2010-01-01

OBJECTIVE Antibiotic timing is used as a quality standard for hospital accreditation and is an important quality measure. The study aim was to identify barriers in the process of first dose antibiotic administration on the pediatric floors at a tertiary healthcare center and carry out and test an intervention to improve turnaround time to less than one hour. METHODS We conducted a quasi-experimental pre-post study of hospitalized pediatric patients up to 18 years of age initiated on intravenous antibiotics. Every order for a first dose intravenous antibiotic was assessed on all pediatric floors (10/2008). Orders that did not meet the overall turnaround time goal of ≤ 1 hour were identified. A root cause analysis (RCA) was performed to identify reasons for delayed antibiotic administration. Barriers identified in the RCA were used to develop interventions (03/2009) to improve compliance, and the proportion of orders that met the goal was compared pre- (10/2008–02/2009) and post-intervention (04/2009–05/2009). RESULTS During the pre-intervention assessment period, 32 out of 46 total physician orders for a first dose intravenous antibiotic did not meet the one-hour overall turnaround goal. A main reason for delay was failure to label antibiotic orders as first dose. We designed an intervention that included antibiotic audits and individualized feedback to prescribers. The mean ± SD time from the written physician order to drug administration was 228 ± 58 minutes; timing improved to 55 ± 4 minutes after the intervention. The proportion of antibiotics administered within one hour improved from 42.2% to 63% (p=0.0015). CONCLUSIONS We identified system barriers associated with delayed antibiotic administration. Antibiotic timing was improved after continued surveillance and individualized feedback to providers. PMID:22477810

Building a new predictor for multiple linear regression technique-based corrective maintenance turnaround time.

PubMed

Cruz, Antonio M; Barr, Cameron; Puñales-Pozo, Elsa

2008-01-01

This research's main goals were to build a predictor for a turnaround time (TAT) indicator for estimating its values and use a numerical clustering technique for finding possible causes of undesirable TAT values. The following stages were used: domain understanding, data characterisation and sample reduction and insight characterisation. Building the TAT indicator multiple linear regression predictor and clustering techniques were used for improving corrective maintenance task efficiency in a clinical engineering department (CED). The indicator being studied was turnaround time (TAT). Multiple linear regression was used for building a predictive TAT value model. The variables contributing to such model were clinical engineering department response time (CE(rt), 0.415 positive coefficient), stock service response time (Stock(rt), 0.734 positive coefficient), priority level (0.21 positive coefficient) and service time (0.06 positive coefficient). The regression process showed heavy reliance on Stock(rt), CE(rt) and priority, in that order. Clustering techniques revealed the main causes of high TAT values. This examination has provided a means for analysing current technical service quality and effectiveness. In doing so, it has demonstrated a process for identifying areas and methods of improvement and a model against which to analyse these methods' effectiveness.

An evaluation of superminicomputers for thermal analysis

NASA Technical Reports Server (NTRS)

Storaasli, O. O.; Vidal, J. B.; Jones, G. K.

1962-01-01

The feasibility and cost effectiveness of solving thermal analysis problems on superminicomputers is demonstrated. Conventional thermal analysis and the changing computer environment, computer hardware and software used, six thermal analysis test problems, performance of superminicomputers (CPU time, accuracy, turnaround, and cost) and comparison with large computers are considered. Although the CPU times for superminicomputers were 15 to 30 times greater than the fastest mainframe computer, the minimum cost to obtain the solutions on superminicomputers was from 11 percent to 59 percent of the cost of mainframe solutions. The turnaround (elapsed) time is highly dependent on the computer load, but for large problems, superminicomputers produced results in less elapsed time than a typically loaded mainframe computer.

Setting the Bar for School Turnaround: How Ambitious, Public Goals Can Drive School Turnaround

ERIC Educational Resources Information Center

Stanton, Larry; Segal, Alison

2013-01-01

A state education agency (SEA) can pull a powerful lever for school turnaround by setting goals publicly and releasing reports on progress toward those goals at turnaround schools to build public support for turnaround efforts. SEAs can gather information for reporting from data they already have available. This report clarifies indicators and…

Decreased mortality associated with prompt Gram staining of blood cultures.

PubMed

Barenfanger, Joan; Graham, Donald R; Kolluri, Lavanya; Sangwan, Gaurav; Lawhorn, Jerry; Drake, Cheryl A; Verhulst, Steven J; Peterson, Ryan; Moja, Lauren B; Ertmoed, Matthew M; Moja, Ashley B; Shevlin, Douglas W; Vautrain, Robert; Callahan, Charles D

2008-12-01

Gram stains of positive blood cultures are the most important factor influencing appropriate therapy. The sooner appropriate therapy is initiated, the better. Therefore, it is reasonable to expect that the sooner Gram stains are performed, the better. To determine the value of timely Gram stains and whether improvement in Gram stain turnaround time (TAT) is feasible, we compared data for matched pairs of patients with cultures processed promptly (<1 hour TAT) with data for patients with cultures not processed promptly (> or =1 hour TAT) and then monitored TAT by control charting.In 99 matched pairs, average difference in time to detection of positive blood cultures within a pair of patients was less than 0.1 hour. For the less than 1 hour TAT group, the average TAT and crude mortality were 0.1 hour and 10.1%, respectively; for the 1 hour or longer TAT group, they were 3.3 hours and 19.2%, respectively (P < .0001 and P = .0389, respectively). After multifaceted efforts, we achieved significant improvement in the TAT for Gram stains.

Air Cargo Transportation Route Choice Analysis

NASA Technical Reports Server (NTRS)

Obashi, Hiroshi; Kim, Tae-Seung; Oum, Tae Hoon

2003-01-01

Using a unique feature of air cargo transshipment data in the Northeast Asian region, this paper identifies the critical factors that determine the transshipment route choice. Taking advantage of the variations in the transport characteristics in each origin-destination airports pair, the paper uses a discrete choice model to describe the transshipping route choice decision made by an agent (i.e., freight forwarder, consolidator, and large shipper). The analysis incorporates two major factors, monetary cost (such as line-haul cost and landing fee) and time cost (i.e., aircraft turnaround time, including loading and unloading time, custom clearance time, and expected scheduled delay), along with other controls. The estimation method considers the presence of unobserved attributes, and corrects for resulting endogeneity by use of appropriate instrumental variables. Estimation results find that transshipment volumes are more sensitive to time cost, and that the reduction in aircraft turnaround time by 1 hour would be worth the increase in airport charges by more than $1000. Simulation exercises measures the impacts of alternative policy scenarios for a Korean airport, which has recently declared their intention to be a future regional hub in the Northeast Asian region. The results suggest that reducing aircraft turnaround time at the airport be an effective strategy, rather than subsidizing to reduce airport charges.

The National Shipbuilding Research Program. Environmental Studies and Testing (Phase V)

DTIC Science & Technology

2000-11-20

development of an analytical procedure for toxic organic compounds, including TBT ( tributyltin ), whose turnaround time would be in the order of minutes...Cost of the Subtask was $20,000. Subtask #33 - Turnaround Analytical Method for TBT This Subtask performed a preliminary investigation leading to the...34Quick TBT Analytical Method" that will yield reliable results in 15 minutes, a veritable breakthrough in sampling technology. The Subtask was managed by

Partnering with Engineers to Identify and Empirically Evaluate Delays in Magnetic Resonance Imaging Laying the Foundations for Quality Improvement and System-based Practice in Radiology.

PubMed

Brandon, Catherine J; Holody, Michael; Inch, Geoffrey; Kabcenell, Michael; Schowalter, Diane; Mullan, Patricia B

2012-01-01

The aim of this study was to evaluate the feasibility of partnering with engineering students and critically examining the merit of the problem identification and analyses students generated in identifying sources impeding effective turnaround in a large university department of diagnostic radiology. Turnaround involves the time and activities beginning when a patient enters the magnetic resonance scanner room until the patient leaves, minus the time the scanner is conducting the protocol. A prospective observational study was conducted, in which four senior undergraduate industrial and operations engineering students interviewed magnetic resonance staff members and observed all shifts. On the basis of 150 hours of observation, the engineering students identified 11 process steps (eg, changing coils). They charted machine use for all shifts, providing a breakdown of turnaround time between appropriate process and non-value-added time. To evaluate the processes occurring in the scanning room, the students used a work-sampling schedule in which a beeper sounded 2.5 times per hour, signaling the technologist to identify which of 11 process steps was occurring. This generated 2147 random observations over a 3-week period. The breakdown of machine use over 105 individual studies showed that non-value-added time accounted for 62% of turnaround time. Analysis of 2147 random samples of work showed that scanners were empty and waiting for patients 15% of the total time. Analyses showed that poor communication delayed the arrival of patients and that no one had responsibility for communicating when scanning was done. Engineering students used rigorous study design and sampling methods to conduct interviews and observations. This led to data-driven definition of problems and potential solutions to guide systems-based improvement. Copyright © 2012 AUR. Published by Elsevier Inc. All rights reserved.

Evaluation of a pulsed xenon ultraviolet light device for isolation room disinfection in a United Kingdom hospital.

PubMed

Hosein, Ian; Madeloso, Rosie; Nagaratnam, Wijayaratnam; Villamaria, Frank; Stock, Eileen; Jinadatha, Chetan

2016-09-01

Pathogen transmission from contaminated surfaces can cause hospital-associated infections. Although pulsed xenon ultraviolet (PX-UV) light devices have been shown to decrease hospital room bioburden in the United States, their effectiveness in United Kingdom (UK) hospitals is less understood. Forty isolation rooms at the Queens Hospital (700 beds) in North London, UK, were sampled for aerobic bacteria after patient discharge, after manual cleaning with a hypochlorous acid-troclosene sodium solution, and after PX-UV disinfection. PX-UV device efficacy on known organisms was tested by exposing inoculated agar plates in a nonpatient care area. Turnaround times for device usage were recorded, and a survey of hospital staff for perceptions of the device was undertaken. After PX-UV disinfection, the bacterial contamination measured in colony forming units (CFU) decreased by 78.4%, a 91% reduction from initial bioburden levels prior to terminal cleaning. PX-UV exposure resulted in a 5-log CFU reduction for multidrug-resistant organisms (MDROs) on spiked plates. The average device turnaround time was 1 hour, with minimal impact on patient throughput. Ward staff were enthusiastic about device deployment, and device operators reported physical comfort in usage. PX-UV use decreased bioburden in patient discharge rooms and on agar plates spiked with MDROs. The implementation of the PX-UV device was well received by hospital cleaning and ward staff, with minimal disruption to patient flow. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

Relegation and Reversion: Longitudinal Analysis of School Turnaround and Decline

ERIC Educational Resources Information Center

Hochbein, Craig

2012-01-01

School turnaround has become a popular strategy for improvement of chronically low-performing schools. Research related to school turnaround has relied substantially upon case studies. These case studies often focus on successful turnarounds and report immediate outcomes, failing to provide information about the sustainability of the results. In…

The role of monitoring interpretive rates, concordance between cytotechnologist and pathologist interpretations before sign-out, and turnaround time in gynecologic cytology quality assurance: findings from the College of American Pathologists Gynecologic Cytopathology Quality Consensus Conference working group 1.

PubMed

Clary, Karen M; Davey, Diane D; Naryshkin, Sonya; Austin, R Marshall; Thomas, Nicole; Chmara, Beth Anne; Sugrue, Chiara; Tworek, Joseph

2013-02-01

The College of American Pathologists (CAP) conducted a national survey of gynecologic cytology quality assurance (QA) practices. Experts in gynecologic cytology were asked to join 5 working groups that studied the survey data on different aspects of QA. Evaluating the survey data and follow-up questions online, together with a review of pertinent literature, the working groups developed a series of preliminary statements on good laboratory practices in cytology QA. These were presented at a consensus conference and electronic voting occurred. To evaluate a set of QA monitors in gynecologic cytology. Working group 1 evaluated (1) monitoring interpretive rate categories for Papanicolaou tests (Pap tests), (2) concordance of cytotechnologist and pathologist interpretations before sign-out, and (3) turnaround time for Pap tests. The statements are based on a survey of gynecologic cytology QA practice patterns and of opinions from working group members and consensus conference attendees. The outcomes of this process demonstrate the current state of practice patterns in gynecologic cytology QA. Monitoring interpretive rates for all Bethesda System categories is potentially useful, and it is most useful to monitor interpretive rates for cytotechnologists individually and in comparison to the entire laboratory. Laboratories need to determine what level of discrepancy between cytotechnologist and pathologist interpretations of Pap tests is important to track. Laboratories should consider formalizing procedures and policies to adjudicate such discrepant interpretations. Turnaround time should be monitored in gynecologic cytology, but individual laboratories should determine how to measure and use turnaround time internally.

24/7/365 in-house radiologist coverage: effect on resident education.

PubMed

Collins, Jannette; Gruppen, Larry D; Bailey, Janet E; Bokhari, Syed Ahmad Jamal; Paladin, Angelisa M; Robbins, Jessica; White, Richard D

2014-07-01

To compare programs with and without 24-hour/7 days a week/365 days a year (24/7/365) in-house radiologist coverage regarding resident perceptions of their on-call experience, volume of resident dictations on call, and report turnaround time. Residents from six academic radiology departments were invited to participate in an 11-item online survey. Survey items were related to workload, level of autonomy, faculty feedback, comfort level, faculty supervision, and overall educational experience while on call from 8 pm to 8 am. Each site provided data on imaging volume, radiologist coverage, volume of examinations dictated by residents, number of residents on call, and report turnaround time from 8 pm to 8 am. F-ratios and eta-squares were calculated to determine the relationships between dependent and independent variables. A P value < .05 was considered statistically significant. A total of 146 (67%) of 217 residents responded. Residents in programs with 24/7/365 in-house radiologist coverage dictated a lower percentage of examinations (46%) compared with other residents (81%) and rated faculty feedback more positively (mean 3.8 vs. 3.3) but rated their level of autonomy (mean 3.6 vs. 4.5) and educational experience (mean 3.6 vs. 4.2) more negatively (all P < .05). Report turnaround time was lower in programs with 24/7/365 coverage than those without (mean 1.7 hours vs. 9.1 hours). The majority of resident comments were negative and related to loss of autonomy with 24/7/365 coverage. More rapid report turnaround time related to 24/7/365 coverage may come at the expense of resident education. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

School Turnaround Principals: What Does Initial Research Literature Suggest They Are Doing to Be Successful?

ERIC Educational Resources Information Center

Meyers, Coby V.; Hambrick Hitt, Dallas

2017-01-01

As the research literature on principals leading school turnaround grows, determining whether or not real differences between good, even effective, principals and turnaround principals becomes increasingly important. Recent federal government policy and investment established turnaround models that emphasize the role of the school principal,…

Shuttle's 160 hour ground turnaround - A design driver

NASA Technical Reports Server (NTRS)

Widick, F.

1977-01-01

Turnaround analysis added a new dimension to the Space Program with the advent of the Space Shuttle. The requirement to turn the flight hardware around in 160 working hours from landing to launch was a significant design driver and a useful tool in forcing the integration of flight and ground systems design to permit an efficient ground operation. Although there was concern that time constraints might increase program costs, the result of the analysis was to minimize facility requirements and simplify operations with resultant cost savings.

An Integrated Gate Turnaround Management Concept Leveraging Big Data/Analytics for NAS Performance Improvements

NASA Technical Reports Server (NTRS)

Chung, William; Chachad, Girish; Hochstetler, Ronald

2016-01-01

The Integrated Gate Turnaround Management (IGTM) concept was developed to improve the gate turnaround performance at the airport by leveraging relevant historical data to support optimization of airport gate operations, which include: taxi to the gate, gate services, push back, taxi to the runway, and takeoff, based on available resources, constraints, and uncertainties. By analyzing events of gate operations, primary performance dependent attributes of these events were identified for the historical data analysis such that performance models can be developed based on uncertainties to support descriptive, predictive, and prescriptive functions. A system architecture was developed to examine system requirements in support of such a concept. An IGTM prototype was developed to demonstrate the concept using a distributed network and collaborative decision tools for stakeholders to meet on time pushback performance under uncertainties.

Rebuilding Organizational Capacity in Turnaround Schools: Insights from the Corporate, Government, and Non-Profit Sectors

ERIC Educational Resources Information Center

Murphy, Joseph; Meyers, Coby V.

2009-01-01

In this article, we provide a grounded narrative of capacity building in the turnaround equation by exploring the turnaround literature outside of education and applying it to troubled schools. Our analysis is based upon reviews of: (1) 14 comprehensive, historical volumes that examine the turnaround phenomenon; (2) 16 book-length analyses of…

Turnaround Schools as a U-Turn for Student Achievement: The Rotary of School Reform Efforts

ERIC Educational Resources Information Center

Mette, Ian M.

2012-01-01

This case study presents data to support the notion that turnaround school policy can improve the efficiency of how traditionally low-performing schools function. The schools that were successful in implementing the UVA Turnaround Program training developed a clear understanding of the expectations for participating in the UVA Turnaround Program…

Lead Turnaround Partners: How the Emerging Marketplace of Lead Turnaround Partners Is Changing School Improvement

ERIC Educational Resources Information Center

Corbett, Julie

2011-01-01

This report describes the use of Lead Turnaround Partners (LTPs) in the current School Improvement Grant (SIG) program and provides the results of document review, surveys, and interviews with eight State Education Agencies and seven Lead Turnaround Partner organizations. The study focuses on the implementation of the transformation and turnaround…

District Readiness to Support School Turnaround: A Users' Guide to Inform the Work of State Education Agencies and Districts

ERIC Educational Resources Information Center

Player, Daniel; Hambrick Hitt, Dallas; Robinson, William

2014-01-01

This guide provides state education agencies (SEAs) and districts (LEAs) with guidance about how to assess the district's readiness to support school turnaround initiatives. Often, school turnaround efforts focus only on the school's structure and leadership. Rarely do policymakers or practitioners think about school turnaround as a system-level…

School Turnaround: Cristo Rey Boston High School Case Study

ERIC Educational Resources Information Center

Thielman, Jeff

2012-01-01

The mandates of the federal No Child Left Behind Law, including the threat of closing a school for underperformance, have led to multiple public school turnaround attempts. Because turnaround is a relatively new area of focus in education, there is limited research on what does and does not work, and even the definition of turnaround is a work in…

The University of Colorado OSO-8 spectrometer experiment. IV - Mission operations

NASA Technical Reports Server (NTRS)

Hansen, E. R.; Bruner, E. C., Jr.

1979-01-01

The remote operation of two high-resolution ultraviolet spectrometers on the OSO-8 satellite is discussed. Mission operations enabled scientific observers to plan observations based on current solar data, interact with the observing program using real- or near real-time data and commands, evaluate quick-look instrument data, and analyze the observations for publication. During routine operations, experiments were planned a day prior to their execution, and the data from these experiments received a day later. When a shorter turnaround was required, a real-time mode was available. Here, the real-time data and command links into the remote control center were used to evaluate experiment operation and make satellite pointing or instrument configuration changes with a 1-90 minute turnaround.

STEPS: lean thinking, theory of constraints and identifying bottlenecks in an emergency department.

PubMed

Ryan, A; Hunter, K; Cunningham, K; Williams, J; O'Shea, H; Rooney, P; Hickey, F

2013-04-01

This study aimed to identify the bottlenecks in patients' journeys through an emergency department (ED). For each stage of the patient journey, the average times were compared between two groups divided according to the four hour time frame and disproportionate delays were identified using a significance test These bottlenecks were evaluated with reference to a lean thinking value-stream map and the five focusing steps of the theory of constraints. A total of 434 (72.5%) ED patients were tracked over one week. Logistic regression showed that patients who had radiological tests, blood tests or who were admitted were 4.4, 4.1 and 7.7 times more likely, respectively, to stay over four hours in the ED than those who didn't The stages that were significantly delayed were the time spent waiting for radiology (p = 0.001), waiting for the in-patient team (p = 0.004), waiting for a bed (p < 0.001) and ED doctor turnaround time (p < 0.001).

Do Diagnosis Delays Impact Receipt of Test Results? Evidence from the HIV Early Infant Diagnosis Program in Uganda

PubMed Central

Mugambi, Melissa Latigo; Deo, Sarang; Kekitiinwa, Adeodata; Kiyaga, Charles; Singer, Mendel E.

2013-01-01

Background There is scant evidence on the association between diagnosis delays and the receipt of test results in HIV Early Infant Diagnosis (EID) programs. We determine the association between diagnosis delays and other health care system and patient factors on result receipt. Methods We reviewed 703 infant HIV test records for tests performed between January 2008 and February 2009 at a regional referral hospital and level four health center in Uganda. The main outcome was caregiver receipt of the test result. The primary study variable was turnaround time (time between sample collection and result availability at the health facility). Additional variables included clinic entry point, infant age at sample collection, reported HIV status and receipt of antiretroviral prophylaxis for prevention of mother-to-child transmission. We conducted a pooled analysis in addition to separate analyses for each facility. We estimated the relative risk of result receipt using modified Poisson regression with robust standard errors. Results Overall, the median result turnaround time, was 38 days. 59% of caregivers received infant test results. Caregivers were less likely to receive results at turnaround times greater than 49 days compared to 28 days or fewer (ARR = 0.83; 95% CI = 0.70–0.98). Caregivers were more likely to receive results at the PMTCT clinic (ARR = 1.81; 95% CI = 1.40–2.33) and less likely at the pediatric ward (ARR = 0.54; 95% CI = 0.37–0.81) compared to the immunization clinic. At the level four health center, result receipt was half as likely among infants older than 9 months compared to 3 months and younger (ARR= 0.47; 95% CI = 0.25–0.93). Conclusion In this study setting, we find evidence that longer turnaround times, clinic entry point and age at sample collection may be associated with receipt of infant HIV test results. PMID:24282502

Windows of National Opportunity: An Excerpt from the Center on School Turnaround's Report on State Supports for Turnaround

ERIC Educational Resources Information Center

Scott, Caitlin; Lasley, Nora

2014-01-01

In 2014, state and national leaders found many aspects of turning around America's low-performing schools even more daunting than in the previous year. These views were revealed in the Center on School Turnaround's (CST's) 2014 February/March survey of school turnaround leaders in State Education Agencies (SEA) and directors of the nation's…

Comparison of turnaround time and total cost of HIV testing before and after implementation of the 2014 CDC/APHL Laboratory Testing Algorithm for diagnosis of HIV infection.

PubMed

Chen, Derrick J; Yao, Joseph D

2017-06-01

Updated recommendations for HIV diagnostic laboratory testing published by the Centers for Disease Control and Prevention and the Association of Public Health Laboratories incorporate 4th generation HIV immunoassays, which are capable of identifying HIV infection prior to seroconversion. The purpose of this study was to compare turnaround time and cost between 3rd and 4th generation HIV immunoassay-based testing algorithms for initially reactive results. The clinical microbiology laboratory database at Mayo Clinic, Rochester, MN was queried for 3rd generation (from November 2012 to May 2014) and 4th generation (from May 2014 to November 2015) HIV immunoassay results. All results from downstream supplemental testing were recorded. Turnaround time (defined as the time of initial sample receipt in the laboratory to the time the final supplemental test in the algorithm was resulted) and cost (based on 2016 Medicare reimbursement rates) were assessed. A total of 76,454 and 78,998 initial tests were performed during the study period using the 3rd generation and 4th generation HIV immunoassays, respectively. There were 516 (0.7%) and 581 (0.7%) total initially reactive results, respectively. Of these, 304 (58.9%) and 457 (78.7%) were positive by supplemental testing. There were 10 (0.01%) cases of acute HIV infection identified with the 4th generation algorithm. The most frequent tests performed to confirm an HIV-positive case using the 3rd generation algorithm, which were reactive initial immunoassay and positive HIV-1 Western blot, took a median time of 1.1 days to complete at a cost of $45.00. In contrast, the most frequent tests performed to confirm an HIV-positive case using the 4th generation algorithm, which included a reactive initial immunoassay and positive HIV-1/-2 antibody differentiation immunoassay for HIV-1, took a median time of 0.4 days and cost $63.25. Overall median turnaround time was 2.2 and 1.5 days, and overall median cost was $63.90 and $72.50 for 3rd and 4th generation algorithms, respectively. Both 3rd and 4th generation HIV immunoassays had similar total numbers of tests performed and positivity rates during the study period. A greater proportion of reactive 4th generation immunoassays were confirmed to be positive, and the 4th generation algorithm identified several cases of acute HIV infection that would have been missed by the 3rd generation algorithm. The 4th generation algorithm had a more rapid turnaround time but higher cost for confirmed positive HIV infections and overall, compared to the 3rd generation algorithm. Copyright © 2017 Elsevier B.V. All rights reserved.

A Simulation Based Approach for Contingency Planning for Aircraft Turnaround Operation System Activities in Airline Hubs

NASA Technical Reports Server (NTRS)

Adeleye, Sanya; Chung, Christopher

2006-01-01

Commercial aircraft undergo a significant number of maintenance and logistical activities during the turnaround operation at the departure gate. By analyzing the sequencing of these activities, more effective turnaround contingency plans may be developed for logistical and maintenance disruptions. Turnaround contingency plans are particularly important as any kind of delay in a hub based system may cascade into further delays with subsequent connections. The contingency sequencing of the maintenance and logistical turnaround activities were analyzed using a combined network and computer simulation modeling approach. Experimental analysis of both current and alternative policies provides a framework to aid in more effective tactical decision making.

Laboratory-based clinical audit as a tool for continual improvement: an example from CSF chemistry turnaround time audit in a South-African teaching hospital.

PubMed

Imoh, Lucius C; Mutale, Mubanga; Parker, Christopher T; Erasmus, Rajiv T; Zemlin, Annalise E

2016-01-01

Timeliness of laboratory results is crucial to patient care and outcome. Monitoring turnaround times (TAT), especially for emergency tests, is important to measure the effectiveness and efficiency of laboratory services. Laboratory-based clinical audits reveal opportunities for improving quality. Our aim was to identify the most critical steps causing a high TAT for cerebrospinal fluid (CSF) chemistry analysis in our laboratory. A 6-month retrospective audit was performed. The duration of each operational phase across the laboratory work flow was examined. A process-mapping audit trail of 60 randomly selected requests with a high TAT was conducted and reasons for high TAT were tested for significance. A total of 1505 CSF chemistry requests were analysed. Transport of samples to the laboratory was primarily responsible for the high average TAT (median TAT = 170 minutes). Labelling accounted for most delays within the laboratory (median TAT = 71 minutes) with most delays occurring after regular work hours (P < 0.05). CSF chemistry requests without the appropriate number of CSF sample tubes were significantly associated with delays in movement of samples from the labelling area to the technologist's work station (caused by a preference for microbiological testing prior to CSF chemistry). A laboratory-based clinical audit identified sample transportation, work shift periods and use of inappropriate CSF sample tubes as drivers of high TAT for CSF chemistry in our laboratory. The results of this audit will be used to change pre-analytical practices in our laboratory with the aim of improving TAT and customer satisfaction.

Teacher Pay-for-Performance in School Turnaround: How Bonuses and Differentiated Pay Scales Can Help Support School Turnaround. Meeting the Turnaround Challenge: Strategies, Resources & Tools to Transform a Framework into Practice

ERIC Educational Resources Information Center

Mass Insight Education (NJ1), 2009

2009-01-01

Given the importance of good teaching and leadership for school success, turnaround schools should think carefully about how to structure professional environments that reward and motivate excellence. A system of "Pay-for-Contribution" that includes tools such as hard-to-staff and skill shortage pay, performance pay, and/or retention…

Parallel computation of GA search for the artery shape determinants with CFD

NASA Astrophysics Data System (ADS)

Himeno, M.; Noda, S.; Fukasaku, K.; Himeno, R.

2010-06-01

We studied which factors play important role to determine the shape of arteries at the carotid artery bifurcation by performing multi-objective optimization with computation fluid dynamics (CFD) and the genetic algorithm (GA). To perform it, the most difficult problem is how to reduce turn-around time of the GA optimization with 3D unsteady computation of blood flow. We devised two levels of parallel computation method with the following features: level 1: parallel CFD computation with appropriate number of cores; level 2: parallel jobs generated by "master", which finds quickly available job cue and dispatches jobs, to reduce turn-around time. As a result, the turn-around time of one GA trial, which would have taken 462 days with one core, was reduced to less than two days on RIKEN supercomputer system, RICC, with 8192 cores. We performed a multi-objective optimization to minimize the maximum mean WSS and to minimize the sum of circumference for four different shapes and obtained a set of trade-off solutions for each shape. In addition, we found that the carotid bulb has the feature of the minimum local mean WSS and minimum local radius. We confirmed that our method is effective for examining determinants of artery shapes.

Effects of Lean Six Sigma application in healthcare services: a literature review.

PubMed

Ahmed, Selim; Manaf, Noor H A; Islam, Rafikul

2013-01-01

The healthcare organization is the place where defects and mistakes cannot be tolerated. A simple mistake can cost a human life so defects or mistakes must be eliminated in healthcare service processes. A Lean Six Sigma (LSS) approach is the best option in a healthcare environment for dealing with a critical patient. The LSS methodology optimizes the average reduction of a desired process. The expected results can be reductions in several aspects of healthcare such as patient waiting time in emergency departments, lost charges for billing in patient financial services, delinquent medical records, diagnostic result turnaround times, accounts receivable days, patients' length of stay, or medication errors. This paper mainly discusses the effects of the LSS approach in different hospitals around the world according to the literature review. This review also discusses the relationship between LSS as well as their impacts on healthcare services based on literature review.

Response rate, response time, and economic costs of survey research: A randomized trial of practicing pharmacists.

PubMed

Hardigan, Patrick C; Popovici, Ioana; Carvajal, Manuel J

2016-01-01

There is a gap between increasing demands from pharmacy journals, publishers, and reviewers for high survey response rates and the actual responses often obtained in the field by survey researchers. Presumably demands have been set high because response rates, times, and costs affect the validity and reliability of survey results. Explore the extent to which survey response rates, average response times, and economic costs are affected by conditions under which pharmacist workforce surveys are administered. A random sample of 7200 U.S. practicing pharmacists was selected. The sample was stratified by delivery method, questionnaire length, item placement, and gender of respondent for a total of 300 observations within each subgroup. A job satisfaction survey was administered during March-April 2012. Delivery method was the only classification showing significant differences in response rates and average response times. The postal mail procedure accounted for the highest response rates of completed surveys, but the email method exhibited the quickest turnaround. A hybrid approach, consisting of a combination of postal and electronic means, showed the least favorable results. Postal mail was 2.9 times more cost effective than the email approach and 4.6 times more cost effective than the hybrid approach. Researchers seeking to increase practicing pharmacists' survey participation and reduce response time and related costs can benefit from the analytical procedures tested here. Copyright © 2016 Elsevier Inc. All rights reserved.

Validation of Clinical Testing for Warfarin Sensitivity

PubMed Central

Langley, Michael R.; Booker, Jessica K.; Evans, James P.; McLeod, Howard L.; Weck, Karen E.

2009-01-01

Responses to warfarin (Coumadin) anticoagulation therapy are affected by genetic variability in both the CYP2C9 and VKORC1 genes. Validation of pharmacogenetic testing for warfarin responses includes demonstration of analytical validity of testing platforms and of the clinical validity of testing. We compared four platforms for determining the relevant single nucleotide polymorphisms (SNPs) in both CYP2C9 and VKORC1 that are associated with warfarin sensitivity (Third Wave Invader Plus, ParagonDx/Cepheid Smart Cycler, Idaho Technology LightCycler, and AutoGenomics Infiniti). Each method was examined for accuracy, cost, and turnaround time. All genotyping methods demonstrated greater than 95% accuracy for identifying the relevant SNPs (CYP2C9 *2 and *3; VKORC1 −1639 or 1173). The ParagonDx and Idaho Technology assays had the shortest turnaround and hands-on times. The Third Wave assay was readily scalable to higher test volumes but had the longest hands-on time. The AutoGenomics assay interrogated the largest number of SNPs but had the longest turnaround time. Four published warfarin-dosing algorithms (Washington University, UCSF, Louisville, and Newcastle) were compared for accuracy for predicting warfarin dose in a retrospective analysis of a local patient population on long-term, stable warfarin therapy. The predicted doses from both the Washington University and UCSF algorithms demonstrated the best correlation with actual warfarin doses. PMID:19324988

Validation of clinical testing for warfarin sensitivity: comparison of CYP2C9-VKORC1 genotyping assays and warfarin-dosing algorithms.

PubMed

Langley, Michael R; Booker, Jessica K; Evans, James P; McLeod, Howard L; Weck, Karen E

2009-05-01

Responses to warfarin (Coumadin) anticoagulation therapy are affected by genetic variability in both the CYP2C9 and VKORC1 genes. Validation of pharmacogenetic testing for warfarin responses includes demonstration of analytical validity of testing platforms and of the clinical validity of testing. We compared four platforms for determining the relevant single nucleotide polymorphisms (SNPs) in both CYP2C9 and VKORC1 that are associated with warfarin sensitivity (Third Wave Invader Plus, ParagonDx/Cepheid Smart Cycler, Idaho Technology LightCycler, and AutoGenomics Infiniti). Each method was examined for accuracy, cost, and turnaround time. All genotyping methods demonstrated greater than 95% accuracy for identifying the relevant SNPs (CYP2C9 *2 and *3; VKORC1 -1639 or 1173). The ParagonDx and Idaho Technology assays had the shortest turnaround and hands-on times. The Third Wave assay was readily scalable to higher test volumes but had the longest hands-on time. The AutoGenomics assay interrogated the largest number of SNPs but had the longest turnaround time. Four published warfarin-dosing algorithms (Washington University, UCSF, Louisville, and Newcastle) were compared for accuracy for predicting warfarin dose in a retrospective analysis of a local patient population on long-term, stable warfarin therapy. The predicted doses from both the Washington University and UCSF algorithms demonstrated the best correlation with actual warfarin doses.

Manned Orbital Transfer Vehicle (MOTV). Volume 5: Turnaround analysis

NASA Technical Reports Server (NTRS)

Boyland, R. E.; Sherman, S. W.; Morfin, H. W.

1979-01-01

The development of a low-cost reliable turnaround process to employ the MOTV in enhancing the utilization of the geosynchronous space region is analyzed. It is indicated that a routine effective turnaround/maintenance plan must make maximum use of flight data for maintenance planning, a high degree of test automation, and MOTV maintainability features in order to minimize tests, facilitate repair, and reduce manpower requirements. An effective turnaround plan provides a payback of reduced risks.

Identifying causes of laboratory turnaround time delay in the emergency department.

PubMed

Jalili, Mohammad; Shalileh, Keivan; Mojtahed, Ali; Mojtahed, Mohammad; Moradi-Lakeh, Maziar

2012-12-01

Laboratory turnaround time (TAT) is an important determinant of patient stay and quality of care. Our objective is to evaluate laboratory TAT in our emergency department (ED) and to generate a simple model for identifying the primary causes for delay. We measured TATs of hemoglobin, potassium, and prothrombin time tests requested in the ED of a tertiary-care, metropolitan hospital during a consecutive one-week period. The time of different steps (physician order, nurse registration, blood-draw, specimen dispatch from the ED, specimen arrival at the laboratory, and result availability) in the test turnaround process were recorded and the intervals between these steps (order processing, specimen collection, ED waiting, transit, and within-laboratory time) and total TAT were calculated. Median TATs for hemoglobin and potassium were compared with those of the 1990 Q-Probes Study (25 min for hemoglobin and 36 min for potassium) and its recommended goals (45 min for 90% of tests). Intervals were compared according to the proportion of TAT they comprised. Median TATs (170 min for 132 hemoglobin tests, 225 min for 172 potassium tests, and 195.5 min for 128 prothrombin tests) were drastically longer than Q-Probes reported and recommended TATs. The longest intervals were ED waiting time and order processing.  Laboratory TAT varies among institutions, and data are sparse in developing countries. In our ED, actions to reduce ED waiting time and order processing are top priorities. We recommend utilization of this model by other institutions in settings with limited resources to identify their own priorities for reducing laboratory TAT.

Keys to Sustaining Successful School Turnarounds

ERIC Educational Resources Information Center

Duke, Daniel L.

2006-01-01

To identify the changes associated with the school turnaround process, this article reviewed 15 case studies of elementary school turnaround initiatives that sustained improvements for at least two years. Changes were clustered into eight categories: leadership, school policy, programs, organizational processes, staffing, classroom practices,…

"Turnaround" as Shock Therapy: Race, Neoliberalism, and School Reform

ERIC Educational Resources Information Center

Johnson, Amanda Walker

2013-01-01

"Turnaround" strategies of educational reform promise that school closure, reconstitution, privatizing, and reopening them will bring miraculous results. Questioning the implications, this article situates "turnaround" strategies locally, following the closure of a predominantly minority high school in 2008, in Austin, Texas.…

Programing techniques for CDC equipment

NASA Technical Reports Server (NTRS)

Newsom, J. R.; Tiffany, S. H.

1979-01-01

Five techniques reduce core requirements for fast batch turnaround time and interactive-terminal capability. Same techniques increase program versatility, decrease problem-configuration dependence, and facilitate interprogram communication.

National Combustion Code Parallel Performance Enhancements

NASA Technical Reports Server (NTRS)

Quealy, Angela; Benyo, Theresa (Technical Monitor)

2002-01-01

The National Combustion Code (NCC) is being developed by an industry-government team for the design and analysis of combustion systems. The unstructured grid, reacting flow code uses a distributed memory, message passing model for its parallel implementation. The focus of the present effort has been to improve the performance of the NCC code to meet combustor designer requirements for model accuracy and analysis turnaround time. Improving the performance of this code contributes significantly to the overall reduction in time and cost of the combustor design cycle. This report describes recent parallel processing modifications to NCC that have improved the parallel scalability of the code, enabling a two hour turnaround for a 1.3 million element fully reacting combustion simulation on an SGI Origin 2000.

Space transportation system shuttle turnabout analysis report

NASA Technical Reports Server (NTRS)

Reedy, R. E.

1979-01-01

The progress made and the problems encountered by the various program elements of the shuttle program in achieving the 160 hour ground turnaround goal are presented and evaluated. Task assessment time is measured against the program allocation time.

Process dependency of radiation hardness of rapid thermal reoxidized nitrided gate oxides

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

Weishin Lu; Kuanchin Lin; Jenngwo Hwu

The radiation hardness of MOS capacitors with various reoxidized nitrided oxide (RNO) structures is studied by changing the durations of rapid thermal processes during sample preparation and by applying irradiation-then-anneal (ITA) treatments on samples after preparation. It is found that the initial flatband voltage and midgap interface trap density of MOS capacitors exhibit turnaround'' dependency on the total time of nitridation and reoxidation processes. For samples with nitrided oxide (NO) structures, the radiation-induced variations of above parameters are also turnaround''-dependent on nitridation time. However, when the reoxidation process is performed, the radiation hardness for all samples will be gradually improvedmore » with increasing reoxidation time no matter what the nitridation time is. The most radiation-hard process for RNO structures is suggested. Finally, it is found that when ITA treatments are applied on samples after preparation, their radiation hardness is much improved.« less

The Big U-Turn

ERIC Educational Resources Information Center

Hassel, Emily Ayscue; Hassel, Bryan C.

2009-01-01

This article explains what the authors know, from plentiful cross-sector research, about how to engineer turnarounds within existing organizations. It then identifies two critical policy issues that states and districts must address to accelerate the prevalence of real, successful turnarounds in education. Effective turnaround leaders follow a…

Multiprocessing on supercomputers for computational aerodynamics

NASA Technical Reports Server (NTRS)

Yarrow, Maurice; Mehta, Unmeel B.

1991-01-01

Little use is made of multiple processors available on current supercomputers (computers with a theoretical peak performance capability equal to 100 MFLOPS or more) to improve turnaround time in computational aerodynamics. The productivity of a computer user is directly related to this turnaround time. In a time-sharing environment, such improvement in this speed is achieved when multiple processors are used efficiently to execute an algorithm. The concept of multiple instructions and multiple data (MIMD) is applied through multitasking via a strategy that requires relatively minor modifications to an existing code for a single processor. This approach maps the available memory to multiple processors, exploiting the C-Fortran-Unix interface. The existing code is mapped without the need for developing a new algorithm. The procedure for building a code utilizing this approach is automated with the Unix stream editor.

Cutting medical transcription costs.

PubMed

Forsman, John A

2003-07-01

Home-based, production-based medical transcription represents a substantial cost-saving opportunity. Fewer employees are required. Office space is not needed. Outsourcing costs are eliminated. Turnaround time is reduced.

Impact of the New Abbott mPLUS Feature on Clinical Laboratory Efficiencies of Abbott RealTime Assays for Detection of HIV-1, Hepatitis C Virus, Hepatitis B Virus, Chlamydia trachomatis, and Neisseria gonorrhoeae

PubMed Central

Jones, Sara; Wiesneth, Russ; Barry, Cathy; Webb, Erika; Belova, Larissa; Dolan, Peggy; Ho, Shiaolan; Abravaya, Klara; Cloherty, Gavin

2013-01-01

Diagnostic laboratories are under increasing pressure to improve and expand their services. Greater flexibility in sample processing is a critical factor that can improve the time to results while reducing reagent waste, making laboratories more efficient and cost-effective. The introduction of the Abbott mPLUS feature, with the capacity for extended use of amplification reagents, significantly increases the flexibility of the m2000 platform and enables laboratories to customize their workflows based on sample arrival patterns. The flexibility in sample batch size offered by mPLUS enables significant reductions in processing times. For hepatitis B virus tests, a reduction in sample turnaround times of up to 30% (105 min) was observed for batches of 12 samples compared with those for batches of 24 samples; for Chlamydia trachomatis/Neisseria gonorrhoeae tests, the ability to run batches of 24 samples reduced the turnaround time by 83% (54 min) compared with that for batches of 48 samples. Excellent correlations between mPLUS and m2000 standard condition results were observed for all RealTime viral load assays evaluated in this study, with correlation r values of 0.998 for all assays tested. For the qualitative RealTime C. trachomatis/N. gonorrhoeae assay, the overall agreements between the two conditions tested were >98% for C. trachomatis and 100% for N. gonorrhoeae. Comparable precision results were observed for the two conditions tested for all RealTime assays. The enhanced mPLUS capability provides clinical laboratories with increased efficiencies to meet increasingly stringent turnaround time requirements without increased costs associated with discarding partially used amplification reagents. PMID:24088850

Impact of the New Abbott mPLUS feature on clinical laboratory efficiencies of abbott RealTime assays for detection of HIV-1, Hepatitis C Virus, Hepatitis B Virus, Chlamydia trachomatis, and Neisseria gonorrhoeae.

PubMed

Lucic, Danijela; Jones, Sara; Wiesneth, Russ; Barry, Cathy; Webb, Erika; Belova, Larissa; Dolan, Peggy; Ho, Shiaolan; Abravaya, Klara; Cloherty, Gavin

2013-12-01

Diagnostic laboratories are under increasing pressure to improve and expand their services. Greater flexibility in sample processing is a critical factor that can improve the time to results while reducing reagent waste, making laboratories more efficient and cost-effective. The introduction of the Abbott mPLUS feature, with the capacity for extended use of amplification reagents, significantly increases the flexibility of the m2000 platform and enables laboratories to customize their workflows based on sample arrival patterns. The flexibility in sample batch size offered by mPLUS enables significant reductions in processing times. For hepatitis B virus tests, a reduction in sample turnaround times of up to 30% (105 min) was observed for batches of 12 samples compared with those for batches of 24 samples; for Chlamydia trachomatis/Neisseria gonorrhoeae tests, the ability to run batches of 24 samples reduced the turnaround time by 83% (54 min) compared with that for batches of 48 samples. Excellent correlations between mPLUS and m2000 standard condition results were observed for all RealTime viral load assays evaluated in this study, with correlation r values of 0.998 for all assays tested. For the qualitative RealTime C. trachomatis/N. gonorrhoeae assay, the overall agreements between the two conditions tested were >98% for C. trachomatis and 100% for N. gonorrhoeae. Comparable precision results were observed for the two conditions tested for all RealTime assays. The enhanced mPLUS capability provides clinical laboratories with increased efficiencies to meet increasingly stringent turnaround time requirements without increased costs associated with discarding partially used amplification reagents.

Scaling School Turnaround

ERIC Educational Resources Information Center

Herman, Rebecca

2012-01-01

This article explores the research on turning around low performing schools to summarize what we know, what we don't know, and what this means for scaling school turnaround efforts. "School turnaround" is defined here as quick, dramatic gains in academic achievement for persistently low performing schools. The article first considers the…

The Turnaround Fallacy

ERIC Educational Resources Information Center

Smarick, Andy

2010-01-01

For as long as there have been struggling schools in America's cities, there have been efforts to turn them around. But overall, school turnaround efforts have consistently fallen far short of hopes and expectations. Quite simply, turnarounds are not a scalable strategy for fixing America's troubled urban school systems. Fortunately, findings from…

Role of Superintendent in District Turnaround

ERIC Educational Resources Information Center

Evans, James, Jr.

2014-01-01

The purpose of this research study was to evaluate the role of the superintendent in the turnaround process in persistently low achieving school districts. This research identified common threads, principles, and suggestions on turnaround processes and the role of the superintendent through examination of research on leadership and school…

Human Capital in Turnaround Schools

ERIC Educational Resources Information Center

Ferris, Kristen

2012-01-01

Finding, keeping and supporting great educators presents the single biggest challenge to successful school turnarounds. Without teachers and administrators who bring the needed combination of skills and passion, nothing else will achieve the desired effect. The turnaround model supported by the U.S. Department of Education School Improvement Grant…

Turnaround Arts Initiative: Summary of Key Findings

ERIC Educational Resources Information Center

Stoelinga, Sara Ray; Silk, Yael; Reddy, Prateek; Rahman, Nadiv

2015-01-01

Turnaround Arts is a public-private partnership that aims to test the hypothesis that strategically implementing high-quality and integrated arts education programming in high-poverty, chronically underperforming schools adds significant value to school-wide reform. In 2014, the Turnaround Arts initiative completed an evaluation report covering…

Five Myths of School Turnaround Policy and Practice

ERIC Educational Resources Information Center

Meyers, Coby V.; Smylie, Mark A.

2017-01-01

Despite the intensity of funding and numerous intervention efforts in recent school turnaround initiatives, many perspectives, practices, and policies specific to school turnaround appear to be at odds with organizational theory. Yet, many actors in research, policy, and practice arenas appear convinced that their steadfastness will eventually be…

Turnaround as Reform: Opportunity for Meaningful Change or Neoliberal Posturing?

ERIC Educational Resources Information Center

Mette, Ian M.

2013-01-01

This study explores the neoliberal agenda of turnaround school reform efforts in America by examining the application and transformation of a Midwest State Turnaround Schools Project for the public school system. Perceptions of administrators and state-level policy actors are considered. Data were collected from 13 participants during the…

Using Competencies to Improve School Turnaround Principal Success

ERIC Educational Resources Information Center

Steiner, Lucy; Hassel, Emily Ayscue

2011-01-01

This paper aims first to shed light on one element of leadership: the characteristics--or "competencies"--of turnaround leaders who succeed in driving rapid, dramatic change. Second, it recounts the elements of support that districts must provide these leaders to enable and sustain a portfolio of successful school turnarounds.…

School Turnarounds: Resisting the Hype, Giving Them Hope. Education Outlook No. 2

ERIC Educational Resources Information Center

Hess, Frederick M.; Gift, Thomas

2009-01-01

Education reformers are abuzz over school "turnarounds," a simple idea that has undeniable appeal. School turnarounds offer the opportunity to take familiar educational institutions and improve them through coaching, mentoring, capacity building, best practices, and other existing tools. Unlike most reform efforts, which focus on incremental…

Common Leadership Responsibilities of Principals of Successful Turnaround Model Schools

ERIC Educational Resources Information Center

Fullwood, Jezelle

2016-01-01

Purpose: The purpose of this qualitative study was to discover which leadership responsibilities, within the domains of trust, communication, learning, and shared leadership, did elementary and middle school principals of successful turnaround schools commonly perceive as most necessary to lead a turnaround intervention model school. Themes were…

School Turnaround Fever: The Paradoxes of a Historical Practice Promoted as a New Reform

ERIC Educational Resources Information Center

Peck, Craig; Reitzug, Ulrich C.

2014-01-01

School "turnaround" has received significant attention recently in education literature and policy action, especially as a means to dramatically improve urban education. In current common education usage, "turnaround" refers to the rapid, significant improvement in the academic achievement of persistently low-achieving schools.…

Turnaround operations analysis for OTV. Volume 2: Detailed technical report

NASA Technical Reports Server (NTRS)

1988-01-01

The objectives and accomplishments were to adapt and apply the newly created database of Shuttle/Centaur ground operations. Previously defined turnaround operations analyses were to be updated for ground-based OTVs (GBOTVs) and space-based OTVs (SBOTVs), design requirements identified for both OTV and Space Station accommodations hardware, turnaround operations costs estimated, and a technology development plan generated to develop the required capabilities. Technical and programmatic data were provided for NASA pertinent to OTV round and space operations requirements, turnaround operations, task descriptions, timelines and manpower requirements, OTV modular design and booster and Space Station interface requirements. SBOTV accommodations development schedule, cost and turnaround operations requirements, and a technology development plan for ground and space operations and space-based accommodations facilities and support equipment. Significant conclusion are discussed.

Expectations Among Academic Clinicians of Inpatient Imaging Turnaround Time: Does it Correlate with Satisfaction?

PubMed

Chan, Keith T; Carroll, Tamara; Linnau, Ken F; Lehnert, Bruce

2015-11-01

Imaging report turnaround time (RTAT) is an important measure of radiology performance and has become the leading priority in customer satisfaction surveys conducted among nonradiologists, who may not be familiar with the imaging workflow. Our aim was to assess physicians' expected RTAT for commonly ordered studies and determine if satisfaction correlates with met expectations. Retrospective review of inpatient imaging was conducted at a single academic institution, and RTAT for 18,414 studies was calculated. Examinations were grouped by study type, priority, and time of day. A cross-sectional survey instrument was completed by 48 internal medicine and surgery resident physicians with questions regarding RTAT and their level of satisfaction with various examinations. Actual RTAT ranged from 1.6 to 26.0 hours, with chest radiographs and computed tomographies generally faster than magnetic resonance images and ultrasounds. Urgent (STAT) examinations and those ordered during business hours have shorter RTAT. The time for image interpretation largely contributed to the RTAT because of the lack of night-time radiology coverage. Referring physician expectations were consistently shorter than actual RTAT, ranging from 30 minutes to 24 hours. Overall satisfaction scores were inversely correlated with RTAT, with a strong correlation to the time from study order to imaging (r(2) = 0.63) and a weak correlation to the image interpretation time (r(2) = 0.17). Satisfaction scores did not correlate with whether the actual RTAT met expectations (r(2) = 0.06). Referring physician satisfaction is likely multifactorial. Although RTAT has been reported as a priority, shortening turnaround time alone may not directly improve clinician satisfaction. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

Comparison of illumigene Group A Streptococcus Assay with Culture of Throat Swabs from Children with Sore Throats in the New Zealand School-Based Rheumatic Fever Prevention Program.

PubMed

Upton, Arlo; Bissessor, Liselle; Farrell, Elizabeth; Shulman, Stanford T; Zheng, Xiaotian; Lennon, Diana

2016-01-01

Group A streptococcal (GAS) pharyngitis is a particularly important condition in areas of New Zealand where the incidence of acute rheumatic fever remains unacceptably high. Prompt diagnosis and treatment of GAS pharyngitis are cornerstones of the Rheumatic Fever Prevention Programme, but these are hindered by the turnaround time of culture. Tests with excellent performance and rapid turnaround times are needed. For this study, throat swabs (Copan ESwabs) were collected from schoolchildren self-identifying with a sore throat. Samples were tested by routine culture and the illumigene GAS assay using loop-mediated isothermal amplification. Discrepant results were resolved by retesting of the same specimen by an alternative molecular assay. Seven hundred fifty-seven throat swab specimens were tested by both methods. The performance characteristics of the illumigene assay using culture on blood agar as the "gold standard" and following discrepancy analysis were as follows: sensitivity, 82% and 87%, respectively; specificity, 93% and 98%, respectively; positive predictive value, 61% and 88%, respectively; and negative predictive value, 97% and 97%, respectively. In our unique setting of a school-based throat swabbing program, the illumigene assay did not perform quite as well as described in previous reports. Despite this, its improved sensitivity and rapid turnaround time compared with those of culture are appealing. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

Change through persuasion.

PubMed

Garvin, David A; Roberto, Michael A

2005-02-01

Faced with the need for a massive change, most managers respond predictably. They revamp the organization's strategy, shift around staff, and root out inefficiencies. They then wait patiently for performance to improve--only to be bitterly disappointed because they've failed to adequately prepare employees for the change. In this article, the authors contend that to make change stick, leaders must conduct an effective persuasion campaign-one that begins weeks or months before the turn-around plan is set in concrete. Like a political campaign, a persuasion campaign is largely one of differentiation from the past. Turnaround leaders must convince people that the organization is truly on its deathbed-or, at the very least, that radical changes are required if the organization is to survive and thrive. (This is a particularly difficult challenge when years of persistent problems have been accompanied by few changes in the status quo.) And they must demonstrate through word and deed that they are the right leaders with the right plan. Accomplishing all this calls for a four-part communications strategy. Prior to announcing a turnaround plan, leaders need to set the stage for employees' acceptance of it. At the time of delivery, they must present a framework through which employees can interpret information and messages about the plan. As time passes, they must manage the mood so that employees' emotional states support implementation and follow-through. And at critical intervals, they must provide reinforcement to ensure that the desired changes take hold and that there's no backsliding. Using the example of the dramatic turn-around at Boston's Beth Israel Deaconess Medical Center, the authors elucidate the inner workings of a successful change effort.

Laboratory-based clinical audit as a tool for continual improvement: an example from CSF chemistry turnaround time audit in a South-African teaching hospital

PubMed Central

Imoh, Lucius C; Mutale, Mubanga; Parker, Christopher T; Erasmus, Rajiv T; Zemlin, Annalise E

2016-01-01

Introduction Timeliness of laboratory results is crucial to patient care and outcome. Monitoring turnaround times (TAT), especially for emergency tests, is important to measure the effectiveness and efficiency of laboratory services. Laboratory-based clinical audits reveal opportunities for improving quality. Our aim was to identify the most critical steps causing a high TAT for cerebrospinal fluid (CSF) chemistry analysis in our laboratory. Materials and methods A 6-month retrospective audit was performed. The duration of each operational phase across the laboratory work flow was examined. A process-mapping audit trail of 60 randomly selected requests with a high TAT was conducted and reasons for high TAT were tested for significance. Results A total of 1505 CSF chemistry requests were analysed. Transport of samples to the laboratory was primarily responsible for the high average TAT (median TAT = 170 minutes). Labelling accounted for most delays within the laboratory (median TAT = 71 minutes) with most delays occurring after regular work hours (P < 0.05). CSF chemistry requests without the appropriate number of CSF sample tubes were significantly associated with delays in movement of samples from the labelling area to the technologist’s work station (caused by a preference for microbiological testing prior to CSF chemistry). Conclusion A laboratory-based clinical audit identified sample transportation, work shift periods and use of inappropriate CSF sample tubes as drivers of high TAT for CSF chemistry in our laboratory. The results of this audit will be used to change pre-analytical practices in our laboratory with the aim of improving TAT and customer satisfaction. PMID:27346964

Turnaround Necessities: Basic Conditions for an Effective, Sustainable, and Scalable School Turnaround

ERIC Educational Resources Information Center

Robinson, William S.; Buntrock, LeAnn M.

2011-01-01

Turning around chronically low-performing schools is challenging work requiring fundamental rethinking of the change process, and a systemic rather than school-by-school approach. Without a doubt, high-impact school leaders are critical to turnaround success, and pockets of success around the country demonstrate this. However, transformational and…

The State Role in School Turnaround: Emerging Best Practices

ERIC Educational Resources Information Center

Rhim, Lauren Morando, Ed.; Redding, Sam, Ed.

2014-01-01

This publication explores the role of the state education agency (SEA) in school turnaround efforts. An emphasis is placed on practical application of research and best practices related to the SEA's critical leadership role in driving and supporting successful school turnaround efforts. The publication is organized around the four goals of…

The Tenure of Private College and University Presidents

ERIC Educational Resources Information Center

Langbert, Mitchell

2012-01-01

This study fills several gaps. Most turnaround studies ignore post-turnaround executive rewards, and most studies of executive rewards ignore both the effects on rewards of achieving a turnaround and length of service, or tenure, as an element of the reward structure. Previous research about the length of college presidents' tenure in office has…

Sustaining Turnaround at the School and District Levels: The High Reliability Schools Project at Sandfields Secondary School

ERIC Educational Resources Information Center

Schaffer, Eugene; Reynolds, David; Stringfield, Sam

2012-01-01

Beginning from 1 high-poverty, historically low-achieving secondary school's successful turnaround work, this article provides data relative to a successful school turnaround, the importance of external and system-level supports, and the importance of building for sustainable institutionalization of improvements. The evidence suggests the…

Faculty Stakeholders' Perceptions of Leadership and Engagement in an Organizational Turnaround in Higher Education

ERIC Educational Resources Information Center

Brownell, Eileen Vlacancich

2016-01-01

This qualitative study represents an exploration into how faculty stakeholders in higher education experienced leadership actions and their own engagement with an organizational turnaround. Turnaround efforts were aimed at revitalization throughout the institution but little has been studied about faculty experience in this context. An interview…

Progress Report 2013. Turnaround Arts Initiative

ERIC Educational Resources Information Center

Stoelinga, Sara Ray; Joyce, Katie; Silk, Yael

2013-01-01

This interim progress report provides a look at Turnaround Arts schools in their first year, including: (1) a summary of the evaluation design and research questions; (2) a preliminary description of strategies used to introduce the arts in Turnaround Arts schools; and (3) a summary of school reform indicators and student achievement data at…

Theoretical Considerations and Standards for the Use of Turnarounds.

ERIC Educational Resources Information Center

Olson, Clark D.

The term "turnaround" has taken a permanent place among the intercollegiate debate jargon. All too often, the first affirmative rebuttalists charge "turnaround" for every plan or response they do not know how to label properly. After so many "false alarms," judges are too weary or aggravated to notice the real thing,…

Robotics and Automation for Flight Deck Aircraft Servicing

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

Chesser, J.B.; Draper, J.V.; Pin, F.G.

1999-03-01

One of the missions of the Future Aircraft Carriers Program is to investigate methods that would improve aircraft turnaround servicing activities on carrier decks. The major objectives and criteria for evaluating alternative aircraft servicing methods are to reduce workload requirements, turnaround times (TAT), and life-cycle costs (LCC). Technologies in the field of Robotics and Automation (R and A) have the potential to significantly contribute to these objectives. The objective of this study was to investigate aircraft servicing functions on carrier decks which would offer the potentially most significant payoff if improved by various R and A technologies. Improvement in thismore » case means reducing workload, time and LCC. This objective was accomplished using a ''bottom-up'' formalized approach as described in the following.« less

Evaluation of Wet Chemical ICP-AES Elemental Analysis Methods usingSimulated Hanford Waste Samples-Phase I Interim Report

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

Coleman, Charles J.; Edwards, Thomas B.

2005-04-30

The wet chemistry digestion method development for providing process control elemental analyses of the Hanford Tank Waste Treatment and Immobilization Plant (WTP) Melter Feed Preparation Vessel (MFPV) samples is divided into two phases: Phase I consists of: (1) optimizing digestion methods as a precursor to elemental analyses by ICP-AES techniques; (2) selecting methods with the desired analytical reliability and speed to support the nine-hour or less turnaround time requirement of the WTP; and (3) providing baseline comparison to the laser ablation (LA) sample introduction technique for ICP-AES elemental analyses that is being developed at the Savannah River National Laboratory (SRNL).more » Phase II consists of: (1) Time-and-Motion study of the selected methods from Phase I with actual Hanford waste or waste simulants in shielded cell facilities to ensure that the methods can be performed remotely and maintain the desired characteristics; and (2) digestion of glass samples prepared from actual Hanford Waste tank sludge for providing comparative results to the LA Phase II study. Based on the Phase I testing discussed in this report, a tandem digestion approach consisting of sodium peroxide fusion digestions carried out in nickel crucibles and warm mixed-acid digestions carried out in plastic bottles has been selected for Time-and-Motion study in Phase II. SRNL experience with performing this analytical approach in laboratory hoods indicates that well-trained cell operator teams will be able to perform the tandem digestions in five hours or less. The selected approach will produce two sets of solutions for analysis by ICP-AES techniques. Four hours would then be allocated for performing the ICP-AES analyses and reporting results to meet the nine-hour or less turnaround time requirement. The tandem digestion approach will need to be performed in two separate shielded analytical cells by two separate cell operator teams in order to achieve the nine-hour or less turnaround time. Because of the simplicity of the warm mixed-acid method, a well-trained cell operator team may in time be able to perform both sets of digestions. However, having separate shielded cells for each of the methods is prudent to avoid overcrowding problems that would impede a minimal turnaround time.« less

Real time application of whole genome sequencing for outbreak investigation - What is an achievable turnaround time?

PubMed

McGann, Patrick; Bunin, Jessica L; Snesrud, Erik; Singh, Seema; Maybank, Rosslyn; Ong, Ana C; Kwak, Yoon I; Seronello, Scott; Clifford, Robert J; Hinkle, Mary; Yamada, Stephen; Barnhill, Jason; Lesho, Emil

2016-07-01

Whole genome sequencing (WGS) is increasingly employed in clinical settings, though few assessments of turnaround times (TAT) have been performed in real-time. In this study, WGS was used to investigate an unfolding outbreak of vancomycin resistant Enterococcus faecium (VRE) among 3 patients in the ICU of a tertiary care hospital. Including overnight culturing, a TAT of just 48.5 h for a comprehensive report was achievable using an Illumina Miseq benchtop sequencer. WGS revealed that isolates from patient 2 and 3 differed from that of patient 1 by a single nucleotide polymorphism (SNP), indicating nosocomial transmission. However, the unparalleled resolution provided by WGS suggested that nosocomial transmission involved two separate events from patient 1 to patient 2 and 3, and not a linear transmission suspected by the time line. Rapid TAT's are achievable using WGS in the clinical setting and can provide an unprecedented level of resolution for outbreak investigations. Published by Elsevier Inc.

On the Edge: A Study of Small Private Colleges That Have Made a Successful Financial Turnaround

ERIC Educational Resources Information Center

Carey, Amy Bragg

2014-01-01

This article describes a qualitative study that involved two small private universities, examining their process of transformation from institutions headed toward closure to institutions that underwent a successful turnaround. The primary questions that guided the study included the issues and circumstances that led to the need for a turnaround,…

Using Federal Education Formula Funds for School Turnaround Initiatives: Opportunities for State Education Agencies

ERIC Educational Resources Information Center

Junge, Melissa; Krvaric, Sheara

2016-01-01

Much has been written on the subject of school turnaround, but relatively little about how to "pay for" turnaround-related work. Turning around low-performing schools not only requires changing instructional and related practices, but changing spending patterns as well. Too often education dollars are spent on the same costs from…

Dancing in a Minefield: An Analysis of Turnaround Specialists in Arizona Schools

ERIC Educational Resources Information Center

McMillie, Kyann L.

2010-01-01

In 2008, educational leaders from the Arizona Department of Education (ADE) assigned a group of turnaround specialists to work in four failing public schools in a large, urban school district in Phoenix, Arizona in hopes of improving those schools. The utilization of turnaround specialists in failing schools was Arizona's method of enacting…

School Turnaround Teachers: Selection Toolkit. Part of the School Turnaround Collection from Public Impact

ERIC Educational Resources Information Center

Public Impact, 2008

2008-01-01

This toolkit includes these separate sections: (1) Selection Preparation Guide; (2) Day-of-Interview Tools; (3) Candidate Rating Tools; and (4) Candidate Comparison and Decision Tools. Each of the sections is designed to be used at different stages of the selection process. The first section provides turnaround teacher competencies that are the…

On the Edge: A Study of Small Private Colleges That Have Made a Successful Financial Turnaround

ERIC Educational Resources Information Center

Carey, Amy Bragg

2013-01-01

This dissertation was a qualitative research study regarding two small private universities and their process of transformation from an institution headed toward closure to a successful turnaround. The primary questions that guided the study included the factors and persons that contributed to the institutional turnaround, the issues and…

The Effect of Locus of Control on School Turnaround

ERIC Educational Resources Information Center

Walston, Bradford

2012-01-01

This research focused on the school turnaround process in six turnaround elementary schools located in urban and rural areas of the state of North Carolina. The purpose of the study was to learn about the challenges facing the six schools, the process of improving student achievement, and, more specifically, the degree to which adaptive leadership…

Sources of Information for Evaluating Rural Development: An Overview.

ERIC Educational Resources Information Center

Grayburn, Laura; And Others

Designed to help rural development evaluators and other social scientists use their bibliographic search time more efficiently, this information guide presents the following: (1) detailed information on computerized information retrieval systems, including name, location, subject matter, turnaround time, cost, availability, and utility…

Comparison of direct selective versus nonselective agar media plus LIM broth enrichment for determination of group B streptococcus colonization status in pregnant women.

PubMed

Elsayed, Sameer; Gregson, Daniel B; Church, Deirdre L

2003-06-01

Group B streptococcus (GBS) is the most common cause of early-onset neonatal sepsis in developed countries, and determination of the GBS colonization status in pregnant patients near term is essential for the provision of prophylactic measures to prevent early-onset disease. To determine if GBS recovery rates and/or result turnaround times for vaginal or combined vaginal/rectal swab specimens from pregnant patients near term are enhanced if swabs are inoculated initially onto selective versus nonselective agar media, in addition to the standard Centers for Disease Control and Prevention method. Prospective laboratory analysis. Urban health region/centralized diagnostic microbiology laboratory. Pregnant women presenting for routine obstetrical care and collection of vaginal or combined vaginal/rectal swab specimens for GBS testing at 35 to 37 weeks' gestation. Culture of specimens directly onto selective (5% sheep blood with colistin and nalidixic acid) or nonselective (5% sheep blood) agar media, in addition to LIM broth enrichment and terminal subculture. Group B streptococcus recovery rate and culture result turnaround time. A total of 639 specimens were tested, with 128 (20%) positive for GBS. Sixty-three isolates were recovered on direct agar media at 24 hours, of which 16 (12.5%) were isolated on selective plates only. An additional 38 isolates were recovered at 48 hours from direct plates. Twenty-seven (21.1%) isolates that failed to grow on direct plates were recovered from the LIM broth subculture only. Three (2.3%) isolates not recovered from LIM broths were detected at 48 hours on the direct selective (2 isolates) and nonselective (1 isolate) agar plates. A 24-hour result turnaround time was achieved for 63 (49.2%) and 47 (36.7%) of the 128 culture-positive specimens for direct selective and nonselective plates, respectively (chi2 = 76.63, P <.001). Use of direct selective agar media, in addition to LIM broth enrichment, for the determination of the GBS colonization status in pregnant patients near term results in decreased turnaround time for reporting positive results.

Ninety to Nothing: a PDSA quality improvement project.

PubMed

Prybutok, Gayle Linda

2018-05-14

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

Rapid identification of pathogens directly from blood culture bottles by Bruker matrix-assisted laser desorption laser ionization-time of flight mass spectrometry versus routine methods.

PubMed

Jamal, Wafaa; Saleem, Rola; Rotimi, Vincent O

2013-08-01

The use of matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) for identification of microorganisms directly from blood culture is an exciting dimension to the microbiologists. We evaluated the performance of Bruker SepsiTyper kit™ (STK) for direct identification of bacteria from positive blood culture. This was done in parallel with conventional methods. Nonrepetitive positive blood cultures from 160 consecutive patients were prospectively evaluated by both methods. Of 160 positive blood cultures, the STK identified 114 (75.6%) isolates and routine conventional method 150 (93%). Thirty-six isolates were misidentified or not identified by the kit. Of these, 5 had score of >2.000 and 31 had an unreliable low score of <1.7. Four of 8 yeasts were identified correctly. The average turnaround time using the STK was 35 min, including extraction steps and 30:12 to 36:12 h with routine method. The STK holds promise for timely management of bacteremic patients. Copyright © 2013 Elsevier Inc. All rights reserved.

Lean management in academic surgery.

PubMed

Collar, Ryan M; Shuman, Andrew G; Feiner, Sandra; McGonegal, Amy K; Heidel, Natalie; Duck, Mary; McLean, Scott A; Billi, John E; Healy, David W; Bradford, Carol R

2012-06-01

Lean is a management system designed to enhance productivity by eliminating waste. Surgical practice offers many opportunities for improving efficiency. Our objective was to determine whether systematic implementation of lean thinking in an academic otolaryngology operating room improves efficiency and profitability and preserves team morale and educational opportunities. In an 18-month prospective quasi-experimental study, a multidisciplinary task force systematically implemented lean thinking within an otolaryngology operating room of an academic health system. Operating room turnover time and turnaround time were measured during a baseline period; an observer-effect period in which workers were made aware that their efficiency was being measured but before implementing lean changes; and an intervention period after redesign principles had been used. The impact on teamwork, morale, and surgical resident education were measured during the baseline and intervention periods through validated surveys. A profit model was applied to estimate the financial implications of the study. There was no difference between the baseline and observer-effect periods of the study for turnover time (p = 0.98) or turnaround time (p = 0.20). During the intervention period, the mean turnover time and turnaround time were significantly shorter than during the baseline period (29 vs 38 minutes; p < 0.001 and 69 vs 89 minutes; p < 0.001, respectively). The composite morale score suggested improved morale after implementation (p = 0.011). Educational metrics were unchanged before and after implementation. The annual opportunity revenue for the involved operating room is $330,000; when extrapolated throughout the operating rooms, lean thinking could create 6,500 hours of capacity annually. Application of lean management techniques to a single operating room and surgical service improved operating room efficiency and morale, sustained resident education, and can provide considerable financial gains when scaled to an entire academic surgical suite. Copyright © 2012. Published by Elsevier Inc.

Optimal turnaround time for direct identification of microorganisms by mass spectrometry in blood culture.

PubMed

Randazzo, Adrien; Simon, Marc; Goffinet, Pierre; Classen, Jean-François; Hougardy, Nicolas; Pierre, Pascal; Kinzinger, Philippe; Mauel, Etienne; Goffinet, Jean-Sébastien

2016-11-01

During the past few years, several studies describing direct identification of bacteria from blood culture using mass spectrometry have been published. These methods cannot, however, be easily integrated into a common laboratory workflow because of the high hands-on time they require. In this paper, we propose a new method of identification with a short hands-on time and a turnaround time shorter than 15min. Positive blood bottles were homogenised and 600μL of blood were transferred to an Eppendorf tube where 600μL of lysis buffer were added. After homogenisation, a centrifugation step of 4min at 10,500g was performed and the supernatant was discarded. The pellet was then washed and loaded in quadruplicate into wells of a Vitek® MS-DS plate. Each well was covered with a saturated matrix solution and a MALDI-TOF mass spectrometry analysis was performed. Species were identified using the software Myla 3.2.0-2. We analysed 266 positive blood culture bottles. A microorganism grew in 261 cultures, while five bottles remained sterile after 48h of incubation in subculture. Our method reaches a probability of detection at the species level of 77.8% (203/261) with a positive predictive value of 99.5% (202/203). We developed a new method for the identification of microorganisms using mass spectrometry, directly performed from a positive blood culture. This method has short hands-on time and turnaround time and can easily take place in the workflow of a laboratory, with comparable results in performance with other methods reported in the literature. Copyright © 2016 Elsevier B.V. All rights reserved.

An economic analysis for optimal distributed computing resources for mask synthesis and tape-out in production environment

NASA Astrophysics Data System (ADS)

Cork, Chris; Lugg, Robert; Chacko, Manoj; Levi, Shimon

2005-06-01

With the exponential increase in output database size due to the aggressive optical proximity correction (OPC) and resolution enhancement technique (RET) required for deep sub-wavelength process nodes, the CPU time required for mask tape-out continues to increase significantly. For integrated device manufacturers (IDMs), this can impact the time-to-market for their products where even a few days delay could have a huge commercial impact and loss of market window opportunity. For foundries, a shorter turnaround time provides a competitive advantage in their demanding market, too slow could mean customers looking elsewhere for these services; while a fast turnaround may even command a higher price. With FAB turnaround of a mature, plain-vanilla CMOS process of around 20-30 days, a delay of several days in mask tapeout would contribute a significant fraction to the total time to deliver prototypes. Unlike silicon processing, masks tape-out time can be decreased by simply purchasing extra computing resources and software licenses. Mask tape-out groups are taking advantage of the ever-decreasing hardware cost and increasing power of commodity processors. The significant distributability inherent in some commercial Mask Synthesis software can be leveraged to address this critical business issue. Different implementations have different fractions of the code that cannot be parallelized and this affects the efficiency with which it scales, as is described by Amdahl"s law. Very few are efficient enough to allow the effective use of 1000"s of processors, enabling run times to drop from days to only minutes. What follows is a cost aware methodology to quantify the scalability of this class of software, and thus act as a guide to estimating the optimal investment in terms of hardware and software licenses.

Differences in the Policies, Programs, and Practices (PPPs) and Combination of PPPs across Turnaround, Moderately Improving, and Not Improving Schools

ERIC Educational Resources Information Center

Herman, Rebecca; Huberman, Mette

2012-01-01

The TALPS study aims to build on the existing research base to develop promising methodologies to identify chronically low-performing and turnaround schools, as well as to identify promising strategies for turning around chronically low-performing schools. By looking specifically at schools identified as turnaround, in comparison to nonturnaround…

Academic Turnarounds: Restoring Vitality to Challenged American Colleges and Universities. ACE/Praeger Series on Higher Education

ERIC Educational Resources Information Center

MacTaggart, Terrence, Ed.

2007-01-01

This book discusses the early indicators of a college or university's need for a turnaround. It outlines financial trends and other indicators of distress, as well as benchmarks for the various stages of an effective turnaround strategy. The book will help trustees, presidents, and faculty members diagnose whether they are in denial about the true…

78 FR 48464 - Comment request for Information Collection for Quick Turnaround Surveys of All Statutes and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-08

... employment and training or related activities. Each survey will be designed on an ad hoc basis and will focus... basis. ETA will make every effort to coordinate the quick turnaround surveys with other research it is... Collection for Quick Turnaround Surveys of All Statutes and Programs for Which the Employment and Training...

Transfer of patients with ST-elevation myocardial infarction for primary percutaneous coronary intervention: a province-wide evaluation of "door-in to door-out" delays at the first hospital.

PubMed

Lambert, Laurie J; Brown, Kevin A; Boothroyd, Lucy J; Segal, Eli; Maire, Sébastien; Kouz, Simon; Ross, Dave; Harvey, Richard; Rinfret, Stéphane; Xiao, Yongling; Nasmith, James; Bogaty, Peter

2014-06-24

Interhospital transfer of patients with ST-elevation myocardial infarction (STEMI) for primary percutaneous coronary intervention (PPCI) is associated with longer delays to reperfusion, related in part to turnaround ("door in" to "door out," or DIDO) time at the initial hospital. As part of a systematic, province-wide evaluation of STEMI care, we examined DIDO times and associations with patient, hospital, and process-of-care factors. We performed medical chart review for STEMI patients transferred for PPCI during a 6-month period (October 1, 2008, through March 31, 2009) and linked these data to ambulance service databases. Two core laboratory cardiologists reviewed presenting ECGs to identify left bundle-branch block and, in the absence of left bundle-branch block, definite STEMI (according to both cardiologists) or an ambiguous reading. Median DIDO time was 51 minutes (25th to 75th percentile: 35-82 minutes); 14.1% of the 988 patients had a timely DIDO interval (≤30 minutes as recommended by guidelines). The data-to-decision delay was the major contributor to DIDO time. Female sex, more comorbidities, longer symptom duration, arrival by means other than ambulance, arrival at a hospital not exclusively transferring for PPCI, arrival at a center with a low STEMI volume, and an ambiguous ECG were independently associated with longer DIDO time. When turnaround was timely, 70% of patients received timely PPCI (door-to-device time ≤90 minutes) versus 14% if turnaround was not timely (P<0.0001). Benchmark DIDO times for STEMI patients transferred for PPCI were rarely achieved. Interventions aimed at facilitating the transfer decision, particularly in cases of ECGs that are difficult to interpret, are likely to have the best impact on reducing delay to reperfusion. © 2014 American Heart Association, Inc.

An Integrated Gate Turnaround Management Concept Leveraging Big Data Analytics for NAS Performance Improvements

NASA Technical Reports Server (NTRS)

Chung, William W.; Ingram, Carla D.; Ahlquist, Douglas Kurt; Chachad, Girish H.

2016-01-01

"Gate Turnaround" plays a key role in the National Air Space (NAS) gate-to-gate performance by receiving aircraft when they reach their destination airport, and delivering aircraft into the NAS upon departing from the gate and subsequent takeoff. The time spent at the gate in meeting the planned departure time is influenced by many factors and often with considerable uncertainties. Uncertainties such as weather, early or late arrivals, disembarking and boarding passengers, unloading/reloading cargo, aircraft logistics/maintenance services and ground handling, traffic in ramp and movement areas for taxi-in and taxi-out, and departure queue management for takeoff are likely encountered on the daily basis. The Integrated Gate Turnaround Management (IGTM) concept is leveraging relevant historical data to support optimization of the gate operations, which include arrival, at the gate, departure based on constraints (e.g., available gates at the arrival, ground crew and equipment for the gate turnaround, and over capacity demand upon departure), and collaborative decision-making. The IGTM concept provides effective information services and decision tools to the stakeholders, such as airline dispatchers, gate agents, airport operators, ramp controllers, and air traffic control (ATC) traffic managers and ground controllers to mitigate uncertainties arising from both nominal and off-nominal airport gate operations. IGTM will provide NAS stakeholders customized decision making tools through a User Interface (UI) by leveraging historical data (Big Data), net-enabled Air Traffic Management (ATM) live data, and analytics according to dependencies among NAS parameters for the stakeholders to manage and optimize the NAS performance in the gate turnaround domain. The application will give stakeholders predictable results based on the past and current NAS performance according to selected decision trees through the UI. The predictable results are generated based on analysis of the unique airport attributes (e.g., runway, taxiway, terminal, and gate configurations and tenants), and combined statistics from past data and live data based on a specific set of ATM concept-of-operations (ConOps) and operational parameters via systems analysis using an analytic network learning model. The IGTM tool will then bound the uncertainties that arise from nominal and off-nominal operational conditions with direct assessment of the gate turnaround status and the impact of a certain operational decision on the NAS performance, and provide a set of recommended actions to optimize the NAS performance by allowing stakeholders to take mitigation actions to reduce uncertainty and time deviation of planned operational events. An IGTM prototype was developed at NASA Ames Simulation Laboratories (SimLabs) to demonstrate the benefits and applicability of the concept. A data network, using the System Wide Information Management (SWIM)-like messaging application using the ActiveMQ message service, was connected to the simulated data warehouse, scheduled flight plans, a fast-time airport simulator, and a graphic UI. A fast-time simulation was integrated with the data warehouse or Big Data/Analytics (BAI), scheduled flight plans from Aeronautical Operational Control AOC, IGTM Controller, and a UI via a SWIM-like data messaging network using the ActiveMQ message service, illustrated in Figure 1, to demonstrate selected use-cases showing the benefits of the IGTM concept on the NAS performance.

Patient flow improvement for an ophthalmic specialist outpatient clinic with aid of discrete event simulation and design of experiment.

PubMed

Pan, Chong; Zhang, Dali; Kon, Audrey Wan Mei; Wai, Charity Sue Lea; Ang, Woo Boon

2015-06-01

Continuous improvement in process efficiency for specialist outpatient clinic (SOC) systems is increasingly being demanded due to the growth of the patient population in Singapore. In this paper, we propose a discrete event simulation (DES) model to represent the patient and information flow in an ophthalmic SOC system in the Singapore National Eye Centre (SNEC). Different improvement strategies to reduce the turnaround time for patients in the SOC were proposed and evaluated with the aid of the DES model and the Design of Experiment (DOE). Two strategies for better patient appointment scheduling and one strategy for dilation-free examination are estimated to have a significant impact on turnaround time for patients. One of the improvement strategies has been implemented in the actual SOC system in the SNEC with promising improvement reported.

Methodology for CFD Design Analysis of National Launch System Nozzle Manifold

NASA Technical Reports Server (NTRS)

Haire, Scot L.

1993-01-01

The current design environment dictates that high technology CFD (Computational Fluid Dynamics) analysis produce quality results in a timely manner if it is to be integrated into the design process. The design methodology outlined describes the CFD analysis of an NLS (National Launch System) nozzle film cooling manifold. The objective of the analysis was to obtain a qualitative estimate for the flow distribution within the manifold. A complex, 3D, multiple zone, structured grid was generated from a 3D CAD file of the geometry. A Euler solution was computed with a fully implicit compressible flow solver. Post processing consisted of full 3D color graphics and mass averaged performance. The result was a qualitative CFD solution that provided the design team with relevant information concerning the flow distribution in and performance characteristics of the film cooling manifold within an effective time frame. Also, this design methodology was the foundation for a quick turnaround CFD analysis of the next iteration in the manifold design.

The continuous adjoint approach to the k-ε turbulence model for shape optimization and optimal active control of turbulent flows

NASA Astrophysics Data System (ADS)

Papoutsis-Kiachagias, E. M.; Zymaris, A. S.; Kavvadias, I. S.; Papadimitriou, D. I.; Giannakoglou, K. C.

2015-03-01

The continuous adjoint to the incompressible Reynolds-averaged Navier-Stokes equations coupled with the low Reynolds number Launder-Sharma k-ε turbulence model is presented. Both shape and active flow control optimization problems in fluid mechanics are considered, aiming at minimum viscous losses. In contrast to the frequently used assumption of frozen turbulence, the adjoint to the turbulence model equations together with appropriate boundary conditions are derived, discretized and solved. This is the first time that the adjoint equations to the Launder-Sharma k-ε model have been derived. Compared to the formulation that neglects turbulence variations, the impact of additional terms and equations is evaluated. Sensitivities computed using direct differentiation and/or finite differences are used for comparative purposes. To demonstrate the need for formulating and solving the adjoint to the turbulence model equations, instead of merely relying upon the 'frozen turbulence assumption', the gain in the optimization turnaround time offered by the proposed method is quantified.

Cost-effectiveness analysis of computerized ECG interpretation system in an ambulatory health care organization.

PubMed

Carel, R S

1982-04-01

The cost-effectiveness of a computerized ECG interpretation system in an ambulatory health care organization has been evaluated in comparison with a conventional (manual) system. The automated system was shown to be more cost-effective at a minimum load of 2,500 patients/month. At larger monthly loads an even greater cost-effectiveness was found, the average cost/ECG being about $2. In the manual system the cost/unit is practically independent of patient load. This is primarily due to the fact that 87% of the cost/ECG is attributable to wages and fees of highly trained personnel. In the automated system, on the other hand, the cost/ECG is heavily dependent on examinee load. This is due to the relatively large impact of equipment depreciation on fixed (and total) cost. Utilization of a computer-assisted system leads to marked reduction in cardiologists' interpretation time, substantially shorter turnaround time (of unconfirmed reports), and potential provision of simultaneous service at several remotely located "heart stations."

Multiple pre- and post-analytical lean approaches to the improvement of the laboratory turnaround time in a large core laboratory.

PubMed

Lou, Amy H; Elnenaei, Manal O; Sadek, Irene; Thompson, Shauna; Crocker, Bryan D; Nassar, Bassam A

2017-10-01

Core laboratory (CL), as a new business model, facilitates consolidation and integration of laboratory services to enhance efficiency and reduce costs. This study evaluates the impact of total laboratory automation system (TLA), electric track vehicle (ETV) system and auto-verification (AV) of results on overall turnaround time (TAT) (phlebotomy to reporting TAT: PR-TAT) within a CL setting. Mean, median and percentage of outlier (OP) for PR-TAT were compared for pre- and post-CL eras using five representative tests based on different request priorities. Comparison studies were also carried out on the intra-laboratory TAT (in-lab to reporting TAT: IR-TAT) and the delivery TAT (phlebotomy to in-lab TAT: PI-TAT) to reflect the efficiency of the TLA (both before and after introducing result AV) and ETV systems respectively. Median PR-TATs for the urgent samples were reduced on average by 16% across all representative analytes. Median PR-TATs for the routine samples were curtailed by 51%, 50%, 49%, 34% and 22% for urea, potassium, thyroid stimulating hormone (TSH), complete blood count (CBC) and prothrombin time (PT) respectively. The shorter PR-TAT was attributed to a significant reduction of IR-TAT through the TLA. However, the median PI-TAT was delayed when the ETV was used. Application of various AV rules shortened the median IR-TATs for potassium and urea. However, the OP of PR-TAT for the STAT requests exceeding 60min were all higher than those from the pre-CL era. TLA and auto-verification rules help to efficiently manage substantial volumes of urgent and routine samples. However, the ETV application as it stands shows a negative impact on the PR-TAT. Copyright © 2017 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Measuring and managing radiologist workload: application of lean and constraint theories and production planning principles to planning radiology services in a major tertiary hospital.

PubMed

MacDonald, Sharyn L S; Cowan, Ian A; Floyd, Richard; Mackintosh, Stuart; Graham, Rob; Jenkins, Emma; Hamilton, Richard

2013-10-01

We describe how techniques traditionally used in the manufacturing industry (lean management, the theory of constraints and production planning) can be applied to planning radiology services to reduce the impact of constraints such as limited radiologist hours, and to subsequently reduce delays in accessing imaging and in report turnaround. Targets for imaging and reporting were set aligned with clinical needs. Capacity was quantified for each modality and for radiologists and recorded in activity lists. Demand was quantified and forecasting commenced based on historical referral rates. To try and mitigate the impact of radiologists as a constraint, lean management processes were applied to radiologist workflows. A production planning process was implemented. Outpatient waiting times to access imaging steadily decreased. Report turnaround times improved with the percentage of overnight/on-call reports completed by a 1030 target time increased from approximately 30% to 80 to 90%. The percentage of emergency and inpatient reports completed within one hour increased from approximately 15% to approximately 50% with 80 to 90% available within 4 hours. The number of unreported cases on the radiologist work-list at the end of the working day reduced. The average weekly accuracy for demand forecasts for emergency and inpatient CT, MRI and plain film imaging was 91%, 83% and 92% respectively. For outpatient CT, MRI and plain film imaging the accuracy was 60%, 55% and 77% respectively. Reliable routine weekly and medium to longer term service planning is now possible. Tools from industry can be successfully applied to diagnostic imaging services to improve performance. They allow an accurate understanding of the demands on a service, capacity, and can reliably predict the impact of changes in demand or capacity on service delivery. © 2013 The Royal Australian and New Zealand College of Radiologists.

The Turnaround Challenge: Why America's Best Opportunity to Dramatically Improve Student Achievement Lies in Our Worst-Performing Schools. Supplement to the Main Report

ERIC Educational Resources Information Center

Calkins, Andrew; Guenther, William; Belfiore, Grace; Lash, Dave

2007-01-01

The turnaround recommendations and framework in "The Turnaround Challenge" grew out of both new research and synthesis of extensive existing research, as carried out by Mass Insight Education & Research Institute and its partners since September 2005. If the main report is the tip of the proverbial iceberg, this supplement represents…

"I've Never Seen People Work So Hard!" Teachers' Working Conditions in the Early Stages of School Turnaround

ERIC Educational Resources Information Center

Cucchiara, Maia Bloomfield; Rooney, Erin; Robertson-Kraft, Claire

2015-01-01

School turnaround--a reform strategy that strives for quick and dramatic transformation of low-performing schools--has gained prominence in recent years. This study uses interviews and focus groups conducted with 86 teachers in 13 schools during the early stages of school turnaround in a large urban district to examine teachers' perceptions of the…

A Comparison of Three Commercial Online Vendors.

ERIC Educational Resources Information Center

Hoover, Ryan E.

1979-01-01

Compares database update currency, number of hits, elapsed time, number of offline prints or online types, offline print turnaround time, vendor rates, total search cost, and discounted search cost based on vendor discount rates for five simple searches run on three major commercial vendors' online systems. (CWM)

BIOSENSORS FOR ENVIRONMENTAL APPLICATIONS

EPA Science Inventory

A review, with 19 references, is given on challenges and possible opportunities for the development of biosensors for environmental monitoring applications. The high cost and slow turnaround times typically associated with the measurement of regulated pollutants clearly indicates...

75 FR 15726 - Comment Request for Information Collection for Quick Turnaround Surveys of the Workforce...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-30

... requested data can be provided in the desired format, reporting burden (time and financial resources) is... respondents can be properly assessed. Currently, the Employment and Training [[Page 15727

The First 90 Days of the New Middle School Principal in a Turnaround School: In-Depth Case Study of the Transition Period (First 90 Days)

ERIC Educational Resources Information Center

Baeza, Marco A.

2010-01-01

This study analyzed skills, strategies, and theories that new middle school principals used to be successful during their transition period (the first 90 days) in turnaround schools. Based on research on transitions, three research questions guided the study: 1. Do middle school principals in a turnaround school situation find the transition…

39 CFR 121.4 - Package Services.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Center Facility (SCF) turnaround Package Services mail accepted at the origin SCF before the day-zero...) Package Services mail accepted at origin before the day-zero Critical Entry Time is 3 days, for each... Center (NDC) Package Services mail accepted at origin before the day-zero Critical Entry Time is 4 days...

Customising turnaround time indicators to requesting clinician: a 10-year study through balanced scorecard indicators.

PubMed

Salinas, Maria; López-Garrigós, Maite; Santo-Quiles, Ana; Gutierrez, Mercedes; Lugo, Javier; Lillo, Rosa; Leiva-Salinas, Carlos

2014-09-01

The purpose of this study is, first to present a 10-year monitoring of postanalytical turnaround time (TAT) adapted to different clinicians and patient situations, second to evaluate and analyse the indicators results during that period of time, and finally to show a synthetic appropriate indicator to be included in the balanced scorecard management system. TAT indicator for routine samples was devised as the percentage of certain key tests that were verified before a specific time on the phlebotomy day. A weighted mean synthetic indicator was also designed. They were calculated for inpatients at 15:00 and 12:00 and for primary care patients only at 15:00. The troponin TAT of emergency department patients, calculated as the difference between the troponin verification and registration time, was selected as the stat laboratory TAT indicator. The routine and stat TAT improved along the 10-year study period. The synthetic indicator showed the same trend. The implementation of systematic and continuous monitoring over years, promoted a continuous improvement in TAT which will probably benefit patient outcome and safety.

39 CFR 121.3 - Standard Mail.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Facility (SCF) turnaround Standard Mail® pieces accepted at origin before the day-zero Critical Entry Time... origin before the day-zero Critical Entry Time is 4 days when the OPD&C/F and the ADC are the same... before the day-zero Critical Entry Time is 5 days for each remaining 3-digit ZIP Code origin-destination...

Mobile Healthcare System for Health Checkups and Telemedicine in Post-Disaster Situations.

PubMed

Hu, Min; Sugimoto, Megumi; Hargrave, Andrew Rebeiro; Nohara, Yasunobu; Moriyama, Michiko; Ahmed, Ashir; Shimizu, Shuji; Nakashima, Naoki

2015-01-01

Portable Healthcare Clinic (PHC) is a mobile healthcare system comprising of medical sensors and health assessment criteria. It has been applied in Bangladesh for the last two years as a pilot program to identify non-communicable diseases. In this study, we adapted PHC to fit post-disaster conditions. The PHC health assessment criteria are redesigned to deal with emergency cases and healthcare worker insufficiency. A new algorithm makes an initial assessment of age, symptoms, and whether the person is seeing a doctor. These changes will make the turn-around time shorter and will enable reaching the most affected patients better. We tested the operability and turn-around time of the adapted system at the debris flow disaster shelters in Hiroshima, Japan. Changing the PHC health assessment criteria and other solutions such as a list of medicine preparation makes the PHC system switch into an emergency mode more smoothly following a natural disaster.

Performance evaluation of a particle-enhanced turbidimetric cystatin C assay on the Abbott ci8200 analyzer.

PubMed

Flodin, Mats; Larsson, Anders

2009-06-01

Glomerular filtration rate (GFR) is widely accepted as the best overall measure of kidney function. Cystatin C is a novel endogenous GFR marker that has been shown to be superior to creatinine for estimation of GFR in several studies. There is a need for cystatin C assays adapted to routine chemistry instrument to minimize turnaround times and allowing 24 h/day availability. We have evaluated a new cystatin C assay developed for Architect cSystem (Abbott Laboratories, Abbott Park, IL, USA). The cystatin C assay showed good agreement with the corresponding assay from Dade Behring (Deerfield, IL, USA). The assay has a very low total imprecision and a good linearity. The new cystatin C assay is an interesting alternative to current cystatin C assays. On an Architect cSystem the assay can be performed with the same turnaround times and availability as creatinine.

National Combustion Code: Parallel Implementation and Performance

NASA Technical Reports Server (NTRS)

Quealy, A.; Ryder, R.; Norris, A.; Liu, N.-S.

2000-01-01

The National Combustion Code (NCC) is being developed by an industry-government team for the design and analysis of combustion systems. CORSAIR-CCD is the current baseline reacting flow solver for NCC. This is a parallel, unstructured grid code which uses a distributed memory, message passing model for its parallel implementation. The focus of the present effort has been to improve the performance of the NCC flow solver to meet combustor designer requirements for model accuracy and analysis turnaround time. Improving the performance of this code contributes significantly to the overall reduction in time and cost of the combustor design cycle. This paper describes the parallel implementation of the NCC flow solver and summarizes its current parallel performance on an SGI Origin 2000. Earlier parallel performance results on an IBM SP-2 are also included. The performance improvements which have enabled a turnaround of less than 15 hours for a 1.3 million element fully reacting combustion simulation are described.

Off the Clock: What More Time Can (and Can't) Do for School Turnarounds. Education Sector Reports

ERIC Educational Resources Information Center

Silva, Elena

2012-01-01

If less time in the classroom is a cause of poor student performance, can adding more time be the cure? This strategy underlies a major effort to fix the nation's worst public schools. Billions of federal stimulus dollars are being spent to expand learning time on behalf of disadvantaged children. And extended learning time (ELT) is being proposed…

Effect of ADAMTS13 activity turnaround time on plasma utilization for suspected thrombotic thrombocytopenic purpura.

PubMed

Connell, Nathan T; Cheves, Tracey; Sweeney, Joseph D

2016-02-01

Thrombotic thrombocytopenic purpura (TTP) due to deficiency of the von Willebrand-cleaving protease ADAMTS13 is a hematologic emergency that requires prompt initiation of therapeutic plasma exchange (TPE). Long turnaround times (TATs) have precluded the use of pre-TPE measurement of ADAMTS13 activity for the initial diagnosis in most institutions. An in-house rapid TAT (r-TAT) assay for ADAMTS13 activity was implemented after 18 months of validation. In a quasi-experimental design using interrupted time series analysis, patterns of plasma utilization in patients with suspected TTP were assessed after implementation of this assay for ADAMTS13 activity and compared to utilization patterns for patients who received plasma exchange before r-TAT assay implementation designated the standard TAT period. In the 18 months after implementation of the r-TAT ADAMTS13 assay, there was a significant reduction in plasma utilization per patient suspected of having TTP (mean, 144.5 units vs. 63.3 units of plasma per patients suspected of having TTP; p = 0.002). The mean number of exchanges per patient and mean number of exchanges after achieving a platelet count of at least 150 × 10(9) /L were lower in the r-TAT cohort (p < 0.001 for both). There was no significant difference in 30-day mortality. Implementation of a rapid turnaround assay for ADAMTS13 resulted in a significant reduction in plasma utilization for patients with suspected TTP, without an increase in mortality. This study demonstrates that these data, provided in a timely fashion, can avoid unnecessary plasma exchange in patients who do not have TTP. © 2015 AABB.

WINCADRE (COMPUTER-AIDED DATA REVIEW AND EVALUATION)

EPA Science Inventory

WinCADRE (Computer-Aided Data Review and Evaluation) is a Windows -based program designed for computer-assisted data validation. WinCADRE is a powerful tool which significantly decreases data validation turnaround time. The electronic-data-deliverable format has been designed ...

How do hospital professionals involved in a randomised controlled trial perceive the value of genotyping vs. PCR-ribotyping for control of hospital acquired C. difficile infections?

PubMed Central

2014-01-01

Background Despite scientific advances in typing of C. difficile strains very little is known about how hospital staff use typing results during periods of increased incidence (PIIs). This qualitative study, undertaken alongside a randomised controlled trial (RCT), explored this issue. The trial compared ribotyping versus more rapid genotyping (MLVA or multilocus variable repeat analysis) and found no significant difference in post 48 hour cases (C difficile transmissions). Methods In-depth qualitative interviews with senior staff in 11/16 hospital trusts in the trial (5 MLVA and 6 Ribotyping). Semi-structured interviews were conducted at end of the trial period. Transcripts were content analysed using framework analysis supported by NVivo-8 software. Common sub-themes were extracted by two researchers independently. These were compared and organised into over-arching categories or ‘super-ordinate themes’. Results The trial recorded that 45% of typing tests had some impact on infection control (IC) activities. Interviews indicated that tests had little impact on initial IC decisions. These were driven by hospital protocols and automatically triggered when a PII was identified. To influence decision-making, a laboratory turnaround time < 3 days (ideally 24 hours) was suggested; MLVA turnaround time was 5.3 days. Typing results were predominantly used to modify initiated IC activities such as ward cleaning, audits of practice or staff training; major decisions (e.g. ward closure) were unaffected. Organisational factors could limit utilisation of MLVA results. Results were twice as likely to be reported as ‘aiding management’ (indirect benefit) than impacting on IC activities (direct effect). Some interviewees considered test results provided reassurance about earlier IC decisions; others identified secondary benefits on organisational culture. An underlying benefit of improved discrimination provided by MLVA typing was the ability to explore epidemiology associated with CDI cases in a hospital more thoroughly. Conclusions Ribotyping and MLVA are both valued by users. MLVA had little additional direct impact on initial infection control decisions. This would require reduced turnaround time. The major impact is adjustments to earlier IC measures and retrospective reassurance. For this, turnaround time is less important than discriminatory power. The potential remains for wider use of genotyping to examine transmission routes. PMID:24656142

A Software Engineering Paradigm for Quick-turnaround Earth Science Data Projects

NASA Astrophysics Data System (ADS)

Moore, K.

2016-12-01

As is generally the case with applied sciences professional and educational programs, the participants of such programs can come from a variety of technical backgrounds. In the NASA DEVELOP National Program, the participants constitute an interdisciplinary set of backgrounds, with varying levels of experience with computer programming. DEVELOP makes use of geographically explicit data sets, and it is necessary to use geographic information systems and geospatial image processing environments. As data sets cover longer time spans and include more complex sets of parameters, automation is becoming an increasingly prevalent feature. Though platforms such as ArcGIS, ERDAS Imagine, and ENVI facilitate the batch-processing of geospatial imagery, these environments are naturally constricting to the user in that they limit him or her to the tools that are available. Users must then turn to "homemade" scripting in more traditional programming languages such as Python, JavaScript, or R, to automate workflows. However, in the context of quick-turnaround projects like those in DEVELOP, the programming learning curve may be prohibitively steep. In this work, we consider how to best design a software development paradigm that addresses two major constants: an arbitrarily experienced programmer and quick-turnaround project timelines.

Kuss Middle School: Expanding Time to Accelerate School Improvement

ERIC Educational Resources Information Center

Massachusetts 2020, 2012

2012-01-01

In 2004, Kuss Middle School became the first school declared "Chronically Underperforming" by the state of Massachusetts. But by 2010, Kuss had transformed itself into a model for schools around the country seeking a comprehensive turnaround strategy. Kuss is using increased learning time as the primary catalyst to accelerate learning,…

39 CFR 121.3 - Standard Mail.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Facility (SCF) turnaround Standard Mail® pieces accepted at origin before the day zero Critical Entry Time... origin before the day zero Critical Entry Time is 4 days when the OPD&C/F and the ADC are the same... intra-Network Distribution Center (NDC) Standard Mail pieces accepted at origin before the day-zero...

39 CFR 121.3 - Standard Mail.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Facility (SCF) turnaround Standard Mail® pieces accepted at origin before the day zero Critical Entry Time... origin before the day zero Critical Entry Time is 4 days when the OPD&C/F and the ADC are the same... intra-Network Distribution Center (NDC) Standard Mail pieces accepted at origin before the day-zero...

Early infant diagnosis of HIV in Myanmar: call for innovative interventions to improve uptake and reduce turnaround time.

PubMed

Thiha, Soe; Shewade, Hemant Deepak; Philip, Sairu; Aung, Thet Ko; Kyaw, Nang Thu Thu; Oo, Myo Minn; Kyaw, Khine Wut Yee; War, May Wint; Oo, Htun Nyunt

2017-01-01

In collaboration with the national AIDS program, early infant diagnosis (EID) is implemented by Integrated HIV Care (IHC) program through its anti-retroviral therapy (ART) centers across 10 cities in five states and regions of Myanmar. Blood samples from the ART centers are sent using public transport to a centralized PCR facility. Among HIV-exposed babies <9 months at enrolment into IHC program (2013-15), to describe the EID cascade (enrolment, sample collection for PCR, result receipt by mother, HIV diagnosis and ART initiation) and factors associated with delayed (>8 weeks of age) or no blood sample collection for EID. Retrospective cohort study involving record review. A predictive poisson regression model with robust variance estimates was fitted for risk factors of delayed or no sample collection. Of 1349 babies, 523 (39%) of the babies' mothers were on ART before pregnancy. Timely uptake of EID (<8 weeks of age) was 47% (633/1349); sample collection was delayed in 27% (367/1349) and not done in 26% (349/1349) babies. Among samples collected (n = 1000), 667 results were received by the mother; 52 (5%) were HIV-infected; among them 42 (81%) were initiated on ART. Median (IQR) turnaround time from sample collection to result receipt by mother and time to initiate ART from result receipt by mother was 7 (4,12) and 8.5 (6,16) weeks, respectively. Mothers not on ART before pregnancy and distance of ART center from PCR facility (more than 128 km) were the risk factors of delayed or no sample collection. Improving provision of ART to mothers (through universal 'test and treat') is urgently required, which has the potential to improve the timely uptake of EID as well. Interventions to reduce turnaround times, like point of care EID testing and/or systematic use of mobile technology to communicate results, are needed.

Improving efficiency and safety in external beam radiation therapy treatment delivery using a Kaizen approach.

PubMed

Kapur, Ajay; Adair, Nilda; O'Brien, Mildred; Naparstek, Nikoleta; Cangelosi, Thomas; Zuvic, Petrina; Joseph, Sherin; Meier, Jason; Bloom, Beatrice; Potters, Louis

Modern external beam radiation therapy treatment delivery processes potentially increase the number of tasks to be performed by therapists and thus opportunities for errors, yet the need to treat a large number of patients daily requires a balanced allocation of time per treatment slot. The goal of this work was to streamline the underlying workflow in such time-interval constrained processes to enhance both execution efficiency and active safety surveillance using a Kaizen approach. A Kaizen project was initiated by mapping the workflow within each treatment slot for 3 Varian TrueBeam linear accelerators. More than 90 steps were identified, and average execution times for each were measured. The time-consuming steps were stratified into a 2 × 2 matrix arranged by potential workflow improvement versus the level of corrective effort required. A work plan was created to launch initiatives with high potential for workflow improvement but modest effort to implement. Time spent on safety surveillance and average durations of treatment slots were used to assess corresponding workflow improvements. Three initiatives were implemented to mitigate unnecessary therapist motion, overprocessing of data, and wait time for data transfer defects, respectively. A fourth initiative was implemented to make the division of labor by treating therapists as well as peer review more explicit. The average duration of treatment slots reduced by 6.7% in the 9 months following implementation of the initiatives (P = .001). A reduction of 21% in duration of treatment slots was observed on 1 of the machines (P < .001). Time spent on safety reviews remained the same (20% of the allocated interval), but the peer review component increased. The Kaizen approach has the potential to improve operational efficiency and safety with quick turnaround in radiation therapy practice by addressing non-value-adding steps characteristic of individual department workflows. Higher effort opportunities are identified to guide continual downstream quality improvements. Copyright © 2017 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

Decreasing Turnaround Time and Increasing Patient Satisfaction in a Safety Net Hospital-Based Pediatrics Clinic Using Lean Six Sigma Methodologies.

PubMed

Jayasinha, Yasangi

2016-01-01

Increasingly, health care quality indicators are focusing on patient-centeredness as an indicator of performance. The National Quality Forum lists assessment of patient experience, often conducted using patient surveys, as a top priority. We developed a patient-reported time stamp data collection tool that was used to collect cycle times in a safety net hospital-based outpatient pediatrics clinic. Data were collected using patient-reported survey to obtain cycle times in Pediatric clinic, as well as qualitative and quantitative patient satisfaction data. Several rapid-cycle improvements were performed using Lean Six Sigma methodologies to reduce cycle time by eliminating waste and revise unnecessary processes to improve operational effectiveness and patient and staff satisfaction. A total of 94 surveys were collected and revealed average cycle time of 113 minutes. Our measured patient satisfaction rating was 87%. Discharge and check-in processes were identified as the least efficient and were targeted for intervention. Following implementation, the overall cycle time was decreased from 113 to 90 minutes. Patient satisfaction ratings increased from 87% to 95%. We demonstrate that using Lean Six Sigma tools can be invaluable to clinical restructuring and redesign and results in measurable, improved outcomes in care delivery.

Anatomy of a public health agency turnaround: the case of the general health district in Mahoning County.

PubMed

Honoré, Peggy A; Stefanak, Matthew; Dessens, Scott

2012-01-01

A turnaround describes an organization's ability to recover from successive periods of decline. Current and projected declines in US economic conditions continue to place local public health departments at risk of fiscal exigency. This examination focused on turnaround methodologies used by a local public health department to reverse successive periods of operational and financial declines. Illustrations are provided on the value added by implementing financial ratio and trend analysis in addition to using evidence-based private sector turnaround strategies of retrenchment, repositioning, and reorganization. Evidence has shown how the financial analysis and strategies aided in identifying operational weakness and set in motion corrective measures. The Public Health Uniform Data System is introduced along with a list of standards offered for mainstreaming these and other routine stewardship practices to diagnose, predict, and prevent agency declines.

Transforming Schools through Expanded Learning Time: Orchard Gardens K-8 Pilot School. Update 2013

ERIC Educational Resources Information Center

Chan, Roy

2013-01-01

For years, Orchard Gardens K-8 Pilot School was plagued by low student achievement and high staff turnover. Then, in 2010, with an expanded school schedule made possible through federal funding, Orchard Gardens began a remarkable turnaround. Today, the school is demonstrating how increased learning time, combined with other key turnaround…

WINCADRE INORGANIC (WINDOWS COMPUTER-AIDED DATA REVIEW AND EVALUATION)

EPA Science Inventory

WinCADRE (Computer-Aided Data Review and Evaluation) is a Windows -based program designed for computer-assisted data validation. WinCADRE is a powerful tool which significantly decreases data validation turnaround time. The electronic-data-deliverable format has been designed in...

Overset Grid Methods Applied to Nonlinear Potential Flows

NASA Technical Reports Server (NTRS)

Holst, Terry; Kwak, Dochan (Technical Monitor)

2000-01-01

The objectives of this viewgraph presentation are to develop Chimera-based potential methodology which is compatible with overflow and overflow infrastructure, creating options for an advanced problem solving environment and to significantly reduce turnaround time for aerodynamic analysis and design (primarily cruise conditions).

Geo-referenced digital data acquisition and processing system using LiDAR technology.

DOT National Transportation Integrated Search

2006-02-01

LiDAR technology, introduced in the late 90s, has received wide acceptance in airborne surveying as a leading : tool for obtaining high-quality surface data at decimeter-level vertical accuracy in an unprecedentedly short : turnaround time. State-of-...

Extending solid state laser performance

NASA Astrophysics Data System (ADS)

Miesak, Ed

2017-02-01

Coherent Diode-Pumped Solid-State Orlando (CDO), formerly known as Lee Laser, headquartered in Orlando Florida produces CW and pulsed solid state lasers. Primary wavelengths include 1064 nm, 532 nm, and 355 nm. Other wavelengths produced include 1320 nm, 15xx nm, and 16xx nm. Pulse widths are in the range of singles to hundreds of nanoseconds. Average powers are in the range of a few watts to 1000 watts. Pulse repetition rates are typically in the range of 100 Hz to 100 KHz. Laser performance parameters are often modified according to customer requests. Laser parameters that can be adjusted include average power, pulse repetition rate, pulse length, beam quality, and wavelength. Laser parameters are typically cross-coupled such that adjusting one may change some or all of the others. Customers often request one or more parameters be changed without changing any of the remaining parameters. CDO has learned how to accomplish this successfully with rapid turn-around times and minimal cost impact. The experience gained by accommodating customer requests has produced a textbook of cause and effect combinations of laser components to accomplish almost any parameter change request. Understanding the relationships between component combinations provides valuable insight into lasing effects allowing designers to extend laser performance beyond what is currently available. This has led to several break through products, i.e. >150W average power 355 nm, >60W average power 6 ps 1064 nm, pulse lengths longer than 400 ns at 532 nm with average power >100W, >400W 532 nm with pulse lengths in the 100 ns range.

The use of vouchers in HIV prevention, referral treatment, and care for young MSM and young transgender people in Dhaka, Bangladesh: experience from ‘HIM’ initiative

PubMed Central

Oyewale, Tajudeen O.; Ahmed, Shale; Ahmed, Farid; Tazreen, Mona; Uddin, Ziya; Rahman, Anisur; Oyediran, Kola A.

2016-01-01

Introduction The study described the effectiveness of a voucher scheme to access sexual and reproductive health and HIV services among young MSM and transgender people aged 15–24 years in Dhaka, Bangladesh, a country with HIV prevalence of less than 0.1%. Methods Descriptive and analytical methods were used to assess the net effects of biodemographic factors of the respondents on the voucher scheme. Effectiveness of the scheme was contextualized as target population coverage, and turnaround time of voucher redemption to access services. Results and discussion A total of 210 (87.9%) out of the 239 vouchers distributed were redeemed. The mean age of the identified young people was 19.6 years (SD = +2.6 years). The coverage of the scheme against the target population of 200 young MSM and 936 young transgender people was 88% (n = 175) and 4% (n = 35) respectively, with P < 0.001. The median turnaround time for voucher redemption was 7 days. The predictors of voucher turnaround time were age, education, and population group (P < 0.001). HIV testing and counselling was accessed by 160 (76%) respondents, one was positive and linked to antiretroviral treatment and 110 (52%) were diagnosed and treated for sexually transmitted infections. Conclusion The voucher scheme was effective in linking young MSM with sexual and reproductive health and HIV services in Dhaka, Bangladesh. The findings are consistent with the low HIV prevalence in the country. The scheme is, however, not optimal for linking young transgender people with services. PMID:26945145

Characteristics of Occupational Exposure to Benzene during Turnaround in the Petrochemical Industries.

PubMed

Chung, Eun-Kyo; Shin, Jung-Ah; Lee, Byung-Kyu; Kwon, Jiwoon; Lee, Naroo; Chung, Kwang-Jae; Lee, Jong-Han; Lee, In-Seop; Kang, Seong-Kyu; Jang, Jae-Kil

2010-09-01

The level of benzene exposure in the petrochemical industry during regular operation has been well established, but not in turnaround (TA), where high exposure may occur. In this study, the characteristics of occupational exposure to benzene during TA in the petrochemical companies were investigated in order to determine the best management strategies and improve the working environment. This was accomplished by evaluating the exposure level for the workers working in environments where benzene was being produced or used as an ingredient during the unit process. From 2003 to 2008, a total of 705 workers in three petrochemical companies in Korea were studied. Long- and short-term (< 1 hr) samples were taken during TAs. TA was classified into three stages: shut-down, maintenance and start-up. All works were classified into 12 occupation categories. The long-term geometric mean (GM) benzene exposure level was 0.025 (5.82) ppm (0.005-42.120 ppm) and the short-term exposure concentration during TA was 0.020 (17.42) ppm (0.005-61.855 ppm). The proportions of TA samples exceeding the time-weighted average, occupational exposure level (TWA-OEL in Korea, 1 ppm) and the short-term exposure limit (STEL-OEL, 5 ppm) were 4.1% (20 samples of 488) and 6.0% (13 samples of 217), respectively. The results for the benzene exposure levels and the rates of exceeding the OEL were both statistically significant (p < 0.05). Among the 12 job categories of petrochemical workers, mechanical engineers, plumbers, welders, fieldman and scaffolding workers exhibited long-term samples that exceeded the OEL of benzene, and the rate of exceeding the OEL was statistically significant for the first two occupations (p < 0.05). These findings suggest that the periodic work environment must be assessed during non-routine works such as TA.

Turnaround Time for Early Infant HIV Diagnosis in Rural Zambia: A Chart Review

PubMed Central

Sutcliffe, Catherine G.; van Dijk, Janneke H.; Hamangaba, Francis; Mayani, Felix; Moss, William J.

2014-01-01

Background Early infant HIV diagnosis is challenging in sub-Saharan Africa, particularly in rural areas where laboratory capacity is limited. Specimens must be transported to central laboratories for testing, leading to delays in diagnosis and initiation of antiretroviral therapy. This study was undertaken in rural Zambia to measure the turnaround time for confirmation of HIV infection and identify delays in diagnosis. Methods Chart reviews were conducted from 2010–2012 for children undergoing early infant HIV diagnosis at Macha Hospital in Zambia. Relevant dates, receipt of drugs by mother and child for the prevention of mother-to-child transmission (PMTCT), and test results were abstracted. Results 403 infants provided 476 samples for early infant diagnosis. The median age at the “6-week” and “6-month” assessments was 8.1 weeks and 7.0 months, respectively. The majority of mothers (80%) and infants (67%) received PMTCT. The median time between sample collection and arrival at the central laboratory in Lusaka was 17 days (IQR: 10, 28); arrival at the central laboratory to testing was 6 days (IQR: 5, 11); testing to return of results to the clinic was 29 days (IQR: 17, 36); arrival of results at the clinic to return of results to the caregiver was 45 days (IQR: 24, 79). The total median time from sample collection to return of results to the caregiver was 92 days (IQR: 84, 145). The proportion of HIV PCR positive samples was 12%. The total median turnaround time was shorter for HIV PCR positive as compared to negative or invalid samples (85 vs. 92 days; p = 0.08). Conclusions Delays in processing and communicating test results were identified, particularly in returning results from the central laboratory to the clinic and from the clinic to the caregiver. A more efficient process is needed so that caregivers can be provided test results more rapidly, potentially resulting in earlier treatment initiation and better outcomes for HIV-infected infants. PMID:24475214

The role of total laboratory automation in a consolidated laboratory network.

PubMed

Seaberg, R S; Stallone, R O; Statland, B E

2000-05-01

In an effort to reduce overall laboratory costs and improve overall laboratory efficiencies at all of its network hospitals, the North Shore-Long Island Health System recently established a Consolidated Laboratory Network with a Core Laboratory at its center. We established and implemented a centralized Core Laboratory designed around the Roche/Hitachi CLAS Total Laboratory Automation system to perform the general and esoteric laboratory testing throughout the system in a timely and cost-effective fashion. All remaining STAT testing will be performed within the Rapid Response Laboratories (RRLs) at each of the system's hospitals. Results for this laboratory consolidation and implementation effort demonstrated a decrease in labor costs and improved turnaround time (TAT) at the core laboratory. Anticipated system savings are approximately $2.7 million. TATs averaged 1.3 h within the Core Laboratory and less than 30 min in the RRLs. When properly implemented, automation systems can reduce overall laboratory expenses, enhance patient services, and address the overall concerns facing the laboratory today: job satisfaction, decreased length of stay, and safety. The financial savings realized are primarily a result of labor reductions.

Computer Networking with the Victorian Correspondence School.

ERIC Educational Resources Information Center

Conboy, Ian

During 1985 the Education Department installed two-way radios in 44 remote secondary schools in Victoria, Australia, to improve turn-around time for correspondence assignments. Subsequently, teacher supervisors at Melbourne's Correspondence School sought ways to further augument audio interactivity with computer networking. Computer equipment was…

Reengineering the laboratory: strategic process and systems innovation to improve performance. Recreating our role on the health-care team.

PubMed

Johnson, E

1995-01-01

The author describes reengineering efforts in the laboratory of a 550-bed hospital. Key benefits include reduced costs, improved turnaround time, and redirection of staff into new roles in information management and outreach.

Novel molecular diagnostic tools for malaria elimination: a review of options from the point of view of high-throughput and applicability in resource limited settings.

PubMed

Britton, Sumudu; Cheng, Qin; McCarthy, James S

2016-02-16

As malaria transmission continues to decrease, an increasing number of countries will enter pre-elimination and elimination. To interrupt transmission, changes in control strategies are likely to require more accurate identification of all carriers of Plasmodium parasites, both symptomatic and asymptomatic, using diagnostic tools that are highly sensitive, high throughput and with fast turnaround times preferably performed in local health service settings. Currently available immunochromatographic lateral flow rapid diagnostic tests and field microscopy are unlikely to consistently detect infections at parasite densities less than 100 parasites/µL making them insufficiently sensitive for detecting all carriers. Molecular diagnostic platforms, such as PCR and LAMP, are currently available in reference laboratories, but at a cost both financially and in turnaround time. This review describes the recent progress in developing molecular diagnostic tools in terms of their capacity for high throughput and potential for performance in non-reference laboratories for malaria elimination.

Accurate Detection of Streptococcus pyogenes at the Point of Care Using the cobas Liat Strep A Nucleic Acid Test.

PubMed

Wang, Fangnian; Tian, Yu; Chen, Lingjun; Luo, Robert; Sickler, Joanna; Liesenfeld, Oliver; Chen, Shuqi

2017-10-01

The performance of a polymerase chain reaction-based point-of-care assay, the cobas Strep A Nucleic Acid Test for use on the cobas Liat System (cobas Liat Strep A assay), for the detection of group A Streptococcus bacteria was evaluated in primary care settings. Throat swab specimens from 427 patients were tested with the cobas Liat Strep A assay and a rapid antigen detection test (RADT) by existing medical staff at 5 primary care clinics, and results were compared with bacterial culture. The cobas Liat Strep A assay demonstrated equivalent sensitivity (97.7%) and specificity (93.3%) to reference culture with a 15-minute turnaround time. In comparison to RADTs, the cobas Liat Strep A assay showed improved sensitivity (97.7% Liat vs 84.5% RADT). The Clinical Laboratory Improvement Amendments-waived cobas Liat Strep A assay demonstrated the ease of use and improved turnaround time of RADTs along with the sensitivity of culture.

BetaScint{trademark} fiber-optic sensor for detecting strontium-90 and uranium-238 in soil. Innovative technology summary report

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

NONE

1998-12-01

Accurate measurements of radioactivity in soils contaminated with Strontium-90 (Sr-90) or Uranium-238 (U-238) are essential for many DOE site remediation programs. These crucial measurements determine if excavation and soil removal is necessary, where remediation efforts should be focused, and/or if a site has reached closure. Measuring soil contamination by standard EPA laboratory methods typically takes a week (accelerated analytical test turnaround) or a month (standard analytical test turnaround). The time delay extends to operations involving heavy excavation equipment and associated personnel which are the main costs of remediation. This report describes an application of the BetaScint{trademark} fiber-optic sensor that measuresmore » Sr-90 or U-238 contamination in soil samples on site in about 20 minutes, at a much lower cost than time-consuming laboratory methods, to greatly facilitate remediation. This report describes the technology, its performance, its uses, cost, regulatory and policy issues, and lessons learned.« less

Distance reporting in digital pathology: A study on 950 cases

PubMed Central

Vodovnik, Aleksandar

2015-01-01

Background: Increased workload, case complexity, financial constraints, and staffing shortages justify wider implementations of digital pathology. One of its main advantages is distance reporting. Aim: A feasibility study was conducted at our institution in order to achieve comprehensive pathology services available by distance. Methods: One senior pathologist reported 950 cases (3,650 slides) by distance during 19 weeks. Slides were scanned by ScanScope AT Turbo (Aperio) and digital images accessed through SymPathy (Tieto) on a 14” laptop. Mobile phone, mobile broadband, broadband over Wi-Fi and broadband were used for internet connections along with a virtual private network technology (VPN). Lync (Microsoft) was tested for one case consultation and resident's teaching session. Larger displays were accessed when available. Effects of ergonomics and working flexibility on the user experience were observed. Details on network speed, frequency of technical issues, data usage, scanning, and turnaround, were collected and evaluated. Turnaround was compared to in-office microscopic reporting, measured from the registration to sign off. Results: Network speeds varied 1–80 Mbps (median download speed 8–65 Mbps). 20 Mbps were satisfactory for the instant upload of digital images. VPN, image viewer, and laptop failed on two occasions each. An estimated data usage per digital image was 10 MB (1–50 MB). Two cases (15 slides) were deferred to microscopic slides (0.21/0.41%) due to scanty material and suboptimal slide quality. Additional nine cases (15 slides) needed to be rescanned for various reasons (0.95/0.41%). Average turnaround was shorter, and the percentage of cases reported up to 3 days higher (3.13 days/72.25%) comparing with in-office microscopic reporting (3.90 days/40.56%). Larger displays improved the most user experience at magnifications over ×20. Conclusions: Existing IT solutions at our institution allow efficient and reliable distance reporting for the core pathology services in histology and cytology. Stable network speeds, fully integrated laboratory information management system, technical reliability, working flexibility, larger displays, and shorter turnaround contributed to the overall satisfaction with distance reporting. A further expansion of our pathology services available by distance, diagnostic and educational, rely on gaining experience in digital reporting and marginal IT investment. Adjustments to the organization of pathology services may follow to fully benefit from the implementation of digital pathology. PMID:25969793

Distance reporting in digital pathology: A study on 950 cases.

PubMed

Vodovnik, Aleksandar

2015-01-01

Increased workload, case complexity, financial constraints, and staffing shortages justify wider implementations of digital pathology. One of its main advantages is distance reporting. A feasibility study was conducted at our institution in order to achieve comprehensive pathology services available by distance. One senior pathologist reported 950 cases (3,650 slides) by distance during 19 weeks. Slides were scanned by ScanScope AT Turbo (Aperio) and digital images accessed through SymPathy (Tieto) on a 14" laptop. Mobile phone, mobile broadband, broadband over Wi-Fi and broadband were used for internet connections along with a virtual private network technology (VPN). Lync (Microsoft) was tested for one case consultation and resident's teaching session. Larger displays were accessed when available. Effects of ergonomics and working flexibility on the user experience were observed. Details on network speed, frequency of technical issues, data usage, scanning, and turnaround, were collected and evaluated. Turnaround was compared to in-office microscopic reporting, measured from the registration to sign off. Network speeds varied 1-80 Mbps (median download speed 8-65 Mbps). 20 Mbps were satisfactory for the instant upload of digital images. VPN, image viewer, and laptop failed on two occasions each. An estimated data usage per digital image was 10 MB (1-50 MB). Two cases (15 slides) were deferred to microscopic slides (0.21/0.41%) due to scanty material and suboptimal slide quality. Additional nine cases (15 slides) needed to be rescanned for various reasons (0.95/0.41%). Average turnaround was shorter, and the percentage of cases reported up to 3 days higher (3.13 days/72.25%) comparing with in-office microscopic reporting (3.90 days/40.56%). Larger displays improved the most user experience at magnifications over ×20. Existing IT solutions at our institution allow efficient and reliable distance reporting for the core pathology services in histology and cytology. Stable network speeds, fully integrated laboratory information management system, technical reliability, working flexibility, larger displays, and shorter turnaround contributed to the overall satisfaction with distance reporting. A further expansion of our pathology services available by distance, diagnostic and educational, rely on gaining experience in digital reporting and marginal IT investment. Adjustments to the organization of pathology services may follow to fully benefit from the implementation of digital pathology.

Improvement of laboratory turnaround time using lean methodology.

PubMed

Gupta, Shradha; Kapil, Sahil; Sharma, Monica

2018-05-14

Purpose The purpose of this paper is to discuss the implementation of lean methodology to reduce the turnaround time (TAT) of a clinical laboratory in a super speciality hospital. Delays in report delivery lead to delayed diagnosis increased waiting time and decreased customer satisfaction. The reduction in TAT will lead to increased patient satisfaction, quality of care, employee satisfaction and ultimately the hospital's revenue. Design/methodology/approach The generic causes resulting in increasing TAT of clinical laboratories were identified using lean tools and techniques such as value stream mapping (VSM), Gemba, Pareto Analysis and Root Cause Analysis. VSM was used as a tool to analyze the current state of the process and further VSM was used to design the future state with suggestions for process improvements. Findings This study identified 12 major non-value added factors for the hematology laboratory and 5 major non-value added factors for the biochemistry lab which were acting as bottlenecks resulting in limiting throughput. A four-month research study by the authors together with hospital quality department and laboratory staff members led to reduction of the average TAT from 180 to 95minutes in the hematology lab and from 268 to 208 minutes in the biochemistry lab. Practical implications Very few improvement initiatives in Indian healthcare are based on industrial engineering tools and techniques, which might be due to a lack of interaction between healthcare and engineering. The study provides a positive outcome in terms of improving the efficiency of services in hospitals and identifies a scope for lean in the Indian healthcare sector. Social implications Applying lean in the Indian healthcare sector gives its own potential solution to the problem caused, due to a wide gap between lean accessibility and lean implementation. Lean helped in changing the mindset of an organization toward providing the highest quality of services with faster delivery at an optimal cost. Originality/value This paper is an effort to reduce the gap between healthcare and industrial engineering and enhancing the use of lean practices in Indian healthcare. The study is motivated toward implementing lean methodology successfully in services.

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

Steffen, Jason H.; Hotchkiss, Jon

We report the results of an experimental comparison of different airplane boarding methods. This test was conducted in a mock 757 fuselage, located on a Southern California soundstage, with 12 rows of six seats and a single aisle. Five methods were tested using 72 passengers of various ages. We found a significant reduction in the boarding times of optimized methods over traditional methods. These improved methods, if properly implemented, could result in a significant savings to airline companies. The process of boarding an airplane is of interest to a variety of groups. The public is interested both as a curiosity,more » as it is something that they may regularly experience, and as a consumer, as their experiences good or bad can affect their loyalties. Airline companies and their employees also have a stake in an efficient boarding procedure as time saved in the boarding process may result is monetary savings, in the quality of interactions with passengers, and in the application of human resources to the general process of preparing an airplane for departure. A recent study (Nyquist and McFadden, 2008) indicates that the average cost to an airline company for each minute of time spent at the terminal is roughly $30. Thus, each minute saved in the turn-around time of a flight has the potential to generate over $16,000,000 in annual savings (assuming an average of 1500 flights per day). While the boarding process may not be the primary source of delay in returning an airplane to the skies, reducing the boarding time may effectively eliminate passenger boarding as a contributor in any meaningful measure. Consequently, subsequent efforts to streamline the other necessary tasks, such as refueling and maintenance, would be rewarded with a material reduction in time at the gate for each flight.« less

Experimental test of airplane boarding methods

DOE PAGES

Steffen, Jason H.; Hotchkiss, Jon

2011-10-26

We report the results of an experimental comparison of different airplane boarding methods. This test was conducted in a mock 757 fuselage, located on a Southern California soundstage, with 12 rows of six seats and a single aisle. Five methods were tested using 72 passengers of various ages. We found a significant reduction in the boarding times of optimized methods over traditional methods. These improved methods, if properly implemented, could result in a significant savings to airline companies. The process of boarding an airplane is of interest to a variety of groups. The public is interested both as a curiosity,more » as it is something that they may regularly experience, and as a consumer, as their experiences good or bad can affect their loyalties. Airline companies and their employees also have a stake in an efficient boarding procedure as time saved in the boarding process may result is monetary savings, in the quality of interactions with passengers, and in the application of human resources to the general process of preparing an airplane for departure. A recent study (Nyquist and McFadden, 2008) indicates that the average cost to an airline company for each minute of time spent at the terminal is roughly $30. Thus, each minute saved in the turn-around time of a flight has the potential to generate over $16,000,000 in annual savings (assuming an average of 1500 flights per day). While the boarding process may not be the primary source of delay in returning an airplane to the skies, reducing the boarding time may effectively eliminate passenger boarding as a contributor in any meaningful measure. Consequently, subsequent efforts to streamline the other necessary tasks, such as refueling and maintenance, would be rewarded with a material reduction in time at the gate for each flight.« less

34. BOILER HOUSE, COAL CONVEYOR AND TURNAROUND TRACK FOR COAL ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

34. BOILER HOUSE, COAL CONVEYOR AND TURN-AROUND TRACK FOR COAL CARS (NOTE: COAL CAR No. 6 IN FAR BACK GROUND) - Delaware County Electric Company, Chester Station, Delaware River at South end of Ward Street, Chester, Delaware County, PA

Real-Time Patient Survey Data During Routine Clinical Activities for Rapid-Cycle Quality Improvement

PubMed Central

Jones, Robert E

2015-01-01

Background Surveying patients is increasingly important for evaluating and improving health care delivery, but practical survey strategies during routine care activities have not been available. Objective We examined the feasibility of conducting routine patient surveys in a primary care clinic using commercially available technology (Web-based survey creation, deployment on tablet computers, cloud-based management of survey data) to expedite and enhance several steps in data collection and management for rapid quality improvement cycles. Methods We used a Web-based data management tool (survey creation, deployment on tablet computers, real-time data accumulation and display of survey results) to conduct four patient surveys during routine clinic sessions over a one-month period. Each survey consisted of three questions and focused on a specific patient care domain (dental care, waiting room experience, care access/continuity, Internet connectivity). Results Of the 727 available patients during clinic survey days, 316 patients (43.4%) attempted the survey, and 293 (40.3%) completed the survey. For the four 3-question surveys, the average time per survey was overall 40.4 seconds, with a range of 5.4 to 20.3 seconds for individual questions. Yes/No questions took less time than multiple choice questions (average 9.6 seconds versus 14.0). Average response time showed no clear pattern by order of questions or by proctor strategy, but monotonically increased with number of words in the question (<20 words, 21-30 words, >30 words)—8.0, 11.8, 16.8, seconds, respectively. Conclusions This technology-enabled data management system helped capture patient opinions, accelerate turnaround of survey data, with minimal impact on a busy primary care clinic. This new model of patient survey data management is feasible and sustainable in a busy office setting, supports and engages clinicians in the quality improvement process, and harmonizes with the vision of a learning health care system. PMID:25768807

Real-time patient survey data during routine clinical activities for rapid-cycle quality improvement.

PubMed

Wofford, James Lucius; Campos, Claudia L; Jones, Robert E; Stevens, Sheila F

2015-03-12

Surveying patients is increasingly important for evaluating and improving health care delivery, but practical survey strategies during routine care activities have not been available. We examined the feasibility of conducting routine patient surveys in a primary care clinic using commercially available technology (Web-based survey creation, deployment on tablet computers, cloud-based management of survey data) to expedite and enhance several steps in data collection and management for rapid quality improvement cycles. We used a Web-based data management tool (survey creation, deployment on tablet computers, real-time data accumulation and display of survey results) to conduct four patient surveys during routine clinic sessions over a one-month period. Each survey consisted of three questions and focused on a specific patient care domain (dental care, waiting room experience, care access/continuity, Internet connectivity). Of the 727 available patients during clinic survey days, 316 patients (43.4%) attempted the survey, and 293 (40.3%) completed the survey. For the four 3-question surveys, the average time per survey was overall 40.4 seconds, with a range of 5.4 to 20.3 seconds for individual questions. Yes/No questions took less time than multiple choice questions (average 9.6 seconds versus 14.0). Average response time showed no clear pattern by order of questions or by proctor strategy, but monotonically increased with number of words in the question (<20 words, 21-30 words, >30 words)-8.0, 11.8, 16.8, seconds, respectively. This technology-enabled data management system helped capture patient opinions, accelerate turnaround of survey data, with minimal impact on a busy primary care clinic. This new model of patient survey data management is feasible and sustainable in a busy office setting, supports and engages clinicians in the quality improvement process, and harmonizes with the vision of a learning health care system.

Microsatellite Imputation for parental verification from SNP across multiple Bos taurus and indicus breeds

USDA-ARS?s Scientific Manuscript database

Microsatellite markers (MS) have traditionally been used for parental verification and are still the international standard in spite of their higher cost, error rate, and turnaround time compared with Single Nucleotide Polymorphisms (SNP)-based assays. Despite domestic and international demands fro...

Implementation of Peer-Reviewed Homework Assignments

ERIC Educational Resources Information Center

Zare, Richard N.; Cox, Charles T., Jr.; Murphy, Katherine; Bayas, Camille

2017-01-01

In large, introductory courses, instructors and teaching assistants often struggle to provide detailed feedback on student homework in a timely manner. Here we describe a peer-reviewed homework system that provides quick turnaround while offering flexibility in the construction of homework problems. Homework is administered through a cycle, which…

Add Interest to Your Social Studies Curriculum without Cost.

ERIC Educational Resources Information Center

Bloom, Marion G.; And Others

1992-01-01

Lists a sampling of free materials and their sources for use by social studies teachers. Includes videos, maps, pamphlets, booklets, games, posters, and travel brochures from Norway, Saudi Arabia, Germany, and Korea among others. Provides source addresses, turnaround times, and descriptions of the materials. (DK)

Utilization of stat test priority in the clinical laboratory: a College of American Pathologists q-probes study of 52 institutions.

PubMed

Volmar, Keith E; Wilkinson, David S; Wagar, Elizabeth A; Lehman, Christopher M

2013-02-01

Utilization of stat testing priority is a balance between safe, efficient patient management and resource expenditure. To determine the rate of stat testing, compare rates among institutions, and determine the distribution of turnaround time expectations for different turnaround time priorities. During a 7-day period, participants prospectively determined the total number of chemistry, hematology, and coagulation billable tests from inpatients and emergency department patients. Among these, the total numbers of billable tests performed stat were identified. Laboratories also reported the levels of test priority they offered and turnaround expectations for each level of test priority. Fifty institutions submitted data for the study, with 2 additional participants submitting partial results. Participants identified 639 589 chemistry, hematology, and coagulation billable tests, with 229 896 (35.9%) performed stat. The stat rate varied from 21.3% at the 10th percentile to 55.4% at the 90th percentile, with a median of 37.0% of participants' tests performed stat. Laboratories include a mean of 206 tests in chemistry, hematology, and coagulation test menus, with 67% of these tests offered stat. The fraction of the test menu offered stat varied from 29.0% at the 10th percentile to 97.8% at the 90th percentile, with a median of 73.3% of tests on the menu offered stat. The most common number of testing priorities offered by participating laboratories was 3 (44.2%). Among the 52 participating laboratories, the median stat testing rate was 37.0% and a median 73.3% of the test menu was offered stat.

Massive metrology using fast e-beam technology improves OPC model accuracy by >2x at faster turnaround time

NASA Astrophysics Data System (ADS)

Zhao, Qian; Wang, Lei; Wang, Jazer; Wang, ChangAn; Shi, Hong-Fei; Guerrero, James; Feng, Mu; Zhang, Qiang; Liang, Jiao; Guo, Yunbo; Zhang, Chen; Wallow, Tom; Rio, David; Wang, Lester; Wang, Alvin; Wang, Jen-Shiang; Gronlund, Keith; Lang, Jun; Koh, Kar Kit; Zhang, Dong Qing; Zhang, Hongxin; Krishnamurthy, Subramanian; Fei, Ray; Lin, Chiawen; Fang, Wei; Wang, Fei

2018-03-01

Classical SEM metrology, CD-SEM, uses low data rate and extensive frame-averaging technique to achieve high-quality SEM imaging for high-precision metrology. The drawbacks include prolonged data collection time and larger photoresist shrinkage due to excess electron dosage. This paper will introduce a novel e-beam metrology system based on a high data rate, large probe current, and ultra-low noise electron optics design. At the same level of metrology precision, this high speed e-beam metrology system could significantly shorten data collection time and reduce electron dosage. In this work, the data collection speed is higher than 7,000 images per hr. Moreover, a novel large field of view (LFOV) capability at high resolution was enabled by an advanced electron deflection system design. The area coverage by LFOV is >100x larger than classical SEM. Superior metrology precision throughout the whole image has been achieved, and high quality metrology data could be extracted from full field. This new capability on metrology will further improve metrology data collection speed to support the need for large volume of metrology data from OPC model calibration of next generation technology. The shrinking EPE (Edge Placement Error) budget places more stringent requirement on OPC model accuracy, which is increasingly limited by metrology errors. In the current practice of metrology data collection and data processing to model calibration flow, CD-SEM throughput becomes a bottleneck that limits the amount of metrology measurements available for OPC model calibration, impacting pattern coverage and model accuracy especially for 2D pattern prediction. To address the trade-off in metrology sampling and model accuracy constrained by the cycle time requirement, this paper employs the high speed e-beam metrology system and a new computational software solution to take full advantage of the large volume data and significantly reduce both systematic and random metrology errors. The new computational software enables users to generate large quantity of highly accurate EP (Edge Placement) gauges and significantly improve design pattern coverage with up to 5X gain in model prediction accuracy on complex 2D patterns. Overall, this work showed >2x improvement in OPC model accuracy at a faster model turn-around time.

76 FR 13136 - Notice of Submission for OMB Review

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-10

... design; (3) analyze the impact of receipt of RTT funds on student outcomes using an interrupted time series design; and (4) investigate the relationship between STM turnaround models (and strategies within...-performing schools. The evaluation is designed to (1) study the implementation of RTT and SIG; (2) analyze...

75 FR 78230 - Notice of Proposed Information Collection Requests

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-15

... discontinuity design; (3) analyze the impact of receipt of RTT funds on student outcomes using an interrupted time series design; and (4) investigate the relationship between STM turnaround models (and strategies... (STMs) in the lowest-performing schools. The evaluation is designed to (1) study the implementation of...

How to get parts out of prison (without paperwork).

PubMed

Brown, K

1998-11-01

This article describes the business relationship between a manufacturing company and a vendor that is a minimum-security correctional facility. In particular, it describes a set of revisions in the purchasing and delivery process that reduced the amount of paperwork substantially and also reduced the turnaround time.

75 FR 74024 - Notice of Submission for OMB Review

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-30

... purpose of the Study of School Turnaround is to document over time the intervention models, approaches... with school principals, district administrators and state officials; site visits to case study schools... study team will conduct in-depth case studies over three years, and two sets of 10 ``special topics...

39 CFR 121.4 - Package Services.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Center Facility (SCF) turnaround Package Services mail accepted at the origin SCF before the day zero... origin before the day-zero Critical Entry Time is 3 days, for each remaining (non-intra-SCF) 3-digit ZIP... intra-Network Distribution Center (NDC) Package Services mail accepted at origin before the day-zero...

39 CFR 121.4 - Package Services.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Center Facility (SCF) turnaround Package Services mail accepted at the origin SCF before the day zero... origin before the day-zero Critical Entry Time is 3 days, for each remaining (non-intra-SCF) 3-digit ZIP... intra-Network Distribution Center (NDC) Package Services mail accepted at origin before the day-zero...

Turning Schools around

ERIC Educational Resources Information Center

Johnson, Sabrina

2011-01-01

Schools across the country are seeking creative ways to meet the high demands of school accountability. For example, in Montgomery (AL) Public Schools, "turnaround specialists" work at the direction of the local system's board of education. The district decided to treat turnaround specialists as partners who work with school principals…

Mixing Metaphors: Building Infrastructure for Large Scale School Turnaround

ERIC Educational Resources Information Center

Peurach, Donald J.; Neumerski, Christine M.

2015-01-01

The purpose of this analysis is to increase understanding of the possibilities and challenges of building educational infrastructure--the basic, foundational structures, systems, and resources--to support large-scale school turnaround. Building educational infrastructure often exceeds the capacity of schools, districts, and state education…

Process configuration of Liquid-nitrogen Energy Storage System (LESS) for maximum turnaround efficiency

NASA Astrophysics Data System (ADS)

Dutta, Rohan; Ghosh, Parthasarathi; Chowdhury, Kanchan

2017-12-01

Diverse power generation sector requires energy storage due to penetration of variable renewable energy sources and use of CO2 capture plants with fossil fuel based power plants. Cryogenic energy storage being large-scale, decoupled system with capability of producing large power in the range of MWs is one of the options. The drawback of these systems is low turnaround efficiencies due to liquefaction processes being highly energy intensive. In this paper, the scopes of improving the turnaround efficiency of such a plant based on liquid Nitrogen were identified and some of them were addressed. A method using multiple stages of reheat and expansion was proposed for improved turnaround efficiency from 22% to 47% using four such stages in the cycle. The novelty here is the application of reheating in a cryogenic system and utilization of waste heat for that purpose. Based on the study, process conditions for a laboratory-scale setup were determined and presented here.

Nonpreemptive run-time scheduling issues on a multitasked, multiprogrammed multiprocessor with dependencies, bidimensional tasks, folding and dynamic graphs

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

Miller, Allan Ray

1987-05-01

Increases in high speed hardware have mandated studies in software techniques to exploit the parallel capabilities. This thesis examines the effects a run-time scheduler has on a multiprocessor. The model consists of directed, acyclic graphs, generated from serial FORTRAN benchmark programs by the parallel compiler Parafrase. A multitasked, multiprogrammed environment is created. Dependencies are generated by the compiler. Tasks are bidimensional, i.e., they may specify both time and processor requests. Processor requests may be folded into execution time by the scheduler. The graphs may arrive at arbitrary time intervals. The general case is NP-hard, thus, a variety of heuristics aremore » examined by a simulator. Multiprogramming demonstrates a greater need for a run-time scheduler than does monoprogramming for a variety of reasons, e.g., greater stress on the processors, a larger number of independent control paths, more variety in the task parameters, etc. The dynamic critical path series of algorithms perform well. Dynamic critical volume did not add much. Unfortunately, dynamic critical path maximizes turnaround time as well as throughput. Two schedulers are presented which balance throughput and turnaround time. The first requires classification of jobs by type; the second requires selection of a ratio value which is dependent upon system parameters. 45 refs., 19 figs., 20 tabs.« less

Impact of electronic order management on the timeliness of antibiotic administration in critical care patients.

PubMed

Cartmill, Randi S; Walker, James M; Blosky, Mary Ann; Brown, Roger L; Djurkovic, Svetolik; Dunham, Deborah B; Gardill, Debra; Haupt, Marilyn T; Parry, Dean; Wetterneck, Tosha B; Wood, Kenneth E; Carayon, Pascale

2012-11-01

To examine the effect of implementing electronic order management on the timely administration of antibiotics to critical-care patients. We used a prospective pre-post design, collecting data on first-dose IV antibiotic orders before and after the implementation of an integrated electronic medication-management system, which included computerized provider order entry (CPOE), pharmacy order processing and an electronic medication administration record (eMAR). The research was performed in a 24-bed adult medical/surgical ICU in a large, rural, tertiary medical center. Data on the time of ordering, pharmacy processing and administration were prospectively collected and time intervals for each stage and the overall process were calculated. The overall turnaround time from ordering to administration significantly decreased from a median of 100 min before order management implementation to a median of 64 min after implementation. The first part of the medication use process, i.e., from order entry to pharmacy processing, improved significantly whereas no change was observed in the phase from pharmacy processing to medication administration. The implementation of an electronic order-management system improved the timeliness of antibiotic administration to critical-care patients. Additional system changes are required to further decrease the turnaround time. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Single-pair fluorescence resonance energy transfer analysis of mRNA transcripts for highly sensitive gene expression profiling in near real time.

PubMed

Peng, Zhiyong; Young, Brandon; Baird, Alison E; Soper, Steven A

2013-08-20

Expression analysis of mRNAs transcribed from certain genes can be used as important sources of biomarkers for in vitro diagnostics. While the use of reverse transcription quantitative PCR (RT-qPCR) can provide excellent analytical sensitivity for monitoring transcript numbers, more sensitive approaches for expression analysis that can report results in near real-time are needed for many critical applications. We report a novel assay that can provide exquisite limits-of-quantitation and consists of reverse transcription (RT) followed by a ligase detection reaction (LDR) with single-pair fluorescence resonance energy transfer (spFRET) to provide digital readout through molecular counting. For this assay, no PCR was employed, which enabled short assay turnaround times. To facilitate implementation of the assay, a cyclic olefin copolymer (COC) microchip, which was fabricated using hot embossing, was employed to carry out the LDR in a continuous flow format with online single-molecule detection following the LDR. As demonstrators of the assay's utility, MMP-7 mRNA was expression profiled from several colorectal cancer cell lines. It was found that the RT-LDR/spFRET assay produced highly linear calibration plots even in the low copy number regime. Comparison to RT-qPCR indicated a better linearity over the low copy number range investigated (10-10,000 copies) with an R(2) = 0.9995 for RT-LDR/spFRET and R(2) = 0.98 for RT-qPCR. In addition, differentiating between copy numbers of 10 and 50 could be performed with higher confidence using RT-LDR/spFRET. To demonstrate the short assay turnaround times obtainable using the RT-LDR/spFRET assay, a two thermal cycle LDR was carried out on amphiphysin gene transcripts that can serve as important diagnostic markers for ischemic stroke. The ability to supply diagnostic information on possible stroke events in short turnaround times using RT-LDR/spFRET will enable clinicians to treat patients effectively with appropriate time-sensitive therapeutics.

Single-Pair Fret Analysis of mRNA Transcripts for Highly Sensitive Gene Expression Profiling in Near Real Time

PubMed Central

Peng, Zhiyong; Young, Brandon; Baird, Alison E.; Soper, Steven A.

2013-01-01

Expression analysis of mRNAs transcribed from certain genes can be used as important sources of biomarkers for in vitro diagnostics. While the use of reverse transcription quantitative PCR (RT-qPCR) can provide excellent analytical sensitivity for monitoring transcript numbers, more sensitive approaches for expression analysis that can report results in near real-time are needed for many critical applications. We report a novel assay that can provide exquisite limits-of-quantitation and consists of reverse transcription (RT) followed by a ligase detection reaction (LDR) with single-pair fluorescence resonance energy transfer (spFRET) to provide digital readout through molecular counting. For this assay, no PCR was employed, which enabled short assay turnaround times. To facilitate implementation of the assay, a cyclic olefin copolymer (COC) microchip, which was fabricated using hot embossing, was employed to carry out the LDR in a continuous flow format with on-line single-molecule detection following the LDR. As demonstrators of the assay's utility, MMP-7 mRNA was expression profiled from several colorectal cancer cell lines. It was found that the RT-LDR/spFRET assay produced highly linear calibration plots even in the low copy number regime. Comparison to RT-qPCR indicated a better linearity over the low copy number range investigated (10 − 10,000 copies) with an R2 = 0.9995 for RT-LDR/spFRET and R2 = 0.98 for RT-qPCR. In addition, differentiating between copy numbers of 10 and 50 could be performed with higher confidence using RT-LDR/spFRET. To demonstrate the short assay turnaround times obtainable using the RT-LDR/spFRET assay, a 2 thermal cycle LDR was carried out on amphiphysin gene transcripts that can serve as important diagnostic markers for ischemic stroke. The ability to supply diagnostic information on possible stroke events in short turnaround times using RT-LDR/spFRET will enable clinicians to treat patients effectively with appropriate time-sensitive therapeutics. PMID:23869556

Manned geosynchronous mission requirements and systems analysis study extension

NASA Technical Reports Server (NTRS)

1981-01-01

Turnaround requirements for the manned orbital transfer vehicle (MOTV) baseline and alternate concepts with and without a space operations center (SOC) are defined. Manned orbital transfer vehicle maintenance, refurbishment, resupply, and refueling are considered as well as the most effective combination of ground based and space based turnaround activities. Ground and flight operations requirements for abort are identified as well as low cost approaches to space and ground operations through maintenance and missions sensitivity studies. The recommended turnaround mix shows that space basing MOTV at SOC with periodic return to ground for overhaul results in minimum recurring costs. A pressurized hangar at SOC reduces labor costs by approximately 50%.

The Fulton County Medical Examiner's experience with the Federal Bureau of Investigation National Missing Person DNA Database Program, 2004-2007.

PubMed

Heninger, Michael; Hanzlick, Randy

2011-03-01

Medical examiners and coroners occasionally encounter unidentified human bodies, which remain unidentified for extended periods. In such cases, when traditional methods of identification have failed or cannot be used, DNA profiling may be used. The Federal Bureau of Investigation has a National Missing Person DNA database (NMPDD) laboratory to which samples may be submitted on such cases and from possible relatives or environments of unidentified decedents. This article describes the experience of the Fulton County Medical Examiner (FCME) in submitting samples to the NMPDD laboratory. A database was established at the FCME to track the submission of samples from unidentified decedents to the NMPDD laboratory for DNA testing along with the results and turnaround times. In December 2004, the FCME inventoried all cases for which samples were available and began to submit them to the NMPDD laboratory for testing. DNA testing and isolation rates, sample type, and turnaround times were tabulated in October 2006 for samples submitted between December 16, 2004 and December 16, 2005. An overall summary of data was also prepared concerning the status of all samples submitted as of April 17, 2007. During the 1-year study period, samples from 77 unidentified decedents were submitted to the laboratory. As of October 2006 (22 months after submission of the first samples and 10 months after submission of the last samples), testing had been completed on 53% of the samples submitted, and 68% of those tested resulted in a mitochondrial DNA profile. Turnaround times ranged from 66 to 557 days, improved with time, and had a mean of 107 days for specimens submitted during the latter part of the study period. As of April 17, 2007, we had submitted samples involving 84 unidentified decedents. Seventy-five percent of the samples have now been tested. Data from the NMPDD laboratory have resulted in 4 identifications by comparison with putative relatives, 4 exclusions, and no cold hits through comparison NMPDD DNA profiles from missing persons. More extensive data are presented in the body of this article. The NMPDD laboratory provides useful and free services to medical examiners, coroners, and law enforcement agencies that require DNA services regarding missing and unidentified persons. Turnaround times have improved. The success of the system in getting cold hits will be heavily dependent on law enforcement filing missing persons reports and submission of reference samples from putative relatives of the decedent. We recommend collecting specimens for DNA analysis early on in the postmortem investigation, submitting samples to the NMPDD laboratory or one of its participating laboratories when traditional methods for identification cannot be used or have failed, not burying bodies until a DNA profile has been obtained, and not cremating unidentified remains.

Review of "What's Trust Got to Do with It?"

ERIC Educational Resources Information Center

Mathis, William J.

2012-01-01

This report offers recommendations for building community support for federal school turnaround approaches, particularly in communities that oppose these approaches. Parents, the report concludes, want improvement but cherish their local schools and distrust the turnaround options mandated from above by higher levels of government. Thus,…

Making Sense of School Turnarounds

ERIC Educational Resources Information Center

Hess, Frederick M.

2012-01-01

Today, in a sector flooded with $3.5 billion in School Improvement Grant funds and the resulting improvement plans, there's great faith that "turnaround" strategies are a promising way to tackle stubborn problems with persistently low-performing schools. Unlike traditional reform efforts, with their emphasis on incremental improvement, turnarounds…

Improving Emergency Department radiology transportation time: a successful implementation of lean methodology.

PubMed

Hitti, Eveline A; El-Eid, Ghada R; Tamim, Hani; Saleh, Rana; Saliba, Miriam; Naffaa, Lena

2017-09-05

Emergency Department overcrowding has become a global problem and a growing safety and quality concern. Radiology and laboratory turnaround time, ED boarding and increased ED visits are some of the factors that contribute to ED overcrowding. Lean methods have been used in the ED to address multiple flow challenges from improving door-to-doctor time to reducing length of stay. The objective of this study is to determine the effectiveness of using Lean management methods on improving Emergency Department transportation times for plain radiography. We performed a before and after study at an academic urban Emergency Department with 49,000 annual visits after implementing a Lean driven intervention. The primary outcome was mean radiology transportation turnaround time (TAT). Secondary outcomes included overall study turnaround time from order processing to preliminary report time as well as ED length of stay. All ED patients undergoing plain radiography 6 months pre-intervention were compared to all ED patients undergoing plain radiography 6 months post-intervention after a 1 month washout period. Post intervention there was a statistically significant decrease in the mean transportation TAT (mean ± SD: 9.87 min ± 15.05 versus 22.89 min ± 22.05, respectively, p-value <0.0001). In addition, it was found that 71.6% of patients in the post-intervention had transportation TAT ≤ 10 min, as compared to 32.3% in the pre-intervention period, p-value <0.0001, with narrower interquartile ranges in the post-intervention period. Similarly, the "study processing to preliminary report time" and the length of stay were lower in the post-intervention as compared to the pre-intervention, (52.50 min ± 35.43 versus 54.04 min ± 34.72, p-value = 0.02 and 3.65 h ± 5.17 versus 4.57 h ± 10.43, p < 0.0001, respectively), in spite of an increase in the time it took to elease a preliminary report in the post-intervention period. Using Lean change management techniques can be effective in reducing transportation time to plain radiography in the Emergency Department as well as improving process reliability.

A filmless radiology department in a full digital regional hospital: quantitative evaluation of the increased quality and efficiency.

PubMed

Nitrosi, Andrea; Borasi, Giovanni; Nicoli, Franco; Modigliani, Gino; Botti, Andrea; Bertolini, Marco; Notari, Pietro

2007-06-01

Reggio Emilia hospital installed Picture Archiving and Communications Systems (PACS) as the final step towards a completely digital clinical environment completing the HIS/EMR and 1,400 web/terminals for patient information access. Financial benefits throughout the hospital were assessed upfront and measured periodically. Key indicators (radiology exam turnaround time, number of radiology procedures performed, inpatients length of stay before and after the PACS implementation, etc.) were analyzed and values were statistically tested to assess workflow and productivity improvements. The hospital went "filmless" in 28 weeks. Between the half of 2004 and the respective period in 2003, overall Radiology Department productivity increased by 12%, TAT improved by more than 60%. Timelier patient care resulted in decreased lengths of stay. Neurology alone experienced a 12% improvement in average patient stay. To quantify the impact of PACS on the average hospital stays and the expected productivity benefits to inpatient productivity were used a "high level" and a "detailed" business model. Annual financial upsides have exceeded $1.9 millions/year. A well-planned PACS deployment simplifies imaging workflow and improves patient care throughout the hospital while delivering substantial financial benefits. Staff buy-in was the key in this process and on-going training and process monitoring are a must.

Skills acquired in research and public health in the specialty of family and community nursing in the Valencian Community.

PubMed

García-Martínez, Pedro; Lozano-Vidal, Ruth; Herraiz-Ortiz, María Del Carmen; Collado-Boira, Eladio

To evaluate the acquisition of skills in research and public health specialists in family and community nursing. Descriptive and analytical study on a population of specialist nurse members of with the Valencian Primary Nurse Society. Measured with anonymous self-administered questionnaire on activities implemented and turnaround time in the training period. The questionnaire was conducted and reviewed based on the training programme of the specialty. Sixteen of the 41 specialists responded. The four year groups of nurses who had finished their training were represented as well as seven national teaching units. The results show high heterogeneity in the activities developed in the training. The average rotation in public health is 7.07 weeks, with range of 0 to 16 weeks. The mean number of educational sessions is 2.69 in the two years. The average number of research projects is 1.19. The result shows a specialisation process with training gaps in the skills of research and public health that could be remedied. Some practitioners claim that they finish their specialisation without undertaking research activities or completing the minimum proposed shifts. There is no process of improvement in the four year groups studied. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Pre-K as School Turnaround Strategy

ERIC Educational Resources Information Center

Buenafe, Anthony Q.

2011-01-01

Both state and local school systems, recognizing the strong and growing evidence of pre-kindergarten's effectiveness in closing achievement gaps, are implementing early learning programs as part of their education reform efforts. In low-performing districts, pre-k has emerged as a promising turnaround strategy, reaching children before they become…

Retirees Turn Around Low-Performing Schools

ERIC Educational Resources Information Center

Stover, Del

2007-01-01

In the last few years, a number of states, education associations, and universities have launched new programs to build up the cadre of school turnaround specialists. These programs are often modeled on the experiences of consultants in the corporate world. This article discusses the advantages of using turnaround specialists and describes the…

78 FR 68096 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Quick...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-13

... Training Administration (ETA) sponsored information collection request (ICR) titled, ``Quick Turnaround... Information and Regulatory Affairs, Attn: OMB Desk Officer for DOL- ETA, Office of Management and Budget, Room... authority for the ETA to conduct quick turnaround surveys on Workforce Investment Act (WIA) related issues...

School Turnaround Leaders: Competencies for Success. Part of the School Turnaround Collection from Public Impact

ERIC Educational Resources Information Center

Public Impact, 2008

2008-01-01

Evidence collected over the last 30 years suggests that effective school leaders significantly influence student learning and other aspects of school performance. Documented experience also indicates that individual leaders in failing organizations in various sectors, including education, can effect rapid, dramatic improvements. School turnaround…

Key Decisions of a First-Year "Turnaround" Principal

ERIC Educational Resources Information Center

Duke, Daniel; Salmonowicz, Michael

2010-01-01

This article examines the decisions made by one principal in her first year as a school turnaround specialist in a low-performing urban elementary school. Researchers focused on decisions related to the principal's three high-priority concerns: (1) elimination of an ineffective instructional program; (2) creation of a culture of teacher…

Policy Perspective: School Turnaround in England. Utilizing the Private Sector

ERIC Educational Resources Information Center

Corbett, Julie

2014-01-01

This paper, written by strategic partner of the Center on School Turnaround (CST), Julie Corbett, provides research and examples on England's approach to turning around its lowest performing schools. The English education system utilizes private vendors to support chronically low-performing schools and districts. The introduction is followed by…

Turnaround: Leading Stressed Colleges and Universities to Excellence

ERIC Educational Resources Information Center

Martin, James; Samels, James E.

2008-01-01

Nearly one thousand colleges and universities in the United States face major challenges--from catastrophic hurricanes to loss of accreditation to sagging enrollment. What can leaders of such at-risk institutions do to improve their situation? "Turnaround" gives college and university leaders the tools they need to put their fragile institutions…

CAD/CAM, Creativity, and Discipline Lead to Turnaround School Success

ERIC Educational Resources Information Center

Gorman, Lynn

2012-01-01

Miami Central High School technology teacher Frank Houghtaling thinks the connection between theory and application is one reason his students perform better on the Florida Comprehensive Assessment Test (FCAT). The impressive turnaround school drew local and national attention last spring when one of Houghtaling's students, Dagoberto Cruz, won…

Turnarounds to Transfer: Design beyond the Modes

ERIC Educational Resources Information Center

Eddy, Jennifer

2014-01-01

In "Turnarounds to Transfer," teachers design a collection of tasks toward the summative performance goal but go beyond the Communicative mode criteria: they must assess for transfer. Transfer design criteria must include a complexity or variation that make learners engage critical thinking skills and call upon a repertoire of knowledge…

Importing Leaders for School Turnarounds: Lessons and Opportunities

ERIC Educational Resources Information Center

Kowal, Julie; Hassel, Emily Ayscue

2011-01-01

One of the biggest challenges in education today is identifying talented candidates to successfully lead turnarounds of persistently low-achieving schools. Evidence suggests that the traditional principal pool is already stretched to capacity and cannot supply enough leaders to fix failing schools. But potentially thousands of leaders capable of…

Turnaround, Transformational, or Transactional Leadership: An Ethical Dilemma in School Reform

ERIC Educational Resources Information Center

Mette, Ian M.; Scribner, Jay P.

2014-01-01

This case was written for school leaders, specifically building-level principals and central office administrators attempting to implement school turnaround reform efforts. Often, leaders who embark on this type of organizational change work in intense environments that produce high levels of pressure to demonstrate improvement in student…

Turnaround Momentum Still Fragile

ERIC Educational Resources Information Center

Klein, Alyson

2012-01-01

The federal program providing billions of dollars to help states and districts close or remake some of their worst-performing schools remains a work in progress after two years, with more than 1,200 turnaround efforts under way but still no definitive verdict on its effectiveness. The School Improvement Grant (SIG) program, supercharged by a…

Turning around Schools: A View from Teachers as Policy Implementers

ERIC Educational Resources Information Center

Chisum, Jamie B.

2014-01-01

This single case study examines how stakeholders of a local education agency (LEA) understand and implement state turnaround policy for its chronically underperforming schools. While there is ample research on how to improve chronically underperforming schools, that research becomes limited when looking at turnaround implementation actions that…

Chronically Low-Performing Schools and Turnaround: Evidence from Three States

ERIC Educational Resources Information Center

Hansen, Michael; Choi, Kilchan

2012-01-01

The criteria for determining the student outcomes that define a school as having "turned around" are not well defined, and the definition of turnaround performance varies across studies. Although current policy initiatives offer guidelines for identifying CLP schools, there is no standard definition or methodology in common usage. This…

Turning around Schools: A View from School Leaders as Policy Implementers

ERIC Educational Resources Information Center

Geiser, Jill S.

2014-01-01

This single case study examines how stakeholders of a local education agency (LEA) understand and implement state turnaround policy for its chronically underperforming schools. While there is ample research on how to improve chronically underperforming schools, that research becomes limited when looking at turnaround implementation actions that…

Mission Operations of the Mars Exploration Rovers

NASA Technical Reports Server (NTRS)

Bass, Deborah; Lauback, Sharon; Mishkin, Andrew; Limonadi, Daniel

2007-01-01

A document describes a system of processes involved in planning, commanding, and monitoring operations of the rovers Spirit and Opportunity of the Mars Exploration Rover mission. The system is designed to minimize command turnaround time, given that inherent uncertainties in terrain conditions and in successful completion of planned landed spacecraft motions preclude planning of some spacecraft activities until the results of prior activities are known by the ground-based operations team. The processes are partitioned into those (designated as tactical) that must be tied to the Martian clock and those (designated strategic) that can, without loss, be completed in a more leisurely fashion. The tactical processes include assessment of downlinked data, refinement and validation of activity plans, sequencing of commands, and integration and validation of sequences. Strategic processes include communications planning and generation of long-term activity plans. The primary benefit of this partition is to enable the tactical portion of the team to focus solely on tasks that contribute directly to meeting the deadlines for commanding the rover s each sol (1 sol = 1 Martian day) - achieving a turnaround time of 18 hours or less, while facilitating strategic team interactions with other organizations that do not work on a Mars time schedule.

Flow cytometry shows added value in diagnosing lymphoma in brain biopsies.

PubMed

van der Meulen, Matthijs; Bromberg, Jacoline E C; Lam, King H; Dammers, Ruben; Langerak, Anton W; Doorduijn, Jeanette K; Kros, Johan M; van den Bent, Martin J; van der Velden, Vincent H J

2018-05-10

To assess the sensitivity, specificity and turnaround time of flow cytometric analysis on brain biopsies compared to histology plus immunohistochemistry analysis in tumors with clinical suspicion of lymphoma. All brain biopsies performed between 2010 and 2015 at our institution and analyzed by both immunohistochemistry and flow cytometry were included in this retrospective study. Immunohistochemistry was considered the gold standard. In a total of 77 biopsies from 71 patients, 49 lymphomas were diagnosed by immunohistochemistry, flow cytometry results were concordant in 71 biopsies (92,2%). We found a specificity and sensitivity of flow cytometry of 100% and 87,8%, respectively. The time between the biopsy and reporting the result (turnaround time) was significantly shorter for flow cytometry, compared to immunohistochemistry (median: 1 versus 5 days). Flow cytometry has a high specificity and can confirm the diagnosis of a lymphoma significantly faster than immunohistochemistry. This allows for rapid initiation of treatment in this highly aggressive tumor. However, since its sensitivity is less than 100%, we recommend to perform histology plus immunohistochemistry in parallel to flow cytometry. This article is protected by copyright. All rights reserved. © 2018 International Clinical Cytometry Society.

High efficiency endocrine operation protocol: From design to implementation.

PubMed

Mascarella, Marco A; Lahrichi, Nadia; Cloutier, Fabienne; Kleiman, Simcha; Payne, Richard J; Rosenberg, Lawrence

2016-10-01

We developed a high efficiency endocrine operative protocol based on a mathematical programming approach, process reengineering, and value-stream mapping to increase the number of operations completed per day without increasing operating room time at a tertiary-care, academic center. Using this protocol, a case-control study of 72 patients undergoing endocrine operation during high efficiency days were age, sex, and procedure-matched to 72 patients undergoing operation during standard days. The demographic profile, operative times, and perioperative complications were noted. The average number of cases per 8-hour workday in the high efficiency and standard operating rooms were 7 and 5, respectively. Mean procedure times in both groups were similar. The turnaround time (mean ± standard deviation) in the high efficiency group was 8.5 (±2.7) minutes as compared with 15.4 (±4.9) minutes in the standard group (P < .001). Transient postoperative hypocalcemia was 6.9% (5/72) and 8.3% (6/72) for the high efficiency and standard groups, respectively (P = .99). In this study, patients undergoing high efficiency endocrine operation had similar procedure times and perioperative complications compared with the standard group. The proposed high efficiency protocol seems to better utilize operative time and decrease the backlog of patients waiting for endocrine operation in a country with a universal national health care program. Copyright © 2016 Elsevier Inc. All rights reserved.

Culture Morph

ERIC Educational Resources Information Center

Heid, Susan D.

2007-01-01

Historically, it's been an unavoidable truth: IT people and library people have not been inclined to come to the concept of service with the same view. For IT, it's been all about keeping the servers and systems up, the websites going, and the help desk calls and their turnaround times to a minimum. For library professionals, service has meant…

24 CFR 901.10 - Indicator #1, vacancy rate and unit turnaround time.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Indicator #1, vacancy rate and unit... HOUSING AND URBAN DEVELOPMENT PUBLIC HOUSING MANAGEMENT ASSESSMENT PROGRAM § 901.10 Indicator #1, vacancy... computation: (1) Units approved for non-dwelling use. (2) Employee occupied units. (3) Vacant units approved...

Highly Accurate Antibody Assays for Early and Rapid Detection of Tuberculosis in African and Asian Elephants

USDA-ARS?s Scientific Manuscript database

Tuberculosis (TB) in elephants is a re-emerging zoonotic disease caused primarily by Mycobacterium tuberculosis. Current methods for screening and diagnosis rely on trunk wash culture, which has serious limitations due to low test sensitivity, slow turn-around time, and variable sample quality. Inn...

Building Turnaround Capacity for Urban School Improvement: The Role of Adaptive Leadership and Defined Autonomy

ERIC Educational Resources Information Center

Conrad, Jill K.

2013-01-01

This dissertation examines the levels of and relationships between technical leadership, adaptive leadership, and defined autonomy among Denver school leaders along with their combined effects on school growth gains over time. Thirty principals provided complete responses to an online survey that included existing scales for technical leadership,…

Northern Network Committee Interlibrary Loan Survey Report.

ERIC Educational Resources Information Center

California State Univ. and Colleges, Los Angeles. Northern Library Regional Cooperation Board.

All libraries of the 19 campuses in the California State University system were surveyed about their interlibrary loan operations. Information concerning the turnaround time was sought in three specific areas: (1) from date of patron request to date of patron receipt; (2) from date of library request to date of patron notification; and (3) from…

The Students in Front of Us: Reform for the Current Generation of Urban High School Students

ERIC Educational Resources Information Center

Burks, Joe; Hochbein, Craig

2015-01-01

The implementation of education policies requiring the turnaround of persistently low-achieving schools has demanded reforms that will not only improve achievement, but also deliver results in a short period of time. To meet such demands, Jefferson County Public Schools educators implemented Project Proficiency (PP). Results from…

Imputation of microsatellite alleles from dense SNP genotypes for parentage verification across multiple Bos taurus and Bos indicus breeds

USDA-ARS?s Scientific Manuscript database

Microsatellite markers (MS) have traditionally been used for parental verification and are still the international standard in spite of their higher cost, error rate, and turnaround time compared with Single Nucleotide Polymorphisms (SNP) -based assays. Despite domestic and international demands fr...

Learning Walks: Build Hearty Appetites for Professional Development

ERIC Educational Resources Information Center

Steiny, Julia

2009-01-01

Mike Carbone has been the principal of Kickemuit Middle School in Warren, Rhode Island, since 1990. He's seen some bad times there before a dramatic turnaround. When asked what finally got his school's engine revved and moving the school forward, he said without hesitation: "Learning walks." In this article, the author describes how…

Preparing Turnaround Leaders for High Needs Urban Schools

ERIC Educational Resources Information Center

Lochmiller, Chad R.; Chesnut, Colleen E.

2017-01-01

Purpose: The purpose of this paper is to describe the program structure and design considerations of a 25-day, full-time apprenticeship in a university-based principal preparation program. Design/Methodology/ Approach: The study used a qualitative case study design that drew upon interviews and focus groups with program participants as well as…

Tough Questions for Tough Times

ERIC Educational Resources Information Center

Parrett, William; Budge, Kathleen

2009-01-01

Six high-performing/high-poverty schools provide insights into what it takes to make a dramatic turnaround. School leaders had to make tough calls--and many of those decisions were about how to use resources. The budget in a high-performing, high-poverty school is a moral document, reflective of the school's beliefs about the conditions necessary…

Navy Maintenance: The P-3 Aircraft Overhaul Program Can Be Improved.

DTIC Science & Technology

1987-06-01

Air Sys- tems Command’s Naval Aviation Logistics Center, we obtained data on aircraft turnaround times, mobilization requirements, and aircraft over...480 561 637 P-3 Workload as a Percent of 23 22 25 27 Total FINDING Z: Aplicability of Procedural Changes To Other Aircraft. The GAO observed that the

The Psychological Record: Reaffirming the Past and Embracing the Future

ERIC Educational Resources Information Center

Rehfeldt, Ruth Anne

2007-01-01

In providing an outlet for manuscripts from all areas of scientific psychology, it was the founders' intentions that authors would experience a more rapid turn-around from submission to publication than was the case with other general psychology journals at the time. Despite difficulties created by World War II, "The Psychological Record" remained…

Automation, consolidation, and integration in autoimmune diagnostics.

PubMed

Tozzoli, Renato; D'Aurizio, Federica; Villalta, Danilo; Bizzaro, Nicola

2015-08-01

Over the past two decades, we have witnessed an extraordinary change in autoimmune diagnostics, characterized by the progressive evolution of analytical technologies, the availability of new tests, and the explosive growth of molecular biology and proteomics. Aside from these huge improvements, organizational changes have also occurred which brought about a more modern vision of the autoimmune laboratory. The introduction of automation (for harmonization of testing, reduction of human error, reduction of handling steps, increase of productivity, decrease of turnaround time, improvement of safety), consolidation (combining different analytical technologies or strategies on one instrument or on one group of connected instruments) and integration (linking analytical instruments or group of instruments with pre- and post-analytical devices) opened a new era in immunodiagnostics. In this article, we review the most important changes that have occurred in autoimmune diagnostics and present some models related to the introduction of automation in the autoimmunology laboratory, such as automated indirect immunofluorescence and changes in the two-step strategy for detection of autoantibodies; automated monoplex immunoassays and reduction of turnaround time; and automated multiplex immunoassays for autoantibody profiling.

Application of the Toyota Production System improves core laboratory operations.

PubMed

Rutledge, Joe; Xu, Min; Simpson, Joanne

2010-01-01

To meet the increased clinical demands of our hospital expansion, improve quality, and reduce costs, our tertiary care, pediatric core laboratory used the Toyota Production System lean processing to reorganize our 24-hour, 7 d/wk core laboratory. A 4-month, consultant-driven process removed waste, led to a physical reset of the space to match the work flow, and developed a work cell for our random access analyzers. In addition, visual controls, single piece flow, standard work, and "5S" were instituted. The new design met our goals as reflected by achieving and maintaining improved turnaround time (TAT; mean for creatinine reduced from 54 to 23 minutes) with increased testing volume (20%), monetary savings (4 full-time equivalents), decreased variability in TAT, and better space utilization (25% gain). The project had the unanticipated consequence of eliminating STAT testing because our in-laboratory TAT for routine testing was less than our prior STAT turnaround goal. The viability of this approach is demonstrated by sustained gains and further PDCA (Plan, Do, Check, Act) improvements during the 4 years after completion of the project.

Implementation of a 'lean' cytopathology service: towards routine same-day reporting.

PubMed

Hewer, Ekkehard; Hammer, Caroline; Fricke-Vetsch, Daniela; Baumann, Cinzia; Perren, Aurel; Schmitt, Anja M

2018-05-01

To systematically assess the effects of a Lean management intervention in an academic cytopathology service. We monitored outcomes including specimen turnaround times during stepwise implementation of a lean cytopathology workflow for gynaecological and non-gynaecological cytology. The intervention resulted in a major reduction of turnaround times for both gynaecological (3rd quartile 4.1 vs 2.3 working days) and non-gynaecological cytology (3rd quartile 1.9 vs. 1.2 working days). Introduction of fully electronic reporting had additional effect over continuous staining of slides alone. The rate of non-gynaecological specimens reported the same day increased from 4.5% to 56.5% of specimens received before noon. Lean management principles provide a useful framework for organization of a cytopathology workflow. Stepwise implementation beginning with a simplified gynaecological cytology workflow allowed involved staff to monitor the effects of individual changes and allowed for a smooth transition. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Optimization of subculture and DNA extraction steps within the whole genome sequencing workflow for source tracking of Salmonella enterica and Listeria monocytogenes.

PubMed

Gimonet, Johan; Portmann, Anne-Catherine; Fournier, Coralie; Baert, Leen

2018-06-16

This work shows that an incubation time reduced to 4-5 h to prepare a culture for DNA extraction followed by an automated DNA extraction can shorten the hands-on time, the turnaround time by 30% and increase the throughput while maintaining the WGS quality assessed by high quality Single Nucleotide Polymorphism analysis. Copyright © 2018. Published by Elsevier B.V.

Time and motion studies of National Health Service cataract theatre lists to determine strategies to improve efficiency.

PubMed

Roberts, Harry W; Myerscough, James; Borsci, Simone; Ni, Melody; O'Brart, David P S

2017-11-24

To provide a quantitative assessment of cataract theatre lists focusing on productivity and staffing levels/tasks using time and motion studies. National Health Service (NHS) cataract theatre lists were prospectively observed in five different institutions (four NHS hospitals and one private hospital). Individual tasks and their timings of every member of staff were recorded. Multiple linear regression analyses were performed to investigate possible associations between individual timings and tasks. 140 operations were studied over 18 theatre sessions. The median number of scheduled cataract operations was 7 (range: 5-14). The average duration of an operation was 10.3 min±(SD 4.11 min). The average time to complete one case including patient turnaround was 19.97 min (SD 8.77 min). The proportion of the surgeons' time occupied on total duties or operating ranged from 65.2% to 76.1% and from 42.4% to 56.7%, respectively. The correlations of the surgical time to patient time in theatre was R 2 =0.95. A multiple linear regression model found a significant association (F(3,111)=32.86, P<0.001) with R 2 =0.47 between the duration of one operation and the number of allied healthcare professionals (AHPs), the number of AHP key tasks and the time taken to perform these key tasks by the AHPs. Significant variability in the number of cases performed and the efficiency of patient flow were found between different institutions. Time and motion studies identified requirements for high-volume models and factors relating to performance. Supporting the surgeon with sufficient AHPs and tasks performed by AHPs could improve surgical efficiency up to approximately double productivity over conventional theatre models. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

An evaluation of superminicomputers for thermal analysis

NASA Technical Reports Server (NTRS)

Storaasli, O. O.; Vidal, J. B.; Jones, G. K.

1982-01-01

The use of superminicomputers for solving a series of increasingly complex thermal analysis problems is investigated. The approach involved (1) installation and verification of the SPAR thermal analyzer software on superminicomputers at Langley Research Center and Goddard Space Flight Center, (2) solution of six increasingly complex thermal problems on this equipment, and (3) comparison of solution (accuracy, CPU time, turnaround time, and cost) with solutions on large mainframe computers.

Impact of Early Detection of Respiratory Viruses by Multiplex PCR Assay on Clinical Outcomes in Adult Patients

PubMed Central

Schuetz, Audrey N.; Jenkins, Stephen G.; Calfee, David P.; Walsh, Thomas J.; Wells, Martin T.; Hollenberg, James P.; Glesby, Marshall J.

2016-01-01

Rapid and definitive diagnosis of viral respiratory infections is imperative in patient triage and management. We compared the outcomes for adult patients with positive tests for respiratory viruses at a tertiary care center across two consecutive influenza seasons (winters of 2010-2011 and 2012). Infections were diagnosed by conventional methods in the first season and by multiplex PCR (FilmArray) in the second season. FilmArray decreased the time to diagnosis of influenza compared to conventional methods (median turnaround times of 1.7 h versus 7.7 h, respectively; P = 0.015); FilmArray also decreased the time to diagnosis of non-influenza viruses (1.5 h versus 13.5 h, respectively; P < 0.0001). Multivariate logistic regression found that a diagnosis of influenza by FilmArray was associated with significantly lower odds ratios (ORs) for admission (P = 0.046), length of stay (P = 0.040), duration of antimicrobial use (P = 0.032), and number of chest radiographs (P = 0.005), when controlling for potential confounders. We conclude that the rapid turnaround time, multiplex nature of the test (allowing simultaneous detection of an array of viruses), and superior sensitivity of FilmArray may improve the evaluation and management of patients suspected of having respiratory virus infections. PMID:27225406

Can States Take Over and Turn Around School Districts? Evidence from Lawrence, Massachusetts

ERIC Educational Resources Information Center

Schueler, Beth E.; Goodman, Joshua S.; Deming, David J.

2017-01-01

The Every Student Succeeds Act (ESSA) requires states to identify and turn around struggling schools, with federal school improvement money required to fund evidence-based policies. Most research on turnarounds has focused on individual schools, whereas studies of district-wide turnarounds have come from relatively exceptional settings and…

Choosing a School Turnaround Provider. Lessons Learned. Volume 1, Issue 3

ERIC Educational Resources Information Center

Lockwood, Anne Turnbaugh; Fleischman, Steve

2010-01-01

Droves of school turnaround providers are chasing the massive federal infusion of funds flowing into failing schools. They arrive armed with glossy materials, impressive sounding claims, and, often, citing their prior relationships or experiences with one's school to support their promises of great service and impressive outcomes. But, are their…

California Turnaround Schools: An Analysis of School Improvement Grant Effectiveness

ERIC Educational Resources Information Center

Graham, Khalil N.

2013-01-01

The purpose of this study was to evaluate the effectiveness of School Improvement Grants (SIGs) in the state of California (CA) in increasing student achievement using the turnaround implementation model. The American Recovery and Reinvestment Act of 2009 (ARRA) included educational priorities focused on fixing America's lowest achieving schools.…

Straight A's: Public Education Policy and Progress. Volume 10, Number 11

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2010

2010-01-01

"Straight A's: Public Education Policy and Progress" is a biweekly newsletter that focuses on education news and events both in Washington, DC and around the country. The following articles are included in this issue: (1) Turnaround or Full Speed Ahead?: House Committee Raises Concerns with School Turnaround Models Included in Obama…

Fiery Passion and Relentless Commitment: The Lived Experiences of African American Women Principals in Turnaround Model Schools

ERIC Educational Resources Information Center

Aldaco, Adrienne L. Gratten

2016-01-01

Chronically low performing schools in the United States have required targeted support and interventions to increase student achievement. In recent years, the school turnaround model has emerged as a swift, dramatic, comprehensive approach to implementing interventions in the lowest performing schools (Calkins, Guenther, Belfiore, & Lash,…

Turning around Maple Shade Middle School: A Principal's Initial Reform Efforts

ERIC Educational Resources Information Center

Salmonowicz, Michael J.; Levy, Melissa K.

2009-01-01

This case was written for use in courses dealing with school administration, specifically those related to organizational change, school improvement/turnaround, and the principalship. It explores a veteran principal's first year as a "turnaround specialist" in a low-performing middle school, where she works with a sense of urgency to achieve an…

Portrait of a Turnaround Leader in a High Needs District

ERIC Educational Resources Information Center

Hewitt, Kimberly Kappler; Reitzug, Ulrich

2015-01-01

Using portraiture methodology involving interview, observation, and artifact data, this study portrays a turnaround leader, Dr. Susan Gray, in a high needs, rural district in the Southeast. In three years, Gray led Lincoln Elementary from nearly being reconstituted to being an award-winning school. Gray has subsequently been assigned other…

Turning around Failing Organizations: Insights for Educational Leaders

ERIC Educational Resources Information Center

Murphy, Joseph

2010-01-01

Purpose: In this article, we review the literature from the organizational sciences to develop a grounded narrative of turnaround in education. Approach: The approach is a review of literature. We employ an integrated process to unpack and make sense of the turnaround literature from the organizational sciences. We rely on strategies appropriate…

Democratic School Turnarounds: Pursuing Equity and Learning from Evidence

ERIC Educational Resources Information Center

Trujillo, Tina; Renée, Michelle

2013-01-01

the report "Democratic School Turnarounds" considers the democratic tensions inherent in the federal School Improvement Grant (SIG) policy's market-based school reforms and critiques the research base that many of these reforms are based on. It concludes with a set of recommendations that re-center the purposes of public education…

Turnaround Arts Initiative: Final Evaluatiion Report

ERIC Educational Resources Information Center

Stoelinga, Sara Ray; Silk, Yael; Reddy, Prateek; Rahman, Nadiv

2015-01-01

The President's Committee on the Arts and the Humanities (PCAH) released the results of an independent study that shows substantial gains in student achievement at schools participating in its Turnaround Arts initiative. The eight schools' in the pilot phase of the initiative, showing increases in reading and math scores, as well as an increase in…

School Turnaround Teachers: Competencies for Success. Part of the School Turnaround Collection from Public Impact

ERIC Educational Resources Information Center

Public Impact, 2008

2008-01-01

Individual teachers have the largest single school effect on student performance. Documented experience also indicates that individual teachers in high-poverty schools can effect rapid, dramatic student learning improvements within their own classrooms. Organization-wide change of a similar magnitude takes a broader effort with daring leadership…

Transforming Turnaround Schools in China: Strategies, Achievements, and Challenges

ERIC Educational Resources Information Center

Liu, Peng

2016-01-01

The existence of turnaround schools has been a problem in the Chinese education system. There are diverse causes including the education system itself, the financial system, and other issues. However, there has been a lack of research to help us fully understand this phenomenon. This article provides a holistic perspective on the strategies the…

Varifocal liquid lens based on microelectrofluidic technology.

PubMed

Chang, Jong-hyeon; Jung, Kyu-Dong; Lee, Eunsung; Choi, Minseog; Lee, Seungwan; Kim, Woonbae

2012-11-01

This Letter presents a tunable liquid lens based on microelectrofluidic technology. In the microelectrofluidic lens (MEFL), electrowetting in the hydrophobic surface channel induces the Laplace pressure difference between two fluidic interfaces on the lens aperture and the surface channel. Then, the pressure difference makes the lens curvature tunable. In spite of the contact angle saturation, the narrow surface channel increases the Laplace pressure to have a wide range of optical power variation in the MEFL. The magnitude of the applied voltage determines the lens curvature in the analog mode MEFL. Digital operation is also possible when the control electrodes of the MEFL are patterned to have an array. The lens aperture and maximum surface channel diameter were designed to 3.2 mm and 6.4 mm, respectively, with a channel height of 0.2 mm for an optical power range between +210 and -30 D. By switching the control electrodes, the averaged transit time in steps and turnaround time were as low as 2.4 ms and 16.5 ms, respectively, in good agreement with the simulation results. It is expected that the proposed MEFL may be widely used with advantages of wide variation of the optical power with fast and precise controllability in a digital manner.

Design and implementation of software for automated quality control and data analysis for a complex LC/MS/MS assay for urine opiates and metabolites.

PubMed

Dickerson, Jane A; Schmeling, Michael; Hoofnagle, Andrew N; Hoffman, Noah G

2013-01-16

Mass spectrometry provides a powerful platform for performing quantitative, multiplexed assays in the clinical laboratory, but at the cost of increased complexity of analysis and quality assurance calculations compared to other methodologies. Here we describe the design and implementation of a software application that performs quality control calculations for a complex, multiplexed, mass spectrometric analysis of opioids and opioid metabolites. The development and implementation of this application improved our data analysis and quality assurance processes in several ways. First, use of the software significantly improved the procedural consistency for performing quality control calculations. Second, it reduced the amount of time technologists spent preparing and reviewing the data, saving on average over four hours per run, and in some cases improving turnaround time by a day. Third, it provides a mechanism for coupling procedural and software changes with the results of each analysis. We describe several key details of the implementation including the use of version control software and automated unit tests. These generally useful software engineering principles should be considered for any software development project in the clinical lab. Copyright © 2012 Elsevier B.V. All rights reserved.

High mortality in HIV-infected children diagnosed in hospital underscores need for faster diagnostic turnaround time in prevention of mother-to-child transmission of HIV (PMTCT) programs.

PubMed

Wagner, Anjuli; Slyker, Jennifer; Langat, Agnes; Inwani, Irene; Adhiambo, Judith; Benki-Nugent, Sarah; Tapia, Ken; Njuguna, Irene; Wamalwa, Dalton; John-Stewart, Grace

2015-02-15

Despite expanded programs for prevention of mother-to-child HIV transmission (PMTCT), HIV-infected infants may not be diagnosed until they are ill. Comparing HIV prevalence and outcomes in infants diagnosed in PMTCT programs to those in hospital settings may improve pediatric HIV diagnosis strategies. HIV-exposed infants <12 months old were recruited from 9 PMTCT sites in public maternal child health (MCH) clinics or from an inpatient setting in Nairobi, Kenya and tested for HIV using HIV DNA assays. A subset of HIV-infected infants <4.5 months of age was enrolled in a research study and followed for 2 years. HIV prevalence, number needed to test, infant age at testing, and turnaround time for tests were compared between PMTCT programs and hospital sites. Among the enrolled cohort, baseline characteristics, survival, and timing of antiretroviral therapy (ART) initiation were compared between infants diagnosed in PMTCT programs versus hospital. Among 1,923 HIV-exposed infants, HIV prevalence was higher among infants tested in hospital than PMTCT early infant diagnosis (EID) sites (41% vs. 11%, p < 0.001); the number of HIV-exposed infants needed to test to diagnose one infection was 2.4 in the hospital vs. 9.1 in PMTCT. Receipt of HIV test results was faster among hospitalized infants (7 vs. 25 days, p < 0.001). Infants diagnosed in hospital were older at the time of testing than PMTCT diagnosed infants (5.0 vs. 1.6 months, respectively, p < 0.001). In the subset of 99 HIV-infected infants <4.5 months old followed longitudinally, hospital-diagnosed infants did not differ from PMTCT-diagnosed infants in time to ART initiation; however, hospital-diagnosed infants were >3 times as likely to die (HR = 3.1, 95% CI = 1.3-7.6). Among HIV-exposed infants, hospital-based testing was more likely to detect an HIV-infected infant than PMTCT testing. Because young symptomatic infants diagnosed with HIV during hospitalization have very high mortality, every effort should be made to diagnose HIV infections before symptom onset. Systems to expedite turnaround time at PMTCT EID sites and to routinize inpatient pediatric HIV testing are necessary to improve pediatric HIV outcomes.

Textiles, Tariffs, and Turnarounds: Profits Improved.

ERIC Educational Resources Information Center

Aronoff, Craig

1986-01-01

The U.S. textile industry may serve as a classic study on regeneration through market forces. The industry has recently made a turnaround in profits after having been recognized as an industry that was losing most of its profits to overseas producers. The reasons for the emerging strength of the industry is that it began to innovate after a…

A Case Study of Change Strategies Implemented in a Turnaround Elementary School

ERIC Educational Resources Information Center

Colson, Jo Ann

2012-01-01

This case study examined the change strategies in a turnaround school at the elementary level to understand and describe how change occurred and was sustained at this campus. This study examined the factors which contributed to the change in academic success of students, examined beliefs about change that led to the change process, identified the…

Investigating the Role of Human Resources in School Turnaround: Evidence from Two States

ERIC Educational Resources Information Center

Hansen, Michael

2012-01-01

Teachers are generally recognized as the schooling factor accounting for the highest proportion of student learning outcomes (Aaronson et al., 2007; Hanushek, 1986). This implies the quick and dramatic improvement in school performance observed in turnaround (TA) schools was associated with a major change in the performance of its teachers. This…

Developing Arizona Turnaround Leaders to Build High-Capacity Schools in the Midst of Accountability Pressures and Changing Demographics

ERIC Educational Resources Information Center

Ylimaki, Rose M.; Brunderman, Lynnette; Bennett, Jeffrey V.; Dugan, Thad

2014-01-01

Today's accountability policies and changing demographics have created conditions in which leaders must rapidly build school capacity and improve outcomes in culturally diverse schools. This article presents findings from a mixed-methods evaluation of an Arizona Turnaround Leadership Development Project. The project drew on studies of turnaround…

The Effects of School Turnaround in Tennessee's Achievement School District and Innovation Zones

ERIC Educational Resources Information Center

Zimmer, Ron; Henry, Gary T.; Kho, Adam

2017-01-01

In recent years, the federal government has invested billions of dollars to reform chronically low-performing schools. To fulfill their federal Race to the Top grant agreement, Tennessee implemented three turnaround strategies that adhered to the federal restart and transformation models: (a) placed schools under the auspices of the Achievement…

The Turnaround Mindset: Aligning Leadership for Student Success

ERIC Educational Resources Information Center

Fairchild, Tierney Temple; DeMary, Jo Lynne

2011-01-01

This book provides a valuable balance between what one must know and what one must do to turn around low-performing schools. The 3-E framework simplifies this complex process by focusing resources on the environment, the executive, and the execution of the turnaround plan. Central to each of these components is a spotlight on the values supporting…

Turning Around Failing Schools: Policy Insights from the Corporate, Government, and Nonprofit Sectors

ERIC Educational Resources Information Center

Murphy, Joseph

2009-01-01

In this article, the author reviews research from the organizational sciences to develop turnaround policy guidelines that may prove useful for policy makers and educators. The approach is an integrative review of the literature. The author employs a comprehensive process to unpack and make sense of the turnaround literature from the…

Tinkering and Turnarounds: Understanding the Contemporary Campaign to Improve Low-Performing Schools

ERIC Educational Resources Information Center

Duke, Daniel L.

2012-01-01

An unprecedented amount of attention in recent years has been focused on turning around low-performing schools. Drawing on insights from Tyack and Cuban's (1995) "Tinkering Toward Utopia," the article analyzes the forces behind the school turnaround phenomenon and how they have evolved since passage of the No Child Left Behind Act. The…

The Reading Turn-Around: A Five Part Framework for Differentiated Instruction. Practitioners Bookshelf, Language & Literacy Series

ERIC Educational Resources Information Center

Jones, Stephanie; Clarke, Lane; Enriquez, Grace

2009-01-01

This book demonstrates a five-part framework for teachers, reading specialists, and literacy coaches who want to help their least engaged students become powerful readers. Merging theory and practice, the guide offers successful strategies to reach your "struggling" learners. The authors show how you can "turn-around" your instructional practice,…

Rural Economic Development Consequences of the Population Turnaround in Northern Lower Michigan.

ERIC Educational Resources Information Center

West, Patrick C.; And Others

Consequences of population turnaround for rural economic development are examined in a 9-county region of Northern Lower Michigan. Data from census reports and 374 usable responses to a questionnaire mailed to a random sample of property owners drawn from 1982 county tax assessment rolls were used to test competing hypotheses about rural…

The Project L.I.F.T. Story: Early Lessons from a Public-Private Education Turnaround Initiative

ERIC Educational Resources Information Center

Kim, Juli; Ellison, Shonaka

2015-01-01

Leading Charlotte foundations formed a funding collaborative to support a five-year district turnaround initiative to dramatically improve educational outcomes for students in the West Charlotte High School corridor, one of the city's lowest-performing feeder zones. The "Project L.I.F.T." initiative involves four areas of education…

The Rural Turnaround in Ohio: Some Evidence Related to Implications.

ERIC Educational Resources Information Center

Thomas, Donald W.; Bachtel, Douglas C.

Limited to residents of small towns, villages and the rural open country, the study assessed the implications of the rural turnaround in the southern Ohio counties of Athens, Gallia, Jackson, Meigs, and Vinton. All five counties experienced outmigration in the 1950s, and all but Athens County lost population through outmigration in the 1960s. In…

The Double Bind for Women: Exploring the Gendered Nature of Turnaround Leadership in a Principal Preparation Program

ERIC Educational Resources Information Center

Weiner, Jennie Miles; Burton, Laura J.

2016-01-01

In this study of nine participants in a turnaround principal preparation program, Jennie Miles Weiner and Laura J. Burton explore how gender role identity shaped participants' views of effective principal leadership and their place within it. The authors find that although female and male participants initially framed effective leadership…

Turnaround Principals: An Unmistakable Conclusion--Site-Level Success Stems from Superintendent Support

ERIC Educational Resources Information Center

Burbach, Harold J.; Butler, Alfred R., IV

2005-01-01

The authors of this article were recently privileged to spend five days with a group of 10 talented principals who have been charged with turning around academically low-performing schools in their respective districts. These principals were selected as participants in a Turnaround Specialist Program initiated by Gov. Mark R. Warner of Virginia…

Participatory Democracy and Struggling Schools: Making Space for Youth in School Turnarounds

ERIC Educational Resources Information Center

Kirshner, Ben; Jefferson, Anton

2015-01-01

Background/Context:Federal policy, as codified in Race to the Top (RTT) funding guidelines, outlines four types of intervention: turnaround, restart, closure, and transformation. RTT has embraced a technocratic paradigm for school reform that frames choice less as the opportunity for the public to deliberate about what it wants from its schools…

17 CFR 240.17Ad-2 - Turnaround, processing, and forwarding of items.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 17 Commodity and Securities Exchanges 3 2011-04-01 2011-04-01 false Turnaround, processing, and forwarding of items. 240.17Ad-2 Section 240.17Ad-2 Commodity and Securities Exchanges SECURITIES AND EXCHANGE... be filed with the Comptroller of the Currency shall be filed with the Office of the Comptroller of...

17 CFR 240.17Ad-2 - Turnaround, processing, and forwarding of items.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Turnaround, processing, and forwarding of items. 240.17Ad-2 Section 240.17Ad-2 Commodity and Securities Exchanges SECURITIES AND EXCHANGE... be filed with the Comptroller of the Currency shall be filed with the Office of the Comptroller of...

Under soggy skies on a Sunday morning, the Space Shuttle Endeavour is encased in the Mate-DeMate gantry during turnaround processing at NASA DFRC

NASA Image and Video Library

2008-12-07

Under soggy skies on a Sunday morning, the Space Shuttle Endeavour is encased in the Mate-DeMate gantry during turnaround processing at NASA's Dryden Flight Research Center following its STS-126 landing at Edwards Air Force Base a week earlier.

Portfolio District Reform Meets School Turnaround: Early Implementation Findings from the Los Angeles Public School Choice Initiative

ERIC Educational Resources Information Center

Marsh, Julie A.; Strunk, Katharine O.; Bush, Susan

2013-01-01

Purpose: Despite the popularity of school "turnaround" and "portfolio district" management as solutions to low performance, there has been limited research on these strategies. The purpose of this paper is to address this gap by exploring the strategic case of Los Angeles Unified School District's Public School Choice…

Turnaround High School Principals: Recruit, Prepare and Empower Leaders of Change.

ERIC Educational Resources Information Center

Schmidt-Davis, Jon; Bottoms, Gene

2012-01-01

Recent studies make one reality clear: While multiple factors can cause a low-performing high school to be in a turnaround situation, every high school that makes dramatic academic improvement has strong, effective school leadership. Turning a school around is no work for novices. It takes a skilled, visionary and proactive principal to pull apart…

Incorporating Early Learning Strategies in the School Improvement Grants (SIG) Program

ERIC Educational Resources Information Center

Connors-Tadros, Lori; Dunn, Lenay; Martella, Jana; McCauley, Carlas

2015-01-01

The Center on Enhancing Early Learning Outcomes (CEELO) and the Center on School Turnaround (CST) collaborated to develop case studies of three selected schools receiving SIG funds that have, with the support of their districts, promoted the use of early childhood programming (PK-3) as a key strategy in their schools' turnaround models. The goal…

School Turnaround Leaders: Selection Toolkit. Part of the School Turnaround Collection from Public Impact

ERIC Educational Resources Information Center

Public Impact, 2008

2008-01-01

This toolkit includes the following separate sections: (1) Selection Preparation Guide; (2) Day-of-Interview Tools; (3) Candidate Rating Tools; and (4) Candidate Comparison and Decision Tools. Each of the sections is designed to be used at different stages of the selection process. The first section provides a list of competencies that would…

Gamed by the System: Adequate Yearly Progress as an Indicator of Persistently Low-Achieving School Performance

ERIC Educational Resources Information Center

Hochbein, Craig; Mitchell, Amanda M.; Pollio, Martin

2013-01-01

The recent policy focus on the turnaround of persistently low-achieving schools has generated considerable debate about the reforms needed to dramatically and quickly increase school performance. The purpose of this article is not to focus on specific turnaround interventions, but rather on the identification of schools slated to receive these…

Turnaround Policy and Practice: A Case Study of Turning around a Failing School with English-Language-Learners

ERIC Educational Resources Information Center

Reyes, Augustina; Garcia, Andres

2014-01-01

In an era of school reform and high stakes accountability, the major challenge in education is to turnaround the nation's lowest-performing schools. National policy provides abundant resources with often restrictive prerequisites. Research indicates that quality principals and teachers are the most important factors for turning around the lowest…

How to Know when Dramatic Change Is on Track: Leading Indicators of School Turnarounds

ERIC Educational Resources Information Center

Kowal, Julie; Ableidinger, Joe

2011-01-01

In recent years, national policymakers have placed new emphasis on "school turnarounds" as a strategy for rapid, dramatic improvement in chronically failing schools, calling on education leaders to turn around performance in the 5,000 lowest-achieving schools nationwide. This goal may seem daunting, given the dismal success rates of…

Hospital turnaround strategies.

PubMed

Langabeer, James

2008-01-01

Despite reports of higher profitability in recent years, hospitals are failing at a faster rate than ever before. Although many hospitals leave decisions regarding revenues and costs to chief financial officers and their staff, this is a recipe for disaster. From research conducted over the last 4 years on hospital bankruptcies and turnarounds, the author found that a common series of actions will help organizations evade collapse. The author explored these turnaround strategies through research and analysis of a variety of hospitals and health systems that had a high probability of immediate financial crisis or collapse. His continued observation and analysis of these hospitals in subsequent years showed that most hospitals never emerge from their bleak financial conditions. However, a few hospital administrations have successfully turned around their organizations.

Automation of checkout for the shuttle operations era

NASA Technical Reports Server (NTRS)

Anderson, J. A.; Hendrickson, K. O.

1985-01-01

The Space Shuttle checkout is different from its Apollo predecessor. The complexity of the hardware, the shortened turnaround time, and the software that performs ground checkout are outlined. Generating new techniques and standards for software development and the management structure to control it are implemented. The utilization of computer systems for vehicle testing is high lighted.

The Learning Principal[R]. Volume 4, Number 7

ERIC Educational Resources Information Center

von Frank, Valerie, Ed.

2009-01-01

"The Learning Principal" is an eight-page newsletter published eight times a year. It focuses on the important and unique work of school principals. This issue includes: (1) A Learning Community Is Built on Trust (Valerie von Frank); (2) School Leadership: Q & A: Turnaround Doesn't Have to Take Years, Just Solid Leadership (Valerie von Frank); (3)…

Characteristics of Occupational Exposure to Benzene during Turnaround in the Petrochemical Industries

PubMed Central

Shin, Jung-Ah; Lee, Byung-Kyu; Kwon, Jiwoon; Lee, Naroo; Chung, Kwang-Jae; Lee, Jong-Han; Lee, In-Seop; Kang, Seong-Kyu; Jang, Jae-Kil

2010-01-01

Objectives The level of benzene exposure in the petrochemical industry during regular operation has been well established, but not in turnaround (TA), where high exposure may occur. In this study, the characteristics of occupational exposure to benzene during TA in the petrochemical companies were investigated in order to determine the best management strategies and improve the working environment. This was accomplished by evaluating the exposure level for the workers working in environments where benzene was being produced or used as an ingredient during the unit process. Methods From 2003 to 2008, a total of 705 workers in three petrochemical companies in Korea were studied. Long- and short-term (< 1 hr) samples were taken during TAs. TA was classified into three stages: shut-down, maintenance and start-up. All works were classified into 12 occupation categories. Results The long-term geometric mean (GM) benzene exposure level was 0.025 (5.82) ppm (0.005-42.120 ppm) and the short-term exposure concentration during TA was 0.020 (17.42) ppm (0.005-61.855 ppm). The proportions of TA samples exceeding the time-weighted average, occupational exposure level (TWA-OEL in Korea, 1 ppm) and the short-term exposure limit (STEL-OEL, 5 ppm) were 4.1% (20 samples of 488) and 6.0% (13 samples of 217), respectively. The results for the benzene exposure levels and the rates of exceeding the OEL were both statistically significant (p < 0.05). Among the 12 job categories of petrochemical workers, mechanical engineers, plumbers, welders, fieldman and scaffolding workers exhibited long-term samples that exceeded the OEL of benzene, and the rate of exceeding the OEL was statistically significant for the first two occupations (p < 0.05). Conclusion These findings suggest that the periodic work environment must be assessed during non-routine works such as TA. PMID:22953163

A Rural School/Community: A Case Study of a Dramatic Turnaround & Its Implications for School Improvement.

ERIC Educational Resources Information Center

Carlson, Robert V.

This paper presents a case study of a rural community exhibiting a dramatic turnaround in community support for a new school bond issue. Demographic change was partly responsible for the change in community attitudes, with two waves of immigration altering the long-term conservative orientation of this community. After a series of failed…

State Capacity to Support School Turnaround. NCEE Evaluation Brief. NCEE 2015-4012

ERIC Educational Resources Information Center

Tanenbaum, Courtney; Boyle, Andrea; Graczewski, Cheryl; James-Burdumy, Susanne; Dragoset, Lisa; Hallgren, Kristin

2015-01-01

One objective of the U.S. Department of Education's (ED) School Improvement Grants (SIG) and Race to the Top (RTT) program is to help states enhance their capacity to support the turnaround of low-performing schools. This capacity may be important, given how difficult it is to produce substantial and sustained achievement gains in low-performing…

Beyond Turnaround: A Synthesis of Relevant Frameworks for Leaders of Sustained Improvement in Previously Low-Performing Schools

ERIC Educational Resources Information Center

Hitt, Dallas Hambrick; Meyers, Coby V.

2018-01-01

We understand very little about what is special that leaders do to facilitate improvement that is both transformational and lasting in previously persistently failing schools in the United States. Relatively little is understood about change not just during the initial turnaround stage, but that "endures" on the larger journey as the…

The "City of Firsts" Charts a New Path on Turnaround. Linking State and Local School Improvement

ERIC Educational Resources Information Center

Jochim, Ashley; Opalka, Alice

2017-01-01

In 2014, the Springfield Public School district in Massachusetts had tried just about every strategy in the turnaround playbook to improve a set of struggling middle schools, but these efforts failed to generate the desired improvement. In 2015, drawing inspiration from national efforts to infuse schools with enhanced autonomy and accountability,…

A Case Study of a Turnaround High School: An Examination of the Maryland State Department of Education Breakthrough Center Intervention

ERIC Educational Resources Information Center

Galindo, Claudia; Stein, Kathleen; Schaffer, Eugene

2016-01-01

This study examined the Maryland State Department of Education Breakthrough Center (BTC) engagement in a Baltimore City turnaround high school. Utilizing a case-study design and mixed-methods research, data were collected through interviews, informal observations, and review of administrative and achievement documents. Beginning in the 2011-2012…

Investing for Sustainable Turnaround. Sustaining School Turnaround at Scale. Brief 2

ERIC Educational Resources Information Center

Education Resource Strategies, 2012

2012-01-01

The Federal government has brought the issue of low-performing schools to the forefront of public conversation by committing $3.5 billion over three years to turn around these schools. As of March 2011, over 1200 schools across the country had been awarded School Improvement Grants (SIG). Given the magnitude of this short-term investment and the…

Operational Authority, Support, and Monitoring of School Turnaround. NCEE Evaluation Brief. NCEE 2014-4008

ERIC Educational Resources Information Center

Herman, Rebecca; Graczewski, Cheryl; James-Burdumy, Susanne; Murray, Matthew; Perez-Johnson, Irma; Tanenbaum, Courtney

2013-01-01

The federal School Improvement Grants (SIG) program, to which $3 billion were allocated under the American Recovery and Reinvestment Act of 2009 (ARRA), supports schools attempting to turn around a history of low performance. School turnaround also is a focus of Race to the Top (RTT), another ARRA-supported initiative, which involved a roughly $4…

Are Bad Schools Immortal? The Scarcity of Turnarounds and Shutdowns in Both Charter and District Sectors

ERIC Educational Resources Information Center

Stuit, David A.

2010-01-01

This study investigates the successes of the charter and district sectors in eliminating bad schools via dramatic turnarounds in performance and/or shutdowns. It identified 2,025 low-performing charter and district schools across ten states, each of which is home to a sizable number of charter schools. These particular schools were tracked from…

A Case Study of Essential Components of School Success in a Turnaround School

ERIC Educational Resources Information Center

Cronin, Jodi Lynn

2016-01-01

School reform and turnaround efforts have been in the public eye since the signing of the Elementary and Secondary Act (ESEA) into law by President Lyndon Baines Johnson in 1965. Research has been focused on the School Improvement Grant, as well as the essential components that improve performance of schools. This qualitative case examines one…

Turnaround Schools: Practices Used by Nationally Recognized Principals to Improve Student Achievement in High Poverty Schools

ERIC Educational Resources Information Center

Brown, Angela Antuanette

2012-01-01

The specific purpose of this study was to identify the practices used by leaders of National Blue Ribbon Awarded Schools to successfully turnaround a school or to maintain proficient achievement scores within the school. The school principals answered a four part questionnaire for this study. Part 1 of the questionnaire asked about the extent to…

Recent Advances in Point-of-Care Diagnostics for Cardiac Markers

PubMed Central

2014-01-01

National and international cardiology guidelines have recommended a 1-hour turnaround time for reporting results of cardiac troponin to emergency department personnel, measured from the time of blood collection to reporting. Use of point-of-care testing (POCT) can reduce turnaround times for cardiac markers, but current devices are not as precise or sensitive as central laboratory assays. The gap is growing as manufacturers of mainframe immunoassay instruments have or will release troponin assays that are even higher than those currently available. These assays have analytical sensitivity that enables detection of nearly 100% of all healthy subjects which is not possible for current POCT assays. Use of high sensitivity troponin results in a lower value for the 99th percentile of a healthy population. Clinically, this enables for the detection of more cases of myocardial injury. In order to compete analytically, next generation POCT assays will to make technologic advancements, such as the use of microfluidic to better control sample delivery, nanoparticles or nanotubes to increase the surface-to-volume ratios for analytes and antibodies, and novel detection schemes such as chemiluminescence and electrochemical detectors to enhance analytical sensitivity. Multi-marker analysis using POCT is also on the horizon for tests that complement cardiac troponin. PMID:27683464

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

Bhattacharya, Sourav; Dialektopoulos, Konstantinos F.; Romano, Antonio Enea

The maximum size of a cosmic structure is given by the maximum turnaround radius—the scale where the attraction due to its mass is balanced by the repulsion due to dark energy. We derive generic formulae for the estimation of the maximum turnaround radius in any theory of gravity obeying the Einstein equivalence principle, in two situations: on a spherically symmetric spacetime and on a perturbed Friedman-Robertson-Walker spacetime. We show that the two formulae agree. As an application of our formula, we calculate the maximum turnaround radius in the case of the Brans-Dicke theory of gravity. We find that for thismore » theory, such maximum sizes always lie above the ΛCDM value, by a factor 1 + 1/3ω, where ω>> 1 is the Brans-Dicke parameter, implying consistency of the theory with current data.« less

Searching for Constraints on Starobinsky's Model with a Disappearing Cosmological Constant on Galaxy Cluster Scales

NASA Astrophysics Data System (ADS)

Alexeyev, S. O.; Latosh, B. N.; Echeistov, V. A.

2017-12-01

Predictions of the f( R)-gravity model with a disappearing cosmological constant (Starobinsky's model) on scales characteristic of galaxies and their clusters are considered. The absence of a difference in the mass dependence of the turnaround radius between Starobinsky's model and General Relativity accessible to observation at the current accuracy of measurements has been established. This is true both for small masses (from 109 M Sun) corresponding to an individual galaxy and for masses corresponding to large galaxy clusters (up to 1015 M Sun). The turnaround radius increases with parameter n for all masses. Despite the fact that some models give a considerably smaller turnaround radius than does General Relativity, none of the models goes beyond the bounds specified by the observational data.

Rapid identification of microorganisms from positive blood cultures by testing early growth on solid media using matrix-assisted laser desorption ionization-time of flight mass spectrometry.

PubMed

Gonzalez, Mark D; Weber, Carol J; Burnham, Carey-Ann D

2016-06-01

We performed a retrospective analysis of a simple modification to MALDI-TOF MS for microorganism identification to accurately improve the turnaround time (TAT) for identification of Enterobacteriaceae recovered in blood cultures. Relative to standard MALDI-TOF MS procedures, we reduced TAT from 28.3 (n=90) to 21.2h (n=107). Copyright © 2016 Elsevier Inc. All rights reserved.

Effects of Nonlinear Inhomogeneity on the Cosmic Expansion with Numerical Relativity.

PubMed

Bentivegna, Eloisa; Bruni, Marco

2016-06-24

We construct a three-dimensional, fully relativistic numerical model of a universe filled with an inhomogeneous pressureless fluid, starting from initial data that represent a perturbation of the Einstein-de Sitter model. We then measure the departure of the average expansion rate with respect to this homogeneous and isotropic reference model, comparing local quantities to the predictions of linear perturbation theory. We find that collapsing perturbations reach the turnaround point much earlier than expected from the reference spherical top-hat collapse model and that the local deviation of the expansion rate from the homogeneous one can be as high as 28% at an underdensity, for an initial density contrast of 10^{-2}. We then study, for the first time, the exact behavior of the backreaction term Q_{D}. We find that, for small values of the initial perturbations, this term exhibits a 1/a scaling, and that it is negative with a linearly growing absolute value for larger perturbation amplitudes, thereby contributing to an overall deceleration of the expansion. Its magnitude, on the other hand, remains very small even for relatively large perturbations.

CHROMagar Orientation Medium Reduces Urine Culture Workload

PubMed Central

Manickam, Kanchana; Karlowsky, James A.; Adam, Heather; Lagacé-Wiens, Philippe R. S.; Rendina, Assunta; Pang, Paulette; Murray, Brenda-Lee

2013-01-01

Microbiology laboratories continually strive to streamline and improve their urine culture algorithms because of the high volumes of urine specimens they receive and the modest numbers of those specimens that are ultimately considered clinically significant. In the current study, we quantitatively measured the impact of the introduction of CHROMagar Orientation (CO) medium into routine use in two hospital laboratories and compared it to conventional culture on blood and MacConkey agars. Based on data extracted from our Laboratory Information System from 2006 to 2011, the use of CO medium resulted in a 28% reduction in workload for additional procedures such as Gram stains, subcultures, identification panels, agglutination tests, and biochemical tests. The average number of workload units (one workload unit equals 1 min of hands-on labor) per urine specimen was significantly reduced (P < 0.0001; 95% confidence interval [CI], 0.5326 to 1.047) from 2.67 in 2006 (preimplementation of CO medium) to 1.88 in 2011 (postimplementation of CO medium). We conclude that the use of CO medium streamlined the urine culture process and increased bench throughput by reducing both workload and turnaround time in our laboratories. PMID:23363839

Development of a thyroid function strategy for general practice.

PubMed Central

Ramachandran, S; Milles, J J; Wells, M B; Hall, R A

1998-01-01

A study was carried out to investigate a thyroid stimulating hormone (TSH) frontline strategy that could potentially result in a more straightforward interpretation of thyroid function tests, a reduction in the number of inappropriate referrals to medical outpatients, an improvement in the 'turnaround time' of results, and a reduction in the number of unnecessary tests carried out, thereby reducing costs. PMID:10071403

National Combustion Code: Parallel Performance

NASA Technical Reports Server (NTRS)

Babrauckas, Theresa

2001-01-01

This report discusses the National Combustion Code (NCC). The NCC is an integrated system of codes for the design and analysis of combustion systems. The advanced features of the NCC meet designers' requirements for model accuracy and turn-around time. The fundamental features at the inception of the NCC were parallel processing and unstructured mesh. The design and performance of the NCC are discussed.

Adoption of Lean Principles in a High-Volume Molecular Diagnostic Microbiology Laboratory

PubMed Central

Mitchell, P. Shawn; Mandrekar, Jayawant N.

2014-01-01

Clinical laboratories are constantly facing challenges to do more with less, enhance quality, improve test turnaround time, and reduce operational expenses. Experience with adopting and applying lean concepts and tools used extensively in the manufacturing industry is described for a high-volume clinical molecular microbiology laboratory, illustrating how operational success and benefits can be achieved. PMID:24829247

New methods and materials for molding and casting ice formations

NASA Technical Reports Server (NTRS)

Reehorst, Andrew L.; Richter, G. Paul

1987-01-01

This study was designed to find improved materials and techniques for molding and casting natural or simulated ice shapes that could replace the wax and plaster method. By utilizing modern molding and casting materials and techniques, a new methodology was developed that provides excellent reproduction, low-temperature capability, and reasonable turnaround time. The resulting casts are accurate and tough.

Aqua-Aura QuickDAM (QDAM) 2.0 Ops Concept

NASA Technical Reports Server (NTRS)

Nidhiry, John

2015-01-01

The presentation describes the Quick Debris Avoidance Maneuver (QDAM) 2.0 process used the Aqua and Aura flight teams to (a) reduce the work load and dependency on staff and systems; (b) reduce turn-around time and provide emergency last minute capabilities; and (c) increase burn parameter flexibility. The presentation also compares the QDAM 2.0 process to previous approaches.

Evaluating and Measuring the Return on Investment of an Emergency Center Health Care Professional Picture Archiving and Communication Systems Training Program

ERIC Educational Resources Information Center

Roelandt, James P.

2012-01-01

Picture archiving and communication system (PACS) workflow directly affects the quality of emergency patient care through radiology exam turn-around times and the speed of delivery of diagnostic radiology results. This study was a mixed methods training and performance improvement study that evaluated the effectiveness and value of a hospital…

Incorporating BEAMing technology as a liquid biopsy into clinical practice for the management of colorectal cancer patients: an expert taskforce review.

PubMed

García-Foncillas, J; Alba, E; Aranda, E; Díaz-Rubio, E; López-López, R; Tabernero, J; Vivancos, A

2017-12-01

The importance of mutation identification for advanced colorectal cancer treatment with anti-epidermal growth factor receptor agents is well established. However, due to delays in turnaround time, low-quality tissue samples, and/or lack of standardization of testing methods a significant proportion of patients are being treated without the information that Kirsten rat sarcoma and neuroblastoma rat sarcoma (RAS) testing can provide. The detection of mutated circulating tumor DNA by BEAMing technology addresses this gap in care and allows these patients to receive international guideline-recommended expanded RAS testing with rapid turnaround times. Furthermore, the overall concordance between OncoBEAM RAS colorectal cancer testing and standard of care tissue testing is very high (93.3%). This article presents an overview of the clinical utility and potential applications of this minimally invasive method, such as early detection of emergent resistance to anti-epidermal growth factor receptor therapy. If appropriately implemented, BEAMing technology holds considerable promise to enhance the quality of patient care and improve clinical outcomes. © The Author 2017. Published by Oxford University Press on behalf of the European Society for Medical Oncology.

Development and validation of a fast and simple multi-analyte procedure for quantification of 40 drugs relevant to emergency toxicology using GC-MS and one-point calibration.

PubMed

Meyer, Golo M J; Weber, Armin A; Maurer, Hans H

2014-05-01

Diagnosis and prognosis of poisonings should be confirmed by comprehensive screening and reliable quantification of xenobiotics, for example by gas chromatography-mass spectrometry (GC-MS) or liquid chromatography-mass spectrometry (LC-MS). The turnaround time should be short enough to have an impact on clinical decisions. In emergency toxicology, quantification using full-scan acquisition is preferable because this allows screening and quantification of expected and unexpected drugs in one run. Therefore, a multi-analyte full-scan GC-MS approach was developed and validated with liquid-liquid extraction and one-point calibration for quantification of 40 drugs relevant to emergency toxicology. Validation showed that 36 drugs could be determined quickly, accurately, and reliably in the range of upper therapeutic to toxic concentrations. Daily one-point calibration with calibrators stored for up to four weeks reduced workload and turn-around time to less than 1 h. In summary, the multi-analyte approach with simple liquid-liquid extraction, GC-MS identification, and quantification over fast one-point calibration could successfully be applied to proficiency tests and real case samples. Copyright © 2013 John Wiley & Sons, Ltd.

Process improvement for regulatory analyses of custom-blend fertilizers.

PubMed

Wegner, Keith A

2014-01-01

Chemical testing of custom-blend fertilizers is essential to ensure that the products meet the formulation requirements. For purposes of proper crop nutrition and consumer protection, regulatory oversight promotes compliance and particular attention to blending and formulation specifications. Analyses of custom-blend fertilizer products must be performed and reported within a very narrow window in order to be effective. The Colorado Department of Agriculture's Biochemistry Laboratory is an ISO 17025 accredited facility and conducts analyses of custom-blend fertilizer products primarily during the spring planting season. Using the Lean Six Sigma (LSS) process, the Biochemistry Laboratory has reduced turnaround times from as much as 45 days to as little as 3 days. The LSS methodology focuses on waste reduction through identifying: non-value-added steps, unneeded process reviews, optimization of screening and confirmatory analyses, equipment utilization, nonessential reporting requirements, and inefficient personnel deployment. Eliminating these non-value-added activities helped the laboratory significantly shorten turnaround time and reduce costs. Key improvement elements discovered during the LSS process included: focused sample tracking, equipment redundancy, strategic supply stocking, batch size optimization, critical sample paths, elimination of nonessential QC reviews, and more efficient personnel deployment.

Developing a lean culture in the laboratory.

PubMed

Napoles, Leyda; Quintana, Maria

2006-07-25

The Director of Pathology at Jackson Memorial Hospital was interested in improving the operational efficiencies of the department in order to enhance the department's level of service in conjunction with the expansion of the overall health system. The decision was made to implement proven Lean practices in the laboratory under the direction of a major consulting firm. This article details the scope of the initial project as well as the operating principles of Lean manufacturing practices as applied to the clinical laboratory. The goals of the project were to improve turnaround times of laboratory results, reduce inventory and supply costs, improve staff productivity, maximize workflow, and eliminate waste. Extensive data gathering and analysis guided the work process by highlighting the areas of highest opportunity. This systematic approach resulted in recommendations for the workflow and physical layout of the laboratory. It also included the introduction of "standard workflow" and "visual controls" as critical items that streamlined operational efficiencies. The authors provide actual photographs and schematics of the reorganization and improvements to the physical layout of the laboratory. In conclusion, this project resulted in decreased turnaround times and increased productivity, as well as significant savings in the overall laboratory operations.

A new approach for the laboratory culture of the fathead minnow, Pimephales promelas.

PubMed

Gordon, Denise A; Smith, Mark E; Wratschko, Melissa; Agard, David; Holden, Lisa; Wilcox, Steve; Lazorchak, James M

2014-01-01

Fathead minnows are routinely cultured for use in aquatic toxicology studies. A new mass culture system described in the present study consisted of 6 stainless steel tanks, each containing 68 fish and 20 spawning substrates. Spawning results are compared with a previous system of 22 individual glass aquaria, which contained 16 fish and 4 spawning substrates per tank. During a 19-mo period, the new system produced an average of 4105 eggs/d, compared with an average of 2465 eggs/d with the previous system. Labor and maintenance were reduced with the new system. The stainless steel tanks eliminated aquaria glass breakage, and daily water use was reduced by 45%. Analysis of reference toxicant data from fish cultured using both systems indicated no change in the sensitivity of the test animals. Analyses of 2009 egg production data determined that a 6:1 to 7:1 female to male ratio had a significantly positive impact on egg production levels and that 6-mo-old breeding stock should be introduced to the spawning tanks in mid-spring for optimal egg production during the rest of the year. Implementing a stainless steel mass culture system significantly increased efficiency of egg production; reduced turnaround delay of mature animal availability for toxicity and molecular testing; and reduced labor time, costs, and inherent safety hazards, compared with glass aquaria systems. © 2013 SETAC.

School Improvement and Urban Renewal: The Impact of a Turnaround School's Performance on Real Property Values in Its Surrounding Community

ERIC Educational Resources Information Center

Jacobson, Stephen L.; Szczesek, Jill

2013-01-01

This study investigates the economic impact of a "turnaround" school on real property values in its surrounding community as related to the argument introduced by Tiebout in 1956 correlating local public goods, in this case school success, to housing-location decision making. Using single-family home sales found on the Multiple Listing System and…

Evaluation of Massachusetts Office of District and School Turnaround Assistance to Commissioner's Districts and Schools: Impact of School Redesign Grants

ERIC Educational Resources Information Center

LiCalsi, Christina; Citkowicz, Martyna; Friedman, Lawrence B.; Brown, Megan

2015-01-01

The Massachusetts Office of District and School Turnaround (ODST) assists the Commissioner's Districts (the 10 largest districts in the state) and schools within those districts. The assistance focuses on turning around the lowest performing schools in the district while building district capacity to support improvement in other district schools.…

District Support Systems for the Alignment of Curriculum, Instruction, and Assessment: Can We Predict Student Achievement in Reading and Writing for School Turnaround?

ERIC Educational Resources Information Center

Abbott, Laura Lynn Tanner

2014-01-01

The purpose of this quantitative non-experimental predictive study was to determine if CIA alignment factors and related district support systems are associated with student achievement to enable the turnaround of schools in crisis. This study aimed to utilize the District Snapshot Tool to determine if the district systems that support CIA…

Distributed computer system enhances productivity for SRB joint optimization

NASA Technical Reports Server (NTRS)

Rogers, James L., Jr.; Young, Katherine C.; Barthelemy, Jean-Francois M.

1987-01-01

Initial calculations of a redesign of the solid rocket booster joint that failed during the shuttle tragedy showed that the design had a weight penalty associated with it. Optimization techniques were to be applied to determine if there was any way to reduce the weight while keeping the joint opening closed and limiting the stresses. To allow engineers to examine as many alternatives as possible, a system was developed consisting of existing software that coupled structural analysis with optimization which would execute on a network of computer workstations. To increase turnaround, this system took advantage of the parallelism offered by the finite difference technique of computing gradients to allow several workstations to contribute to the solution of the problem simultaneously. The resulting system reduced the amount of time to complete one optimization cycle from two hours to one-half hour with a potential of reducing it to 15 minutes. The current distributed system, which contains numerous extensions, requires one hour turnaround per optimization cycle. This would take four hours for the sequential system.

[Increasing Number of Road Traffic Fatalities in Germany - Turnaround or Snap-Shot].

PubMed

Brand, S; Schmucker, U; Lob, G; Haasper, C; Juhra, C; Hell, W; Rieth, P; Matthes, G

2017-04-01

Introduction: For the first time since 20 years, the number of road accident fatalities in 2011 increased on German roads compared to earlier periods. Methods and Results: The presented paper submitted by the expert group for accident prevention investigates and discusses possible reasons for the observed increase in road traffic fatalities. Results: Climate changes as well as changes in economic environment, and technological progress in car and passenger safety are identified as possible reasons for the observed increase. Discussion: Mentioning the "Decade of Action for Road Safety" initiated by the UNO and coordinated by the WHO, the overall goal is a worldwide reduction of accident related road fatalities. But prognostic calculations predict an asymptotic approximation to a limit of road fatalities. To achieve a reduction by half until 2020 intense collaboration and disproportional expenditure are necessary. Conclusion: From the authors' point of view the current increase of traffic fatalities in Germany is rated as a snapshot rather than a turnaround. Georg Thieme Verlag KG Stuttgart · New York.

Applications of ISES for the atmospheric sciences

NASA Technical Reports Server (NTRS)

Hoell, James M., Jr.

1990-01-01

The proposed Information Sciences Experiment System (ISES) will offer the opportunity for real-time access to measurements acquired aboard the Earth Observation System (Eos) satellite. These measurements can then be transmitted to remotely located ground based stations. The application of such measurements to issues related to atmospheric science which was presented to a workshop convened to review possible application of the ISES in earth sciences is summarized. The proposed protocol for Eos instruments requires that measurement results be available in a central data archive within 72 hours of acquiring data. Such a turnaround of raw satellite data to the final product will clearly enhance the timeliness of the results. Compared to the time that results from many current satellite programs, the 72 hour turnaround may be considered real time. Examples are discussed showing how real-time measurements from one or more of the proposed Eos instruments could have been applied to the study of certain issues important to global atmospheric chemistry. Each of the examples discussed is based upon a field mission conducted during the past five years. Each of these examples will emphasize how real-time data could have been used to alter the course of a field experiment, thereby enhancing the scientific output. For the examples, brief overviews of the scientific rationale and objectives, the region of operation, the measurements aboard the aircraft, and finally how one or more of the proposed Eos instruments could have provided data to enhance the productivity of the mission are discussed.

Laboratory sample turnaround times: do they cause delays in the ED?

PubMed

Gill, Dipender; Galvin, Sean; Ponsford, Mark; Bruce, David; Reicher, John; Preston, Laura; Bernard, Stephani; Lafferty, Jessica; Robertson, Andrew; Rose-Morris, Anna; Stoneham, Simon; Rieu, Romelie; Pooley, Sophie; Weetch, Alison; McCann, Lloyd

2012-02-01

Blood tests are requested for approximately 50% of patients attending the emergency department (ED). The time taken to obtain the results is perceived as a common reason for delay. The objective of this study was therefore to investigate the turnaround time (TAT) for blood results and whether this affects patient length of stay (LOS) and to identify potential areas for improvement. A time-in-motion study was performed at the ED of the John Radcliffe Hospital (JRH), Oxford, UK. The duration of each of the stages leading up to receipt of 101 biochemistry and haematology results was recorded, along with the corresponding patient's LOS. The findings reveal that the mean time for haematology results to become available was 1 hour 6 minutes (95% CI: 29 minutes to 2 hours 13 minutes), while biochemistry samples took 1 hour 42 minutes (95% CI: 1 hour 1 minute to 4 hours 21 minutes), with some positive correlation noted with the patient LOS, but no significant variation between different days or shifts. With the fastest 10% of samples being reported within 35 minutes (haematology) and 1 hour 5 minutes (biochemistry) of request, our study showed that delays can be attributable to laboratory TAT. Given the limited ability to further improve laboratory processes, the solutions to improving TAT need to come from a collaborative and integrated approach that includes strategies before samples reach the laboratory and downstream review of results. © 2010 Blackwell Publishing Ltd.

Surgical Pathology Resident Rotation Restructuring at a Tertiary Care Academic Center.

PubMed

Mehr, Chelsea R; Obstfeld, Amrom E; Barrett, Amanda C; Montone, Kathleen T; Schwartz, Lauren E

2017-01-01

Changes in the field of pathology and resident education necessitate ongoing evaluation of residency training. Evolutionary change is particularly important for surgical pathology rotations, which form the core of anatomic pathology training programs. In the past, we organized this rotation based on subjective insight. When faced with the recent need to restructure the rotation, we strove for a more evidence-based process. Our approach involved 2 primary sources of data. We quantified the number of cases and blocks submitted per case type to estimate workload and surveyed residents about the time required to gross specimens in all organ systems. A multidisciplinary committee including faculty, residents, and staff evaluated the results and used the data to model how various changes to the rotation would affect resident workload, turnaround time, and other variables. Finally, we identified rotation structures that equally distributed work and created a point-based system that capped grossing time for residents of different experience. Following implementation, we retrospectively compared turnaround time and duty hour violations before and after these changes and surveyed residents about their experiences with both systems. We evaluated the accuracy of the point-based system by examining grossing times and comparing them to the assigned point values. We found overall improvement in the rotation following the implementation. As there is essentially no literature on the subject of surgical pathology rotation organization, we hope that our experience will provide a road map to improve pathology resident education at other institutions.

Turnaround in an aged persons' mental health service in crisis: a case study of organisational renewal.

PubMed

Stafrace, Simon; Lilly, Alan

2008-08-01

This case study demonstrates how leadership was harnessed to turn around a decline in the performance of an aged persons' mental health service - the Namarra Nursing Home at Caulfield General Medical Centre in Melbourne, Australia. In 2000 the nursing home faced a crisis of public confidence due to failings in the management of quality, clinical risk and human resources within the service. These problems reflected structural and operational shortcomings in the clinical directorate and wider organisation. In this article, we detail the process of turnaround from the perspective of senior executive managers with professional and operational responsibility for the service. This turnaround required attention to local clinical accountability and transformation of the mental health program from a collocated but operationally isolated service to one integrated within the governance structures of the auspicing organisation.

Applying Systems Engineering Reduces Radiology Transport Cycle Times in the Emergency Department.

PubMed

White, Benjamin A; Yun, Brian J; Lev, Michael H; Raja, Ali S

2017-04-01

Emergency department (ED) crowding is widespread, and can result in care delays, medical errors, increased costs, and decreased patient satisfaction. Simultaneously, while capacity constraints on EDs are worsening, contributing factors such as patient volume and inpatient bed capacity are often outside the influence of ED administrators. Therefore, systems engineering approaches that improve throughput and reduce waste may hold the most readily available gains. Decreasing radiology turnaround times improves ED patient throughput and decreases patient waiting time. We sought to investigate the impact of systems engineering science targeting ED radiology transport delays and determine the most effective techniques. This prospective, before-and-after analysis of radiology process flow improvements in an academic hospital ED was exempt from institutional review board review as a quality improvement initiative. We hypothesized that reorganization of radiology transport would improve radiology cycle time and reduce waste. The intervention included systems engineering science-based reorganization of ED radiology transport processes, largely using Lean methodologies, and adding no resources. The primary outcome was average transport time between study order and complete time. All patients presenting between 8/2013-3/2016 and requiring plain film imaging were included. We analyzed electronic medical record data using Microsoft Excel and SAS version 9.4, and we used a two-sample t-test to compare data from the pre- and post-intervention periods. Following the intervention, average transport time decreased significantly and sustainably. Average radiology transport time was 28.7 ± 4.2 minutes during the three months pre-intervention. It was reduced by 15% in the first three months (4.4 minutes [95% confidence interval [CI] 1.5-7.3]; to 24.3 ± 3.3 min, P=0.021), 19% in the following six months (5.4 minutes, 95% CI [2.7-8.2]; to 23.3 ± 3.5 min, P=0.003), and 26% one year following the intervention (7.4 minutes, 95% CI [4.8-9.9]; to 21.3 ± 3.1 min, P=0.0001). This result was achieved without any additional resources, and demonstrated a continual trend towards improvement. This innovation demonstrates the value of systems engineering science to increase efficiency in ED radiology processes. In this study, reorganization of the ED radiology transport process using systems engineering science significantly increased process efficiency without additional resource use.

Applying Systems Engineering Reduces Radiology Transport Cycle Times in the Emergency Department

PubMed Central

White, Benjamin A.; Yun, Brian J.; Lev, Michael H.; Raja, Ali S.

2017-01-01

Introduction Emergency department (ED) crowding is widespread, and can result in care delays, medical errors, increased costs, and decreased patient satisfaction. Simultaneously, while capacity constraints on EDs are worsening, contributing factors such as patient volume and inpatient bed capacity are often outside the influence of ED administrators. Therefore, systems engineering approaches that improve throughput and reduce waste may hold the most readily available gains. Decreasing radiology turnaround times improves ED patient throughput and decreases patient waiting time. We sought to investigate the impact of systems engineering science targeting ED radiology transport delays and determine the most effective techniques. Methods This prospective, before-and-after analysis of radiology process flow improvements in an academic hospital ED was exempt from institutional review board review as a quality improvement initiative. We hypothesized that reorganization of radiology transport would improve radiology cycle time and reduce waste. The intervention included systems engineering science-based reorganization of ED radiology transport processes, largely using Lean methodologies, and adding no resources. The primary outcome was average transport time between study order and complete time. All patients presenting between 8/2013–3/2016 and requiring plain film imaging were included. We analyzed electronic medical record data using Microsoft Excel and SAS version 9.4, and we used a two-sample t-test to compare data from the pre- and post-intervention periods. Results Following the intervention, average transport time decreased significantly and sustainably. Average radiology transport time was 28.7 ± 4.2 minutes during the three months pre-intervention. It was reduced by 15% in the first three months (4.4 minutes [95% confidence interval [CI] 1.5–7.3]; to 24.3 ± 3.3 min, P=0.021), 19% in the following six months (5.4 minutes, 95% CI [2.7–8.2]; to 23.3 ± 3.5 min, P=0.003), and 26% one year following the intervention (7.4 minutes, 95% CI [4.8–9.9]; to 21.3 ± 3.1 min, P=0.0001). This result was achieved without any additional resources, and demonstrated a continual trend towards improvement. This innovation demonstrates the value of systems engineering science to increase efficiency in ED radiology processes. Conclusion In this study, reorganization of the ED radiology transport process using systems engineering science significantly increased process efficiency without additional resource use. PMID:28435492

Efficiency improvements of offline metrology job creation

NASA Astrophysics Data System (ADS)

Zuniga, Victor J.; Carlson, Alan; Podlesny, John C.; Knutrud, Paul C.

1999-06-01

Progress of the first lot of a new design through the production line is watched very closely. All performance metrics, cycle-time, in-line measurement results and final electrical performance are critical. Rapid movement of this lot through the line has serious time-to-market implications. Having this material waiting at a metrology operation for an engineer to create a measurement job plan wastes valuable turnaround time. Further, efficient use of a metrology system is compromised by the time required to create and maintain these measurement job plans. Thus, having a method to develop metrology job plans prior to the actual running of the material through the manufacture area can significantly improve both cycle time and overall equipment efficiency. Motorola and Schlumberger have worked together to develop and test such a system. The Remote Job Generator (RJG) created job plans for new device sin a manufacturing process from an NT host or workstation, offline. This increases available system tim effort making production measurements, decreases turnaround time on job plan creation and editing, and improves consistency across job plans. Most importantly this allows job plans for new devices to be available before the first wafers of the device arrive at the tool for measurement. The software also includes a database manager which allows updates of existing job plans to incorporate measurement changes required by process changes or measurement optimization. This paper will review the result of productivity enhancements through the increased metrology utilization and decreased cycle time associated with the use of RJG. Finally, improvements in process control through better control of Job Plans across different devices and layers will be discussed.

Rapid-viability PCR method for detection of live, virulent Bacillus anthracis in environmental samples.

PubMed

Létant, Sonia E; Murphy, Gloria A; Alfaro, Teneile M; Avila, Julie R; Kane, Staci R; Raber, Ellen; Bunt, Thomas M; Shah, Sanjiv R

2011-09-01

In the event of a biothreat agent release, hundreds of samples would need to be rapidly processed to characterize the extent of contamination and determine the efficacy of remediation activities. Current biological agent identification and viability determination methods are both labor- and time-intensive such that turnaround time for confirmed results is typically several days. In order to alleviate this issue, automated, high-throughput sample processing methods were developed in which real-time PCR analysis is conducted on samples before and after incubation. The method, referred to as rapid-viability (RV)-PCR, uses the change in cycle threshold after incubation to detect the presence of live organisms. In this article, we report a novel RV-PCR method for detection of live, virulent Bacillus anthracis, in which the incubation time was reduced from 14 h to 9 h, bringing the total turnaround time for results below 15 h. The method incorporates a magnetic bead-based DNA extraction and purification step prior to PCR analysis, as well as specific real-time PCR assays for the B. anthracis chromosome and pXO1 and pXO2 plasmids. A single laboratory verification of the optimized method applied to the detection of virulent B. anthracis in environmental samples was conducted and showed a detection level of 10 to 99 CFU/sample with both manual and automated RV-PCR methods in the presence of various challenges. Experiments exploring the relationship between the incubation time and the limit of detection suggest that the method could be further shortened by an additional 2 to 3 h for relatively clean samples.

Comparison of BD GeneOhm Methicillin-Resistant Staphylococcus aureus (MRSA) PCR versus the CHROMagar MRSA Assay for Screening Patients for the Presence of MRSA Strains▿

PubMed Central

Boyce, John M.; Havill, Nancy L.

2008-01-01

We compared the BD GeneOhm methicillin-resistant Staphylococcus aureus (MRSA) real-time PCR assay with the CHROMagar MRSA assay for the detection of MRSA in 286 nasal surveillance specimens. Compared with the CHROMagar MRSA assay, PCR had sensitivity, specificity, positive predictive value, and negative predictive values of 100%, 98.6%, 95.8%, and 100%, respectively. The mean PCR turnaround time was 14.5 h. PMID:18032616

Space shuttle solid rocket booster cost-per-flight analysis technique

NASA Technical Reports Server (NTRS)

Forney, J. A.

1979-01-01

A cost per flight computer model is described which considers: traffic model, component attrition, hardware useful life, turnaround time for refurbishment, manufacturing rates, learning curves on the time to perform tasks, cost improvement curves on quantity hardware buys, inflation, spares philosophy, long lead, hardware funding requirements, and other logistics and scheduling constraints. Additional uses of the model include assessing the cost per flight impact of changing major space shuttle program parameters and searching for opportunities to make cost effective management decisions.

The Launch Processing System for Space Shuttle.

NASA Technical Reports Server (NTRS)

Springer, D. A.

1973-01-01

In order to reduce costs and accelerate vehicle turnaround, a single automated system will be developed to support shuttle launch site operations, replacing a multiplicity of systems used in previous programs. The Launch Processing System will provide real-time control, data analysis, and information display for the checkout, servicing, launch, landing, and refurbishment of the launch vehicles, payloads, and all ground support systems. It will also provide real-time and historical data retrieval for management and sustaining engineering (test records and procedures, logistics, configuration control, scheduling, etc.).

Rapid-cycle testing cuts bed turnaround by 85%.

PubMed

2004-11-01

You can use rapid-cycle testing to try out new approaches to overcrowding much more frequently than with more traditional process improvement strategies. Improving bed turnaround notification can yield dramatic improvements. Telling staff they have to try a new process only for three days makes it easier to gain buy-in. Look for old policies that are no longer needed, yet continue to keep your staff bogged down.

Definition of technology development missions for early space stations orbit transfer vehicle serving. Phase 2, task 1: Space station support of operational OTV servicing

NASA Technical Reports Server (NTRS)

1983-01-01

Representative space based orbital transfer vehicles (OTV), ground based vehicle turnaround assessment, functional operational requirements and facilities, mission turnaround operations, a comparison of ground based versus space based tasks, activation of servicing facilities prior to IOC, fleet operations requirements, maintenance facilities, OTV servicing facilities, space station support requirements, and packaging for delivery are discussed.

A Sensitive Branched DNA HIV-1 Signal Amplification Viral Load Assay with Single Day Turnaround

PubMed Central

Baumeister, Mark A.; Zhang, Nan; Beas, Hilda; Brooks, Jesse R.; Canchola, Jesse A.; Cosenza, Carlo; Kleshik, Felix; Rampersad, Vinod; Surtihadi, Johan; Battersby, Thomas R.

2012-01-01

Branched DNA (bDNA) is a signal amplification technology used in clinical and research laboratories to quantitatively detect nucleic acids. An overnight incubation is a significant drawback of highly sensitive bDNA assays. The VERSANT® HIV-1 RNA 3.0 Assay (bDNA) (“Versant Assay”) currently used in clinical laboratories was modified to allow shorter target incubation, enabling the viral load assay to be run in a single day. To dramatically reduce the target incubation from 16–18 h to 2.5 h, composition of only the “Lysis Diluent” solution was modified. Nucleic acid probes in the assay were unchanged. Performance of the modified assay (assay in development; not commercially available) was evaluated and compared to the Versant Assay. Dilution series replicates (>950 results) were used to demonstrate that analytical sensitivity, linearity, accuracy, and precision for the shorter modified assay are comparable to the Versant Assay. HIV RNA-positive clinical specimens (n = 135) showed no significant difference in quantification between the modified assay and the Versant Assay. Equivalent relative quantification of samples of eight genotypes was demonstrated for the two assays. Elevated levels of several potentially interfering endogenous substances had no effect on quantification or specificity of the modified assay. The modified assay with drastically improved turnaround time demonstrates the viability of signal-amplifying technology, such as bDNA, as an alternative to the PCR-based assays dominating viral load monitoring in clinical laboratories. Highly sensitive bDNA assays with a single day turnaround may be ideal for laboratories with especially stringent cost, contamination, or reliability requirements. PMID:22479381

A sensitive branched DNA HIV-1 signal amplification viral load assay with single day turnaround.

PubMed

Baumeister, Mark A; Zhang, Nan; Beas, Hilda; Brooks, Jesse R; Canchola, Jesse A; Cosenza, Carlo; Kleshik, Felix; Rampersad, Vinod; Surtihadi, Johan; Battersby, Thomas R

2012-01-01

Branched DNA (bDNA) is a signal amplification technology used in clinical and research laboratories to quantitatively detect nucleic acids. An overnight incubation is a significant drawback of highly sensitive bDNA assays. The VERSANT® HIV-1 RNA 3.0 Assay (bDNA) ("Versant Assay") currently used in clinical laboratories was modified to allow shorter target incubation, enabling the viral load assay to be run in a single day. To dramatically reduce the target incubation from 16-18 h to 2.5 h, composition of only the "Lysis Diluent" solution was modified. Nucleic acid probes in the assay were unchanged. Performance of the modified assay (assay in development; not commercially available) was evaluated and compared to the Versant Assay. Dilution series replicates (>950 results) were used to demonstrate that analytical sensitivity, linearity, accuracy, and precision for the shorter modified assay are comparable to the Versant Assay. HIV RNA-positive clinical specimens (n = 135) showed no significant difference in quantification between the modified assay and the Versant Assay. Equivalent relative quantification of samples of eight genotypes was demonstrated for the two assays. Elevated levels of several potentially interfering endogenous substances had no effect on quantification or specificity of the modified assay. The modified assay with drastically improved turnaround time demonstrates the viability of signal-amplifying technology, such as bDNA, as an alternative to the PCR-based assays dominating viral load monitoring in clinical laboratories. Highly sensitive bDNA assays with a single day turnaround may be ideal for laboratories with especially stringent cost, contamination, or reliability requirements.

A comparison of time-shared vs. batch development of space software

NASA Technical Reports Server (NTRS)

Forthofer, M.

1977-01-01

In connection with a study regarding the ground support software development for the Space Shuttle, an investigation was conducted concerning the most suitable software development techniques to be employed. A time-sharing 'trial period' was used to determine whether or not time-sharing would be a cost-effective software development technique for the Ground Based Shuttle system. It was found that time-sharing substantially improved job turnaround and programmer access to the computer for the representative group of ground support programmers. Moreover, this improvement resulted in an estimated saving of over fifty programmer days during the trial period.

Outsourcing Library Technical Services. A How-To-Do-It Manual for Librarians. How-To-Do-It Manuals for Librarians, Number 69.

ERIC Educational Resources Information Center

Hirshon, Arnold; Winters, Barbara

In the effort to reduce costs, improve productivity, enhance quality of services, and improve turnaround time for ordering, receiving, and cataloging new materials, libraries are increasingly turning to outsourcing as a strategic management tool to help them maximize use of their fiscal and human resources. This guide covers all aspects of…

Delta Clipper vehicle design for supportability

NASA Astrophysics Data System (ADS)

Smiljanic, Ray R.; Klevatt, Paul L.; Steinmeyer, Donald A.

1993-02-01

The paper describes the Single Stage Rocket Technology (SSRT) Delta Clipper vehicle design. As a means of reducing vehicle processing and turnaround times, the SSRT Delta Clipper design, contrary to past practices, incorporates support ability engineering features into its initial set of design requirements. The engineering process used to 'design-in' supportability into the Delta Clipper vehicle is described in detail and is illustrated using diagrams.

Using corporate finance to engineer an organizational turnaround.

PubMed

Sussman, Jason H; Dziesinski, Ray R

2002-11-01

Georgia's Southern Regional Medical Center used a proven corporate finance approach to dramatically improve its financial position and integrate its strategic and financial planning. Managers throughout the organization were educated about principles of corporate finance. Reliable cash-flow projections were used to create a multiyear glide path to financial stability. Initiatives were tied to specific time frames and quantifiable financial goals and underwent a standardized review process.

INM Integrated Noise Model Version 2. Programmer’s Guide

DTIC Science & Technology

1979-09-01

cost, turnaround time, and system-dependent limitations. 3.2 CONVERSION PROBLEMS Item Item Item No. Desciption Category 1 BLOCK DATA Initialization IBM ...Restricted 2 Boolean Operations Differences Call Statement Parameters Extensions 4 Data Initialization IBM Restricted 5 ENTRY Differences 6 EQUIVALENCE...Machine Dependent 7 Format: A CDC Extension 8 Hollerith Strings IBM Restricted 9 Hollerith Variables IBM Restricted 10 Identifier Names CDC Extension

Application of computer graphics in the design of custom orthopedic implants.

PubMed

Bechtold, J E

1986-10-01

Implementation of newly developed computer modelling techniques and computer graphics displays and software have greatly aided the orthopedic design engineer and physician in creating a custom implant with good anatomic conformity in a short turnaround time. Further advances in computerized design and manufacturing will continue to simplify the development of custom prostheses and enlarge their niche in the joint replacement market.

An Analysis of Unplanned Requirements and Their Impact on the Naval Electronic Systems Command

DTIC Science & Technology

1976-06-01

Evaluation Repair Turnaround Time Ship Alteration Management Information System Shipbuilding and Conversion, Navy Standard Hardware Program Ships Parts...pending assigment of a NSN. Such equipments would have little opportunity to accumulate any demand history. Secondly, the relatively low percentage of...mentioned above. Unfortunately, sufficient historical information was not available to fully accomplish this goal. In the case of assets acquired from

No Turning Back: A Case Study Analysis of Leadership Practices of Organizational Turnaround at A North Carolina Historically Black High School

ERIC Educational Resources Information Center

Chavis, William M.

2016-01-01

Despite the seeming progressiveness in moving from "Plessy v. Ferguson" to "Brown v. Board of Education," and from the Jim Crow era to the Civil Rights Movement, schools continue to exist that are racially homogenous and segregated at the core. Many of these schools were created in times of harsh legislation that mandated a…

Clinical effectiveness of rapid tests for methicillin resistant Staphylococcus aureus (MRSA) in hospitalized patients: a systematic review

PubMed Central

2011-01-01

Background Methicillin resistant Staphylococcus aureus (MRSA) are often resistant to multiple classes of antibiotics. The research objectives of this systematic review were to evaluate the clinical effectiveness of polymerase chain reaction (PCR) versus chromogenic agar for MRSA screening, and PCR versus no screening for several clinical outcomes, including MRSA colonization and infection rates. Methods An electronic literature search was conducted on studies evaluating polymerase chain reaction techniques and methicillin (also spelled meticillin) resistant Staphylococcus aureus that were published from 1993 onwards using Medline, Medline In-Process & Other Non-Indexed Citations, BIOSIS Previews, and EMBASE. Due to the presence of heterogeneity in the selected studies, the clinical findings of individual studies were described. Results Nine studies that compared screening for MRSA using PCR versus screening using chromogenic agar in a hospital setting, and two studies that compared screening using PCR with no or targeted screening were identified. Some studies found lower MRSA colonization and acquisition, infection, and transmission rates in screening with PCR versus screening with chromogenic agar, and the turnaround time for screening test results was lower for PCR. One study reported a lower number of unnecessary isolation days with screening using PCR versus screening with chromogenic agar, but the proportion of patients isolated was similar between both groups. The turnaround time for test results and number of isolation days were lower for PCR versus chromogenic agar for MRSA screening. Conclusions The use of PCR for MRSA screening demonstrated a lower turnaround time and number of isolation days compared with chromogenic agar. Given the mixed quality and number of studies (11 studies), gaps remain in the published literature and the evidence remains insufficient. In addition to screening, factors such as the number of contacts between healthcare workers and patients, number of patients attended by one healthcare worker per day, probability of colonization among healthcare workers, and MRSA status of hospital shared equipment and hospital environment must be considered to control the transmission of MRSA in a hospital setting. PMID:22151575

The combined positive impact of Lean methodology and Ventana Symphony autostainer on histology lab workflow

PubMed Central

2010-01-01

Background Histologic samples all funnel through the H&E microtomy staining area. Here manual processes intersect with semi-automated processes creating a bottleneck. We compare alternate work processes in anatomic pathology primarily in the H&E staining work cell. Methods We established a baseline measure of H&E process impact on personnel, information management and sample flow from historical workload and production data and direct observation. We compared this to performance after implementing initial Lean process modifications, including workstation reorganization, equipment relocation and workflow levelling, and the Ventana Symphony stainer to assess the impact on productivity in the H&E staining work cell. Results Average time from gross station to assembled case decreased by 2.9 hours (12%). Total process turnaround time (TAT) exclusive of processor schedule changes decreased 48 minutes/case (4%). Mean quarterly productivity increased 8.5% with the new methods. Process redesign reduced the number of manual steps from 219 to 182, a 17% reduction. Specimen travel distance was reduced from 773 ft/case to 395 ft/case (49%) overall, and from 92 to 53 ft/case in the H&E cell (42% improvement). Conclusions Implementation of Lean methods in the H&E work cell of histology can result in improved productivity, improved through-put and case availability parameters including TAT. PMID:20181123

Comparison of two matrix-assisted laser desorption ionization-time of flight mass spectrometry methods with conventional phenotypic identification for routine identification of bacteria to the species level.

PubMed

Cherkaoui, Abdessalam; Hibbs, Jonathan; Emonet, Stéphane; Tangomo, Manuela; Girard, Myriam; Francois, Patrice; Schrenzel, Jacques

2010-04-01

Bacterial identification relies primarily on culture-based methodologies requiring 24 h for isolation and an additional 24 to 48 h for species identification. Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) is an emerging technology newly applied to the problem of bacterial species identification. We evaluated two MALDI-TOF MS systems with 720 consecutively isolated bacterial colonies under routine clinical laboratory conditions. Isolates were analyzed in parallel on both devices, using the manufacturers' default recommendations. We compared MS with conventional biochemical test system identifications. Discordant results were resolved with "gold standard" 16S rRNA gene sequencing. The first MS system (Bruker) gave high-confidence identifications for 680 isolates, of which 674 (99.1%) were correct; the second MS system (Shimadzu) gave high-confidence identifications for 639 isolates, of which 635 (99.4%) were correct. Had MS been used for initial testing and biochemical identification used only in the absence of high-confidence MS identifications, the laboratory would have saved approximately US$5 per isolate in marginal costs and reduced average turnaround time by more than an 8-h shift, with no loss in accuracy. Our data suggest that implementation of MS as a first test strategy for one-step species identification would improve timeliness and reduce isolate identification costs in clinical bacteriology laboratories now.

Pharmacist involvement in a multidisciplinary initiative to reduce sepsis-related mortality.

PubMed

Beardsley, James R; Jones, Catherine M; Williamson, John; Chou, Jason; Currie-Coyoy, Margaret; Jackson, Teresa

2016-02-01

Pharmacy department contributions to a medical center's broad initiative to improve sepsis care outcomes are described. Timely and appropriate antimicrobial therapy is a key factor in optimizing treatment outcomes in patients with severe sepsis or septic shock. The inpatient pharmacy at Wake Forest Baptist Health implemented standardized processes to reduce order turnaround time and facilitate prompt antibiotic administration as part of the hospital's multidisciplinary "Code Sepsis" initiative. The program includes (1) nurse-conducted screening for sepsis using a standard assessment instrument, (2) pager alerts notifying rapid-response, pharmacy, and other personnel of cases of suspected sepsis, (3) activation of an electronic order set including guideline-based antibiotic therapy recommendations based on local pathogen patterns, and (4) a protocol allowing pharmacists to select an antibiotic regimen if providers are busy with other patient care duties. Assessments conducted during and after implementation of the Code Sepsis initiative showed improvements in key program metrics. The mean ± S.D. time from receipt of a Code Sepsis page to antibiotic delivery was reduced to 14.1 ± 13.7 minutes, the mean time from identification of suspected sepsis to antibiotic administration was reduced to 31 minutes in the hospital's intensive care units and to 51 minutes in non-critical care units, and the institution's performance on a widely used measure of sepsis-related mortality improved dramatically. Implementation of the Code Sepsis initiative was associated with reductions in order turnaround time, time to antibiotic administration, and sepsis-related mortality. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Turnaround Insights from the Organizational Sciences: A Review of the Empirical Evidence and the Development of a Staged Model of Recovery with Potential Implications for the PK-12 Education Sector

ERIC Educational Resources Information Center

Murphy, Joseph

2008-01-01

In this article, we review research from the organizational sciences to develop lessons for educators and policy makers. The approach is an integrative review of the literature. We employ a comprehensive process to unpack and make sense of the turnaround literature from the organizational sciences. We rely on strategies appropriate for document…

Turnarounds require team building and rebuilding. Interview by Donald E. L. Johnson.

PubMed

Knoble, J K

1989-11-01

James K. Knoble, president of the 369-bed JFK Medical Center, Atlantis, Fla., and former president of Methodist Medical Center of Illinois, Peoria, is in the midst of his third turnaround situation since he became a hospital CEO in 1965. Knoble is known as a CEO who keeps close track of the business environment, works closely with his board and medical staff and is effective at building a staff and delegating significant operating responsibilities. At JFK, whose previous administrator stole large sums of money and left it with serious financial and operating problems, Knoble is back in the operating mode. He is again a hands-on hospital operator, working closely with department heads as well as with the board and medical staff. In this interview with Health Care Strategic Management's editor and publisher, Donald E.L. Johnson, Knoble discusses his team building and turnaround strategy and JFK's progress during the last 18 months.

Pharmacogenetics of clopidogrel: comparison between a standard and a rapid genetic testing.

PubMed

Saracini, Claudia; Vestrini, Anna; Galora, Silvia; Armillis, Alessandra; Abbate, Rosanna; Giusti, Betti

2012-06-01

CYP2C19 variant alleles are independent predictors of clopidogrel response variability and occurrence of major adverse cardiovascular events in high-risk vascular patients on clopidogrel therapy. Increasing evidence suggests a combination of platelet function testing with CYP2C19 genetic testing may be more effective in identifying high-risk individuals for alternative antiplatelet therapeutic strategies. A crucial point in evaluating the use of these polymorphisms in clinical practice, besides test accuracy, is the cost of the genetic test and rapid availability of the results. One hundred acute coronary syndrome patients were genotyped for CYP2C19*2,*3,*4,*5, and *17 polymorphisms with two platforms: Verigene(®) and the TaqMan(®) system. Genotyping results obtained by the classical TaqMan approach and the rapid Verigene approach showed a 100% concordance for all the five polymorphisms investigated. The Verigene system had shorter turnaround time with respect to TaqMan. The cost of reagents for TaqMan genotyping was lower than that for the Verigene system, but the effective manual staff involvement and the relative cost resulted in higher cost for TaqMan than for Verigene. The Verigene system demonstrated good performance in terms of turnaround time and cost for the evaluation of the clopidogrel poor metabolizer status, giving genetic information in suitable time (206 min) for a therapeutic strategy decision.

Improving medical imaging report turnaround times: the role of technolgy.

PubMed

Marquez, Luis O; Stewart, Howard

2005-01-01

At Southern Ohio Medical Center (SOMC), the medical imaging department and the radiologists expressed a strong desire to improve workflow. The improved workflow was a major motivating factor toward implementing a new RIS and speech recognition technology. The need to monitor workflow in a real-time fashion and to evaluate productivity and resources necessitated that a new solution be found. A decision was made to roll out both the new RIS product and speech recognition to maximize the resources to interface and implement the new solution. Prior to implementation of the new RIS, the medical imaging department operated in a conventional electronic-order-entry to paper request manner. The paper request followed the study through exam completion to the radiologist. SOMC entered into a contract with its PACS vendor to participate in beta testing and clinical trials for a new RIS product for the US market. Backup plans were created in the event the product failed to function as planned--either during the beta testing period or during clinical trails. The last piece of the technology puzzle to improve report turnaround time was voice recognition technology. Speech recognition enhanced the RIS technology as soon as it was implemented. The results show that the project has been a success. The new RIS, combined with speech recognition and the PACS, makes for a very effective solution to patient, exam, and results management in the medical imaging department.

Efficiency of an automated reception and turnaround time management system for the phlebotomy room.

PubMed

Yun, Soon Gyu; Shin, Jeong Won; Park, Eun Su; Bang, Hae In; Kang, Jung Gu

2016-01-01

Recent advances in laboratory information systems have largely been focused on automation. However, the phlebotomy services have not been completely automated. To address this issue, we introduced an automated reception and turnaround time (TAT) management system, for the first time in Korea, whereby the patient's information is transmitted directly to the actual phlebotomy site and the TAT for each phlebotomy step can be monitored at a glance. The GNT5 system (Energium Co., Ltd., Korea) was installed in June 2013. The automated reception and TAT management system has been in operation since February 2014. Integration of the automated reception machine with the GNT5 allowed for direct transmission of laboratory order information to the GNT5 without involving any manual reception step. We used the mean TAT from reception to actual phlebotomy as the parameter for evaluating the efficiency of our system. Mean TAT decreased from 5:45 min to 2:42 min after operationalization of the system. The mean number of patients in queue decreased from 2.9 to 1.0. Further, the number of cases taking more than five minutes from reception to phlebotomy, defined as the defect rate, decreased from 20.1% to 9.7%. The use of automated reception and TAT management system was associated with a decrease of overall TAT and an improved workflow at the phlebotomy room.

Text processing for technical reports (direct computer-assisted origination, editing, and output of text)

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

De Volpi, A.; Fenrick, M. R.; Stanford, G. S.

1980-10-01

Documentation often is a primary residual of research and development. Because of this important role and because of the large amount of time consumed in generating technical reports, particularly those containing formulas and graphics, an existing data-processing computer system has been adapted so as to provide text-processing of technical documents. Emphasis has been on accuracy, turnaround time, and time savings for staff and secretaries, for the types of reports normally produced in the reactor development program. The computer-assisted text-processing system, called TXT, has been implemented to benefit primarily the originator of technical reports. The system is of particular value tomore » professional staff, such as scientists and engineers, who have responsibility for generating much correspondence or lengthy, complex reports or manuscripts - especially if prompt turnaround and high accuracy are required. It can produce text that contains special Greek or mathematical symbols. Written in FORTRAN and MACRO, the program TXT operates on a PDP-11 minicomputer under the RSX-11M multitask multiuser monitor. Peripheral hardware includes videoterminals, electrostatic printers, and magnetic disks. Either data- or word-processing tasks may be performed at the terminals. The repertoire of operations has been restricted so as to minimize user training and memory burden. Spectarial staff may be readily trained to make corrections from annotated copy. Some examples of camera-ready copy are provided.« less

Efficiency of an Automated Reception and Turnaround Time Management System for the Phlebotomy Room

PubMed Central

Yun, Soon Gyu; Park, Eun Su; Bang, Hae In; Kang, Jung Gu

2016-01-01

Background Recent advances in laboratory information systems have largely been focused on automation. However, the phlebotomy services have not been completely automated. To address this issue, we introduced an automated reception and turnaround time (TAT) management system, for the first time in Korea, whereby the patient's information is transmitted directly to the actual phlebotomy site and the TAT for each phlebotomy step can be monitored at a glance. Methods The GNT5 system (Energium Co., Ltd., Korea) was installed in June 2013. The automated reception and TAT management system has been in operation since February 2014. Integration of the automated reception machine with the GNT5 allowed for direct transmission of laboratory order information to the GNT5 without involving any manual reception step. We used the mean TAT from reception to actual phlebotomy as the parameter for evaluating the efficiency of our system. Results Mean TAT decreased from 5:45 min to 2:42 min after operationalization of the system. The mean number of patients in queue decreased from 2.9 to 1.0. Further, the number of cases taking more than five minutes from reception to phlebotomy, defined as the defect rate, decreased from 20.1% to 9.7%. Conclusions The use of automated reception and TAT management system was associated with a decrease of overall TAT and an improved workflow at the phlebotomy room. PMID:26522759

Impact of reference change value (RCV) based autoverification on turnaround time and physician satisfaction

PubMed Central

Fernández-Grande, Esther; Valera-Rodriguez, Carolina; Sáenz-Mateos, Luis; Sastre-Gómez, Amparo; García-Chico, Pilar; Palomino-Muñoz, Teodoro J.

2017-01-01

Background For a quicker delivery of laboratory test results to the hospital emergency department (ED), we implemented an autoverification system based on the reference change value (RCV). The aim of this study was to assess how the RCV based autoverification reflected on turnaround time (TAT) and on physician satisfaction. Materials and methods The laboratory information system (LIS) was programmed to autoverify the results as long as they were within the range settled by RCV, so that the autoverified results were reported to the physician as soon as the tests were carried out, without any further intervention. We analyzed the same three-month periods’ TAT and verification time (VFT) from the years prior to and following the implementation of RCV autoverification. The change in physicians’ satisfaction levels was assessed using the hospital’s Annual Physician Satisfaction Survey (APSS). Over sixty percent of physicians completed the questionnaire, and the amount of daily ED test requests (nearly three hundred) did not vary throughout the duration of this study. Results Mann-Whitney U test showed that the VFT was significantly reduced in all the test but troponin I. There were substantial reductions in TAT medians (haemogram, 75%; fibrinogen, 41%; prothrombin time, 40%; sodium, 27%). The percentage of physicians satisfied with the haematological and biochemical tests´ TAT increased from 84% to 93% and from 86% to 91% respectively. Conclusions Our results reveal that VFT and TAT were severely reduced in most emergency tests, greatly improving physicians’ satisfaction with TAT. PMID:28694725

Communication gaps in nursing home transfers to the ED: impact on turnaround time, disposition, and diagnostic testing.

PubMed

Nelson, Drew; Washton, Danae; Jeanmonod, Rebecca

2013-04-01

This study aims to determine the source of communication gaps in history of present illness (HPI), medical history, and advanced directives in nursing home (NH) patients transferred to the emergency department (ED). We also attempt to determine if these gaps create differences in patient turnaround time (TAT), disposition decision, or diagnostic testing. A convenience sample of patients transferred from NHs to a level 1 community trauma center was enrolled by the physicians caring for them. The physicians assessed the adequacy and source of the history for each patient. The patient's chart was then retrospectively reviewed to determine disposition, ED TAT, and diagnostic tests ordered. One hundred patients were enrolled. Physicians found that NH paperwork contained adequate HPI 35% of the time. Patients could provide their own HPI 28% of the time. In 32% of patients, adequate HPI could not be obtained from the patient, NH paperwork, or NH personnel. Comparing patients in whom adequate HPI was available (n = 68) to those in whom HPI was not available (n = 32), there was no difference in TAT (146 vs 173 minutes, P = .22), admissions (60% vs 66%, P = .66), or diagnostic testing (P = .89-1.0). Emergency department physicians often do not have adequate HPI in patients transferred from NHs. The absence of adequate information does not affect patient TAT, disposition decision, or ED diagnostic testing. Copyright © 2013 Elsevier Inc. All rights reserved.

Comparative evaluation of three commercial systems for nucleic acid extraction from urine specimens.

PubMed

Tang, Yi-Wei; Sefers, Susan E; Li, Haijing; Kohn, Debra J; Procop, Gary W

2005-09-01

A nucleic acid extraction system that can handle small numbers of specimens with a short test turnaround time and short hands-on time is desirable for emergent testing. We performed a comparative validation on three systems: the MagNA Pure compact system (Compact), the NucliSens miniMAG extraction instrument (miniMAG), and the BioRobot EZ1 system (EZ1). A total of 75 urine specimens submitted for polyomavirus BK virus detection were used. The human beta-actin gene was detected on 75 (100%), 75 (100%), and 72 (96%) nucleic acid extracts prepared by the miniMAG, EZ1, and Compact, respectively. The miniMAG produced the highest quantity of nucleic acids and the best precision among the three systems. The agreement rate was 100% for BKV detection on nucleic acid extracts prepared by the three extraction systems. When a full panel of specimens was run, the hands-on time and test turnaround time were 105.7 and 121.1 min for miniMAG, 6.1 and 22.6 min for EZ1, and 7.4 and 33.7 min for Compact, respectively. The EZ1 and Compact systems processed automatic nucleic acid extraction properly, providing a good solution to the need for sporadic but emergent specimen detection. The miniMAG yielded the highest quantity of nucleic acids, suggesting that this system would be the best for specimens containing a low number of microorganisms of interest.

State Policies to Transform Struggling Schools: How Various State Policies Can Be Used to Enable School & District Turnaround. Meeting the Turnaround Challenge: Strategies, Resources & Tools to Transform a Framework into Practice

ERIC Educational Resources Information Center

Mass Insight Education (NJ1), 2009

2009-01-01

State governments wield significant authority in the management of public schools. As a nexus for federal funding, state funding, and regulatory authority, states have both the legal and financial power to help drive school change. The "No Child Left Behind Act" has required each state to create a system of standards-based assessment and…

Strategic Performance Management Evaluation for the Navy’s Splice Local Area Networks.

DTIC Science & Technology

1985-04-01

Communications Agency (DCA)/Federal Data Corporation (FDC) literature; an extensive survey of academic and professional book and article literature... interesting closing note on strategic planning characteristics is that the period during which collapse or disaster develops is of the same order as the...accepted set of standards. In computer performance, such things as paging rates , throughput, input/output channel usage, turnaround * 32 EM-. time

Increasing Open Source Software Integration on the Department of Defense Unclassified Desktop

DTIC Science & Technology

2008-06-01

free and legal access to the source code grants the user or operating agency considerable power and control . Commercial, off-the-shelf (COTS...COMMAND, CONTROL AND COMMUNICATIONS (C-3)) from the NAVAL POSTGRADUATE SCHOOL June 2008 Author: Steven A. Schearer Approved...Network. This fee also entitles users to unlimited web support with a two-business-day turnaround time. The retail price for a one year, basic

Making sense from space-time data in laboratory experiments on space plasma processes

NASA Technical Reports Server (NTRS)

Gekelman, Walter; Bamber, James; Leneman, David; Vincena, Steve; Maggs, James; Rosenberg, Steve

1995-01-01

A number of visualization techniques are discussed in a laboratory experiment designed to study phenomena that occur in space. Visualization tools are used to design the apparatus, collect data, and make one-, two-, and three-dimensional plots of the results. These tools are an indispensable part of the experiment because the data sets are hundreds of megabytes in size and rapid turnaround is required.

Combustor Simulation

NASA Technical Reports Server (NTRS)

Norris, Andrew

2003-01-01

The goal was to perform 3D simulation of GE90 combustor, as part of full turbofan engine simulation. Requirements of high fidelity as well as fast turn-around time require massively parallel code. National Combustion Code (NCC) was chosen for this task as supports up to 999 processors and includes state-of-the-art combustion models. Also required is ability to take inlet conditions from compressor code and give exit conditions to turbine code.

Adoption of lean principles in a high-volume molecular diagnostic microbiology laboratory.

PubMed

Mitchell, P Shawn; Mandrekar, Jayawant N; Yao, Joseph D C

2014-07-01

Clinical laboratories are constantly facing challenges to do more with less, enhance quality, improve test turnaround time, and reduce operational expenses. Experience with adopting and applying lean concepts and tools used extensively in the manufacturing industry is described for a high-volume clinical molecular microbiology laboratory, illustrating how operational success and benefits can be achieved. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

Evaluation of second-generation sequencing of 19 dilated cardiomyopathy genes for clinical applications.

PubMed

Gowrisankar, Sivakumar; Lerner-Ellis, Jordan P; Cox, Stephanie; White, Emily T; Manion, Megan; LeVan, Kevin; Liu, Jonathan; Farwell, Lisa M; Iartchouk, Oleg; Rehm, Heidi L; Funke, Birgit H

2010-11-01

Medical sequencing for diseases with locus and allelic heterogeneities has been limited by the high cost and low throughput of traditional sequencing technologies. "Second-generation" sequencing (SGS) technologies allow the parallel processing of a large number of genes and, therefore, offer great promise for medical sequencing; however, their use in clinical laboratories is still in its infancy. Our laboratory offers clinical resequencing for dilated cardiomyopathy (DCM) using an array-based platform that interrogates 19 of more than 30 genes known to cause DCM. We explored both the feasibility and cost effectiveness of using PCR amplification followed by SGS technology for sequencing these 19 genes in a set of five samples enriched for known sequence alterations (109 unique substitutions and 27 insertions and deletions). While the analytical sensitivity for substitutions was comparable to that of the DCM array (98%), SGS technology performed better than the DCM array for insertions and deletions (90.6% versus 58%). Overall, SGS performed substantially better than did the current array-based testing platform; however, the operational cost and projected turnaround time do not meet our current standards. Therefore, efficient capture methods and/or sample pooling strategies that shorten the turnaround time and decrease reagent and labor costs are needed before implementing this platform into routine clinical applications.

Assessing Very Early Infant Diagnosis Turnaround Times: Findings from a Birth Testing Pilot in Lesotho

PubMed Central

Hoffman, Heather J.; Mokone, Majoalane; Tukei, Vincent J.; Nchephe, Matsepeli; Phalatse, Mamakhetha; Tiam, Appolinaire; Guay, Laura; Mofenson, Lynne

2017-01-01

Very early infant diagnosis (VEID) (testing within two weeks of life), combined with rapid treatment initiation, could reduce early infant mortality. Our study evaluated turnaround time (TAT) to receipt of infants' HIV test results and ART initiation if HIV-infected, with and without birth testing availability. Data from facility records and national databases were collected for 12 facilities offering VEID, as part of an observational prospective cohort study, and 10 noncohort facilities. HIV-exposed infants born in January–June 2016 and any cohort infant diagnosed as HIV-infected at birth or six weeks were included. The median TAT from blood draw to caregiver result receipt was 76.5 days at birth and 63 and 70 days at six weeks at cohort and noncohort facilities, respectively. HIV-exposed infants tested at birth were approximately one month younger when their caregivers received results versus those tested at six weeks. Infants diagnosed at birth initiated ART about two months earlier (median 6.4 weeks old) than those identified at six weeks (median 14.8 weeks). However, the long TAT for testing at both birth and six weeks illustrates the prolonged process for specimen transport and result return that could compromise the effectiveness of adding VEID to existing overburdened EID systems. PMID:29410914

National Space Transportation System (NSTS) technology needs

NASA Technical Reports Server (NTRS)

Winterhalter, David L.; Ulrich, Kimberly K.

1990-01-01

The National Space Transportation System (NSTS) is one of the Nation's most valuable resources, providing manned transportation to and from space in support of payloads and scientific research. The NSTS program is currently faced with the problem of hardware obsolescence, which could result in unacceptable schedule and cost impacts to the flight program. Obsolescence problems occur because certain components are no longer being manufactured or repair turnaround time is excessive. In order to achieve a long-term, reliable transportation system that can support manned access to space through 2010 and beyond, NASA must develop a strategic plan for a phased implementation of enhancements which will satisfy this long-term goal. The NSTS program has initiated the Assured Shuttle Availability (ASA) project with the following objectives: eliminate hardware obsolescence in critical areas, increase reliability and safety of the vehicle, decrease operational costs and turnaround time, and improve operational capability. The strategy for ASA will be to first meet the mandatory needs - keep the Shuttle flying. Non-mandatory changes that will improve operational capability and enhance performance will then be considered if funding is adequate. Upgrade packages should be developed to install within designated inspection periods, grouped in a systematic approach to reduce cost and schedule impacts, and allow the capability to provide a Block 2 Shuttle (Phase 3).

A model for consolidation of clinical microbiology laboratory services within a multihospital health-care system.

PubMed

Carter, Elliot; Stubbs, James R; Bennett, Betsy

2004-01-01

To determine the cost-effectiveness of consolidating clinical microbiology services in a three-hospital health-care network while maintaining high-quality laboratory services, a retrospective review of the total costs of maintaining separate clinical microbiology laboratories within our health-care system was compared to the cost of providing these services after consolidation. Turnaround times before and after consolidation were compared to assess efficiency of the consolidated services. Input of clinicians was also solicited to ensure that quality of services and customer satisfaction remained high. The results of the consolidation project show that the net fiscal saving because of consolidation of clinical microbiology services within our health-care system will be approximately 100,000 dollars per fiscal year. This value includes increased courier charges as well as personnel savings. Although fiscal savings are an integral part of any laboratory consolidation plan, the financial considerations must be balanced by quality of service. The response to consolidation from clinicians was decidedly mixed before implementation of the plan because of fear of increased turnaround times and limited access to laboratory information. The consolidation process, however, was smooth with few physician complaints. The consolidation of our clinical microbiology services illustrates that significant financial savings can be achieved without compromise of efficiency or quality of service.

Laboratory Automation and Intra-Laboratory Turnaround Time: Experience at the University Hospital Campus Bio-Medico of Rome.

PubMed

Angeletti, Silvia; De Cesaris, Marina; Hart, Jonathan George; Urbano, Michele; Vitali, Massimiliano Andrea; Fragliasso, Fulvio; Dicuonzo, Giordano

2015-12-01

Intra-laboratory turnaround time (TAT) is a key indicator of laboratory performance. Improving TAT is a complex task requiring staff education, equipment acquisition, and adequate TAT monitoring. The aim of the present study was to evaluate the intra-laboratory TAT after laboratory automation implementation (June 2013-June 2014) and to compare it to that in the preautomation period (July 2012-May 2013). Intra-laboratory TAT was evaluated both as the mean TAT registered and the percentage of outlier (OP) exams. The mean TAT was 36, 38, and 34 min during the study periods, respectively. These values respected the goal TAT established at 45 min. The OP, calculated at 45 min as well as at 60 min, decreased from 26 to 21 and from 11 to 5, respectively. From a focused analysis on blood count cell, troponin I, and prothrombin (PT) test, TAT improvement was more evident for tests requiring longer preanalytical process. The follow-up of TAT from June 2013 to June 2014 revealed the reduction of the mean TAT as well as of the OP exams after automation implementation and that automation more strongly affects the test in the preanalytical phase including centrifugation of the sample, such as troponin I and PT. © 2015 Society for Laboratory Automation and Screening.

Technical evaluation of the novel preanalytical module on instrumentation laboratory ACL TOP: advancing automation in hemostasis testing.

PubMed

Lippi, Giuseppe; Ippolito, Luigi; Favaloro, Emmanuel J

2013-10-01

Automation in hemostasis testing is entering an exciting and unprecedented phase. This study was planned to assess the performance of the new preanalytical module on the hemostasis testing system Instrumentation Laboratory ACL TOP. The evaluation included interference studies to define reliable thresholds for rejecting samples with significant concentrations of interfering substances; within-run imprecision studies of plasma indices on four different interference degrees for each index; comparison studies with reference measures of hemolysis index, bilirubin, and triglycerides on clinical chemistry analyzers; and calculation of turnaround time with and without automatic performance of preanalytical check. The upper limits for sample rejection according to our interference studies were 3.6 g/L for hemoglobin, 13.6 mg/dL for bilirubin, and 1454 mg/dL for triglycerides. We found optimal precision for all indices (0.6% to 3.1% at clinically relevant thresholds) and highly significant correlations with reference measures on clinical chemistry analyzers (from 0.985 to 0.998). The limited increase of turnaround time (i.e., +3% and +5% with or without cap-piercing), coupled with no adjunctive costs over performance of normal coagulation assays, contribute to make the automatic check of plasma indices on ACL TOP a reliable and practical approach for improving testing quality and safeguarding patient safety.

Technical and financial evaluation of assays for progesterone in canine practice in the UK.

PubMed

Moxon, R; Copley, D; England, G C W

2010-10-02

The concentration of progesterone was measured in 60 plasma samples from bitches at various stages of the oestrous cycle, using commercially available quantitative and semi-quantitative ELISA test kits, as well as by two commercial laboratories undertaking radioimmunoassay (RIA). The RIA, which was assumed to be the 'gold standard' in terms of reliability and accuracy, was the most expensive method when analysing more than one sample per week, and had the longest delay in obtaining results, but had minimal requirements for practice staff time. When compared with the RIA, the quantitative ELISA had a strong positive correlation (r=0.97, P<0.05) and a sensitivity and specificity of 70.6 per cent and 100.0 per cent, respectively, and positive and negative predictive values of 100.0 per cent and 71.0 per cent, respectively, with an overall accuracy of 90.0 per cent. This method was the least expensive when analysing five or more samples per week, but had longer turnaround times than that of the semi-quantitative ELISA and required more staff time. When compared with the RIA, the semi-quantitative ELISA had a sensitivity and specificity of 100.0 per cent and 95.5 per cent, respectively, and positive and negative predictive values of 73.9 per cent and 77.8 per cent, respectively, with an overall accuracy of 89.2 per cent. This method was more expensive than the quantitative ELISA when analysing five or more samples per week, but had the shortest turnaround time and low requirements in terms of staff time.

Comparative evaluation of two rapid field tests for malaria diagnosis: Partec Rapid Malaria Test® and Binax Now® Malaria Rapid Diagnostic Test.

PubMed

Nkrumah, Bernard; Acquah, Samuel Ek; Ibrahim, Lukeman; May, Juergen; Brattig, Norbert; Tannich, Egbert; Nguah, Samuel Blay; Adu-Sarkodie, Yaw; Huenger, Frank

2011-05-23

About 90% of all malaria deaths in sub-Saharan Africa occur in children under five years. Fast and reliable diagnosis of malaria requires confirmation of the presence of malaria parasites in the blood of patients with fever or history suggestive of malaria; hence a prompt and accurate diagnosis of malaria is the key to effective disease management. Confirmation of malaria infection requires the availability of a rapid, sensitive, and specific testing at an affordable cost. We compared two recent methods (the novel Partec Rapid Malaria Test® (PT) and the Binax Now® Malaria Rapid Diagnostic Test (BN RDT) with the conventional Giemsa stain microscopy (GM) for the diagnosis of malaria among children in a clinical laboratory of a hospital in a rural endemic area of Ghana. Blood samples were collected from 263 children admitted with fever or a history of fever to the pediatric clinic of the Agogo Presbyterian Hospital. The three different test methods PT, BN RDT and GM were performed independently by well trained and competent laboratory staff to assess the presence of malaria parasites. Results were analyzed and compared using GM as the reference standard. In 107 (40.7%) of 263 study participants, Plasmodium sp. was detected by GM. PT and BN RDT showed positive results in 111 (42.2%) and 114 (43.4%), respectively. Compared to GM reference standard, the sensitivities of the PT and BN RDT were 100% (95% CI: 96.6-100) and 97.2% (95% CI: 92.0-99.4), respectively, specificities were 97.4% (95% CI: 93.6-99.3) and 93.6% (95% CI: 88.5-96.9), respectively. There was a strong agreement (kappa) between the applied test methods (GM vs PT: 0.97; p < 0.001 and GM vs BN RDT: 0.90; p < 0.001). The average turnaround time per tests was 17 minutes. In this study two rapid malaria tests, PT and BN RDT, demonstrated a good quality of their performance compared to conventional GM. Both methods require little training, have short turnaround times, are applicable as well as affordable and can therefore be considered as alternative diagnostic tools in malaria endemic areas. The species of Plasmodium cannot be identified.

Comparative evaluation of two rapid field tests for malaria diagnosis: Partec Rapid Malaria Test® and Binax Now® Malaria Rapid Diagnostic Test

PubMed Central

2011-01-01

Background About 90% of all malaria deaths in sub-Saharan Africa occur in children under five years. Fast and reliable diagnosis of malaria requires confirmation of the presence of malaria parasites in the blood of patients with fever or history suggestive of malaria; hence a prompt and accurate diagnosis of malaria is the key to effective disease management. Confirmation of malaria infection requires the availability of a rapid, sensitive, and specific testing at an affordable cost. We compared two recent methods (the novel Partec Rapid Malaria Test® (PT) and the Binax Now® Malaria Rapid Diagnostic Test (BN RDT) with the conventional Giemsa stain microscopy (GM) for the diagnosis of malaria among children in a clinical laboratory of a hospital in a rural endemic area of Ghana. Methods Blood samples were collected from 263 children admitted with fever or a history of fever to the pediatric clinic of the Agogo Presbyterian Hospital. The three different test methods PT, BN RDT and GM were performed independently by well trained and competent laboratory staff to assess the presence of malaria parasites. Results were analyzed and compared using GM as the reference standard. Results In 107 (40.7%) of 263 study participants, Plasmodium sp. was detected by GM. PT and BN RDT showed positive results in 111 (42.2%) and 114 (43.4%), respectively. Compared to GM reference standard, the sensitivities of the PT and BN RDT were 100% (95% CI: 96.6-100) and 97.2% (95% CI: 92.0-99.4), respectively, specificities were 97.4% (95% CI: 93.6-99.3) and 93.6% (95% CI: 88.5-96.9), respectively. There was a strong agreement (kappa) between the applied test methods (GM vs PT: 0.97; p < 0.001 and GM vs BN RDT: 0.90; p < 0.001). The average turnaround time per tests was 17 minutes. Conclusion In this study two rapid malaria tests, PT and BN RDT, demonstrated a good quality of their performance compared to conventional GM. Both methods require little training, have short turnaround times, are applicable as well as affordable and can therefore be considered as alternative diagnostic tools in malaria endemic areas. The species of Plasmodium cannot be identified. PMID:21605401

Rapid-Viability PCR Method for Detection of Live, Virulent Bacillus anthracis in Environmental Samples ▿

PubMed Central

Létant, Sonia E.; Murphy, Gloria A.; Alfaro, Teneile M.; Avila, Julie R.; Kane, Staci R.; Raber, Ellen; Bunt, Thomas M.; Shah, Sanjiv R.

2011-01-01

In the event of a biothreat agent release, hundreds of samples would need to be rapidly processed to characterize the extent of contamination and determine the efficacy of remediation activities. Current biological agent identification and viability determination methods are both labor- and time-intensive such that turnaround time for confirmed results is typically several days. In order to alleviate this issue, automated, high-throughput sample processing methods were developed in which real-time PCR analysis is conducted on samples before and after incubation. The method, referred to as rapid-viability (RV)-PCR, uses the change in cycle threshold after incubation to detect the presence of live organisms. In this article, we report a novel RV-PCR method for detection of live, virulent Bacillus anthracis, in which the incubation time was reduced from 14 h to 9 h, bringing the total turnaround time for results below 15 h. The method incorporates a magnetic bead-based DNA extraction and purification step prior to PCR analysis, as well as specific real-time PCR assays for the B. anthracis chromosome and pXO1 and pXO2 plasmids. A single laboratory verification of the optimized method applied to the detection of virulent B. anthracis in environmental samples was conducted and showed a detection level of 10 to 99 CFU/sample with both manual and automated RV-PCR methods in the presence of various challenges. Experiments exploring the relationship between the incubation time and the limit of detection suggest that the method could be further shortened by an additional 2 to 3 h for relatively clean samples. PMID:21764960

Improving Autopsy Report Turnaround Times by Implementing Lean Management Principles.

PubMed

Cromwell, Susan; Chiasson, David A; Cassidy, Debra; Somers, Gino R

2018-01-01

The autopsy is an integral part of the service of a large academic pathology department. Timely reporting is central to providing good service and is beneficial for many stakeholders, including the families, the clinical team, the hospital, and the wider community. The current study aimed to improve hospital-consented autopsy reporting times (turnaround time, TAT) by using lean principles modified for a healthcare setting, with an aim of signing out 90% of autopsies in 90 days. An audit of current and historical TATs was performed, and a working group incorporating administrative, technical, and professional staff constructed a value stream map documenting the steps involved in constructing an autopsy report. Two areas of delay were noted: examination of the microscopy and time taken to sign-out the report after the weekly autopsy conference. Several measures were implemented to address these delays, including visual tracking using a whiteboard and individualized tracking sheets, weekly whiteboard huddles, and timelier scheduling of clinicopathologic conference rounds. All measures resulted in an improvement of TATs. In the 30 months prior to the institution of lean, 37% of autopsies (53/144) were signed out in 90 days, with a wide variation in reporting times. In the 30 months following the institution of lean, this improved to 74% (136/185) ( P < .0001, Fisher exact test), with a marked reduction in variability. Further, the time from autopsy to presentation at weekly clinicopathological rounds was also reduced (median: 73 days prior to lean; 63 days post-lean). The application of lean principles to autopsy sign-out workflow can significantly improve TATs and reduce variability, without changing staffing levels or significantly altering scheduling structure.

Autoverification process improvement by Six Sigma approach: Clinical chemistry & immunoassay.

PubMed

Randell, Edward W; Short, Garry; Lee, Natasha; Beresford, Allison; Spencer, Margaret; Kennell, Marina; Moores, Zoë; Parry, David

2018-05-01

This study examines effectiveness of a project to enhance an autoverification (AV) system through application of Six Sigma (DMAIC) process improvement strategies. Similar AV systems set up at three sites underwent examination and modification to produce improved systems while monitoring proportions of samples autoverified, the time required for manual review and verification, sample processing time, and examining characteristics of tests not autoverified. This information was used to identify areas for improvement and monitor the impact of changes. Use of reference range based criteria had the greatest impact on the proportion of tests autoverified. To improve AV process, reference range based criteria was replaced with extreme value limits based on a 99.5% test result interval, delta check criteria were broadened, and new specimen consistency rules were implemented. Decision guidance tools were also developed to assist staff using the AV system. The mean proportion of tests and samples autoverified improved from <62% for samples and <80% for tests, to >90% for samples and >95% for tests across all three sites. The new AV system significantly decreased turn-around time and total sample review time (to about a third), however, time spent for manual review of held samples almost tripled. There was no evidence of compromise to the quality of testing process and <1% of samples held for exceeding delta check or extreme limits required corrective action. The Six Sigma (DMAIC) process improvement methodology was successfully applied to AV systems resulting in an increase in overall test and sample AV by >90%, improved turn-around time, reduced time for manual verification, and with no obvious compromise to quality or error detection. Copyright © 2018 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Quantifying stratospheric ozone trends: Complications due to stratospheric cooling

NASA Astrophysics Data System (ADS)

McLinden, C. A.; Fioletov, V.

2011-02-01

Recent studies suggest that ozone turnaround (the second stage of ozone recovery) is near. Determining precisely when this occurs, however, will be complicated by greenhouse gas-induced stratospheric cooling as ozone trends derived from profile data in different units and/or vertical co-ordinates will not agree. Stratospheric cooling leads to simultaneous trends in air density and layer thicknesses, confounding the interpretation of ozone trends. A simple model suggests that instruments measuring ozone in different units may differ as to the onset of turnaround by a decade, with some indicting a continued decline while others an increase. This concept was illustrated by examining the long-term (1979-2005) ozone trends in the SAGE (Stratospheric Aerosol and Gas Experiment) and SBUV (Solar Backscatter Ultraviolet) time series. Trends from SAGE, which measures number density as a function of altitude, and SBUV, which measures partial column as a function of pressure, are known to differ by 4-6%/decade in the upper stratosphere. It is shown that this long-standing difference can be reconciled to within 2%/decade when the trend in temperature is properly accounted for.

A novel technology to control proppant backproduction

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

Card, R.J.; Howard, P.R.; Feraud, J.P.

1995-11-01

A new technology has been developed to control proppant backproduction and to increase flexibility in well turnaround and production strategies. The technology has been used successfully on several hundred hydraulic fracturing treatments. In this technology, a mixture of fibers and proppant is pumped into the fracture to form a mixture of fibers and proppant is pumped into the fracture to form a pack that is resistant to proppant backproduction under typical oil/gas production conditions. The proppant/fiber mixture depends on a physical mechanism rather than chemical bonding to increase pack resistance to flowback. There are no minimum closure stress, temperature, ormore » shut-in time requirements associated with the use of this technology, which increases the flexibility available to the operator to optimize well turnaround and production strategy. This paper reviews the laboratory data relevant to the understanding and application of this technology. Studies include proppant pack resistance to flowback in one- and two-phase flow, the effect of cyclic loading, aging phenomena, permeability/conductivity studies, and fluid/breaker interactions. The benefits of the technology are illustrated with field studies.« less

HL-20 operations and support requirements for the Personnel Launch System mission

NASA Technical Reports Server (NTRS)

Morris, W. D.; White, Nancy H.; Caldwell, Ronald G.

1993-01-01

The processing, mission planning, and support requirements were defined for the HL-20 lifting-body configuration that can serve as a Personnel Launch System. These requirements were based on the assumption of an operating environment that incorporates aircraft and airline support methods and techniques that are applicable to operations. The study covered the complete turnaround process for the HL-20, including landing through launch, and mission operations, but did not address the support requirements of the launch vehicle except for the integrated activities. Support is defined in terms of manpower, staffing levels, facilities, ground support equipment, maintenance/sparing requirements, and turnaround processing time. Support results were drawn from two contracted studies, plus an in-house analysis used to define the maintenance manpower. The results of the contracted studies were used as the basis for a stochastic simulation of the support environment to determine the sufficiency of support and the effect of variance on vehicle processing. Results indicate the levels of support defined for the HL-20 through this process to be sufficient to achieve the desired flight rate of eight flights per year.

Developing a gate-array capability at a research and development laboratory

NASA Astrophysics Data System (ADS)

Balch, J. W.; Current, K. W.; Magnuson, W. G., Jr.; Pocha, M. D.

1983-03-01

Experiences in developing a gate array capability for low volume applications in a research and development (R and D) laboratory are described. By purchasing unfinished wafers and doing the customization steps in-house. Turnaround time was shortened to as little as one week and the direct costs reduced to as low as $5K per design. Designs generally require fast turnaround (a few weeks to a few months) and very low volumes (1 to 25). Design costs must be kept at a minimum. After reviewing available commercial gate array design and fabrication services, it was determined that objectives would best be met by using existing internal integrated circuit fabrication facilities, the COMPUTERVISION interactive graphics layout system, and extensive computational capabilities. The reasons and the approach taken for; selection for a particular gate array wafer, adapting a particular logic simulation program, and how layout aids were enhanced are discussed. Testing of the customized chips is described. The content, schedule, and results of the internal gate array course recently completed are discussed. Finally, problem areas and near term plans are presented.

Comparison of the Immulite and RIA assay methods for measuring peripheral blood progesterone levels in Greyhound bitches.

PubMed

Chapwanya, A; Clegg, T; Stanley, P; Vaughan, L

2008-09-15

Determination of optimal breeding time in bitches earmarked for single insemination only is based on measurement of peripheral blood serum or plasma progesterone concentration. In this paper a comparison is made between radioimmune assay (RIA) and chemoluminescent assay (Immulite) for determination of P4 concentrations in the bitch. The Immulite assay is shown to be an accurate and reliable method for serum or plasma P4 measurement. It compares favourably with other methods in terms of turn-around time, cost and accessibility for veterinarians in practice.

Sharing the skies: the Gemini Observatory international time allocation process

NASA Astrophysics Data System (ADS)

Margheim, Steven J.

2016-07-01

Gemini Observatory serves a diverse community of four partner countries (United States, Canada, Brazil, and Argentina), two hosts (Chile and University of Hawaii), and limited-term partnerships (currently Australia and the Republic of Korea). Observing time is available via multiple opportunities including Large and Long Pro- grams, Fast-turnaround programs, and regular semester queue programs. The slate of programs for observation each semester must be created by merging programs from these multiple, conflicting sources. This paper de- scribes the time allocation process used to schedule the overall science program for the semester, with emphasis on the International Time Allocation Committee and the software applications used.

Effectiveness of screening hospital admissions to detect asymptomatic carriers of Clostridium difficile: a modeling evaluation.

PubMed

Lanzas, Cristina; Dubberke, Erik R

2014-08-01

Both asymptomatic and symptomatic Clostridium difficile carriers contribute to new colonizations and infections within a hospital, but current control strategies focus only on preventing transmission from symptomatic carriers. Our objective was to evaluate the potential effectiveness of methods targeting asymptomatic carriers to control C. difficile colonization and infection (CDI) rates in a hospital ward: screening patients at admission to detect asymptomatic C. difficile carriers and placing positive patients into contact precautions. We developed an agent-based transmission model for C. difficile that incorporates screening and contact precautions for asymptomatic carriers in a hospital ward. We simulated scenarios that vary according to screening test characteristics, colonization prevalence, and type of strain present at admission. In our baseline scenario, on average, 42% of CDI cases were community-onset cases. Within the hospital-onset (HO) cases, approximately half were patients admitted as asymptomatic carriers who became symptomatic in the ward. On average, testing for asymptomatic carriers reduced the number of new colonizations and HO-CDI cases by 40%-50% and 10%-25%, respectively, compared with the baseline scenario. Test sensitivity, turnaround time, colonization prevalence at admission, and strain type had significant effects on testing efficacy. Testing for asymptomatic carriers at admission may reduce both the number of new colonizations and HO-CDI cases. Additional reductions could be achieved by preventing disease in patients who are admitted as asymptomatic carriers and developed CDI during the hospital stay.

Causes and impact of specimen rejection in a clinical chemistry laboratory.

PubMed

Cao, Liyun; Chen, Meng; Phipps, Ron A; Del Guidice, Robert E; Handy, Beverly C; Wagar, Elizabeth A; Meng, Qing H

2016-07-01

Pre-analytical errors necessitate specimen rejection and negatively affect patient safety. Our purpose was to investigate the factors leading to specimen rejection and its impact. Specimen rejections in a clinical chemistry laboratory during a 1-year period were reviewed retrospectively and analyzed for frequency, cause, circumstances, and impact. Of the 837,862 specimens received, 2178 (0.26%) were rejected. The most common reasons for specimen rejection were contamination (n=764, 35.1%), inappropriate collection container/tube (n=330, 15.2%), quantity not sufficient (QNS) (n=329, 15.1%), labeling errors (n=321, 14.7%), hemolyzed specimen (n=205, 9.4%), and clotted specimen (n=203, 9.3%). The analytes most often affected were glucose (n=192, 8.8%); calcium (n=152, 7.0%), magnesium (n=148, 6.8%), potassium (n=137, 6.3%), creatinine (n=100, 4.6%), and blood urea nitrogen (n=97, 4.4%). Outpatient service and blood draw by phlebotomists were associated with low rejection rates (536/493,501 or 0.11% and 368/586,503 or 0.06%, respectively). Recollection due to specimen rejection increased the turnaround time by an average of 108min. The total cost for the recollection was around $43,210 USD with an average cost around $21.9 USD. The factors associated with rejection are remediable by improved training and quality assurance measures. Policies and procedures specific to specimen collection, transportation, and preparation should be strictly followed. Copyright © 2016 Elsevier B.V. All rights reserved.

Coupled-Flow Simulation of HP-LP Turbines Has Resulted in Significant Fuel Savings

NASA Technical Reports Server (NTRS)

Veres, Joseph P.

2001-01-01

Our objective was to create a high-fidelity Navier-Stokes computer simulation of the flow through the turbines of a modern high-bypass-ratio turbofan engine. The simulation would have to capture the aerodynamic interactions between closely coupled high- and low-pressure turbines. A computer simulation of the flow in the GE90 turbofan engine's high-pressure (HP) and low-pressure (LP) turbines was created at GE Aircraft Engines under contract with the NASA Glenn Research Center. The three-dimensional steady-state computer simulation was performed using Glenn's average-passage approach named APNASA. The areas upstream and downstream of each blade row mutually interact with each other during engine operation. The embedded blade row operating conditions are modeled since the average passage equations in APNASA actively include the effects of the adjacent blade rows. The turbine airfoils, platforms, and casing are actively cooled by compressor bleed air. Hot gas leaks around the tips of rotors through labyrinth seals. The flow exiting the high work HP turbines is partially transonic and, therefore, has a strong shock system in the transition region. The simulation was done using 121 processors of a Silicon Graphics Origin 2000 (NAS 02K) cluster at the NASA Ames Research Center, with a parallel efficiency of 87 percent in 15 hr. The typical average-passage analysis mesh size per blade row was 280 by 45 by 55, or approx.700,000 grid points. The total number of blade rows was 18 for a combined HP and LP turbine system including the struts in the transition duct and exit guide vane, which contain 12.6 million grid points. Design cycle turnaround time requirements ran typically from 24 to 48 hr of wall clock time. The number of iterations for convergence was 10,000 at 8.03x10(exp -5) sec/iteration/grid point (NAS O2K). Parallel processing by up to 40 processors is required to meet the design cycle time constraints. This is the first-ever flow simulation of an HP and LP turbine. In addition, it includes the struts in the transition duct and exit guide vanes.

Experimental fusion of different versions of the total laboratory automation system and improvement of laboratory turnaround time.

PubMed

Chung, Hee-Jung; Song, Yoon Kyung; Hwang, Sang-Hyun; Lee, Do Hoon; Sugiura, Tetsuro

2018-02-25

Use of total laboratory automation (TLA) system has expanded to microbiology and hemostasis and upgraded to second and third generations. We herein report the first successful upgrades and fusion of different versions of the TLA system, thus improving laboratory turnaround time (TAT). A 21-day schedule was planned from the time of pre-meeting to installation and clinical sample application. We analyzed the monthly TAT in each menu, distribution of the "out of range for acceptable TAT" samples, and "prolonged time out of acceptable TAT," before and after the upgrade and fusion. We installed and customized hardware, middleware, and software. The one-way CliniLog 2.0 version track, 50.0-m long, was changed to a 23.2-m long one-way 2.0 version and an 18.7-m long two-way 4.0 version. The monthly TAT in the outpatient samples, before and after upgrading the TLA system, were uniformly satisfactory in the chemistry and viral marker menus. However, in the tumor marker menu, the target TAT (98.0% of samples ≤60 minutes) was not satisfied during the familiarization period. There was no significant difference in the proportion of "out of acceptable TAT" samples, before and after the TLA system upgrades (7.4‰ and 8.5‰). However, the mean "prolonged time out of acceptable TAT" in the chemistry samples was significantly shortened to 17.4 (±24.0) minutes after the fusion, from 34.5 (±43.4) minutes. Despite experimental challenges, a fusion of the TLA system shortened the "prolonged time out of acceptable TAT," indicating a distribution change in overall TAT. © 2018 Wiley Periodicals, Inc.

Predictors of chain acquisition among independent dialysis facilities.

PubMed

Pozniak, Alyssa S; Hirth, Richard A; Banaszak-Holl, Jane; Wheeler, John R C

2010-04-01

To determine the predictors of chain acquisition among independent dialysis providers. Retrospective facility-level data combined from CMS Cost Reports, Medical Evidence Forms, Annual Facility Surveys, and claims for 1996-2003. Independent dialysis facilities' probability of acquisition by a dialysis chain (overall and by chain size) was estimated using a discrete time hazard rate model, controlling for financial and clinical performance, practice patterns, market factors, and other facility characteristics. The sample includes all U.S. freestanding dialysis facilities that report not being chain affiliated for at least 1 year between 1997 and 2003. Above-average costs and better quality outcomes are significant determinants of dialysis chain acquisition. Facilities in larger markets were more likely to be acquired by a chain. Furthermore, small dialysis chains have different acquisition strategies than large chains. Dialysis chains appear to employ a mix of turn-around and cream-skimming strategies. Poor financial health is a predictor of chain acquisition as in other health care sectors, but the increased likelihood of chain acquisition among higher quality facilities is unique to the dialysis industry. Significant differences among predictors of acquisition by small and large chains reinforce the importance of using a richer classification for chain status.

Numerical investigation of drag and heat flux reduction mechanism of the pulsed counterflowing jet on a blunt body in supersonic flows

NASA Astrophysics Data System (ADS)

Zhang, Rui-rui; Huang, Wei; Yan, Li; Li, Lang-quan; Li, Shi-bin; Moradi, R.

2018-05-01

To design a kind of aerospace vehicle, the drag and heat flux reduction are the most important factors. In the current study, the counterflowing jet, one of the effective drag and heat flux reduction concepts, is investigated numerically by the two-dimensional axisymmetric Reynolds-averaged Navier-Stokes equations coupled with the SST k-ω turbulence model. An axisymmetric numerical simulation mode of the counterflowing jet on the supersonic vehicle nose-tip is established, and the numerical method employed is validated by the experimental schlieren images and experimental data in the open literature. A pulsed counterflowing jet scheme is proposed, and it uses a sinusoidal function to control the total and static pressures of the counterflowing jet. The obtained results show that the long penetration mode does not exist in the whole turnaround, even in a relatively small range of the jet total and static pressures, and this is different from the phenomenon obtained under the steady condition in the open literature. At the same time, it is observed that the variation of the physical parameters, such as the Stanton number induced by the pulsed jet, has an obvious periodicity and hysteresis phenomenon.

Annual Surveillance Summary: Clostridium difficile Infections in the Military Health System (MHS), 2015

DTIC Science & Technology

2017-03-01

NMCPHC-EDC-TR-189-2017 By Charlotte Neumann and Uzo Chukwuma EpiData Center Department Prepared March 2017 Approved for public release...In February 2012, the US Food and Drug Administration (FDA) informed the public that proton pump inhibitors (PPIs) may be associated with an...been the most widely used test due to its rapid turnaround time and low cost . However, EIA has a sensitivity and specificity of approximately 75

Comparision between bed side testing of blood glucose by glucometer vs centralized testing in a tertiary care hospital.

PubMed

Baig, Ayaz; Siddiqui, Imran; Jabbar, Abdul; Azam, Syed Iqbal; Sabir, Salman; Alam, Shahryar; Ghani, Farooq

2007-01-01

To determine the accuracy, turnaround time and cost effectiveness of bedside monitoring of blood glucose levels by non-laboratory health care workers and centralized testing of blood glucose by automated analyzer in a tertiary care hospital. The study was conducted in Section of Chemical Pathology, Department of Pathology and Microbiology and Section of Endocrinology Department of Medicine, Aga Khan University and Hospital Karachi, from April 2005 to March 2006. One hundred and ten patients were included in the study. The blood glucose levels were analyzed on glucometer (Precision Abbott) by finger stick, using Biosensor Technology. At the same time venous blood was obtained to analyze glucose in clinical laboratory on automated analyzer (SYNCHRON CX7) by glucose oxidase method. We observed good correlation between bed side glucometer and laboratory automated analyzer for glucose values between 3.3 mmol/L (60 mg/dl) and 16.7 (300 mg/dl). A significant difference was observed for glucose values less than 3.3 mmol/L (p = 0.002) and glucose values more than 16.67 mmol/l (p = 0.049). Mean Turnaround time for glucometer and automated analyzer were 0.08 hours and 2.49 hours respectively. The cost of glucose testing with glucometer was 48.8% lower than centralized lab based testing. Bedside glucometer testing, though less expensive does not have good accuracy in acutely ill patient with either very high or very low blood glucose levels.

Initial conditions and modeling for simulations of shock driven turbulent material mixing

DOE PAGES

Grinstein, Fernando F.

2016-11-17

Here, we focus on the simulation of shock-driven material mixing driven by flow instabilities and initial conditions (IC). Beyond complex multi-scale resolution issues of shocks and variable density turbulence, me must address the equally difficult problem of predicting flow transition promoted by energy deposited at the material interfacial layer during the shock interface interactions. Transition involves unsteady large-scale coherent-structure dynamics capturable by a large eddy simulation (LES) strategy, but not by an unsteady Reynolds-Averaged Navier–Stokes (URANS) approach based on developed equilibrium turbulence assumptions and single-point-closure modeling. On the engineering end of computations, such URANS with reduced 1D/2D dimensionality and coarsermore » grids, tend to be preferred for faster turnaround in full-scale configurations.« less

Comparison of long-term trends from reanalyses

NASA Astrophysics Data System (ADS)

Kozubek, M.

2017-12-01

The long-term trend of different atmospheric parameters has been studied separately during previous years in many papers. This study is focused on the temperature, wind (u and v component), geopotential height and water vapour trends during 1979-2016. We present the trend for each month with respect to ozone turnaround during mid 1990s. The different reanalyses (MERRA, ERA-Interim, JRA-55 and NCEP-NOE) are used for comparison. We analyzed every grid point to reduce the problem with zonal averages in different pressure levels. The results will show the complex view on the trend in the middle atmosphere (troposphere, stratosphere and lower mesosphere). This comparison can give us the clue which reanalysis is better for studying different phenomena (QBO, NAO, ENSO, etc.) and which one has some issues.

Rapid counterclockwise shift rotation in air traffic control: effects on sleep and night work.

PubMed

Signal, T Leigh; Gander, Philippa H

2007-09-01

In Air Traffic Control, counterclockwise rapidly rotating shift schedules are often employed but may result in significant sleep loss. This has potential consequences for performance, particularly if a night shift is worked. As part of a large-scale field study, the pattern of sleep across a 4-d counterclockwise, rapidly rotating schedule (afternoon, day, morning, night shift) was documented and relationships between prior sleep and performance during the night shift were investigated. There were 28 controllers who completed 4 periods of data collection which included 2 d before and 2 d after a 4-d shift cycle. Sleep was recorded using an actigraph and sleep diary, and performance on each night shift was measured three times using the Psychomotor Vigilance Task. Across the work week, sleep duration decreased largely due to earlier rise times associated with shift start times moving backward. In the short turn-around between the morning and night shift, 90% of controllers slept for an average of 2.2 h. Improved performance on the night shift was related only to longer periods of sleep the night prior. This study demonstrates that a 4-d counterclockwise, rapidly rotating schedule results in a progressive reduction in sleep and consequently the rapid accumulation of a sleep debt. To help maintain their performance on the night shift, it is recommended that controllers attempt to obtain at least 6 h sleep the night before a night shift. It is also recommended that ATC providers educate their workforce about this issue.

SSME 3-D Turnaround Duct flow analysis - CFD predictions

NASA Technical Reports Server (NTRS)

Brankovic, Andreja; Stowers, Steven T.; Mcconnaughey, Paul

1988-01-01

CFD analysis is presently employed to obtain an improved flowfield for an individual flowpath in the case of the Space Shuttle Main Engine's High Pressure Fuel Turbopump Turn-Around Duct (TAD), which conducts the flow exiting from the gas turbines into the fuel bowl. It is demonstrated that the application of CFD to TAD flow analysis, giving attention to the duct's configuration and to the number, shape, and alignment of the diffuser struts, can enhance understanding of flow physics and result in improved duct design and performance.

Two Hour Evaluation and Referral Model for Shorter Turnaround Times in the emergency department.

PubMed

Burke, John A; Greenslade, Jaimi; Chabrowska, Jadwiga; Greenslade, Katherine; Jones, Sally; Montana, Jacqueline; Bell, Anthony; O'Connor, Alan

2017-06-01

The objective of this study was to assess the implementation of a novel ED model of care, which combines clinical streaming, team-based assessment and early senior consultation to reduce length of stay. A pre-post-intervention study was used to compare ED performance following an extensive clinical redesign programme. Clinical teams and work sequences were reconfigured to promote the role of the staff specialist, with a focus on earlier decisions regarding disposition. Primary outcome measures were ED length of stay and National Emergency Access Target (NEAT) compliance. Secondary outcomes included referral and workup times, wait times by triage category, ambulance offload times, ward discharges and unit transfers within 24 h of admission, representation within 48 h, and Medical Emergency Response Team (MERT) calls within 24 h of admission. Two seasonally matched 26 week intervals were compared with adjustment for demographics, triage category and arrival by ambulance. Overall, there was an 18.4% rise in NEAT performance (95% confidence interval (CI): 17.7-19.1) while ED length of stay decreased by a total of 86.8 min (95% CI: 83.6-90.1). Time series analysis did not suggest any preexisting trends to explain these results. The average time to referral decreased by 74.7 min (95% CI: 69.8-79.6) and waiting times decreased across all triage categories. Rates of MERT activation and unplanned representation were unchanged. A facilitated team leader role for senior doctors can help to reduce length of stay by via early disposition, without significant risks to the patient. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

The Impact of a Health IT Changeover on Medical Imaging Department Work Processes and Turnaround Times

PubMed Central

Georgiou, A.; Lymer, S.; Hordern, A.; Ridley, L.; Westbrook, J.

2015-01-01

Summary Objectives To assess the impact of introducing a new Picture Archiving and Communication System (PACS) and Radiology Information System (RIS) on: (i) Medical Imaging work processes; and (ii) turnaround times (TATs) for x-ray and CT scan orders initiated in the Emergency Department (ED). Methods We employed a mixed method study design comprising: (i) semi-structured interviews with Medical Imaging Department staff; and (ii) retrospectively extracted ED data before (March/April 2010) and after (March/April 2011 and 2012) the introduction of a new PACS/RIS. TATs were calculated as: processing TAT (median time from image ordering to examination) and reporting TAT (median time from examination to final report). Results Reporting TAT for x-rays decreased significantly after introduction of the new PACS/RIS; from a median of 76 hours to 38 hours per order (p<.0001) for patients discharged from the ED, and from 84 hours to 35 hours (p<.0001) for patients admitted to hospital. Medical Imaging staff reported that the changeover to the new PACS/RIS led to gains in efficiency, particularly regarding the accessibility of images and patient-related information. Nevertheless, assimilation of the new PACS/RIS with existing Departmental work processes was considered inadequate and in some instances unsafe. Issues highlighted related to the synchronization of work tasks (e.g., porter arrangements) and the material set up of the work place (e.g., the number and location of computers). Conclusions The introduction of new health IT can be a “double-edged sword” providing improved efficiency but at the same time introducing potential hazards affecting the effectiveness of the Medical Imaging Department. PMID:26448790

Augmenting the impact of technology adoption with financial incentive to improve radiology report signature times.

PubMed

Andriole, Katherine P; Prevedello, Luciano M; Dufault, Allen; Pezeshk, Parham; Bransfield, Robert; Hanson, Richard; Doubilet, Peter M; Seltzer, Steven E; Khorasani, Ramin

2010-03-01

Radiology report signature time (ST) can be a substantial component of total report turnaround time. Poor turnaround time resulting from lengthy ST can adversely affect patient care. The combination of technology adoption with financial incentive was evaluated to determine if ST improvement can be augmented and sustained. This prospective study was performed at a 751-bed, urban, tertiary care adult teaching hospital. Test-site imaging volume approximated 48,000 examinations per month. The radiology department has 100 trainees and 124 attending radiologists serving multiple institutions. Over a study period of 4 years and 4 months, three interventions focused on radiologist signature performance were implemented: 1) a notification paging application that alerted radiologists when reports were ready for signature, 2) a picture archiving and communications systems (PACS)-integrated speech recognition report generation system, and 3) a departmental financial incentive to reward radiologists semiannually for ST performance. Signature time was compared before and after the interventions. Wilcoxon and linear regression statistical analyses were used to assess the significance of trends. Technology adoption (paging plus speech recognition) reduced median ST from >5 to <1 hour (P < .001) and 80th-percentile ST from >24 to 15 to 18 hours (P < .001). Subsequent addition of a financial incentive further improved 80th-percentile ST to 4 to 8 hours (P < .001). The gains in median and 80th-percentile ST were sustained over the final 31 months of the study period. Technology interventions coupled with financial incentive can result in synergistic and sustainable improvement in radiologist report-signing behavior. The addition of a financial incentive leads to better performance than that achievable through technology alone.

Diagnostic accuracy and turnaround time of the Xpert MTB/RIF assay in routine clinical practice.

PubMed

Kwak, Nakwon; Choi, Sun Mi; Lee, Jinwoo; Park, Young Sik; Lee, Chang-Hoon; Lee, Sang-Min; Yoo, Chul-Gyu; Kim, Young Whan; Han, Sung Koo; Yim, Jae-Joon

2013-01-01

The Xpert MTB/RIF assay was introduced for timely and accurate detection of tuberculosis (TB). The aim of this study was to determine the diagnostic accuracy and turnaround time (TAT) of Xpert MTB/RIF assay in clinical practice in South Korea. We retrospectively reviewed the medical records of patients in whom Xpert MTB/RIF assay using sputum were requested. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for the diagnosis of pulmonary tuberculosis (PTB) and detection of rifampicin resistance were calculated. In addition, TAT of Xpert MTB/RIF assay was compared with those of other tests. Total 681 patients in whom Xpert MTB/RIF assay was requested were included in the analysis. The sensitivity, specificity, PPV and NPV of Xpert MTB/RIF assay for diagnosis of PTB were 79.5% (124/156), 100.0% (505/505), 100.0% (124/124) and 94.0% (505/537), respectively. Those for the detection of rifampicin resistance were 57.1% (8/14), 100.0% (113/113), 100.0% (8/8) and 94.9% (113/119), respectively. The median TAT of Xpert MTB/RIF assay to the report of results and results confirmed by physicians in outpatient settings were 0 (0-1) and 6 (3-7) days, respectively. Median time to treatment after initial evaluation was 7 (4-9) days in patients with Xpert MTB/RIF assay, but was 21 (7-33.5) days in patients without Xpert MTB/RIF assay. Xpert MTB/RIF assay showed acceptable sensitivity and excellent specificity for the diagnosis of PTB and detection of rifampicin resistance in areas with intermediate TB burden. Additionally, the assay decreased time to the initiation of anti-TB drugs through shorter TAT.

Diagnostic Accuracy and Turnaround Time of the Xpert MTB/RIF Assay in Routine Clinical Practice

PubMed Central

Kwak, Nakwon; Choi, Sun Mi; Lee, Jinwoo; Park, Young Sik; Lee, Chang-Hoon; Lee, Sang-Min; Yoo, Chul-Gyu; Kim, Young Whan; Han, Sung Koo; Yim, Jae-Joon

2013-01-01

The Xpert MTB/RIF assay was introduced for timely and accurate detection of tuberculosis (TB). The aim of this study was to determine the diagnostic accuracy and turnaround time (TAT) of Xpert MTB/RIF assay in clinical practice in South Korea. We retrospectively reviewed the medical records of patients in whom Xpert MTB/RIF assay using sputum were requested. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for the diagnosis of pulmonary tuberculosis (PTB) and detection of rifampicin resistance were calculated. In addition, TAT of Xpert MTB/RIF assay was compared with those of other tests. Total 681 patients in whom Xpert MTB/RIF assay was requested were included in the analysis. The sensitivity, specificity, PPV and NPV of Xpert MTB/RIF assay for diagnosis of PTB were 79.5% (124/156), 100.0% (505/505), 100.0% (124/124) and 94.0% (505/537), respectively. Those for the detection of rifampicin resistance were 57.1% (8/14), 100.0% (113/113), 100.0% (8/8) and 94.9% (113/119), respectively. The median TAT of Xpert MTB/RIF assay to the report of results and results confirmed by physicians in outpatient settings were 0 (0–1) and 6 (3–7) days, respectively. Median time to treatment after initial evaluation was 7 (4–9) days in patients with Xpert MTB/RIF assay, but was 21 (7–33.5) days in patients without Xpert MTB/RIF assay. Xpert MTB/RIF assay showed acceptable sensitivity and excellent specificity for the diagnosis of PTB and detection of rifampicin resistance in areas with intermediate TB burden. Additionally, the assay decreased time to the initiation of anti-TB drugs through shorter TAT. PMID:24204834

Impact of Glucose Measurement Processing Delays on Clinical Accuracy and Relevance

PubMed Central

Jangam, Sujit R.; Hayter, Gary; Dunn, Timothy C.

2013-01-01

Background In a hospital setting, glucose is often measured from venous blood in the clinical laboratory. However, laboratory glucose measurements are typically not available in real time. In practice, turn-around times for laboratory measurements can be minutes to hours. This analysis assesses the impact of turn-around time on the effective clinical accuracy of laboratory measurements. Methods Data obtained from an earlier study with 58 subjects with type 1 diabetes mellitus (T1DM) were used for this analysis. In the study, glucose measurements using a YSI glucose analyzer were obtained from venous blood samples every 15 min while the subjects were at the health care facility. To simulate delayed laboratory results, each YSI glucose value from a subject was paired with one from a later time point (from the same subject) separated by 15, 30, 45, and 60 min. To assess the clinical accuracy of a delayed YSI result relative to a real-time result, the percentage of YSI pairs that meet the International Organization for Standardization (ISO) 15197:2003(E) standard for glucose measurement accuracy (±15 mg/dl for blood glucose < 75 mg/dl, ±20% for blood glucose ≥ 75 mg/dl) was calculated. Results It was observed that delays of 15 min or more reduce clinical accuracy below the ISO 15197:2003(E) recommendation of 95%. The accuracy was less than 65% for delays of 60 min. Conclusion This analysis suggests that processing delays in glucose measurements reduce the clinical relevance of results in patients with T1DM and may similarly degrade the clinical value of measurements in other patient populations. PMID:23759399

Building a Protocol Expressway: The Case of Mayo Clinic Cancer Center

PubMed Central

McJoynt, Terre A.; Hirzallah, Muhanad A.; Satele, Daniel V.; Pitzen, Jason H.; Alberts, Steven R.; Rajkumar, S. Vincent

2009-01-01

Purpose Inconsistencies and errors resulting from nonstandard processes, together with redundancies, rework, and excess workload, lead to extended time frames for clinical trial protocol development. This results in dissatisfaction among sponsors, investigators, and staff and restricts the availability of novel treatment options for patients. Methods A team of experts from Mayo Clinic formed, including Protocol Development Unit staff and management from the three Mayo Clinic campuses (Florida, Minnesota, and Arizona), a systems and procedures analyst, a quality office analyst, and two physician members to address the identified deficiencies. The current-state process was intensively reviewed, and improvement steps were taken to accelerate the development and approval of cancer-related clinical trials. The primary goal was to decrease the time from receipt of a new protocol through submission to an approving authority, such as the National Cancer Institute or institutional review board. Results Using the Define, Measure, Analyze, Improve, Control (DMAIC) framework infused with Lean waste-reduction methodologies, areas were identified for improvement, including enhancing first-time quality and processing new studies on a first-in/first-out basis. The project was successful in improving the mean turnaround time for internally authored protocols (P < .001) from 25.00 weeks (n = 41; range, 3.43 to 94.14 weeks) to 10.15 weeks (n = 14; range, 4.00 to 22.14 weeks). The mean turnaround time for externally authored protocols was improved (P < .001) from 20.61 weeks (n = 85; range, 3.29 to 108.57 weeks) to 7.79 weeks (n = 50; range, 2.00 to 20.86 weeks). Conclusion DMAIC framework combined with Lean methodologies is an effective tool to structure the definition, planning, analysis, and implementation of significant process changes. PMID:19564529

Building a protocol expressway: the case of Mayo Clinic Cancer Center.

PubMed

McJoynt, Terre A; Hirzallah, Muhanad A; Satele, Daniel V; Pitzen, Jason H; Alberts, Steven R; Rajkumar, S Vincent

2009-08-10

Inconsistencies and errors resulting from nonstandard processes, together with redundancies, rework, and excess workload, lead to extended time frames for clinical trial protocol development. This results in dissatisfaction among sponsors, investigators, and staff and restricts the availability of novel treatment options for patients. A team of experts from Mayo Clinic formed, including Protocol Development Unit staff and management from the three Mayo Clinic campuses (Florida, Minnesota, and Arizona), a systems and procedures analyst, a quality office analyst, and two physician members to address the identified deficiencies. The current-state process was intensively reviewed, and improvement steps were taken to accelerate the development and approval of cancer-related clinical trials. The primary goal was to decrease the time from receipt of a new protocol through submission to an approving authority, such as the National Cancer Institute or institutional review board. Using the Define, Measure, Analyze, Improve, Control (DMAIC) framework infused with Lean waste-reduction methodologies, areas were identified for improvement, including enhancing first-time quality and processing new studies on a first-in/first-out basis. The project was successful in improving the mean turnaround time for internally authored protocols (P < .001) from 25.00 weeks (n = 41; range, 3.43 to 94.14 weeks) to 10.15 weeks (n = 14; range, 4.00 to 22.14 weeks). The mean turnaround time for externally authored protocols was improved (P < .001) from 20.61 weeks (n = 85; range, 3.29 to 108.57 weeks) to 7.79 weeks (n = 50; range, 2.00 to 20.86 weeks). DMAIC framework combined with Lean methodologies is an effective tool to structure the definition, planning, analysis, and implementation of significant process changes.

Precise turnaround time measurement of laboratory processes using radiofrequency identification technology.

PubMed

Mayer, Horst; Brümmer, Jens; Brinkmann, Thomas

2011-01-01

To implement Lean Six Sigma in our central laboratory we conducted a project to measure single pre-analytical steps influencing turnaround time (TAT) of emergency department (ED) serum samples. The traditional approach of extracting data from the Laboratory Information System (LIS) for a retrospective calculation of a mean TAT is not suitable. Therefore, we used radiofrequency identification (RFID) chips for real time tracking of individual samples at any pre-analytical step. 1,200 serum tubes were labelled with RFID chips and were provided to the emergency department. 3 RFID receivers were installed in the laboratory: at the outlet of the pneumatic tube system, at the centrifuge, and in the analyser area. In addition, time stamps of sample entry at the automated sample distributor and communication of results from the analyser were collected from LIS. 1,023 labelled serum tubes arrived at our laboratory. 899 RFID tags were used for TAT calculation. The following transfer times were determined (median 95th percentile in min:sec): pneumatic tube system --> centrifuge (01:25/04:48), centrifuge --> sample distributor (14:06/5:33), sample distributor --> analysis system zone (02:39/15:07), analysis system zone --> result communication (12:42/22:21). Total TAT was calculated at 33:19/57:40 min:sec. Manual processes around centrifugation were identified as a major part of TAT with 44%/60% (median/95th percentile). RFID is a robust, easy to use, and error-free technology and not susceptible to interferences in the laboratory environment. With this study design we were able to measure significant variations in a single manual sample transfer process. We showed that TAT is mainly influenced by manual steps around the centrifugation process and we concluded that centrifugation should be integrated in solutions for total laboratory automation.

Impact of glucose measurement processing delays on clinical accuracy and relevance.

PubMed

Jangam, Sujit R; Hayter, Gary; Dunn, Timothy C

2013-05-01

In a hospital setting, glucose is often measured from venous blood in the clinical laboratory. However, laboratory glucose measurements are typically not available in real time. In practice, turn-around times for laboratory measurements can be minutes to hours. This analysis assesses the impact of turn-around time on the effective clinical accuracy of laboratory measurements. Data obtained from an earlier study with 58 subjects with type 1 diabetes mellitus (T1DM) were used for this analysis. In the study, glucose measurements using a YSI glucose analyzer were obtained from venous blood samples every 15 min while the subjects were at the health care facility. To simulate delayed laboratory results, each YSI glucose value from a subject was paired with one from a later time point (from the same subject) separated by 15, 30, 45, and 60 min. To assess the clinical accuracy of a delayed YSI result relative to a real-time result, the percentage of YSI pairs that meet the International Organization for Standardization (ISO) 15197:2003(E) standard for glucose measurement accuracy (±15 mg/dl for blood glucose < 75 mg/dl, ±20% for blood glucose ≥ 75 mg/dl) was calculated. It was observed that delays of 15 min or more reduce clinical accuracy below the ISO 15197:2003(E) recommendation of 95%. The accuracy was less than 65% for delays of 60 min. This analysis suggests that processing delays in glucose measurements reduce the clinical relevance of results in patients with T1DM and may similarly degrade the clinical value of measurements in other patient populations. © 2013 Diabetes Technology Society.

Commercialization of microfluidic devices.

PubMed

Volpatti, Lisa R; Yetisen, Ali K

2014-07-01

Microfluidic devices offer automation and high-throughput screening, and operate at low volumes of consumables. Although microfluidics has the potential to reduce turnaround times and costs for analytical devices, particularly in medical, veterinary, and environmental sciences, this enabling technology has had limited diffusion into consumer products. This article analyzes the microfluidics market, identifies issues, and highlights successful commercialization strategies. Addressing niche markets and establishing compatibility with existing workflows will accelerate market penetration. Copyright © 2014 Elsevier Ltd. All rights reserved.

Rapid turn-around mapping of wildfires and disasters with airborne infrared imagery fro the new FireMapper® 2.0 and Oilmapper systems

Treesearch

James W. Hoffman; Lloyd L. Coulter; Philip J Riggan

2005-01-01

The new FireMapper® 2.0 and OilMapper airborne, infrared imaging systems operate in a "snapshot" mode. Both systems feature the real time display of single image frames, in any selected spectral band, on a daylight readable tablet PC. These single frames are displayed to the operator with full temperature calibration in color or grayscale renditions. A rapid...

Recent development in software and automation tools for high-throughput discovery bioanalysis.

PubMed

Shou, Wilson Z; Zhang, Jun

2012-05-01

Bioanalysis with LC-MS/MS has been established as the method of choice for quantitative determination of drug candidates in biological matrices in drug discovery and development. The LC-MS/MS bioanalytical support for drug discovery, especially for early discovery, often requires high-throughput (HT) analysis of large numbers of samples (hundreds to thousands per day) generated from many structurally diverse compounds (tens to hundreds per day) with a very quick turnaround time, in order to provide important activity and liability data to move discovery projects forward. Another important consideration for discovery bioanalysis is its fit-for-purpose quality requirement depending on the particular experiments being conducted at this stage, and it is usually not as stringent as those required in bioanalysis supporting drug development. These aforementioned attributes of HT discovery bioanalysis made it an ideal candidate for using software and automation tools to eliminate manual steps, remove bottlenecks, improve efficiency and reduce turnaround time while maintaining adequate quality. In this article we will review various recent developments that facilitate automation of individual bioanalytical procedures, such as sample preparation, MS/MS method development, sample analysis and data review, as well as fully integrated software tools that manage the entire bioanalytical workflow in HT discovery bioanalysis. In addition, software tools supporting the emerging high-resolution accurate MS bioanalytical approach are also discussed.

Appraisal of Emissions from Ocean-going Vessels Coming to Kolkata Port, India

NASA Astrophysics Data System (ADS)

Mandal, Anindita; Biswas, Jhumoor; Roychowdhury, Soma; Farooqui, Zuber M.

2017-12-01

Rapid economic growth has escalated India's share in international trade. The pressure on these ports, which handle a substantial portion of the trade, has increased to perform with optimal efficiency, and decrease turnaround time so as to increase the number of ships visiting the port area. The caveat is that increased shipping activity is accompanied by enhanced emissions of harmful pollutants and green house gases. This study has revealed increased turnaround time for ships resulting in substantial emissions from auxiliary engines. There should be an optimum balance between operational control and environmental control of pollutants. Kolkata is a megacity with active riverine ports that can generate high levels of air quality emissions, especially NOx, SOx and particulate matter. An exhaustive annual emissions inventory based on ocean going vessels activity has been developed for 2013-2014 for Kolkata port, using recent EPA approved methodology. This includes greenhouse gas emissions from marine engines as well. The study indicates that amongst the different categories of ocean going ships, containers contribute the most (49%) of air and greenhouse gas emissions in 75th percentile class and above followed by general cargo (14%) and oil tankers (13%). The study depicts existing status of marine emissions in Kolkata port from ocean going vessels, which would serve in development of integrated air quality and climate change management plans and serve as a prototype for other major ports of India.

Simulation of robotic courier deliveries in hospital distribution services.

PubMed

Rossetti, M D; Felder, R A; Kumar, A

2000-06-01

Flexible automation in the form of robotic couriers holds the potential for decreasing operating costs while improving delivery performance in hospital delivery systems. This paper discusses the use of simulation modeling to analyze the costs, benefits, and performance tradeoffs related to the installation and use of a fleet of robotic couriers within hospital facilities. The results of this study enable a better understanding of the delivery and transportation requirements of hospitals. Specifically, we examine how a fleet of robotic couriers can meet the performance requirements of the system while maintaining cost efficiency. We show that for clinical laboratory and pharmaceutical deliveries a fleet of six robotic couriers can achieve significant performance gains in terms of turn-around time and delivery variability over the current system of three human couriers per shift or 13 FTEs. Specifically, the simulation results indicate that using robotic couriers to perform both clinical laboratory and pharmaceutical deliveries would result in a 34% decrease in turn-around time, and a 38% decrease in delivery variability. In addition, a break-even analysis indicated that a positive net present value occurs if nine or more FTEs are eliminated with a resulting ROI of 12%. This analysis demonstrates that simulation can be a valuable tool for examining health care distribution services and indicates that a robotic courier system may yield significant benefits over a traditional courier system in this application.

Evolution of a residue laboratory network and the management tools for monitoring its performance.

PubMed

Lins, E S; Conceição, E S; Mauricio, A De Q

2012-01-01

Since 2005 the National Residue & Contaminants Control Plan (NRCCP) in Brazil has been considerably enhanced, increasing the number of samples, substances and species monitored, and also the analytical detection capability. The Brazilian laboratory network was forced to improve its quality standards in order to comply with the NRCP's own evolution. Many aspects such as the limits of quantification (LOQs), the quality management systems within the laboratories and appropriate method validation are in continuous improvement, generating new scenarios and demands. Thus, efficient management mechanisms for monitoring network performance and its adherence to the established goals and guidelines are required. Performance indicators associated to computerised information systems arise as a powerful tool to monitor the laboratories' activity, making use of different parameters to describe this activity on a day-to-day basis. One of these parameters is related to turnaround times, and this factor is highly affected by the way each laboratory organises its management system, as well as the regulatory requirements. In this paper a global view is presented of the turnaround times related to the type of analysis, laboratory, number of samples per year, type of matrix, country region and period of the year, all these data being collected from a computerised system called SISRES. This information gives a solid background to management measures aiming at the improvement of the service offered by the laboratory network.

Advanced Compatibility Characterization Of AF-M315E With Spacecraft Propulsion System Materials Project

NASA Technical Reports Server (NTRS)

McClure, Mark B.; Greene, Benjamin

2014-01-01

All spacecraft require propulsion systems for thrust and maneuvering. Propulsion systems can be chemical, nuclear, electrical, cold gas or combinations thereof. Chemical propulsion has proven to be the most reliable technology since the deployment of launch vehicles. Performance, storability, and handling are three important aspects of liquid chemical propulsion. Bipropellant systems require a fuel and an oxidizer for propulsion, but monopropellants only require a fuel and a catalyst for propulsion and are therefore simpler and lighter. Hydrazine is the state of the art propellant for monopropellant systems, but has drawbacks because it is highly hazardous to human health, which requires extensive care in handling, complex ground ops due to safety and environmental considerations, and lengthy turnaround times for reusable spacecraft. All users of hydrazine monopropellant must contend with these issues and their associated costs. The development of a new monopropellant, intended to replace hydrazine, has been in progress for years. This project will apply advanced techniques to characterize the engineering properties of materials used in AF-M315E propulsion systems after propellant exposure. AF-M315E monopropellant has been selected HQ's Green Propellant Infusion Mission (GPIM) to replace toxic hydrazine for improved performance and reduce safety and health issues that will shorten reusable spacecraft turn-around time. In addition, this project will fundamentally strengthen JSC's core competency to evaluate, use and infuse liquid propellant systems.

Intermediate Palomar Transient Factory: Realtime Image Subtraction Pipeline

DOE PAGES

Cao, Yi; Nugent, Peter E.; Kasliwal, Mansi M.

2016-09-28

A fast-turnaround pipeline for realtime data reduction plays an essential role in discovering and permitting followup observations to young supernovae and fast-evolving transients in modern time-domain surveys. In this paper, we present the realtime image subtraction pipeline in the intermediate Palomar Transient Factory. By using highperformance computing, efficient databases, and machine-learning algorithms, this pipeline manages to reliably deliver transient candidates within 10 minutes of images being taken. Our experience in using high-performance computing resources to process big data in astronomy serves as a trailblazer to dealing with data from large-scale time-domain facilities in the near future.

Intermediate Palomar Transient Factory: Realtime Image Subtraction Pipeline

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

Cao, Yi; Nugent, Peter E.; Kasliwal, Mansi M.

A fast-turnaround pipeline for realtime data reduction plays an essential role in discovering and permitting followup observations to young supernovae and fast-evolving transients in modern time-domain surveys. In this paper, we present the realtime image subtraction pipeline in the intermediate Palomar Transient Factory. By using highperformance computing, efficient databases, and machine-learning algorithms, this pipeline manages to reliably deliver transient candidates within 10 minutes of images being taken. Our experience in using high-performance computing resources to process big data in astronomy serves as a trailblazer to dealing with data from large-scale time-domain facilities in the near future.

Laboratory Automation and Middleware.

PubMed

Riben, Michael

2015-06-01

The practice of surgical pathology is under constant pressure to deliver the highest quality of service, reduce errors, increase throughput, and decrease turnaround time while at the same time dealing with an aging workforce, increasing financial constraints, and economic uncertainty. Although not able to implement total laboratory automation, great progress continues to be made in workstation automation in all areas of the pathology laboratory. This report highlights the benefits and challenges of pathology automation, reviews middleware and its use to facilitate automation, and reviews the progress so far in the anatomic pathology laboratory. Copyright © 2015 Elsevier Inc. All rights reserved.

Email notification combined with off site signing substantially reduces resident approval to faculty verification time.

PubMed

Deitte, Lori A; Moser, Patricia P; Geller, Brian S; Sistrom, Chris L

2011-06-01

Attending radiologist signature time (AST) is a variable and modifiable component of overall report turnaround time. Delays in finalized reports have potential to undermine radiologists' value as consultants and adversely affect patient care. This study was performed to evaluate the impact of notebook computer distribution and daily automated e-mail notification on reducing AST. Two simultaneous interventions were initiated in the authors' radiology department in February 2010. These included the distribution of a notebook computer with preloaded software for each attending radiologist to sign radiology reports and daily automated e-mail notifications for unsigned reports. The digital dictation system archive and the radiology information system were queried for all radiology reports produced from January 2009 through August 2010. The time between resident approval and attending radiologist signature before and after the intervention was analyzed. Potential unintended "side effects" of the intervention were also studied. Resident-authored reports were signed, on average, 2.53 hours sooner after the intervention. This represented a highly significant (P = .003) decrease in AST with all else held equal. Postintervention reports were authored by residents at the same rate (about 70%). An unintended "side effect" was that attending radiologists were less likely to make changes to resident-authored reports after the intervention. E-mail notification combined with offsite signing can reduce AST substantially. Notebook computers with preloaded software streamline the process of accessing, editing, and signing reports. The observed decrease in AST reflects a positive change in the timeliness of report signature. Copyright © 2011 AUR. Published by Elsevier Inc. All rights reserved.

Olefin unit primary fractionator on-line Petro-Blast Lancing

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

Adams, W.D.; Rutan, C.R.

1994-12-31

Today`s commodity chemicals market forces companies to find innovative ways to extend unit on line operation between turnarounds such that they will remain economically competitive. At the OxyChem Chocolate Bayou facility the Primary Fractionator, quench oil column, fouling defined the length of the run between Olefin Unit turnarounds. Polymer growth on the valve trays restricted vapor flow through the column. This increased the column pressure drop which resulted in severe flooding. The inability to cool the furnace effluent while separating the fuel oil and gasoline components would cause premature shutdowns. Fouling locations were defined using gamma scan techniques and pressuremore » surveys. Nozzles were welded and hot tapped at strategic locations around the column. A high pressure Petro-Blast Lancing technique, inserted through the nozzles, was then used to clean the trays. The operation has extended the unit run length although the column may require additional Petro-Blast Lancing before the next scheduled plant turnaround. If this schedule holds, a two year extension in the unit run length will be realized.« less

ATS simultaneous and turnaround ranging experiments

NASA Technical Reports Server (NTRS)

Watson, J. S.; Putney, B. H.

1971-01-01

This report explains the data reduction and spacecraft position determination used in conjunction with two ATS experiments - Trilateration and Turnaround Ranging - and describes in detail a multilateration program that is used for part of the data reduction process. The process described is for the determination of the inertial position of the satellite, and for formating input for related programs. In the trilateration procedure, a geometric determination of satellite position is made from near simultaneous range measurements made by three different tracking stations. Turnaround ranging involves two stations; one, the master station, transmits the signal to the satellite and the satellite retransmits the signal to the slave station which turns the signal around to the satellite which in turn retransmits the signal to the master station. The results of the satellite position computations using the multilateration program are compared to results of other position determination programs used at Goddard. All programs give nearly the same results which indicates that because of its simplicity and computational speed the trilateration technique is useful in obtaining spacecraft positions for near synchronous satellites.

The positive impact of simultaneous implementation of the BD FocalPoint GS Imaging System and lean principles on the operation of gynecologic cytology.

PubMed

Wong, Rebecca; Levi, Angelique W; Harigopal, Malini; Schofield, Kevin; Chhieng, David C

2012-02-01

Our cytology laboratory, like many others, is under pressure to improve quality and provide test results faster while decreasing costs. We sought to address these issues by introducing new technology and lean principles. To determine the combined impact of the FocalPoint Guided Screener (GS) Imaging System (BD Diagnostics-TriPath, Burlington, North Carolina) and lean manufacturing principles on the turnaround time (TAT) and productivity of the gynecologic cytology operation. We established a baseline measure of the TAT for Papanicolaou tests. We then compared that to the performance after implementing the FocalPoint GS Imaging System and lean principles. The latter included value-stream mapping, workflow modification, and a first in-first out policy. The mean (SD) TAT for Papanicolaou tests before and after the implementation of FocalPoint GS Imaging System and lean principles was 4.38 (1.28) days and 3.20 (1.32) days, respectively. This represented a 27% improvement in the average TAT, which was statistically significant (P < .001). In addition, the productivity of staff improved 17%, as evidenced by the increase in slides screened from 8.85/h to 10.38/h. The false-negative fraction decreased from 1.4% to 0.9%, representing a 36% improvement. In our laboratory, the implementation of FocalPoint GS Imaging System in conjunction with lean principles resulted in a significant decrease in the average TAT for Papanicolaou tests and a substantial increase in the productivity of cytotechnologists while maintaining the diagnostic quality of gynecologic cytology.

Histiocytoid Sweet Syndrome Diagnosed with Concurrent Myelodysplastic Syndrome with t(1;3) on Bone Marrow Examination

DTIC Science & Technology

2017-10-08

your materials. If you have any questions or concerns. please contact the 5g CRD/Publications and Presentations Section at 292-7141 for assistance. 8...and approval. 10. If your manuscript is accepted for scientific publication, please contact the 59 CRD/Publications and Presentations Section at 292...reduce turn-around time. If you have any questions regarding legal reviews, please contact the legal office at (210) 671-5795/3365, OSN 473. NOTE

Inertial Sensor Characterization for Inertial Navigation and Human Motion Tracking Applications

DTIC Science & Technology

2012-06-01

sensor to the pendulum. The time he took to design this part in SolidWorks so that I could have it printed on a 3D printer was greatly appreciated...I would also like to thank Daniel Sakoda for his quick turnaround in printing the mounting bracket using a 3D printer . Lastly, I would like to...sensors provide three-dimensional ( 3D ) orientation, acceleration, rate of turn, and magnetic field information. Manufacturers specify both static and

Holographic entanglement entropy and cyclic cosmology

NASA Astrophysics Data System (ADS)

Frampton, Paul H.

2018-06-01

We discuss a cyclic cosmology in which the visible universe, or introverse, is all that is accessible to an observer while the extroverse represents the total spacetime originating from the time when the dark energy began to dominate. It is argued that entanglement entropy of the introverse is the more appropriate quantity to render infinitely cyclic, rather than the entropy of the total universe. Since vanishing entanglement entropy implies disconnected spacetimes, at the turnaround when the introverse entropy is zero the disconnected extroverse can be jettisoned with impunity.

Advanced Concept

NASA Image and Video Library

2004-04-15

It is predicted that by the year 2040, there will be no distinction between a commercial airliner and a commercial launch vehicle. Fourth Generation Reusable Launch Vehicles (RLVs) will be so safe and reliable that no crew escape system will be necessary. Every year there will be in excess of 10,000 flights and the turn-around time between flights will be just hours. The onboard crew will be able to accomplish a launch without any assistance from the ground. Provided is an artist's concept of these fourth generation space vehicles.

Space Shuttle crew compartment debris-contamination

NASA Technical Reports Server (NTRS)

Goodman, Jerry R.; Villarreal, Leopoldo J.

1992-01-01

Remedial actions undertaken to reduce debris during manned flights and ground turnaround operations at Kennedy Space Center and Palmdale are addressed. They include redesign of selected ground support equipment and Orbiter hardware to reduce particularization/debris generation; development of new detachable filters for air-cooled avionics boxes; application of tape-on screens to filter debris; and implementation of new Orbiter maintenance and turnaround procedures to clean filters and the crew compartment. Most of these steps were implemented before the return-to-flight of STS-26 in September 1988 which resulted in improved crew compartment habitability and less potential for equipment malfunction.

Meeting the challenge of a group practice turnaround.

PubMed

Porn, L M

2001-03-01

Many healthcare organizations that acquired group practices to enhance their market share have found that the practices have not met their financial goals. Turning around a financially troubled, hospital-owned group practice is challenging but not impossible for healthcare organizations that take certain basic actions. Direction, data, desire, dedication, and drive must be present to effect the financial turnaround of a group practice. The healthcare organization needs to evaluate the practice's strategy and operations and identify the issues that are hindering the practice's ability to optimize revenues. Efforts to achieve profitable operations have to be ongoing.

Impact of GeneXpert MTB/RIF assay on triage of respiratory isolation rooms for inpatients with presumed tuberculosis: a hypothetical trial.

PubMed

Chaisson, Lelia H; Roemer, Marguerite; Cantu, David; Haller, Barbara; Millman, Alexander J; Cattamanchi, Adithya; Davis, J Lucian

2014-11-15

Placing inpatients with presumed active pulmonary tuberculosis in respiratory isolation pending results of serial sputum acid-fast bacilli (AFB) smear microscopy is standard practice in high-income countries. However, this diagnostic strategy is slow and yields few tuberculosis diagnoses. We sought to determine if replacing microscopy with the GeneXpert MTB/RIF (Xpert) nucleic acid amplification assay could reduce testing time and usage of isolation rooms. We prospectively followed inpatients at San Francisco General Hospital undergoing tuberculosis evaluation. We performed smear microscopy and Xpert testing on concentrated sputum, and calculated diagnostic accuracy for both strategies in reference to serial sputum mycobacterial culture. We measured turnaround time for microscopy and estimated hypothetical turnaround times for Xpert on concentrated and unconcentrated sputum. We compared median and total isolation times for microscopy to those estimated for the 2 Xpert strategies. Among 139 patients with 142 admissions, median age was 54 years (interquartile range [IQR], 43-60 years); 32 (23%) patients were female, and 42 (30%) were HIV seropositive. Serial sputum smear microscopy and a single concentrated sputum Xpert had identical sensitivity (89%; 95% confidence interval [CI], 52%-100%) and similar specificity (99% [95% CI, 96%-100%] vs 100% [95% CI, 97%-100%]). A single concentrated sputum Xpert could have saved a median of 35 hours (IQR, 24-36 hours) in unnecessary isolation compared with microscopy, and a single unconcentrated sputum Xpert, 45 hours (IQR, 35-46 hours). Replacing serial sputum smear microscopy with a single sputum Xpert could eliminate most unnecessary isolation for inpatients with presumed tuberculosis, greatly benefiting patients and hospitals. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

If you text them, they will come: using the HIV infant tracking system to improve early infant diagnosis quality and retention in Kenya.

PubMed

Finocchario-Kessler, Sarah; Gautney, Brad J; Khamadi, Samoel; Okoth, Vincent; Goggin, Kathy; Spinler, Jennifer K; Mwangi, Anne; Kimanga, Davies; Clark, Kristine F; Olungae, Helen D; Preidis, Geoffrey A

2014-07-01

The objective of this study is to evaluate the impact of the HIV Infant Tracking System (HITSystem) for quality improvement of early infant diagnosis (EID) of HIV services. This observational pilot study compared 12 months of historical preintervention EID outcomes at one urban and one peri-urban government hospital in Kenya to 12 months of intervention data to assess retention and time throughout the EID cascade of care. Mother-infant pairs enrolled in EID at participating hospitals before (n = 320) and during (n = 523) the HITSystem pilot were eligible to participate. The HITSystem utilizes Internet-based coordination of the multistep PCR cycle, automated alerts to trigger prompt action from providers and laboratory technicians, and text messaging to notify mothers when results are ready or additional action is needed. The main outcome measures were retention throughout EID services, meeting time-sensitive targets and improving results turn-around time, and increasing early antiretroviral therapy (ART) initiation among HIV-infected infants. The HITSystem was associated with an increase in the proportion of HIV-exposed infants retained in EID care at 9 months postnatal (45.1-93.0% urban; 43.2-94.1% peri-urban), a decrease in turn-around times between sample collection, PCR results and notification of mothers in both settings, and a significant increase in the proportion of HIV-infected infants started on antiretroviral therapy at each hospital(14 vs. 100% urban; 64 vs. 100% peri-urban). The HITSystem maximizes the use of easily accessible technology to improve the quality and efficiency of EID services in resource-limited settings.

Multi-centre evaluation of mass spectrometric identification of anaerobic bacteria using the VITEK® MS system.

PubMed

Garner, O; Mochon, A; Branda, J; Burnham, C-A; Bythrow, M; Ferraro, M; Ginocchio, C; Jennemann, R; Manji, R; Procop, G W; Richter, S; Rychert, J; Sercia, L; Westblade, L; Lewinski, M

2014-04-01

Accurate and timely identification of anaerobic bacteria is critical to successful treatment. Classic phenotypic methods for identification require long turnaround times and can exhibit poor species level identification. Matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) is an identification method that can provide rapid identification of anaerobes. We present a multi-centre study assessing the clinical performance of the VITEK(®) MS in the identification of anaerobic bacteria. Five different test sites analysed a collection of 651 unique anaerobic isolates comprising 11 different genera. Multiple species were included for several of the genera. Briefly, anaerobic isolates were applied directly to a well of a target plate. Matrix solution (α-cyano-4-hydroxycinnamic acid) was added and allowed to dry. Mass spectra results were generated with the VITEK(®) MS, and the comparative spectral analysis and organism identification were determined using the VITEK(®) MS database 2.0. Results were confirmed by 16S rRNA gene sequencing. Of the 651 isolates analysed, 91.2% (594/651) exhibited the correct species identification. An additional eight isolates were correctly identified to genus level, raising the rate of identification to 92.5%. Genus-level identification consisted of Actinomyces, Bacteroides and Prevotella species. Fusobacterium nucleatum, Actinomyces neuii and Bacteroides uniformis were notable for an increased percentage of no-identification results compared with the other anaerobes tested. VITEK(®) MS identification of clinically relevant anaerobes is highly accurate and represents a dramatic improvement over other phenotypic methods in accuracy and turnaround time. © 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.

Evaluation of whole genome sequencing and software tools for drug susceptibility testing of Mycobacterium tuberculosis.

PubMed

van Beek, J; Haanperä, M; Smit, P W; Mentula, S; Soini, H

2018-04-11

Culture-based assays are currently the reference standard for drug susceptibility testing for Mycobacterium tuberculosis. They provide good sensitivity and specificity but are time consuming. The objective of this study was to evaluate whether whole genome sequencing (WGS), combined with software tools for data analysis, can replace routine culture-based assays for drug susceptibility testing of M. tuberculosis. M. tuberculosis cultures sent to the Finnish mycobacterial reference laboratory in 2014 (n = 211) were phenotypically tested by Mycobacteria Growth Indicator Tube (MGIT) for first-line drug susceptibilities. WGS was performed for all isolates using the Illumina MiSeq system, and data were analysed using five software tools (PhyResSE, Mykrobe Predictor, TB Profiler, TGS-TB and KvarQ). Diagnostic time and reagent costs were estimated for both methods. The sensitivity of the five software tools to predict any resistance among strains was almost identical, ranging from 74% to 80%, and specificity was more than 95% for all software tools except for TGS-TB. The sensitivity and specificity to predict resistance to individual drugs varied considerably among the software tools. Reagent costs for MGIT and WGS were €26 and €143 per isolate respectively. Turnaround time for MGIT was 19 days (range 10-50 days) for first-line drugs, and turnaround time for WGS was estimated to be 5 days (range 3-7 days). WGS could be used as a prescreening assay for drug susceptibility testing with confirmation of resistant strains by MGIT. The functionality and ease of use of the software tools need to be improved. Copyright © 2018 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

A lightweight distributed framework for computational offloading in mobile cloud computing.

PubMed

Shiraz, Muhammad; Gani, Abdullah; Ahmad, Raja Wasim; Adeel Ali Shah, Syed; Karim, Ahmad; Rahman, Zulkanain Abdul

2014-01-01

The latest developments in mobile computing technology have enabled intensive applications on the modern Smartphones. However, such applications are still constrained by limitations in processing potentials, storage capacity and battery lifetime of the Smart Mobile Devices (SMDs). Therefore, Mobile Cloud Computing (MCC) leverages the application processing services of computational clouds for mitigating resources limitations in SMDs. Currently, a number of computational offloading frameworks are proposed for MCC wherein the intensive components of the application are outsourced to computational clouds. Nevertheless, such frameworks focus on runtime partitioning of the application for computational offloading, which is time consuming and resources intensive. The resource constraint nature of SMDs require lightweight procedures for leveraging computational clouds. Therefore, this paper presents a lightweight framework which focuses on minimizing additional resources utilization in computational offloading for MCC. The framework employs features of centralized monitoring, high availability and on demand access services of computational clouds for computational offloading. As a result, the turnaround time and execution cost of the application are reduced. The framework is evaluated by testing prototype application in the real MCC environment. The lightweight nature of the proposed framework is validated by employing computational offloading for the proposed framework and the latest existing frameworks. Analysis shows that by employing the proposed framework for computational offloading, the size of data transmission is reduced by 91%, energy consumption cost is minimized by 81% and turnaround time of the application is decreased by 83.5% as compared to the existing offloading frameworks. Hence, the proposed framework minimizes additional resources utilization and therefore offers lightweight solution for computational offloading in MCC.

Performance and user acceptance of the Bhutan febrile and malaria information system: report from a pilot study.

PubMed

Tobgay, Tashi; Samdrup, Pema; Jamtsho, Thinley; Mannion, Kylie; Ortega, Leonard; Khamsiriwatchara, Amnat; Price, Ric N; Thriemer, Kamala; Kaewkungwal, Jaranit

2016-01-29

Over the last decade, Bhutan has made substantial progress in controlling malaria. The country is now in an elimination phase, aiming to achieve no locally transmitted malaria by 2018. However, challenges remain and innovative control strategies are needed to overcome these. The evaluation and user acceptance of a robust surveillance tool applicable for informing malaria elimination activities is reported here. The Bhutan Febrile and Malaria Information System (BFMIS) is a combination of web-based and mobile technology that captures malariometric surveillance data and generates real time reports. The system was rolled out at six sites and data uploaded regularly for analysis. Data completeness, accuracy and data turnaround time were accessed by comparison to traditional paper based surveillance records. User acceptance and willingness for further roll out was assessed using qualitative and quantitative data. Data completeness was nearly 10 % higher using the electronic system than the paper logs, and accuracy and validity of both approaches was comparable (up to 0.05 % in valid data and up to 3.06 % inaccurate data). Data turnaround time was faster using the BFMIS. General user satisfaction with the BFMIS was high, with high willingness of health facilities to adopt the system. Qualitative interviews revealed several areas for improvement before scale up. The BFMIS had numerous advantages over the paper-based system and based on the findings of the survey the Vector-Borne Disease Control Programme has taken the decision to incorporate the BMFIS and expand its use throughout all areas at risk for malaria as a key surveillance tool.

Translating a National Laboratory Strategic Plan into action through SLMTA in a district hospital laboratory in Botswana.

PubMed

Ntshambiwa, Keoratile; Ntabe-Jagwer, Winnie; Kefilwe, Chandapiwa; Samuel, Fredrick; Moyo, Sikhulile

2014-01-01

The Ministry of Health (MOH) of Botswana adopted Strengthening Laboratory Management Toward Accreditation (SLMTA), a structured quality improvement programme, as a key tool for the implementation of quality management systems in its public health laboratories. Coupled with focused mentorship, this programme aimed to help MOH achieve the goals of the National Laboratory Strategic Plan to provide quality and timely clinical diagnoses. This article describes the impact of implementing SLMTA in Sekgoma Memorial Hospital Laboratory (SMHL) in Serowe, Botswana. SLMTA implementation in SMHL included trainings, improvement projects, site visits and focused mentorship. To measure progress, audits using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist were conducted at baseline and exit of the programme, with scores corresponding to a zero- to five-star scale. Turnaround times, customer satisfaction, and several other health service indicators were tracked. The laboratory scored 53% (zero stars) at the baseline audit and 80% (three stars) at exit. Nearly three years later, the laboratory scored 85% (four stars) in an official audit conducted by the African Society for Laboratory Medicine. Turnaround times became shorter after SLMTA implementation, with reductions ranging 19% to 52%; overall patient satisfaction increased from 56% to 73%; and clinician satisfaction increased from 41% to 72%. Improvements in inventory management led to decreases in discarded reagents, reducing losses from US $18 000 in 2011 to $40 in 2013. The SLMTA programme contributed to enhanced performance of the laboratory, which in turn yielded potential positive impacts for patient care at the hospital.

A Lightweight Distributed Framework for Computational Offloading in Mobile Cloud Computing

PubMed Central

Shiraz, Muhammad; Gani, Abdullah; Ahmad, Raja Wasim; Adeel Ali Shah, Syed; Karim, Ahmad; Rahman, Zulkanain Abdul

2014-01-01

The latest developments in mobile computing technology have enabled intensive applications on the modern Smartphones. However, such applications are still constrained by limitations in processing potentials, storage capacity and battery lifetime of the Smart Mobile Devices (SMDs). Therefore, Mobile Cloud Computing (MCC) leverages the application processing services of computational clouds for mitigating resources limitations in SMDs. Currently, a number of computational offloading frameworks are proposed for MCC wherein the intensive components of the application are outsourced to computational clouds. Nevertheless, such frameworks focus on runtime partitioning of the application for computational offloading, which is time consuming and resources intensive. The resource constraint nature of SMDs require lightweight procedures for leveraging computational clouds. Therefore, this paper presents a lightweight framework which focuses on minimizing additional resources utilization in computational offloading for MCC. The framework employs features of centralized monitoring, high availability and on demand access services of computational clouds for computational offloading. As a result, the turnaround time and execution cost of the application are reduced. The framework is evaluated by testing prototype application in the real MCC environment. The lightweight nature of the proposed framework is validated by employing computational offloading for the proposed framework and the latest existing frameworks. Analysis shows that by employing the proposed framework for computational offloading, the size of data transmission is reduced by 91%, energy consumption cost is minimized by 81% and turnaround time of the application is decreased by 83.5% as compared to the existing offloading frameworks. Hence, the proposed framework minimizes additional resources utilization and therefore offers lightweight solution for computational offloading in MCC. PMID:25127245

National survey on turnaround time of clinical biochemistry tests in 738 laboratories in China.

PubMed

Zhang, Xiaoyan; Fei, Yang; Wang, Wei; Zhao, Haijian; Wang, Minqi; Chen, Bingquan; Zhou, Jie; Wang, Zhiguo

2018-02-01

This survey was initiated to estimate the current status of turnaround time (TAT) monitoring of clinical biochemistry in China, provide baseline data for establishment of quality specifications and analyze the impact factors of TAT. 738 laboratories were included. Questionnaires involved general information and data of related indicators of TAT during 1 week were provided to participating laboratories. Nine quality indicators were covered, which were medians, 90th and outlier rates of pre-examination, examination, and post-examination TAT. The 25th percentile, median, and 75th percentile of TATs were calculated as optimum, desirable, and minimum quality specifications. Percentages and sigma values were used to describe the outlier rates. Mann-Whitney and Kruskal-Wallis tests were used to identify the potential impacts of TAT. Response rate of this survey was 46.44%. More than 50% of the laboratories indicated they had set up target TATs in three time intervals and monitored TATs generally. The post-examination TAT of most laboratories was 0min, while the pre-examination and examination TAT varied. Sigma values of outlier rates for 45%~60% of laboratories were above 4, while 15%~20% of labs whose sigma values were below 3. Group comparisons suggested nurse or mechanical pipeline transportation, link laboratory information system with hospital information system, and using computer reporting instead of printing report were related to shorter TATs. Despite of the remarkable progresses of TATs in China, there was also room to improve. Laboratories should strengthen the construction of information systems, identify reasons for TAT delay to improve the service quality continuously. © 2017 Wiley Periodicals, Inc.

4th generation HIV screening in Massachusetts: a partnership between laboratory and program.

PubMed

Goodhue, Tammy; Kazianis, Arthur; Werner, Barbara G; Stiles, Tracy; Callis, Barry P; Dawn Fukuda, H; Cranston, Kevin

2013-12-01

The Massachusetts Department of Public Health's (MDPH) Office of HIV/AIDS (OHA) and Hinton State Laboratory Institute (HSLI) have offered HIV screening since 1985. Point-of-care screening and serum collection for laboratory-based testing is conducted at clinic and non-clinic-based sites across Massachusetts as part of an integrated communicable disease screening intervention. MDPH aimed to transition to a 4th generation HIV screening-based algorithm for testing all serum specimens collected at OHA-funded programs and submitted to the HSLI to detect acute HIV infections, detect and differentiate HIV-1 and HIV-2 infections, eliminate indeterminate results, reduce cost and turnaround time, and link newly diagnosed HIV+ individuals to care. The HSLI and OHA created a joint project management team to plan and lead the transition. The laboratory transitioned successfully to a 4th generation screening assay as part of a revised diagnostic algorithm. In the 12 months since implementation, a total of 7984 serum specimens were tested with 258 (3.2%) positive for HIV-1 and one positive for HIV-2. Eight were reported as acute HIV-1 infections. These individuals were linked to medical care and partner services in a timely manner. Turnaround time was reduced and the laboratory realized an overall cost savings of approximately 15%. The identification of eight acute HIV infections in the first year underscores the importance of using the most sensitive screening tests available. A multi-disciplinary program and laboratory team was critical to the success of the transition, and the lessons learned may be useful for other jurisdictions. Published by Elsevier B.V.

Aiming at "de feet" and diabetes: a rural model to increase annual foot examinations.

PubMed

Beem, Susie E; Machala, Margaret; Holman, Craig; Wraalstad, Randal; Bybee, Ann

2004-10-01

Something is afoot in south central Idaho. After 2 years of work, the percentage of people with diabetes receiving recommended annual foot examinations has increased by 13.8%, exceeding the state average. This turnaround, from being the region with the lowest percentage of foot examinations in the state, was made possible when South Central District Health joined diabetes coalition members to develop a comprehensive program that maximizes limited resources in the rural, 8-county service area. Key program components include (1) development of a curriculum on CD-ROM called 2 Minute Diabetes Foot Examination, (2) training area physicians and nurses in the curriculum, (3) incorporating the curriculum into the nursing program at the local college, (4) offering free foot-screening clinics to targeted populations, and (5) conducting public education and outreach.

Aiming at “De Feet” and Diabetes: A Rural Model to Increase Annual Foot Examinations

PubMed Central

Beem, Susie E.; Machala, Margaret; Holman, Craig; Wraalstad, Randal; Bybee, Ann

2004-01-01

Something is afoot in south central Idaho. After 2 years of work, the percentage of people with diabetes receiving recommended annual foot examinations has increased by 13.8%, exceeding the state average. This turnaround, from being the region with the lowest percentage of foot examinations in the state, was made possible when South Central District Health joined diabetes coalition members to develop a comprehensive program that maximizes limited resources in the rural, 8-county service area. Key program components include (1) development of a curriculum on CD-ROM called 2 Minute Diabetes Foot Examination, (2) training area physicians and nurses in the curriculum, (3) incorporating the curriculum into the nursing program at the local college, (4) offering free foot-screening clinics to targeted populations, and (5) conducting public education and outreach. PMID:15451726

The radiology digital dashboard: effects on report turnaround time.

PubMed

Morgan, Matthew B; Branstetter, Barton F; Lionetti, David M; Richardson, Jeremy S; Chang, Paul J

2008-03-01

As radiology departments transition to near-complete digital information management, work flows and their supporting informatics infrastructure are becoming increasingly complex. Digital dashboards can integrate separate computerized information systems and summarize key work flow metrics in real time to facilitate informed decision making. A PACS-integrated digital dashboard function designed to alert radiologists to their unsigned report queue status, coupled with an actionable link to the report signing application, resulted in a 24% reduction in the time between transcription and report finalization. The dashboard was well received by radiologists who reported high usage for signing reports. Further research is needed to identify and evaluate other potentially useful work flow metrics for inclusion in a radiology clinical dashboard.

Conversion-Integration of MSFC Nonlinear Signal Diagnostic Analysis Algorithms for Realtime Execution of MSFC's MPP Prototype System

NASA Technical Reports Server (NTRS)

Jong, Jen-Yi

1996-01-01

NASA's advanced propulsion system Small Scale Magnetic Disturbances/Advanced Technology Development (SSME/ATD) has been undergoing extensive flight certification and developmental testing, which involves large numbers of health monitoring measurements. To enhance engine safety and reliability, detailed analysis and evaluation of the measurement signals are mandatory to assess its dynamic characteristics and operational condition. Efficient and reliable signal detection techniques will reduce the risk of catastrophic system failures and expedite the evaluation of both flight and ground test data, and thereby reduce launch turn-around time. During the development of SSME, ASRI participated in the research and development of several advanced non- linear signal diagnostic methods for health monitoring and failure prediction in turbomachinery components. However, due to the intensive computational requirement associated with such advanced analysis tasks, current SSME dynamic data analysis and diagnostic evaluation is performed off-line following flight or ground test with a typical diagnostic turnaround time of one to two days. The objective of MSFC's MPP Prototype System is to eliminate such 'diagnostic lag time' by achieving signal processing and analysis in real-time. Such an on-line diagnostic system can provide sufficient lead time to initiate corrective action and also to enable efficient scheduling of inspection, maintenance and repair activities. The major objective of this project was to convert and implement a number of advanced nonlinear diagnostic DSP algorithms in a format consistent with that required for integration into the Vanderbilt Multigraph Architecture (MGA) Model Based Programming environment. This effort will allow the real-time execution of these algorithms using the MSFC MPP Prototype System. ASRI has completed the software conversion and integration of a sequence of nonlinear signal analysis techniques specified in the SOW for real-time execution on MSFC's MPP Prototype. This report documents and summarizes the results of the contract tasks; provides the complete computer source code; including all FORTRAN/C Utilities; and all other utilities/supporting software libraries that are required for operation.

Going digital: a narrative overview of the clinical and organisational impacts of eHealth technologies in hospital practice.

PubMed

Keasberry, Justin; Scott, Ian A; Sullivan, Clair; Staib, Andrew; Ashby, Richard

2017-12-01

Objective The aim of the present study was to determine the effects of hospital-based eHealth technologies on quality, safety and efficiency of care and clinical outcomes. Methods Systematic reviews and reviews of systematic reviews of eHealth technologies published in PubMed/Medline/Cochrane Library between January 2010 and October 2015 were evaluated. Reviews of implementation issues, non-hospital settings or remote care or patient-focused technologies were excluded from analysis. Methodological quality was assessed using a validated appraisal tool. Outcome measures were benefits and harms relating to electronic medical records (EMRs), computerised physician order entry (CPOE), electronic prescribing (ePrescribing) and computerised decision support systems (CDSS). Results are presented as a narrative overview given marked study heterogeneity. Results Nineteen systematic reviews and two reviews of systematic reviews were included from 1197 abstracts, nine rated as high quality. For EMR functions, there was moderate-quality evidence of reduced hospitalisations and length of stay and low-quality evidence of improved organisational efficiency, greater accuracy of information and reduced documentation and process turnaround times. For CPOE functions, there was moderate-quality evidence of reductions in turnaround times and resource utilisation. For ePrescribing, there was moderate-quality evidence of substantially fewer medications errors and adverse drug events, greater guideline adherence, improved disease control and decreased dispensing turnaround times. For CDSS, there was moderate-quality evidence of increased use of preventive care and drug interaction reminders and alerts, increased use of diagnostic aids, more appropriate test ordering with fewer tests per patient, greater guideline adherence, improved processes of care and less disease morbidity. There was conflicting evidence regarding effects on in-patient mortality and overall costs. Reported harms were alert fatigue, increased technology interaction time, creation of disruptive workarounds and new prescribing errors. Conclusion eHealth technologies in hospital settings appear to improve efficiency and appropriateness of care, prescribing safety and disease control. Effects on mortality, readmissions, total costs and patient and provider experience remain uncertain. What is known about the topic? Healthcare systems internationally are undertaking large-scale digitisation programs with hospitals being a major focus. Although predictive analyses suggest that eHealth technologies have the potential to markedly transform health care delivery, contemporary peer-reviewed research evidence detailing their benefits and harms is limited. What does this paper add? This narrative overview of 19 systematic reviews and two reviews of systematic reviews published over the past 5 years provides a summary of cumulative evidence of clinical and organisational effects of contemporary eHealth technologies in hospital practice. EMRs have the potential to increase accuracy and completeness of clinical information, reduce documentation time and enhance information transfer and organisational efficiency. CPOE appears to improve laboratory turnaround times and decrease resource utilisation. ePrescribing significantly reduces medication errors and adverse drug events. CDSS, especially those used at the point of care and integrated into workflows, attract the strongest evidence for substantially increasing clinician adherence to guidelines, appropriateness of disease and treatment monitoring and optimal medication use. Evidence of effects of eHealth technologies on discrete clinical outcomes, such as morbid events, mortality and readmissions, is currently limited and conflicting. What are the implications for practitioners? eHealth technologies confer benefits in improving quality and safety of care with little evidence of major hazards. Whether EMRs and CPOE can affect clinical outcomes or overall costs in the absence of auxiliary support systems, such as ePrescribing and CDSS, remains unclear. eHealth technologies are evolving rapidly and the evidence base used to inform clinician and managerial decisions to invest in these technologies must be updated continually. More rigorous field research using appropriate evaluation methods is needed to better define real-world benefits and harms. Customisation of eHealth applications to the context of patient-centred care and management of highly complex patients with multimorbidity will be an ongoing challenge.

Development of Report Turnaround Times in a University Department of Radiology during Implementation of a Reformed Curriculum for Undergraduate Medical Education.

PubMed

Albrecht, Liane; Maurer, Martin H; Seithe, Tim; Braun, Joachim; Gummert, Richard; Auer, Jonas; Sponheuer, Keno; Meyl, Tobias Philipp; Hamm, Bernd; de Bucourt, Maximilian

2018-03-01

 The implementation of a reformed curriculum for undergraduate medical education with a problem-oriented focus and more bedside teaching in small groups increases the academic teaching workload. The aim of this study was to investigate whether this increase in teaching duties is associated with an increase in report turnaround times of radiologists or increased unplanned absence during term times compared with term breaks (lecture-free periods) and over the whole period under investigation.  The database of all radiological examinations performed at a large German university hospital was retrospectively analyzed for a two-year period from the winter term 2011/12 to the summer term 2013. A total of 192 984 radiological examinations performed during this period were included in an analysis of reporting times (i. e., time from end of examination to completion of report) during term times versus term breaks. Reporting times were analyzed for all radiological examinations and for intensive care unit (ICU) patients. In addition, radiologists' schedules were analyzed in terms of teaching duties, unplanned absence, vacation days, and days away from work for education and training.  During the period under investigation, the teaching load increased from overall 1.75 hours/day in the winter term 2011/12 to 6.49 hours/day in the summer term 2013 and in the term break from overall 0.10 hours/day in the winter term 2011/12 to 0.71 hours/day in the summer term 2013. Reporting time increased during this period (p < 0.05) but remained shorter during term times than during term breaks. The difference between term and term break for ICU patients was not significant. There was no increase in unplanned absences during term times.  Overall, radiologists' reporting times increased during the period when the reformed curriculum for undergraduate medical education was implemented. As this was observed both during term and during term breaks, increased teaching duties alone cannot serve as a sole causal explanation. · Digital high-quantitative parameters can be used to evaluate workflow in radiology.. · Reporting time can be a criterion for efficient staffing.. · The acquisition and evaluation of parameters such as reporting times could lead to a more efficient resource allocation by providing hints of changed framework conditions and changing working intensities and/or capicity reserves - which may not be immediately apparent.. · During the period under investigation with the implementation of a teaching-intensive reformed curriculum for undergraduate medical education there was an increase in reporting time, which was not significant in intense care units.. · Since during the period under investigation the increase in reporting times can be stated both during term time and in the lecture free period, the implementation of the reformed curriculum for undergraduate medical education alone cannot serve as a sole causal explanation.. · Albrecht L, Maurer MH, Seithe T et al. Development of the Report Turnaround Times in a University Department of Radiology during Implementation of a Reformed Curriculum for Undergraduate Medical Education. Fortschr Röntgenstr 2018; 190: 259 - 264. © Georg Thieme Verlag KG Stuttgart · New York.

Block-structured grids for complex aerodynamic configurations: Current status

NASA Technical Reports Server (NTRS)

Vatsa, Veer N.; Sanetrik, Mark D.; Parlette, Edward B.

1995-01-01

The status of CFD methods based on the use of block-structured grids for analyzing viscous flows over complex configurations is examined. The objective of the present study is to make a realistic assessment of the usability of such grids for routine computations typically encountered in the aerospace industry. It is recognized at the very outset that the total turnaround time, from the moment the configuration is identified until the computational results have been obtained and postprocessed, is more important than just the computational time. Pertinent examples will be cited to demonstrate the feasibility of solving flow over practical configurations of current interest on block-structured grids.

Geophysical Research Letters: New policies improve top-cited geosciences journal

USGS Publications Warehouse

Calais, Eric; Diffenbaugh, Noah; D'Odorico, Paolo; Harris, Ruth; Knorr, Wolfgang; Lavraud, Benoit; Mueller, Anne; Peterson, William; Rignot, Eric; Srokosz, Meric; Strutton, Peter; Tyndall, Geoff; Wysession, Michael; Williams, Paul

2010-01-01

Geophysical Research Letters (GRL) is the American Geophysical Union's premier journal of fast, groundbreaking communication. It rapidly publishes high- impact,letter-length articles, and it is the top-cited multidisciplinary geosciences journal over the past 10 years, with an impact factor that increased again in 2009, to 3.204. For manuscripts submitted to GRL, the median time to first and final decision is 23 and 27 days, respectively—a 35% improvement since 2007—and the median time from submission to publication is 13 weeks for 90% of GRL papers—a 25% improvement since 2007. Among high-impact publications in the geosciences, GRL has the fastest turnaround.

Predictors of Chain Acquisition among Independent Dialysis Facilities

PubMed Central

Pozniak, Alyssa S; Hirth, Richard A; Banaszak-Holl, Jane; Wheeler, John R C

2010-01-01

Objective To determine the predictors of chain acquisition among independent dialysis providers. Data Sources Retrospective facility-level data combined from CMS Cost Reports, Medical Evidence Forms, Annual Facility Surveys, and claims for 1996–2003. Study Design Independent dialysis facilities' probability of acquisition by a dialysis chain (overall and by chain size) was estimated using a discrete time hazard rate model, controlling for financial and clinical performance, practice patterns, market factors, and other facility characteristics. Data Collection The sample includes all U.S. freestanding dialysis facilities that report not being chain affiliated for at least 1 year between 1997 and 2003. Principal Findings Above-average costs and better quality outcomes are significant determinants of dialysis chain acquisition. Facilities in larger markets were more likely to be acquired by a chain. Furthermore, small dialysis chains have different acquisition strategies than large chains. Conclusions Dialysis chains appear to employ a mix of turn-around and cream-skimming strategies. Poor financial health is a predictor of chain acquisition as in other health care sectors, but the increased likelihood of chain acquisition among higher quality facilities is unique to the dialysis industry. Significant differences among predictors of acquisition by small and large chains reinforce the importance of using a richer classification for chain status. PMID:20148985

Evaluation of GeneXpert MTB/RIF for detecting Mycobacterium tuberculosis in a hospital in China.

PubMed

Tang, Tingyu; Liu, Fang; Lu, Xiaoling; Huang, Qingdong

2017-04-01

Objective To evaluate the performance of GeneXpert MTB/RIF in diagnosing pulmonary tuberculosis (TB) in China. Methods This cross-sectional study included sputum specimens of 240 suspected TB cases. Specimens were examined by light microscopy for the presence of acid-fast bacilli, which were cultured by the BACTEC MGIT 960 (M960) system and detected by the GeneXpert MTB/RIF assay. The positive rate, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and average turnaround time of methods were evaluated. Results The positive rate was 36.6% (87/238) for the GeneXpert MTB/RIF assay and 34.0% (81/238) by M960 culture, with no significant difference between methods (χ 2  = 0.33, p > 0.05). According to culture results, sensitivity of the GeneXpert MTB/RIF assay was 84.0% (68/81), specificity was 87.8% (129/147), the PPV was 78.2% (68/87), and the NPV was 87.2% (129/148). The agreement for results between Gene Xpert MTB/RIF and the M960 system was 82.8% and the Kappa value was 0.73. Conclusion The GeneXpert MTB/RIF assay is a simple, rapid, and accurate test for detecting Mycobacterium tuberculosis in sputum specimens.

Analysis of N-Nitrosodimethylamine and N-Nitrodimethylamine in Groundwater

NASA Technical Reports Server (NTRS)

Greene, Ben; Mast, Dion; Baker, David L.

2006-01-01

A method for the analytical determination of N-nitrosodimethylamine (NDMA) and N-nitrodimethylamine (DMN) at parts-per-trillion (ppt) concentrations in groundwater is reported. The method uses a solid phase extraction (SPE) cartridge containing 2 g of activated coconut charcoal to extract a 500-mL water sample. NDMA and DMN are eluted from the SPE cartridge using acetone. The acetone is concentrated and brought to a final volume of 1.0 mL, which results in a theoretical 500-fold concentration of the analytes. The extracts are analyzed by gas chromatography (GC) with a nitrogenphosphorous detector (NPD), which is a highly sensitive and relatively inexpensive technique. The measured extraction efficiencies averaged 61 percent for NDMA and 74 percent for DMN. Extraction efficiencies were independent of NDMA and DMN concentrations from 40 to 2000 ppt. Several samples could be extracted then analyzed in a single day with the use of an extraction manifold and GC autosampler. A reporting limit of 10 ppt for NDMA and DMN was achieved. The MDLs for NDMA and DMN were 6.4 and 5.8 ppt, respectively. A typical turn-around time from beginning of extraction to reporting was 4 h. The method avoids the use of halogenated solvents, such as dichloromethane, and subsequent solvent exchange procedures necessary for use of the NPD detector.

Are commercial providers a viable option for clinical bacterial sequencing?

PubMed

Raven, Kathy; Blane, Beth; Churcher, Carol; Parkhill, Julian; Peacock, Sharon J

2018-04-05

Bacterial whole-genome sequencing in the clinical setting has the potential to bring major improvements to infection control and clinical practice. Sequencing instruments are not currently available in the majority of routine microbiology laboratories worldwide, but an alternative is to use external sequencing providers. To foster discussion around this we investigated whether send-out services were a viable option. Four providers offering MiSeq sequencing were selected based on cost and evaluated based on the service provided and sequence data quality. DNA was prepared from five methicillin-resistant Staphylococcus aureus (MRSA) isolates, four of which were investigated during a previously published outbreak in the UK together with a reference MRSA isolate (ST22 HO 5096 0412). Cost of sequencing per isolate ranged from £155 to £342 and turnaround times from DNA postage to arrival of sequence data ranged from 12 to 63 days. Comparison of commercially generated genomes against the original sequence data demonstrated very high concordance, with no more than one single nucleotide polymorphism (SNP) difference on core genome mapping between the original sequences and the new sequence for all four providers. Multilocus sequence type could not be assigned based on assembly for the two cheapest sequence providers due to fragmented assemblies probably caused by a lower output of sequence data per isolate. Our results indicate that external providers returned highly accurate genome data, but that improvements are required in turnaround time to make this a viable option for use in clinical practice.

Physician satisfaction with clinical laboratory services: a College of American Pathologists Q-probes study of 138 institutions.

PubMed

Jones, Bruce A; Bekeris, Leonas G; Nakhleh, Raouf E; Walsh, Molly K; Valenstein, Paul N

2009-01-01

Monitoring customer satisfaction is a valuable component of a laboratory quality improvement program. To survey the level of physician satisfaction with hospital clinical laboratory services. Participating institutions provided demographic and practice information and survey results of physician satisfaction with defined aspects of clinical laboratory services, rated on a scale of 1 (poor) to 5 (excellent). One hundred thirty-eight institutions participated in this study and submitted a total of 4329 physician surveys. The overall satisfaction score for all institutions ranged from 2.9 to 5.0. The median overall score for all participants was 4.1 (10th percentile, 3.6; 90th percentile, 4.5). Physicians were most satisfied with the quality/reliability of results and staff courtesy, with median values of excellent or good ratings of 89.9%. Of the 5 service categories that received the lowest percentage values of excellent/good ratings (combined scores of 4 and 5), 4 were related to turnaround time for inpatient stat, outpatient stat, routine, and esoteric tests. Surveys from half of the participating laboratories reported that 96% to 100% of physicians would recommend the laboratory to other physicians. The category most frequently selected as the most important category of laboratory services was quality/reliability of results (31.7%). There continues to be a high level of physician satisfaction and loyalty with clinical laboratory services. Test turnaround times are persistent categories of dissatisfaction and present opportunities for improvement.

From customer satisfaction survey to corrective actions in laboratory services in a university hospital.

PubMed

Oja, Paula I; Kouri, Timo T; Pakarinen, Arto J

2006-12-01

To find out the satisfaction of clinical units with laboratory services in a university hospital, to point out the most important problems and defects in services, to carry out corrective actions, and thereafter to identify the possible changes in satisfaction. and Senior physicians and nurses-in-charge of the clinical units at Oulu University Hospital, Finland. Customer satisfaction survey using a questionnaire was carried out in 2001, indicating the essential aspects of laboratory services. Customer-specific problems were clarified, corrective actions were performed, and the survey was repeated in 2004. In 2001, the highest dissatisfaction rates were recorded for computerized test requesting and reporting, turnaround times of tests, and the schedule of phlebotomy rounds. The old laboratory information system was not amenable to major improvements, and it was renewed in 2004-05. Several clinical units perceived turnaround times to be long, because the tests were ordered as routine despite emergency needs. Instructions about stat requesting were given to these units. However, no changes were evident in the satisfaction level in the 2004 survey. Following negotiations with the clinics, phlebotomy rounds were re-scheduled. This resulted in a distinct increase in satisfaction in 2004. Satisfaction survey is a screening tool that identifies topics of dissatisfaction. Without further clarifications, it is not possible to find out the specific problems of customers and to undertake targeted corrective actions. Customer-specific corrections are rarely seen as improvements in overall satisfaction rates.

Trends in Testing for Mycobacterium tuberculosis Complex From US Public Health Laboratories, 2009-2013.

PubMed

Tyrrell, Frances; Stafford, Cortney; Yakrus, Mitchell; Youngblood, Monica; Hill, Andrew; Johnston, Stephanie

We investigated data from US public health laboratories funded through the Centers for Disease Control and Prevention's Tuberculosis Elimination and Laboratory Cooperative Agreement to document trends and challenges in meeting national objectives in tuberculosis (TB) laboratory diagnoses. We examined data on workload and turnaround time from public health laboratories' progress reports during 2009-2013. We reviewed methodologies, laboratory roles, and progress toward rapid detection of Mycobacterium tuberculosis complex through nucleic acid amplification (NAA) testing. We compared selected data with TB surveillance reports to estimate public health laboratories' contribution to national diagnostic services. During the study period, culture and drug susceptibility tests decreased, but NAA testing increased. Public health laboratories achieved turnaround time benchmarks for drug susceptibility tests at lower levels than for acid-fast bacilli smear and identification from culture. NAA positivity in laboratories among surveillance-reported culture-positive TB cases increased from 26.6% (2355 of 8876) in 2009 to 40.0% (2948 of 7358) in 2013. Public health laboratories provided an estimated 50.9% (4285 of 8413 in 2010) to 57.2% (4210 of 7358 in 2013) of culture testing and 88.3% (6822 of 7727 in 2011) to 94.4% (6845 of 7250 in 2012) of drug susceptibility tests for all US TB cases. Public health laboratories contribute substantially to TB diagnoses in the United States. Although testing volumes mostly decreased, the increase in NAA testing indicates continued progress in rapid M tuberculosis complex detection.

NASA Advanced Concepts Office, Earth-To-Orbit Team Design Process and Tools

NASA Technical Reports Server (NTRS)

Waters, Eric D.; Garcia, Jessica; Beers, Benjamin; Philips, Alan; Holt, James B.; Threet, Grady E., Jr.

2013-01-01

The Earth to Orbit (ETO) Team of the Advanced Concepts Office (ACO) at NASA Marshal Space Flight Center (MSFC) is considered the preeminent group to go to for prephase A and phase A concept definition. The ACO team has been at the forefront of a multitude of launch vehicle studies determining the future direction of the Agency as a whole due, in part, to their rapid turnaround time in analyzing concepts and their ability to cover broad trade spaces of vehicles in that limited timeframe. Each completed vehicle concept includes a full mass breakdown of each vehicle to tertiary subsystem components, along with a vehicle trajectory analysis to determine optimized payload delivery to specified orbital parameters, flight environments, and delta v capability. Additionally, a structural analysis of the vehicle based on material properties and geometries is performed as well as an analysis to determine the flight loads based on the trajectory outputs. As mentioned, the ACO Earth to Orbit Team prides themselves on their rapid turnaround time and often need to fulfill customer requests within limited schedule or little advanced notice. Due to working in this fast paced environment, the ETO team has developed some finely honed skills and methods to maximize the delivery capability to meet their customer needs. This paper will describe the interfaces between the 3 primary disciplines used in the design process; weights and sizing, trajectory, and structural analysis, as well as the approach each discipline employs to streamline their particular piece of the design process.

Development and validation of a real-time TaqMan assay for the detection and enumeration of Pseudomonas fluorescens ATCC 13525 used as a challenge organism in testing of food equipments.

PubMed

Saha, Ratul; Bestervelt, Lorelle L; Donofrio, Robert S

2012-02-01

Pseudomonas fluorescens ATCC 13525 is used as the challenge organism to evaluate the efficacy of the clean-in-place (CIP) process of food equipment (automatic ice-maker) as per NSF/ANSI Standard 12. Traditional culturing methodology is presently used to determine the concentration of the challenge organism, which takes 48 h to confirm the cell density. Storage of the challenge preparation in the refrigerator might alter the cell density as P. fluorescens is capable of growing at 4 °C. Also, background organism can grow on the Pseudomonas F agar (PFA) used for the recovery of P. fluorescens thus affecting the results of the test. Real-time TaqMan assay targeting the cpn60 gene was developed for the enumeration and the identification of P. fluorescens because of its specificity, accuracy, and shorter turnaround time. The TaqMan primer-probe pair developed using the Allele ID® 7.0 probe design software was highly specific and sensitive for the target organism. The sensitivity of the assay was 10 colony forming units (CFU)/mL. The assay was also successful in determining the concentration of the challenge preparation within 2 h. Based on these observations, TaqMan assay targeting the cpn60 gene can be efficiently used for strain level identification and enumeration of bacteria. Pseudomonas fluorescens ATCC 13525 is used as a challenge organism in the efficacy testing of clean-in-place process of food equipments. Currently, culturing technique is used for its identification and estimation, which is not only time-consuming but also prone to error. Real-time TaqMan assay is more specific, sensitive, and accurate along with a shorter turnaround time compared to culturing techniques, thereby increasing the overall quality of the testing methodology to evaluate the clean-in-place process critical for the food industry to protect public health and safety. © 2012 Institute of Food Technologists®

Into the black. 1993 Hospital Turnaround Contest winners.

PubMed

Cerne, F; Bergman, R

1993-07-20

Turning a hospital around takes a lot more than adjusting the financials, as the winners and finalists in the Great Comebacks 1993: The Hospital Turnaround Contest demonstrate. In every case we report on, the hospital being recognized has worked intensively with its community to reassess the services needed by its patients, build support for major management and delivery changes, and articulate the reasons for the strategies being used. Each of the eight hospital organizations we profile, which are spread across the country from Texas to Wisconsin to Maine to North Carolina--has put together its own version of success--in other words, eight lessons in innovation and progress.

Big data, miniregistries: a rapid-turnaround solution to get quality improvement data into the hands of medical specialists.

PubMed

Herrinton, Lisa J; Liu, Liyan; Altschuler, Andrea; Dell, Richard; Rabrenovich, Violeta; Compton-Phillips, Amy L

2015-01-01

The cost to build and to maintain traditional registries for many dire, complex, low-frequency conditions is prohibitive. The authors used accessible technology to develop a platform that would generate miniregistries (small, routinely updated datasets) for surveillance, to identify patients who were missing elected utilization and to influence clinicians to change practices to improve care. The platform, tested in 5 medical specialty departments, enabled the specialists to rapidly and effectively communicate clinical questions, knowledge of disease, clinical workflows, and improve opportunities. Each miniregistry required 1 to 2 hours of collaboration by a specialist. Turnaround was 1 to 14 days.

A review of aircraft turnaround operations and simulations

NASA Astrophysics Data System (ADS)

Schmidt, Michael

2017-07-01

The ground operational processes are the connecting element between aircraft en-route operations and airport infrastructure. An efficient aircraft turnaround is an essential component of airline success, especially for regional and short-haul operations. It is imperative that advancements in ground operations, specifically process reliability and passenger comfort, are developed while dealing with increasing passenger traffic in the next years. This paper provides an introduction to aircraft ground operations focusing on the aircraft turnaround and passenger processes. Furthermore, key challenges for current aircraft operators, such as airport capacity constraints, schedule disruptions and the increasing cost pressure, are highlighted. A review of the conducted studies and conceptual work in this field shows pathways for potential process improvements. Promising approaches attempt to reduce apron traffic and parallelize passenger processes and taxiing. The application of boarding strategies and novel cabin layouts focusing on aisle, door and seat, are options to shorten the boarding process inside the cabin. A summary of existing modeling and simulation frameworks give an insight into state-of-the-art assessment capabilities as it concerns advanced concepts. They are the prerequisite to allow a holistic assessment during the early stages of the preliminary aircraft design process and to identify benefits and drawbacks for all involved stakeholders.

Development and application of a model for the analysis of trades between space launch system operations and acquisition costs

NASA Astrophysics Data System (ADS)

Nix, Michael B.

2005-12-01

Early design decisions in the development of space launch systems determine the costs to acquire and operate launch systems. Some sources indicate that as much as 90% of life cycle costs are fixed by the end of the critical design review phase. System characteristics determined by these early decisions are major factors in the acquisition cost of flight hardware elements and facilities and influence operations costs through the amount of maintenance and support labor required to sustain system function. Operations costs are also dependent on post-development management decisions regarding how much labor will be deployed to meet requirements of market demand and ownership profit. The ability to perform early trade-offs between these costs is vital to the development of systems that have the necessary capacity to provide service and are profitable to operate. An Excel-based prototype model was developed for making early analyses of trade-offs between the costs to operate a space launch system and to acquire the necessary assets to meet a given set of operational requirements. The model, integrating input from existing models and adding missing capability, allows the user to make such trade-offs across a range of operations concepts (required flight rates, staffing levels, shifts per workday, workdays per week and per year, unreliability, wearout and depot maintenance) and the number, type and capability of assets (flight hardware elements, processing and supporting facilities and infrastructure). The costs and capabilities of hypothetical launch systems can be modeled as a function of interrelated turnaround times and labor resource levels, and asset loss and retirement. The number of flight components and facilities required can be calculated and the operations and acquisition costs compared for a specified scenario. Findings, based on the analysis of a hypothetical two stage to orbit, reusable, unmanned launch system, indicate that the model is suitable for the trade-off analyses desired. The minimum turnaround time/maximum labor allocation for specific hardware configurations and characteristics and corresponding asset requirements can be estimated. Either turnaround time or resources can be varied and the resulting operations and acquisition costs can be compared. Asset reliability, wearout and depot maintenance intervals and durations can be varied as well to analyze the effects on costs. Likewise, the effects on operations and acquisitions costs of the introduction of alternative technologies that affect reliability, maintainability and supportability in various hardware configurations can be evaluated.

Alchemy: A Web 2.0 Real-time Quality Assurance Platform for Human Immunodeficiency Virus, Hepatitis C Virus, and BK Virus Quantitation Assays.

PubMed

Agosto-Arroyo, Emmanuel; Coshatt, Gina M; Winokur, Thomas S; Harada, Shuko; Park, Seung L

2017-01-01

The molecular diagnostics laboratory faces the challenge of improving test turnaround time (TAT). Low and consistent TATs are of great clinical and regulatory importance, especially for molecular virology tests. Laboratory information systems (LISs) contain all the data elements necessary to do accurate quality assurance (QA) reporting of TAT and other measures, but these reports are in most cases still performed manually: a time-consuming and error-prone task. The aim of this study was to develop a web-based real-time QA platform that would automate QA reporting in the molecular diagnostics laboratory at our institution, and minimize the time expended in preparing these reports. Using a standard Linux, Nginx, MariaDB, PHP stack virtual machine running atop a Dell Precision 5810, we designed and built a web-based QA platform, code-named Alchemy. Data files pulled periodically from the LIS in comma-separated value format were used to autogenerate QA reports for the human immunodeficiency virus (HIV) quantitation, hepatitis C virus (HCV) quantitation, and BK virus (BKV) quantitation. Alchemy allowed the user to select a specific timeframe to be analyzed and calculated key QA statistics in real-time, including the average TAT in days, tests falling outside the expected TAT ranges, and test result ranges. Before implementing Alchemy, reporting QA for the HIV, HCV, and BKV quantitation assays took 45-60 min of personnel time per test every month. With Alchemy, that time has decreased to 15 min total per month. Alchemy allowed the user to select specific periods of time and analyzed the TAT data in-depth without the need of extensive manual calculations. Alchemy has significantly decreased the time and the human error associated with QA report generation in our molecular diagnostics laboratory. Other tests will be added to this web-based platform in future updates. This effort shows the utility of informatician-supervised resident/fellow programming projects as learning opportunities and workflow improvements in the molecular laboratory.

"Ask The Pathologist": An Internet Forum Facilitating Communication Between Cancer Registrars and Pathologists.

PubMed

Strickland-Marmol, Leah B; Muro-Cacho, Carlos A; Washington, Kay; Foulis, Philip R

2018-05-30

- Cancer registrars should work closely with pathologists to ensure compliance with reporting standards. Many registrars, however, have little contact with pathologists, resulting in a lack of "real-time" interaction that is essential for their professional activities and development. - To facilitate registrars' case management, as cancer biology becomes more complex, we developed the ATP (Ask the Pathologist) forum as a place to ask pathology-related questions about neoplasms, such as terminology, biology, histologic classification, extent of disease, molecular markers, and prognostic factors. - Questions posted are reviewed by the ATP multidisciplinary oversight committee, which consists of 3 pathologists, 4 cancer registrars, 1 internal medicine physician, the pathology resident member of the College of American Pathologists Cancer Committee, and 2 medical technologists. The oversight committee may answer the question. Alternatively, the committee may forward the question to a content expert pathologist, determine that the question is better suited for another reference Web site, or both. - Since September 2013, when the ATP forum became available, users have posted 284 questions, of which 48 (17%) related to gastrointestinal tumors, 43 (15%) to breast tumors, and 37 (13%) to general pathology. The average turnaround time, from question posted to response, is 11.1 days. - The ATP forum has had a positive impact in the daily activities of cancer registrars. Of 440 registrars surveyed, more than 90% considered that questions were answered satisfactorily, and one-third reported that ATP answers affected how they managed a given case.

An improved ant colony optimization algorithm with fault tolerance for job scheduling in grid computing systems

PubMed Central

Idris, Hajara; Junaidu, Sahalu B.; Adewumi, Aderemi O.

2017-01-01

The Grid scheduler, schedules user jobs on the best available resource in terms of resource characteristics by optimizing job execution time. Resource failure in Grid is no longer an exception but a regular occurring event as resources are increasingly being used by the scientific community to solve computationally intensive problems which typically run for days or even months. It is therefore absolutely essential that these long-running applications are able to tolerate failures and avoid re-computations from scratch after resource failure has occurred, to satisfy the user’s Quality of Service (QoS) requirement. Job Scheduling with Fault Tolerance in Grid Computing using Ant Colony Optimization is proposed to ensure that jobs are executed successfully even when resource failure has occurred. The technique employed in this paper, is the use of resource failure rate, as well as checkpoint-based roll back recovery strategy. Check-pointing aims at reducing the amount of work that is lost upon failure of the system by immediately saving the state of the system. A comparison of the proposed approach with an existing Ant Colony Optimization (ACO) algorithm is discussed. The experimental results of the implemented Fault Tolerance scheduling algorithm show that there is an improvement in the user’s QoS requirement over the existing ACO algorithm, which has no fault tolerance integrated in it. The performance evaluation of the two algorithms was measured in terms of the three main scheduling performance metrics: makespan, throughput and average turnaround time. PMID:28545075