Case Studies in Continuous Process Improvement

NASA Technical Reports Server (NTRS)

Mehta, A.

1997-01-01

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

Continuous Improvement in the Industrial and Management Systems Engineering Programme at Kuwait University

ERIC Educational Resources Information Center

Aldowaisan, Tariq; Allahverdi, Ali

2016-01-01

This paper describes the process employed by the Industrial and Management Systems Engineering programme at Kuwait University to continuously improve the programme. Using a continuous improvement framework, the paper demonstrates how various qualitative and quantitative analyses methods, such as hypothesis testing and control charts, have been…

Improving the Way Higher Education Institutions Study Themselves: Use and Impact of Academic Improvement Systems. Professional File. Number 118, Fall 2010

ERIC Educational Resources Information Center

Bender, Kim K.; Jonson, Jessica L.; Siller, Thomas J.

2010-01-01

Can higher education institutions continue using planning and self-evaluation processes that are decades old without any reform? Several recent monographs urge institutions to embrace continuous improvement processes that engage systematic planning and department self-evaluation across whole campuses, but they do not show institutions how to do…

Speaking the right language: the scientific method as a framework for a continuous quality improvement program within academic medical research compliance units.

PubMed

Nolte, Kurt B; Stewart, Douglas M; O'Hair, Kevin C; Gannon, William L; Briggs, Michael S; Barron, A Marie; Pointer, Judy; Larson, Richard S

2008-10-01

The authors developed a novel continuous quality improvement (CQI) process for academic biomedical research compliance administration. A challenge in developing a quality improvement program in a nonbusiness environment is that the terminology and processes are often foreign. Rather than training staff in an existing quality improvement process, the authors opted to develop a novel process based on the scientific method--a paradigm familiar to all team members. The CQI process included our research compliance units. Unit leaders identified problems in compliance administration where a resolution would have a positive impact and which could be resolved or improved with current resources. They then generated testable hypotheses about a change to standard practice expected to improve the problem, and they developed methods and metrics to assess the impact of the change. The CQI process was managed in a "peer review" environment. The program included processes to reduce the incidence of infections in animal colonies, decrease research protocol-approval times, improve compliance and protection of animal and human research subjects, and improve research protocol quality. This novel CQI approach is well suited to the needs and the unique processes of research compliance administration. Using the scientific method as the improvement paradigm fostered acceptance of the project by unit leaders and facilitated the development of specific improvement projects. These quality initiatives will allow us to improve support for investigators while ensuring that compliance standards continue to be met. We believe that our CQI process can readily be used in other academically based offices of research.

An interval programming model for continuous improvement in micro-manufacturing

NASA Astrophysics Data System (ADS)

Ouyang, Linhan; Ma, Yizhong; Wang, Jianjun; Tu, Yiliu; Byun, Jai-Hyun

2018-03-01

Continuous quality improvement in micro-manufacturing processes relies on optimization strategies that relate an output performance to a set of machining parameters. However, when determining the optimal machining parameters in a micro-manufacturing process, the economics of continuous quality improvement and decision makers' preference information are typically neglected. This article proposes an economic continuous improvement strategy based on an interval programming model. The proposed strategy differs from previous studies in two ways. First, an interval programming model is proposed to measure the quality level, where decision makers' preference information is considered in order to determine the weight of location and dispersion effects. Second, the proposed strategy is a more flexible approach since it considers the trade-off between the quality level and the associated costs, and leaves engineers a larger decision space through adjusting the quality level. The proposed strategy is compared with its conventional counterparts using an Nd:YLF laser beam micro-drilling process.

Relationships between Climate, Process, and Performance in Continuous Quality Improvement Groups

ERIC Educational Resources Information Center

Wilkens, Roxanne; London, Manuel

2006-01-01

This study examined relationships between group climate (participants' learning orientation, feelings of psychological safety, and self-disclosure), process (feedback and conflict), and performance in continuous quality improvement groups. Forty-nine participants in eight hospital groups were surveyed as the groups neared completion. Groups were…

The role of CQI in the strategic planning process.

PubMed

Sahney, V K; Warden, G L

1993-01-01

This article describes the strategic planning process used to define the health care needs of a region and to prepare Henry Ford Health System (HFHS) to meet the needs of the 21st century. It presents key applications of continuous quality improvement in the development and implementation of the strategic plans for HFHS; explains how HFHS adapted the Deming/Shewhart cycle of continuous improvement for the purpose of improving its planning process; and delineates how the strategic planning, financial planning, and quality planning processes have been integrated.

Measuring and improving the quality of postoperative epidural analgesia for major abdominal surgery using statistical process control charts.

PubMed

Duncan, Fiona; Haigh, Carol

2013-10-01

To explore and improve the quality of continuous epidural analgesia for pain relief using Statistical Process Control tools. Measuring the quality of pain management interventions is complex. Intermittent audits do not accurately capture the results of quality improvement initiatives. The failure rate for one intervention, epidural analgesia, is approximately 30% in everyday practice, so it is an important area for improvement. Continuous measurement and analysis are required to understand the multiple factors involved in providing effective pain relief. Process control and quality improvement Routine prospectively acquired data collection started in 2006. Patients were asked about their pain and side effects of treatment. Statistical Process Control methods were applied for continuous data analysis. A multidisciplinary group worked together to identify reasons for variation in the data and instigated ideas for improvement. The key measure for improvement was a reduction in the percentage of patients with an epidural in severe pain. The baseline control charts illustrated the recorded variation in the rate of several processes and outcomes for 293 surgical patients. The mean visual analogue pain score (VNRS) was four. There was no special cause variation when data were stratified by surgeons, clinical area or patients who had experienced pain before surgery. Fifty-seven per cent of patients were hypotensive on the first day after surgery. We were able to demonstrate a significant improvement in the failure rate of epidurals as the project continued with quality improvement interventions. Statistical Process Control is a useful tool for measuring and improving the quality of pain management. The applications of Statistical Process Control methods offer the potential to learn more about the process of change and outcomes in an Acute Pain Service both locally and nationally. We have been able to develop measures for improvement and benchmarking in routine care that has led to the establishment of a national pain registry. © 2013 Blackwell Publishing Ltd.

Creating a standardized process to offer the standard of care: continuous process improvement methodology is associated with increased rates of sperm cryopreservation among adolescent and young adult males with cancer.

PubMed

Shnorhavorian, Margarett; Kroon, Leah; Jeffries, Howard; Johnson, Rebecca

2012-11-01

There is limited literature on strategies to overcome the barriers to sperm banking among adolescent and young adult (AYA) males with cancer. By standardizing our process for offering sperm banking to AYA males before cancer treatment, we aimed to improve rates of sperm banking at our institution. Continuous process improvement is a technique that has recently been applied to improve health care delivery. We used continuous process improvement methodologies to create a standard process for fertility preservation for AYA males with cancer at our institution. We compared rates of sperm banking before and after standardization. In the 12-month period after implementation of a standardized process, 90% of patients were offered sperm banking. We demonstrated an 8-fold increase in the proportion of AYA males' sperm banking, and a 5-fold increase in the rate of sperm banking at our institution. Implementation of a standardized process for sperm banking for AYA males with cancer was associated with increased rates of sperm banking at our institution. This study supports the role of standardized health care in decreasing barriers to sperm banking.

Developing an Effective Assessment Process To Support Institutional Effectiveness Efforts.

ERIC Educational Resources Information Center

Albert, Angela R.; Pet-Armacost, Julia

This paper describes a process and an organizational structure in which Institutional Effectiveness (IE) can thrive. When such a system is implemented, continuous quality improvement can be sustained for the long term. Key concepts and philosophies found in the literature regarding continuous quality improvement and assessment in higher education…

A continuous silicon-coating facility

NASA Technical Reports Server (NTRS)

Butter, C.; Heaps, J. D.

1979-01-01

Automatic continuous silicon-coating facility is used to process 100 by 10 cm graphite-coated ceramic substrates for silicon solar cells. Process reduces contamination associated with conventional dip-coating processes, improving material service life.

Omega-3 production by fermentation of Yarrowia lipolytica: From fed-batch to continuous.

PubMed

Xie, Dongming; Miller, Edward; Sharpe, Pamela; Jackson, Ethel; Zhu, Quinn

2017-04-01

The omega-3 fatty acid, cis-5,8,11,14,17-eicosapentaenoic acid (C20:5; EPA) has wide-ranging benefits in improving heart health, immune function, and mental health. A sustainable source of EPA production through fermentation of metabolically engineered Yarrowia lipolytica has been developed. In this paper, key fed-batch fermentation conditions were identified to achieve 25% EPA in the yeast biomass, which is so far the highest EPA titer reported in the literature. Dynamic models of the EPA fermentation process were established for analyzing, optimizing, and scaling up the fermentation process. In addition, model simulations were used to develop a two-stage continuous process and compare to single-stage continuous and fed- batch processes. The two stage continuous process, which is equipped with a smaller growth fermentor (Stage 1) and a larger production fermentor (Stage 2), was found to be a superior process to achieve high titer, rate, and yield of EPA. A two-stage continuous fermentation experiment with Y. lipolytica strain Z7334 was designed using the model simulation and then tested in a 2 L and 5 L fermentation system for 1,008 h. Compared with the standard 2 L fed-batch process, the two-stage continuous fermentation process improved the overall EPA productivity by 80% and EPA concentration in the fermenter by 40% while achieving comparable EPA titer in biomass and similar conversion yield from glucose. During the long-term experiment it was also found that the Y. lipolytica strain evolved to reduce byproduct and increase lipid production. This is one of the few continuous fermentation examples that demonstrated improved productivity and concentration of a final product with similar conversion yield compared with a fed-batch process. This paper suggests the two-stage continuous fermentation could be an effective process to achieve improved production of omega-3 and other fermentation products where non-growth or partially growth associated kinetics characterize the process. Biotechnol. Bioeng. 2017;114: 798-812. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Template for success: using a resident-designed sign-out template in the handover of patient care.

PubMed

Clark, Clancy J; Sindell, Sarah L; Koehler, Richard P

2011-01-01

Report our implementation of a standardized handover process in a general surgery residency program. The standardized handover process, sign-out template, method of implementation, and continuous quality improvement process were designed by general surgery residents with support of faculty and senior hospital administration using standard work principles and business models of the Virginia Mason Production System and the Toyota Production System. Nonprofit, tertiary referral teaching hospital. General surgery residents, residency faculty, patient care providers, and hospital administration. After instruction in quality improvement initiatives, a team of general surgery residents designed a sign-out process using an electronic template and standard procedures. The initial implementation phase resulted in 73% compliance. Using resident-driven continuous quality improvement processes, real-time feedback enabled residents to modify and improve this process, eventually attaining 100% compliance and acceptance by residents. The creation of a standardized template and protocol for patient handovers might eliminate communication failures. Encouraging residents to participate in this process can establish the groundwork for successful implementation of a standardized handover process. Integrating a continuous quality-improvement process into such an initiative can promote active participation of busy general surgery residents and lead to successful implementation of standard procedures. Copyright © 2011 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Supply Operations (DLA-O) Total Quality Management (TQM) Master Plan

DTIC Science & Technology

1989-07-01

This document briefly outlines the DLA Directorate of Supply Operations plan to implement total quality management . It seeks to provide better...service to customers at a lower cost through continuous process improvement and commitment from everyone in the organization. Keywords: TQM (total Quality Management ), Supply operations; Continuous process improvement. (KR)

20 CFR 220.180 - Determining continuation or cessation of disability.

Code of Federal Regulations, 2010 CFR

2010-04-01

... exceptions to medical improvement may be considered at any point in this process; (f) If medical improvement... Activity or Medical Improvement § 220.180 Determining continuation or cessation of disability. Evaluation... the annuitant's impairment(s) is not medically disabling, has there been medical improvement as...

Just-In-Time Inventory Management; Application and Recommendations for Naval Hospital, Oakland.

DTIC Science & Technology

1992-12-01

108 c. Break Bulk on Stored Material .................. 110 d. Emphasize Continuous Quality Improvement ...... 111 4. Streamline Order Processing for...manpower. 4. Use of existing industry automation to expedite order processing to the prime vendor. The intent of this research is to present the JIT...34* Collection of baseline data. "* Break bulk on stored material. 85 • Emphasize continuous quality improvement. 4. Streamline order processing for PV

Daily Management System of the Henry Ford Production System: QTIPS to Focus Continuous Improvements at the Level of the Work.

PubMed

Zarbo, Richard J; Varney, Ruan C; Copeland, Jacqueline R; D'Angelo, Rita; Sharma, Gaurav

2015-07-01

To support our Lean culture of continuous improvement, we implemented a daily management system designed so critical metrics of operational success were the focus of local teams to drive improvements. We innovated a standardized visual daily management board composed of metric categories of Quality, Time, Inventory, Productivity, and Safety (QTIPS); frequency trending; root cause analysis; corrective/preventive actions; and resulting process improvements. In 1 year (June 2013 to July 2014), eight laboratory sections at Henry Ford Hospital employed 64 unique daily metrics. Most assessed long-term (>6 months), monitored process stability, while short-term metrics (1-6 months) were retired after successful targeted problem resolution. Daily monitoring resulted in 42 process improvements. Daily management is the key business accountability subsystem that enabled our culture of continuous improvement to function more efficiently at the managerial level in a visible manner by reviewing and acting based on data and root cause analysis. Copyright© by the American Society for Clinical Pathology.

Texas Solar Collaboration Action Plan

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

Winland, Chris

2013-02-14

Texas Solar Collaboration Permitting and Interconenction Process Improvement Action Plan. San Antonio-specific; Investigate feasibility of using electronic signatures; Investigate feasibility of enabling other online permitting processes (e.g., commercial); Assess need for future document management and workflow/notification IT improvements; Update Information Bulletin 153 regarding City requirements and processes for PV; Educate contractors and public on CPS Energy’s new 2013 solar program processes; Continue to discuss “downtown grid” interconnection issues and identify potential solutions; Consider renaming Distributed Energy Resources (DER); and Continue to participate in collaborative actions.

Research on the Relation the Characteristics of the Faculty and the Commitment to Continuous Improvement of Motivations and Student Study Processes

ERIC Educational Resources Information Center

Chen, Kun-Dang; Chen, Ping-Kuo

2017-01-01

This study focused on China's higher education system and explored if personality traits were a mediator of the relationship between motivational mechanisms and continuous improvement, and further explored if leadership change was a moderator of the relationship between personality traits and continuous improvement of the motivations and student…

A clinical nurse specialist-led intervention to enhance medication adherence using the plan-do-check-act cycle for continuous self-improvement.

PubMed

Russell, Cynthia L

2010-01-01

A clinical nurse specialist-led intervention to improve medication adherence in chronically ill adults using renal transplant recipients as an exemplar population is proposed. Meta-analyses and systematic reviews of chronically ill and transplant patients indicate that patient-specific characteristics not only are poor and inconsistent predictors for medication nonadherence but also are not amenable to intervention. Adherence has not meaningfully improved, despite meta-analyses and systematic narrative reviews of randomized controlled trials (RCTs) dealing with medication nonadherence in acutely and chronically ill persons and RCTs dealing with transplant patients. Interventions with a superior potential to enhance medication adherence must be developed. Use of a clinical nurse specialist-led continuous self-improvement intervention with adult renal transplant recipients is proposed. Continuous self-improvement focuses on improving personal systems thinking and behavior using the plan-do-check-act process. Electronic medication monitoring reports, one of several objective measures of medication adherence, are used by the clinician to provide patient feedback during the check process on medication-taking patterns. Continuous self-improvement as an intervention holds promise in supporting patient self-management and diminishing the blame that clinicians place on patients for medication nonadherence. Using an objective measure of medication adherence such as an electronic monitoring report fosters collaborative patient-clinician discussions of daily medication-taking patterns. Through collaboration, ideas for improving medication taking can be explored. Changes can be followed and evaluated for effectiveness through the continuous self-improvement process. Future studies should include RCTs comparing educational and/or behavioral interventions to improve medication adherence.

An intelligent processing environment for real-time simulation

NASA Technical Reports Server (NTRS)

Carroll, Chester C.; Wells, Buren Earl, Jr.

1988-01-01

The development of a highly efficient and thus truly intelligent processing environment for real-time general purpose simulation of continuous systems is described. Such an environment can be created by mapping the simulation process directly onto the University of Alamba's OPERA architecture. To facilitate this effort, the field of continuous simulation is explored, highlighting areas in which efficiency can be improved. Areas in which parallel processing can be applied are also identified, and several general OPERA type hardware configurations that support improved simulation are investigated. Three direct execution parallel processing environments are introduced, each of which greatly improves efficiency by exploiting distinct areas of the simulation process. These suggested environments are candidate architectures around which a highly intelligent real-time simulation configuration can be developed.

Applying a Continuous Quality Improvement Model To Assess Institutional Effectiveness.

ERIC Educational Resources Information Center

Roberts, Keith

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

Can Schools Meet the Promise of Continuous Improvement?

ERIC Educational Resources Information Center

Elgart, Mark A.

2018-01-01

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

A framework for the continual improvement of behavioral healthcare. Part II--Policy for leadership.

PubMed

Redelheim, P S; Pomeroy, L H; Batalden, P

1994-01-01

In the first part of this article, published in the November/December 1993 issue of Behavioral Healthcare Tomorrow, the authors presented a framework for understanding the process of continuous quality improvement in the behavioral healthcare setting. Four elements of continual improvement were identified: underlying knowledge, policy for leadership, tools and methods, and daily work applications. They showed how traditional professional knowledge of one's subject, discipline and values must be augmented by improvement knowledge--which quality improvement guru W. Edwards Deming calls "the system of profound knowledge." In Part II, they focus on the second element of continual improvement, the importance of organizational leadership.

Continuous improvement in managing R&D: A TQM approach at SkogForsk, Sweden

Treesearch

Magnus Larsson

1999-01-01

Continuous improvement is an imperative process for any organization) even in the R&D field) who wants to stay competitive and alive. Our experience is that the most important ingredients in this process are engagement and participation by everybody) shared visions) and a holistic view of the organization. Structural changes and quick fixes cannot accomplish this....

Factors Influencing Team Performance in a Continuous Quality Improvement Process in the Wisconsin Technical College System

ERIC Educational Resources Information Center

Pietz, Victoria Lynn

2014-01-01

Continuous Quality Improvement (CQI) programs are growing in popularity in higher education settings and a key component is the use of work groups, which require active employee involvement. The problem addressed in this research was the lack of employee engagement in the Quality Review Process (QRP), which is a statewide CQI model developed by…

Investigation of a lithium-halogen exchange flow process for the preparation of boronates by using a cryo-flow reactor.

PubMed

Newby, James A; Huck, Lena; Blaylock, D Wayne; Witt, Paul M; Ley, Steven V; Browne, Duncan L

2014-01-03

Conducting low-temperature organometallic reactions under continuous flow conditions offers the potential to more accurately control exotherms and thus provide more reproducible and scalable processes. Herein, progress towards this goal with regards to the lithium-halogen exchange/borylation reaction is reported. In addition to improving the scope of substrates available on a research scale, methods to improve reaction profiles and expedite purification of the products are also described. On moving to a continuous system, thermocouple measurements have been used to track exotherms and provide a level of safety for continuous processing of organometallic reagents. The use of an in-line continuous liquid-liquid separation device to circumvent labour intensive downstream off-line processing is also reported. Copyright © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

A Roadmap for the Implementation of Continued Process Verification.

PubMed

Boyer, Marcus; Gampfer, Joerg; Zamamiri, Abdel; Payne, Robin

2016-01-01

In 2014, the members of the BioPhorum Operations Group (BPOG) produced a 100-page continued process verification case study, entitled "Continued Process Verification: An Industry Position Paper with Example Protocol". This case study captures the thought processes involved in creating a continued process verification plan for a new product in response to the U.S. Food and Drug Administration's guidance on the subject introduced in 2011. In so doing, it provided the specific example of a plan developed for a new molecular antibody product based on the "A MAb Case Study" that preceded it in 2009.This document provides a roadmap that draws on the content of the continued process verification case study to provide a step-by-step guide in a more accessible form, with reference to a process map of the product life cycle. It could be used as a basis for continued process verification implementation in a number of different scenarios: For a single product and process;For a single site;To assist in the sharing of data monitoring responsibilities among sites;To assist in establishing data monitoring agreements between a customer company and a contract manufacturing organization. The U.S. Food and Drug Administration issued guidance on the management of manufacturing processes designed to improve quality and control of drug products. This involved increased focus on regular monitoring of manufacturing processes, reporting of the results, and the taking of opportunities to improve. The guidance and practice associated with it is known as continued process verification This paper summarizes good practice in responding to continued process verification guidance, gathered from subject matter experts in the biopharmaceutical industry. © PDA, Inc. 2016.

Continuous Improvement in Schools and Districts: Policy Considerations

ERIC Educational Resources Information Center

Best, Jane; Dunlap, Allison

2014-01-01

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

The efficacy of a continuous quality improvement (CQI) method in a radiological department. Comparison with non-CQI control material.

PubMed

Laurila, J; Standertskjöld-Nordenstam, C G; Suramo, I; Tolppanen, E M; Tervonen, O; Korhola, O; Brommels, M

2001-01-01

To study the efficacy of continuous quality improvement (CQI) compared to ordinary management in an on-duty radiology department. Because of complaints regarding delivery of on-duty radiological services, an improvement was initiated simultaneously at two hospitals, at the HUCH (Helsinki University Central Hospital) utilising the CQI-method, and at the OUH (Oulu University Hospital) with a traditional management process. For the CQI project, a team was formed to evaluate the process with flow-charts, cause and effect diagrams, Pareto analysis and control charts. Interventions to improve the process were based on the results of these analyses. The team at the HUCH implemented the following changes: A radiologist was added to the evening shift between 15:00-22:00 and a radiographer was moved from the morning shift to 15:00-22:00. A clear improvement was achieved in the turn-around time, but in the follow-up some of the gains were lost. Only minimal changes were achieved at the OUH, where the intervention was based on traditional management processes. CQI was an effective method for improving the quality of performance of a radiology department compared with ordinary management methods, but some of this improvement may be subsequently lost without a continuous measurement system.

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

ERIC Educational Resources Information Center

Lake, Erinn

2003-01-01

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

Innovating the Standard Procurement System Through Electronic Commerce Technologies

DTIC Science & Technology

1999-12-01

commerce are emerging almost daily as businesses continue to realize the overwhelming ability of agent applications to reduce costs and improve ...processed using the SPS. The result may reduce cycle time, assist contracting professionals, improve the acquisition process, save money and aid...of innovation processes, and it offers enormous potential for helping organizations achieve major improvements in terms of process cost , time

How to conduct a clinical audit and quality improvement project.

PubMed

Limb, Christopher; Fowler, Alex; Gundogan, Buket; Koshy, Kiron; Agha, Riaz

2017-07-01

Audits and quality improvement projects are vital aspects of clinical governance and continual service improvement in medicine. In this article we describe the process of clinical audit and quality improvement project. Guidance is also provided on how to design an effective audit and bypass barriers encountered during the process.

The RISE Framework: Using Learning Analytics to Automatically Identify Open Educational Resources for Continuous Improvement

ERIC Educational Resources Information Center

Bodily, Robert; Nyland, Rob; Wiley, David

2017-01-01

The RISE (Resource Inspection, Selection, and Enhancement) Framework is a framework supporting the continuous improvement of open educational resources (OER). The framework is an automated process that identifies learning resources that should be evaluated and either eliminated or improved. This is particularly useful in OER contexts where the…

Leading in Reading: Nebraska District Nets Success with Evidence-Based Learning

ERIC Educational Resources Information Center

Mueller, Melanie; Hanson, Ron

2014-01-01

Mueller and Hanson report on a continuous improvement process taking place in the Papillion-La Vista School District in Papillion, Nebraska, where a proactive stance to improved learning for all students focuses directly on the human element as the change agent. The district has implemented a systemic and systematic continuous improvement process…

Nurse managers' experiences in continuous quality improvement in resource-poor healthcare settings.

PubMed

Kakyo, Tracy Alexis; Xiao, Lily Dongxia

2017-06-01

Ensuring safe and quality care for patients in hospitals is an important part of a nurse manager's role. Continuous quality improvement has been identified as one approach that leads to the delivery of quality care services to patients and is widely used by nurse managers to improve patient care. Nurse managers' experiences in initiating continuous quality improvement activities in resource-poor healthcare settings remain largely unknown. Research evidence is highly demanded in these settings to address disease burden and evidence-based practice. This interpretive qualitative study was conducted to gain an understanding of nurse managers' Continuous Quality Improvement experiences in rural hospitals in Uganda. Nurse managers in rural healthcare settings used their role to prioritize quality improvement activities, monitor the Continuous Quality Improvement process, and utilize in-service education to support continuous quality improvement. The nurse managers in our sample encountered a number of barriers during the implementation of Continuous Quality Improvement, including: limited patient participation, lack of materials, and limited human resources. Efforts to address the challenges faced through good governance and leadership development require more attention. © 2017 John Wiley & Sons Australia, Ltd.

[Process management in the hospital pharmacy for the improvement of the patient safety].

PubMed

Govindarajan, R; Perelló-Juncá, A; Parès-Marimòn, R M; Serrais-Benavente, J; Ferrandez-Martí, D; Sala-Robinat, R; Camacho-Calvente, A; Campabanal-Prats, C; Solà-Anderiu, I; Sanchez-Caparrós, S; Gonzalez-Estrada, J; Martinez-Olalla, P; Colomer-Palomo, J; Perez-Mañosas, R; Rodríguez-Gallego, D

2013-01-01

To define a process management model for a hospital pharmacy in order to measure, analyse and make continuous improvements in patient safety and healthcare quality. In order to implement process management, Igualada Hospital was divided into different processes, one of which was the Hospital Pharmacy. A multidisciplinary management team was given responsibility for each process. For each sub-process one person was identified to be responsible, and a working group was formed under his/her leadership. With the help of each working group, a risk analysis using failure modes and effects analysis (FMEA) was performed, and the corresponding improvement actions were implemented. Sub-process indicators were also identified, and different process management mechanisms were introduced. The first risk analysis with FMEA produced more than thirty preventive actions to improve patient safety. Later, the weekly analysis of errors, as well as the monthly analysis of key process indicators, permitted us to monitor process results and, as each sub-process manager participated in these meetings, also to assume accountability and responsibility, thus consolidating the culture of excellence. The introduction of different process management mechanisms, with the participation of people responsible for each sub-process, introduces a participative management tool for the continuous improvement of patient safety and healthcare quality. Copyright © 2012 SECA. Published by Elsevier Espana. All rights reserved.

Taming hazardous chemistry in flow: the continuous processing of diazo and diazonium compounds.

PubMed

Deadman, Benjamin J; Collins, Stuart G; Maguire, Anita R

2015-02-02

The synthetic utilities of the diazo and diazonium groups are matched only by their reputation for explosive decomposition. Continuous processing technology offers new opportunities to make and use these versatile intermediates at a range of scales with improved safety over traditional batch processes. In this minireview, the state of the art in the continuous flow processing of reactive diazo and diazonium species is discussed. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Implementation of Total Employee Involvement as Part of a Continuous Improvement Program at a Fortune 500 Company

ERIC Educational Resources Information Center

Carlson, Kathy Lynn

2012-01-01

Over the last several decades, Continuous Improvement (CI) type initiatives have been implemented in companies across the United States to improve quality, reduce process variation, eliminate waste and ultimately reduce costs. Approximately five years ago, one particular Fortune 500 company implemented CI in its manufacturing facilities. A key…

Rough case-based reasoning system for continues casting

NASA Astrophysics Data System (ADS)

Su, Wenbin; Lei, Zhufeng

2018-04-01

The continuous casting occupies a pivotal position in the iron and steel industry. The rough set theory and the CBR (case based reasoning, CBR) were combined in the research and implementation for the quality assurance of continuous casting billet to improve the efficiency and accuracy in determining the processing parameters. According to the continuous casting case, the object-oriented method was applied to express the continuous casting cases. The weights of the attributes were calculated by the algorithm which was based on the rough set theory and the retrieval mechanism for the continuous casting cases was designed. Some cases were adopted to test the retrieval mechanism, by analyzing the results, the law of the influence of the retrieval attributes on determining the processing parameters was revealed. A comprehensive evaluation model was established by using the attribute recognition theory. According to the features of the defects, different methods were adopted to describe the quality condition of the continuous casting billet. By using the system, the knowledge was not only inherited but also applied to adjust the processing parameters through the case based reasoning method as to assure the quality of the continuous casting and improve the intelligent level of the continuous casting.

Applying Continuous Quality Improvement Principles in Secondary School Vocational Education, with Emphasis on Special Populations.

ERIC Educational Resources Information Center

McLean, Gary N.

1993-01-01

Principles of quality management applicable to education for secondary special populations include process orientation, cascading, top commitment, vertical/horizontal communication, continuous improvement, shared vision, primacy of customers, investment in people, constancy of purpose, and shared goal setting. (JOW)

Continuous improvement in the Industrial and Management Systems Engineering programme at Kuwait University

NASA Astrophysics Data System (ADS)

Aldowaisan, Tariq; Allahverdi, Ali

2016-07-01

This paper describes the process employed by the Industrial and Management Systems Engineering programme at Kuwait University to continuously improve the programme. Using a continuous improvement framework, the paper demonstrates how various qualitative and quantitative analyses methods, such as hypothesis testing and control charts, have been applied to the results of four assessment tools and other data sources to improve performance. Important improvements include the need to reconsider two student outcomes as they were difficult to implement in courses. In addition, through benchmarking and the engagement of Alumni and Employers, key decisions were made to improve the curriculum and enhance employability.

A continuous quality improvement project to improve the quality of cervical Papanicolaou smears.

PubMed

Burkman, R T; Ward, R; Balchandani, K; Kini, S

1994-09-01

To improve the quality of cervical Papanicolaou smears by continuous quality improvement techniques. The study used a Papanicolaou smear data base of over 200,000 specimens collected between June 1988 and December 1992. A team approach employing techniques such as process flow-charting, cause and effect diagrams, run charts, and a randomized trial of collection methods was used to evaluate potential causes of Papanicolaou smear reports with the notation "inadequate" or "less than optimal" due to too few or absent endocervical cells. Once a key process variable (method of collection) was identified, the proportion of Papanicolaou smears with inadequate or absent endocervical cells was determined before and after employment of a collection technique using a spatula and Cytobrush. We measured the rate of less than optimal Papanicolaou smears due to too few or absent endocervical cells. Before implementing the new collection technique fully by June 1990, the overall rate of less than optimal cervical Papanicolaou smears ranged from 20-25%; by December 1993, it had stabilized at about 10%. Continuous quality improvement can be used successfully to study a clinical process and implement change that will lead to improvement.

IMPROVED TUBULARS FOR BETTER ECONOMICS IN DEEP GAS WELL DRILLING USING MICROWAVE TECHNOLOGY

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

Dinesh Agrawal; Paul Gigl; Mahlon Dennis

2005-03-01

The main objective of the research program has been to improve the rate-of-penetration in deep hostile environments by improving the life cycle and performance of coiled-tubing, an important component of a deep well drilling system for oil and gas exploration, by utilizing the latest developments in the microwave materials technology. Originally, it was proposed to accomplish this by developing an efficient and economically viable continuous microwave process to sinter continuously formed/extruded steel powder for the manufacture of seamless coiled tubing and other tubular products. However, based on the results and faced with insurmountable difficulties in the extrusion and de-waxing processes,more » the approach of achieving the goals of the program has been slightly changed. In the continuation proposal an approach of microwave sintering combined with Cold Isostatic Press (CIP) and joining (by induction or microwave) is adopted. This process can be developed into a semi-continuous sintering process if the CIP can produce parts fast enough to match the microwave sintering rates. Originally, the entire program was spread over three phases with the following goals: Phase I: Demonstration of the feasibility concept of continuous microwave sintering process for tubular steel products. Phase II: Design, building and testing of a prototype microwave system which shall be combined with a continuous extruder for steel tubular objects. Phase III: Execution of the plan for commercialization of the technology by one of the industrial partners. However, since some of the goals of the phase I were not completed, an extension of nine months was granted and we continued extrusion experiments, designed and built semicontinuous microwave sintering unit.« less

Application Process Improvement Yields Results.

ERIC Educational Resources Information Center

Holesovsky, Jan Paul

1995-01-01

After a continuing effort to improve its grant application process, the department of medical microbiology and immunology at the University of Wisconsin-Madison is submitting many more applications and realizing increased funding. The methods and strategy used to make the process more efficient and effective are outlined. (Author/MSE)

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

PubMed

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

2018-06-01

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

Total quality management - It works for aerospace information services

NASA Technical Reports Server (NTRS)

Erwin, James; Eberline, Carl; Colquitt, Wanda

1993-01-01

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

Kaizen: The Search for Quality.

ERIC Educational Resources Information Center

Zimmerman, William J.

1991-01-01

The Japanese concept of Kaizen (continuous improvement) may be applied to higher education institutions. Focus is on improvement of the products produced, the process by which they are delivered, and the people involved in the products and the process. (SK)

Lean Thinking in Libraries: A Case Study on Improving Shelving Turnaround

ERIC Educational Resources Information Center

Kress, Nancy J.

2007-01-01

The University of Chicago's Joseph Regenstein Library Bookstacks Department has used process mapping and continuous improvement to successfully improve its overall operations. The most recent efforts focus on Lean manufacturing, an initiative centered on eliminating waste in manufacturing processes. The conversion of the Bookstacks Department from…

Potential of Continuous Manufacturing for Liposomal Drug Products.

PubMed

Worsham, Robert D; Thomas, Vaughan; Farid, Suzanne S

2018-05-21

Over the last several years, continuous manufacturing of pharmaceuticals has evolved from bulk APIs and solid oral dosages into the more complex realm of biologics. The development of continuous downstream processing techniques has allowed biologics manufacturing to realize the benefits (e.g. improved economics, more consistent quality) that come with continuous processing. If relevant processing techniques and principles are selected, the opportunity arises to develop continuous manufacturing designs for additional pharmaceutical products including liposomal drug formulations. Liposome manufacturing has some inherent aspects that make it favorable for a continuous process. Other aspects such as formulation refinement, materials of construction, and aseptic processing need development, but present an achievable challenge. This paper reviews the current state of continuous manufacturing technology applicable to liposomal drug product manufacturing and an assessment of the challenges and potential of this application. This article is protected by copyright. All rights reserved.

Developing a Continuous Improvement System

DTIC Science & Technology

2016-09-16

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

Strategy for 90% autoverification of clinical chemistry and immunoassay test results using six sigma process improvement.

PubMed

Randell, Edward W; Short, Garry; Lee, Natasha; Beresford, Allison; Spencer, Margaret; Kennell, Marina; Moores, Zoë; Parry, David

2018-06-01

Six Sigma involves a structured process improvement strategy that places processes on a pathway to continued improvement. The data presented here summarizes a project that took three clinical laboratories from autoverification processes that allowed between about 40% to 60% of tests being auto-verified to more than 90% of tests and samples auto-verified. The project schedule, metrics and targets, a description of the previous system and detailed information on the changes made to achieve greater than 90% auto-verification is presented for this Six Sigma DMAIC (Design, Measure, Analyze, Improve, Control) process improvement project.

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

Simpson, L.

ITN Energy Systems, Inc., and Global Solar Energy, Inc., with the assistance of NREL's PV Manufacturing R&D program, have continued the advancement of CIGS production technology through the development of trajectory-oriented predictive/control models, fault-tolerance control, control-platform development, in-situ sensors, and process improvements. Modeling activities to date include the development of physics-based and empirical models for CIGS and sputter-deposition processing, implementation of model-based control, and application of predictive models to the construction of new evaporation sources and for control. Model-based control is enabled through implementation of reduced or empirical models into a control platform. Reliability improvement activities include implementation of preventivemore » maintenance schedules; detection of failed sensors/equipment and reconfiguration to continue processing; and systematic development of fault prevention and reconfiguration strategies for the full range of CIGS PV production deposition processes. In-situ sensor development activities have resulted in improved control and indicated the potential for enhanced process status monitoring and control of the deposition processes. Substantial process improvements have been made, including significant improvement in CIGS uniformity, thickness control, efficiency, yield, and throughput. In large measure, these gains have been driven by process optimization, which, in turn, have been enabled by control and reliability improvements due to this PV Manufacturing R&D program. This has resulted in substantial improvements of flexible CIGS PV module performance and efficiency.« less

Successful integration of ergonomics into continuous improvement initiatives.

PubMed

Monroe, Kimberly; Fick, Faye; Joshi, Madina

2012-01-01

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

Generalized Processing Tree Models: Jointly Modeling Discrete and Continuous Variables.

PubMed

Heck, Daniel W; Erdfelder, Edgar; Kieslich, Pascal J

2018-05-24

Multinomial processing tree models assume that discrete cognitive states determine observed response frequencies. Generalized processing tree (GPT) models extend this conceptual framework to continuous variables such as response times, process-tracing measures, or neurophysiological variables. GPT models assume finite-mixture distributions, with weights determined by a processing tree structure, and continuous components modeled by parameterized distributions such as Gaussians with separate or shared parameters across states. We discuss identifiability, parameter estimation, model testing, a modeling syntax, and the improved precision of GPT estimates. Finally, a GPT version of the feature comparison model of semantic categorization is applied to computer-mouse trajectories.

Design and operation of a continuous integrated monoclonal antibody production process.

PubMed

Steinebach, Fabian; Ulmer, Nicole; Wolf, Moritz; Decker, Lara; Schneider, Veronika; Wälchli, Ruben; Karst, Daniel; Souquet, Jonathan; Morbidelli, Massimo

2017-09-01

The realization of an end-to-end integrated continuous lab-scale process for monoclonal antibody manufacturing is described. For this, a continuous cultivation with filter-based cell-retention, a continuous two column capture process, a virus inactivation step, a semi-continuous polishing step (twin-column MCSGP), and a batch-wise flow-through polishing step were integrated and operated together. In each unit, the implementation of internal recycle loops allows to improve the performance: (a) in the bioreactor, to simultaneously increase the cell density and volumetric productivity, (b) in the capture process, to achieve improved capacity utilization at high productivity and yield, and (c) in the MCSGP process, to overcome the purity-yield trade-off of classical batch-wise bind-elute polishing steps. Furthermore, the design principles, which allow the direct connection of these steps, some at steady state and some at cyclic steady state, as well as straight-through processing, are discussed. The setup was operated for the continuous production of a commercial monoclonal antibody, resulting in stable operation and uniform product quality over the 17 cycles of the end-to-end integration. The steady-state operation was fully characterized by analyzing at the outlet of each unit at steady state the product titer as well as the process (HCP, DNA, leached Protein A) and product (aggregates, fragments) related impurities. © 2017 American Institute of Chemical Engineers Biotechnol. Prog., 33:1303-1313, 2017. © 2017 American Institute of Chemical Engineers.

Continuous Manufacturing of Recombinant Therapeutic Proteins: Upstream and Downstream Technologies.

PubMed

Patil, Rohan; Walther, Jason

2017-03-07

Continuous biomanufacturing of recombinant therapeutic proteins offers several potential advantages over conventional batch processing, including reduced cost of goods, more flexible and responsive manufacturing facilities, and improved and consistent product quality. Although continuous approaches to various upstream and downstream unit operations have been considered and studied for decades, in recent years interest and application have accelerated. Researchers have achieved increasingly higher levels of process intensification, and have also begun to integrate different continuous unit operations into larger, holistically continuous processes. This review first discusses approaches for continuous cell culture, with a focus on perfusion-enabling cell separation technologies including gravitational, centrifugal, and acoustic settling, as well as filtration-based techniques. We follow with a review of various continuous downstream unit operations, covering categories such as clarification, chromatography, formulation, and viral inactivation and filtration. The review ends by summarizing case studies of integrated and continuous processing as reported in the literature.

Continuous quality improvement at work: the first team--Part II.

PubMed

Bolt, B J; Lehany-Trese, A M; Williams, T P

1995-01-01

This second part of a two-part article follows Cape Canaveral Hospital's first continuous quality improvement team through the processes of goal setting, system analysis, data gathering, and problem resolution in the area of patients' assignment to observation status. The team's primary goal was data-driven improvement. As detailed here, the team's solution to improve the use of observation status is both time-efficient and offers opportunities for financial gain.

The NCC project: A quality management perspective

NASA Technical Reports Server (NTRS)

Lee, Raymond H.

1993-01-01

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

Process analytical technology in the pharmaceutical industry: a toolkit for continuous improvement.

PubMed

Scott, Bradley; Wilcock, Anne

2006-01-01

Process analytical technology (PAT) refers to a series of tools used to ensure that quality is built into products while at the same time improving the understanding of processes, increasing efficiency, and decreasing costs. It has not been widely adopted by the pharmaceutical industry. As the setting for this paper, the current pharmaceutical manufacturing paradigm and PAT guidance to date are discussed prior to the review of PAT principles and tools, benefits, and challenges. The PAT toolkit contains process analyzers, multivariate analysis tools, process control tools, and continuous improvement/knowledge management/information technology systems. The integration and implementation of these tools is complex, and has resulted in uncertainty with respect to both regulation and validation. The paucity of staff knowledgeable in this area may complicate adoption. Studies to quantitate the benefits resulting from the adoption of PAT within the pharmaceutical industry would be a valuable addition to the qualitative studies that are currently available.

Updated CCPS Investigation Guidelines book.

PubMed

Philley, J; Pearson, K; Sepeda, A

2003-11-14

Incident investigation standards and performance criteria continue to improve. In recognition, the Center for Chemical Process Safety (CCPS) undertook a major project to upgrade and update the Incident Investigation Guidelines originally published in 1992. These significantly expanded guidelines provide a practical resource for effective investigation of process-related incidents, and reflect changes in good practices and expectations of regulators. This paper highlights the content of the new guidelines with special emphasis on what is new and improved. Entirely new chapters address the topics of legal considerations, the near-miss event, and continuous improvement of the investigation system. The objective of the guidelines is to allow chemical process organizations to develop and implement an incident investigation management system that is effective in identifying underlying causes.

Response to Intervention and Continuous School Improvement: Using Data, Vision, and Leadership to Design, Implement, and Evaluate a Schoolwide Prevention System

ERIC Educational Resources Information Center

Bernhardt, Victoria L.; Hebert, Connie L.

2011-01-01

Ensure the success of your school and improve the learning of "all" students by implementing Response-to-Intervention (RTI) as part of a continuous school improvement (CSI) process. This book shows you how to get your entire staff working together to design, implement, and evaluate a schoolwide prevention system. With specific examples, CSI expert…

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

PubMed

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

2010-01-01

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

Improvement for enhancing effectiveness of universal power system (UPS) continuous testing process

NASA Astrophysics Data System (ADS)

Sriratana, Lerdlekha

2018-01-01

This experiment aims to enhance the effectiveness of the Universal Power System (UPS) continuous testing process of the Electrical and Electronic Institute by applying work scheduling and time study methods. Initially, the standard time of testing process has not been considered that results of unaccurate testing target and also time wasting has been observed. As monitoring and reducing waste time for improving the efficiency of testing process, Yamazumi chart and job scheduling theory (North West Corner Rule) were applied to develop new work process. After the improvements, the overall efficiency of the process possibly increased from 52.8% to 65.6% or 12.7%. Moreover, the waste time could reduce from 828.3 minutes to 653.6 minutes or 21%, while testing units per batch could increase from 3 to 4 units. Therefore, the number of testing units would increase from 12 units up to 20 units per month that also contribute to increase of net income of UPS testing process by 72%.

A Web-Based Course Assessment Tool with Direct Mapping to Student Outcomes

ERIC Educational Resources Information Center

Ibrahim, Walid; Atif, Yacine; Shuaib, Khaled; Sampson, Demetrios

2015-01-01

The assessment of curriculum outcomes is an essential element for continuous academic improvement. However, the collection, aggregation and analysis of assessment data are notoriously complex and time-consuming processes. At the same time, only few developments of supporting electronic processes and tools for continuous academic program assessment…

Applying the Principles of Lean Production to Gastrointestinal Biopsy Handling: From the Factory Floor to the Anatomic Pathology Laboratory.

PubMed

Sugianto, Jessica Z; Stewart, Brian; Ambruzs, Josephine M; Arista, Amanda; Park, Jason Y; Cope-Yokoyama, Sandy; Luu, Hung S

2015-01-01

To implement Lean principles to accommodate expanding volumes of gastrointestinal biopsies and to improve laboratory processes overall. Our continuous improvement (kaizen) project analyzed the current state for gastrointestinal biopsy handling using value-stream mapping for specimens obtained at a 487-bed tertiary care pediatric hospital in Dallas, Texas. We identified non-value-added time within the workflow process, from receipt of the specimen in the histology laboratory to the delivery of slides and paperwork to the pathologist. To eliminate non-value-added steps, we implemented the changes depicted in a revised-state value-stream map. Current-state value-stream mapping identified a total specimen processing time of 507 minutes, of which 358 minutes were non-value-added. This translated to a process cycle efficiency of 29%. Implementation of a revised-state value stream resulted in a total process time reduction to 238 minutes, of which 89 minutes were non-value-added, and an improved process cycle efficiency of 63%. Lean production principles of continuous improvement and waste elimination can be successfully implemented within the clinical laboratory.

Improvement of hospital processes through business process management in Qaem Teaching Hospital: A work in progress.

PubMed

Yarmohammadian, Mohammad H; Ebrahimipour, Hossein; Doosty, Farzaneh

2014-01-01

In a world of continuously changing business environments, organizations have no option; however, to deal with such a big level of transformation in order to adjust the consequential demands. Therefore, many companies need to continually improve and review their processes to maintain their competitive advantages in an uncertain environment. Meeting these challenges requires implementing the most efficient possible business processes, geared to the needs of the industry and market segments that the organization serves globally. In the last 10 years, total quality management, business process reengineering, and business process management (BPM) have been some of the management tools applied by organizations to increase business competiveness. This paper is an original article that presents implementation of "BPM" approach in the healthcare domain that allows an organization to improve and review its critical business processes. This project was performed in "Qaem Teaching Hospital" in Mashhad city, Iran and consists of four distinct steps; (1) identify business processes, (2) document the process, (3) analyze and measure the process, and (4) improve the process. Implementing BPM in Qaem Teaching Hospital changed the nature of management by allowing the organization to avoid the complexity of disparate, soloed systems. BPM instead enabled the organization to focus on business processes at a higher level.

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

ERIC Educational Resources Information Center

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

2017-01-01

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

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

ERIC Educational Resources Information Center

Chambliss, Catherine

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

Influence of Students' Feedback on the Quality of Adult Higher Distance Education Service Delivery

ERIC Educational Resources Information Center

Oduaran, Akpovire

2017-01-01

The evaluation of a program's compliance with service delivery and features necessary for the attainment of the program's educational objectives, student outcomes and continuous improvement is an important element in program accreditation and continuous improvement process. The study reported in this paper investigated the possible effects of…

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

ERIC Educational Resources Information Center

Johnson, Genevieve Marie

2015-01-01

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

Continuous Quality Improvement in a University Setting: The Case of the Department of Vocational and Technical Education at the University of Minnesota.

ERIC Educational Resources Information Center

Copa, George H.

1993-01-01

Discusses the application of continuous quality improvement principles in the Department of Vocational and Technical Education at the University of Minnesota. Reviews the processes that the department incorporated to implement this program and lists future steps and categories of action. (Author)

A Study of Leadership and Continuous Improvement at Leadership Preparatory Academy

ERIC Educational Resources Information Center

Medina Araujo, Jacqueline

2013-01-01

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

Continuous Quality Improvement Tools for Effective Teaching.

ERIC Educational Resources Information Center

Cornesky, Robert A.

This manual presents 15 Continuous Quality Improvement (CQI) tools and techniques necessary for effective teaching. By using the tools and techniques of CQI, teachers will be able to help themselves and their students to focus on the classroom processes. This will permit the teacher and students to plan, organize, implement, and make decisions…

Report: Agency-Wide Application of Region 7 NPDES Program Process Improvements Could Increase EPA Efficiency

EPA Pesticide Factsheets

Report #11-P-0315, July 6, 2011. Although Region 7 NPDES Kaizen event participants continued to follow up on the commitments and action items identified, no single authority was responsible for tracking the process improvement outcomes.

Certification renewal process of the American Board of Orthodontics.

PubMed

Castelein, Paul T; DeLeon, Eladio; Dugoni, Steven A; Chung, Chun-Hsi; Tadlock, Larry P; Barone, Nicholas D; Kulbersh, Valmy P; Sabott, David G; Kastrop, Marvin C

2015-05-01

The American Board of Orthodontics was established in 1929 and is the oldest specialty board in dentistry. Its goal is to protect the public by ensuring competency through the certification of eligible orthodontists. Originally, applicants for certification submitted a thesis, 5 case reports, and a set of casts with appliances. Once granted, the certification never expired. Requirements have changed over the years. In 1950, 15 cases were required, and then 10 in 1987. The Board has continued to refine and improve the certification process. In 1998, certification became time limited, and a renewal process was initiated. The Board continues to improve the recertification process. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Continuous downstream processing for high value biological products: A Review.

PubMed

Zydney, Andrew L

2016-03-01

There is growing interest in the possibility of developing truly continuous processes for the large-scale production of high value biological products. Continuous processing has the potential to provide significant reductions in cost and facility size while improving product quality and facilitating the design of flexible multi-product manufacturing facilities. This paper reviews the current state-of-the-art in separations technology suitable for continuous downstream bioprocessing, focusing on unit operations that would be most appropriate for the production of secreted proteins like monoclonal antibodies. This includes cell separation/recycle from the perfusion bioreactor, initial product recovery (capture), product purification (polishing), and formulation. Of particular importance are the available options, and alternatives, for continuous chromatographic separations. Although there are still significant challenges in developing integrated continuous bioprocesses, recent technological advances have provided process developers with a number of attractive options for development of truly continuous bioprocessing operations. © 2015 Wiley Periodicals, Inc.

Spitzer observatory operations: increasing efficiency in mission operations

NASA Astrophysics Data System (ADS)

Scott, Charles P.; Kahr, Bolinda E.; Sarrel, Marc A.

2006-06-01

This paper explores the how's and why's of the Spitzer Mission Operations System's (MOS) success, efficiency, and affordability in comparison to other observatory-class missions. MOS exploits today's flight, ground, and operations capabilities, embraces automation, and balances both risk and cost. With operational efficiency as the primary goal, MOS maintains a strong control process by translating lessons learned into efficiency improvements, thereby enabling the MOS processes, teams, and procedures to rapidly evolve from concept (through thorough validation) into in-flight implementation. Operational teaming, planning, and execution are designed to enable re-use. Mission changes, unforeseen events, and continuous improvement have often times forced us to learn to fly anew. Collaborative spacecraft operations and remote science and instrument teams have become well integrated, and worked together to improve and optimize each human, machine, and software-system element. Adaptation to tighter spacecraft margins has facilitated continuous operational improvements via automated and autonomous software coupled with improved human analysis. Based upon what we now know and what we need to improve, adapt, or fix, the projected mission lifetime continues to grow - as does the opportunity for numerous scientific discoveries.

Microwave and continuous flow technologies in drug discovery.

PubMed

Sadler, Sara; Moeller, Alexander R; Jones, Graham B

2012-12-01

Microwave and continuous flow microreactors have become mainstream heating sources in contemporary pharmaceutical company laboratories. Such technologies will continue to benefit from design and engineering improvements, and now play a key role in the drug discovery process. The authors review the applications of flow- and microwave-mediated heating in library, combinatorial, solid-phase, metal-assisted, and protein chemistries. Additionally, the authors provide a description of the combination of microwave and continuous flow platforms, with applications in the preparation of radiopharmaceuticals and in drug candidate development. Literature reviewed is chiefly 2000 - 2012, plus key citations from earlier reports. With the advent of microwave irradiation, reactions that normally took days to complete can now be performed in a matter of minutes. Coupled with the introduction of continuous flow microreactors, pharmaceutical companies have an easy way to improve the greenness and efficiency of many synthetic operations. The combined force of these technologies offers the potential to revolutionize discovery and manufacturing processes.

Effective Report Preparation: Streamlining the Reporting Process. AIR 1999 Annual Forum Paper.

ERIC Educational Resources Information Center

Dalrymple, Margaret; Wang, Mindy; Frost, Jacquelyn

This paper describes the processes and techniques used to improve and streamline the standard student reports used at Purdue University (Indiana). Various models for analyzing reporting processes are described, especially the model used in the study, the Shewart or Deming Cycle, a method that aids in continuous analysis and improvement through a…

Quality comparison of continuous steam sterilization segmented-flow aseptic processing versus conventional canning of whole and sliced mushrooms.

PubMed

Anderson, N M; Walker, P N

2011-08-01

This study was carried out to investigate segmented-flow aseptic processing of particle foods. A pilot-scale continuous steam sterilization unit capable of producing shelf stable aseptically processed whole and sliced mushrooms was developed. The system utilized pressurized steam as the heating medium to achieve high temperature-short time processing conditions with high and uniform heat transfer that will enable static temperature penetration studies for process development. Segmented-flow technology produced a narrower residence time distribution than pipe-flow aseptic processing; thus, whole and sliced mushrooms were processed only as long as needed to achieve the target F₀  = 7.0 min and were not overcooked. Continuous steam sterilization segmented-flow aseptic processing produced shelf stable aseptically processed mushrooms of superior quality to conventionally canned mushrooms. When compared to conventionally canned mushrooms, aseptically processed yield (weight basis) increased 6.1% (SD = 2.9%) and 6.6% (SD = 2.2%), whiteness (L) improved 3.1% (SD = 1.9%) and 4.7% (SD = 0.7%), color difference (ΔE) improved 6.0% (SD = 1.3%) and 8.5% (SD = 1.5%), and texture improved 3.9% (SD = 1.7%) and 4.6% (SD = 4.2%), for whole and sliced mushrooms, respectively. Segmented-flow aseptic processing eliminated a separate blanching step, eliminated the unnecessary packaging of water and promoted the use of bag-in-box and other versatile aseptic packaging methods. Segmented-flow aseptic processing is capable of producing shelf stable aseptically processed particle foods of superior quality to a conventionally canned product. This unique continuous steam sterilization process eliminates the need for a separate blanching step, reduces or eliminates the need for a liquid carrier, and promotes the use of bag-in-box and other versatile aseptic packaging methods. © 2011 Institute of Food Technologists®

Selective aqueous extraction of organics coupled with trapping by membrane separation

DOEpatents

van Eikeren, Paul; Brose, Daniel J.; Ray, Roderick J.

1991-01-01

An improvement to processes for the selective extractation of organic solutes from organic solvents by water-based extractants is disclosed, the improvement comprising coupling various membrane separation processes with the organic extraction process, the membrane separation process being utilized to continuously recycle the water-based extractant and at the same time selectively remove or concentrate organic solute from the water-based extractant.

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

ERIC Educational Resources Information Center

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

2010-01-01

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

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

ERIC Educational Resources Information Center

Data Quality Campaign, 2016

2016-01-01

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

Continuous high PRF waveforms for challenging environments

NASA Astrophysics Data System (ADS)

Jaroszewski, Steven; Corbeil, Allan; Ryland, Robert; Sobota, David

2017-05-01

Current airborne radar systems segment the available time-on-target during each beam dwell into multiple Coherent Processing Intervals (CPIs) in order to eliminate range eclipsing, solve for unambiguous range, and increase the detection performance against larger Radar Cross Section (RCS) targets. As a consequence, these radars do not realize the full Signal-to-Noise Ratio (SNR) increase and detection performance improvement that is possible. Continuous High Pulse Repetition Frequency (HPRF) waveforms and processing enables the coherent integration of all available radar data over the full time-on-target. This can greatly increase the SNR for air targets at long range and/or with weak radar returns and significantly improve the detection performance against such targets. TSC worked with its partner KeyW to implement a Continuous HPRF waveform in their Sahara radar testbed and obtained measured radar data on both a ground vehicle target and an airborne target of opportunity. This experimental data was processed by TSC to validate the expected benefits of Continuous HPRF waveforms.

Measuring, managing and maximizing performance of mineral processing plants

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

Bascur, O.A.; Kennedy, J.P.

1995-12-31

The implementation of continuous quality improvement is the confluence of Total Quality Management, People Empowerment, Performance Indicators and Information Engineering. The supporting information technologies allow a mineral processor to narrow the gap between management business objectives and the process control level. One of the most important contributors is the user friendliness and flexibility of the personal computer in a client/server environment. This synergistic combination when used for real time performance monitoring translates into production cost savings, improved communications and enhanced decision support. Other savings come from reduced time to collect data and perform tedious calculations, act quickly with fresh newmore » data, generate and validate data to be used by others. This paper presents an integrated view of plant management. The selection of the proper tools for continuous quality improvement are described. The process of selecting critical performance monitoring indices for improved plant performance are discussed. The importance of a well balanced technological improvement, personnel empowerment, total quality management and organizational assets are stressed.« less

Expectations and perceptions of primary healthcare professionals regarding their own continuous education in Catalonia (Spain): a qualitative study.

PubMed

Mundet-Tuduri, Xavier; Crespo, Ramon; Fernandez-Coll, Ma Luisa; Saumell, Montserrat; Millan-Mata, Flor; Cardona, Àngels; Codern-Bové, Núria

2017-11-15

The planning and execution of continuous education in an organization that provides health services is a complex process. The objectives, learning sequences, and implementation strategies should all be oriented to improving the health of the population. The aim of this study was to analyse the expectations and perceptions of continuous educations by primary healthcare professionals (physicians and nurses) and identify aspects that hinder or encourage the process. A qualitative study with 5 focus groups made up of 25 primary healthcare professionals from the Catalan Health Institute, Barcelona (Catalonia, Spain). The focus groups were audio-recorded and the results transcribed. The analysis involved: a) Reading of the data looking for meanings b) Coding of the data by themes and extracting categories c) Reviewing and refining codes and categories d) Reconstruction of the data providing an explanatory framework for the meanings e) Discussion about the interpretations of the findings and f) Discussed with relevant professionals from PHC (physicians and nurses)"Data regarding thematic content were analyzed with the support of Atlasti 5.1 software. The health needs of the population were often at the core of the learning processes but the participants' views did not always spontaneously refer to improvements in these issues. Common themes that could hinder learning and where identified, including contextual aspects such as work constraints (timetables, places being covered during training) and funding policies. New learning strategies to improve the effectiveness of continuous education were proposed such as the exchange of knowledge, the activation of personal commitment to change, and the improvement of organizational aspects. The primary healthcare professionals in our study viewed continuous education as a professional necessity and would like to translate the knowledge acquired to improving the health of the population. Nevertheless, professional, structural, and organizational issues impede the process.

Use of Gelidium amansii as a promising resource for bioethanol: a practical approach for continuous dilute-acid hydrolysis and fermentation.

PubMed

Park, Jeong-Hoon; Hong, Ji-Yeon; Jang, Hyun Chul; Oh, Seung Geun; Kim, Sang-Hyoun; Yoon, Jeong-Jun; Kim, Yong Jin

2012-03-01

A facile continuous method for dilute-acid hydrolysis of the representative red seaweed species, Gelidium amansii was developed and its hydrolysate was subsequently evaluated for fermentability. In the hydrolysis step, the hydrolysates obtained from a batch reactor and a continuous reactor were systematically compared based on fermentable sugar yield and inhibitor formation. There are many advantages to the continuous hydrolysis process. For example, the low melting point of the agar component in G. amansii facilitates improved raw material fluidity in the continuous reactor. In addition, the hydrolysate obtained from the continuous process delivered a high sugar and low inhibitor concentration, thereby leading to both high yield and high final ethanol titer in the fermentation process. Copyright © 2011 Elsevier Ltd. All rights reserved.

Accelerating quality improvement within your organization: Applying the Model for Improvement.

PubMed

Crowl, Ashley; Sharma, Anita; Sorge, Lindsay; Sorensen, Todd

2015-01-01

To discuss the fundamentals of the Model for Improvement and how the model can be applied to quality improvement activities associated with medication use, including understanding the three essential questions that guide quality improvement, applying a process for actively testing change within an organization, and measuring the success of these changes on care delivery. PubMed from 1990 through April 2014 using the search terms quality improvement, process improvement, hospitals, and primary care. At the authors' discretion, studies were selected based on their relevance in demonstrating the quality improvement process and tests of change within an organization. Organizations are continuously seeking to enhance quality in patient care services, and much of this work focuses on improving care delivery processes. Yet change in these systems is often slow, which can lead to frustration or apathy among frontline practitioners. Adopting and applying the Model for Improvement as a core strategy for quality improvement efforts can accelerate the process. While the model is frequently well known in hospitals and primary care settings, it is not always familiar to pharmacists. In addition, while some organizations may be familiar with the "plan, do, study, act" (PDSA) cycles-one element of the Model for Improvement-many do not apply it effectively. The goal of the model is to combine a continuous process of small tests of change (PDSA cycles) within an overarching aim with a longitudinal measurement process. This process differs from other forms of improvement work that plan and implement large-scale change over an extended period, followed by months of data collection. In this scenario it may take months or years to determine whether an intervention will have a positive impact. By following the Model for Improvement, frontline practitioners and their organizational leaders quickly identify strategies that make a positive difference and result in a greater degree of success.

The experience factory: Can it make you a 5? or what is its relationship to other quality and improvement concepts?

NASA Technical Reports Server (NTRS)

Basili, Victor R.

1992-01-01

The concepts of quality improvements have permeated many businesses. It is clear that the nineties will be the quality era for software and there is a growing need to develop or adapt quality improvement approaches to the software business. Thus we must understand software as an artifact and software as a business. Since the business we are dealing with is software, we must understand the nature of software and software development. The software discipline is evolutionary and experimental; it is a laboratory science. Software is development not production. The technologies of the discipline are human based. There is a lack of models that allow us to reason about the process and the product. All software is not the same; process is a variable, goals are variable, etc. Packaged, reusable, experiences require additional resources in the form of organization, processes, people, etc. There have been a variety of organizational frameworks proposed to improve quality for various businesses. The ones discussed in this presentation include: Plan-Do-Check-Act, a quality improvement process based upon a feedback cycle for optimizing a single process model/production line; the Experience Factory/Quality Improvement Paradigm, continuous improvements through the experimentation, packaging, and reuse of experiences based upon a business's needs; Total Quality Management, a management approach to long term success through customer satisfaction based on the participation of all members of an organization; the SEI capability maturity model, a staged process improvement based upon assessment with regard to a set of key process areas until you reach a level 5 which represents a continuous process improvement; and Lean (software) Development, a principle supporting the concentration of the production on 'value added' activities and the elimination of reduction of 'not value added' activities.

NASA Johnson Space Center: Total quality partnership

NASA Technical Reports Server (NTRS)

Harlan, Charlie; Boyd, Alfred A.

1992-01-01

The development of and benefits realized from a joint NASA, support contractor continuous improvement process at the Johnson Space Center (JSC) is traced. The joint effort described is the Safety, Reliability, and Quality Assurance Directorate relationship with its three support contractors which began in early 1990. The Continuous Improvement effort started in early 1990 with an initiative to document and simplify numerous engineering change evaluation processes. This effort quickly grew in scope and intensity to include process improvement teams, improvement methodologies, awareness, and training. By early 1991, the support contractor had teams in place and functioning, program goals established and a cultural change effort underway. In mid-l991 it became apparent that a major redirection was needed to counter a growing sense of frustration and dissatisfaction from teams and managers. Sources of frustration were isolated to insufficient joint participation on teams, and to a poorly defined vision. Over the next year, the effort was transformed to a truly joint process. The presentation covers the steps taken to define vision, values, goals, and priorities and to form a joint Steering Committee and joint process improvement teams. The most recent assessment against the President's award criteria is presented as a summary of progress. Small, but important improvement results have already demonstrated the value of the joint effort.

Continuous enzymatic hydrolysis of lignocellulosic biomass in a membrane-reactor system: Continuous enzymatic hydrolysis of lignocellulosic biomass in a membrane-reactor system

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

Stickel, Jonathan J.; Adhikari, Birendra; Sievers, David A.

Converting abundant lignocellulosic biomass to sugars as fungible precursors to fuels and chemicals has the potential to diversify the supply chain for those products, but further process improvements are needed to achieve economic viability. In the current work, process intensification of the key enzymatic hydrolysis unit operation is demonstrated by means of a membrane reactor system that was operated continuously. Lignocellulosic biomass (pretreated corn stover) and buffered enzyme solution were fed to a continuously stirred-tank reactor, and clarified sugar solution was withdrawn via a commercial tubular ultrafiltration membrane. The membrane permeance decline and membrane cleaning efficacy were studied and didmore » not vary significantly when increasing fraction insoluble solids (FIS) from 2.5% to 5%. Continuous enzymatic hydrolysis was successfully operated for more than 80 h. A model for the reactor system was able to predict dynamic behavior that was in reasonable agreement with experimental results. The modeled technical performance of anticipated commercial batch and continuous enzymatic hydrolysis processes were compared and showed that continuous operation would provide at least twice the volumetric productivity for the conditions studied. Further improvements are anticipated by better membrane selection and by increasing FIS.« less

Continuous enzymatic hydrolysis of lignocellulosic biomass in a membrane-reactor system: Continuous enzymatic hydrolysis of lignocellulosic biomass in a membrane-reactor system

DOE PAGES

Stickel, Jonathan J.; Adhikari, Birendra; Sievers, David A.; ...

2018-02-21

Converting abundant lignocellulosic biomass to sugars as fungible precursors to fuels and chemicals has the potential to diversify the supply chain for those products, but further process improvements are needed to achieve economic viability. In the current work, process intensification of the key enzymatic hydrolysis unit operation is demonstrated by means of a membrane reactor system that was operated continuously. Lignocellulosic biomass (pretreated corn stover) and buffered enzyme solution were fed to a continuously stirred-tank reactor, and clarified sugar solution was withdrawn via a commercial tubular ultrafiltration membrane. The membrane permeance decline and membrane cleaning efficacy were studied and didmore » not vary significantly when increasing fraction insoluble solids (FIS) from 2.5% to 5%. Continuous enzymatic hydrolysis was successfully operated for more than 80 h. A model for the reactor system was able to predict dynamic behavior that was in reasonable agreement with experimental results. The modeled technical performance of anticipated commercial batch and continuous enzymatic hydrolysis processes were compared and showed that continuous operation would provide at least twice the volumetric productivity for the conditions studied. Further improvements are anticipated by better membrane selection and by increasing FIS.« less

A Prototype for the Support of Integrated Software Process Development and Improvement

NASA Astrophysics Data System (ADS)

Porrawatpreyakorn, Nalinpat; Quirchmayr, Gerald; Chutimaskul, Wichian

An efficient software development process is one of key success factors for quality software. Not only can the appropriate establishment but also the continuous improvement of integrated project management and of the software development process result in efficiency. This paper hence proposes a software process maintenance framework which consists of two core components: an integrated PMBOK-Scrum model describing how to establish a comprehensive set of project management and software engineering processes and a software development maturity model advocating software process improvement. Besides, a prototype tool to support the framework is introduced.

Severe postpartum haemorrhage after vaginal delivery: a statistical process control chart to report seven years of continuous quality improvement.

PubMed

Dupont, Corinne; Occelli, Pauline; Deneux-Tharaux, Catherine; Touzet, Sandrine; Duclos, Antoine; Bouvier-Colle, Marie-Hélène; Rudigoz, René-Charles; Huissoud, Cyril

2014-07-01

Severe postpartum haemorrhage after vaginal delivery: a statistical process control chart to report seven years of continuous quality improvement To use statistical process control charts to describe trends in the prevalence of severe postpartum haemorrhage after vaginal delivery. This assessment was performed 7 years after we initiated a continuous quality improvement programme that began with regular criteria-based audits Observational descriptive study, in a French maternity unit in the Rhône-Alpes region. Quarterly clinical audit meetings to analyse all cases of severe postpartum haemorrhage after vaginal delivery and provide feedback on quality of care with statistical process control tools. The primary outcomes were the prevalence of severe PPH after vaginal delivery and its quarterly monitoring with a control chart. The secondary outcomes included the global quality of care for women with severe postpartum haemorrhage, including the performance rate of each recommended procedure. Differences in these variables between 2005 and 2012 were tested. From 2005 to 2012, the prevalence of severe postpartum haemorrhage declined significantly, from 1.2% to 0.6% of vaginal deliveries (p<0.001). Since 2010, the quarterly rate of severe PPH has not exceeded the upper control limits, that is, been out of statistical control. The proportion of cases that were managed consistently with the guidelines increased for all of their main components. Implementation of continuous quality improvement efforts began seven years ago and used, among other tools, statistical process control charts. During this period, the prevalence of severe postpartum haemorrhage after vaginal delivery has been reduced by 50%. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

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

PubMed

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

2009-08-01

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

A continuous quality improvement team approach to adverse drug reaction reporting.

PubMed

Flowers, P; Dzierba, S; Baker, O

1992-07-01

Crossfunctional teams can generate more new ideas, concepts, and possible solutions than does a department-based process alone. Working collaboratively can increase knowledge of teams using CQI approaches and appropriate tools. CQI produces growth and development at multiple levels resulting from involvement in the process of incremental improvement.

Process Improvement Education with Professionals in the Addiction Treatment Field

ERIC Educational Resources Information Center

Pulvermacher, Alice

2006-01-01

Continuing education is being provided to professionals in the addiction treatment field to help them develop skills in process improvement and better meet the needs and requests they encounter. Access and retention of individuals seeking addiction treatment have been two of the greatest challenges addiction treatment professionals face.…

Gaining customer knowledge: obtaining and using customer judgments for hospitalwide quality improvement.

PubMed

Nelson, E C; Caldwell, C; Quinn, D; Rose, R

1991-03-01

Customer knowledge is an essential feature of hospitalwide quality improvement. All systems and processes have customers. The aim is to use customer knowledge and voice of the customer measurement to plan, design, improve, and monitor these systems and processes continuously. In this way, the hospital stands the best chance of meeting customers' needs and, hopefully, delivering services that are so outstanding that customers will be surprised and delighted. There are many methods, both soft and hard, that can be used to increase customer knowledge. One useful strategy is to use a family of quality measures that reflect the voice of the customer. These measures can generate practical and powerful customer knowledge information that is essential to performing strategic planning, deploying quality policy, designing new services, finding targets for improvements, and monitoring those continuous improvements based on customers' judgments.

Induction of labour: a continuous quality improvement and peer review program to improve the quality of care

PubMed Central

Harris, Susan; Buchinski, Bev; Gryzbowski, Stefan; Janssen, Patti; Mitchell, G.W. Erle; Farquharson, Duncan

2000-01-01

This article describes a program developed to improve the process of planned induction of labour and to reduce the rates of inappropriate induction. The setting is a tertiary-care maternity hospital in urban Vancouver, BC, in which 7000 deliveries take place annually. Approximately 65% of these can be considered primary care; the remainder are secondary- or tertiary-level cases. Continuous quality improvement (CQI) methods were used by a multidisciplinary team, which included nursing staff, physicians, health records personnel and a CQI facilitator. Interventions included the development of a new induction-booking process, clear criteria for induction, feedback to caregivers about changes and a peer review system to oversee and maintain improvement. The overall induction rate for the institution decreased, and this change has been maintained. PMID:11079064

Direct Measurement and Evaluation for Mechanical Engineering Programme Outcomes: Impact on Continuous Improvement

ERIC Educational Resources Information Center

Tahir, Mohd Faizal Mat; Khamis, Nor Kamaliana; Wahid, Zaliha; Ihsan, Ahmad Kamal Ariffin Mohd; Ghani, Jaharah Ab; Sabri, Mohd Anas Mohd; Sajuri, Zainuddin; Abdullah, Shahrum; Sulong, Abu Bakar

2013-01-01

Universiti Kebangsaan Malaysia (UKM) is a research university that continuously undergoes an audit and accreditation process for the management of its courses. The Faculty of Engineering and the Built Environment (FKAB) is subjected to such processes, one of them is the auditing conducted by the Engineering Accreditation Council (EAC), which gives…

Development of rapid continuous dyeing process for heavy-weight nylon 6,6 carpet

USDA-ARS?s Scientific Manuscript database

An improved continuous dyeing process for coloration of heavy-weight (60-70 oz/yd2), residential nylon 6,6 carpet is reported. By inserting a slot steam applicator after the dye pad and before the box steamer to preheat the carpet to around 180°F (greater than the nylon wet glass transition temperat...

Achieving continuous improvement in laboratory organization through performance measurements: a seven-year experience.

PubMed

Salinas, Maria; López-Garrigós, Maite; Gutiérrez, Mercedes; Lugo, Javier; Sirvent, Jose Vicente; Uris, Joaquin

2010-01-01

Laboratory performance can be measured using a set of model key performance indicators (KPIs). The design and implementation of KPIs are important issues. KPI results from 7 years are reported and their implementation, monitoring, objectives, interventions, result reporting and delivery are analyzed. The KPIs of the entire laboratory process were obtained using Laboratory Information System (LIS) registers. These were collected automatically using a data warehouse application, spreadsheets and external quality program reports. Customer satisfaction was assessed using surveys. Nine model laboratory KPIs were proposed and measured. The results of some examples of KPIs used in our laboratory are reported. Their corrective measurements or the implementation of objectives led to improvement in the associated KPIs results. Measurement of laboratory performance using KPIs and a data warehouse application that continuously collects registers and calculates KPIs confirmed the reliability of indicators, indicator acceptability and usability for users, and continuous process improvement.

The importance of continuing education for transplant coordination staff.

PubMed

Tokalak, Ibrahim; Emiroğlu, Remzi; Karakayali, Hamdi; Bilgin, Nevzat; Haberal, Mehmet

2005-06-01

Continuous quality improvement activities are necessary to achieve excellence at any institution. The Başkent University Hospitals have implemented continuous in-service training programs to improve all health services provided. Also, continuing medical education programs are being instituted in organ procurement and transplantation centers. In addition to receiving basic orientation and training upon hiring, transplant coordination staff complete forms that detail their current training status, further job training needed, and other courses of interest. The information is used to monitor skill levels, to determine the success of educational programs, and to identify further education that is needed. Our aim is to improve the quality of transplant coordination activities and increase organ donation at the hospitals in our network through effective monitoring and evaluation of continuous in-service training. These training programs enhance staff members' understanding of and participation in procedures related to transplantation and improves the total quality of the transplantation process. In the near future, this training model may be used to improve the donor hospital education program in Turkey.

Process improvement to enhance existing stroke team activity toward more timely thrombolytic treatment.

PubMed

Cho, Han-Jin; Lee, Kyung Yul; Nam, Hyo Suk; Kim, Young Dae; Song, Tae-Jin; Jung, Yo Han; Choi, Hye-Yeon; Heo, Ji Hoe

2014-10-01

Process improvement (PI) is an approach for enhancing the existing quality improvement process by making changes while keeping the existing process. We have shown that implementation of a stroke code program using a computerized physician order entry system is effective in reducing the in-hospital time delay to thrombolysis in acute stroke patients. We investigated whether implementation of this PI could further reduce the time delays by continuous improvement of the existing process. After determining a key indicator [time interval from emergency department (ED) arrival to intravenous (IV) thrombolysis] and conducting data analysis, the target time from ED arrival to IV thrombolysis in acute stroke patients was set at 40 min. The key indicator was monitored continuously at a weekly stroke conference. The possible reasons for the delay were determined in cases for which IV thrombolysis was not administered within the target time and, where possible, the problems were corrected. The time intervals from ED arrival to the various evaluation steps and treatment before and after implementation of the PI were compared. The median time interval from ED arrival to IV thrombolysis in acute stroke patients was significantly reduced after implementation of the PI (from 63.5 to 45 min, p=0.001). The variation in the time interval was also reduced. A reduction in the evaluation time intervals was achieved after the PI [from 23 to 17 min for computed tomography scanning (p=0.003) and from 35 to 29 min for complete blood counts (p=0.006)]. PI is effective for continuous improvement of the existing process by reducing the time delays between ED arrival and IV thrombolysis in acute stroke patients.

How Visual Management for Continuous Improvement Might Guide and Affect Hospital Staff: A Case Study.

PubMed

Ulhassan, Waqar; von Thiele Schwarz, Ulrica; Westerlund, Hugo; Sandahl, Christer; Thor, Johan

2015-01-01

Visual management (VM) tools such as whiteboards, often employed in Lean thinking applications, are intended to be helpful in improving work processes in different industries including health care. It remains unclear, however, how VM is actually applied in health care Lean interventions and how it might influence the clinical staff. We therefore examined how Lean-inspired VM using whiteboards for continuous improvement efforts related to the hospital staff's work and collaboration. Within a case study design, we combined semistructured interviews, nonparticipant observations, and photography on 2 cardiology wards. The fate of VM differed between the 2 wards; in one, it was well received by the staff and enhanced continuous improvement efforts, whereas in the other ward, it was not perceived to fit in the work flow or to make enough sense in order to be sustained. Visual management may enable the staff and managers to allow communication across time and facilitate teamwork by enabling the inclusion of team members who are not present simultaneously; however, its adoption and value seem contingent on finding a good fit with the local context. A combination of continuous improvement and VM may be helpful in keeping the staff engaged in the change process in the long run.

Improving Service Delivery in a County Health Department WIC Clinic: An Application of Statistical Process Control Techniques

PubMed Central

Boe, Debra Thingstad; Parsons, Helen

2009-01-01

Local public health agencies are challenged to continually improve service delivery, yet they frequently operate with constrained resources. Quality improvement methods and techniques such as statistical process control are commonly used in other industries, and they have recently been proposed as a means of improving service delivery and performance in public health settings. We analyzed a quality improvement project undertaken at a local Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinic to reduce waiting times and improve client satisfaction with a walk-in nutrition education service. We used statistical process control techniques to evaluate initial process performance, implement an intervention, and assess process improvements. We found that implementation of these techniques significantly reduced waiting time and improved clients' satisfaction with the WIC service. PMID:19608964

1996 State Transportation Improvement Program

DOT National Transportation Integrated Search

1996-01-01

The Wyoming Transportation Department utilizes a continuing and comprehensive procress of Needs Analysis, Priority Rating, Financial Analysis, and Manpower Analysis. This "State Transportation Improvement Program" is the culmination of that process. ...

Process of Continual Improvement in a School of Nursing.

ERIC Educational Resources Information Center

Norman, Linda D.; Lutenbacher, Melanie

1996-01-01

Vanderbilt University School of Nursing used the Batalden model of systems improvement to change its program. The model analyzes services and products, customers, social community need, and customer knowledge to approach improvements in a systematic way. (JOW)

Networked Improvement Communities: The Discipline of Improvement Science Meets the Power of Networks

ERIC Educational Resources Information Center

LeMahieu, Paul G.; Grunow, Alicia; Baker, Laura; Nordstrum, Lee E.; Gomez, Louis M.

2017-01-01

Purpose: The purpose of this paper is to delineate an approach to quality assurance in education called networked improvement communities (NICs) that focused on integrating the methodologies of improvement science with few of the networks. Quality improvement, the science and practice of continuously improving programs, practices, processes,…

How an educational improvement project improved the summative evaluation of medical students.

PubMed

Hoffman, K G; Brown, R Margaret A; Gay, J W; Headrick, L A

2009-08-01

At the University of Missouri-Columbia School of Medicine (USA) "commitment to improving quality and safety in healthcare" is one of eight key characteristics set as goals for our graduates. As educators, commitment to continuous improvement in the educational experience has been modelled through improvement of the Medical Student Performance Evaluation (MSPE) letter (formerly the Dean's letter). This educational improvement project decreased waste, increased collaboration and developed locally useful knowledge. By applying continuous improvement principles to the construction of the MSPE the overall efficiency of the process could be enhanced, and the MSPE committee was able to spend less cognitive energy on structure and format and focus more on the content of the letters. Four MSPE cycles have been completed using a new Web-based system; after each cycle, additional enhancements were identified and implemented. This work adds to the literature, as it describes the application of continuous improvement principles to an educational system.

Sustaining a Mature Risk Management Process: Ensuring the International Space Station for a Vibrant Future

NASA Technical Reports Server (NTRS)

Raftery, Michael; Carter-Journet, Katrina

2013-01-01

The International Space Station (ISS) risk management methodology is an example of a mature and sustainable process. Risk management is a systematic approach used to proactively identify, analyze, plan, track, control, communicate, and document risks to help management make risk-informed decisions that increase the likelihood of achieving program objectives. The ISS has been operating in space for over 14 years and permanently crewed for over 12 years. It is the longest surviving habitable vehicle in low Earth orbit history. Without a mature and proven risk management plan, it would be increasingly difficult to achieve mission success throughout the life of the ISS Program. A successful risk management process must be able to adapt to a dynamic program. As ISS program-level decision processes have evolved, so too has the ISS risk management process continued to innovate, improve, and adapt. Constant adaptation of risk management tools and an ever-improving process is essential to the continued success of the ISS Program. Above all, sustained support from program management is vital to risk management continued effectiveness. Risk management is valued and stressed as an important process by the ISS Program.

Office of Command Security Total Quality Management Plan

DTIC Science & Technology

1989-07-01

outlines the Office of Command Security instruction for TQM implementation. Keywords: TQM (Total Quality Management ), DLA Office of Command Security, Continuous process improvement, Automatic data processing security.

Kaizen method for esophagectomy patients: improved quality control, outcomes, and decreased costs.

PubMed

Iannettoni, Mark D; Lynch, William R; Parekh, Kalpaj R; McLaughlin, Kelley A

2011-04-01

The majority of costs associated with esophagectomy are related to the initial 3 days of hospital stay requiring intensive care unit stays, ventilator support, and intraoperative time. Additional costs arise from hospital-based services. The major cost increases are related to complications associated with the procedure. We attempted to define these costs and identify expense management by streamlining care through strict adherence to patient care maps, operative standardization, and rapid discharge planning to reduce variability. Utilizing methods of Kaizen philosophy we evaluated all processes related to the entire experience of esophageal resection. This process has taken over 5 years to achieve, with quality and cost being tracked over this time period. Cost analysis included expenses related to intensive care unit, anesthesia, disposables, and hospital services. Quality improvement measures were related to intraoperative complications, in-hospital complications, and postoperative outcomes. The Institutional Review Board approved the use of anonymous data from standard clinical practice because no additional treatment was planned (observational study). Utilizing a continuous process improvement methodology, a 43% reduction in cost per case has been achieved with a significant increase in contribution margin for esophagectomy. The length of stay has been reduced from 14 days to 5. With intraoperative and postoperative standardization the leak rate has dropped from 12% to less than 3% to no leaks in our current Kaizen modification of care in our last 64 patients. Utilizing lean manufacturing techniques and continuous process evaluation we have attempted to eliminate variability, standardized the phases of care resulting in improved outcomes, decreased length of stay, and improved contribution margins. These Kaizen improvements require continuous interventions, strict adherence to care maps, and input from all levels for quality improvements. Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Quality improvement in the use of medications through a drug use evaluation service.

PubMed

Stevenson, J G; Bakst, C M; Zaran, F K; Rybak, M J; Smolarek, R T; Alexander, M R

1992-10-01

Continuous quality improvement methods have the potential to improve processes that cross several disciplines. The medication system is one in which coordination of activities between physicians, pharmacists, and nurses is essential for optimal therapy to occur. DUE services can play an important role in helping to ensure that patients receive high-quality pharmaceutical care. It is necessary for pharmacy managers to review the structure, goals, and outcomes of their DUE programs to ensure that they are consistent with a philosophy of continuous improvement in the quality of drug therapy.

Process Improvements in Training Device Acceptance Testing: A Study in Total Quality Management

DTIC Science & Technology

1990-12-12

Quality Management , a small group of Government and industry specialists examined the existing training device acceptance test process for potential improvements. The agreed-to mission of the Air Force/Industry partnership was to continuously identify and promote implementable approaches to minimize the cost and time required for acceptance testing while ensuring that validated performance supports the user training requirements. Application of a Total Quality process improvement model focused on the customers and their requirements, analyzed how work was accomplished, and

Using Institutional Effectiveness Data To Stimulate Improvement...Getting Data off the Shelf and into the Hands of Stakeholders. AIR 2000 Annual Forum Paper.

ERIC Educational Resources Information Center

Hill, Sandy; Willekens, Rene G.

This paper outlines a successful, stakeholder driven, continuous improvement process that is currently used at Estrella Mountain Community College, Arizona. The process is designed to address the next step of what to do with institutional effectiveness data after it has been collected and reported. Many institutional effectiveness processes stop…

Economy of Force: Continuous Process Improvement And The Air Service

DTIC Science & Technology

2017-06-01

a household goods move, viewed from the perspective of a customer when interacting with a service organization, assists in demonstrating this...improvement (CPI) as well. The components of a process that deliver a value-added effect to a consumer of the goods or services generated by the process...CPI is largely about the “voice of the customer ” and all organizations, service or production based, have customers and processes. There are value

42 CFR 480.107 - Limitations on redisclosure.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs... the Act or for CMS to process sanctions under section 1156 of the Act; (d) If the health care services...

Total quality management: It works for aerospace information services

NASA Technical Reports Server (NTRS)

Erwin, James; Eberline, Carl; Colquitt, Wanda

1993-01-01

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

Demonstrating PQS Effectiveness and Driving Continual Improvement: Evidence-Based Risk Reduction.

PubMed

Ramnarine, Emma; O'Donnell, Kevin

2018-04-18

Product knowledge grows and evolves during the life of a product. In order to maintain a state of control and deliver product with consistent quality throughout its commercial life, continuous improvement and product lifecycle management become essential. The practical link between product and process knowledge, risk-based control strategies, and continual improvement and innovation can be made stronger through evidence-based risk reduction. Regulatory relief and flexibility in post approval change management and overall product lifecycle management will only be possible with effective application of science and risk-based concepts and demonstrated effectiveness of the PQS in assuring a state of control. Copyright © 2018, Parenteral Drug Association.

Parameter prediction based on Improved Process neural network and ARMA error compensation in Evaporation Process

NASA Astrophysics Data System (ADS)

Qian, Xiaoshan

2018-01-01

The traditional model of evaporation process parameters have continuity and cumulative characteristics of the prediction error larger issues, based on the basis of the process proposed an adaptive particle swarm neural network forecasting method parameters established on the autoregressive moving average (ARMA) error correction procedure compensated prediction model to predict the results of the neural network to improve prediction accuracy. Taking a alumina plant evaporation process to analyze production data validation, and compared with the traditional model, the new model prediction accuracy greatly improved, can be used to predict the dynamic process of evaporation of sodium aluminate solution components.

An exploratory survey of methods used to develop measures of performance

NASA Astrophysics Data System (ADS)

Hamner, Kenneth L.; Lafleur, Charles A.

1993-09-01

Nonmanufacturing organizations are being challenged to provide high-quality products and services to their customers, with an emphasis on continuous process improvement. Measures of performance, referred to as metrics, can be used to foster process improvement. The application of performance measurement to nonmanufacturing processes can be very difficult. This research explored methods used to develop metrics in nonmanufacturing organizations. Several methods were formally defined in the literature, and the researchers used a two-step screening process to determine the OMB Generic Method was most likely to produce high-quality metrics. The OMB Generic Method was then used to develop metrics. A few other metric development methods were found in use at nonmanufacturing organizations. The researchers interviewed participants in metric development efforts to determine their satisfaction and to have them identify the strengths and weaknesses of, and recommended improvements to, the metric development methods used. Analysis of participants' responses allowed the researchers to identify the key components of a sound metrics development method. Those components were incorporated into a proposed metric development method that was based on the OMB Generic Method, and should be more likely to produce high-quality metrics that will result in continuous process improvement.

Paths of Adoption: Routes to Continuous Process Improvement

DTIC Science & Technology

2014-07-01

To obtain a process the team will use: The Team Lead has worked on teams with good processes and wants their new team to start out on the right foot ...eventually going to have to eat the entire process-improvement elephant . So, how do you get the “Never- Adopters” to undertake the effort? The key is to...Air Warfare Center Abstract. This paper covers the different types of teams the authors have en- countered as NAVAIR Internal Process Coaches and how

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.

Systems approach to managing educational quality in the engineering classroom

NASA Astrophysics Data System (ADS)

Grygoryev, Kostyantyn

Today's competitive environment in post-secondary education requires universities to demonstrate the quality of their programs in order to attract financing, and student and academic talent. Despite significant efforts devoted to improving the quality of higher education, systematic, continuous performance measurement and management still have not reached the level where educational outputs and outcomes are actually produced---the classroom. An engineering classroom is a complex environment in which educational inputs are transformed by educational processes into educational outputs and outcomes. By treating a classroom as a system, one can apply tools such as Structural Equation Modeling, Statistical Process Control, and System Dynamics in order to discover cause-and-effect relationships among the classroom variables, control the classroom processes, and evaluate the effect of changes to the course organization, content, and delivery, on educational processes and outcomes. Quality improvement is best achieved through the continuous, systematic application of efforts and resources. Improving classroom processes and outcomes is an iterative process that starts with identifying opportunities for improvement, designing the action plan, implementing the changes, and evaluating their effects. Once the desired objectives are achieved, the quality improvement cycle may start again. The goal of this research was to improve the educational processes and outcomes in an undergraduate engineering management course taught at the University of Alberta. The author was involved with the course, first, as a teaching assistant, and, then, as a primary instructor. The data collected from the course over four years were used to create, first, a static and, then, a dynamic model of a classroom system. By using model output and qualitative feedback from students, changes to the course organization and content were introduced. These changes led to a lower perceived course workload and increased the students' satisfaction with the instructor, but the students' overall satisfaction with the course did not change significantly, and their attitude toward the course subject actually became more negative. This research brought performance measurement to the level of a classroom, created a dynamic model of the classroom system based on the cause-and-effect relationships discovered by using statistical analysis, and used a systematic, continuous improvement approach to modify the course in order to improve selected educational processes and outcomes.

42 CFR 475.102 - Eligibility of physician-sponsored organizations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS QUALITY IMPROVEMENT ORGANIZATIONS Utilization and Quality Control Quality Improvement Organizations § 475.102 Eligibility of physician-sponsored..., during the contract evaluation process, a set number of bonus points. [49 FR 7207, Feb. 27, 1984...

Implementation of the World Health Organization Regional Office for Africa Stepwise Laboratory Quality Improvement Process Towards Accreditation

PubMed Central

Maruta, Talkmore; Ndlovu, Nqobile; Moyo, Sikhulile; Yahaya, Ali Ahmed; Coulibaly, Sheick Oumar; Kasolo, Francis; Turgeon, David; Abrol, Angelii P.

2016-01-01

Background The increase in disease burden has continued to weigh upon health systems in Africa. The role of the laboratory has become increasingly critical in the improvement of health for diagnosis, management and treatment of diseases. In response, the World Health Organization Regional Office for Africa (WHO AFRO) and its partners created the WHO AFRO Stepwise Laboratory (Quality) Improvement Process Towards Accreditation (SLIPTA) program. SLIPTA implementation process WHO AFRO defined a governance structure with roles and responsibilities for six main stakeholders. Laboratories were evaluated by auditors trained and certified by the African Society for Laboratory Medicine. Laboratory performance was measured using the WHO AFRO SLIPTA scoring checklist and recognition certificates rated with 1–5 stars were issued. Preliminary results By March 2015, 27 of the 47 (57%) WHO AFRO member states had appointed a SLIPTA focal point and 14 Ministers of Health had endorsed SLIPTA as the desired programme for continuous quality improvement. Ninety-eight auditors from 17 African countries, competent in the Portuguese (3), French (12) and English (83) languages, were trained and certified. The mean score for the 159 laboratories audited between May 2013 and March 2015 was 69% (median 70%; SD 11.5; interquartile range 62–77). Of these audited laboratories, 70% achieved 55% compliance or higher (2 or more stars) and 1% scored at least 95% (5 stars). The lowest scoring sections of the WHO AFRO SLIPTA checklist were sections 6 (Internal Audit) and 10 (Corrective Action), which both had mean scores below 50%. Conclusion The WHO AFRO SLIPTA is a process that countries with limited resources can adopt for effective implementation of quality management systems. Political commitment, ownership and investment in continuous quality improvement are integral components of the process. PMID:28879103

Quality improvement: the nurse's role.

PubMed

Moran, M J; Johnson, J E

1992-06-01

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

Kaizen: a process improvement model for the business of health care and perioperative nursing professionals.

PubMed

Tetteh, Hassan A

2012-01-01

Kaizen is a proven management technique that has a practical application for health care in the context of health care reform and the 2010 Institute of Medicine landmark report on the future of nursing. Compounded productivity is the unique benefit of kaizen, and its principles are change, efficiency, performance of key essential steps, and the elimination of waste through small and continuous process improvements. The kaizen model offers specific instruction for perioperative nurses to achieve process improvement in a five-step framework that includes teamwork, personal discipline, improved morale, quality circles, and suggestions for improvement. Published by Elsevier Inc.

[Sustainable process improvement with application of 'lean philosophy'].

PubMed

Rouppe van der Voort, Marc B V; van Merode, G G Frits; Veraart, Henricus G N

2013-01-01

Process improvement is increasingly being implemented, particularly with the aid of 'lean philosophy'. This management philosophy aims to improve quality by reducing 'wastage'. Local improvements can produce negative effects elsewhere due to interdependence of processes. An 'integrated system approach' is required to prevent this. Some hospitals claim that this has been successful. Research into process improvement with the application of lean philosophy has reported many positive effects, defined as improved safety, quality and efficiency. Due to methodological shortcomings and lack of rigorous evaluations it is, however, not yet possible to determine the impact of this approach. It is, however, obvious that the investigated applications are fragmentary, with a dominant focus on the instrumental aspect of the philosophy and a lack of integration in a total system, and with insufficient attention to human aspects. Process improvement is required to achieve better and more goal-oriented healthcare. To achieve this, hospitals must develop integrated system approaches that combine methods for process design with continuous improvement of processes and with personnel management. It is crucial that doctors take the initiative to guide and improve processes in an integral manner.

Visit, revamp, and revitalize your business plan: Part 2.

PubMed

Waldron, David

2011-01-01

The diagnostic imaging department strives for the highest quality outcomes in imaging quality, in diagnostic reporting, and in providing a caring patient experience while also satisfying the needs of referring physicians. Understand how tools such as process mapping and concepts such as Six Sigma and Lean Six Sigma can be used to facilitate quality improvements and team building, resulting in staff led process improvement initiatives. Discover how to integrate a continuous staff management cycle to implement process improvements,capture the promised performance improvements, and achieve a culture change away from the "way it has always been done".

Microstructural Characteristic of the Al-Fe-Cu Alloy During High-Speed Repetitive Continuous Extrusion Forming

NASA Astrophysics Data System (ADS)

Hu, Jiamin; Teng, Jie; Ji, Xiankun; Kong, Xiangxin; Jiang, Fulin; Zhang, Hui

2016-11-01

High-speed repetitive continuous extrusion forming process (R-Conform process) was performed on the Al-Fe-Cu alloy. The microstructural evolution and mechanical properties were studied by x-ray diffraction, electron backscatter diffraction, transmission electron microscopy and tensile testing. The results show that a significant improvement of tensile ductility concurs with a considerable loss of tensile strength before four passes, after that the process on mechanical properties variation tends to be steady, indicating an accelerated mechanical softening occurs when comparing to low-speed R-Conform process. Microstructure characterization indicates that the accumulated strain promotes the transformation of low angle boundaries to high angle boundaries, thus leading to the acceleration of continuous dynamic recrystallization process, and the precipitates are broken, spheroidized and homogeneously distribute in Al matrix as increasing R-Conform passes. Massive microshear bands are observed after initial passes of R-Conform process, which may promote continuous dynamic recrystallization and further grain refinement during high-speed R-Conform process.

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

PubMed

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

2014-10-01

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

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

PubMed

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

2015-01-01

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

The Skill Development Processes of Apprenticeship.

ERIC Educational Resources Information Center

Wolek, Francis W.

1999-01-01

Case studies of apprenticeship in the Japanese tea ceremony, traditional crafts, and strategic thinking illustrate novices' growth in internal knowledge through reflective practice of skilled processes. As skilled experts, adult educators are engaged in continually improving the skilled processes they model. (SK)

Software process improvement in the NASA software engineering laboratory

NASA Technical Reports Server (NTRS)

Mcgarry, Frank; Pajerski, Rose; Page, Gerald; Waligora, Sharon; Basili, Victor; Zelkowitz, Marvin

1994-01-01

The Software Engineering Laboratory (SEL) was established in 1976 for the purpose of studying and measuring software processes with the intent of identifying improvements that could be applied to the production of ground support software within the Flight Dynamics Division (FDD) at the National Aeronautics and Space Administration (NASA)/Goddard Space Flight Center (GSFC). The SEL has three member organizations: NASA/GSFC, the University of Maryland, and Computer Sciences Corporation (CSC). The concept of process improvement within the SEL focuses on the continual understanding of both process and product as well as goal-driven experimentation and analysis of process change within a production environment.

Creating meaningful business continuity management programme metrics.

PubMed

Strong, Brian

2010-11-01

The popular axiom, 'what gets measured gets done', is often applied in the quality management and continuous improvement disciplines. This truism is also useful to business continuity practitioners as they continually strive to prove the value of their organisation's investment in a business continuity management (BCM) programme. BCM practitioners must also remain relevant to their organisations as executives focus on the bottom line and maintaining stakeholder confidence. It seems that executives always find a way, whether in a hallway or elevator, to ask BCM professionals about the company's level of readiness. When asked, they must be ready with an informed response. The establishment of a process to measure business continuity programme performance and organisational readiness has emerged as a key component of US Department of Homeland Security 'Voluntary Private Sector Preparedness (PS-Prep) Program' standards where the overarching goal is to improve private sector preparedness for disasters and emergencies. The purpose of this paper is two-fold: to introduce continuity professionals to best practices that should be considered when developing a BCM metrics programme as well as providing a case study of how a large health insurance company researched, developed and implemented a process to measure BCM programme performance and company readiness.

DESC (Defense Electronics Supply Center) Total Quality Management Plan

DTIC Science & Technology

1989-04-01

Paoerwort Reduction Proodt(0704.01 ge. Washington. DC 20S03 4. TITLE AND SUBTITLE Api598 . FUNDING NUMBERS DESC Total Quality Management Master Plan...OF PAGES TQM (Total Quality Management ), Continuous Process Improvement,_________ cTainingManagement 16. PRICE CODE 17. SECURITY CLASSIFICATION 18... QUALITY MANAGEMENT As you read the DESC Total Quality Management Plan, I ask each of you to make a commitment to continuously strive for improvement

Electrostatics in pharmaceutical aerosols for inhalation.

PubMed

Wong, Jennifer; Chan, Hak-Kim; Kwok, Philip Chi Lip

2013-08-01

Electrostatics continues to play an important role in pharmaceutical aerosols for inhalation. Despite its ubiquitous nature, the charging process is complex and not well understood. Nonetheless, significant advances in the past few years continue to improve understanding and lead to better control of electrostatics. The purpose of this critical review is to present an overview of the literature, with an emphasis on how electrostatic charge can be useful in improving pulmonary drug delivery.

A Comparative Case Study Analysis of Administrators Perceptions on the Adaptation of Quality and Continuous Improvement Tools to Community Colleges in the State of Michigan

ERIC Educational Resources Information Center

Mattis, Ted B.

2011-01-01

The purpose of this study was to determine whether community college administrators in the state of Michigan believe that commonly known quality and continuous improvement tools, prevalent in a manufacturing environment, can be adapted to a community college model. The tools, specifically Six Sigma, benchmarking and process mapping have played a…

International Accreditations as Drivers of Business School Quality Improvement

ERIC Educational Resources Information Center

Bryant, Michael

2013-01-01

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

Genomic exploitation of genetic variation for crop improvement

USDA-ARS?s Scientific Manuscript database

Crop plants produce food, fiber, and fuel that are essential to human civilization and mainstays of economic prosperity. Our society continues to cultivate and improve the crop plants for better quality and productivity with sustainable environments. The process of crop genetic improvement has bee...

Continued improvements at one C3RS site

DOT National Transportation Integrated Search

2015-06-01

Human-factors-based solutions, along with process and technology innovations, can make significant contributions to improving safety in the railroad industry. As part of ongoing efforts to address human-factors, FRA implemented the Confidential Close...

Improvements in Production of Single-Walled Carbon Nanotubes

NASA Technical Reports Server (NTRS)

Balzano, Leandro; Resasco, Daniel E.

2009-01-01

A continuing program of research and development has been directed toward improvement of a prior batch process in which single-walled carbon nanotubes are formed by catalytic disproportionation of carbon monoxide in a fluidized-bed reactor. The overall effect of the improvements has been to make progress toward converting the process from a batch mode to a continuous mode and to scaling of production to larger quantities. Efforts have also been made to optimize associated purification and dispersion post processes to make them effective at large scales and to investigate means of incorporating the purified products into composite materials. The ultimate purpose of the program is to enable the production of high-quality single-walled carbon nanotubes in quantities large enough and at costs low enough to foster the further development of practical applications. The fluidized bed used in this process contains mixed-metal catalyst particles. The choice of the catalyst and the operating conditions is such that the yield of single-walled carbon nanotubes, relative to all forms of carbon (including carbon fibers, multi-walled carbon nanotubes, and graphite) produced in the disproportionation reaction is more than 90 weight percent. After the reaction, the nanotubes are dispersed in various solvents in preparation for end use, which typically involves blending into a plastic, ceramic, or other matrix to form a composite material. Notwithstanding the batch nature of the unmodified prior fluidized-bed process, the fluidized-bed reactor operates in a continuous mode during the process. The operation is almost entirely automated, utilizing mass flow controllers, a control computer running software specific to the process, and other equipment. Moreover, an important inherent advantage of fluidized- bed reactors in general is that solid particles can be added to and removed from fluidized beds during operation. For these reasons, the process and equipment were amenable to modification for conversion from batch to continuous production.

Building capacity for the continuous improvement of health-promoting schools.

PubMed

Hoyle, Tena B; Samek, Beverly B; Valois, Robert F

2008-01-01

There has been much educational verbosity over the past decade related to building capacity for effective schools. However, there seems to be a scarcity of clarification about what is meant by school capacity building or how to accomplish and sustain this process. This article describes the preexisting conditions and ongoing processes in Pueblo, Colorado School District 60 (Pueblo 60) that built capacity for the development and continuous improvement of health-promoting schools. Capacity building strategies and a program-planning model for continuous improvement for health-promoting schools were used that included: (a) visionary/effective leadership and management structures, (b) extensive internal and external supports, (c) development and allocation of adequate resources, (d) supportive policies and procedures, and (e) ongoing, embedded professional development. Pueblo 60 strategically developed an infrastructure through which they successfully delivered a wide array of health programs and services. Through building organizational capacity at the school district and school level, additional school health programming can be developed and sustained.

Development of a method for fabricating metallic matrix composite shapes by a continuous mechanical process

NASA Technical Reports Server (NTRS)

Divecha, A. P.

1974-01-01

Attempts made to develop processes capable of producing metal composites in structural shapes and sizes suitable for space applications are described. The processes must be continuous and promise to lower fabrication costs. Special attention was given to the aluminum boride (Al/b) composite system. Results show that despite adequate temperature control, the consolidation characteristics did not improve as expected. Inadequate binder removal was identified as the cause responsible. An Al/c (aluminum-graphite) composite was also examined.

How Implementation of TQM and the Development of a Process Improvement Model, Within a Forward Support Battalion, Can Improve Preparation of the Material Condition Status Report (DA Form 2406)

DTIC Science & Technology

1990-12-01

studies for the continuing education of managers new to the TQM approach , for informing vendors of their responsibilities under a changed process, and...Department of Defense (DoD) is adopting a management approach known as Total Quality Management (TQM) in an effort to improve quality and productivity...individuals selected be highly knowledgeable about the operations in their shop or unit. The main function of PATs is to collect and summarize process data for

Focused process improvement events: sustainability of impact on process and performance in an academic radiology department.

PubMed

Rosenkrantz, Andrew B; Lawson, Kirk; Ally, Rosina; Chen, David; Donno, Frank; Rittberg, Steven; Rodriguez, Joan; Recht, Michael P

2015-01-01

To evaluate sustainability of impact of rapid, focused process improvement (PI) events on process and performance within an academic radiology department. Our department conducted PI during 2011 and 2012 in CT, MRI, ultrasound, breast imaging, and research billing. PI entailed participation by all stakeholders, facilitation by the department chair, collection of baseline data, meetings during several weeks, definition of performance metrics, creation of an improvement plan, and prompt implementation. We explore common themes among PI events regarding initial impact and durability of changes. We also assess performance in each area pre-PI, immediately post-PI, and at the time of the current study. All PI events achieved an immediate improvement in performance metrics, often entailing both examination volumes and on-time performance. IT-based solutions, process standardization, and redefinition of staff responsibilities were often central in these changes, and participants consistently expressed improved internal leadership and problem-solving ability. Major environmental changes commonly occurred after PI, including a natural disaster with equipment loss, a change in location or services offered, and new enterprise-wide electronic medical record system incorporating new billing and radiology informatics systems, requiring flexibility in the PI implementation plan. Only one PI team conducted regular post-PI follow-up meetings. Sustained improvement was frequently, but not universally, observed: in the long-term following initial PI, measures of examination volume showed continued progressive improvements, whereas measures of operational efficiency remained stable or occasionally declined. Focused PI is generally effective in achieving performance improvement, although a changing environment influences the sustainability of impact. Thus, continued process evaluation and ongoing workflow modifications are warranted. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

The use of data for process and quality improvement in long term care and home care: a systematic review of the literature.

PubMed

Sales, Anne E; Bostrom, Anne-Marie; Bucknall, Tracey; Draper, Kellie; Fraser, Kimberly; Schalm, Corinne; Warren, Sharon

2012-02-01

Standardized resident or client assessments, including the Resident Assessment Instrument (RAI), have been available in long term care and home care settings (continuing care sector) in many jurisdictions for a number of years. Although using these data can make quality improvement activities more efficient and less costly, there has not been a review of the literature reporting quality improvement interventions using standardized data. To address 2 questions: (1) How have RAI and other standardized data been used in process or quality improvement activities in the continuing care sector? and (2) Has the use of RAI and similar data resulted in improvements to resident or other outcomes? Searches using a combination of keyword and controlled vocabulary term searches were conducted in MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, the Cochrane Library, and PsychINFO. ELIGIBILITY CRITERIA, PARTICIPANTS, AND INTERVENTIONS: English language publications from database inception to October 2008 were included. Eligibility criteria included the following: (1) set in continuing care (long-term care facility or home care), (2) involved some form of intervention designed to improve quality or process of care, and (3) used standardized data in the quality or process improvement intervention. After reviewing the articles, we grouped the studies according to the type of intervention used to initiate process improvement. Four different intervention types were identified. We organized the results and discussion by these 4 intervention types. Key word searches identified 713 articles, of which we excluded 639 on abstract review because they did not meet inclusion criteria. A further 50 articles were excluded on full-text review, leaving a total of 24 articles. Of the 24 studies, 10 used a defined process improvement model, 8 used a combination of interventions (multimodal), 5 implemented new guidelines or protocols, and 1 used an education intervention. The most frequently cited issues contributing to unsuccessful quality improvement interventions were lack of staff, high staff turnover, and limited time available to train staff in ways that would improve client care. Innovative strategies and supporting research are required to determine how to intervene successfully to improve quality in these settings characterized by low staffing levels and predominantly nonprofessional staff. Research on how to effectively enable practitioners to use data to improve quality of care, and ultimately quality of life, needs to be a priority. Copyright © 2012 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

Ten tools of continuous quality improvement: a review and case example of hospital discharge.

PubMed

Ziegenfuss, J T; McKenna, C K

1995-01-01

Concepts and methods of continuous quality improvement have been endorsed by quality specialists in American Health care, and their use has convinced CEOs that industrial methods can make a contribution to health and medical care. For all the quality improvement publications, there are still few that offer a clear, concise definition and an explanation of the primary tools for teaching purposes. This report reviews ten continuous quality improvement methods including: problem solving cycle, affinity diagrams, cause and effect diagrams, Pareto diagrams, histograms, bar charts, control charts, scatter diagrams, checklists, and a process decision program chart. These do not represent an exhaustive list, but a set of commonly used tools. They are applied to a case study of bed utilization in a university hospital.

Addressing the hidden dimension in nursing education: promoting cultural competence.

PubMed

Carter, Kimberly F; Xu, Yu

2007-01-01

The authors describe a cultural competence quality enhancement process to address the retention challenge of students who speak English as second language and international students as part of a school of nursing's continuous program quality improvement to achieve excellence. The process, strategies, outcomes, and evaluation of the training program are detailed within the given geographical, institutional, and curriculum context. Lessons and continuing challenges are also specified.

Method and apparatus for improved melt flow during continuous strip casting

DOEpatents

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

1991-11-12

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

Using Lean Process Improvement to Enhance Safety and Value in Orthopaedic Surgery: The Case of Spine Surgery.

PubMed

Sethi, Rajiv; Yanamadala, Vijay; Burton, Douglas C; Bess, Robert Shay

2017-11-01

Lean methodology was developed in the manufacturing industry to increase output and decrease costs. These labor organization methods have become the mainstay of major manufacturing companies worldwide. Lean methods involve continuous process improvement through the systematic elimination of waste, prevention of mistakes, and empowerment of workers to make changes. Because of the profit and productivity gains made in the manufacturing arena using lean methods, several healthcare organizations have adopted lean methodologies for patient care. Lean methods have now been implemented in many areas of health care. In orthopaedic surgery, lean methods have been applied to reduce complication rates and create a culture of continuous improvement. A step-by-step guide based on our experience can help surgeons use lean methods in practice. Surgeons and hospital centers well versed in lean methodology will be poised to reduce complications, improve patient outcomes, and optimize cost/benefit ratios for patient care.

Method and apparatus for improved melt flow during continuous strip casting

DOEpatents

Follstaedt, D.W.; King, E.L.; Schneider, K.C.

1991-11-12

The continuous casting of metal strip using the melt overflow process is improved by controlling the weir conditions in the nozzle to provide a more uniform flow of molten metal across the width of the nozzle and reducing the tendency for freezing of metal along the interface with refractory surfaces. A weir design having a sloped rear wall and tapered sidewalls and critical gap controls beneath the weir has resulted in the drastic reduction in edge tearing and a significant improvement in strip uniformity. The floor of the container vessel is preferably sloped and the gap between the nozzle and the rotating substrate is critically controlled. The resulting flow patterns observed with the improved casting process have reduced thermal gradients in the bath, contained surface slag and eliminated undesirable solidification near the discharge area by increasing the flow rates at those points. 8 figures.

Implementation of quality improvement techniques for management and technical processes in the ACRV project

NASA Technical Reports Server (NTRS)

Raiman, Laura B.

1992-01-01

Total Quality Management (TQM) is a cooperative form of doing business that relies on the talents of everyone in an organization to continually improve quality and productivity, using teams and an assortment of statistical and measurement tools. The objective of the activities described in this paper was to implement effective improvement tools and techniques in order to build work processes which support good management and technical decisions and actions which are crucial to the success of the ACRV project. The objectives were met by applications in both the technical and management areas. The management applications involved initiating focused continuous improvement projects with widespread team membership. The technical applications involved applying proven statistical tools and techniques to the technical issues associated with the ACRV Project. Specific activities related to the objective included working with a support contractor team to improve support processes, examining processes involved in international activities, a series of tutorials presented to the New Initiatives Office and support contractors, a briefing to NIO managers, and work with the NIO Q+ Team. On the technical side, work included analyzing data from the large-scale W.A.T.E.R. test, landing mode trade analyses, and targeting probability calculations. The results of these efforts will help to develop a disciplined, ongoing process for producing fundamental decisions and actions that shape and guide the ACRV organization .

Implementation of quality improvement techniques for management and technical processes in the ACRV project

NASA Astrophysics Data System (ADS)

Raiman, Laura B.

1992-12-01

Total Quality Management (TQM) is a cooperative form of doing business that relies on the talents of everyone in an organization to continually improve quality and productivity, using teams and an assortment of statistical and measurement tools. The objective of the activities described in this paper was to implement effective improvement tools and techniques in order to build work processes which support good management and technical decisions and actions which are crucial to the success of the ACRV project. The objectives were met by applications in both the technical and management areas. The management applications involved initiating focused continuous improvement projects with widespread team membership. The technical applications involved applying proven statistical tools and techniques to the technical issues associated with the ACRV Project. Specific activities related to the objective included working with a support contractor team to improve support processes, examining processes involved in international activities, a series of tutorials presented to the New Initiatives Office and support contractors, a briefing to NIO managers, and work with the NIO Q+ Team. On the technical side, work included analyzing data from the large-scale W.A.T.E.R. test, landing mode trade analyses, and targeting probability calculations. The results of these efforts will help to develop a disciplined, ongoing process for producing fundamental decisions and actions that shape and guide the ACRV organization .

Optimizing surface finishing processes through the use of novel solvents and systems

NASA Astrophysics Data System (ADS)

Quillen, M.; Holbrook, P.; Moore, J.

2007-03-01

As the semiconductor industry continues to implement the ITRS (International Technology Roadmap for Semiconductors) node targets that go beyond 45nm [1], the need for improved cleanliness between repeated process steps continues to grow. Wafer cleaning challenges cover many applications such as Cu/low-K integration, where trade-offs must be made between dielectric damage and residue by plasma etching and CMP or moisture uptake by aqueous cleaning products. [2-5] Some surface sensitive processes use the Marangoni tool design [6] where a conventional solvent such as IPA (isopropanol), combines with water to provide improved physical properties such as reduced contact angle and surface tension. This paper introduces the use of alternative solvents and their mixtures compared to pure IPA in removing ionics, moisture, and particles using immersion bench-chemistry models of various processes. A novel Eastman proprietary solvent, Eastman methyl acetate is observed to provide improvement in ionic, moisture capture, and particle removal, as compared to conventional IPA. [7] These benefits may be improved relative to pure IPA, simply by the addition of various additives. Some physical properties of the mixtures were found to be relatively unchanged even as measured performance improved. This report presents our attempts to cite and optimize these benefits through the use of laboratory models.

Six Lessons We Learned Applying Six Sigma

NASA Technical Reports Server (NTRS)

Carroll, Napoleon; Casleton, Christa H.

2005-01-01

As Chief Financial Officer of Kennedy Space Center (KSC), I'm not only responsible for financial planning and accounting but also for building strong partnerships with the CFO customers, who include Space Shuttle and International Space Station operations as well all who manage the KSC Spaceport. My never ending goal is to design, manage and continuously improve our core business processes so that they deliver world class products and services to the CFO's customers. I became interested in Six Sigma as Christa Casleton (KSC's first Six Sigma Black belt) applied Six Sigma tools and methods to our Plan and Account for Travel Costs Process. Her analysis was fresh, innovative and thorough but, even more impressive, was her approach to ensure ongoing, continuous process improvement. Encouraged by the results, I launched two more process improvement initiatives aimed at applying Six Sigma principles to CFO processes that not only touch most of my employees but also have direct customer impact. As many of you know, Six Sigma is a measurement scale that compares the output of a process with customer requirements. That's straight forward, but demands that you not only understand your processes but also know your products and the critical customer requirements. The objective is to isolate and eliminate the causes of process variation so that the customer sees consistently high quality.

Performance improvements of binary diffractive structures via optimization of the photolithography and dry etch processes

NASA Astrophysics Data System (ADS)

Welch, Kevin; Leonard, Jerry; Jones, Richard D.

2010-08-01

Increasingly stringent requirements on the performance of diffractive optical elements (DOEs) used in wafer scanner illumination systems are driving continuous improvements in their associated manufacturing processes. Specifically, these processes are designed to improve the output pattern uniformity of off-axis illumination systems to minimize degradation in the ultimate imaging performance of a lithographic tool. In this paper, we discuss performance improvements in both photolithographic patterning and RIE etching of fused silica diffractive optical structures. In summary, optimized photolithographic processes were developed to increase critical dimension uniformity and featuresize linearity across the substrate. The photoresist film thickness was also optimized for integration with an improved etch process. This etch process was itself optimized for pattern transfer fidelity, sidewall profile (wall angle, trench bottom flatness), and across-wafer etch depth uniformity. Improvements observed with these processes on idealized test structures (for ease of analysis) led to their implementation in product flows, with comparable increases in performance and yield on customer designs.

[Continuous quality improvement in anesthesia].

PubMed

Gaitini, L; Vaida, S; Madgar, S

1998-01-01

Slow continuous quality improvement (SCQI) in anesthesia is a process that allows identification of problems and their causes. Implementing measures to correct them and continuous monitoring to ensure that the problems have been eliminated are necessary. The basic assumption of CQI is that the employees of an organization are competent and working to the best of their abilities. If problems occur they are the consequences of inadequacies in the process rather that in the individual. The CQI program is a dynamic but gradual system that invokes a slower rate of response in comparison with other quality methods, like quality assurance. Spectacular results following a system change are not to be expected an the ideal is slow and continuous improvement. A SCQI program was adapted by our department in May 1994, according to the recommendations of the American Society of Anesthesiologists. Problem identification was based on 65 clinical indicators, reflecting negative events related to anesthesia. Data were collected using a specially designed computer database. 4 events were identified as crossing previously established thresholds (hypertension, hypotension, hypoxia and inadequate nerve block). Statistical process control was used to establish stability of the system and whether negative events were influenced only by the common causes. The causes responsible for these negative events were identified using specific SCQI tools, such as control-charts, cause-effect diagrams and Pareto diagrams. Hypertension and inadequate nerve block were successfully managed. The implementation of corrective measures for the other events that cross the threshold is still in evolution. This program requires considerable dedication on the part of the staff, and it is hoped that it will improve our clinical performance.

High-performance recombinant protein production with Escherichia coli in continuously operated cascades of stirred-tank reactors.

PubMed

Schmideder, Andreas; Weuster-Botz, Dirk

2017-07-01

The microbial expression of intracellular, recombinant proteins in continuous bioprocesses suffers from low product concentrations. Hence, a process for the intracellular production of photoactivatable mCherry with Escherichia coli in a continuously operated cascade of two stirred-tank reactors was established to separate biomass formation (first reactor) and protein expression (second reactor) spatially. Cascades of miniaturized stirred-tank reactors were implemented, which enable the 24-fold parallel characterization of cascade processes and the direct scale-up of results to the liter scale. With PAmCherry concentrations of 1.15 g L -1 cascades of stirred-tank reactors improved the process performance significantly compared to production processes in chemostats. In addition, an optimized fed-batch process was outperformed regarding space-time yield (149 mg L -1  h -1 ). This study implicates continuous cascade processes to be a promising alternative to fed-batch processes for microbial protein production and demonstrates that miniaturized stirred-tank reactors can reduce the timeline and costs for cascade process characterization.

Process Evaluation for Improving K12 Program Effectiveness: Case Study of a National Institutes of Health Building Interdisciplinary Research Careers in Women's Health Research Career Development Program.

PubMed

Raymond, Nancy C; Wyman, Jean F; Dighe, Satlaj; Harwood, Eileen M; Hang, Mikow

2018-06-01

Process evaluation is an important tool in quality improvement efforts. This article illustrates how a systematic and continuous evaluation process can be used to improve the quality of faculty career development programs by using the University of Minnesota's Building Interdisciplinary Research Careers in Women's Health (BIRCWH) K12 program as an exemplar. Data from a rigorous process evaluation incorporating quantitative and qualitative measurements were analyzed and reviewed by the BIRCWH program leadership on a regular basis. Examples are provided of how this evaluation model and processes were used to improve many aspects of the program, thereby improving scholar, mentor, and advisory committee members' satisfaction and scholar outcomes. A rigorous evaluation plan can increase the effectiveness and impact of a research career development plan.

Crystal and Particle Engineering Strategies for Improving Powder Compression and Flow Properties to Enable Continuous Tablet Manufacturing by Direct Compression.

PubMed

Chattoraj, Sayantan; Sun, Changquan Calvin

2018-04-01

Continuous manufacturing of tablets has many advantages, including batch size flexibility, demand-adaptive scale up or scale down, consistent product quality, small operational foot print, and increased manufacturing efficiency. Simplicity makes direct compression the most suitable process for continuous tablet manufacturing. However, deficiencies in powder flow and compression of active pharmaceutical ingredients (APIs) limit the range of drug loading that can routinely be considered for direct compression. For the widespread adoption of continuous direct compression, effective API engineering strategies to address power flow and compression problems are needed. Appropriate implementation of these strategies would facilitate the design of high-quality robust drug products, as stipulated by the Quality-by-Design framework. Here, several crystal and particle engineering strategies for improving powder flow and compression properties are summarized. The focus is on the underlying materials science, which is the foundation for effective API engineering to enable successful continuous manufacturing by the direct compression process. Copyright © 2018 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Monolithic amorphous silicon modules on continuous polymer substrate

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

Grimmer, D.P.

This report examines manufacturing monolithic amorphous silicon modules on a continuous polymer substrate. Module production costs can be reduced by increasing module performance, expanding production, and improving and modifying production processes. Material costs can be reduced by developing processes that use a 1-mil polyimide substrate and multilayers of low-cost material for the front encapsulant. Research to speed up a-Si and ZnO deposition rates is needed to improve throughputs. To keep throughput rates compatible with depositions, multibeam fiber optic delivery systems for laser scribing can be used. However, mechanical scribing systems promise even higher throughputs. Tandem cells and production experience canmore » increase device efficiency and stability. Two alternative manufacturing processes are described: (1) wet etching and sheet handling and (2) wet etching and roll-to-roll fabrication.« less

The process of managerial control in quality improvement initiatives.

PubMed

Slovensky, D J; Fottler, M D

1994-11-01

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

Knowledge Sharing Mechanism: Enabling C2 to Adapt to Changing Environments

DTIC Science & Technology

2007-06-01

seeking to improve upon it. This refinement is called kaizen , the Japanese word for continuous improvement process. With each PDCA Cycle, we can either be...in a hoshin or a kaizen mode depending on our purpose. Additionally, a successful innovation achieved during a hoshin PDCA Cycle can directly lead to a...new kaizen PDCA Cycle because the innovation has allowed us to improve an existing process or artifact. A kaizen PDCA Cycle, likewise can directly

Integrating Remote Sensing Data, Hybrid-Cloud Computing, and Event Notifications for Advanced Rapid Imaging & Analysis (Invited)

NASA Astrophysics Data System (ADS)

Hua, H.; Owen, S. E.; Yun, S.; Lundgren, P.; Fielding, E. J.; Agram, P.; Manipon, G.; Stough, T. M.; Simons, M.; Rosen, P. A.; Wilson, B. D.; Poland, M. P.; Cervelli, P. F.; Cruz, J.

2013-12-01

Space-based geodetic measurement techniques such as Interferometric Synthetic Aperture Radar (InSAR) and Continuous Global Positioning System (CGPS) are now important elements in our toolset for monitoring earthquake-generating faults, volcanic eruptions, hurricane damage, landslides, reservoir subsidence, and other natural and man-made hazards. Geodetic imaging's unique ability to capture surface deformation with high spatial and temporal resolution has revolutionized both earthquake science and volcanology. Continuous monitoring of surface deformation and surface change before, during, and after natural hazards improves decision-making from better forecasts, increased situational awareness, and more informed recovery. However, analyses of InSAR and GPS data sets are currently handcrafted following events and are not generated rapidly and reliably enough for use in operational response to natural disasters. Additionally, the sheer data volumes needed to handle a continuous stream of InSAR data sets also presents a bottleneck. It has been estimated that continuous processing of InSAR coverage of California alone over 3-years would reach PB-scale data volumes. Our Advanced Rapid Imaging and Analysis for Monitoring Hazards (ARIA-MH) science data system enables both science and decision-making communities to monitor areas of interest with derived geodetic data products via seamless data preparation, processing, discovery, and access. We will present our findings on the use of hybrid-cloud computing to improve the timely processing and delivery of geodetic data products, integrating event notifications from USGS to improve the timely processing for response, as well as providing browse results for quick looks with other tools for integrative analysis.

Improving Earth/Prediction Models to Improve Network Processing

NASA Astrophysics Data System (ADS)

Wagner, G. S.

2017-12-01

The United States Atomic Energy Detection System (USAEDS) primaryseismic network consists of a relatively small number of arrays andthree-component stations. The relatively small number of stationsin the USAEDS primary network make it both necessary and feasibleto optimize both station and network processing.Station processing improvements include detector tuning effortsthat use Receiver Operator Characteristic (ROC) curves to helpjudiciously set acceptable Type 1 (false) vs. Type 2 (miss) errorrates. Other station processing improvements include the use ofempirical/historical observations and continuous background noisemeasurements to compute time-varying, maximum likelihood probabilityof detection thresholds.The USAEDS network processing software makes extensive use of theazimuth and slowness information provided by frequency-wavenumberanalysis at array sites, and polarization analysis at three-componentsites. Most of the improvements in USAEDS network processing aredue to improvements in the models used to predict azimuth, slowness,and probability of detection. Kriged travel-time, azimuth andslowness corrections-and associated uncertainties-are computedusing a ground truth database. Improvements in station processingand the use of improved models for azimuth, slowness, and probabilityof detection have led to significant improvements in USADES networkprocessing.

Improvement of radiology services based on the process management approach.

PubMed

Amaral, Creusa Sayuri Tahara; Rozenfeld, Henrique; Costa, Janaina Mascarenhas Hornos; Magon, Maria de Fátima de Andrade; Mascarenhas, Yvone Maria

2011-06-01

The health sector requires continuous investments to ensure the improvement of products and services from a technological standpoint, the use of new materials, equipment and tools, and the application of process management methods. Methods associated with the process management approach, such as the development of reference models of business processes, can provide significant innovations in the health sector and respond to the current market trend for modern management in this sector (Gunderman et al. (2008) [4]). This article proposes a process model for diagnostic medical X-ray imaging, from which it derives a primary reference model and describes how this information leads to gains in quality and improvements. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

AmeriFlux Data System Looking Forward

NASA Astrophysics Data System (ADS)

Agarwal, D.; Cheah, Y. W.; Chu, H.; Keenan, T. F.; Pastorello, G.; Torn, M. S.; Humphrey, M.; Beekwilder, N.

2016-12-01

The AmeriFlux data system is turning 20 along with the network. This anniversary provides an opportunity to reimagine the data system and services to support the next 20 years of AmeriFlux. The next generation goals of the data system will be continuous data quality and consistency improvements, and also increased services to both tower owners and data users. An example change is new data citation capabilities and support leveraging Digital Object Identifiers (DOI) to enable easier citation and improved tracking of data usage. A new processing pipeline will enable more regular production of gap-filled and partitioned datasets. Automation will be continuously increased to help improve the time from data submission to user data availability. New standard data submission and processing formats will enable automation of the data submission and improved QA/QC processes. This new data system is made possible by the extensive work that the AmeriFlux data team at CDIAC has done over the last 20 years in close collaboration with the tower teams. This presentation will provide both a historical perspective and a vision for the future of the AmeriFlux data system.

Improving donation outcomes: hospital development and the Rapid Assessment of Hospital Procurement Barriers in Donation.

PubMed

Siminoff, Laura A; Traino, Heather M

2009-06-01

Deficiencies in the donation process continue to contribute to the shortage of organs available for transplant. Continuous quality improvement of hospitals' donation processes is needed to identify and correct the problems. To test the Rapid Assessment of Hospital Procurement Barriers in Donation (RAPiD), a direct observation technique with a focused ethnographic strategy, for assessing hospitals' donation processes and identifying areas in need of continuous quality improvement interventions. A pre-post assessment of hospitals' barriers to patient identification and referral, and family consent to donation. Seventeen hospitals within the catchment area of a Northeastern organ procurement organization were assessed by using the RAPiD method. Hospital administrators, health care providers, and staff (N = 537) were interviewed as part of the assessments. Interventions, including on-site training and education, and the use of in-house coordinators, were specifically tailored to each hospital's unique set of barriers to donation. The interventions were delivered to the hospitals in the form of recommendations. The participating organ procurement organization was responsible for implementation of the interventions. The RAPiD hospital evaluations revealed gaps in respondents' knowledge of organ donation, brain death, and referral criteria; a reluctance to declare brain death; and a rocky relationship between the hospitals and the organ procurement organization. As a result of the interventions, 9 hospitals' environments for organ donation improved, 7 showed no change, and 1 was worse.

Ergonomics, quality and continuous improvement--conceptual and empirical relationships in an industrial context.

PubMed

Eklund, J

1997-10-01

This paper reviews the literature comparing the fields of ergonomics and quality, mainly in an industrial context, including mutual influences, similarities and differences. Relationships between ergonomics and the factors: work conditions, product design, ISO 9000, continuous improvements and TQM are reviewed in relation to the consequence, application, and process domains. The definitions of ergonomics and quality overlap substantially. Quality deficiencies, human errors and ergonomics problems often have the same cause, which in many cases can be traced to the design of work, workplace and environment e.g. noise, light, postures, loads, pace and work content. In addition, the possibility of performing to a high standard at work is an important prerequisite for satisfaction and well-being. Contradictions between the two fields have been identified in the view of concepts such as standardization, reduction of variability and copying of best practice, requiring further research. The field of quality would gain by incorporating ergonomics knowledge, especially in the areas of work design and human capability, since these factors are decisive for human performance and also therefore the performance of the systems involved. The field of ergonomics, on the other hand, would benefit from developing a stronger emphasis on methodologies and structures for improvement processes, including a clearer link with leadership and company strategies. Just as important is a further development of practicable participative ergonomics methods and tools for use at workplaces by the workers themselves, in order to integrate the top-down and the bottom-up processes and achieve better impact. Using participative processes for problem-solving and continuous improvement, focusing ergonomics and quality jointly has a great potential for improving working conditions and quality results simultaneously, and satisfying most of the interested parties.

Implementation of the World Health Organization Regional Office for Africa Stepwise Laboratory Quality Improvement Process Towards Accreditation.

PubMed

Ndihokubwayo, Jean-Bosco; Maruta, Talkmore; Ndlovu, Nqobile; Moyo, Sikhulile; Yahaya, Ali Ahmed; Coulibaly, Sheick Oumar; Kasolo, Francis; Turgeon, David; Abrol, Angelii P

2016-01-01

The increase in disease burden has continued to weigh upon health systems in Africa. The role of the laboratory has become increasingly critical in the improvement of health for diagnosis, management and treatment of diseases. In response, the World Health Organization Regional Office for Africa (WHO AFRO) and its partners created the WHO AFRO Stepwise Laboratory (Quality) Improvement Process Towards Accreditation (SLIPTA) program. WHO AFRO defined a governance structure with roles and responsibilities for six main stakeholders. Laboratories were evaluated by auditors trained and certified by the African Society for Laboratory Medicine. Laboratory performance was measured using the WHO AFRO SLIPTA scoring checklist and recognition certificates rated with 1-5 stars were issued. By March 2015, 27 of the 47 (57%) WHO AFRO member states had appointed a SLIPTA focal point and 14 Ministers of Health had endorsed SLIPTA as the desired programme for continuous quality improvement. Ninety-eight auditors from 17 African countries, competent in the Portuguese (3), French (12) and English (83) languages, were trained and certified. The mean score for the 159 laboratories audited between May 2013 and March 2015 was 69% (median 70%; SD 11.5; interquartile range 62-77). Of these audited laboratories, 70% achieved 55% compliance or higher (2 or more stars) and 1% scored at least 95% (5 stars). The lowest scoring sections of the WHO AFRO SLIPTA checklist were sections 6 (Internal Audit) and 10 (Corrective Action), which both had mean scores below 50%. The WHO AFRO SLIPTA is a process that countries with limited resources can adopt for effective implementation of quality management systems. Political commitment, ownership and investment in continuous quality improvement are integral components of the process.

Full Spectrum Information Operations and the Information Professional Officer Intermediate Qualification Process: Filling the Gap to Ensure the Continued Leadership of the Information Professional Community in the Area of Information Dominance

DTIC Science & Technology

2005-09-01

information dominance . This thesis provides recommended line items for injection into the IP IQ in the appropriate format with discussions and definitions that address the specific line items. The thesis also provides further recommendations for the continuing improvement and refinement of the IP qualification process, especially in the area of

Factors affecting implementation of accreditation programmes and the impact of the accreditation process on quality improvement in hospitals: a SWOT analysis.

PubMed

Ng, G K B; Leung, G K K; Johnston, J M; Cowling, B J

2013-10-01

The objectives of this review were to identify factors that influence implementation of hospital accreditation programmes and to assess the impact of the accreditation process on quality improvement in public hospitals. Two electronic databases, Medline (OvidSP) and PubMed, were systematically searched. "Public hospital", "hospital accreditation", and "quality improvement" were used as the search terms. A total of 348 citations were initially identified. After critical appraisal and study selection, 26 articles were included in the review. The data were extracted and analysed using a SWOT (strengths, weaknesses, opportunities, threats) analysis. Increased staff engagement and communication, multidisciplinary team building, positive changes in organisational culture, and enhanced leadership and staff awareness of continuous quality improvement were identified as strengths. Weaknesses included organisational resistance to change, increased staff workload, lack of awareness about continuous quality improvement, insufficient staff training and support for continuous quality improvement, lack of applicable accreditation standards for local use, and lack of performance outcome measures. Opportunities included identification of improvement areas, enhanced patient safety, additional funding, public recognition, and market advantage. Threats included opportunistic behaviours, funding cuts, lack of incentives for participation, and a regulatory approach to mandatory participation. By relating the findings to the operational issues of accreditation, this review discussed the implications for successful implementation and how accreditation may drive quality improvement. These findings have implications for various stakeholders (government, the public, patients and health care providers), when it comes to embarking on accreditation exercises.

Defense Depot Tracy Total Quality Management Plan

DTIC Science & Technology

1989-07-01

PAGES TQM (Total Quality Management ), Depot Operations, Continuous Process Improvement 16. PRICE CODE 17. SECURITY CLASSIFICATION 18. SECURITY...make up our pcrceptions of Total Quality Management . Our goal is to improve those proven management processes that have brought us success while being...MANIAGEMENT F. QUALITY AUDITS OF PRODUCTS AND OPERATIONS ASSETS MANAGEMENT 00 i .......... / ~899 29 03 1 EFENSE DEPOT TACY TOTAL QUALITY MANAGEMENT PLAN

Continuous quality improvement at work: the first team--Part I.

PubMed

Bolt, B J; Lehany-Trese, A M; Williams, T P

1994-01-01

This first part of a two-part article describes the process of making the theory of continuous quality improvement a reality. The successes, the failures, and the struggles of the first team effort are outlined. The evolution of the team approach is captured from the perspectives of the quality directors, the facilitator, and the team leader. The team project discussed in this article focused on inpatient admissions and the assignment of patients to observation status.

Report: Improved Acquisition Planning Will Help EPA Reduce Hundreds of Millions of Dollars in High-Risk Contracts

EPA Pesticide Factsheets

Report #18-P-0038, November 15, 2017. Without improving its acquisition planning process, the EPA may continue to spend hundreds of millions of dollars on high-risk contracts that waste taxpayer resources.

Nursing issues in renal replacement therapy: organization, manpower assessment, competency evaluation and quality improvement processes.

PubMed

Graham, Patricia; Lischer, Eileen

2011-01-01

For the patient with acute kidney injury, continuous renal replacement therapy (CRRT) is a treatment option that has application for the hemodynamically unstable critically ill patient. The decision to initiate a continuous renal replacement modality depends not only on the physician, either the nephrologist or intensivist, but also on the availability of specially trained nursing resources. This article will explore the nursing collaborative model of care at a large university-based research and teaching Medical Center in Southern California. The focus will be on nursing issues in CRRT including organization of educational programs, manpower assessment, competency evaluation, and quality improvement processes. © 2011 Wiley Periodicals, Inc.

76 FR 34713 - Proposed Establishment of a Federally Funded Research and Development Center-Third Notice

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-14

... (FFRDC) to facilitate the modernization of business processes and supporting systems and their operations... processes and supporting systems and their operations. Some of the broad task areas that will be utilized..., organizational planning, research and development, continuous process improvement, Independent Verification and...

An adaptive management process for forest soil conservation.

Treesearch

Michael P. Curran; Douglas G. Maynard; Ronald L. Heninger; Thomas A. Terry; Steven W. Howes; Douglas M. Stone; Thomas Niemann; Richard E. Miller; Robert F. Powers

2005-01-01

Soil disturbance guidelines should be based on comparable disturbance categories adapted to specific local soil conditions, validated by monitoring and research. Guidelines, standards, and practices should be continually improved based on an adaptive management process, which is presented in this paper. Core components of this process include: reliable monitoring...

Process Improvement Teams: A TQM Strategy for Improving Community College Systems.

ERIC Educational Resources Information Center

Needham, Robbie Lee; And Others

The three principle elements of Total Quality Management (TQM) are a focus on customers; an attitude of continuous improvement of a system; and the involvement of everyone within an organization. At Delaware County Community College (DCCC) in Media, Pennsylvania, the first phase of implementing TQM focused on educating top management for the…

COMPASS-AIM: A University/P-12 Partnership Innovation for Continuous Improvement

ERIC Educational Resources Information Center

Wilcox, Kristen C.; Lawson, Hal A.; Angelis, Janet I.

2017-01-01

COMPASS-AIM is a set of processes and tools used by participants in a research-practice partnership (RPP) to improve organizational capacities and individual and team competencies for organizational learning and improvement. The "COMPASS" team includes teams of teachers and school leaders who work with a university researcher and expert…

Application of Lean Healthcare methodology in a urology department of a tertiary hospital as a tool for improving efficiency.

PubMed

Boronat, F; Budia, A; Broseta, E; Ruiz-Cerdá, J L; Vivas-Consuelo, D

To describe the application of the Lean methodology as a method for continuously improving the efficiency of a urology department in a tertiary hospital. The implementation of the Lean Healthcare methodology in a urology department was conducted in 3 phases: 1) team training and improvement of feedback among the practitioners, 2) management by process and superspecialisation and 3) improvement of indicators (continuous improvement). The indicators were obtained from the Hospital's information systems. The main source of information was the Balanced Scorecard for health systems management (CUIDISS). The comparison with other autonomous and national urology departments was performed through the same platform with the help of the Hospital's records department (IASIST). A baseline was established with the indicators obtained in 2011 for the comparative analysis of the results after implementing the Lean Healthcare methodology. The implementation of this methodology translated into high practitioner satisfaction, improved quality indicators reaching a risk-adjusted complication index (RACI) of 0.59 and a risk-adjusted mortality rate (RAMR) of 0.24 in 4 years. A value of 0.61 was reached with the efficiency indicator (risk-adjusted length of stay [RALOS] index), with a savings of 2869 stays compared with national Benchmarking (IASIST). The risk-adjusted readmissions index (RARI) was the only indicator above the standard, with a value of 1.36 but with progressive annual improvement of the same. The Lean methodology can be effectively applied to a urology department of a tertiary hospital to improve efficiency, obtaining significant and continuous improvements in all its indicators, as well as practitioner satisfaction. Team training, management by process, continuous improvement and delegation of responsibilities has been shown to be the fundamental pillars of this methodology. Copyright © 2017 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

Continuous recovery of valine in a model mixture of amino acids and salt from Corynebacterium bacteria fermentation using a simulated moving bed chromatography.

PubMed

Park, Chanhun; Nam, Hee-Geun; Jo, Se-Hee; Wang, Nien-Hwa Linda; Mun, Sungyong

2016-02-26

The economical efficiency of valine production in related industries is largely affected by the performance of a valine separation process, in which valine is to be separated from leucine, alanine, and ammonium sulfate. Such separation is currently handled by a batch-mode hybrid process based on ion-exchange and crystallization schemes. To make a substantial improvement in the economical efficiency of an industrial valine production, such a batch-mode process based on two different separation schemes needs to be converted into a continuous-mode separation process based on a single separation scheme. To address this issue, a simulated moving bed (SMB) technology was applied in this study to the development of a continuous-mode valine-separation chromatographic process with uniformity in adsorbent and liquid phases. It was first found that a Chromalite-PCG600C resin could be eligible for the adsorbent of such process, particularly in an industrial scale. The intrinsic parameters of each component on the Chromalite-PCG600C adsorbent were determined and then utilized in selecting a proper set of configurations for SMB units, columns, and ports, under which the SMB operating parameters were optimized with a genetic algorithm. Finally, the optimized SMB based on the selected configurations was tested experimentally, which confirmed its effectiveness in continuous separation of valine from leucine, alanine, ammonium sulfate with high purity, high yield, high throughput, and high valine product concentration. It is thus expected that the developed SMB process in this study will be able to serve as one of the trustworthy ways of improving the economical efficiency of an industrial valine production process. Copyright © 2016 Elsevier B.V. All rights reserved.

EUV process improvement with novel litho track hardware

NASA Astrophysics Data System (ADS)

Stokes, Harold; Harumoto, Masahiko; Tanaka, Yuji; Kaneyama, Koji; Pieczulewski, Charles; Asai, Masaya

2017-03-01

Currently, there are many developments in the field of EUV lithography that are helping to move it towards increased HVM feasibility. Targeted improvements in hardware design for advanced lithography are of interest to our group specifically for metrics such as CD uniformity, LWR, and defect density. Of course, our work is focused on EUV process steps that are specifically affected by litho track performance, and consequently, can be improved by litho track design improvement and optimization. In this study we are building on our experience to provide continual improvement for LWR, CDU, and Defects as applied to a standard EUV process by employing novel hardware solutions on our SOKUDO DUO coat develop track system. Although it is preferable to achieve such improvements post-etch process we feel, as many do, that improvements after patterning are a precursor to improvements after etching. We hereby present our work utilizing the SOKUDO DUO coat develop track system with an ASML NXE:3300 in the IMEC (Leuven, Belgium) cleanroom environment to improve aggressive dense L/S patterns.

Continuous Codes and Standards Improvement (CCSI)

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

Rivkin, Carl H; Burgess, Robert M; Buttner, William J

2015-10-21

As of 2014, the majority of the codes and standards required to initially deploy hydrogen technologies infrastructure in the United States have been promulgated. These codes and standards will be field tested through their application to actual hydrogen technologies projects. Continuous codes and standards improvement (CCSI) is a process of identifying code issues that arise during project deployment and then developing codes solutions to these issues. These solutions would typically be proposed amendments to codes and standards. The process is continuous because as technology and the state of safety knowledge develops there will be a need to monitor the applicationmore » of codes and standards and improve them based on information gathered during their application. This paper will discuss code issues that have surfaced through hydrogen technologies infrastructure project deployment and potential code changes that would address these issues. The issues that this paper will address include (1) setback distances for bulk hydrogen storage, (2) code mandated hazard analyses, (3) sensor placement and communication, (4) the use of approved equipment, and (5) system monitoring and maintenance requirements.« less

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

NASA Technical Reports Server (NTRS)

Oneill, John W.; Gordon-Winkler, Lyn

1992-01-01

What do most of the successful people and organizations in our world have in common? Instead of worrying about the future, they work to create it. They have a plan, or a vision of what they want to accomplish and they focus their efforts on success. Strategic planning has been described as a disciplined, ongoing process to produce fundamental decisions and actions that shape what an organization is, what it does, and how it will respond to a changing environment. This case study discussion will evaluate the relationship between strategic planning and Total Quality Management (TQM), or continuous improvement, through the experience of the NASA Johnson Space Center in developing a strategy for the future. That experience clearly illustrates the value of strategic planning in setting the framework and establishing the overall thrust of continuous improvement initiatives. Equally significant, the fundamentals of a quality culture such as strong customer and supplier partnerships, participative involvement, open communications, and ownership were essential in overcoming the challenges inherent in the planning process. A reinforced management commitment to the quality culture was a clear, long-term benefit.

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

NASA Astrophysics Data System (ADS)

Oneill, John W.; Gordon-Winkler, Lyn

What do most of the successful people and organizations in our world have in common? Instead of worrying about the future, they work to create it. They have a plan, or a vision of what they want to accomplish and they focus their efforts on success. Strategic planning has been described as a disciplined, ongoing process to produce fundamental decisions and actions that shape what an organization is, what it does, and how it will respond to a changing environment. This case study discussion will evaluate the relationship between strategic planning and Total Quality Management (TQM), or continuous improvement, through the experience of the NASA Johnson Space Center in developing a strategy for the future. That experience clearly illustrates the value of strategic planning in setting the framework and establishing the overall thrust of continuous improvement initiatives. Equally significant, the fundamentals of a quality culture such as strong customer and supplier partnerships, participative involvement, open communications, and ownership were essential in overcoming the challenges inherent in the planning process. A reinforced management commitment to the quality culture was a clear, long-term benefit.

Overall equipment efficiency of Flexographic Printing process: A case study

NASA Astrophysics Data System (ADS)

Zahoor, S.; Shehzad, A.; Mufti, NA; Zahoor, Z.; Saeed, U.

2017-12-01

This paper reports the efficiency improvement of a flexographic printing machine by reducing breakdown time with the help of a total productive maintenance measure called overall equipment efficiency (OEE). The methodology is comprised of calculating OEE of the machine before and after identifying the causes of the problems. Pareto diagram is used to prioritize main problem areas and 5-whys analysis approach is used to identify the root cause of these problems. OEE of the process is improved from 34% to 40.2% for a 30 days time period. It is concluded that OEE and 5-whys analysis techniques are useful in improving effectiveness of the equipment and for the continuous process improvement as well.

Process' standardization and change management in higher education. The case of TEI of Athens

NASA Astrophysics Data System (ADS)

Chalaris, Ioannis; Chalaris, Manolis; Gritzalis, Stefanos; Belsis, Petros

2015-02-01

The establishment of mature operational procedures and the effort of standardizing and certifying these procedures is a particularly arduous and demanding task which requires strong commitment from management to the existing objectives, administrative stability and continuity, availability of resources, an adequate implementation team with support from all stakeholders and of course great tolerance until tangible results of the investment are shown. Ensuring these conditions, particularly in times of economic crisis, is an extremely difficult task for large organizations such as TEI of Athens where there is heterogeneity in personnel and changes in the administrative hierarchy arise plethora of additional difficulties and require an effective change management. In this work we depict the path of standardization and certification of administrative functions of TEI of Athens, with emphasis on difficulties encountered and how to address them and in particular issues of change management and the culture related to this effort. The requirement for infrastructure needed to be maintained in processes and tools process & strategic management is embodied, in order to evolve mechanisms for continuous improvement processes and storage / recovery of the resulting knowledge. The work concludes with a general design of a road map of internal audit and continuous improvement processes for a large institution of higher education.

Staff empowerment: a medical record department's preliminary experiences with continuous quality improvement.

PubMed

Markon, E

1992-11-01

After observing the results of continuous quality improvement, no one would argue against its value in the workplace. However, learning to apply the concepts requires change on everyone's part, and the challenge lies in effecting this change. Not everyone will want to work in this type of environment and, if the organization is truly committed to continuous quality improvement, those individuals may have to make hard decisions as to whether the organization is the right place for them to work. Certain skills are required for staff empowerment to be successful, and training in these skills is essential. The medical record department staff learned early in this process that, although the group possessed job skills, interaction and team skills were lacking. The Development Dimensions International program helped the managers and staff identify the weaknesses of the group and provided educational tools for improvement. The changes often are so subtle, the group does not realize anything has changed. It was not until recently, when the medical record department staff was requested by administration to identify department quality improvement projects, that the group looked back at where the process started and realized how different things are today from three years ago--now staff members lead team meetings, work-groups are redesigning their job processes, and teams update the rest of the department staff on its progress at department meetings. Everyone expressed a sense of pride and accomplishment that the group had indeed responded to the challenge. The experiences of the medical record department thus far clearly support empowerment of employees.(ABSTRACT TRUNCATED AT 250 WORDS)

Using quality indicators in anaesthesia: feeding back data to improve care.

PubMed

Benn, J; Arnold, G; Wei, I; Riley, C; Aleva, F

2012-07-01

After recent UK policy developments, considerable attention has been focused upon how clinical specialties measure and report on the quality of care delivered to patients. Defining the right indicators alone is insufficient to close the feedback loop. This narrative review aims to describe and synthesize a diverse body of research relevant to the question of how information from quality indicators can be fed back and used effectively to improve care. Anaesthesia poses certain challenges in the identification of valid outcome indicators sensitive to variations in anaesthetic care. Metrics collected during the immediate post-anaesthetic recovery period, such as patient temperature, patient-reported quality of recovery, and pain and nausea, provide potentially useful information for the anaesthetist, yet this information is not routinely fed back. Reviews of the effects of feeding back performance data to healthcare providers suggest that this may result in small to moderate positive effects upon outcomes and professional practice, with stronger effects where feedback is integrated within a broader quality improvement strategy. The dominant model for use of data within quality improvement is based upon the industrial process control approach, in which care processes are monitored continuously for process changes which are rapidly detectable for corrective action. From this review and experience of implementing these principles in practice, effective feedback from quality indicators is timely, credible, confidential, tailored to the recipient, and continuous. Considerable further work is needed to understand how information from quality indicators can be fed back in an effective way to clinicians and clinical units, in order to support revalidation and continuous improvement.

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

NASA Technical Reports Server (NTRS)

Raiman, Laura B.

1991-01-01

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

Application of a Micro Computer-Based Management Information System to Improve the USAF Service Reporting Process

DTIC Science & Technology

1990-09-01

I. Introduction .......................................... 1 General Issue .................................. 1 Specific Research Problem...viii APPLICATION OF A MICRO COMPUTER-BASED MANAGEMENT INFORMATION SYSTEM TO IMPROVE THE USAF SERVICE REPORTING PROCESS I. Introduction General Issue...continued Transfer MIP Responsibility ,KNT WETSS0GEFORM UNCLASSIFIED 904 JAUG 19: iRR iRRl UUUUI HOWE271652_ D- FF:MCH INFO: NONE E. iUCH DATA DEF: NONE F

Rapid Prototyping of Continuous Fiber Reinforced Ceramic Matrix Composites

NASA Technical Reports Server (NTRS)

Vaidyanathan, R.; Green, C.; Phillips, T.; Cipriani, R.; Yarlagadda, S.; Gillespie, J.; Effinger, M.; Cooper, K. C.; Gordon, Gail (Technical Monitor)

2002-01-01

For ceramics to be used as structural components in high temperature applications, their fracture toughness is improved by embedding continuous ceramic fibers. Ceramic matrix composite (CMC) materials allow increasing the overall operating temperature, raising the temperature safety margins, avoiding the need for cooling, and improving the damping capacity, while reducing the weight at the same time. They also need to be reliable and available in large quantities as well. In this paper, an innovative rapid prototyping technique to fabricate continuous fiber reinforced ceramic matrix composites is described. The process is simple, robust and will be widely applicable to a number of high temperature material systems. This technique was originally developed at the University of Delaware Center for Composite Materials (UD-CCM) for rapid fabrication of polymer matrix composites by a technique called automated tow placement or ATP. The results of mechanical properties and microstructural characterization are presented, together with examples of complex shapes and parts. It is believed that the process will be able to create complex shaped parts at an order of magnitude lower cost than current CVI and PIP processes.

Patient handover in orthopaedics, improving safety using Information Technology.

PubMed

Pearkes, Tim

2015-01-01

Good inpatient handover ensures patient safety and continuity of care. An adjunct to this is the patient list which is routinely managed by junior doctors. These lists are routinely created and managed within Microsoft Excel or Word. Following the merger of two orthopaedic departments into a single service in a new hospital, it was felt that a number of safety issues within the handover process needed to be addressed. This quality improvement project addressed these issues through the creation and implementation of a new patient database which spanned the department, allowing trouble free, safe, and comprehensive handover. Feedback demonstrated an improved user experience, greater reliability, continuity within the lists and a subsequent improvement in patient safety.

Thermographic In-Situ Process Monitoring of the Electron Beam Melting Technology used in Additive Manufacturing

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

Dinwiddie, Ralph Barton; Dehoff, Ryan R; Lloyd, Peter D

2013-01-01

Oak Ridge National Laboratory (ORNL) has been utilizing the ARCAM electron beam melting technology to additively manufacture complex geometric structures directly from powder. Although the technology has demonstrated the ability to decrease costs, decrease manufacturing lead-time and fabricate complex structures that are impossible to fabricate through conventional processing techniques, certification of the component quality can be challenging. Because the process involves the continuous deposition of successive layers of material, each layer can be examined without destructively testing the component. However, in-situ process monitoring is difficult due to metallization on inside surfaces caused by evaporation and condensation of metal from themore » melt pool. This work describes a solution to one of the challenges to continuously imaging inside of the chamber during the EBM process. Here, the utilization of a continuously moving Mylar film canister is described. Results will be presented related to in-situ process monitoring and how this technique results in improved mechanical properties and reliability of the process.« less

Hardening fertilization and nutrient loading of conifer seedlings

Treesearch

R. Kasten Dumroese

2003-01-01

Continuing to fertilize bareroot and container seedlings during the hardening process (from cessation of height growth until lifting) can improve seedling viability. The process of fertilizing during hardening has many names, but in the last decade a new term, nutrient loading, has come into use. The process of nutrient loading seedlings leads to luxury consumption...

Practical Approaches to Quality Improvement for Radiologists.

PubMed

Kelly, Aine Marie; Cronin, Paul

2015-10-01

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

Research possibilities? No! Needs for research to make PV solar energy utilization broadly competitive

NASA Technical Reports Server (NTRS)

Wolf, M.

1982-01-01

The historical progression of efficiency improvements, cost reductions, and performance improvements in modules and photovoltaic systems are described. The potential for future improvements in photovoltaic device efficiencies and cost reductions continues as device concepts, designs, processes, and automated production capabilities mature. Additional step-function improvements can be made as today's simpler devices are replaced by more sophisticated devices.

Improving the preparticipation exam process.

PubMed

Reed, F E

2001-08-01

The Preparticipation Exam for too long has been a mandatory yearly athletic exam and not the base from which a process of continuous athletic care took place. The purpose of this article is not only to introduce improvements in the exam itself but to also describe some extensions of the process that allow us to improve athletic care in South Carolina. It is hoped that a software scanning program will allow compiling of demographic data from individual and group examinations and thus support the method of exam preferred by all physicians in our state. Standard forms will also facilitate communication within the Athletic Care Unit and between physicians involved in athletic care.

TQM (Total Quality Management) SPARC (Special Process Action Review Committees) Handbook

DTIC Science & Technology

1989-08-01

This document describes the techniques used to support and guide the Special Process Action Review Committees for accomplishing their goals for Total Quality Management (TQM). It includes concepts and definitions, checklists, sample formats, and assessment criteria. Keywords: Continuous process improvement; Logistics information; Process analysis; Quality control; Quality assurance; Total Quality Management ; Statistical processes; Management Planning and control; Management training; Management information systems.

Combining the Tasks of Grading Individual Assignments and Assessing Student Outcomes in Project-Based Courses

ERIC Educational Resources Information Center

Dahm, Kevin

2014-01-01

ABET requires that engineering programs demonstrate continuous assessment and continuous improvement in order to be accredited. Central to the process is establishing and assessing measurable "student outcomes" that reflect whether the goals and objectives of the program are being met. This paper examines effective strategies for…

U.S. Army Medical Department Journal (May-June 1998)

DTIC Science & Technology

1998-06-01

patients. Dental Management of a Patient with Osteogenesis Imperfecta is a case report on the dental management of molar extraction in a patient with the...bone-forming disease osteogenesis imperfecta . Through a continual process of evaluation and improvement in training, the AMEDD’s combat medics will continue to conserve the fighting strength.

Steam generator tubing NDE performance

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

Henry, G.; Welty, C.S. Jr.

1997-02-01

Steam generator (SG) non-destructive examination (NDE) is a fundamental element in the broader SG in-service inspection (ISI) process, a cornerstone in the management of PWR steam generators. Based on objective performance measures (tube leak forced outages and SG-related capacity factor loss), ISI performance has shown a continually improving trend over the years. Performance of the NDE element is a function of the fundamental capability of the technique, and the ability of the analysis portion of the process in field implementation of the technique. The technology continues to improve in several areas, e.g. system sensitivity, data collection rates, probe/coil design, andmore » data analysis software. With these improvements comes the attendant requirement for qualification of the technique on the damage form(s) to which it will be applied, and for training and qualification of the data analysis element of the ISI process on the field implementation of the technique. The introduction of data transfer via fiber optic line allows for remote data acquisition and analysis, thus improving the efficiency of analysis for a limited pool of data analysts. This paper provides an overview of the current status of SG NDE, and identifies several important issues to be addressed.« less

Safety Management of a Clinical Process Using Failure Mode and Effect Analysis: Continuous Renal Replacement Therapies in Intensive Care Unit Patients.

PubMed

Sanchez-Izquierdo-Riera, Jose Angel; Molano-Alvarez, Esteban; Saez-de la Fuente, Ignacio; Maynar-Moliner, Javier; Marín-Mateos, Helena; Chacón-Alves, Silvia

2016-01-01

The failure mode and effect analysis (FMEA) may improve the safety of the continuous renal replacement therapies (CRRT) in the intensive care unit. We use this tool in three phases: 1) Retrospective observational study. 2) A process FMEA, with implementation of the improvement measures identified. 3) Cohort study after FMEA. We included 54 patients in the pre-FMEA group and 72 patients in the post-FMEA group. Comparing the risks frequencies per patient in both groups, we got less cases of under 24 hours of filter survival time in the post-FMEA group (31 patients 57.4% vs. 21 patients 29.6%; p < 0.05); less patients suffered circuit coagulation with inability to return the blood to the patient (25 patients [46.3%] vs. 16 patients [22.2%]; p < 0.05); 54 patients (100%) versus 5 (6.94%) did not get phosphorus levels monitoring (p < 0.05); in 14 patients (25.9%) versus 0 (0%), the CRRT prescription did not appear on medical orders. As a measure of improvement, we adopt a dynamic dosage management. After the process FMEA, there were several improvements in the management of intensive care unit patients receiving CRRT, and we consider it a useful tool for improving the safety of critically ill patients.

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

PubMed

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

2016-01-01

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

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

PubMed

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

2016-01-01

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

Atomic clocks and the continuous-time random-walk

NASA Astrophysics Data System (ADS)

Formichella, Valerio; Camparo, James; Tavella, Patrizia

2017-11-01

Atomic clocks play a fundamental role in many fields, most notably they generate Universal Coordinated Time and are at the heart of all global navigation satellite systems. Notwithstanding their excellent timekeeping performance, their output frequency does vary: it can display deterministic frequency drift; diverse continuous noise processes result in nonstationary clock noise (e.g., random-walk frequency noise, modelled as a Wiener process), and the clock frequency may display sudden changes (i.e., "jumps"). Typically, the clock's frequency instability is evaluated by the Allan or Hadamard variances, whose functional forms can identify the different operative noise processes. Here, we show that the Allan and Hadamard variances of a particular continuous-time random-walk, the compound Poisson process, have the same functional form as for a Wiener process with drift. The compound Poisson process, introduced as a model for observed frequency jumps, is an alternative to the Wiener process for modelling random walk frequency noise. This alternate model fits well the behavior of the rubidium clocks flying on GPS Block-IIR satellites. Further, starting from jump statistics, the model can be improved by considering a more general form of continuous-time random-walk, and this could bring new insights into the physics of atomic clocks.

78 FR 48164 - Medicare Program; Revised Process for Making National Coverage Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-07

... monitor, the progress of our review. This is a key element in making our NCD process more efficient, open... internally-generated NCD reviews. As we strive to continually improve our processes and in recognition of the... establishing a new NCD, we would use an expedited process to remove these NCDs. After the effective date of the...

Long-term persistence of quality improvements for an intensive care unit communication initiative using the VALUE strategy.

PubMed

Wysham, Nicholas G; Mularski, Richard A; Schmidt, David M; Nord, Shirley C; Louis, Deborah L; Shuster, Elizabeth; Curtis, J Randall; Mosen, David M

2014-06-01

Communication in the intensive care unit (ICU) is an important component of quality ICU care. In this report, we evaluate the long-term effects of a quality improvement (QI) initiative, based on the VALUE communication strategy, designed to improve communication with family members of critically ill patients. We implemented a multifaceted intervention to improve communication in the ICU and measured processes of care. Quality improvement components included posted VALUE placards, templated progress note inclusive of communication documentation, and a daily rounding checklist prompt. We evaluated care for all patients cared for by the intensivists during three separate 3 week periods, pre, post, and 3 years following the initial intervention. Care delivery was assessed in 38 patients and their families in the pre-intervention sample, 27 in the post-intervention period, and 41 in follow-up. Process measures of communication showed improvement across the evaluation periods, for example, daily updates increased from pre 62% to post 76% to current 84% of opportunities. Our evaluation of this quality improvement project suggests persistence and continued improvements in the delivery of measured aspects of ICU family communication. Maintenance with point-of-care-tools may account for some of the persistence and continued improvements. Copyright © 2014 Elsevier Inc. All rights reserved.

Six sigma: process of understanding the control and capability of ranitidine hydrochloride tablet.

PubMed

Chabukswar, Ar; Jagdale, Sc; Kuchekar, Bs; Joshi, Vd; Deshmukh, Gr; Kothawade, Hs; Kuckekar, Ab; Lokhande, Pd

2011-01-01

The process of understanding the control and capability (PUCC) is an iterative closed loop process for continuous improvement. It covers the DMAIC toolkit in its three phases. PUCC is an iterative approach that rotates between the three pillars of the process of understanding, process control, and process capability, with each iteration resulting in a more capable and robust process. It is rightly said that being at the top is a marathon and not a sprint. The objective of the six sigma study of Ranitidine hydrochloride tablets is to achieve perfection in tablet manufacturing by reviewing the present robust manufacturing process, to find out ways to improve and modify the process, which will yield tablets that are defect-free and will give more customer satisfaction. The application of six sigma led to an improved process capability, due to the improved sigma level of the process from 1.5 to 4, a higher yield, due to reduced variation and reduction of thick tablets, reduction in packing line stoppages, reduction in re-work by 50%, a more standardized process, with smooth flow and change in coating suspension reconstitution level (8%w/w), a huge cost reduction of approximately Rs.90 to 95 lakhs per annum, an improved overall efficiency by 30% approximately, and improved overall quality of the product.

Six Sigma: Process of Understanding the Control and Capability of Ranitidine Hydrochloride Tablet

PubMed Central

Chabukswar, AR; Jagdale, SC; Kuchekar, BS; Joshi, VD; Deshmukh, GR; Kothawade, HS; Kuckekar, AB; Lokhande, PD

2011-01-01

The process of understanding the control and capability (PUCC) is an iterative closed loop process for continuous improvement. It covers the DMAIC toolkit in its three phases. PUCC is an iterative approach that rotates between the three pillars of the process of understanding, process control, and process capability, with each iteration resulting in a more capable and robust process. It is rightly said that being at the top is a marathon and not a sprint. The objective of the six sigma study of Ranitidine hydrochloride tablets is to achieve perfection in tablet manufacturing by reviewing the present robust manufacturing process, to find out ways to improve and modify the process, which will yield tablets that are defect-free and will give more customer satisfaction. The application of six sigma led to an improved process capability, due to the improved sigma level of the process from 1.5 to 4, a higher yield, due to reduced variation and reduction of thick tablets, reduction in packing line stoppages, reduction in re-work by 50%, a more standardized process, with smooth flow and change in coating suspension reconstitution level (8%w/w), a huge cost reduction of approximately Rs.90 to 95 lakhs per annum, an improved overall efficiency by 30% approximately, and improved overall quality of the product. PMID:21607050

Improving Our Odds: Success through Continuous Risk Management

NASA Technical Reports Server (NTRS)

Greenhalgh, Phillip O.

2009-01-01

Launching a rocket, running a business, driving to work and even day-to-day living all involve some degree of risk. Risk is ever present yet not always recognized, adequately assessed and appropriately mitigated. Identification, assessment and mitigation of risk are elements of the risk management component of the "continuous improvement" way of life that has become a hallmark of successful and progressive enterprises. While the application of risk management techniques to provide continuous improvement may be detailed and extensive, the philosophy, ideals and tools can be beneficially applied to all situations. Experiences with the use of risk identification, assessment and mitigation techniques for complex systems and processes are described. System safety efforts and tools used to examine potential risks of the Ares I First Stage of NASA s new Constellation Crew Launch Vehicle (CLV) presently being designed are noted as examples. Recommendations from lessons learned are provided for the application of risk management during the development of new systems as well as for the improvement of existing systems. Lessons learned and suggestions given are also examined for applicability to simple systems, uncomplicated processes and routine personal daily tasks. This paper informs the reader of varied uses of risk management efforts and techniques to identify, assess and mitigate risk for improvement of products, success of business, protection of people and enhancement of personal life.

Feasibility of a virtual learning collaborative to implement an obesity QI project in 29 pediatric practices.

PubMed

John, Tamara; Morton, Michaela; Weissman, Mark; O'Brien, Ellen; Hamburger, Ellen; Hancock, Yolandra; Moon, Rachel Y

2014-04-01

Quality improvement (QI) activities are required to maintain board certification in pediatrics. However, because of lack of training and resources, pediatricians may feel overwhelmed by the need to implement QI activities. Pediatricians also face challenges when caring for overweight and obese children. To create a virtual (online) QI learning collaborative through which pediatric practices could easily develop and implement a continuous QI process. Prospective cohort. Pediatric practices that were part of the Children's National Health Network were invited to participate, with the option to receive continuing medical education and maintenance of certification credits. s) Practices conducted baseline and monthly chart audits, participated in educational webinars and selected monthly practice changes, using Plan-Do-Study-Act cycles. Practices reported activities monthly and periodic feedback was provided to practices about their performance. s) Improvement in (i) body mass index (BMI) percentile documentation, (ii) appropriate nutritional and activity counseling and (iii) follow-up management for high-risk patients. Twenty-nine practices (120 providers) participated, and 24 practices completed all program activities. Monthly chart audits demonstrated continuous improvement in documentation of BMI, abnormal weight diagnosis, nutrition and activity screening and counseling, weight-related health messages and follow-up management of overweight and obese patients. Impact of QI activities on visit duration and practice efficiency was minimal. A virtual learning collaborative was successful in providing a framework for pediatricians to implement a continuous QI process and achieve practice improvements. This format can be utilized to address multiple health issues.

A survey of recipient client physician satisfaction with teleoncology services originating from thunder bay regional health sciences centre.

PubMed

Brigden, Malcolm; Minty, Alana; Pilatzke, Susan; Della Vidova, Lori; Sherrington, Laurie; McPhail, Karen

2008-04-01

The objective of this work was to investigate end user satisfaction and perceived efficacy on the part of client physicians for teleoncology services in Northwestern Ontario. A survey of 98 referring physicians from 17 remote communities in Northwestern Ontario was undertaken primarily to determine overall client physician satisfaction with the teleoncology process. The survey also investigated perceived problems and explored potential solutions. Overall client physician satisfaction was high for the majority of response fields. However, more than 50% of surveyed physicians felt that some aspects of the teleoncology process could be improved with an emphasis on more timely communication of interview results, continuity of care, and improving patients comfort level with the technologies involved. The success of this service is evidenced by its exponential growth since the original introduction in 2001. Ninety-eight percent of referring physicians would continue to use the teleoncology service process.

How drugs are developed and approved by the FDA: current process and future directions.

PubMed

Ciociola, Arthur A; Cohen, Lawrence B; Kulkarni, Prasad

2014-05-01

This article provides an overview of FDA's regulatory processes for drug development and approval, and the estimated costs associated with the development of a drug, and also examines the issues and challenges facing the FDA in the near future. A literature search was performed using MEDLINE to summarize the current FDA drug approval processes and future directions. MEDLINE was further utilized to search for all cost analysis studies performed to evaluate the pharmaceutical industry R&D productivity and drug development cost estimates. While the drug approval process remains at high risk and spans over multiple years, the FDA drug review and approval process has improved, with the median approval time for new molecular drugs been reduced from 19 months to 10 months. The overall cost to development of a drug remains quite high and has been estimated to range from $868M to $1,241M USD. Several new laws have been enacted, including the FDA Safety and Innovation Act (FDASIA) of 2013, which is designed to improve the drug approval process and enhance access to new medicines. The FDA's improved processes for drug approval and post-market surveillance have achieved the goal of providing patients with timely access to effective drugs while minimizing the risk of drug-related harm. The FDA drug approval process is not without controversy, as a number of well-known gastroenterology drugs have been withdrawn from the US market over the past few years. With the approval of the new FDASIA law, the FDA will continue to improve their processes and, working together with the ACG through the FDA-Related Matters Committee, continue to develop safe and effective drugs for our patients.

Optimization of chemical compositions in low-carbon Al-killed enamel steel produced by ultra-fast continuous annealing

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

Dong, Futao, E-mail: dongft@sina.com; Du, Linxiu; Liu, Xianghua

2013-10-15

The influence of Mn,S and B contents on microstructural characteristics, mechanical properties and hydrogen trapping ability of low-carbon Al-killed enamel steel was investigated. The materials were produced and processed in a laboratory and the ultra-fast continuous annealing processing was performed using a continuous annealing simulator. It was found that increasing Mn,S contents in steel can improve its hydrogen trapping ability which is attributed by refined ferrite grains, more dispersed cementite and added MnS inclusions. Nevertheless, it deteriorates mechanical properties of steel sheet. Addition of trace boron results in both good mechanical properties and significantly improved hydrogen trapping ability. The boronmore » combined with nitrogen segregating at grain boundaries, cementite and MnS inclusions, provides higher amount of attractive hydrogen trapping sites and raises the activation energy for hydrogen desorption from them. - Highlights: • We study microstructures and properties in low-carbon Al-killed enamel steel. • Hydrogen diffusion coefficients are measured to reflect fish-scale resistance. • Manganese improves hydrogen trapping ability but decrease deep-drawing ability. • Boron improves both hydrogen trapping ability and deep-drawing ability. • Both excellent mechanical properties and fish-scale resistance can be matched.« less

Opportunities to improve the conversion of food waste to lactate: Fine-tuning secondary factors.

PubMed

RedCorn, Raymond; Engelberth, Abigail S

2017-11-01

Extensive research has demonstrated the potential for bioconversion of food waste to lactate, with major emphasis on adjusting temperature, pH, and loading rate of the fermentation. Each of these factors has a significant effect on lactate production; however, additional secondary factors have received little attention. Here we investigate three additional factors where opportunities exist for process improvement: freezing of samples during storage, discontinuous pH control, and holdover of fermentation broth between fermentations. Freezing samples prior to fermentation was shown to reduce the production rate of lactate by 8%, indicating freeze-thaw should be avoided in experiments. Prior work indicated a trade-off in pH control strategies, where discontinuous pH control correlated with higher lactate accumulation while continuous pH control correlated with higher production rate. Here we demonstrate that continuous pH control can achieve both higher lactate accumulation and higher production rate. Finally, holding over fermentation broth was shown to be a simple method to improve production rate (by 18%) at high food waste loading rates (>140 g volatile solids L -1 ) but resulted in lower lactate accumulation (by 17%). The results inform continued process improvements within the waste treatment of food waste through fermentation to lactic acid.

Improving the continued airworthiness of civil aircraft : a strategy for the FAA's Aircraft Certification Service

DOT National Transportation Integrated Search

1998-01-01

The National Research Council (NRC) was asked to conduct an independent assessment of the safety management process used by the Aircraft Certification Service of the Federal Aviation Administration (FAA) to define how the current process might be imp...

Breeding lettuce for improved fresh-cut processing

USDA-ARS?s Scientific Manuscript database

Lettuce is a widely grown vegetable that is used to make fresh-cut salads, which are popular with consumers due to their convenience. Production and processing of fresh-cut lettuce is continually evolving, offering more products and becoming more efficient. Breeding new lettuce cultivars specialized...

Software process assessments

NASA Technical Reports Server (NTRS)

Miller, Sharon E.; Tucker, George T.; Verducci, Anthony J., Jr.

1992-01-01

Software process assessments (SPA's) are part of an ongoing program of continuous quality improvements in AT&T. Their use was found to be very beneficial by software development organizations in identifying the issues facing the organization and the actions required to increase both quality and productivity in the organization.

Applying PCI in Combination Swivel Head Wrench

NASA Astrophysics Data System (ADS)

Chen, Tsang-Chiang; Yang, Chun-Ming; Hsu, Chang-Hsien; Hung, Hsiang-Wen

2017-09-01

Taiwan’s traditional industries are subject to competition in the era of globalization and environmental change, the industry is facing economic pressure and shock, and now sustainable business can only continue to improve production efficiency and quality of technology, in order to stabilize the market, to obtain high occupancy. The use of process capability indices to monitor the quality of the ratchet wrench to find the key function of the dual-use ratchet wrench, the actual measurement data, The use of process capability Cpk index analysis, and draw Process Capability Analysis Chart model. Finally, this study explores the current situation of this case and proposes a lack of improvement and improvement methods to improve the overall quality and thereby enhance the overall industry.

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

Simpson, L.; Britt, J.; Birkmire, R.

ITN Energy Systems, Inc., and Global Solar Energy, Inc., assisted by NREL's PV Manufacturing R&D program, have continued to advance CIGS production technology by developing trajectory-oriented predictive/control models, fault-tolerance control, control platform development, in-situ sensors, and process improvements. Modeling activities included developing physics-based and empirical models for CIGS and sputter-deposition processing, implementing model-based control, and applying predictive models to the construction of new evaporation sources and for control. Model-based control is enabled by implementing reduced or empirical models into a control platform. Reliability improvement activities include implementing preventive maintenance schedules; detecting failed sensors/equipment and reconfiguring to tinue processing; and systematicmore » development of fault prevention and reconfiguration strategies for the full range of CIGS PV production deposition processes. In-situ sensor development activities have resulted in improved control and indicated the potential for enhanced process status monitoring and control of the deposition processes. Substantial process improvements have been made, including significant improvement in CIGS uniformity, thickness control, efficiency, yield, and throughput. In large measure, these gains have been driven by process optimization, which in turn have been enabled by control and reliability improvements due to this PV Manufacturing R&D program.« less

Producing Cochrane systematic reviews-a qualitative study of current approaches and opportunities for innovation and improvement.

PubMed

Turner, Tari; Green, Sally; Tovey, David; McDonald, Steve; Soares-Weiser, Karla; Pestridge, Charlotte; Elliott, Julian

2017-08-01

Producing high-quality, relevant systematic reviews and keeping them up to date is challenging. Cochrane is a leading provider of systematic reviews in health. For Cochrane to continue to contribute to improvements in heath, Cochrane Reviews must be rigorous, reliable and up to date. We aimed to explore existing models of Cochrane Review production and emerging opportunities to improve the efficiency and sustainability of these processes. To inform discussions about how to best achieve this, we conducted 26 interviews and an online survey with 106 respondents. Respondents highlighted the importance and challenge of creating reliable, timely systematic reviews. They described the challenges and opportunities presented by current production models, and they shared what they are doing to improve review production. They particularly highlighted significant challenges with increasing complexity of review methods; difficulty keeping authors on board and on track; and the length of time required to complete the process. Strong themes emerged about the roles of authors and Review Groups, the central actors in the review production process. The results suggest that improvements to Cochrane's systematic review production models could come from improving clarity of roles and expectations, ensuring continuity and consistency of input, enabling active management of the review process, centralising some review production steps; breaking reviews into smaller "chunks", and improving approaches to building capacity of and sharing information between authors and Review Groups. Respondents noted the important role new technologies have to play in enabling these improvements. The findings of this study will inform the development of new Cochrane Review production models and may provide valuable data for other systematic review producers as they consider how best to produce rigorous, reliable, up-to-date reviews.

Continuous quality improvement for the clinical decision unit.

PubMed

Mace, Sharon E

2004-01-01

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

'Governance of' and 'Governance by': implementing a clinical governance framework in an area mental health service.

PubMed

O'Connor, Nick; Paton, Michael

2008-04-01

A framework developed to promote the understanding and application of clinical governance principles in an area mental health service is described. The framework is operationalized through systems, processes, roles and responsibilities. The development of an explicit and operationalizable framework for clinical governance arose from the authors' experiences in leading and managing mental health services. There is a particular emphasis on improvement of quality of care and patient safety. The framework is informed by recent developments in thinking about clinical governance, including key documents from Australia and the United Kingdom. The operational nature of the framework allows for key components of clinical governance to be described explicitly, communicated effectively, and continually tested and improved. Further consideration and assessment of the value of differing approaches to this task are required. For example, a general, illustrative approach to raise clinician awareness can be contrasted with prescriptive and specified approaches which progressively encompass the many functions and processes of a mental health service. Mental health clinicians and managers can be guided by a framework that will ensure safe, high quality and continually improving processes of care.

Quick and continuous improvement through kaizen blitz.

PubMed

McNichols, T; Hassinger, R; Bapst, G W

1999-05-01

It is our objective to provide you with a step-by-step approach to conducting a kaizen blitz within two days and describe how to achieve dramatic performance improvement with employee buy-in through this process. Kaizen blitz has been used dozens of times by the authors, and in some instances the same area has been blitzed as many as four times, with significant improvements each and every time. Employees have even taken it on themselves to conduct informal blitzes as a continuing improvement effort after a formal blitz has been conducted in their area. Blitzes can succeed in a variety of environments. The morning after the employees of one company attended this presentation, they self initiated a mini-blitz and discovered opportunities for improvement that they enthusiastically presented to management.

Sustaining the Momentum for the Change Process: An Historical Case Study of a Midwestern High School

ERIC Educational Resources Information Center

Onsager, Tim A.

2010-01-01

Although many high schools have failed to bring meaningful change, an increasing number of schools have experienced the successful implementation of a school-wide continuous improvement process. This study explored the change process as experienced by members of a high school community intent on establishing and sustaining change to better meet…

Continuous Quality Improvement: Making the Transition to Education.

ERIC Educational Resources Information Center

Hubbard, Dean L., Ed.

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

Improve processes on healthcare: current issues and future trends.

PubMed

Chen, Jason C H; Dolan, Matt; Lin, Binshan

2004-01-01

Information Technology (IT) is a critical resource for improving today's business competitiveness. However, many healthcare providers do not proactively manage or improve the efficiency and effectiveness of their services with IT. Survival in a competitive business environment demands continuous improvements in quality and service, while rigorously maintaining core values. Electronic commerce continues its development, gaining ground as the preferred means of business transactions. Embracing e-healthcare and treating IT as a strategic tool to improve patient safety and the quality of care enables healthcare professionals to benefit from technology formerly used only for management purposes. Numerous improvement initiatives, introduced by both the federal government and the private sector, seek to better the status quo in IT. This paper examines the current IT climate using an enhanced "Built to Last" model, and comments on future IT strategies within the healthcare industry.

AACSB Accreditation and Possible Unintended Consequences: A Deming View

ERIC Educational Resources Information Center

Stepanovich, Paul; Mueller, James; Benson, Dan

2014-01-01

The AACSB accreditation process reflects basic quality principles, providing standards and a process for feedback for continuous improvement. However, implementation can lead to unintended negative consequences. The literature shows that while institutionalism and critical theory have been used as a theoretical base for evaluating accreditation,…

Organizational Diagnosis: Its Role in Organizational Learning.

ERIC Educational Resources Information Center

Beer, Michael; Spector, Bert

1993-01-01

Sees diagnosis as process that helps organizations enhance their capacity to assess and change dysfunctional aspects of culture and patterns of behavior as basis for developing greater effectiveness and ensuring continuous improvement. Presents framework for understanding "learning diagnosis" in which diagnostic process is part of large-scale…

Latest medical applications of polypropylene.

PubMed

Van Lierde, Stijn

2004-06-01

PP volumes for use in medical applications increase every year for some obvious reasons. The polymer can be processed by practically all techniques and sterilisation and transparency processes, and its properties are continuously improved. Furthermore, it can replace many other materials, and is attractive from a cost and versatility perspective.

Learning Evaluation: blending quality improvement and implementation research methods to study healthcare innovations.

PubMed

Balasubramanian, Bijal A; Cohen, Deborah J; Davis, Melinda M; Gunn, Rose; Dickinson, L Miriam; Miller, William L; Crabtree, Benjamin F; Stange, Kurt C

2015-03-10

In healthcare change interventions, on-the-ground learning about the implementation process is often lost because of a primary focus on outcome improvements. This paper describes the Learning Evaluation, a methodological approach that blends quality improvement and implementation research methods to study healthcare innovations. Learning Evaluation is an approach to multi-organization assessment. Qualitative and quantitative data are collected to conduct real-time assessment of implementation processes while also assessing changes in context, facilitating quality improvement using run charts and audit and feedback, and generating transportable lessons. Five principles are the foundation of this approach: (1) gather data to describe changes made by healthcare organizations and how changes are implemented; (2) collect process and outcome data relevant to healthcare organizations and to the research team; (3) assess multi-level contextual factors that affect implementation, process, outcome, and transportability; (4) assist healthcare organizations in using data for continuous quality improvement; and (5) operationalize common measurement strategies to generate transportable results. Learning Evaluation principles are applied across organizations by the following: (1) establishing a detailed understanding of the baseline implementation plan; (2) identifying target populations and tracking relevant process measures; (3) collecting and analyzing real-time quantitative and qualitative data on important contextual factors; (4) synthesizing data and emerging findings and sharing with stakeholders on an ongoing basis; and (5) harmonizing and fostering learning from process and outcome data. Application to a multi-site program focused on primary care and behavioral health integration shows the feasibility and utility of Learning Evaluation for generating real-time insights into evolving implementation processes. Learning Evaluation generates systematic and rigorous cross-organizational findings about implementing healthcare innovations while also enhancing organizational capacity and accelerating translation of findings by facilitating continuous learning within individual sites. Researchers evaluating change initiatives and healthcare organizations implementing improvement initiatives may benefit from a Learning Evaluation approach.

Student evaluations of the portfolio process.

PubMed

Murphy, John E; Airey, Tatum C; Bisso, Andrea M; Slack, Marion K

2011-09-10

To evaluate pharmacy students' perceived benefits of the portfolio process and to gather suggestions for improving the process. A questionnaire was designed and administered to 250 first-, second-, and third-year pharmacy students at the University of Arizona College of Pharmacy. Although the objectives of the portfolio process were for students to understand the expected outcomes, understand the impact of extracurricular activities on attaining competencies, identify what should be learned, identify their strengths and weaknesses, and modify their approach to learning, overall students perceived the portfolio process as having less than moderate benefit. First-year students wanted more examples of portfolios while second- and third-year students suggested that more time with their advisor would be beneficial. The portfolio process will continue to be refined and efforts made to improve students' perceptions of the process as it is intended to develop the self-assessments skills they will need to improve their knowledge and professional skills throughout their pharmacy careers.

Challenges of using quality improvement methods in nursing homes that "need improvement".

PubMed

Rantz, Marilyn J; Zwygart-Stauffacher, Mary; Flesner, Marcia; Hicks, Lanis; Mehr, David; Russell, Teresa; Minner, Donna

2012-10-01

Qualitatively describe the adoption of strategies and challenges experienced by intervention facilities participating in a study targeted to improve quality of care in nursing homes "in need of improvement". To describe how staff use federal quality indicator/quality measure (QI/QM) scores and reports, quality improvement methods and activities, and how staff supported and sustained the changes recommended by their quality improvement teams. A randomized, two-group, repeated-measures design was used to test a 2-year intervention for improving quality of care and resident outcomes in facilities in "need of improvement". Intervention group (n = 29) received an experimental multilevel intervention designed to help them: (1) use quality-improvement methods, (2) use team and group process for direct-care decision-making, (3) focus on accomplishing the basics of care, and (4) maintain more consistent nursing and administrative leadership committed to communication and active participation of staff in decision-making. A qualitative analysis revealed a subgroup of homes likely to continue quality improvement activities and readiness indicators of homes likely to improve: (1) a leadership team (nursing home administrator, director of nurses) interested in learning how to use their federal QI/QM reports as a foundation for improving resident care and outcomes; (2) one of the leaders to be a "change champion" and make sure that current QI/QM reports are consistently printed and shared monthly with each nursing unit; (3) leaders willing to involve all staff in the facility in educational activities to learn about the QI/QM process and the reports that show how their facility compares with others in the state and nation; (4) leaders willing to plan and continuously educate new staff about the MDS and federal QI/QM reports and how to do quality improvement activities; (5) leaders willing to continuously involve all staff in quality improvement committee and team activities so they "own" the process and are responsible for change. Results of this qualitative analysis can help allocate expert nurse time to facilities that are actually ready to improve. Wide-spread adoption of this intervention is feasible and could be enabled by nursing home medical directors in collaborative practice with advanced practice nurses. Copyright © 2012 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

The need to improve health care in prisons

PubMed Central

Fernandes, Luiz Henrique; Alvarenga, Carlos Willie; dos Santos, Luciane Loures; Pazin, Antonio

2014-01-01

OBJECTIVE To analyze physical structure, working conditions of health professionals and outline of the procedures established in prisons. METHODS We analyzed 34 provisional detention centers and 69 male and six female prison units in the state of Sao Paulo, Southeastern Brazil, in 2009. A self-applied instrument was developed to collect quantitative data on the characteristics of health care structure, equipment and personnel in prisons. Analysis of variance (ANOVA) or equivalent non-parametric tests and Chi-square or Fisher’s tests were used to compare categorical and continuous variables, respectively, between the groups. RESULTS The main problems were delays in the results of laboratory tests and imaging. With respect to the teams, it was observed that a large majority were in conditions close to those proposed by the Bipartite Commission 2013 but without improvement being reflected in the indicators. With respect to the process, more than 60.0% of prisons located in small towns do not have the structural conditions to ensure secondary or tertiary health care for the continuity of treatment. CONCLUSIONS This profile of prisons in the country can be used for planning and monitoring future actions for the continuous improvement of healthcare processes. PMID:24897049

Analysing the external supply chain risk driver competitiveness: a risk mitigation framework and business continuity plan.

PubMed

Blos, Mauricio F; Wee, Hui-Ming; Yang, Joshua

2010-11-01

Innovation challenges for handling supply chain risks have become one of the most important drivers in business competitiveness and differentiation. This study analyses competitiveness at the external supply chain level as a driver of risks and provides a framework for mitigating these risks. The mitigation framework, also called the supply chain continuity framework, provides insight into six stages of the business continuity planning (BCP) process life cycle (risk mitigation management, business impact analysis, supply continuity strategy development, supply continuity plan development, supply continuity plan testing and supply continuity plan maintenance), together with the operational constructs: customer service, inventory management, flexibility, time to market, ordering cycle time and quality. The purpose of the BCP process life cycle and operational constructs working together is to emphasise the way in which a supply chain can deal with disruption risks and, consequently, bring competitive advantage. Future research will consider the new risk scenarios and analyse the consequences to promote the improvement of supply chain resilience.

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

PubMed

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

2009-12-01

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

IARC monographs: 40 years of evaluating carcinogenic hazards to humans.

PubMed

Pearce, Neil; Blair, Aaron; Vineis, Paolo; Ahrens, Wolfgang; Andersen, Aage; Anto, Josep M; Armstrong, Bruce K; Baccarelli, Andrea A; Beland, Frederick A; Berrington, Amy; Bertazzi, Pier Alberto; Birnbaum, Linda S; Brownson, Ross C; Bucher, John R; Cantor, Kenneth P; Cardis, Elisabeth; Cherrie, John W; Christiani, David C; Cocco, Pierluigi; Coggon, David; Comba, Pietro; Demers, Paul A; Dement, John M; Douwes, Jeroen; Eisen, Ellen A; Engel, Lawrence S; Fenske, Richard A; Fleming, Lora E; Fletcher, Tony; Fontham, Elizabeth; Forastiere, Francesco; Frentzel-Beyme, Rainer; Fritschi, Lin; Gerin, Michel; Goldberg, Marcel; Grandjean, Philippe; Grimsrud, Tom K; Gustavsson, Per; Haines, Andy; Hartge, Patricia; Hansen, Johnni; Hauptmann, Michael; Heederik, Dick; Hemminki, Kari; Hemon, Denis; Hertz-Picciotto, Irva; Hoppin, Jane A; Huff, James; Jarvholm, Bengt; Kang, Daehee; Karagas, Margaret R; Kjaerheim, Kristina; Kjuus, Helge; Kogevinas, Manolis; Kriebel, David; Kristensen, Petter; Kromhout, Hans; Laden, Francine; Lebailly, Pierre; LeMasters, Grace; Lubin, Jay H; Lynch, Charles F; Lynge, Elsebeth; 't Mannetje, Andrea; McMichael, Anthony J; McLaughlin, John R; Marrett, Loraine; Martuzzi, Marco; Merchant, James A; Merler, Enzo; Merletti, Franco; Miller, Anthony; Mirer, Franklin E; Monson, Richard; Nordby, Karl-Cristian; Olshan, Andrew F; Parent, Marie-Elise; Perera, Frederica P; Perry, Melissa J; Pesatori, Angela Cecilia; Pirastu, Roberta; Porta, Miquel; Pukkala, Eero; Rice, Carol; Richardson, David B; Ritter, Leonard; Ritz, Beate; Ronckers, Cecile M; Rushton, Lesley; Rusiecki, Jennifer A; Rusyn, Ivan; Samet, Jonathan M; Sandler, Dale P; de Sanjose, Silvia; Schernhammer, Eva; Costantini, Adele Seniori; Seixas, Noah; Shy, Carl; Siemiatycki, Jack; Silverman, Debra T; Simonato, Lorenzo; Smith, Allan H; Smith, Martyn T; Spinelli, John J; Spitz, Margaret R; Stallones, Lorann; Stayner, Leslie T; Steenland, Kyle; Stenzel, Mark; Stewart, Bernard W; Stewart, Patricia A; Symanski, Elaine; Terracini, Benedetto; Tolbert, Paige E; Vainio, Harri; Vena, John; Vermeulen, Roel; Victora, Cesar G; Ward, Elizabeth M; Weinberg, Clarice R; Weisenburger, Dennis; Wesseling, Catharina; Weiderpass, Elisabete; Zahm, Shelia Hoar

2015-06-01

Recently, the International Agency for Research on Cancer (IARC) Programme for the Evaluation of Carcinogenic Risks to Humans has been criticized for several of its evaluations, and also for the approach used to perform these evaluations. Some critics have claimed that failures of IARC Working Groups to recognize study weaknesses and biases of Working Group members have led to inappropriate classification of a number of agents as carcinogenic to humans. The authors of this Commentary are scientists from various disciplines relevant to the identification and hazard evaluation of human carcinogens. We examined criticisms of the IARC classification process to determine the validity of these concerns. Here, we present the results of that examination, review the history of IARC evaluations, and describe how the IARC evaluations are performed. We concluded that these recent criticisms are unconvincing. The procedures employed by IARC to assemble Working Groups of scientists from the various disciplines and the techniques followed to review the literature and perform hazard assessment of various agents provide a balanced evaluation and an appropriate indication of the weight of the evidence. Some disagreement by individual scientists to some evaluations is not evidence of process failure. The review process has been modified over time and will undoubtedly be altered in the future to improve the process. Any process can in theory be improved, and we would support continued review and improvement of the IARC processes. This does not mean, however, that the current procedures are flawed. The IARC Monographs have made, and continue to make, major contributions to the scientific underpinning for societal actions to improve the public's health.

Optimizing process and equipment efficiency using integrated methods

NASA Astrophysics Data System (ADS)

D'Elia, Michael J.; Alfonso, Ted F.

1996-09-01

The semiconductor manufacturing industry is continually riding the edge of technology as it tries to push toward higher design limits. Mature fabs must cut operating costs while increasing productivity to remain profitable and cannot justify large capital expenditures to improve productivity. Thus, they must push current tool production capabilities to cut manufacturing costs and remain viable. Working to continuously improve mature production methods requires innovation. Furthermore, testing and successful implementation of these ideas into modern production environments require both supporting technical data and commitment from those working with the process daily. At AMD, natural work groups (NWGs) composed of operators, technicians, engineers, and supervisors collaborate to foster innovative thinking and secure commitment. Recently, an AMD NWG improved equipment cycle time on the Genus tungsten silicide (WSi) deposition system. The team used total productive manufacturing (TPM) to identify areas for process improvement. Improved in-line equipment monitoring was achieved by constructing a real time overall equipment effectiveness (OEE) calculator which tracked equipment down, idle, qualification, and production times. In-line monitoring results indicated that qualification time associated with slow Inspex turn-around time and machine downtime associated with manual cleans contributed greatly to reduced availability. Qualification time was reduced by 75% by implementing a new Inspex monitor pre-staging technique. Downtime associated with manual cleans was reduced by implementing an in-situ plasma etch back to extend the time between manual cleans. A designed experiment was used to optimize the process. Time between 18 hour manual cleans has been improved from every 250 to every 1500 cycles. Moreover defect density realized a 3X improvement. Overall, the team achieved a 35% increase in tool availability. This paper details the above strategies and accomplishments.

Quality improvement for patients with hip fracture: experience from a multi-site audit.

PubMed

Freeman, C; Todd, C; Camilleri-Ferrante, C; Laxton, C; Murrell, P; Palmer, C R; Parker, M; Payne, B; Rushton, N

2002-09-01

The first East Anglian audit of hip fracture was conducted in eight hospitals during 1992. There were significant differences between hospitals in 90-day mortality, development of pressure sores, median lengths of hospital stay, and in most other process measures. Only about half the survivors recovered their pre-fracture physical function. A marked decrease in physical function (for 31%) was associated with postoperative complications. A re-audit was conducted in 1997 as part of a process of continuing quality improvement. This was an interview and record based prospective audit of process and outcome of care with 3 month follow up. Seven hospitals with trauma orthopaedic departments took part in both audits. Results from the 1992 audit and indicator standards for re-audit were circulated to all orthopaedic consultants, care of the elderly consultants, and lead audit facilitators at each hospital. Processes likely to reduce postoperative complications and improve patient outcomes at 90 days. As this was a multi-site audit, the project group had no direct power to bring about changes within individual NHS hospital trusts. Significant increases were seen in pharmaceutical thromboembolic prophylaxis (from 45% to 81%) and early mobilisation (from 56% to 70%) between 1992 and 1997. There were reduced levels of pneumonia, wound infection, pressure sores, and fatal pulmonary embolism, but no change was recorded in 3 month functional outcomes or mortality. While some hospitals had made improvements in care by 1997, others were failing to maintain their level of good practice. This highlights the need for continuous quality improvement by repeating the audit cycle in order to reach and then improve standards. Rehabilitation and long term support to improve functional outcomes are key areas for future audit and research.

Using PAT to accelerate the transition to continuous API manufacturing.

PubMed

Gouveia, Francisca F; Rahbek, Jesper P; Mortensen, Asmus R; Pedersen, Mette T; Felizardo, Pedro M; Bro, Rasmus; Mealy, Michael J

2017-01-01

Significant improvements can be realized by converting conventional batch processes into continuous ones. The main drivers include reduction of cost and waste, increased safety, and simpler scale-up and tech transfer activities. Re-designing the process layout offers the opportunity to incorporate a set of process analytical technologies (PAT) embraced in the Quality-by-Design (QbD) framework. These tools are used for process state estimation, providing enhanced understanding of the underlying variability in the process impacting quality and yield. This work describes a road map for identifying the best technology to speed-up the development of continuous processes while providing the basis for developing analytical methods for monitoring and controlling the continuous full-scale reaction. The suitability of in-line Raman, FT-infrared (FT-IR), and near-infrared (NIR) spectroscopy for real-time process monitoring was investigated in the production of 1-bromo-2-iodobenzene. The synthesis consists of three consecutive reaction steps including the formation of an unstable diazonium salt intermediate, which is critical to secure high yield and avoid formation of by-products. All spectroscopic methods were able to capture critical information related to the accumulation of the intermediate with very similar accuracy. NIR spectroscopy proved to be satisfactory in terms of performance, ease of installation, full-scale transferability, and stability to very adverse process conditions. As such, in-line NIR was selected to monitor the continuous full-scale production. The quantitative method was developed against theoretical concentration values of the intermediate since representative sampling for off-line reference analysis cannot be achieved. The rapid and reliable analytical system allowed the following: speeding up the design of the continuous process and a better understanding of the manufacturing requirements to ensure optimal yield and avoid unreacted raw materials and by-products in the continuous reactor effluent. Graphical Abstract Using PAT to accelerate the transition to continuous API manufacturing.

Business process study simulation for resource management in an emergency department.

PubMed

Poomkothammal, Velusamy

2006-01-01

Alexandra Hospital conducted a business process reengineering exercise for all its main processes in order to further improve on their efficiencies with the ultimate aim to provide a higher level of services to patients. The goal of the DEM is to manage an anticipated increase in the volume of patients without much increase in resources. As a start, the Department of Emergency (DEM) medicine studied its AS-IS process and has designed and implemented the new TO-BE process. As part of this continuous improvement effort, staff from Nanyang Polytechnic (NYP) has been assigned the task of applying engineering and analytical techniques to simulate the new process. The simulations were conducted to show on process management and resource planning.

Optimizing Web-Based Instruction: A Case Study Using Poultry Processing Unit Operations

ERIC Educational Resources Information Center

O' Bryan, Corliss A.; Crandall, Philip G.; Shores-Ellis, Katrina; Johnson, Donald M.; Ricke, Steven C.; Marcy, John

2009-01-01

Food companies and supporting industries need inexpensive, revisable training methods for large numbers of hourly employees due to continuing improvements in Hazard Analysis Critical Control Point (HACCP) programs, new processing equipment, and high employee turnover. HACCP-based food safety programs have demonstrated their value by reducing the…

Evaluation of Organizational Self-Assessment Tools and Methodologies to Measure Continuous Process Improvement for the Naval Aviation Enterprise

DTIC Science & Technology

2006-09-01

Scully, M., Van Manen , J., & Westney, D. (2005). Managing for the Future: Organizational Behavior & Processes. Mason, OH: South-Western College...equipment, facilities and with increasing importance the resources of information and expertise (Ancona, D., Kochan, T., Scully, M., Van Maanen, J

Using Statistical Process Control to Make Data-Based Clinical Decisions.

ERIC Educational Resources Information Center

Pfadt, Al; Wheeler, Donald J.

1995-01-01

Statistical process control (SPC), which employs simple statistical tools and problem-solving techniques such as histograms, control charts, flow charts, and Pareto charts to implement continual product improvement procedures, can be incorporated into human service organizations. Examples illustrate use of SPC procedures to analyze behavioral data…

Students Matter: Quality Measurements in Online Courses

ERIC Educational Resources Information Center

Unal, Zafer; Unal, Aslihan

2016-01-01

Quality Matters (QM) is a peer review process designed to certify the quality of online courses and online components. It has generated widespread interest and received national recognition for its peer-based approach to quality assurance and continuous improvement in online education. While the entire QM online course design process is…

20 CFR 663.500 - What is the purpose of this subpart?

Code of Federal Regulations, 2010 CFR

2010-04-01

... emphasizes informed customer choice, system performance, and continuous improvement. The eligible provider process is part of the strategy for achieving these goals. Local Boards, in partnership with the State... population groups are served, States and local areas should administer the eligible provider process in a...

Integrating interprofessional education into continuing education: a planning process for continuing interprofessional education programs.

PubMed

Owen, John A; Schmitt, Madeline H

2013-01-01

Informal continuing interprofessional education (CIPE) can be traced back decades in the United States; however, interest in formal CIPE is recent. Interprofessional education (IPE) now is recognized as an important component of new approaches to continuing education (CE) that are needed to increase health professionals' ability to improve outcomes of care. Although there are examples of CIPE programs that are being successfully implemented, a clearly articulated, step-by-step planning process to help guide educators in providing effective CIPE programs is lacking. This lack of guidance poses a significant barrier to increasing the number of CIPE programs in the United States. In this article, we describe a process for developing, implementing, and evaluating CIPE programs using the familiar systematic CE planning process. Limitations of traditional CE also are addressed, and the relationship between CIPE and other new approaches to CE is clarified. Four examples of CIPE programs are provided to illustrate how the planning process can be adapted to include IPE, while implementing recommended changes in traditional CE offerings. The article is concluded with a discussion of some of the challenges that will face CE educators in moving toward a new vision of CE integrated with IPE. Copyright © 2013 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education.

Process-oriented Observational Metrics for CMIP6 Climate Model Assessments

NASA Astrophysics Data System (ADS)

Jiang, J. H.; Su, H.

2016-12-01

Observational metrics based on satellite observations have been developed and effectively applied during post-CMIP5 model evaluation and improvement projects. As new physics and parameterizations continue to be included in models for the upcoming CMIP6, it is important to continue objective comparisons between observations and model results. This talk will summarize the process-oriented observational metrics and methodologies for constraining climate models with A-Train satellite observations and support CMIP6 model assessments. We target parameters and processes related to atmospheric clouds and water vapor, which are critically important for Earth's radiative budget, climate feedbacks, and water and energy cycles, and thus reduce uncertainties in climate models.

The Use of Lean Six Sigma Methodology in Increasing Capacity of a Chemical Production Facility at DSM.

PubMed

Meeuwse, Marco

2018-03-30

Lean Six Sigma is an improvement method, combining Lean, which focuses on removing 'waste' from a process, with Six Sigma, which is a data-driven approach, making use of statistical tools. Traditionally it is used to improve the quality of products (reducing defects), or processes (reducing variability). However, it can also be used as a tool to increase the productivity or capacity of a production plant. The Lean Six Sigma methodology is therefore an important pillar of continuous improvement within DSM. In the example shown here a multistep batch process is improved, by analyzing the duration of the relevant process steps, and optimizing the procedures. Process steps were performed in parallel instead of sequential, and some steps were made shorter. The variability was reduced, giving the opportunity to make a tighter planning, and thereby reducing waiting times. Without any investment in new equipment or technical modifications, the productivity of the plant was improved by more than 20%; only by changing procedures and the programming of the process control system.

Using Six Sigma to reduce medication errors in a home-delivery pharmacy service.

PubMed

Castle, Lon; Franzblau-Isaac, Ellen; Paulsen, Jim

2005-06-01

Medco Health Solutions, Inc. conducted a project to reduce medication errors in its home-delivery service, which is composed of eight prescription-processing pharmacies, three dispensing pharmacies, and six call-center pharmacies. Medco uses the Six Sigma methodology to reduce process variation, establish procedures to monitor the effectiveness of medication safety programs, and determine when these efforts do not achieve performance goals. A team reviewed the processes in home-delivery pharmacy and suggested strategies to improve the data-collection and medication-dispensing practices. A variety of improvement activities were implemented, including a procedure for developing, reviewing, and enhancing sound-alike/look-alike (SALA) alerts and system enhancements to improve processing consistency across the pharmacies. "External nonconformances" were reduced for several categories of medication errors, including wrong-drug selection (33%), wrong directions (49%), and SALA errors (69%). Control charts demonstrated evidence of sustained process improvement and actual reduction in specific medication error elements. Establishing a continuous quality improvement process to ensure that medication errors are minimized is critical to any health care organization providing medication services.

Implementation and Sequencing of Practice Transformation in Urban Practices with Underserved Patients.

PubMed

Quigley, Denise D; Predmore, Zachary S; Chen, Alex Y; Hays, Ron D

Patient-centered medical home (PCMH) has gained momentum as a model for primary-care health services reform. We conducted interviews at 14 primary care practices undergoing PCMH transformation in a large urban federally qualified health center in California and used grounded theory to identify common themes and patterns. We found clinics pursued a common sequence of changes in PCMH transformation: Clinics began with National Committee for Quality Assurance (NCQA) level 3 recognition, adding care coordination staff, reorganizing data flow among teams, and integrating with a centralized quality improvement and accountability infrastructure. Next, they realigned to support continuity of care. Then, clinics improved access by adding urgent care, patient portals, or extending hours. Most then improved planning and management of patient visits. Only a handful worked explicitly on improving access with same day slots, scheduling processes, and test result communication. The clinics' changes align with specific NCQA PCMH standards but also include adding physicians and services, culture changes, and improved communication with patients. NCQA PCMH level 3 recognition is only the beginning of a continuous improvement process to become patient centered. Full PCMH transformation took time and effort and relied on a sequential approach, with an early focus on foundational changes that included use of a robust quality improvement strategy before changes to delivery of and access to care.

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

Bickford, D.F.

During the first two years of radioactive operation of the Defense Waste Processing Facility process, several areas for improvement in melter design were identified. Due to the need for a process that allows continuous melter operation, the down time associated with disruption to melter operation and pouring has significant cost impact. A major objective of this task is to address performance limitations and deficiencies identified by the user.

PSP, TSP, XP, CMMI...Eating the Alphabet Soup!

DTIC Science & Technology

2011-05-19

Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302. Respondents should be aware that notwithstanding any other...4 Q tit t Continuous process improvement Organizational Performance Management Causal Analysis and Resolution Level Focus Process Areas Requirements...Project Management process standardization Risk management Decision Analysis and Resolution Product Integration 2 M d R i t t anage Basic Project

Utilization of Lean Methodology to Refine Hiring Practices in a Clinical Research Center Setting

ERIC Educational Resources Information Center

Johnson, Marcus R.; Bullard, A. Jasmine; Whitley, R. Lawrence

2018-01-01

Background & Aims: Lean methodology is a continuous process improvement approach that is used to identify and eliminate unnecessary steps (or waste) in a process. It increases the likelihood that the highest level of value possible is provided to the end-user, or customer, in the form of the product delivered through that process. Lean…

Using CASE to Exploit Process Modeling in Technology Transfer

NASA Technical Reports Server (NTRS)

Renz-Olar, Cheryl

2003-01-01

A successful business will be one that has processes in place to run that business. Creating processes, reengineering processes, and continually improving processes can be accomplished through extensive modeling. Casewise(R) Corporate Modeler(TM) CASE is a computer aided software engineering tool that will enable the Technology Transfer Department (TT) at NASA Marshall Space Flight Center (MSFC) to capture these abilities. After successful implementation of CASE, it could then go on to be applied in other departments at MSFC and other centers at NASA. The success of a business process is dependent upon the players working as a team and continuously improving the process. A good process fosters customer satisfaction as well as internal satisfaction in the organizational infrastructure. CASE provides a method for business process success through functions consisting of systems and processes business models; specialized diagrams; matrix management; simulation; report generation and publishing; and, linking, importing, and exporting documents and files. The software has an underlying repository or database to support these functions. The Casewise. manual informs us that dynamics modeling is a technique used in business design and analysis. Feedback is used as a tool for the end users and generates different ways of dealing with the process. Feedback on this project resulted from collection of issues through a systems analyst interface approach of interviews with process coordinators and Technical Points of Contact (TPOCs).

Continuous improvement and TQM in health care: an emerging operational paradigm becomes a strategic imperative.

PubMed

Swinehart, K; Green, R F

1995-01-01

Argues that US health care is in a state of crisis. Escalating costs account for 13 per cent of GNP, making health care the third largest industry in the USA, and spending is expected to increase. Claims health-care providers need to control rising costs, improve productivity and flexibility, adopt appropriate technologies, and maintain competitive levels of quality and value. States that TQM may provide an environment that will focus on quality of patient care and continuous quality improvement at all levels of the organization including the governing body, the administrative, managerial, and clinical areas. Any new national or state health-care plan will force providers to be more efficient while maintaining quality standards. Concludes that it will be strategically imperative that health-care providers ranging from family physicians to major medical centres and suppliers ranging from laboratories to pharmaceutical firms establish methods for making rapid continuous improvement and total quality management the cornerstone of the strategic planning process.

How to improve patient satisfaction when patients are already satisfied: a continuous process-improvement approach.

PubMed

Friesner, Dan; Neufelder, Donna; Raisor, Janet; Bozman, Carl S

2009-01-01

The authors present a methodology that measures improvement in customer satisfaction scores when those scores are already high and the production process is slow and thus does not generate a large amount of useful data in any given time period. The authors used these techniques with data from a midsized rehabilitation institute affiliated with a regional, nonprofit medical center. Thus, this article functions as a case study, the findings of which may be applicable to a large number of other healthcare providers that share both the mission and challenges faced by this facility. The methodology focused on 2 factors: use of the unique characteristics of panel data to overcome the paucity of observations and a dynamic benchmarking approach to track process variability over time. By focusing on these factors, the authors identify some additional areas for process improvement despite the institute's past operational success.

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

Sorensen, Christian

The effort to collect and process foam for the purpose of recycling performed by the Material Sustainability and Pollution Prevention (MSP2) team at Sandia National Laboratories is an incredible one, but in order to make it run more efficiently it needed some tweaking. This project started in June of 2015. We used the Value Stream Mapping process to allow us to look at the current state of the foam collection and processing operation. We then thought of all the possible ways the process could be improved. Soon after that we discussed which of the "dreams" were feasible. And finally, wemore » assigned action items to members of the team so as to ensure that the improvements actually occur. These improvements will then, due to varying factors, continue to occur over the next couple years.« less

ViDi-O (View-It and Do-It Online): An Approach to Internet Commerce in a Higher Education Setting.

ERIC Educational Resources Information Center

Kesner, Richard M.

1997-01-01

To improve services and reduce costs, Babson College (Massachusetts) has begun continuous quality improvement and reengineering, moving rapidly toward a client/server information technology environment and Internet/Intranet-enabled business processes. The evolution of the strategy and its products, underlying technologies, and development process…

A Survey of Stemming Algorithms in Information Retrieval

ERIC Educational Resources Information Center

Moral, Cristian; de Antonio, Angélica; Imbert, Ricardo; Ramírez, Jaime

2014-01-01

Background: During the last fifty years, improved information retrieval techniques have become necessary because of the huge amount of information people have available, which continues to increase rapidly due to the use of new technologies and the Internet. Stemming is one of the processes that can improve information retrieval in terms of…

Participatory design in lean production: which contribution from employees? For what end?

PubMed

Perez Toralla, M S; Falzon, P; Morais, A

2012-01-01

The proponents of lean production have pointed to the positive effects of the work organization on employees in terms of autonomy, enhanced skills and empowerment mainly by their participation into the continuous improvement of work process. But studies that have examined this issue suggest that the increase in autonomy is not sufficient to compensate for increases work intensity. Participatory design has grown extensively in manufacturing since the 1980's under the impulsion of the Scandinavian socio-technical system approach and it's central in the model of lean production performance. Its main objectives are to improve quality, increase productivity and safety through employee's participation to the reduction of non-value added activities, such as defined by lean production. In the line of the studies on participatory design and continuous improvement the present study examines the functioning of work groups, based on the kaizen model, the aim of which was to improve the proportion of "value-added activities" and working conditions, essentially physical constraints. The main results are consistent with the literature and show that accelerated forms of re-conception activities give employees limited room for maneuver to elaborate solutions based on the analysis of the real activity. This study is part of a broader initiative that goes in the direction of continuous improvement of the design process itself so that it integrates the real constraints of work and propose changes bases on work as it actually takes place, beyond pre-established performance goals bases on the reduction of "non added value activities".

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

PubMed

Benders, Jos; Bleijerveld, Hans; Schouteten, Roel

2017-10-01

Continuous improvement (CI) programs are potentially powerful means to improve the quality of care. The more positive nurses perceive these programs' effects, the better they may be expected to cooperate. Crucial to this perception is how nurses' quality of working life is affected. We studied this in a nursing department, using the job demands-resources model. We found that two job demands improved, and none of the job resources. Job engagement did not change significantly, while the burnout risk decreased slightly. Overall, the nurses felt the impact to be small yet the changes were in a positive direction. CI can thus be used to improve nurses' working lives and, by restructuring the work processes, the quality of care. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Analysis of the United States Marine Corps Continuous Process Improvement Program Applied to the Contracting Process at Marine Corps Regional Contracting Office - Southwest

DTIC Science & Technology

2007-12-01

37 3. Poka - yoke ............................................................................................37 4. Systems for...Standard operating procedures • Visual displays for workflow and communication • Total productive maintenance • Poka - yoke techniques to prevent...process step or eliminating non-value-added steps, and reducing the seven common wastes, will decrease the total time of a process. 3. Poka - yoke

Simulation Modeling of Software Development Processes

NASA Technical Reports Server (NTRS)

Calavaro, G. F.; Basili, V. R.; Iazeolla, G.

1996-01-01

A simulation modeling approach is proposed for the prediction of software process productivity indices, such as cost and time-to-market, and the sensitivity analysis of such indices to changes in the organization parameters and user requirements. The approach uses a timed Petri Net and Object Oriented top-down model specification. Results demonstrate the model representativeness, and its usefulness in verifying process conformance to expectations, and in performing continuous process improvement and optimization.

Design of a lamella settler for biomass recycling in continuous ethanol fermentation process.

PubMed

Tabera, J; Iznaola, M A

1989-04-20

The design and application of a settler to a continuous fermentation process with yeast recycle were studied. The compact lamella-type settler was chosen to avoid large volumes associated with conventional settling tanks. A rationale of the design method is covered. The sedimentation area was determined by classical batch settling rate tests and sedimentation capacity calculation. Limitations on the residence time of the microorganisms in the settler, rather than sludge thickening considerations, was the approach employed for volume calculation. Fermentation rate tests with yeast after different sedimentation periods were carried out to define a suitable residence time. Continuous cell recycle fermentation runs, performed with the old and new sedimentation devices, show that lamella settler improves biomass recycling efficiency, being the process able to operate at higher sugar concentrations and faster dilution rates.

Humor adds the creative touch to CQI teams.

PubMed

Balzer, J W

1994-07-01

The health care industry is looking to continuous quality improvement as a process to both improve patient care and promote cost effectiveness. Interdisciplinary teams are learning to work together and to use data-driven problem solving. Humor adds a creative and welcome touch to the process that makes it easier and more fun to work in teams. The team leader or facilitator who uses humor along the journey sanctions the risk-taking behavior that accompanies creative solutions to tough problems.

Auditing the nutrition content of patient charts: one hospital's perspective.

PubMed

Skopelianos, S

1993-01-01

Chart audits are traditionally based on patient charts categorized by disease. An alternate approach, using categorization by four types of nutrition care intervention, has been developed by University Hospital. This paper describes the process followed, criteria developed and the results of two complete chart audits. It was shown that nutrition profile forms improved documentation. Overall norms increased significantly from 81.5% to 90% (p < .05). Discussion centres on the evolutionary process from quality assurance to continuous quality improvement.

Improving Operating Room Efficiency: First Case On-Time Start Project.

PubMed

Phieffer, Laura; Hefner, Jennifer L; Rahmanian, Armin; Swartz, Jason; Ellison, Christopher E; Harter, Ronald; Lumbley, Joshua; Moffatt-Bruce, Susan D

Operating rooms (ORs) are costly to run, and multiple factors influence efficiency. The first case on-time start (FCOS) of an OR is viewed as a harbinger of efficiency for the daily schedule. Across 26 ORs of a large, academic medical center, only 49% of cases started on time in October 2011. The Perioperative Services Department engaged an interdisciplinary Operating Room Committee to apply Six Sigma tools to this problem. The steps of this project included (1) problem mapping, (2) process improvements to preoperative readiness, (3) informatics support improvements, and (4) continuous measurement and feedback. By June 2013, there was a peak of 92% first case on-time starts across service lines, decreasing to 78% through 2014, still significantly above the preintervention level of 49% (p = .000). Delay minutes also significantly decreased through the study period (p = .000). Across 2013, the most common delay owners were the patient, the surgeon, the facility, and the anesthesia department. Continuous and sustained improvement of first case on-time starts is attributed to tracking the FCOS metric, establishing embedded process improvement resources and creating transparency of data. This article highlights success factors and barriers to program success and sustainability.

Multisite Assessment of Nursing Continuing Education Learning Needs Using an Electronic Tool.

PubMed

Winslow, Susan; Jackson, Stephanie; Cook, Lesley; Reed, Joanne Williams; Blakeney, Keshia; Zimbro, Kathie; Parker, Cindy

2016-02-01

A continued education needs assessment and associated education plan are required for organizations on the journey for American Nurses Credentialing Center Magnet® designation. Leveraging technology to support the assessment and analysis of continuing education needs was a new venture for a 12-hospital regional health system. The purpose of this performance improvement project was to design and conduct an enhanced process to increase the efficiency and effectiveness of gathering data on nurses' preferences and increase nurse satisfaction with the learner assessment portion of the process. Educators trialed the use of a standardized approach via an electronic survey tool to replace the highly variable processes previously used. Educators were able to view graphical summary of responses by category and setting, which substantially decreased analysis and action planning time for education implementation plans at the system, site, or setting level. Based on these findings, specific continuing education action plans were drafted for each category and classification of nurses. Copyright 2016, SLACK Incorporated.

Process Analytical Technology (PAT): batch-to-batch reproducibility of fermentation processes by robust process operational design and control.

PubMed

Gnoth, S; Jenzsch, M; Simutis, R; Lübbert, A

2007-10-31

The Process Analytical Technology (PAT) initiative of the FDA is a reaction on the increasing discrepancy between current possibilities in process supervision and control of pharmaceutical production processes and its current application in industrial manufacturing processes. With rigid approval practices based on standard operational procedures, adaptations of production reactors towards the state of the art were more or less inhibited for long years. Now PAT paves the way for continuous process and product improvements through improved process supervision based on knowledge-based data analysis, "Quality-by-Design"-concepts, and, finally, through feedback control. Examples of up-to-date implementations of this concept are presented. They are taken from one key group of processes in recombinant pharmaceutical protein manufacturing, the cultivations of genetically modified Escherichia coli bacteria.

Learning to integrate versus inhibiting information is modulated by age.

PubMed

Cappelletti, Marinella; Pikkat, Helen; Upstill, Emily; Speekenbrink, Maarten; Walsh, Vincent

2015-02-04

Cognitive training aiming at improving learning is often successful, but what exactly underlies the observed improvements and how these differ across the age spectrum are currently unknown. Here we asked whether learning in young and older people may reflect enhanced ability to integrate information required to perform a cognitive task or whether it may instead reflect the ability to inhibit task-irrelevant information for successful task performance. We trained 30 young and 30 aging human participants on a numerosity discrimination task known to engage the parietal cortex and in which cue-integration and inhibitory abilities can be distinguished. We coupled training with parietal, motor, or sham transcranial random noise stimulation, known for modulating neural activity. Numerosity discrimination improved after training and was maintained long term, especially in the training + parietal stimulation group, regardless of age. Despite the quantitatively similar improvement in the two age groups, the content of learning differed remarkably: aging participants improved more in inhibitory abilities, whereas younger subjects improved in cue-integration abilities. Moreover, differences in the content of learning were reflected in different transfer effects to untrained but related abilities: in the younger group, improvements in cue integration paralleled improvements in continuous quantity (time and space), whereas in the elderly group, improvements in numerosity-based inhibitory abilities generalized to other measures of inhibition and corresponded to a decline in space discrimination, possibly because conflicting learning resources are used in numerosity and continuous quantity processing. These results indicate that training can enhance different, age-dependent cognitive processes and highlight the importance of identifying the exact processes underlying learning for effective training programs. Copyright © 2015 the authors 0270-6474/15/352213-13$15.00/0.

Exploring Systems That Support Good Clinical Care in Indigenous Primary Health-care Services: A Retrospective Analysis of Longitudinal Systems Assessment Tool Data from High-Improving Services.

PubMed

Woods, Cindy; Carlisle, Karen; Larkins, Sarah; Thompson, Sandra Claire; Tsey, Komla; Matthews, Veronica; Bailie, Ross

2017-01-01

Continuous Quality Improvement is a process for raising the quality of primary health care (PHC) across Indigenous PHC services. In addition to clinical auditing using plan, do, study, and act cycles, engaging staff in a process of reflecting on systems to support quality care is vital. The One21seventy Systems Assessment Tool (SAT) supports staff to assess systems performance in terms of five key components. This study examines quantitative and qualitative SAT data from five high-improving Indigenous PHC services in northern Australia to understand the systems used to support quality care. High-improving services selected for the study were determined by calculating quality of care indices for Indigenous health services participating in the Audit and Best Practice in Chronic Disease National Research Partnership. Services that reported continuing high improvement in quality of care delivered across two or more audit tools in three or more audits were selected for the study. Precollected SAT data (from annual team SAT meetings) are presented longitudinally using radar plots for quantitative scores for each component, and content analysis is used to describe strengths and weaknesses of performance in each systems' component. High-improving services were able to demonstrate strong processes for assessing system performance and consistent improvement in systems to support quality care across components. Key strengths in the quality support systems included adequate and orientated workforce, appropriate health system supports, and engagement with other organizations and community, while the weaknesses included lack of service infrastructure, recruitment, retention, and support for staff and additional costs. Qualitative data revealed clear voices from health service staff expressing concerns with performance, and subsequent SAT data provided evidence of changes made to address concerns. Learning from the processes and strengths of high-improving services may be useful as we work with services striving to improve the quality of care provided in other areas.

Fenestration system energy performance research, implementation, and international harmonization

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

McGowan, Raymond F

The research conducted by the NFRC and its contractors adds significantly to the understanding of several areas of investigation. NFRC enables manufacturers to rate fenestration energy performance to comply with building energy codes, participate in ENERGY STAR, and compete fairly. NFRC continuously seeks to improve its ratings and also seeks to simplify the rating process. Several research projects investigated rating improvement potential such as • Complex Product VT Rating Research • Window 6 and Therm 6 Validation Research Project • Complex Product VT Rating Research Conclusions from these research projects led to important changes and increased confidence in the existingmore » NFRC rating process. Conclusions from the Window 6/Therm 6 project will enable window manufacturers to rate an expanded array of products and improve existing ratings. Some research lead to an improved new rating method called the Component Modeling Approach. A primary goal of the CMA was a simplification of the commercial energy rating process to increase participation and make the commercial industry more competitive and code compliant. The project below contributed towards CMA development: • Component Modeling Approach Condensation Resistance Research NFRC continues to implement the Component Modeling Approach program. The program includes the CMA software tool, CMAST, and several procedural documents to govern the certification process. This significant accomplishment was a response the commercial fenestration industry’s need for a simplification of the present NFRC energy rating method (named site built). To date, most commercial fenestration is self-rated by a variety of techniques. The CMA enables commercial fenestration manufacturers to rate according to the NFRC 100/200 as most commercial energy codes require. International Harmonization NFRC achieved significant international harmonization success by continuing its licensing agreements with the Australian Fenestration Rating Council and the Association of Architectural Aluminum Manufacturers of South Africa (AAAMSA) to produce NFRC certified product ratings in their respective nations. NFRC worked in several other nations to introduce the NFRC ratings system: • India • China • Japan • Canada • Thailand • South Africa • Brazil • Korea NFRC attended or hosted several meetings in each of these nations establishing academic, commercial, industrial, and governmental contacts. NFRC presented the NFRC process and then necessary infrastructure steps necessary to achieve harmonization with the NFRC labeling system. NFRC looks forward to continued work toward harmonization in these nations and potentially others.« less

Improved Tubulars for Better Economics in Deep Gas Well Drilling using Microwave Technology

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

Dinesh Agrawal; Paul Gigl; Mahlon Dennis

2006-02-01

The objective of the research program has been to improve the rate-of-penetration in deep hostile environments by improving the life cycle and performance of coiled-tubing, an important component of a deep well drilling system for oil and gas exploration. The current process of the manufacture long tubular steel products consists of shaping the tube from flat strip, welding the seam and sections into lengths that can be miles long, and coiling onto reels. However, the welds, that are a weak point, now limit the performance of the coil tubing. This is not only from a toughness standpoint but also frommore » a corrosion standpoint. By utilizing the latest developments in the sintering of materials with microwave energy and powder metal extrusion technology for the manufacture of seamless coiled tubing and other tubular products, these problems can be eliminated. The project is therefore to develop a continuous microwave process to sinter continuously steel tubulars and butt-join them using microwave/induction process. The program started about three years ago and now we are in the middle of Phase II. In Phase I (which ended in February 2005) a feasibility study of the extrusion process of steel powder and continuously sinter the extruded tubing was conducted. The research program has been based on the development of microwave technology to process tubular specimens of powder metals, especially steels. The existing microwave systems at the Materials Research Laboratory (MRL) and Dennis Tool Company (DTC) were suitably modified to process tubular small specimens. The precursor powder metals were either extruded or cold isostatically pressed (CIP) to form tubular specimens. After conducting an extensive and systematic investigation of extrusion process for producing long tubes, it was determined that there were several difficulties in adopting extrusion process and it cannot be economically used for producing thousands of feet long green tubing. Therefore, in the Phase II the approach was modified to the microwave sintering combined with Cold Isostatic Press (CIP) and joining (by induction or microwave). This process can be developed into a semi-continuous sintering process if the CIP can produce parts fast enough to match the microwave sintering rates. This report summarizes the progress made to-date in this new approach. The final steel composition matching with the Quality tubing's QT-16Cr80 was short listed and used for all experiments. Bonding experiments using 4 different braze powders were conducted and the process optimized to obtain high degree of bonding strength. For fabrication of green tubulars a large CIP unit was acquired and tested. This equipment is located at the Dennis Tool facility in Houston. Microwave sintering experiments for continuous processing of the CIPed tubes are under progress in order to identify the optimum conditions. There have been some reproducibility problems and we are at present working to resolve these problems.« less

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

PubMed

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

2007-11-01

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

Using TQM/CQI Processes To Guide Development of Independent and Collaborative Learning in Two Levels of Baccalaureate Nursing Students.

ERIC Educational Resources Information Center

Grant, LaVerne F.; Kelley, Jane H.; Northington, LaDonna; Barlow, Delores

2002-01-01

Junior and senior nursing students participated in collaborative learning projects developed using total quality management/continuous quality improvement processes. Seniors mentored and evaluated juniors. Feedback from 37 seniors and 53 juniors was predominantly positive; dissatisfaction centered on time issues and misunderstanding of project…

Application of an auditory model to speech recognition.

PubMed

Cohen, J R

1989-06-01

Some aspects of auditory processing are incorporated in a front end for the IBM speech-recognition system [F. Jelinek, "Continuous speech recognition by statistical methods," Proc. IEEE 64 (4), 532-556 (1976)]. This new process includes adaptation, loudness scaling, and mel warping. Tests show that the design is an improvement over previous algorithms.

Design, Test, Redesign: Simulation in Technology, Engineering, and Design Education Classrooms

ERIC Educational Resources Information Center

Swinson, Ronnie; Clark, Aaron C.; Ernst, Jeremy V.; Sutton, Kevin

2016-01-01

Today's engineers, designers, and technologists are often thrust into the role of problem solver, from the initial design phase of a product or process all the way to final development. Many engineers in manufacturing environments are tasked with solving problems and continuously improving processes to enhance company profitability, efficiency,…

Assessing Faculty Bias in Rating Embedded Assurance of Learning Assignments

ERIC Educational Resources Information Center

Kim, Dong-gook; Helms, Marilyn M.

2016-01-01

Assurance of learning (AoL) processes for continuous improvement and accreditation require business schools to assess program goals. Findings from the process can lead to changes in course design or curriculum. Often AoL assignments are embedded into existing courses and assessed at regular intervals. Faculty members may evaluate an assignment in…

Workshop on Discovery Lessons-Learned

NASA Technical Reports Server (NTRS)

Saunders, M. (Editor)

1995-01-01

As part of the Discovery Program's continuous improvement effort, a Discovery Program Lessons-Learned workshop was designed to review how well the Discovery Program is moving toward its goal of providing low-cost research opportunities to the planetary science community while ensuring continued U.S. leadership in solar system exploration. The principal focus of the workshop was on the recently completed Announcement of Opportunity (AO) cycle, but the program direction and program management were also open to comment. The objective of the workshop was to identify both the strengths and weaknesses of the process up to this point, with the goal of improving the process for the next AO cycle. The process for initializing the workshop was to solicit comments from the communities involved in the program and to use the feedback as the basis for establishing the workshop agenda. The following four sessions were developed after reviewing and synthesizing both the formal feedback received and informal feedback obtained during discussions with various participants: (1) Science and Return on Investment; (2) Technology vs. Risk; Mission Success and Other Factors; (3) Cost; and (4) AO.AO Process Changes and Program Management.

Assuring quality by continuously improving quality: new directions for health record professionals.

PubMed

Howell, W T; Nickle, B W

1991-03-01

Quality improvement is catching fire in the health care community, but there is much work to be done, much to learn, and much to teach. All health care professionals must remember that there are no short cuts to improving quality. American managers are so steeped in a quick-fix mentality that they resist the systematic infrastructure rebuilding described above. They scurry about fighting the same fires over and over, thinking they are doing their jobs. The truth remains that if results are to be improved, not just manipulated, then the processes that produce those results must be improved. For this to occur managers must be given the process improvement technology that separates the world class companies from those who are still wondering what hit them during the 1970s.

Real World Data Driven Evolution of Volvo Cars’ Side Impact Protection Systems and their Effectiveness

PubMed Central

Jakobsson, Lotta; Lindman, Magdalena; Svanberg, Bo; Carlsson, Henrik

2010-01-01

This study analyses the outcome of the continuous improved occupant protection over the last two decades for front seat near side occupants in side impacts based on a real world driven working process. The effectiveness of four generations of improved side impact protection are calculated based on data from Volvo’s statistical accident database of Volvo Cars in Sweden. Generation I includes vehicles with a new structural and interior concept (SIPS). Generation II includes vehicles with structural improvements and a new chest airbag (SIPSbag). Generation III includes vehicles with further improved SIPS and SIPSbag as well as the new concept with a head protecting Inflatable Curtain (IC). Generation IV includes the most recent vehicles with further improvements of all the systems plus advanced sensors and seat belt pretensioner activation. Compared to baseline vehicles, vehicles of generation I reduce MAIS2+ injuries by 54%, generation II by 61% and generation III by 72%. For generation IV effectiveness figures cannot be calculated because of the lack of MAIS2+ injuries. A continuous improved performance is also seen when studying the AIS2+ pelvis, abdomen, chest and head injuries separately. By using the same real world driven working process, future improvements and possibly new passive as well as active safety systems, will be developed with the aim of further improved protection to near side occupants in side impacts. PMID:21050597

Improving ED specimen TAT using Lean Six Sigma.

PubMed

Sanders, Janet H; Karr, Tedd

2015-01-01

Lean and Six Sigma are continuous improvement methodologies that have garnered international fame for improving manufacturing and service processes. Increasingly these methodologies are demonstrating their power to also improve healthcare processes. The purpose of this paper is to discuss a case study for the application of Lean and Six Sigma tools in the reduction of turnaround time (TAT) for Emergency Department (ED) specimens. This application of the scientific methodologies uncovered opportunities to improve the entire ED to lab system for the specimens. This case study provides details on the completion of a Lean Six Sigma project in a 1,000 bed tertiary care teaching hospital. Six Sigma's Define, Measure, Analyze, Improve, and Control methodology is very similar to good medical practice: first, relevant information is obtained and assembled; second, a careful and thorough diagnosis is completed; third, a treatment is proposed and implemented; and fourth, checks are made to determine if the treatment was effective. Lean's primary goal is to do more with less work and waste. The Lean methodology was used to identify and eliminate waste through rapid implementation of change. The initial focus of this project was the reduction of turn-around-times for ED specimens. However, the results led to better processes for both the internal and external customers of this and other processes. The project results included: a 50 percent decrease in vials used for testing, a 50 percent decrease in unused or extra specimens, a 90 percent decrease in ED specimens without orders, a 30 percent decrease in complete blood count analysis (CBCA) Median TAT, a 50 percent decrease in CBCA TAT Variation, a 10 percent decrease in Troponin TAT Variation, a 18.2 percent decrease in URPN TAT Variation, and a 2-5 minute decrease in ED registered nurses rainbow draw time. This case study demonstrated how the quantitative power of Six Sigma and the speed of Lean worked in harmony to improve the blood draw process for a 1,000 bed tertiary care teaching hospital. The blood draw process is a standard process used in hospitals to collect blood chemistry and hematology information for clinicians. The methods used in this case study demonstrated valuable and practical applications of process improvement methodologies that can be used for any hospital process and/or service environment. While this is not the first case study that has demonstrated the use of continuous process improvement methodologies to improve a hospital process, it is unique in the way in which it utilizes the strength of the project focussed approach that adheres more to the structure and rigor of Six Sigma and relied less on the speed of lean. Additionally, the application of these methodologies in healthcare is emerging research.

Continual improvement: A bibliography with indexes, 1992-1993

NASA Technical Reports Server (NTRS)

1994-01-01

This bibliography lists 606 references to reports and journal articles entered into the NASA Scientific and Technical Information Database during 1992 to 1993. Topics cover the philosophy and history of Continual Improvement (CI), basic approaches and strategies for implementation, and lessons learned from public and private sector models. Entries are arranged according to the following categories: Leadership for Quality, Information and Analysis, Strategic Planning for CI, Human Resources Utilization, Management of Process Quality, Supplier Quality, Assessing Results, Customer Focus and Satisfaction, TQM Tools and Philosophies, and Applications. Indexes include subject, personal author, corporate source, contract number, report number, and accession number.

77 FR 41273 - Core Values and Characteristics of the Department

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-13

... the product of a 2-year collaborative and comprehensive development process, which was motivated by a... continuous improvement, and be thoughtful and decisive in leadership, accountable for their actions, willing...

5 CFR 960.107 - Authorized activities.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 960.107 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS... resources in finance, internal auditing, personnel management, automated data processing applications... educational development of Government employees, improvement of labor-management relations, equal employment...

5 CFR 960.107 - Authorized activities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 960.107 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS... resources in finance, internal auditing, personnel management, automated data processing applications... educational development of Government employees, improvement of labor-management relations, equal employment...

5 CFR 960.107 - Authorized activities.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 960.107 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS... resources in finance, internal auditing, personnel management, automated data processing applications... educational development of Government employees, improvement of labor-management relations, equal employment...

Conducting Research on the International Space Station Using the EXPRESS Rack Facilities

NASA Technical Reports Server (NTRS)

Thompson, Sean W.; Lake, Robert E.

2014-01-01

EXPRESS Racks provide capability for payload access to ISS resources. The successful on-orbit operations and versatility of the EXPRESS Rack has facilitated the operations of many scientific areas, with the promise of continued payload support for years to come. EXPRESS Racks are currently deployed in the US Lab, Columbus and JEM. Process improvements and enhancements continue to improve the accommodations and make the integration and operations process more efficient. Payload Integration Managers serve as the primary interface between the ISS Program and EXPRESS Payload Developers. EXPRESS Project coordinates across multiple functional areas and organizations to ensure integrated EXPRESS Rack and subrack products and hardware are complete, accurate, on time, safe, and certified for flight. NASA is planning to expand the EXPRESS payload capacity by developing new Basic Express Racks expected to be on ISS in 2018.

Synthesis of branched polymers under continuous-flow microprocess: an improvement of the control of macromolecular architectures.

PubMed

Bally, Florence; Serra, Christophe A; Brochon, Cyril; Hadziioannou, Georges

2011-11-15

Polymerization reactions can benefit from continuous-flow microprocess in terms of kinetics control, reactants mixing or simply efficiency when high-throughput screening experiments are carried out. In this work, we perform for the first time the synthesis of branched macromolecular architecture through a controlled/'living' polymerization technique, in tubular microreactor. Just by tuning process parameters, such as flow rates of the reactants, we manage to generate a library of polymers with various macromolecular characteristics. Compared to conventional batch process, polymerization kinetics shows a faster initiation step and more interestingly an improved branching efficiency. Due to reduced diffusion pathway, a characteristic of microsystems, it is thus possible to reach branched polymers exhibiting a denser architecture, and potentially a higher functionality for later applications. Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Development of Maltodextrin-Based Immediate-Release Tablets Using an Integrated Twin-Screw Hot-Melt Extrusion and Injection-Molding Continuous Manufacturing Process.

PubMed

Puri, Vibha; Brancazio, Dave; Desai, Parind M; Jensen, Keith D; Chun, Jung-Hoon; Myerson, Allan S; Trout, Bernhardt L

2017-11-01

The combination of hot-melt extrusion and injection molding (HME-IM) is a promising process technology for continuous manufacturing of tablets. However, there has been limited research on its application to formulate crystalline drug-containing immediate-release tablets. Furthermore, studies that have applied the HME-IM process to molded tablets have used a noncontinuous 2-step approach. The present study develops maltodextrin (MDX)-based extrusion-molded immediate-release tablets for a crystalline drug (griseofulvin) using an integrated twin-screw HME-IM continuous process. At 10% w/w drug loading, MDX was selected as the tablet matrix former based on a preliminary screen. Furthermore, liquid and solid polyols were evaluated for melt processing of MDX and for impact on tablet performance. Smooth-surfaced tablets, comprising crystalline griseofulvin solid suspension in the amorphous MDX-xylitol matrix, were produced by a continuous process on a twin-screw extruder coupled to a horizontally opening IM machine. Real-time HME process profiles were used to develop automated HME-IM cycles. Formulation adjustments overcame process challenges and improved tablet strength. The developed MDX tablets exhibited adequate strength and a fast-dissolving matrix (85% drug release in 20 min), and maintained performance on accelerated stability conditions. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Quality Control in Clinical Laboratory Samples

DTIC Science & Technology

2015-01-01

is able to find and correct flaws in the analytical processes of a lab before potentially incorrect patient resu lts are released. According to...verifi es that the results produced are accurate and precise . Clinical labs use management of documentation as well as inco rporation of a continuous...improvement process to streamline the overall quality control process . QC samples are expected to be identical and tested identically to patient

Management systems, patient quality improvement, resource availability, and substance abuse treatment quality.

PubMed

Fields, Dail; Roman, Paul M; Blum, Terry C

2012-06-01

To examine the relationships among general management systems, patient-focused quality management/continuous process improvement (TQM/CPI) processes, resource availability, and multiple dimensions of substance use disorder (SUD) treatment. Data are from a nationally representative sample of 221 SUD treatment centers through the National Treatment Center Study (NTCS). The design was a cross-sectional field study using latent variable structural equation models. The key variables are management practices, TQM/continuous quality improvement (CQI) practices, resource availability, and treatment center performance. Interviews and questionnaires provided data from treatment center administrative directors and clinical directors in 2007-2008. Patient-focused TQM/CQI practices fully mediated the relationship between internal management practices and performance. The effects of TQM/CQI on performance are significantly larger for treatment centers with higher levels of staff per patient. Internal management practices may create a setting that supports implementation of specific patient-focused practices and protocols inherent to TQM/CQI processes. However, the positive effects of internal management practices on treatment center performance occur through use of specific patient-focused TQM/CPI practices and have more impact when greater amounts of supporting resources are present. © Health Research and Educational Trust.

Management Systems, Patient Quality Improvement, Resource Availability, and Substance Abuse Treatment Quality

PubMed Central

Fields, Dail; Roman, Paul M; Blum, Terry C

2012-01-01

Objective To examine the relationships among general management systems, patient-focused quality management/continuous process improvement (TQM/CPI) processes, resource availability, and multiple dimensions of substance use disorder (SUD) treatment. Data Sources/Study Setting Data are from a nationally representative sample of 221 SUD treatment centers through the National Treatment Center Study (NTCS). Study Design The design was a cross-sectional field study using latent variable structural equation models. The key variables are management practices, TQM/continuous quality improvement (CQI) practices, resource availability, and treatment center performance. Data Collection Interviews and questionnaires provided data from treatment center administrative directors and clinical directors in 2007–2008. Principal Findings Patient-focused TQM/CQI practices fully mediated the relationship between internal management practices and performance. The effects of TQM/CQI on performance are significantly larger for treatment centers with higher levels of staff per patient. Conclusions Internal management practices may create a setting that supports implementation of specific patient-focused practices and protocols inherent to TQM/CQI processes. However, the positive effects of internal management practices on treatment center performance occur through use of specific patient-focused TQM/CPI practices and have more impact when greater amounts of supporting resources are present. PMID:22098342

APC implementation in Chandra Asri - ethylene plant

NASA Astrophysics Data System (ADS)

Sidiq, Mochamad; Mustofa, Ali

2017-05-01

Nowadays, the modern process plants are continuously improved for maximizing production, Optimization of the energy and raw material and reducing the risk. Due to many disturbances appearance between the process units, hence, the failure of one unit might have a bad effect on the overall productivity. Ethylene Plant have significant opportunities for using Advanced Process Control (APC) technologies to improve operation stability, push closer to quality or equipment limit, and improve the capability of process units to handle disturbances. APC implementation had considered a best answer for solving multivariable control problem. PT. Chandra Asri Petrochemical, Tbk (CAP) operates a large naphtha cracker complex at Cilegon, Indonesia. To optimize the plant operation and to enhance the benefit, Chandra Asri has been decided to implement Advance Process Control (APC) for ethylene plant. The APC implementation technology scopes at CAP are as follows: 1. Hot Section : Furnaces, Quench Tower 2. Cold Section : Demethanizer, Deethanizer, Acetylene Converter, Ethylene Fractionator, Depropanizer, Propylene Fractionator, Debutanizer

Using a Networked Improvement Community Approach to Design and Scale up Social Psychological Interventions in Schools. Conference Paper

ERIC Educational Resources Information Center

Barron, Kenneth E.; Hulleman, Chris S.; Inouye, R. Bryce; Hartka, Thomas A.

2015-01-01

In our session, we showcase work from a researcher-practitioner partnership between James Madison University, the University of Virginia, and Harrisonburg City Public Schools that is focused on developing a continuous improvement process to translate social-psychological interventions into teaching practices that enhance motivation and learning.…

Incorporating Total Quality Management in an Engineering Design Course. Report 5-1993.

ERIC Educational Resources Information Center

Wilczynski, V.; And Others

One definition of creativity is the conviction that each and every existing idea can be improved. It is proposed that creativity in an engineering design process can be encouraged by the adoption of Total Quality Management (TQM) methods based on a commitment to continuous improvement. This paper addresses the introduction and application of TQM…

Improving the Financial Aid Delivery Process and the Federal Family Education Loan Program: Program Recommendations.

ERIC Educational Resources Information Center

Coalition for Student Loan Reform, Washington, DC.

This publication presents a set of eight recommended reforms and improvements for delivering financial aid to postsecondary students especially the Federal Family Education Loan Program (FFELP). The recommendations are: (1) make applying for student aid simpler for students; (2) assure the continued availability of a dependable, reliable source of…

E-learning process maturity level: a conceptual framework

NASA Astrophysics Data System (ADS)

Rahmah, A.; Santoso, H. B.; Hasibuan, Z. A.

2018-03-01

ICT advancement is a sure thing with the impact influencing many domains, including learning in both formal and informal situations. It leads to a new mindset that we should not only utilize the given ICT to support the learning process, but also improve it gradually involving a lot of factors. These phenomenon is called e-learning process evolution. Accordingly, this study attempts to explore maturity level concept to provide the improvement direction gradually and progression monitoring for the individual e-learning process. Extensive literature review, observation, and forming constructs are conducted to develop a conceptual framework for e-learning process maturity level. The conceptual framework consists of learner, e-learning process, continuous improvement, evolution of e-learning process, technology, and learning objectives. Whilst, evolution of e-learning process depicted as current versus expected conditions of e-learning process maturity level. The study concludes that from the e-learning process maturity level conceptual framework, it may guide the evolution roadmap for e-learning process, accelerate the evolution, and decrease the negative impact of ICT. The conceptual framework will be verified and tested in the future study.

Development of a course review process.

PubMed

Persky, Adam M; Joyner, Pamela U; Cox, Wendy C

2012-09-10

To describe and assess a course review process designed to enhance course quality. A course review process led by the curriculum and assessment committees was designed for all required courses in the doctor of pharmacy (PharmD) program at a school of pharmacy. A rubric was used by the review team to address 5 areas: course layout and integration, learning outcomes, assessment, resources and materials, and learner interaction. One hundred percent of targeted courses, or 97% of all required courses, were reviewed from January to August 2010 (n=30). Approximately 3.5 recommendations per course were made, resulting in improvement in course evaluation items related to learning outcomes. Ninety-five percent of reviewers and 85% of course directors agreed that the process was objective and the course review process was important. The course review process was objective and effective in improving course quality. Future work will explore the effectiveness of an integrated, continual course review process in improving the quality of pharmacy education.

Student Evaluations of the Portfolio Process

PubMed Central

Airey, Tatum C.; Bisso, Andrea M.; Slack, Marion K.

2011-01-01

Objective. To evaluate pharmacy students’ perceived benefits of the portfolio process and to gather suggestions for improving the process. Methods. A questionnaire was designed and administered to 250 first-, second-, and third-year pharmacy students at the University of Arizona College of Pharmacy. Results. Although the objectives of the portfolio process were for students to understand the expected outcomes, understand the impact of extracurricular activities on attaining competencies, identify what should be learned, identify their strengths and weaknesses, and modify their approach to learning, overall students perceived the portfolio process as having less than moderate benefit. First-year students wanted more examples of portfolios while second- and third-year students suggested that more time with their advisor would be beneficial. Conclusions. The portfolio process will continue to be refined and efforts made to improve students’ perceptions of the process as it is intended to develop the self-assessments skills they will need to improve their knowledge and professional skills throughout their pharmacy careers. PMID:21969718

Overview of Automotive Core Tools: Applications and Benefits

NASA Astrophysics Data System (ADS)

Doshi, Jigar A.; Desai, Darshak

2017-08-01

Continuous improvement of product and process quality is always challenging and creative task in today's era of globalization. Various quality tools are available and used for the same. Some of them are successful and few of them are not. Considering the complexity in the continuous quality improvement (CQI) process various new techniques are being introduced by the industries, as well as proposed by researchers and academia. Lean Manufacturing, Six Sigma, Lean Six Sigma is some of the techniques. In recent years, there are new tools being opted by the industry, especially automotive, called as Automotive Core Tools (ACT). The intention of this paper is to review the applications and benefits along with existing research on Automotive Core Tools with special emphasis on continuous quality improvement. The methodology uses an extensive review of literature through reputed publications—journals, conference proceedings, research thesis, etc. This paper provides an overview of ACT, its enablers, and exertions, how it evolved into sophisticated methodologies and benefits used in organisations. It should be of value to practitioners of Automotive Core Tools and to academics who are interested in how CQI can be achieved using ACT. It needs to be stressed here that this paper is not intended to scorn Automotive Core Tools, rather, its purpose is limited only to provide a balance on the prevailing positive views toward ACT.

Application of Six Sigma towards improving surgical outcomes.

PubMed

Shukla, P J; Barreto, S G; Nadkarni, M S

2008-01-01

Six Sigma is a 'process excellence' tool targeting continuous improvement achieved by providing a methodology for improving key steps of a process. It is ripe for application into health care since almost all health care processes require a near-zero tolerance for mistakes. The aim of this study is to apply the Six Sigma methodology into a clinical surgical process and to assess the improvement (if any) in the outcomes and patient care. The guiding principles of Six Sigma, namely DMAIC (Define, Measure, Analyze, Improve, Control), were used to analyze the impact of double stapling technique (DST) towards improving sphincter preservation rates for rectal cancer. The analysis using the Six Sigma methodology revealed a Sigma score of 2.10 in relation to successful sphincter preservation. This score demonstrates an improvement over the previous technique (73% over previous 54%). This study represents one of the first clinical applications of Six Sigma in the surgical field. By understanding, accepting, and applying the principles of Six Sigma, we have an opportunity to transfer a very successful management philosophy to facilitate the identification of key steps that can improve outcomes and ultimately patient safety and the quality of surgical care provided.

Leveraging data to systematically improve care: coronary artery disease management at Geisinger.

PubMed

Graf, Thomas; Erskine, Alistair; Steele, Glenn D

2014-01-01

Coronary artery disease is complex chronic disease best managed by a team empowered by actionable data and a comprehensive approach, the ability to improve intermediate outcomes was dramatically enhanced after Geisinger created a system of care to do so. Continuous measurement of critical data elements of process and intermediate outcome measures allows the delivery of actionable information to the most appropriate team member, including the patients and family as team members. Continuous monitoring of the overall program looking for trends and opportunities across sites and regions allows for program enhancements. The comprehensive "all-or-none" bundled approach to care, which has already realized a 300% improvement, will be further enhanced by incorporating additional "Big Data" flows.

SEL's Software Process-Improvement Program

NASA Technical Reports Server (NTRS)

Basili, Victor; Zelkowitz, Marvin; McGarry, Frank; Page, Jerry; Waligora, Sharon; Pajerski, Rose

1995-01-01

The goals and operations of the Software Engineering Laboratory (SEL) is reviewed. For nearly 20 years the SEL has worked to understand, assess, and improve software and the development process within the production environment of the Flight Dynamics Division (FDD) of NASA's Goddard Space Flight Center. The SEL was established in 1976 with the goals of reducing: (1) the defect rate of delivered software, (2) the cost of software to support flight projects, and (3) the average time to produce mission-support software. After studying over 125 projects of FDD, the results have guided the standards, management practices, technologies, and the training within the division. The results of the studies have been a 75 percent reduction in defects, a 50 percent reduction in cost, and a 25 percent reduction in development time. Over time the goals of SEL have been clarified. The goals are now stated as: (1) Understand baseline processes and product characteristics, (2) Assess improvements that have been incorporated into the development projects, (3) Package and infuse improvements into the standard SEL process. The SEL improvement goal is to demonstrate continual improvement of the software process by carrying out analysis, measurement and feedback to projects with in the FDD environment. The SEL supports the understanding of the process by study of several processes including, the effort distribution, and error detection rates. The SEL assesses and refines the processes. Once the assessment and refinement of a process is completed, the SEL packages the process by capturing the process in standards, tools and training.

Improving maternal care with a continuous quality improvement strategy: a report from the Interventions to Minimize Preterm and Low Birth Weight Infants through Continuous Improvement Techniques (IMPLICIT) Network.

PubMed

Bennett, Ian M; Coco, Andrew; Anderson, Janice; Horst, Michael; Gambler, Angela S; Barr, Wendy Brooks; Ratcliffe, Stephen

2009-01-01

Maternal medical care (prenatal and postpartum) involves a set of clinical interventions addressing risk factors associated with important maternal and infant outcomes. Programs to increase the rate of delivery of these interventions in clinical practice have not been widely implemented. A practice-based research network focused on developing continuous quality improvement (CQI) processes for maternal care among 10 family medicine residency training sites in the northeastern United States (the IMPLICIT Network) from January 2003 through September 2007. Documented delivery of 5 standard maternal care interventions was assessed before and after initiating a program to increase their frequency. Proportion chart analyses were conducted comparing the period before and after implementation of the CQI interventions. Data were available for 3936 pregnancies during the course of the study period. Results varied across the clinical interventions. Significant improvement in care processes was seen for 3 screening activities: (1) prenatal depression symptomatology (by 15 weeks' gestation); (2) screening for smoking at 30 weeks' gestation; (3) and postpartum contraception planning. Screening for smoking by 15 weeks' gestation and testing for asymptomatic bacteriuria were already conducted >90% of the time during the baseline period and did not increase significantly after initiating the CQI program. Screening for postpartum depression symptomatology was recorded in 50% to 60% of women before the CQI program and did not increase significantly. A practice-based research network of family medicine residency practices focused on CQI outcomes was successful in increasing the delivery of some maternal care interventions.

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

PubMed

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

2013-01-01

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

Needs assessment and implementation of an employee assistance program: promoting a healthier work force.

PubMed

Monfils, M K

1995-05-01

1. The functions of a continuous quality improvement tool used by Deming--the Plan, Do, Check, Act Cycle--can be applied to the assessment, implementation, and ongoing evaluation of an Employee Assistance Program (EAP). 2. Various methods are available to assess the need for an EAP. As much data as possible should be collected to qualify and quantify the need so that management can make an informed decision and develop measures to determine program effectiveness. 3. Once an EAP is implemented, it should be monitored continually against the effectiveness measures initially developed. Using a continuous quality improvement process, the occupational health nurse and the EAP provider can establish a dynamic relationship that allows for growth beyond the original design and increased effectiveness of service to employees.

Increasing Pap smear rates at an urban Aboriginal Community Controlled Health Service through translational research and continuous quality improvement.

PubMed

Dorrington, Melanie S; Herceg, Ana; Douglas, Kirsty; Tongs, Julie; Bookallil, Marianne

2015-01-01

This article describes translational research (TR) and continuous quality improvement (CQI) processes used to identify and address barriers and facilitators to Pap smear screening within an urban Aboriginal Community Controlled Health Service (ACCHS). Rapid Plan-Do-Study-Act (PDSA) cycles were conducted, informed by client surveys, a data collection tool, focus groups and internal research. There was a statistically significant increase in Pap smear numbers during PDSA cycles, continuing at 10 months follow up. The use of TR with CQI appears to be an effective and acceptable way to affect Pap smear screening. Community and service collaboration should be at the core of research in Aboriginal and Torres Strait Islander health settings. This model is transferrable to other settings and other health issues.

Consequences of atomic layer etching on wafer scale uniformity in inductively coupled plasmas

NASA Astrophysics Data System (ADS)

Huard, Chad M.; Lanham, Steven J.; Kushner, Mark J.

2018-04-01

Atomic layer etching (ALE) typically divides the etching process into two self-limited reactions. One reaction passivates a single layer of material while the second preferentially removes the passivated layer. As such, under ideal conditions the wafer scale uniformity of ALE should be independent of the uniformity of the reactant fluxes onto the wafers, provided all surface reactions are saturated. The passivation and etch steps should individually asymptotically saturate after a characteristic fluence of reactants has been delivered to each site. In this paper, results from a computational investigation are discussed regarding the uniformity of ALE of Si in Cl2 containing inductively coupled plasmas when the reactant fluxes are both non-uniform and non-ideal. In the parameter space investigated for inductively coupled plasmas, the local etch rate for continuous processing was proportional to the ion flux. When operated with saturated conditions (that is, both ALE steps are allowed to self-terminate), the ALE process is less sensitive to non-uniformities in the incoming ion flux than continuous etching. Operating ALE in a sub-saturation regime resulted in less uniform etching. It was also found that ALE processing with saturated steps requires a larger total ion fluence than continuous etching to achieve the same etch depth. This condition may result in increased resist erosion and/or damage to stopping layers using ALE. While these results demonstrate that ALE provides increased etch depth uniformity, they do not show an improved critical dimension uniformity in all cases. These possible limitations to ALE processing, as well as increased processing time, will be part of the process optimization that includes the benefits of atomic resolution and improved uniformity.

A Mixed-Methods Research Framework for Healthcare Process Improvement.

PubMed

Bastian, Nathaniel D; Munoz, David; Ventura, Marta

2016-01-01

The healthcare system in the United States is spiraling out of control due to ever-increasing costs without significant improvements in quality, access to care, satisfaction, and efficiency. Efficient workflow is paramount to improving healthcare value while maintaining the utmost standards of patient care and provider satisfaction in high stress environments. This article provides healthcare managers and quality engineers with a practical healthcare process improvement framework to assess, measure and improve clinical workflow processes. The proposed mixed-methods research framework integrates qualitative and quantitative tools to foster the improvement of processes and workflow in a systematic way. The framework consists of three distinct phases: 1) stakeholder analysis, 2a) survey design, 2b) time-motion study, and 3) process improvement. The proposed framework is applied to the pediatric intensive care unit of the Penn State Hershey Children's Hospital. The implementation of this methodology led to identification and categorization of different workflow tasks and activities into both value-added and non-value added in an effort to provide more valuable and higher quality patient care. Based upon the lessons learned from the case study, the three-phase methodology provides a better, broader, leaner, and holistic assessment of clinical workflow. The proposed framework can be implemented in various healthcare settings to support continuous improvement efforts in which complexity is a daily element that impacts workflow. We proffer a general methodology for process improvement in a healthcare setting, providing decision makers and stakeholders with a useful framework to help their organizations improve efficiency. Published by Elsevier Inc.

Multilingualism, Language Policy and Creative Writing in Kenya

ERIC Educational Resources Information Center

Mbithi, Esther K

2014-01-01

Language use and creative writing go hand in hand. In the process of exploring language, we also engage in the study of literature. An engagement with literature is, indeed, a continuing process of improving our capacity to use language and refining our sensibility to good language use. In Kenya, there are clearly discernible patterns of creative…

Identifying and locating surface defects in wood: Part of an automated lumber processing system

Treesearch

Richard W. Conners; Charles W. McMillin; Kingyao Lin; Ramon E. Vasquez-Espinosa

1983-01-01

Continued increases in the cost of materials and labor make it imperative for furniture manufacturers to control costs by improved yield and increased productivity. This paper describes an Automated Lumber Processing System (ALPS) that employs computer tomography, optical scanning technology, the calculation of an optimum cutting strategy, and 1 computer-driven laser...

Syntax "and" Semantics: A Teaching Model.

ERIC Educational Resources Information Center

Wolfe, Frank

In translating perception into written language, a child must learn an encoding process which is a continuation of the process of improving sensing of the world around him or her. To verbalize an object (a perception) we use frames which name a referent, locate the referent in space and time, identify its appearance and behavior, and define terms…

An Integrated Approach for Conducting a Behavioral Systems Analysis

ERIC Educational Resources Information Center

Diener, Lori H.; McGee, Heather M.; Miguel, Caio F.

2009-01-01

The aim of this paper is to illustrate how to conduct a Behavioral Systems Analysis (BSA) to aid in the design of targeted performance improvement interventions. BSA is a continuous process of analyzing the right variables to the right extent to aid in planning and managing performance at the organization, process, and job levels. BSA helps to…

Improving the medical records department processes by lean management.

PubMed

Ajami, Sima; Ketabi, Saeedeh; Sadeghian, Akram; Saghaeinnejad-Isfahani, Sakine

2015-01-01

Lean management is a process improvement technique to identify waste actions and processes to eliminate them. The benefits of Lean for healthcare organizations are that first, the quality of the outcomes in terms of mistakes and errors improves. The second is that the amount of time taken through the whole process significantly improves. The purpose of this paper is to improve the Medical Records Department (MRD) processes at Ayatolah-Kashani Hospital in Isfahan, Iran by utilizing Lean management. This research was applied and an interventional study. The data have been collected by brainstorming, observation, interview, and workflow review. The study population included MRD staff and other expert staff within the hospital who were stakeholders and users of the MRD. The MRD were initially taught the concepts of Lean management and then formed into the MRD Lean team. The team then identified and reviewed the current processes subsequently; they identified wastes and values, and proposed solutions. The findings showed that the MRD units (Archive, Coding, Statistics, and Admission) had 17 current processes, 28 wastes, and 11 values were identified. In addition, they offered 27 comments for eliminating the wastes. The MRD is the critical department for the hospital information system and, therefore, the continuous improvement of its services and processes, through scientific methods such as Lean management, are essential. The study represents one of the few attempts trying to eliminate wastes in the MRD.

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

Smith, Donald F.; Schulz, Carl; Konijnenburg, Marco

High-resolution Fourier transform ion cyclotron resonance (FT-ICR) mass spectrometry imaging enables the spatial mapping and identification of biomolecules from complex surfaces. The need for long time-domain transients, and thus large raw file sizes, results in a large amount of raw data (“big data”) that must be processed efficiently and rapidly. This can be compounded by largearea imaging and/or high spatial resolution imaging. For FT-ICR, data processing and data reduction must not compromise the high mass resolution afforded by the mass spectrometer. The continuous mode “Mosaic Datacube” approach allows high mass resolution visualization (0.001 Da) of mass spectrometry imaging data, butmore » requires additional processing as compared to featurebased processing. We describe the use of distributed computing for processing of FT-ICR MS imaging datasets with generation of continuous mode Mosaic Datacubes for high mass resolution visualization. An eight-fold improvement in processing time is demonstrated using a Dutch nationally available cloud service.« less

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

PubMed Central

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

2013-01-01

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

Quality improvement on the acute inpatient psychiatry unit using the model for improvement.

PubMed

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

2013-01-01

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

TQM: the essential concepts.

PubMed

Chambers, D W

1998-01-01

This is an introduction to the major concepts in total quality management, a loose collection of management approaches that focus on continuous improvement of processes, guided by routine data collection and adjustment of the processes. Customer focus and involvement of all members of an organization are also characteristics commonly found in TQM. The seventy-five-year history of the movement is sketched from its beginning in statistical work on quality assurance through the many improvements and redefinitions added by American and Japanese thinkers. Essential concepts covered include: control cycles, focus on the process rather than the defects, the GEAR model, importance of the customer, upstream quality, just-in-time, kaizen, and service quality.

Continuous fiber-reinforced titanium aluminide composites

NASA Technical Reports Server (NTRS)

Mackay, R. A.; Brindley, P. K.; Froes, F. H.

1991-01-01

An account is given of the fabrication techniques, microstructural characteristics, and mechanical behavior of a lightweight, high service temperature SiC-reinforced alpha-2 Ti-14Al-21Nb intermetallic-matrix composite. Fabrication techniques under investigation to improve the low-temperature ductility and environmental resistance of this material system, while reducing manufacturing costs to competitive levels, encompass powder-cloth processing, foil-fiber-foil processing, and thermal-spray processing. Attention is given to composite microstructure problems associated with fiber distribution and fiber-matrix interfaces, as well as with mismatches of thermal-expansion coefficient; major improvements are noted to be required in tensile properties, thermal cycling effects, mechanical damage, creep, and environmental effects.

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

PubMed

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

2013-08-01

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

Progressing beyond SLMTA: Are internal audits and corrective action the key drivers of quality improvement?

PubMed

Maina, Robert N; Mengo, Doris M; Mohamud, Abdikher D; Ochieng, Susan M; Milgo, Sammy K; Sexton, Connie J; Moyo, Sikhulile; Luman, Elizabeth T

2014-01-01

Kenya has implemented the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme to facilitate quality improvement in medical laboratories and to support national accreditation goals. Continuous quality improvement after SLMTA completion is needed to ensure sustainability and continue progress toward accreditation. Audits were conducted by qualified, independent auditors to assess the performance of five enrolled laboratories using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist. End-of-programme (exit) and one year post-programme (surveillance) audits were compared for overall score, star level (from zero to five, based on scores) and scores for each of the 12 Quality System Essential (QSE) areas that make up the SLIPTA checklist. All laboratories improved from exit to surveillance audit (median improvement 38 percentage points, range 5-45 percentage points). Two laboratories improved from zero to one star, two improved from zero to three stars and one laboratory improved from three to four stars. The lowest median QSE scores at exit were: internal audit; corrective action; and occurrence management and process improvement (< 20%). Each of the 12 QSEs improved substantially at surveillance audit, with the greatest improvement in client management and customer service, internal audit and information management (≥ 50 percentage points). The two laboratories with the greatest overall improvement focused heavily on the internal audit and corrective action QSEs. Whilst all laboratories improved from exit to surveillance audit, those that focused on the internal audit and corrective action QSEs improved substantially more than those that did not; internal audits and corrective actions may have acted as catalysts, leading to improvements in other QSEs. Systematic identification of core areas and best practices to address them is a critical step toward strengthening public medical laboratories.

Progressing beyond SLMTA: Are internal audits and corrective action the key drivers of quality improvement?

PubMed Central

Mengo, Doris M.; Mohamud, Abdikher D.; Ochieng, Susan M.; Milgo, Sammy K.; Sexton, Connie J.; Moyo, Sikhulile; Luman, Elizabeth T.

2014-01-01

Background Kenya has implemented the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme to facilitate quality improvement in medical laboratories and to support national accreditation goals. Continuous quality improvement after SLMTA completion is needed to ensure sustainability and continue progress toward accreditation. Methods Audits were conducted by qualified, independent auditors to assess the performance of five enrolled laboratories using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist. End-of-programme (exit) and one year post-programme (surveillance) audits were compared for overall score, star level (from zero to five, based on scores) and scores for each of the 12 Quality System Essential (QSE) areas that make up the SLIPTA checklist. Results All laboratories improved from exit to surveillance audit (median improvement 38 percentage points, range 5–45 percentage points). Two laboratories improved from zero to one star, two improved from zero to three stars and one laboratory improved from three to four stars. The lowest median QSE scores at exit were: internal audit; corrective action; and occurrence management and process improvement (< 20%). Each of the 12 QSEs improved substantially at surveillance audit, with the greatest improvement in client management and customer service, internal audit and information management (≥ 50 percentage points). The two laboratories with the greatest overall improvement focused heavily on the internal audit and corrective action QSEs. Conclusion Whilst all laboratories improved from exit to surveillance audit, those that focused on the internal audit and corrective action QSEs improved substantially more than those that did not; internal audits and corrective actions may have acted as catalysts, leading to improvements in other QSEs. Systematic identification of core areas and best practices to address them is a critical step toward strengthening public medical laboratories. PMID:29043193

An Imager Gaussian Process Machine Learning Methodology for Cloud Thermodynamic Phase classification

NASA Astrophysics Data System (ADS)

Marchant, B.; Platnick, S. E.; Meyer, K.

2017-12-01

The determination of cloud thermodynamic phase from MODIS and VIIRS instruments is an important first step in cloud optical retrievals, since ice and liquid clouds have different optical properties. To continue improving the cloud thermodynamic phase classification algorithm, a machine-learning approach, based on Gaussian processes, has been developed. The new proposed methodology provides cloud phase uncertainty quantification and improves the algorithm portability between MODIS and VIIRS. We will present new results, through comparisons between MODIS and CALIOP v4, and for VIIRS as well.

AFSO 21: Identifying Potential Failure Points in Sustaining Continuous Process Improvement Across the Air Force

DTIC Science & Technology

2007-04-01

Michael W. Wynne, and the Air Force Chief of Staff, General T. Michael Moseley, “our strategy will be a comprehensive effort to improve our work processes...5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7...property of the United States government. ii AU/ACSC/2307/AY07 Preface I have always been a proponent of working smarter and not harder. I

A method for evaluating treatment quality using in vivo EPID dosimetry and statistical process control in radiation therapy.

PubMed

Fuangrod, Todsaporn; Greer, Peter B; Simpson, John; Zwan, Benjamin J; Middleton, Richard H

2017-03-13

Purpose Due to increasing complexity, modern radiotherapy techniques require comprehensive quality assurance (QA) programmes, that to date generally focus on the pre-treatment stage. The purpose of this paper is to provide a method for an individual patient treatment QA evaluation and identification of a "quality gap" for continuous quality improvement. Design/methodology/approach A statistical process control (SPC) was applied to evaluate treatment delivery using in vivo electronic portal imaging device (EPID) dosimetry. A moving range control chart was constructed to monitor the individual patient treatment performance based on a control limit generated from initial data of 90 intensity-modulated radiotherapy (IMRT) and ten volumetric-modulated arc therapy (VMAT) patient deliveries. A process capability index was used to evaluate the continuing treatment quality based on three quality classes: treatment type-specific, treatment linac-specific, and body site-specific. Findings The determined control limits were 62.5 and 70.0 per cent of the χ pass-rate for IMRT and VMAT deliveries, respectively. In total, 14 patients were selected for a pilot study the results of which showed that about 1 per cent of all treatments contained errors relating to unexpected anatomical changes between treatment fractions. Both rectum and pelvis cancer treatments demonstrated process capability indices were less than 1, indicating the potential for quality improvement and hence may benefit from further assessment. Research limitations/implications The study relied on the application of in vivo EPID dosimetry for patients treated at the specific centre. Sampling patients for generating the control limits were limited to 100 patients. Whilst the quantitative results are specific to the clinical techniques and equipment used, the described method is generally applicable to IMRT and VMAT treatment QA. Whilst more work is required to determine the level of clinical significance, the authors have demonstrated the capability of the method for both treatment specific QA and continuing quality improvement. Practical implications The proposed method is a valuable tool for assessing the accuracy of treatment delivery whilst also improving treatment quality and patient safety. Originality/value Assessing in vivo EPID dosimetry with SPC can be used to improve the quality of radiation treatment for cancer patients.

Improving brain injury cognitive rehabilitation by personalized telerehabilitation services: Guttmann neuropersonal trainer.

PubMed

Solana, Javier; Cáceres, César; García-Molina, Alberto; Opisso, Eloy; Roig, Teresa; Tormos, José M; Gómez, Enrique J

2015-01-01

Cognitive rehabilitation aims to remediate or alleviate the cognitive deficits appearing after an episode of acquired brain injury (ABI). The purpose of this work is to describe the telerehabilitation platform called Guttmann Neuropersonal Trainer (GNPT) which provides new strategies for cognitive rehabilitation, improving efficiency and access to treatments, and to increase knowledge generation from the process. A cognitive rehabilitation process has been modeled to design and develop the system, which allows neuropsychologists to configure and schedule rehabilitation sessions, consisting of set of personalized computerized cognitive exercises grounded on neuroscience and plasticity principles. It provides remote continuous monitoring of patient's performance, by an asynchronous communication strategy. An automatic knowledge extraction method has been used to implement a decision support system, improving treatment customization. GNPT has been implemented in 27 rehabilitation centers and in 83 patients' homes, facilitating the access to the treatment. In total, 1660 patients have been treated. Usability and cost analysis methodologies have been applied to measure the efficiency in real clinical environments. The usability evaluation reveals a system usability score higher than 70 for all target users. The cost efficiency study results show a relation of 1-20 compared to face-to-face rehabilitation. GNPT enables brain-damaged patients to continue and further extend rehabilitation beyond the hospital, improving the efficiency of the rehabilitation process. It allows customized therapeutic plans, providing information to further development of clinical practice guidelines.

[Perceptions about continuous training of Chilean health care teachers].

PubMed

Pérez V, Cristhian; Fasce H, Eduardo; Coloma N, Katherine; Vaccarezza G, Giulietta; Ortega B, Javiera

2013-06-01

Continuous training of teachers, in discipline and pedagogical topics, is a key step to improve the quality of educational processes. To report the perception of Chilean teachers of undergraduate health care programs, about continuous training activities. Twenty teachers working at different undergraduate health care programs in Chile were interviewed. Maximum variation and theoretical sampling methods were used to select the sample. Data was analyzed by open coding, according to the Grounded Theory guidelines. Nine categories emerged from data analysis: Access to continuous training, meaning of training in discipline, activities of continuous training in discipline, meaning of continuous training in pedagogy, kinds of continuous training in pedagogy, quality of continuous training in pedagogy, ideal of continuous training in pedagogy, outcomes of continuous training in pedagogy and needs for continuous training in pedagogy. Teachers of health care programs prefer to participate in contextualized training activities. Also, they emphasize their need of training in evaluation and teaching strategies.

Numerical Solutions of the Mean-Value Theorem: New Methods for Downward Continuation of Potential Fields

NASA Astrophysics Data System (ADS)

Zhang, Chong; Lü, Qingtian; Yan, Jiayong; Qi, Guang

2018-04-01

Downward continuation can enhance small-scale sources and improve resolution. Nevertheless, the common methods have disadvantages in obtaining optimal results because of divergence and instability. We derive the mean-value theorem for potential fields, which could be the theoretical basis of some data processing and interpretation. Based on numerical solutions of the mean-value theorem, we present the convergent and stable downward continuation methods by using the first-order vertical derivatives and their upward continuation. By applying one of our methods to both the synthetic and real cases, we show that our method is stable, convergent and accurate. Meanwhile, compared with the fast Fourier transform Taylor series method and the integrated second vertical derivative Taylor series method, our process has very little boundary effect and is still stable in noise. We find that the characters of the fading anomalies emerge properly in our downward continuation with respect to the original fields at the lower heights.

Recent National Transonic Facility Test Process Improvements (Invited)

NASA Technical Reports Server (NTRS)

Kilgore, W. A.; Balakrishna, S.; Bobbitt, C. W., Jr.; Adcock, J. B.

2001-01-01

This paper describes the results of two recent process improvements; drag feed-forward Mach number control and simultaneous force/moment and pressure testing, at the National Transonic Facility. These improvements have reduced the duration and cost of testing. The drag feed-forward Mach number control reduces the Mach number settling time by using measured model drag in the Mach number control algorithm. Simultaneous force/moment and pressure testing allows simultaneous collection of force/moment and pressure data without sacrificing data quality thereby reducing the overall testing time. Both improvements can be implemented at any wind tunnel. Additionally the NTF is working to develop and implement continuous pitch as a testing option as an additional method to reduce costs and maintain data quality.

Recent National Transonic Facility Test Process Improvements (Invited)

NASA Technical Reports Server (NTRS)

Kilgore, W. A.; Balakrishna, S.; Bobbitt, C. W., Jr.; Adcock, J. B.

2001-01-01

This paper describes the results of two recent process improvements; drag feed-forward Mach number control and simultaneous force/moment and pressure testing, at the National Transonic Facility. These improvements have reduced the duration and cost of testing. The drag feedforward Mach number control reduces the Mach number settling time by using measured model drag in the Mach number control algorithm. Simultaneous force/moment and pressure testing allows simultaneous collection of force/moment and pressure data without sacrificing data quality thereby reducing the overall testing time. Both improvements can be implemented at any wind tunnel. Additionally the NTF is working to develop and implement continuous pitch as a testing option as an additional method to reduce costs and maintain data quality.

A benchmarking program to reduce red blood cell outdating: implementation, evaluation, and a conceptual framework.

PubMed

Barty, Rebecca L; Gagliardi, Kathleen; Owens, Wendy; Lauzon, Deborah; Scheuermann, Sheena; Liu, Yang; Wang, Grace; Pai, Menaka; Heddle, Nancy M

2015-07-01

Benchmarking is a quality improvement tool that compares an organization's performance to that of its peers for selected indicators, to improve practice. Processes to develop evidence-based benchmarks for red blood cell (RBC) outdating in Ontario hospitals, based on RBC hospital disposition data from Canadian Blood Services, have been previously reported. These benchmarks were implemented in 160 hospitals provincewide with a multifaceted approach, which included hospital education, inventory management tools and resources, summaries of best practice recommendations, recognition of high-performing sites, and audit tools on the Transfusion Ontario website (http://transfusionontario.org). In this study we describe the implementation process and the impact of the benchmarking program on RBC outdating. A conceptual framework for continuous quality improvement of a benchmarking program was also developed. The RBC outdating rate for all hospitals trended downward continuously from April 2006 to February 2012, irrespective of hospitals' transfusion rates or their distance from the blood supplier. The highest annual outdating rate was 2.82%, at the beginning of the observation period. Each year brought further reductions, with a nadir outdating rate of 1.02% achieved in 2011. The key elements of the successful benchmarking strategy included dynamic targets, a comprehensive and evidence-based implementation strategy, ongoing information sharing, and a robust data system to track information. The Ontario benchmarking program for RBC outdating resulted in continuous and sustained quality improvement. Our conceptual iterative framework for benchmarking provides a guide for institutions implementing a benchmarking program. © 2015 AABB.

Total Quality Management Implementation Plan.

DTIC Science & Technology

1989-06-01

Quality Management Implementation Plan 6. AUTHOR(S) 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8. PERFORMING ORGANIZATION Defense General...E 14. SUBJECT TERMS 15. NUMBER OF PAGES TOM (Total Quality Management ), Continuous Process Improvement,_________ Depot Operations, Supply Support 16

77 FR 3242 - Comprehensive Centers Program

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-23

... believe the centers must focus on helping SEAs (1) create sustainable organizational structures and... organizational structures and effective performance management systems, building staff expertise within those... for evaluating and continuously improving organizational structures and processes; c. Draws on the...

Recommended techniques for effective maintainability. A continuous improvement initiative of the NASA Reliability and Maintainability Steering Committee

NASA Technical Reports Server (NTRS)

1994-01-01

This manual presents a series of recommended techniques that can increase overall operational effectiveness of both flight and ground based NASA systems. It provides a set of tools that minimizes risk associated with: (1) restoring failed functions (both ground and flight based); (2) conducting complex and highly visible maintenance operations; and (3) sustaining a technical capability to support the NASA mission using aging equipment or facilities. It considers (1) program management - key elements of an effective maintainability effort; (2) design and development - techniques that have benefited previous programs; (3) analysis and test - quantitative and qualitative analysis processes and testing techniques; and (4) operations and operational design techniques that address NASA field experience. This document is a valuable resource for continuous improvement ideas in executing the systems development process in accordance with the NASA 'better, faster, smaller, and cheaper' goal without compromising safety.

Using ergonomics checkpoints to support a participatory ergonomics intervention in an industrially developing country (IDC)--a case study.

PubMed

Helali, Faramarz

2009-01-01

To achieve ergonomics awareness in 3 subsidiary companies, an intervention team was formed. The aims of this study were to implement basic ergonomics through a participatory ergonomics intervention process that can support a continuous learning process and lead to an improvement in health and safety as well as in the work systems in the organization. The findings of this study (i.e., method, continuous learning and integration) were key to making the participatory ergonomics intervention successful. Furthermore, 4 issues of the ergonomics checkpoints (i.e., work schedules, work tasks, healthy work organization and learning) for assessing the work system were found suitable for both changing work schedules and for improving the work system. This paper describes the result of this project and also the experiences gained and the conclusions reached from using the International Labour Office's ergonomics checkpoints in the industries of industrially developing country.

Based on Cu as framework constructed nanoporous CuO/Cu composites by a dealloy method for sodium-ion battery anode

NASA Astrophysics Data System (ADS)

Zheng, Tian; Li, Guangda; Li, Deming; Meng, Xiangeng

2018-05-01

Nanoporous CuO/Cu composites with a continuous channel structure were fabricated through a corroding Cu-Al alloy process. The width of the continuous channels was about 20 50 nm. Nanoporous structure could effectively sustain the volume expansion during the Na+ insertion/extraction process and shorten the Na+ diffusion length as well, which thus helps improve the Na+ storage performance. Moreover, the nanoporous structure can improve the contact area between the electrolyte and the electrode, leading to an increment in the number of Na+ insertion/extraction sites. When used as the anode for sodium-ion batteries, the CuO/Cu exhibited an initial capacity of 580 mAh g-1, and the capacity is maintained at 200 mAh g-1 after 200 cycles at a current density of 500 mA g-1.

Overview of the United States Department of Energy's ARM (Atmospheric Radiation Measurement) Program

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

Stokes, G.M.; Tichler, J.L.

The Department of Energy (DOE) is initiating a major atmospheric research effort, the Atmospheric Radiation Measurement Program (ARM). The program is a key component of DOE's research strategy to address global climate change and is a direct continuation of DOE's decade-long effort to improve the ability of General Circulation Models (GCMs) to provide reliable simulations of regional, and long-term climate change in response to increasing greenhouse gases. The effort is multi-disciplinary and multi-agency, involving universities, private research organizations and more than a dozen government laboratories. The objective of the ARM Research is to provide an experimental testbed for the studymore » of important atmospheric effects, particularly cloud and radiative processes, and to test parameterizations of these processes for use in atmospheric models. This effort will support the continued and rapid improvement of GCM predictive capability. 2 refs.« less

The Robust Learning Model with a Spiral Curriculum: Implications for the Educational Effectiveness of Online Master Degree Programs

ERIC Educational Resources Information Center

Neumann, Yoram; Neumann, Edith; Lewis, Shelia

2017-01-01

This study integrated the Spiral Curriculum approach into the Robust Learning Model as part of a continuous improvement process that was designed to improve educational effectiveness and then assessed the differences between the initial and integrated models as well as the predictability of the first course in the integrated learning model on a…

Shared ownership: what's the future?

PubMed

Roth, Karen L

2013-01-01

The status of library consortia has evolved over time in terms of their composition and alternative negotiating models. New purchasing models may allow improved library involvement in the acquisitions process and improved methods for meeting users' future needs. Ever-increasing costs of library resources and the need to reduce expenses make it necessary to continue the exploration of library consortia for group purchases.

78 FR 52991 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing of Proposed Rule Change...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-27

..., 2014, a separate price improvement process for public customer and non-public customer PIXL Orders that... price equal to or within a range of 2.49-2.51. Assume a public customer or non-public customer order to... continue to afford the same price improvement opportunities for public customer and non-public customer...

New technologies emerge.

PubMed

Gray, S P

1997-01-01

Technology vendors continue to invent new devices, systems and processes to sell to the health care industry. Drugs, instruments and procedures continue to improve and address disease and injury treatment needs. In addition to these direct medical treatment innovations and enhancements, a number of new supporting systems and products have emerged. These support technologies hold significant promise for managers to make day-to-day execution of health care delivery more cost effective and customer friendly.

NDE Process Development Specification for SRB Composite Nose Cap

NASA Technical Reports Server (NTRS)

Suits, M.

1999-01-01

The Shuttle Upgrade program is a continuing improvement process to enable the Space Shuttle to be an effective space transportation vehicle for the next few decades. The Solid Rocket Booster (SRB), as a component of that system, is currently undergoing such an improvement. Advanced materials, such as composites, have given us a chance to improve performance and to reduce weight. The SRB Composite Nose Cap (CNC) program aims to replace the current aluminum nose cap, which is coated with a Thermal Protection System and poses a possible debris hazard, with a lighter, stronger, CNC. For the next 2 years, this program will evaluate the design, material selection, properties, and verification of the CNC. This particular process specification cites the methods and techniques for verifying the integrity of such a nose cap with nondestructive evaluation.

Earthdata Search Client: Usability Review Process, Results, and Implemented Changes, Using Earthdata Search Client as a Case Study

NASA Technical Reports Server (NTRS)

Siarto, Jeff; Reese, Mark; Shum, Dana; Baynes, Katie

2016-01-01

User experience and visual design are greatly improved when usability testing is performed on a periodic basis. Design decisions should be tested by real users so that application owners can understand the effectiveness of each decision and identify areas for improvement. It is important that applications be tested not just once, but as a part of a continuing process that looks to build upon previous tests. NASA's Earthdata Search Client has undergone a usability study to ensure its users' needs are being met and that users understand how to use the tool efficiently and effectively. This poster will highlight the process followed for usability study, the results of the study, and what has been implemented in light of the results to improve the application's interface.

Analysis on electronic control unit of continuously variable transmission

NASA Astrophysics Data System (ADS)

Cao, Shuanggui

Continuously variable transmission system can ensure that the engine work along the line of best fuel economy, improve fuel economy, save fuel and reduce harmful gas emissions. At the same time, continuously variable transmission allows the vehicle speed is more smooth and improves the ride comfort. Although the CVT technology has made great development, but there are many shortcomings in the CVT. The CVT system of ordinary vehicles now is still low efficiency, poor starting performance, low transmission power, and is not ideal controlling, high cost and other issues. Therefore, many scholars began to study some new type of continuously variable transmission. The transmission system with electronic systems control can achieve automatic control of power transmission, give full play to the characteristics of the engine to achieve optimal control of powertrain, so the vehicle is always traveling around the best condition. Electronic control unit is composed of the core processor, input and output circuit module and other auxiliary circuit module. Input module collects and process many signals sent by sensor and , such as throttle angle, brake signals, engine speed signal, speed signal of input and output shaft of transmission, manual shift signals, mode selection signals, gear position signal and the speed ratio signal, so as to provide its corresponding processing for the controller core.

Model based adaptive control of a continuous capture process for monoclonal antibodies production.

PubMed

Steinebach, Fabian; Angarita, Monica; Karst, Daniel J; Müller-Späth, Thomas; Morbidelli, Massimo

2016-04-29

A two-column capture process for continuous processing of cell-culture supernatant is presented. Similar to other multicolumn processes, this process uses sequential countercurrent loading of the target compound in order maximize resin utilization and productivity for a given product yield. The process was designed using a novel mechanistic model for affinity capture, which takes both specific adsorption as well as transport through the resin beads into account. Simulations as well as experimental results for the capture of an IgG antibody are discussed. The model was able to predict the process performance in terms of yield, productivity and capacity utilization. Compared to continuous capture with two columns operated batch wise in parallel, a 2.5-fold higher capacity utilization was obtained for the same productivity and yield. This results in an equal improvement in product concentration and reduction of buffer consumption. The developed model was used not only for the process design and optimization but also for its online control. In particular, the unit operating conditions are changed in order to maintain high product yield while optimizing the process performance in terms of capacity utilization and buffer consumption also in the presence of changing upstream conditions and resin aging. Copyright © 2016 Elsevier B.V. All rights reserved.

Enhancing Zeolite Performance by Catalyst Shaping in a Mesoscale Continuous-Flow Diels-Alder Process.

PubMed

Seghers, Sofie; Lefevere, Jasper; Mullens, Steven; De Vylder, Anton; Thybaut, Joris W; Stevens, Christian V

2018-03-26

In contrast to most lab-scale batch procedures, a continuous-flow implementation requires a thorough consideration of the solid catalyst design. In a previous study, irregular zeolite pellets were applied in a miniaturized continuous-flow reactor for the Diels-Alder reaction in the construction of norbornene scaffolds. After having faced the challenges of continuous operation, the aim of this study is to exploit catalyst structuring. To this end, microspheres with high uniformity and various sphere diameters were synthesized according to the vibrational droplet coagulation method. The influence of the use of these novel zeolite shapes in a mesoscale continuous-flow Diels-Alder process of cyclopentadiene and methyl acrylate is discussed. An impressive enhancement of catalyst lifetime is demonstrated, as even after a doubled process time of 14 h, the microspheres still exceeded the conversion after 7 h when using zeolite pellets by 30 %. A dual reason is found for this beneficial impact of catalyst shaping. The significant improvement in catalyst longevity can be attributed to the interplay of the chemical composition and the porosity structure of the microspheres. © 2018 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Realization of process improvement at a diagnostic radiology department with aid of simulation modeling.

PubMed

Oh, Hong-Choon; Toh, Hong-Guan; Giap Cheong, Eddy Seng

2011-11-01

Using the classical process improvement framework of Plan-Do-Study-Act (PDSA), the diagnostic radiology department of a tertiary hospital identified several patient cycle time reduction strategies. Experimentation of these strategies (which included procurement of new machines, hiring of new staff, redesign of queue system, etc.) through pilot scale implementation was impractical because it might incur substantial expenditure or be operationally disruptive. With this in mind, simulation modeling was used to test these strategies via performance of "what if" analyses. Using the output generated by the simulation model, the team was able to identify a cost-free cycle time reduction strategy, which subsequently led to a reduction of patient cycle time and achievement of a management-defined performance target. As healthcare professionals work continually to improve healthcare operational efficiency in response to rising healthcare costs and patient expectation, simulation modeling offers an effective scientific framework that can complement established process improvement framework like PDSA to realize healthcare process enhancement. © 2011 National Association for Healthcare Quality.

John M. Eisenberg Patient Safety Awards. System innovation: Concord Hospital.

PubMed

Uhlig, Paul N; Brown, Jeffrey; Nason, Anne K; Camelio, Addie; Kendall, Elise

2002-12-01

The Cardiac Surgery Program at Concord Hospital (Concord, NH) restructured clinical teamwork for improved safety and effectiveness on the basis of theory and practice from human factors science, aviation safety, and high-reliability organization theory. A team-based, collaborative rounds process--the Concord Collaborative Care Model--that involved use of a structured communications protocol was conducted daily at each patient's bedside. The entire care team agreed to meet at the same time each day (8:45 AM to 9:30 AM) to share information and develop a plan of care for each patient, with patient and family members as active participants. The cardiac surgery team developed a structured communications protocol adapted from human factors science. To provide a forum for discussion of team goals and progress and to address system-level concerns, a biweekly system rounds process was established. Following implementation of collaborative rounds, mortality of Concord Hospital's cardiac surgery patients declined significantly from expected rates. Satisfaction rates of open heart patients scores were consistently in the 97th-99th percentile nationally. A quality of work life survey indicated that in every category, providers expressed greater satisfaction with the collaborative care process than with the traditional rounds process. Practice patterns in the Cardiac Surgery Program at Concord Hospital have changed to a much more collaborative and participatory process, with improved outcomes, happier patients, and more satisfied practitioners. A culture of continuous program improvement has been implemented that continues to evolve and produce benefits.

Process monitoring and visualization solutions for hot-melt extrusion: a review.

PubMed

Saerens, Lien; Vervaet, Chris; Remon, Jean Paul; De Beer, Thomas

2014-02-01

Hot-melt extrusion (HME) is applied as a continuous pharmaceutical manufacturing process for the production of a variety of dosage forms and formulations. To ensure the continuity of this process, the quality of the extrudates must be assessed continuously during manufacturing. The objective of this review is to provide an overview and evaluation of the available process analytical techniques which can be applied in hot-melt extrusion. Pharmaceutical extruders are equipped with traditional (univariate) process monitoring tools, observing barrel and die temperatures, throughput, screw speed, torque, drive amperage, melt pressure and melt temperature. The relevance of several spectroscopic process analytical techniques for monitoring and control of pharmaceutical HME has been explored recently. Nevertheless, many other sensors visualizing HME and measuring diverse critical product and process parameters with potential use in pharmaceutical extrusion are available, and were thoroughly studied in polymer extrusion. The implementation of process analytical tools in HME serves two purposes: (1) improving process understanding by monitoring and visualizing the material behaviour and (2) monitoring and analysing critical product and process parameters for process control, allowing to maintain a desired process state and guaranteeing the quality of the end product. This review is the first to provide an evaluation of the process analytical tools applied for pharmaceutical HME monitoring and control, and discusses techniques that have been used in polymer extrusion having potential for monitoring and control of pharmaceutical HME. © 2013 Royal Pharmaceutical Society.

Orion Heat Shield Manufacturing Producibility Improvements for the EM-1 Flight Test Program

NASA Technical Reports Server (NTRS)

Koenig, William J.; Stewart, Michael; Harris, Richard F.

2018-01-01

This paper describes how the ORION program is incorporating improvements in the heat shield design and manufacturing processes reducing programmatic risk and ensuring crew safety in support of NASA's Exploration missions. The approach for the EFT-1 heat shield utilized a low risk Apollo heritage design and manufacturing process using an Avcoat TPS ablator with a honeycomb substrate to provide a one piece heat shield to meet the mission re-entry heating environments. The EM-1 mission will have additional flight systems installed to fly to the moon and return to Earth. Heat shield design and producibility improvements have been incorporated in the EM-1 vehicle to meet deep space mission requirements. The design continues to use the Avcoat material, but in a block configuration to enable improvements in consistant and repeatable application processes using tile bonding experience developed on the Space Shuttle Transportation System Program.

[Audit and feedback, and continuous quality improvement strategies to improve the quality of care for type 2 diabetes: a systematic review of literature].

PubMed

Vecchi, Simona; Agabiti, Nera; Mitrova, Susanna; Cacciani, Laura; Amato, Laura; Davoli, Marina; Bargagli, Anna Maria

2016-01-01

we analysed evidence on effective interventions to improve the quality of care and management in patients with diabetes type 2. This review focuses particularly on audit and feedback intervention, targeted to healthcare providers, and continuous quality improvement (CQI) involving health professionals and health care systems, respectively. we searched The Cochrane Library, PubMed, and EMBASE (search period: January 2005-December 2015) to identify systematic reviews (SR) and randomized controlled trials (RCTs) considering patients' outcomes and process measures as quality indicators in diabetes care. Selection of studies and data extraction were carried out independently by two reviewers. Methodological quality of individual studies was assessed using the checklist «Assessment of methodological quality of systematic review» (AMSTAR) and the Cochrane's tool, respectively. We produced summaries of results for each study design. the search process resulted in 810 citations. One SR and 7 RCTs that compared any intervention in which audit and feedback and CQI was a component vs. other interventions were selected. The SR found that audit and feedback activity was associated with improvements of glycaemic (mean difference: 0.26; 95%CI 0.08;0.44) and cholesterol control (mean difference: 0.03; 95%CI -0.04;0.10). CQI interventions were not associated with an improvement of quality of diabetes care. The RCTs considered in this review compared a broad range of interventions including feedback as unique activity or as part of more complex strategies. The methodological quality was generally poor in all the included trials. the available evidence suggests that audit and feedback and CQI improve quality of care in diabetic patients, although the effect is small and heterogeneous among process and outcomes indicators.

Improved functionality of graphene and carbon nanotube hybrid foam architecture by UV-ozone treatment

NASA Astrophysics Data System (ADS)

Wang, Wei; Ruiz, Isaac; Lee, Ilkeun; Zaera, Francisco; Ozkan, Mihrimah; Ozkan, Cengiz S.

2015-04-01

Optimization of the electrode/electrolyte double-layer interface is a key factor for improving electrode performance of aqueous electrolyte based supercapacitors (SCs). Here, we report the improved functionality of carbon materials via a non-invasive, high-throughput, and inexpensive UV generated ozone (UV-ozone) treatment. This process allows precise tuning of the graphene and carbon nanotube hybrid foam (GM) transitionally from ultrahydrophobic to hydrophilic within 60 s. The continuous tuning of surface energy can be controlled by simply varying the UV-ozone exposure time, while the ozone-oxidized carbon nanostructure maintains its integrity. Symmetric SCs based on the UV-ozone treated GM foam demonstrated enhanced rate performance. This technique can be readily applied to other CVD-grown carbonaceous materials by taking advantage of its ease of processing, low cost, scalability, and controllability.Optimization of the electrode/electrolyte double-layer interface is a key factor for improving electrode performance of aqueous electrolyte based supercapacitors (SCs). Here, we report the improved functionality of carbon materials via a non-invasive, high-throughput, and inexpensive UV generated ozone (UV-ozone) treatment. This process allows precise tuning of the graphene and carbon nanotube hybrid foam (GM) transitionally from ultrahydrophobic to hydrophilic within 60 s. The continuous tuning of surface energy can be controlled by simply varying the UV-ozone exposure time, while the ozone-oxidized carbon nanostructure maintains its integrity. Symmetric SCs based on the UV-ozone treated GM foam demonstrated enhanced rate performance. This technique can be readily applied to other CVD-grown carbonaceous materials by taking advantage of its ease of processing, low cost, scalability, and controllability. Electronic supplementary information (ESI) available. See DOI: 10.1039/c4nr06795a

High-resolution multiphoton microscopy with a low-power continuous wave laser pump.

PubMed

Chen, Xiang-Dong; Li, Shen; Du, Bo; Dong, Yang; Wang, Ze-Hao; Guo, Guang-Can; Sun, Fang-Wen

2018-02-15

Multiphoton microscopy (MPM) has been widely used for three-dimensional biological imaging. Here, based on the photon-induced charge state conversion process, we demonstrated a low-power high-resolution MPM with a nitrogen vacancy (NV) center in diamond. Continuous wave green and orange lasers were used to pump and detect the two-photon charge state conversion, respectively. The power of the laser for multiphoton excitation was 40 μW. Both the axial and lateral resolutions were improved approximately 1.5 times compared with confocal microscopy. The results can be used to improve the resolution of the NV center-based quantum sensing and biological imaging.

TQM in a test environment

NASA Technical Reports Server (NTRS)

Chambers, Gary D.; King, Elizabeth A.; Oleson, Keith

1992-01-01

In response to the changing aerospace economic climate, Martin Marietta Astronautics Group (MMAG) has adopted a Total Quality Management (TQM) philosophy to maintain a competitive edge. TQM emphasizes continuous improvement of processes, motivation to improve from within, cross-functional involvement, people empowerment, customer satisfaction, and modern process control techniques. The four major initiatives of TQM are Product Excellence, Manufacturing Resource Planning (MRP II), People Empowerment, and Subcontract Management. The Defense Space and Communications (DS&C) Test Lab's definition and implementation of the MRP II and people empowerment initiatives within TQM are discussed. The application of MRP II to environmental test planning and operations processes required a new and innovative approach. In an 18 month span, the test labs implemented MRP II and people empowerment and achieved a Class 'A' operational status. This resulted in numerous benefits, both tangible and intangible, including significant cost savings and improved quality of life. A detailed description of the implementation process and results are addressed.

TQM in a test environment

NASA Astrophysics Data System (ADS)

Chambers, Gary D.; King, Elizabeth A.; Oleson, Keith

1992-11-01

In response to the changing aerospace economic climate, Martin Marietta Astronautics Group (MMAG) has adopted a Total Quality Management (TQM) philosophy to maintain a competitive edge. TQM emphasizes continuous improvement of processes, motivation to improve from within, cross-functional involvement, people empowerment, customer satisfaction, and modern process control techniques. The four major initiatives of TQM are Product Excellence, Manufacturing Resource Planning (MRP II), People Empowerment, and Subcontract Management. The Defense Space and Communications (DS&C) Test Lab's definition and implementation of the MRP II and people empowerment initiatives within TQM are discussed. The application of MRP II to environmental test planning and operations processes required a new and innovative approach. In an 18 month span, the test labs implemented MRP II and people empowerment and achieved a Class 'A' operational status. This resulted in numerous benefits, both tangible and intangible, including significant cost savings and improved quality of life. A detailed description of the implementation process and results are addressed.

Chinese ethnic meat products: Continuity and development.

PubMed

Zeng, Weicai; Wen, Wenting; Deng, Yue; Tian, Yuanyuan; Sun, Honghu; Sun, Qun

2016-10-01

With their distinctive sensory characterizations and unique processing technologies, Chinese ethnic meat products possess great potential for development and continuity in modern China's meat industry. Due to the greater demand for meat products and higher quality and safety concerns in economically fast growing China, the development and continuity of ethnic meat products face its own unique challenges. In this review, the classification of typical ethnic products and their characteristics, and the research progress on their quality and processing technologies are discussed. The application of innovative and green technologies to improve the safety and quality of ethnic meat products for greater industrialization and sustainable development is highlighted. Furthermore, the strategy for promoting the production of Chinese ethnic meat products during the next five years is presented. Copyright © 2016 Elsevier Ltd. All rights reserved.

Multi-offset GPR methods for hyporheic zone investigations

USGS Publications Warehouse

Brosten, T.R.; Bradford, J.H.; McNamara, J.P.; Gooseff, M.N.; Zarnetske, J.P.; Bowden, W.B.; Johnston, M.E.

2009-01-01

Porosity of stream sediments has a direct effect on hyporheic exchange patterns and rates. Improved estimates of porosity heterogeneity will yield enhanced simulation of hyporheic exchange processes. Ground-penetrating radar (GPR) velocity measurements are strongly controlled by water content thus accurate measures of GPR velocity in saturated sediments provides estimates of porosity beneath stream channels using petrophysical relationships. Imaging the substream system using surface based reflection measurements is particularly challenging due to large velocity gradients that occur at the transition from open water to saturated sediments. The continuous multi-offset method improves the quality of subsurface images through stacking and provides measurements of vertical and lateral velocity distributions. We applied the continuous multi-offset method to stream sites on the North Slope, Alaska and the Sawtooth Mountains near Boise, Idaho, USA. From the continuous multi-offset data, we measure velocity using reflection tomography then estimate water content and porosity using the Topp equation. These values provide detailed measurements for improved stream channel hydraulic and thermal modelling. ?? 2009 European Association of Geoscientists & Engineers.

Reducing cognitive skill decay and diagnostic error: theory-based practices for continuing education in health care.

PubMed

Weaver, Sallie J; Newman-Toker, David E; Rosen, Michael A

2012-01-01

Missed, delayed, or wrong diagnoses can have a severe impact on patients, providers, and the entire health care system. One mechanism implicated in such diagnostic errors is the deterioration of cognitive diagnostic skills that are used rarely or not at all over a prolonged period of time. Existing evidence regarding maintenance of effective cognitive reasoning skills in the clinical education, organizational training, and human factors literatures suggest that continuing education plays a critical role in mitigating and managing diagnostic skill decay. Recent models also underscore the role of system level factors (eg, cognitive decision support tools, just-in-time training opportunities) in supporting clinical reasoning process. The purpose of this manuscript is to offer a multidisciplinary review of cognitive models of clinical decision making skills in order to provide a list of best practices for supporting continuous improvement and maintenance of cognitive diagnostic processes through continuing education. Copyright © 2012 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education.

Coal-oil coprocessing at HTI - development and improvement of the technology

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

Stalzer, R.H.; Lee, L.K.; Hu, J.

1995-12-31

Co-Processing refers to the combined processing of coal and petroleum-derived heavy oil feedstocks. The coal feedstocks used are those typically utilized in direct coal liquefaction: bituminous, subbituminous, and lignites. Petroleum-derived oil, is typically a petroleum residuum, containing at least 70 W% material boiling above 525{degrees}C. The combined coal and oil feedstocks are processed simultaneously with the dual objective of liquefying the coal and upgrading the petroleum-derived residuum to lower boiling (<525{degrees}C) premium products. HTI`s investigation of the Co-Processing technology has included work performed in laboratory, bench and PDU scale operations. The concept of co-processing technology is quite simple and amore » natural outgrowth of the work done with direct coal liquefaction. A 36 month program to evaluate new process concepts in coal-oil coprocessing at the bench-scale was begun in September 1994 and runs until September 1997. Included in this continuous bench-scale program are provisions to examine new improvements in areas such as: interstage product separation, feedstock concentrations (coal/oil), improved supported/dispersed catalysts, optimization of reactor temperature sequencing, and in-line hydrotreating. This does not preclude other ideas from DOE contracts and other sources that can lead to improved product quality and economics. This research work has led to important findings which significantly increased liquid yields, improved product quality, and improved process economics.« less

ThedaCare's business performance system: sustaining continuous daily improvement through hospital management in a lean environment.

PubMed

Barnas, Kim

2011-09-01

For 2003-2008, ThedaCare, a community health system in Wisconsin, achieved significant improvements in quality and the elimination of waste through the development of an improvement system, which included Value Stream analysis, rapid improvement events, and projects applied to specific processes. However, to meet its continuous daily improvement goals, particularly the goal of increasing productivity by 10% annually, ThedaCare needed to change the way its managers and leaders (in its hospital division) conduct and manage their daily work. Accordingly, it developed its Business Performance System (BPS) to achieve and sustain continuous daily improvement. BUILDING THE BPS: ThedaCare devised a multipart pilot project, consisting of "learning to see" and then, "problem solving." On completion of the 15-week alpha phase (6 units) in July 2009, the BPS was spread to the beta pilot (12 units; September 2009-January 2010) and then to cohort 3 (10 units; September 2010-January 2011). Each alpha unit improved performance on (1) the key driver metric of increasing productivity from 2008 to year-end 2009 (by 1%-11%) and (2) its respective safety/ quality drivers over the respective 2008 baselines. For 2010, improvements across the alpha, beta, and cohort 3 units were found for 11 of the 14 safety/quality drivers-85% of the 11 customer satisfaction drivers, 83% of 6 people engagement drivers; and 48% of 23 financial stewardship drivers. The tools developed for the BPS have enabled teams to see, prioritize, and pursue continuous daily improvement opportunities. Unit leaders now have a structured management reporting system to reduce variation in their management styles. Leaders all now follow leadership standard work, and their daily work is now consistently aligned with the hospital and system strategy.

An investigation into underwater wet welding using the flux cored arc welding process

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

Brydon, A.M.; Nixon, J.H.

1995-12-31

For the last two years, Cranfield has been carrying out a program of process investigations into wet underwater welding (Graham and Nixon 1993, Nixon and Webb 1994), and has demonstrated that it is possible to markedly improve the stability and consistency of the process by using control techniques developed for hyperbaric welding. In the project reported below, an initial evaluation of wet flux cored arc welding was undertaken. Although there continues to be considerable resistance to the use of wet welding on structures in the North Sea, continued pressure to reduce repair and maintenance costs is causing the industry tomore » re-examine techniques previously discounted, such as wet welding (Anon 1993).« less

Commercial biotechnology processing thermal control for transfer payloads to/from the International Space Station

NASA Astrophysics Data System (ADS)

Jennings, William M.; Vellinger, John C.; Deuser, Mark S.

2000-01-01

Biotechnology is undergoing a period of rapid and sustained growth, a trend which is expected to continue as the general population ages and as new medical treatments and products are conceived. As pharmaceutical and biomedical companies continue to search for improved methods of production and, for answers to basic research questions, they will seek out new avenues of research. Space processing on the International Space Station (ISS) offers such an opportunity! Space is rapidly becoming an industrial laboratory for biotechnology research and processing. Space bioprocessing offers exciting possibilities for developing new pharmaceuticals and medical treatments which can be used to benefit mankind on Earth. It also represents a new economic frontier for the private sector. .

Space Shuttle Program Primary Avionics Software System (PASS) Success Legacy -Major Accomplishments and Lessons Learned

NASA Technical Reports Server (NTRS)

Orr, James K.

2010-01-01

This presentation has shown the accomplishments of the PASS project over three decades and highlighted the lessons learned. Over the entire time, our goal has been to continuously improve our process, implement automation for both quality and increased productivity, and identify and remove all defects due to prior execution of a flawed process in addition to improving our processes following identification of significant process escapes. Morale and workforce instability have been issues, most significantly during 1993 to 1998 (period of consolidation in aerospace industry). The PASS project has also consulted with others, including the Software Engineering Institute, so as to be an early evaluator, adopter, and adapter of state-of-the-art software engineering innovations.

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

NASA Technical Reports Server (NTRS)

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

1993-01-01

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

Integrating MRP (materiel requirements planning) into modern business.

PubMed

Lunn, T

1994-05-01

Time is the commodity of the '90s. Therefore, we all must learn how to use our manufacturing systems to shorten lead time and increase customer satisfaction. The objective of this article is to discuss practical ways people integrate the techniques of materiel requirements planning (MRP) systems with just-in-time (JIT) execution systems to increase customer satisfaction. Included are examples of new ways people use MRP systems to exemplify the process of continuous improvement--multiple items on work orders, consolidated routings, flexing capacity, and other new developments. Ways that successful companies use MRP II for planning and JIT for execution are discussed. There are many examples of how to apply theory to real life situations and a discussion of techniques that work to keep companies in the mode of continuous improvement. Also included is a look at hands-on, practical methods people use to achieve lead time reduction and simplify bills of material. Total quality management concepts can be applied to the MRP process itself. This in turn helps people improve schedule adherence, which leads to customer satisfaction.

Transformation of safety culture on the San Antonio service unit of Union Pacific Railroad

DOT National Transportation Integrated Search

2012-10-31

The Federal Railroad Administration conducted a pilot demonstration of Clear Signal for Action (CSA), a risk reduction process : that combines peer-to-peer feedback, continuous improvement, and safety leadership development. An independent formative ...

5 CFR 850.101 - Purpose and scope.

Code of Federal Regulations, 2011 CFR

2011-01-01

....101 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS... processing system created by the Office of Personnel Management's (OPM's) Retirement Systems Modernization (RSM) initiative. RSM is OPM's strategic initiative to improve the quality and timeliness of services...

Applying Lean to the AC-130 Maintenance Process for the Royal Saudi Air Force

DTIC Science & Technology

2016-09-01

inventory management. Quality Management Poor quality of maintenance contributes to rework , which is an obvious form of waste. It would be very...consequences of rework are very significant. Within the C-130 maintenance squadron, quality must be achieved through continual process improvements, rather...maintenance “product” quality by lowering measurable process outputs such as amount of rework , number of maintenance-induced failures, and so on. 71

Post-event reviews: Using a quantitative approach for analysing incident response to demonstrate the value of business continuity programmes and increase planning efficiency.

PubMed

Vaidyanathan, Karthik

2017-01-01

Business continuity management is often thought of as a proactive planning process for minimising impact from large-scale incidents and disasters. While this is true, and it is critical to plan for the worst, consistently validating plan effectiveness against smaller disruptions can enable an organisation to gain key insights about its business continuity readiness, drive programme improvements, reduce costs and provide an opportunity to quantitatively demonstrate the value of the programme to management. This paper describes a post mortem framework which is used as a continuous improvement mechanism for tracking, reviewing and learning from real-world events at Microsoft Customer Service & Support. This approach was developed and adopted because conducting regular business continuity exercises proved difficult and expensive in a complex and distributed operations environment with high availability requirements. Using a quantitative approach to measure response to incidents, and categorising outcomes based on such responses, enables business continuity teams to provide data-driven insights to leadership, change perceptions of incident root cause, and instil a higher level of confidence towards disaster response readiness and incident management. The scope of the framework discussed here is specific to reviewing and driving improvements from operational incidents. However, the concept can be extended to learning and evolving readiness plans for other types of incidents.

Electrodialysis operation with buffer solution

DOEpatents

Hryn, John N [Naperville, IL; Daniels, Edward J [Orland Park, IL; Krumdick, Greg K [Crete, IL

2009-12-15

A new method for improving the efficiency of electrodialysis (ED) cells and stacks, in particular those used in chemical synthesis. The process entails adding a buffer solution to the stack for subsequent depletion in the stack during electrolysis. The buffer solution is regenerated continuously after depletion. This buffer process serves to control the hydrogen ion or hydroxide ion concentration so as to protect the active sites of electrodialysis membranes. The process enables electrodialysis processing options for products that are sensitive to pH changes.

Influences of operational parameters on phosphorus removal in batch and continuous electrocoagulation process performance.

PubMed

Nguyen, Dinh Duc; Yoon, Yong Soo; Bui, Xuan Thanh; Kim, Sung Su; Chang, Soon Woong; Guo, Wenshan; Ngo, Huu Hao

2017-11-01

Performance of an electrocoagulation (EC) process in batch and continuous operating modes was thoroughly investigated and evaluated for enhancing wastewater phosphorus removal under various operating conditions, individually or combined with initial phosphorus concentration, wastewater conductivity, current density, and electrolysis times. The results revealed excellent phosphorus removal (72.7-100%) for both processes within 3-6 min of electrolysis, with relatively low energy requirements, i.e., less than 0.5 kWh/m 3 for treated wastewater. However, the removal efficiency of phosphorus in the continuous EC operation mode was better than that in batch mode within the scope of the study. Additionally, the rate and efficiency of phosphorus removal strongly depended on operational parameters, including wastewater conductivity, initial phosphorus concentration, current density, and electrolysis time. Based on experimental data, statistical model verification of the response surface methodology (RSM) (multiple factor optimization) was also established to provide further insights and accurately describe the interactive relationship between the process variables, thus optimizing the EC process performance. The EC process using iron electrodes is promising for improving wastewater phosphorus removal efficiency, and RSM can be a sustainable tool for predicting the performance of the EC process and explaining the influence of the process variables.

A Review of the Literature Related to the Change Process Schools Undergo to Sustain PLCs

ERIC Educational Resources Information Center

Jones, Christopher M.; Thessin, Rebecca A.

2015-01-01

This literature review examines the existing literature on the role of the principal in the change process to create a context for change to both develop professional learning communities (PLCs) and sustain a context of continuous improvement over time. The Brown and Anfara (2003) framework was used as a theoretical lens to analyze the literature…

Knowledge Management Capabilities and Organizational Performance: An Investigation into the Effects of Knowledge Infrastructure and Processes on Organizational Performance

ERIC Educational Resources Information Center

Cho, Taejun

2011-01-01

Knowledge is one of the most important assets for surviving in the modern business environment. The effective management of that asset mandates continuous adaptation by organizations, and requires employees to strive to improve the company's work processes. Organizations attempt to coordinate their unique knowledge with traditional means as well…

Metrics Handbook (Air Force Systems Command)

NASA Astrophysics Data System (ADS)

1991-08-01

The handbook is designed to help one develop and use good metrics. It is intended to provide sufficient information to begin developing metrics for objectives, processes, and tasks, and to steer one toward appropriate actions based on the data one collects. It should be viewed as a road map to assist one in arriving at meaningful metrics and to assist in continuous process improvement.

Studies for the Loss of Atomic and Molecular Species from Io

NASA Technical Reports Server (NTRS)

Smyth, William H.

1998-01-01

Continued effort is reported to improve the emission rates of various emission lines for atomic oxygen and sulfur. Atomic hydrogen has been included as a new species in the neutral cloud model. The pertinent lifetime processes for hydrogen in the plasma torus and the relevant excitation processes for H Lyman-alpha emission in Io's atmosphere are discussed.

Ergonomics and Kaizen as strategies for competitiveness: a theoretical and practical in an automotive industry.

PubMed

Vieira, Leandro; Balbinotti, Giles; Varasquin, Adriano; Gontijo, Leila

2012-01-01

With increased international competitiveness in the automotive industry, came the concern of the companies save costs and lower production costs. For this purpose many ways are designed to reduce costs and waste of raw materials and reduce activities that do not aggregate value to manufacturing processes. In the early XVII appears the manufacturing system, which processes were hard with little concern for the health and safety of employees and conditions of the workplace. After the advent of the production system called lean manufacturing, a new paradigm in terms of production system capable of providing high levels of productivity and quality. It is based on waste elimination that occur during the production process. After began a new way of thinking, creating a culture of continuous improvement and lean process with no waste and reducing costs, without neglecting the welfare worker and improving the conditions of their work environment. This paper presents a reflection on the application of ergonomics in a lean production system of an automotive industry, using methodology based on the Kaizen (Continuous Improvement) to gain performance and improving the conditions of the workplace, also will be presented with positive and negative points in using this methodology in relation to ergonomics. The research will be conducted by collecting data 'in loco' and interviews with workers. Some studies show that in companies that are lean system and using the methodology of Kaizen, the results of product quality, levels of absenteeism and accidents are better than those obtained in companies that do not apply the same concept.

Dictionary-based image reconstruction for superresolution in integrated circuit imaging.

PubMed

Cilingiroglu, T Berkin; Uyar, Aydan; Tuysuzoglu, Ahmet; Karl, W Clem; Konrad, Janusz; Goldberg, Bennett B; Ünlü, M Selim

2015-06-01

Resolution improvement through signal processing techniques for integrated circuit imaging is becoming more crucial as the rapid decrease in integrated circuit dimensions continues. Although there is a significant effort to push the limits of optical resolution for backside fault analysis through the use of solid immersion lenses, higher order laser beams, and beam apodization, signal processing techniques are required for additional improvement. In this work, we propose a sparse image reconstruction framework which couples overcomplete dictionary-based representation with a physics-based forward model to improve resolution and localization accuracy in high numerical aperture confocal microscopy systems for backside optical integrated circuit analysis. The effectiveness of the framework is demonstrated on experimental data.

Academic/State/Federal collaborations and the improvement of practices in disaster mental health services and evaluation.

PubMed

Watson, Patricia J; Ruzek, Josef I

2009-05-01

Academic, state, and federal agencies collaborated over the last 9 years to improve disaster mental health services and evaluation. This process, which included literature reviews, a number of expert panels, and case studies, is described. The products resulting from this process have included the development of a systematic cross-site evaluation of the federally funded crisis counseling program and field guides for interventions aimed at providing services to distressed individuals in the immediate aftermath of disasters and to individuals needing resilience skills training weeks or months after the event. Future improvement of disaster mental health services calls for continued research, evaluation, training, and intervention development.

Application of kaizen methodology to foster departmental engagement in quality improvement.

PubMed

Knechtges, Paul; Decker, Michael Christopher

2014-12-01

The Toyota Production System, also known as Lean, is a structured approach to continuous quality improvement that has been developed over the past 50 years to transform the automotive manufacturing process. In recent years, these techniques have been successfully applied to quality and safety improvement in the medical field. One of these techniques is kaizen, which is the Japanese word for "good change." The central tenant of kaizen is the quick analysis of the small, manageable components of a problem and the rapid implementation of a solution with ongoing, real-time reassessment. Kaizen adds an additional "human element" that all stakeholders, not just management, must be involved in such change. Because of the small size of the changes involved in a kaizen event and the inherent focus on human factors and change management, a kaizen event can serve as good introduction to continuous quality improvement for a radiology department. Copyright © 2014. Published by Elsevier Inc.

Satellite-tracking and Earth dynamics research programs

NASA Technical Reports Server (NTRS)

1982-01-01

The activities carried out by the Smithsonian Astrophysical Observatory (SAO) are described. The SAO network continued to track LAGEOS at highest priority for polar motion and Earth rotation studies, and for other geophysical investigations, including crustal dynamics, Earth and ocean tides, and the general development of precision orbit determination. The network performed regular tracking of several other retroreflector satellites including GEOS-1, GEOS-3, BE-C, and Starlette for refined determinations of station coordinates and the Earth's gravity field and for studies of solid Earth dynamics. A major program in laser upgrading continued to improve ranging accuracy and data yield. This program includes an increase in pulse repetition rate from 8 ppm to 30 ppm, a reduction in laser pulse width from 6 nsec to 2 to 3 nsec, improvements in the photoreceiver and the electronics to improve daylight ranging, and an analog pulse detection system to improve range noise and accuracy. Data processing hardware and software are discussed.

Examining the potential of information technology to improve public insurance application processes: enrollee assessments from a concurrent mixed method analysis.

PubMed

Mishra, Abhay Nath; Ketsche, Patricia; Marton, James; Snyder, Angela; McLaren, Susan

2014-01-01

To assess the perceived readiness of Medicaid and Children's Health Insurance Program (CHIP) enrollees to use information technologies (IT) in order to facilitate improvements in the application processes for these public insurance programs. We conducted a concurrent mixed method study of Medicaid and CHIP enrollees in a southern state. We conducted focus groups to identify enrollee concerns regarding the current application process and their IT proficiency. Additionally, we surveyed beneficiaries via telephone about their access to and use of the Internet, and willingness to adopt IT-enabled processes. 2013 households completed the survey. We used χ(2) analysis for comparisons across different groups of respondents. A majority of enrollees will embrace IT-enabled enrollment, but a small yet significant group continues to lack access to facilitating technologies. Moreover, a segment of beneficiaries in the two programs continues to place a high value on personal interactions with program caseworkers. IT holds the promise of improving efficiency and reducing barriers for enrollees, but state and federal agencies managing public insurance programs need to ensure access to traditional processes and make caseworkers available to those who require and value such assistance, even after implementing IT-enabled processes. The use of IT-enabled processes is essential for effectively managing eligibility and enrollment determinations for public programs and private plans offered through state or federally operated exchanges. However, state and federal officials should be cognizant of the technological readiness of recipients and provide offline help to ensure broad participation in the insurance market. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Supercritical fluids as alternative, safe, food-processing media: an overview.

PubMed

Da Cruz Francisco, José; Szwajcer Dey, Estera

2003-01-01

The continuous growth of world population and its concentration in the urban areas require food supplies that are continuous, sufficient and of good quality. To resolve this problem techniques have been developed for increasing food quantity and quality. The techniques are applied throughout the food chain from production, conservation and during distribution to the consumers (from "the field to the fork"). During handling of food, chemicals are often deliberately added to achieve improved processing and better quality. This is one of the main reasons food undergoes different kinds of contamination. This overview focuses on the application of supercritical fluids as media for handling food materials during processing with the perspective of reducing chemical contamination of food. Examples of developmental applications of this technique and on research work in process are presented. Emphasis is given to extraction and biotransformation techniques.

Unsupervised Approaches for Post-Processing in Computationally Efficient Waveform-Similarity-Based Earthquake Detection

NASA Astrophysics Data System (ADS)

Bergen, K.; Yoon, C. E.; OReilly, O. J.; Beroza, G. C.

2015-12-01

Recent improvements in computational efficiency for waveform correlation-based detections achieved by new methods such as Fingerprint and Similarity Thresholding (FAST) promise to allow large-scale blind search for similar waveforms in long-duration continuous seismic data. Waveform similarity search applied to datasets of months to years of continuous seismic data will identify significantly more events than traditional detection methods. With the anticipated increase in number of detections and associated increase in false positives, manual inspection of the detection results will become infeasible. This motivates the need for new approaches to process the output of similarity-based detection. We explore data mining techniques for improved detection post-processing. We approach this by considering similarity-detector output as a sparse similarity graph with candidate events as vertices and similarities as weighted edges. Image processing techniques are leveraged to define candidate events and combine results individually processed at multiple stations. Clustering and graph analysis methods are used to identify groups of similar waveforms and assign a confidence score to candidate detections. Anomaly detection and classification are applied to waveform data for additional false detection removal. A comparison of methods will be presented and their performance will be demonstrated on a suspected induced and non-induced earthquake sequence.

Development of a continuous broad-energy-spectrum electron source

NASA Technical Reports Server (NTRS)

Adamo, R. C.; Nanevicz, J. E.

1985-01-01

The development of a practical prototype, large-area, continuous-spectrum, multienergy electron source to simulate the lower energy (approx = 1 to 30 keV) portion of the geosynchronous orbit electron environment was investigated. The results of future materials-charging tests using this multienergy source should significantly improve the understanding of actual in-orbit charging processes and should help to resolve some of the descrepancies between predicted and observed spacecraft materials performance.

DPSC (Defense Personnel Support Center) Total Quality Management Master Plan

DTIC Science & Technology

1989-07-01

SUBTITLE 5. FUNDING NUMBERS DPSC Total Quality Management Master Plan 6. AUTHOR(S) 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) B. PERFORMING...quality supported solider, sailor, airman and marine. % j cl 1 14. SUBJECT TERMS I 1S. NUMBER OF PAGES TQM (Total Quality Management ), Continuous...THE COMMANDER ON TOTAL QUALITY MANAGEMENT i SECTION I INTRODUCTION 1 II CONCEPTS 6 TQM Basics 7 Continuous Process Improvement 7 DoD TQM Philosophy 9

Integrating Contextualized Math in the MultiCraft Curricula at Sauk Valley Community College. Pathways to Results: Implementation Partnerships Strategy Brief

ERIC Educational Resources Information Center

Rockey, Marci

2016-01-01

Sauk Valley Community College (SVCC) has returned to the Pathways to Results (PTR) process to analyze and improve a new pathway each year for the last five years. They have become so invested in PTR that they have institutionalized its use into their approach to program review and continuous improvement, creating an institutional PTR team…

Improving Person-Job Congruence during the Classification Process: Item Development and Initial Testing of a Pictorial Interest Instrument

DTIC Science & Technology

2006-09-01

classification by making it applicant- centric while improving job satisfaction and performance , reducing attrition, and increasing continuation...produce greater job satisfaction , increase performance , and lengthen tenure. The difficulty the Navy faces is that enlisted applicants have limited work...P-J) fit. Empirically, job performance , employee satisfaction , and retention are contingent upon appropriately matching personnel with their desired

EUV patterning improvement toward high-volume manufacturing

NASA Astrophysics Data System (ADS)

Kuwahara, Yuhei; Matsunaga, Koichi; Kawakami, Shinichiro; Nafus, Kathleen; Foubert, Philippe; Goethals, Anne-Marie

2015-03-01

Extreme ultraviolet lithography (EUVL) technology is a promising candidate for a semiconductor process for 18nm half pitch and beyond. So far, the studies of EUV for manufacturability have been focused on particular aspects. It still requires fine resolution, uniform and smooth patterns, and low defectivity, not only after lithography but also after the etch process. Tokyo Electron Limited and imec are continuously collaborating to improve manufacturing quality of the process of record (POR) on a CLEAN TRACKTM LITHIUS ProTMZ-EUV. This next generation coating/developing system has been upgraded with defectivity reduction enhancements which are applied along with TELTM best known methods. We have evaluated process defectivity post lithography and post etch. Apart from defectivity, FIRMTM rinse material and application compatibility with sub 18nm patterning is improved to prevent line pattern collapse and increase process window on next generation resist materials. This paper reports on the progress of defectivity and patterning performance optimization towards the NXE:3300 POR.

A Web Centric Architecture for Deploying Multi-Disciplinary Engineering Design Processes

NASA Technical Reports Server (NTRS)

Woyak, Scott; Kim, Hongman; Mullins, James; Sobieszczanski-Sobieski, Jaroslaw

2004-01-01

There are continuous needs for engineering organizations to improve their design process. Current state of the art techniques use computational simulations to predict design performance, and optimize it through advanced design methods. These tools have been used mostly by individual engineers. This paper presents an architecture for achieving results at an organization level beyond individual level. The next set of gains in process improvement will come from improving the effective use of computers and software within a whole organization, not just for an individual. The architecture takes advantage of state of the art capabilities to produce a Web based system to carry engineering design into the future. To illustrate deployment of the architecture, a case study for implementing advanced multidisciplinary design optimization processes such as Bi-Level Integrated System Synthesis is discussed. Another example for rolling-out a design process for Design for Six Sigma is also described. Each example explains how an organization can effectively infuse engineering practice with new design methods and retain the knowledge over time.

Continuous desalting of refolded protein solution improves capturing in ion exchange chromatography: A seamless process.

PubMed

Walch, Nicole; Jungbauer, Alois

2017-06-01

Truly continuous biomanufacturing processes enable an uninterrupted feed stream throughout the whole production without the need for holding tanks. We have utilized microporous anion and cation exchangers into which only salts, but not proteins, can penetrate into the pores for desalting of protein solutions, while diafiltration or dilution is usually employed for feed adjustments. Anion exchange and cation exchange chromatography columns were connected in series to remove both anions and cations. To increase operation performance, a continuous process was developed comprised of four columns. Continuous mode was achieved by staggered cycle operation, where one set of columns, consisting of one anion exchange and one cation exchange column, was loaded during the regeneration of the second set. Refolding, desalting and subsequent ion exchange capturing with a scFv as the model protein was demonstrated. The refolding solution was successfully desalted resulting in a consistent conductivity below 0.5 mS/cm from initial values of 10 to 11 mS/cm. With continuous operation process time could be reduced by 39% while productivity was increased to 163% compared to batch operation. Desalting of the protein solution resulted in up to 7-fold higher binding capacities in the subsequent ion exchange capture step with conventional protein binding resins. © 2017 The Authors. Biotechnology Journal published by WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Improving the medical records department processes by lean management

PubMed Central

Ajami, Sima; Ketabi, Saeedeh; Sadeghian, Akram; Saghaeinnejad-Isfahani, Sakine

2015-01-01

Background: Lean management is a process improvement technique to identify waste actions and processes to eliminate them. The benefits of Lean for healthcare organizations are that first, the quality of the outcomes in terms of mistakes and errors improves. The second is that the amount of time taken through the whole process significantly improves. Aims: The purpose of this paper is to improve the Medical Records Department (MRD) processes at Ayatolah-Kashani Hospital in Isfahan, Iran by utilizing Lean management. Materials and Methods: This research was applied and an interventional study. The data have been collected by brainstorming, observation, interview, and workflow review. The study population included MRD staff and other expert staff within the hospital who were stakeholders and users of the MRD. Statistical Analysis Used: The MRD were initially taught the concepts of Lean management and then formed into the MRD Lean team. The team then identified and reviewed the current processes subsequently; they identified wastes and values, and proposed solutions. Results: The findings showed that the MRD units (Archive, Coding, Statistics, and Admission) had 17 current processes, 28 wastes, and 11 values were identified. In addition, they offered 27 comments for eliminating the wastes. Conclusion: The MRD is the critical department for the hospital information system and, therefore, the continuous improvement of its services and processes, through scientific methods such as Lean management, are essential. Originality/Value: The study represents one of the few attempts trying to eliminate wastes in the MRD. PMID:26097862

Space Flight Software Development Software for Intelligent System Health Management

NASA Technical Reports Server (NTRS)

Trevino, Luis C.; Crumbley, Tim

2004-01-01

The slide presentation examines the Marshall Space Flight Center Flight Software Branch, including software development projects, mission critical space flight software development, software technical insight, advanced software development technologies, and continuous improvement in the software development processes and methods.

COMPACT, CONTINUOUS MONITORING FOR VOLATILE ORGANIC COMPOUNDS - PHASE I

EPA Science Inventory

Improved methods for onsite measurement of multiple volatile organic compounds are needed for process control, monitoring, and remediation. This Phase I SBIR project sets forth an optical measurement method that meets these needs. The proposed approach provides an instantaneous m...

The Learning Organization: Theory into Practice.

ERIC Educational Resources Information Center

Otala, Matti

1995-01-01

Key elements of learning organizations are as follows: understanding strengths, weaknesses, threats, and opportunities; open-book management; streamlined processes; team spirit; lifelong learning and skill recycling; and removing anxiety. A learning organization consists of empowered, motivated people committed to improving continuously. (SK)

Metric Development for Continuous Process Improvement

DTIC Science & Technology

2011-03-01

observable ( Cropley , 1998). All measurement is done within a context (Morse, 2003), which is shaped by a purpose, existing knowledge, capabilities, and...performance: metrics for entrepreneurship and strategic management research. Cheltenham, UK: Edward Elgar, 2006. Print. 9. Cropley , D. H., “Towards

An Indoor Continuous Positioning Algorithm on the Move by Fusing Sensors and Wi-Fi on Smartphones.

PubMed

Li, Huaiyu; Chen, Xiuwan; Jing, Guifei; Wang, Yuan; Cao, Yanfeng; Li, Fei; Zhang, Xinlong; Xiao, Han

2015-12-11

Wi-Fi indoor positioning algorithms experience large positioning error and low stability when continuously positioning terminals that are on the move. This paper proposes a novel indoor continuous positioning algorithm that is on the move, fusing sensors and Wi-Fi on smartphones. The main innovative points include an improved Wi-Fi positioning algorithm and a novel positioning fusion algorithm named the Trust Chain Positioning Fusion (TCPF) algorithm. The improved Wi-Fi positioning algorithm was designed based on the properties of Wi-Fi signals on the move, which are found in a novel "quasi-dynamic" Wi-Fi signal experiment. The TCPF algorithm is proposed to realize the "process-level" fusion of Wi-Fi and Pedestrians Dead Reckoning (PDR) positioning, including three parts: trusted point determination, trust state and positioning fusion algorithm. An experiment is carried out for verification in a typical indoor environment, and the average positioning error on the move is 1.36 m, a decrease of 28.8% compared to an existing algorithm. The results show that the proposed algorithm can effectively reduce the influence caused by the unstable Wi-Fi signals, and improve the accuracy and stability of indoor continuous positioning on the move.

Impact of osmotic stress and ethanol inhibition in yeast cells on process oscillation associated with continuous very-high-gravity ethanol fermentation

PubMed Central

2013-01-01

Background VHG fermentation is a promising process engineering strategy aiming at improving ethanol titer, and thus saving energy consumption for ethanol distillation and distillage treatment. However, sustained process oscillation was observed during continuous VHG ethanol fermentation, which significantly affected ethanol fermentation performance of the system. Results Sustained process oscillation was investigated in continuous VHG ethanol fermentation, and stresses exerted on yeast cells by osmotic pressure from unfermented sugars and ethanol inhibition developed within the fermentation system were postulated to be major factors triggering this phenomenon. In this article, steady state was established for continuous ethanol fermentation with LG medium containing 120 g/L glucose, and then 160 g/L non-fermentable xylose was supplemented into the LG medium to simulate the osmotic stress on yeast cells under the VHG fermentation condition, but the fermentation process was still at steady state, indicating that the impact of osmotic stress on yeast cells was not the main reason for the process oscillation. However, when 30 g/L ethanol was supplemented into the LG medium to simulate the ethanol inhibition in yeast cells under the VHG fermentation condition, process oscillation was triggered, which was augmented with extended oscillation period and exaggerated oscillation amplitude as ethanol supplementation was increased to 50 g/L, but the process oscillation was gradually attenuated when the ethanol supplementations were stopped, and the steady state was restored. Furthermore, gas stripping was incorporated into the continuous VHG fermentation system to in situ remove ethanol produced by Saccharomyces cerevisiae, and the process oscillation was also attenuated, but restored after the gas stripping was interrupted. Conclusions Experimental results indicated that ethanol inhibition rather than osmotic stress on yeast cells is one of the main factors triggering the process oscillation under the VHG fermentation condition, and in the meantime gas stripping was validated to be an effective strategy for attenuating the process oscillation. PMID:24041271

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

PubMed

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

2016-06-01

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

Developing and executing quality improvement projects (concept, methods, and evaluation).

PubMed

Likosky, Donald S

2014-03-01

Continuous quality improvement, quality assurance, cycles of change--these words of often used to express the process of using data to inform and improve clinical care. Although many of us have been exposed to theories and practice of experimental work (e.g., randomized trial), few of us have been similarly exposed to the science underlying quality improvement. Through the lens of a single-center quality improvement study, this article exposes the reader to methodology for conducting such studies. The reader will gain an understanding of these methods required to embark on such a study.

Investigation on the Effect of a Pre-Center Drill Hole and Tool Material on Thrust Force, Surface Roughness, and Cylindricity in the Drilling of Al7075.

PubMed

Ghasemi, Amir Hossein; Khorasani, Amir Mahyar; Gibson, Ian

2018-01-16

Drilling is one of the most useful metal cutting processes and is used in various applications, such as aerospace, electronics, and automotive. In traditional drilling methods, the thrust force, torque, tolerance, and tribology (surface roughness) are related to the cutting condition and tool geometry. In this paper, the effects of a pre-center drill hole, tool material, and drilling strategy (including continuous and non-continuous feed) on thrust force, surface roughness, and dimensional accuracy (cylindricity) have been investigated. The results show that using pre-center drill holes leads to a reduction of the engagement force and an improvement in the surface quality and cylindricity. Non-continuous drilling reduces the average thrust force and cylindricity value, and High Speed Steels HSS-Mo (high steel speed + 5-8% Mo) reduces the maximum quantity of cutting forces. Moreover, cylindricity is directly related to cutting temperature and is improved by using a non-continuous drilling strategy.

Investigation on the Effect of a Pre-Center Drill Hole and Tool Material on Thrust Force, Surface Roughness, and Cylindricity in the Drilling of Al7075

PubMed Central

Ghasemi, Amir Hossein; Khorasani, Amir Mahyar

2018-01-01

Drilling is one of the most useful metal cutting processes and is used in various applications, such as aerospace, electronics, and automotive. In traditional drilling methods, the thrust force, torque, tolerance, and tribology (surface roughness) are related to the cutting condition and tool geometry. In this paper, the effects of a pre-center drill hole, tool material, and drilling strategy (including continuous and non-continuous feed) on thrust force, surface roughness, and dimensional accuracy (cylindricity) have been investigated. The results show that using pre-center drill holes leads to a reduction of the engagement force and an improvement in the surface quality and cylindricity. Non-continuous drilling reduces the average thrust force and cylindricity value, and High Speed Steels HSS-Mo (high steel speed + 5–8% Mo) reduces the maximum quantity of cutting forces. Moreover, cylindricity is directly related to cutting temperature and is improved by using a non-continuous drilling strategy. PMID:29337858

Fifteen years of continuous improvement of quality care of type 2 diabetes mellitus in primary care in Catalonia, Spain.

PubMed

Mata-Cases, M; Roura-Olmeda, P; Berengué-Iglesias, M; Birulés-Pons, M; Mundet-Tuduri, X; Franch-Nadal, J; Benito-Badorrey, B; Cano-Pérez, J F

2012-03-01

To assess the evolution of type 2 diabetes mellitus (T2DM) quality indicators in primary care centers (PCC) as part of the Group for the Study of Diabetes in Primary Care (GEDAPS) Continuous Quality Improvement (GCQI) programme in Catalonia. Sequential cross-sectional studies were performed during 1993-2007. Process and outcome indicators in random samples of patients from each centre were collected. The results of each evaluation were returned to each centre to encourage the implementation of correcting interventions. Sixty-four different educational activities were performed during the study period with the participation of 2041 professionals. Clinical records of 23,501 patients were evaluated. A significant improvement was observed in the determination of some annual process indicators: HbA(1c) (51.7% vs. 88.9%); total cholesterol (75.9% vs. 90.9%); albuminuria screening (33.9% vs. 59.4%) and foot examination (48.9% vs. 64.2%). The intermediate outcome indicators also showed significant improvements: glycemic control [HbA(1c) ≤ 7% (< 57 mmol/mol); (41.5% vs. 64.2%)]; total cholesterol [≤ 200 mg/dl (5.17 mmol/l); (25.5% vs. 65.6%)]; blood pressure [≤ 140/90 mmHg; (45.4% vs. 66.1%)]. In addition, a significant improvement in some final outcome indicators such as prevalence of foot ulcers (7.6% vs. 2.6%); amputations (1.9% vs. 0.6%) and retinopathy (18.8% vs. 8.6%) was observed. Although those changes should not be strictly attributed to the GCQI programme, significant improvements in some process indicators, parameters of control and complications were observed in a network of primary care centres in Catalonia. © 2012 Blackwell Publishing Ltd.

Fifteen years of continuous improvement of quality care of type 2 diabetes mellitus in primary care in Catalonia, Spain

PubMed Central

Mata-Cases, M; Roura-Olmeda, P; Berengué-Iglesias, M; Birulés-Pons, M; Mundet-Tuduri, X; Franch-Nadal, J; Benito-Badorrey, B; Cano-Pérez, J F

2012-01-01

Aims To assess the evolution of type 2 diabetes mellitus (T2DM) quality indicators in primary care centers (PCC) as part of the Group for the Study of Diabetes in Primary Care (GEDAPS) Continuous Quality Improvement (GCQI) programme in Catalonia. Methods Sequential cross-sectional studies were performed during 1993–2007. Process and outcome indicators in random samples of patients from each centre were collected. The results of each evaluation were returned to each centre to encourage the implementation of correcting interventions. Sixty-four different educational activities were performed during the study period with the participation of 2041 professionals. Results Clinical records of 23,501 patients were evaluated. A significant improvement was observed in the determination of some annual process indicators: HbA1c (51.7% vs. 88.9%); total cholesterol (75.9% vs. 90.9%); albuminuria screening (33.9% vs. 59.4%) and foot examination (48.9% vs. 64.2%). The intermediate outcome indicators also showed significant improvements: glycemic control [HbA1c ≤ 7% (< 57 mmol/mol); (41.5% vs. 64.2%)]; total cholesterol [≤ 200 mg/dl (5.17 mmol/l); (25.5% vs. 65.6%)]; blood pressure [≤ 140/90 mmHg; (45.4% vs. 66.1%)]. In addition, a significant improvement in some final outcome indicators such as prevalence of foot ulcers (7.6% vs. 2.6%); amputations (1.9% vs. 0.6%) and retinopathy (18.8% vs. 8.6%) was observed. Conclusions Although those changes should not be strictly attributed to the GCQI programme, significant improvements in some process indicators, parameters of control and complications were observed in a network of primary care centres in Catalonia. PMID:22340449

Prediction model of austenite growth and the role of MnS inclusions in non-quenched and tempered steel

NASA Astrophysics Data System (ADS)

Jiang, Bo; Wu, Meng; Sun, He; Wang, Zhilin; Zhao, Zhigang; Liu, Yazheng

2018-01-01

The austenite growth behavior of non-quenched and tempered steels (casted by continuous casting and molding casting processes) was studied. The austenite grain size of steel B casted by continuous casting process is smaller than that of steel A casted by molding casting process at the same heating parameters. The abnormal austenite growth temperature of the steels A and B are 950 °C and 1000 °C, respectively. Based on the results, the models for the austenite grain growth below and above the abnormal austenite growth temperature of the investigated steels were established. The dispersedly distributed fine particles MnS in steel B is the key factor refining the austenite grain by pinning the migration of austenite grain boundary. The elongated inclusions MnS are ineffective in preventing the austenite grain growth at high heating temperature. For the non-quenched and tempered steel, the continuous casting process should be adopted and the inclusion MnS should be elliptical, smaller in size and distributed uniformly in order to refine the final microstructure and also improve the mechanical properties.

Energy Efficiency of the Outotec® Ausmelt Process for Primary Copper Smelting

NASA Astrophysics Data System (ADS)

Wood, Jacob; Hoang, Joey; Hughes, Stephen

2017-03-01

The global, non-ferrous smelting industry has witnessed the continual development and evolution of processing technologies in a bid to reduce operating costs and improve the safety and environmental performance of processing plants. This is particularly true in the copper industry, which has seen a number of bath smelting technologies developed and implemented during the past 30 years. The Outotec® Ausmelt Top Submerged Lance Process is one such example, which has been widely adopted in the modernisation of copper processing facilities in China and Russia. Despite improvements in the energy efficiency of modern copper smelting and converting technologies, additional innovation and development is required to further reduce energy consumption, whilst still complying with stringent environmental regulations. In response to this challenge, the Ausmelt Process has undergone significant change and improvement over the course of its history, in an effort to improve its overall competitiveness, particularly with respect to energy efficiency and operating costs. This paper covers a number of recent advances to the technology and highlights the impacts of these developments in reducing energy consumptions for a range of different copper flowsheets. It also compares the energy efficiency of the Ausmelt Process against the Bottom Blown Smelting process, which has become widely adopted in China over the past 5-10 years.

Sigma Metrics Across the Total Testing Process.

PubMed

Charuruks, Navapun

2017-03-01

Laboratory quality control has been developed for several decades to ensure patients' safety, from a statistical quality control focus on the analytical phase to total laboratory processes. The sigma concept provides a convenient way to quantify the number of errors in extra-analytical and analytical phases through the defect per million and sigma metric equation. Participation in a sigma verification program can be a convenient way to monitor analytical performance continuous quality improvement. Improvement of sigma-scale performance has been shown from our data. New tools and techniques for integration are needed. Copyright © 2016 Elsevier Inc. All rights reserved.

Development and Implementation of a Quality Improvement Process for Echocardiographic Laboratory Accreditation.

PubMed

Gilliland, Yvonne E; Lavie, Carl J; Ahmad, Homaa; Bernal, Jose A; Cash, Michael E; Dinshaw, Homeyar; Milani, Richard V; Shah, Sangeeta; Bienvenu, Lisa; White, Christopher J

2016-03-01

We describe our process for quality improvement (QI) for a 3-year accreditation cycle in echocardiography by the Intersocietal Accreditation Commission (IAC) for a large group practice. Echocardiographic laboratory accreditation by the IAC was introduced in 1996, which is not required but could impact reimbursement. To ensure high-quality patient care and community recognition as a facility committed to providing high-quality echocardiographic services, we applied for IAC accreditation in 2010. Currently, there is little published data regarding the IAC process to meet echocardiography standards. We describe our approach for developing a multicampus QI process for echocardiographic laboratory accreditation during the 3-year cycle of accreditation by the IAC. We developed a quarterly review assessing (1) the variability of the interpretations, (2) the quality of the examinations, (3) a correlation of echocardiographic studies with other imaging modalities, (4) the timely completion of reports, (5) procedure volume, (6) maintenance of Continuing Medical Education credits by faculty, and (7) meeting Appropriate Use Criteria. We developed and implemented a multicampus process for QI during the 3-year accreditation cycle by the IAC for Echocardiography. We documented both the process and the achievement of those metrics by the Echocardiography Laboratories at the Ochsner Medical Institutions. We found the QI process using IAC standards to be a continuous educational experience for our Echocardiography Laboratory physicians and staff. We offer our process as an example and guide for other echocardiography laboratories who wish to apply for such accreditation or reaccreditation. © 2016, Wiley Periodicals, Inc.

Continuous Adaptive Population Reduction (CAPR) for Differential Evolution Optimization.

PubMed

Wong, Ieong; Liu, Wenjia; Ho, Chih-Ming; Ding, Xianting

2017-06-01

Differential evolution (DE) has been applied extensively in drug combination optimization studies in the past decade. It allows for identification of desired drug combinations with minimal experimental effort. This article proposes an adaptive population-sizing method for the DE algorithm. Our new method presents improvements in terms of efficiency and convergence over the original DE algorithm and constant stepwise population reduction-based DE algorithm, which would lead to a reduced number of cells and animals required to identify an optimal drug combination. The method continuously adjusts the reduction of the population size in accordance with the stage of the optimization process. Our adaptive scheme limits the population reduction to occur only at the exploitation stage. We believe that continuously adjusting for a more effective population size during the evolutionary process is the major reason for the significant improvement in the convergence speed of the DE algorithm. The performance of the method is evaluated through a set of unimodal and multimodal benchmark functions. In combining with self-adaptive schemes for mutation and crossover constants, this adaptive population reduction method can help shed light on the future direction of a completely parameter tune-free self-adaptive DE algorithm.

WHAT DOESNT GET MEASURED - DOESNT GET DONE: IMPLEMENTING CONTINUOUS PROCESS IMPROVEMENT IN THE AIR FORCE RESERVE

DTIC Science & Technology

2016-04-01

Practical Problem Solving Method RMD Resource Management Decision ROI Return on Investment SECAF Secretary of the Air Force SECNAV Secretary of...AFSO21 and now AF CPI, this program seeks to train and certify an organic cadre of CPI practitioners to support the use of its standard problem solving ...process known as the AF Practical Problem Solving Method (PPSM) to solve mission critical process deficiencies. The PPSM leverages several industry

An "All Teach, All Learn" Approach to Research Capacity Strengthening in Indigenous Primary Health Care Continuous Quality Improvement.

PubMed

McPhail-Bell, Karen; Matthews, Veronica; Bainbridge, Roxanne; Redman-MacLaren, Michelle Louise; Askew, Deborah; Ramanathan, Shanthi; Bailie, Jodie; Bailie, Ross

2018-01-01

In Australia, Indigenous people experience poor access to health care and the highest rates of morbidity and mortality of any population group. Despite modest improvements in recent years, concerns remains that Indigenous people have been over-researched without corresponding health improvements. Embedding Indigenous leadership, participation, and priorities in health research is an essential strategy for meaningful change for Indigenous people. To centralize Indigenous perspectives in research processes, a transformative shift away from traditional approaches that have benefited researchers and non-Indigenous agendas is required. This shift must involve concomitant strengthening of the research capacity of Indigenous and non-Indigenous researchers and research translators-all must teach and all must learn. However, there is limited evidence about how to strengthen systems and stakeholder capacity to participate in and lead continuous quality improvement (CQI) research in Indigenous primary health care, to the benefit of Indigenous people. This paper describes the collaborative development of, and principles underpinning, a research capacity strengthening (RCS) model in a national Indigenous primary health care CQI research network. The development process identified the need to address power imbalances, cultural contexts, relationships, systems requirements and existing knowledge, skills, and experience of all parties. Taking a strengths-based perspective, we harnessed existing knowledge, skills and experiences; hence our emphasis on capacity "strengthening". New insights are provided into the complex processes of RCS within the context of CQI in Indigenous primary health care.

An “All Teach, All Learn” Approach to Research Capacity Strengthening in Indigenous Primary Health Care Continuous Quality Improvement

PubMed Central

McPhail-Bell, Karen; Matthews, Veronica; Bainbridge, Roxanne; Redman-MacLaren, Michelle Louise; Askew, Deborah; Ramanathan, Shanthi; Bailie, Jodie; Bailie, Ross; Matthews, Veronica

2018-01-01

In Australia, Indigenous people experience poor access to health care and the highest rates of morbidity and mortality of any population group. Despite modest improvements in recent years, concerns remains that Indigenous people have been over-researched without corresponding health improvements. Embedding Indigenous leadership, participation, and priorities in health research is an essential strategy for meaningful change for Indigenous people. To centralize Indigenous perspectives in research processes, a transformative shift away from traditional approaches that have benefited researchers and non-Indigenous agendas is required. This shift must involve concomitant strengthening of the research capacity of Indigenous and non-Indigenous researchers and research translators—all must teach and all must learn. However, there is limited evidence about how to strengthen systems and stakeholder capacity to participate in and lead continuous quality improvement (CQI) research in Indigenous primary health care, to the benefit of Indigenous people. This paper describes the collaborative development of, and principles underpinning, a research capacity strengthening (RCS) model in a national Indigenous primary health care CQI research network. The development process identified the need to address power imbalances, cultural contexts, relationships, systems requirements and existing knowledge, skills, and experience of all parties. Taking a strengths-based perspective, we harnessed existing knowledge, skills and experiences; hence our emphasis on capacity “strengthening”. New insights are provided into the complex processes of RCS within the context of CQI in Indigenous primary health care. PMID:29761095

Total Quality Management Implementation Plan: Defense Depot, Ogden

DTIC Science & Technology

1989-07-01

NUMBERS Total Quality Management Implementation Plan Defense Depot Ogden 6. AUTHOR(S) 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8. PERFORMING...PAGES TQM (Total Quality Management ), Continuous Process Improvement, Depot Operations, Process Action Teams 16. PRICE CODE 17. SECURITY...034 A Message From The Commander On Total Quality Management i fully support the DLA aoproacii to Total Quality Management . As stated by General

ERTS-B imagery interpretation techniques in the Tennessee Valley

NASA Technical Reports Server (NTRS)

Gonzalez, R. C. (Principal Investigator)

1973-01-01

There are no author-identified significant results in this report. The proposed investigation is a continuation of an ERTS-1 project. The principal missions are to serve as the principal supporter on computer and image processing problems for the multidisciplinary ERTS effort of the University of Tennessee, and to carry out research in improved methods for the computer processing, enhancement, and recognition of ERTS imagery.

Resist process optimization for further defect reduction

NASA Astrophysics Data System (ADS)

Tanaka, Keiichi; Iseki, Tomohiro; Marumoto, Hiroshi; Takayanagi, Koji; Yoshida, Yuichi; Uemura, Ryouichi; Yoshihara, Kosuke

2012-03-01

Defect reduction has become one of the most important technical challenges in device mass-production. Knowing that resist processing on a clean track strongly impacts defect formation in many cases, we have been trying to improve the track process to enhance customer yield. For example, residual type defect and pattern collapse are strongly related to process parameters in developer, and we have reported new develop and rinse methods in the previous papers. Also, we have reported the optimization method of filtration condition to reduce bridge type defects, which are mainly caused by foreign substances such as gels in resist. Even though we have contributed resist caused defect reduction in past studies, defect reduction requirements continue to be very important. In this paper, we will introduce further process improvements in terms of resist defect reduction, including the latest experimental data.

Improving Initiation and Tracking of Research Projects at an Academic Health Center: A Case Study.

PubMed

Schmidt, Susanne; Goros, Martin; Parsons, Helen M; Saygin, Can; Wan, Hung-Da; Shireman, Paula K; Gelfond, Jonathan A L

2017-09-01

Research service cores at academic health centers are important in driving translational advancements. Specifically, biostatistics and research design units provide services and training in data analytics, biostatistics, and study design. However, the increasing demand and complexity of assigning appropriate personnel to time-sensitive projects strains existing resources, potentially decreasing productivity and increasing costs. Improving processes for project initiation, assigning appropriate personnel, and tracking time-sensitive projects can eliminate bottlenecks and utilize resources more efficiently. In this case study, we describe our application of lean six sigma principles to our biostatistics unit to establish a systematic continual process improvement cycle for intake, allocation, and tracking of research design and data analysis projects. The define, measure, analyze, improve, and control methodology was used to guide the process improvement. Our goal was to assess and improve the efficiency and effectiveness of operations by objectively measuring outcomes, automating processes, and reducing bottlenecks. As a result, we developed a web-based dashboard application to capture, track, categorize, streamline, and automate project flow. Our workflow system resulted in improved transparency, efficiency, and workload allocation. Using the dashboard application, we reduced the average study intake time from 18 to 6 days, a 66.7% reduction over 12 months (January to December 2015).

Does appraisal enhance learning, improve practice and encourage continuing professional development? A survey of general practitioners' experiences of appraisal.

PubMed

Finlay, Karen; McLaren, Susan

2009-01-01

Revalidation of the medical profession is under review and a system has been proposed to ensure doctors meet standards of practice and professionalism. The current appraisal system allows clinicians to chart their progress and identify developmental needs in order to improve performance. Appraisal is now an annual compulsory requirement for all doctors. The aim of the study was to investigate the experiences of general practitioners (GPs) of the current appraisal process. The specific objectives were to consider the impact the appraisal process had exerted on their learning, practice and individual continuing professional development (CPD). We employed a cross-sectional design using a postal questionnaire sent to all doctors who work as GPs (n = 385) in West Kent. Questionnaires were returned from 71.7% of doctors (n = 276). The key findings obtained were that 47.5% (n = 131) of doctors stated that taking part in the appraisal process had enhanced their learning, 40.2% (n = 111) felt that the appraisal process had improved their practice and 55.8% (n = 154) stated that the appraisal process had encouraged their CPD. Qualitative findings derived from thematic analysis of open questions revealed that participants viewed the role of the appraiser as respected peer to be vital and there was a need for independence in the appraiser's appointment. The time-consuming nature of the appraisal process was emphasised, with little protected time for preparation of documentation and engagement in CPD. Concerns were expressed about links between appraisal and revalidation. Many doctors considered that the appraisal process had enhanced their learning, improved their practice and encouraged their CPD. A vital, independent role for the appraiser was emphasised as was a need to review the time-consuming nature of the current appraisal process, together with identifying protected time to complete this and CPD engagement. As the role of appraisal within the revalidation process changes it is recognised that ensuring the quality, consistency and nature of appraisal will be essential to maintain the confidence of patients and doctors.

Continuous Firefly Algorithm for Optimal Tuning of Pid Controller in Avr System

NASA Astrophysics Data System (ADS)

Bendjeghaba, Omar

2014-01-01

This paper presents a tuning approach based on Continuous firefly algorithm (CFA) to obtain the proportional-integral- derivative (PID) controller parameters in Automatic Voltage Regulator system (AVR). In the tuning processes the CFA is iterated to reach the optimal or the near optimal of PID controller parameters when the main goal is to improve the AVR step response characteristics. Conducted simulations show the effectiveness and the efficiency of the proposed approach. Furthermore the proposed approach can improve the dynamic of the AVR system. Compared with particle swarm optimization (PSO), the new CFA tuning method has better control system performance in terms of time domain specifications and set-point tracking.

Development of a core sheath process for production of oxide fibers

NASA Technical Reports Server (NTRS)

Freske, S.

1972-01-01

Improvements were sought in an oxide fiber of a core sheath configuration intended for structural applications at 2000 F (1093 C). Discontinuities in the core were eliminated by using core materials other than pure alumina, and continuous core sheath fibers were produced. In the case of some core materials, the continuous sections were sufficiently long for applications in short fiber composites. Creep at 2000 F (1093 C) was found to be due, in most cases, to breaks in the core, allowing the glass sheath to creep. Evidence was obtained indicating that a closer match between the thermal expansion coefficient of the sheath and the core would greatly improve the strength.

Gainsharing Strategies, Physician Champions, Getting Physician Buy In.

PubMed

Anoushiravani, Afshin A; Nunley, Ryan M

2017-06-01

As healthcare spending continues to outpace economic growth, legislators and healthcare economists have explored many processes aimed at improving efficiency and reducing waste. Gainsharing or the general concept that organizations and their employees can work together to continually improve outcomes at reduced expenditures in exchange for a portion of the savings has been shown to be effective within the healthcare system. Although gainsharing principles may be applicable to healthcare organizations and their physician partners, specific parameters should be followed when implementing these arrangements. This article will discuss 10 gainsharing strategies aimed at properly aligning healthcare organizations and physicians, which if followed will ensure the successful implementation of gainsharing initiatives. Copyright © 2017. Published by Elsevier Inc.

The journey

NASA Astrophysics Data System (ADS)

Cohen, Lori A.

1995-12-01

Kodak Optical Products has embarked on a journey that will ultimately lead to manufacturing excellence and total customer satisfaction. With quality as our compass we have already obtained ISO 9001 and Manufacturing Resource Planning (MRP) II certifications. Seeking and attaining these certifications enabled us to understand and enhance fundamentals relative to the operation of our business. This has provided a solid foundation from which we can launch continuous improvement activities. Now we continue our journey to such destinations as 10X reduction in both defects and cycle time, measuring and reducing our cost of poor quality, and upgrading our quality information system. Our presentation will emphasize our 10X improvement process and how it applies to high-volume production of precision plastic optics.

EMMC process for combined removal of organics, nitrogen and an odor producing substance.

PubMed

Yang, P Y; Su, R; Kim, S J

2003-12-01

In order to improve the process performance regarding the removal of organics, nitrogen, and an odor-causing compound (sulfide) contained in domestic wastewater, an entrapped-mixed-microbial cell (EMMC) with and without humic substances for both fixed and moving carrier reactors and conventional suspended growth culture (i.e. conventional activated sludge process) were investigated simultaneously. Both synthetic (simulated to the organics concentration of general domestic sewage) and actual domestic wastewater were investigated under operational conditions of 12 h of hydraulic retention time (HRT) with 1 h of aeration and 1 h of non-aeration, and 6 h of HRT with continuous aeration, at a room temperature of 25 +/- 2 degrees C. It was found that entrapping humic substances in the EMMC carriers had no impact on the removal of organics, nitrogen, and the odor-producing compound. Additionally, the performance of the EMMC moving carrier system for the removal of these pollutants is similar to that of the EMMC fixed carrier system. In general, the EMMC associated systems which provide high solids retention time achieve a better removal of chemical oxygen demand (COD), nitrogen, and the odor-producing substance than the suspended growth system for both HRTs of 6 h (continuous aeration) and 12 h (1 h of aeration and 1 h of non-aeration). Both the fixed and moving carrier EMMC processes, therefore, have the potential for improvement or replacement of the existing conventional activated sludge process with regard to improving the effluent qualities (such as COD, nitrogen and odor-producing compound) for reuse/disposal.

Continuous and pulsed laser high power beam combiner for additive manufacturing applications

NASA Astrophysics Data System (ADS)

Bassignana, Marta; Califano, Alessio; Pescarmona, Francesco; Braglia, Andrea; Perrone, Guido

2018-02-01

Laser-based additive manufacturing (AM) from metal powders is emerging as the new industrial revolution, although current fabrication approaches still require long mechanical post-processing to improve the final surface quality and meet the design tolerances. To overcome this limitation, the next generation machines are expected to complement laser AM with laser ablation (LA) to implement surface finishing and micro texturing already during the device growth process. With this aim, a new beam combiner to allow the real-time interchange of additive and subtractive processes using the same scanner head has been designed. Extensive tests have been carried out using a 6 kW continuous-wave laser similar to that used for the metal powder fusion and a nanosecond 100W pulsed source similar to that used for laser ablation.

Continuous cultivation of photosynthetic microorganisms: Approaches, applications and future trends.

PubMed

Fernandes, Bruno D; Mota, Andre; Teixeira, Jose A; Vicente, Antonio A

2015-11-01

The possibility of using photosynthetic microorganisms, such as cyanobacteria and microalgae, for converting light and carbon dioxide into valuable biochemical products has raised the need for new cost-efficient processes ensuring a constant product quality. Food, feed, biofuels, cosmetics and pharmaceutics are among the sectors that can profit from the application of photosynthetic microorganisms. Biomass growth in a photobioreactor is a complex process influenced by multiple parameters, such as photosynthetic light capture and attenuation, nutrient uptake, photobioreactor hydrodynamics and gas-liquid mass transfer. In order to optimize productivity while keeping a standard product quality, a permanent control of the main cultivation parameters is necessary, where the continuous cultivation has shown to be the best option. However it is of utmost importance to recognize the singularity of continuous cultivation of cyanobacteria and microalgae due to their dependence on light availability and intensity. In this sense, this review provides comprehensive information on recent breakthroughs and possible future trends regarding technological and process improvements in continuous cultivation systems of microalgae and cyanobacteria, that will directly affect cost-effectiveness and product quality standardization. An overview of the various applications, techniques and equipment (with special emphasis on photobioreactors) in continuous cultivation of microalgae and cyanobacteria are presented. Additionally, mathematical modeling, feasibility, economics as well as the applicability of continuous cultivation into large-scale operation, are discussed. Copyright © 2015 Elsevier Inc. All rights reserved.

The Total Quality Classroom.

ERIC Educational Resources Information Center

Bonstingl, John Jay

1992-01-01

Deming's quality-focused principles contradict Taylor's top-down, authoritarian industrial model. Deming advises educators to fix the system instead of blaming individual teachers for student apathy and low achievement. In the new paradigm, education will be a process that encourages continual progress through improving one's abilities, expanding…

Quality-Focused Management.

ERIC Educational Resources Information Center

Needham, Robbie Lee

1993-01-01

Presents the quality-focused management (QFM) system and explains the departure QFM makes from established community college management practices. Describes the system's self-directed teams engaged in a continuous improvement process driven by customer demand and long-term commitment to quality and cost control. (13 references.) (MAB)

Transportation improvement program and air quality conformity determination federal fiscal years 2008-2011

DOT National Transportation Integrated Search

2007-01-01

In order to be eligible for federal funds, urbanized areas are required to maintain a continuing, cooperative, and comprehensive (3C) transportation planning process that results in plans and programs consistent with the planning objectives of the me...

Outpatient Pharmacy Civilian Prescription Pathway Process Improvement

DTIC Science & Technology

1998-03-01

Thompson, MSC, USN provided me throughout the residency phase of the program. He devoted time to give counsel and guidance while continually stressing ...service Surgeon General. The term civilian practitioner includes Pharmacy 2 4 doctors of medicine, osteopathy , dentistry or podiatry who are

How streamlining telecommunications can cut IT expense.

PubMed

McIntyre, Greg

2016-02-01

Hospitals and health systems can save IT expenses by implementing more efficient processes in accordance with the principles of effective telecommunications expense management. This approach involves three primary steps: Inventory of existing infrastructure. Charge verification. Optimization of rates and design for continual improvement.

On the use of continuous flash suppression for the study of visual processing outside of awareness

PubMed Central

Yang, Eunice; Brascamp, Jan; Kang, Min-Suk; Blake, Randolph

2014-01-01

The interocular suppression technique termed continuous flash suppression (CFS) has become an immensely popular tool for investigating visual processing outside of awareness. The emerging picture from studies using CFS is that extensive processing of a visual stimulus, including its semantic and affective content, occurs despite suppression from awareness of that stimulus by CFS. However, the current implementation of CFS in many studies examining processing outside of awareness has several drawbacks that may be improved upon for future studies using CFS. In this paper, we address some of those shortcomings, particularly ones that affect the assessment of unawareness during CFS, and ones to do with the use of “visible” conditions that are often included as a comparison to a CFS condition. We also discuss potential biases in stimulus processing as a result of spatial attention and feature-selective suppression. We suggest practical guidelines that minimize the effects of those limitations in using CFS to study visual processing outside of awareness. PMID:25071685

Preparing systems engineering and computing science students in disciplined methods, quantitative, and advanced statistical techniques to improve process performance

NASA Astrophysics Data System (ADS)

McCray, Wilmon Wil L., Jr.

The research was prompted by a need to conduct a study that assesses process improvement, quality management and analytical techniques taught to students in U.S. colleges and universities undergraduate and graduate systems engineering and the computing science discipline (e.g., software engineering, computer science, and information technology) degree programs during their academic training that can be applied to quantitatively manage processes for performance. Everyone involved in executing repeatable processes in the software and systems development lifecycle processes needs to become familiar with the concepts of quantitative management, statistical thinking, process improvement methods and how they relate to process-performance. Organizations are starting to embrace the de facto Software Engineering Institute (SEI) Capability Maturity Model Integration (CMMI RTM) Models as process improvement frameworks to improve business processes performance. High maturity process areas in the CMMI model imply the use of analytical, statistical, quantitative management techniques, and process performance modeling to identify and eliminate sources of variation, continually improve process-performance; reduce cost and predict future outcomes. The research study identifies and provides a detail discussion of the gap analysis findings of process improvement and quantitative analysis techniques taught in U.S. universities systems engineering and computing science degree programs, gaps that exist in the literature, and a comparison analysis which identifies the gaps that exist between the SEI's "healthy ingredients " of a process performance model and courses taught in U.S. universities degree program. The research also heightens awareness that academicians have conducted little research on applicable statistics and quantitative techniques that can be used to demonstrate high maturity as implied in the CMMI models. The research also includes a Monte Carlo simulation optimization model and dashboard that demonstrates the use of statistical methods, statistical process control, sensitivity analysis, quantitative and optimization techniques to establish a baseline and predict future customer satisfaction index scores (outcomes). The American Customer Satisfaction Index (ACSI) model and industry benchmarks were used as a framework for the simulation model.

Advanced membrane devices. Interim report for October 1996--September 1997

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

Laciak, D.V.; Langsam, M.; Lewnard, J.J.

1997-12-31

Under this Cooperative Agreement, Air Products and Chemicals, Inc. has continued to investigate and develop improved membrane technology for removal of carbon dioxide from natural gas. The task schedule for this reporting period included a detailed assessment of the market opportunity (Chapter 2), continued development and evaluation of membranes and membrane polymers (Chapter 3) and a detailed economic analysis comparing the potential of Air Products membranes to that of established acid gas removal processes (Chapter 4).

Exemplary Care and Learning Sites: A Model for Achieving Continual Improvement in Care and Learning in the Clinical Setting

PubMed Central

Ogrinc, Greg; Hoffman, Kimberly G.; Stevenson, Katherine M.; Shalaby, Marc; Beard, Albertine S.; Thörne, Karin E.; Coleman, Mary T.; Baum, Karyn D.

2016-01-01

Problem Current models of health care quality improvement do not explicitly describe the role of health professions education. The authors propose the Exemplary Care and Learning Site (ECLS) model as an approach to achieving continual improvement in care and learning in the clinical setting. Approach From 2008–2012, an iterative, interactive process was used to develop the ECLS model and its core elements—patients and families informing process changes; trainees engaging both in care and the improvement of care; leaders knowing, valuing, and practicing improvement; data transforming into useful information; and health professionals competently engaging both in care improvement and teaching about care improvement. In 2012–2013, a three-part feasibility test of the model, including a site self-assessment, an independent review of each site’s ratings, and implementation case stories, was conducted at six clinical teaching sites (in the United States and Sweden). Outcomes Site leaders reported the ECLS model provided a systematic approach toward improving patient (and population) outcomes, system performance, and professional development. Most sites found it challenging to incorporate the patients and families element. The trainee element was strong at four sites. The leadership and data elements were self-assessed as the most fully developed. The health professionals element exhibited the greatest variability across sites. Next Steps The next test of the model should be prospective, linked to clinical and educa tional outcomes, to evaluate whether it helps care delivery teams, educators, and patients and families take action to achieve better patient (and population) outcomes, system performance, and professional development. PMID:26760058

CAE for Injection Molding — Past, Present and the Future

NASA Astrophysics Data System (ADS)

Wang, Kuo K.

2004-06-01

It is well known that injection molding is the most effective process for mass-producing discrete plastic parts of complex shape to the highest precision at the lowest cost. However, due to the complex property of polymeric materials undergoing a transient non-isothermal process, it is equally well recognized that the quality of final products is often difficult to be assured. This is particularly true when a new mold or material is encountered. As a result, injection molding has often been viewed as an art than a science. During the past few decades, numerical simulation of injection molding process based on analytic models has become feasible for practical use as computers became faster and cheaper continually. A research effort was initiated at the Cornell Injection Molding Program (CIMP) in 1974 under a grant from the National Science Foundation. Over a quarter of the century, CIMP has established some scientific bases ranging from materials characterization, flow analysis, to prediction of part quality. Use of such CAE tools has become common place today in industry. Present effort has been primarily aimed at refinements of many aspects of the process. Computational efficiency and user-interface have been main thrusts by commercial software developers. Extension to 3-dimensional flow analysis for certain parts has drawn some attention. Research activities are continuing on molding of fiber-filled materials and reactive polymers. Expanded molding processes such as gas-assisted, co-injection, micro-molding and many others are continually being investigated. In the future, improvements in simulation accuracy and efficiency will continue. This will include in-depth studies on materials characterization. Intelligent on-line process control may draw more attention in order to achieve higher degree of automation. As Internet technology continues to evolve, Web-based CAE tools for design, production, remote process monitoring and control can come to path. The CAE tools will eventually be integrated into an Enterprise Resources Planning (ERP) system as the trend of enterprise globalization continues.

Flow chemistry using milli- and microstructured reactors-from conventional to novel process windows.

PubMed

Illg, Tobias; Löb, Patrick; Hessel, Volker

2010-06-01

The terminology Novel Process Window unites different methods to improve existing processes by applying unconventional and harsh process conditions like: process routes at much elevated pressure, much elevated temperature, or processing in a thermal runaway regime to achieve a significant impact on process performance. This paper is a review of parts of IMM's works in particular the applicability of above mentioned Novel Process Windows on selected chemical reactions. First, general characteristics of microreactors are discussed like excellent mass and heat transfer and improved mixing quality. Different types of reactions are presented in which the use of microstructured devices led to an increased process performance by applying Novel Process Windows. These examples were chosen to demonstrate how chemical reactions can benefit from the use of milli- and microstructured devices and how existing protocols can be changed toward process conditions hitherto not applicable in standard laboratory equipment. The used milli- and microstructured reactors can also offer advantages in other areas, for example, high-throughput screening of catalysts and better control of size distribution in a particle synthesis process by improved mixing, etc. The chemical industry is under continuous improvement. So, a lot of research is being done to synthesize high value chemicals, to optimize existing processes in view of process safety and energy consumption and to search for new routes to produce such chemicals. Leitmotifs of such undertakings are often sustainable development(1) and Green Chemistry(2).

Influenza immunizations in the elderly: a continuous quality improvement project.

PubMed

Juma, A; Evans, M F; Bloom, J

2000-08-01

As part of the continuous quality improvement program at The Toronto Hospital's Department of Family & Community Medicine (TTH-DFCM), it was considered necessary to examine the structures, processes and outcomes of influenza immunization for the elderly. The study sought to (a) document the current influenza immunization process; (b) quantify influenza immunization rates for elderly patients during two consecutive immunization seasons (1996 and 1997), and compare these rates across physician teams, attending staff vs. residents, patient gender, and patient age groups; (c) compare influenza immunization rates with other centers; and (d) identify barriers and propose solutions to improve influenza immunization rates in the elderly. Evaluation Formative Research. A computerized roster of 15,000 patients at The Toronto Hospital, Department of Family and Community Medicine, a University of Toronto academic teaching center. Active patients age 65 years and over. Influenza immunization. Physician Teams, Physician status, Patient gender, and Patient age group. Immunization rates of attendees increased from 75.4% to 78.7%; over 3% increase from 1996 to 1997. Major subgroups which benefited from increased immunization rates were patients in the Blue team, patients age 70-74 years, and female patients. This study presents a rigorous examination of the components of the influenza immunization program, and demonstrates improved immunization rates over a two-year period. Suggestions for future action have been identified. The study design can also serve as a model for future clinical quality improvement projects.

Chapter 24: Strategic Energy Management (SEM) Evaluation Protocol. The Uniform Methods Project: Methods for Determining Energy Efficiency Savings for Specific Measures

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

Stewart, James

Strategic energy management (SEM) focuses on achieving energy-efficiency improvements through systematic and planned changes in facility operations, maintenance, and behaviors (OM&B) and capital equipment upgrades in large energy-using facilities, including industrial buildings, commercial buildings, and multi-facility organizations such as campuses or communities. Facilities can institute a spectrum of SEM actions, ranging from a simple process for regularly identifying energy-savings actions, to establishing a formal, third-party recognized or certified SEM framework for continuous improvement of energy performance. In general, SEM programs that would be considered part of a utility program will contain a set of energy-reducing goals, principles, and practices emphasizingmore » continuous improvements in energy performance or savings through energy management and an energy management system (EnMS).« less

Lapse in Institutional Animal Care and Use Committee Continuing Reviews.

PubMed

Tsan, Min-Fu; Grabenbauer, Michael; Nguyen, Yen

2016-01-01

The United States federal animal welfare regulations and the Public Health Service Policy on Humane Care and Use of Laboratory Animals require that institutional animal care and use committees (IACUCs) conduct continuing reviews of all animal research activities. However, little is known about the lapse rate of IACUC continuing reviews, and how frequently investigators continue research activities during the lapse. It is also not clear what factors may contribute to an institution's lapse in IACUC continuing reviews. As part of the quality assurance program, the Department of Veterans Affairs (VA) has collected performance metric data for animal care and use programs since 2011. We analyzed IACUC continuing review performance data at 74-75 VA research facilities from 2011 through 2015. The IACUC continuing review lapse rates improved from 5.6% in 2011 to 2.7% in 2015. The rate of investigators continuing research activities during the lapse also decreased from 47.2% in 2012 to 7.4% in 2015. The type of IACUCs used and the size of animal research programs appeared to have no effect in facility's rates of lapse in IACUC continuing reviews. While approximately 80% of facilities reported no lapse in IACUC continuing reviews, approximately 14% of facilities had lapse rates of >10% each year. Some facilities appeared to be repeat offenders. Four facilities had IACUC lapse rates of >10% in at least 3 out of 5 years, suggesting a system problem in these facilities requiring remedial actions to improve their IACUC continuing review processes.

The Quality Education Checklist: An Instrument for Self-Auditing. Developing Quality Schools: Learning Module #2. Making It Work--The Quality Schools Approach.

ERIC Educational Resources Information Center

Barlosky, Martin; Lawton, Stephen

The Quality Education Checklist focuses on key inputs, processes, and outputs of schools needed to ensure continuous improvement. Intended as a self-auditing aid for schools, the checklist may also be used as a method to define the priority of areas for improvement, as a way to gather information from customers, as a professional development…

A Study on Improving Logistics in a Production Enterprise in the Automotive Domain

NASA Astrophysics Data System (ADS)

Muntean, A.; Inţă, M.; Stroilă, I. A.

2016-11-01

In order to remain on the market and to overcome competition, companies need to develop and implement a strategy of continuous improvement. This is based on customer satisfaction needs, management based on realities and respect for people. In order to meet market requirements global road Faurecia Company uses a system called "Faurecia Excellence System", a system that promotes continuous improvement. FES system controls all activities of Faurecia, from research and development to sales including production and company functions and implements all 114 main procedures. This paper examines the current activity and introduce the new methods to improve manufacturing processes. These new methods are based on some fundamental concepts, namely: a high level of stocks blocks resources and can mask other problems decreasing visibility and communication; product quality is essential and the goods must be produced only when needed using Kanban principle. Additional expenditure with purchased raw materials regarding storage until they are needed, identification and packaging for storage, inventory costs were reduced using a JIT based principle in purchasing.Thus, the paper proposes reorganizing production by reducing the level of stocks using JIT principle and production time. The application made in software Arena refers to simulating the fabrication process to reduce throughput time.

Applying Lean Six Sigma methodologies to improve efficiency, timeliness of care, and quality of care in an internal medicine residency clinic.

PubMed

Fischman, Daniel

2010-01-01

Patients' connectedness to their providers has been shown to influence the success of preventive health and disease management programs. Lean Six Sigma methodologies were employed to study workflow processes, patient-physician familiarity, and appointment compliance to improve continuity of care in an internal medicine residency clinic. We used a rapid-cycle test to evaluate proposed improvements to the baseline-identified factors impeding efficient clinic visits. Time-study, no-show, and patient-physician familiarity data were collected to evaluate the effect of interventions to improve clinic efficiency and continuity of medical care. Forty-seven patients were seen in each of the intervention and control groups. The wait duration between the end of triage and the resident-patient encounter was statistically shorter for the intervention group. Trends toward shorter wait times for medical assistant triage and total encounter were also seen in the intervention group. On all measures of connectedness, both the physicians and patients in the intervention group showed a statistically significant increased familiarity with each other. This study shows that incremental changes in workflow processes in a residency clinic can have a significant impact on practice efficiency and adherence to scheduled visits for preventive health care and chronic disease management. This project used a structured "Plan-Do-Study-Act" approach.

Finding a balance between "value added" and feeling valued: revising models of care. The human factor of implementing a quality improvement initiative using Lean methodology within the healthcare sector.

PubMed

Deans, Rachel; Wade, Shawna

2011-01-01

Growing demand from clients waiting to access vital services in a healthcare sector under economic constraint, coupled with the pressure for ongoing improvement within a multi-faceted organization, can have a significant impact on the front-line staff, who are essential to the successful implementation of any quality improvement initiative. The Lean methodology is a management system for continuous improvement based on the Toyota Production System; it focuses on two main themes: respect for people and the elimination of waste or non-value-added activities. Within the Lean process, value-added is used to describe any activity that contributes directly to satisfying the needs of the client, and non-value-added refers to any activity that takes time, space or resources but does not contribute directly to satisfying client needs. Through the revision of existing models of service delivery, the authors' organization has made an impact on increasing access to care and has supported successful engagement of staff in the process, while ensuring that the focus remains on the central needs of clients and families accessing services. While the performance metrics continue to exhibit respectable results for this strategic priority, further gains are expected over the next 18-24 months.

On-line confidence monitoring during decision making.

PubMed

Dotan, Dror; Meyniel, Florent; Dehaene, Stanislas

2018-02-01

Humans can readily assess their degree of confidence in their decisions. Two models of confidence computation have been proposed: post hoc computation using post-decision variables and heuristics, versus online computation using continuous assessment of evidence throughout the decision-making process. Here, we arbitrate between these theories by continuously monitoring finger movements during a manual sequential decision-making task. Analysis of finger kinematics indicated that subjects kept separate online records of evidence and confidence: finger deviation continuously reflected the ongoing accumulation of evidence, whereas finger speed continuously reflected the momentary degree of confidence. Furthermore, end-of-trial finger speed predicted the post-decisional subjective confidence rating. These data indicate that confidence is computed on-line, throughout the decision process. Speed-confidence correlations were previously interpreted as a post-decision heuristics, whereby slow decisions decrease subjective confidence, but our results suggest an adaptive mechanism that involves the opposite causality: by slowing down when unconfident, participants gain time to improve their decisions. Copyright © 2017 Elsevier B.V. All rights reserved.

Low-Temperature Wafer-Scale Deposition of Continuous 2D SnS2 Films.

PubMed

Mattinen, Miika; King, Peter J; Khriachtchev, Leonid; Meinander, Kristoffer; Gibbon, James T; Dhanak, Vin R; Räisänen, Jyrki; Ritala, Mikko; Leskelä, Markku

2018-04-19

Semiconducting 2D materials, such as SnS 2 , hold immense potential for many applications ranging from electronics to catalysis. However, deposition of few-layer SnS 2 films has remained a great challenge. Herein, continuous wafer-scale 2D SnS 2 films with accurately controlled thickness (2 to 10 monolayers) are realized by combining a new atomic layer deposition process with low-temperature (250 °C) postdeposition annealing. Uniform coating of large-area and 3D substrates is demonstrated owing to the unique self-limiting growth mechanism of atomic layer deposition. Detailed characterization confirms the 1T-type crystal structure and composition, smoothness, and continuity of the SnS 2 films. A two-stage deposition process is also introduced to improve the texture of the films. Successful deposition of continuous, high-quality SnS 2 films at low temperatures constitutes a crucial step toward various applications of 2D semiconductors. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Control by quality: proposition of a typology.

PubMed

Pujo, P; Pillet, M

The application of Quality tools and methods in industrial management has always had a fundamental impact on the control of production. It influences the behavior of the actors concerned, while introducing the necessary notions and formalizations, especially for production systems with little or no automation, which constitute a large part of the industrial activity. Several quality approaches are applied in the workshop and are implemented at the level of the control. In this paper, the authors present a typology of the various approaches that have successively influenced control, such as statistical process control, quality assurance, and continuous improvement. First the authors present a parallel between production control and quality organizational structure. They note the duality between control, which is aimed at increasing productivity, and quality, which aims to satisfy the needs of the customer. They also note the hierarchical organizational structure of these two systems of management with, at each level, the notion of a feedback loop. This notion is fundamental to any kind of decision making. The paper is organized around the operational, tactical, and strategic levels, by describing for each level the main methods and tools for control by quality. The overview of these tools and methods starts at the operational level, with the Statistical Process Control, the Taguchi technique, and the "six sigma" approach. On the tactical level, we find a quality system approach, with a documented description of the procedures introduced in the firm. The management system can refer here to Quality Assurance, Total Productive Maintenance, or Management by Total Quality. The formalization through procedures of the rules of decision governing the process control enhances the validity of these rules. This leads to the enhancement of their reliability and to their consolidation. All this counterbalances the human, intrinsically fluctuating, behavior of the control operators. Strategic control by quality is then detailed, and the two main approaches, the continuous improvement approach and the proactive improvement approach, are introduced. Finally, the authors observe that at each of the three levels, the continuous process improvement, which is a component of Total Quality, becomes an essential preoccupation for the control. Ultimately, the recursive utilization of the Deming cycle remains the best practice for the control by quality.

Evaluating Process Effectiveness to Reduce Risk

NASA Technical Reports Server (NTRS)

Shepherd, Christena C.

2017-01-01

It is well documented that government agencies do not have the same incentive as the private sector to focus on process effectiveness and continual improvement of those processes. It is also well documented whenever government agencies fail to deliver efficient, effective, consistent, and fair services to the citizens. In spite of the various "reinventing government" and "effectiveness initiatives" of the past decades, and in spite of the efforts on the part of many agencies to improve, government in general still lags behind industry in creating a culture of effective processes and systems. While the tragic events that unfolded recently in Flint, Michigan, teach us that running government "like a business" does not always take the needs of the citizenry into account, there are many lessons and techniques from the private sector that government agencies can use to improve. The incentive to improve, while mandated by various administrations1, needs to come from within the workforce, in order to effectively take root. The best, most effective incentive is to reduce, control or eliminate risk. Government agencies face some of the same risks as the private sector, while some are unique. While ISO 310002 has been around since 2009, risk has taken on increased visibility within the private sector with the advent of the emphasis on risk-based thinking in ISO 9001:20153. The relationship between risk-based thinking and effective processes is simple and direct. Those processes that are well thought out and standardized (i.e. Plan-Do-Check-Act), will have taken into account the applicable policy, statutory, regulatory, safety, quality and technical parameters, which may not occur to someone performing the process with minimal experience or training; and thus protect the employees, the public and the agency from statutory and regulatory violations; delay in providing services; non-delivery of services; harm to public or employee safety and health; cost overruns; breaches in security; loss of confidence in government; failure of publicly funded projects; damage to the environment; ethics violations, and the list goes on; with local, national and even international consequences. The Plan-Do-Check-Act process, also known as the "process approach" can be used at any time to establish and standardize a process, and it can also be used to check periodically for "process creep" (i.e., informal, unauthorized changes that have occurred over time), any necessary updates and improvements. While ISO 9001 compliance is not mandated for all government agencies, if interpreted correctly, it can be useful in establishing a framework and implementing effective management systems and processes.4 Another method that can be used to evaluate effectiveness is the scorecard definitions in Mallory's Process Management Standard5 as a basis for evaluating work on the process level on effective, and continuously improved and improving processes. With processes on the lower end of the scale, agencies are vulnerable to a great many risks, with employees and managers making up many of the rules as they go, leading to the above listed negative results. Without clear guidance for nominal operations, off-nominal situations can, and do, increase the likelihood of chaos. In an increasingly technical environment, with inter-agency communication and collaboration becoming the norm, agencies need to come to grips with the fact that processes can become rapidly outdated, and that the technical community should take on an increased role in the maturation of the agency's processes. Industry has long known that effective processes are also efficient, and process improvement methods such as Kaizen, Lean, Six Sigma, 5S, and mistake proofing lead to increased productivity, improved quality, and decreased cost. Again, government agencies have different concerns, but inefficiencies and mistakes can have dire and wide reaching consequences for the public that they serve. While no one goes to work planning to cause harm, it is up to agencies to establish upper level systems, which make establishment and compliance with processes possible. Again, Mallory provides us with a Systems Management Standard6, similar to the Process Management Standard, with a scale of 0-5 for systems effectiveness and maturity. Deming determined that "eighty-five percent of the reasons for failure are deficiencies in the systems and process rather than the employee. The role of management is to change the process rather than badgering individual employees to do better." 7 It is not just the working level employees who need effective processes, but the mid-and upper level managers as well. A disciplined management culture sets the tone for the employees, aids both routine and off-nominal decision-making, and incorporates risk -based thinking into the systems and processes as a matter of normal activity. Figure 1, illustrates the relationship between ineffective and effective processes and risk, through the use of the "stoplight" colors that are commonly used to show serious situations (red), situations which may be improving or deteriorating depending on trends (yellow), and situations that are under control and continuously improved (green).

Building a Foundation of Continuous Improvement in a Rapidly Changing Environment: The Dartmouth-Hitchcock Value Institute Experience.

PubMed

McGrath, Susan P; Blike, George T

2015-10-01

A performance improvement competency development program, known as the Value Institute (VI), was established at Dartmouth-Hitchcock (D-H; Lebanon, New Hampshire) in 2011 to develop a performance improvement-focused workforce and systems capable of meeting the challenges of creating a sustainable health system. A tiered competency development program that provides patient safety, health care quality, and improvement science education, and an execution support infrastructure that enables access to performance improvement tools for all employees, comprise the core of the VI. At 20 months after the launch of the first VI classes, more than 10% of all employees were trained to the Yellow Belt level, and approximately 1.5% of all employees became advanced practitioners (Green Belts or Black Belts). Improvement projects have focused on both clinical and business process optimization, as well as regulatory and accreditation compliance and patient safety. Project savings during the two years of operation have exceeded the investment of resources to establish this long-term performance improvement capability by 2.5 times. The D-H VI model promotes multidisciplinary team-based learning, incremental skill development, and access to a common continuous improvement vocabulary and method for all employees-all key to building the teams and momentum needed for successful execution of improvement work and to maintain outcomes. Initial outcomes, represented by organizational spread, project execution status, participants' feedback scores, and return on investment estimates, suggest that robust team-based learning combined with coaching provides sufficient depth and breadth of learning and effective opportunities to gain practical experience in continuous improvement.

Guidelines for Risk-Based Changeover of Biopharma Multi-Product Facilities.

PubMed

Lynch, Rob; Barabani, David; Bellorado, Kathy; Canisius, Peter; Heathcote, Doug; Johnson, Alan; Wyman, Ned; Parry, Derek Willison

2018-01-01

In multi-product biopharma facilities, the protection from product contamination due to the manufacture of multiple products simultaneously is paramount to assure product quality. To that end, the use of traditional changeover methods (elastomer change-out, full sampling, etc.) have been widely used within the industry and have been accepted by regulatory agencies. However, with the endorsement of Quality Risk Management (1), the use of risk-based approaches may be applied to assess and continuously improve established changeover processes. All processes, including changeover, can be improved with investment (money/resources), parallel activities, equipment design improvements, and standardization. However, processes can also be improved by eliminating waste. For product changeover, waste is any activity not needed for the new process or that does not provide added assurance of the quality of the subsequent product. The application of a risk-based approach to changeover aligns with the principles of Quality Risk Management. Through the use of risk assessments, the appropriate changeover controls can be identified and controlled to assure product quality is maintained. Likewise, the use of risk assessments and risk-based approaches may be used to improve operational efficiency, reduce waste, and permit concurrent manufacturing of products. © PDA, Inc. 2018.

How Digital Image Processing Became Really Easy

NASA Astrophysics Data System (ADS)

Cannon, Michael

1988-02-01

In the early and mid-1970s, digital image processing was the subject of intense university and corporate research. The research lay along two lines: (1) developing mathematical techniques for improving the appearance of or analyzing the contents of images represented in digital form, and (2) creating cost-effective hardware to carry out these techniques. The research has been very effective, as evidenced by the continued decline of image processing as a research topic, and the rapid increase of commercial companies to market digital image processing software and hardware.

Improving financial performance by modeling and analysis of radiology procedure scheduling at a large community hospital.

PubMed

Lu, Lingbo; Li, Jingshan; Gisler, Paula

2011-06-01

Radiology tests, such as MRI, CT-scan, X-ray and ultrasound, are cost intensive and insurance pre-approvals are necessary to get reimbursement. In some cases, tests may be denied for payments by insurance companies due to lack of pre-approvals, inaccurate or missing necessary information. This can lead to substantial revenue losses for the hospital. In this paper, we present a simulation study of a centralized scheduling process for outpatient radiology tests at a large community hospital (Central Baptist Hospital in Lexington, Kentucky). Based on analysis of the central scheduling process, a simulation model of information flow in the process has been developed. Using such a model, the root causes of financial losses associated with errors and omissions in this process were identified and analyzed, and their impacts were quantified. In addition, "what-if" analysis was conducted to identify potential process improvement strategies in the form of recommendations to the hospital leadership. Such a model provides a quantitative tool for continuous improvement and process control in radiology outpatient test scheduling process to reduce financial losses associated with process error. This method of analysis is also applicable to other departments in the hospital.

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

PubMed

Quon, Bradley S; Goss, Christopher H

2011-12-01

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

Opportunities for bio-based packaging technologies to improve the quality and safety of fresh and further processed muscle foods.

PubMed

Cutter, Catherine Nettles

2006-09-01

It has been well documented that vacuum or modified atmosphere packaging materials, made from polyethylene- or other plastic-based materials, have been found to improve the stability and safety of raw or further processed muscle foods. However, recent research developments have demonstrated the feasibility, utilization, and commercial application of a variety of bio-based polymers or bio-polymers made from a variety of materials, including renewable/sustainable agricultural commodities, and applied to muscle foods. A variety of these bio-based materials have been shown to prevent moisture loss, drip, reduce lipid oxidation and improve flavor attributes, as well as enhancing the handling properties, color retention, and microbial stability of foods. With consumers demanding more environmentally friendly packaging and a desire for more natural products, bio-based films or bio-polymers will continue to play an important role in the food industry by improving the quality of many products, including fresh or further processed muscle foods.

The FEM simulation of continuous rotary extrusion (CRE) of aluminum alloy AA3003

NASA Astrophysics Data System (ADS)

Rajendran, Nijenthan; Valberg, Henry; Misiolek, Wojciech Z.

2017-10-01

Continuous Rotary Extrusion (CRE) process is also known in literature under Conform TM name and it is mainly used for the continuous extrusion of Aluminum and Copper alloys. CRE use a feedstock in the form of rod, powders and chips, which are fed into the groove of the rotating wheel. As the wheel rotates the feedstock moves along with it due to friction with the wheel. Once the feedstock reaches the abutment the material deforms plastically and it is extruded through the die. CRE has lot to offer when compared to other more conventional extrusion processes such as low energy input, no limit in billet length as it is a continuous process as well as improved material physical properties due to plastic deformation under constant parameters. In this work a FEM model has been developed using Deform TM 3D, to study the metal flow and state variables of AA3003 CRE extrusion. The effect of extrusion wheel velocity has been investigated. The results show that increase in wheel velocity will heat up the feedstock metal due to high shear deformation and higher friction, which significantly changes metal flow conditions at the die exit.

A Brief Study of Software Engineering Professional Continuing Education in DoD Acquisition

DTIC Science & Technology

2010-04-01

Lifecycle Processes (IEEE 12207 ) (810) 37% 61% 2% Guide to the Software Engineering Body of K l d (SWEBOK) (804) 67% 31% 2% now e ge Software...Engineering-Software Measurement Process ( ISO /IEC 15939) (797) 55% 44% 2% Capability Maturity Model Integration (806) 17% 81% 2% Six Sigma Process...Improvement (804) 7% 91% 1% ISO 9000 Quality Management Systems (803) 10% 89% 1% 28 Conclusions Significant problem areas R i tequ remen s Management Very

Stratospheric Aerosol and Gas Experiment, SAGE III on ISS, An Earth Science Mission on the International Space Station, Schedule Risk Analysis, A Project Perspective

NASA Technical Reports Server (NTRS)

Bonine, Lauren

2015-01-01

The presentation provides insight into the schedule risk analysis process used by the Stratospheric Aerosol and Gas Experiment III on the International Space Station Project. The presentation focuses on the schedule risk analysis process highlighting the methods for identification of risk inputs, the inclusion of generic risks identified outside the traditional continuous risk management process, and the development of tailored analysis products used to improve risk informed decision making.

DISC (Defense Industrial Supply Center) TQM (Total Quality Management) Operations Plan

DTIC Science & Technology

1989-07-01

This document represents the continuance of the Defense Industrial Supply Center implementation of Total Quality Management which began in 1986. It...outlines how DISC intends to emphasize process improvement through the integration of all TQM initiates. Quality management at DISC prescribes defining

An Experiential Approach to Benchmarking Curriculum

ERIC Educational Resources Information Center

Grandzol, John R.; Grandzol, Christian J.

2011-01-01

Continuous curriculum improvement derives from a variety of perspectives, opportunities, and approaches. In this brief, we describe a process that facilitated student participation in curriculum development. We took our Supply Chain Management students to a regional conference affiliated with APICS and had them assess their knowledge readiness…

Intercity passenger rail : Amtrak needs to improve its decision making process for its route and service proposals

DOT National Transportation Integrated Search

2002-04-01

The National Railroad Passenger Corporation (Amtrak) is the nation's intercity passenger rail operator. In recent years, facing the continuing deterioration of its financial condition and its attempt to eliminate its need for federal operating assist...

Maximum-entropy description of animal movement.

PubMed

Fleming, Chris H; Subaşı, Yiğit; Calabrese, Justin M

2015-03-01

We introduce a class of maximum-entropy states that naturally includes within it all of the major continuous-time stochastic processes that have been applied to animal movement, including Brownian motion, Ornstein-Uhlenbeck motion, integrated Ornstein-Uhlenbeck motion, a recently discovered hybrid of the previous models, and a new model that describes central-place foraging. We are also able to predict a further hierarchy of new models that will emerge as data quality improves to better resolve the underlying continuity of animal movement. Finally, we also show that Langevin equations must obey a fluctuation-dissipation theorem to generate processes that fall from this class of maximum-entropy distributions when the constraints are purely kinematic.

Research, development and demonstration of nickel-iron batteries for electric-vehicle propulsion

NASA Astrophysics Data System (ADS)

1982-03-01

Full-size, prototype cell, module and battery fabrication and evaluation, aimed at advancing the technical capabilities of the nickel-iron battery, while simultaneously reducing its potential cost in materials and process areas are discussed. Improved electroprecipitation process nickel electrodes of design thickness (2.5 mm) are now being prepared that display stable capacities for the C/3 drain rate with less than 10% capacity decline for greater than 1000 test cycles. Iron electrodes of the composite-type are delivering 24 Ah at the target thickness (1.0 mm). Iron electrodes also are displaying capacity stability for greater than 1000 test cycles in continuing 3-plate cell tests. Finished cells delivered 57 to 63 Wh/kg at C/3, and have demonstrated cyclic stability up to 1200 cycles at 80 percent depth of discharge profiles. Modules exceeded 580 test cycles and remain on test. Reduction in nickel electrode swelling (and concurrent stack starvation), to improve cycling, continues to be an area of major effort to reach the final battery cycle life objectives.

Treatment of vegetable oily wastewater using an integrated microfiltration-reverse osmosis system.

PubMed

Yu, Xiaoli; Zhong, Zhaoxiang; Xing, Weihong

2010-01-01

Vegetable oil processing plants and catering trade often generate a large amount of oil-containing wastewater, which causes serious environmental problems. The objective of this work was to explore the feasibility of vegetable oil wastewater treatment with an integrated microfiltration-reverse osmosis (MF-RO) process. The influence of operational parameters on the separation behaviors were investigated in MF process. In MF continuous process the steady flux was around 90 (L/m(2) h) when the concentrated multiple reached 16, and the oil content in permeate was less than 12 mg/L. In the RO continuous process, antifouling membrane was used to treat permeate from the ceramic membrane process in order to improve the water quality. The RO process had a permeate flux of 24 (L/m(2) h) and water recovery rate of 95%. The permeate from the RO stage was free of oil, and its TOC and conductivity were less than 0.6 mg/L and 50 micros/cm, respectively. The results demonstrated that the two stage membrane process combining MF and RO is highly efficient in the treatment of oil-containing wastewater.

Evaluation of olivine refractories for TES

NASA Astrophysics Data System (ADS)

Gay, B. M.; Cochrane, R. L.; Palmour, H., III; Paisley, M. J.

1982-02-01

The principal objectives of this program are to (1) experimentally determine the degree of improvement in thermal and mechanical performance that can be obtained with an olivine thermal storage brick made of domestic materials using advanced processing techniques compared with state-of-the-art as represented by commercial European bricks, (2) conduct an assessment of existing German ceramic process technology and determine its adaptability to domestic raw materials and manufacturing practices, and (3) investigate, on a limited basis, method for further improvement of domestic-olivine brick. To date, accomplishments include (1) installation of improved, computer-based instrumentation, (2) the use of this system to determine performance characteristics of a set of heat storage refractories under cyclic use conditions, (3) acquisition of the services of a knowledgeable European consultant, (4) continued lab-scale process/property optimization studies, and (5) comparative testing of olivine-based and magnesite-based heat storage refractories in the calorimetric test facility at Purdue University.

Involving vendors in continuous quality improvement efforts.

PubMed

McDevitt, M C

1995-03-01

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

The research of new type stratified water injection process intelligent measurement technology

NASA Astrophysics Data System (ADS)

Zhao, Xin

2017-10-01

To meet the needs of injection and development of Daqing Oilfield, the injection of oil from the early stage of general water injection to the subdivision of water is the purpose of improving the utilization degree and the qualified rate of water injection, improving the performance of water injection column and the matching process. Sets of suitable for high water content of the effective water injection technology supporting technology. New layered water injection technology intelligent measurement technology will be more information testing and flow control combined into a unified whole, long-term automatic monitoring of the work of the various sections, in the custom The process has the characteristics of "multi-layer synchronous measurement, continuous monitoring of process parameters, centralized admission data", which can meet the requirement of subdivision water injection, but also realize the automatic synchronization measurement of each interval, greatly improve the efficiency of tiered injection wells to provide a new means for the remaining oil potential.

A multi-institutional quality improvement initiative to transform education for chronic illness care in resident continuity practices.

PubMed

Stevens, David P; Bowen, Judith L; Johnson, Julie K; Woods, Donna M; Provost, Lloyd P; Holman, Halsted R; Sixta, Constance S; Wagner, Ed H

2010-09-01

There is a gap between the need for patient-centered, evidence-based primary care for the large burden of chronic illness in the US, and the training of resident physicians to provide that care. To improve training for residents who provide chronic illness care in teaching practice settings. US teaching hospitals were invited to participate in one of two 18-month Breakthrough Series Collaboratives-either a national Collaborative, or a subsequent California Collaborative-to implement the Chronic Care Model (CCM) and related curriculum changes in resident practices. Most practices focused on patients with diabetes mellitus. Educational redesign strategies with related performance measures were developed for curricular innovations anchored in the CCM. In addition, three clinical measures-HbA1c <7%, LDL <100 mg/dL, and blood pressure

A Multi-Institutional Quality Improvement Initiative to Transform Education for Chronic Illness Care in Resident Continuity Practices

PubMed Central

Bowen, Judith L.; Johnson, Julie K.; Woods, Donna M.; Provost, Lloyd P.; Holman, Halsted R.; Sixta, Constance S.; Wagner, Ed H.

2010-01-01

BACKGROUND There is a gap between the need for patient-centered, evidence-based primary care for the large burden of chronic illness in the US, and the training of resident physicians to provide that care. OBJECTIVE To improve training for residents who provide chronic illness care in teaching practice settings. DESIGN US teaching hospitals were invited to participate in one of two 18-month Breakthrough Series Collaboratives—either a national Collaborative, or a subsequent California Collaborative—to implement the Chronic Care Model (CCM) and related curriculum changes in resident practices. Most practices focused on patients with diabetes mellitus. Educational redesign strategies with related performance measures were developed for curricular innovations anchored in the CCM. In addition, three clinical measures—HbA1c <7%, LDL <100 mg/dL, and blood pressure ≤130/80—and three process measures—retinal and foot examinations, and patient self-management goals—were tracked. PARTICIPANTS Fifty-seven teams from 37 self-selected teaching hospitals committed to implement the CCM in resident continuity practices; 41 teams focusing on diabetes improvement participated over the entire duration of one of the Collaboratives. INTERVENTIONS Teaching-practice teams—faculty, residents and staff—participated in Collaboratives by attending monthly calls and regular 2-day face-to-face meetings with the other teams. The national Collaborative faculty led calls and meetings. Each team used rapid cycle quality improvement (PDSA cycles) to implement the CCM and curricular changes. Teams reported education and clinical performance measures monthly. RESULTS Practices underwent extensive redesign to establish CCM elements. Education measures tracked substantial development of CCM-related learning. The clinical and process measures improved, however inconsistently, during the Collaboratives. CONCLUSIONS These initiatives suggest that systematic practice redesign for implementing the CCM along with linked educational approaches are achievable in resident continuity practices. Improvement of clinical outcomes in such practices is daunting but achievable. PMID:20737232

The evolution and development of an instrument to measure essential professional nursing practices.

PubMed

Kramer, Marlene; Brewer, Barbara B; Halfer, Diana; Hnatiuk, Cynthia Nowicki; MacPhee, Maura; Schmalenberg, Claudia

2014-11-01

Nursing continues to evolve from a task-oriented occupation to a holistic professional practice. Increased professionalism requires accurate measurement of care processes and practice. Nursing studies often omit measurement of the relationship between structures in the work environment and processes of care or between processes of care and patient outcomes. Process measurement is integral to understanding and improving nursing practice. This article describes the development of an updated Essentials of Magnetism process measurement instrument for clinical nurses (CNs) practicing on inpatient units in hospitals. It has been renamed Essential Professional Nursing Practices: CN.

The SEL Adapts to Meet Changing Times

NASA Technical Reports Server (NTRS)

Pajerski, Rose S.; Basili, Victor R.

1997-01-01

Since 1976, the Software Engineering Laboratory (SEL) has been dedicated to understanding and improving the way in which one NASA organization, the Flight Dynamics Division (FDD) at Goddard Space Flight Center, develops, maintains, and manages complex flight dynamics systems. It has done this by developing and refining a continual process improvement approach that allows an organization such as the FDD to fine-tune its process for its particular domain. Experimental software engineering and measurement play a significant role in this approach. The SEL is a partnership of NASA Goddard, its major software contractor, Computer Sciences Corporation (CSC), and the University of Maryland's (LTM) Department of Computer Science. The FDD primarily builds software systems that provide ground-based flight dynamics support for scientific satellites. They fall into two sets: ground systems and simulators. Ground systems are midsize systems that average around 250 thousand source lines of code (KSLOC). Ground system development projects typically last 1 - 2 years. Recent systems have been rehosted to workstations from IBM mainframes, and also contain significant new subsystems written in C and C++. The simulators are smaller systems averaging around 60 KSLOC that provide the test data for the ground systems. Simulator development lasts up to 1 year. Most of the simulators have been built in Ada on workstations. The SEL is responsible for the management and continual improvement of the software engineering processes used on these FDD projects.

Progress on glass ceramic ZERODUR enabling nanometer precision

NASA Astrophysics Data System (ADS)

Jedamzik, Ralf; Kunisch, Clemens; Nieder, Johannes; Weber, Peter; Westerhoff, Thomas

2016-03-01

The Semiconductor Industry is making continuous progress in shrinking feature size developing technologies and process to achieve < 10 nm feature size. The required Overlay specification for successful production is in the range one nanometer or even smaller. Consequently, materials designed into metrology systems of exposure or inspection tools need to fulfill ever tighter specification on the coefficient of thermal expansion (CTE). The glass ceramic ZERODUR® is a well-established material in critical components of microlithography wafer stepper and offered with an extremely low coefficient of thermal expansion, the tightest tolerance available on market. SCHOTT is continuously improving manufacturing processes and it's method to measure and characterize the CTE behavior of ZERODUR®. This paper is focusing on the "Advanced Dilatometer" for determination of the CTE developed at SCHOTT in the recent years and introduced into production in Q1 2015. The achievement for improving the absolute CTE measurement accuracy and the reproducibility are described in detail. Those achievements are compared to the CTE measurement accuracy reported by the Physikalische Technische Bundesanstalt (PTB), the National Metrology Institute of Germany. The CTE homogeneity is of highest importance to achieve nanometer precision on larger scales. Additionally, the paper presents data on the short scale CTE homogeneity and its improvement in the last two years. The data presented in this paper will explain the capability of ZERODUR® to enable the extreme precision required for future generation of lithography equipment and processes.

Improving the quality of the order-writing process for inpatient orders and outpatient prescriptions.

PubMed

Meyer, T A

2000-12-15

Because many preventable medication errors occur at the ordering stage, a program for improving the quality of writing inpatient orders and outpatient prescriptions at one institution was developed. To determine whether potential problems existed in the order-writing process for inpatients, all physician orders for a seven-day period in 1997 were reviewed (n = 3740). More than 10% of all orders had illegible handwriting or were written with a felt-tip pen, which makes NCR copies difficult to read. Other potential errors were also identified. Following educational programs for physicians and residents focusing on the importance of writing orders clearly, physician orders were reviewed for a 24-hour period (n = 654). The use of felt-tip pens decreased to 1.37% of all orders, and no orders had illegible handwriting. A similar quality improvement approach was used to evaluate the outpatient prescription-writing process. A review of all new prescriptions for a consecutive seven-day period at a local hospital-owned community pharmacy (n = 1425) revealed that about 15% of the prescriptions had illegible handwriting and roughly 10% were incomplete. Additional data were gathered through a survey sent to 71 outside provider pharmacies requesting information on problems related to prescriptions written by physicians from the institution; 66% responded. Failure to print prescriber name (96%), illegible signature (94%), failure to include DEA number (89%), and illegible handwriting other than signature (69%) were reported as the main problems. Each physician was given a self-inking name stamp to use when writing prescriptions. In addition, educational programs covering examples of poorly written prescriptions and the legal requirements of a prescription were held for physicians and residents. A follow-up survey showed that 72% of pharmacies saw stamps being used; when stamps were not used, however, illegible signatures continued to be a problem. Follow-up reviews of outpatient prescriptions indicate improvements in handwriting and completeness, but continuing educational efforts are needed. The quality of order writing for inpatients and outpatients continues to be monitored on a regular basis. Ongoing educational programs, follow-up reminders, and feedback to physicians have greatly improved the prescription-writing habits of physicians.

[Improving patient safety through voluntary peer review].

PubMed

Kluge, S; Bause, H

2015-01-01

The intensive care unit (ICU) is one area of the hospital in which processes and communication are of primary importance. Errors in intensive care units can lead to serious adverse events with significant consequences for patients. Therefore quality and risk-management are important measures when treating critically ill patients. A pragmatic approach to support quality and safety in intensive care is peer review. This approach has gained significant acceptance over the past years. It consists of mutual visits by colleagues who conduct standardised peer reviews. These reviews focus on the systematic evaluation of the quality of an ICU's structure, its processes and outcome. Together with different associations, the State Chambers of Physicians and the German Medical Association have developed peer review as a standardized tool for quality improvement. The common goal of all stakeholders is the continuous and sustainable improvement in intensive care with peer reviews significantly increasing and improving communication between professions and disciplines. Peer reviews secure the sustainability of planned change processes and consequently lead the way to an improved culture of quality and safety.

Impact of 5 years of lean six sigma in a University Medical Center.

PubMed

Niemeijer, Gerard C; Trip, Albert; de Jong, Laura J; Wendt, Klaus W; Does, Ronald J M M

2012-01-01

Lean Six Sigma (LSS) is an originally industry-based methodology for cost reduction and quality improvement. In more recent years, LSS was introduced in health care as well. This article describes the experiences of the University Medical Center Groningen, the second largest hospital in the Netherlands, with LSS. It was introduced in 2007 to create the financial possibility to develop innovations. In this article, we describe how LSS was introduced, and how it developed in the following years. We zoom in at the traumatology department, where all main processes have been analyzed and improved. An evaluation after 5 years shows that LSS helped indeed reducing cost and improving quality. Moreover, it aided the transition of the organization from purely problem oriented to more process oriented, which in turn is helpful in eliminating waste and finding solutions for difficult problems. A major benefit of the program is that own employees are trained to become project leaders for improvement. Several people from the primary process were thus stimulated and equipped to become role models for continuous improvement.

Design and Performance Analysis of a new Rotary Hydraulic Joint

NASA Astrophysics Data System (ADS)

Feng, Yong; Yang, Junhong; Shang, Jianzhong; Wang, Zhuo; Fang, Delei

2017-07-01

To improve the driving torque of the robots joint, a wobble plate hydraulic joint is proposed, and the structure and working principle are described. Then mathematical models of kinematics and dynamics was established. On the basis of this, dynamic simulation and characteristic analysis are carried out. Results show that the motion curve of the joint is continuous and the impact is small. Moreover the output torque of the joint characterized by simple structure and easy processing is large and can be rotated continuously.